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Sample records for acute mercury poisoning

  1. [Mercury poisoning].

    Science.gov (United States)

    Bensefa-Colas, L; Andujar, P; Descatha, A

    2011-07-01

    Mercury is a widespread heavy metal with potential severe impacts on human health. Exposure conditions to mercury and profile of toxicity among humans depend on the chemical forms of the mercury: elemental or metallic mercury, inorganic or organic mercury compounds. This article aims to reviewing and synthesizing the main knowledge of the mercury toxicity and its organic compounds that clinicians should know. Acute inhalation of metallic or inorganic mercury vapours mainly induces pulmonary diseases, whereas chronic inhalation rather induces neurological or renal disorders (encephalopathy and interstitial or glomerular nephritis). Methylmercury poisonings from intoxicated food occurred among some populations resulting in neurological disorders and developmental troubles for children exposed in utero. Treatment using chelating agents is recommended in case of symptomatic acute mercury intoxication; sometimes it improves the clinical effects of chronic mercury poisoning. Although it is currently rare to encounter situations of severe intoxication, efforts remain necessary to decrease the mercury concentration in the environment and to reduce risk on human health due to low level exposure (dental amalgam, fish contamination by organic mercury compounds…). In case of occupational exposure to mercury and its compounds, some disorders could be compensated in France. Clinicians should work with toxicologists for the diagnosis and treatment of mercury intoxication. Copyright © 2010 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  2. Acute mercury poisoning: a case report

    Science.gov (United States)

    2010-01-01

    Background Mercury poisoning can occur as a result of occupational hazard or suicide attempt. This article presents a 36-year-old case admitted to emergency department (ED) due to exposure to metallic mercury. Case Presentatıon A 36-year-old woman presented to the ED with a three-day history of abdominal pain, diarrhea and fever. One week ago her daughter had brought mercury in the liquid form from the school. She had put it on the heating stove. One day later, her 14-month old sister baby got fever and died before admission to the hospital. Her blood pressure was 134/87 mmHg; temperature, 40.2°C; heart rate 105 bpm and regular; respiration, 18 bpm; O2 saturation, 96%. Nothing was remarkable on examination and routine laboratory tests. As serine or urinary mercury levels could not be tested in the city, symptomatic chelation treatment with N-acetyl cysteine (NAC) was instituted with regard to presumptive diagnosis and history. At the 7th day of admission she was discharged without any sequelae or complaint. At the discharge day blood was drawn and sent for mercury levels which turned out to be 30 μg/dL (normal range: 0 - 10 μg/dL). Conclusion Public education on poisoning and the potential hazards of mercury are of vital importance for community health. PMID:20302609

  3. Acute mercury poisoning: a case report

    Directory of Open Access Journals (Sweden)

    Aktas Can

    2010-03-01

    Full Text Available Abstract Background Mercury poisoning can occur as a result of occupational hazard or suicide attempt. This article presents a 36-year-old case admitted to emergency department (ED due to exposure to metallic mercury. Case Presentatıon A 36-year-old woman presented to the ED with a three-day history of abdominal pain, diarrhea and fever. One week ago her daughter had brought mercury in the liquid form from the school. She had put it on the heating stove. One day later, her 14-month old sister baby got fever and died before admission to the hospital. Her blood pressure was 134/87 mmHg; temperature, 40.2°C; heart rate 105 bpm and regular; respiration, 18 bpm; O2 saturation, 96%. Nothing was remarkable on examination and routine laboratory tests. As serine or urinary mercury levels could not be tested in the city, symptomatic chelation treatment with N-acetyl cysteine (NAC was instituted with regard to presumptive diagnosis and history. At the 7th day of admission she was discharged without any sequelae or complaint. At the discharge day blood was drawn and sent for mercury levels which turned out to be 30 μg/dL (normal range: 0 - 10 μg/dL. Conclusion Public education on poisoning and the potential hazards of mercury are of vital importance for community health.

