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Sample records for acute atropine intoxication

  1. Acute atropine intoxication with psychiatric symptoms by herbal infusion of Pulmonaria officinalis (Lungwort

    Enrique Baca-García

    2007-06-01

    Full Text Available Background and objectives: Lungwort infusion is a preparation extracted from Pulmonaria officinalis which is occasionally used as a folk remedy for the common cold. The current report aims to describe acute atropine intoxications with delirium caused by Lungwort infusion in several members of the same family. Methods: Description of three case reports. Search of literature through Medline. Results: Three generations of a same family presented acute and moderately severe atropine intoxications after drinking an infusion prepared with Pulmonaria officinalis. Conclusions: Despite the lack of scientific evidence for its clinical use, medicinal plants continue being widely used. In spite of severe adverse effects reported, the general thought is that herbal remedies are harmless. To our knowledge, this is the first report of acute atropine intoxications with psychiatric symptoms secondary to Pulmonaria officinalis in several members of a family. We suspect that the lungwort infusion may have been contaminated with some other substance with atropinic properties.

  2. Acute Theophylline Intoxication: Case Report

    Zehra Baykal Tutal

    2016-01-01

    Full Text Available Theophylline is an efficient bronchodilatator, which is used in the treatment of the disease such like Chronic Obstructive Pulmoner Disease (COPD neonatal apnea, bradycardial syndrome. Blood levels of theophylline above 15 ug/ml have risk of intoxication. Acute and chronic intoxication can be seen. Nausea, vomitin, agitation, palpitation and metabolic abnormalities such as, hyperglisemia, hypokalemia, impairment in acid base equilibrium and leukocytosis can be seen in acute theophylline intoxication. Acute theophylline intoxications can result life threatening situations such as convulsions, ventricular arrhythmias and death. Theophylline intoxications are often iatrogenic. In this case, the clinical course of a patient with COPD who took theophylline with the intention of suicide attempt is to mentioned and discussion of diagnosis, treatment and clinical course of acute theophylline intoxication was to aimed.

  3. [Acute intoxication with isopropanol].

    Steinmann, D; Faber, T; Auwärter, V; Heringhaus, C

    2009-02-01

    Isopropanol is an ingredient of commonly used industrial and household agents. Intoxication can occur unintentionally, in suicide attempts or by alcohol abusers when used as a substitute for ethanol. Symptoms involve the gastrointestinal tract, the central nervous system, and the cardiovascular system at higher doses. Mortality is especially high in patients with deep coma and marked hypotension. This report describes a case of life-threatening isopropanol intoxication of a prison inmate successfully treated by haemodialysis.

  4. [Thyroid function tests in acute drug intoxication].

    Tseng, F Y; Chen, C S

    1992-03-01

    It is well known that thyroid function tests may be changed in non-thyroidal illnesses. To understand the influence of acute drug intoxication on thyroid function tests, 31 drug intoxicated patients without previous thyroid disorders and systemic diseases were included in our study. T3, T4, TSH, and resin T3 uptake were checked as soon as they arrived at our emergency service and were compared to that of 58 healthy volunteers. Within 31 patients, 14 were intoxicated by organophosphorous compounds, 6 by sedatives and hypnotics, 3 by strong acid, 2 by paraquet, 2 by rodenticides (warfarin), 2 by lysol and the other 2 were intoxicated by acetaminophen. The mean T3 and TSH levels were significantly lower in the drug intoxicated group. Among the 31 patients, 14 (45.2%) had a low T3, 2 (6.5%) had a low T3 and T4, and 6 (19.3%) had an elevated T4. All of the patients with an elevated T4 were intoxicated by organophosphates. If we divided the 31 patients into 2 subgroups: organophosphate intoxicated group and non-organophosphate intoxicated group, T4 and FT4I were significantly higher in the former group. Thyroid function tests became normal after treatment in 27 patients, discharged in good general condition. T3 and T4 became extremely low in 4 patients before they expired. The present study confirms that acute drug intoxication, like other non-thyroidal illnesses, affects thyroid function tests. Acute organophosphate intoxication may cause transient hyperthyroxinemia.

  5. Acute methaemoglobinaemia initially treated as organophosphate poisoning leading to atropine toxicity

    Srinivas Kakhandki

    2012-01-01

    Full Text Available A case of unknown compound poisoning is presented. It was initially treated as organophosphate poisoning with lack of response. A timely diagnosis of acute methaemoglobinaemia and iatrogenic atropine toxicity was made based on clinical evaluation. Treatment of methaemoglobinaemia using oral methylene blue and of atropine toxicity with supportive measures could save the patient.

  6. Acute Hydrocephaly Following Methadone Intoxication in a Child

    Afshin FAYYAZI

    2012-03-01

    Full Text Available Infantile methadone intoxication has been on the rise since the usage of methadone in opioid detoxification programs. We report a 30-month-old child with encephalopathy and acute hydrocephaly following methadone intoxication.

  7. Acute pancreatitis and acute renal failure complicating doxylamine succinate intoxication.

    Lee, Yang Deok; Lee, Soo Teik

    2002-06-01

    Doxylamine succinate is an antihistaminic drugwith additional hypnotic, anticholinergic and local anesthetic effects first described in 1948. In Korea and many other countries, it is a common-over-the counter medication frequently involved in overdoses. Clinical symtomatology of doxylamine succinate overdose includes somnolence, coma, seizures, mydriasis, tachycardia, psychosis, and rhabdomyolysis. A serious complication may be rhabdomyolysis with subsequent impairment of renal function and acute renal failure. We report a case of acute renal failure and acute pancreatitis complicating a doxylamine succinate intoxication.

  8. Acute intoxications: differences in management between six Dutch hospitals.

    Duineveld, C.; Vroegop, M.; Schouren, L.; Hoedemaekers, A.; Schouten, J.A.; Moret-Hartman, M.; Kramers, C.

    2012-01-01

    CONTEXT: Acute intoxications are frequently seen in Dutch hospitals. Based on single-centre studies and the fact that there are no clear guidelines, we hypothesised that hospital admission of acute intoxications may vary. Furthermore, decontamination treatment of poisonings may differ between hospit

  9. Quantification by HPLC-MS/MS of atropine in human serum and clinical presentation of six mild-to-moderate intoxicated atropine-adulterated-cocaine users

    Boermans, PAMM; Go, HS; Wessels, AMA; Uges, DRA

    2006-01-01

    An unexpectedly high number of initially suspected cocaine-intoxicated patients was presented to a general hospital in Lelystad, The Netherlands. Based on the unusual toxidram rate of not fitting cocaine intoxication, the suspicion of co-presence of an anticholinergic agent was raised. A newly devel

  10. Intravenous pyridoxine in acute ethanol intoxication.

    Mardel, S; Phair, I; O'Dwyer, F; Henry, J A

    1994-05-01

    Intravenous pyridoxine was evaluated as an agent for the reversal of ethanol-induced central nervous depression in a randomised double blind controlled study of 108 patients presenting with a clinical diagnosis of acute ethanol intoxication to two accident and emergency departments. Level of consciousness, measured by a modified Glasgow coma scale, showed no significant change after a single 1 g dose of intravenous pyridoxine when compared to controls given saline. The mean fall in blood alcohol concentration after one hour was 33 mg dl-1 (7.2 mmol l-1) in both groups suggesting that pyridoxine has no antidotal action and no short term effect on the rate of metabolism of ethanol.

  11. Acute cattle intoxication from Nerium oleander pods.

    Soto-Blanco, B; Fontenele-Neto, J D; Silva, D M; Reis, P F C C; Nóbrega, J E

    2006-01-01

    Seven outbreaks of acute intoxication from oleander (Nerium oleander) in cattle were reported in Northeast of Brazil. A total of 92 cattle were poisoned by oleander in 7 different herds; 57 animals died (67% of affected cattle). All cases reported here occurred during dry season. Two of the outbreaks resulted from offering oleander triturated and mixed with fodder. In the other cases, accidental ingestion of residual parts of oleander derived from pruning or cutting plants on grazing land were responsible. Clinical signs were diverse; the most common were locomotion disturbances, diarrhoea, depression and sudden death. Postmortem findings varied from no significant lesions to widespread haemorrhage. The presence of oleander leaves in the rumen was noted in all cases. The lack of information about the toxicity of oleanders was the main cause for the accident, which prompt us to stimulate wide divulgation of the common toxic plants.

  12. ACUTE METHANOL INTOXICATIONS – A CHALLENGE FOR CLINICAL TOXICOLOGY

    Petko Marinov

    2016-10-01

    Full Text Available Purpose: Methanol (CH3OH is a monohydric alcohol, vastly used both in housekeeping and industry. Although the acute methanol intoxications are rare, they may include life-threatening symptoms, substantial lethality and negative consequences such as neurological disorders and vision damage. Aim of the work is to conduct a retrospective study on the acute methanol intoxications within Varna region for a 10-year period (2006-2015. Material/Methods: This study covers 39 patients of the Clinic for Intensive Treatment of Acute Intoxications and Toxicoallergies at Naval Hospital – Varna, all of which had their diagnosis confirmed, including gas chromatography methods. Results: Methanol intoxication prevalence showed male/female ratio close to 2.9:1. The major part of the cases concerned economically active population, the age group of 25-60 being the most affected. In all instances an oral methanol intake has been involved. Death occurred in 14 cases (35.9%

  13. Cardiogenic shock due to acute tramadol intoxication.

    Perdreau, Elodie; Iriart, Xavier; Mouton, Jean-Baptiste; Jalal, Zakaria; Thambo, Jean-Benoît

    2015-01-01

    Tramadol is a common analgesic, widely prescribed because of its efficiency and safety. We report the case of a 7-year-old child admitted in cardiac intensive care unit for cardiogenic shock due to tramadol intoxication. Without any past history, the child was admitted at emergency room for generalised convulsion, followed by respiratory distress. Cardiogenic shock was suspected after clinical examination and chest X-ray and confirmed by transthoracic echocardiography showing low left ventricular ejection fraction (1 mg/L) and O-desmethyltramadol (>1.5 mg/L). Hemodynamic support by inotropic drug infusion and diuretics was necessary. Left ventricular function normalised after 2 days of treatment allowing drug infusion weaning. Cardiac magnetic resonance imaging performed 3 days after admission confirmed normal left ventricular ejection fraction and volumes without evidence of late gadolinium enhancement. Cardiogenic shock due to tramadol intoxication is rare but exists. Negative inotropic effect of high doses of tramadol has been suspected. Quick recovery is possible.

  14. Oxime and atropine failure to prevent intermediate syndrome development in acute organophosphate poisoning

    Vučinić Slavica

    2013-01-01

    Full Text Available Introduction. Intermediate syndrome (IMS was described a few decades ago, however, there is still a controversy regarding its exact etiology, risk factors, diagnostic parameters and required therapy. Considering that acute poisonings are treated in different types of medical institutions this serious complication of organophosphate insecticide (OPI poisoning is frequently overlooked. The aim of this paper was to present a case of IMS in organophosphate poisoning, which, we believe, provides additional data on the use of oxime or atropine. Case report. After a well-resolved cholinergic crisis, the patient developed clinical presentation of IMS within the first 72 h from deliberate malathion ingestion. The signs of IMS were weakness of proximal limb muscles and muscles innervated by motor cranial nerves, followed by the weakness of respiratory muscles and serious respiratory insufficiency. Malathion and its active metabolite were confirmed by analytical procedure (liquid chromatography-mass spectrometry. Pralidoxime methylsulphate, adiministered as a continuous infusion until day 8 (total dose 38.4 g, and atropine until the day 10 (total dose 922 mg did not prevent the development of IMS, hence the mechanical ventilation that was stopped after 27 h had to be continued until the day 10. Conclusion. Continuous pralidoxime methylsulphate infusion with atropine did not prevent the development of IMS, most likely due to the delayed treatment and insufficient oxime dose but also because of chemical structure and lipophilicity of ingested OPI. A prolonged intensive care monitoring and respiratory care are the key management for the intermediate syndrome. [Projekat Ministarstva nauke Republike Srbije, br. OI 176018, No. 46009

  15. Acute isoniazid intoxication: seizures, acidosis and coma.

    Temmerman, W; Dhondt, A; Vandewoude, K

    1999-08-01

    Isoniazid (INH) is the most widely used of the antituberculosis drugs. An acute overdose is potentially fatal and is characterized by the clinical triad of repetitive seizures unresponsive to the usual anticonvulsants, metabolic acidosis with a high anion gap and coma. The diagnosis of INH overdose should be considered in any patient who presents with an unexplained metabolic acidosis and convulsions. The cornerstone of therapy consists in pyridoxine (vitamin B6) and the dose should be equal to the amount of INH ingested. When conservative therapy fails or in case of renal insufficiency, dialysis must be considered. Severe central nervous toxicity can also be caused by chronic ingestion of higher than therapeutic doses of INH. In those cases pyridoxine-therapy can be useful as well. In the present paper a case of acute overdose of INH is reported, followed by a review of the literature.

  16. [Acute oral suicidal intoxication with captan--a case report].

    Chodorowski, Zygmunt; Sein Anand, Jacek; Waldman, Wojciech

    2004-01-01

    According to the best of our knowledge the second case of acute intoxication with captan was described. In this paper a 22-year old female was admitted to the Department of Toxicology with a nausea, weakness, numbness of upper limbs and substernal pain. She said that these symptoms began two hours after suicidal ingestion of 5.0 g of captan. At admission the patient was alert. Temperature was 37 degrees C, heart rate 100-120 b/min., BP 100-120/60-70 mm Hg and breathing rate 17/min. WBC were slightly elevated 12.4 x 10(3)/microl as well as the creatine kinase activity 329 U/L. ECG showed inversion of a T segment in V1-V4 leads. ECHO-sound made in 4th and 120th day after the onset of intoxication showed no changes, with EF--70%. Temporary increase of creatine kinase activity as well as the presence of inverted T segment in V1-V4 leads may suggest cardiotoxic effects of captan during acute intoxication.

  17. Comparison of two commonly practiced atropinization regimens in acute organophosphorus and carbamate poisoning, doubling doses vs. ad hoc: a prospective observational study.

    Perera, P M S; Shahmy, S; Gawarammana, I; Dawson, A H

    2008-06-01

    There is a wide variation and lack of evidence in current recommendations for atropine dosing schedules leading to subsequent variation in clinical practice. Therefore, we sought to examine the safety and effectiveness of a titrated vs. ad hoc atropine treatment regimen in a cohort of patients with acute cholinesterase inhibitor pesticide poisoning. A prospective cohort study was conducted in three district secondary referral hospitals in Sri Lanka using a structured data collection form that collected details of clinical symptoms and outcomes of cholinesterase inhibitor pesticide poisoning, atropine doses, and signs of atropinization. We compared two hospitals that used a titrated dosing protocol based on a structured monitoring sheet for atropine infusion with another hospital using an ad hoc regime. During the study, 272 symptomatic patients with anticholinesterase poisoning requiring atropine were admitted to the three hospitals. Outcomes of death and ventilation were analyzed for all patients, 226 patients were prospectively assessed for atropine toxicity. At baseline, patients in the titrated dose cohort had clinical signs consistent with greater toxicity. This in part may be due to ingestion of more toxic organophosphates. They received less pralidoxime and atropine, and were less likely to develop features of atropine toxicity, such as delirium (1% vs. 17%), hallucinations (1% vs. 35%), or either (1% vs. 35%) and need for patient restraint (3% vs. 48%) compared with the ad hoc dose regime. After adjusting for the pesticides ingested, there was no difference in mortality and ventilatory rates between protocols. Ad hoc high dose atropine regimens are associated with more frequent atropine toxicity without any obvious improvement in patient outcome compared with doses titrated to clinical effect. Atropine doses should be titrated against response and toxicity. Further education and the use of a structured monitoring sheet may assist in more appropriate

  18. Case report of acute vitamin D intoxication in an infant

    Radlović Nedeljko

    2014-01-01

    Full Text Available Introduction. Vitamin D intoxication represents a rare and potentially serious pathological condition caused by the excess of calcium and phosphorus. We are presenting an infant with vitamin D intoxication due to excessive daily administration, as well as therapeutic procedures that prevented its adverse effects. Case Outline. A 1.5-month-old female infant, born at term, exclusively breastfed and without any complaints and abnormalities of physical findings, was observed due to the data that during the preceding month, by her mother’s mistake, she had received about 200,000 IU of vitamin D3. Laboratory analyses showed a high serum level of 25(OHD (>400 nmol/L and calcium (2.72 mmol/L, lowered PTH (6.6 pg/ml and high urinary calcium/creatinine ratio (1.6, while other findings, including urotract ultrasonography image, were within normal limits. Treatment based on the discontinuation of vitamin D administration, infant’s forced water intake, as well as the application of 2-month prednisolone and 4-month phenobarbitone and furosemide, resulted in complete normalization of the laboratory indicators of vitamin D overdose, as well as the prevention of its adverse effects. Conclusion. By timely recognition and adequate treatment, including triple therapy with prednisolone, phenobarbitone and furosemide, adverse effects of acute vitamin D intoxication can be prevented.

  19. Death due to acute tetrachloroethylene intoxication in a chronic abuser.

    Amadasi, Alberto; Mastroluca, Lavinia; Marasciuolo, Laura; Caligara, Marina; Sironi, Luca; Gentile, Guendalina; Zoja, Riccardo

    2015-05-01

    Volatile substances are used widespread, especially among young people, as a cheap and easily accessible drug. Tetrachloroethylene is one of the solvents exerting effects on the central nervous system with experiences of disinhibition and euphoria. The case presented is that of a 27-year-old female, found dead by her father at home with cotton swabs dipped in the nostrils. She was already known for this type of abuse and previously admitted twice to the hospital for nonfatal acute poisonings. The swabs were still soaked in tetrachloroethylene. Toxicological and histological investigations demonstrated the presence of an overlap between chronic intake of the substance (with high concentrations in sites of accumulation, e.g., the adipose tissue, and contemporary tissue damage, as histologically highlighted) and acute intoxication as final cause of death, with a concentration of 158 mg/L in cardiac blood and 4915 mg/kg in the adipose tissue. No other drugs or medicines were detected in body fluids or tissues, and to our knowledge, this is the highest concentration ever detected in forensic cases. This peculiar case confirms the toxicity of this substance and focuses on the importance of complete histological and toxicological investigations in the distinction between chronic abuse and acute intoxication.

  20. ApproachtoAcuteIronIntoxication: A Case Report

    Ülkü Özgül

    2011-12-01

    Full Text Available In adults, the main causes of iron poisoning are intake suicide attempts and an overdose of iron during pregnancy. The severity of intoxication depends on the amount of iron. When serum iron level exceeds the iron binding capacity of the body, free radicals occurs, leading to lipid peroxidation and cellular membrane damage. In iron poisoning, especially the liver, heart, kidney, lung, and hematologic systems are affected negatively. Acute iron poisoning can cause serious complications resulting in death. Clinical, laboratory observation and early treatment are important. In this case report, we examined to approach the acute iron poisoning with the occasion of high-dose iron intake for suicide attempt. (Journal of the Turkish Society Intensive Care 2011; 9: 107-9ntakeforsuicideattempt. (Journal of theTurkishSocietyIntensiveCare 2011; 9: 107-9

  1. Acute Hydrocephaly Following Methadone Intoxication in a Child

    Afshin FAYYAZI

    2012-03-01

    Full Text Available How to Cite this Article: Fayyazi A, Khajeh A, Bagheri M, Ahmadi S. Acute Hydrocephaly Following Methadone Intoxication in a Child. Iranian Journal of ChildNeurology 2012;6(1:35-38.Infantile methadone intoxication has been on the rise since the usage of methadone in opioid detoxification programs. We report a 30-month-old child with encephalopathy and acute hydrocephaly following methadone intoxication. References:1. Nazari H. Clinical approach to methadone toxication.Quarterly journal of Addiction 2007;2:18-20.2. Plummer JL, Gourlay GK, Cherry DA, Cousins MJ.Estimation of methadone clearance: application in themanagement of cancer pain. Pain 1988 Jun;33(3:313-22.3. Davies D, DeVlaming D, Haines C. Methadoneanalgesia for children with advanced cancer. PediatrBlood Cancer 2008 Sep;51(3:393-7.4. Riascos R, Kumfa P, Rojas R, Cuellar H, Descartes F.Fatal methadone intoxication in a child. Emerg Radiol2008 Jan;15(1:67-70.5. Binchy JM, Molyneux EM, Manning J. Accidental ingestion of methadone by children in Merseyside.BMJ 1994 May 21;308(6940:1335-6.6. Li L, Levine B, Smialek JE. Fatal methadone poisoningin children: Maryland 1992-1996. Subst Use Misuse2000 Aug;35(9:1141-8.7. Milroy CM, Forrest AR. Methadone deaths: atoxicological analysis. J Clin Pathol 2000 Apr;53(4:277-81.8. Afzali S, Jafari MR. One year study of chest X-raychanges in opiate-poisoned patients in Hamadan. JQom Uni Med Sci 2010; 4(2:3-7.9. Zamani N, Sanaei-Zadeh H, Mostafazadeh B. Hallmarksof opium poisoning in infants and toddlers. Trop Doct2010 Oct; 40(4:220-2.10. Besharat S, Besharat M, Akhavan Masouleh A, JabbariA, Yazdi HR. Opium intoxication in children under 5years old, Golestan- Iran (2006-07. J Gorgan Uni MedSci Spring 2010;12(1:85-9.11. Izadi Mood N, Gheshlaghi F, Sharafi SE. Fatalpoisoning cases admitted to the emergency departmentof poisoning, Noor Hospital, Isfahan. J Legal Med IslRep Iran 2003;9(31:122-26.12. Boushehri B, Yekta Z, Zareei-Kheirabad A, Kabiri SH

  2. Acute interstitial nephritis with acetaminophen and alcohol intoxication

    Alexopoulou Iakovina

    2011-04-01

    Full Text Available Abstract Drug-induced acute interstitial nephritis (AIN represents a growing cause of renal failure in current medical practice. While antimicrobials and non-steroidal anti-inflammatory drugs are typically associated with drug-induced AIN, few reports have been made on the involvement of other analgesics. We report our experience in managing a 17-year-old female with AIN and subsequent renal injury following an acetaminophen overdose in conjunction with acute alcohol intoxication. It is well established that acetaminophen metabolism, particularly at high doses, produces reactive metabolites that may induce renal and hepatic toxicity. It is also plausible however, that such reactive species could instead alter renal peptide immunogenicity, thereby inducing AIN. In the following report, we review a possible mechanism for the acetaminophen-induced AIN observed in our patient and also discuss the potential involvement of acute alcohol ingestion in disease onset. The objective of our report is to increase awareness of healthcare professionals to the potential involvement of these commonly used agents in AIN pathogenesis.

  3. Acute Alcohol Intoxication in Patients with Mild Traumatic Brain Injury: Characteristics, Recovery and Outcome

    Scheenen, Myrthe; de Koning, Myrthe; van der Horn, Harm; van der Naalt, Joukje; Spikman, Jacoba

    2015-01-01

    Objectives. To investigate the incidence of acute alcohol intoxication (AAI) at the time of sustaining mild traumatic brain injury (mTBI), describe the characteristics of this intoxicated subgroup, and evaluate recovery and outcome in comparison to sober mTBI patients. Methods. Multicenter cohort st

  4. Experimental study on therapy of ultraviolet blood irradiation and oxygenation in acute soman intoxication in rabbits

    ZHANG Xian-qing; MU Shi-jie; ZHANG Xiao-di; CHEN Rui; XIA Ai-jun; LIANG Xin; HAI Chun-xu

    2005-01-01

    Objective: To study the therapy effect of ultraviolet blood irradiation and oxygenation(UBIO) on blood AChe activity and lung injury due to acute soman intoxication in rabbits. Methods :Forty rabbits were randomly divided into 4 groups: normal control group, intoxication group, routine therapy group and UBIO therapy group. Blood AChe activity and artery blood gas were analyzed 2 h after intoxication. ACP and AKP activities in BALF were determined respectively. Results:Blood AChe activity in intoxication group was lower than that in normal control group (P<0. 05). BALF ACP and AKP activities in intoxication group were higher than that in normal control group. Blood AChe activities in UBIO therapy group increased and were higher than that in intoxication and routine therapy groups. Compared with intoxication group, BALF ACP and AKP activities were decreased (P<0.05) in UBIO therapy group,while artery blood pH, PaO2 and SaO2 increased (P<0.05). Conclusion: UBIO therapy can elevate blood AChe activity and alleviate lung injury induced by soman intoxication. So it may be a new way to treat acute soman intoxication.

  5. Acute Intoxication by Transdermal Opium Application in Infants: Two Case Reports

    Iraj Sedighi

    2012-05-01

    Full Text Available Background: Acute opium intoxication is one of the most common causes of poisoning in children in Iran. Although most cases are accidental, traditional misuse of opium for symptomatic therapy of various childhood diseases also contributes to high rate of opium intoxication in Iran. Cases: Here, we report two cases of opium intoxication in infants resulted from transdermal application of opium on burned skin. To our knowledge this is the first case report of intoxication from transdermal misuse of opium. Conclusion: Health care providers should be aware about signs and symptoms of opium intoxication in children. Opium intoxication should be suspected in each child with history of a recent burn injury that presented with decreased level of consciousness.

  6. Diagnostic and therapeutic approach for acute paraquat intoxication.

    Gil, Hyo-wook; Hong, Jung-Rak; Jang, Si-Hyong; Hong, Sae-Yong

    2014-11-01

    Paraquat (PQ) has known negative human health effects, but continues to be commonly used worldwide as a herbicide. Our clinical data shows that the main prognostic factor is the time required to achieve a negative urine dithionite test. Patient survival is a 100% when the area affected by ground glass opacity is <20% of the total lung volume on high-resolution computed tomography imaging 7 days post-PQ ingestion. The incidence of acute kidney injury is approximately 50%. The average serum creatinine level reaches its peak around 5 days post-ingestion, and usually normalizes within 3 weeks. We obtain two connecting lines from the highest PQ level for the survivors and the lowest PQ level among the non-survivors at a given time. Patients with a PQ level between these two lines are considered treatable. The following treatment modalities are recommended to preserve kidney function: 1) extracorporeal elimination, 2) intravenous antioxidant administration, 3) diuresis with a fluid, and 4) cytotoxic drugs. In conclusion, this review provides a general overview on the diagnostic procedure and treatment modality of acute PQ intoxication, while focusing on our clinical experience.

  7. Clinical analysis of acute organophosphate poisoning using atropine and penehyclidine hydrochloride atropine about 80 cases%急性有机磷中毒使用长托宁和阿托品临床80例分析

    刘丽; 王正康; 牟丽琴

    2012-01-01

    目的 探讨在急性有机磷中毒时使用长托宁(盐酸戊乙奎醚)对阿托品剂量、时间使用的影响.方法 将我院自2003~2009年共收治80例急性有机磷中毒患者分为对照组和治疗组.治疗组为阿托品、碘解磷定加长托宁,对照组为常规使用使用阿托品、碘解磷定组,分析两组患者阿托品用量、维持时间及病死率.结果 长托宁可以使轻、中、重急性有机磷中毒患者减少阿托品用药总量,治疗组分别为15、76、101mg,对照组分别为43、83、840mg减少阿托品用药次数,治疗组分别为:15、23、30次,对照组分别为:20、35、94次,缩短阿托品化时间,治疗组分别为:1.5、3、5h,对照组分别为:3、5、8h,缩短治愈时间:治疗组分别为:3、4、5d,对照组分别为:4、5、6d,两组比较差异有统计学意义.结论 急性有机磷中毒配合使用长托宁,减少阿托品使用总量及维持时间,并且不易发生反跳,病死率降低,长托宁是一种比阿托品效果好、不良反应少的新型抗胆碱能药.%To explore in acute organophosphate poisoning "to use long temple, use of atropine doses. Methods From 2003 -2009 1995,23 cases of acute organophosphate poisoning 80 cases of patients in the control group and divided into treatment group, the treatment group for atropine and recent iodine, torre for extended for routine use of atropine in recent, iodine, analyzes two groups for group patients maintain time and atropine, mortality. Results Torre would make long mild, moderate, and severe acute organophosphale poisoning patients reduce total drug treatment group and atropine 15mg respectively, 76mg, l0lmg, respectively, in 43mg83mg, 840mg reduce atropine, drug treatment group is respectively: 15 times, 23 times, 30 times, respectively is; 20 times, 35, 94, shorten the time of atropine, the treatment group is respectively: 1.5h 5h and control, 3h, respectively, the 5h and 8h: 3h, shorten the time: treatment group cure

  8. Acute lead intoxication in a female battery worker: Diagnosis and management

    Hadjichristodoulou Christos; Rachiotis George; Dounias George

    2010-01-01

    Abstract Lead is a significant occupational and environmental hazard. Battery industry is one of the settings related to lead intoxication. Published information on the use of oral chelating agents for the treatment of anaemia in the context of acute lead intoxication is limited. The patient was a 33 year immigrant female worker in a battery manufacture for 3 months. She complained for malaise that has been developed over the past two weeks. Pallor of skin and conjunctiva was the only sign fo...

  9. Intoxicación aguda en perro por toxinas de sapo (Bufo bufo - Acute intoxication in a dog by toxins of a toad (Bufo bufo

    Fernández-Palacios, O´Connor, Rocío

    2009-04-01

    Full Text Available ResumenLas intoxicaciones por toxinas de sapo no son frecuentes en España y su incidencia es mayor en primavera y verano. En este trabajo describimos un caso de intoxicación aguda de una perra de 4 años de edad tras la aprehensión de un sapo (Bufo bufo en la zona de Huelva. Los signos de una intoxicación comenzaron a los 15 minutos de entrar en contacto con el sapo muriendo a las 3 horas sin responder al tratamiento suministrado (corticoides, atropina, fluidoterapia y acepromazina. Aunque el diagnóstico fue precoz, a pesar del tratamiento se produjo la muerte en 3 horas.SummaryIntoxications by toad toxins are not frequent in Spain, and its incidence is greater in spring and summer. In this work it is described a case of an acute intoxication of a dog of 4 years old by toad toxins (Bufo bufo in the area of Huelva. The animal began to show signs of intoxication 15 minutes after the contact with the toad, dying 3 hours later without any response to the provided treatment (corticoids, atropine, fluidotherapy and acepromazine. Although the diagnosis was precocious and the treatment was administrated, after 3 hours the animal died.

  10. Acute isoniazid intoxication: an uncommon cause of convulsion, coma and acidosis.

    Uzman, Sinan; Uludağ Yanaral, Tümay; Toptaş, Mehmet; Koç, Alparslan; Taş, Aytül; Bican, Gülşen

    2013-01-01

    Despite the widespread use, suicidal ingestion of isoniazid is a rare condition in Turkey. We reported a case of acute isoniazid intoxication associated with alcohol intake presenting with convulsion, coma and metabolic acidosis. The patient was treated successfully with intravenous pyridoxine administration. Early recognation and appropriate treatment in the intensive care unit is very important to prevent mortality in patients with acute isoniazid toxicity.

  11. Surprising hair analysis results following acute carbofuran intoxication.

    Dulaurent, S; Gaulier, J M; Zouaoui, K; Moesch, C; François, B; Lachâtre, G

    2011-10-10

    We present two non fatal cases of intoxication with carbofuran (CBF) documented by hair analysis. Carbofuran and 3-hydroxycarbofuran (OHCBF, its main metabolite) hair concentrations were determined using a liquid chromatography-tandem mass spectrometry method. The obtained results were surprising if we consider several hair analyses previously published and based on a theory of the presence of xenobiotic in the only segment that comprised its intake. Among the two intoxication cases, we noticed the presence of CBF and OHCBF in hair segments corresponding to 45 days before, and more than 100 days after, the day of intoxication. Additionally, repeated hair samplings and subsequent analysis revealed a decrease of the carbofuran's concentration during the hair life.

  12. [Hemoperfusion in the treatment of acute valproic acid intoxication].

    Peces, R; Fernández, E J; Sánchez, R J; Peces, C; Montero, A; Selgas, R

    2007-01-01

    Valproic acid is increasingly used in the treatment of epilepsy, and also prescribed for bipolar affective disorders, schizoaffective disorders, schizophrenia and migraine prophylaxis. Valproic acid intoxication with suicide attempt is a relatively common clinical problem that can result in coma, respiratory depression, pancytopenia, hemodynamic instability and death. The drug's relatively low molecular weight, small volume of distribution and saturable protein-binding render it potentially amenable to exracorporeal removal (hemodialysis, hemoperfusion or hemofiltration ), but published experience is scarce. We describe a case report involving valproic acid intoxication with ingestion of ethanol, who was successfully treated with charcoal hemoperfusion. With this treatment the half-life of valproic acid was reduced with rapid lowering of valproic acid levels and clinical improvement. Based on our experience in this patient and a review of previously reported cases, charcoal hemoperfusion should be considered for serious valproic acid intoxication because free as well as bound drug fractions are eliminated via this technique.

  13. [Extended hemoperfusion in the treatment of acute carbamazepine intoxication].

    Peces, R; Azorín, S; Peces, C; Selgas, R

    2010-01-01

    Carbamazepine is used in the treatment of epilepsy, and also prescribed in neuralgic pain syndromes, and certain affective disorders. Carbamazepine intoxication with suicide attempt is a relatively common clinical problem that can result in coma, respiratory depression, arrhythmia, hemodynamic instability and death. The drug's relatively high molecular weight, elevated volume of distribution and intense protein-binding render it difficult to extracorporeal removal, but published experience with hemoperfusion or hemodialysis present variable results. We describe a case report involving carbamazepine intoxication who was successfully treated with charcoal hemoperfusion. With this treatment the half-life of carbamazepine was reduced with rapid lowering of carbamazepine levels and clinical improvement. Based on our experience in this patient and a review of previously reported cases, extended charcoal hemoperfusion should be considered for serious carbamazepine intoxication because free as well as bound drug fractions are eliminated via this technique.

  14. Preclinical study comparing the antidotal effect of clonidine with atropine for the treatment of acute malathion poisoning in the albino rats

    Suresha K. R.

    2016-12-01

    Full Text Available Background: In developing countries 2–3 million people are acutely poisoned by organophosphorus (OP pesticides every year. There is a pressing need for new affordable antidotes and in this context clonidine which has central effect (α2 agonist has been evaluated in the albino rats presenting with signs or symptoms of acute malathion poisoning. And compared with atropine for the acte malathion poisoning in albino rats. Methods: This was a preclinical study conducted on albino rats of either sex weighing 100-150 grams were randomly divided into 4 groups (6/group. Malathion was given at the lethal dose of 54 mg/kg body weight (BW by gavage to each group. Group 1: normal saline intraperioneal (i.p. Group 2: Post treated with atropine 1.5 mg/kg BW (i.p. Group 3: Pre treated with clonidine 1mg/ kg BW (i.p, 10 minutes priore malathion. Group 4: Pre treated with clonidine and post treated with atropine. The above groups were observed for straub tail, muscle fasciculation, piloerection, lacrimation, defecation/ urination; salivation, tremors, gasping and convulsion and were recorded at time 0, 15, 30, 45 and 60 minutes after poisoning. The latency of onset of tremors, loss of righting reflex and tremors were recorded. Results were presented as percentage occurrence and Mean ± SEM. Repeated measure one way ANOVA and Fisher’s Least Significant Difference post hoc test for comparison between groups. P-value of 0.05 or less was considered for statistical significance. Results: The central effects namely straubs tail and whole body tremors are significantly improved compared to control and atropine with clonidine group (p<0.05. However convulsion shows improve in atropine alone and atropine with clonidine groups. The overall survival time has significantly increased compared to control and atropine and atropine with clonidine (P<0.05.Clonidine has not shown any effect on survival time. Conclusions: Clonidine has some central protective effect in

  15. [Acute intoxication in adults - what you should know].

    Zilker, Th

    2014-01-01

    Ingestion of household products and plants are the leading cause for calls to the poison control centres as far as children are involved. Severe intoxication in children has become infrequent due to childproofed package and blister packs for drugs. Chemical accidents in adults give rise to hospital admission in only 5 %. Suicidal selfpoisonings are still a challenge for paramedics, emergency and hospital doctors. Natural toxins as amatoxins, cholchicine and snakebites can lead to severe intoxication. Sedatives, antidepressants and analgesics are the drugs which are often used for suicidal intent due to their availability. Quetiapine and paracetamol are the drugs which are ingested for attempted suicide/ suicide mostly. The treatment of poisoning centers on the severity which can be judged by the poison severity score, the Reed classification or the GCS.Most intoxicated patients can be treated symptomatically or by intensive care measurements. Antidotal treatment however is needed for some specific poisonings.Exact sample drawing is essential for diagnostic and forensic purposes. There is no evidence based proof for the effectiveness of primary detoxification from the gastrointestinal tract like forced emesis, gastric lavage or the use of cathartics. Early after the ingestion of a harmful substance the administration of activated charcoal seems advisable. Hemodialysis can remove water soluble substances with a small volume of distribution. Multiple charcoal administration may exhibit some influence on secondary detoxification. Provision of evidence of the efficacy for newer antidotes like hydroxocobalamin in smoke inhalation, fomepizol for toxic alcohols and silibinin for amanita poisoning are emerging. Two recently recommended therapeutic principles have still to demonstrate their ability: Firstly the treatment of patients with calcium receptor antagonistic and beta-receptor antagonistic agents poisoning by high dose of insulin plus glucose, secondly the

  16. Transient leucopenia, thrombocytopenia and anaemia associated with severe acute phenobarbital intoxication in a dog.

    Khoutorsky, A; Bruchim, Y

    2008-07-01

    A nine-year-old Labrador retriever dog was admitted to the emergency unit of the Hebrew University Veterinary Teaching Hospital with acute-onset tremors and coma. It had recently ingested a large quantity of phenobarbital and had a high serum phenobarbital concentration. On this basis, a diagnosis of acute phenobarbital intoxication was made. Significant leucopenia, thrombocytopenia and mild anaemia developed on the third day after admission. The leucopenia resolved on day 6 and the thrombocytopenia on day 13. The red blood cell count remained low for the next month. The dog was discharged on day 13 at which time it was ambulatory but weak. It was completely recovered clinically eight days later. In summary, high levels of serum phenobarbital as a result of acute intoxication induced pancytopenia, which improved when the serum phenobarbital level was normalised.

  17. Lithium Intoxication

    Sermin Kesebir

    2011-09-01

    Full Text Available Lithium has been commonly used for the treatment of several mood disorders particularly bipolar disorder in the last 60 years. Increased intake and decreased excretion of lithium are the main causes for the development of lithium intoxication. The influence of lithium intoxication on body is evaluated as two different groups; reversible or irreversible. Irreversible damage is usually related with the length of time passed as intoxicated. Acute lithium intoxication could occur when an overdose of lithium is received mistakenly or for the purpose of suicide. Patients may sometimes take an overdose of lithium for self-medication resulting in acute intoxication during chronic, while others could develop chronic lithium intoxication during a steady dose treatment due to a problem in excretion of drug. In such situations, it is crucial to be aware of risk factors, to recognize early clinical symptoms and to conduct a proper medical monitoring. In order to justify or exclude the diagnosis, quantitative evaluation of lithium in blood and toxicologic screening is necessary. Following the monitoring schedules strictly and urgent intervention in case of intoxication would definitely reduce mortality and sequela related with lithium intoxication. In this article, the etiology, frequency, definition, clinical features and treatment approaches to the lithium intoxication have been briefly reviewed.

  18. ENFOQUE DEL PACIENTE CON INTOXICACIÓN AGUDA POR PLAGUICIDAS ORGANOS FOSFORADOS Organophosphorates: acute intoxication practical issues

    Carlos Mauricio Hurtado Clavijo

    2005-10-01

    Full Text Available Un gran número de insecticidas organofosforados se usan en todo el mundo a diario. Las intoxicaciones ocurren generalmente de forma accidental por exposición laboral, o intencional, con fines suicidas. Los organofosforados producen sus efectos tóxicos a través de la inhibición de la acetilcolinesterasa, la enzima responsable de la hidrólisis del neurotransmisor acetilcolina, produciendo ácido acético y colina, productos químicamente inertes. La unión entre los organofosforados y la acetilcolina es una unión irreversible espontáneamente, sin embargo, puede ser reversible con el uso de antídotos específico llamados oximas. La administración temprana de pralidoxima es crucial y muy útil si se inicia en las primeras seis horas luego de la intoxicación aguda. La atropina produce un beneficio clínico dramático para los síntomas muscarínicos del síndrome colinérgico. Pueden ocurrir complicaciones importantes en los pacientes por intoxicación con organofosforados, como hipotensión, arritmias cardíacas fatales, síndrome intermedio, distres respiratorio, neumonía y aún disfunción cerebral severa.Every day more organic phosphorus insecticides, are used in the entire world. Intoxications happen generally accidentally for exhibition work, or intentional as suicides. Organic phosphorus compounds, produces toxic effects, through the inhibition of the acetylcholinesterase, the enzyme responsible for the hydrolisys of the acetylcholine, neurotransmisor producing acetic acid and colina, chemically inert products. The binding between the organic phosphorus compounds and the acetylcholine is spontaneously and irreversible, however, it can be reversible with the use of an antidote specific called oximas. The early administration of pralidoxima is crucial, great benefits are obtained if it begins in the first six hours after the acute intoxication. Atropine produces a dramatic clinical benefit for the symptoms muscarinic of the syndrome

  19. ACUTE NARCOTIC DRUG INTOXICATIONS: ETIOLOGY, SEX/AGE DISTRIBUTION AND CLINICAL OUTCOME

    Petko Marinov

    2017-01-01

    Full Text Available Purpose: Poisoning with drugs is a serious medical and social problem worldwide. Retrospective analysis of acute poisoning with narcotic drugs had been performed in Varna region for 25 years (1991-2015. Material and Methods: The number of patients received hospital treatment after poisonings with narcotic substances was 677, which represented 3.9% of all acute exogenous intoxications. Results: Narcotic poisonings were more common in men – 546 (80.6%, than in women – 131 (19.4 %. The ratio male/ female was 4.17:1. The largest number of intoxications were in the age group up to 24 years – 1123 (66%, and only 2.65% of patients were over 45 years. Death was registered in 6 (0.9% patients.

  20. From divination to madness: features of acute intoxication with Salvia use.

    Winslow, Munidasa; Mahendran, Rathi

    2014-04-01

    Salvia divinorum is a psychoactive botanical plant that is increasingly used for the 'legal' highs that it can produce. It is readily available for purchase on the Internet, and most abusers are unaware of the toxicity and abuse potential associated with its use. As the use of novel compounds among abusers is not uncommon, physicians need to increase their awareness and recognition of these new substances. Herein, we report a case of an acute presentation of Salvia intoxication.

  1. Corrections by melatonin of liver mitochondrial disorders under diabetes and acute intoxication in rats.

    Cheshchevik, Vitali T; Dremza, Iosif K; Lapshina, Elena A; Zabrodskaya, Svetlana V; Kujawa, Jolanta; Zavodnik, Ilya B

    2011-08-01

    The aim of the present work was to investigate the mechanisms of oxidative damage of the liver mitochondria under diabetes and intoxication in rats as well as to evaluate the possibility of corrections of mitochondrial disorders by pharmacological doses of melatonin. The experimental (30 days) streptozotocin-induced diabetes mellitus caused a significant damage of the respiratory activity in rat liver mitochondria. In the case of succinate as a respiratory substrate, the ADP-stimulated respiration rate V₃ considerably decreased (by 25%, p diabetic liver damage. Acute rat carbon tetrachloride-induced intoxication resulted in considerable decrease of the phosphorylation coefficient because of uncoupling of the oxidation and phosphorylation processes in the liver mitochondria. The melatonin administration during diabetes (10 mg·kg⁻¹ body weight, 30 days, daily) showed a considerable protective effect on the liver mitochondrial function, reversing the decreased respiration rate V₃ and the diminished ACR to the control values both for succinate-dependent respiration and for glutamate-dependent respiration. The melatonin administration to intoxicated animals (10 mg·kg⁻¹ body weight, three times) partially increased the rate of succinate-dependent respiration coupled with phosphorylation. The impairment of mitochondrial respiratory plays a key role in the development of liver injury under diabetes and intoxication. Melatonin might be considered as an effector that regulates the mitochondrial function under diabetes.

  2. [Effect of acute alcohol intoxication on lipid peroxidation in testis and adrenal glands of rats].

    Khokha, A M; Kashko, M F; Antsulevich, S N; Doroshkevich, N A; Voronov, P P

    1993-01-01

    Hormones level and lipid peroxidation processes under influence of acute alcohol intoxication are tested in testes and adrenals of rats. Ethanol marker effects--the rise of corticosterone biosynthesis and depression of testosterone concentration--were reproduced in the experiment. At the moment of maximal changes in steroid levels indices characterising lipid peroxidation didn't differ from the control. At the early stage of the experiment transient shifts in malonic dialdehyde and dienic conjugates levels were noted. The data obtained does not agree with the hypothesis of acute ethanol effects in testes and adrenals being mediated through the changes of lipid peroxidation rate.

  3. Acute arsine intoxication as a consequence of metal burnishing operations.

    Romeo, L; Apostoli, P; Kovacic, M; Martini, S; Brugnone, F

    1997-09-01

    The report concerns a 30-year-old factory worker, employed in a small galvanizing plant for over ten years in the burnishing, copper- and nickel-plating of small metal articles for the shoe industry. Acute arsine poisoning was attributed to the use of a dilute solution of CuSO4 (3%), HCl (32%), and As2O3 (2%) for burnishing metal (Fe-Zn) shoelace eyelet holes, in the absence of local exhaust ventilation and with no respiratory protection. Arsine caused severe intravascular hemolysis with a rapid drop in hematocrit and hemoglobin levels. Other body organs were involved as a result of the hypoxic effect of anemia and hemolysis, or as a direct toxic effect of the arsine itself. Our experience confirms that exchange transfusion is capable of rapidly arresting the adverse effects of arsine. The importance of preventive measures and worker information to avoid acute arsine poisoning is emphasized.

  4. Determination of in Histochemical Changes of Internal Organs Under Acute Alcoholic Intoxications in Russia

    Vugar Mammadov

    2011-12-01

    Full Text Available AIM: During forensic-medical autopsies experts must very often assess degree and the role of acute alcohol intoxications in mechanisms of death. This becomes more actual in the cases of sudden death from different diseases especially cardiac, brain and liver origin, mechanical injuries, mechanical asphyxia etc. METHOD: This study aims to show that blood concentration of alcohol must not be only criteria during assessment of severity of intoxications and their influence on patogenesis. Epidemiological screening of 320 medico-legal reports assesses the role of sex, age, ethnicity and other peculiarities. RESULTS: Special histochemical investigations of ethanol oxidizing enzymes were also conducted on materials taken from 167 autopsies. CONCLUSION: Study suggests that morpho-functional histochemical tests must be entered in the list of methods of postmortem diagnostics during autopsies of cases with the background of ethanol poisoning, especially for differential diagnosis of acute alcohol intoxication, alcohol cardiomyopathy and ischemic heart disease. [TAF Prev Med Bull 2011; 10(6.000: 641-648

  5. Acute intoxication caused by synthetic cannabinoids 5F-ADB and MMB-2201: A case series.

    Barceló, Bernardino; Pichini, Simona; López-Corominas, Victoria; Gomila, Isabel; Yates, Christopher; Busardò, Francesco Paolo; Pellegrini, Manuela

    2017-02-02

    Synthetic cannabinoids are relatively new substances of abuse. Recently, abuse of synthetic cannabinoids has been increasingly reported in the lay press and medical literature. When new compounds are introduced, their use is initially not restricted by prohibition therefore their consumption cannot be verified by standard drug tests. The use of these compounds among adolescents and young adults is constantly growing, making it important for emergency services to be familiar with the signs and symptoms of intoxication present. Overdose and chronic use of these substances can cause adverse effects including altered mental status, tachycardia, and loss of consciousness. Here, we report five cases of acute intoxication by synthetic cannabinoids 5F-ADB and MMB-2201 with analytical confirmation.

  6. Polypharmacy May Be the Cause of Acute Lithium Intoxication at the Second Day of Treatment

    Tursun Irfan

    2015-12-01

    Full Text Available Lithium is frequently used as a mood stabilizer in patients with mood disorders. Lithium has a narrow therapeutic index and high toxicity. Predisposing factors for intoxication are advanced age, diet disturbances, comorbid medical conditions affecting heart, kidneys or central nervous system and polypharmacy. CASE REPORT: Here we present a case of a 74-year-old woman with a history of Parkinson’s disease, hypertension and bipolar disorder. She was using quetiapine, valsartan with hydrochlorothiazide and levodopa with carbidopa. She presented with altered mental status and muscle rigidity. The patient was admitted with acute lithium intoxication after her second dose of treatment. Blood lithium level increased to 3.58 mEq/L. The woman was hospitalized in the Internal Medicine Intensive Care Unit. With hydration, her symptoms resolved and her lithium level returned to normal after 118 hours. CONCLUSIONS: Prescribing physicians and emergency room physicians should be aware of conditions which may cause a decreased threshold for intoxication.

  7. Acute lead intoxication in a female battery worker: Diagnosis and management

    Hadjichristodoulou Christos

    2010-07-01

    Full Text Available Abstract Lead is a significant occupational and environmental hazard. Battery industry is one of the settings related to lead intoxication. Published information on the use of oral chelating agents for the treatment of anaemia in the context of acute lead intoxication is limited. The patient was a 33 year immigrant female worker in a battery manufacture for 3 months. She complained for malaise that has been developed over the past two weeks. Pallor of skin and conjunctiva was the only sign found in physical examination. The blood test on admission revealed normochromic anaemia. Endoscopic investigation of the gastrointestinal system was negative for bleeding. The bone marrow biopsy was unrevealing. At baseline no attention has been paid to patient's occupational history. Afterwards the patient's occupational history has been re-evaluated and she has been screened for lead intoxication. The increased levels of the lead related biomarkers of exposure and effect confirmed the diagnosis. The patient received an oral chelating agent and an improvement in clinical picture, and levels of haematological and lead related biochemical parameters have been recorded. No side effect and no rebound effect were observed. This case report emphasizes the importance of the occupational history in the context of the differential diagnosis. Moreover, this report indicates that lead remains a significant occupational hazard especially in the small scale battery industry

  8. Acute lead intoxication in a female battery worker: Diagnosis and management.

    Dounias, George; Rachiotis, George; Hadjichristodoulou, Christos

    2010-07-07

    Lead is a significant occupational and environmental hazard. Battery industry is one of the settings related to lead intoxication. Published information on the use of oral chelating agents for the treatment of anaemia in the context of acute lead intoxication is limited. The patient was a 33 year immigrant female worker in a battery manufacture for 3 months. She complained for malaise that has been developed over the past two weeks. Pallor of skin and conjunctiva was the only sign found in physical examination. The blood test on admission revealed normochromic anaemia. Endoscopic investigation of the gastrointestinal system was negative for bleeding. The bone marrow biopsy was unrevealing.At baseline no attention has been paid to patient's occupational history. Afterwards the patient's occupational history has been re-evaluated and she has been screened for lead intoxication. The increased levels of the lead related biomarkers of exposure and effect confirmed the diagnosis. The patient received an oral chelating agent and an improvement in clinical picture, and levels of haematological and lead related biochemical parameters have been recorded. No side effect and no rebound effect were observed. This case report emphasizes the importance of the occupational history in the context of the differential diagnosis. Moreover, this report indicates that lead remains a significant occupational hazard especially in the small scale battery industry.

  9. [Treatment of acute lithium intoxication with high-flux haemodialysis membranes].

    Peces, R; Fernández, E J; Regidor, D; Peces, C; Sánchez, R; Montero, A; Selgas, R

    2006-01-01

    Lithium carbonate is commonly prescribed for the treatment of bipolar (manic-depressive) disorders. However, because of its narrow therapeutic index an excessive elevation of serum lithium concentration, either during chronic maintenance therapy or after an acute overdose, can result in serious toxicity. In addition to supportive care, the established treatment of severe lithium toxicity is haemodialysis. Conventional haemodialysis can reduce serum lithium rapidly, but post-dialysis rebound elevations with recurrent toxicity have been documented in old publications. High-flux membranes should be capable of removing more lithium per hour of haemodialysis, but published values are not available. We report here three patients with acute lithium intoxication who were treated successfully with bicarbonate and high-flux haemodialysis membranes. Our patients presented with a severe degree of intoxication, based on the amount of drug ingested, the initial serum lithium level, the severity of neurologic symptoms and systemic manifestations. Two patients developed acute renal failure probably as a result of volume depletion since it was rapidly reversible by haemodialysis and infusion therapy. In addition, consecutive haemodialysis sessions and improvement of renal function allowed a rapid decrease in serum lithium levels without haemodynamic instability or rebound elevations in lithium concentration. The effectiveness of the procedure in these cases can be attributed to the use of bicarbonate dialysate and high-efficiency dialysers. This is the first report describing the effect of high-efficiency dialysers on lithium pharmacokinetic. Using this technique the elimination rate of lithium was found to be greater than previously reported with haemodialysis.

  10. [Comparative characteristics of glucose metabolism in the liver of rats under acute alcohol and morphine intoxication].

    Lelevich, S V

    2011-01-01

    The comparative analysis effect of acute alcohol and morphine intoxications on rats on hepatic glycolysis and pentose phosphate pathway was done. The dose-dependent inhibitory effect of ethanol on activity of limiting enzymes of these metabolic ways, as well as anaerobic reorientation of glucose metabolism was recognised with the increase of the dose of the intake alcohol. Morfine (10 mg/kg) activated enymes of glycolysis and pentose phosphate pathway, but in contrast to ethanol it did not influence these parameters at the dose 20 or 40 mg/kg.

  11. Blood, urine, and hair kinetic analysis following an acute lead intoxication.

    Ho, G; Keutgens, A; Schoofs, R; Kotolenko, S; Denooz, R; Charlier, C

    2011-01-01

    A case of lead exposure resulting from the accidental ingestion of a lead-containing solution is reported. Because of clinical management rapidly performed through chelation therapy by 2,3-dimercaptopropane sulfonate sodium and meso-2,3-dimercaptosuccinic acid, blood lead levels of this 51-year-old patient were moderate (412.9 μg/L) and no clinical symptoms were observed. Numerous blood and urine samples were collected for kinetic analysis of lead elimination. However, we report the first case in which hair samples were analyzed to determine the excretion level of lead after acute intoxication.

  12. Protective effect induced by atropine, carbamates, and 2-pyridine aldoxime methoiodide Artemia salina larvae exposed to fonofos and phosphamidon.

    Victoria Barahona, M; Sánchez-Fortún, Sebastián

    2007-01-01

    The acute toxicity of fonofos and phosphamidon on three age classes of Artemia salina was evaluated. An increase in toxicity of these organophosphorous (OP) insecticides was found following longer development of A. salina. The effects of pretreatment with the nonselective muscarinic antagonist atropine, the two reversible acetylcholinesterease inhibitors physostigmine and pyridostigmine, and the cholinesterase-reactivating oxime 2-pyridine aldoxime methoiodide (2-PAM), as individual and combined pretreatments, on OP-induced lethality in 24 h Artemia were also investigated. The lethal action of both OP insecticides was prevented by pretreatment of 24 h Artemia with atropine and 2-PAM, while physostigmine proved ineffective against intoxication with both OP insecticides and pyridostigmine exhibited a low synergic effect. In both cases, the inhibitory effects of combinations of atropine (10(-5)M) plus 2-PAM were greater than those elicited by either drug alone, with the maximum protection afforded being 100%. Combined pretreatment of atropine (10(-5)M) plus physostigmine practically abolished the lethal effects induced by both insecticides. Pretreatment with 2-PAM (10(-6)M) plus physostigmine afforded maximal protection of 100% and 76% on the lethality induced by fonofos and phosphamidon, respectively. The data obtained suggest that the combination of atropine plus 2-PAM or physostigmine and the combined pretreatment of 2-PAM plus physostigmine are effective in the prevention of the lethal effects induced by fonofos and phosphamidon in A. salina larvae.

  13. Prophylaxis Against Nerve Agent Intoxications

    Jiri Patocka

    2006-11-01

    Full Text Available The acute toxicity of organophosphates is usually attributed to their irreversible inhibitionof an enzyme acetylcholinesterase that hydrolyses the neurotransmitter acetylcholine. Theresultant increase in concentration of acetylcholine at the cholinergic synapses of the peripheraland central nervous system, and neuromuscular junction is manifested by over-stimulation ofthe cholinergic neurotransmission. Current antidotal regimens for organophosphate poisoningconsisting of a post-exposure therapy with anticholinergics such as atropine, acetylcholinesterasereactivators (oximes, benzodiazepines have some limitations. Therefore, effective prophylaxisbefore intoxication is of a special interest. Four fundamental prophylactic methods are: (iprotection of acetylcholinesterase against irreversible inhibition by organophosphates usingdifferent reversible inhibitors, (ii protection against neurotoxic effect of organophosphates usingbenzodiazepines, memantine, NMDA receptor blockers, (iii administration of cholinesterasepreparations of different sources (sometimes commercially available at present acting asbioscavengers, and (iv gene therapy being a new treatment modality under intensive researchusing enzymes hydrolysing/splitting organophosphates with the aim to eliminate toxic agentbefore it is transported to the target organs.

  14. In-hospital mortality and long-term survival of patients with acute intoxication admitted to the ICU

    Brandenburg, Raya; Brinkman, Sylvia; De Keizer, Nicolette F.; Meulenbelt, Jan; De Lange, Dylan W.

    2014-01-01

    OBJECTIVE: To assess in-hospital and long-term mortality of Dutch ICU patients admitted with an acute intoxication. DESIGN: Cohort of ICU admissions from a national ICU registry linked to records from an insurance claims database. SETTING: Eighty-one ICUs (85% of all Dutch ICUs). PATIENTS: Seven tho

  15. Acute intoxication patients presenting to an emergency department in The Netherlands: admit or not? Prospective testing of two algorithms.

    Ambrosius, R.G.; Vroegop, M.P.; Jansman, F.G.A.; Hoedemaekers, C.W.E.; Aarnoutse, R.E.; Wilt, G.J. van der; Kramers, C.

    2012-01-01

    STUDY OBJECTIVE: After acute intoxication, most patients presenting to the emergency department (ED)--76% of them in The Netherlands--are admitted to hospital. Many will not need medical treatment on the ward. The authors tested two algorithms in the ED, based on vital parameters, ECG findings, and

  16. Are there biomedical criteria to assess an acute carbon dioxide intoxication by a volcanic emission?

    Stupfel, Maurice; Le Guern, François

    1989-11-01

    On August 21, 1987, more than 1800 people, thousands of head of cattle and countless wild animals, including birds, were killed by a gas release which occurred during about 4 hours at the lake in the crater Iwi at Nyos in Cameroon; plant life was mostly unaffected. An international inquiry was performed by British, French, Italian, Japanese and U.S. volcanologists and physicians to determine what had been the cause of this disaster. An international conference organised by United Nations Educational Scientific, and Cultural Organisation (U.N.E.S.C.O.), the Cameroon Government and the U.N. Economic Commission for Africa held in Yaoundé March, 1987 concluded: 'that the cause of sudden death was suffocation (asphyxia) in a carbon dioxide atmosphere' The medical findings have been explained by asphyxia caused by carbon dioxide. The presence of other volcanic gases, e.g. hydrogen sulfide, cannot be ruled out' (Sigvaldason, 1989, this issue). This paper reviews what is mainly known about an acute carbon dioxide intoxication in order to disprove or confirm the diagnosis and helps to interpret the field observations and testimonies to provide a basis to discuss the prevention of such an intoxication.

  17. Motor performance during and following acute alcohol intoxication in healthy non-alcoholic subjects

    Poulsen, Mette Buch; Jakobsen, Johannes Klitgaard; Andersen, Henning

    2007-01-01

    ). To detect a reduced activation of the central motor pathways superimposed external electrical stimulations during voluntary contractions were applied. Creatine kinase (CK) was measured to detect any alcohol-induced changes in sarcolemmal integrity. No change was seen in isokinetic as well as in isometric......Chronic alcohol abuse has adverse effects on skeletal muscle, and reduced muscle strength is frequently seen in chronic alcoholics. In this study the acute effects of moderate alcohol intoxication on motor performance was evaluated in 19 non-alcoholic healthy subjects (10 women, 9 men......). A randomised double-blinded placebo controlled design was applied to subjects receiving alcohol in juice and pure juice at two separate test periods. Isokinetic and isometric muscle strength and endurance were determined before, during, 24 and 48 h after the ingestion of alcohol in juice and juice (placebo...

  18. A Heart too Drunk to Drive; AV Block following Acute Alcohol Intoxication.

    van Stigt, Arthur H; Overduin, Ruben J; Staats, Liza C; Loen, Vera; van der Heyden, Marcel A G

    2016-02-29

    Acute excessive alcohol consumption is associated with heart rhythm disorders like atrial fibrillation but also premature ventricular contractions, collectively known as the "holiday heart syndrome". More rarely but clinically significant are reports of atrioventricular (AV) conduction disturbances in binge drinkers with no underlying heart disease or chronic alcohol consumption. To obtain better insights into common denominators and the potential underlying mechanisms we collected and compared individual case reports of AV block following acute alcohol intoxication in otherwise healthy people. By screening PubMed, Google Scholar, Scopus and JSTOR, fifteen cases were found of which eight were sufficiently documented for full analysis. Blood alcohol levels ranged from 90 to 958 mg/dl (19 to 205 mM). Second and third degree AV block was observed most (6/8) albeit that in two of these patients a vagal stimulus led to deterioration from first into higher order AV block. In all cases, patients reverted to normal sinus rhythm upon becoming sober again. Mildly lowered body temperature (35.9 ± 0.5°C) was observed but can be excluded as a major cause of conduction blockade. We hypothesize that ethanol induced partial inhibition of calcium and potentially also sodium currents in conductive tissue structures may be one of the mechanisms of conduction slowing and block that may become exaggerated upon increased vagal tone. An impairment of gap junction function cannot be excluded as a contributing factor. In conclusion, cases of documented alcohol induced AV block are very rare but events can occur at relatively low serum alcohol levels which should prompt to awareness of this phenomenon in alcohol intoxicated patients.

  19. Selenium intoxication with selenite broth resulting in acute renal failure and severe gastritis

    Kamble P

    2009-01-01

    Full Text Available Selenium (Se is an essential trace element in human and animal nutrition. It is also widely utilized in industrial processes. Reports of acute selenium toxicity in humans are rare. We report a case of a 23-year-old female who consumed about 100 mL of liquid selenite broth and presented with severe nausea, vomiting, abdominal pain, hematemesis and acute renal failure (ARF. The serum selenium level was significantly increased. Gastro-duodenoscopy revealed severe corrosive gastritis. Renal biopsy showed features of acute tubular necrosis (ATN, affecting primarily the proximal tubules. The patient was managed with gastric lavage, blood transfusions, infusion of fresh frozen plasma (FFP and platelet concentrates and hemo-dialysis. The patient was discharged five weeks after admission and her renal functions reco-vered completely by eight weeks after admission. She continues to be on regular follow-up for any possible sequelae of mucosal corrosive damage. This case highlights a case of selenium intoxication from selenite broth resulting in ARF and corrosive gastritis. The recovery was complete.

  20. Acute heroin intoxication in a baby chronically exposed to cocaine and heroin: a case report

    Pichini Simona

    2011-07-01

    Full Text Available Abstract Introduction Acute intoxication with drugs of abuse in children is often only the tip of the iceberg, actually hiding chronic exposure. Analysis using non-conventional matrices such as hair can provide long-term information about exposure to recreational drugs. Case presentation We report the case of a one-month-old Caucasian boy admitted to our pediatric emergency unit with respiratory distress and neurological abnormalities. A routine urine test was positive for opiates, suggesting an acute opiate ingestion. No other drugs of misuse, such as cocaine, cannabis, amphetamines or derivatives, were detected in the baby's urine. Subsequently, hair samples from the baby and the parents were collected to evaluate the possibility of chronic exposure to drug misuse by segmental analysis. Opiates and cocaine metabolites were detected in hair samples from the baby boy and his parents. Conclusions In light of these and previous results, we recommend hair analysis in babies and children from risky environments to detect exposure to heroin and other drug misuse, which could provide the basis for specific social and health interventions.

  1. Marijuana intoxication

    Cannabis intoxication; Intoxication - marijuana (cannabis); Pot; Mary Jane; Weed; Grass; Cannabis ... The intoxicating effects of marijuana include relaxation, ... to fast and predictable signs and symptoms. Eating marijuana ...

  2. Management of exogenous intoxication by carbamates and organophosphates at an emergency unit

    Sydney Correia Leão

    2015-10-01

    Full Text Available Summary Objectives: to evaluate and indicate the procedure to be followed in the health unit, both for diagnosis and the treatment of acute exogenous intoxications by carbamates or organophosphates. Methods: a descriptive study based on retrospective analysis of the clinical history of patients diagnosed with intoxication by carbamates or organophosphates admitted at the emergency unit of the Hospital de Urgências de Sergipe Governador João Alves (HUSE between January and December of 2012. Some criteria were evaluated, such as: intoxicating agent; patient's age and gender; place of event, cause, circumstances and severity of the intoxication; as well as signs and symptoms of the muscarinic, nicotinic and neurological effects. Results: seventy patients (average age: 25±19.97 formed the study's population. It was observed that 77.14% of them suffered carbamate intoxication. However, organophosphate intoxications were more severe, with 68.75% of patients presenting moderate to severe forms. Suicide attempt was the leading cause of poisoning, with 62 cases (88.57% of total. Atropine administration was an effective therapeutic approach for treating signs and symptoms, which included sialorrhea (p=0.0006, nausea (p=0. 0029 and emesis (p lt0.0001. The use of activated charcoal was shown effective, both in combating the signs and symptoms presented by both patient groups (p <0.0001. Conclusion: it is concluded that the use of atropine and activated charcoal is highly effective to treat the signs and symptoms developed by patients presenting acute exogenous intoxication by carbamates or organophosphates.

  3. Intravenous injection of Xuebijing attenuates acute kidney injury in rats with paraquat intoxication

    Xu, Jia-jun; Zhen, Jian-tao; Tang, Li; Lin, Qing-ming

    2017-01-01

    BACKGROUND: The study aimed to investigate the therapeutic benefits of intravenous Xuebijing on acute kidney injury (AKI) in rats with paraquat intoxication. METHODS: Male Sprague-Dawley rats were randomly divided equally into three groups: sham group (n=8), paraquat group (n=8) and Xuebijing-treated group (n=8) using a random number table. The rats were intraperitoneally injected with 50 mg/kg of paraquat. One hour after paraquat administration, the rats were treated intravenously with Xuebijing (8 mL/kg). At 12 hours after paraquat administration, serum was collected to evaluate kidney function, then the rats were sacrificed and kidney samples were immediately harvested. AKI scores were evaluated by renal histopathology and pro-inflammatory cytokines mRNA levels in kidney were assayed using real-time RT-PCR. RESULTS: Serum urea nitrogen, creatinine and AKI scores were significantly higher in the paraquat group, compared with the sham group (Pparaquat group (Pparaquat group (Pparaquat poisoning by suppressing inflammatory response. PMID:28123623

  4. Arousal effects of orexin A on acute alcohol intoxication-induced coma in rats.

    Jia, Xiaojun; Yan, Jie; Xia, Jianxia; Xiong, Jiaxiang; Wang, Tianhao; Chen, Yuan; Qi, Aiping; Yang, Nian; Fan, Shuangyi; Ye, Jianning; Hu, Zhian

    2012-02-01

    The key role of the hypothalamic neuropeptides orexins in maintenance and promotion of arousal has been well established in normal mammalian animals, but whether orexins exert arousal effects under pathological condition such as coma was little studied. In this study, a model of unconscious rats induced by acute alcohol intoxication was used to examine the effects of orexins through intracerebroventricular injection. The results revealed that either orexin A or orexin B induced decrease of duration of loss of right reflex in alcohol-induced unconscious rats. In the presence of the selective orexin receptor 1 antagonist SB 334867 and orexin receptor 2 antagonist TCS OX2 29, the excitatory action of orexin A was completely blocked. Our data further presented that orexin A also induced reduction of delta power in EEG in these rats. Single-unit recording experiment in vivo demonstrated that orexin A could evoke increase of firing activity of prefrontal cortex neurons in unconscious rats. This excitation was completely inhibited by an H(1) receptor antagonist, pyrilamine, whereas application of α(1)-adrenoreceptor antagonist prazosin or 5-HT(2) selective receptor antagonist ritanserin partially attenuated the excitatory effects of orexin A on these neurons. Consistently, the results of EEG recordings showed that microinjection of pyrilamine, prazosin, or ritanserin suppressed reduction of delta power in EEG induced by orexin A on unconscious rats. Thus, these data suggest that orexins exert arousal effects on alcohol-induced unconscious rats by the promotion of cortical activity through activation of histaminergic, noradrenergic and serotonergic systems. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.

  5. Coorection Of Lipid Peroxydation And Antioxydant Protective System By Mexidol And Glycine In Patients With Acute Ethanol Intoxication

    R.S. Farshatov

    2009-12-01

    Full Text Available The research goal is to study lipid peroxydation and ferments of antioxidant protection in group of patients with an acute alcohol intoxication and their correction by medicaments with antioxidant activity (mexidol, glycine and their combination. Patients with diagnosis of ethanol toxic action of moderate severity degree were under study. There were 4 groups - receiving standard therapy, standard therapy and glycine, standard therapy and mexidol, patients receiving standard therapy with combination of mexidol and glycine. Clinical condition and changes in system "lipid peroxidation - antioxidant protection» were estimated. The expressed improvement was revealed applying standard therapy with combination of mexidol and glycine

  6. Rat liver mitochondrial damage under acute or chronic carbon tetrachloride-induced intoxication: Protection by melatonin and cranberry flavonoids

    Cheshchevik, V.T. [Institute for Pharmacology and Biochemistry, National Academy of Sciences of Belarus, Len. Kom. Blvd. - 50, 230017 Grodno (Belarus); Department of Biochemistry, Yanka Kupala Grodno State University, Len. Kom. Blvd. - 50, 230017 Grodno (Belarus); Lapshina, E.A.; Dremza, I.K.; Zabrodskaya, S.V. [Institute for Pharmacology and Biochemistry, National Academy of Sciences of Belarus, Len. Kom. Blvd. - 50, 230017 Grodno (Belarus); Reiter, R.J. [Department of Cellular and Structural Biology, University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, TX 78229–3900 (United States); Prokopchik, N.I. [Grodno State Medical University, Gorkogo - 80, 230015 Grodno (Belarus); Zavodnik, I.B., E-mail: zavodnik_il@mail.ru [Institute for Pharmacology and Biochemistry, National Academy of Sciences of Belarus, Len. Kom. Blvd. - 50, 230017 Grodno (Belarus); Department of Biochemistry, Yanka Kupala Grodno State University, Len. Kom. Blvd. - 50, 230017 Grodno (Belarus)

    2012-06-15

    In current societies, the risk of toxic liver damage has markedly increased. The aim of the present work was to carry out further research into the mechanism(s) of liver mitochondrial damage induced by acute (0.8 g/kg body weight, single injection) or chronic (1.6 g/ kg body weight, 30 days, biweekly injections) carbon tetrachloride – induced intoxication and to evaluate the hepatoprotective potential of the antioxidant, melatonin, as well as succinate and cranberry flavonoids in rats. Acute intoxication resulted in considerable impairment of mitochondrial respiratory parameters in the liver. The activity of mitochondrial succinate dehydrogenase (complex II) decreased (by 25%, p < 0.05). Short-term melatonin treatment (10 mg/kg, three times) of rats did not reduce the degree of toxic mitochondrial dysfunction but decreased the enhanced NO production. After 30-day chronic intoxication, no significant change in the respiratory activity of liver mitochondria was observed, despite marked changes in the redox-balance of mitochondria. The activities of the mitochondrial enzymes, succinate dehydrogenase and glutathione peroxidase, as well as that of cytoplasmic catalase in liver cells were inhibited significantly. Mitochondria isolated from the livers of the rats chronically treated with CCl{sub 4} displayed obvious irreversible impairments. Long-term melatonin administration (10 mg/kg, 30 days, daily) to chronically intoxicated rats diminished the toxic effects of CCl{sub 4}, reducing elevated plasma activities of alanine aminotransferase and aspartate aminotransferase and bilirubin concentration, prevented accumulation of membrane lipid peroxidation products in rat liver and resulted in apparent preservation of the mitochondrial ultrastructure. The treatment of the animals by the complex of melatonin (10 mg/kg) plus succinate (50 mg/kg) plus cranberry flavonoids (7 mg/kg) was even more effective in prevention of toxic liver injury and liver mitochondria damage

  7. 阿托品联合奥美拉唑在急性胃炎治疗中的应用效果观察%Observation on the Results of Atropine Plus Omeprazole in the Treatment of Acute Gastritis

    刘冬曼

    2016-01-01

    Objective To investigate the effect of the application of atropine combined with omeprazole in treating acute gastritis.Methods72 cases of acute gastritis were divided into two groups,the treatment group used atropine therapy plus omeprazole,control group used omeprazole alone,compared efficacy and drug safety.Results Treatment group’total effective rate was 94.4%,significantly higher than 77.8% in control group(P<0.05). The incidence of adverse reactions in the treatment group and the control group were statistically significant. Conclusion Omeprazole and atropine in the treatment of acute gastritis have significant,and can reduce adverse reactions in patients after treatment.%目的:探讨阿托品联合奥美拉唑在急性胃炎治疗中的应用效果。方法将72例急性胃炎患者分为两组,治疗组应用阿托品联合奥美拉唑治疗,对照组单纯应用奥美拉唑治疗,对比2组疗效以及用药安全性。结果治疗组治疗总有效率是94.4%,高于对照组的77.8%(P<0.05);治疗组、对照组的不良反应发生率组间对比差异有统计学意义(P<0.05)。结论阿托品联合奥美拉唑在急性胃炎治疗中的应用效果满意,且可减少患者用药后不良反应。

  8. Acute Alcohol Intoxication Decreases Glucose Metabolism but Increases Acetate Uptake in the Human Brain

    Volkow, Nora D.; Kim, Sung Won; Wang, Gene-Jack; Alexoff, David; Logan, Jean; Muench, Lisa; Shea, Colleen; Telang, Frank; Fowler, Joanna S.; Wong, Christopher; Benveniste, Helene; Tomasi, Dardo

    2012-01-01

    Alcohol intoxication results in marked reductions in brain glucose metabolism, which we hypothesized reflect not just its GABAergic enhancing effects but also metabolism of acetate as an alternative brain energy source. To test this hypothesis we separately assessed the effects of alcohol intoxication on brain glucose and acetate metabolism using Positron Emission Tomography (PET). We found that alcohol intoxication significantly decreased whole brain glucose metabolism (measured with FDG) with the largest decrements in cerebellum and occipital cortex and the smallest in thalamus. In contrast, alcohol intoxication caused a significant increase in [1-11C]acetate brain uptake (measured as standard uptake value, SUV), with the largest increases occurring in cerebellum and the smallest in thalamus. In heavy alcohol drinkers [1-11C]acetate brain uptake during alcohol challenge trended to be higher than in occasional drinkers (p <0.06) and the increases in [1-11C]acetate uptake in cerebellum with alcohol were positively associated with the reported amount of alcohol consumed (r=0.66, p<0.01). Our findings corroborate a reduction of brain glucose metabolism during intoxication and document an increase in brain acetate uptake. The opposite changes observed between regional brain metabolic decrements and regional increases in [1-11C]acetate uptake support the hypothesis that during alcohol intoxication the brain may rely on acetate as an alternative brain energy source and provides preliminary evidence that heavy alcohol exposures may facilitate the use of acetate as an energy substrate. These findings raise the question of the potential therapeutic benefits that increasing plasma acetate concentration (ie ketogenic diets) may have in alcoholics undergoing alcohol detoxification. PMID:22947541

  9. Gamma-hydroxybutyric acid (GHB) measurement by GC-MS in blood, urine and gastric contents, following an acute intoxication in Belgium.