  4. Acute Mercury Poisoning in a Group of School Children.

    Science.gov (United States)

    Güngör, Olcay; Özkaya, Ahmet Kağan; Kirik, Serkan; Dalkiran, Tahir; Güngör, Gülay; Işikay, Sedat; Davutoğlu, Mehmet; Dilber, Cengiz

    2016-12-12

    Elemental mercury is a toxic liquid element that is used widely in the home, medicine, agriculture, and industry. It is readily vaporized and inhaled at room temperature. Thereby, inhalation can cause acute or chronic poisoning. Mercury can be found in environmental naturally find but some dangers sources give rise to contaminations. It can be very dangerous to all living organisms, especially children. This study presents the features of mercury poisoning in a group of pediatric cases. Data were obtained for 29 pediatric cases exposed to elemental mercury in a high school chemistry laboratory in Turkey. Patients with a blood mercury level exceeding 10 μg/L or a urine mercury level exceeding 15 μg/L were considered to have mercury poisoning. The patients were treated with 2,3-dimercaptopropane sulfonic acid or D-penicillamine. Twenty-nine children with mercury poisoning were admitted to the hospital. The median duration of exposure was 58 (range, 15-120) minutes. Ten (29%) children were asymptomatic. Physical and neurological examinations were normal in 19 (65.5%) children. The most common presenting complaint was headache. The most common neurological abnormality, partly dilated/dilated pupils, was present in 9 (31%) children. Mercury levels were measured in blood samples every 5 days, and the median blood mercury level was 51.98 (range, 24.9-86.4) μg/L. There was a positive correlation between the duration of exposure and maximum blood/urine mercury levels (P = 0.001). Elemental mercury exposure is potentially toxic; its symptomatology varies, especially in children. Secure storage of mercury and other toxic substances and provision of information about this subject to individuals who might be exposed to mercury and their families might help to prevent mercury poisoning.

  5. Acute mercury poisoning among children in two provinces of Turkey.

    Science.gov (United States)

    Carman, Kursat Bora; Tutkun, Engin; Yilmaz, Hinc; Dilber, Cengiz; Dalkiran, Tahir; Cakir, Baris; Arslantas, Didem; Cesaretli, Yildirim; Aykanat, Selin Aktaş

    2013-06-01

    Elemental mercury exposure occurs frequently and is potentially a toxic, particularly in children. Children are often attracted to elemental mercury because of its color, density, and tendency to form beads. Clinical manifestations of elemental mercury intoxication vary depending on its form, concentration, route of ingestion, and the duration of exposure. We present data on 179 pediatric cases of elemental mercury poisoning from exposure to mercury in schools in two different provinces of Turkey. Of all patients, 160 children had both touched/played with the mercury and inhaled its vapors, while 26 children had only inhaled the mercury vapor, two children reported having tasted the mercury. The median duration of exposure was 5 min (min 1-max 100), and 11 (6 %) children were exposed to the mercury for more than 24 h at home. More than half of the children (51.9 %) were asymptomatic at admission. Headache was the most common presenting complaint. The results of physical and neurological examinations were normal in 80 (44.6 %) children. Mid-dilated/dilated pupils were the most common neurological abnormality, and this sign was present in 90 (50.2 %) children. Mercury levels were measured in 24-h urine samples daily, and it was shown that the median urinary level of mercury was 29.80 μg/L (min, 2.40 μg/L; max, 4,687 μg/L). A positive correlation was also found between the duration of exposure and urinary mercury levels (r = 0.23, p = 0.001). All patients were followed up for 6 months. On the first follow-up visit performed 1 month after discharge, the neurological examinations of all patients were normal except for those patients with peripheral neuropathy and visual field defects. On the last follow-up visit at the sixth month, only two children still experienced visual field defects. In conclusion, this study is one of the largest case series of mercury intoxication of students in schools. Elemental mercury exposure can be potentially toxic, and its

  6. Acute mercury poisoning presenting as fever of unknown origin in an adult woman: a case report

    Science.gov (United States)

    2014-01-01

    Introduction Mercury intoxication may present in a wide range of clinical forms from a simple disease to fatal poisoning. This article presents a case of acute mercury poisoning, a rare condition that presents challenges for diagnosis with fever of unknown origin. Case presentation A 52-year-old Caucasian woman was admitted to the hospital with high fever, sore throat, a rash over her entire body, itching, nausea, and extensive muscle pain. She had cervical, bilateral axillary and mediastinal lymphadenopathies. We learned that her son and husband had similar symptoms. After excluding infectious pathologies, autoimmune diseases and malignancy were investigated. Multiple organs of our patient were involved and her fever persisted at the fourth week of admission. A repeat medical history elicited that her son had brought mercury home from school and put it on the hot stove, and the family had been exposed to the fumes for a long period of time. Our patient’s serum and urine mercury levels were high. She was diagnosed with mercury poisoning and treated accordingly. Conclusions Mercury vapor is a colourless and odorless substance. Therefore, patients with various unexplained symptoms and clinical conditions should be questioned about possible exposure to mercury. PMID:25084829

  7. Ophthalmic findings in acute mercury poisoning in adults: A case series study.

    Science.gov (United States)