    Bodson, Q; Denooz, R; Serpe, P; Charlier, C

    2008-01-01

    Gamma-hydroxybutyrate (GHB, sodium oxybate) is a compound related to neuromodulator gamma-aminobutyric acid (GABA), emerging as a recreational drug of abuse and as a rape drug. GHB-related emergencies have dramatically increased in the 1990s, but a decrease is observed since 2000. We describe the case of an acute GHB intoxication in a 28-year-old male who fell unconscious after ingestion of a mouthful of an unknown beverage, and required medical support for 2 days. A cocaine abuse was also detected by preliminary toxicological screening, but the clinical presentation was not typical of cocaine intoxication. A simple liquid-liquid extraction was used for quantitation of GHB, followed by disilyl-derivatization and analysis in selective ion monitoring (SIM) mode by gas chromatography-mass spectrometry (GC-MS), using GHB-d6 as internal standard. High concentrations of GHB were detected in urine (3020 mg/L) and gastric contents (71487 mg/L) at admission. After a 6-hours delay, GHB was still present in urine at 2324 mg/L and in blood at 43 mg/L. The clinical symptoms of cocaine intoxication were diminished by GHB consumption, and the cerebral scan was modified. Attention must thus be paid to acute intoxications with surprising clinical symptoms, and GHB has probably to be added to the preliminary toxicological screening. Data available regarding GHB are briefly reviewed, and our results are compared with previously published reports of non-fatal GHB intoxication.

  10. Treatment of Metformin Intoxication Complicated by Lactic Acidosis and Acute Kidney Injury: The Role of Prolonged Intermittent Hemodialysis.

    Regolisti, Giuseppe; Antoniotti, Riccardo; Fani, Filippo; Greco, Paolo; Fiaccadori, Enrico

    2017-02-17

    Metformin intoxication with lactic acidosis, a potentially lethal condition, may develop in diabetic patients when the drug dose is inappropriate and/or its clearance is reduced. Diagnosis and therapy may be delayed due to nonspecific symptoms at presentation, with severe anion gap metabolic acidosis and elevated serum creatinine values being the most prominent laboratory findings. Confirmation requires measurement of serum metformin by high-performance liquid chromatography-tandem mass spectrometry, but this technique is available only at specialized institutions and cannot be relied on as a guide to immediate treatment. Thus, based on strong clinical suspicion, renal replacement therapy must be started promptly to achieve efficient drug clearance and correct the metabolic acidosis. However, because metformin accumulates in the intracellular compartment with prolonged treatment, a rebound in serum concentrations due to redistribution is expected at the end of dialysis. We report a case of metformin intoxication, severe lactic acidosis, and acute kidney injury in a diabetic patient with pre-existing chronic kidney disease stage 3, treated effectively with sustained low-efficiency dialysis. We discuss the pathophysiology, differential diagnosis, and treatment options and highlight specific pharmacokinetic issues that should be considered in selecting the appropriate modality of renal replacement therapy.

  11. Diagnosing and quantification of acute alcohol intoxication. Comparison of dual-energy CT with biochemical analysis. Initial experience

    Korkusuz, H. [Frankfurt Univ. Hospital (Germany). Dept. of Nuclear Medicine; Abbas Raschidi, B.; Keese, D.; Kromen, W.; Bauer, R.W.; Vogl, T.J. [Frankfurt Univ. Hospital (Germany). Dept. of Diagnostic and Interventional Radiology; Namgaladze, D. [Frankfurt Univ. (Germany). Dept. of Biochemistry

    2012-12-15

    Purpose: To quantify the correlation between fat content of an acute alcohol intoxication and the difference of computer tomography attenuation value in dual-energy CT in comparison to biochemical triglyceride analysis and to evaluate qualitatively the value of DECT in the diagnosis of fatty liver caused by ethanol-dosage in rats. Materials and Methods: DECT at 140 kV and 80 kV was performed on 20 rats before and two days after the administration of 3 ml of 50 % ethanol. The CT attenuation value in the livers at 140 kV, 80 kV and the differences between them in Hounsfield units ({Delta}H) were collected. Parts of the liver (100 mg) were measured in biochemical triglyceride analysis as the reference standard. A blood sample was also taken to measure specific liver enzymes. Results: Linear correlation between biochemical triglyceride analysis and CT density of {Delta}H was found (r = 0.949). 140 kV attenuation data were between 44 HU and 61.3 HU, 80 kV attenuation data were between 58.4 HU and 64.7 HU, and {Delta}H data were between 3.4 HU and 14.4 HU (p {<=} 0.037). The biochemical triglyceride analysis data were between 7.1 mg/g and 41.1 mg/g. The hepatic enzymes serum aspartate (ASAT) aminotransferase and alanine aminotransferase (ALAT) were elevated in all rats. ASAT correlated directly with {Delta}HU (r = -0.86). Conclusion: DECT provides a non-invasive method to determine and evaluate hepatic fat content after acute alcohol intoxication. It provides the possibility to detect and quantify the hepatic fat content of liver graft. (orig.)

  12. Skin discolouration with acute onset parkinsonism secondary to systemic zirconium intoxication.

    Ryu, Hwa J; Yoon, Su J; Park, Jong-Tae; Kim, Young H; Jung, Jin M; Park, Moon-Ho; Rhyu, Im J; Kwon, Do-Young

    2014-01-01

    A 72-year-old woman presented with suspected parkinsonism and discolouration of the skin especially on sun-exposed areas. Thorough investigation revealed systemic zirconium intoxication due to intake of metallic colloids as a home remedy as a cause of the skin colour change. There may be an association between skin discolouration and her parkinsonism. This is unique in that various clinical manifestations developed following systemic ingestion of zirconium and this should serve as a warning on the risk of taking illicit dietary supplements.

  13. 1630例急性中毒的流行病学调查分析%An epidemiological analysis in 1630 cases of acute intoxication

    黎敏; 宋维; 郭敏; 陈文腾; 詹峰; 张君

    2014-01-01

    目的:探讨急性中毒的流行病学分布和影响预后的危险因素,为防治急性中毒提供依据。方法收集2002-01-01~2013-12-31急性中毒病例1630例,研究急性中毒的流行病学分布、治疗费用及预后的影响因素。结果1630例病例中,农药中毒比例最高达28.7%,其次是药品中毒21.4%;杀鼠剂中毒的预后最差,而食品类中毒预后最好;百草枯中毒发病例数和费用呈现增加趋势;影响预后的危险因素包括年龄(OR=1.017)、入院状况(OR=1.583)、抢救次数(OR=7.227),而住院天数为保护因素(OR=0.884)。结论急性中毒的职业分布与当地的经济社会分工体系有密切联系。急性中毒患者年龄偏小或偏大均提示预后较差。应立即加强对毒物/化学物生产企业、毒物使用、市场营销等方面的监管。%Objective To explore epidemiological distribution and risk factors of acute intoxication prognosis , and to provide the basis of prevention and treatment for acute intoxication . Methods We collected 1630 cases of acute intoxication in our hospital from January lst 2002 to December 31st 2013, and investigated the epidemiological distribution , treatment cost and risk factors about acute intoxication prognosis .Results In 1630 cases, there was 28.7% poisoned by pesticide intoxication, and 21.4%by drug intoxication.Rodenticide intoxication existed the worst prognosis , but foods type of intoxication prognosis was the best .The incidence cases and cost of parquat intoxication showed increasing trend .The risk factors affecting the prognosis of acute intoxication included age (OR=1.017), hospital admission state (OR=1.583) and salvage times (OR=7.227), but hospital stay was the protective factors of prognosis .Conclusion Occupational distribution of acute poisoning is closely linked to local economic and social system .Too small or too large age indicates poor prognosis

  14. Cholinesterase-inhibiting and genotoxic effects of acute carbofuran intoxication in man: a case report.

    Zeljezic, Davor; Vrdoljak, Ana Lucic; Kopjar, Nevenka; Radic, Bozica; Milkovic Kraus, Sanja

    2008-10-01

    Carbofuran belongs to the group of N-methylcarbamate insecticides used for the control of soil-dwelling and foliar-feeding insects in various crops; its consumption totals approximately 20,000 tonnes per year. Although the neurological effects on human beings have been well documented, little is known on its impact on the genome. A 38-year-old, healthy male worker employed in a carbofuran production facility accidentally inhaled the dust of the active ingredient carbofuran. Thirty minutes later, he experienced weakness, fatigue, perspiration, breathing difficulties, cephalalgia, disorientation, abdominal pain and vomiting. Blood samples were taken to measure cholinesterase activity, and to perform the alkaline comet assay and micronucleus assay combined with pancentromeric probes. Analyses were repeated 72 hr after intoxication and compared with the results obtained from regular monitoring conducted 10 days prior to the accident. Cholinesterase activity showed the highest correlation with the number of apoptotic cells, comet assay tail length, and number of long-tailed nuclei, suggesting that these are the genomic end-points primarily affected by carbofuran intake. Only a weak correlation was detected for the total number of micronuclei, centromere-containing micronuclei and nuclear buds. Since those end-points increased significantly 72 hr after the accident, they could be considered as late biomarkers of the effects of carbofuran intoxication. The results of this report suggest that, in the interests of higher standards in risk assessment and health hazard protection, periodical medical examination of carbamate-exposed populations should include genotoxicity testing in addition to the assessment of cholinesterase activity.

  15. In vitro and in vivo comparison of sulfur donors as antidotes to acute cyanide intoxication.

    Baskin, S I; Porter, D W; Rockwood, G A; Romano, J A; Patel, H C; Kiser, R C; Cook, C M; Ternay, A L

    1999-01-01

    Antidotes for cyanide (CN) intoxication include the use of sulfane sulfur donors (SSDs), such as thiosulfate, which increase the conversion of CN to thiocyanate by the enzyme rhodanese. To develop pretreatments that might be useful against CN, SSDs with greater lipophilicity than thiosulfate were synthesized and assessed. The ability of SSDs to protect mice against 2LD50 of sodium cyanide (NaCN) administered either 15 or 60 min following administration of an SSD was assessed. To study the mechanism of action of the SSD, the candidate compounds were examined in vitro for their effect on rhodanese and 3-mercaptopyruvate sulfurtransferase (MST) activity under increasing SSD concentrations. Tests were conducted on nine candidate SSDs: ICD1021 (3-hydroxypyridin-2-yl N-[(N-methyl-3-aminopropyl)]-2-aminoethyl disulfide dihydrochloride), ICD1022, (3-hydroxypyridin-2-yl N-[(N-methyl-3-aminopropyl)]-2-aminoethyl disulfide trihydrochloride), ICD1584 (diethyl tetrasulfide), ICD1585 (diallyl tetrasulfide), ICD1587 (diisopropyl tetrasulfide); ICD1738 (N-(3-aminopropyl)-2-aminoethyl 2-oxopropyl disulfide dihydrochloride), ICD1816 (3,3'-tetrathiobis-N-acctyl-L-alanine), ICD2214 (2-aminoethyl 4-methoxyphenyl disulfide hydrochloride) and ICD2467 (bis(4-methoxyphenyl) disulfide). These tests demonstrated that altering the chemical substituent of the longer chain sulfide modified the ability of the candidate SSD to protect against CN toxicity. At least two of the SSDs at selected doses provided 100% protection against 2LD50 of NaCN, normally an LD99. All compounds were evaluated using locomotor activity as a measure of potential adverse behavioral effects. Positive hypoactivity relationships were found with several disulfides but none was found with ICD1584, a tetrasulfide. Separate studies suggest that the chemical reaction of potassium cyanide (KCN) and cystine forms the toxic metabolite 2-iminothiazolidine-4-carboxylic acid. An alternative detoxification pathway, one not primarily

  16. [Acute alcohol intoxication among children and adolescents admitted to the Department of Pediatrics, Pediatric Endocrinology and Diabetes, Medical University of Silesia, Katowice during 2000-2010--preliminary study].

    Kamińska, Halla; Agnieszka, Zachurzok-Buczyńska; Gawlik, Aneta; Małecka-Tendera, Ewa

    2012-01-01

    The alcohol drinking at the young age is a risk factor of alcohol addiction later in life, and is connected with school problems, binge drinking, tobacco addiction, illegal drug use, violence, crime commitment, and risky sexual behaviors. Alcohol drinking in the last 12 months is declared by 78% Polish children. The aim of the study was to evaluate the frequency of admissions due to alcohol intoxication to the Department of Pediatrics, Pediatric Endocrinology and Diabetes, Pediatric Center of Silesia and the identification of the risk factors of the acute alcohol intoxication among Polish children and adolescents. Ten-year retrospective study includes investigation of patients medical records from the Department of Pediatrics. Among 8048 patients hospitalized in the Department of Pediatrics between the years 2000-2010, 220 (2.7%) cases of acute alcohol poisoning occurred The detailed data analysis from 139 patients [66 (47.5%) girls, 73 (52,5%) boys] was done. In the years 2006-2010 the number of girls admitted to the department increased in comparison to boys. The largest group of patients was at age between 14 and 16 years [61 (44%) children]. The blood alcohol concentration at the moment of admission to the hospital was 0.1 to 4.0 per thousand. In most cases (92.8%) the alcohol intoxication was intentional. Five percent of them were suicide attempts. In the youngest group of children alcohol abuse was unintentional. 23 (16.5%) of patients initially needed admission to the intensive care unit. In 30 (21.6%) patient the family was incomplete and five times more often father was absent. The alcohol addiction occurs in 18 (13.0%) fathers and 10 (7.2%) mothers of our patients. It is concluded that over the last decade the number of girls admitted due to alcohol abuse increased. Children at school grade between 7-9 are intoxicated most often. One six of intoxicated patents needed hospitalization at intensive care unit.

  17. Pharmacodynamic and pharmacokinetic effects of flumazenil and theophylline application in rats acutely intoxicated by diazepam

    2009-01-01

    Background/Aim. The majority of symptoms and signs of acute diazepam poisoning are the consequence of its sedative effect on the CNS affecting selectively polisynaptic routes by stimulating inhibitory action of GABA. The aim of the present study was to examine the effects of combined application of theophylline and flumazenil on sedation and impaired motor function activity in acute diazepam poisoning in rats. Methods. Male Wistar rats were divided in four main groups and treated as follows: ...

  18. Effect of acute lindane and alcohol intoxication on serum concentration of enzymes and fatty acids in rats.

    Radosavljević, T; Mladenović, D; Vucević, D; Petrović, J; Hrncić, D; Djuric, D; Loncar-Stevanović, H; Stanojlović, O

    2008-05-01

    This study examines possible synergistic effects of lindane and ethanol on inducing liver injury and serum fatty acid derangement in adult male Wistar rats. When administered together, ethanol and lindane-induced even more pronounced increase of alanine aminotransferase (165 +/- 10 U/L) and gamma-glutamyltranspeptidase activity (10.3 +/- 0.6 U/L) than after isolated administration of either substance. In addition, separate administration of lindane and ethanol was followed by a significant decrease of linoleic acid level in the serum (301 +/- 38 mg/L, 276 +/- 35 mg/L vs. 416 +/- 48 mg/L). However, when ethanol administration was followed by lindane injection, serum linoleic acid was at the similar level found in the control group (516 +/- 62 mg/L). Ethanol-treated rats that received lindane 30 min after ethanol administration have shown a marked increase of palmitic (421 +/- 27 mg/L) and linolic acid level (43 +/- 5 mg/L) in comparison with rats that have been treated only with ethanol (316+/-26 mg/L for palmitic and 32 +/- 2 mg/L for linolic acid) or lindane (295 +/- 26 mg/L for palmitic and 301 +/- 38 mg/L for linolic acid). Linolic acid level was significantly greater in comparison with control group (29 +/- 1 mg/L). In conclusion, this study found enough evidence to support the hypothesis that acute ethanol intoxication potentiates lindane-induced liver injury and enhances lipid derangement.

  19. Investigations on Blood Activities of Some Enzymes in Dogs After Acute Intoxication with the Carbamate Insecticide Carbofuran

    Rumen Binev

    2016-10-01

    Full Text Available Experiments for monitoring of changes in blood enzyme activities were carried out in dogs after acute intoxication with the carbamate insecticide carbofuran (Carbosan 35 СТ. The studies involved one control and 6 experimental groups of dogs (total n=42, treated once orally with increasing doses of the preparation via oesophageal probe: 0.525 mg/kg (experimental group I, 1.05 mg/kg (experimental group II, 2.1 mg/kg (experimental group III, 3.5 mg/kg (experimental group IV, 5.25 mg/kg (experimental group V and 10.5 mg/kg (LD50, (experimental group VI, corresponding to 1/20, 1/10, 1/5, 1/3, 1/2 and LD50, oral doses for albino rats. Blood samples were obtained from v. antebrachi cephalica or v. jugularis in the course of 3 consecutive days prior to the treatment (hours -48, -24 and 0 and on post treatment hours 1, 3, 5, 7, 24 and 48 from all groups for analysis of acetylcholinesterase (AChE, aspartate aminotransferase (ASAT, alanine aminotransferase (ALAT, amylase (AMY, gamma-glutamyltransferase (g-GT, alkaline phosphatase (ALP and lactate dehydrogenase (LDH. It was established that the tested carbamate insecticide provoked lower blood activity of AChE and increased the levels of ASAT, ALAT, AMY, g-GT, AP and LDH between post treatment hours 1 and 7; afterwards, the studied parameters regained the respective control values.

  20. Influence of acute ethanol intoxication on neuronal apoptosis and Bcl-2 protein expression after severe traumatic brain injury in rats

    HE Min; LIU Wei-guo; WEN Liang; DU Hang-gen; YIN Li-chun; CHEN Li

    2013-01-01

    To study the influence and mechanism of acute ethanol intoxication (AEI) on rat neuronal apoptosis after severe traumatic brain injury (TBI).Methods:Ninety-six Sprague-Dawley rats were randomly divided into four groups:normal control,AEI-only,TBI-only and TBI+AEI (n=24 for each).Severe TBI model was developed according to Feeney's method.Rats in TBI+AEI group were firstly subjected to AEI,and then suffered head trauma.In each group,animals were sacrificed at 6 h,24 h,72 h,and 168 h after TBI.The level of neuronal apoptosis and the expression of Bcl-2 protein were determined by TUNEL assay and immunohistochemical method,respectively.Results:Apoptotic cells mainly distributed in the cortex and white matter around the damaged area.Neuronal apoptosis significantly increased at 6 h after trauma and peaked at 72 h.Both the level of neuronal apoptosis and expression of Bcl-2 protein in TBI-only group and TBI+AEI group were higher than those in control group (P<0.05).Compared with TBI-only group,the two indexes were much higher in TBI+AEI group at all time points (P<0.05).Conclusion:Our findings suggest that AEI can increase neuronal apoptosis after severe TBI.

  1. Acute acetaminophen intoxication leads to hepatic iron loading by decreased hepcidin synthesis.

    Swelm, R.P.L. van; Laarakkers, J.M.M.; Blous, L.; Peters, J.G.P.; Blaney Davidson, E.N.; Kraan, P.M. van der; Swinkels, D.W.; Masereeuw, R.; Russel, F.G.M.

    2012-01-01

    Acetaminophen (APAP), a major cause of acute liver injury in the Western world, is mediated by metabolism and oxidative stress. Recent studies have suggested a role for iron in potentiating APAP-induced liver injury although its regulatory mechanism is not completely understood. The current study wa

  2. Drinking to near death--acute water intoxication leading to neurogenic stunned myocardium.

    Losonczy, Lia I; Lovallo, Emily; Schnorr, C Daniel; Mantuani, Daniel

    2016-01-01

    Neurogenic stunned myocardium is a rare disease entity that has been typically described as a consequence of subarachnoid hemorrhage and, less commonly, seizures. Here we describe a case of a healthy young woman who drank excessive free water causing acute hyponatremia complicated by cerebral edema and seizure, leading to cardiogenic shock from neurogenic stunned myocardium. Two days later, she had complete return of her normal cardiac function.

  3. Cytokine Changes following Acute Ethanol Intoxication in Healthy Men: A Crossover Study

    Sudan Prasad Neupane

    2016-01-01

    Full Text Available Alcohol is a known modulator of the innate immune system. Owing to the absence of human studies, alcohol’s effect on circulating cytokine profile remains unclear. We investigated the effect of acute high dose alcohol consumption on systemic cytokine release. After an overnight fasting, alcohol-experienced healthy male volunteers (N=20 aged 25–45 years were given oral ethanol in the form of vodka (4.28 mL/kg which they drank over a period of 30 minutes reaching peak blood alcohol concentration of 0.12% (SD 0.028. Blood samples were obtained prior to alcohol intake as well as 2, 7, and 12 hours thereafter. Serum levels of the inflammatory cytokines IL-1β, IL-1Ra, IL-6, IL-10, IL-17, IFN-γ, MCP-1, and TNF-α were determined by the multibead-based assay. Baseline cytokine levels were not related to BMI, hepatic parameters, electrolytes, glucose, or morning cortisol levels. Within 2 hours of alcohol intake, levels of IL-1Ra were elevated and remained so throughout the assessment period (p for trend = 0.015. In contrast, the levels of the chemokine MCP-1 dropped acutely followed by steadily increasing levels during the observation period (p<0.001. The impact of sustained elevated levels of MCP-1 even after the clearance of blood alcohol content deserves attention.

  4. Bioconcentration and Acute Intoxication of Brazilian Freshwater Fishes by the Methyl Parathion Organophosphate Pesticide

    João Bosco de Salles

    2015-01-01

    Full Text Available Three species of freshwater Brazilian fishes (pacu, Piaractus mesopotamicus; piavussu, Leporinus macrocephalus, and curimbatá, Prochilodus lineatus were exposed to an acute dose of 5 ppm methyl parathion organophosphate pesticide. Three to five individuals per species were exposed, one at a time, to 40 liters tap water spiked with Folidol 600. Pesticide concentrations and cholinesterase (ChE activities were evaluated in serum, liver, brain, heart, and muscle. The bioconcentration of methyl parathion was similar for all studied fishes. Brain tissue showed the highest pesticide concentration, reaching 80 ppm after exposure for 30 min to methyl parathion. Three to 5 hours of 5 ppm methyl parathion exposure provoked the death of all P. lineatus at 92% brain AChE inhibition, whereas fish from the other two species survived for up to 78 hours with less than 80% brain AChE inhibition. Our results indicate that acute toxic effects of methyl parathion to fish are correlated with brain AChE sensitivity to methyl paraoxon.

  5. Bioconcentration and Acute Intoxication of Brazilian Freshwater Fishes by the Methyl Parathion Organophosphate Pesticide

    Bosco de Salles, João; Matos Lopes, Renato; de Salles, Cristiane M. C.; Cassano, Vicente P. F.; de Oliveira, Manildo Marcião; Cunha Bastos, Vera L. F.; Bastos, Jayme Cunha

    2015-01-01

    Three species of freshwater Brazilian fishes (pacu, Piaractus mesopotamicus; piavussu, Leporinus macrocephalus, and curimbatá, Prochilodus lineatus) were exposed to an acute dose of 5 ppm methyl parathion organophosphate pesticide. Three to five individuals per species were exposed, one at a time, to 40 liters tap water spiked with Folidol 600. Pesticide concentrations and cholinesterase (ChE) activities were evaluated in serum, liver, brain, heart, and muscle. The bioconcentration of methyl parathion was similar for all studied fishes. Brain tissue showed the highest pesticide concentration, reaching 80 ppm after exposure for 30 min to methyl parathion. Three to 5 hours of 5 ppm methyl parathion exposure provoked the death of all P. lineatus at 92% brain AChE inhibition, whereas fish from the other two species survived for up to 78 hours with less than 80% brain AChE inhibition. Our results indicate that acute toxic effects of methyl parathion to fish are correlated with brain AChE sensitivity to methyl paraoxon. PMID:26339593

  6. Suppression of torsades de pointes by atropine.

    Tan, H L; Wilde, A A; Peters, R J

    1998-01-01

    A 67 year old woman with a history of chronic atrial fibrillation presented with asthma cardiale. She took no medication and there was no family history of long QT syndrome. She was treated with furosemide, nitroprusside, acenocoumarol, and digoxin. Two days later excessively prolonged RR intervals, which were terminated by escape beats with a right bundle branch block morphology, suggested impending total AV block. There was also severe QT (0.48 s) and QTc (0.56) interval prolongation with bizarre inverted TU waves and multifocal premature ventricular complexes within the U waves. The patient experienced angina pectoris followed by episodes of torsades de pointes, which were interpreted as the result of bradycardia, and the bradycardia as the result of high grade AV block induced by increased vagal tone caused by ischaemia in the presence of digoxin intoxication (serum digoxin was 2.5 micrograms/l). Subsequent atropine infusion sped up the ventricular rate and shortened the QT (0.39) and QTc (0.51) intervals. Digoxin was replaced by metoprolol to control ventricular rate and angina pectoris. Within days, QT and QTc intervals became normal and the U waves disappeared. Neither torsades de pointes nor angina pectoris recurred. Based on a review of the literature, it is suggested that the electrophysiological mechanism of this effect is not only an increase of the heart rate, but also a direct action of muscarinic receptor antagonism on Purkinje cells and ventricular refractoriness.

  7. How CAGE, RAPS4QF and AUDIT can help practitioners for patients admitted with acute alcohol intoxication in emergency departments?

    Georges eBrousse

    2014-06-01

    Full Text Available Aims: To help clinicians to identify the severity of Alcohol Use Disorders (AUD from optimal thresholds found for recommended scales. Especially, taking account of the high prevalence of alcohol dependence among patients admitted to the Emergency Department (ED for acute alcohol intoxication (AAI, we propose to define thresholds of severity of dependence based on the AUDIT score.Methods: All patients admitted to the ED with AAI (blood alcohol level >0.8g/L, in a two-month period, were assessed using the CAGE, RAPS-QF and AUDIT, with the alcohol dependence/abuse section of the Mini International Neuropsychiatric Interview (MINI used as the gold standard. To explore the relation between the AUDIT and the MINI the sum of the positive items on the MINI (dependence as a quantitative variable and as an ordinal parameter were analyzed. From the threshold score (TS found for each scale we proposed intervals of severity of Alcohol Use Disorders (AUDs. Results: The mean age of the sample (122 males, 42 females was 46 years. Approximately 12 % of the patients were identified with alcohol abuse and 78 % with dependence (DSM-IV. Cut points were determined for the AUDIT in order to distinguish mild and moderate dependence from severe dependence. A strategy of intervention based on levels of severity of AUD was proposed. Conclusion: Different thresholds proposed for the CAGE, RAPS4-QF and AUDIT could be used to guide the choice of intervention for a patient: brief intervention, brief negotiation interviewing or longer more intensive motivational intervention.

  8. Pharmacodynamic and pharmacokinetic effects of flumazenil and theophylline application in rats acutely intoxicated by diazepam

    Šegrt Zoran

    2009-01-01

    Full Text Available Background/Aim. The majority of symptoms and signs of acute diazepam poisoning are the consequence of its sedative effect on the CNS affecting selectively polisynaptic routes by stimulating inhibitory action of GABA. The aim of the present study was to examine the effects of combined application of theophylline and flumazenil on sedation and impaired motor function activity in acute diazepam poisoning in rats. Methods. Male Wistar rats were divided in four main groups and treated as follows: group I - with increasing doses of diazepam in order to produce the highest level of sedation and motor activity impairment; group II - diazepam + different doses of flumazenil; group III - diazepam + different doses of theophylline; group IV - diazepam + combined application of theophylline and flumazenil. Concentrations of diazepam and its metabolites were measured with LC-MS. The experiment was performed on a commercial apparatus for spontaneous motor-activity registration (LKBFarad, Sweden. Assessment of diazepam- induced neurotoxic effects and effects after theophylline and flumazenil application was performed with rotarod test on a commercial apparatus (Automatic treadmill for rats, Ugo Basile, Italy. Results. Diazepam in doses of 10 mg/kg and 15 mg/kg produced long-time and reproducible pharmacodynamic effects. Single application of flumazenil or theophylline antagonized effects of diazepam, but not completely. Combined application of flumazenile and theophylline resulted in best effects on diazepaminduced impairment of motoric activity and sedation. As a result of theopylline application there was better elimination of diazepam and its metabolites. Conclusion. Combined application of flumazenil and theophylline resulted in the best antidotal effects in the treatment of diazepam poisoned rats. These effects are a result of different mechanisms of their action, longer half-life of theophylline in relation to that of flumezenil and presumably the

  9. Effects of atropine and penehyclidine with different opportunity combination on severe acute organophosphate pesticide poisoning%阿托品与长托宁不同时机联合对重度急性有机磷农药中毒疗效的影响

    张随玉

    2013-01-01

    Objective To observe the influence of atropine,penehyclidine with different opportunity combination on severe acute organophosphate pesticide poisoning (AOPP).Methods Eighty-nine cases of severe AOPP patients were divided into two groups randomly:began joint group (43 cases) and atropinization combination group (46 cases).The began joint group immediately treated with atropine,penehyclidine at hospital admission.The atropinization combination group combined atropine with penehyclidine to maintain atropinization state after reaching atropinization with atropine.Dynamically observe the changes of CHE activity,recorded the number of poisoning rebound,atropine poisoning,intermediate syndrome,death and atropinization time,length of stay,the clinical efficacy of two groups were analyzed.Results Compared with the begain joint group,in the atropinization combination group the time of atropinization,CHE activity resumed to 50% and hospitalization was obviously shortened [atropinization time:(54.6-± 18.3) min to (65.3 ± 23.1) min (P < 0.01),CHE activity resumed 50% time (4.2 ±1.9)d to (5.3 ±2.6)d (P<0.05),hospital stays:(15.1 ±5.6)d to (18.2 ±6.8) d (P<0.05),poisoning rebound,atropine poisoning incidence was lower poisoning rebound:2.1% to 13.9%,atropine poisoning:4.3% to 18.6% (P < 0.05).IMS incidence,mortality have no significant difference average,(P > 0.05).Conclusions After quickly reached atropinization with atropine,small doses of penehyclidine and the joint use of atropine maintain atropinization state treatment of severe AOPP can reduce the incidence of complications,patients smoothly through dangerous period,reduce hospital stays and cut down medical costs.%目的 观察阿托品、长托宁在不同治疗时机联合对重度急性有机磷农药中毒(AOPP)疗效的影响.方法 将89例重度AOPP患者,随机分为开始联合组(43例)及阿托品化联合组(46例),开始联合组在入院后即行阿托品、长托宁联合治疗,

  10. Post-exposure administration of diazepam combined with soluble epoxide hydrolase inhibition stops seizures and modulates neuroinflammation in a murine model of acute TETS intoxication

    Vito, Stephen T., E-mail: stvito@ucdavis.edu [Department of Entomology, College of Agricultural and Environmental Sciences, University of California-Davis, Davis, CA 95616 (United States); Austin, Adam T., E-mail: aaustin@ucdavis.edu [Department of Pediatrics, School of Medicine, University of California-Davis Medical Center, Sacramento, CA 95817 (United States); Banks, Christopher N., E-mail: Christopher.Banks@oehha.ca.gov [Department of Molecular Biosciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616 (United States); Inceoglu, Bora, E-mail: abinceoglu@ucdavis.edu [Department of Entomology, College of Agricultural and Environmental Sciences, University of California-Davis, Davis, CA 95616 (United States); Bruun, Donald A., E-mail: dabruun@ucdavis.edu [Department of Molecular Biosciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616 (United States); Zolkowska, Dorota, E-mail: dzolkowska@gmail.com [Department of Neurology, School of Medicine, University of California-Davis, Sacramento, CA 95817 (United States); Tancredi, Daniel J., E-mail: djtancredi@ucdavis.edu [Department of Pediatrics, School of Medicine, University of California-Davis Medical Center, Sacramento, CA 95817 (United States); Rogawski, Michael A., E-mail: rogawski@ucdavis.edu [Department of Neurology, School of Medicine, University of California-Davis, Sacramento, CA 95817 (United States); Hammock, Bruce D., E-mail: bdhammock@ucdavis.edu [Department of Entomology, College of Agricultural and Environmental Sciences, University of California-Davis, Davis, CA 95616 (United States); Lein, Pamela J., E-mail: pjlein@ucdavis.edu [Department of Molecular Biosciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616 (United States)

    2014-12-01

    Tetramethylenedisulfotetramine (TETS) is a potent convulsant poison for which there is currently no approved antidote. The convulsant action of TETS is thought to be mediated by inhibition of type A gamma-aminobutyric acid receptor (GABA{sub A}R) function. We, therefore, investigated the effects of post-exposure administration of diazepam, a GABA{sub A}R positive allosteric modulator, on seizure activity, death and neuroinflammation in adult male Swiss mice injected with a lethal dose of TETS (0.15 mg/kg, ip). Administration of a high dose of diazepam (5 mg/kg, ip) immediately following the second clonic seizure (approximately 20 min post-TETS injection) effectively prevented progression to tonic seizures and death. However, this treatment did not prevent persistent reactive astrogliosis and microglial activation, as determined by GFAP and Iba-1 immunoreactivity and microglial cell morphology. Inhibition of soluble epoxide hydrolase (sEH) has been shown to exert potent anti-inflammatory effects and to increase survival in mice intoxicated with other GABA{sub A}R antagonists. The sEH inhibitor TUPS (1 mg/kg, ip) administered immediately after the second clonic seizure did not protect TETS-intoxicated animals from tonic seizures or death. Combined administration of diazepam (5 mg/kg, ip) and TUPS (1 mg/kg, ip, starting 1 h after diazepam and repeated every 24 h) prevented TETS-induced lethality and influenced signs of neuroinflammation in some brain regions. Significantly decreased microglial activation and enhanced reactive astrogliosis were observed in the hippocampus, with no changes in the cortex. Combining an agent that targets specific anti-inflammatory mechanisms with a traditional antiseizure drug may enhance treatment outcome in TETS intoxication. - Highlights: • Acute TETS intoxication causes delayed and persistent neuroinflammation. • Diazepam given post-TETS prevents lethal tonic seizures but not neuroinflammation. • A soluble epoxide hydrolase

  11. Atropine and Other Anticholinergic Drugs

    2007-01-01

    compromise near- who first analyzed the pharmacology and toxicol- vision in the case of accidental use. Military re- ogy of tabun obtained from captured...Lipp JA and Dola TJ (1978). Effect of atropine upon 290-293. the cerebrovascular system during soman-induced NakajimaT.Ohta S. Morita H etal. (1997...sarin: Clinical manifes- Wills JH (1963). Pharmacological antagonists of the tations and treatment of accidental poisoning by anticholinesterase agents

  12. 急性铊中毒研究进展%Advance in studies on acute intoxication of thallium

    邱玲玲; 宋治; 陈茹

    2013-01-01

    Thallium is a toxic and rare heavy metal. There are several common pathways for acute intoxication of thallium to human being, such as respiratory, digestive or dermal route, especially the oral way. It is known that the inhibition of potassium in Na+-K+-ATPase, the alteration of membrane physical properties, the binding with thiol enzyme, the impaired mitochondrial function and interaction with riboflavin to disrupt electron transfer may play a role in thallium toxicity. The exact mechanisms still remain poorly understood. Neurotoxicity is the most prominent clinical symptom for thallium toxicity. When a person showed symptoms of alopecia, peripheral neuropathy together with gastrointestinal disorders, it is reasonable to consider the possibility of thallium toxicity. When the value of thallium level in blood or urinary is more than 100 μg/L or 200 μg/L, it can be used for diagnosis of thallium toxicity. Oral consumption of Prussian and blood purification are main strategies for thallium detoxification.%铊是一种有毒的罕见的重金属,急性铊中毒常见途径有呼吸道、消化道、皮肤吸收,尤以消化道途径最常见.目前铊中毒机制尚未明确,可能与竞争性抑制钾离子、改变脂质体的膜属性、结合含有巯基的酶、损害线粒体功能及结合核黄素而破坏电子传递机制有关.临床上铊的神经毒性表现最突出,当出现胃肠道症状、周围神经病及脱发三联征时要高度怀疑铊中毒.血铊质量浓度大于100 μg/L,尿铊大于200 μg/L具有诊断意义.口服普鲁士蓝及血液净化为临床主要的解毒方法.

  13. Comparative study of penehyclidime hydrochloride and atropine in treatment of acute organophosphate pesticide poisoning%盐酸戊乙奎醚与阿托品治疗急性有机磷农药中毒疗效比较研究

    朱艳霞; 杨贤义; 肖敏

    2012-01-01

    Objective To compare the clinical efficacy of penehyclidime hydrochloride and atropine in treatment of a-cute organophosphate pesticide poisoning. Methods Totally 76 patients within six hours of organophosphorus pesticide poisoning were randomly divided into penehyclidime hydrochloride group (re = 38) and atropine group ( n = 38 ),they were all combined with pralidoxime chloride,different doses of penehyclidime hydrochloride and atropine were given according to difference degrees of severity which was ranged in terms of cholinesterase value. The clinical efficacy of two groups was compared. Results The penehyclidime hydrochloride group,the poisoning symptoms time,cuative time and CHE recovery time were compared with that of the atropine group,the difference was statistically significant (P < 0. 01) ; The incidence rate of adverse reactions significantly less than that of the atropine group ( P < 0. 01). Conclusion Penehyclidime hydrochloride in treatment of acute organophosphate pesticide poisoning is safer and more effective than atropine.%目的 比较盐酸戊乙奎醚与阿托品治疗急性有机磷农药中毒的临床疗效.方法 76例6h内有机磷农药中毒者随机分成盐酸戊乙奎醚组(38例)和阿托品组(38例),均配伍用氯解磷定,分别按照胆碱酯酶数值划分的轻中重度程度,给予不同剂量的盐酸戊乙奎醚及阿托品,比较两组患者的临床疗效.结果 盐酸戊乙奎醚组的中毒症状消失时间、治愈时间、CHE恢复时间与阿托品组比较,差异均有统计学意义(P<0.01);并且不良反应的发生率明显比阿托品组低(P<0.01).结论 盐酸戊乙奎醚治疗急性有机磷农药中毒疗效确切,不良反应少,优于阿托品.

  14. 急性百草枯中毒的救治分析%Treatment of acute Paraquat Intoxication

    金克清; 吴化奎

    2010-01-01

    Objective To analyze and sum up treatment of paraquat intoxication. Methods We retrospectively analyzed the clinical data of 8 cases of paraquat intoxication. Result Of the total number,2 cases abandoned treament, 1 case died,5 cases survived,of survival rate is 62. 5%. Conclusion We take measures as early as possible, such as gastrolavaging completely, stomach intestine adsorbing, catharsis, continious blood purification and apply a large dose of xuebijing and hormone, thus can improve the survival rate of paraquat intoxication.%目的 探讨百草枯中毒的救治方法.方法 对8例百草枯中毒患者临床资料进行回顾性分析.结果 2例放弃治疗,1例死亡,5例存活,存活率62.5%.结论 尽早采取彻底洗胃、胃肠内吸附、导泻、持续血液净化、应用大剂量血必净、激素等综合治疗措施能提高百草枯中毒患者的存活率.

  15. Neuroprotective role of heat shock protein 70 in the rostral ventrolateral medulla during acute mevinphos intoxication in the rat.

    Chang, Chi; Chang, Alice Y W; Chan, Samuel H H

    2004-01-01

    Heat shock protein (HSP) is a family of highly conserved proteins that respond to stress and participate actively in cytoprotection. Within the HSP family, HSP70 is the major inducible member that confers protection against cell death. This study investigated whether HSP70 plays a neuroprotective role at the rostral ventrolateral medulla (RVLM), the origin of sympathetic neurogenic vasomotor tone in the medulla oblongata where the organophosphate insecticide mevinphos (Mev) acts to elicit cardiovascular toxicity. Experiments were carried out in adult male Sprague-Dawley rats that were maintained under propofol anesthesia. Intravenous administration of Mev (960 microg/kg) induced a significant increase in the HSP70 level in the ventrolateral medulla during phase I ('pro-life' phase), and returned to baseline during phase II ('pro-death' phase) Mev intoxication. Compared to artificial cerebrospinal fluid, normal mouse serum (1:20), or sense hsp70 oligonucleotide (50 pmol) pretreatment, microinjection of an anti-HSP70 antiserum (1:20) or an antisense hsp70 oligonucleotide (50 pmol) bilaterally into the RVLM significantly increased mortality, shortened the duration of phase I intoxication and augmented the induced hypotension in rats that received Mev (960 microg/ kg, i.v.). These results suggest that HSP70 induced in the RVLM during Mev intoxication provides neuroprotection against the organophosphate poison via prevention of cardiovascular depression.

  16. Antioxidant, hepatoprotective and hypolipidemic effects of methanolic root extract of Cassia singueana in rats following acute and chronic carbon tetrachloride intoxication

    Ottu OJ; Atawodi SE; Onyike E

    2013-01-01

    Objective: To evaluate in vivo antioxidant and hepatoprotective activities of the methanolic extract of the root of Cassia singueana in rats following acute and chronic carbon tetrachloride intoxication. Methods: Malondialdehyde (MDA), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and bilirubin as indices of liver damage and lipid peroxidation were detected in rats after intraperitoneal administration of extract (5 mg/kg). Results: The liver, kidney and heart showed significant reduction (P<0.05) in the levels of MDA from (0.18±0.04), (0.23±0.07) and (0.26±0.10) nmol/mg respectively in the CCl4 control to (0.15±0.03), (0.17±0.04) and (0.17±0.07) nmol/mg protein in groups pre-treated with the extract for three days at 5 mg/kg). Similarly, compared to the CCl4 control, significant reduction (P<0.05) in serum AST, ALT and bilirubin as well as in level of total cholesterol and MDA with concomitant increase in HDL cholesterol, superoxide dismutase and catalase levels when CCl4-intoxicated rats were treated with Cassia singueana root extract for two weeks. Conclusions:These results suggest that methanolic extract of Cassia singueana contain potent antioxidant compounds that can offer significant protection against hepatic and oxidative injuries.

  17. A Herbal Composition of Semen Hoveniae, Radix Puerariae, and Fructus Schisandrae Shows Potent Protective Effects on Acute Alcoholic Intoxication in Rodent Models

    Jie Xiong

    2012-01-01

    Full Text Available This study is designed to evaluate the effects of a herbal composition of Semen Hoveniae, Radix Puerariae and Fructus Schisandrae (SRF against acute alcoholic intoxication. The animals were treated with SRF extract (SRFE for 14 days, and ethanol was conducted subsequent to the final treatment. The effects of SRFE on righting reflex, inebriety rates, kinetic parameters of blood ethanol and acetaldehyde were determined. In addition; levels of alcohol dehydrogenase (ADH and aldehyde dehydrogenase (ALDH, the activities of cytochrome P450 2E1 (CYP2E1, selected antioxidative enzymes, and the contents of malonaldehyde (MDA were measured. SRFE-pretreated rodents exhibited lower rates of intoxication, longer times to loss of righting reflex, and shortened times to recovery of righting reflex than in controls. The peak concentrations and area under the time-concentration curves were lower in the pretreated animals than in controls, which corresponded to higher levels of ADH and ALDH in both gastrointestines and livers of the SRFE-treated animals. The activities of CYP2E1 were lower in SRFE-pretreated animals, which also exhibited higher activities of some antioxidant enzymes and lower hepatic MDA levels. These findings suggest that the anti-inebriation effects of SRFE may involve inhibition of ethanol absorption, promotion of ethanol metabolism, and enhancing hepatic anti-oxidative functions.

  18. 北京地区急性酒精中毒发病规律研究%Epidemiologic pattern of acute alcohol intoxication in Beijing

    何艳; 徐腾达; 王厚力; 李涛; 吉栩; 于学忠

    2011-01-01

    目的 分析北京地区急性酒精中毒流行病学特点及与工作状态、季节因素的相关性.方法 收集2007-08-01~2009-07-31期间北京急救中心记录的急性酒精中毒病例数据,分析急性酒精中毒的月份和季节性发病差异,并用ANOVA方法分析工作状态对急性酒精中毒事件的影响.结果 7090例急性酒精中毒患者中,男性占84.1%;20~29岁年龄段的发病例数和校正发病率在各年龄段中均是最高值,20~29岁年龄段的校正发病率分别为30~39岁、40~49岁及50~59岁年龄段的1.13、1.28和2.09倍.急性酒精中毒发病高峰在冬季,峰值在1月份,7月份是急性酒精中毒发病的第2个高峰.与正常工作日相比,休息日前一天和休息日急性酒精中毒的病例数均显著增加(P<0.05).结论 北京地区急性酒精中毒在年轻人群中高发,并有明显的季节性差异,冬夏季高发;急性酒精中毒具有明显的"休息日效应",休息日前一天及休息日发病率显著增加.%Objective To investigate the epidemiological pattern of acute alcohol intoxication in the municipality of Beijing and its relations with working status and seasonal factors. Methods According to gender, age, the onset time of the month, the season and the working state of the day, a total of 7090 cases of acute alcohol intoxication were grouped. Chi - square test was performed for the evaluation of the variation of monthly and seasonal distribution. One - way ANOVA was performed to compare the incidence cases on the days of different working state. Results The mean age of all the cases was (33.7±12.0) years old. Acute alcohol intoxication of male cases accounted for 84.1% . Two peaks were noticed in winter and summer. Compared with ordinary working days, more incidences were noticed in the days before the rest day and the rest days. Conclusion The incidence of acute alcohol intoxication has significant distributing differences in gender, age group, season

  19. [A case of acute ethanol intoxication with remarkable hyperglycemia by "ume-shu", a Japanese apricot liquor made with a large amount of sugar].

    Sugano, Takayuki; Kojima, Naoki; Kaneko, Susumu; Ishida, Junro; Terada, Taizo; Inagawa, Hiroshi; Okada, Yasusei

    2002-07-01

    A 19-year-old woman ingested 2.2 L of "umeshu", a Japanese apricot liquor made with a large amount of sugar. She was unconscious and in shock. The estimated blood ethanol concentration was 607 mg/dl, and the blood glucose level was 576 mg/dl. Because her respiration and circulation was highly suppressed, blood purification was indicated. Continuous hemodiafiltration (CHDF) was performed instead of hemodialysis because her hemodynamics was unstable. After CHDF was instituted, her blood glucose level reduced to normal range, and her consciousness became alert. CHDF was effective in eliminating ethanol and stabilizing her hemodynamics within an early stage. Though acute ethanol intoxication is known to inhibit glucogenesis, leading to hypoglycemia, marked hyperglycemia was seen in this case. Ingestion of a large amount of glucose-rich liquor and being in shock seemed to be the causes of hyperglycemia.

  20. Pesticide use, erythrocyte acetylcholinesterase level and self-reported acute intoxication symptoms among vegetable farmers in Nepal

    Neupane, Dinesh; Jors, E.; Brandt, L.

    2014-01-01

    intoxication and Erythrocyte Acetylcholinesterase(AChE) levels among vegetable farmers with a control group of blood donors in Nepal. Methods: A cross-sectional study was carried out among 90 pesticide-exposed farmers and a control group of 90 blood donors. Participants were randomly selected and data were...... gathered through questionnaires, observation and blood test. Chi-square test, logistic regression and Student's t-test were used for data analysis to describe pesticide use and compare symptoms and AChE levels between the two groups. This study was approved by Nepal Health Research Council. Results......E level among farmers. Education and information of farmers should be undertaken to remediate these problems....

  1. Comparative efficacy of diazepam and avizafone against sarin-induced neuropathology and respiratory failure in guinea pigs: influence of atropine dose.

    Taysse, L; Calvet, J-H; Buée, J; Christin, D; Delamanche, S; Breton, P

    2003-06-30

    This investigation compared the efficacy of diazepam and the water-soluble prodiazepam-avizafone-in sarin poisoning therapy. Guinea pigs, pretreated with pyridostigmine 0.1 mg/kg, were intoxicated with 4LD(50) of sarin (s.c. route) and 1 min after intoxication treated by intramuscular injection of atropine (3 or 33.8 mg/kg), pralidoxime (32 mg/kg) and either diazepam (2 mg/kg) or avizafone (3.5 mg/kg). EEG and pneumo-physiological parameters were simultaneously recorded. When atropine was administered at a dose of 3 mg/kg, seizures were observed in 87.5% of the cases; if an anticonvulsant was added (diazepam (2 mg/kg) or avizafone (3.5 mg/kg)), seizure was prevented but respiratory disorders were observed. At 33.8 mg/kg, atropine markedly increased the seizure threshold and prevented early respiratory distress induced by sarin. When diazepam was administered together with atropine, seizures were not observed but 62.5% of the animals displayed respiratory difficulties. These symptoms were not observed when using avizafone. The pharmacokinetic data showed marked variation of the plasma levels of atropine and diazepam in different antidote combination groups, where groups receiving diazepam exhibited the lowest concentration of atropine in plasma. Taken together, the results indicate that avizafone is suitable in therapy against sarin when an anticonvulsant is judged necessary.

  2. Acute toxicity of some synthetic cyanogens in rats: time-dependent cyanide generation and cytochrome oxidase inhibition in soft tissues after sub-lethal oral intoxication.

    Rao, Pooja; Singh, Poonam; Yadav, Shiv Kumar; Gujar, Niranjan L; Bhattacharya, Rahul

    2013-09-01

    Cyanogens include complex nitrile-containing compounds that can generate free cyanide of toxicological significance. Acute toxicity, time-dependent cyanide generation and cytochrome oxidase (CYTOX) inhibition in soft tissues, and urinary thiocyanate levels were measured after acute cyanogen intoxication in rats. Order of cyanogens in terms of LD₅₀ was: malononitrile (MCN)>propionitrile (PCN)≈sodium nitroprusside (SNP)>acrylonitrile (ACN)>succinonitrile (SCN)>acetonitrile (ATCN) for oral, and SNP>MCN>ACN>PCN>SCN>ATCN for intraperitoneal and subcutaneous routes. MCN was most toxic by oral (LD₅₀=66.4 mg/kg) and SNP by intraperitoneal (LD₅₀=16.7 mg/kg) and subcutaneous (LD₅₀=11.9 mg/kg) routes. Minimum survival time (25 min) was recorded after 4.0 LD₅₀ ATCN. Order of cyanogens (0.75 LD₅₀; oral) on the basis of maximum blood cyanide and time of peak cyanide generation were: ATCN>SNP>SCN>PCN>MCN>ACN, and MCN (30 min)PCN≈ACN (8h)

  3. Patients with hepatocellular carcinoma related to prior acute arsenic intoxication and occult HBV: Epidemiological, clinical and therapeutic results after 14 years of follow-up

    Teresa Casanovas-Taltavull; Josepa Ribes; Ana Berrozpe; Sara Jordan; Aurora Casanova; Concha Sancho; Carles Valls; F Xavier Bosch

    2006-01-01

    Little is known about the long-term survivors of acute arsenic intoxication. We present here a clinical case report of a man with chronic hepatitis B virus (HBV) infection who developed hepatocellular carcinoma four years after acute arsenic poisoning. HBsAg was detected in serum in 1990 when he voluntarily donated blood.In 1991, the patient suffered from severe psychological depression that led him to attempt suicide by massive ingestion of an arsenic-containing rodenticide. He survived with polyneuropathy and paralysis of the lower limbs, and has been wheelchair-bound since then. During participation in a follow-up study conducted among HBV carriers, abdominal ultrasound detected a two-centimeter liver mass consistent with hepatocellular carcinoma. The tumor was confirmed by computed tomography (CT) and magnetic resonance image (MRI). Because of his significant comorbidity, the patient received palliative treatment with transarterial lipiodol chemoembolization (TACE) on three occasions (1996, 1997 and 1999).At his most recent visit in May 2005, the patient was asymptomatic, liver enzymes were normal and the tumor was in remission on ultrasound.

  4. Investigation of the possible protective role of gallic acid on paraoxanase and arylesterase activities in livers of rats with acute alcohol intoxication.

    Kartkaya, Kazim; Oğlakçi, Ayşegül; Şentürk, Hakan; Bayramoğlu, Gökhan; Canbek, Mediha; Kanbak, Güngör

    2013-04-01

    Gallic acid, a polyphenyl class natural product from gallnut and green tea, is known to be antioxidant, anti-inflammatory and radical scavenger. In this study, we aimed to investigate the possible protective effects of gallic acid on paraoxonase and arylesterase activities in liver exposed to acute alcohol intoxication. Paraoxonase and arylesterase activities in liver tissue and serum aspartate aminotransferase, alanine aminotransferase and lactate dehydrogenase levels were measured. Histological investigations were also made. In our study, we observed a significant increase of serum alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase activities, which are indicators of liver damage after acute ethanol consumption. Gallic acid therapy has significantly reduced the increase in these biomarkers, indicating a possible hepatoprotective effect of gallic acid. Ethanol consumption caused a significant decrease in liver paraoxonase activity (P Gallic acid treatment partly restored this decreased paraoxonase activity, which resulted from ethanol administration. A gallic acid dose of 100 mg/kg was observed as highest restoring effect for paraoxonase activity (P gallic acid treatment restored the loss of this activity due to ethanol exposure (P gallic acid ameliorates the liver damage caused by excessive alcohol consumption in a dose-dependent way. Our results in this study showed that gallic acid might have a protective effect against alcoholic liver disease.

  5. Comparative Evaluation of Carbamates as Prophylactic Agents against Organophosphate Intoxication Rats

    A. K. Chatterjee

    1992-04-01

    Full Text Available Investigates the effects of two well-known carbamates, physostigmine and pyridostigmine against organophosphorous compound and nerve gas toxicity. Physostigmine pretreatment for 30 min enhanced the survival time of rats against DFP intoxication whereas it did not have any effect with sarin poisoning. However, pyridostigmine pretreatment did not produce any significant effect on survival time either against DFP or sarin intoxication. Treatment with atropine along with carbamates further enhanced significantly the survival time against DFP poisoning.

  6. Management of Treatment and Prevention of Acute OP Pesticide Poisoning by Medical Informatics, Telemedicine and Nanomedicine

    Ganesh Chandra Sahoo

    2013-10-01

    Full Text Available Acute organophosphorous pesticide (OP poisoning kills a lot of people each year. Treatment of acute OP poisoning is of very difficult task and is a time taking event. Present day informatics methods (telemedicine, bioinformatics methods (data mining, molecular modeling, docking, cheminformatics, and nanotechnology (nanomedicine should be applied in combination or separately to combat the rise of death rate due to OP poisoning. Use of informatics method such as Java enabled camera mobiles will enable us early detection of insecticidal poisoning. Even the patients who are severely intoxicated (suicidal attempts can be diagnosed early. Telemedicine can take care for early diagnosis and early treatment. Simultaneously efforts must be taken with regard to nanotechnology to find lesser toxic compounds (use less dose of nanoparticle mediated compounds: nano-malathion as insecticides and find better efficacy of lesser dose of compounds for treatment (nano-atropine of OP poisoning. Nano-apitropine (atropine oxide may be a better choice for OP poisoning treatment as the anticholinergic agent; apitropine and hyoscyamine have exhibited higher binding affinity than atropine sulfate. Synthesis of insecticides (malathion with an antidote (atropine, apitropine in nanoscale range will prevent the lethal effect of insecticides.

  7. Effects of acute MDMA intoxication on mood and impulsivity: role of the 5-HT2 and 5-HT1 receptors.

    Janelle H P van Wel

    Full Text Available UNLABELLED: MDMA induces positive mood and increases impulse control during intoxication, but only a few studies on the neuropharmacological mechanisms underlying these processes have been conducted. It was hypothesized that pretreatment with 5-HT(1 and 5-HT(2 receptor blockers would prevent MDMA effects on mood and impulsivity. Subjects (N = 17 participated in a double-blind, placebo controlled, within-subject design involving 6 experimental conditions consisting of pretreatment (T1 and treatment (T2. T1 preceded T2 by 30 minutes. T1-T2 combinations were: placebo-placebo, 20 mg pindolol-placebo, 50 mg ketanserin-placebo, placebo-75 mg MDMA, 20 mg pindolol-75 mg MDMA and 50 mg ketanserin-75 g MDMA. Subjects completed a Profile of Mood States (POMS questionnaire and several impulsivity tasks (Stop signal task, Matching familiar figures task, Cue dependent reversal learning task at 1.5 hrs post-treatment. MDMA alone increased both positive (vigor, arousal, friendliness, elation, positive mood and negative affect (anxiety, confusion as assessed by the POMS questionnaire. MDMA also increased stop reaction time in the Stop signal task and reaction time in the Matching familiar figures task. Pretreatment with ketanserin blocked MDMA effects on positive affect, but not negative affect. Ketanserin did not influence the effects of MDMA on impulsivity. Pindolol did not interact with MDMA on any of the measures. In conclusion, 5-HT(2 receptors mediate positive moods induced by MDMA but not negative moods or impulsivity. 5-HT(1 receptors do not appear to be involved in MDMA effects on mood and impulse control. TRIAL REGISTRATION: Nederlands Trial Register NTR2352.

  8. MRI findings in 6 cases of children by inadvertent ingestion of diphenoxylate-atropine

    Xiao Lianxiang [Shandong University School of Medicine, Shandong Medical Imaging Research Institute , No. 44 West Wenhua Road, Jinan 250012 (China); Lin Xiangtao, E-mail: yishui1982@126.com [Shandong University School of Medicine, Shandong Medical Imaging Research Institute, No. 44 West Wenhua Road, Jinan 250012 (China); Cao Jinfeng [Shandong University School of Medicine, Shandong Medical Imaging Research Institute , No. 44 West Wenhua Road, Jinan 250012 (China); Wang Xueyu [Division of Pediatrics, Shandong Provincial Hospital, Shandong University, No. 324 Jingwu Road, Jinan 250021 (China); Wu Lebin [Shandong Medical Imaging Research Institute, No. 324 Jingwu Road, Jinan 250021 (China)

    2011-09-15

    Purpose: Compound diphenoxylate (diphenoxylate-atropine) poisoning can cause toxic encephalopathy in children, and magnetic resonance imaging (MRI) of the brain in this condition has not been reported. This study is to analyze brain MRI findings and to investigate the relations between MRI features and possible pathophysiological changes in children. Methods: Six children accidentally swallowed compound diphenoxylate, 4 males, 2 females, aged 20-46 months, average 33 months. Quantity of ingested diphenoxylate-atropine was from 6 to 30 tablets, each tablet contains diphenoxylate 2.5 mg and atropine 0.025 mg. These patients were referred to our hospital within 24 h after diphenoxylate-atropine ingestion, and underwent brain MRI scan within 24-72 h after emergency treatment. The characteristics of conventional MRI were analyzed. Results: These pediatric patients had various symptoms of opioid intoxication and atropine toxicity. Brain MRI showed abnormal low signal intensity on T1-weighted images (T1WI) and abnormal high signal intensity on T2-weighted images (T2WI) and fluid-attenuated inversion recovery (FLAIR) imaging in bilateral in all cases; abnormal high signal intensity on T1WI, T2WI and FLAIR in 4 cases. Encephalomalacia was observed in 3 cases during follow-up. Conclusion: In the early stage of compound diphenoxylate poisoning in children, multiple extensive edema-necrosis and hemorrhagic-necrosis focus were observed in basic nucleus, pallium and cerebellum, these resulted in the corresponding brain dysfunction with encephalomalacia. MRI scan in the early stage in this condition may provide evidences of brain impairment, and is beneficial for the early diagnosis, treatment and prognosis assessment.

  9. The effect of acute alcohol intoxication on gut wall integrity in healthy male volunteers; a randomized controlled trial

    de Jong, Willem-Jan; Cleveringa, A. M.; Greijdanus, B.; Meyer, P.; Heineman, E.; Hulscher, J. B.

    2015-01-01

    The aim of the study is to determine the effect of acute alcohol consumption on enterocytes. Chronic alcohol consumption has been known to induce a decrease in gut wall integrity in actively drinking alcoholics and patients with alcohol-induced liver disease. Data on the extent of the damage induced

  10. Comparative studies of oral administration of marine collagen peptides from Chum Salmon (Oncorhynchus keta) pre- and post-acute ethanol intoxication in female Sprague-Dawley rats.

    Liang, Jiang; Li, Qiong; Lin, Bing; Yu, Yongchao; Ding, Ye; Dai, Xiaoqian; Li, Yong

    2014-09-01

    The present study aimed to evaluate the effect of an oral administration of marine collagen peptides (MCPs) pre- and post-acute ethanol intoxication in female Sprague-Dawley (SD) rats. MCPs were orally administered to rats at doses of 0 g per kg bw, 2.25 g per kg bw, 4.5 g per kg bw and 9.0 g per kg bw, prior to or after the oral administration of ethanol. Thirty minutes after ethanol treatment, the effect of MCPs on motor incoordination and hypnosis induced by ethanol were investigated using a screen test, fixed speed rotarod test (5 g per kg bw ethanol) and loss of righting reflex (7 g per kg bw ethanol). In addition, the blood ethanol concentrations at 30, 60, 90, and 120 minutes after ethanol administration (5 g per kg bw ethanol) were measured. The results of the screen test and fixed speed rotarod test suggested that treatment with MCPs at 4.5 g per kg bw and 9.0 g per kg bw prior to ethanol could attenuate ethanol-induced loss of motor coordination. Moreover, MCP administered both pre- and post-ethanol treatment had significant potency to alleviate the acute ethanol induced hypnotic states in the loss of righting reflex test. At 30, 60, 90 and 120 minutes after ethanol ingestion at 5 g per kg bw, the blood ethanol concentration (BEC) of control rats significantly increased compared with that in the 4.5 g per kg bw and 9.0 g per kg bw MCP pre-treated groups. However, post-treatment with MCPs did not exert a significant inhibitory effect on the BEC of the post-treated groups until 120 minutes after ethanol administration. Therefore, the anti-inebriation effect of MCPs was verified in SD rats with the possible mechanisms related to inhibiting ethanol absorption and facilitating ethanol metabolism. Moreover, the efficiency was better when MCPs were administered prior to ethanol.

  11. GHB pharmacology and toxicology: acute intoxication, concentrations in blood and urine in forensic cases and treatment of the withdrawal syndrome.

    Busardò, Francesco P; Jones, Alan W

    2015-01-01

    The illicit recreational drug of abuse, γ-hydroxybutyrate (GHB) is a potent central nervous system depressant and is often encountered during forensic investigations of living and deceased persons. The sodium salt of GHB is registered as a therapeutic agent (Xyrem®), approved in some countries for the treatment of narcolepsy-associated cataplexy and (Alcover®) is an adjuvant medication for detoxification and withdrawal in alcoholics. Trace amounts of GHB are produced endogenously (0.5-1.0 mg/L) in various tissues, including the brain, where it functions as both a precursor and a metabolite of the major inhibitory neurotransmitter γ-aminobutyric acid (GABA). Available information indicates that GHB serves as a neurotransmitter or neuromodulator in the GABAergic system, especially via binding to the GABA-B receptor subtype. Although GHB is listed as a controlled substance in many countries abuse still continues, owing to the availability of precursor drugs, γ-butyrolactone (GBL) and 1,4-butanediol (BD), which are not regulated. After ingestion both GBL and BD are rapidly converted into GHB (t½ ~1 min). The Cmax occurs after 20-40 min and GHB is then eliminated from plasma with a half-life of 30-50 min. Only about 1-5% of the dose of GHB is recoverable in urine and the window of detection is relatively short (3-10 h). This calls for expeditious sampling when evidence of drug use and/or abuse is required in forensic casework. The recreational dose of GHB is not easy to estimate and a concentration in plasma of ~100 mg/L produces euphoria and disinhibition, whereas 500 mg/L might cause death from cardiorespiratory depression. Effective antidotes to reverse the sedative and intoxicating effects of GHB do not exist. The poisoned patients require supportive care, vital signs should be monitored and the airways kept clear in case of emesis. After prolonged regular use of GHB tolerance and dependence develop and abrupt cessation of drug use leads to unpleasant

  12. A Young Adult with Unintentional Acute Parenteral Iron intoxication Treated with Oral Chelation: The Use of Liver Ferriscan.

    Vincenzo De Sanctis

    2016-12-01

    Full Text Available Acute iron poisoning in humans has not been adequately studied. Toxicity depends on the severity of iron overload. Manifestation of acute iron poisoning, defined as a serum iron concentration >300 µg/dL (55 µmol/L within 12 hours of ingestion, by oral route include numerous symptoms which appear in progressive stages.  Systemic toxicity is expected with an ingestion of 60 mg/kg.  A 27 year old female nurse presented to hematology department with iron toxicity 1 week after self-injecting herself with 20 ampoules of IV iron (4000 mg elemental iron, 60 mg/kg. Her vital signs were stable but she had mild hepatic tenderness.

  13. Neuronal Death Following Soman Intoxication: Necrosis or Apoptosis?

    2006-05-01

    progression of apoptotic cell death in the rat piriform cortex after soman intoxication. At various time intervals after seizure onset, animals were...We investigated the temporal progression of apoptotic cell death in the rat piriform cortex after soman intoxication. At various time intervals...and neuronal loss after acute soman exposure included the piriform cortex, hippocampus, septum, entorhinal cortex, dentate gyrus, amygdala, and

  14. 院外快速血糖检测在急性酒精中毒的应用%Application of fast blood glucose detection for acute alcohol intoxication patient In prehospital

    班宇侠; 蒋小燕

    2012-01-01

    目的 探讨院外救治急性酒精中毒患者时,应用检测快速血糖的意义和必要性.方法 对108 例因"急性酒精中毒"呼叫120救护车的患者行快速血糖检测.结果 血糖正常者54例;血糖<2.8 mmol/L 者13例;血糖≧11.1 mmol/L 者36例;血糖结果提示"Hi测不出"者5例.结论 急性酒精中毒患者的血糖 复杂多变,院外救治中应常规检测血糖,对血糖变化异常患者给予正确的处理,为安全转运提供保障,更 为院内进一步系统治疗提供依据.%Objective To explore the application of fast blood glucose detection for acute alcohol intoxication patient in pre-hospital.Method 108 patients who called for 120 first aid ambulance for acute alcohol intoxication were analyzed. Result The normal blood glucose;in 108 cases were 54 cases,anb blood glucose<2.8 mmol/1 were 13 cases; blood glucose ≧ 11.1 mmol/lwere 36cases; and there 5 cases can' t be detected.. Conclusion The blood glucose of acute alcohol intoxication patient were complexity, blood detection should be used in prehospital rescue regularly, and give proper treatment to abnormal glucose patient for provide operational security, and offer a reference for systematical treatment in hospital.

  15. 急性酒精中毒不同处理方法效果比较分析%Comparative analysis of different treatment effect of acute alcohol intoxication

    何善益

    2014-01-01

    Objective:To comparatively analyze different treatment effect of acute alcohol intoxication.Methods:80 patients with acute alcohol intoxication were selected.They were average divided into the control group and the observation group.The control group was given the anti-alcohol treatment of sweet water,coffee,drink strong tea and vitamin B.The observation group was injected naloxone therapy.The effects of two groups were compared.Results:The treatment effect of the observation group was superior than that of the control group.The difference of the efficacy of the two groups was statistically significant(P<0.05). Conclusion:Naloxone can be effective in the treatment of acute alcohol intoxication,has the effective,safe,feasible treatment characteristics.%目的:对比分析急性酒精中毒不同处理效果。方法:收治急性酒精中毒患者80例,将其平均分为两组,即对照组与观察组。对照组实施糖水、咖啡、喝浓茶以及维生素B解酒治疗,观察组注射纳洛酮治疗,对比两组治疗效果。结果:观察组治疗效果优于对照组,两组疗效差异有统计学意义,P<0.05。结论:纳洛酮能够有效治疗急性酒精中毒,具有有效、安全、可行的治疗特点。

  16. The use of carbamates, atropine, and 2-pyridine aldoxime methoiodide in the protection of Artemia salina against poisoning by carbophenothion.

    Sánchez-Fortún, S; Barahona, V

    2001-09-01

    The acute toxicity of carbophenothion to three age classes of Artemia salina was evaluated. An increase in toxicity of carbophenothion was found following longer development of A. salina. The effect of pretreatment with the nonselective muscarinic antagonist atropine, the two reversible acetylcholinesterase-inhibitors physostigmine and pyridostigmine, and the cholinesterase-reactivating oxime 2-pyridine aldoxime methochloride (2-PAM) on carbophenothion-induced lethality in 24-h-old A. salina was also investigated. The lethal action of carbophenothion was completely prevented by pretreatment of A. salina with 2-PAM. Atropine and pyridostigmine afforded a maximal protection of approximately 87% and 72%, respectively, compared to control values. In contrast, physostigmine was ineffective. The inhibitory effects of combinations of 10(-5) M atropine with physostigmine, pyridostigmine, or 2-PAM were greater than those elicited by either drug alone, with the maximum protection afforded being 92.58%, 100%, and 100%, respectively. In the presence of 10(-7) M atropine, neither pyridostigmine nor 2-PAM provided additional inhibition of the lethality compared to that with either drug alone, whereas the protection afforded by 10(-7) M atropine plus physostigmine increased as the concentration of carbamate increased (up to 10(-3) M). Pretreatment with pyridostigmine or physostigmine plus 2-PAM (10(-6) M) slightly enhanced the maximal inhibition of carbophenothion lethality compared to that with either drug alone. It is suggested that the most active combined pretreatment studied here was physostigmine plus atropine.

  17. 急性氯氰菊酯中毒合并急性酒精中毒的临床探讨%Clinical study of acute cypermethrin poisoning afifliated with acute alcohol intoxication

    瞿海龙; 梁璐; 麻月云

    2014-01-01

    Objective To determine the effects of plasma concentration of alcohol on blood cypermethrin concentration and the prognosis of the patients when acute cypermethrin poisoning afifliated with acute alcohol intoxication. Methods 60 cypermethrin poisoning cases were divided into mixed cypermethrin group and cypermethrin group , blood samples were taken on admission from patients, the cypermethrin concentration were detected, blood alcohol concentration also detected in mixed group. Sex, age, cypermethrin concentration, mortality rate were analysised, meanwhile, speaman correlation were used to investigate whether associations between alcohol and cypermethrin. Results Compared with patients with no alcohol in their blood, patients with detectable alcohol were more likely to be male, the cypermethrin concentration and death rate were more higher than control group (P<0.05). There was a positive correlation between alcohol and cypermethrin levels. Conclusion Acute cypermethrin poisoning afifliated with acute alcohol intoxication is associated with higher blood concentrations of cypermethrin and increased risk of death.%目的:探讨急性氯氰菊酯中毒合并急性酒精中毒时,血浆酒精浓度及氯氰菊酯浓度相关性及此类患者的预后。方法对60例急性氯氰菊酯中毒患者,根据中毒前是否饮酒分为混合中毒组与单纯中毒组,所有患者行血浆氯氰菊酯浓度检测,对混合中毒组患者行血浆酒精浓度检测;对两组患者的一般资料(性别、年龄、氯氰菊酯浓度)及死亡率进行统计学处理,并对酒精浓度与氯氰菊酯浓度相关性进行分析。结果两组患者存在性别差异,混合中毒组男性明显高于女性(P<0.05);混合中毒组患者血液中氯氰菊酯含量、病死率明显升高(P<0.05);混合中毒组患者血浆酒精浓度与血液中氯氰菊酯浓度呈正相关,饮酒量越多,氯氰菊酯中毒程度越重。结论急性氯氰

  18. [Research on whether atropine can be substituted by the powerful cycloplegic cyclopentolate].

    Xu, Jiang-tao

    2012-09-01

    For a long time, atropine eye ointment has been widely used as the cycloplegic for children's optometry in China, while internationally, cyclopentolate gutta is widely used as the first choice for cycloplegic. In recent years, 1% cyclopentolate hydrochloride ocular humor has been introduced to our country. This effective and powerful cycloplegic has already been paid close attention to by domestic pedo-ophthalmologists. According to a serious of studies both home and abroad on the therapeutic effects of the own control drugs, the cycloplegia effect of cyclopentolate is close to the atropine. Cyclopentolate can be widely used for the cycloplegia before optometry for the Chinese children. However, the effect of cyclopentolate is still not as good as atropine. So, for the children with farsightedness within 7 years old, all esotropia children, Am children, and children who suffer from decreased vision acuteness and needs to be excluded from accommodative myopia, atropine eye ointment should be routinely used for cycloplegia before optometry. In this article, we also discuss the medication dosage, medication method, possible drug adverse reactions of cyclopentolate humor ocular and the coping measures at the same time.

  19. Naloxone combined with Water-soluble Multivitamins in the treatment of acute alcohol intoxication%纳洛酮联合水溶性多种维生素治疗急性酒精中毒

    方迎春

    2011-01-01

    Objective: To study the curative effect of Naloxone combined with Water-soluble Multivitamins in the treatment of acute alcohol intoxication. Methods: 152 cases of acute intoxication patients from 2003-2009 were collected and randomly divided into treatment group (78 cases) and control group (74 cases). The treatment group was treated by Naloxone combined with Water-soluble Multivitamins in intravenous injection method, the control group was treated only by Naloxone in intravenous injection method. Curative effect in two groups after 2 and 4 hours of treatment were observed. Results:The effective rate of the treatment group was 96.5%, and the control group was 94.5%, there was no significant difference in two groups (P>0.05); however, there were significant differences between two groups in average consciousness time (P<0.05). Conclusion: The adoption of Naloxone combined with Water-soluble Multivitamins in the treatment of acute alcohol intoxication, which can accelerate the body's ethanol metabolization and have the significant effect on consciousness-regaining.%目的:探讨纳洛酮联合水溶性多种维生素救治急性酒精中毒疗效.方法:收集2003~2009年间急性酒精中毒患者152例,将其分为治疗组(78例)和对照组(74例).治疗组采用纳洛酮联合水溶性多种维生素静脉滴注,对照组单用纳洛酮静脉滴注,分别于2、4 h后观察疗效.结果:治疗组有效率为96.5%,对照组有效率为94.5%,两组有效率比较,差异无统计学意义(P>0.05);两组患者清醒时间比较,治疗组比对照组短,差异有统计学意义(P<0.05).结论:采用纳洛酮联合水溶性多种维生素救治急性酒精中毒患者能加速人体血中乙醇代谢,有显著的促醒作用.

  20. Effectiveness study of atropine for progressive myopia in Europeans

    Polling, J.R.; Kok, R.G.; Tideman, J.W.; Meskat, B.; Klaver, C.C.W.

    2016-01-01

    PurposeRandomized controlled trials have shown the efficacy of atropine for progressive myopia, and this treatment has become the preferred pattern for this condition in Taiwan. This study explores the effectiveness of atropine 0.5% treatment for progressive high myopia and adherence to therapy in a

  1. Seizure disorders and anemia associated with chronic borax intoxication.

    Gordon, A S; Prichard, J S; Freedman, M H

    1973-03-17

    During the course of investigation of two infants with seizure disorders it was discovered that both had been given large amounts of a preparation of borax and honey which resulted in chronic borate intoxication. In one child a profound anemia developed as well. The symptoms of chronic borate intoxication are different from those of the acute poisoning with which we are more familiar. The borax and honey preparations are highly dangerous and should no longer be manufactured or distributed for sale.

  2. Preanesthetic care. Intoxication and trauma.

    Watson, T D; Lee, J F

    1976-01-01

    On the basis of the above discussion, a number of useful guidelines appear for the anesthetic management of alcohol and drug abusers. 1. Because of the decreased ability of intoxicated patients to withstand hemorrhage, blood replacement therapy should probably be instituted earlier than in the nonintoxicated patient. 2. Because the chronic alcoholic may actually be iso-osmotically overhydrated, fluid therapy must be planned with care. 3. Because of the tendency to hypoglycemia, glucose should be added to the fluid management regimen. 4. Because of the enzyme induction effect of chronic ETOH ingestion, anesthetic agents that are in part metabolized (methoxyflurane, halothane, fluroxene) are perhaps best avoided. Increased ability to metabolize anesthetic agents appears to be associated with toxicity. 5. Because ETOH is a CNS depressant and has been shown to have amnesia-inducing properties, supplementation of nitrous oxide-relaxant technique with narcotics or other depressant drugs should be reduced, if not eliminated. 6. Because acutely intoxicated individuals are more prone to hypothermia, their core temperature should be monitored intraoperatively. All intravenous fluids should be warmed and a warming blanket should be employed, if necessary, to maintain body temperature. 7. Because of the sympathomimetic effect of many of the drugs, pulse and blood pressure can be misleading in the assessment of blood loss.

  3. Analysis of brain metabolism changes induced by acute potassium cyanide intoxication by 31P NMR in vivo using chronically implanted surface coils.

    Decorps, M; Lebas, J F; Leviel, J L; Confort, S; Remy, C; Benabid, A L

    1984-03-12

    Chronic implantation of surface coils on the skull has been developed to record 31P NMR spectra of the brain in unanesthetized rats. Intraperitoneal sublethal potassium cyanide doses induce strong and reversible changes in high-energy phosphate compounds in the brain, similar in part to those induced by ischemia. These effects are dose-dependent as far as phosphocreatine, inorganic orthophosphates and pH are concerned; ATP does not seem to be altered by KCN doses ranging from 3 to 5 mg/kg but starts decreasing at a dose of 6 mg/kg. The fraction of Mg2+ complexed ATP which could be estimated as about 90% was not affected by KCN intoxication. For high doses (6 mg/kg) a new peak, appearing on the upfield side of the inorganic phosphate peak, may correspond to an acidic compartment, the significance of which is discussed.

  4. MERCURY INTOXICATION IN GRASS CARP (CTENOPHARYNGODON IDELLA)

    2004-01-01

    The present project was carried out to study the effects of acute and chronic mercury intoxication in Grass carp (Ctenopharyngodon idella). For acute phase experiment, 48 fish were divided into four equal groups (A, B, C and D). Groups B, C and D were given HgCl2 at sublethal dose as 0.4, 0.5 and 0.6 mg/L, respectively, while group A acted as control. Skin, gills and kidneys were isolated from the fish after 48 and 96 hours for pathological studies. For chronic phase, 72 fish were divided int...

  5. Lipid Therapy for Intoxications

    Robben, Joris Henricus; Dijkman, Marieke Annet

    2017-01-01

    This review discusses the use of intravenous lipid emulsion (ILE) in the treatment of intoxications with lipophilic agents in veterinary medicine. Despite growing scientific evidence that ILE has merit in the treatment of certain poisonings, there is still uncertainty on the optimal composition of t

  6. A case of acute intoxication due to combined use of fentanyl and 3,4-dichloro-N-[2-(dimethylamino)cyclohexyl]-N-methylbenzamide (U-47700).

    Coopman, Vera; Blanckaert, Peter; Van Parys, Geert; Van Calenbergh, Serge; Cordonnier, Jan

    2016-09-01

    A 30-year old man was found dead in his home after inhaling fumes of a powder burned on aluminum foil. Blood and urine were taken by the medical examiner during the external body examination and submitted to the laboratory for a comprehensive systematic toxicological analysis. A toxic fentanyl level of 10.9μg/L was measured in the subclavian blood. Police investigation revealed that the man searched the internet for information on new psychotropic substances, among others including U-47700. A powder found in the victims' home was transferred to the laboratory for analysis, in which trace amounts of fentanyl (0.0035%, m/m) and U-47700 (0.0012%, m/m) were identified by gas chromatography mass spectrometry. U-47700 is an opioid analgesic drug, considered to have a potency of approximately 7.5 times that of morphine. A target analysis on U-47700 was performed using liquid-liquid extraction and ultra performance liquid chromatography tandem mass spectrometry operating in multiple reaction monitoring mode. The method validation was based on the Scientific Working Group of Forensic Toxicology document 'Standard Practices of Method Validation in Forensic Toxicology'. In blood and urine the U-47700 concentration was 13.8 and 71.0μg/L, respectively. To the author's knowledge, this is the first case report of a fatal intoxication involving U-47700 abused as a new psychotropic substance.

  7. Resource utilization and outcomes of intoxicated drivers

    Camera Lindsay J

    2010-08-01

    to pay ≥ 90% of the charges. Further research using multivariable analysis is needed to determine if these apparent outcomes differences are driven by acute intoxication, and the tendency for endotracheal intubation and ICU admission, rather than injury severity.

  8. Bacterial Intoxication Evokes Cellular Senescence with Persistent DNA Damage and Cytokine Signaling

    Blazkova, Hana; Krejcikova, Katerina; Moudry, Pavel;

    2009-01-01

    to such intoxication are mechanistically incompletely understood. Here we show that both normal and cancer cells (BJ, IMR-90 and WI-38 fibroblasts, HeLa and U2-OS cell lines) that survive the acute phase of intoxication by Haemophilus ducreyi CDT possess the hallmarks of cellular senescence. This characteristic...

  9. [Intoxication of botulinum toxin].

    Chudzicka, Aleksandra

    2015-09-01

    Botulinum toxin is an egzotoxin produced by Gram positive bacteria Clostridium botulinum. It is among the most potent toxins known. The 3 main clinical presentations of botulism are as follows: foodborne botulism, infant botulism and wound botulism. The main symptom of intoxication is flat muscles paralysis. The treatment is supportive care and administration of antitoxin. In prevention the correct preparing of canned food is most important. Botulinum toxin is accepted as a biological weapon.

  10. 急性百草枯中毒的药物治疗进展%Progress in Medication Treatment for Acute Paraquat Intoxication

    向小卫

    2012-01-01

    At present poisoning by paraquat herbicide is still a major medical problem. The very high fatality of paraquat is due to inherent toxicity and lack of effective treatments. Paraquat generates reactive oxygen species which cause cellular damage via lipid peroxidation, activation of NF-KB , mitochondrial damage and apoptosis in many organs. Paraquat intoxication rescue is mainly the regular and symptomatic treatment, including reducing the absorption of poison( wash stomach, active carbon absorption ), speeding up the discharge poison( katharsis , diuresis , blood dialysis/blood perfusion )and medication( vitamin C/E , glutathione etc. ), though the general effect is not satisfactory.%除草剂百草枯中毒目前仍是一个主要的医学问题,由于固有的毒性和缺乏有效的治疗方法,百草枯中毒的病死率很高.百草枯产生活性氧类,通过脂质过氧化反应、激活核因子κB、线粒体损伤和细胞凋亡在许多器官造成细胞损伤.百草枯中毒的抢救主要是常规和对症治疗,包括减少毒物的吸收(洗胃、活性炭吸附)、加快毒物的排泄(导泻、利尿、血液透析/血液灌流)以及药物治疗(维生素C/E、谷胱甘肽等),总体疗效仍不满意.

  11. 辛伐他汀对急性百草枯中毒大鼠炎症因子的作用%Effect of simvastatin on inflammatory factor in acute paraquat-intoxicated rats

    杨贤义; 刘梅; 朱艳霞; 张绪国; 陈立东; 谢华; 肖敏

    2012-01-01

    Objective To investigate the effect of simvastatin on inflammatory factor in acute para-quat-intoxicated rats, and to explore the inhibition of statins on inflammatory response in paraquat-intoxicated rats. Methods Seventy-two healthy Sprague-Dawley rats were randomly divided into three groups: the control group, Paraquat-intoxicated (PQ) group and Simvastatin group, with 24 rats in each group. The model of Paraquat-in-toxicated rats was established by intragastric PQ (120 mg/kg) administration. Two hours later, 20 mg/kg Simvastatin were administrated in Simvastatin group, while 10 ml/kg saline was administered intragastrically in the control group and PQ group. The levels of Interleukin-1 beta (IL-1β), Interleukin-2 (IL-2) and tumou necrosis infactor-α (TNF-α) in serum were determined 6 h, 24 h and 72 h after treatment. Results 6 h, 24 h, 72 h after treatment, the levels of IL-1β and IL-2 in serum significantly increased in PQ group than the control group, and the levels in Simvastatin group were significantly lower than that in PQ group (P<0.05). The level of TNF-α increased significantly in PQ group compared with con-trol group, and the level in Simvastatin group was significantly lower than that in PQ group (P0.05) which decresaed after 6 h, increased after 24 h and then decresaed again. Conclusion Simvastatin can inhibit the release of TNF-a in serum with acute paraquat-intoxicated rats, which can also reduce me releases of IL-lβand IL-2 to certain degree. Statins may play an inhibited role in systemic inflammatory response in acute PQ rats.%目的 观察辛伐他汀对急性百草枯中毒大鼠炎性因子表达的影响,探讨他汀类药物对急性百草枯中毒大鼠全身炎性反应的抑制作用.方法 72只SD大鼠随机分为对照组、中毒组(PQ组)和辛伐他汀组.按120 mg/kg百草枯灌胃造成急性百草枯中毒模型,2h后辛伐他汀组留置胃管并注入辛伐他汀20 mg/kg,对照组和PQ组插胃管并注入10 ml

  12. Human Bone Marrow Mesenchymal Stem Cell-Derived Hepatocytes Improve the Mouse Liver after Acute Acetaminophen Intoxication by Preventing Progress of Injury

    Peggy Stock

    2014-04-01

    Full Text Available Mesenchymal stem cells from human bone marrow (hMSC have the potential to differentiate into hepatocyte-like cells in vitro and continue to maintain important hepatocyte functions in vivo after transplantation into host mouse livers. Here, hMSC were differentiated into hepatocyte-like cells in vitro (hMSC-HC and transplanted into livers of immunodeficient Pfp/Rag2−/− mice treated with a sublethal dose of acetaminophen (APAP to induce acute liver injury. APAP induced a time- and dose-dependent damage of perivenous areas of the liver lobule. Serum levels of aspartate aminotransferase (AST increased to similar levels irrespective of hMSC-HC transplantation. Yet, hMSC-HC resided in the damaged perivenous areas of the liver lobules short-term preventing apoptosis and thus progress of organ destruction. Disturbance of metabolic protein expression was lower in the livers receiving hMSC-HC. Seven weeks after APAP treatment, hepatic injury had completely recovered in groups both with and without hMSC-HC. Clusters of transplanted cells appeared predominantly in the periportal portion of the liver lobule and secreted human albumin featuring a prominent quality of differentiated hepatocytes. Thus, hMSC-HC attenuated the inflammatory response and supported liver regeneration after acute injury induced by acetaminophen. They hence may serve as a novel source of hepatocyte-like cells suitable for cell therapy of acute liver diseases.

  13. Mad honey intoxication: A systematic review on the 1199 cases.

    Silici, Sibel; Atayoglu, A Timucin

    2015-12-01

    Mad honey, produced by honeybees from the nectars of Rhododendron genus (R. ponticum and R. luteum) flowers, is widely used in indigenous medicine, especially in the treatment of hypertension and sexual dysfunction. However, the consumption of this honey can result in intoxication soon after. The diagnosis of honey poisoning and a full understanding of its treatment is important for both effective and immediate treatment, and also for the prevention of unnecessary costs. Upon the evaluation of approximately 34 years of case reports between 1981 and 2014, it was found that the cases of poisoning were more frequently reported in males (75.17%) and between the ages 41 to 65. The most common complaints related to honey poisoning were dizziness, nausea, presyncope and the ECG findings were: sinus bradycardia (79.58%), complete atrioventricular block (45.83%), atrioventricular block (30.91%), ST-segment elevation (22.63%), and nodal rhythm (11.27%), As a result of the evaluation of 1199 cases, it was found that no deaths were reported. The patients were most frequently treated with 0.5 mg atropine (37.79%), 1 mg atropine (49.73%), salin (iv fluid) (65.35%), and generally the patients were discharged within 24 h after recovery.

  14. Unpacking intoxication, racialising disability.

    Chen, Mel Y

    2015-06-01

    This article examines concepts whose strictly medical applications have only partly informed their widespread use and suggests that demonstrably shared logics motivate our thinking across domains in the interest of a politically just engagement. It considers exchanges between the culturally complex concepts of 'toxicity' and 'intoxication', assessing the racialised conditions of their animation in several geopolitically--and quite radically--distinct scenarios. First, the article sets the framework through considering the racial implications of impairment and disability language of 'non-toxic' finance capital in the contemporary US financial crisis. Shifting material foci from 'illiquid financial bodies' to opiates while insisting that neither is 'more' metaphorically toxic than the other, the article turns to address the role of opium and temporality in the interanimations of race and disability in two sites of 19th-century British empire: Langdon Down's clinic for idiocy, and China's retort on opium to Queen Victoria. The article concludes with a provocation that suggests yet another crossing of borders, that between researcher and researched: 'intoxicated method' is a hypothetical mode of approach that refuses idealised research positions by 'critically disabling' the idealised cognitive and conceptual lens of analysis.

  15. Immediate and Long-Term Outcome of Acute H2S Intoxication Induced Coma in Unanesthetized Rats: Effects of Methylene Blue

    Sonobe, Takashi; Chenuel, Bruno; Cooper, Timothy K.; Haouzi, Philippe

    2015-01-01

    Background Acute hydrogen sulfide (H2S) poisoning produces a coma, the outcome of which ranges from full recovery to severe neurological deficits. The aim of our study was to 1- describe the immediate and long-term neurological effects following H2S-induced coma in un-anesthetized rats, and 2- determine the potential benefit of methylene blue (MB), a compound we previously found to counteract acute sulfide cardiac toxicity. Methods NaHS was administered IP in un-sedated rats to produce a coma (n = 34). One minute into coma, the rats received MB (4 mg/kg IV) or saline. The surviving rats were followed clinically and assigned to Morris water maze (MWM) and open field testing then sacrificed at day 7. Results Sixty percent of the non-treated comatose rats died by pulseless electrical activity. Nine percent recovered with neurological deficits requiring euthanasia, their brain examination revealed major neuronal necrosis of the superficial and middle layers of the cerebral cortex and the posterior thalamus, with variable necrosis of the caudate putamen, but no lesions of the hippocampus or the cerebellum, in contrast to the typical distribution of post-ischemic lesions. The remaining animals displayed, on average, a significantly less effective search strategy than the control rats (n = 21) during MWM testing. Meanwhile, 75% of rats that received MB survived and could perform the MWM test (P<0.05 vs non-treated animals). The treated animals displayed a significantly higher occurrence of spatial search than the non-treated animals. However, a similar proportion of cortical necrosis was observed in both groups, with a milder clinical presentation following MB. Conclusion In conclusion, in rats surviving H2S induced coma, spatial search patterns were used less frequently than in control animals. A small percentage of rats presented necrotic neuronal lesions, which distribution differed from post-ischemic lesions. MB dramatically improved the immediate survival and spatial

  16. Immediate and Long-Term Outcome of Acute H2S Intoxication Induced Coma in Unanesthetized Rats: Effects of Methylene Blue.

    Takashi Sonobe

    Full Text Available Acute hydrogen sulfide (H2S poisoning produces a coma, the outcome of which ranges from full recovery to severe neurological deficits. The aim of our study was to 1--describe the immediate and long-term neurological effects following H2S-induced coma in un-anesthetized rats, and 2--determine the potential benefit of methylene blue (MB, a compound we previously found to counteract acute sulfide cardiac toxicity.NaHS was administered IP in un-sedated rats to produce a coma (n = 34. One minute into coma, the rats received MB (4 mg/kg i.v. or saline. The surviving rats were followed clinically and assigned to Morris water maze (MWM and open field testing then sacrificed at day 7.Sixty percent of the non-treated comatose rats died by pulseless electrical activity. Nine percent recovered with neurological deficits requiring euthanasia, their brain examination revealed major neuronal necrosis of the superficial and middle layers of the cerebral cortex and the posterior thalamus, with variable necrosis of the caudate putamen, but no lesions of the hippocampus or the cerebellum, in contrast to the typical distribution of post-ischemic lesions. The remaining animals displayed, on average, a significantly less effective search strategy than the control rats (n = 21 during MWM testing. Meanwhile, 75% of rats that received MB survived and could perform the MWM test (P<0.05 vs non-treated animals. The treated animals displayed a significantly higher occurrence of spatial search than the non-treated animals. However, a similar proportion of cortical necrosis was observed in both groups, with a milder clinical presentation following MB.In conclusion, in rats surviving H2S induced coma, spatial search patterns were used less frequently than in control animals. A small percentage of rats presented necrotic neuronal lesions, which distribution differed from post-ischemic lesions. MB dramatically improved the immediate survival and spatial search strategy in the

  17. Chelation in Metal Intoxication

    Swaran J.S. Flora

    2010-06-01

    Full Text Available Chelation therapy is the preferred medical treatment for reducing the toxic effects of metals. Chelating agents are capable of binding to toxic metal ions to form complex structures which are easily excreted from the body removing them from intracellular or extracellular spaces. 2,3-Dimercaprol has long been the mainstay of chelation therapy for lead or arsenic poisoning, however its serious side effects have led researchers to develop less toxic analogues. Hydrophilic chelators like meso-2,3-dimercaptosuccinic acid effectively promote renal metal excretion, but their ability to access intracellular metals is weak. Newer strategies to address these drawbacks like combination therapy (use of structurally different chelating agents or co-administration of antioxidants have been reported recently. In this review we provide an update of the existing chelating agents and the various strategies available for the treatment of heavy metals and metalloid intoxications.

  18. 急性百草枯中毒患者预后影响因素的研究%Study on the prognosis of patients with acute paraquat intoxication

    刘鹏; 何跃忠; 王浩春; 李光; 张成岗; 张锡刚; 孟庆义

    2011-01-01

    目的 探讨影响急性百草枯中毒患者预后的因素.方法 对111例急性百草枯中毒患者早期血浆和尿液中百草枯浓度、血液白细胞计数、肝肾功能、血清淀粉酶、电解质及动脉血气分析进行回顾性分析.结果 111例中毒患者存活43例,死亡68例,病死率为61.3%;血浆中百草枯浓度≤8.0 μg/ml,尿液中百草枯浓度≤276.0 μg/ml的中毒患者可能存活,但血浆中检测不到百草枯的中毒患者也可发生死亡.生存组患者血浆中百草枯、尿液中百草枯浓度[(0.82±1.70)、(28.12±51.17)μg/ml]明显低于死亡组[(9.32±12.04)、(384.53±597.93)μg/ml],差异有统计学意义(P<0.01);死亡组外周血白细胞总数、血清肌酐含量、天冬氨酸转氨酶活力、血清淀粉酶活力明显高于生存组,差异有统计学意义(P<0.05,P<0.01);死亡组易于出现代谢性酸中毒.logistic回归分析表明,百草枯中毒患者的生存率与血浆、尿液中百草枯浓度、外周血白细胞总数、肌酐、BE值相关.结论 高浓度的血浆、尿液中百草枯,白细胞增高、肾功能障碍及代谢性酸中毒是影响百草枯中毒患者预后的重要因素.%Objective To study the correlation factors of acute paraquat intoxication prognosis.Methods The early paraquat concentration in plasma and urine, leukocyte count, hepatic and renal function,amylase, electrolyte and the parameters of arterial blood gas were analyzed retrospectively in 111 patients with acute paraquat intoxication. Results 43 cases( 38.7% ) of all the 111 patients survived and the other 68 cases (61.3%) died. The patient, whose paraquat concentration was not more than 8.0 μg/ml in plasma and 276.0 μg/ml in urine,could survive. But some patients could die,only if there was no paraquat found in plasma. The paraquat levels in plasma and urine were significantly lower in survivors [ ( 0.82± 1.70 ), ( 28.12±51.17 ) μg/ml]than in nonsurvivors [(9.32 ± 12.04), ( 384.53

  19. Predictors of Poor Prognosis in Aluminum Phosphide Intoxication

    Fakhredin Taghaddosi Nejad

    2012-05-01

    Full Text Available Background: Aluminum phosphide as a fumigant is extensively used for wheat preservation from rodents and bugs especially in silos worldwide. There is increasing number of acute intoxication with this potentially lethal compound because of its easy availability. We have tried to locate predictors of poor prognosis in patients with aluminum phosphide intoxication in order to find patients who need more strict medical cares. Methods: All cases of aluminum phosphide intoxication that had been referred to our hospital during April 2008 to March 2010 were studied by their medical dossiers. Pertinent data including vital signs, demographic features, clinical and lab findings, and incidence of any complication were collected and analyzed by the relevant statistical methods. Results: Sixty seven cases of aluminum phosphide intoxication were included in the study. 44.8% of them were male. 97% of cases were suicidal. Mean amount of ingestion was 1.23+/- 0.71 tablets. Mortality rate was 41.8%. ECG abnormality and need for mechanical ventilation had negative relation with outcome. Conclusion: Correlation between some findings and complications with outcome in aluminum phosphide intoxication can be used as guidance for risk assessment and treatment planning in the patients.

  20. Can anisodamine be a potential substitute for high-dose atropine in cases of organophosphate poisoning?

    Wang, W; Chen, Q-F; Ruan, H-L; Chen, K; Chen, B; Wen, J-M

    2014-11-01

    A case of organophosphate (OP) poisoning was admitted to the emergency room. The patient accepted treatment with pralidoxime (PAM), atropine, and supporting therapy. It was observed that even after 22 h after treatment, 960 mg of atropine was not enough for the patient to be atropinized. However, a 160-mg follow-up treatment of anisodamine was quite enough for atropinization after 4 h. As a case report, more studies are required before any definite conclusion can be reached regarding the use of anisodamine as a potential substitute for high-dose atropine in cases of OP poisoning.

  1. Obstrucción aguda de la vía respiratoria superior y rabdomiolisis luego de intoxicación por tintura para el cabello Acute upper respiratory obstruction and rhabdomiolysis due to intoxication with a hair dye

    Claudia Arroyave

    2004-09-01

    the airway involvement the patient presented acute pulmonary edema and subsequently pneumonia that required antibioticotherapy. Additionally, she had severe rhabdomyolysis that was treated with adequate fluid administration to avoid alterations in renal function. She remained at hospital for ten days and was discharged in good condition. We review the possible pathophysiologic mechanisms, the clinical manifestations and the treatment of paraphenylenediamine intoxication because this compound was the most important cause of the clinical manifestations of our patient.

  2. Delayed Encephalopathy of Carbon Monoxide Intoxication and Treatment with Hyperbaric Oxygen: A Case Report

    Fatma Polat

    2012-09-01

    Full Text Available Delayed encephalopathy (DE is a neuropsychiatric syndrome that can arise generally within 20 days of acute carbon monoxide (CO intoxication after apparent recovery and involves variable degrees of cognitive deficits, personality changes, movement disorders and focal neurologic deficits. We report a 35-year-old female patient with delayed encephalopathy due to CO intoxication, presenting with cognitive impairment and mild parkinsonism despite receiving hyberbaric oxigen therapy (HBO. Magnetic resonance imaging showed abnormal signal intensity and decreased diffusivity at both caudate nuclei and globus pallidus. She continued to receive additional HBO therapy and complete recovery was reached within six months. The positive effect of early HBO therapy of selected patients in reversing the acute effects of CO intoxication is appearant. We here also review the beneficial effect of HBO in preventing or limitating the late neurocognitive deficits associated with severe CO intoxication.

  3. Comparison of exercise, dobutamine-atropine and dipyridamole-atropine stress echocardiography in detecting coronary artery disease

    Nedeljkovic, Ivana; Ostojic, Miodrag; Beleslin, Branko; Djordjevic-Dikic, Ana; Stepanovic, Jelena; Nedeljkovic, Milan; Stojkovic, Sinisa; Stankovic, Goran; Saponjski, Jovica; Petrasinovic, Zorica; Giga, Vojislav; Mitrovic, Predrag

    2006-01-01

    Background Dipyridamole and dobutamine stress echocardiography testing are most widely utilized, but their sensitivity remained suboptimal in comparison to routine exercise stress echocardiography. The aim of our study is to compare, head-to-head, exercise, dobutamine and dipyridamole stress echocardiography tests, performed with state-of-the-art protocols in a large scale prospective group of patients. Methods Dipyridamole-atropine (Dipatro: 0.84 mg/kg over 10 min i.v. dipyridamole with addition of up to 1 mg of atropine), dobutamine-atropine (Dobatro: up to 40 mcg/kg/min i.v. dobutamine with addition of up to 1 mg of atropine) and exercise (Ex, Bruce) were performed in 166 pts. Of them, 117 pts without resting wall motion abnormalities were enrolled in study (91 male; mean age 54 ± 10 years; previous non-transmural myocardial infarction in 32 pts, angina pectoris in 69 pts and atypical chest pain in 16 pts). Tests were performed in random sequence, in 3 different days, within 5 day period under identical therapy. All patients underwent coronary angiography. Results Significant coronary artery disease (CAD; ≥50% diameter stenosis) was present in 69 pts (57 pts 1-vessel CAD, 12 multivessel CAD) and absent in 48 pts. Sensitivity (Sn) was 96%, 93% and 90%, whereas specificity (Sp) was 92%, 92% and 87% for Dobatro, Dipatro and Ex, respectively (p = ns). Concomitant beta blocker therapy did not influence peak rate-pressure product and Sn of Dobatro and Dipatro (p = ns). Conclusion When state-of-the-art protocols are used, dipyridamole and dobutamine stress echocardiography have comparable and high diagnostic accuracy, similar to maximal post-exercise treadmill stress echocardiography. PMID:16672046

  4. Comparison of exercise, dobutamine-atropine and dipyridamole-atropine stress echocardiography in detecting coronary artery disease

    Petrasinovic Zorica

    2006-05-01

    Full Text Available Abstract Background Dipyridamole and dobutamine stress echocardiography testing are most widely utilized, but their sensitivity remained suboptimal in comparison to routine exercise stress echocardiography. The aim of our study is to compare, head-to-head, exercise, dobutamine and dipyridamole stress echocardiography tests, performed with state-of-the-art protocols in a large scale prospective group of patients. Methods Dipyridamole-atropine (Dipatro: 0.84 mg/kg over 10 min i.v. dipyridamole with addition of up to 1 mg of atropine, dobutamine-atropine (Dobatro: up to 40 mcg/kg/min i.v. dobutamine with addition of up to 1 mg of atropine and exercise (Ex, Bruce were performed in 166 pts. Of them, 117 pts without resting wall motion abnormalities were enrolled in study (91 male; mean age 54 ± 10 years; previous non-transmural myocardial infarction in 32 pts, angina pectoris in 69 pts and atypical chest pain in 16 pts. Tests were performed in random sequence, in 3 different days, within 5 day period under identical therapy. All patients underwent coronary angiography. Results Significant coronary artery disease (CAD; ≥50% diameter stenosis was present in 69 pts (57 pts 1-vessel CAD, 12 multivessel CAD and absent in 48 pts. Sensitivity (Sn was 96%, 93% and 90%, whereas specificity (Sp was 92%, 92% and 87% for Dobatro, Dipatro and Ex, respectively (p = ns. Concomitant beta blocker therapy did not influence peak rate-pressure product and Sn of Dobatro and Dipatro (p = ns. Conclusion When state-of-the-art protocols are used, dipyridamole and dobutamine stress echocardiography have comparable and high diagnostic accuracy, similar to maximal post-exercise treadmill stress echocardiography.

  5. A case of bilateral sudden hearing loss and tinnitus after salicylate intoxication.

    Kim, Sang Min; Jo, Joon-Man; Baek, Moo Jin; Jung, Kyu Hwan

    2013-04-01

    Salicylate, the active ingredient of aspirin can cause sensorineural hearing loss and tinnitus when plasma concentrations reach a critical level. The ototoxic mechanisms of salicylate remain unclear but hearing and tinnitus usually recovers a few days after intoxication. There have been few reports of salicylate-induced ototoxicity in Korea, and the majority is caused by a low dose of aspirin. Herein, we report a case of sudden hearing loss and tinnitus after acute salicylate intoxication and review recent updates on salicylate ototoxicity.

  6. Neuromuscular disorders in chronic alcohol intoxication

    A. Yu. Emelyanova

    2015-01-01

    Full Text Available The paper reviews the present-day Russian and foreign literature on neuromuscular disorders in chronic alcohol intoxication. The most common manifestations of alcohol disease include alcoholic polyneuropathy (PNP and alcohol-induced skeletal muscle injury. The clinical polymorphism of alcoholic PNP is discussed. The paper considers a chronic sensory automatic form due to the direct toxic effects of ethanol and its metabolites during long-term alcohol intoxication, as well as acute/subacute sensorimotor neuropathy, the basis for the pathogenesis of which is B group vitamins, predominantly thiamine, deficiency that develops in the presence of drinking bouts concurrent with malnutrition and/or alcohol-related gastrointestinal tract diseases. In addition to nonuse of alcohol and a properly balanced diet, antioxidant therapy with alphalipoic acid and neurotropic B group vitamins is considered to be pathogenetic therapy for neuropathy. The most common and least studied clinicalform of alcohol-induced musculoskeletal injury is chronic alcoholic myopathy (AM, the diagnostic standard for which is morphometricand immunohistochemical examination of a muscle biopsy specimen. The morphological base for this form of myopathy is predominantly type 2 muscle fiber atrophy caused by impaired protein synthesis and a decreased regenerative potential of muscle fiber. The efficacy of antioxidants and leucine-containing amino acid mixtures in the treatment of chronic AM is discussed.

  7. Gender, age, and educational level attribute to blood alcohol concentration in hospitalized intoxicated adolescents: A cohort study

    Zanten, van E.; Ploeg, van der T.; Van Hoof, Joris J.; Lely, van der Nicolaas

    2013-01-01

    Background The prevalence of adolescents hospitalized with acute alcohol intoxication, mainly because of severe reduced consciousness, is increasing. However, the characteristics of these adolescents are mainly unidentified. In this clinical research, we aimed to identify factors that attribute to h

  8. Influence of exogenous 5'-nucleotides on acute alcohol intoxication in rats%外源性5'-核苷酸对大鼠急性乙醇中毒的影响

    江清浩; 蔡夏夏; 井路路; 林兵; 李勇; 王军波

    2011-01-01

    目的:探讨外源性5'-核苷酸对大鼠急性乙醇中毒的影响.方法:将24只雄性SD大鼠随机分成4组:生理盐水组、低剂量核苷酸组、中剂量核苷酸组和高剂量核苷酸组.乙醇染毒前30 min,各组分别用生理盐水、低剂量(0.2g/kg体重)、中剂量(0.8g/kg体重)、高剂量(3.2g/kg体重)核苷酸灌胃,乙醇染毒剂量为3g/kg体重,染毒后进行旷场实验、转棒实验,检测血清乙醇浓度、血清谷草转氨酶、谷丙转氨酶、总甘油三酯、总胆固醇、高密度脂蛋白胆固醇、白蛋白、总蛋白水平,超氧化物歧化酶活性和丙二醛含量,检测肝乙醇脱氢酶活性,评价核苷酸对急性乙醇中毒的影响.结果:外源性5'-核苷酸干预能够使大鼠血液乙醇浓度降低,高剂量核苷酸组与生理盐水组相比[(0.56±0.18g/L)vs.(1.11±0.44g/L),P<0.05],差异具有统计学意义,低剂量核苷酸组(1.04±0.35g/L)和中剂量核苷酸组(0.93±0.14g/L)与生理盐水组相比也较低,但差异无统计学意义;各组肝乙醇脱氢酶活性差异无统计学意义,各组大鼠神经行为学表现、血清生化水平和抗氧化水平差异也无统计学意义.结论:外源性5'-核苷酸干预对大鼠急性乙醇中毒无明显影响.%Objective: To investigate effects of exogenous 5'-nucleotides on acute alcohol intoxication in SD rats. Methods: In our study, 24 male SD rats were randomly divided into 4 groups which included a control group treated with normal saline and three experimental groups treated with low, medium and high doses of exogenous 5'-nucleotides (0.2, 0.8, 3.2 g/kg body weight). All the rats were gavaged with 50% ethanol 30 minutes after treatment. Then rotarod test and open field test were taken to assess rats' neurobehavior changes; Tail blood samples were collected to test blood ethanol concentration; Then all the rats were anesthetized and killed to collect blood and liver samples. Contents of serum alanine amino transferase

  9. Acute ethanol intoxication aggravates traumatic brain injury in rats and its relation to oxygen free radicals%急性乙醇中毒对大鼠颅脑损伤后神经系统的影响及其氧自由基损伤机制的研究

    汤崇辉; 许信龙; 傅小君; 魏晓捷; 潘红松; 方战舰

    2011-01-01

    目的 探讨急性乙醇中毒对大鼠颅脑创伤后神经系统的影响及其氧自由基损伤机制.方法 Feeney法制作大鼠重型颅脑损伤模型,乙醇灌胃法建立急性乙醇中毒模型.48只雄性SD大鼠随机分为单纯急性乙醇中毒组(A组)、单纯颅脑创伤组(B组)、急性乙醇中毒合并颅脑创伤组(C组)和假手术组(D组)各12只.在伤后1、6、24、72h进行行为学评分;在伤后72h,各组随机取其中6只在麻醉下经心脏灌注4%多聚甲醛固定脑组织,TUNEL法测凋亡细胞数;其余6只快速断头取水肿带脑组织,测定脑组织内SOD活性及MDA含量.结果 C组大鼠的行为学评分最低,恢复最慢;其脑组织内MDA含量最高,SOD含量最低;其神经细胞凋亡最多.结论 急性乙醇中毒可加重颅脑创伤后氧自由基的损害,增加神经细胞的凋亡,影响神经功能的恢复.%Objective To investigate the influence of acute ethanol intoxication (AEI) on traumatic brain injury (TBI) in rats and its relation to oxygen free radicals.Methods Severe traumatic brain injury model was established by Feeny method in rats, and acute ethanol intoxication was induced by gastric gavage.Forty- eight male SD rats were randomly divided into 4 groups: acute ethanol intoxication group (A), traumatic brain injury group (B), acute ethanol intoxication with traumatic brain injury group (C) and sham operation group (D).The behavioral scores were examined at 1h, 6h, 24h and 72h after injury.After 72h, 6 rats from each group were sacrificed and brain specimens were collected.The apoptotic cells were detected by TUNEL method; the superoxide dismutase (SOD) and malondialdehyde (MDA) were determined.Data were analyzed by one- way ANOVA Results The behavior score of group C was the lowest (P<0.05) and delayed to recover (P<0.05).In group C the content of MDA was the highestand SODwas the lowest(P<0.05); the percentage ofapoptosis cells was the highest among 4 groups (P<0.05).Conclusion

  10. Analysis of risk factors for prognosis of patients with acute paraquat intoxication%急性百草枯中毒患者预后危险因素分析

    焦峰军; 祝文; 王涛宁; 袁亚迎; 亢锴; 刘敏龙

    2015-01-01

    Objective To explore the risk factors influencing the prognosis by analyzing clinical data of patients with acute paraquat intoxication, and to assess the prognostic values of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, sequential organ failure assessment (SOFA) score, and Acute Kidney Injury Network (AKIN) stage.Methods The clinical data of patients with acute paraquat intoxication admitted into the First People's Hospital of Xianyang City during October 2005 to May 2015 were retrospectively analyzed.The patients were divided into death group and survival group according to 28-day outcome after poisoning.The gender, age, body weight index, toxin dose, time elapsed from poisoning to gastric lavage, time elapsed from poisoning to hemoperfusion (HP), times of HP treatment, white blood cell count (WBC), alanine aminotransferase (ALT), aspartate transaminase (AST), total bilirubin (TBil), serum creatinine (SCr), blood urea nitrogen (BUN), creatine kinase (CK) were determined at admission.Arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), arterial lactate (Lac), and APACHE Ⅱ score, SOFA score and AKIN stage were recorded and compared between two groups.The receiver operating characteristic (ROC) curve was plotted for APACHE Ⅱ score, SOFA score and AKIN stage to analyze the prognostic value for patients with acute paraquat intoxication.Results There were 118 cases in total,with 64 survivors and 54 deaths in 28 days, and the fatality rate was 45.76%.Compared with survival group, the toxic dose (mL: 66.29 ± 27.40 vs.29.16 ± 19.40), time elapsed from poisoning to gastric lavage (minutes: 60.37 ± 26.68 vs.41.17± 14.82), WBC count (× 109/L: 16.86±2.77 vs.10.25 ± 2.60), ALT (U/L: 53.94± 10.85 vs.36.40±9.21),SCr (μmol/L: 159.69±42.85 vs.81.73±34.40) at admission as well as Lac (mmol/L: 3.06± 1.33 vs.1.71 ±0.88),APACHE Ⅱ score (6.46±2.38 vs.3.31 ± 1.51), SOFA score (3.31 ± 1.06 vs.2

  11. 枳子、葛根花和苦参混合药物对小鼠急性酒精中毒的防治作用%Prevention and Cure of Acute Alcohol Intoxica-tion in Mice by Administration of Compound of Japanese Raisintree Fruit, Lobed Kudzuvine Flower Bud and Lightyellow Sophora Root

    孔玲; 李杰; 张秀珍

    2014-01-01

    Objective We aimed to investigate the preventive and therapeutical effect of compound of traditional Chinese drugs (Japanese raisintree fruit, lobed kudzuvine flower bud and lightyel ow sophora root) on acute alcohol intoxication in mice. [Method] Acute alcohol intoxication was induced by administering alcohol to mice. Three different doses (low, middle and high) of compound of traditional Chinese drugs were administered to mice before and after administering alcohol respectively to investigate the preventive and therapeutical effect of drugs on acute alcohol intox-ication through doing statistical analysis about drunk mice and their sleeping time. The concentration of malondialdehyde (MDA), reduced glutathione (GSH) and triglyc-erides (TG) in liver was also determined to investigate the protective effect of drugs on liver. [Result] The efficacy of compound of traditional Chinese drugs on acute al-cohol intoxication was dose-dependent. High-dose administration decreased the number of drunk mice significantly compared with control group; middle- and high-dose administration reduced the sleeping time of drunk mice and the concentration of MDA and TG in liver tissue; three doses al increased the concentration of GSH. [Conclusion] The compound of Japanese raisintree fruit, lobed kudzuvine flower bud and lightyel ow sophora root had preventive and therapeutical effect on hangover, and it also had certain preventive and therapeutical effect on liver damage caused by alcohol.%[目的]探讨中药枳子、葛根花和苦参混合药物对小鼠急性酒精中毒的防治作用。[方法]采用酒精灌胃法建立小鼠急性酒精中毒模型,灌喂低、中、高3种剂量的药物,进行先药后酒的预防醉酒和先酒后药的治疗醉酒试验,统计醉酒小鼠数目和小鼠睡眠时间,并通过检测小鼠肝组织中的丙二醛( MDA)、还原型谷胱甘肽(GSH)及血清甘油三酯(TG)的含量,研究药物对小鼠肝的保护作用

  12. Water intoxication in adult cattle.

    Kawahara, Naoya; Ofuji, Sosuke; Abe, Sakae; Tanaka, Ai; Uematsu, Masami; Ogata, Yoshimi

    2016-05-01

    Water intoxication is a common disorder in calves and is usually characterized by transient hemoglobinuria. In contrast, the condition is very rare in adult cattle, with few reports on naturally occurring cases. In the present report, four female Japanese Black cattle, aged 16-25 months, showed neurological signs when they drank water following a water outage. Hemoglobinuria was not grossly observed, while severe hyponatremia was revealed by laboratory tests. Autopsy indicated cerebral edema with accumulation of serous fluid in expanded Virchow-Robin spaces. These results indicate the possibility of water intoxication associated with cerebral edema due to severe dilutional hyponatremia in adult cattle.

  13. [Intentional paracetamol intoxication in children

    Bisschops, L.L.; Bisschops, W.A.; Vroegop, M.P.; Rossum, L.K. van; Kramers, C.

    2011-01-01

    As paracetamol is widely used and easily available acetaminophen auto-intoxication is frequently seen. In the majority of patients no complications will occur, but in a small group it may lead to liver damage and death. Children are less susceptible to complications than adults. Cornerstone of treat

  14. Ruta Graveolens intoxication.

    Seak, Chen-June; Lin, Chih-Chuan

    2007-01-01

    We describe a case of unintentional poisoning from Ruta Graveolens, a medicinal herb that is used for heart protection in Taiwan. A 78-year-old woman developed bradycardia, acute renal failure with hyperkalemia, and coagulopathy after three days of consuming a decoction made from Ruta Graveolens for the treatment of palpitations and heart protection. She was treated with hemodialysis in the emergency department for hyperkalemia. Her bradycardia and hypotension improved gradually three days later. Ruta use might cause multi-organ toxicity. We believe this case report helps in the recognition of the systemic toxicity of Ruta Graveolens.

  15. The influence of ultraviolet blood irradiation and oxygenation on oxygen free radicals metabolism in rabbits with soman intoxication

    2006-01-01

    Objective: To investigate the effect of ultraviolet blood irradiation and oxygenation (UBIO) on the metabolism of oxygen free radicals in rabbits with acute soman intoxication. Methods: One hundred rabbits were randomly divided into 5 groups: normal control group, intoxication group, routine therapy group, UBIO therapy group and combined therapy group. After 14 d, the concentration of malondiadehyde (MDA) and activity of superoxide dismutase (SOD), glutathionperoxidase (GSH-Px), catalase (CAT)and total antioxidative capacity (T-AOC) in serum were determined respectively. Results: Compared with the normal control group, the concentration of MDA and activity of CAT in the intoxication group were significantly higher (P < 0. 05 ), but SOD, GSH-Px activity and T-AOC were significantly lower (P<0.05). After UBIO or combined therapy, serum MDA level was significantly lower in comparison with intoxication group (P<0.05), but the activity of SOD, GSH-Px, CAT and T AOC were higher than intoxication group(P<0.05). Conclusion: There is an obvious oxygen free radical injury in rabbits with acute soman intoxication. UBIO can improve the antioxidation ability of rabbits and may be applied to treat acute soman intoxication as adjunctive therapy.

  16. Hyperbaric oxygen therapy of encephalopathy tarda induced by CO intoxication%一氧化碳中毒迟发脑病的高压氧治疗

    杨金华; 王金春

    2003-01-01

    @@ INTRODUCTION Encephalopathy tarda of CO intoxication is the result of incomplete therapy or in- timely treatment of acut intermedium or severe CO intoxication leading to a series of nerve system injury.Due to long period of course,serious condition and unlcrear mechanism,therapy is difficult and poor effect.

  17. 辛伐他汀对急性百草枯中毒大鼠炎性细胞因子的影响%Effect of pretreatment with simvastatin on inflammatory factor in acute paraquat-intoxicated rats

    杨贤义; 刘梅; 朱艳霞; 张绪国; 陈立东; 谢华; 肖敏

    2012-01-01

    目的 观察辛伐他汀对急性百草枯中毒大鼠炎性细胞因子表达的影响,探讨他汀类药物对急性百草枯中毒大鼠全身炎症反应的抑制作用.方法 72只雌性SD大鼠随机分为对照组、中毒组和辛伐他汀组各24只.百草枯水剂按120mg/kg灌胃大鼠,建立大鼠急性百草枯中毒模型,辛伐他汀组在制备百草枯中毒模型前7d,以辛伐他汀20 mg/(kg·d)+生理盐水稀释后灌胃,对照组与中毒组均留置胃管并注射10 mL/(kg·d)生理盐水,连续7d,1次/d;于给药后6,24,72h采集血标本,采用ELISA法检测3组大鼠血清白细胞介素(interleukin,IL)-1β、IL-2和肿瘤坏死因子(tumor necrosis factor,TNF)-α水平.结果 中毒组给药后6,24 h时血清IL-1β水平明显高于对照组(P<0.05),给药后6h时血清IL-2水平明显高于对照组(P<0.05),给药后6,24,72 h时血清TNF-α水平高于对照组(P<0.05);辛伐他汀组给药后6,24,72 h时血清IL-1β及TNF-α水平明显低于中毒组(P<0.05),给药后6,72 h时血清IL-2水平明显低于中毒组(P<0.05).结论 辛伐他汀预处理可抑制急性百草枯中毒大鼠血清TNF-α、IL-1β和IL-2的释放,对急性百草枯中毒大鼠全身炎症反应有一定抑制作用.%Objective To approach the inhibition effect of statins on inflammatory response in acute paraquat intoxicated (PQ) rats by observing the influence of simvastatin on plasma inflammatory factors. Methods Seventy-two healthy SD rats were randomly divided into three groups: control group, PQ group and simvastatin group, with 24 rats in each group. The PQ model was established by gavage of paraquat 120 mg/kg in both groups. The simvastatin group was pretreated with simvastatin (20 mg/(kg o d)) a week before gavage, and PQ group and control group were given normal saline 10 mL/kg by gavage, once a day, for totally 7 days. The levels of interleukin-1 beta (IL-1β) , interleukin-2 (IL-2) and tumor necrosis factor-a (TNF-a) in serum were

  18. Unintentional baclofen intoxication in the management of alcohol use disorder.

    Reichmuth, Philipp; Blanc, Anne-Laure; Tagan, Damien

    2015-09-22

    In recent years, there has been a growing interest in using baclofen for the management of alcohol use disorder. This off-label indication usually involves high doses of the medication. We report a case of severe baclofen overdose in a 66-year-old man. The patient was found severely agitated, and he presented with delirium and auditory hallucinations. At hospital admission, his daily dose was 180 mg baclofen. He was admitted to the intensive care unit for sedation and supportive care. When sedation was withdrawn, the patient presented with a normal neurological status. In this clinical context, baclofen intoxication was suspected. This was confirmed by measuring blood baclofen levels. This intoxication was probably mediated by a combination of risk factors including a high daily dose of baclofen and acute renal failure, conducive to drug accumulation.

  19. MERCURY INTOXICATION IN GRASS CARP (CTENOPHARYNGODON IDELLA

    M. S. Khan, S. A. Khan, Z. I. Chaudhary, M. N. Khan,1 A. Aslam , K. Ashraf2, R. M. Ayyub and M. F. Rai.

    2004-01-01

    Full Text Available The present project was carried out to study the effects of acute and chronic mercury intoxication in Grass carp (Ctenopharyngodon idella. For acute phase experiment, 48 fish were divided into four equal groups (A, B, C and D. Groups B, C and D were given HgCl2 at sublethal dose as 0.4, 0.5 and 0.6 mg/L, respectively, while group A acted as control. Skin, gills and kidneys were isolated from the fish after 48 and 96 hours for pathological studies. For chronic phase, 72 fish were divided into five groups (E, F, G, H and I, containing 12 fish each except group E which contained 24 fish. Groups F, G, H and I were given HgCl2 at sublethal dose of 0.3 mg/L for 4, 8, 12 and 16 days, respectively, while group E acted as control. Skin, gills and kidneys were isolated from each group (F, G, H and I after 4, 8, 12 and 16 days respectively for pathological studies. During chronic phase in the treatment groups normal histology of epidermis was disturbed with increased number of immature cells. Overall, skin layers were atrophied and withered. Histopathology of gills showed hyperplasia of epithelial cells of gill filaments, fusion of secondary lamellae giving a club shaped appearance of filaments and contraction and sloughing of respiratory epithelium in groups F, G, H and I. Histopathological examination of kidneys also showed a wide range of toxicity lesions and destruction in treatment groups (F, G, H and I. Disintegration and disorganization of cells of both renal and haemopoitic systems including dilatation of capillaries and thickening of basal lumen were observed. Mild to sever tubular epithelial degeneration, karyolysis, dilation and shrinkage of Bowman’s capsule and glomerulus were also observed. In chronic phase experiment, fish showed clinical signs including restlessness, difficult breathing, fin flickering and jerky movements. Suppressed growth rate was also observed in treatment groups (F, G, H and I. During acute phase, after 48 hours, these

  20. 氟马西尼联合醒脑静注射液治疗急性苯二氮卓类中毒97例的疗效观察%The effect of flumazenil and Xingnaojing treatment of 97 cases acute Benzodiazepine class of sedative-hypnotic drugs intoxication

    曾剑; 肖小培; 周咏梅

    2011-01-01

    Objective To discuss the effect of flumazenil and Xingnaojing treatment of acute Benzodiazepine class of sedative-hypnotic drugs intoxication .Methods Patients were randomly divided into two groups, based on the combined treatment, group I were given flumazenil + Xingnaojing treatment; group II were given flumazenil treatment only. Results mild cases, group I and II consciousness recovery time in comparison has no difference (P >0. 05) ;in moderate and severe cases of group I and II were significantly difference(P <0. 01). Conclusion Flumazenil and Xingnaojing stability in the treatment of acute Benzodiazepine class of sedative-hypnotic drugs intoxication have synergistic effect ,and the effect than flumazenil only.%目的 讨论氟马西尼与醒脑静联合治疗急性安定中毒的疗效.方法 患者随机分成2组,在综合治疗的基础上Ⅰ组给予氟马西尼+醒脑静治疗;Ⅱ组给予氟马西尼治疗.结果 Ⅰ、Ⅱ组意识恢复时间在轻度患者中比较差异无统计学意义(P>0.05);在中、重度患者中.Ⅰ组与Ⅱ组比较有差异有统计学意义(P<0.01).结论 氟马西尼与醒脑静在治疗急性安定中毒时有协同作用,疗效优于单用氟马西尼.

  1. Fatal diquat intoxication

    Jović-Stošić Jasmina

    2009-01-01

    Full Text Available Background. Since the introduction of diquat in agriculture practice in 1960's, about 40 cases of poisoning have been described in detail in medical literature. Case report. We presented two cases. A case one, a 35-year-old, previously healthy, woman ingested 14% diquat solution. The poisoning had fulminant course, consisted of severe stomachache, vomiting, cardiocirculatory shock, respiratory failure and cardiac arrest 20 hours post-ingestion. Autopsy revealed myocardial infarction, bronchopneumonia and incipient renal damage. A case two, a 64-year-old man developed severe gastroenteritis, corrosive lesions of mucosal surfaces, acute renal injury, arrhythmias, brain stem infarction and bronchopneumonia. The diagnosis of diquat poisoning was made retrospectively upon the clinical picture and identification of pesticides he had been exposed to. The patient died 18 days post-exposure. The most prominent findings on autopsy were pontine hemorrhage and infarction, bronchopneumonia, left ventricle papillary muscle infarction and renal tubular damage. Conclusion. Cardiocirculatory disturbances led to fatal complications, the heart and brain infarction. We pointed out the heart as one of the most severely affected organs in diquat poisoning.

  2. Effect of Intensive Atropine Doses (Rapid Incremental Loading and Titration for Management of Organophosphorus Pesticide Poisoning: a Case Series

    Abu Saleh Ahmed

    2014-03-01

    Full Text Available Background:Acute poisoning with organophosphorus (OP pesticides is a common method of suicide and entails considerable mortality in Bangladesh. The objective of this study was to evaluate the effects and outcomes of a protocol for treatment of OP poisoning that included titrated incremental atropine as loading dose and slow infusion for maintenance.  Methods:In this prospective descriptive case series, definitive OP poisoned patients were enrolled in an adult medicine unit of Dhaka Medical College Hospital from April 2006 to April 2007. Clinical examinations were done as soon as the patient entered the ward. Patient’s demographics, comorbid conditions and the occurrence of specific clinical outcomes including death, need for assisted ventilation and clinical complications were recorded. The patients were treated according to the protocol. Results: A total of 56 patients were enrolled over the study period. The median age of the study population was 22.5 years. Most patients were men (67.8%. The most common clinical presentation was miosis (58.9%. In total, 11 patients died (19.6%. Intermediate syndrome developed in 12 patients (21.4% and 6 of them died. Assisted ventilation was required in 16 cases (28.5. Patients with diastolic blood pressure ≤ 70 mmHg and/or GCS ≤ 10 were significantly less likely to survive (P = 0.02, 0.006, respectively. Moreover, early respiratory failure (P < 0.001 and the need for assisted ventilation (P < 0.001 were significantly higher among deceased cases. The mortality rate in this study was similar to previous studies. The frequency of atropine toxicity in the present study (1.8% was considerably lower than conventional regimen used in previous studies. Conclusion:Using the new protocol, lower rate of atropine toxicity developed in victims. Hence, the new protocol appears to be safer and its effectiveness should be further evaluated in case control studies in Bangladesh.    How to cite this article: Ahmed AS

  3. Atropine sulfate for treatment of bradycardia in a patient with morbid obesity: what may happen when you least expect it.

    Carron, Michele; Veronese, Stefano

    2015-01-29

    A 74-year-old morbidly obese man was scheduled for surgical repair of an incisional ventral hernia. Anaesthesia was induced with propofol and fentanyl, and maintained with desflurane. A second dose of fentanyl 0.2 mg, given before starting surgery, resulted in sinus bradycardia and mild decrease of arterial blood pressure. Atropine sulfate 0.5 mg was administered. One minute later, the ECG rhythm on the monitor changed to third degree atrioventricular block with a ventricular response rate of 40 beats/min associated with marked hypotension. Isoproterenol 0.02 mg reverted the atrioventricular block to sinus rhythm. Cardiac enzymes and ECG ruled out acute myocardial ischaemia. The surgical procedure and the recovery from anaesthesia were uneventful. The patient was discharged from the hospital on the fifth postoperative day. For the treatment of bradycardia atropine sulfate should be adjusted at least to lean body weight in order to avoid paradoxical heart rate response in patients with obesity.

  4. Intoxicated eyewitnesses: Better than their reputation?

    Compo, Nadja Schreiber; Evans, Jacqueline R; Carol, Rolando N; Villalba, Daniella; Ham, Lindsay S; Garcia, Tracy; Rose, Stefan

    2012-04-01

    According to law enforcement, many witnesses are intoxicated either at the time of the crime, the interview, or both (Evans et al., Public Policy Law 15(3):194-221, 2009). However, no study to date has examined whether intoxicated witnesses' recall is different from sober witnesses' and whether they are more vulnerable to misinformation using an ecologically valid experimental design. Intoxicated, placebo, and sober witnesses observed a live, staged theft, overheard subsequent misinformation about the theft, and took part in an investigative interview. Participants generally believed they witnessed a real crime and experienced a real interview. Intoxicated witnesses were not different from placebo or sober witnesses in the number of accurate details, inaccurate details, or "don't know" answers reported. All the participants demonstrated a misinformation effect, but there were no differences between intoxication levels: Intoxicated participants were not more susceptible to misinformation than sober or placebo participants. Results are discussed in the light of their theoretical and applied relevance.

  5. Effects of hemoperfusion on toxic ingredients in plasma and histopathology in acute rabbits with acute intoxication of Radix Aconiti Kusmezoffii Monkshood%血液灌流对急性草乌中毒兔血浆毒性成分及组织病理学的影响

    邱俏檬; 刘刚; 卢中秋; 王志翊; 梁欢

    2009-01-01

    Objective To explore effects of hcmoperfusion on toxic ingredients in plasma of rabbiis with a-cute intoxication of Radix Aconiti Kusmezoffii Monkshood.Method Sixteen male Japanese Giant Ear Rabbits were randomly divided into acute poisoning(AP)group and acute poisoning + hemoperfusion(AH)group(8 an-hnals in each group).Acute poisoning models were established in rabbits of both groups with intragastric adminis-tration of Radix Aconiti Kusmezoffii Monkshood liquid in dose of 1 mL/kg in order to produce arrhythm which oc-curred within ode hour after intragastric administration was regarded as the criteria of successful animal model.and then hemoperfusion with active carbon was performed for 2 hours in AH group.The pathological chanses of brain,myocardium and hepatic tissues were observed.The plasma concentrations of toxicants including mesaconitine,a-conitine and hypaconitine were measured by using HPLC-MS at 1 h,2 h,3 h,and 6 h after poisoning.Student's T test was used to identify the significance.Results The brain.myocardium and hepatic tissues of the rabbits in AP group showed hyperemia and edema which were attenuated after hemoperfusion.The plasma concentrations of mesaconitine,aconitine and hypaconitine revealed no significant differences between AP group and AH group with-in one hour after poisoning(P>0.05),while at 2 h and 3 h after poisoning,the plasma concentrations of mesaconitine were(2.11±1.08)ng/mL,(2.02±1.46)ng/mL,respectively,aconitine(39.70±9.31)ng/mL,(19.71±16.06)ng/mL,respectively,and hypaconitine(1.70±0.71)ng/mL,(2.12±1.33)ng/mL,respec-fively in AH group,and they were significantly lower than those in AP group(P<0.05).Conclusions The the plasma concentrations of mesaconitine,aconitine and hypaconitine were lower and the histopathological changes were attenuated after hemoperfusion.Hemoperfusion is a good intervention for acute intoxication of Radix Aconiti Kusmezoffii Monkshood.%目的 探讨血液灌流对急性草乌中毒兔血浆毒

  6. Gamma-hydroxybutyrate and cocaine intoxication in a Danish child

    de Knegt, Victoria Elizabeth; Breindahl, Torben; Harboe, Kirstine Moll

    2016-01-01

    GHB intoxication must be considered in children with coma and a suspicion of drug intoxication. Furthermore, mixed intoxication with several substances and the possibility of unpredictable symptom profiles should be anticipated to ensure optimal symptomatic treatment of patients....

  7. Effect of acid secretion blockade on acute gastric mucosal lesions induced by Tityus serrulatus scorpion toxin in anaesthetized rats.

    Melo, Júnio Rios; de Araújo, Gnana Keith Marques; da Luz, Magda Maria Profeta; da Conceição, Sérgio Alexandre; Lisboa, Felipe Assis; Moraes-Santos, Tasso; Cunha-Melo, José Renan

    2006-10-01

    Scorpion venom (TX) promotes gastric acid and pepsin secretion leading to acute gastric mucosal lesions (AGML), when injected in animals. The goal of the present study was to observe the effects of acid gastric secretion blockers over the incidence of TX-induced AGML in vivo. To verify this model, we used male albino rats, fasted 18-20 h (n=122) and anaesthetized with urethane (1.4 g/kg, i.p.). Their trachea and left femoral vein were both cannulated; the first to avoid airway obstructions during scorpion intoxication and the second for administration of saline, TX and acid blockers. Following the surgical procedure, the animals were divided in 10 groups of at least 10 animals each. Control groups were injected with NaCl 0.9% 1 ml/kg (n=10) or TX 375 microg/kg (n=32). Test groups (n=10, each) received atropine 5 mg/kg, cimetidine 10mg/kg, ranitidine 2.5mg/kg, ranitidine 5mg/kg, omeprazol 1 mg/kg, omeprazol 4 mg/kg, octreotide 80 and octreotide 100 microg/kg 10 min before the TX was injected. After 1h of intoxication, the stomach was resected for macroscopic study and the gastric secretion was collected for volume, pH and acid output assessment. We observed that all blockers were able to completely or partially prevent the TX-induced acid secretion as well as the AGML (p<0.05). Our data suggest the TX-induced AGML can be prevented by different class of acid blockers injected before the intoxication.

  8. Effects of Alcohol Intoxication on Anger Experience and Expression among Partner Assaultive Men

    Eckhardt, Christopher I.

    2007-01-01

    The author investigated the acute effects of alcohol intoxication on anger experience and expression among 46 maritally violent (MV) and 56 maritally nonviolent (NV) men randomly assigned to receive alcohol, placebo, or no alcohol. Participants completed an anger-arousing articulated thoughts in simulated situations (ATSS) paradigm and imagined…

  9. Synthetic legal intoxicating drugs: the emerging 'incense' and 'bath salt' phenomenon.

    Jerry, Jason; Collins, Gregory; Streem, David

    2012-04-01

    Synthetic legal intoxicating drugs (SLIDs), such as those commonly contained in products sold over the counter as "bath salts" and "incense," have risen tremendously in popularity in the past few years. These drugs can have powerful adverse effects, including acute psychosis with delusions, hallucinations, and potentially dangerous, bizarre behavior.

  10. AMPA receptor potentiation can prevent ethanol-induced intoxication.

    Jones, Nicholas; Messenger, Marcus J; O'Neill, Michael J; Oldershaw, Anna; Gilmour, Gary; Simmons, Rosa M A; Iyengar, Smriti; Libri, Vincenzo; Tricklebank, Mark; Williams, Steve C R

    2008-06-01

    We present a substantial series of behavioral and imaging experiments, which demonstrate, for the first time, that increasing AMPA receptor-mediated neurotransmission via administration of potent and selective biarylsulfonamide AMPA potentiators LY404187 and LY451395 reverses the central effects of an acutely intoxicating dose of ethanol in the rat. Using pharmacological magnetic resonance imaging (phMRI), we observed that LY404187 attenuated ethanol-induced reductions in blood oxygenation level dependent (BOLD) in the anesthetized rat brain. A similar attenuation was apparent when measuring local cerebral glucose utilization (LCGU) via C14-2-deoxyglucose autoradiography in freely moving conscious rats. Both LY404187 and LY451395 significantly and dose-dependently reversed ethanol-induced deficits in both motor coordination and disruptions in an operant task where animals were trained to press a lever for food reward. Both prophylactic and acute intervention treatment with LY404187 reversed ethanol-induced deficits in motor coordination. Given that LY451395 and related AMPA receptor potentiators/ampakines are tolerated in both healthy volunteers and elderly patients, these data suggest that such compounds may form a potential management strategy for acute alcohol intoxication.

  11. WILD HONEY INTOXICATION: CASE REPORT

    Munire Babayigit

    2013-09-01

    Full Text Available Wild honey intoxication (WHI is a rare disease that results from consuming honey produced by Rhododendron polen feeded bees. WHI develops due to grayanotoxin (GT that it contains. WHI might present with mild symptoms of gastrointestinal, cardiovascular and neurological systems or might also present in a life threatining form with AV block and cardiovascular collaps. In this report we aimed to present clinical presentation and treatment of a case of WHI. [J Contemp Med 2013; 3(3.000: 197-199

  12. Intoxication in cattle from Cestrum diurnum.

    Durand, R; Figueredo, J M; Mendoza, E

    1999-02-01

    Twenty-six Holstein calves with clinical and pathological effects suggesting a toxic plant intoxication were studied. A view of the plants in the region and blood examination (hemogram, albumin, total protein, calcium and phosphorus) and determination of bone calcium were done. Five calves were slaughtered and pathological examinations were performed. Observed metabolic, pathological and clinical alterations were compatible with intoxication from Cestrum diurnum.

  13. Split-dose atropine versus glycopyrrolate with neostigmine for reversal of gallamine-induced neuromuscular blockade

    Wetterslev, J; Jarnvig, I; Jørgensen, L N

    1991-01-01

    The effects of a split-dose of atropine sulphate versus a single dose of glycopyrrolate given with neostigmine for the reversal of gallamine-induced neuromuscular blockade were studied in 55 patients undergoing gynaecological surgery. The patients were randomized to receive either a single dose...... of glycopyrrolate (7 micrograms.kg-1) or two doses of atropine (8 micrograms.kg-1 each), given with an interval of 1 min. There were no differences between the two methods with respect to percentage heart rate changes, salivation or arousal time. Four patients demonstrated cardiac arhythmias in the atropine group......, whereas none occurred in the glycopyrrolate group (P less than 0.05). It is concluded that a split-dose of atropine has similar chronotropic effects to a single dose of glycopyrrolate for the reversal of gallamine-induced neuromuscular blockade. However, the finding of a higher incidence of cardiac...

  14. Anticonvulsants for Nerve Agent-Induced Seizures: The Influence of the Therapeutic Dose of Atropine

    2007-01-01

    Organophosphorous nerve agents-induced cological Basis of Therapeutics, 10th ed. (Hardman JG, Limbird LE, and ( Gilman seizures and efficacy of atropine...us.army.mil Taylor P (2001) Anticholinesterase agents, in Goodman and Gilman’s The Pharrna-

  15. Neonatal mydriasis due to effects of atropine used for maternal Tik-20 poisoning.

    Shah A

    1995-01-01

    Full Text Available A neonate was born to a mother who had consumed an organophosphorus(OPC compound with suicidal intent. The mother was administered atropine and this caused mydriasis in the neonate without any other pharmacological effects. There was no evidence of placental dysfunction. There are no case reports of OPC consumed in pregnancy and its effect on neonates or of effects of massive doses of atropine in the mother and its effects on the fetus or the newborn.

  16. [Intoxication with Monkshood (Aconitum napellus)].

    Tuinema, Rinske M; Uijlings, Ruben; Dijkman, Marieke A; van den Broek, Marcel P H; de Lange, Dylan W

    2009-01-01

    Three patients presented with an intoxication caused by Aconitum napellus, commonly known as Aconite, Monkshood or Wolfsbane. The first patient, a woman aged 24, was resuscitated after accidental ingestion of plant material 'from nature'. She experienced severe ventricular tachyarrhythmias. After discharge she returned with identical symptoms, which were now interpreted as intentional intoxication in a suicide attempt. She was referred to the Psychiatry department. The second patient was a 2-year-old boy who had cutaneous exposure to Aconite. Except for some red spots around his mouth there were no other symptoms. The third patient was a 34-year-old woman who ate Monkshood, which she mistook for parsley. Alarmed by the bitter taste she contacted the hospital. She was treated with stomach lavage which removed most of the ingested plant material, and with activated charcoal. She had no symptoms during observation in the hospital. Aconite alkaloids are known to cause ventricular arrhythmia by a prolonged activation of sodium channels. Because there is no antidote, treatment is largely supportive but serious arrhythmias and respiratory arrest need to be anticipated.

  17. 阿托品不同给药方式治疗有机磷中毒的疗效分析%Comparison of Different Methods of Administering Atropine in the Treatment of Organophosphate Poisoning

    李志; 何伟峰; 邹海军

    2012-01-01

    目的:探讨临床救治有机磷中毒的患者使用阿托品时采用不同给药方式的疗效差异.方法:将我院在2007年6月~2010年10月收治的101例急性有机磷中毒的患者随机分为三组,I组患者给予阿托品人工静脉推注;II组患者先给予阿托品人工静脉推注,患者达到阿托品化后采用微量泵给药;III组患者直接使用用微量泵给药,比较三组患者的疗效和并发症.结果:II组患者和III组患者的疗效优于I组患者,并发症低于I组患者,p<0.05;III组患者阿托品化时间最长,与I组和II组比较,p<0.05.结论:采用阿托品人工静脉推注,待患者阿托品化再给予微量泵给药,其疗效较好,不良反应少,患者阿托品化更稳定,值得在临床推广使用.%Objective:Clinical treatment of patients with organophosphate poisoning atropine administered in different ways when the difference in efficacy.Methods:In our hospital in June 2007~October 2010 treated 101 cases of acute organophosphate poisoning were randomly divided into three groups, I group were treated with intravenous injection of atropine and artificial; Ⅱ patients are atropine artificial intravenous injection, the patient achieved using micro-pump after atropine administration; Ⅲ patients directly with micro-pump delivery, three groups of patients compared the efficacy and complications.Results:Group Ⅱ and Ⅲ patients were more effective than group I patients, complications than group I patients, p <0.05; Ⅲ longest of atropine in patients with Group Ⅰ and Ⅱ group, p <0.05. Conclusion:The use of artificial intravenous injection of atropine, atropine and then be given to patients with micro-pump delivery, the better effect, adverse reactions, patients with atropine is more stable, it is in clinical use.

  18. Preparation and Evaluation of Veterinary 0.1% Injectable Solution of Atropine Sulphate

    F K Mohammad

    2012-06-01

    Full Text Available This study introduces the know-how of preparing a multiple injection form atropine sulphate solution. An injectable aqueous solution of atropine sulphate at a concentration of 0.1%. was prepared under aseptic conditions in dark glass bottles each containing 50 ml. The preparation was intended for animal use only. It contained 1g atropine sulphate, 9 g sodium chloride as a normal saline, benzyl alcohol 15 ml as a preservative and water for injection up to 1000 ml. The pH of the solution was adjusted to 4.2 (range 3.0-6.5. The preparation of 0.1% atropine sulphate solution was clear colorless solution free from undesired particles. It complied with the requirements for injectable solutions. Further, the preparation was safe when used under laboratory conditions in chicks, rats and donkeys. It was also effective in preventing dichlorvos (an organophosphate insecticide-induced poisoning in chicks in a manner comparable to a commercial preparation of 0.1% atropine sulphate. In conclusion, the know-how of a preparation of 0.1% atropine sulphate solution is presented for veterinary use. [Vet. World 2012; 5(3.000: 145-149

  19. [Myocardial damage and paroxysmal ventricular tachycardia in a dog after Albuterol intoxication].

    Matos, J; Jenni, S; Fischer, N; Bienz, H; Glaus, T

    2012-07-01

    Intoxication with the beta2-agonist Albuterol may lead to immediate signs of beta-adrenergic stimulation like excitation, tachypnea and tachycardia. Furthermore, it typically causes severe hypokalemia, which then leads to muscle weakness and which predisposes to ventricular arrhythmias. We describe a dog where albuterol intoxication caused runs of fast paroxysmal ventricular tachycardia that persisted after normalization of the hypokalemia. Based on a markedly elevated serum troponin I level acute myocardial damage was identified as cause of the tachyarrhythmia. Repeated Troponin I measurements and Holter-ECGs were the means to document complete cure.

  20. Stress echocardiography in warmblood horses: comparison of dobutamine/atropine with treadmill exercise as cardiac stressors.

    Gehlen, Heidrun; Marnette, Silke; Rohn, Karl; Stadler, Peter

    2006-01-01

    The purpose of this study was to determine whether the combination of dobutamine and atropine causes cardiac stress equivalent to treadmill exercise. Therefore, electrocardiography and echocardiography were performed on 10 warmblood horses before, during, and after different cardiac stress tests. Stressors consisted of a standardized treadmill exercise and combined administration of dobutamine (7.5 microg/kg/min) and atropine (5 microg/kg). Maxima heart rates were achieved during the treadmill exercise (175 +/- 10 bpm). After exercise, a rapid decrease in heart rate was observed. Subsequently, a stress echocardiography for which a heart rate >100 bpm was required could only be performed within 1 minute after exercise. The mean heart rate during echocardiography was 136 +/- 8 bpm after exercise. The combination of dobutamine and atropine also resulted in a significant increase in heart rate, up to 141 +/- 20 bpm. Maxima heart rate was significantly higher during the treadmill exercise, but the decrease in heart rate was significantly slower after dobutamine and atropine administration. Over a period of 7.9 minutes, the mean heart rate was 123 +/- 8 bpm during dobutamine and atropine administration. Consequently, the combination of both drugs offered sufficient time for detailed examinations. Overall, echocardiographic examination identified a decrease in left ventricular (LV) dimensions, an increase in LV wall thickness, and a decrease in stroke volume after the treadmill exercise and during pharmacologic stress testing compared with baseline. Changes in echocardiographic variables generally were more pronounced during dobutamine and atropine administration. Similar to stress echocardiography in humans, in horses the combination of dobutamine and atropine is useful to produce an increase in heart rate comparable with what is achieved with exercise but without the need of increasing dobutamine dosage.