    Aslan, Lokman; Aslankurt, Murat; Bozkurt, Selim; Aksoy, Adnan; Ozdemir, Murat; Gizir, Harun; Yasar, Ibrahim

    2015-08-01

    The aim of this study is to report ophthalmic findings of acute mercury poisoning in 48 adults referred to emergency department. Full ophthalmologic examination including the best corrected visual acuity, external eye examination, reaction to light, a slit-lamp examination, funduscopy, intraocular pressure measurements, and visual field (VF) and color vision (CV) tests were performed at the presentation and repeated after 6 months. The parametric values of VF test, the mean deviation (MD), and pattern standard deviation (PSD) were recorded in order to compare patients and the 30 healthy controls. The mean parameter of color confusion index in patients was found to be statistically different than controls (p effect on the visual system, especially CV and VF. We propose that emphasizing the public education on the potential hazards of mercury is crucial for preventive community health. © The Author(s) 2013.

  8. Cases of acute mercury poisoning by mercury vapor exposure during the demolition of a fluorescent lamp factory.

    Science.gov (United States)

    Do, Sang Yoon; Lee, Chul Gab; Kim, Jae Yoon; Moon, Young Hoon; Kim, Min Sung; Bae, In Ho; Song, Han Soo

    2017-01-01

    In 2015, workers dismantling a fluorescent lamp factory in Korea were affected by mercury poisoning from exposure to mercury vapor. Eighteen out of the 21 workers who participated in the demolition project presented with symptoms of poisoning and, of these, 10 had persistent symptoms even at 18 months after the initial exposure to mercury vapor. Early symptoms of 18 workers included a general skin rash, pruritus, myalgia, sleep disturbance, and cough and sputum production. Following alleviation of these initial symptoms, late symptoms, such as easy fatigue, insomnia, bad dreams, and anxiety disorder, began to manifest in 10 out of 18 patients. Seven workers underwent psychiatric care owing to sleep disturbance, anxiety disorder, and depression, and three workers underwent dermatologic treatment for hyperpigmentation, erythematous skin eruption, and chloracne-like skin lesions. Furthermore, three workers developed a coarse jerky movement, two had swan neck deformity of the fingers, and two received care at an anesthesiology clinic for paresthesia, such as burning sensation, cold sensation, and pain. Two workers underwent urologic treatment for dysfunction of the urologic system and impotence. However, symptomatic treatment did not result in satisfactory relief of these symptoms. Awareness of the perils of mercury and prevention of mercury exposure are critical for preventing health hazards caused by mercury vapor. Chelation therapy should be performed promptly following mercury poisoning to minimize damage.

  9. Chelation Therapy for Mercury Poisoning

    Directory of Open Access Journals (Sweden)

    Rong Guan

    2009-01-01

    Full Text Available Chelation therapy has been the major treatment for heavy metal poisoning. Various chelating agents have been developed and tested for treatment of heavy metal intoxications, including mercury poisoning. It has been clearly shown that chelating agents could rescue the toxicity caused by heavy metal intoxication, but the potential preventive role of chelating agents against heavy metal poisoning has not been explored much. Recent paper by Siddiqi and colleagues has suggested a protective role of chelating agents against mercury poisoning, which provides a promising research direction for broader application of chelation therapy in prevention and treatment of mercury poisoning.

  10. Chelation Therapy for Mercury Poisoning

    OpenAIRE

    Rong Guan; Han Dai

    2009-01-01

    Chelation therapy has been the major treatment for heavy metal poisoning. Various chelating agents have been developed and tested for treatment of heavy metal intoxications, including mercury poisoning. It has been clearly shown that chelating agents could rescue the toxicity caused by heavy metal intoxication, but the potential preventive role of chelating agents against heavy metal poisoning has not been explored much. Recent paper by Siddiqi and colleagues has suggested a protective role o...