  1. Intoxicação aguda por nitrogênio através de inalação em paciente com insuficiência respiratória e coma: relato de caso Acute nitrogen intoxication by patient inhalation with breathing insufficiency and coma: case report

    Pedro Henrique Masjuan Torrecillas

    2006-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Apresentação de um caso único não encontrado na literatura nacional. O objetivo deste relato foi apresentar um caso de grave intoxicação por nitrogênio líquido (NO, com edema agudo de pulmão e encefalopatia isquêmica, em que se obteve bom desfecho, provavelmente, pela rapidez no atendimento e na administração adequada da terapêutica. RELATO DO CASO: Paciente do sexo masculino, 26 anos, encontrado desacordado havia aproximadamente uma hora, em sala fechada onde havia uma máquina utilizada para manutenção do gelo de pista de patinação. Constatou-se aspiração de conteúdo gástrico e edema das vias respiratórias altas. A intubação na emergência foi difícil pelo intenso edema de laringe. O paciente desenvolveu edema agudo de pulmão e sinais de edema encefálico por encefalopatia anóxica. Evoluiu com melhora pulmonar lenta com ventilação protetora para síndrome da angústia respiratória aguda (volume corrente de 5 mL/kg, PEEP de 15 cmH2O e corticoterapia com hidrocortisona (200 mg a cada seis horas para tratamento de broncoespasmo. CONCLUSÕES: Trata-se do primeiro caso publicado em nosso meio de intoxicação por nitrogênio. Na literatura internacional encontram-se várias citações de situações semelhantes ao deste caso pelo fato de existir varias pistas de gelo para prática de esportes como por exemplo o hockey. Há relatos de exacerbações de quadros de broncoespasmo nas pessoas que assistem ao jogo, apresentando-se de forma tardia, por vezes até sete a dez horas após a exposição aos vapores que exalam destas pistas que são ricas em nitrogênio.BACKGROUND AND OBJECTIVES: To present the first case reported in the Brazilian literature of liquid nitrogen intoxication. The objective of this report was to present a case of severe intoxication by liquid nitrogen, with acute lung edema and ischemic encephalopathy, which a good outcome, due to a fast diligence and a proper therapy

  2. New Drugs for Pretreatment of Organophosphonate Intoxication

    1990-02-20

    COPY A D L£> SRI PROJECT PYU-4681 NEW DRUGS FOR PRETREATMENT OF ORGANOPHOSPHONATE INTOXICATION FINAL REPORT AD-B145 250 Daniel W. Parish, Allen...BB WORK UNIT ACCESSION NO. 099 11. TITLE (indud* Security Oaofficattofl) New Drugs for Pretreatment of Organophosphonate Intoxication...undertaken for the U.S. Army Medical Research and Development Command (MRDC) under Contract DAMD17-88-C-8001, " New Drugs for Pretreatment of

  3. The Effect of Atropine on Post-ECT Bradycardia in Patients with Major Depressive Disorder

    Hassan Farashbandi

    2014-08-01

    Full Text Available Background: Electroconvulsive therapy (ECT is utilized for treatment of a range of psychiatric disorders including major depressive disorder (MDD. One of the major complications in using ECT is cardiovascular problems i.e., bradycardia. The present study was designed to investigate the effect of atropine on the pulse rate (PR of the patients under treatment with ECT. Materials and Methods: In this randomized clinical trial, 30 patients with diagnosis of MDD who received atropine before ECT treatment (control group were compared with 30 patients with the same diagnosis without receiving atropine (experimental group under ECT treatment. Both groups received ECT under the same term and condition. The PR of the patients were recorded 7 times (twice before anesthesia and ECT and 5 fixed one min intervals immediately after receiving ECT; for 10 sessions of treatment with ECT (3 times a week. The results were analyzed using repeated measure analysis of variance. The PR under 50 was the cut off point for differentiating the patients suffering from bradycardia and those without it. Results: Slight increment in PRs for experimental group (patient who did not receive atropine in contrast to control group were observed, but it did not reach a statistically significant level. The gender (male/female did not have different PR. The age of the patients and initial PR (regarded as co-variances did not show significant effect on PR for total sample. Conclusion: There seems to be not necessary to use atropine treatment for depressed patients receiving ECT.

  4. Construction and analytical application of ion-selective piezoelectric sensor for atropine sulfate.

    Long, Y; Lei, L; Li, W; He, D; Nie, L; Yao, S

    1999-11-01

    The method describes the use of a piezoelectric quartz crystal (PQC) as a substitute for ion-selective electrodes. The approach is feasible when the membrane materials are electrically non-conductive and membrane potential measurements are consequently not possible. An ion-selective piezoelectric sensor sensitive to atropine sulfate was constructed by coating a PVC membrane containing activant on one the side of a PQC. On the basis of selective adsorption of atropine ions across the modified film and the sensitive mass response of PQC, the method exhibits a sensitive, rapid response and is easy to operate without pretreatment of the sample. The logarithm of the frequency shift gave a linear relationship with the logarithm of atropine sulfate concentration in the 1.0 x 10(-8)-1.0 x 10(-3) M range with a detection limit of 5.0 x 10(-9) M at pH 7.0. Recoveries were from 98.7-102.2%. Two activants, atropine tetraphenylborate and atropine dipicrylaminate, were synthesized and investigated. Influencing factors were also examined and optimized. The results for real samples obtained by the proposed method agreed with those obtained by conventional methods.

  5. Dan Nang Xue blockade with Innovar and Atropine to prevent internal organpull response

    Yu Chuan Liu; Qi Sheng Liang; Yun Chun Zhang; Xue Wu Ling

    2000-01-01

    AIM To observe the effects of Innovar and Atropine on Visceral pull response.METHODS Patients were randomly divided into two groups. The experimental group was treated by DanNang Xue blockade with Innovar 4 mL and Atropine 0.5 mg (n = 40) and the control group was treated byabdominal vagus blockade with 10 mL of 10 g/L Lidocaine (n = 40). Dan Nang Xue was chosen for insertionof No 5 needle (5 cm in length) after local sterilization. The acupoint of Dan Nang Xue is located at theoutside of knee-jont and it is one-finger wider below Yanglingquan can be found. A sensitive point. Theneedle was inserted between tibia and fibulae, lifted, thrusted and twirled until the patient felt ache. Innovarand Atropine were injected on Dan Nang Xue and the acupoint was gently messaged.RESULTS Patients in the experimental group remained quiet during operation. Neither nausea or vomitingnor uncomfortable reaction was complained, 85% of the patients belonged to grade m. Acupunctureenhanced the peristalsis of gallbladder and biliary secretions. Atropine relieved muscular spasm andprevented vomiting. A low heart rate was noted in the control during abdominal survey and gallbladder pull(P<0.05).CONCLUSION Dan Nang Xue blockade with innovar and atropine can prevent visceral pull response.

  6. Characterization of a Mouse Model of Oral Potassium Cyanide Intoxication.

    Sabourin, Patrick J; Kobs, Christina L; Gibbs, Seth T; Hong, Peter; Matthews, Claire M; Patton, Kristen M; Sabourin, Carol L; Wakayama, Edgar J

    2016-09-01

    Potassium cyanide (KCN) is an inhibitor of cytochrome C oxidase causing rapid death due to hypoxia. A well-characterized model of oral KCN intoxication is needed to test new therapeutics under the Food and Drug Administration Animal Rule. Clinical signs, plasma pH and lactate concentrations, biomarkers, histopathology, and cyanide and thiocyanate toxicokinetics were used to characterize the pathology of KCN intoxication in adult and juvenile mice. The acute oral LD50s were determined to be 11.8, 11.0, 10.9, and 9.9 mg/kg in water for adult male, adult female, juvenile male, and juvenile female mice, respectively. The time to death was rapid and dose dependent; juvenile mice had a shorter mean time to death. Juvenile mice displayed a more rapid onset and higher incidence of seizures. The time to observance of respiratory signs and prostration was rapid, but mice surviving beyond 2 hours generally recovered fully within 8 hours. At doses up to the LD50, there were no gross necropsy or microscopic findings clearly attributed to administration of KCN in juvenile or adult CD-1 mice from 24 hours to 28 days post-KCN challenge. Toxicokinetic analysis indicated rapid uptake, metabolism, and clearance of plasma cyanide. Potassium cyanide caused a rapid, dose-related decrease in blood pH and increase in serum lactate concentration. An increase in fatty acid-binding protein 3 was observed at 11.5 mg/kg KCN in adult but not in juvenile mice. These studies provide a characterization of KCN intoxication in adult and juvenile mice that can be used to screen or conduct preclinical efficacy studies of potential countermeasures.

  7. Atropine-sensitive, tetrodotoxin-resistant contraction induced by noradrenaline in isolated cat rectum.

    Neya,Toshiaki

    1985-02-01

    Full Text Available Effects of noradrenaline (NA on the isolated rectal circular muscle of the cats were studied in comparison with the effects on the internal anal sphincter (IAS. NA (10(-8-10(-7 g/ml caused tonic contraction in four of 15 strips of the rectum taken from 15 animals, and in all 15 strips of the IAS. Phenylephrine also induced rectal and IAS contraction. Rectal contraction induced by NA was resistant to phentolamine, yohimbine, propranolol, hexamethonium and tetrodotoxin, but blocked by atropine. IAS contraction induced by NA was resistant to propranolol, atropine, hexamethonium and tetrodotoxin, but blocked by phentolamine and yohimbine. It is suggested that an atropine-sensitive excitatory adrenergic mechanism other than the excitatory alpha-adrenergic mechanism exists in the rectal circular muscle.

  8. Histamine, histamine intoxication and intolerance.

    Kovacova-Hanuskova, E; Buday, T; Gavliakova, S; Plevkova, J

    2015-01-01

    Excessive accumulation of histamine in the body leads to miscellaneous symptoms mediated by its bond to corresponding receptors (H1-H4). Increased concentration of histamine in blood can occur in healthy individuals after ingestion of foods with high contents of histamine, leading to histamine intoxication. In individuals with histamine intolerance (HIT) ingestion of food with normal contents of histamine causes histamine-mediated symptoms. HIT is a pathological process, in which the enzymatic activity of histamine-degrading enzymes is decreased or inhibited and they are insufficient to inactivate histamine from food and to prevent its passage to blood-stream. Diagnosis of HIT is difficult. Multi-faced, non-specific clinical symptoms provoked by certain kinds of foods, beverages and drugs are often attributed to different diseases, such as allergy and food intolerance, mastocytosis, psychosomatic diseases, anorexia nervosa or adverse drug reactions. Correct diagnosis of HIT followed by therapy based on histamine-free diet and supplementation of diamine oxidase can improve patient's quality of life.

  9. Profound Hypoglycemia with Ecstasy Intoxication

    Perliveh Carrera

    2015-01-01

    Full Text Available Background. 3,4-Methylenedioxymethamphetamine (MDMA or ecstasy is a synthetic drug that is commonly abused for its stimulant and euphoric effects. Adverse MDMA effects include hyperthermia, psychomotor agitation, hemodynamic compromise, renal failure, hyponatremia, and coma. However, endogenous hyperinsulinemia with severe persistent hypoglycemia has not been reported with MDMA use. Case Report. We report the case of a 29-year-old woman who remained severely hypoglycemic requiring continuous intravenous infusion of high-dose dextrose solutions for more than 24 hours after MDMA intoxication. Serum insulin and C-peptide levels confirmed marked endogenous hyperinsulinemia as the cause of the severe hypoglycemia. Why Should an Emergency Physician Be Aware of This? Immediate and frequent monitoring of blood glucose should be instituted in patients presenting with MDMA ingestion particularly if found to be initially hypoglycemic. Early recognition can help prevent the deleterious effects of untreated hypoglycemia that can add to the morbidity from MDMA use. Clinicians need to be aware of this side effect of MDMA so they can carefully monitor and treat it, especially in patients presenting with altered mental status.

  10. Comparative study of oral and intramuscular atropine sulphate as a premedicant in paediatric age group.

    Chaudhari L

    1989-01-01

    Full Text Available The use of atropine sulphate in the paediatric age group as a premedicant orally in a dosage of 0.02 mg/kg body weight 70 minutes prior to surgery was found to be as effective as atropine sulphate given intramuscularly 35 minutes prior to surgery in a dosage of 0.01 mg/kg body weight. This avoids the unpleasant memory of needle prick; The duration of effect as studied in the normal healthy children not subjected to surgery was found to be 2 1/2-3 hours.

  11. Determination of atropine using Mn-doped ZnS quantum dots as novel luminescent sensitizers

    Azizi, Seyed Naser [Analytical Division, Faculty of Chemistry, University of Mazandaran, Babolsar 4741695447 (Iran, Islamic Republic of); Chaichi, Mohammad Javad, E-mail: jchaichi@yahoo.com [Analytical Division, Faculty of Chemistry, University of Mazandaran, Babolsar 4741695447 (Iran, Islamic Republic of); Shakeri, Parmis [Analytical Division, Faculty of Chemistry, University of Mazandaran, Babolsar 4741695447 (Iran, Islamic Republic of); Bekhradnia, Ahmadreza [Pharmaceutical Sciences Research Center, Department of Medicinal Chemistry, Mazandaran University of Medical Sciences, Sari (Iran, Islamic Republic of)

    2013-12-15

    A novel chemiluminescence (CL) method using water-soluble Mn-doped ZnS quantum dots (QDs) as sensitizers is proposed for the chemiluminometric determination of atropine in pharmaceutical formulation. Water-soluble Mn-doped ZnS QDs were synthesized by using L-cysteine as stabilizer in aqueous solutions. The nanoparticles were structurally and optically characterized by X-ray powder diffraction (XRD), dynamic light scattering (DLS), Fourier transform infrared spectroscopy (FTIR), UV–vis absorption spectroscopy and photoluminescence (PL) emission spectroscopy. It was found that ZnS quantum dots acted as enhancers of the weak CL emission produced upon oxidation of sulfite by Ce(IV) in acidic medium. Trace amounts of atropine improved the sensitize effect of ZnS quantum dots yielding a significant chemiluminescence enhancement of the Ce(IV)–SO{sub 3}{sup 2−}–ZnS QD system. Therefore, a new CL analysis system was developed for the determination of atropine. Under the optimum conditions, there is a good linear relationship between the relative chemiluminescence intensity and the concentration of atropine in the range of 1×10{sup −9}–1×10{sup −6} M of atropine with a correlation coefficient (R{sup 2}) of 0.9992. The limit of detection of this system was found to be 2.54×10{sup −10} M. This method is not only simple, sensitive and low cost, but also reliable for practical applications. -- Highlights: • Mn-doped ZnS quantum dots could enhance the chemiluminescence (CL) of cerium(IV)–sodium sulfite system. • ZnS quantum dots were used as the nanocatalyst. • Trace amounts of atropine improved the sensitize effect of ZnS quantum dots. • This work is introduced as a new method for the determination of atropine commercial drugs. • Detection limit of atropine was obtained 2.54×10{sup −10} mol L{sup −1}.

  12. Efficacy of atropine combined with paroxetine in vagus nerve excitatory panic disorder

    Du N

    2015-07-01

    Full Text Available Na Du, Xue-Li Sun Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, People’s Republic of China Abstract: Panic disorder is often associated with the autonomic nervous system pattern – sympathetic activation and parasympathetic (vagal withdrawal. However, we present one special case here to show a totally reversed pathogenesis – vagal activation occupying the leading role, which requires atropine to cure the patient’s symptoms. Through this report, it is reasonably proven that panic disorder may be a heterogeneous condition, whose mechanism might be the imbalance between the sympathetic and parasympathetic tone. Keywords: panic disorder, vagal activation, bradycardia, atropine

  13. Combined approach to demonstrate acetylcholinesterase activity changes in the rat brain following tabun intoxication and its treatment.

    Bajgar, Jiri; Hajek, Petr; Kassa, Jiri; Slizova, Dasa; Krs, Otakar; Karasova, Jana Zdarova; Fusek, Josef; Capek, Lukas; Voicu, Victor A

    2012-01-01

    Reactivation effects of K203 and currently available oximes (obidoxime, HI-6) in combination with atropine on acetylcholinesterase activities in the brain parts of rats poisoned with tabun were studied. The activity was determined by quantitative histochemical and biochemical methods correlating between them very well. The tabun-induced changes in acetylcholinsterase activity as well as in reactivation potency of reactivators used were different in various parts of the brain. Pontomedullar area seems to be important for observed changes following tabun intoxication and its treatment. From the oximes studied, the reactivation effect of K203 was comparable with obidoxime; HI-6 was ineffective. Combination of bio- and histochemical methods allow fine differentiation among the action of different oximes following tabun poisoning.

  14. [Severe hydrogen sulfide intoxication: a pediatric case of survival].

    Claudet, I; Marcoux, M-O; Karsenty, C; Rittié, J-L; Honorat, R; Lelong-Tissier, M-C

    2012-03-01

    We report a paediatric case of survival following severe hydrogen sulfide (H2S) gas intoxication. A 13-year-old boy was found submerged to the neck in a manure tank. He was hypothermic, unresponsive with bilateral mydriasis, and had poor oxygen saturation. After intubation, he was transferred to the paediatric intensive care unit of a tertiary care children's hospital. He developed acute respiratory distress syndrome (ARDS) requiring high frequency percussive ventilation. Cardiac evaluation was significant for myocardial infarction and left ventricular function impairment. He completely recovered from the respiratory and cardiac failure. Neurological examinations showed abnormal signals on MRI in the semi-oval center and in the frontal cortex. Follow-up detected partial impairment of axonal fibers of the right external popliteal sciatic nerve. Paediatric cases of survival after H2S intoxication have been rarely reported. Such exposures can evolve to severe ARDS and benefit from high frequency percussive ventilation. Hypothermia and other metabolic abnormalities are now better explained thanks to actual knowledge about endogenous H2S function. Lessons learned from paediatric accidents should result in better information about this threat for farmers and families living in houses with septic tanks, reducing the risk to their own and their children's safety.

  15. Evaluation of Suicide and Intoxication Cases Admitted to our Newly Opened Intensive Care Unit

    Nalan Muhammedoğlu

    2014-09-01

    Full Text Available Aim: The aim of this study was to evaluate the suicide and intoxication cases between April 2011 and April 2013. Methods: We retrospectively analyzed hospital records of patients who were admitted to our intensive care unit due to suicide and intoxication. The age, sex, intoxication causes, laboratory analyses, treatment refusal rates, and the prognosis were evaluated. Results: A total of 308 patients (105 males, 203 females were admitted to the intensive care unit. The mean age of the patients was 27.45±10.26 years (males: 28.70±9.86 years, females: 26.80±10.43 years. There were only 4 patients over 65 years of age. 275 patients had drug intoxication (antidepressant drug, pain killer, antibiotic, etc. and 33 patients had other causes of intoxication. When analyzing the prognosis; a total of 234 patients were discharged after initial treatment and 57 patients were discharged due to treatment refusal. 15 patients were referred for inpatient psychiatric treatment, 1 patient to the Alcohol and Drug Addiction Treatment Center (AMATEM and 1 patient was referred to İstanbul University Medical Faculty due to acute hepatic failure. Conclusion: The patients admitted to our intensive care unit due to suicide and intoxications were mainly females (65.9% and individuals of young age (median age: 27.45 years. Female patients had used antidepressants for suicide attempts and males had used antiflu-acetaminophen combinations. No mortality was observed. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52:153-7

  16. Fatal alcohol intoxication in women: A forensic autopsy study from Slovakia

    Straka Lubomir

    2011-12-01

    Full Text Available Abstract Background Plenty of information related to alcoholism can be found in the literature, however, the studies have mostly dealt with the predominance of male alcoholism and data related to addiction in women are desperately scarce and difficult to find. Basic demographic data focusing on the impact of acute alcohol intoxication on the circumstances of death and social behaviour in the alcohol addicted female population are needed especially in the prevention of alcohol related mortality. Methods A retrospective forensic autopsy study of all accidental deaths due to alcohol intoxication over a 12-year period was performed in order to evaluate the locations, circumstances, mechanisms and causes of death. Results A sample of 171 cases of intoxicated women who died due to blood alcohol concentration (BAC equal to or higher than 2 g/kg was selected. Among them 36.26% (62/171 of women died due to acute alcohol intoxication (AAI. We noted an increase in the number of deaths in women due to AAI from 2 in 1994 up to 5 in 2005 (an elevation of 150% between the years 1994-2005. The age structure of deaths in women due to BAC and AAI followed the Gaussian distribution with a dominant group of women aged 41-50 years (45.16% and 35.09% respectively. The most frequent place of death (98% among women intoxicated by alcohol was their own home. The study suggests a close connection between AAI and violence against women. Conclusions The increasing number of cases of death of women suffering from AAI has drawn attention to the serious problem of alcoholism in women in the Slovak Republic during the process of integration into "western" lifestyle and culture.

  17. Treatment of theophylline intoxication using continuous venovenous haemofiltration

    Koeijers, J.J.; Verhoeven, C.L.; Boersma, H.H.; van Mook, W.N.K.A

    2008-01-01

    Theophylline intoxication can cause serious complications such as seizures, cardiac arrhythmias and eventually cardiac arrest. Because of these potentially life-threatening clinical manifestations of theophylline intoxication, treatment methods that rapidly eliminate the drug are essential. These me

  18. Accidental salinomycin intoxication in calves.

    Omidi, Arash; Aslani, Mohammad R; Movassaghi, Ahmad R; Mohri, Mehrdad; Dadfar, Mohammad

    2010-10-01

    Twenty-four 10- to 16-week-old calves in a dairy herd in Birjand, Iran, inadvertently received an excessive dose of salinomycin mixed with barley grain. There was 58% mortality within 10 d. The calves had high serum AST, LDH, and CK activities; histopathologic lesions in myocardium, liver, and kidneys; and clinical signs associated with acute and congestive heart failure.

  19. A Double-Blind Atropine Trial for Active Learning of Autonomic Function

    Fry, Jeffrey R.; Burr, Steven A.

    2011-01-01

    Here, we describe a human physiology laboratory class measuring changes in autonomic function over time in response to atropine. Students use themselves as subjects, generating ownership and self-interest in the learning as well as directly experiencing the active link between physiology and pharmacology in people. The class is designed to…

  20. Prophylactic administration of atropine attenuates the negative haemodynamic effects of propofol/remifentanil induction of anaesthesia.

    Poterman, Marieke; Scheeren, Thomas; van der Velde, M.I.; Struys, Michel; Kalmar, A.F.

    2013-01-01

    Background and Goal of Study:   Induction of anaesthesia with propofol and remifentanil often induces unwanted bradycardia and hypotension. This raises the concern for preserving haemodynamic stability and adequate tissue oxygenation. We previously demonstrated that atropine significantly improves h

  1. Atropine increases the positive adrenergic effects of norepinephrine : A pilot study.

    Kalmar, A.F.; Weening, Mariska; Struys, Michel; Scheeren, Thomas

    2012-01-01

    Background and Goal of Study: Atropine is a competitive antagonist of cholinergic receptors and is widely used to blunt the increased vagal tone that is often caused by surgical manipulations. It increases heart rate(HR) with minimal effects on mean arterial pressure(MAP) and cardiac output(CO). Nor

  2. Permanent alterations in muscarinic receptors and pupil size produced by chronic atropinization in kittens

    Smith, E.L.; Redburn, D.A.; Harwerth, R.S.; Maguire, G.W.

    1984-02-01

    Chronic mydriasis was induced in six kittens (four monocular, two binocular) and two adult cats (both monocular) by the daily topical application of atropine. Both the kittens and the adult cats were atropinized for a 13-week period with the treatment regimen beginning at the time of eye opening for the kittens. Pupil size measurements, obtained 1 year after the atropinization were discontinued, revealed that, although the pupils of the adult cats were normal, the pupils of the kittens' treated eyes were consistently smaller than pupils in control eyes. The status of the muscarinic receptors in the kittens' irides was investigated using /sup 3/H-QNB binding assays. In comparison with iris muscle homogenates from the control eyes, those from the treated eyes demonstrated an eightfold increase in the number of receptor binding sites. The results indicate that pupil size can be altered permanently by chronic mydriasis initiated early in the life of a kitten and that the permanent change in pupil size may result, in part, from a type of permanent supersensitivity response in the muscle following chronic blockade of muscarinic transmission by atropine.

  3. Electrocardiogram of rabbits experimentally intoxicated with carbaryl.

    Kossakowski, S

    1987-01-01

    Experiments were carried out on 24 rabbits intoxicated intragastrically with carbaryl in single doses of 500, 750, 1000 and 1250 mg/kg. Electrocardiograms (ECGs) were performed in 3 limb leads before and 1, 2, 4, 6h and 1, 2, 4, 6, 14d after intoxication and in a final stage of lethal intoxications--in a continuous manner. It has been found that, depending on the intensification of disease, ECG changes were characterized by the decreased heart rate with stimulations coming from the left ventricle, premature supraventricular stimulations, increased T wave amplitude and its reversion. These changes, except two lethal cases (1250 mg/kg), were compensated but the compensatory heart abilities decreased with increasing carbaryl doses.

  4. Dose-response effects of atropine and HI-6 treatment of organophosphorus poisoning in guinea pigs

    Koplovitz, I.; Menton, R.; Matthews, C.; Shutz, M.; Nalls, C.

    1995-12-31

    H1-6 (1-2-hydrnxyiminomethyl-1 pyridino-3-(4-carbameyl- 1--pyddino)-2- oxaprnpane dichioride) has been evaluated as an oxime alternative to pralidoxime, and toxogonin in the treatment of organophosphorus (OP) poisoning. The dose response effects of atropine (ATR) and HI-6 were investigated to more fully explore the interaction of these compounds in the treatment of OP poisoning. ATR, HI-6 and various combinations of the two drugs were evaluated against lethal poisoning by soman (GD) and tabun (GA) in guinea pigs. The effect of adjunctive diazepam treatment on the efficacy of atropine and HI-6 against soman was also investigated. Animals of either sex were challenged s.c. with OP and treated i.m. 1 min later with ATR and/or HI-6. When used, diazepam was injected immediately after ATR+HI6. LD50s of each treatment were calculated from probit models based on 24-hour survival against 5 levels of nerve agent and 6 animals per challenge level. A protective index (PI) was calculated by dividing the nerve agent LD50 in the presence of treatment by the LD50 in the absence of treatment. Treatment with HI-6 alone had little effect on the toxicity of either OP. Treatment with ATR alone was more effective than HI-6 alone and was significantly more effective against soman than against tabun. When used in combination atropine and HI-6 had a strong synergistic effect against both agents. The dose of atropine used with HI-6 was critical in determining the efficacy of HI-6 against either agent. The slopes of the dose-lethality curves were minimally affected by the dose of ATR or HI-6. Adjunctive treatment with diazepam enhanced the efficacy of HI-6 and atropine against soman.

  5. Mechanism of Cooperativity and Nonlinear Release Kinetics in Multivalent Dendrimer-Atropine Complexes.

    Mukherjee, Jhindan; Wong, Pamela T; Tang, Shengzhuang; Gam, Kristina; Coulter, Alexa; Baker, James R; Choi, Seok Ki

    2015-12-01

    Despite extensive studies on drug delivery using multivalent complexation systems, the biophysical basis for release kinetics remains poorly defined. The present study addresses this aspect involved in the complexation of a fifth generation poly(amidoamine) (PAMAM) dendrimer with atropine, an essential antidote used for treating organophosphate poisoning. First, we designed (1)H NMR titration studies for determining the molecular basis of the drug complexation with a glutarate-modified anionic dendrimer. These provide evidence pointing to a combination of electrostatic and hydrophobic interactions as the driving forces for dendrimer complexation with the alkaloid drug molecule. Second, using LC-MS/MS spectrometry, we determined the dissociation constants (KD) at steady state and also measured the drug release kinetics of atropine complexes with four negatively charged dendrimer types. Each of these dendrimers has a high payload capacity for up to ∼ 100 atropine molecules. However, the affinity of the atropine to the carrier was highly dependent on the drug to dendrimer ratio. Thus, a complex made at a lower loading ratio (≤ 0.1) displayed greater atropine affinity (KD ≈ μM) than other complexes prepared at higher ratios (>10), which showed only mM affinity. This negative cooperative variation in affinity is tightly associated with the nonlinear release kinetics observed for each complex in which drug release occurs more slowly at the later time phase at a lower loading ratio. In summary, the present study provides novel insights on the cooperativity as the mechanistic basis for nonlinear release kinetics observed in multivalent carrier systems.

  6. Chronic lead intoxication; Chronische Bleiintoxikation

    Wieseler, B.; Leng, G. [Duesseldorf Univ. (Germany). Inst. fuer Hygiene; Lenz, S.; Schultz, C. [Klinikum Remscheid GmbH, Remscheid (Germany); Wilhelm, M. [Bochum Univ. (Germany). Inst. fuer Hygiene, Sozial- und Umweltmedizin

    1999-02-01

    The case of a female 68 years old patient is described. Here, a chronic lead intoxication was diagnosed after a two year old medical history with increasing attacks of colic-like abdominal pain often described as life-threatening. After repeated hospitalizations and intensive search for the cause of the symptoms, porphyria and anemia was found to be a sign of a chronic lead poisoning. The blood lead concentrations were always about a level of 600 {mu}g/L. The source of exposure could not be found by now. Neither home inspection nor environmental investigations have shown a recent source of lead intake by the patient. However, a possible occupational source of lead exposure at a blast furnace was established by anamnesis for 1952 to 1962. Thus, osteoporosis induced lead mobilisation was suspected. Noticeable are the results of the six abdominal survey radiographies taken during hospitalization within one year; three radiographies were taken following clinical admission and three before discharge of the patient. In comparison, the course shows a chronic relapsing alimentary supply from metallic particles of unknown genesis. The patient was treated with the sodium salt of 2,3-dimercapto-1-propansulfonic acid (DMPS, Dimaval{sup TM}). She was free of complain afterwards. Following therapy, the blood lead concentrations fell under a level of 400 {mu}m/L, but after several weeks the lead level raised up to the original level of 600 {mu}g/L. (orig.) [Deutsch] Es wird eine 68jaehrige Patientin vorgestellt, bei der nach fast zweijaehriger Krankengeschichte, die gekennzeichnet war durch rezidivierende, teils als lebensbedrohlich geschilderte Bauchkoliken, eine chronische Bleiintoxikation diagnostiziert wurde. Erst nach wiederholten stationaeren Krankenhausaufenthalten mit intensiver Suche nach der Krankheitsursache wurden das Krankheitsbild und die Laborwerte durch Zusatzuntersuchungen ergaenzt, so dass sich in der festgestellten Porphyrie und Anaemie die Diagnose der

  7. Brain injury due to acute organophosphate poisoning Magnetic resonance imaging manifestation and pathological characteristics

    2007-01-01

    BACKGROUND: Acute organophosphate poisoning can cause injuries of multiple visceras; especially,central nervous system injury can increase risk factors of patients with severe acute organophosphate poisoning. An application of modem image may increase diagnostic rate of brain injury in an earlier period and provide evidences for clinical treatment.OBJECTIVE: To reveal imaging manifestations, pathological characteristics and multi-ways injured mechanism of brain injury due to acute organophosphate poisoning.DESIGN: Contrast observational study.SETTING: Department of Medical Image, the Second Hospital of Hebei Medical University.MATERIALS: The experiment was carried out in the Department of Nerve Molecule Imaging Medicine and Laboratory of Neurology, the Second Hospital of Hebei Medical University from August 2003 to February 2004. A total of 30 healthy cats weighing 2.8 - 3.5 g and of both genders were selected from Animal Experimental Center of Hebei Medical University.METHODS: Thirty healthy cats were randomly divided into control group (n =5) and intoxication group (n=25). Cats in the control group were subcutaneously injected with 0.3 mL/kg saline at four points; while, cats in the intoxication group were subcutaneously injected with 400 g/L 0.3 mL/kg O,O-dimethyl-S-(methoxycarbonylmethyl) thiophosphate at four points. Two minutes after intoxication, cats received muscular injection with 0.5 mg/kg atropine sulfate, and then, brain tissues were collected from parietal lobe, basal ganglia, hippocampus, cerebellum and brain stem were observed at 3, 6, 24 hours, 3 and 7 days after intoxication respectively under optic microscope and electron microscope and expressions of acetylcholinesterase (AChE), choline acetyltransferase (ChAT), glial fibrillary acidic protein (GFAP),glutamic acid (Glu) and γ-amino butyric acid after immunohistochemical staining.MAIN OUTCOME MEASURES: Results of MRI examinations; histological changes under optic microscope and electron

  8. A comparison of the effects of atropine on real-feeding and sham-feeding of sucrose in rats.

    Nissenbaum, J W; Sclafani, A

    1988-02-01

    In Experiment 1 the influence of atropine methyl nitrate on the sham-feeding response of adult female rats to a sucrose solution was determined. Atropine (1 or 5 mg/kg) reliably suppressed the sham-intake of sucrose when the drug was administered 30 or 0 min prior to, or 17 min after the start of the feeding session. The suppressive effect was less, however, when the drug was administered 30 min before testing compared to the other two injection-test conditions. In Experiment 2 atropine failed to reliably decrease the real-feeding of a sucrose solution whether it was injected 30, 15, or 0 min prior to testing. These results were replicated in Experiment 3; atropine (0 min injection-test interval) reduced the sham-intake but not the real-intake of a sucrose solution. However, atropine decreased the rate of feeding under both real- and sham-feeding conditions. The fact that atropine reduced feeding rate but not meal size in the real-feeding condition was attributed to the drug's lack of effect on postingestive satiety. The present findings along with other recent results indicate that (1) the injection-test interval is a potentially important variable in studies involving atropine; (2) results obtained with sham-feeding animals do not always generalize to real-feeding animals; and (3) cholinergically-mediated cephalic responses are of questionable importance in the control of meal size.

  9. The effects of beta-blockers on dobutamine-atropine stress echocardiography: early protocol versus standard protocol

    Weitzel Luis H

    2006-07-01

    Full Text Available Abstract Background To study the effects of Beta-blockers during Dobutamine Stress Echocardiography (DSE comparing the hemodynamic benefits of an early administration of atropine in patients taking or not Beta-blockers. Methods One hundred and twenty-one patients were submitted to dobutamine stress echocardiography for the investigation of myocardial ischemia. The administration of atropine was randomized into two groups: A or B (early protocol when atropine was administered at 10 and 20 mcg/kg/min of dobutamine, respectively and C (standard protocol with atropine at 40 mcg/kg/min of dobutamine. Analysis of the effects of Beta-blockers was done regarding the behavior pattern of heart rate and blood pressure, test time, number of conclusive and inconclusive (negative sub-maximum test results, total doses of atropine and dobutamine, and general complications. Results Beta-blocked patients who received early atropine (Group A&B had a significantly lower double product (p = 0.008, a higher mean test time (p = 0.010 and required a higher dose of atropine (p = 0.0005 when compared to the patients in this group who were not Beta-blocked. The same findings occurred in the standard protocol (Group C, however the early administration of atropine reduced test time both in the presence and absence of this therapy (p = 0.0001. The patients with Beta-blockers in Group A&B had a lower rate of inconclusive tests (26% compared to those in Group C (40%. Complications were similar in both groups. Conclusion The chronotropic response during dobutamine stress echocardiography was significantly reduced with the use of Beta-blockers. The early administration of atropine optimized the hemodynamic response, reduced test time in patients with or without Beta-blockers and reduced the number of inconclusive tests in the early protocol.

  10. Effect of five acetylcholinesterase reactivators on tabun-intoxicated rats: induction of oxidative stress versus reactivation efficacy.

    Pohanka, Miroslav; Karasova, Jana Zdarova; Musilek, Kamil; Kuca, Kamil; Kassa, Jiri

    2009-08-01

    Oxime reactivators HI-6, obidoxime, trimedoxime, K347 and K628 were investigated as drugs designed for treatment of tabun intoxication. The experiments were performed on rats in order to simulate real conditions. Rats were intoxicated with one LD(50 )of tabun and treated with atropine and mentioned reactivators. Activities of erythrocyte acetylcholinesterase (AChE), plasma butyrylcholinesterase (BChE) and brain AChE were measured as markers of reactivation efficacy. An estimation of low molecular weight antioxidant levels using cyclic voltammetry was the second examination parameter. The evaluation of cholinesterases activity showed good reactivation potency of blood AChE and plasma BChE by commercially available obidoxime and newly synthesized K347. The potency of oximes to reactivate brain AChE was lower due to the poor blood-brain barrier penetration of used compounds. Commercially available reactivator HI-6 and newly synthesized K628 caused oxidative stress measured by cyclic voltammetry as antioxidant level. The oxidative stress provoked by HI-6 and K628 was found to be significant on probability level P = 0.05. The others reactivators did not affect antioxidant levels.

  11. EPIDEMIOLOGICAL STUDY OF DRUG INTOXICATION IN CHILDREN

    F. Cheraghali M. Taymori

    2006-05-01

    Full Text Available Unintentional drug intoxication is still a major cause of morbidity and mortality in young children. In order to study the epidemiological pattern of childhood drug poisoning in Golestan province, all cases diagnosed with poisoning from 1997 to 2002 in the only pediatric hospital in province were recruited. During this period 563 cases of poisoned children were hospitalized in Taleqani hospital, of these 305 cases were due to drug poisoning. Opium was responsible for more than half of the poisoning cases, and 91% of deaths, among drug intoxicated children. Metoclopramide, benzodiazepines, tricyclic antidepressants and anticonvulsants were among the other frequent causes of poisoning. Neurological symptoms were the most prominent symptoms of poisoning and more than 80% of cases showed some neurological symptoms. Mortality rate among the cases was 3.6% and of total of 11 deaths, 10 were poisoned with opium. About 61% of cases were hospitalized between 24-48 hrs. Most of the poisoning cases in young children were unintentional and in many cases, their parents played a critical role in their intoxication. This role specially is crucial in infants and children under one year of age. Parents in Golestan province use opium widely for symptomatic treatment of routine illnesses in their young children and overdose of opium may cause severe intoxication and even death of the child.

  12. Platelet aggregation associated with ethanol intoxication

    Volk, S.; Walenga, J.; Fareed, J.; Schumacher, H. (Loyola Univ. Medical Center, Maywood, IL (USA))

    1989-02-09

    Alcohol is known to produce profound effects on blood; during chronic intoxication, prolongation of bleeding time has been reported. Utilizing human platelet rich plasma, we have studied the effect of alcohol on epinephrine, arachidonic acid and ADP induced aggregation. Control responses were obtained with saline from which the relative inhibition by alcohol was calculated. These studies were carried out at a concentration of 1.25-5.0 mg/ml which represents 0.125-0.5% alcohol blood levels. From 25 normal male and female volunteers, without prior hemostatic defects or drug ingestion, a dose-dependent inhibition by alcohol of all three agonist induced aggregations was noted. Alcohol itself did not produce any aggregation response. These studies demonstrate that alcohol at levels which are reached during intoxication is capable of impairing platelet function. The implication of this finding on the bleeding complications in healthy intoxicated patients may be significant during traumatic events, and individuals taking antiplatelet drugs may present a more serious hemostatic deficit during alcohol intoxication.

  13. A patient with clove oil intoxication

    Dyrbye, B.A.; Dubois, L.; Vink, R.; Horn, J.

    2012-01-01

    The article discusses the case of a 67-year-old man who was brought to the emergency room because of inability to speak and confusion. His medical history revealed hypertension and alcohol abuse. His neurological symptoms and laboratory abnormalities are caused by intoxication with clove oil combine

  14. Increased acetylcholine esterase activity produced by the administration of an aqueous extract of the seed kernel of Thevetia peruviana and its role on acute and subchronic intoxication in mice

    Rubén Marroquín-Segura

    2014-01-01

    Full Text Available Background: The real mechanism for Thevetia peruviana poisoning remains unclear. Cholinergic activity is important for cardiac function regulation, however, the effect of T. peruviana on cholinergic activity is not well-known. Objective: To study the effect of the acute administration of an aqueous extract of the seed kernel of T. peruviana on the acetylcholine esterase (AChE activity in CD1 mice as well its implications in the sub-chronic toxicity of the extract. Materials and Methods: A dose of 100 mg/kg of the extract was administered to CD1 mice and after 7 days, serum was obtained for ceruloplasmin (CP quantitation and liver function tests. Another group of mice received a 50 mg/kg dose of the extract 3 times within 1 h time interval and AChE activity was determined for those animals. Heart tissue histological preparation was obtained from a group of mice that received a daily 50 mg/kg dose of the extract by a 30-days period. Results: CP levels for the treated group were higher than those for the control group (Student′s t-test, P ≤ 0.001. AChE activity in the treated group was significantly higher than the control group (Tukey test, control vs. T. peruviana, P ≤ 0.001. Heart tissue histological preparations showed leukocyte infiltrates and necrotic areas, consistent with infarcts. Conclusion: The increased levels of AChE and the hearth tissue infiltrative lesions induced by the aqueous seed kernel extract of T. peruviana explains in part the poisoning caused by this plant, which can be related to an inflammatory process.

  15. Dose-response effects of atropine and HI-6 treatment of organophosphorus poisoning in guinea pigs.

    Koplovitz, I; Menton, R; Matthews, C; Shutz, M; Nalls, C; Kelly, S

    1995-01-01

    HI-6 (1-2-hydroxyiminomethyl-1-pyridino-3-(4-carbamoyl-1-pyridino -2- oxapropane dichloride) has been evaluated as an oxime alternative to pralidoxime, and toxogonin in the treatment of organophosphorus (OP) poisoning. The dose response effects of atropine (ATR) and HI-6 were investigated to more fully explore the interaction of these compounds in the treatment of OP poisoning. ATR, HI-6 and various combinations of the two drugs were evaluated against lethal poisoning by soman (GD) and tabun (GA) in guinea pigs. The effect of adjunctive diazepam treatment on the efficacy of atropine and HI-6 against soman was also investigated. Animals of either sex were challenged s.c. with OP and treated i.m. 1 min later with ATR and/or HI-6. When used, diazepam was injected immediately after ATR+HI6. LD50s of each treatment were calculated from probit models based on 24-hour survival against 5 levels of nerve agent and 6 animals per challenge level. A protective index (PI) was calculated by dividing the nerve agent LD50 in the presence of treatment by the LD50 in the absence of treatment. Treatment with HI6 alone had little effect on the toxicity of either OP. Treatment with ATR alone was more effective than HI-6 alone and was significantly more effective against soman than against tabun. When used in combination atropine and HI-6 had a strong synergistic effect against both agents. The dose of atropine used with HI-6 was critical in determining the efficacy of HI-6 against either agent. The slopes of the dose-lethality curves were minimally affected by the dose of ATR or HI-6. Adjunctive treatment with diazepam enhanced the efficacy of HI-6 and atropine against soman. It is concluded that 1) ATR has a large effect on the efficacy of HI-6 against OP poisoning, 2) the dose of ATR must be carefully selected in studies investigating the efficacy of HI-6 against OP poisoning, 3) the effective dose of ATR in the guinea pig is approximately 16 mg/kg, and 4) diazepam is a useful

  16. Musculus gastrocnemius tetanus kinetics in alcohol-intoxicated rats with experimentally-induced hindlimb vascular ischemia under conditions of low-frequence muscle fatigue

    O. A. Melnychuk

    2014-04-01

    Full Text Available Alcohol intoxication and ischemic injury of skeletal muscles often accompany each other. It is shown that patients hospitalized with chronic alcoholism develop muscle fatigue. Skeletal muscle dysfunction in alcohol-dependent patients is caused by ethanol-associated myofibrillar atrophy and metabolic disbalance, while compression-ischemic lesions result from unconsciousness of the patient, in case of taking the critical alcohol dose. Therefore, the aim of this study is to discover typical m. gastrocnemius (cap. med. tetanic kinetics changes in alcohol intoxicated rats with experimentally induced vascular ischemia of hindlimb muscles under conditions of low-frequency progressive muscle fatigue. Experiments were carried out on 10 young male Wistar rats (149.5 ± 5.8 g kept under standard vivarium conditions and diet. The investigation was conducted in two phases: chronic (30 days and acute (3 hours experiment. All surgical procedures were carried out aseptically under general anesthesia. Ishemic m. gastrocnemius (cap. med. tetanic kinetic changes and force productivity in alcohol intoxicated rats were investigated in the isometric mode, with direct electrical stimulation. The fatigue of m. gastrocnemius (cap. med. was evaluated by three characteristic criteria: the first sag effect, the secondary force rise, the second sag effect. There have been 10 similar experiments: 5 series in each study group with 10 tetanic runs in each series. The highest amplitude of the native m. gastrocnemius (cap. med. tetanus relative to isoline was taken as 100% force response. The same pattern of m. gastrocnemius (cap. med. low-frequency fatigue development was found in both rat groups under study. It is evidenced by the absence of substantial m. gastrocnemius (cap. med. tetanus kinetics differences in alcohol intoxicated rats, compared with non-alcohol intoxicated rats during fatigue test. However, the appreciable m. gastrocnemius (cap. med. tetanic force reduction

  17. Chronic fructose intoxication after infancy in children with hereditary fructose intolerance. A cause of growth retardation.

    Mock, D M; Perman, J A; Thaler, M; Morris, R C

    1983-09-29

    In two unrelated boys, 5.3 and 3.8 years of age with hereditary fructose intolerance, apparently isolated growth retardation (-2.71 S.D. and -2.40 S.D.) occurred after infancy, even though acute symptomatic fructose intoxication was prevented by restriction of dietary fructose. When more stringent restriction of dietary fructose was instituted (approximately 40 mg per kilogram of body weight per day), growth velocity increased from the 25th to the 97th percentile in one child and from well below the 3d to above the 75th percentile in the other. When restriction of dietary fructose was experimentally relaxed (from 10 to 250 mg per kilogram per day), neither boy had symptoms, hypoglycemia, or evidence of hepatic or renal dysfunction, but both had sustained hyperuricemia and hyperuricosuria and increases in the plasma concentration and urinary excretion of magnesium. We conclude that in patients with hereditary fructose intolerance, clinically important chronic fructose intoxication can occur after infancy without causing symptoms of acute fructose intoxication and can be expressed as an apparently isolated, reversible retardation of somatic growth with a continuing disorder of adenine nucleotide metabolism, characterized in part by recurrently increased rates of degradation of adenine nucleotides.

  18. Effect of atropine-dobutamine stress test on left ventricular echocardiographic parameters in untrained warmblood horses.

    Sandersen, Charlotte F; Detilleux, Johanne; de Moffarts, Brieuc; Van Loon, Gunther; Amory, Hélène

    2006-01-01

    The aim of this study was to investigate the effect of combined atropine low-dose dobutamine stress test on left ventricular parameters in adult warmblood horses, to establish a potential protocol for pharmacological stress echocardiography. Seven healthy untrained warmblood horses aged 9 to 22 years were used. Heart rate (HR) and left ventricular B- and M-mode dimensions were recorded at baseline and during stress testing with 35 microg/kg atropine IV followed by incremental dobutamine infusion of 2 to 6 microg/kg/min. HR increased significantly (P stress test induced significant changes in left ventricular echocardiographic parameters in adult warmblood horses. Additional research should evaluate the value of this stress test in horses suffering from cardiac disease.

  19. Evaluation of Atropine-Xylazine as a Sedative in Buffalo Calves (Bubalus bubalis

    S. Singh

    2010-02-01

    Full Text Available Twelve experimental trials were undertaken on clinically healthy male buffalo calves. Atropine was administered @ 0.04 mg/kg, IM and xylazine was administered @ 0.04 mg/kg, IM. Following atropine-xylazine administration, a decrease in spontaneous activity was seen in all the animals. Lowering of head was observed in three animals. Haemoglobin reduced significantly at 15 minute after xylazine administration. A significant reduction in mean arterial pressure (MAP was also seen at 30 and 45 minute after xylazine administration. The pulse pressure increased significantly after 5 minute of xylazine administration. The central venous pressure (CVP increased significantly at 30 minute and 45 minute of xylazine administration.

  20. Optimal choice of acetylcholinesterase reactivators for antidotal treatment of nerve agent intoxication.

    Bajgar, Jirí

    2010-01-01

    The studies dealing with mechanism of organophosphates (OP)/nerve agent action, prophylaxis and treatment of intoxications is a very hot topic at present. Though the research is very intensive, unfortunately, up to now, there is not universal or significantly better reactivator sufficiently effective against all nerve agents/OP when compared with presently available oximes (pralidoxime, methoxime, obidoxime, trimedoxime, HI-6). The use of the most effective reactivator (HI-6) using simple type of autoinjector (e.g. ComboPen) is strictly limited because of decomposition of HI-6 in solution. Thanks to better solubility it is clear that another salt of HI-6 (dimethanesulfonate, HI-6 DMS) is more convenient for the use as antidote against nerve agents in the autoinjector than HI-6 chloride (Cl). It was clearly demonstrated that reactivation potency of HI-6 DMS in comparison with HI-6 Cl in vivo was the same and bioavailability of HI-6 DMS is better than that of HI-6 Cl. Three chambered autoinjector allows administration of all three antidotes (atropine, reactivator, diazepam) simultaneously. Moreover, the content of chambers can be changed according to proposed requirements. Possible way to solve the problem of universal reactivator could be the use of two reactivators. Three chambered autoinjector is an ideal device for this purpose.

  1. Investigation of Vision and Performance After Administration of Cholinergic Blocking Agents. III. Atropine.

    1983-05-01

    P., Kemp, K. & Wetherell, A. Some effects of 2mg i.m. atropine and 5mg i.m. diazepam , separately and combined, on human performance. Proc. Brit...Impaired coordination 0 1 2 3 4 Tense 0 1 2 3 4 Restless 0 1 2 3 4 Depressed 0 1 2 3 4 Anxious 0 1 2 3 4 Fatigued 0 1 2 3 4 Unable to concentrate 0 1 2 3 4

  2. Intravenously administered oxotremorine and atropine, in doses known to affect pain threshold, affect the intraspinal release of acetylcholine in rats

    Abelson, Klas S P; Höglund, A Urban

    2002-01-01

    muscarinic agonists and antagonists modify nociceptive threshold by affecting intraspinal release of acetylcholine (ACh). Catheters were inserted into the femoral vein in rats maintained on isoflurane anaesthesia for administration of oxotremorine (10-300 microg/kg) and atropine (0.1, 10, 5000 microg....../kg). Spinal microdialysis probes were placed intraspinally at approximately the C2-C5 spinal level for sampling of acetylcholine and dialysis delivery of atropine (0.1, 1, 10 nM). Additionally, the tail-flick behaviour was tested on conscious rats injected intraperitoneally with saline, atropine (10, 100....... Intravenously administered atropine, in a dose that produced hyperalgesia (5000 microg/kg) in the tail-flick test, significantly decreased the intraspinal release of acetylcholine. Our results suggest an association between pain threshold and acetylcholine release in spinal cord. It is also suggested...

  3. Theobromine intoxication in a red fox and a European badger in Sweden.

    Jansson, D S; Galgan, V; Schubert, B; Segerstad, C H

    2001-04-01

    A red fox (Vulpes vulpes) and a European badger (Meles meles) were found dead on a golf-course in October 1997 near Stockholm (Sweden). At necropsy, both animals were obese and the main finding was acute circulatory collapse. Theobromine intoxication was suspected as chocolate waste was available at a nearby farm and no other cause of death could be detected. Gastric contents and samples of liver from both animals were analyzed by reversed-phase high pressure liquid chromatography for the presence of methylxanthines. Theobromine and caffeine were detected in gastric contents and theobromine was identified in the liver samples from both animals. This appears to be the first report of theobromine intoxication in the red fox and the European badger.

  4. Carbofuran-Induced Acute Pancreatitis

    Rizos E

    2004-01-01

    Full Text Available CONTEXT: Carbamate insecticides are widely used in commercial agriculture and home gardening. A serious side effect of organophosphate and carbamate intoxication is the development of acute pancreatitis. CASE REPORT: A 36-year-old Caucasian woman was admitted to our hospital with cholinergic crisis and pancreatitis soon after the ingestion of a carbamate insecticide (carbofuran. An abdominal CT scan disclosed pancreatic necrosis with intrapancreatic fluid collection, consistent with the development of a pancreatic pseudocyst in a subsequent CT scan. No predisposing factor for pancreatitis was evident. Pseudocholinesterase levels returned to normal 7 days later and the patient was discharged in good physical condition one month after admission. DISCUSSION: Although acute pancreatitis is not infrequent after organophosphate intoxication, it is quite rare after carbamate ingestion and has not been previously reported after carbofuran intoxication.

  5. High mortality due to accidental salinomycin intoxication in sheep

    Ashrafihelan Javad

    2014-09-01

    Full Text Available In February 2012, 100% mortality was reported in a herd with 79 local sheep that were kept around of Abhar, Northwest of Iran. The ration for adult sheep was daily mixed (40 kg straw, 25 kg wheat and 2 kg Vit-C premix and accidentally 1 500 g of salinomycin (Salinomycin 12% Premix; Aras Bazar Laboratories, Iran had been added to the ration (22388 mg/kg = 22388 ppm and overnight was fed to herd. At the morning, 78 sheep were founded dead and one of them showed convulsive seizures. Postmortem examination revealed pulmonary congestion and edema, hemorrhages in abomasum, large pale kidney and white streak lines in myocardium. Main histopathologic lesions were extensive subepicardial and intercardiomyofibers hemorrhages, extensive cardiomyolysis and myocarditis in heart, severe hyperemia and extensive acute tubular necrosis (ATN in kidneys and focal necrosis and retention of bile cholangitis in the liver. In this study, on the basis of the history, observation of the ionophore remnant in the ration, clinical signs, gross and histopathological findings, acute salinomycin intoxication is definitely diagnosed.

  6. 高铁血红蛋白生成剂(MFA)对急性硫化氢中毒动物治疗作用的实验研究%The experimental study on the treatment of acute hydrogen sulfide intoxication with methemoglobin froming agent(MFA)

    秦景香; 游全程; 王仁仪; 程崇全; 杨松涛; 吴进

    2001-01-01

    Objective To study the therapeutic effect of MFA against acute H2S intoxication.Methods Forty rats were divided into four groups: normal control group, poisoned control group, methylene blue group and 4-DMAP group. The later three groups were exposed to lethal concentration of H2S for 2 minutes, and then the later two rat groups were given methylene blue and 4-DMAP respectively. After 2 hours observation all the animals were killed, and the levels of CK, LDH, AST, ALT, Tb, MHb and SMHb in blood and pathological changes of lung were examined. Results The levels of MHb and SMHb in the two MFA treated groups increased significantly, and those in 4-DMAP group were even higher than those in methylene blue group. The lung tissues in poisoned control group were mainly hyperemia and partly edema, whereas the lungs of the two treated groups mainly appeared hyperemia. Conclusion MFA was proved to be antidotal to H2S poisoning, however, the efficacy of 4-DMAP seemed to be better than that of methylene blue.%目的 通过动物实验探讨MAF对急性硫化氢中毒的治疗作用。方法 将40只大鼠分为正常对照组、染毒对照组、美蓝求治组、4-DMAP救治组。以致死浓度的硫化氢染毒2 min,对两组救治组动物分别给以美蓝和4-DMAP进行急救,2 h后做相应生化及病理检查。结果 两救治组MHb\\, SMHb显著高于两对照组,4-DMAP组MHb\\,SMHb明显高于美蓝组;染毒对照组肺组织明显充血、水肿,两救治组主要表现为充血。结论 MFA对急性硫化氢中毒动物起到解毒作用,而4-DMAP效果优于美蓝。

  7. Interaction of aconitine with bovine serum albumin and effect of atropine sulphate and glycyrrhizic acid on the binding

    Huang Yun, E-mail: hy9317536@126.com [Pharmaceutical College, Hebei Medical University, 361 Zhongshan East Road, Shijiazhuang City, Hebei Province 050017 (China); Cui Lijian [Traditional Chinese Medical College, Hebei Medical University, Shijiazhuang 050091 (China); Wang Jianming; Huo Kun; Chen Chen; Zhan Wenhong; Wang Yongli [Pharmaceutical College, Hebei Medical University, 361 Zhongshan East Road, Shijiazhuang City, Hebei Province 050017 (China)

    2012-02-15

    The interaction of aconitine with bovine serum albumin (BSA) and effect of atropine sulphate and glycyrrhizic acid on binding constant, binding sites, and conformation were studied in an aqueous buffer solution (pH 7.40) by ultraviolet absorption and fluorescence spectroscopy. The study results show that aconitine quenched the endogenous fluorescence of BSA via a dynamic quenching procedure. Predominant intermolecular forces between aconitine and BSA were hydrophobic interactions, which stabilized the complex of aconitine-BSA. The distance between the donor and acceptor was 2.62 nm. The conformation of BSA was investigated by synchronous fluorescence techniques, indicating that the microenvironment around tryptophan (Trp) residues was changed. Furthermore, with the addition of atropine sulphate or glycyrrhizic acid, binding constant and the number of binding sites of aconitine to BSA were decreased, and the conformation had no change, which provide an important theoretical support for aconitine detoxification by atropine sulphate and glycyrrhizic acid. - Highlights: Black-Right-Pointing-Pointer Effect of atropine or glycyrrhizic acid on aconitine-BSA binding. Black-Right-Pointing-Pointer UV-vis absorption and fluorescence spectroscopic techniques used. Black-Right-Pointing-Pointer Aconitine quenched BSA fluorescence via dynamic quenching with r=2.62 nm. Black-Right-Pointing-Pointer Atropine sulphate and glycyrrhizic acid decreased K{sub A} and n of aconitine-BSA. Black-Right-Pointing-Pointer Support for aconitine detoxification by atropine and glycyrrhizic acid.

  8. A comparative study of clonidine versus a combination of diazepam and atropine for premedication in orthopaedic patients.

    Chaurasia S

    1999-07-01

    Full Text Available Sixty patients in the age group of 18-60 years of A.S.A. Grade I/II risk, scheduled for elective orthopaedic surgeries under general anaesthesia were studied for pre-medication with either oral clonidine or with combination of effects of diazepam & atropine. Patients in Group A (clonidine group received tablet clonidine 100 mcg (1 tablet if less than 50 kg in weight and 200 mcg if weighing more than 50 kg two hours before surgery. Patients in Group B (Diazepam-atropine group received one tablet of Diazepam (10 mg orally two hours before surgery and injection atropine-sulphate 0.01 mg/kg half an hour preoperatively by intramuscular route. In our study, the sedative and anti-sialogogue effects of clonidine were comparable to those of diazepam-atropine combination, which are commonly used premedicants. The anti-anxiety effect of clonidine was found to be better than that of diazepam-atropine combination. Clonidine also proved to be a better agent for the attenuation of pressor response to laryngoscopy and intubation. Thus, oral clonidine is a better premedicant compared to atropine-diazepam combination. Also, it is a more acceptable agent because of its oral route of administration.

  9. Clinically and electrophysiologically diagnosed botulinum intoxication.

    Kotan, Dilcan; Aygul, Recep; Ceylan, Mustafa; Yilikoglu, Yalcin

    2013-01-03

    In this case report, clinical and electrophysiological findings of 43-year-old female patient who developed Clostridium botulinum intoxication after consumption of home-made canned food are presented. Following the sudden onset of severe nausea and vomiting, diplopia, blurred vision, bilateral ptosis, weakness, speech and swallowing difficulties have developed and the patient declared that she has just tasted the canned beans after she had rinsed them several times. The case, where serological tests cannot be performed, was diagnosed clinically and treated with antitoxin immediately. During follow-up, consecutive nerve stimulation was performed and significant incremental response was observed. There was an improvement in symptoms within 2 weeks, and in 5 or 6 weeks the symptoms had disappeared completely. Electrodiagnostic studies revealed that the findings turned to normal. The case showed that immediate antitoxin treatment is life-saving even the diagnosis of botulinum intoxication is based on clinical findings.

  10. Methamphetamine intoxication in a dog: case report

    Pei, Zengyang; Zhang, Xu

    2014-01-01

    Background Methamphetamine abuse has undergone a dramatic worldwide increase, and represents a significant and global issue for public health. Incidents of methamphetamine intoxication and death in humans are relatively commonplace. Because of its increasing illicit availability, together with legitimate use in human medicine, accidental or intentional exposure to methamphetamine in dogs is becoming a more likely scenario. Case presentation A 3-year-old, 3.7 kg intact female Miniature Poodle ...

  11. [Intoxications specific to the Aquitaine region].

    Bédry, R; Gromb, S

    2009-07-01

    Some intoxications are more specifically linked to the Aquitaine region than to other regions of France, due to environmental circumstances (fauna, flora, climate) or traditional activities (gastronomy). Three types of intoxications are particular in this area. Pine processionary caterpillar envenomations (Thaumetopoea pityocampa), a Southern Europe pinewood parasite, are frequently encountered in the Landes' forest. They are responsible of ocular and/or skin lesions with urticaria or contact dermatitis, seldom associated with immediate IgE hypersensitivity. According to the south Atlantic coastal region geology and the marine streams, venomous marine animals are mainly located in Charente-Maritime for jellyfish, in Gironde and in Landes for weeverfish and in Atlantic Pyrenees for sea anemone. Usually not dangerous, first-aid workers treat most cases of these envenomations. Some endemic mushrooms (Tricholoma auratum) which grow on the dunes of the Atlantic coastal region, are usually considered as very good comestibles, but were recently responsible for serious intoxications: T.auratum was responsible of several cases of rhabdomyolysis, without neurological involvement, nor renal or hepatic lesion. Three deaths were notified. Animal studies confirmed the responsibility of the mushrooms.

  12. Interstitial Pulmonary Edema Following Bromocarbamide Intoxication

    Sugihara, H.; Hagedorn, M.; Bōttcher, D.; Neuhof, H.; Mittermayer, Ch.

    1974-01-01

    Bromocarbamides are sleep-inducing drugs which can lead, in man, to intoxication and death due to respiratory failure. To prove whether hemodynamic factors or the changed endothelial permeability induce pulmonary edema, animal experiments were performed. The fine structural changes in pulmonary edema in rabbits were observed at 60, 90 and 120 minutes after oral administration. The major findings were a) large blebs between capillary endothelium and alveolar epithelium and b) interstitial edema of the vessel wall. The bleb contents were much less electron dense than the blood contents in the capillary. Colloidal carbon did not enter the bleb or the edematous interstitial tissue. Exogenous peroxidase uptake in pinocytotie vesicles increased in pathologic cases. The hemodynamic measurements in animal receiving artificial respiration which maintained the blood pO2 at a steady state showed similar blebs in the pulmonary vessels, indicating that anoxia is not the major cause of the vascular lesion. Moreover, pulmonary arterial pressure and pulmonary vascular resistance could be held in the normal range in artificially respirated animals under bromocarbamide intoxication. Thus, hemodynamic factors are not likely to play a pathogenetic role in bringing about pulmonary edema. The chief, early factor is the increased endothelial permeability due to increased cytoplasmic transport. From this a practical suggestion for treating patients with bromocarbamide intoxication is derived: the usual fluid replacement in shock patients should be handled with great care to avoid fluid overload of the lung. ImagesFig 1Fig 2Fig 3Fig 4Fig 5Fig 6 PMID:4835993

  13. Spirituality, intoxication and addiction: six forms of relationship.

    Room, Robin

    2013-09-01

    The paper considers six connections between spirituality and intoxication or addiction. They are: intoxication as a means of communication with a spiritual world; intoxication as destroying spirituality; shared use and intoxication as creating and validating community; spirituality and religion as a means of collective sobering-up; spirituality in individual sobering up; and abstinence as a spiritual practice, a witness, or a badge of membership in a spiritual community. Intoxication can either enhance or impede spirituality, both at individual and collective levels. Spirituality is often important in sobering up, both individually and collectively, and abstinence is a part of spiritual or religious practice in some traditions. But a full account must acknowledge the diversity in the interactions of spirituality and intoxication or addiction.

  14. INTOXICATION AND CRIMINAL LIABILITY IN INTERNATIONAL CRIMINAL LAW

    ZGAGA SABINA

    2014-01-01

    The principle of actio libera in causa or the effect of a perpetrator's voluntary intoxication on the existence of a criminal act is controversial in international criminal law. The present legislation, as contained in the Rome Statute, is a compromise between different legal systems. It allows the exclusion of a criminal act based on the fact that the perpetrator was involuntarily intoxicated and he or she cannot be ascribed guilt for the act of intoxication and the criminal act. In the Rome...

  15. Acute cyanide Intoxication: A rare case of survival

    Durga Jethava

    2014-01-01

    Full Text Available A 30-year-old male jewellery factory worker accidentally ingested silver potassium cyanide and was brought to the emergency department in a state of shock and profound metabolic acidosis. This patient was managed hypothetically with use of injection thiopentone sodium intravenously until the antidote was received. Cyanide is a highly cytotoxic poison and it rapidly reacts with the trivalent iron of cytochrome oxidase thus paralysing the aerobic respiration. The result is severe lactic acidosis, profound shock, and its fatal outcome. The patient dies of cardio-respiratory arrest secondary to dysfunction of the medullary centres. It is rapidly absorbed, symptoms begin few seconds after exposure and death usually occurs in <30 min. The average lethal dose for potassium cyanide is about 250 mg. We used repeated doses of thiopentone sodium till the antidote kit was finally in our hands, hypothesising that it contains thiol group similar to the antidote thiosulphate. Moreover, it is an anticonvulsant. We were successful in our attempts and the patient survived though the specific antidotes could be administered after about an hour.

  16. Acute barium intoxication following ingestion of soap water solution

    Nandita Joshi

    2012-01-01

    Full Text Available We present a rare case in which a young girl ingested a solution of a hair-removing soap. The ingestion resulted in profound hypokalemia and severe acidosis leading to flaccid paralysis, respiratory arrest and ventricular arrhythmias. Ultimately the patient made complete recovery. The soapwas found to contain barium sulfide. The degree of paralysis and acidosis appeared to be directly related to serum potassium levels.

  17. [Acute caffeine intoxication after intake of 'herbal energy capsules'

    Kromhout, H.E.; Landstra, A.M.; Luin, M. van; Setten, P.A. van

    2008-01-01

    Two males, 15 and 17 years old respectively, presented at the Emergency Department complaining of cramping abdominal pain, nausea and vomiting after ingestion of energy capsules. Physical examination revealed sinus tachycardia and slight abdominal pain. Laboratory examination showed substantial hypo

  18. Intoxicated children at an intensive care unit: popular medicine risks, complications and costs.

    Consuelo de Rovetto

    2009-12-01

    Full Text Available Introduction: The Hospital Universitario del Valle (HUV at the Pediatrics Intensive Care Unit (PICU admits intoxicated patients, erroneously medicated by «teguas» or family members with serious aggravation of basic diseases or generating severe intoxications. Absent reports of these practices in Colombia motivated the publication of this case series Objective: To report a series of pediatric intoxication cases secondary to oral or dermatological application of varied substances by healers («teguas» or family members, leading to admission at the PICU, and to describe complications and hospital costs of these events. Methodology: Clinical charts of patients admitted to the PICU with diagnosis of exogenous intoxication during May 2001 to September 2004, were reviewed. Of 28 registered cases during that time, only 14 clinical charts were recovered. Variables evaluated included: age, gender, proceeding, administered substance, person responsible for the administration, complications, days of mechanical ventilation, total days at the intensive care unit and average costs. Of the 14 medical records with exogenous intoxications only 5 cases were involuntary and 9 were related to the administration of substances by quacks or family members; these are the ones reported in this series. Results: We report a total of 9 intoxicated patients, 5 girls and 4 boys, with an age range from 1 to 24 months, all from Cali. Topical administered substances: alcohol 6/9, vinegar 1/9; oral: aspirin 2/9, paico 1/9, and unidentified herbs 1/9. Administered substances by teguas: 6 patients; 3 by family members. All patients had metabolic acidosis with an increased anion gap: 27 in average (range from 21 to 32. All required mechanical ventilation (2 to 32 day range. Average hospital day costs were $6’657,800 pesos (around U$3,000.oo. Three patients died and 4 presented acute renal failure, 2 convulsions, 2 nosocomial infections, 1 subglotic stenosis. Conclusions and

  19. Intoxicated children at an intensive care unit: popular medicine risks, complications and costs

    Consuelo de Rovetto

    2009-09-01

    Full Text Available Introduction: The Hospital Universitario del Valle (HUV at the Pediatrics Intensive Care Unit (PICU admits intoxicated patients, erroneously medicated by «teguas» or family members with serious aggravation of basic diseases or generating severe intoxications. Absent reports of these practices in Colombia motivated the publication of this case seriesObjective: To report a series of pediatric intoxication cases secondary to oral or dermatological application of varied substances by healers («teguas» or family members, leading to admission at the PICU, and to describe complications and hospital costs of these events.Methodology: Clinical charts of patients admitted to the PICU with diagnosis of exogenous intoxication during May 2001 to September 2004, were reviewed. Of 28 registered cases during that time, only 14 clinical charts were recovered. Variables evaluated included: age, gender, proceeding, administered substance, person responsible for the administration, complications, days of mechanical ventilation, total days at the intensive care unit and average costs. Of the 14 medical records with exogenous intoxications only 5 cases were involuntary and 9 were related to the administration of substances by quacks or family members; these are the ones reported in this series.Results: We report a total of 9 intoxicated patients, 5 girls and 4 boys, with an age range from 1 to 24 months, all from Cali. Topical administered substances: alcohol 6/9, vinegar 1/9; oral: aspirin 2/9, paico 1/9, and unidentified herbs 1/9. Administered substances by teguas: 6 patients; 3 by family members. All patients had metabolic acidosis with an increased anion gap: 27 in average (range from 21 to 32. All required mechanical ventilation (2 to 32 day range. Average hospital day costs were $6’657,800 pesos (around U$3,000.oo. Three patients died and 4 presented acute renal failure, 2 convulsions, 2 nosocomial infections, 1 subglotic stenosis.Conclusions and

  20. Scavenging of photogenerated oxidative species by antimuscarinic drugs: atropine and derivatives.

    Criado, Susana; Guardianelli, Carina; Tuninetti, Jimena; Molina, Patricia; García, Norman A

    2002-01-01

    The quenching ability of photogenerated oxidative species by some antimuscarinic drugs generically named atropines (e.g. atropine [I] eucatropine [II], homatropine [III] and scopolamine [IV]) have been investigated employing stationary photolysis, polarographic detection of dissolved oxygen, stationary and time-resolved fluorescence spectroscopy, and laser flash photolysis. Using Rose Bengal as a dye sensitiser for singlet molecular oxygen, O(2)((1)Delta(g)), generation, compounds I-IV behave as moderate chemical plus physical quenchers of the oxidative species. Correlation between kinetic and electrochemical data indicates that the process is possibly driven by a charge-transfer interaction. The situation is somewhat more complicated employing the natural pigment riboflavin (Rf) as a sensitiser. Compounds I and II complex Rf ground state, diminishing the quenching ability towards singlet and triplet excited state of the pigment. On the other hand, compounds III and IV effectively quench Rf excited states, protecting the pigment against photodegradation. Under anaerobic conditions, semireduced Rf (Rf(.-)) is formed through quenching of excited triplet Rf. Nevertheless, although Rf(.-) is a well-known generator of the reactive species superoxide radical anion by reductive quenching in the presence of oxygen, the process of O(2)((1)Delta(g)) production prevails over superoxide radical generation, due to the relatively low rate constants for the quenching of triplet Rf by the atropines (in the order of 10(7) M(-1)s(-1) for compounds III and IV) in comparison to the rate constant for the quenching by ground state oxygen, approximately two orders of magnitude higher, yielding O(2)((1)Delta(g)). Compound I is the most promising O(2)((1)Delta(g)) physical scavenger, provided that it exhibits the higher value for the overall quenching rate constant and only 11% of the quenching process leads to its own chemical damage.

  1. Atropine and ODQ antagonize tetanic fade induced by L-arginine in cats

    J.M. Cruciol-Souza

    1999-10-01

    Full Text Available Although it has been demonstrated that nitric oxide (NO released from sodium nitrite induces tetanic fade in the cat neuromuscular preparations, the effect of L-arginine on tetanic fade and its origin induced by NO have not been studied in these preparations. Furthermore, atropine reduces tetanic fade induced by several cholinergic and anticholinergic drugs in these preparations, whose mechanism is suggested to be mediated by the interaction of acetylcholine with inhibitory presynaptic muscarinic receptors. The present study was conducted in cats to determine the effects of L-arginine alone or after pretreatment with atropine or 1H-[1,2,4]oxadiazole [4,3-a]quinoxalin-1-one (ODQ on neuromuscular preparations indirectly stimulated at high frequency. Drugs were injected into the middle genicular artery. L-arginine (2 mg/kg and S-nitroso-N-acetylpenicillamine (SNAP; 16 µg/kg induced tetanic fade. The Nw-nitro-L-arginine (L-NOARG; 2 mg/kg alone did not produce any effect, but reduced the tetanic fade induced by L-arginine. D-arginine (2 mg/kg did not induce changes in tetanic fade. The tetanic fade induced by L-arginine or SNAP was reduced by previous injection of atropine (1.0 µg/kg or ODQ (15 µg/kg. ODQ alone did not change tetanic fade. The data suggest that the NO-synthase-GC pathway participates in the L-arginine-induced tetanic fade in cat neuromuscular preparations. The tetanic fade induced by L-arginine probably depends on the action of NO at the presynaptic level. NO may stimulate guanylate cyclase increasing acetylcholine release and thereby stimulating presynaptic muscarinic receptors.

  2. Psychiatric and Medical Management of Marijuana Intoxication in the Emergency Department

    Bui, Quan M.

    2015-05-01

    Full Text Available We use a case report to describe the acute psychiatric and medical management of marijuana intoxication in the emergency setting. A 34-year-old woman presented with erratic, disruptive behavior and psychotic symptoms after recreational ingestion of edible cannabis. She was also found to have mild hypokalemia and QT interval prolongation. Psychiatric management of cannabis psychosis involves symptomatic treatment and maintenance of safety during detoxification. Acute medical complications of marijuana use are primarily cardiovascular and respiratory in nature; electrolyte and electrocardiogram monitoring is indicated. This patient’s psychosis, hypokalemia and prolonged QTc interval resolved over two days with supportive treatment and minimal intervention in the emergency department. Patients with cannabis psychosis are at risk for further psychotic sequelae. Emergency providers may reduce this risk through appropriate diagnosis, acute treatment, and referral for outpatient care. [West J Emerg Med. 2015;16(3:414–417.

  3. Atropine Ophthalmic

    ... eye examinations to dilate (open) the pupil, the black part of the eye through which you see. ... hands thoroughly with soap and water. Use a mirror or have someone else apply the ointment. Avoid ...

  4. Atropine-induced non-sustained polymorphic ventricular tachycardia: A rare case

    Mesut Aydın

    2014-09-01

    Full Text Available A 40 years old male with history of unexplained recurrent presyncope and palpitation episodes referred to cardiology department. Patient had no past medical history. Subsequently, electrophysiology study was performed to detect any underlying atrioventricular nodal disease or inducible tachyarrhythmias. During this period, 1.0 mg of atropine was injected intravenously to performed stimulation and patient suddenly developed polymorphic ventricular tachycardia that could not be terminated with overdrive pacing. Ventricular tachycardia was terminated spontaneously, two minutes later. J Clin Exp Invest 2014; 5 (3: 449-451

  5. Atropine’s Effects upon the Heart and Its Systemic Output,

    1986-01-01

    efficiency in terms of oxygen utilization diminished from about 28% to 21%. At the same time as Gorlin and associates initially described the excess...studies of Gorlin and Scott’s groups represent the only attempts, to date, to define the metabolic cost to the heart due to atropine. Unfortunately, neither...toxicity and effectiveness in anticholines- terase therapy. J.A.M.A. 159:1181-1184, 1959. 121. GORLIN , R., M.H. SMITH, and H.P. FLETCHER. Studies on the

  6. Acute vergiftigingen bij mens en dier. Jaaroverzicht 2005-2006. Nationaal Vergiftigingen Informatie Centrum

    Velzen AG van; Gorcum TF van; Riel AJHP van; Meulenbelt J; Vries I de; VIC

    2007-01-01

    In 2005 the National Poisons Information Centre (NVIC) received 36,375 enquiries and in 2006, 37,088, all on acute intoxications of humans and animals. These enquiries concerned about 50,000 exposures to chemical substances per year. More than half of these intoxications were due to a medication ove

  7. Effect of Acetaldehyde Intoxication and Withdrawal on NPY Expression: Focus on Endocannabinoidergic System Involvement.

    Plescia, Fulvio; Brancato, Anna; Marino, Rosa Anna Maria; Vita, Carlotta; Navarra, Michele; Cannizzaro, Carla

    2014-01-01

    Acetaldehyde (ACD), the first alcohol metabolite, plays a pivotal role in the rewarding, motivational, and addictive properties of the parental compound. Many studies have investigated the role of ACD in mediating neurochemical and behavioral effects induced by alcohol administration, but very little is known about the modulation of neuropeptide systems following ACD intoxication and withdrawal. Indeed, the neuropeptide Y (NPY) system is altered during alcohol withdrawal in key regions for cerebrocortical excitability and neuroplasticity. The primary goal of this research was to investigate the effects of ACD intoxication and withdrawal by recording rat behavior and by measuring NPY immunoreactivity in hippocampus and NAcc, two brain regions mainly involved in processes which encompass neuroplasticity in alcohol dependence. Furthermore, on the basis of the involvement of endocannabinoidergic system in alcohol and ACD reinforcing effects, the role of the selective CB1 receptor antagonist AM281 in modulating NPY expression during withdrawal was assessed. Our results indicate that (i) ACD intoxication induced a reduction in NPY expression in hippocampus and NAcc; (ii) symptoms of physical dependence, similar to alcohol's, were scored at 12 h from the last administration of ACD; and (iii) NPY levels increased in early and prolonged acute withdrawal in both brain regions examined. The administration of AM281 was able to blunt signs of ACD-induced physical dependence, to modulate NPY levels, and to further increase NPY expression during ACD withdrawal both in hippocampus and NAcc. In conclusion, the present study shows that complex plastic changes take place in NPY system during ACD intoxication and subsequent withdrawal in rat hippocampal formation and NAcc. The pharmacological inhibition of CB1 signaling could counteract the neurochemical imbalance associated with ACD, and alcohol withdrawal, likely boosting the setting up of homeostatic functional recovery.

  8. Hyperammonemia,brain edema and blood-brain barrier alterations in prehepatic portal hypertensive rats and paravrtamol intoxication

    Camila Scorticati; Juan P. Prestifilippo; Francisco X. Eizayaga; José L. Castro; Salvador Romay; Maria A. Fernández; Abraham Lemberg; Juan C. Perazzo

    2004-01-01

    AIM: To study the blood-brain barrier integrity, brain edema,animal behavior and ammonia plasma levels in prehepatic portal hypertensive rats with and without acute liver intoxication.METHODS: Adults male Wistar rats were divided into four groups. Group Ⅰ: sham operation; Ⅱ: Prehepatic portal hypertension, produced by partial portal vein ligation; Ⅲ:Acetaminophen intoxication and Ⅳ: Prehepatic portal hypertension plus acetaminophen. Acetaminophen was administered to produce acute hepatic injury. Portal pressure, liver serum enzymes and ammonia plasma levels were determined. Brain cortex water content was registered and trypan blue was utilized to study blood brain barrier integrity. Reflexes and behavioral tests were recorded.RESULTS: Portal hypertension was significantly elevated in groups Ⅱ and Ⅳ. Liver enzymes and ammonia plasma levels were increased in groups Ⅱ, Ⅳ and Ⅳ. Prehepatic portal hypertension (group Ⅱ), acetaminophen intoxication (group Ⅲ) and both (group Ⅳ) had changes in the blood brain-barrier integrity (trypan blue) and hyperammonemia. Cortical edema was present in rats with acute hepatic injury in groups Ⅲ and Ⅳ. Behavioral test (rota rod) was altered in group Ⅳ.CONCLUSION: These results suggest the possibility of another pathway for cortical edema production because blood brain barrier was altered (vasogenic) and hyperammonemia was registered (cytotoxic). Group Ⅳ, with behavioral altered test, can be considered as a model for study at an early stage of portal-systemic encephalopathy.

  9. Efficacy of prophylaxis and treatment against soman intoxication

    Philippens, I.H.C.H.M.; Jongsma, M.J.; Vanwersch, R.A.P.

    2004-01-01

    The efficacy against lethality and post-intoxication incapacitation after 2x LD50 soman of different subacute pretreatment scenarios of 12 days was tested with or without post-intoxication therapy in guinea pigs. These pretreatment regimes were 1) the currently used pretreatment with pyridostigmine

  10. Efficacy of pretreatment and treatment against soman intoxication

    Philippens, I.H.C.H.M.; Jongsma, M.J.; Vanwersch, R.A.

    2006-01-01

    The efficacy against lethality and post-intoxication incapacitation after 2x LD50 soman of different subacute pretreatment scenarios of 12 days was tested with or without post-intoxication therapy in guinea pigs. These pretreatment regimes were 1) the currently used pyridostigmine (PYR, 0.04 mg/kg/h

  11. A Methanol Intoxication Outbreak From Recreational Ingestion of Fracking Fluid.

    Collister, David; Duff, Graham; Palatnick, Wesley; Komenda, Paul; Tangri, Navdeep; Hingwala, Jay

    2017-01-19

    Single-patient methanol intoxications are a common clinical presentation, but outbreaks are rare and usually occur in settings in which there is limited access to ethanol and methanol is consumed as a substitute. In this case report, we describe an outbreak of methanol intoxications that was challenging from a public health perspective and discuss strategies for managing such an outbreak.

  12. Perfil clínico y demográfico de pacientes atendidos en los servicios de urgencias, por intoxicación aguda con sustancias psicoactivas. Bogotá D.C, julio 2010junio 2011 Clinical and demographic profile of patients nursed in urgency services due to acute intoxication with psychoactive substances in Bogotá

    Karla Mabel Cárdenas L

    2012-12-01

    general. It has been estimated that it contributes towards the rapid propagation of infectious diseases such as HIV and hepatitis. Society thus cannot afford to ignore such threat and must address such abuse. Objective. Determining the clinical and demographic profile of patients suffering acute psychoactive substance poisoning who were attended by emergency services in Bogotá, 20102011. Methods. This was a descriptive, retrospective study which emerged from reviewing 1,073 records kept by the Colombian Public Health Surveillance System (Sistema Nacional de Vigilancia en Salud Pública related to cases of people suffering from psychoactive substance poisoning who had been attended by emergency services in Bogotá, 20102011. The corresponding clinical histories were reviewed to establish the patients' clinical profile. Simple and stratified frequency were calculated, using 95% confidence intervals (95%CI, for sociodemographic variables, type of psychoactive substance and clinical manifestation. Results. Males aged 2534 years old consulted most (73%, intoxication for criminal purposes predominating (58% having been drugged to reduce resistance to assault. Benzodiazepines were implicated in 83% of the cases; 80% of clinical manifestations were neurological. Conclusion. Exposure with criminal intent predominated in this work's results; it would seem to be a phenomenon which has not been documented in the scientific literature reviewed here. Benzodiazepine exposure (the substance implicated in poisoning cases was similar to that obtained by Uribe et al., (2005 and that found in other substancerelated disorder studies.

  13. Hemolytic uremic syndrome associated with paraquat intoxication.

    Jang, Ha Nee; Bae, Eun Jin; Hwang, Kyungo; Kang, Yeojin; Yun, Seongeun; Cho, Hyun Seop; Chang, Se-Ho; Park, Dong Jun

    2014-06-01

    We report a case of a 66-year-old patient with paraquat intoxication resulting in the requirement for hemoperfusion, hemodialysis, and plasma exchange. His initial serum paraquat level was 0.24 µg/mL (0.0-0.1 µg/mL). Activated charcoal (50 g) was administered orally, and high-dose N-acetylcysteine (150 mg/kg) was administered intravenously. In addition, immediate 4 h hemoperfusion was also performed for three consecutive days after admission. Hemodialysis was started on the 4th day after admission because of uremia. On the 9th day after admission, laboratory findings demonstrated hemolytic uremic syndrome (HUS): microangiopathic hemolytic anemia (MAHA), thrombocytopenia, elevated reticulocyte count, and lactate dehydrogenase (LDH). Plasma exchange was performed three times consecutively. Anemia and thrombocytopenia were improved, and LDH was normalized after plasma exchange. Urine output increased to 2240 mL/day on the 18th day after admission, and hemodialysis was discontinued. He is currently being observed at our follow-up clinic without renal impairment or pulmonary dysfunction for 1.5 years since discharge. We should suspect paraquat-associated HUS when thrombocytopenia and anemia are maintained for a long time after paraquat intoxication.

  14. In Vivo Nanodetoxication for Acute Uranium Exposure

    Luis Guzmán

    2015-06-01

    Full Text Available Accidental exposure to uranium is a matter of concern, as U(VI is nephrotoxic in both human and animal models, and its toxicity is associated to chemical toxicity instead of radioactivity. We synthesized different PAMAM G4 and G5 derivatives in order to prove their interaction with uranium and their effect on the viability of red blood cells in vitro. Furthermore, we prove the effectiveness of the selected dendrimers in an animal model of acute uranium intoxication. The dendrimer PAMAM G4-Lys-Fmoc-Cbz demonstrated the ability to chelate the uranyl ion in vivo, improving the biochemical and histopathologic features caused by acute intoxication with uranium.

  15. Involvement of GABA transporters in atropine-treated myopic retina as revealed by iTRAQ quantitative proteomics.

    Barathi, Veluchamy A; Chaurasia, Shyam S; Poidinger, Michael; Koh, Siew Kwan; Tian, Dechao; Ho, Candice; Iuvone, P Michael; Beuerman, Roger W; Zhou, Lei

    2014-11-07

    Atropine, a muscarinic antagonist, is known to inhibit myopia progression in several animal models and humans. However, the mode of action is not established yet. In this study, we compared quantitative iTRAQ proteomic analysis in the retinas collected from control and lens-induced myopic (LIM) mouse eyes treated with atropine. The myopic group received a (-15D) spectacle lens over the right eye on postnatal day 10 with or without atropine eye drops starting on postnatal day 24. Axial length was measured by optical low coherence interferometry (OLCI), AC-Master, and refraction was measured by automated infrared photorefractor at postnatal 24, 38, and 52 days. Retinal tissue samples were pooled from six eyes for each group. The experiments were repeated twice, and technical replicates were also performed for liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis. MetaCore was used to perform protein profiling for pathway analysis. We identified a total of 3882 unique proteins with retina proteome reported to date. Thirty proteins were found to be up-regulated (ratio for myopia/control > global mean ratio + 1 standard deviation), and 28 proteins were down-regulated (ratio for myopia/control retinas. Pathway analysis using MetaCore revealed regulation of γ-aminobutyric acid (GABA) levels in the myopic eyes. Detailed analysis of the quantitative proteomics data showed that the levels of GABA transporter 1 (GAT-1) were elevated in myopic retina and significantly reduced after atropine treatment. These results were further validated with immunohistochemistry and Western blot analysis. In conclusion, this study provides a comprehensive quantitative proteomic analysis of atropine-treated mouse retina and suggests the involvement of GABAergic signaling in the antimyopic effects of atropine in mouse eyes. The GABAergic transmission in the neural retina plays a pivotal role in the maintenance of axial eye growth in mammals.

  16. Antimuscarinic-induced convulsions in fasted animals after food intake: evaluation of the effects of levetiracetam, topiramate and different doses of atropine.

    Büget, Bahar; Türkmen, Aslı Zengin; Allahverdiyev, Oruc; Enginar, Nurhan

    2016-01-01

    This study evaluated the effects of different doses of atropine and new antiepileptics, levetiracetam and topiramate, on the development of convulsions triggered by food intake in antimuscarinic-treated fasted animals. Mice deprived of food for 24 h and treated i.p. with atropine at a dose of 2.4 or 24 mg/kg developed convulsions after being allowed to eat ad libitum. No convulsions were observed in fasted animals treated with 0.24 mg/kg atropine. There was no difference in the incidence of convulsions between the two atropine treatments, but latency to convulsions was longer in 24 mg/kg atropine treated animals. The lowest dose of atropine, 0.24 mg/kg, caused stage 1 and stage 2 activity, but did not provide the convulsive endpoint (stage 3, 4, 5 activity). Administration of levetiracetam (50 or 200 mg/kg) or topiramate (50 or 100 mg/kg) to another group of 24-h fasted mice was ineffective in reducing the incidence of convulsions developed in the animals after 2.4 mg/kg atropine treatment and food intake. However, the higher dose of levetiracetam prolonged the onset of convulsions. Present results demonstrated the efficacy of low and high doses of atropine on the development of convulsions in fasted animals and provided additional evidence for the ineffectiveness of antiepileptic treatment in these seizures.

  17. Drugs of abuse: management of intoxication and antidotes.

    Montoya, Ivan D; McCann, David J

    2010-01-01

    Illicit drug intoxications are an increasing public health problem for which, in most cases, no antidotes are clinically available. The diagnosis and treatment of these intoxications requires a trained clinician with experience in recognizing the specific signs and symptoms of intoxications to individual drugs as well as polydrug intoxications, which are more the rule than the exception. To make the diagnosis, the clinical observation and a urine toxicology test are often enough. Evaluating the blood levels of drugs is frequently not practical because the tests can be expensive and results may be delayed and unavailable to guide the establishment of a treatment plan. Other laboratory tests may be useful depending on the drug or drugs ingested and the presence of other medical complications. The treatment should be provided in a quiet, safe and reassuring environment. Vital signs should be closely monitored. Changes in blood pressure, respiratory frequency and temperature should be promptly treated, particularly respiratory depression (in cases of opiate intoxication) or hyperthermia (in cases of cocaine or amphetamine intoxication). Intravenous fluids should be administered as soon as possible. Other psychiatric and medical complication should receive appropriate symptomatic treatment. Research on immunotherapies, including vaccines, monoclonal and catalytic antibodies, seems to be a promising approach that may yield specific antidotes for drugs of abuse, helping to ameliorate the morbidity and mortality associated with illicit drug intoxications.

  18. A multidisciplinary overview of intoxicating snuff rituals in the western hemisphere.

    de Smet, P A

    1985-03-01

    Part one of the paper discusses ethnobotanical, chemical and general pharmacological aspects of intoxicating snuff rituals in the western hemisphere. Four categories of ritual snuff ingredients arise from this multidisciplinary approach: It is well established that the plant contains one or more psychoactive principles and the Indian use of the plant as a ritual snuff ingredient is confirmed or quite probable: Anadenanthera, Erythroxylum, Nicotiana, Virola; It is well established that the plant contains one or more psychoactive principles, but the Indian use of the plant as a ritual snuff ingredient is not well recorded or even unlikely: Banisteriopsis, Cannabis, Datura, Ilex guayusa; The Indian use of the plant as a ritual snuff ingredient is confirmed or quite probable, but it is not well established that the plant contains one or more psychoactive principles: Justicia pectoralis, Pagamea macrophylla, Tanaecium nocturnum; The Indian use of the plant as a ritual snuff ingredient is not well recorded, and it is not well established that the plant contains one or more psychoactive principles: Acorus calamus, Capsicum, Macquira sclerophylla, Piper interitum. Part two of the paper discusses the nasal pharmacokinetics and efficacy of possible ritual snuff constituents. The literature yields convincing clinical evidence that atropine, cocaine, nicotine and scopolamine are effective following nasal application, but experimental confirmation of the efficacy of nasal tryptamine alkaloids is still awaited. In self-experiments, 6.4 mg/kg of caffeine produced substantial plasma levels via the nasal route, but 0.5 mg/kg of harmine did not produce measurable plasma levels, when taken as a nasal powder. Without additional experiments, it is difficult to give a definite explanation for this negative result.

  19. Oral intoxication of mice with Shiga toxin type 2a (Stx2a) and protection by anti-Stx2a monoclonal antibody 11E10.

    Russo, L M; Melton-Celsa, A R; Smith, M A; Smith, M J; O'Brien, A D

    2014-03-01

    Shiga toxin (Stx)-producing Escherichia coli (STEC) strains cause food-borne outbreaks of hemorrhagic colitis and, less commonly, a serious kidney-damaging sequela called the hemolytic uremic syndrome (HUS). Stx, the primary virulence factor expressed by STEC, is an AB5 toxin with two antigenically distinct forms, Stx1a and Stx2a. Although both toxins have similar biological activities, Stx2a is more frequently produced by STEC strains that cause HUS than is Stx1a. Here we asked whether Stx1a and Stx2a act differently when delivered orally by gavage. We found that Stx2a had a 50% lethal dose (LD50) of 2.9 μg, but no morbidity occurred after oral intoxication with up to 157 μg of Stx1a. We also compared several biochemical and histological parameters in mice intoxicated orally versus intraperitoneally with Stx2a. We discovered that both intoxication routes caused similar increases in serum creatinine and blood urea nitrogen, indicative of kidney damage, as well as electrolyte imbalances and weight loss in the animals. Furthermore, kidney sections from Stx2a-intoxicated mice revealed multifocal, acute tubular necrosis (ATN). Of particular note, we detected Stx2a in kidney sections from orally intoxicated mice in the same region as the epithelial cell type in which ATN was detected. Lastly, we showed reduced renal damage, as determined by renal biomarkers and histopathology, and full protection of orally intoxicated mice with monoclonal antibody (MAb) 11E10 directed against the toxin A subunit; conversely, an irrelevant MAb had no therapeutic effect. Orally intoxicated mice could be rescued by MAb 11E10 6 h but not 24 h after Stx2a delivery.

  20. Intoxicação aguda por aldrin: relação dos níveis séricos com efeitos tóxicos no homem Acute intoxication by aldrin: relationship between clinical signs and serum levels in man

    Wilson Andrade Carvalho

    1990-02-01

    inseticida.In the attempt to correlate clinical findings with serum levels of aldrin, sixteen patients were followed-up after acute intoxication by this agent. Eight of them, males and females, aged from 1 to 37 years, presented no or light symptoms (some discomfort and nausea. The serum of one of these patients was found to contain 16.6 ppb of aldrin and that of another, 1.41 ppb of dieldrin. A group of five patients, aged from two to 30 years, showed symptoms of moderate severity, reporting nausea, vomiting, drowsiness, dyspnea, sweating, mild jerking, rise in blood pressure and convulsions. Of these cases, two were accidental and three were attempted suicides, the majority achieving complete recovery within 24 hours. Serum levels of aldrin were between 6.98 ppb and 26.3 ppb and of dieldrin between 82.00 and 314.18 ppb. We found three severe cases, aged from 21 to 35 years, two attempted suicides and one occupational case. Two of these patients died and one of them presented hypothermia, coma, absence of reflexes and generalized convulsions, and another presented abdominal pain, paleness, sweating, cold extremities, dyspnea, hyperthermia and generalized convulsions. In the first one that died the serum levels were: of aldrin 30.00 ppb and of dieldrin 720 ppb. In the other levels of 747.3 ppb of aldrin and 1,314.00 ppb of dieldrin were found. The third had less serious symptoms and presented serum levels of aldrin of 31.05 ppb and of dieldrin 147.11 ppb. These data seem to indicate that the serum levels of aldrin or of its metabolite dieldrin do not show great correlation between clinical signs and acute toxicity, because patients were found that presented serious symptoms, such as convulsions, without presenting other prior clinical signs and in whom the blood levels of aldrin and dieldrin were found to be as low as 7.2 ppb and 90.40 ppb, respectively. The lethal blood levels were 700 ppb of aldrin and raged from 720 ppb to 1,314.00 ppb of dieldrin.

  1. Salt wastage, plasma volume contraction and hypokalemic paralysis in self-induced water intoxication.

    Tanneau, R S; Pennec, Y L; Morin, J F; Codet, J P; Bourbigot, B; Garre, M; Le Menn, G

    1993-01-01

    Eleven episodes of severe hyponatremia secondary to hiccup-induced potomania were recorded in 3 years in a man who had essential hypertension, a low protein intake and a normal diluting ability. Paradoxical increase in hematocrit and plasma protein with acute extensive natriuresis was associated as well as urine potassium loss and hypokalemia producing paralysis in 1 episode. During a chronic water loading test, the defect in water excretion was related to a low urine solute delivery which was partially reverted by the natriuretic response to plasma volume expansion, promoting water diuresis. In acute water intoxication, this natriuretic response was exaggerated, producing a brisk water diuresis. Plasma volume was rapidly normalized but without any improvement in plasma sodium due to the concomitant negative sodium balance. Thus, water diuresis persisted until plasma volume was significantly contracted. Potassium loss appeared to be related to sodium excretion. Metabolic disturbances have not reoccurred despite persistent hiccup and potomania during 2 years of urea therapy.

  2. Leaching of zinc compound from rubber stoppers into the contents of automatic atropine injectors.

    Ellin, R I; Kaminskis, A; Zvirblis, P; Sultan, W E; Shutz, M B; Matthews, R

    1985-07-01

    This report describes how a material within the cartridge of an automatic injector contaminated its contents. On prolonged storage, a formulation that contained atropine produced lethality in mice. The toxic material originated from zinc compounds that were present in the rubber stopper and plunger of the container and that subsequently leached into the formulation. The contents of cartridges that contained greater than or equal to 0.75 mg/mL of solubilized zinc were lethal to at least 20% of the mice tested; those that contained 0.42 mg/mL showed no lethality. The problem resulted from the physicochemical properties of the rubber, not the concentration of zinc used in the vulcanization process.

  3. Acute severe organophosphate poisoning in a child who was successfully treated with therapeutic plasma exchange, high-volume hemodiafiltration, and lipid infusion.

    Yesilbas, Osman; Kihtir, Hasan S; Altiti, Mohammad; Petmezci, Mey Talip; Balkaya, Seda; Bursal Duramaz, Burcu; Ersoy, Melike; Sevketoglu, Esra

    2016-10-01

    Acute severe organophosphate poisoning is a serious complication seen in developing and agricultural countries. Pralidoxime and high dose atropine are the standard treatments. There is no consensus about acute severe organophosphate poisonings that are unresponsive to pralidoxime, atropine, and supportive therapies. We report a case of acute severe organophosphate poisoning that was unresponsive to standard treatments and successfully treated with high-volume continuous venovenous hemodiafiltration and therapeutic plasma exchange combined with lipid infusion. J. Clin. Apheresis 31:467-469, 2016. © 2015 Wiley Periodicals, Inc.

  4. Quantitative coronary angiography in the estimation of the functional significance of coronary stenosis: correlations with dobutamine-atropine stress test

    J.M.P. Baptista da Silva (José); M. Arnese (Mariarosaria); J.R.T.C. Roelandt (Jos); P.M. Fioretti (Paolo); D.T.J. Keane (David); J. Escaned (Javier); C. di Mario (Carlo); P.W.J.C. Serruys (Patrick); H. Boersma (Eric)

    1994-01-01

    textabstractOBJECTIVES. The purpose of this study was to determine the predictive value of quantitative coronary angiography in the assessment of the functional significance of coronary stenosis as judged from the development of left ventricular wall motion abnormalities during dobutamine-atropine s

  5. NEUROMUSCULAR AND CARDIOVASCULAR EFFECTS OF NEOSTIGMINE AND METHYL-ATROPINE ADMINISTERED AT DIFFERENT DEGREES OF ROCURONIUM-INDUCED NEUROMUSCULAR BLOCK

    VANDENBROEK, L; PROOST, JH; WIERDA, JMKH; NJOO, MD; HENNIS, PJ

    1994-01-01

    The neuromuscular and cardiovascular effects of neostigmine, 40 mug kg-1, and methyl-atropine, 7 mug kg-1, administered at different degrees of rocuronium-induced (600 mug kg-1) neuromuscular block were evaluated. In one group of patients spontaneous recovery was awaited (Group A; n = 20). Neostigmi

  6. Isolation and identification of trichothecenes from Fusarium compactum suspected in the aetiology of a major intoxication of sandhill cranes.

    Cole, Richard J.; Dorner, Joe W.; Gilbert, John; Mortimer, David N.; Crews, Colin; Mitchell, J.C.; Windingstad, Ronald M.; Nelson, Paul E.; Cutler, Horace G.

    1988-01-01

    Isoneosolaniol (4,8-diacetoxy-12,13-epoxytrichothec-9-ene-3,15-diol) and other unidentified trichothecene mycotoxins were isolated from culture extracts of two highly toxigenic strains of Fusarium compactum cultured from waste peanuts involved in an acute intoxication of sandhill cranes (Grus canadensis). Neosolaniol and other unidentified trichothecenes were detected in waste peanuts collected from affected areas. The structure of isoneosolaniol was determined by 1H and 13C NMR analyses and by high-resolution mass spectometry. Isoneosolaniol was hightly toxic to 1-day-old chickens and to a HEp2 cell culture assay. It was concluded that the most logical cause of the sandhill crane intoxication was Fusarium spp. Contaminated peanuts and various trichothecene mycotoxins acting alone or in conjunction with other Fusarium mycotoxins.

  7. Severe childhood amitriptyline intoxication and plasmapheresis: a case report.

    Karacı, Mehmet; Özçetin, Mustafa; Dilsiz, Günter; Güçlü-Songür, Yaşar Gözde

    2013-01-01

    Tricyclic antidepressant intoxication is one of the most frequently encountered and life-threatening causes of intoxication among referrals to emergency departments due to drug intoxication. There is no known antidote against any of the tricyclic antidepressants. The American Society for Apheresis (ASFA) recommends plasmapheresis to support primary treatment in this type of drug poisoning, which does not respond to certain and traditional treatments. We present a 15-year-old girl who ingested amitriptyline with suicidal intent. On admission, she was in a comatose state (Glasgow Coma Scale score: 5), with no spontaneous respiration and presence of pathological reflexes. Due to the intake history of lethal doses and the severe clinical picture, plasmapheresis was performed. She was discharged on her fifth day of hospitalization.Due to the high plasma protein binding property of amitriptyline, plasma exchange therapy should be considered in cases of severe amitriptyline intoxication as a life-saving therapeutic modality.

  8. Intralipid emulsion treatment as an antidote in lipophilic drug intoxications.

    Eren Cevik, Sebnem; Tasyurek, Tanju; Guneysel, Ozlem

    2014-09-01

    Intravenous lipid emulsion (ILE) is a lifesaving treatment of lipophilic drug intoxications. Not only does ILE have demonstrable efficacy as an antidote to local anesthetic toxicity, it is also effective in lipophilic drug intoxications. Our case series involved 10 patients with ingestion of different types of lipophilic drugs. Intravenous lipid emulsion treatment improved Glasgow Coma Scale or blood pressure and pulse rate or both according to the drug type. Complications were observed in 2 patients (minimal change pancreatitis and probable ILE treatment-related fat infiltration in lungs). In our case series, ILE was used for different lipophilic drug intoxications to improve cardiovascular and neurologic symptoms. According to the results, it was found that ILE treatment is a lifesaving agent in lipophilic drug intoxications and it can be used in unconscious patients who have cardiac and/or neurologic symptoms but no history of a specific drug ingestion.

  9. [Sudden unilateral sensorineural hearing loss after carbon monoxide intoxication].

    Michalska-Piechowiak, Teresa; Miarzyńska, Maria; Perlik-Gattner, Irena

    2004-01-01

    A case of unilateral sensorineural hearing loss of the left ear after carbon monoxide intoxication was presented. The diagnosis was based upon an interview, medical examinations and audiometric investigations. Results of diagnostic evaluations, clinical presentation and treatment were discussed. Hearing improvement was obtained after 6 days of treatment and normal hearing returned after 14 days. Patients who suffer from CO intoxication are at risk of hearing impairment, therefore, there is a need for audiometric follow up in these patients.

  10. Diphenyl Ditelluride Intoxication Triggers Histological Changes in Liver, Kidney, and Lung of Mice

    da Luz, Sônia Cristina Almeida; Daubermann, Melissa Falster; Thomé, Gustavo Roberto; dos Santos, Matheus Mülling; Ramos, Angelica; Torres Salazar, Gerson; da Rocha, João Batista Teixeira; Barbosa, Nilda Vargas

    2015-01-01

    Tellurium compounds may be cytotoxic to different cells types. Thus, this work evaluated the effect of diphenyl ditelluride ((PhTe)2), an organotellurium commonly used in organic synthesis, on the morphology of liver, kidney, and lung. Adult mice were acutely (a subcutaneous single dose: 250 μmol/kg) or subchronically (one daily subcutaneous dose: 10 or 50 μmol/kg for 7 and 14 days) exposed to (PhTe)2. Afterwards, the histological analyses of liver, kidney, and lungs were performed. Liver histology revealed that the hepatocytes of mice subchronically exposed to (PhTe)2 presented cytoplasmic vacuolization, hydropic degeneration, and hyperchromatic nuclei. Subchronic exposure to 50 μmol/kg (PhTe)2 also caused hepatic necrosis. Microvesicular and macrovesicular steatosis were identified in liver of mice acutely exposed to (PhTe)2. Acute and subchronic intoxication with (PhTe)2 induced changes on epithelial cells of renal tubules, namely, loss of brush border and cytoplasmatic vacuolization. Atrophy and hypertrophy, cast proteinaceous formation, and acute tubular necrosis were also identified in renal tissue. Mice subchronically exposed to 50 μmol/kg (PhTe)2 developed intra-alveolar edema and alveolar wall congestion in some areas of lungs. Acute exposure to (PhTe)2 did not cause histological changes in lungs. Our data show that (PhTe)2 may be considered a histotoxic agent for liver, kidney, and lung. PMID:26236579

  11. Diphenyl ditelluride intoxication triggers histological changes in liver, kidney, and lung of mice.

    da Luz, Sônia Cristina Almeida; Daubermann, Melissa Falster; Thomé, Gustavo Roberto; Dos Santos, Matheus Mülling; Ramos, Angelica; Torres Salazar, Gerson; da Rocha, João Batista Teixeira; Barbosa, Nilda Vargas

    2015-01-01

    Tellurium compounds may be cytotoxic to different cells types. Thus, this work evaluated the effect of diphenyl ditelluride ((PhTe)2), an organotellurium commonly used in organic synthesis, on the morphology of liver, kidney, and lung. Adult mice were acutely (a subcutaneous single dose: 250 μmol/kg) or subchronically (one daily subcutaneous dose: 10 or 50 μmol/kg for 7 and 14 days) exposed to (PhTe)2. Afterwards, the histological analyses of liver, kidney, and lungs were performed. Liver histology revealed that the hepatocytes of mice subchronically exposed to (PhTe)2 presented cytoplasmic vacuolization, hydropic degeneration, and hyperchromatic nuclei. Subchronic exposure to 50 μmol/kg (PhTe)2 also caused hepatic necrosis. Microvesicular and macrovesicular steatosis were identified in liver of mice acutely exposed to (PhTe)2. Acute and subchronic intoxication with (PhTe)2 induced changes on epithelial cells of renal tubules, namely, loss of brush border and cytoplasmatic vacuolization. Atrophy and hypertrophy, cast proteinaceous formation, and acute tubular necrosis were also identified in renal tissue. Mice subchronically exposed to 50 μmol/kg (PhTe)2 developed intra-alveolar edema and alveolar wall congestion in some areas of lungs. Acute exposure to (PhTe)2 did not cause histological changes in lungs. Our data show that (PhTe)2 may be considered a histotoxic agent for liver, kidney, and lung.

  12. Diphenyl Ditelluride Intoxication Triggers Histological Changes in Liver, Kidney, and Lung of Mice

    Sônia Cristina Almeida da Luz

    2015-01-01

    Full Text Available Tellurium compounds may be cytotoxic to different cells types. Thus, this work evaluated the effect of diphenyl ditelluride ((PhTe2, an organotellurium commonly used in organic synthesis, on the morphology of liver, kidney, and lung. Adult mice were acutely (a subcutaneous single dose: 250 μmol/kg or subchronically (one daily subcutaneous dose: 10 or 50 μmol/kg for 7 and 14 days exposed to (PhTe2. Afterwards, the histological analyses of liver, kidney, and lungs were performed. Liver histology revealed that the hepatocytes of mice subchronically exposed to (PhTe2 presented cytoplasmic vacuolization, hydropic degeneration, and hyperchromatic nuclei. Subchronic exposure to 50 μmol/kg (PhTe2 also caused hepatic necrosis. Microvesicular and macrovesicular steatosis were identified in liver of mice acutely exposed to (PhTe2. Acute and subchronic intoxication with (PhTe2 induced changes on epithelial cells of renal tubules, namely, loss of brush border and cytoplasmatic vacuolization. Atrophy and hypertrophy, cast proteinaceous formation, and acute tubular necrosis were also identified in renal tissue. Mice subchronically exposed to 50 μmol/kg (PhTe2 developed intra-alveolar edema and alveolar wall congestion in some areas of lungs. Acute exposure to (PhTe2 did not cause histological changes in lungs. Our data show that (PhTe2 may be considered a histotoxic agent for liver, kidney, and lung.

  13. Acute koolmonoxide-intoxicatie bij tien personen

    de Vries I; Hegger C; Joore JCA; Savelkoul TJF; Meulenbelt J

    1992-01-01

    January 1992 ten persons (all adults, seven women and three men) were admitted to the special unit for calamities of the Intensive Care and Clinical Toxicology department of the University Hospital Utrecht with symptoms of an acute carbon monixide intoxication. All persons were exployees of the sam

  14. Addition of atropine to submaximal exercise stress testing in patients evaluated for suspected ischaemia with SPECT imaging: a randomized, placebo-controlled trial

    Manganelli, Fiore; Sauro, Rosario; Di Lorenzo, Emilio; Rosato, Giuseppe [San Giuseppe Moscati Hospital, Department of Cardiology and Heart Surgery, Avellino (Italy); Spadafora, Marco; Varrella, Paola; Peluso, Giuseppina [San Giuseppe Moscati Hospital, Nuclear Medicine Unit, Avellino (Italy); Daniele, Stefania [Institute of Diagnostic and Nuclear Development (SDN), Naples (Italy); Cuocolo, Alberto [Institute of Diagnostic and Nuclear Development (SDN), Naples (Italy); University Federico II, Department of Biomorphological and Functional Sciences, Naples (Italy); National Council of Research, Institute of Biostructures and Bioimages, Naples (Italy)

    2011-02-15

    To evaluate the effects of the addition of atropine to exercise testing in patients who failed to achieve their target heart rate (HR) during stress myocardial perfusion imaging with single-photon emission computed tomography (SPECT). The study was a prospective, randomized, placebo-controlled design. Patients with suspected or known coronary artery disease who failed to achieve a target HR ({>=}85% of maximal predicted HR) during exercise SPECT imaging were randomized to receive intravenous atropine (n = 100) or placebo (n = 101). The two groups of patients did not differ with respect to demographic or clinical characteristics. A higher proportion of patients in the atropine group achieved the target HR compared to the placebo group (60% versus 3%, p < 0.0001). SPECT imaging was abnormal in a higher proportion of patients in the atropine group as compared to the placebo group (57% versus 42%, p < 0.05). Stress-induced myocardial ischaemia was present in more patients in the atropine group as compared to placebo (47% versus 29%, p < 0.01). In both groups of patients, no major side effects occurred. The addition of atropine at the end of exercise testing is more effective than placebo in raising HR to adequate levels, without additional risks of complications. The use of atropine in patients who initially failed to achieve their maximal predicted HR is associated with a higher probability of achieving a diagnostic myocardial perfusion study. (orig.)

  15. Fatal mephedrone intoxication--a case report.

    Adamowicz, Piotr; Tokarczyk, Bogdan; Stanaszek, Roman; Slopianka, Markus

    2013-01-01

    A death caused by a new designer drug, 4-methylmethcathinone (mephedrone), is reported. Eight small plastic bags containing white powder were found in the jacket of a young dead male. Spot tests conducted by the police officer indicated the presence of 4-bromo-2,5-dimethoxyphenethylamine (2C-B) in the powders. Laboratory routine screening analyses of blood and vitreous humor did not reveal any positive results; therefore, 2C-B was excluded. Analysis of powders was conducted using gas chromatography-mass spectrometry and high-pressure liquid chromatography with diode array detection. The purity of mephedrone found in all powder samples was in the range of 80.4-87.3%. In connection with these findings, blood and vitreous humor samples were analyzed for mephedrone. Analyses were conducted using liquid chromatography-tandem mass spectrometry. Mephedrone was found in blood and vitreous humor at the concentrations of 5.5 and 7.1 µg/mL, respectively, revealing that this was a fatal mephedrone intoxication.

  16. Retrospective Evaluation of Intoxication Cases Presented to Sivas Numune Hospital

    Yadigar Yılmaz

    2013-12-01

    Full Text Available Aim: In this study, we aimed to evaluate the epidemiological and demographic features and prognosis of all patients admitted to the emergency department and followed in intensive care unit due to poisoning. Methods: We resrospectively evaluated the patients over 14 years of age, who attended to the emergency department and was followed in our intensive care unit due to poisoning, were evaluated according to their demographic characteristics, anamnesis and prognosis. Results: Of 1894 patients, who were admitted to the emergency department, 1034 were female (54.8%. The mean age was 32.76±14.88 years. 36.4% of these patients were suicide attempters. Three hundred twenty-eight patients (17.3% were admitted to the intensive care unit. Two hundred thirty-four (17.3% were females and the mean age was 27.98±13.87 years. Of those patients, 263 (80.2% were treated for drug intoxications, 33 (10.1% for carbonmonoxide (CO intoxications, 18 (5.5% for food intoxications, 4 (1.2% for insecticide poisoning, 4 (1.2% for bee sting, 3 (0.9% for rat poison intoxications, 1 (0,3% for alcohol intoxication, and 1 (0.3% was treated for snakebite. 80.5% of them were suicide attempters. The most frequently taken drugs were antidepressants (25.8%. Conclusion: Intoxication cases admitted to the emergency department and intensive care unit were mostly young women, and drug overdose was the most common attempted method of suicide. The most frequent used drugs were antidepressants. In this study, we determined the patient profile of intoxication in Sivas province. (The Medical Bulletin of Haseki 2013; 51: 178-82

  17. Paraquat intoxication and associated pathological findings in three dogs in South Africa.

    Williams, June H; Whitehead, Zandri; Van Wilpe, Erna

    2016-11-09

    Paraquat is a bipyridylium non-selective contact herbicide commonly used worldwide. When ingestion occurs by humans and animals either accidentally, intentionally or maliciously, paraquat selectively accumulates in the lungs resulting in the production of oxygen-free radicals, causing membrane damage and cell death. Intoxicated subjects typically show progressive and fatal pulmonary haemorrhage, collapse and oedema. In individuals surviving the acute phase, pulmonary fibrosis develops. Gastrointestinal-, renal- and central nervous system clinical signs may also occur. Owing to the lack of effective treatment and absence of an antidote, the prognosis is poor. The clinical presentation, clinicopathological findings and treatment are briefly described of three dogs from one South African household, intoxicated with paraquat. Macroscopic and microscopic lesions in one dog that was necropsied, as well as pulmonary ultrastructure are detailed and illustrated for academic reference. All dogs presented with tachypnoea and dyspnoea 2-3 days after accidental paraquat ingestion. Treatment was aimed at reducing gastrointestinal absorption, enhancing elimination by diuresis and avoiding further oxidative damage by administration of antioxidants. All dogs, however, became progressively hypoxic despite treatment and were euthanised. Paraquat toxicity should be a differential diagnosis in dogs with unexplained progressive respiratory and gastrointestinal signs and renal failure. The local veterinary profession should be aware of accidental or intentional paraquat toxicity of animals. Existing literature, variations possible in canine clinical signs, measured parameters, lesions, as well as possible treatments, promising experimental antidotes and management options are discussed.

  18. Paraquat intoxication and associated pathological findings in three dogs in South Africa

    June H. Williams

    2016-02-01

    Full Text Available Paraquat is a bipyridylium non-selective contact herbicide commonly used worldwide. When ingestion occurs by humans and animals either accidentally, intentionally or maliciously, paraquat selectively accumulates in the lungs resulting in the production of oxygen-free radicals, causing membrane damage and cell death. Intoxicated subjects typically show progressive and fatal pulmonary haemorrhage, collapse and oedema. In individuals surviving the acute phase, pulmonary fibrosis develops. Gastrointestinal-, renal- and central nervous system clinical signs may also occur. Owing to the lack of effective treatment and absence of an antidote, the prognosis is poor. The clinical presentation, clinicopathological findings and treatment are briefly described of three dogs from one South African household, intoxicated with paraquat. Macroscopic and microscopic lesions in one dog that was necropsied, as well as pulmonary ultrastructure are detailed and illustrated for academic reference. All dogs presented with tachypnoea and dyspnoea 2–3 days after accidental paraquat ingestion. Treatment was aimed at reducing gastrointestinal absorption, enhancing elimination by diuresis and avoiding further oxidative damage by administration of antioxidants. All dogs, however, became progressively hypoxic despite treatment and were euthanised. Paraquat toxicity should be a differential diagnosis in dogs with unexplained progressive respiratory and gastrointestinal signs and renal failure. The local veterinary profession should be aware of accidental or intentional paraquat toxicity of animals. Existing literature, variations possible in canine clinical signs, measured parameters, lesions, as well as possible treatments, promising experimental antidotes and management options are discussed.

  19. [Prolonged convulsion after intoxication of alachlor herbicide (Lasso): a case report].

    Naito, Hiromichi; Nagae, Masaharu; Okahara, Shuji; Maeyama, Hiroki; Okada, Daisuke; Hagioka, Shingo; Morimoto, Naoki

    2011-03-01

    We experienced a case of alachlor herbicide (Lasso) intoxication. A 57-year-old man was transported to our hospital by ambulance after ingesting 450 mL of Lasso. He was unconscious and had difficulty in breathing. Gastric lavage was performed after tracheal intubation and the patient was placed on mechanical ventilation. Activated charcoal and laxative were administrated. Even after admission, disturbance of consciousness persisted. He had liver and kidney disorders but these did not progress to multiple organ failure. He experienced convulsions from day 4 and was administered anticonvulsants. Convulsion was intractable and needed long-term treatment. His general condition improved until discharge. He was weaned from mechanical ventilation and recovered consciousness, but he still displayed tremors. The herbicide (Lasso) is a combination of alachlor and monochlorobenzene. Studies have shown that alachlor is neurotoxic and monochlorobenzene accumulates in the brain. In case of intoxication with the herbicide Lasso, treatment is required for ameliorating neurotoxic effects and intractable convulsion as well as liver and kidney disorders, gastrointestinal mucosal damage, hematopoietic disorder, and acute circulatory failure.

  20. Intoxicación por alcoholes Alcohol intoxication

    J. Roldán

    2003-01-01

    Full Text Available La intoxicación etílica es la primera toxicomanía en muchos países del mundo. Afecta a todos los tramos de edad, en los dos sexos y en casi todos los grupos sociales. La mortalidad asociada sólo a la intoxicación etílica aguda es excepcional, pero puede ser un importante factor si coexiste con ingesta de otras drogas de abuso. Es responsable directo de más de la mitad de los accidentes de tráfico. El diagnóstico es fácil por la anamnesis y la clínica y se puede confirmar determinando el nivel de etanol en sangre. El tratamiento es de sostén, intentando proteger al paciente de complicaciones secundarias. El metanol o alcohol de quemar se utiliza como disolvente, encontrándose también como adulterante de bebidas alcohólicas. La intoxicación vía oral es la más frecuente. Oxidado en el hígado a través de la enzima alcohol deshidrogenasa, la toxicidad se debe a sus metabolitos, formaldehído y ácido fórmico. La clínica consiste fundamentalmente en cefalea, náuseas, vómitos, hipotensión y depresión del SNC. El nervio óptico es especialmente sensible pudiendo producirse una ceguera total e irreversible. El etilenglicol se utiliza como disolvente y anticongelante; la toxicidad se debe a la acumulación de sus metabolitos. La clínica incluye síntomas comunes con la intoxicación metílica. Puede ocurrir fallo renal por necrosis tubular y depósito de cristales de oxalato.Alcohol intoxication is the principal drug addiction in many countries of the world. It affects all age groups, both sexes and almost all social groups. Mortality associated with acute alcohol poisoning on its own is exceptional, but it can be an important factor if it coexists with recreational drugs. It is directly responsible for more than half of traffic accidents. Diagnosis is easy by means of anamnesis and clinical examination, and can be confirmed by determining the level of ethanol in the bloodstream. Supportive care is the best therapy in order to

  1. Animal models that best reproduce the clinical manifestations of human intoxication with organophosphorus compounds.

    Pereira, Edna F R; Aracava, Yasco; DeTolla, Louis J; Beecham, E Jeffrey; Basinger, G William; Wakayama, Edgar J; Albuquerque, Edson X

    2014-08-01

    The translational capacity of data generated in preclinical toxicological studies is contingent upon several factors, including the appropriateness of the animal model. The primary objectives of this article are: 1) to analyze the natural history of acute and delayed signs and symptoms that develop following an acute exposure of humans to organophosphorus (OP) compounds, with an emphasis on nerve agents; 2) to identify animal models of the clinical manifestations of human exposure to OPs; and 3) to review the mechanisms that contribute to the immediate and delayed OP neurotoxicity. As discussed in this study, clinical manifestations of an acute exposure of humans to OP compounds can be faithfully reproduced in rodents and nonhuman primates. These manifestations include an acute cholinergic crisis in addition to signs of neurotoxicity that develop long after the OP exposure, particularly chronic neurologic deficits consisting of anxiety-related behavior and cognitive deficits, structural brain damage, and increased slow electroencephalographic frequencies. Because guinea pigs and nonhuman primates, like humans, have low levels of circulating carboxylesterases-the enzymes that metabolize and inactivate OP compounds-they stand out as appropriate animal models for studies of OP intoxication. These are critical points for the development of safe and effective therapeutic interventions against OP poisoning because approval of such therapies by the Food and Drug Administration is likely to rely on the Animal Efficacy Rule, which allows exclusive use of animal data as evidence of the effectiveness of a drug against pathologic conditions that cannot be ethically or feasibly tested in humans.

  2. Use of atropine to predict the accommodative component in esotropia with hypermetropia

    Mihir Kothari

    2011-01-01

    Full Text Available This cohort study included children with esotropia and hypermetropia of ≥ +2.0 diopters (D. The deviation was measured at presentation, under atropine cycloplegia and 3 months after full refractive correction. Of 44 children with a mean age of 5.2 ± 2.4 years, 25 were males. Eighteen (41% had fully refractive accommodative esotropia (RAE, 10 (23% had partial accommodative esotropia (PAE, and 5 (11% had nonaccommodative esotropia (NAE. Eleven (25% had convergence excess (CE. Under cycloplegia, all with RAE and RAE with CE had orthotropia. There was no significant change in the deviation in the patients with NAE. The deviation under cycloplegia and that with full refractive correction in PAE and PAE with CE (with +3.0 D addition were not different. The intraclass correlation coefficient for deviation under cycloplegia and after full refractive correction (+3.0 D addition for CE was 0.89. It was concluded that ocular deviation under cycloplegia can help to predict the accommodative component in esotropia with hypermetropia.

  3. Sedation of children for auditory brainstem response using ketamine-midazolam-atropine combination - a retrospective analysis.

    Bocskai, Tímea; Németh, Adrienne; Bogár, Lajos; Pytel, József

    2013-12-01

    Authors investigated sedation quality in children for auditory brainstem response testing. Two-hundred and seventy-six sedation procedures were retrospectively analyzed using recorded data focusing on efficacy of sedation and complications. Intramuscular ketamine-midazolam-atropine combination was administered on sedation preceded by narcotic suppository as pre-medication. On using the combination vital parameters remained within normal range, the complication rate was minimal. Pulse rate, arterial blood pressure and pulse oxymetry readings were stable, hypoventilation developed in 4, apnoea in none of the cases, post-sedation agitation occurred in 3 and nausea and/or vomiting in 2 cases. Repeated administration of narcotic agent was necessary in a single case only. Our practice is suitable for the sedation assisting hearing examinations in children. It has no influence on the auditory brainstem testing, the conditions necessary for the test can be met entirely with minimal side-effects. Our practice provides a more lasting sedation time in children during the examination hence there is no need for the repetition of the narcotics.

  4. Hawthorn (Crataegus monogyna Jacq.) extract exhibits atropine-sensitive activity in a cultured cardiomyocyte assay.

    Salehi, Satin; Long, Shannon R; Proteau, Philip J; Filtz, Theresa M

    2009-01-01

    Hawthorn (Crataegus spp.) plant extract is used as a herbal alternative medicine for the prevention and treatment of various cardiovascular diseases. Recently, it was shown that hawthorn extract preparations caused negative chronotropic effects in a cultured neonatal murine cardiomyocyte assay, independent of beta-adrenergic receptor blockade. The aim of this study was to further characterize the effect of hawthorn extract to decrease the contraction rate of cultured cardiomyocytes. To test the hypothesis that hawthorn is acting via muscarinic receptors, the effect of hawthorn extract on atrial versus ventricular cardiomyocytes in culture was evaluated. As would be expected for activation of muscarinic receptors, hawthorn extract had a greater effect in atrial cells. Atrial and/or ventricular cardiomyocytes were then treated with hawthorn extract in the presence of atropine or himbacine. Changes in the contraction rate of cultured cardiomyocytes revealed that both muscarinic antagonists significantly attenuated the negative chronotropic activity of hawthorn extract. Using quinuclidinyl benzilate, L-[benzylic-4,4'-(3)H] ([(3)H]-QNB) as a radioligand antagonist, the effect of a partially purified hawthorn extract fraction to inhibit muscarinic receptor binding was quantified. Hawthorn extract fraction 3 dose-dependently inhibited [(3)H]-QNB binding to mouse heart membranes. Taken together, these findings suggest that decreased contraction frequency by hawthorn extracts in neonatal murine cardiomyocytes may be mediated via muscarinic receptor activation.

  5. Percutaneous exposure to the nerve agent VX: Efficacy of combined atropine, obidoxime and diazepam treatment.

    Joosen, Marloes J A; van der Schans, Marcel J; van Helden, Herman P M

    2010-10-06

    The nerve agent VX is most likely to enter the body via liquid contamination of the skin. After percutaneous exposure, the slow uptake into the blood, and its slow elimination result in toxic levels in plasma for a period of several hours. Consequently, this has implications for the development of toxic signs and for treatment onset. In the present study, clinical signs, toxicokinetics and effects on respiration, electroencephalogram and heart rate were investigated in hairless guinea pigs after percutaneous exposure to 500 microg/kg VX. We found that full inhibition of AChE and partial inhibition of BuChE in blood were accompanied by the onset of clinical signs, reflected by a decline in respiratory minute volume, bronchoconstriction and a decrease in heart rate. Furthermore, we investigated the therapeutic efficacy of a single dose of atropine, obidoxime and diazepam, administered at appearance of first clinical signs, versus that of repetitive dosing of these drugs on the reappearance of signs. A single shot treatment extended the period to detrimental physiological decline and death for several hours, whereas repetitive administration remained effective as long as treatment was continued. In conclusion, percutaneous VX poisoning showed to be effectively treatable when diagnosed on time and when continued over the entire period of time during which VX, in case of ineffective decontamination, penetrates the skin.

  6. Isolation of atropine and scopolamine from plant material using liquid-liquid extraction and EXtrelut(®) columns.

    Śramska, Paula; Maciejka, Artur; Topolewska, Anna; Stepnowski, Piotr; Haliński, Łukasz P

    2017-02-01

    Tropane alkaloids are toxic secondary metabolites produced by Solanaceae plants. Among them, plants from Datura genus produce significant amounts of scopolamine and hyoscyamine; the latter undergoes racemization to atropine during isolation. Because of their biological importance, toxic properties and commonly reported food and animal feed contamination by different Datura sp. organs, there is a constant need for reliable methods for the analysis of tropane alkaloids in many matrices. In the current study, three extraction and sample-clean up procedures for the determination of scopolamine and atropine in plant material were compared in terms of their effectiveness and repeatability. Standard liquid-liquid extraction (LLE) and EXtrelut(®) NT 3 columns were used for the sample clean-up. Combined ultrasound-assisted extraction and 24h static extraction using ethyl acetate, followed by multiple LLE steps was found the most effective separation method among tested. However, absolute extraction recovery was relatively low and reached 45-67% for atropine and 52-73% for scopolamine, depending on the compound concentration. The same method was also the most effective one for the isolation of target compounds from Datura stramonium leaves. EXtrelut(®) columns, on the other hand, displayed relatively low effectiveness in isolating atropine and scopolamine from such a complex matrix and hence could not be recommended. The most effective method was also applied to the extraction of alkaloids from roots and stems of D. stramonium. Quantitative analyses were performed using validated method based on gas chromatography with flame ionization detector (GC-FID). Based on the results, the importance of the proper selection of internal standards in the analysis of tropane alkaloids was stressed out.

  7. Analysis of Atropine test in 97 cases%阿托品试验97例分析

    黄丽红; 曲鹏

    2011-01-01

    [ Objective ] To discuss the clinical value of atropine test on the suspected sick sinus syndrome (SSS) cases.[ Method] Atropine test was performed in 97 patients with suspected SSS who had sinus bradycardia. Transesophageal atrial pacing (TAP) in the positive ones was used to confirm the diagnosis of SSS. [ Results] Among the 97 cases,there were 78whose fastest heart rates were less than 90 beats per minute. Positive rate was 80.4%. And according to the TAP, it was indicated that there were totally 70 SSS sufferers in those 78 cases. The percentage of conformity was 89.7%. [ Conclusion]Atropine test is a simple method and it is better to choose the suspected SSS sufferers that have sinus bradycardia for atropine test so that to raise the percentage of diagnosis.%[目的]探讨对疑有病态窦房结综合征(sick sinus syndrome,SSS)患者行阿托品试验的临床价值.[方法]对97例疑有SSS的窦性心动过缓患者做阿托品试验,其中阳性者行食管心房调搏检查以进一步明确SSS之诊断.[结果]97例中78例最快心率<90次/min,阳性率80.4%;78例行食管心房调搏提示SSS 70例,符合率89.7%.[结论]阿托品试验方法简便,应用于疑有SSS的窦性心动过缓患者可提高对SSS的检出率.

  8. Attention to advertising and memory for brands under alcohol intoxication.

    Orquin, Jacob L; Jeppesen, Heine B; Scholderer, Joachim; Haugtvedt, Curtis

    2014-01-01

    In an attempt to discover new possibilities for advertising in uncluttered environments marketers have recently begun using ambient advertising in, for instance, bars and pubs. However, advertising in such licensed premises have to deal with the fact that many consumers are under the influence of alcohol while viewing the ad. This paper examines the effect of alcohol intoxication on attention to and memory for advertisements in two experiments. Study 1 used a forced exposure manipulation and revealed increased attention to logos under alcohol intoxication consistent with the psychopharmacological prediction that alcohol intoxication narrows attention to the more salient features in the visual environment. Study 2 used a voluntary exposure manipulation in which ads were embedded in a magazine. The experiment revealed that alcohol intoxication reduces voluntary attention to ads and leads to a significant reduction in memory for the viewed ads. In popular terms consuming one or two beers reduces brand recall from 40 to 36% while being heavily intoxicated further reduces brand recall to 17%.

  9. Alcohol consumption and escalatory aggression in intoxicated and sober dyads.

    Leonard, K E

    1984-01-01

    It has been suggested that alcohol ingestion facilitates escalatory processes in aggressive interactions. The present study examined interaction patterns in intoxicated, sober and mixed dyads. Thirty pairs of men college students were randomly assigned to these conditions. Subjects who received alcohol received .964 g of absolute alcohol per kg of body weight. At the beginning of each trial in a reaction-time competition, each member of the dyad selected the shock level that he wanted his opponent to receive if the opponent was slower on the trial. Further, each member was informed by feedback lights of the shock level that his opponent had selected for him. The results indicated that the intoxicated dyads selected higher shock levels than did the sober dyads. Mixed dyads tended to select lower shock levels than intoxicated dyads but higher shock levels than sober dyads. However, these differences were not statistically significant. Additionally, intoxicated dyads escalated in aggression over the first block of six trials, whereas neither sober nor mixed dyads evidenced such an escalation. One interpretation of these findings is that the cognitive disruption caused by the alcohol interfered with the subjects' ability to evaluate the consequences of their behavior and to interpret the behavior of their opponents. A second interpretation is that, because of the expectancy effects associated with alcohol consumption, intoxicated dyads did not feel constrained to a nonaggressive stance. Finally, the value of the dyadic-interaction paradigm in the study of alcohol-related violence was discussed.

  10. Attention to advertising and memory for brands under alcohol intoxication

    Jacob L. Orquin

    2014-03-01

    Full Text Available In an attempt to discover new possibilities for advertising in uncluttered environments marketers have recently begun using ambient advertising in, for instance, bars and pubs. However, advertising in such licensed premises have to deal with the fact that many consumers are under the influence of alcohol while viewing the ad. This paper examines the effect of alcohol intoxication on attention to and memory for advertisements in two experiments. Study 1 used a forced exposure manipulation and revealed increased attention to logos under alcohol intoxication consistent with the psychopharmacological prediction that alcohol intoxication narrows attention to the more salient features in the visual environment. Study 2 used a voluntary exposure manipulation in which ads were embedded in a magazine. The experiment revealed that alcohol intoxication reduces voluntary attention to ads and leads to a significant reduction in memory for the viewed ads. In popular terms consuming one or two beers reduces brand recall from 40 % to 36 % while being heavily intoxicated further reduces brand recall to 17 %.

  11. Oral cadmium chloride intoxication in mice

    Andersen, O; Nielsen, J B; Svendsen, P

    1988-01-01

    Diethyldithiocarbamate (DDC) is known to alleviate acute toxicity due to injection of cadmium salts. However, when cadmium chloride was administered by the oral route, DDC enhanced rather than alleviated the acute toxicity; both oral and intraperitoneal (i.p.) administration of DDC had this effect....... Thus, orally administered DDC enhanced cadmium-induced duodenal and ileal tissue damage and inhibition of peristalsis, as indicated by an increased intestinal transit time. At low cadmium doses, the whole-body retention of cadmium was increased by oral DDC administration. Intraperitoneally administered...

  12. Methyltin intoxication in six men; toxicologic and clinical aspects

    Rey, C.; Reinecke, H.J.; Besser, R.

    1984-04-01

    Neurologic and psychiatric symptoms such as headache, tinnitus, defective hearing, changing desorientation and aggressiveness are initial symptoms of methyltin chloride intoxication. Some patients also developed epileptic equivalents, such as dreamy attacks and central ventilation transaminases. Laboratory findings included low levels of serum potassium, leucocytosis and elevated transaminases. The excretion rate of tin in the urine correlated with the severity of the intoxication. There was no measurable effect of plasma separation or d-penicillamine therapy on tin excretion in the urine or on the clinical picture. The long-term prognosis of severely intoxicated persons is poor. To prevent such events workers need to be warned of the risk and dangers of working with organo-metallic compounds. The effectiveness of protective clothes and gas masks should be checked. In exposed workers regular testing is advised of tin concentrations in the urine.

  13. [Fatal intoxication with the new designer drug 25C-NBOMe].

    Tarpgaard, Maren; Mærkedahl, Rikke; Lauridsen, Karen Buch

    2015-08-24

    This is a case report of a 22-year-old man, who snorted the content of three capsules of the new designer drug 25C-NBOMe (2-(4-chloro-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine). 1-2 hours after the intake he became unconscious with generalized seizures, so he was intubated prehospitally and brought to the local hospital. At admission he had acute renal failure and was severely metabolic acidotic with potassium 8.6 mmol/l, lactate 28 mmol/l and pH 6.69. Despite maximal therapy he died ten hours after admission. 25C-NBOMe is currently legal in most parts of the world, and fatal intoxication with the drug has not yet been described in Scandinavia.

  14. Copper intoxication inhibits aerobic nucleotide synthesis in Streptococcus pneumoniae

    Johnson, Michael D. L.; Kehl-Fie, Thomas E.; Rosch, Jason W.

    2015-01-01

    Copper is universally toxic in excess, a feature exploited by the human immune system to facilitate bacterial clearance. The mechanism of copper intoxication remains unknown for many bacterial species. Here, we demonstrate that copper toxicity in Streptococcus pneumoniae is independent from oxidative stress but, rather, is the result of copper inhibiting the aerobic dNTP biosynthetic pathway. Furthermore, we show that copper-intoxicated S. pneumoniae is rescued by manganese, which is an essential metal in the aerobic nucleotide synthesis pathway. These data provide insight into new targets to enhance copper-mediated toxicity during bacterial clearance. PMID:25730343

  15. Attention to advertising and memory for brands under alcohol intoxication

    Orquin, Jacob Lund; Jeppesen, Heine B.; Scholderer, Joachim

    2014-01-01

    In an attempt to discover new possibilities for advertising in uncluttered environments marketers have recently begun using ambient advertising in, for instance, bars and pubs. However, advertising in such licensed premises have to deal with the fact that many consumers are under the influence...... of alcohol while viewing the ad. This paper examines the effect of alcohol intoxication on attention to and memory for advertisements in two experiments. Study 1 used a forced exposure manipulation and revealed increased attention to logos under alcohol intoxication consistent with the psychopharmacological...

  16. Acute alcoholic myopathy, rhabdomyolysis and acute renal failure : a case report.

    Singh S

    2000-01-01

    Full Text Available A case of middle aged male who developed swelling and weakness of muscles in the lower limbs following a heavy binge of alcohol is being reported. He had myoglobinuria and developed acute renal failure for which he was dialyzed. Acute alcoholic myopathy is not a well recognized condition and should be considered in any intoxicated patient who presents with muscle tenderness and weakness.

  17. Atropine-resistant depolarization in the guinea-pig small intestine.

    Bywater, R A; Holman, M E; Taylor, G S

    1981-07-01

    1. Junction potentials were recorded from the circular muscle cells of the guinea-pig ileum following transmural stimulation in the presence of atropine at 30 degrees C.2. Single stimuli produced a transient hyperpolarization, the inhibitory junction potential (i.j.p.). At high stimulus strengths the i.j.p. was followed by a post-stimulus depolarization (PSD).3. During repetitive stimulation the magnitude of the hyperpolarization decreased; however, at the end of the stimulus period the PSD was enhanced and often reached threshold for the generation of action potentials. Thus, the size of the PSD was not directly related to the degree of the preceding hyperpolarization.4. Hyperpolarization of the circular muscle cells was produced by the application of anodal current using large external electrodes. Rapid cessation of the applied current produced a transient after-depolarization which was shorter in time course than the PSD following the i.j.p. If the applied anodal current was reduced slowly (at a rate which mimicked the decrease in the hyperpolarization during repetitive nerve stimulation) no after-depolarization was observed.5. Conditioning hyperpolarization of the circular muscle cells reduced the amplitude of the i.j.p. The i.j.p. was reversed at membrane potentials greater than approximately -90 mV.6. The PSD did not appear to be due to the extracellular accumulation of potassium ions following the i.j.p. since the PSD persisted even when the i.j.p. was reversed.7. The neurotoxin apamin reversibly abolished the i.j.p. and unmasked a transient excitatory junction potential (e.j.p.) with a variable latency (350-900 ms).

  18. Summary of four scientific studies on Arsenicum album high dilution effect against Arsenic intoxication in mice

    Laurence Terzan

    2012-09-01

    Full Text Available Background: Groundwater arsenic affects millions of people in about 20 countries. In West Bengal (India and Bangladesh alone over 100 million people are exposed. The arsenic concentration in contaminated groundwater in Bangladesh was above the maximum permissible level of 0.05 mg/l as recommended by WHO for developing countries [1]. Drinking water is not the only source of poisoning. In arsenic contaminated areas, crops, vegetables, cereals, poultry, cattle, etc, also contain traces of arsenic. Chronic arsenic intoxication has been associated with several diseases such as melanosis, leuco-melanosis, hyperkeratosis, oedema, skin cancer… Cazin et al [2], have demonstrated the effect of high dilutions of arsenic compounds. They noted increased arsenic elimination from blood through urine and faeces in intoxicated rats. According to these research, the aim of Khuda Buksh studies [3-4-5] was to investigate whether high dilution Arsenicum album have any effect on arsenic accumulation in different tissues and to understand also how this high dilution could produce a protective effect on all the different organs. Methodology: Firstly, the effect of Arsenicum album 30 cH on the amount of arsenic accumulation was determined by spectrophotometric analysis in four tissues namely liver, kidney and testis in mice intoxicated by arsenic. The protective effect in chronic and acute arsenic intoxicated mice of Arsenicum Album 6cH, 30cH and 200cH has been evaluated using not only the activities of enzymatic and biomarker toxicity (aspartate amino transferase (AST, alanine amino transferase (ALT, acid phosphatase (AcP, alkaline phosphatase (AlkP, lipid peroxidation (LPO and reduced glutathione (GSH but also the cytogenetical parameters (chromosome aberrations (CA, mitotic index (MI, sperm head anomaly (SHA etc., . Because, it is well demonstrated that these enzymes biomarkers reflect the degree of hepatotoxicity and oxidative stress caused by

  19. Mass-media publicity campaign on driving while intoxicated.

    Wesemann, P.

    1986-01-01

    Mass media publicity campaigns against driving while intoxicated have been conducted in the netherlands for a number of years. A new, more aggressive approach was introduced in 1984 with the slogan "alcohol ..... all too easily a crime". Goals of this campaign were (1) internationalization of the le

  20. Zinc protects renal function during cadmium intoxication in the rat.

    Jacquillet, G; Barbier, O; Cougnon, M; Tauc, M; Namorado, M C; Martin, D; Reyes, J L; Poujeol, P

    2006-01-01

    This study investigates the effect in the rat of chronic CdCl2 intoxication (500 microg Cd2+/kg, daily i.p. injection for 5 days) on renal function and the changes in tight junction proteins claudin-2, claudin-3, and claudin-5 present in rat kidney. We also studied the effect of coadministration of ZnCl2 (500 microg Zn2+/kg) during chronic CdCl2 intoxication. Our results indicate that 1) most of the filtered Cd2+ is reabsorbed within the kidney; 2) chronic Cd2+ intoxication can induce a change in renal handling of ions without altering glomerular filtration rate; 3) a delayed nephropathy, showing Fanconi-like features, appears more than 5 days after the end of CdCl2 exposure; 4) epithelial integrity is altered by chronic Cd2+ intoxication affecting the expression and localization of claudin tight junction proteins; and 5) cotreatment with Zn2+ protects against the renal toxic effects of Cd2+, preventing altered claudin expression and inhibiting apoptosis. In conclusion, these results show that Cd2+ toxicity and cellular toxic mechanisms are complex, probably affecting both membrane transporters and tight junction proteins. Finally, Zn2+ supplementation may provide a basis for future treatments.

  1. Chronic Vitamin D Intoxication in Captive Iberian Lynx (Lynx pardinus.

    Ignacio Lopez

    Full Text Available To document the biochemical and pathologic features of vitamin D intoxication in lynx and to characterize mineral metabolism in healthy lynx, blood samples were obtained from 40 captive lynx that had been receiving excessive (approximately 30 times the recommended dose vitamin D3 in the diet, and from 29 healthy free ranging lynx. Tissue samples (kidney, stomach, lung, heart and aorta were collected from 13 captive lynx that died as a result of renal disease and from 3 controls. Vitamin D intoxication resulted in renal failure in most lynx (n = 28, and widespread extraskeletal calcification was most severe in the kidneys and less prominent in cardiovascular tissues. Blood minerals and calciotropic hormones in healthy lynx were similar to values reported in domestic cats except for calcitriol which was higher in healthy lynx. Changes in mineral metabolism after vitamin D intoxication included hypercalcemia (12.0 ± 0.3 mg/dL, hyperphosphatemia (6.3 ± 0.4 mg/dL, increased plasma calcidiol (381.5 ± 28.2 ng/mL and decreased plasma parathyroid hormone (1.2 ± 0.7 pg/mL. Hypercalcemia and, particularly, hyperphosphatemia were of lower magnitude that what has been previously reported in the course of vitamin D intoxication in other species. However, extraskeletal calcifications were severe. The data suggest that lynx are sensitive to excessive vitamin D and extreme care should be taken when supplementing this vitamin in captive lynx diets.

  2. Digoxin intoxication: An old enemy in modern era

    Bahadir Kirilmaz; Serkan Saygi; Hasan Gungor; Ugur Onsel Turk; Emin Alio(g)lu; Serdar Akyuz; Fatih Asgun; Istemihan Tengiz; Ertugrul Ercan

    2012-01-01

    Objectives Although development of new treatment modalities limited digoxin usage, digoxin intoxication is still an important issuewhich could be easily overlooked. In this report, we analyzed a case series definitively diagnosed as digoxin intoxication in the modern era.Methods We analyzed 71 patients hospitalized with digoxin intoxication confirmed by history, complaints, clinical and electrocardiograph(ECG) findings, and serum digoxin levels > 2.0 ng/mL, during a five year period. The demographic and clinical data, indications for digoxinuse, digoxin dosage, concurrent medications, laboratory data, hospital monitoring, and ECG findings were obtained from all patients.Results Thirty-eight of 71 patients (53.5%) had symptoms of heart failure during admission or later. Sixty-four percent of patients wereolder than 75 years. The percentage of females was 67%. Atrial fibrillation, hypertension and gastrointestinal complaints were more frequentin the females (64% in females, 30% in males, P = 0.007; 81% in female, 52% in males, P = 0.01; 50% in female, 17.3% in males, P = 0.008,respectively). The mortality rate during the hospital course was 7%. Conclusions This report demonstrated the reduced mortality rates inpatients with digoxin intoxication over the study period. Gastrointestinal complaints are the most common symptoms in this population.

  3. Chronic Vitamin D Intoxication in Captive Iberian Lynx (Lynx pardinus)

    Muñoz, Luis; Raya, Ana; Lopez, Guillermo; Aguilera-Tejero, Escolástico

    2016-01-01

    To document the biochemical and pathologic features of vitamin D intoxication in lynx and to characterize mineral metabolism in healthy lynx, blood samples were obtained from 40 captive lynx that had been receiving excessive (approximately 30 times the recommended dose) vitamin D3 in the diet, and from 29 healthy free ranging lynx. Tissue samples (kidney, stomach, lung, heart and aorta) were collected from 13 captive lynx that died as a result of renal disease and from 3 controls. Vitamin D intoxication resulted in renal failure in most lynx (n = 28), and widespread extraskeletal calcification was most severe in the kidneys and less prominent in cardiovascular tissues. Blood minerals and calciotropic hormones in healthy lynx were similar to values reported in domestic cats except for calcitriol which was higher in healthy lynx. Changes in mineral metabolism after vitamin D intoxication included hypercalcemia (12.0 ± 0.3 mg/dL), hyperphosphatemia (6.3 ± 0.4 mg/dL), increased plasma calcidiol (381.5 ± 28.2 ng/mL) and decreased plasma parathyroid hormone (1.2 ± 0.7 pg/mL). Hypercalcemia and, particularly, hyperphosphatemia were of lower magnitude that what has been previously reported in the course of vitamin D intoxication in other species. However, extraskeletal calcifications were severe. The data suggest that lynx are sensitive to excessive vitamin D and extreme care should be taken when supplementing this vitamin in captive lynx diets. PMID:27243456

  4. Fatal carbon monoxide intoxication after acetylene gas welding of pipes.

    Antonsson, Ann-Beth; Christensson, Bengt; Berge, Johan; Sjögren, Bengt

    2013-06-01

    Acetylene gas welding of district heating pipes can result in exposure to high concentrations of carbon monoxide. A fatal case due to intoxication is described. Measurements of carbon monoxide revealed high levels when gas welding a pipe with closed ends. This fatality and these measurements highlight a new hazard, which must be promptly prevented.