  11. An Enigmatic Case of Acute Mercury Poisoning: Clinical, Immunological Findings and Platelet Function

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    Ilka Kleffner

    2017-09-01

    Full Text Available Severe mercury intoxication is very rare in developed countries, but still occurs as the result of volatile substance abuse, suicide attempts, occupational hazards, or endemic food ingestion as reported in the cases of public health disasters in Iraq and in Minamata Bay, Japan. Here, we describe the dramatic physical and cognitive decline of a 23-year-old patient caused by a severe methyl mercury (MeHg intoxication of unknown origin. We show serial magnetic resonance imaging (MRI of the patient’s brain, as well as ex vivo analyses of blood and cerebrospinal fluid including multicolor flow cytometric measurements, functional assays of hemostaseologic efficacy, and evaluation of regulatory effector molecules. Together with the clinical history, our findings show the progressive neuronal degeneration accompanying the deterioration of the patient. Moreover, the ex vivo analyses display alterations of thrombocyte function and coagulation, as well as an immunological milieu facilitating autoimmunity. Despite the successful reduction of the MeHg concentration in the patient’s blood with erythrocyte apheresis and chelator therapy, his condition did not improve and led to a persistent vegetative state. This case illustrates the neurotoxicity of MeHg following severe intoxication for the first time by serial MRI. Data on immune-cell and thrombocyte function as well as on coagulation in mercury poisoning reveal potential implications for anticoagulation and immunomodulatory treatment.

  12. Mercury poisoning in wildlife

    Science.gov (United States)

    Heinz, G.H.; Fairbrother, Anne; Locke, Louis N.; Hoff, Gerald L.

    1996-01-01

    Mercury is an intriguing contaminant because it has complex chemical properties, a wide range of harmful effects, and an infinite persistence in the environment. Die-offs of wildlife due to mercury have occurred in many countries, especially before mercury seed dressings were banned. Today, most mercury problems are associated with aquatic environments. Methylmercury, the most toxic chemical form, attacks many organ systems, but damage to the central nervous system is most severe. Harmful wet-weight concentrations of mercury, as methylmercury, in the tissues of adult birds and mammals range from about 8-30 ppm in the brain, 20-60 ppm in liver, 20-60 ppm in kidney, and 15-30 ppm in muscle. Young animals may be more sensitive.

  13. Mercury poisoning through intravenous administration

    Science.gov (United States)

    Lu, Qiuying; Liu, Zilong; Chen, Xiaorui

    2017-01-01

    Abstract Rationale: Metallic mercury poisoning through intravenous injection is rare, especially for a homicide attempt. Diagnosis and treatment of the disease are challenging. Patient concerns: A 34-year-old male presented with pyrexia, chill, fatigue, body aches, and pain of the dorsal aspect of right foot. Another case is that of a 29-year-old male who committed suicide by injecting himself metallic mercury 15 g intravenously and presented with dizzy, dyspnea, fatigue, sweatiness, and waist soreness. Diagnosis: The patient's condition in case 1 was deteriorated after initial treatment. Imaging studies revealed multiple high-density spots throughout the body especially in the lungs. On further questioning, the patient's girlfriend acknowledged that she injected him about 40 g mercury intravenously 11 days ago. The diagnosis was then confirmed with a urinary mercury concentration of 4828 mg/L. Interventions: Surgical excision, continuous blood purification, plasma exchange, alveolar lavage, and chelation were performed successively in case 1. Blood irrigation and chelation therapy were performed in case 2. Outcomes: The laboratory test results and organ function of the patient in case 1 gradually returned to normal. However, in case 2, the patient's dyspnea was getting worse and he finally died due to toxic encephalopathy and respiratory failure. Lessons: Early diagnosis and appropriate treatment are critical for intravenous mercury poisoning. It should be concerned about the combined use of chelation agents and other treatments, such as surgical excision, hemodialysis and plasma exchange in clinical settings. PMID:29145289

  14. Article Commentary: Chelation Therapy for Mercury Poisoning

    Directory of Open Access Journals (Sweden)

    Rong Guan

    2009-01-01

    Full Text Available Chelation therapy has been the major treatment for heavy metal poisoning. Various chelating agents have been developed and tested for treatment of heavy metal intoxications, including mercury poisoning. It has been clearly shown that chelating agents could rescue the toxicity caused by heavy metal intoxication, but the potential preventive role of chelating agents against heavy metal poisoning has not been explored much. Recent paper by Siddiqi and colleagues has suggested a protective role of chelating agents against mercury poisoning, which provides a promising research direction for broader application of chelation therapy in prevention and treatment of mercury poisoning.

  15. Metallic mercury poisoning.

    Science.gov (United States)

    Kamitsuka, M; Robertson, W O; Fligner, C

    1984-01-01

    Among traditional toxins, mercury has an infamous heritage. Despite 2,000 years of recognized dangers, it continues to menace mankind. Bygone years focused on the dangers of the inorganic form, the past two decades have uncovered aftermaths of the organic form. Over the past ten years our Center has seen patients afflicted by the metallic form via four different avenues of exposure. In the first instance, a toddler succumbed to the effects of accidentally spilled high school chemistry quicksilver on a dining room carpet. In the second, a broken mercury switch in an infant isolette, was responsible for environmental contamination and infants' exposures. In a third, misguided efforts to extract gold from ore affected an entire family and particularly their male toddler with disastrous pulmonary problems. A fourth instance saw intravenous injection of metallic mercury lead to a most unusual chest radiograph and be associated with the demise of an already severely affected cardiac cripple. Highlights of each of these cases will be reviewed as they illustrate the importance of identifying the precise form of any chemical involved in a exposure and the essentiality of such information in predicting toxicity and recommending treatment.