  5. Heart Rate Variability in Children with Tricyclic Antidepressant Intoxication

    Ener Cagri Dinleyici

    2013-01-01

    Full Text Available The aim of this study was to evaluate HRV in children requiring intensive care unit stays due to TCA poisoning between March 2009 and July 2010. In the time-domain nonspectral evaluation, the SDNN (P<0.001, SDNNi (P<0.05, RMSDD (P<0.01, and pNN50 (P<0.01 were found to be significantly lower in the TCA intoxication group. The spectral analysis of the data recorded during the first 5 minutes after intensive care unit admission showed that the values of the nLF (P<0.05 and the LF/HF ratio (P=0.001 were significantly higher in the TCA intoxication group, while the nHF (P=0.001 values were significantly lower. The frequency-domain spectral analysis of the data recorded during the last 5 minutes showed a lower nHF (P=0.001 in the TCA intoxication group than in the controls, and the LF/HF ratio was significantly higher (P<0.05 in the intoxication group. The LF/HF ratio was higher in the seven children with seizures (P<0.001. These findings provided us with a starting point for the value of HRV analysis in determining the risk of arrhythmia and convulsion in TCA poisoning patients. HRV can be used as a noninvasive testing method in determining the treatment and prognosis of TCA poisoning patients.

  6. Electroretinogram and Histopathologic Changes of the Retina after Methanol Intoxication

    CHEN Jie-min; ZHU Guang-you; ZHAO Zi-qin; XIA Wen-tao

    2013-01-01

    In order to study the functional and structural alterations of the retina in SD rat model after methanol intoxication,35 rats were divided randomly into five groups administrated with saline,3-day high dose,7-day high dose,3-day low dose and 7-day low dose methanol separately.The retinal function of each group was assessed by flash electroretinogram (F-ERG) 3 and 7 days after methanol poisoning.The microstructure and ultrastructure of the retina were observed at the same time.The high-dose methanol intoxication induced irreversible retinal functional and structural damages 3 days after poisoning,which included prolonged latency and reduced amplitude of the Max-reaction of F-ERG.These injuries were aggravated 7 days after poisoning.Meanwhile,the latency and amplitude of the Cone-reaction of F-ERG were also affected 3 days after poisoning,but there were no further worsening tendency 7 days after poisoning.The retinal histological analysis showed cellular edema,heteromorphy and disarrangement,tissular loosen of the inner nuclear layer and photoreceptors layer.The mitochondrial damage began at the photoreceptors layer and developed further into the inner nuclear layer.The low-dose methanol intoxication only caused transient damage of the retina.Our results showed that the function and structure of the photoreceptor and inner nuclear layer were the primary target of methanol intoxication and that the rod cells were more sensitive to methanol intoxication than the cone cells.The mitochondrial damage developed from outer layer to inner layer of the retina.

  7. Antibody protection against botulinum neurotoxin intoxication in mice.

    Cheng, Luisa W; Stanker, Larry H; Henderson, Thomas D; Lou, Jianlong; Marks, James D

    2009-10-01

    Adulteration of food or feed with any of the seven serotypes of botulinum neurotoxin (BoNT) is a potential bioterrorism concern. Currently, there is strong interest in the development of detection reagents, vaccines, therapeutics, and other countermeasures. A sensitive immunoassay for detecting BoNT serotype A (BoNT/A), based on monoclonal antibodies (MAbs) F1-2 and F1-40, has been developed and used in complex matrices. The epitope for F1-2 has been mapped to the heavy chain of BoNT/A, and the epitope of F1-40 has been mapped to the light chain. The ability of these MAbs to provide therapeutic protection against BoNT/A intoxication in mouse intravenous and oral intoxication models was tested. High dosages of individual MAbs protected mice well both pre- and postexposure to BoNT/A holotoxin. A combination therapy consisting of antibodies against both the light and heavy chains of the toxin, however, significantly increased protection, even at a lower MAb dosage. An in vitro peptide assay for measuring toxin activity showed that pretreatment of toxin with these MAbs did not block catalytic activity but instead blocked toxin entry into primary and cultured neuronal cells. The timing of antibody rescue in the mouse intoxication models revealed windows of opportunity for antibody therapeutic treatment that correlated well with the biologic half-life of the toxin in the serum. Knowledge of BoNT intoxication and antibody clearance in these mouse models and understanding of the pharmacokinetics of BoNT are invaluable for future development of antibodies and therapeutics against intoxication by BoNT.

  8. Efficacy of chelation therapy to remove aluminium intoxication.

    Fulgenzi, Alessandro; De Giuseppe, Rachele; Bamonti, Fabrizia; Vietti, Daniele; Ferrero, Maria Elena

    2015-11-01

    There is a distinct correlation between aluminium (Al) intoxication and neurodegenerative diseases (ND). We demonstrated how patients affected by ND showing Al intoxication benefit from short-term treatment with calcium disodium ethylene diamine tetraacetic acid (EDTA) (chelation therapy). Such therapy further improved through daily treatment with the antioxidant Cellfood. In the present study we examined the efficacy of long-term treatment, using both EDTA and Cellfood. Slow intravenous treatment with the chelating agent EDTA (2 g/10 mL diluted in 500 mL physiological saline administered in 2 h) (chelation test) removed Al, which was detected (using inductively coupled plasma mass spectrometry) in urine samples collected from patients over 12 h. Patients that revealed Al intoxication (expressed in μg per g creatinine) underwent EDTA chelation therapy once a week for ten weeks, then once every two weeks for a further six or twelve months. At the end of treatment (a total of 22 or 34 chelation therapies, respectively), associated with daily assumption of Cellfood, Al levels in the urine samples were analysed. In addition, the following blood parameters were determined: homocysteine, vitamin B12, and folate, as well as the oxidative status e.g. reactive oxygen species (ROS), total antioxidant capacity (TAC), oxidized LDL (oxLDL), and glutathione. Our results showed that Al intoxication reduced significantly following EDTA and Cellfood treatment, and clinical symptoms improved. After treatment, ROS, oxLDL, and homocysteine decreased significantly, whereas vitamin B12, folate and TAC improved significantly. In conclusion, our data show the efficacy of chelation therapy associated with Cellfood in subjects affected by Al intoxication who have developed ND.

  9. Determination of Atropine Sulfate in Human Urines by Capillary Electrophoresis Using Chemical Modified Electrode as Electrochemiluminescence Sensor

    Min Zhou

    2011-01-01

    Full Text Available A Ru(bpy3 2+-based electrochemiluminescence (ECL detection coupled with capillary electrophoresis (CE was developed for the determination of atropine sulfate on the basis of an Eu-PB modified platinum electrode as the working electrode. The analyte was injected to separation capillary of 50 cm length (25 μm i.d., 360 μm o.d. by electrokinetic injection for 10 s at 10 kV. Parameters related to the separation and detection were discussed and optimized. It was proved that 10 mM phosphate buffer at pH 8.0 could achieve the most favorable resolution, and the high sensitivity of detection was obtained by using the detection potential at 1.15 V and 5 mM Ru(bpy3 2+ in 80 mM phosphate buffer at pH 8.0 in the detection reservoir. Under the optimized conditions, the ECL peak area was in proportion to atropine sulfate concentration in the range from 0.08 to 20 μg⋅mL−1 with a detection limit of 50 ng⋅mL−1 (3σ. The relative standard derivations of migration time and peak area were 0.81 and 3.19%, respectively. The developed method was successfully applied to determine the levels of atropine sulfate in urine samples of patients with recoveries between 90.9 and 98.6%.

  10. ASSESSMENT OF THE DEGREE OF INTOXICATION AND THE FORECAST LEVEL OF THE INTEGRAL INDEX OF INTOXICATION UNDER CERTAIN INFECTIOUS DISEASES

    M. Y. Marzhokhova

    2016-01-01

    Full Text Available The Purpose of this research was to study indicators syndrome of endogenous intoxication in patients with erysipelas and herpes infection that can be used to predict relapse in these diseases.Based on the goal were examined in 54 patients with primary, erythematous form of erysipelas of different localization and 42 patients with the localized form of herpes infection in the dynamics of these diseases.Determined the level of substances of low and medium molecular weight (HV and SMM, and oligopeptides, as well as the Integral index of intoxication by the method of M. I. Malakhov (1994 and Lowry (1991. To assess the value of the Integral index of intoxication in the prediction of relapses were calculated odds ratio.Revealed the dependence of studied parameters of disease and completeness of recovery.Level measurement HV and SMM and oligopeptides allows us to calculate the Integral index of intoxication, which can be used as a prognostic criterion of recurrence as erysipelas, and herpes infection.

  11. Visual hallucinations on eye closure associated with atropine toxicity. A neurological analysis and comparison with other visual hallucinations.

    Fisher, C M

    1991-02-01

    Visual hallucinations of remarkable intensity began shortly after intravenous atropine and persisted for 11 days. They were present only when the eyes were closed and were associated with heightened dreaming and disturbed sleep. The patient remained lucid and described his experiences to his attendants. Our patient's hallucinations bore some resemblance to hypnagogic hallucinations and this became the basis for the hypothesis that the hallucinations originated in the sleep-dream system of the brain stem. It is speculated that a similar site--a metabolic locus minoris resistentiae may play a part in other types of visual hallucinations and in delirium.

  12. [Risk of acute hepatic insufficiency in children due to chronic accidental overdose of paracetamol (acetaminophen)

    Hameleers-Snijders, P.; Hogeveen, M.; Smeitink, J.A.M.; Kramers, C.; Draaisma, J.M.T.

    2007-01-01

    Two girls aged 4 and 3 years, respectively, experienced acute liver failure due to accidental ingestion of supratherapeutic doses of paracetamol (90 mg/kg/day or more). Recognition of chronic paracetamol intoxication as a cause of acute hepatic failure is often delayed. It is important to consider t

  13. Protective effects of penehyclidine hydrochloride on acute lung injury caused by severe dichlorvos poisoning in swine

    CUI Juan; LI Chun-sheng; HE Xin-hua; SONG Yu-guo

    2013-01-01

    Background Organophosphate poisoning is an important health problem in developing countries which causes death mainly by inducing acute lung injury.In this study,we examined the effects of penehyclidine hydrochloride (PHC),a selective M-receptor inhibitor,on dichlorvos-induced acute lung injury in swine.Methods Twenty-two female swines were randomly divided into control (n=5),dichlorvos (n=6),atropine (n=6),and PHC (n=5) groups.Hemodynamic data,extravascular lung water index (EVLWI),and pulmonary vascular permeability index (PVPI) were monitored; blood gas analysis and acetylcholinesterase (AchE) levels were measured.PaO2/FiO2,cardiac index (Cl),and pulmonary vascular resistance indices (PVRI) were calculated.At termination of the study,pulmonary tissue was collected for ATPase activity determination and wet to dry weight ratio (W/D) testing 6 hours post-poisoning.TUNEL assay,and Bax,Bcl-2,and caspase-3 expression were applied to pulmonary tissue,and histopathology was observed.Results After poisoning,PHC markedly decreased PVRI,increased CI more effectively than atropine.Anticholinergic treatment reduced W/D,apoptosis index (AI),and mitigated injury to the structure of lung; however,PHC reduced AI and caspase-3 expression and improved Bcl-2/Bax more effectively than atropine.Atropine and PHC improved ATPase activities; a significant difference between groups was observed in Ca2+-ATPase activity,but not Na+-K+-ATPase activity.Conclusions The PHC group showed mild impairment in pathology,less apoptotic cells,and little impact on cardiac function compared with the atropine group in dichlorvos-induced acute lung injury.

  14. Neuroprotection against diisopropylfluorophosphate in acute hippocampal slices

    Ferchmin, P. A.; Pérez, Dinely; Cuadrado, Brenda L.; Carrasco, Marimée; Martins, Antonio H.; Eterović, Vesna A.

    2015-01-01

    Diisopropylfluorophosphate (DFP) is an irreversible inhibitor of acetylcholine esterase (AChE) and a surrogate of the organophosphorus (OP) nerve agent sarin. The neurotoxicity of DFP was assessed as a reduction of population spike (PS) area elicited by synaptic stimulation in acute hippocampal slices. Two classical antidotes, atropine, and pralidoxime, and two novel antidotes, 4R-cembranotriene-diol (4R) and a caspase 9 inhibitor, were tested. Atropine, pralidoxime, and 4R significantly protected when applied 30 min after DFP. The caspase inhibitor was neuroprotective when applied 5–10 min before or after DFP, suggesting that early synaptic apoptosis is responsible for the loss of PSs. It is likely that apoptosis starts at the synapses and, if antidotes are not applied, descends to the cell bodies, causing death. The acute slice is a reliable tool for mechanistic studies, and the assessment of neurotoxicity and neuroprotection with PS areas is, in general, pharmacologically congruent with in vivo results and predicts the effect of drugs in vivo. 4R was first found to be neuroprotective in slices and later we demonstrated that 4R is neuroprotective in vivo. The mechanism of neurotoxicity of OPs is not well understood, and there is a need for novel antidotes that could be discovered using acute slices. PMID:26438150

  15. Optimizing the Treatment of Acute Duct-Destructive Pancreatitis

    Zhakiev, Bazylbek S.; Karsakbayev, Uteugali G.; Kelimberdiev, Mersaid S.; ?uhamedgalieva, Bodagoz M.; K?nonenko, Aleksander F.

    2016-01-01

    The search for new methods for treating duct-destructive pancreatitis is a relevant problem. Endogenous intoxication and oxidative stress that accompany acute pancreatitis often progress even after surgery, which forces one to search for additional possibilities of preventing these severe consequences. This research studied the effect of small…

  16. Sodium cromoglycate and atropine block the fall in FEV1 but not the cough induced by hypotonic mist.

    Fuller, R W; Collier, J G

    1984-01-01

    In a group of patients with mild asthma the inhalation of mist derived from ultrasonically nebulised distilled water caused an increase in cough and a fall in FEV1. Double blind administration for five minutes of sodium cromoglycate (from an original solution containing 30 mg/ml) or atropine (2 mg/ml) by inhalation from a Minineb nebuliser, 30 minutes before the mist challenge, caused a significant reduction in the fall in FEV1 (p less than 0.05), but not in cough, by comparison with the protection afforded by placebo (saline). In a second study the fall in FEV1 caused by the inhalation of distilled water was not significantly different from that seen in response to hypotonic sodium chloride (1.7 g/l, 58 mmol/l), but both produced a significantly greater fall than did a similar mist containing sodium cromoglycate at an original concentration of 10 mg/ml (58 mmol/l). The results show that both atropine and sodium cromoglycate can block the fall in FEV1 due to mist and that protection by sodium cromoglycate is immediate. These results suggest that sodium cromoglycate blocks the nervous reflexes concerned in the response to mist, probably in the afferent limb of the reflex. PMID:6437001

  17. The effects of oxotremorine, epibatidine, atropine, mecamylamine and naloxone in the tail-flick, hot-plate, and formalin tests in the naked mole-rat (Heterocephalus glaber)

    Dulu, Thomas D; Kanui, Titus I; Towett, Philemon K

    2014-01-01

    -plate, and the formalin tests. The effects of co-administration of the muscarinic receptor antagonist atropine, the nicotinic receptor antagonist mecamylamine, and the opioid receptor antagonist naloxone were also investigated. Oxotremorine and epibatidine induced a significant, dose-dependent antinociceptive effect...... in the tail-flick, hot-plate, and formalin tests, respectively. The effects of oxotremorine and epibatidine were blocked by atropine and mecamylamine, respectively. In all three nociceptive tests, naloxone in combination with oxotremorine or epibatidine enhanced the antinociceptive effects of the drugs....... The present study demonstrated that stimulation of muscarinic and nicotinic receptors produces antinociceptive effects in the naked-mole rat. The reversal effect of atropine and mecamylamine suggests that this effect is mediated by cholinergic receptors. As naloxone increases the antinociceptive effects...

  18. Hemorheological changes and hematometric erythrocyte characteristics in rats after sodium nitrite intoxication

    Ivanov, Ivan; Gluhcheva, Yordanka; Petrova, Emilia; Antonova, Nadia

    2014-05-01

    Sodium nitrite (NaNO2) is a precursor to a variety of organic compounds (pharmaceuticals, dyes and pesticides), but it is best known as a food additive. The aim of the study is to investigate the influence of acute (i.p.) treatment of Wistar rats with NaNO2 (at the dose of 50 mg/kg b.w.) on the blood rheological properties and erythrocyte hematometric indices (Hb, HCT, RBC, MCV, RDW, MCH, MCHC). The significant differences were not found in the whole blood viscosity (WBV) values of the control and NaNO2-treated groups. The changes in the erythrocyte hematometric indices were statistically significant for RDW, MCHC and MCH at the 1st hour, five- and ten days after NaNO2 administration. Interestingly, at the day 5th of the NaNO2 treatment we obtained statistically significant lower values for the RBC count, Hb, HCT, RDW, as well as elevated indices MCV (no statistically significant), MCH, MCHC. The results obtained indicate that hemorheological and hematometric parameters examined should be monitored in cases of acute exposure to nitrites — for the purposes of clinical toxicology. The quantitative values of hematometric indices reported in our experimental model could be suitable for predicting NaNO2 intoxication and methemoglobinemia in animals and humans.

  19. Immediate S-100B and neuron-specific enolase plasma measurements for rapid evaluation of primary brain damage in alcohol-intoxicated, minor head-injured patients.

    Mussack, Thomas; Biberthaler, Peter; Kanz, Karl Georg; Heckl, Ute; Gruber, Rudolf; Linsenmaier, Ulrich; Mutschler, Wolf; Jochum, Marianne

    2002-11-01

    The neuroproteins S-100B and neuron-specific enolase (NSE) released into the circulation are suggested to be reliable markers for primary brain damage. However, safe identification of relevant post-traumatic complications after minor head injury (MHI) is often hampered by acute intoxication of the patients. The objective of this study was to determine the diagnostic validity of immediate plasma measurements of S-100B and NSE in comparison with neurological examinations and cerebral computed tomography (CCT) findings in alcohol-intoxicated MHI patients. One hundered thrity-nine MHI individuals were enrolled in this prospective study during Munich's Oktoberfest 2000. Plasma levels of S-100B and NSE as well as serum alcohol and glucose values were determined by fully automated assays immediately after admission. The results were compared with Glasgow Coma Scale score, a brief neurological examination, and the CCT findings. Without being influenced by alcohol, median S-100B levels of the CCT+ group were significantly increased compared with those of the CCT- group (P < 0.001). NSE, alcohol, and glucose levels showed no significant group differences. As calculated by the ROC analysis, a cutoff value of 0.21 ng/mL with an area under the curve of 0.864 clearly differentiates between CCT+ and CCT- patients at a sensitivity of 100%, a specificity of 50.0%, and a positive likelihood ratio of 2.0. Although acute alcohol intoxication did not confound plasma measurements of S-100B and NSE, only S-100B levels below the cutoff level of 0.21 ng/mL seem to indicate absence of primary brain damage. Thus, in addition to routine neurological examinations, S-100B measurements immediately after admission might help to reduce CCT scans in alcohol-intoxicated patients early after MHI.

  20. 强效睫状肌麻痹剂环戊通能否替代阿托品%Research on whether atropine can be substituted by the powerful cycloplegic cyclopentolate

    许江涛

    2012-01-01

    For a long time,atropine eye ointment has been widely used as the cycloplegic for children's optometry in China,while internationally,cyclopentolate gutta is widely used as the first choice for cycloplegic.In recent years,1% cyclopentolate hydrochloride ocular humor has been introduced to our country.This effective and powerful cycloplegic has already been paid close attention to by domestic pedoophthalmiaters.According to a serious of studies both home and abroad on the therapeutic effects of the own control drugs,the cycloplegia effect of cyclopentolate is close to the atropine. Cyclopentolate can be widely used for the cycloplegia before optometry for the Chinese children.However,the effect of cyclopentolate is still not as good as atropine. So,for the children with farsightedness within 7 years old,all esotropia children,Am children,and children who suffer from decreased vision acuteness and needs to be excluded from accommodative myopia, atropine eye ointment should be routinely used for cycloplegia before optometry.In this article,we also discuss the medication dosage,medication method,possible drug adverse reactions of cyclopentolate humor ocular and the coping measures at the same time.%阿托品眼膏长期以来都是中国儿童验光主流使用的睫状肌麻痹剂,而国际上则普遍使用环戊通滴眼液作为一线的睫状肌麻痹药物.近年来,国内引了进1%盐酸环戊通眼液,这种快速强效的睫状肌麻痹剂已被国内小儿眼科医师所关注.一系列国内外自身对照药物疗效研究证实,环戊通的睫状肌麻痹效果接近于阿托品,能广泛应用于中国儿童验光前的睫状肌麻痹.尽管如此,其药物疗效仍略逊于阿托品,故对于7岁以内的远视儿童、所有内斜视儿童、混合性散光儿童及短期内视力下降需要排除调节性近视的儿童,验光前仍应常规使用阿托品眼膏行睫状肌麻痹.本文同时对环戊通眼液的用药剂量、用药方法、可

  1. Central respiratory failure during acute organophosphate poisoning.

    Carey, Jennifer L; Dunn, Courtney; Gaspari, Romolo J

    2013-11-01

    Organophosphate (OP) pesticide poisoning is a global health problem with over 250,000 deaths per year. OPs affect neuronal signaling through acetylcholine (Ach) neurotransmission via inhibition of acetylcholinesterase (AChE), leading to accumulation of Ach at the synaptic cleft and excessive stimulation at post-synaptic receptors. Mortality due to OP agents is attributed to respiratory dysfunction, including central apnea. Cholinergic circuits are integral to many aspects of the central control of respiration, however it is unclear which mechanisms predominate during acute OP intoxication. A more complete understanding of the cholinergic aspects of both respiratory control as well as neural modification of pulmonary function is needed to better understand OP-induced respiratory dysfunction. In this article, we review the physiologic mechanisms of acute OP exposure in the context of the known cholinergic contributions to the central control of respiration. We also discuss the potential central cholinergic contributions to the known peripheral physiologic effects of OP intoxication.

  2. Hair analysis to document non-fatal pesticide intoxication cases.

    Dulaurent, S; Gaulier, J M; Baudel, J L; Fardet, L; Maury, E; Lachâtre, G

    2008-03-21

    We reported two non-fatal cases of intoxication with pesticides namely alachlor and carbofuran. Hair stand samples were collected from two men approximately 1 year after alachlor intoxication for case 1, and 14 days after the last exposure for case 2. Hair analysis was performed using a liquid chromatography-tandem mass spectrometry method. In case 1, alachlor was detected in the 5 analysed hair segments (concentrations between 12 and 136 pg/mg) and its metabolites were not detected. In case 2, carbofuran and its main metabolite (3-hydroxycarbofuran) were detected in the hair strand (global analysis) at the concentrations of 207 and 164 pg/mg, respectively. However, additional data are required in order to interpret such results.

  3. [Evaluation of the endogenous intoxication syndrome in food toxic infections].

    Marzhokhova, M Iu; Zhelikhazheva, Zh M

    2009-01-01

    To study the endogenous intoxication syndrome in patients with food toxic infections is essential in revealing the pathogenetic mechanisms underlying this disease. For this, the authors measured the level of low and average molecular weight, as well as their protein component--oligopeptides in plasma, red blood cells, and urine in the course of the disease. There were increased levels of the study parameters, which depended on the stage and degree of a pathological process. The determination of the level of low and average molecular weight and oligopeptides in plasma, red blood cells, and urine may serve as a marker of the intoxication syndrome; the level of the study parameters may be used as additional criteria for the severity of the process, the prediction of disease development and comorbidity, and as a criterion for recovery completeness.

  4. Combined intoxication with methylone and 5-MeO-MIPT.

    Shimizu, Eiji; Watanabe, Hiroyuki; Kojima, Takashi; Hagiwara, Hiroko; Fujisaki, Mihisa; Miyatake, Ryosuke; Hashimoto, Kenji; Iyo, Masaomi

    2007-01-30

    Although preclinical studies suggest that methylone (2-methylamino-1-[3,4-methylenedioxyphenyl]propan-1-one) and 5-MeO-MIPT (5-methoxy-N-methyl,N-isopropyl tryptamine) may have psychostimulant properties, the scientific reports about the clinical effects of these agents are scant. We describe a 27-year-old male patient with substance intoxication after a single ingestion of the mixture of methylone and 5-MeO-MIPT. Though he bought the drug as pure methylone powder via an internet order, our chemical analyses indicated that the drug was composed of about 60% methylone (120 mg) and 38% 5-MeO-MIPT (76 mg). This case report suggests that clinicians should be alert to the possibility of the emergence of methylone or 5-MeO-MIPT intoxication, and substance-related mental disorder may be complicated by combined use of other psychoactive drugs.

  5. A SURVEY ON LEAD INTOXICATION IN LEAD MINERS

    P. Meshgi

    1972-12-01

    Full Text Available A survey on lead intoxication in lead mine workers was carried out among Khanehsorme, lead miners in NajafAabad and also in Ab-bagh lead miners in Shahreza, both located in district of Esfahan, Iran. The studies were carried out on 62 miners out of 82 employees in Khanehsorme, 25 miners out of 27 employees in Ab-bagh lead miners and 47 rural inhabitants in the surroundings of mines were selected as the Control group. Clinical examinations were done. Age and sex group, working hours, type of work, and duration of service and previous occupation of workers were questioned. The determination of lead in urine was done according to Truhaut et Boudene's method and the content of blood Hemoglobin was performed according to Sali method. Results obtained in lead miners in comparison with the control group showed the absorption of lead and consequently lead intoxication was observed some extent.

  6. Vitamin A intoxication from reef fish liver consumption in Bermuda.

    Dewailly, E; Rouja, P; Schultz, E; Julien, P; Tucker, T

    2011-09-01

    We report three historical cases of severe vitamin A intoxication in anglers who had consumed reef fish liver caught in Bermuda. The subsequent analyses of 35 fish livers from seven different fish species revealed that very high concentrations of vitamin A exist in tropical fish liver, even in noncarnivorous fish species. Large variations in concentrations were observed between specimens and between species. The angling population and (especially) pregnant women should be advised of this potential health threat.

  7. Drug Intoxicated Irregular Fighters: Complications, Dangers, and Responses

    2008-03-01

    norms offer that chance. Outside agencies, NGOs and the UN Office of the High Commissioner for Refugees ( UNHCR ) should begin to put such...has argued, the desire to seek intoxication may be a “fourth drive” in human beings after hunger, thirst, and sex .2 Such a drive appears to have an...regional stability. For example, carnival activities in Yugoslavia sent waves of refugees throughout Europe and eventually led to a Western military

  8. Effect of a mixture of pyridostigmine and atropine on forced expiratory volume (FEV1), and serum cholinesterase activity in normal subjects

    Feldt-Rasmussen, B F; Gefke, Kaj; Mosbech, H

    1985-01-01

    Pyridostigmine 0.143 mg kg-1 (maximum 10 mg) and atropine 0.0143 mg kg-1 (maximum 1 mg) were administered i.v. to six healthy male volunteers. Peripheral venous blood samples were drawn for measurement of serum cholinesterase activity. Maximum inhibition of the enzyme was found 5 min after...... injection with a decrease to 27 +/- 5% (mean +/- SEM) of the original activity. Forced expiratory volume in the first 1s (FEV1) was measured at fixed time intervals for 90 min. No decrease in FEV1 was observed; on the contrary, there was a small increase. We conclude that atropine effectively antagonizes...

  9. Peganum harmala L. Intoxication in a Pregnant Woman

    Mohamed Adnane Berdai

    2014-01-01

    Full Text Available Peganum harmala L. is a plant widely distributed in the Mediterranean region. It is commonly used in traditional medicine in Morocco as sedative and abortifacient but exposes users to the risk of overdose and poisoning. The pharmacologically active compounds of this plant include a number of β-carboline and quinazoline alkaloids responsible of its pharmacological and toxicological effects. We report the case of a 24-year-old woman, 22 weeks pregnant, intoxicated with the seeds of Peganum harmala L. On admission, she had disturbance of consciousness, uterine contraction, and oliguria. Laboratory tests revealed renal failure and liver injury, and she benefited then from hemodialysis. During hospitalization, she was intubated after deterioration of consciousness and presented a spontaneous expulsion of the fetus. After extubation, she kept unusual sequelae: cerebellar ataxia and peripheral polyneuropathy. Physicians in regions using Peganum harmala L. as traditional medicine must be able to detect symptoms of its toxicity, in order to establish early gastrointestinal decontamination. The prognosis of this intoxication is variable; most cases can be managed successfully; but in high doses of intoxication, evolution can be fatal.

  10. Cyanide intoxication induced exocytotic epinephrine release in rabbit myocardium.

    Kawada, T; Yamazaki, T; Akiyama, T; Sato, T; Shishido, T; Inagaki, M; Tatewaki, T; Yanagiya, Y; Sugimachi, M; Sunagawa, K

    2000-05-12

    Cyanide intoxication, which has been used as a model of energy depletion at cardiac sympathetic nerve terminals, causes non-exocytotic release of norepinephrine (NE). However, the effect of cyanide intoxication on cardiac epinephrine (Epi) release remains unknown. Using cardiac microdialysis in the rabbit, we measured dialysate Epi and NE concentrations as indices of myocardial interstitial Epi and NE levels, respectively. Local administration of sodium cyanide (30 mM) through the dialysis probe increased both Epi and NE levels (from 11.3+/-2.3 to 32.3+/-4.4 pg/ml and from 33.6+/-6.1 to 389.0+/-71.8 pg/ml, respectively, mean+/-S.E., P<0.01). Local desipramine (100 microM) administration suppressed the cyanide induced NE response without affecting the Epi response. In contrast, local omega-conotoxin GVIA (10 microM) administration partially suppressed the cyanide induced NE response and totally abolished the Epi response. In conclusion, cyanide intoxication causes N-type Ca(2+) channel dependent exocytotic Epi release as well as inducing N-type Ca(2+) channel independent non-exocytotic NE release.

  11. Methanol intoxication: pathological changes of central nervous system (17 cases).

    Karayel, Ferah; Turan, Arzu A; Sav, Aydin; Pakis, Isil; Akyildiz, Elif U; Ersoy, Gokhan

    2010-03-01

    The nervous system has increased susceptibility for methanol intoxication. The aim of this study is to investigate various central nervous system lesions of methanol intoxication in 17 cases autopsied in the mortuary department of the Council of Forensic Medicine in Istanbul, Turkey. The reasons of methanol intoxication in the cases was likely the unwitting ingestion of methanol while drinking illegal alcohol. Survival times ranged from several hours to days. In 8 cases (47%), cerebral edema and in 9 cases (53%) at occipital, temporal and parietal cortex, basal ganglia and pons, petechial bleeding was observed. In addition to these findings, hemorrhagic necrosis were observed in thalamus, putamen, and globus pallidus in 5 cases (29.4%) and, in cerebral cortex in another 3 cases (17.6%). In 3 of the cases (17.6%) in which cerebral edema was found, herniation findings accompanied to the situation and in 2 cases (11.7%), pons bleeding was observed. Around the basal ganglia, in 2 of the cases with hemorrhagic necrosis, the situation ended with a ventricular compression. In 7 cases (41%), the associated findings of chronic ischemic changes in cortical neurons, lacunae formation, degeneration of granular cell layer of the cerebellum, and reactive gliosis were considered as the results of chronic alcoholism.

  12. Methomyl-Induced Severe Acute Pancreatitis: Possible Etiological Association

    Ioannides M; Christodoulides P; Symeonides M; Vounou E; Tsikkos S; Achillews G; Koukouvas M; Makrides C

    2005-01-01

    CONTEXT: N-methyl carbamate insecticides are widely used in homes, gardens and agriculture. They share the capacity to inhibit cholinesterase enzymes with organophosphates and therefore share similar symptomatology during acute and chronic exposures. One of the serious effects of organophosphate and carbamate intoxication is the development of acute pancreatitis and subsequent intrapancreatic fluid formation. CASE REPORT: An 18-year old Caucasian man was admitted to our Intensive Care Unit wi...

  13. Husband/Partner Intoxication and Intimate Partner Violence Against Women in the Philippines.

    Kerridge, Bradley T; Tran, Phu

    2016-09-01

    This study examined husband/partner intoxication and experience with physical, sexual, and emotional intimate partner violence against women (IPVAW) using data derived from a nationally representative survey conducted in the Philippines in 2013. Multivariate logistic regression analyses were used to examine the association between intoxication and 3 different types of intimate partner violence against women. Multinomial logistic regression was used to examine intoxication and severity of violence. In this sample, 28.8% of women reported experiencing any form of intimate partner violence and 92.9% of women reported their partner being intoxicated at least sometimes. Intoxication was significantly associated with all 3 types of intimate partner violence, while the odds of experiencing one form of IPVAW versus no form of IPVAW and 2 forms of IPVAW versus 1 form of IPVAW was greater among women reporting frequency of husband/partner intoxication as often.

  14. Salade malade: malignant ventricular arrhythmias due to an accidental intoxication with Aconitum napellus

    Weijters, B.J.; Verbunt, R.J.A.M.; Hoogsteen, J.; Visser, R.F.

    2008-01-01

    Intoxication with Aconitum napellus is rare in our regions. Aconite alkaloids can cause ventricular arrhythmia by a prolonged activation of sodium channels. Because the margin of safety is low between the analgesic and toxic dose, intoxication is not rare when Aconite is used in herbal medicine. We present a case in which a 39-year-old male was accidentally intoxicated with Aconite. Even though no antidote or adequate therapy is available he was successfully resuscitated. (Neth Heart J 2008;1...

  15. The Defense of Involuntary Intoxication by Prescribed Medications: An Appellate Case Review.

    Piel, Jennifer

    2015-09-01

    The defense of involuntary intoxication has long been an exception to the general notion that intoxication is not a defense to criminal liability. The consumption of medications prescribed by a physician can form the basis of an involuntary-intoxication defense. In this article, I review cases where defendants relied on the use of prescribed medications for an involuntary-intoxication defense. The medications most frequently implicated by defendants are listed by name and by class. From the case law, I provide a summary of the defense and a review of the pitfalls of the defense to serve as practice pointers for forensic evaluators.

  16. Antibody/doxycycline combined therapy for pulmonary ricinosis: Attenuation of inflammation improves survival of ricin-intoxicated mice

    Yoav Gal

    2014-01-01

    Full Text Available Ricin, a highly toxic plant-derived toxin, is considered a potential weapon in biological warfare due to its high availability and ease of preparation. Pulmonary exposure to ricin results in the generation of an acute edematous inflammation followed by respiratory insufficiency and death. Passive immunization with polyclonal anti-ricin antibodies conferred protection against pulmonary ricinosis, however, at clinically-relevant time points for treatment, survival rates were limited. In this study, intranasal instillation of a lethal dose of ricin to mice, served as a lung challenge model for the evaluation and comparison of different therapeutic modalities against pulmonary ricinosis. We show that treatment with doxycycline resulted in a significant reduction of pro-inflammatory cytokines, markers of oxidative stress and capillary permeability in the lungs of the mice. Moreover, survival rates of mice intoxicated with ricin and treated 24 h later with anti-ricin antibody were significantly improved by co-administration of doxycycline. In contrast, co-administration of the steroid drug dexamethasone with anti-ricin antibodies did not increase survival rates when administered at late hours after intoxication, however dexamethasone did exert a positive effect on survival when applied in conjunction with the doxycycline treatment. These studies strongly suggest that combined therapy, comprised of neutralizing anti-ricin antibodies and an appropriate anti-inflammatory agent, can promote high-level protection against pulmonary ricinosis at clinically-relevant time points post-exposure.

  17. Low level nose-only exposure to the nerve agent soman: Toxicokinetics of soman stereoisomers and cholinesterase inhibition in atropinized guinea pigs

    Benschop, H.P.; Trap, H.C.; Spruit, H.E.T.; Wiel, H.J. van der; Langenberg, J.P.; Jong, L.P.A. de

    1998-01-01

    In order to initiate a quantitative basis for the toxicology of low level exposure to nerve agents, the toxicokinetics of soman stereoisomers during nose-only exposure for 5 h to 20 ppb (160 μg/m3) of C(±)P(±)- soman in air were studied in restrained, anesthetized, and atropinized guinea pigs. The c

  18. Combinations of ketamine and atropine are neuroprotective and reduce neuroinflammation after a toxic status epilepticus in mice

    Dhote, Franck, E-mail: franck.dhote@irba.fr [Département de Toxicologie et risques chimiques, Institut de Recherche Biomédicale des armées – Centre de recherches du Service de santé des armées IRBA-CRSSA, 24 avenue des Maquis du Grésivaudan, B.P. 87, 38702 La Tronche cedex (France); Carpentier, Pierre; Barbier, Laure [Département de Toxicologie et risques chimiques, Institut de Recherche Biomédicale des armées – Centre de recherches du Service de santé des armées IRBA-CRSSA, 24 avenue des Maquis du Grésivaudan, B.P. 87, 38702 La Tronche cedex (France); Peinnequin, André [Département Effets biologiques des rayonnements, Institut de Recherche Biomédicale des armées – Centre de recherches du Service de santé des armées IRBA-CRSSA, 24 avenue des Maquis du Grésivaudan, B.P. 87, 38702 La Tronche cedex (France); Baille, Valérie; Pernot, Fabien; Testylier, Guy; Beaup, Claire; Foquin, Annie [Département de Toxicologie et risques chimiques, Institut de Recherche Biomédicale des armées – Centre de recherches du Service de santé des armées IRBA-CRSSA, 24 avenue des Maquis du Grésivaudan, B.P. 87, 38702 La Tronche cedex (France); and others

    2012-03-01

    Epileptic seizures and status epilepticus (SE) induced by the poisoning with organophosphorus nerve agents (OP), like soman, are accompanied by neuroinflammation whose role in seizure-related brain damage (SRBD) is not clear. Antagonists of the NMDA glutamate ionotropic receptors are currently among the few compounds able to arrest seizures and provide neuroprotection even during refractory status epilepticus (RSE). Racemic ketamine (KET), in combination with atropine sulfate (AS), was previously shown to counteract seizures and SRBD in soman-poisoned guinea-pigs. In a mouse model of severe soman-induced SE, we assessed the potentials of KET/AS combinations as a treatment for SE/RSE-induced SRBD and neuroinflammation. When starting 30 min after soman challenge, a protocol involving six injections of a sub-anesthetic dose of KET (25 mg/kg) was evaluated on body weight loss, brain damage, and neuroinflammation whereas during RSE, anesthetic protocols were considered (KET 100 mg/kg). After confirming that during RSE, KET injection was to be repeated despite some iatrogenic deaths, we used these proof-of-concept protocols to study the changes in mRNA and related protein contents of some inflammatory cytokines, chemokines and adhesion molecules in cortex and hippocampus 48 h post-challenge. In both cases, the KET/AS combinations showed important neuroprotective effects, suppressed neutrophil granulocyte infiltration and partially suppressed glial activation. KET/AS could also reduce the increase in mRNA and related pro-inflammatory proteins provoked by the poisoning. In conclusion, the present study confirms that KET/AS treatment has a strong potential for SE/RSE management following OP poisoning. The mechanisms involved in the reduction of central neuroinflammation remain to be studied. -- Highlights: ► During soman-induced status epilepticus, ketamine-atropine limit brain damage. ► Molecular neuroinflammatory response is strongly decreased. ► Glial activation is

  19. Acute unilateral parotid gland swelling after lateral decubitus position under general anesthesia

    Aysun Postaci

    2012-01-01

    Full Text Available Acute swelling of the parotid gland after general anesthesia (commonly known as anesthesia mumps or acute postoperative sialadenitis is a rare but declared complication of anesthesia. The etiology is not clear, but some possible causes such as obstruction of glandular excretory ducts caused by patient position and increase in the viscosity of the saliva because of acute dehydratation and/or medications like atropin have been proposed. We report a swelling in the left preauricular and postauricular region extending to the angle of the mandibule in a 35-year-old patient after left lateral decubitus position for laparoscopic nephrectomy.

  20. Acute unilateral parotid gland swelling after lateral decubitus position under general anesthesia.

    Postaci, Aysun; Aytac, Ismail; Oztekin, Cetin Volkan; Dikmen, Bayazit

    2012-07-01

    Acute swelling of the parotid gland after general anesthesia (commonly known as anesthesia mumps or acute postoperative sialadenitis) is a rare but declared complication of anesthesia. The etiology is not clear, but some possible causes such as obstruction of glandular excretory ducts caused by patient position and increase in the viscosity of the saliva because of acute dehydratation and/or medications like atropin have been proposed. We report a swelling in the left preauricular and postauricular region extending to the angle of the mandibule in a 35-year-old patient after left lateral decubitus position for laparoscopic nephrectomy.

  1. Clinical and pathological studies on intoxication in horses from freshly cut Jimson weed (Datura stramonium-contaminated maize intended for ensiling : clinical communication

    R. Binev

    2006-06-01

    Full Text Available Spontaneous intoxication in 34 horses after ingesting freshly harvested maize that was to be used for ensiling and heavily contaminated with young Datura stramonium plants, is described. The clinical status of all horses was monitored for 7 days, and included body (rectal temperature, respiratory and heart rates, colour and moistness of visible mucosae, changes in pupil size, appetite, thirst, general behaviour, locomotion, sensory perceptions, urination and defaecation. The intoxication was accompanied by altered clinical status, namely mild hyperthermia, tachycardia, polypnoea, dyspnoea and shallow breathing, mydriasis, dry oral, rectal, vaginal and nasal mucosae, acute gastric dilatation and severe intestinal gas accumulation, anorexia to complete refusal of feed, decreased or absent thirst, absence of defaecation and urination. As a result of the treatment, the clinical parameters normalised between days 2 and 5. Necropsies and pathological studies were performed on two horses that died, revealing toxic liver dystrophy, cardiac lesions and substantial dystrophic and necrotic processes in the kidneys. The observed clinical signs, the pathomorphological changes and the applied therapy could be used in the diagnosis, differential diagnosis, prognosis and treatment of Jimson weed intoxication.

  2. Cytogenetic investigations on leucocytes of cattle intoxicated with fluoride

    Leonard, A.; Deknudt, G.; Decat, G.; Leonard, E.D.

    1977-04-01

    The sources of atmospheric fluoride include the burning of soft coal and the manufacturing of aluminium, steel, lead, copper, nickel, phosphate fertilizers, brick and pottery kilns. Cattle which grazed in the vicinity of a plant manufacturing enamel and which displayed signs of chronic fluoride poisoning such as osteosclerosis and mottled enamel or dental fluorosis were investigated for the presence of structural chromatid and chromosome aberrations. Venous blood was incubated for 48 h, and 100 cells were analyzed for each animal. No statistical difference in the incidence of such anomalies was observed between the controls and the intoxicated animals.

  3. Prophylaxis and Treatment of Cyanide Intoxication. Cyanide - Mechanism of Prophylaxis.

    1983-04-15

    AD-A142 380 PROPHYLAXIS AND TREATMENT OF CYANIDE INTOXICATION I/f CYANIDE - MECHANISM OF PROPHYLAXISU) WASHINGTON STATE UNIV PULLMAN d L WAY 15 APR...invaluable contributions to completion of this work. My thanks to fellow students Linda Baker, for helping write a computer program which provided...8217 COMPILED BY KORIAT, LICHTENSTEIN, AND FISCHHOFF(1980) 25 ’PROGRAM DEVELOPED BY 26 ’JOHN R. TIFFANY AND LINDA S. BAKER 27 30 LI$:’A’:L2$:’A’:L3$:’B’:L4$:’B

  4. Severe methemoglobinemia due to food intoxication in infants.

    Murone, Anne-Joëlle Bosset; Stucki, Pascal; Roback, Mark G; Gehri, Mario

    2005-08-01

    The purpose of this case report is to illustrate food intoxication in infants as a consequence of fennel ingestion. Four cases of methemoglobinemia (MetHb) are presented here. Each patient ate homemade fennel purée a few hours prior to arriving to the emergency department with cyanosis unresponsive to oxygen, in the absence of suspected cyanotic heart disease. All 4 patients received treatment with methylene blue and fully recovered. Our cases emphasize that improper handling and storing of vegetables can lead to life-threatening MetHb.

  5. [Increasing number of teenagers with alcohol intoxication admitted to hospital: result of successful treatment approach rather than an increasing problem].

    Lemmens, Paul

    2012-01-01

    Admissions of adolescents with acute alcohol intoxication to Dutch hospitals have been increasing since 2003. This trend has been attributed mainly to changes in drinking practices of adolescents. However, research shows a declining trend in binge drinking among Dutch teenagers. It is argued that the rise in admissions is primarily the result of a successful intervention initiated around 2003 by the Dutch Paediatric Surveillance Centre (NSCK), which has raised awareness of the problems related to underage drinking and has led the public to call for medical attention for a comatose youngster more rapidly. The rhetorical presentation of adolescent drinking as a growing problem runs the risk of inflating this problem, with moral antecedents, not uncommon when professionals deal with behaviour-related health issues. Rather than blaming the problematic drinker, the positive effects of this innovative approach should be emphasized.

  6. Successful treatment of polydipsia, water intoxication, and delusional jealousy in an alcohol dependent patient with clozapine.

    Margetić, Branimir; Aukst-Margetić, Branka; Zarković-Palijan, Tija

    2006-09-30

    The beneficial effect of clozapine on polydipsia and water intoxication in patients with schizophrenia has been demonstrated many times. The authors report a successful clozapine treatment of polydipsia, intermittent water intoxication, and delusional jealousy of an alcoholic. This is a rare case of clozapine treatment of a non-schizophrenic patient affected by polydipsia.

  7. Current status of rodenticide intoxication in Brazil: a preliminary survey from 2009 to 2011

    Solange Papini

    2014-10-01

    Full Text Available The chemical control of rodents with anticoagulant products, especially derivatives of the coumarin chemical group, is legally authorised in Brazil. These products provide effective control and are safe for humans. However, the use of illegal 'rodenticides' has increased in many Brazilian cities recently, accompanied by increased numbers of suicides, homicides, and intoxications. The National Toxicology Information System (Sinitox registers the number of rodenticide intoxications, including suicides, but does not differentiate between the legal and illegal rodenticides. Intoxications by rodenticides outnumber those by illicit drugs and pesticides. A survey of data from 2005-2011 revealed an average of about 3,800 intoxications per year, about 60% of which were suicides. Many of these intoxications probably involved illegal rodenticides, some with unknown chemical compositions, which confound the data on rodenticide intoxication. This evaluation of Sinitox data highlighted the need to ensure the proper use of the term 'rodenticide' when registering intoxication cases. Intoxication by-products that are not rodenticides, but are erroneously used for this purpose, should be classified separately to improve the quality of information.

  8. Regulatory Self-Efficacy as a Moderator of Peer Socialization Relating to Italian Adolescents' Alcohol Intoxication

    Rabaglietti, Emanuela; Burk, William J.; Giletta, Matteo

    2012-01-01

    The present study investigated regulatory self-efficacy (RSE) as a predictor of friendship and adolescent alcohol intoxication and as a moderator of peer socialization processes related to alcohol intoxication. The longitudinal sample included 457 Italian adolescents (262 females and 195 males) ranging in age of 14 to 20 years (M = 16.1 years of…

  9. 32 CFR 636.5 - Army administrative actions against intoxicated drivers.

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Army administrative actions against intoxicated drivers. 636.5 Section 636.5 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY... INSTALLATIONS) Fort Stewart, Georgia § 636.5 Army administrative actions against intoxicated drivers. For...

  10. 32 CFR 634.12 - Army administrative actions against intoxicated drivers.

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Army administrative actions against intoxicated drivers. 634.12 Section 634.12 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY... § 634.12 Army administrative actions against intoxicated drivers. Army commanders will take...

  11. Regulatory Self-efficacy as a Moderator of Peer Socialization Relating to Italian Adolescents' Alcohol Intoxication

    Rabaglietti, E.; Burk, W.J.; Giletta, M.

    2012-01-01

    The present study investigated regulatory self-efficacy (RSE) as a predictor of friendship and adolescent alcohol intoxication and as a moderator of peer socialization processes related to alcohol intoxication. The longitudinal sample included 457 Italian adolescents (262 females and 195 males) rang

  12. Effects of mixing alcohol with caffeinated beverages on subjective intoxication: A systematic review and meta-analysis

    Benson, S.; Verster, J. C.; Alford, C.; Scholey, A.

    2014-01-01

    It has been suggested that mixing alcohol with energy drinks or other caffeinated beverages may alter\\ud the awareness of (or ‘mask’) intoxication. The proposed reduction in subjective intoxication may have\\ud serious consequences by increasing the likelihood of engaging in potentially dangerous activities while\\ud intoxicated. A literature search was conducted to collect all studies measuring subjective intoxication\\ud after administration of alcohol with energy drinks, or with other caffein...

  13. Methomyl-Induced Severe Acute Pancreatitis: Possible Etiological Association

    Ioannides M

    2005-03-01

    Full Text Available CONTEXT: N-methyl carbamate insecticides are widely used in homes, gardens and agriculture. They share the capacity to inhibit cholinesterase enzymes with organophosphates and therefore share similar symptomatology during acute and chronic exposures. One of the serious effects of organophosphate and carbamate intoxication is the development of acute pancreatitis and subsequent intrapancreatic fluid formation. CASE REPORT: An 18-year old Caucasian man was admitted to our Intensive Care Unit with cholinergic crisis symptomatology, after the ingestion of an unknown amount of a carbamate insecticide (methomyl. Pseudocholinesterase levels were 2 kU/L on the day of admission (reference range: 5.4-13.2 kU/L. Two days after admission, an abdominal CT scan revealed blurring of the peripancreatic fat planes, inflammation and swelling of the pancreas, and a substantial amount of ascitic fluid in the left anterior pararenal space and pelvis. Paracentesis and analysis of the ascitic fluid demonstrated findings diagnostic of pancreatic ascites. There had been no other evident predisposing factors for acute pancreatitis, other than methomyl intoxication. Eleven days after admission, pseudocholinesterase levels returned to normal, while a new abdominal CT scan revealed the formation of intrapancreatic fluid collection. The patient was discharged in good physical condition two weeks after admission. A follow up abdominal CT scan performed one month later showed a significant reduction in the size of the intrapancreatic fluid. DISCUSSION: Acute pancreatitis is not uncommon after organophosphate intoxication and carbamates share the same risk as organophosphorus pesticides. The development of acute pancreatitis and subsequent intrapancreatic fluid collection after methomyl intoxication has not previously been reported. This is the first case reported of acute pancreatitis and pancreatic ascite formation after anticholinesterase insecticide ingestion.

  14. DO SOBER EYEWITNESSES OUTPERFORM ALCOHOL INTOXICATED EYEWITNESSES IN A LINEUP?

    Claudia Fahlke

    2013-01-01

    Full Text Available Although alcohol intoxicated eyewitnesses are common, there are only a few studies in the area. The aim of the current study is to investigate how different doses of alcohol affect eyewitness lineup identification performance. The participants (N = 123 were randomly assigned to a 3 [Beverage: control (0.0 g/kg ethanol vs. lower (0.4 g/kg ethanol vs. higher alcohol dose (0.7 g/kg ethanol] X 2 (Lineup: target-present vs. target-absent between-subject design. Participants consumed two glasses of beverage at an even pace for 15 minutes. Five minutes after consumption the participants witnessed a film depicting a staged kidnapping. Seven days later, the participants returned to the laboratory and were asked to identify the culprit in a simultaneous lineup. The result showed that overall, the participants performed better than chance; however, their lineup performance was poor. There were no significant effects of alcohol intoxication with respect to performance, neither in target-present nor target-absent lineups. The study’s results suggest that eyewitnesses who have consumed a lower (0.4 g/kg ethanol or a higher (0.7 g/kg ethanol dose of alcohol perform at the same level as sober eyewitnesses in a lineup. The results are discussed in relation to the alcohol myopia theory and suggestions for future research are made.

  15. OCCURRENCE OF INTOXICATION BY TOXIC PLANTS IN BRAZIL

    Claudio Junior Getter

    2011-04-01

    Full Text Available The toxic plants are those that by means of contact or ingestion, provoke damage to human and animal health, same times causing death. This study has as purpose, to realize an analysis of the accidents occurs with toxicant plants in Brazil. Many control centers, are working to diminish the cases, that Just during the 1991 to 2000, registered a total of 14774 cases of intoxication and poisoning (I/P in the country. The result show that male is most committed, the age who most show the cases of poisoning is between 01-09 years old, this age prevailed on all country regions. The urban areas is where most occurs often. In the biggest part of the registers the intoxication was accidentally when children’s are playing game with the plants. On this period the number of death were of about 48 cases, a surprise was that the northeast region show almost 50% of the cases. Although wait of the control Center and the scientific community to realize a educative, looking for the sensibilization of the society.

  16. Intoxications with the monoamine oxidase inhibitor tranylcypromine: an analysis of fatal and non-fatal events.

    Gahr, Maximilian; Schönfeldt-Lecuona, Carlos; Kölle, Markus A; Freudenmann, Roland W

    2013-11-01

    Tranylcypromine (TCP) is a non-selective and irreversible monoamine oxidase inhibitor and an effective agent in the treatment of major depression. It features a complex pharmacologic profile and overdoses might induce severe intoxications. To identify typical clinical presentations of TCP-intoxications, range of associated TCP-dosages and possible differences between fatal and non-fatal intoxications a systematic review of all previously published cases of TCP-intoxications was conducted. We detected n=20 reports of TCP-intoxications in the literature (fatalities n=10). Mean age was 36.7 years (median 37); the majority of patients were female (60%). Frequent findings in patients with TCP-intoxications were disturbance of consciousness/cognitive dysfunction (90%), cardio-vascular symptoms (55%), hyperthermia (50%), respiratory distress (45%), delirium (45%), muscular rigidity (30%) and renal failure (20%). Suicidal intent was present in n=18 (90%) patients. First clinical symptoms related to TCP-intoxication developed on average in less than 1 day. The average dosage related to TCP-intoxication was 677 mg. The highest survived TCP-dosage was 4000 mg and the lowest fatal dosage was 170 mg. Patients with fatal intoxications were on average older (40.5 vs. 32.8 years) and developed a more rapid onset of symptoms (0.2 vs. 0.8 days). Death occurred after a mean time of 0.6 days; symptom relief in patients with non-fatal intoxications developed on average after 3.2 days. Considering the large dose spectrum between survived and lethal TCP-dosages individual susceptibility factors might play a role regarding the severity of clinical symptoms independently of the ingested dosage.

  17. Differential hepatoprotective mechanisms of rutin and quercetin in CCl4-intoxicated BALB/cN mice

    Robert DOMITROVI(C); Hrvoje JAKOVAC; Vanja VASILJEV MARCHESI; Sanda VLADIMIR-KNE(Z)EVI(C); Olga CVIJANOVI(C); (Z)arko TADI(C); (Z)eljko ROMI(C); Dario RAHELI(C)

    2012-01-01

    Aim:To investigate the mechanisms underlying the protective effects of quercetin-rutinoside (rutin) and its aglycone quercetin against CCl4-induced liver damage in mice.Methods:BALB/cN mice were intraperitoneally administered rutin (10,50,and 150 mg/kg) or quercetin (50 mg/kg) once daily for 5 consecutive days,followed by the intraperitoneal injection of CCl4 in olive oil (2 mL/kg,10% v/v).The animals were sacrificed 24 h later.Blood was collected for measuring the activities of ALT and AST,and the liver was excised for assessing Cu/Zn superoxide dismutase (SOD) activity,GSH and protein concentrations and also for immunoblotting.Portions of the livers were used for histology and immunohistochemistry. Results:Pretreatment with rutin and,to a lesser extent,with quercetin significantly reduced the activity of plasma transaminases and improved the histological signs of acute liver damage in CCl4-intoxicated mice.Quercetin prevented the decrease in Cu/Zn SOD activity in CCl4-intoxicated mice more potently than rutin.However,it was less effective in the suppression of nitrotyrosine formation.Quercetin and,to a lesser extent,rutin attenuated the inflammation in the liver by down-regulating the CCl4-induced activation of nuclear factor-kappa B (NF-κB),tumor necrosis factor-α (TNF-α) and cyclooxygenase (COX-2).The expression of inducible nitric oxide synthase (iNOS) was more potently suppressed by rutin than by quercetin.Treatment with both flavonoids significantly increased NF-E2-related factor 2 (Nrf2) and heme oxygenase (HO-1) expression in injured livers,although quercetin was less effective than rutin at an equivalent dose.Quercetin more potently suppressed the expression of transforming growth factor-β1 (TGF-β1) than rutin.Conclusion:Rutin exerts stronger protection against nitrosative stress and hepatocellular damage but has weaker antioxidant and antiinflammatory activities and antifibrotic potential than quercetin,which may be attributed to the presence of a

  18. Identification of atropine- and P2X1 receptor antagonist-resistant, neurogenic contractions of the urinary bladder.

    Kennedy, Charles; Tasker, Paul N; Gallacher, Gemma; Westfall, Timothy D

    2007-01-24

    Acetylcholine and ATP are excitatory cotransmitters in parasympathetic nerves. We used P2X1 receptor antagonists to further characterize the purinergic component of neurotransmission in isolated detrusor muscle of guinea pig urinary bladder. In the presence of atropine (1 microM) and prazosin (100 nM), pyridoxalphosphate-6-azophenyl-2',4'-disulfonic acid (PPADS) (0.1-100 microM) and suramin (1-300 microM) inhibited contractions evoked by 4 Hz nerve stimulation in a concentration-dependent manner (IC50 of 6.9 and 13.4 microM, respectively). Maximum inhibition was 50-60%, which was unaffected by coadministration of the ectonucleotidase inhibitor ARL67156 (6-N,N-diethyl-D-beta,gamma-dibromomethyleneATP) (100 microM). The remaining responses were abolished by tetrodotoxin (1 microM). PPADS and suramin also reduced contractions to exogenous ATP (300 microM) by 40-50%, but abolished those to the P2X1 agonist alpha,beta-methyleneATP (alpha,beta-meATP) (1 microM). The P2X1 antagonists reactive blue 2, NF279 (8,8'-[carbonylbis(imino-4,1-phenylenecarbonylimino-4,1-phenylenecarbonylimino)] bis-1,3,5-naphthalenetrisulfonic acid), MRS2159 (pyridoxal-alpha5-phosphate-6-phenylazo-4'-carboxylic acid) (100 microM), and NF449 [4,4',4,4-(carbonylbis(imino-5,1,3-benzenetriylbis(carbonylimino)))tetrakis-benzene-1,3-disulfonic acid] (3 microM) abolished contractions to alpha,beta-meATP (1 microM; n = 4-5), but only reduced contractions evoked by 4 Hz nerve stimulation by approximately 40-60% (n = 4-6) and ATP by 30-60% (n = 4-7). However, prolonged exposure to alpha,beta-meATP (50 microM) abolished contractions evoked by all three stimuli (n = 5-12). PPADS (100 microM) and suramin (300 microM) reduced the peak neurogenic contraction of the mouse urinary bladder to 30-40% of control. At the same concentrations, the P2X1 antagonists abolished the nonadrenergic, purinergic component of neurogenic contractions in the guinea pig vas deferens (n = 4-5). Thus, P2X1 receptor antagonists inhibit

  19. Vasoespasmo coronariano induzido pela ecocardiografia sob estresse pela dobutamina-atropina Coronary spasm induced by dobutamine-atropine stress echocardiography

    Fábio A. Bogaz

    2006-12-01

    Full Text Available Relatamos caso de mulher de 45 anos de idade, com antecedentes de hipertensão arterial sistêmica e tabagismo, submetida a ecocardiografia sob estresse pela dobutamina-atropina para investigação de doença arterial coronariana. No pico do estresse, a paciente apresentou dor precordial súbita e de forte intensidade. O eletrocardiograma de doze derivações revelou elevação do segmento ST nas derivações DII, DIII, aVF, V5 e V6 e depressão do segmento ST nas derivações DI, aVL, V2 e V3. Pela monitoração das imagens ecocardiográficas foi observado aparecimento de discinesia do septo inferior e acinesia da parede inferior do ventrículo esquerdo. O exame foi interrompido imediatamente, a paciente foi medicada e evoluiu com melhora da dor precordial e das alterações de motilidade segmentar. A angiografia coronariana revelou lesões coronarianas irregulares com menos de 50% de obstrução do diâmetro luminal. Trata-se de um caso de vasoespasmo coronariano induzido por estimulação alfa-adrenérgica durante a ecocardiografia sob estresse pela dobutamina-atropina.This is the report on a 45-year-old female, with a history of systemic arterial hypertension and cigarette smoking, submitted to dobutamine-atropine stress echocardiography for the investigation of coronary artery disease. At stress peak, the patient reported sudden, highly intense precordial pain. The 12-lead electrocardiogram showed ST segment elevation in DII, DIII, aVF, V5 and V6, and depression in DI, aVL, V2 and V3. Echocardiographic imaging monitoring showed dyskinesia of inferior septum and akinesia of inferior wall. The test was interrupted immediately. The patient was medicated and improved her precordial pain condition as well as wall motion abnormalities. Coronary angiography showed irregular coronary lesions with <50% luminal diameter obstruction. It is a case of coronary spasm induced by alpha-adrenergic stimulation during dobutamine-atropine stress

  20. 二巯基丙磺酸钠对杀虫单中毒小鼠琥珀酸脱氢酶的保护作用%Protective antidotal effects of 2.3-D imercaptopr opane-1-sulfonate sodium on the Succinate dehydrogenase activities in acute So d ium ammonium dimethyl-2-propano-1.3-dithiosulfate monohydrate intoxication mice

    陈秀芳; 王佳珍; 胡国新; 林丹; 陈醒言

    2001-01-01

    Objective:To investigate the mechanism of acute Sodium ammonium dimethyl-2-propano-1.3-dithiosulfate monohydrate(SC D) p oison and the protective antidotal effects of 2.3-Dimercaptopropane-1-sulfona te sodium(Na-DMPS) on Succinate dehydrogenase(SDH) activities in mice.Methods:The mice were randomly divided into three groups: Contr ol group, SCD group, (Na-DMPS) group. The activities of Succinate dehydrogenas e (SDH) in mitochondria of liver and myocardium and Lactic dehydrogenase(LDH) acti vities in plasma of three groups were determined.Results:SDH decreased significantly (P<0.05) an d LDH increased remarkably (P<0.001) in SCD group compared with those of control group. SDH enha nced obviously (P<0.05) and LDH reduced notably (P<0.001) in (Na-DMPS + SCD) group than those of SCD group.Conclusion:SCD could inhibit the activities of SDH of mitochond ria consequently suppressing cell respiration in mice. Na-DMPS could antagonize significantly the inhibiting effects of SCD on the activities of SDH. This ant agonistic actions play an important role in preventing and curing SCD pois on.%目的:研究杀虫单(SCD)的中毒机理及二巯基 丙磺酸钠(Na-DMPS)对琥珀酸脱氢酶(SDH)的保护作用。方法:小鼠随机分为三组:对照组、SCD 组、(Na-DMPS + SCD)组。观察三 组小鼠肝及心肌线粒体琥珀酸脱氢酶(SDH)、血浆乳酸脱氢酶(LDH)活力的变化。结果:与对照组相比,SCD 组SDH活力显著下降(P<0.05), LDH 明显升高(P<0 .001);( Na-DMPS + SCD )组SDH活力较SCD组明显升高(P<0.05),LDH显 著降低(P<0.001) 。结论:SCD可抑制线粒体 SDH活力,抑制细胞呼吸。Na-DMPS 可拮抗其抑制 作用,这种拮抗作用在防治SCD中毒方面具有重要意义。

  1. Acute isoniazid neurotoxicity in childhood.

    Citak, Agop; Kaya, Ozlen; Uçsel, Raif; Karaböcüoğlu, Metin; Uzel, Nedret

    2002-01-01

    Acute isoniazid (INH) poisoning is uncommon in children. Although most physicians are aware of INH hepatotoxicity, acute INH poisoning and its treatment are not well recognized. INH is increasingly being used to control the spread of tuberculosis, and physicians should know its potentially fatal effects. INH overdose is known to result in rapid onset of seizures, metabolic acidosis and prolonged obtundation. We report two cases of obtundation secondary to INH overdose that was immediately reversed by pyridoxine. Parenteral pyridoxine administration is an effective method in INH intoxication. The intravenous form of pyridoxine must be available in the emergency care units, and INH toxicity should be suspected in any patient with refractory seizures and metabolic acidosis.

  2. Plasma carnitine concentrations after chronic alcohol intoxication 

    Alina Kępka

    2013-05-01

    Full Text Available Background: Carnitine transports fatty acids from the cytoplasm to the mitochondrial matrix, where the fatty acids are oxidized. Chronic alcohol consumption reduces the concentration of carnitine and interferes with oxidative processes occurring in the cell.Aim: The assessment of carnitine concentrations in plasma of chronically intoxicated alcohol dependent persons in a 49-day abstinence period.Material/Methods: The study included 31 patients (5 women and 27 men aged from 26 to 60 years (44.6± 8.9 and 32 healthy subjects (15 women and 17 men aged 22-60 years (39.8± 9.4. The patients’ alcohol dependence ranged from 2 to 30 years (13.6± 7.5. Examined subjects consumed 75-700 g of ethanol/day (226.9± 151.5. Plasma concentrations of free and total carnitine were measured three times: at the first (T0, 30th (T30 and 49th (T49 day of hospital detoxification. Free (FC and total (TC carnitine were determined by the spectrophotometric method. Plasma acylcarnitine (AC concentration was calculated from the difference between TC and FC; then the AC/FC ratio was calculated. To determine statistically significant differences for related variables, Student’s t-test was used.Results: At T0, alcoholics had significantly lower concentration of FC and TC (p < 0.05 in plasma, as compared to the control group. In comparison to controls, at T30, plasma TC and FC (p < 0.01 as well as AC (p < 0.001 were reduced. The lowest concentration of TC, FC and AC (p < 0.001was found at T49. The ratio of AC/FC at T0 had a tendency to be higher in alcoholics than in the control group (p = 0.05, whereas at T49 it was significantly lower in alcoholics as compared to the control subjects (p < 0.05.Conclusions: Chronic alcohol intoxication causes a plasma deficiency of carnitine. Forty-nine days of abstinence showed a significant decrease in the concentration of TC, FC and AC. Further research is necessary to clarify whether a low level of plasma carnitine

  3. Clonidine overdose.

    Marruecos, L; Roglan, A; Frati, M E; Artigas, A

    1983-12-01

    A case of acute intoxication in a 60-yr-old woman who ingested 20 mg of clonidine is presented. The patient showed CNS depression (bradycardia, hypotonia) with systemic hypertension and peripheral vasoconstriction. She was treated with atropine and sodium nitroprusside. There was no recurrence and the patient recovered in 8 days.

  4. Stability study of a new antidote drug combination (Atropine-HI-6-Prodiazepam) for treatment of organophosphate poisoning.

    Clair, P; Wiberg, K; Granelli, I; Carlsson Bratt, I; Blanchet, G

    2000-01-01

    The main purpose of this study was to investigate the chemical stability of a new antidote combination for the treatment of organophosphate poisoning. The antidote combination was packed (enclosed) in two plastic compartments separated by a barrier film. One of them contained a powder oxime cholinesterase reactivator (HI-6-monohydrate 1-[[[4-(aminocarbonyl)pyridinio]methoxy]methyl]-2-[(hydro xyimino)meth yl]-pyridinium dichloride). The other contained an anticholinergic (Atropine) and an anticonvulsant (Prodiazepam or Avizafone (L-lysyl-N-(2-benzoyl-4-chlorophenyl)-N-methyl-glycinamide dihydrochloride) drug in a liquid mixture. The plastic compartments were mounted in an autoinjector device to study the dissolution of HI-6 by ejection of the solution. Drug analysis was performed by high-performance liquid chromatography. The results obtained after 6 months show that this new antidote combination is stable. The amount of each antidote is unchanged during the study. Some known degradation products can be detected in small amounts. The autoinjector mechanism used, gives a complete dissolution of HI-6 powder in the liquid mixture throughout the study.

  5. Double-blind comparison of oral transmucosal fentanyl citrate with oral meperidine, diazepam, and atropine as preanesthetic medication in children with congenital heart disease.

    Goldstein-Dresner, M C; Davis, P J; Kretchman, E; Siewers, R D; Certo, N; Cook, D R

    1991-01-01

    The effectiveness of oral transmucosal fentanyl citrate (OTFC) as preanesthetic medication was compared with oral meperidine, diazepam, and atropine (MDA) in 40 pediatric patients scheduled to undergo repair of congenital heart defects. In a double-blinded manner, patients received a fentanyl lollipop (20-25 micrograms/kg) and a placebo oral solution (0.4 ml/kg) (n = 20) or a placebo lollipop and an oral solution (0.4 ml/kg) of meperidine (1.5 mg/kg), diazepam (0.2 mg/kg), and atropine (0.02 mg/kg) (n = 20). The patient's vital signs, systolic and diastolic blood pressures, heart rate, respiratory rate, and oxyhemoglobin saturation (SpO2), as well as activity and apprehension scores were evaluated and recorded at baseline and at 10-min intervals. The patient's emotional status at the time of parental separation and at induction of anesthesia were also assessed. Side effects and onset of action were observed. After OTFC, onset of sedation was significantly faster than with the oral solution of meperidine, diazepam, and atropine. In both groups there was no significant change in heart rate. Although systolic blood pressure, diastolic blood pressure, and respiratory rate showed statistically significant decreases, these changes were not clinically significant. The child's emotional status at the time of separation from the parents and during induction was similar in both groups. Side effects with OTFC were more frequent: nose itching occurred in 65%, body itching in 10%, and vomiting in 30%. Two patients (10%) in the OTFC-treated group became hypoxemic (SpO2 less than 90) and required supplemental oxygen. In the group receiving oral meperidine, diazepam, and atropine, 10% had mild facial pruritus and 5% complained of a dry mouth.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. [Aspects of psychotherapy in diabetes mellitus with accompanying alcoholic intoxication].

    Sidorov, P I; Novikova, I A; Solov'ev, A G

    2001-01-01

    120 patients with different types of diabetes mellitus were divided into groups by the presence and intensity of accompanying alcoholic intoxication: group 1--no alcohol intake; group 2--rare alcohol intake; group 3--moderate alcohol intake; group 4--alcoholic abuse. Experimental psychological methods were used together with psychotherapeutic approaches: Wiesbaden's questionnaire (WIPPF), Lusher's and MMPI tests. For each group of the patients some recommendations are given for application of the above techniques. Thus in patients from the 1-3 groups it is worthwhile to perform a positive psychotherapy directed to the development of the body/sensation sphere (according to WIPPF), that is a care about physical and mental state (including autotraining and training of communication). In the alcohol abusing patients the main point should be fantasy/future sphere (according to WIPPF) in the ranges of the same positive psychotherapy directed to forming positive world view and correction of the interpersonal relations.

  7. Intoxication of nontarget wildlife with rodenticides in northwestern Kansas.

    Ruder, Mark G; Poppenga, Robert H; Bryan, John A; Bain, Matt; Pitman, Jim; Keel, M Kevin

    2011-01-01

    The perception of prairie dogs (Cynomys spp.) both as a nuisance species and a keystone species presents a significant challenge to land, livestock, and wildlife managers. Anticoagulant and nonanticoagulant rodenticides are commonly employed to control prairie dog populations throughout their range. Chlorophacinone, and to a lesser extent zinc phosphide, are widely used in northwestern Kansas for controlling black-tailed prairie dog (Cynomys ludovicianus) populations. Although zinc phosphide poisoning of gallinaceous birds is not uncommon, there are few published accounts of nontarget chlorophacinone poisoning of wildlife. We report three mortality events involving nontarget rodenticide poisoning in several species, including wild turkeys (Meleagris gallopavo), a raccoon (Procyon lotor), and an American badger (Taxidea taxus). This includes the first documentation of chlorophacinone intoxication in wild turkeys and an American badger in the literature. The extent of nontarget poisoning in this area is currently unknown and warrants further investigation.

  8. Zinc phosphide intoxication of wild turkeys (Meleagris gallopavo).

    Poppenga, Robert H; Ziegler, Andre F; Habecker, Perry L; Singletary, Don L; Walter, Mark K; Miller, Paul G

    2005-01-01

    Zinc phosphide (Zn3P2) is a rodenticide used to control a variety of small mammal species. It is available over-the-counter or as a restricted-use pesticide depending on how it is to be applied. The toxicity of Zn3P2 is dependent on the species exposed, whether the animal is able to vomit or not, and whether it is ingested on a full or empty stomach. Nontarget species can be exposed through inadvertent or intentional product misapplication. In this article we describe four mortality events in which wild turkeys (Meleagris gallopavo) were believed to have been intoxicated following the ingestion of baits containing Zn3P2.

  9. [Chronic thallium intoxication in five German pointers of one litter].

    Gassner, G; Tholen, V; Ternes, W

    2000-01-01

    The difficulty of diagnosis and therapy of chronic thallium intoxication is described in five German Pointers with the same skin disease. The detection of thallium in cases of skin lesions like the cutaneous erythema with oedema and crusts or in chronic cases with multifocal alopecia is difficult. The first diagnostic information was gathered in this case from the high thallium level in the urine. The thallium concentration in the hair is subject to great variations, even in physiologic conditions. The trichogramme showed in this case pathognomonic changes like adhesion of the hair follicles. Differential diagnosis for this symmetric alopezia without pruritus are hormonal disturbances or, in puppies, the generalized form of demodicosis. The five affected dogs were treated with Fe III-Hexacyanoferrat. The clinical appearance of the skin improved slowly during a period of 1-2 months.

  10. Infections and Intoxications from the Ocean: Risks of the Shore.

    Clemence, Mark A; Guerrant, Richard L

    2015-12-01

    Marine and coastal regions provide a diverse range of foods and serve as recreation and leisure areas for large numbers of people in many parts of the world. However, they also serve as environments associated with numerous hazards. The number of cases of fish- and shellfish-related food poisonings in the United States has increased in recent years, accounting for over 600,000 illnesses, with 3,000 hospitalizations and 94 deaths annually. Human diseases due to pathogenic Vibrio species can result from both ingestion of contaminated shellfish and exposure of open wounds to contaminated seawater. A variety of infections may result from human interactions with marine life, including sharks, barracudas, and moray eels. This chapter covers some of the risks of the shore, including fish and shellfish intoxications, infections related to Vibrio species, and infections resulting from marine trauma.

  11. [Biological activity of selenorganic compounds at heavy metal salts intoxication].

    Rusetskaya, N Y; Borodulin, V B

    2015-01-01

    Possible mechanisms of the antitoxic action of organoselenium compounds in heavy metal poisoning have been considered. Heavy metal toxicity associated with intensification of free radical oxidation, suppression of the antioxidant system, damage to macromolecules, mitochondria and the genetic material can cause apoptotic cell death or the development of carcinogenesis. Organic selenium compounds are effective antioxidants during heavy metal poisoning; they exhibit higher bioavailability in mammals than inorganic ones and they are able to activate antioxidant defense, bind heavy metal ions and reactive oxygen species formed during metal-induced oxidative stress. One of promising organoselenium compounds is diacetophenonyl selenide (DAPS-25), which is characterized by antioxidant and antitoxic activity, under conditions including heavy metal intoxication.

  12. Chelation therapy in intoxications with mercury, lead and copper

    Cao, yang; Skaug, Marit Aralt; Andersen, Ole;

    2015-01-01

    mobilize deposits of mercury as well as of lead into the urine. These drugs can be administered orally and have relatively low toxicity compared to the classical antidote dimercaptopropanol (BAL). d-Penicillamine has been widely used in copper overload, although 2,3-dimercaptosuccinic acid......In the present review we provide an update of the appropriate use of chelating agents in the treatment of intoxications with compounds of mercury, lead and copper. The relatively new chelators meso-2,3-dimercaptosuccinic acid (DMSA) and 2,3-dimercapto-propanesulphonate (DMPS) can effectively...... or tetrathiomolybdate may be more suitable alternatives today. In copper-toxicity, a free radical scavenger might be recommended as adjuvant to the chelator therapy...

  13. Adverse effects and intoxications related to medicinal/harmful plants

    Mateja VONČINA

    2015-12-01

    Full Text Available Many wild plants around us have beneficial effects on our body and can be used as food. People are more and more interested in the medicinal plants. Many of them began gathering and preparing plants for the relief of symptoms of diseases or as a food dietary. Due to the lack of knowledge of plants, mistaking plants that contain toxins for medical plants may happen and cause adverse effects or even poisoning. The Poison Control Centre in Ljubljana keeps records of patients who have been admitted to the department because of adverse effects from the ingestion of certain plants. We analysed 64 cases, which were registered by the Poison Control Centre between January 2000 and December 2013. The aim of the present study was to determine which plants cause the most intoxications in Slovenia.

  14. Hydrotelluric fluorotic intoxication in North Yemen. First results

    Claudon, M.; Viallard, Y.; Elmerich, A.

    The X Ray Department of the French medical mission of Taez receives patients coming from the whole Arab Yemen Republic (country situated in the south of the arab peninsula). Radiology has been a mean of detection and a mean of research of an important centre of osteofluorosis, a disease which had not been studied in this country until then. 47 cases have been collected throughout one year. The hydrotelluric origin of the intoxication has been proved by dosages of the spring waters used for drinking. The main usual clinical and radiological features of the disease are found in that population. The radiological classification proposed by ROHOLM has few clinical correlative interests, but seems available for epidemiological investigation. A first map of the North Yemen for chronic fluorisis has been drawn.

  15. Refractory cardiopulmonary failure after glyphosate surfactant intoxication: a case report

    Chang Chia-Chu

    2009-01-01

    Full Text Available Abstract Background Glyphosate is an herbicide considered to be of low toxicity to humans because its effects are specific to plants. However, fatal reactions to glyphosate have been reported after the ingestion of large amounts. Pulmonary edema, shock, and arrhythmia were the reported causes of mortality. Case presentation We present the case of a 57-year-old woman who was admitted to the emergency department unconsciousness after ingestion of glyphosate surfactant in a suicide attempt. Metabolic acidosis, refractory respiratory failure, and shock developed during hospitalization. Despite aggressive supportive care, the patient died in the hospital. Conclusion The toxicokinetics of glyphosate surfactant is complicated. Respiratory failure, metabolic acidosis, tachycardia, elevated creatinine, and hyperkalemia are poor prognostic factors if presented. Physicians should consider using hemodialysis early to improve the outcome of patients with glyphosate surfactant intoxication.

  16. Salade malade: malignant ventricular arrhythmias due to an accidental intoxication with Aconitum napellus.

    Weijters, B J; Verbunt, R J A M; Hoogsteen, J; Visser, R F

    2008-01-01

    Intoxication with Aconitum napellus is rare in our regions. Aconite alkaloids can cause ventricular arrhythmia by a prolonged activation of sodium channels. Because the margin of safety is low between the analgesic and toxic dose, intoxication is not rare when Aconite is used in herbal medicine. We present a case in which a 39-year-old male was accidentally intoxicated with Aconite. Even though no antidote or adequate therapy is available he was successfully resuscitated. (Neth Heart J 2008;16:96-9.).

  17. Charcoal Hemoperfusion vs. High Efficiency Hemodialysis in Carbamazepine Intoxication: A Case Report

    Arzu KAHVECİ

    2011-05-01

    Full Text Available Carbamazapine is a commonly used antiepileptic agent. Neurological abnormalities which can progress to coma, arrhythmias, respiratory depression and eye abnormalities such as nystagmus are seen in an intoxication setting. There is no specific antidote for the treatment of carbamazepine intoxication and supportive therapy is generally recommended. Carbamazepine is not removed through conventional hemodialysis as it highly bound to proteins. Charcoal hemoperfusion has been reported as the standard effective treatment method. Herein we report a 23-year-old woman with high dose carbamazepine overdose treated with high efficiency hemodialysis and charcoal hemoperfusion. We also discuss a comparison of the methods used for carbamazepine intoxication.

  18. Levosimendan as Treatment Option in Severe Verapamil Intoxication: A Case Report and Review of the Literature

    Mirjam Osthoff

    2010-01-01

    Levosimendan, an inotropic agent, that enhances myofilament response to calcium, increases myocardial contraction and could therefore be beneficial in verapamil intoxication. Here, we report the case of a 60-year-old patient with clinically severe verapamil poisoning who presented with shock, bradycardia, and sopor. Standard therapy including high-dose inotropes failed to ameliorate the signs of intoxication. But additional therapy with levosimendan led to rapid improvement. Based on this observation, the literature is reviewed focusing on utilization of levosimendan in the treatment of calcium channel blocker overdose. We suggest to consider levosimendan as additional treatment option in patients with cardiovascular shock due to verapamil intoxication that are refractory to standard management.

  19. Neurocognitive effects of chronic lead intoxication in Andean children.

    Counter, S A; Buchanan, L H; Rosas, H D; Ortega, F

    1998-09-18

    Lead (Pb) intoxication in children has been associated with neurodevelopmental disabilities which may result in motor and cognitive impairment. We conducted blood lead (PbB) measurements, neurological examinations and cognitive tests on children living in Ecuadorian villages where Pb is used extensively in the glazing of ceramics. Group I consisted of 55 children with a mean PbB level of 48.0 microg/dl (SD: 26.4, range: 9.2-119.1 microg/dl) who received PbB tests and complete neurological examinations. An appreciable number of the children with elevated PbB levels were normal on specific components of the neurological examination. Among the children who showed neurological deficits, higher PbB levels were associated with abnormal tendon reflexes, finger tapping, visual pursuit, size discrimination, draw-a-person, and math calculation skills. Group II consisted of 41 children with a mean PbB level of 47.4 microg/dl (SD: 22.0, range: 6.6-84.7 microg/dl) who were administered Raven's Coloured Progressive Matrices (RCPM) non-verbal reasoning test. Performance on RCPM was abnormal in 22 (53.7%) of 41 children. Children with abnormal RCPM scores had higher PbB levels (t-test: P=0.030). There was a significant inverse correlation between RCPM scores and PbB levels for children ages 9 years and older (r=-0.618, P=0.011). Males had higher mean PbB levels as a function of age than females (t-test: P=0.037), and more males showed neurocognitive deficits. The results demonstrate a range of neurological responses in children with chronically elevated PbB levels from apparent exceptional neuro-physiological tolerance of PbB intoxication, to some fine motor and cognitive deficits.

  20. Cestrum diurnum intoxication in normal and hyperparathyroid pigs.

    Kasali, O B; Krook, L; Pond, W G; Wasserman, R H

    1977-04-01

    The effect of ingestion of dried leaves of Cestrum diurnum, a plant shown to contain a 1,25-dihydroxycholecalciferol-like principle, was tested in normal pigs fed 1.2% calcium and 1.0% phosphorus for 10 weeks from weaning and in hyperparathyroid pigs fed 0.8% calcium and 1.6% phosphorus for the same periods of time. Addition of 3% Cestrum diurnum leaf meal rapidly resulted in decreased feed consumption and weight gain, hypercalcemia and hypophosphatasemia. In normal pigs, plasma calcium rose to 16 mg/100 ml within one week and remained high for the 4 week experimental period. In hyperparathyroid pigs with hypocalcemia, plasma calcium rose to 12.75 mg/100 ml within one week and later approached 15 mg/100 ml. Ingestion of Cestrum diurnum retarded cell differentiation of growth cartilages. Arrested osteocytic osteolysis was observed within one week with osteopetrosis of epiphyses and metaphyses. The negative effect on the resorbing osteocytes then caused osteonecrosis which, in combination with lack of bone formation because of atrophy of osteoblasts, resulted in osteopenia within 4 weeks. Dystrophic calcinosis occurred within 2 weeks and was widespread after 4 weeks in lungs, kidneys, heart and vessels. Atrophy of parathyroid cells was severe after one week. Hyperparathyroid pigs responded with skeletal lesions, dystrophic calcinosis and parathyroid atrophy more rapidly and severely than normal pigs. The biochemical and anatomical changes in Cestrum diurnum ingestion are closely similar to those in vitamin D3 intoxication in pigs. Whereas pigs can tolerate large amounts of vitamin D3 because of feed-back control of 1 alpha-hydroxylation in the kidney, this control point is by-passed in Cestrum diurnum ingestion and intoxication occurs promptly.

  1. Magnetic Resonance Imaging Findings in Chronic Carbon Monoxide Intoxication

    Durak, A. C.; Coskun, A.; Yikilmaz, A.; Erdogan, F.; Mavili, E.; Guven, M. [Hospital of Erciyes Univ., Kayseri (Turkey). Dept. of Radiology

    2005-05-01

    Purpose: To define the cranial magnetic resonance imaging (MRI) features of the chronic stage of carbon monoxide (CO) poisoning in patients with and without neuropsychiatric sequelae. Material and Methods: Eight patients who had neither symptoms nor neurological sequelae and eight patients with neuropsychiatric sequelae were included in the study. Patients aged between 9 to 57 (mean 32.2 years). All patients had been comatose at initial admittance and awoke after normobaric 100% oxygen therapy within 1-7 days. In this study, the patients were being examined with routine cranial MRI between 1 and 10 years (mean 3.4 years) after exposure to CO. Results: The most common finding was bilateral symmetric hyperintensity of the white matter, which was more significant in the centrum semiovale, with relative sparing of the temporal lobes and anterior parts of the frontal lobes on T2-weighted and FLAIR images in all patients. Cerebral cortical atrophy was seen in 10 patients; mild atrophy of cerebellar hemispheres in 8; and vermian atrophy in 11. Corpus callosum was atrophic in one patient. Bilateral globus pallidus lesions were seen in three patients. The lesions were hypointense on T1-weighted images and hyperintense on T2-weighted and FLAIR images. Conclusion: Patients with severe CO intoxication may develop persistent cerebral changes independently of their neuropsychiatric findings in the chronic stage. They may present with characteristic MRI findings as described here, even if asymptomatic. The history of CO exposure is therefore helpful for recognizing and interpreting the MRI findings of chronic stage CO intoxication.

  2. Peripheral markers of oxidative stress in chronic mercuric chloride intoxication

    Gutierrez L.L.P.

    2006-01-01

    Full Text Available The present study was designed to evaluate the time course changes in peripheral markers of oxidative stress in a chronic HgCl2 intoxication model. Twenty male adult Wistar rats were treated subcutaneously daily for 30 days and divided into two groups of 10 animals each: Hg, which received HgCl2 (0.16 mg kg-1 day-1, and control, receiving the same volume of saline solution. Blood was collected at the first, second and fourth weeks of Hg administration to evaluate lipid peroxidation (LPO, total radical trapping antioxidant potential (TRAP, and superoxide dismutase (Cu,Zn-SOD, glutathione peroxidase (GPx, glutathione-S-transferase (GST, and catalase (CAT. HgCl2 administration induced a rise (by 26% in LPO compared to control (143 ± 10 cps/mg hemoglobin in the second week and no difference was found at the end of the treatment. At that time, GST and GPx were higher (14 and 24%, respectively in the Hg group, and Cu,Zn-SOD was lower (54% compared to control. At the end of the treatment, Cu,Zn-SOD and CAT were higher (43 and 10%, respectively in the Hg group compared to control (4.6 ± 0.3 U/mg protein; 37 ± 0.9 pmol/mg protein, respectively. TRAP was lower (69% in the first week compared to control (43.8 ± 1.9 mM Trolox. These data provide evidence that HgCl2 administration is accompanied by systemic oxidative damage in the initial phase of the process, which leads to adaptive changes in the antioxidant reserve, thus decreasing the oxidative injury at the end of 30 days of HgCl2 administration. These results suggest that a preventive treatment with antioxidants would help to avoid oxidative damage in subjects with chronic intoxication.

  3. Acute vergiftigingen bij mens en dier - Jaaroverzicht 2004 - Nationaal Vergiftigingen Informatie Centrum

    Gorcum TF van; Velzen AG van; Riel AJHP van; Meulenbelt J; Vries I de; NVIC

    2005-01-01

    The National Poisons Information Centre (NVIC) of the National Institute for Public Health and the Environment (RIVM) was consulted in 2004 more frequently about acute intoxications than in 2003, representing an increase of about 6%. In 2004, over 35,000 enquiries were received about more than 47,00

  4. Acute Alcohol Effects on Repetition Priming and Word Recognition Memory with Equivalent Memory Cues

    Ray, Suchismita; Bates, Marsha E.

    2006-01-01

    Acute alcohol intoxication effects on memory were examined using a recollection-based word recognition memory task and a repetition priming task of memory for the same information without explicit reference to the study context. Memory cues were equivalent across tasks; encoding was manipulated by varying the frequency of occurrence (FOC) of words…

  5. REM sleep pathways and anticholinesterase intoxication: A mechanism for nerve agent-induced, central respiratory failure.

    Kok, A.

    1993-01-01

    The mechanism of death following exposure to anticholinesterases, such as the highly toxic nerve agents soman and VX, and other organophosphate anticholinesterases such as the insecticide parathion, remains unclear, although evidence from nerve agent research suggests that death occurs by an atropin

  6. Comparação das alterações hemodinâmicas na intoxicação aguda com bupivacaína e ropivacaína por via venosa em suínos Comparación de las alteraciones hemodinámicas en la intoxicación aguda con bupivacaina y ropivacaína por vía venosa en cerdos Comparison of hemodynamic changes in acute intoxication with intravenous bupivacaine and ropivacaine in swine

    Marcos De Simone Melo

    2009-10-01

    of both agents in swine, simulating the intoxication that can be seen during regional blocks in humans. METHODS: Large-White swine were anesthetized with thiopental, followed by endotracheal intubation and controlled mechanical ventilation. Hemodynamic parameters included non-invasive blood pressure and catheterization of the pulmonary artery. After 30 minutes, animals were randomly divided into two groups, and 4 mg.kg-1 of one of the agents was administered intravenously without the knowledge of the investigator. Hemodynamic parameters were evaluated at rest and 1, 5, 10, 15, 20, and 30 minutes after intoxication. RESULTS: The hemodynamic repercussions of acute bupivacaine intoxication were more important and prolonged than in ropivacaine intoxication. With bupivacaine, the cardiac index showed greater and more prolonged reduction, mean arterial pressure and heart rate had more prolonged reduction, central venous pressure showed a more prolonged increase, and pulmonary wedge pressure increased more for more prolonged time. The impact on the systemic vascular resistance index showed that vasomotricity was partially maintained, increased in both groups, and, paradoxically, was greater and longer-lasting with bupivacaine. CONCLUSIONS: In swine, ropivacaine caused less hemodynamic repercussions than bupivacaine when the same doses were administered intravenously.

  7. Cases of organophosphate poisoning treated with high-dose of atropine in an intensive care unit and the novel treatment approaches.

    Karakus, Ali; Celik, Muhammet Murat; Karcioglu, Murat; Tuzcu, Kasim; Erden, Ersin Sukru; Zeren, Cem

    2014-06-01

    Organophosphate poisoning is a life-threatening condition, which is being responsible for the symptoms due to cholinergic effects. Clinical status and blood levels of cholinesterase are used its diagnosis. While atropine and pralidoxime (PAM) appear as essential medications, hemofiltration treatments and lipid solutions have been widely studied in recent years. In this study, the importance of high-dose atropine therapy and early intervention and novel treatment approaches are discussed. Records of a total of 25 patients treated for organophosphate poisoning in the intensive care unit (ICU) between April 2007 and December 2011 were evaluated retrospectively. Of the 25 patients, 14 (56%) were male and 11 (44%) were female with a mean age of 34.8 ± 17.66 years (range: 14-77 years). The patients were most frequently admitted in June (n = 4) and July (n = 4) (16%). Of the 25 patients, 22 patients (88%) were poisoned by oral intake, two (8%) by inhalation, and one (4%) by dermal route. Of them, 20 patients (80%) took organophosphates intentionally for suicidal purposes, while five (20%) cases poisoned due to accidental exposure. The scores of Glasgow Coma Scale of nine patients (36%) were below 8 point upon admission to hospital. The highest dose of atropine given was 100 mg intravenously on admission and 100 mg/h/day during follow-up. The total dose given was 11.6 g/12 days. A total of 11 patients (44%) were on mechanical ventilation for a mean duration of 5.73 ± 4.83 days. The mean duration of ICU stay was 6.52 ± 4.80 days. Of all, 23 patients (92%) were discharged in good clinical condition and one patient (4%) was referred to another hospital. This study suggests that atropine can be administered until secretions disappear and intensive care should be exerted in follow-up of these patients. In addition, in case of necessity for high doses, sufficient amounts of atropine and PAM should be available in hospitals.

  8. EFFECTS OF THE LITHIUM – CONTAINING SORBENT ON TERMS OF BEHAVIORAL REACTIONS UNDER CHRONIC ALCOHOL INTOXICATION MODEL

    A. A. Kotlyarova

    2016-01-01

    Full Text Available Lithium preparations are widely used for stabilize mood in case of bipolar affective disorder. Currently neuroprotective and neuroregenerative effects of lithium are of interest as in case of acute brain injury, also in chronic neurodegenerative diseases such as dementia, alcoholism, Alzheimer disease, etc. [1–5]. In clinical practice use of lithium preparations is limited due to difficult adjustment of drug dosage, necessity of monitoring its concentration in blood, side effects development as a result of accumulation of lithium in a body. For the purpose of improvement of pharmacologic properties lithium is combined with other agents (for example modifying sorbent thus it can produce longer-term and more harmless (less side reactions effect in the long view. Lithium immobilization on sorption basis will allow to use sorbent as detoxicant and carrying agent of drugs to body. The purpose of the work is studying the effect of the lithium – containing sorbent on terms of behavioral reactions under chronic alcohol intoxication model.Materials and methods. During the work we used nonlinear mice – males, which weight 25–30 g (180 animals. Chronic alcohol intoxication was precipitated via 40% proof spirit injections (oral supplementation in quantity of 3 g/kg during 2 weeks, additionally mice drunk 5% proof spirit from drinking bowl. Each experimental group consisted of 10 animals. Study drugs were inserted inside while ethanol injecting. Control animals were inserted 0,9% salin solution. Emotional state of animals was assessed through forced swim test, short – term memory assessment was performed through conditioned passive avoidance reflex. Effect of chronic alcohol intoxication on the parameters of conditioned reflex activity was measured every 7 days.Results. It was found that the investigated lithium-containing sorbent increases: the number of mice are trained passive avoidance reflex, remembering percent of electric shock

  9. Levosimendan as treatment option in severe verapamil intoxication: a case report and review of the literature.

    Osthoff, Mirjam; Bernsmeier, Christine; Marsch, Stephan C; Hunziker, Patrick R

    2010-01-01

    Cardiovascular shock due to verapamil intoxication is often refractory to standard resuscitation methods. Recommended therapy includes prevention of further absorption of the drug, inotropic therapy, calcium gluconate, and hyperinsulinemia/euglycemia therapy. Often further measures are needed such as ventricular pacing or mechanical circulatory support. Still, mortality remains high. Levosimendan, an inotropic agent, that enhances myofilament response to calcium, increases myocardial contraction and could therefore be beneficial in verapamil intoxication. Here, we report the case of a 60-year-old patient with clinically severe verapamil poisoning who presented with shock, bradycardia, and sopor. Standard therapy including high-dose inotropes failed to ameliorate the signs of intoxication. But additional therapy with levosimendan led to rapid improvement. Based on this observation, the literature is reviewed focusing on utilization of levosimendan in the treatment of calcium channel blocker overdose. We suggest to consider levosimendan as additional treatment option in patients with cardiovascular shock due to verapamil intoxication that are refractory to standard management.

  10. Adolescent alcohol intoxication in the dutch hospital departments of pediatrics: A 2-year comparison study

    Hoof, J.J. van; Lely, N. van der; Bouthoorn, S.H.; Dalen, W.E. van; Pereira, R.R.

    2011-01-01

    Purpose: To monitor the prevalence of, and the circumstances leading to, adolescent alcohol intoxication admissions in Dutch hospital departments of pediatrics. Methods: Data were collected in 2007 and 2008, using the Dutch Pediatric Surveillance System, in which pediatricians received questionnaire

  11. Drugs and pharmaceuticals: management of intoxication and antidotes.

    Smith, Silas W

    2010-01-01

    The treatment of patients poisoned with drugs and pharmaceuticals can be quite challenging. Diverse exposure circumstances, varied clinical presentations, unique patient-specific factors, and inconsistent diagnostic and therapeutic infrastructure support, coupled with relatively few definitive antidotes, may complicate evaluation and management. The historical approach to poisoned patients (patient arousal, toxin elimination, and toxin identification) has given way to rigorous attention to the fundamental aspects of basic life support--airway management, oxygenation and ventilation, circulatory competence, thermoregulation, and substrate availability. Selected patients may benefit from methods to alter toxin pharmacokinetics to minimize systemic, target organ, or tissue compartment exposure (either by decreasing absorption or increasing elimination). These may include syrup of ipecac, orogastric lavage, activated single- or multi-dose charcoal, whole bowel irrigation, endoscopy and surgery, urinary alkalinization, saline diuresis, or extracorporeal methods (hemodialysis, charcoal hemoperfusion, continuous venovenous hemofiltration, and exchange transfusion). Pharmaceutical adjuncts and antidotes may be useful in toxicant-induced hyperthermias. In the context of analgesic, anti-inflammatory, anticholinergic, anticonvulsant, antihyperglycemic, antimicrobial, antineoplastic, cardiovascular, opioid, or sedative-hypnotic agents overdose, N-acetylcysteine, physostigmine, L-carnitine, dextrose, octreotide, pyridoxine, dexrazoxane, leucovorin, glucarpidase, atropine, calcium, digoxin-specific antibody fragments, glucagon, high-dose insulin euglycemia therapy, lipid emulsion, magnesium, sodium bicarbonate, naloxone, and flumazenil are specifically reviewed. In summary, patients generally benefit from aggressive support of vital functions, careful history and physical examination, specific laboratory analyses, a thoughtful consideration of the risks and benefits of

  12. The Methods of Committing and Alcohol Intoxication of Suicides in Southwestern Croatia from 1996 to 2005

    Čoklo, Miran; Stemberga, Valter; Cuculić, Dražen; Šoša, Ivan; Jerković, Romana; Bosnar, Alan

    2008-01-01

    Alcohol is the psychoactive substance most frequently associated with suicidal behavior.We hypothesized that the level of alcohol intoxication and the choice of specific methods of committing suicide are related. Suicides in the Southwestern Croatia in a 10-year period, especially regarding the method of committing and alcohol intoxication, were analyzed. Ten various methods of committing suicide were recorded. The average blood alcohol concentration at the moment of suicide was 0...

  13. Identify Melatonin as a Novel Therapeutic Reagent in the Treatment of 1-Bromopropane(1-BP) Intoxication

    2016-01-01

    Abstract 1-Bromopropane (1-BP) has been used as an alternative for fluoride compounds and 1-BP intoxication may involve lung, liver, and central neural system (CNS). Our previous studies showed that 1-BP impaired memory ability by compromising antioxidant cellular defenses. Melatonin is a powerful endogenous antioxidant, and the objective of this study was to explore the therapeutic role of melatonin in the treatment of 1-BP intoxication. Rats were intragastrically treated with 1-BP with or w...

  14. LC-ESI MS/MS quantification of atropine and six other antimuscarinic tropane alkaloids in plasma.

    John, Harald; Binder, Tobias; Höchstetter, Hans; Thiermann, Horst

    2010-01-01

    We have developed and validated a quantitative liquid chromatography electrospray ionization tandem mass spectrometry (LC-ESI MS/MS) procedure for the simultaneous determination of seven natural and semisynthetic tropane alkaloids in plasma: atropine (d-hyoscyamine/l-hyoscyamine), cocaine, homatropine, ipratropium, littorine, N-butylscopolamine, and scopolamine. Plasma and serum samples were precipitated for deproteinization (recovery 88-94%), followed by reversed-phase-based liquid chromatography prior to positive electrospray ionization for detection by multiple reaction monitoring using a linear ion trap quadrupole mass spectrometer. All analytes were quantified using cocaine-d3 as an internal standard suitable and reliable for robust, precise (coefficient of variation 2-13%), and accurate (87-122%) measurement within a linear range of 3 orders of magnitude (0.05-50 ng/ml plasma). The method was exemplarily applied to stability studies in phosphate-buffered saline, human serum, and rabbit serum. Each alkaloid was incubated separately and samples were taken at distinct incubation time points. Supernatants of diverse alkaloids at corresponding time points were pooled and subjected to simultaneous LC-ESI MS/MS quantification. This combinatorial analysis design allowed us to analyze the stability of samples with a drastically reduced number of chromatographic runs. In the presence of rabbit serum, all tropane alkaloids tested were degraded significantly within minutes to hours, with the exception of the stable semisynthetic compounds ipratropium and N-butylscopolamine. In contrast, in the presence of equal concentrations of human serum, no degradation was observed for any of the compounds, with the exception of cocaine. Relevant enzymes involved in enzymatic degradation are discussed.

  15. ENDOGENOUS INTOXICATION IN ANIMALS OF DIFFERENT AGE GROUPS IN CASE OF POLYTRAUMA

    S. R. Pidruchna

    2017-02-01

    Full Text Available Background.  Associated injury is a worldwide social and economic problem. Age related aspects of endogenous intoxication are not studied comprehensively. Annually, from 44 000 to 65 000 citizens die because of traumatic injuries. As a result, this number increased by 32.6% for the last 10 years.     The detoxification system, as a component of the functional systems of the organism, experiences significant changes in case of polytrauma. Objective. The study was aimed to discover pathogenetic peculiarities of the multiple trauma in age aspect in different disease periods and to explore the level of endogenous intoxication in this condition. Methods. The experiments were performed on 72 white male rats aged 3, 6 and 12 months, which underwent simulation of severe skeletal trauma and examination of the contents of middle mass molecules and endogenous intoxication index (markers of endogenous intoxication in 1, 4 and 24 hours after the associated injury. Results. The most significant increase of the middle mass molecules was fixed in 24 hours after modeling of severe skeletal injuries in all groups of animals, especially it was the most pronounced in 12-month-old animals. The erythrocyte intoxication index reached the highest level in 4 hours after the injury, its increase was most significant in sexually mature adult animals. Conclusion. A significant increasing of endogenous intoxication markers in 12-month-old rats, if compared to 3- and 6-month-old animals, can be caused by the decrease in compensatory protection mechanisms.

  16. The Evaluation of the Potency of Newly Developed Oximes (K727, K733 and Trimedoxime to Counteract Acute Neurotoxic Effects of Tabun in Rats

    Jiří Kassa

    2016-03-01

    Full Text Available Aim: The ability of two newly developed oximes (K727, K733 to reduce tabun-induced acute neurotoxic signs and symptoms was evaluated and compared with currently available trimedoxime in rats. Methods: The neuroprotective effects of the oximes studied combined with atropine on Wistar rats poisoned with tabun at a lethal dose (380 μg/kg i.m.; 90% of LD50 value were evaluated. Tabun-induced neurotoxicity was monitored by the functional observational battery consisting of 38 measurements of sensory, motor and autonomic nervous functions at 2 hours following tabun challenge. Results: All tested oximes combined with atropine enable tabun-poisoned rats to survive till the end of experiment. Both newly developed oximes (K727, K733 combined with atropine were able to decrease tabun-induced neurotoxicity in the case of lethal poisoning although they did not eliminate all tabun-induced acute neurotoxic signs and symptoms. Conclusion: The ability of both novel bispyridinium oximes to decrease tabun-induced acute neurotoxicity was slightly lower than that of trimedoxime. Therefore, the newly developed oximes are not suitable for the replacement of commonly used oximes such as trimedoxime in the treatment of acute tabun poisonings.

  17. Acute oral toxicity of the herbicide BUREX EKO in pheasants.

    Legáth, J; Mlynarcíková, H; Svický, E; Lenhardt, L; Kacmár, P; Benová, K; Kovác, G

    1996-12-01

    The aim of this study was to determine the acute LD50, clinical symptoms and pathological changes of acute BUREX EKO intoxication in pheasants according to OECD No 205. Medium lethal dose (LD50) of BUREX EKO in pheasant is 3.84 ml/kg body weight with the upper level of reliability 4.50 ml and lower level of reliability 3.27 ml/kg body weight. As far as the calculation to the effective substance is concerned it is 1077 mg of chloridazone per kg body weight with the interval of reliability from 919 to 1263 mg/kg body weight. Calculated the effective substance of chloridazone (3.84 ml is LD50 of BUREX EKO which contains 1077 mg of chloridazone) BUREX EKO can be classified as the moderately toxic substance to pheasants. There were following clinical symptoms of the BUREX EKO intoxication in pheasants: apathy, drowsiness, incapability to move, ruffled feathers, slight diarrhoea, strenuous respiration, tonico-clonical cramps before death, decease with the head expressively bent rearwards. There was a relatively fast beginning of rigor mortis in dead pheasants. Pathologico-anatomical dissection of the pheasants obtained under conditions of acute intoxication did not reveal any changes on the organs of both experimental and control pheasants which would be immediately connected with the effect of the administered substance. Hyperaemia was recorded by histologico-pathological investigation of the liver and kidneys. No changes on the brain and intestine wall were recorded.

  18. Acute arsenic poisoning: clinical, toxicological, histopathological, and forensic features.

    Tournel, Gilles; Houssaye, Cédric; Humbert, Luc; Dhorne, Christine; Gnemmi, Viviane; Bécart-Robert, Anne; Nisse, Patrick; Hédouin, Valéry; Gosset, Didier; Lhermitte, Michel

    2011-01-01

    This report describes a suicide case by acute arsenic intoxication via intravenous injection. A 30-year-old woman injected arsenic As (V) (sodium arseniate disodique: Disodium Hydrogena Arsenik RP) in a successful suicide attempt. Three hours following administration, the woman developed severe digestive symptoms. She was admitted to a hospital and transferred to the intensive care unit within 12 h of the massive administration of arsenic. Despite therapeutic efforts, over the next 2 h she developed multiorgan failure and died. A postmortem examination was performed. Pulmonary edema and congestion of liver were apparent. As (V) and As (III) were determined by high performance liquid chromatography and inductively coupled plasma mass spectrometry after mineralization of samples by concentrated nitric acid. Toxicological analysis revealed high concentrations of arsenic in biological fluids as well as in organs. Histopathological examination showed a typical indication of myocarditis. These findings were in agreement with acute arsenic poisoning. The symptoms developed by this young woman (intoxication by intravenous administration) were comparable to oral intoxication. The clinical signs, survival time, and administration type are discussed in light of the literature on acute and chronic arsenic poisoning.

  19. Intoxication due to Papaver rhoeas (Corn Poppy: Five Case Reports

    Yahya Kemal Günaydın

    2015-01-01

    Full Text Available Introduction. In this paper, we aimed to present five Papaver rhoeas intoxication cases, which is very rare in the literature. Case 1. A 35-year-old female patient was admitted to our emergency room with the complaints of nausea, restlessness, and dyspnea developing 3 hours after eating Papaver rhoeas. On physical examination, her general condition was moderate; she was conscious and the vital findings were normal. The pupils were myotic. She was transferred to the toxicology intensive care unit as she experienced a generalized tonic clonic seizure lasting for three minutes. Case 2. A 41-year-old female patient was brought to our emergency room by 112 ambulance as she had contractions in her arms and legs, unconsciousness, and foam coming from her mouth two hours after Papaver rhoeas ingestion. On physical examination, she was confused, the pupils were myotic, and she was tachycardic. Arterial blood gases analysis revealed lactic acidosis. Case 3. A 38-year-old female patient was admitted to our emergency room with complaints of nausea and vomiting two hours after ingestion of Papaver rhoeas. Her physical examination and tests were normal. Case 4. A 34-year-old male patient was admitted to our emergency room with complaints of numbness and loss of power in his arms and legs one hour after Papaver rhoeas ingestion. He was hospitalized at the toxicology intensive care unit for follow-up and treatment. Dyspnea and bradycardia developed on the follow-up. The oxygen saturation without oxygen support was 90%. ECG revealed sinus bradycardia. The cardiac enzymes did not increase. Case 5. A 42-year-old female patient was brought to our emergency room by 112 ambulance with contractions in her arms and legs and unconsciousness two hours after Papaver rhoeas ingestion. On her physical examination, she was confused and the pupils were myotic. Arterial blood gases analysis revealed lactic acidosis. Conclusion. All patients were followed up for a few days and

  20. Toxicokinetics of the nerve agent (+/-)-VX in anesthetized and atropinized hairless guinea pigs and marmosets after intravenous and percutaneous administration.

    van der Schans, Marcel J; Lander, Brenda J; van der Wiel, Herma; Langenberg, Jan P; Benschop, Hendrik P

    2003-08-15

    intoxication in particular due to gradual replacement of carbamate on AChE by (+/-)-VX, whereas classical treatment of intoxication with oximes is hampered by the short persistence of oximes relative to the agent.

  1. Brain antioxidant responses to acute iron and copper intoxications in rats.

    Semprine, Jimena; Ferrarotti, Nidia; Musacco-Sebio, Rosario; Saporito-Magriñá, Christian; Fuda, Julián; Torti, Horacio; Castro-Parodi, Mauricio; Damiano, Alicia; Boveris, Alberto; Repetto, Marisa G

    2014-11-01

    Dose- and time-dependent antioxidant responses to Fe (0-60 mg kg(-1)) and Cu overloads (0-30 mg kg(-1)) in rat brains are described by the C50 and the t1/2, the brain metal concentration and the time for half maximal oxidative responses. Brain GSH and the GSH/GSSG ratio markedly decreased after Fe and Cu treatments (50-80%) with a t1/2 of 9-10 h for GSH and of 4 h for GSH/GSSG for both metals. The GSH/GSSG ratio was the most sensitive indicator of brain oxidative stress. The decrease of GSH and the increase of in vivo chemiluminescence had similar time courses. The C50 for brain chemiluminescence, GSH and hydrophilic and lipophilic antioxidants were in similar ranges (32-36 μg Fe g(-1) brain and 10-18 μg Cu g(-1) brain), which indicated a unique free-radical mediated process for each metal. The brain concentration of hydrophilic and lipophilic antioxidants decreased after Fe and Cu loads; hydrophilic antioxidants decreased by 46-68% with a t1/2 of 10-11 h and lipophilic antioxidants decreased by 75-45% with a t1/2 of 10-12 h. Cu,Zn-SOD and CAT activities and the protein expression were adaptively increased (100-90% after Fe and Cu loads), with a t1/2 of 8-12 h. GPx-4 activity decreased after both metal loads by 73-27% with a t1/2 of 8-4 h with decreased protein expression.

  2. Tissue damage after acute intoxication by polychlorinated biphenyls (PCBs in cockroaches Blattella germanica

    S Lambiase

    2009-06-01

    Full Text Available It is common knowledge that polychlorinated biphenyls (PCBs represent a serious threat to the health of both vertebrates and invertebrates. As far as the former are concerned, especially as regards human beings, a broad literature describes the direct and indirect effects induced by the PCBs on their systems and organs. Among invertebrates, the information available is mostly related to arthropods and is, however, very scarce. The aim of this work was to evaluate the effects of polychlorinated biphenyls (PCBs on tissues and organs of individuals belonging to a species of Blattaria (Blattella germanica treated with various doses of this toxic material. The pathologies found became more serious as the dosage increased and were present throughout the entire digestive system, in the fat body and in the male gonads: in these areas cell and tissue breakdown and severely damaged spermiogenesis were observed. In particular, the testicles, Malpighian tubules and fat body accumulated an amorphous basophilic PAS-positive substance. Furthermore, the NOS-dependent NADPH diaphorase activity pattern in the retina and optic lobes was more evident in the treated than in the control insects.

  3. Laryngeal choking on food and acute ethanol intoxication in adults--An autopsy study.

    Nikolić, Slobodan; Zivković, Vladimir; Dragan, Babic; Juković, Fehim

    2011-01-01

    The retrospective autopsy study included 98 adults who died because of laryngeal choking on a bolus of food: 67 men and 31 women (χ(2)=6.843, pintoxicated (z=-7.126, pintoxication in individuals without mental disorders, were the most important risk factors for bolus death.

  4. Acute experimental tabun-induced intoxication and its therapy in rats.

    Krejcová, G; Kassa, J

    2004-03-01

    Pharmacological pretreatment and antidotal treatment on tabun-induced neurotoxicity were studied in male albino rats that were poisoned with a lethal dose of tabun (280 microg/kg i.m.; 100% of LD50 value) and observed at 24 hours and 7 days following tabun challenge. The neurotoxicity of tabun was evaluated using a Functional observational battery and an automatic measurement of motor activity. Pharmacological pretreatment as well as antidotal treatment were able to reverse most of tabun-induced neurotoxic signs observed at 24 hours following tabun poisoning. However, there was not significant difference between the efficacy of profylaxis and antidotal treatment to eliminate tabun-induced neurotoxicity. The combination of profylactic pretreatment and antidotal treatment seems to be slightly more effective in the elimination of tabun-induced neurotoxicity in rats at 24 hours following tabun challenge in comparison with the administration of profylactic pretreatment or antidotal treatment alone. At 7 days following tabun poisoning, very few neurotoxic signs in tabun-poisoned rats were observed regardless of administration of pharmacological pretreatment or antidotal treatment. Thus, our findings confirm that the combination of pharmacological pretreatment and antidotal treatment is not only able to protect the experimental animals from the lethal effects of tabun but also to eliminate most of tabun-induced signs of neurotoxicity in tabun-poisoned rats.

  5. Acute cadmium intoxication: influence of cyproterone acetate on the testis and epididymis of the rat.

    Francavilla, S; Moscardelli, S; Francavilla, F; Casasanta, N; Properzi, G; Martini, M; Santiemma, V

    1981-02-01

    The changes resulting from treatment with cadmium were studied following the histological changes, the modification of both vascular permeability to vital dyes and of alkaline phosphatase activity in rat testis and epididymis. The testicular extravasation of acriflavine started 90 min following parenteral injection of cadmium and increased thereafter synchronous with an increase in testicular and epididymal weights due to edema. At 14 and 24 hr a striking decrease of interstitial fluorescence and tubular degeneration were noted in testis and caput epididymis due to thrombosis of the microvascular circulation. The barrier noted at 8 hr following cadmium injection. No changes of alkaline phosphatase activity was detected in testicular and epididymal blood vessels after cadmium injection. Previous treatment with cyproterone acetate accelerated the appearance of such alterations. The interstitial nuclear staining with acriflavine appeared in the testis at 1 hr and was diffuse at 90 and 120 min. cyproterone acetate seemed to accelerate the appearance of tubular degeneration at 8 hr after cadmium injection. The changes of the male rat gonad following cadmium treatment were characterized by an increased vascular permeability and generalized thrombosis. An inbalance of androgen stimulation seems to increase the blood vessels susceptibility to cadmium.

  6. Acute phenylbutazone intoxication in the mature horse: a morphological, ultrastructural and biochemical study

    Meschter, C.L.

    1987-01-01

    Phenylbutazone (PB) administered to adult horses at a dose of 13.46 mg PB/kg bodyweight produces gastrointestinal ulceration by 24 hours and renal crest necrosis by 48 hours. In the gastrointestinal tract, PB initially causes a microvascular lesion characterized ultrastructurally by swelling, lysis, and necrosis of the microvascular endothelial cells. Damage to the endothelium results in microhemorrhage, stasis, and thrombosis. Necrosis and then sloughing of the surrounding tissue follows. This results in mucosal ulceration. In the kidney, damage to the medullary interstitial cell is initially characterized by intracellular vacuolization and cytoplasmic swelling. Necrosis and infiltration neutrophilic leukocytes of the medullary interstitium then occurs and sloughing of the renal crest follows. The uptake of radiolabeled calcium is increased in the kidney and duodenum indicating that cell damage occurs. In cultured equine aortic endothelial and bovine aortic endothelial cells, Pb causes a dose-dependent decrease in lactic dehydrogenase and alkaline phosphatase activity.

  7. ACUTE POISONING WITH BENZODIAZEPINES AND OTHER HYPNOTICS: ETIOLOGIC CAUSE, SEX/AGE DISTRIBUTION AND CLINICAL OUTCOME

    Petko Marinov

    2016-11-01

    Full Text Available Purpose: Poisoning with drugs occupies a leading position among the causes of acute intoxications. Etiological distribution of medicated poisoning in different countries, even if they are adjacent, is different. In the most studies it was reported that the highest incidence of poisoning is with benzodiazepines or other psychoactive drugs. A retrospective analysis of acute poisoning with benzodiazepines and other hypnotic drugs in the Varna region for 25 years period – from 1991 to 2015 was carried out. Material and Methods: The number of patients who received hospital treatment after poisoning with benzodiazepines is 1741, and those with other hypnotics is 293, representing respectively 26.37% and 4.44% of all drug intoxications. Results: The share of poisoning with benzodiazepines and hypnotics compared to all acute intoxications is 11.66%. They are more common in women – 1566 (77%. Men are 468 (23%, the ratio of men to women was 3.34:1. The largest number of intoxications is in the age group up to 24 years - 1123 (55.2%, and only 4.1% of patients over 60 years. Intentional suicide attempts are 1896 (93.2%. Death is registered in 8 (0.4% patients.

  8. Assisted suicide by fentanyl intoxication due to excessive transdermal application.

    Juebner, Martin; Fietzke, Mathias; Beike, Justus; Rothschild, Markus A; Bender, Katja

    2014-11-01

    Herein, we report a case of an assisted suicide committed by application of 34 matrix-based fentanyl-containing transdermal therapeutic systems (TTS) with different release rates. The TTS were supplied by the husband but administered by the deceased herself. Besides routine systematic toxicological analysis (STA), the concentrations of fentanyl and norfentanyl were determined in the blood (femoral and heart), urine, stomach content, brain, lung tissue, musculus iliopsoas, liver, kidney, bile and in some of the used TTS by LC-MS/MS. Blood levels of fentanyl were 60.6 μg/L in femoral blood and 94.1 μg/L in heart blood. These concentrations are in good concordance with levels described in cases with accidental or lethal suicidal fentanyl patch application. The organ distribution indicates an influence of post-mortem redistribution. The levels of residual fentanyl in the TTS were also determined. STA furthermore revealed supratherapeutic levels of bromazepam. Thus, the cause of death was a combination of fentanyl and bromazepam intoxication. However, considering the determined levels of fentanyl and norfentanyl in the entire set of specimens and the high toxicity in comparison to bromazepam, fentanyl was the leading toxic noxa.

  9. Polyneuropathy induced by n-hexane intoxication in Taiwan.

    Huang, Chin-Chang

    2008-03-01

    n-Hexane and methyl n-butyl ketone share a common metabolite, 2,5-hexanedione, a potent neurotoxin. Neurotoxic effects to both peripheral and central nervous systems may occur after occupational exposure or recreational abuse of n-hexane. Initial clinical manifestations include numbness and tingling sensation in the toes and fingers, followed by progressive weakness and areflexia, particularly in the distal limbs. Chronic low-dose n-hexane exposure, often observed in industrial workers, apparently causes axonal loss with sensory impairment. Subacute high-dose n-hexane exposure, often observed in glue-sniffers, can cause axonal swelling and secondary demyelination with muscle wasting and weakness. Electrophysiological studies demonstrate prominent prolongation of distal latencies, slowing of nerve conduction velocities, and conduction block with temporal dispersion particularly in severely intoxicated patients. Pathological hallmarks include giant axonal swelling with secondary demyelination and relative loss of large myelinated fibers. Giant axons are accumulated by 10 nm neurofilaments. The clinical course tends to be biphasic with "coasting" for 2-3 months, followed by a slow recovery for about 1-2 years after cessation of exposure to n-hexane. Prognosis is usually favorable. Severely affected patients may develop sequelae of muscle wasting, foot drop, and spasticity. Increased awareness of the n-hexane neurotoxicity in industrial workers and glue sniffers as well as use of safe solvents and adequate ventilation systems are important for preventing n-hexane toxicity.

  10. Children intoxications: what is abuse and what is not abuse.

    Dinis-Oliveira, Ricardo Jorge; Magalhães, Teresa

    2013-04-01

    The curiosity and the natural tendency to explore the environment put young children at an increased risk of poisoning over older children and adults. Poisonings are a significant area of concern from 1 year of age and progressively contribute more to overall rates of morbidity and mortality until children reach adulthood. Particularly, the abuse of children by poisoning is also highly common with thousands of fatalities. A practical strategy is presented that aims to alert health, forensic, and law enforcement professionals to this problem and to demystify the preconception that it is a rare form of abuse or neglect. Compounds that are foreign to a living organism (xenobiotics) and those present within body (endobiotics), mainly involved in children intoxications and contextual examples related to exposure are also reviewed. Particular concern is given to concepts in the field of children poisoning. The described history and the clinical and toxicological evaluation are discussed, and harmonized protocols regarding correct procedures for sample collection to forensic toxicological analysis are proposed. Since children are particularly vulnerable to the toxic effects of high doses of xenobiotics and endobiotics, special consideration on the preparation of the environment that surrounds children in order minimize all possible risks will be also considered.

  11. Clinical features and management of intoxication due to hallucinogenic drugs.

    Leikin, J B; Krantz, A J; Zell-Kanter, M; Barkin, R L; Hryhorczuk, D O

    1989-01-01

    Hallucinogenic drugs are unique in that they produce the desired hallucinogenic effects at what are considered non-toxic doses. The hallucinogenic drugs can be categorised into 4 basic groups: indole alkaloid derivatives, piperidine derivatives, phenylethylamines and the cannabinols. The drugs reviewed include lysergic acid diethylamide (LSD), phencyclidine (PCP), cocaine, amphetamines, opiates, marijuana, psilocybin, mescaline, and 'designer drugs.' Particularly noteworthy is that each hallucinogen produces characteristic behavioural effects which are related to its serotonergic, dopaminergic or adrenergic activity. Cocaine produces simple hallucinations, PCP can produce complex hallucinations analogous to a paranoid psychosis, while LSD produces a combination of hallucinations, pseudohallucinations and illusions. Dose relationships with changes in the quality of the hallucinatory experience have been described with amphetamines and, to some extent, LSD. Flashbacks have been described with LSD and alcohol. Management of the intoxicated patient is dependent on the specific behavioural manifestation elicited by the drug. The principles involve differentiating the patient's symptoms from organic (medical or toxicological) and psychiatric aetiologies and identifying the symptom complex associated with the particular drug. Panic reactions may require treatment with a benzodiazepine or haloperidol. Patients with LSD psychosis may require an antipsychotic. Patients exhibiting prolonged drug-induced psychosis may require a variety of treatments including ECT, lithium and l-5-hydroxytryptophan.

  12. Comparing the preventive effect of 2 percent Topical Lidocaine and Intravenous Atropine on oculocardiac reflex in Ophthalmological Surgeries under General Anesthesia

    Parvin Sajedi

    2013-01-01

    Full Text Available Background: The current study aimed to determine preventive effect of 2 percent topical xylocaine on oculocardiac reflex in ophthalmological surgeries except strabismus, including retinal detachment and vitrectomy with scleral buckling under general anesthesia. Methods: A randomized controlled clinical trial was carried out on 150 patients aged 18-90 years undergoing ophthalmological surgeries under general anesthesia. Samples randomly divided into the experimental group (received four drops of 2 percent topical xylocaine instilled in desired eye and control group (received 0.5 mg atropine sulfate injection. Systolic, diastolic and mean arterial blood pressure of patients and baseline heart rate were recorded. They were compared regarding the incidence of bradycardia, heart rate less than 60 beats/minute, hypotension and blood pressure less than 90 mm/Hg. Data were analyzed by Statistical Package for the Social Sciences software version 20 using Chi-square and ANOVA. Results: The difference between two groups was not statistically significant regarding demographic and basic variables. The incidence of bradycardia in both groups was respectively (90.7 percent vs. 17.3 percent, heart rate less than 60 beats/minute (40 percent vs. 13.3 percent, hypotension (76 percent vs. 32 percent and blood pressure less than 90 mmHg was (28 percent vs. 8 percent. Accordingly, the differences between both groups were statistically significant (P > 0.001. Conclusions: The preventive impact of topical xylocaine upon oculocardiac reflex in ophthalmological surgeries such as retinal detachment and vitrectomy with scleral buckling under general anesthesia was less effective than that of atropine injection. Therefore, to avoid this reflex in high-risk patients, injecting atropine would be safer.

  13. Clinical rescue experience of 42 cases of acute organophosphate poisoning%42例急性有机磷中毒抢救的临床体会

    陈旭华

    2011-01-01

    Objective To summarize the rescue method of acute organophosphate poisoning. Methods Forty- two cases of patients with organophosphate poisoning were pumped into at ropine by the micro- pump continually. Strict observation was done before atropinization was com pleted in order to prevent excessive Atropine intake and atropine poisoning. Results Five out of 42 cases were reported dead and the remaining cases were improved and discharged after treatment. The total cure rate was 88.10%. The average atropinization time was (138.5 ± 38.2) min, and at ropinization process required (78.3 ± 6.8) mg. Two cases (4.76%) had Atropine overdose and poi soning, 3 cases (7. 14%) condition rebounding, and 2 cases (4. 76%) intermediate syndrome. Conclusion Using continuous micro - pump into the Atropine in acute organophosphate poisoning rescue can reduce the required dose of atropinization and reduce the risk of overdose and poisoning.%目的 总结急性有机磷中毒抢救的方法.方法 对42例有机磷中毒患者进行持续微量泵泵入阿托品,严格观察使之阿托品化,防止出现阿托品过量以及阿托品中毒.结果 42例病例除5例死亡外,其余病例均经治疗后好转出院,治愈率88.10%.患者达到阿托品化的平均时间为(138.5±38.2) min,阿托品化需药量(78.3±6.8) mg.出现阿托品过量及中毒2例(4.76%),出现病情反跳3例(7.14%),出现中间综合征者2例(4.76%).结论 在急性有机磷中毒的抢救中使用持续微量泵入阿托品,可以降低达到阿托品化的需药量,并且可以降低出现阿托品过量及中毒的风险.

  14. Acute pancreatitis

    ... its blood vessels. This problem is called acute pancreatitis. Acute pancreatitis affects men more often than women. Certain ... pancreatitis; Pancreas - inflammation Images Digestive system Endocrine glands Pancreatitis, acute - CT scan Pancreatitis - series References Forsmark CE. Pancreatitis. ...

  15. Cystitis - acute

    Uncomplicated urinary tract infection; UTI - acute cystitis; Acute bladder infection; Acute bacterial cystitis ... cause. Menopause also increases the risk for a urinary tract infection. The following also increase your chances of having ...

  16. Acute sensory neuropathy-neuronopathy from pyridoxine overdose.

    Albin, R L; Albers, J W; Greenberg, H S; Townsend, J B; Lynn, R B; Burke, J M; Alessi, A G

    1987-11-01

    We report two patients who developed an acute, profound, and permanent sensory deficit after treatment with massive doses of parenteral pyridoxine. Aside from rapid onset, their clinical picture resembles that described in chronic pyridoxine neurotoxicity. It also is consonant with experimental models of acute pyridoxine intoxication and is probably secondary to a sensory ganglion neuronopathy. These patients also had transient autonomic dysfunction, mild weakness, nystagmus, lethargy, and respiratory depression. These previously undocumented features may be attributable to either the preservative used in the parenteral pyridoxine preparation or to the exceptionally high doses of pyridoxine these patients received.

  17. Effect of acute and delayed hyperbaric oxygen therapy on cyanide whole blood levels during acute cyanide intoxication

    Lawson-Smith, P; Jansen, E C; Hilsted, Linda Maria

    2011-01-01

    causing depletion of adenosine triphosphate. Hyperbaric oxygen (HBO2) is recommended for treating carbon monoxide poisoning. The therapeutic effect is due to a high oxygen pressure removing carbon monoxide from the cells. We hypothesise that HBO2 induces changes in whole-blood-cyanide by a competitive...

  18. Anticholinergic drugs--functional antidotes for the treatment of tabun intoxication.

    Krejcová, Gabriela; Kassa, Jirí

    2004-01-01

    1. To study the influence of antidotes on tabun-induced neurotoxicity, the rats were injected intramuscularly with organophosphate tabun (LD50). The efficacy of choice antidotal treatment consisting of acetylcholinesterase reactivator obidoxime and one of four anticholinergic drugs (atropine, benactyzine, biperiden, scopolamine) was compared. 2. Testing of tabun-induced neurotoxicity progress was carried out using the method Functional observational battery. The experimental animals as well as controls were observed at 24 hours and 7 days following tabun or saline administration. 3. The results were compared to the condition of animals without anticholinergic drug (oxime alone) and control rats that received physiological solution instead of tabun and treatment. Antidotal treatment involving centrally acting anticholinergic drugs (benactyzine, biperiden, scopolamine) showed significantly higher neuroprotective efficacy compared to antidotal treatment containing atropine.

  19. Acute toxicity of several organophosphorous insecticides and protection by cholinergic antagonists and 2-PAM on Artemia salina larvae.

    Sánchez-Fortún, S; Sanz, F; Barahona, M V

    1996-10-01

    The acute toxicity of chlorpyrifos, methylchlorpyrifos, parathion and methylparathion to three age classes of Artemia salina was determined. In general, A. salina 24-h old was less sensitive to these organophosphorous insecticides (OPI) than A. salina 48-h old and A. salina 48-h old was significantly more tolerant than A. salina 72-h old, in contrast, chlorpyrifos was equally toxic to A. salina 48- and 72-h old. There were some differences among the three age classes of A. salina in the relative order of toxicity of OPI tested. The rank order of toxicity to A. salina 48-h old was methylparathion salina 24- and 72-h old it was methylparathion = parathion Artemia salina 24-h old was investigated. The lethal action of OPI tested was completely prevented by pretreatment of Artemia salina 24-h old with 2-PAM (10(-5) M) and atropine (10(-4 )M). However no concentration of hexamethonium, pirenzepine or AF-DX 116 protected 100% of the animals poisoned by LC84 of the OPI selected, maximum protection obtained was 71 to 88%. In contrast, the maximum inhibition of mortality obtained with AF-DX 116 pretreatment was about 55% because this compound was used at concentrations which were non toxic to control Artemia salina. Atropine, hexamethonium, pirenzepine, AF-DX 116 and 2-PAM afforded 50 % protection (IC50) of Artemia salina against mortality by LC84 of the OPI selected at concentrations in the range of 6.62x10(-7)-1.6x10(-6) M, 2. 38x10(-4)-2.05x10(-3)M, 8.91x10(-7)-1.24x10(-6) M, 9.66x10(-8)-1. 34x10(-7 )M, and 1.95x10(-8)-2.73x10(-8 )M, respectively. Pretreatment of atropine plus 2-PAM to determine whether this combination afforded greater inhibition of the lethality induced by four OPI tested than pretreatment with either atropine or 2-PAM alone was investigated. Atropine (10(-5) M) in combination with 2-PAM (10(-7 )M) inhibited completely the acute toxicity of all OPI tested, while the pretreatment with atropine (10(-6) M) plus 2-PAM at the same concentration gave a

  20. Exogenous drug intoxication among young people of Rio Grande do Sul

    Elisa Inês Klinger

    2016-10-01

    Full Text Available Background and objective: the wide variety of drugs available in the market, brought important changes in the aspect of drug use, however, there are also problems related to these products, among these, exogenous intoxication, considered a world wide problem in the health sector, especially among women. The aim of the study was to analyze the data reported by exogenous drug intoxication among young adults of Rio Grande do Sul. Methods: it is an ecological descriptive study of cases of exogenous drug intoxication of individuals between 20-39 years of age, from Rio Grande do Sul, reported in the years 2011-2015, at Information System for Notifiable Diseases (SINAN. Results: 1,278 notifications of exogenous intoxication caused by drugs were found. Of these, 76.29% of the cases were female, 85.21% were white, 25.98% had incomplete primary education and 85.52% lived in urban areas. Of the reported cases, it highlights the 1,038 cases of attempted suicide (81.22%, followed by 68 cases of self-medication (5.32%. Conclusions: the exogenous drug intoxication among young adults in Rio Grande do Sul is serious and worrying, indicating the importance of educational measures of prevention and health promotion in this population.

  1. [Histopathology of meibomian gland abnormalities in experimental PenCB intoxicated beagle treated with squalane].

    Kohno, T; Ohnishi, Y

    1989-05-01

    In order to examine the effect of squalane to excrete PCB from the intoxicated animals, histopathological studies of Meibomian gland abnormalities were carried out in experimental PenCB (3,4,5,3',4'-pentachlorobiphenyl) intoxicated beagles treated with squalane. All experimental animals except a control group showed characteristic changes of Meibomian glands: dilation of the duct and squamous metaplasia of the alveolar cells. According to the degree of these findings, five stages were divided in the processes of Medibomian gland changes. The PenCB intoxicated dogs initially showed mild pathological changes of the glands and later moderate to severe degrees of findings. In the PenCB intoxicated animals treated with squalane, severe degree of Meibomian gland findings were found in the early stage and mild to moderate abnormalities in the late stage. The concentration of PenCB in blood varied in each animal, and the animals with advanced Medibomian gland abnormalities tended to have high level of PenCB concentration in blood. In conclusion, the effect of squalane to excrete PCB from the intoxicated animals were not determined in this study.

  2. Occupational pesticide intoxications among farmers in Bolivia: a cross-sectional study

    Huici Omar

    2006-04-01

    Full Text Available Abstract Background Pesticide use and its consequences are of concern in Bolivia due to an intensive and increasing use. Methods To assess the magnitude and reasons for occupational pesticide intoxication, a cross-sectional study with interviews and blood-tests was performed among 201 volunteer farmers from 48 villages in the temperate and subtropical valleys in the eastern part of the Andes Mountains in Bolivia. Of these 171 male farmers using pesticides in their agricultural production were used in the statistical analysis, including linear- and logistic regression analysis. Results This study documented a frequent use of the most toxic pesticides among farmers who have had almost no instructions in how to use pesticides and protect themselves against the dangers of intoxication, reflected in the hazardous practices used when handling pesticides. Symptoms of intoxications were common in connection with spraying operations. The risk of experiencing symptoms and the serum cholinesterase activity were influenced by whether or not organophosphates were used and the number of times sprayed. The experience of symptoms was moreover influenced by the hygienic and personal protective measures taken during spraying operations while this had no influence on the serum cholinesterase level. Conclusion The study showed that occupational pesticide intoxications were common among farmers and did depend on multiple factors. Pesticide use is probably one of the largest toxicological problems in Bolivia, and a coordinated action by authorities, society and international bodies is needed to limit the number of intoxications and the environmental pollution.

  3. Cannabidiol Rescues Acute Hepatic Toxicity and Seizure Induced by Cocaine

    Luciano Rezende Vilela

    2015-01-01

    Full Text Available Cocaine is a commonly abused illicit drug that causes significant morbidity and mortality. The most severe and common complications are seizures, ischemic strokes, myocardial infarction, and acute liver injury. Here, we demonstrated that acute cocaine intoxication promoted seizure along with acute liver damage in mice, with intense inflammatory infiltrate. Considering the protective role of the endocannabinoid system against cell toxicity, we hypothesized that treatment with an anandamide hydrolysis inhibitor, URB597, or with a phytocannabinoid, cannabidiol (CBD, protects against cocaine toxicity. URB597 (1.0 mg/kg abolished cocaine-induced seizure, yet it did not protect against acute liver injury. Using confocal liver intravital microscopy, we observed that CBD (30 mg/kg reduced acute liver inflammation and damage induced by cocaine and prevented associated seizure. Additionally, we showed that previous liver damage induced by another hepatotoxic drug (acetaminophen increased seizure and lethality induced by cocaine intoxication, linking hepatotoxicity to seizure dynamics. These findings suggest that activation of cannabinoid system may have protective actions on both liver and brain induced by cocaine, minimizing inflammatory injury promoted by cocaine, supporting its further clinical application in the treatment of cocaine abuse.

  4. Identification of low and high frequency ranges for heart rate variability and blood pressure variability analyses using pharmacological autonomic blockade with atropine and propranolol in swine.

    Poletto, Rosangela; Janczak, Andrew M; Marchant-Forde, Ruth M; Marchant-Forde, Jeremy N; Matthews, Donald L; Dowell, Carol A; Hogan, Daniel F; Freeman, Lynetta J; Lay, Donald C

    2011-05-03

    Understanding autonomic nervous system functioning, which mediates behavioral and physiological responses to stress, offers great potential for assessing farm animal stress and welfare. Evaluation of heart rate variability (HRV) and blood pressure variability (BPV), using time and frequency domain analyses may provide a sensitive and reliable measure of affective states and stress-mediated changes in sympathetic and parasympathetic tones. The aim of this research was to define low (LF) and high frequency (HF) power spectral ranges using pharmacological autonomic blockade, and to examine HRV and BPV parameter changes in response to atropine and propranolol in swine. Ten, 13-week old, barrows (n=6) and gilts (n=4) underwent surgery to place an intra-cardiac electrode and a blood pressure catheter attached to a biotelemetric transmitter; pigs had a 3-week recovery period prior to data collection. Each pig was subjected to administration of 4 intravenous (i.v.) drug treatments: a control treatment, 3 mL of saline, and 3 blockade treatments; 0.1 mg/kg of atropine, 1.0 mg/kg of propranolol, and .1 mg/kg of atropine together with 1.0 mg/kg of propranolol. All treatments were delivered by injection in the jugular vein with a minimum of 48 h between individual treatments. Behavior, ECG and blood pressure data were recorded continuously for a total of 1h, from 30 min pre-injection to 30 min post-injection. For data analyses, two 512-beat intervals were selected for each treatment while the pig was lying and inactive. The first interval was selected from the pre-injection period (baseline), and the second was selected between 10 and 30 min post-injection. Time and frequency domain (power spectral density) analyses were performed on each data interval. Subsequent, LF and HF bands from the power spectral densities were defined based on general linear and regression analyses. The HRV and BPV were computed with a covariate (baseline) factorial analysis of treatment by sex

  5. Acute Bronchitis

    ... Smoking also slows down the healing process. Acute bronchitis treatment Most cases of acute bronchitis can be treated at home.Drink fluids, but ... bronchial tree. Your doctor will decide if this treatment is right for you. Living with acute bronchitis Most cases of acute bronchitis go away on ...

  6. Ecstasy intoxication as an unusual cause of epileptic seizures in young children.

    Pauwels, Steven; Lemmens, Francis; Eerdekens, Kim; Penders, Joris; Poesen, Koen; Desmet, Koen; Vermeersch, Pieter

    2013-11-01

    In light of the widespread use of ecstasy, it is surprising that only few cases of intoxicated young children have been reported. Patients almost invariably present with convulsions accompanied by sympathetic signs and symptoms such as hyperthermia. Two new cases of toddlers intoxicated with ecstasy are described. The first patient, a 19-month-old boy, presented with convulsions but no sympathetic signs. The pediatrician's suspicion was raised because of the absence of a postictal state. The second patient, a 20-month-old girl, had a more typical presentation with convulsions and hyperthermia. Her story illustrates the fact that immunoassays for toxicological screening can easily miss traces of additional illicit drugs present in the urine such as cocaine. The presence of other illicit drugs provides clues to the child's risky environment and should lead to further investigation. Finally, we review the available literature on ecstasy intoxication to summarize the key presenting manifestations.

  7. Two cases of near-fatal gamma-butyrolactone (GBL) ingestion and intoxication.

    van Vugt, R; Hofhuizen, C M

    2012-01-01

    We present two cases of GBL intoxication. Patient A is a 45-year old man who lost consciousness after drinking a clear unknown liquid. He was brought to the Emergency Departement (ED) after he was intubated. His partner notified the liquid could be GBL, a prodrug for GHB. He regained consciousness 16 hours later in the intensive care unit (ICU) where he could be successfully extubated. Patient B is a 25-year old man who was found unconscious at home with next to him an empty bottle of GBL. He was intubated in the intensive care unit. He could be extubated after 12 hours. GBL intoxication is becoming a more frequent problem and overdosage of GBL can rapidly occur because of its rapid onset and high potency when compared to GHB. We discuss the clinical course and complications after GBL ingestion and intoxication.

  8. Benzodiazepine/GABA receptor complex during severe ethanol intoxication and withdrawal in the rat

    Hemmingsen, R.; Braestrup, C.; Nielsen, M.; Barry, D.I. (Dept. of Psychiatry, Rigshospitalet, Copenhagen, St. Hans Mental Hospital, Roskilde, and Ferrosan Research Laboratory, Soeborg, Denmark)

    1982-01-01

    The benzodiazepine/GABA (gammaaminobutyric acid) receptor complex was investigated during severe ethanol intoxication and withdrawal in the rat. The intragastric intubation technique was used to establish physical ethanol dependence in the animals. Cerebral cortex from male Wistar rats was studied 1) after 31/2 days of severe ethanol intoxication, 2) during the ethanol withdrawal reaction and 3) in a control group. The effect of GABA-ergic activation by muscimol and THIP (4,5,6,7-tetrahydroisoxazole(5,4-c)pyridin-3-01) on /sup 3/H-diazepam binding was unchanged during ethanol intoxication and withdrawal, as was the affinity constant (Ksub(D)) and the maximal number of binding sites (Bsub(max)) for /sup 3/H-flunitrazepam. In conclusion, the benzodiazepine/GABA receptor complex is unlikely to play any causual part in physical ethanol dependence.

  9. Intoxication after Extreme Oral Overdose of Quetiapine to Attempt Suicide: Pharmacological Concerns of Side Effects

    C. Müller

    2009-01-01

    Full Text Available Quetiapine is an atypical antipsychotic approved for the treatment of patients with psychotic disorders. Since approvement several case reports about intoxication with quetiapine were linked mainly with tachycardia, QTc-prolongation, somnolence, and hyperglycemia. Here, we present the first case report of an intoxication with an extreme overdose of quetiapine (36 g, ingested by a 32-year-old female (62 kg bodyweight to attempt suicide. Symptoms associated with intoxication were coma without arterial hypotension, persistent tachycardia, hyperglycemia, and transient hypothyreoidism. QTc-interval was moderately extended. Management consisted of intubation for airway protection, gastric lavage, the use of activated charcoal, i.v. saline, and observation for 17 hours on an intensive care unit. Despite the extremely high dose of quetiapine, the patient recovered completely without residual symptoms.

  10. Acute diarrhea in children

    Radlović Nedeljko

    2015-01-01

    Full Text Available Acute diarrhea (AD is the most frequent gastroenterological disorder, and the main cause of dehydration in childhood. It is manifested by a sudden occurrence of three or more watery or loose stools per day lasting for seven to 10 days, 14 days at most. It mainly occurs in children until five years of age and particularly in neonates in the second half-year and children until the age of three years. Its primary causes are gastrointestinal infections, viral and bacterial, and more rarely alimentary intoxications and other factors. As dehydration and negative nutritive balance are the main complications of AD, it is clear that the compensation of lost body fluids and adequate diet form the basis of the child’s treatment. Other therapeutic measures, except antipyretics in high febrility, antiparasitic drugs for intestinal lambliasis, anti-amebiasis and probiotics are rarely necessary. This primarily regards uncritical use of antibiotics and intestinal antiseptics in the therapy of bacterial diarrhea. The use of antiemetics, antidiarrhetics and spasmolytics is unnecessary and potentially risky, so that it is not recommended for children with AD.

  11. 阿托品化定量管理在有机磷中毒患者护理中的应用%Application of the Quantitative Management of Atropine in the Nursing Care for Organophosphate Poison-ing Patients

    徐立; 赵芳芳; 郑佳佳; 胡敏; 张玲

    2016-01-01

    目的:探讨阿托品量化的优质管理,降低有机磷中毒患者出现阿托品中毒现象的概率。方法通过对阿托品化量表的使用,比较量表使用前后对照组和实验组出现的阿托品中毒现象及有机磷中毒反跳的发生率。结果阿托品化量表使用管理后,救治过程中阿托品中毒现象及有机磷中毒反跳现象的发生率,与量表使用管理前比较差异显著( P<0.05)。结论量表的使用管理不仅增强护理人员对患者用药观察的准确度,更减少患者阿托品中毒及有机磷中毒反跳的现象发生。%Objective To explore high -quality quantitative management of atropine and to reduce the risk of atropine poisoning in organophosphate poisoning patients .Methods To compare the incidences of the atro-pine poisoning and the bounce organophosphorus poisoning between the experimental group and the control group before and after using the atropine scale .Results There is significant difference in the incidences of atropine poi-soning and bounce organophosphorus poisoning before and after the use of the scale (P<0.05).Conclusion The use of the scale can not only increase the accuracy of medication observation , but also reduce the adverse reaction of atropine poisoning and bounce organophosphorus poisoning .

  12. Ecstasy intoxication: the toxicological basis for treatment Intoxicação por êxtase: bases toxicológicas para o tratamento

    Maristela Ferigolo

    2003-01-01

    Full Text Available Youngsters are increasingly using 3,4 methylenedioxymethamphetamine, known as ecstasy, because it is wrongly believed that it does not induce harm. However, there are many reports of adverse effects, including acute intoxication, abuse potential, and possible neurotoxic effects. Therefore, health care providers need to promptly recognize the symptoms of systemic intoxication in order to initiate early treatment. The drug is used by the oral route for long hours during crowded dance parties. Acutely, ecstasy increases the release of serotonin and decreases its reuptake, leading to hypertension, hyperthermia, trismus, and vomiting. There is debate on whether recreational doses of ecstasy cause permanent damage to human serotonergic neurons. Ecstasy users showed a high risk of developing psychopathological disturbances. The prolonged use of ecstasy might induce dependence, characterized by tolerance and hangover. Acute ecstasy intoxication needs emergency-type treatment to avoid the dose-dependent increase in adverse reactions and in severity of complications. There are no specific antidotes to be used during acute intoxication. Supportive measures and medical treatment for each one of the complications should be implemented, keeping in mind that symptoms originate mainly from the central nervous system and the cardiovascular system.Os jovens estão cada vez mais usando o 3,4-metilenodioximetanfetamina, conhecido como êxtase, pois acreditam que não causa danos. Entretanto, existem muitos relatos de efeitos adversos, incluindo a intoxicação aguda, abuso potencial e possíveis efeitos neurotóxicos. Portanto, profissionais da área da saúde necessitam reconhecer prontamente os sintomas da intoxicação a fim de iniciar o tratamento o mais breve possível. A droga é usada via oral durante várias horas de festas com danças. Agudamente, o êxtase aumenta a liberação do serotonina e diminui sua recaptação, levando a hipertensão, hipertermia

  13. Effects of mixing alcohol with caffeinated beverages on subjective intoxication : A systematic review and meta-analysis

    Benson, Sarah; Verster, Joris C; Alford, Chris; Scholey, Andrew

    2014-01-01

    It has been suggested that mixing alcohol with energy drinks or other caffeinated beverages may alter the awareness of (or 'mask') intoxication. The proposed reduction in subjective intoxication may have serious consequences by increasing the likelihood of engaging in potentially dangerous activitie

  14. Age of onset of first alcohol intoxication and subsequent alcohol use among urban American Indian adolescents.

    Henry, Kimberly L; McDonald, James N; Oetting, Eugene R; Walker, Patricia Silk; Walker, R Dale; Beauvais, Fred

    2011-03-01

    The objective was to assess the effect of early onset intoxication on subsequent alcohol involvement among urban American Indian youth. The data come from the American Indian Research (AIR) project, a panel study of urban Indian youth residing in King County, Washington. Data were collected annually from the adolescent and his/her primary caregiver from the 1988-89 school year to the 1996-97 school year, providing a total of nine waves of data. Early intoxication (by age 14) was related to delinquency, family history of alcohol abuse or dependence, poverty, broken family structure, less family cohesiveness, and more family conflict. The effects of these characteristics were, therefore, partialed out in testing effects of early intoxication on later alcohol involvement. Two-part latent growth models of alcohol use and alcohol problems were specified. Effects of early onset intoxication on these trajectories, as well as lifetime alcohol abuse or dependence by the transition to young adulthood, were examined. Findings indicate that adolescents who experienced their first intoxication early (by age 14), used alcohol more heavily from the ages of 16 to 18, experienced more problems related to the alcohol's use from the ages of 16 to 18, and were more likely to have a diagnosed alcohol disorder by the final wave of data collection. Congruent with similar studies in the general population, early intoxication appears to be associated with a deleterious course of alcohol involvement during adolescence and into the transition to young adulthood among urban American Indian youth. Implications for prevention are discussed.

  15. A comparison of the potency of newly developed oximes (K347, K628) and currently available oximes (obidoxime, HI-6) to counteract acute neurotoxic effects of Tabun in rats.

    Kassa, Jirí; Karasová, Jana Zdarová; Tesarová, Sandra; Musílek, Kamil; Kuca, Kamil

    2010-01-01

    The ability of newly developed oximes (K347, K628) to reduce tabun-induced acute neurotoxic signs and symptoms was compared with currently available oximes (obidoxime, HI-6) using a functional observational battery. The neuroprotective effects of the oximes studied (K347, K628, obidoxime, HI-6) combined with atropine on rats poisoned with tabun at a sublethal dose (220 microg/kg i.m.; 80% of LD50 value) were evaluated. Tabun-induced neurotoxicity was monitored by a functional observational battery and automatic measurement of motor activity at 24 hours following tabun challenge. The results indicate that all tested oximes combined with atropine enable tabun-poisoned rats to survive 24 hours following tabun challenge. Both newly developed oximes (K347, K628) combined with atropine are able to decrease tabun-induced neurotoxicity in the case of sublethal poisonings but they do not eliminate all tabun-induced acute neurotoxic signs and symptoms. Their ability to decrease the tabun-induced acute neurotoxicity is higher than that of the oxime HI-6 and it is slightly slower than the neuroprotective efficacy of obidoxime. As the neuroprotective potency of both newly developed oximes (K347, K628) is not as high as the potency of obidoxime, they are not a suitable replacement for obidoxime for the treatment of acute tabun poisonings.

  16. Neurology of acute organophosphate poisoning

    Singh Gagandeep

    2009-01-01

    Full Text Available Acute organophosphate (OP poisoning is one of the most common poisonings in emergency medicine and toxicological practice in some of the less-developed nations in South Asia. Traditionally, OP poisoning comes under the domain of emergency physicians, internists, intensivists, and toxicologists. However, some of the complications following OP poisoning are neurological and involve neurologists. The pathophysiological basis for the clinical manifestations of OP poisoning is inactivation of the enzyme, acetylcholinesterase at the peripheral nicotinic and muscarinic and central nervous system (CNS nerve terminals and junctions. Nicotinic manifestations occur in severe cases and late in the course; these comprise of fasciculations and neuromuscular paralysis. There is a good correlation between the electrophysiological abnormalities and the severity of the clinical manifestations. Neurophysiological abnormalities characteristic of nicotinic junctions (mainly neuromuscular junction dysfunction include: (1 single, supramaximal electrical-stimulus-induced repetitive response/s, (2 decrement-increment response to high frequency (30 Hz repetitive nerve stimulation (RNS, and (3 decremental response to high frequency (30 Hz RNS. Atropine ameliorates muscarinic manifestations. Therapeutic agents that can ameliorate nicotinic manifestations, mainly neuromuscular, are oximes. However, the evidence for this effect is inconclusive. This may be due to the fact that there are several factors that determine the therapeutic effect of oximes. These factors include: The OP compound responsible for poisoning, duration of poisoning, severity of poisoning, and route of exposure. There is also a need to study the effect of oximes on the neurophysiological abnormalities.

  17. Acute Pancreatitis Caused By Mushroom Poisoning

    Samet Karahan Research Fellow

    2016-01-01

    Full Text Available Of the more than 5000 species of mushrooms known, 100 types are toxic and approximately 10% of these toxic types can cause fatal toxicity. A type of mushroom called Amanita phalloides is responsible for 95% of toxic mushroom poisonings. In this article, we report 2 cases of mushroom poisonings caused by Lactarius volemus, known as Tirmit by the local people. The patient and his wife were admitted to the emergency room with abdominal pain, nausea, and vomiting 20 hours after consuming Lactarius volemus, an edible type of mushroom. The patients reported that they had been collecting this mushroom from the mountains and eating them for several years but had never developed any clinicopathology to date. Further examination of the patients revealed a very rare case of acute pancreatitis due to mushroom intoxication. The male patient was admitted to the intensive care unit while his wife was followed in the internal medicine service, because of her relative mild clinical symptoms. Both patients recovered without sequelae and were discharged. In this article, we aimed to emphasize that gastrointestinal symptoms are often observed in mushroom intoxications and can be confused with acute pancreatitis, thus leading to misdiagnosis of patients. Early diagnosis and appropriate treatment can improve patients’ prognosis and prevent the development of complications.

  18. [EFFECT OF 4-METHYLPYRAZOLE ON IMMUNE RESPONSE, FUNCTION OF Th1 AND Th2 LYMPHOCYTES, AND CYTOKINE CONCENTRATION IN RAT BLOOD AFTER ACUTE METHANOL POISONING].

    Zabrodskii, P F; Maslyakov, V V; Gromov, M S

    2016-01-01

    It was established in experiments on noninbred albino rats that the acute intoxication with methanol (1.0 LD50) decreased cellular and humoral immune responses, Th2-lymphocyte activity (to a greater extent as compared to the function of Th1 cells), reduced the blood concentration of immunoregulatory (IFN-g, IL-2, IL-4) and proinflammatory (TNF, IL-1b, IL-6) cytokines on the average by 36.5% (p Methanol antidote 4-methylpyrazole (non-competitive inhibitor of alcohol dehydrogenase) administered upon acute intoxication with methanol at a dose of 1.0 DL50 partially reduces the intoxication-induced suppression of humoral and cellular immune response, activity of T-helper cells, and production of IL-4 and restores blood levels of TNF, IL-1b, IFN-γ, IL-4, IL-2, IL-6 to the control values.

  19. Fatal cytisine intoxication and analysis of biological samples with LC-MS/MS.

    Musshoff, F; Madea, B

    2009-04-15

    We report about a fatal cytisine intoxication in a 20-year-old man who, according to his mother, had drunken tea prepared from plant material of Laburnum anagyroides with the toxic pyridine-like alkaloid as ingredient, which exhibits pharmacological effects similar to nicotine. Using a liquid chromatographic-mass spectrometric (LC-MS) procedure cytisine was quantified in post-mortem specimens. By exclusion of other causes of death an intoxication was determined as the cause of death with respiratory failure as the pathophysiological mechanism.

  20. Is gender a risk factor for pesticide intoxications among farmers in Bolivia?

    Jørs, Erik; Hay-Younes, Jasmin; Condarco, Madelaine A;

    2013-01-01

    seen. Being a female and having a low educational level were risk factors for "poor knowledge on pesticides" and a "risky behavior when handling pesticides." Females reported more symptoms of intoxication. The gender differences on knowledge and handling practices might explain why females report more......This study compares gender differences regarding knowledge, practice, and symptoms of intoxication when handling pesticides in farming. Data were gathered in La Paz County, Bolivia, in 2008 and 2009. Poor knowledge on safe handling, hazardous working practices, and use of very toxic pesticides were...

  1. An intravenous organophosphate poisoning with intermediate syndrome: An unusual way of intoxication

    Badhe Ashok

    2006-01-01

    Full Text Available Organophosphate (OP poisoning is very common form of poisoning in Indian population because of its availability and easy access. Intoxication occurs following the absorption of OP agents through gastrointestinal tract, skin and respiratory tract and rarely by intramuscular or intravenous route. The clinical features depend on the amount of the poison consumed, it′s concentration, the route of administration and the time of instituting therapy. We are reporting a case of an intravenous monochrotophos poisoning, an unusual way of intoxication, which was managed in our ICU.

  2. Brain marker protein changes after short- and long-term ethanol intoxication and withdrawal in the rat

    Clemmesen, L; Jørgensen, Ole Steen; Hemmingsen, R

    1987-01-01

    for D3, possibly indicating degradation of mature synapses; increased concentration of proteins D2 and MM during withdrawal, the D2 changes possibly indicating formation of new synapses; increased concentration of D1 protein and MM during long-term intoxication. We suggest that the changes in brain......The brain marker proteins, D1, D2, and D3, localised to neuronal membranes, and mitochondrial and cytoplasmic marker proteins (MM and CM), were studied during 1-6 days (short term) intragastrically-induced severe ethanol intoxication and during 1 month (long-term) ethanol intoxication established...... by a liquid diet regimen. The concentrations of the same brain proteins were also measured during withdrawal from the ethanol intoxication periods. Three categories of effect were encountered: decreased concentration of brain marker proteins during severe short-term intoxication the effect being most marked...

  3. Can Urtica dioica supplementation attenuate mercury intoxication in Wistar rats?

    Wafa Siouda

    2015-12-01

    supplemented rats. Conclusion: Nettle leaves have not only played a clear protective role during Hg intoxication, but it also enhanced hepatic, renal and testicular GSH level of Wistar rats.

  4. A rat model of nerve agent exposure applicable to the pediatric population: The anticonvulsant efficacies of atropine and GluK1 antagonists

    Miller, Steven L., E-mail: stevenmiller17@gmail.com [Department of Anatomy, Physiology, and Genetics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814 (United States); Program in Neuroscience, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814 (United States); Aroniadou-Anderjaska, Vassiliki, E-mail: vanderjaska@usuhs.edu [Department of Anatomy, Physiology, and Genetics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814 (United States); Department of Psychiatry, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814 (United States); Program in Neuroscience, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814 (United States); Figueiredo, Taiza H., E-mail: taiza.figueiredo.ctr@usuhs.edu [Department of Anatomy, Physiology, and Genetics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814 (United States); Prager, Eric M., E-mail: eric.prager683@gmail.com [Department of Anatomy, Physiology, and Genetics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814 (United States); Program in Neuroscience, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814 (United States); Almeida-Suhett, Camila P., E-mail: camilapalmeida@gmail.com [Department of Anatomy, Physiology, and Genetics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814 (United States); Program in Neuroscience, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814 (United States); Apland, James P., E-mail: james.p.apland.civ@mail.mil [Neurotoxicology Branch, U.S. Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD 21010 (United States); and others

    2015-04-15

    Inhibition of acetylcholinesterase (AChE) after nerve agent exposure induces status epilepticus (SE), which causes brain damage or death. The development of countermeasures appropriate for the pediatric population requires testing of anticonvulsant treatments in immature animals. In the present study, exposure of 21-day-old (P21) rats to different doses of soman, followed by probit analysis, produced an LD{sub 50} of 62 μg/kg. The onset of behaviorally-observed SE was accompanied by a dramatic decrease in brain AChE activity; rats who did not develop SE had significantly less reduction of AChE activity in the basolateral amygdala than rats who developed SE. Atropine sulfate (ATS) at 2 mg/kg, administered 20 min after soman exposure (1.2 × LD{sub 50}), terminated seizures. ATS at 0.5 mg/kg, given along with an oxime within 1 min after exposure, allowed testing of anticonvulsants at delayed time-points. The AMPA/GluK1 receptor antagonist LY293558, or the specific GluK1 antagonist UBP302, administered 1 h post-exposure, terminated SE. There were no degenerating neurons in soman-exposed P21 rats, but both the amygdala and the hippocampus were smaller than in control rats at 30 and 90 days post-exposure; this pathology was not present in rats treated with LY293558. Behavioral deficits present at 30 days post-exposure, were also prevented by LY293558 treatment. Thus, in immature animals, a single injection of atropine is sufficient to halt nerve agent-induced seizures, if administered timely. Testing anticonvulsants at delayed time-points requires early administration of ATS at a low dose, sufficient to counteract only peripheral toxicity. LY293558 administered 1 h post-exposure, prevents brain pathology and behavioral deficits. - Highlights: • The LD{sub 50} of soman was determined in postnatal-day-21 rats. • Rats with no seizures after 1.2XLD{sub 50} soman had less reduction of AChE in the amygdala. • Atropine sulfate (ATS) at 2 mg/kg, given at 20 min after

  5. Cysteamine-colon and cysteamine-duodenum lesions in rats. Attenuation by gastric pentadecapeptide BPC 157, cimetidine, ranitidine, atropine, omeprazole, sulphasalazine and methylprednisolone.

    Sikiric, P; Seiwerth, S; Grabarevic, Z; Balen, I; Aralica, G; Gjurasin, M; Komericki, L; Perovic, D; Ziger, T; Anic, T; Prkacin, I; Separovic, J; Stancic-Rokotov, D; Lovric-Bencic, M; Mikus, D; Staresinic, M; Aralica, J; DiBiaggio, N; Simec, Z; Turkovic, B; Rotkvic, I; Mise, S; Rucman, R; Petek, M; Sebecic, B; Ivasovic, Z; Boban-Blagaic, A; Sjekavica, I

    2001-01-01

    Recently, we showed cysteamine-duodenal lesions without gastric acid, since they were induced also in gastrectomized rats, as in naive rats, and they were inhibited by the novel stomach pentadecapeptide BPC 157 as well as standard antiulcer drugs (i.e. cimetidine, ranitidine, omeprazole, bromocriptine, atropine). Therefore, as an advantage of considering cysteamine as a directly acting cytotoxic agent and mentioned agents as direct cytoprotective agents, the present focus was on the ulcerogenic effect of cysteamine and protective effect of gastroduodenal antiulcer agents outside upper gastrointestinal tract (i.e. in colon). Intrarectal administration of the cysteamine (200 or 400 mg/kg b.w) produced severe colon lesions (i.e. transmural inflammation with serosal involvement) in rats (30 min-72 h-experimental period), apparently distinctive from smaller lesions after non-specific irritant enema [diluted HCl solution, pH 3.8 (adjusted to pH of cysteamine solution (pH 3.8)]. All of the tested antiulcer agents were applied simultaneously with cysteamine enema (8 cm from the anus, in a volume of the 1.0 ml/rat) intraperitoneally (i.p.), intragastrically (i.g.) or intrarectally (i.r.). Pentadecapeptide BPC 157 (10 microg or 10 ng/kg b.w.), given in either regimen, previously shown to have, besides others, a particular beneficial activity just in the intestinal mucosa, inhibited these cysteamine colon lesions (assessed after 30 min, 60 min, 180 min, 24 h, 48 h, 72 h following cysteamine in a dose of either 200 or 400 mg/kg i.r.). Cysteamine-colon lesions were also attenuated by standard antiulcer agents (mg/kg b.w.), given i.p., i.g., or i.r., such as ranitidine (10), cimetidine (50), omeprazole (10), atropine (10), together with methylprednisolone (1), and sulphasalazine (50, i.r.), assessed 30 min following application of 200 mg of cysteamine. Finally, standard cysteamine duodenal lesions (assessed 24 h after a subcutaneous application of 400 mg/kg of cysteamine) were

  6. Hazards of Secondary Bromadiolone Intoxications Evaluated using High-performance Liquid Chromatography with Electrochemical Detection

    René Kizek

    2007-07-01

    Full Text Available This study reported on the possibility of intoxications of non-target wild animalsassociated with use of bromadiolone as the active component of rodenticides withanticoagulation effects. A laboratory test was done with earthworms were exposed tobromadiolone-containing granules under the conditions specified in the modified OECD207 guideline. No mortality of earthworms was observed during the fourteen days longexposure. When the earthworms from the above test became a part of the diet of commonvoles in the following experiment, no mortality of consumers was observed too. However,electrochemical analysis revealed higher levels of bromadiolone in tissues fromearthworms as well as common voles compared to control animals. There were determinedcomparable levels of bromadiolone in the liver tissue of common voles after primary(2.34±0.10 μg/g and secondary (2.20±0.53 μg/g intoxication. Therefore, the risk ofsecondary intoxication of small mammalian species feeding on bromadiolone-containing earthworms is the same as of primary intoxication through baited granules. Bromadiolone bio-accumulation in the food chain was monitored using the newly developed analytical procedure based on the use of a liquid chromatography coupled with electrochemical detector (HPLC-ED. The HPLC-ED method allowed to determine the levels of bromadiolone in biological samples and is therefore suitable for examining the environmental hazards of this substance.

  7. Catechol-Bisphosphonate Conjugates:New Potential Chelating Agents for Metal Intoxication Therapy

    Guang Yu XU; Chun Hao YANG; Bo LIU; Xi Han WU; Yu Yuan XIE

    2004-01-01

    In a quest for better chelating therapy drugs for the treatment of intoxication by Fe, Al, or actinides, two new series of mixed catechol-bisphosphonate through amide linkage were synthesized.Benzyl group was used as protecting group to avoid the breakage of amide by acid hydrolysis or imcomplete reaction in silylation-dealkylation using bromotrimethylsilane.

  8. Brain MR finding of {beta}-fluoroethyl acetate rodenticide intoxication: a case report

    Kim, Ji Young; Jung, Cheol Kyu; Lee, Seung Ro; Park, Dong Woo [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

    2008-05-15

    {beta}-fluoroethyl acetate rodenticide intoxication can manifest as several different clinical abnormalities such as respiratory, neurologic, cardiologic and fluid-electrolyte problems. We report here on the MR findings of a case that showed symmetric cytotoxic edema in the while matter of the cerebral hemispheres after the ingestion of {beta} - fluoroethyl acetate rodenticide by a woman who was attempting suicide.

  9. Beneficial effects of TCP on soman intoxication in guinea pigs : seizures, brain damage and learning behaviour

    Groot, D.M.G. de; Bierman, E.P.B.; Bruijnzeel, P.L.B.; Carpentier, P.; Kulig, B.M.; Lallement, G.; Melchers, B.P.C.; Philippens, I.H.C.H.M.; Huygevoort, A.H.B.M. van

    2001-01-01

    Poisoning with the potent nerve agent soman produces a cascade of central nervous system (CNS) effects characterized by severe convulsions and eventually death. In animals that survive a soman intoxication, lesions in the amygdala, piriform cortex, hippocampus and thalamus can be observed. In order

  10. Are restrained eaters accurate monitors of their intoxication? Results from a field experiment.

    Buchholz, Laura J; Crowther, Janis H; Olds, R Scott; Smith, Kathryn E; Ridolfi, Danielle R

    2013-04-01

    Brief interventions encourage college students to eat more before drinking to prevent harm (Dimeff et al., 1999), although many women decrease their caloric intake (Giles et al., 2009) and the number of eating episodes (Luce et al., 2012) prior to drinking alcohol. Participants were 37 undergraduate women (24.3% Caucasian) who were recruited from a local bar district in the Midwest. This study examined whether changes in eating after intending to drink interacted with dietary restraint to predict accuracy of one's intoxication. Results indicated that changes in eating significantly moderated the relationship between dietary restraint and accuracy of one's intoxication level. After eating more food before intending to drink, women higher in restraint were more likely to overestimate their intoxication than women lower in restraint. There were no differences between women with high levels and low levels of dietary restraint in the accuracy of their intoxication after eating less food before intending to drink. Future research would benefit from examining interoceptive awareness as a possible mechanism involved in this relationship.

  11. Assessing Driving while Intoxicated (DWI) Offender Characteristics and Drinking Problems Utilizing the Numerical Drinking Profile (NDP)

    Barry, Adam E.; Misra, Ranjita; Dennis, Maurice

    2006-01-01

    Driving a vehicle under the influence of alcohol is a major public health concern. By distinguishing the type of individuals violating driving while intoxicated (DWI) sanctions, intervention programs will be better suited to reduce drinking and driving. The purpose of this study was to examine the personal characteristics of DWI offenders and…

  12. Statistical parametric mapping in brain single photon computed emission tomography after carbon monoxide intoxication.

    Watanabe, N; Nohara, S; Matsuda, H; Sumiya, H; Noguchi, K; Shimizu, M; Tsuji, S; Kinuya, S; Shuke, N; Yokoyama, K; Seto, H

    2002-04-01

    The purpose of this retrospective study was to assess regional cerebral blood flow in patients after carbon monoxide intoxication by using brain single photon emission computed tomography and statistical parametric mapping. Eight patients with delayed neuropsychiatric sequelae and ten patients with no neuropsychiatric symptoms after carbon monoxide intoxication were studied with brain single photon emission tomography imaging with 99mTc-hexamethyl-propyleneamine oxime. Forty-four control subjects were also studied. We used the adjusted regional cerebral blood flow images in relative flow distribution (normalization of global cerebral blood flow for each subject to 50 ml x 100 g(-1) x min(-1) with proportional scaling) to compare these groups with statistical parametric mapping. Using this technique, significantly decreased regional cerebral blood flow was noted extensively in the bilateral frontal lobes as well as the bilateral insula and a part of the right temporal lobe in the patients with delayed neuropsychiatric sequelae as compared with normal volunteers (Pparametric mapping is a useful technique for highlighting differences in regional cerebral blood flow in patients following carbon monoxide intoxication as compared with normal volunteers. The selectively reduced blood flow noted in this investigation supports the contention that the decrease following carbon monoxide intoxication may be prolonged and further worsen in the frontal lobe. In addition, the present study may help to clarify the characteristics of the pathophysiological alteration underlying delayed neuropsychiatric sequelae.

  13. Surfactant therapy restores gas exchange in lung injury due to paraquat intoxication in rats

    K.L. So; E. de Buijzer; D.A.M.P.J. Gommers (Diederik); U. Kaisers; P.J.J. van Genderen (Perry); B.F. Lachmann (Burkhard)

    1998-01-01

    textabstractParaquat is a weed killer which causes often fatal lung damage in humans and other animals. There is evidence that the pulmonary surfactant system is involved in the pathophysiology of respiratory failure after paraquat intoxication and, therefore, the possi

  14. A Cost Analysis of Web-Enhanced Training to Reduce Alcohol Sales to Intoxicated Bar Patrons

    Page, Timothy F.; Nederhoff, Dawn M.; Ecklund, Alexandra M.; Horvath, Keith J.; Nelson, Toben F.; Erickson, Darin J.; Toomey, Traci L.

    2015-01-01

    Objective: The purpose of this study was to document the development and testing costs of the Enhanced Alcohol Risk Management (eARM) intervention, a web enhanced training program to prevent alcohol sales to intoxicated bar patrons and to estimate its implementation costs in a "real world", non-research setting. Methods: Data for this…

  15. Mechanism of Action of Botulinum Neurotoxin and Overview of Medical Countermeasures for Intoxication

    2008-01-01

    from the animals’ fur during the course of performingthe necropsies. Signs and symptoms of intoxication, consisting of dysphagia , dysphonia, dizziness...at doses above 20 mg/kg in mice (Adler et al., 1997). Second, at the highest tolerated dose, TPEN only increased survival by 2-3 h following a 20 LDso

  16. Ricinus communis intoxications in human and veterinary medicine-a summary of real cases.

    Worbs, Sylvia; Köhler, Kernt; Pauly, Diana; Avondet, Marc-André; Schaer, Martin; Dorner, Martin B; Dorner, Brigitte G

    2011-10-01

    Accidental and intended Ricinus communis intoxications in humans and animals have been known for centuries but the causative agent remained elusive until 1888 when Stillmark attributed the toxicity to the lectin ricin. Ricinus communis is grown worldwide on an industrial scale for the production of castor oil. As by-product in castor oil production ricin is mass produced above 1 million tons per year. On the basis of its availability, toxicity, ease of preparation and the current lack of medical countermeasures, ricin has gained attention as potential biological warfare agent. The seeds also contain the less toxic, but highly homologous Ricinus communis agglutinin and the alkaloid ricinine, and especially the latter can be used to track intoxications. After oil extraction and detoxification, the defatted press cake is used as organic fertilizer and as low-value feed. In this context there have been sporadic reports from different countries describing animal intoxications after uptake of obviously insufficiently detoxified fertilizer. Observations in Germany over several years, however, have led us to speculate that the detoxification process is not always performed thoroughly and controlled, calling for international regulations which clearly state a ricin threshold in fertilizer. In this review we summarize knowledge on intended and unintended poisoning with ricin or castor seeds both in humans and animals, with a particular emphasis on intoxications due to improperly detoxified castor bean meal and forensic analysis.

  17. Compliance with the Legislation on Alcohol Serving and Selling and Alcohol Intoxications in Adolescents

    Hoof, van Joris J.; Boeynaems, Gerben; Vanderlely, Nicolaas

    2014-01-01

    Purpose: study the relation between compliance to the legal age limits for alcohol sales and alcohol intoxication in adolescents. Methods: from 2007 till 2012 we collected data on adolescents, with a positive BAC, treated in a hospital. Within the Dutch Pediatric Surveillance System (NSCK), pediatr

  18. Women's condom use assertiveness and sexual risk-taking: effects of alcohol intoxication and adult victimization.

    Stoner, Susan A; Norris, Jeanette; George, William H; Morrison, Diane M; Zawacki, Tina; Davis, Kelly Cue; Hessler, Danielle M

    2008-09-01

    This experiment examined relationships among adulthood victimization, sexual assertiveness, alcohol intoxication, and sexual risk-taking in female social drinkers (N=161). Women completed measures of sexual assault and intimate partner violence history and sexual assertiveness before random assignment to 1 of 4 beverage conditions: control, placebo, low dose (.04%), or high dose (.08%). After drinking, women read a second-person story involving a sexual encounter with a new partner. As protagonist of the story, each woman rated her likelihood of condom insistence and unprotected sex. Victimization history and self-reported sexual assertiveness were negatively related. The less sexually assertive a woman was, the less she intended to insist on condom use, regardless of intoxication. By reducing the perceived health consequences of unprotected sex, intoxication indirectly decreased condom insistence and increased unprotected sex. Findings extend previous work by elucidating possible mechanisms of the relationship between alcohol and unprotected sex - perceived health consequences and situational condom insistence - and support the value of sexual assertiveness training to enhance condom insistence, especially since the latter relationship was robust to intoxication.

  19. Oral administration of piperine for the control of aflatoxin intoxication in rats

    Thalita B. Gagini

    2010-06-01

    Full Text Available Aflatoxins are mycotoxins that have important toxic effects on human and animal health, even if consumed at low doses. The oral administration of piperine (1.12 mg/kg during 23 days in rats seemingly interfered with the toxicity of aflatoxins, decreasing hepatic injuries and the leukocyte depletion in experimentally intoxicated animals.

  20. The Effect of Vitamin C on the Erythrocyte Antioxidant Enzymes in Intoxicated-Lead Rat Offsprings

    Eshginia, Samira; Marjani, Abdoljalal

    2013-01-01

    Objective: Lead exposure or lead poisoning is known to cause a large spectrum of physiological, biochemical, and behavioural disorders in animals. This study was aimed at assessing the effect of vitamin C on the erythrocyte superoxide dismutase, glutathione peroxidase and the glutathione reductase activities in intoxicated- lead rat offsprings.

  1. 浅析抢救有机磷中毒次生阿托品过量%Analysis of secondary consequences of atropine overdose in the rescue of organophosphate poisoning

    郑凤云

    2015-01-01

    目的:为了更好地避免有机磷中毒抢救中因应用阿托品过量产生的次生后果.方法:筛查出236例有机磷中毒患者中,因抢救有机磷中毒使用阿托品过量(中毒)的 32 例临床资料.结果:30 例病人经调整阿托品用量及积极综合对症治疗后最终痊愈出院,两例既往有糖尿病的患者因合并肺部感染死于呼吸衰竭.结论:正确地应用阿托品是抢救成功的关键.%Objective: To avoid the secondary consequences of atropine overdose in the rescue of organophosphate poisoning. Methods: The clinical data of 32 case treated with atropine overdose was selected among 236 cases of organophosphate poisoning. Results: 30 cases of patients after adjusting the dosage of atropine and active comprehensive symptomatic treatment eventually recovered and discharged, while 2 cases with diabetes combined with pulmonary infection died of respiratory failure. Conclusion: The correct application of atropine is a key to the success of the rescue.

  2. Morphine protects against methylmercury intoxication: a role for opioid receptors in oxidative stress?

    Allan Costa-Malaquias

    Full Text Available Mercury is an extremely dangerous environmental contaminant responsible for episodes of human intoxication throughout the world. Methylmercury, the most toxic compound of this metal, mainly targets the central nervous system, accumulating preferentially in cells of glial origin and causing oxidative stress. Despite studies demonstrating the current exposure of human populations, the consequences of mercury intoxication and concomitant use of drugs targeting the central nervous system (especially drugs used in long-term treatments, such as analgesics are completely unknown. Morphine is a major option for pain management; its global consumption more than quadrupled in the last decade. Controversially, morphine has been proposed to function in oxidative stress independent of the activation of the opioid receptors. In this work, a therapeutic concentration of morphine partially protected the cellular viability of cells from a C6 glioma cell line exposed to methylmercury. Morphine treatment also reduced lipid peroxidation and totally prevented increases in nitrite levels in those cells. A mechanistic study revealed no alteration in sulfhydryl groups or direct scavenging at this opioid concentration. Interestingly, the opioid antagonist naloxone completely eliminated the protective effect of morphine against methylmercury intoxication, pointing to opioid receptors as the major contributor to this action. Taken together, the experiments in the current study provide the first demonstration that a therapeutic concentration of morphine is able to reduce methylmercury-induced oxidative damage and cell death by activating the opioid receptors. Thus, these receptors may be a promising pharmacological target for modulating the deleterious effects of mercury intoxication. Although additional studies are necessary, our results support the clinical safety of using this opioid in methylmercury-intoxicated patients, suggesting that normal analgesic doses could

  3. Acute methanol toxicity in minipigs

    Dorman, D.C.; Dye, J.A.; Nassise, M.P.; Ekuta, J.; Bolon, B.

    1993-01-01

    The pig has been proposed as a potential animal model for methanol-induced neuro-ocular toxicosis in humans because of its low liver tetrahydrofolate levels and slower rate of formate metabolism compared to those of humans. To examine the validity of this animal model, 12 4-month-old female minipigs (minipig YU) were given a single oral dose of water or methanol at 1.0, 2.5, or 5.0 g/kg body wt by gavage (n = 3 pigs/dose). Dose-dependent signs of acute methanol intoxication, which included mild CNS depression, tremors, ataxia, and recumbency, developed within 0.5 to 2.0 hr, and resolved by 52 hr. Methanol- and formate-dosed pigs did not develop optic nerve lesions, toxicologically significant formate accumulation, or metabolic acidosis. Based on results following a single dose, female minipigs do not appear to be overtly sensitive to methanol and thus may not be a suitable animal model for acute methanol-induced neuroocular toxicosis.

  4. Acute pancreatitis

    Bo-Guang Fan

    2010-01-01

    Full Text Available Background : Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims : The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods : We reviewed the English-language literature (Medline addressing pancreatitis. Results : Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions : Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  5. Acute pancreatitis

    Bo-Guang Fan

    2010-05-01

    Full Text Available Background: Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims: The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods: We reviewed the English-language literature (Medline addressing pancreatitis. Results: Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions: Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  6. Leukemoid reaction in a patient with acute lymphoblastic leukemia following the

    Osman Yokuş

    2013-06-01

    Full Text Available The occurrence of persistent neutrophilic leukocytosisabove 50,000 cells/μL for reasons other thanleukemia is defined as leukemoid reaction. Chronicmyelogenous leukemia (CML and chronic neutrophilicleukemia (CNL should be excluded, and underlyingdiseases or causes should be examined,in differential diagnosis. The most commonly observedcauses of leukemoid reactions are severeinfections, intoxications, malignancies, severe hemorrhage,or acute hemolysis [1]. J Clin Exp Invest2013; 4 (2: 258-259

  7. Experimental Therapeutics Against the Toxic and Lethal Effects Resulting from Acute Exposure to Nerve Agents Without Carbamate Pretreatment in Guinea Pigs

    2010-09-01

    induced airway blockage and acute autonomic effects such as mucoid-salivary hypersecretion, reduced airway patency, bradycardia, atrioventricular (AV...acute agent exposure. These included oro- facial movements (indicative of immoderate secretion), mild degree of dystonia/ataxia, and a short period of...intoxicated animals. At 24 hr post-CWA exposure, both the respiratory rate and breathing patterns across Groups 6-10 were comparable to those of

  8. Acute effects of a sarin-like organophosphorus agent, bis(isopropyl methyl)phosphonate, on cardiovascular parameters in anaesthetized, artificially ventilated rats

    Watanabe, Yoshimasa [Department of Pharmacology, Graduate School of Medical Sciences, Nagoya City University, Nagoya (Japan); Itoh, Takeo, E-mail: titoh@med.nagoya-cu.ac.jp [Department of Pharmacology, Graduate School of Medical Sciences, Nagoya City University, Nagoya (Japan); Shiraishi, Hiroaki [Department of Forensic Medicine, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima (Japan); Maeno, Yoshitaka [Department of Forensic Medical Science, Graduate School of Medical Sciences, Nagoya City University, Nagoya (Japan); Arima, Yosuke; Torikoshi, Aiko; Namera, Akira [Department of Forensic Medicine, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima (Japan); Makita, Ryosuke [Department of Nursing, Faculty of Health Sciences, Hiroshima Cosmopolitan University, Hiroshima (Japan); Yoshizumi, Masao [Department of Cardiovascular Physiology and Medicine, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima (Japan); Nagao, Masataka [Department of Forensic Medicine, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima (Japan)

    2013-10-01

    The organophosphorus compound sarin irreversibly inhibits acetylcholinesterase. We examined the acute cardiovascular effects of a sarin-like organophosphorus agent, bis(isopropyl methyl)phosphonate (BIMP), in anaesthetized, artificially ventilated rats. Intravenous administration of BIMP (0.8 mg/kg; the LD50 value) induced a long-lasting increase in blood pressure and tended to increase heart rate. In rats pretreated with the non-selective muscarinic-receptor antagonist atropine, BIMP significantly increased both heart rate and blood pressure. In atropine-treated rats, hexamethonium (antagonist of ganglionic nicotinic receptors) greatly attenuated the BIMP-induced increase in blood pressure without changing the BIMP-induced increase in heart rate. In rats treated with atropine plus hexamethonium, intravenous phentolamine (non-selective α-adrenergic receptor antagonist) plus propranolol (non-selective β-adrenergic receptor antagonist) completely blocked the BIMP-induced increases in blood pressure and heart rate. In atropine-treated rats, the reversible acetylcholinesterase inhibitor neostigmine (1 mg/kg) induced a transient increase in blood pressure, but had no effect on heart rate. These results suggest that in anaesthetized rats, BIMP induces powerful stimulation of sympathetic as well as parasympathetic nerves and thereby modulates heart rate and blood pressure. They may also indicate that an action independent of acetylcholinesterase inhibition contributes to the acute cardiovascular responses induced by BIMP. - Highlights: • A sarin-like agent BIMP markedly increased blood pressure in anaesthetized rats. • Muscarinic receptor blockade enhanced the BIMP-induced increase in blood pressure. • Ganglionic nicotinic receptor blockade attenuated the BIMP-induced response. • Blockade of α- as well as β-receptors attenuated the BIMP-induced response.

  9. Decrease in salivary lactoferrin output in chronically intoxicated alcohol-dependent patients

    Napoleon Waszkiewicz

    2012-07-01

    Full Text Available

    Salivary lactoferrin is a glycoprotein involved in the elimination of pathogens and the prevention of massive overgrowth of microorganisms that affect oral and general health. A high concentration of lactoferrin in saliva is often considered to be a marker of damage to the salivary glands, gingivitis, or leakage through inflamed or damaged oral mucosa, infiltrated particularly by neutrophils. We conducted a study to determine the effect of chronic alcohol intoxication on salivary lactoferrin concentration and output. The study included 30 volunteers consisting of ten non-smoking male patients after chronic alcohol intoxication (group A, and 20 control nonsmoking male social drinkers (group C with no history of alcohol abuse. Resting whole saliva was collected 24 to 48 hours after a chronic alcohol intoxication period. Lactoferrin was assessed by enzyme-linked immunosorbent assay. For all participants, the DMFT index (decayed, missing, or filled teeth, gingival index (GI and papilla bleeding index (PBI were assessed. The differences between groups were evaluated using the Mann–Whitney U test. We noticed significantly decreased salivary flow (SF in alcohol dependent patients after chronic alcohol intoxication (A, compared to the control group (C. Although there was no significant difference in salivary lactoferrin concentration between the alcohol dependent group A and the control group C, we found significantly decreased lactoferrin output in group A compared to group C. We found a significant correlation between the amount of daily alcohol use and a decrease in lactoferrin output. There was a significant increase in GI and a tendency of PBI to increase in group A compared to group C. We demonstrated that chronic alcohol intoxication decreases SF and lactoferrin output. The decreased lactoferrin output in persons chronically intoxicated by alcohol may be the result of lactoferrin exhaustion during drinking (due to its alcohol-related lower

  10. Gerstmann's syndrome following an acute herpes simplex encephalitis.

    Ilchevsky, S; Boev, I; Kazakova, T

    1998-01-01

    The authors present a rare clinical case of a woman who developed Gerstmann's syndrome following an acute Herpes simplex viral encephalitis. Clinical observation and laboratory evaluation were performed during the acute phase of the disease. After that the follow-up continued for one-year period. The localization of the pathologic process was determined by computerized tomography, conducted periodically. The characteristics of the clinical picture are interpreted in the context of the contemporary concepts of the topical diagnosis of Gerstmann's syndrome. The possibility of a sudden onset of acute Herpes simplex viral encephalitis without a preceding febrile-intoxication syndrome is worth noting. Conclusions are drawn stressing the need of an early etiologic treatment and the importance of the rehabilitation activities during the convalescence period.

  11. Effect of hyperbaric oxygen therapy on whole blood cyanide concentrations in carbon monoxide intoxicated patients from fire accidents

    Lawson-Smith, Pia; Jansen, Erik C; Hilsted, Linda;

    2010-01-01

    Hydrogen cyanide (HCN) and carbon monoxide (CO) may be important components of smoke from fire accidents. Accordingly, patients admitted to hospital from fire accidents may have been exposed to both HCN and CO. Cyanide (CN) intoxication results in cytotoxic hypoxia leading to organ dysfunction...... and animal experiments have shown that in rats exposed to CN intoxication, HBO can increase the concentration of CN in whole blood....

  12. Radiological strategy in acute stroke in children

    Paonessa, Amalia [Dept. of Neuroradiology, University Hospital ' S. Salvatore' , L' Aquila (Italy)], E-mail: apaonessa7@hotmail.com; Limbucci, Nicola [Dept. of Neuroradiology, University Hospital ' S. Salvatore' , L' Aquila (Italy); Tozzi, Elisabetta [Dept. of Pediatrics, University Hospital ' S. Salvatore' , L' Aquila (Italy); Splendiani, Alessandra; Gallucci, Massimo [Dept. of Neuroradiology, University Hospital ' S. Salvatore' , L' Aquila (Italy)

    2010-04-15

    The aim of the study was to estimate the preponderance of patterns of pediatric stroke, ischemic or hemorrhagic, their etiologies and the correct diagnostic protocol for acute management. Forty-one consecutive pediatric patients (age range 5-16 years) with an acute stroke observed in acute phase during a 10-year period, were retrospectively evaluated. Twenty-three patients underwent magnetic resonance imaging (MRI), 3 cases were studied by computed tomography (CT) without MRI, and 15 underwent both CT and MRI studies. In 9 cases, intra-arterial digital subtraction angiography (IADSA) was performed after non-invasive preliminary assessment. Seventeen hemorrhagic (41%) and 24 ischemic (59%) strokes were found. Among hemorrhagic forms, 5 cases were due to arteriovenous malformation (AVM), 7 to cavernoma, and 2 to aneurysm. Among ischemic forms, 2 were due to sickle-cell disease, 1 to hyperomocysteinemia, 1 to moyamoya syndrome, 1 to pseudoxantoma elasticum, 3 to prothrombotic state, 1 to Fabry's disease, 1 concomitant with CO intoxication, 5 to venous sinus thrombosis, and 4 to cardio-embolic state. Etiology remains unknown in 8 cases (20.5%). This study shows a moderate prevalence of ischemic over hemorrhagic strokes. Moreover, personal experience suggests that MRI is always more informative than CT and in selected cases should be the first-choice examination in the acute phase.

  13. Acute cholecystitis

    Halpin, Valerie

    2014-01-01

    Acute cholecystitis causes unremitting right upper quadrant pain, anorexia, nausea, vomiting, and fever, and if untreated can lead to perforations, abscess formation, or fistulae. About 95% of people with acute cholecystitis have gallstones.It is thought that blockage of the cystic duct by a gallstone or local inflammation can lead to acute cholecystitis, but we don't know whether bacterial infection is also necessary.

  14. Acute tramadol poisoning and its clinical and laboratory findings

    Rahimi, Hamid Reza; Soltaninejad, Kambiz; Shadnia, Shahin

    2014-01-01

    Background: Tramadol is a centrally acting analgesic with opioid and nonopioid properties, which extensively used in the relief of mild to moderate pain. Tramadol poisoning is a common cause of acute pharmaceutical poisoning in Iran. There are a few studies about clinical and laboratory findings related to acute tramadol poisoning. Therefore, the aim of this study was to demonstrate the clinical and laboratory findings in tramadol acute poisoning cases. Materials and Methods: This was a retrospective descriptive study of patients with acute tramadol poisoning who referred to Loghman Hakim Hospital Poison Center during January to April 2012. Data such as patient's age, sex, time of ingestion, ingested dose, cause of poisoning, mean duration of hospitalization, patient's clinical presentations, laboratory findings, therapeutic measures, and patient's outcome have collected in a predesigned checklist. Results: A total of 144 patients including 111 men (77%) and 33 women (23%) with acute tramadol poisoning was included in this study. The mean ingested dose was 1971.2 mg (100-20000 mg). Seizure (47.91%) was the most frequent clinical symptom. Blood gas on admission showed pH (7.3 ± 0.1), PCO2 (49.7 ± 8.6 mmHg) and HCO3− (24.1 ± 3.8 mEq/L), indicating pure acute respiratory acidosis may be occurred in tramadol-intoxicated patients. There were significant differences between tramadol-intoxicated cases with and without a seizure with regard to the time interval between ingestion and admission on hospital, ingested dose and PCO2. Conclusion: Seizure and rise of PCO2 were the most findings in this study. PMID:25535500

  15. Pharmacological interventions in the treatment of the acute effects of cannabis: a systematic review of literature

    Crippa José AS

    2012-01-01

    Full Text Available Abstract Background Cannabis intoxication is related to a number of physical and mental health risks with ensuing social costs. However, little attention has been given to the investigation of possible pharmacological interactions in this condition. Objective To review the available scientific literature concerning pharmacological interventions for the treatment of the acute effects of cannabis. Methods A search was performed on the Pubmed, Lilacs, and Scielo online databases by combining the terms cannabis, intoxication, psychosis, anxiety, and treatment. The articles selected from this search had their reference lists checked for additional publications related to the topic of the review. Results The reviewed articles consisted of case reports and controlled clinical trials and are presented according to interventions targeting the physiological, psychiatric, and cognitive symptoms provoked by cannabis. The pharmacological interventions reported in these studies include: beta-blockers, antiarrhythmic agents, antagonists of CB-1 and GABA-benzodiazepine receptors, antipsychotics, and cannabidiol. Conclusion Although scarce, the evidence on pharmacological interventions for the management of cannabis intoxication suggests that propanolol and rimonabant are the most effective compounds currently available to treat the physiological and subjective effects of the drug. Further studies are necessary to establish the real effectiveness of these two medications, as well as the effectiveness of other candidate compounds to counteract the effects of cannabis intoxication, such as cannabidiol and flumazenil.

  16. Antagonism of Acute Sulfide Poisoning in Mice by Nitrite Anion without Methemoglobinemia.

    Cronican, Andrea A; Frawley, Kristin L; Ahmed, Humza; Pearce, Linda L; Peterson, Jim

    2015-07-20

    There are currently no FDA-approved antidotes for H2S/sulfide intoxication. Sodium nitrite, if given prophylactically to Swiss Webster mice, was shown to be highly protective against the acute toxic effects of sodium hydrosulfide (∼LD40 dose) with both agents administered by intraperitoneal injections. However, sodium nitrite administered after the toxicant dose did not detectably ameliorate sulfide toxicity in this fast-delivery, single-shot experimental paradigm. Nitrite anion was shown to rapidly produce NO in the bloodstream, as judged by the appearance of EPR signals attributable to nitrosylhemoglobin and methemoglobin, together amounting to less than 5% of the total hemoglobin present. Sulfide-intoxicated mice were neither helped by the supplemental administration of 100% oxygen nor were there any detrimental effects. Compared to cyanide-intoxicated mice, animals surviving sulfide intoxication exhibited very short knockdown times (if any) and full recovery was extremely fast (∼15 min) irrespective of whether sodium nitrite was administered. Behavioral experiments testing the ability of mice to maintain balance on a rotating cylinder showed no motor impairment up to 24 h post sulfide exposure. It is argued that antagonism of sulfide inhibition of cytochrome c oxidase by NO is the crucial antidotal activity of nitrite rather than formation of methemoglobin.

  17. Profile of users intoxicated by drugs of abuse and association with death

    Lúcia Margarete dos Reis

    2016-05-01

    Full Text Available Objective: to characterize the profile of users intoxicated by drugs of abuse reported to a center of information and toxicological assistance and related this to the occurrence of deaths. Methods: study of case series reported in the 2010-2011 biennium after active case finding. Data were obtained from epidemiological records filed in the center and submitted to univariate analysis, with chi-squared test and Fischer test. Results: three hundred and thirty nine cases were found, most were men (87.3%, with basic education (61.0% and elderly (37.2%. Alcohol use (83.8% and chronic intoxications (89.9% were predominant. Clinical complications were present in most medical diagnoses (63.4%. However, mortality was higher in the event deferral by cold and fire weapons. Conclusion: the consumption of drugs of abuse influences morbidity and mortality, particularly in men aged at 60 years or above and with low level of education.

  18. Biomimetic enzyme nanocomplexes and their use as antidotes and preventive measures for alcohol intoxication

    Liu, Yang; Du, Juanjuan; Yan, Ming; Lau, Mo Yin; Hu, Jay; Han, Hui; Yang, Otto O.; Liang, Sheng; Wei, Wei; Wang, Hui; Li, Jianmin; Zhu, Xinyuan; Shi, Linqi; Chen, Wei; Ji, Cheng; Lu, Yunfeng

    2013-03-01

    Organisms have sophisticated subcellular compartments containing enzymes that function in tandem. These confined compartments ensure effective chemical transformation and transport of molecules, and the elimination of toxic metabolic wastes. Creating functional enzyme complexes that are confined in a similar way remains challenging. Here we show that two or more enzymes with complementary functions can be assembled and encapsulated within a thin polymer shell to form enzyme nanocomplexes. These nanocomplexes exhibit improved catalytic efficiency and enhanced stability when compared with free enzymes. Furthermore, the co-localized enzymes display complementary functions, whereby toxic intermediates generated by one enzyme can be promptly eliminated by another enzyme. We show that nanocomplexes containing alcohol oxidase and catalase could reduce blood alcohol levels in intoxicated mice, offering an alternative antidote and prophylactic for alcohol intoxication.

  19. Vitamin D and Risk for Vitamin A Intoxication in an 18-Month-Old Boy

    Barreca, Massimo; Galiano, Rossella; Galati, Maria Concetta; Raiola, Giuseppe

    2016-01-01

    An 18-month-old boy presented with abdominal pain, vomiting, diarrhea, and poor appetite for 6 days. He had been given a multivitamin preparation once daily, containing 50.000 IU of vitamin D and 10.000 IU of vitamin A for a wide anterior fontanelle for about three months. He presented with hypercalcemia, low levels of parathyroid hormone (PTH), and very high serum 25-hydroxyvitamin D (25-OHD) levels. Renal ultrasound showed nephrocalcinosis. He did not have sign or symptom of vitamin A intoxication. Patient was successfully treated with intravenous hydration, furosemide, and prednisolone. With treatment, serum calcium returned rapidly to the normal range and serum 25-OHD levels were reduced progressively. In conclusion the diagnosis of vitamin D deficiency rickets without checking 25-OHD levels may cause redundant treatment that leads to vitamin D intoxication (VDI). PMID:27478669

  20. Atrioventricular block induced by mad-honey intoxication: confirmation of diagnosis by pollen analysis.

    Cagli, Kumral Ergun; Tufekcioglu, Omac; Sen, Nihat; Aras, Dursun; Topaloglu, Serkan; Basar, Nur; Pehlivan, Sevil

    2009-01-01

    An unusual type of food poisoning, mad-honey intoxication, can be observed in the Black Sea region of Turkey and various other parts of the world. It can occur after ingestion of grayanotoxin-contaminated honey produced from the nectar of Rhododendron ponticum and other plant species, chiefly of the Ericaceae and Sapindaceae families. Mad-honey intoxication can result in severe cardiac complications, such as complete atrioventricular block. The diagnosis is generally reached on the basis of the patient's history of honey intake. In this report, we describe the case of a patient who had mad-honey-related complete atrioventricular block; in this instance, the diagnosis was confirmed by a pollen analysis of the suspect honey.

  1. Intravenous lipid emulsion and dexmedetomidine for treatment of feline permethrin intoxication: a report from 4 cases

    G. Ceccherini

    2015-08-01

    Full Text Available Four cases of feline permethrin intoxication are described. The cause of intoxication is the application of canine permethrin spot-on product (Advantix®, Bayer by the owners. Principal clinical guidelines recommends the use of anticonvulsant drugs to treat seizures or neurological symptoms after initial stabilization and dermal decontamination. The use of lipid emulsion had an increasing interest in the last decade for treatment of toxicosis caused by lipophilic drugs as reported in human and in veterinary medical practices. All cats presented in this study, were treated with intravenous lipid emulsion (ILE at variable dosages, and dexmedetomidine was also administered by intravenous way. No adverse reaction such as thrombophlebitis, overload circulation or others was noticed during and after administration of ILE. Dexmedetomidine was proved to be helpful in tranquillizing the cats. All cats were discharged in good condition faster than other cases treated without their use.

  2. [History of ignorance of methylmercury toxicity and intoxication in Japan in relation to Minamata disease].

    Ishihara, Nobuo

    2014-01-01

    The first reports of methylmercury intoxication appeared in 1865 and 1866. These reports had sensational effects in European countries, and were introduced not only in journals but also in newspapers. These two reports were referable in Japan at the latest in 1927. The formation of organic mercury in the production of acetoaldehyde was also referable in 1906 in Japan. In 1931 (one year before the start of acetoaldehyde production in Minamata) these important reports cited above were referable in Kumamoto University, and there were warnings about the toxicity of organic mercury and environmental pollution prior to the start of acetoaldehyde production. However, not only the plant, authorities (Ministry of Welfare), and Kumamoto Prefectural Office, but also the scientists completely ignored these reports. Waste was dumped into the environment without any treatment. Serious pollution of the environment by organic mercury started, which resulted in the outbreak of Minamata disease (=methylmercury intoxication).

  3. Vitamin D and Risk for Vitamin A Intoxication in an 18-Month-Old Boy

    Valentina Talarico

    2016-01-01

    Full Text Available An 18-month-old boy presented with abdominal pain, vomiting, diarrhea, and poor appetite for 6 days. He had been given a multivitamin preparation once daily, containing 50.000 IU of vitamin D and 10.000 IU of vitamin A for a wide anterior fontanelle for about three months. He presented with hypercalcemia, low levels of parathyroid hormone (PTH, and very high serum 25-hydroxyvitamin D (25-OHD levels. Renal ultrasound showed nephrocalcinosis. He did not have sign or symptom of vitamin A intoxication. Patient was successfully treated with intravenous hydration, furosemide, and prednisolone. With treatment, serum calcium returned rapidly to the normal range and serum 25-OHD levels were reduced progressively. In conclusion the diagnosis of vitamin D deficiency rickets without checking 25-OHD levels may cause redundant treatment that leads to vitamin D intoxication (VDI.

  4. Decisions in drug adverse reactions, intoxications and unexpected responses to herbal medicines as public health problems

    Álvarez-Falconí, Pedro P.; Médico Farmacólogo, Bachiller en Derecho, Doctor en Medicina. Centro Nacional de Salud Pública, Instituto Nacional de Salud. Lima, Perú. Laboratorio de Investigación en Plantas Medicinales, Instituto Nacional de Salud. Lima, Perú.

    2007-01-01

    This review evaluates the relevant information on a variety of adverse drug reactions serious, real or potential, attributed to some drugs relatively recent introduction into the world market, in addition, on some intoxications by contaminated medicines, all of which contributed to decision-making in the past and present, by regulatory authorities in drugs in several countries. It explores the broad strategies related to the pillars of the drug policies, the historical and current events ...

  5. The Effect of Ethanol Intoxication on the Spectral Characteristics for Blood Components of White Rats

    Korobova O.; Dudok T.; Trach I.; Moroz O.; Vlokh I.; Vlokh R.

    2003-01-01

    The present paper is devoted to studying, with the aid of different organic dyes, the transmittance spectra of hemoglobin and immunoglobulin G extracted from the blood of laboratory rats, which have been chronically intoxicated with ethanol. The differences in the spectra are detected, when compare with those for the control group. It is shown that the presence of ethanol in blood probably leads to uncoiling partially the hemoglobin molecules. The essential difference is also found in the tra...

  6. Autopsy report for a caffeine intoxication case and review of the current literature

    Yamamoto, Takuma; Yoshizawa, Katsuhiko; Kubo, Shin-ichi; EMOTO, Yuko; Hara, Kenji; Waters, Brian; Umehara, Takahiro; Murase, Takehiko; Ikematsu, Kazuya

    2014-01-01

    Caffeine (1,3,7-trimethylxanthine) is a popular mild central nervous system stimulant found in the leaves, seeds and fruits of various plants and in foodstuffs such as coffee, tea, and chocolate, among others. Caffeine is widely used and is not associated with severe side effects when consumed at relatively low doses. Although rarely observed, overdoses can occur. However, only a few fatal caffeine intoxication cases have been reported in the literature. Herein, we report the pathological exa...

  7. ENDOGENOUS INTOXICATION IN ANIMALS OF DIFFERENT AGE GROUPS IN CASE OF POLYTRAUMA

    S. R. Pidruchna; H. M. Stepanova; B. O. Pereviznyk; N. A. Vasylyshyn; Hudyma, A. A.

    2017-01-01

    Background.  Associated injury is a worldwide social and economic problem. Age related aspects of endogenous intoxication are not studied comprehensively. Annually, from 44 000 to 65 000 citizens die because of traumatic injuries. As a result, this number increased by 32.6% for the last 10 years.     The detoxification system, as a component of the functional systems of the organism, experiences significant changes in case of polytrauma. Objective. The study was aimed to discover pathogen...

  8. Distinct Roles for CdtA and CdtC during Intoxication by Cytolethal Distending Toxins.

    Shandee D Dixon

    Full Text Available Cytolethal distending toxins (CDTs are heterotrimeric protein exotoxins produced by a diverse array of Gram-negative pathogens. The enzymatic subunit, CdtB, possesses DNase and phosphatidylinositol 3-4-5 trisphosphate phosphatase activities that induce host cell cycle arrest, cellular distension and apoptosis. To exert cyclomodulatory and cytotoxic effects CDTs must be taken up from the host cell surface and transported intracellularly in a manner that ultimately results in localization of CdtB to the nucleus. However, the molecular details and mechanism by which CDTs bind to host cells and exploit existing uptake and transport pathways to gain access to the nucleus are poorly understood. Here, we report that CdtA and CdtC subunits of CDTs derived from Haemophilus ducreyi (Hd-CDT and enteropathogenic E. coli (Ec-CDT are independently sufficient to support intoxication by their respective CdtB subunits. CdtA supported CdtB-mediated killing of T-cells and epithelial cells that was nearly as efficient as that observed with holotoxin. In contrast, the efficiency by which CdtC supported intoxication was dependent on the source of the toxin as well as the target cell type. Further, CdtC was found to alter the subcellular trafficking of Ec-CDT as determined by sensitivity to EGA, an inhibitor of endosomal trafficking, colocalization with markers of early and late endosomes, and the kinetics of DNA damage response. Finally, host cellular cholesterol was found to influence sensitivity to intoxication mediated by Ec-CdtA, revealing a role for cholesterol or cholesterol-rich membrane domains in intoxication mediated by this subunit. In summary, data presented here support a model in which CdtA and CdtC each bind distinct receptors on host cell surfaces that direct alternate intracellular uptake and/or trafficking pathways.

  9. Distinct Roles for CdtA and CdtC during Intoxication by Cytolethal Distending Toxins

    Tamilselvam, Batcha; Spiegelman, Lindsey M.; Son, Sophia B.; Eshraghi, Aria; Blanke, Steven R.; Bradley, Kenneth A.

    2015-01-01

    Cytolethal distending toxins (CDTs) are heterotrimeric protein exotoxins produced by a diverse array of Gram-negative pathogens. The enzymatic subunit, CdtB, possesses DNase and phosphatidylinositol 3-4-5 trisphosphate phosphatase activities that induce host cell cycle arrest, cellular distension and apoptosis. To exert cyclomodulatory and cytotoxic effects CDTs must be taken up from the host cell surface and transported intracellularly in a manner that ultimately results in localization of CdtB to the nucleus. However, the molecular details and mechanism by which CDTs bind to host cells and exploit existing uptake and transport pathways to gain access to the nucleus are poorly understood. Here, we report that CdtA and CdtC subunits of CDTs derived from Haemophilus ducreyi (Hd-CDT) and enteropathogenic E. coli (Ec-CDT) are independently sufficient to support intoxication by their respective CdtB subunits. CdtA supported CdtB-mediated killing of T-cells and epithelial cells that was nearly as efficient as that observed with holotoxin. In contrast, the efficiency by which CdtC supported intoxication was dependent on the source of the toxin as well as the target cell type. Further, CdtC was found to alter the subcellular trafficking of Ec-CDT as determined by sensitivity to EGA, an inhibitor of endosomal trafficking, colocalization with markers of early and late endosomes, and the kinetics of DNA damage response. Finally, host cellular cholesterol was found to influence sensitivity to intoxication mediated by Ec-CdtA, revealing a role for cholesterol or cholesterol-rich membrane domains in intoxication mediated by this subunit. In summary, data presented here support a model in which CdtA and CdtC each bind distinct receptors on host cell surfaces that direct alternate intracellular uptake and/or trafficking pathways. PMID:26618479

  10. Distinct Roles for CdtA and CdtC during Intoxication by Cytolethal Distending Toxins.

    Dixon, Shandee D; Huynh, Melanie M; Tamilselvam, Batcha; Spiegelman, Lindsey M; Son, Sophia B; Eshraghi, Aria; Blanke, Steven R; Bradley, Kenneth A

    2015-01-01

    Cytolethal distending toxins (CDTs) are heterotrimeric protein exotoxins produced by a diverse array of Gram-negative pathogens. The enzymatic subunit, CdtB, possesses DNase and phosphatidylinositol 3-4-5 trisphosphate phosphatase activities that induce host cell cycle arrest, cellular distension and apoptosis. To exert cyclomodulatory and cytotoxic effects CDTs must be taken up from the host cell surface and transported intracellularly in a manner that ultimately results in localization of CdtB to the nucleus. However, the molecular details and mechanism by which CDTs bind to host cells and exploit existing uptake and transport pathways to gain access to the nucleus are poorly understood. Here, we report that CdtA and CdtC subunits of CDTs derived from Haemophilus ducreyi (Hd-CDT) and enteropathogenic E. coli (Ec-CDT) are independently sufficient to support intoxication by their respective CdtB subunits. CdtA supported CdtB-mediated killing of T-cells and epithelial cells that was nearly as efficient as that observed with holotoxin. In contrast, the efficiency by which CdtC supported intoxication was dependent on the source of the toxin as well as the target cell type. Further, CdtC was found to alter the subcellular trafficking of Ec-CDT as determined by sensitivity to EGA, an inhibitor of endosomal trafficking, colocalization with markers of early and late endosomes, and the kinetics of DNA damage response. Finally, host cellular cholesterol was found to influence sensitivity to intoxication mediated by Ec-CdtA, revealing a role for cholesterol or cholesterol-rich membrane domains in intoxication mediated by this subunit. In summary, data presented here support a model in which CdtA and CdtC each bind distinct receptors on host cell surfaces that direct alternate intracellular uptake and/or trafficking pathways.

  11. Is there a role for progesterone in the management of acute organophosphate poisoning during pregnancy?

    Jafarzadeh, Mostafa; Nasrabadi, Zeynab Nasri; Sheikhazadi, Ardeshir; Abbaspour, Abdollah; Vasigh, Shayesteh; Yousefinejad, Vahid; Marashi, Sayed Mahdi

    2013-06-01

    Organophosphates are commonly used pesticides and cause about one million unintentional and 2 million suicidal exposures with up to 300,000 fatalities every year around the world. Toxicity of organophosphates is due to inhibition cholinesterase activity and prolonging the effects of acetylcholine in the receptor site. Clinical features of organophosphate poisoning are defecation, urination, miosis, bronchorrhea, emesis, lacrimation and salivation. Spontaneous abortion reported some when in pregnant patients. Intravenous administration of benzodiazepines, atropine and pralidoxime is the formal treatment of this toxicity. Atropine and pralidoxime have been assigned to pregnancy class C by the FDA and should be recommended for use in pregnant women clinically suffer organophosphate poisoning. Benzodiazepines have been assigned to pregnancy class D and should be avoided during pregnancy. Clinical experiments suggest transplacental transfer of organophosphates is possible, and fetal sensitivity is probable, but a single acute overdose most likely don't make any physical deformities, therefore termination of pregnancy is not imperative. Nonetheless, no definite strategy focused on maintaining pregnancy. Here we propose an idea that in any female case of acute organophosphate poisoning in childbearing range of age, maternal serum Beta-HCG should be tested for pregnancy and prophylactic progesterone should be used in pregnant cases of organophosphate poisoning.

  12. Fresh frozen plasma as a successful antidotal supplement in acute organophosphate poisoning.

    Vučinić, Slavica; Zlatković, Milica; Antonijević, Biljana; Ćurčić, Marijana; Bošković, Bogdan

    2013-06-01

    Despite improvements to intensive care management and specific pharmacological treatments (atropine, oxime, diazepam), the mortality associated with organophosphate (OP) poisoning has not substantially decreased. The objective of this examination was to describe the role of fresh frozen plasma (FFP) in acute OP poisoning. After a deliberate ingestion of malathion, a 55-year-old male suffering from miosis, somnolence, bradycardia, muscular fasciculations, rales on auscultation, respiratory insufficiency, as well as from an inhibition of red blood cell acetylcholinesterase (AChE) and plasma butyrylcholinesterase (BuChE), was admitted to hospital. Malathion was confirmed in a concentration of 18.01 mg L(-1). Apart from supportive measures (including mechanical ventilation for four days), antidotal treatment with atropine, oxime-pralidoxime methylsulphate (Contrathion(R)), and diazepam was administered, along with FFP. The potentially beneficial effects of FFP therapy included a prompt increase of BuChE activity (from 926 IU L(-1) to 3277 IU L(-1); reference range from 7000 IU L(-1) to 19000 IU L(-1)) and a reduction in the malathion concentration, followed by clinical recovery. Due to BuChE replacement, albumin content, and volume restitution, FFP treatment may be used as an alternative approach in patients with acute OP poisoning, especially when oximes are not available.

  13. Cases of acute poisoning admitted to Clinical Hospital Merkur in Zagreb in 1999.

    Prkacin, I; Vujanić, S; Dabo, N; Palcić, I; Naumovski-Mihalić, S

    2001-11-01

    This paper describes 170 cases of acute poisoning in 60 men and 110 women admitted to emergency room from January through November 1999. Ninety-eight percent of acute poisonings were self-inflicted, and 90% occurred at home. Drugs were used in 134 (79%) suicide attempts. Eighty-one acute poisonings were caused by benzodiazepines (48%) and 19 by antidepressants (11%). Alcohol intoxication, alone or combined with the intake of psychoactive drug (28 cases, 16%) predominated in men. Cocaine was the most common narcotic drug, taken by 31 patients (16%). Other acute poisonings involved ecstasy (4 cases), CO (6 cases), and HCl inhalation (2 cases). Previous suicide attempts due to depression were found in 68 patients (40%). Fifty patients (29%) were comatose on admission, 24 were transferred to intensive care, and 3 died. Data such as these can be very useful for handling self-inflicted acute poisonings and for planning long-term health care activities.

  14. Acute forearm compressive myopathy syndrome secondary to upper limb entrapment: an unusual cause of renal failure.

    Tachtsi, Maria D; Kalogirou, Thomas E; Atmatzidis, Stefanos K; Papadimitriou, Dimitrios K; Atmatzidis, Konstantinos S

    2011-05-01

    Compressive myopathy syndrome (SCM) is a syndrome characterized by the lesion of skeletal muscle resulting in subsequent release of intracellular contents (myoglobin, creatine phosphokinase, potassium, etc.) into the circulatory system, which can cause potentially lethal complications. There are numerous causes that can lead to SCM resulting to acute rhabdomyolysis, and many patients present with multiple causes. The most common potentially lethal complication is acute renal failure. The occurrence of acute rhabdomyolysis should be considered as a possibility in any patient who can remain stationary for long periods, or is in a coma, or is intoxicated in any form. We report the rare case of a 26-year-old patient who developed SCM caused by ischemia reperfusion, with subsequent acute rhabdomyolysis and acute renal failure after prolonged compression of the right upper extremity.

  15. Study II: mechanoreceptive sensation is of increased importance for human postural control under alcohol intoxication.

    Modig, F; Patel, M; Magnusson, M; Fransson, P A

    2012-03-01

    Standing postural stability relies on input from visual, vestibular, proprioceptive and mechanoreceptive sensors. When the information from any of these sensors is unavailable or disrupted, the central nervous system maintains postural stability by relying more on the contribution from the reliable sensors, termed sensory re-weighting. Alcohol intoxication is known to affect the integrity of the vestibular and visual systems. The aim was to assess how mechanoreceptive sensory information contributed to postural stability at 0.00% (i.e. sober), 0.06% and 0.10% blood alcohol concentration (BAC) in 25 healthy subjects (mean age 25.1 years). The subjects were assessed with eyes closed and eyes open under quiet standing and while standing was perturbed by repeated, random-length, vibratory stimulation of the calf muscles. Plantar cutaneous mechanoreceptive sensation was assessed for both receptor types: slowly adapting (tactile sensitivity) and rapidly adapting (vibration perception). The correlation between recorded torque variance and the sensation from both mechanoreceptor types was calculated. The recorded stability during alcohol intoxication was significantly influenced by both the tactile sensation and vibration perception of the subjects. Moreover, the study revealed a fluctuating association between the subjects' vibration perception and torque variance during balance perturbations, which was significantly influenced by the level of alcohol intoxication, vision and adaptation. Hence, one's ability to handle balance perturbations under the influence of alcohol is strongly dependent on accurate mechanoreceptive sensation and efficient sensory re-weighting.

  16. Intoxication of a Young Girl Reveals the Pitfalls of GHB Rapid Screening.

    Franken, Linda G; Andrews, Louise M; Slooff, Valerie D; de Wildt, Saskia N; Koch, Birgit C P

    2016-02-01

    The authors discuss the case of a 14-year-old girl who was transferred to the ICU of our hospital with ethanol intoxication (3.3 g/L), loss of consciousness (E5M3V1), and severe amnesia on recovery that was suspected of gamma-hydroxybutyric acid (GHB) intoxication. STAT toxicology screening may be necessary, when sexual assault under GHB intoxication is suspected. Therefore, the initial analysis of a urine sample was performed with a new enzymatic assay analysis for GHB. The enzymatic assay reported a GHB concentration of 26 mg/L, which is above the cut-off value of 10 mg/L. This cut-off value is to differentiate endogenous and exogenous levels because low levels of GHB occur naturally in the body. However, confirmation of these results by gas chromatography, which is common practice to confirm a positive GHB, gave a negative result. This discrepancy is probably contributed to interference of ethanol with the assay. This is a substantial downside of the GHB rapid screening, since the combination of GHB and ethanol is common. It is therefore advised to confirm that the positive GHB results are lower than 50 mg/L by gas chromatography, when using the rapid screening. This way the false-positive results and consequent inappropriate social and legal actions may be avoided.

  17. Effects of phytate on thyroid gland of rats intoxicated with cadmium.

    Mohamed, Tarek Mostafa; Salama, Afrah F; El Nimr, Tarek M; El Gamal, Doaa M

    2015-12-01

    Cadmium (Cd) is one of the most dangerous occupational and environmental toxins. The objective of the present study is to examine the potential prophylactic effects of phytic acid (PA) on thyroid hormones of male rats intoxicated with Cd. The male albino rats were divided into five groups: group I (control) was fed with the basal diet, group II was intoxicated with Cd in drinking water, groups III, IV, and V were intoxicated with Cd in drinking water and fed with the diet containing 3.5, 7, and 10 g of PA/kg, respectively. The results indicated that the serum calcium, iron (Fe), and total Fe binding capacity levels and serum T3 and T4 in Cd-treated rats of group II were decreased when compared with the control group, while PA-administered groups with Cd showed a significant improvement when compared with the Cd-treated rats only. Serum thyroid stimulating hormone (TSH) level was significantly increased in Cd-treated rats compared with the control group, while the addition of PA in diet decreased the high levels of TSH. These results indicated a prophylactic effect of PA against Cd-induced toxicity in rats.

  18. Safety Issues of Chinese Medicine:A Review of Intoxication Cases in Hong Kong

    NG; Kit-ying; CHENG; Chuen-lung

    2009-01-01

    Chinese medicine (CM) has been widely used in Hong Kong for centuries. In fact, CM practitioners currently provide over 20% of the medical consultations in Hong Kong and about 60% of the population has previously used CM. In 1999, the Legislative Council passed the Chinese Medicine Ordinance with aims to govern practice, use, trading, and manufacturing of CM in Hong Kong. While it is usually safe to use CM under proper application and guidance, there have been frequent reports on intoxication and fatalities. The misuse of potent/toxic CM, because of misidentification or overdose, can cause severe aconite, aristolochic acid, anticholinergic, podophyllin, grayanotoxin, pyrrolizidine alkaloids, matrine, gelsemine, teucvin, and strychnine poisoning. In this review, we summarized CM intoxication cases in Hong Kong, concentrating on the discussion of toxic and adverse effects as well as the quality control of CM. By increasing the awareness of CM toxicity, we hope to enhance the regulatory process and stimulate further research on their toxic dose, toxic ingredients, intoxication mechanisms, and quality control.

  19. Molecular Pathology of Pulmonary Edema in Forensic Autopsy Cases with Special Regard to Fatal Methamphetamine Intoxication.

    Du, Yu; Jin, Hong-Nian; Zhao, Rui; Zhao, Dong; Xue, Ye; Zhu, Bao-Li; Guan, Da-Wei; Xie, Xiao-Li; Wang, Qi

    2016-11-01

    Pulmonary edema is a common finding in fatal methamphetamine intoxication. However, the underlying mechanism remains poorly understood. This study investigated the molecular pathology of alveolar damage involving pulmonary edema in forensic autopsy cases. Seven candidate reference genes (RPL13A, YWHAZ, GUSB, SDHA, GAPDH, B2M, and ACTB) were evaluated in the lung by the geNorm module in qBase(plus) software. RPL13A, YWHAZ, and GUSB were identified as the most stable reference genes. Using these validated reference genes, intrapulmonary mRNA expressions of matrix metalloproteinases (MMPs), intercellular adhesion molecule-1 (ICAM-1), claudin-5 (CLDN-5), and aquaporins (AQPs) were examined. Relative mRNA quantification using TaqMan real-time PCR assay demonstrated higher expressions of all markers except for AQP-5 in fatal METH intoxication cases. These findings suggested alveolar damage and compensatory response in fatal METH intoxication cases. Systematic analysis of gene expressions using real-time qPCR is a useful tool in forensic death investigation.

  20. A Family Clustered Nitrite Intoxication Investigation in Gaoxin District, Suzhou, China, 2013.

    Ruiping Wang

    2013-12-01

    Full Text Available In April, 2013, a Suzhou Hospital reported a nitrite intoxication patient in coma as well as 2 family members with the similar symptom 5 days ahead. We investigated the event to identify the cause, source and possible pollution ways of the contamination.We defined case as any person living in YSHY community who has cyanosis and with at least one of the following symptoms: dizziness, headache, fatigue, tachycardia, drowsiness, nausea, vomiting, abdominal pain or diar-rhea during April 15 to April 25, 2013. We searched for case by interviewing community residents and reviewing clinics' medical records; information was then retrospectively collected on the patient's food history, cooking procedures and food sources.We identified 3 nitrite intoxication cases, 1 male and 2 female from a family. The interval time between dinner and onset was < 1 hour. Retrospective survey showed 'sugar stir and mix asparagus' on April 17 and 'scrambled asparagus' on April 21 were suspected foods. Both suspected dishes had 'sugar' added, sourced from a clean-up of a neighboring rental house. Nitrite was detected in a vomitus sample, the 'sugar' and two leftover food samples.This family clustered nitrite intoxication was induced by using unidentified nitrite as sugar to cook dishes. We recommend sodium nitrite should be dyed with bright colors to avoid mistaking it for plain salt or sugar, health departments strengthen food hygiene propaganda to improve people's recognition of food safety, and to alert them the dangerous of eating unidentified or unknown source food.