  16. Mercury poisoning | Shamley | South African Medical Journal

    African Journals Online (AJOL)

    The diagnosis of mercury poisoning requires a high index of suspicion. Mercury poisoning in a patient involved in illicit gold extraction is reported and 6 other cases considered. Some of the clinical features and treatment of this condition are discussed. S Afr Med J 1989; 76: 114-116 ...

  17. [Acute pesticide poisoning].

    Science.gov (United States)

    Durán-Nah, J J; Collí-Quintal, J

    2000-01-01

    To describe the epidemiologic pattern of acute pesticide poisoning (APP) in a general hospital in Merida, Yucatan, Mexico. From 1994 to 1998, 33 patients 13 years of age or older with diagnosis of APP were studied. Descriptive statistics were used to analyze information. Males were frequently affected (82%), specially those coming from rural areas (60%). The mean age of the group was 34 +/- 15.8 years. In 79% of the cases, pesticides were used to commit suicide and 33% of poisoning cases were due to organophospate pesticides. The mortality rate was 12%. In this small sample, acute poisoning from pesticides in the agricultural setting may be underestimated, since it was less frequent than in the general population. APP was more commonly used by indigent people to commit suicide.

  18. [Acute arsenic poisoning].

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    Montelescaut, Etienne; Vermeersch, Véronique; Commandeur, Diane; Huynh, Sophie; Danguy des Deserts, Marc; Sapin, Jeanne; Ould-Ahmed, Mehdi; Drouillard, Isabelle

    2014-01-01

    Acute arsenic poisoning is a rare cause of suicide attempt. It causes a multiple organs failure caused by cardiogenic shock. We report the case of a patient admitted twelve hours after an ingestion of trioxide arsenic having survived thanks to a premature treatment.

  19. Mercury vapor inhalation and poisoning of a family.

    Science.gov (United States)

    Oz, Serife Gul; Tozlu, Mukaddes; Yalcin, Songul Siddika; Sozen, Tumay; Guven, Gulay Sain

    2012-08-01

    Acute mercury vapor poisoning is a rare but fatal toxicological emergency. People are exposed to mercury in daily life by the way of foods, vaccines, antiseptics, ointments, amalgam or occupation. We present here, the clinical picture and management of four members of the same family who were exposed to elemental mercury. Three of the family members were seen in another hospital with malaise, fever, eritematous rash and pulmonary problems. Their questioning revealed the mercury exposure. Having a suspicion of heavy metal intoxication, blood and urine mercury levels were measured and mercury intoxication was diagnosed. On admission to our hospital, two patients already had chelation therapy. In three of them we found three distinct abnormalities: encephalopathy, nephrotic syndrome and polyneuropathy. The fourth family member had minor symptoms. This family is an example for the inhalation exposure resulting from inappropriate handling of liquid mercury. During the first days, flu like illness ensues. Then, severe pulmonary, neurological, renal, hepatic, hematological and dermatological dysfunctions develop. Blood and urine mercury levels should be tested on suspicion, but it must be kept in mind that blood level is unreliable in predicting the severity of mercury toxicity. The priority in the treatment should be removing the patient from the source of exposure. Then British anti-Lewisite, edetate calcium disodium, penicillamine, Sodium 2,3-dimercaptopropane-1-sulfhonate and 2,3-dimercaptosuccinic acid can be used for binding the mercury. We conclude that since mercury-containing devices are present in daily life, physicians must be able to recognize the clinical manifestations and treatment of mercury poisoning.

  20. Inorganic mercury poisoning associated with skin-lightening cosmetic products.

    Science.gov (United States)

    Chan, Thomas Y K

    2011-12-01

    Mercury and mercury salts, including mercurous chloride and mercurous oxide, are prohibited for use in cosmetic products as skin-lightening agents because of their high toxicity. Yet, the public continue to have access to these products. Reports of skin-lightening cosmetic products containing mercury and cases of mercury poisoning following the use of such products were identified using Medline (1950 - 28 March 2011) with mercury, mercury compounds, mercury poisoning, cosmetics and skin absorption as the subject headings. These searches identified 118 citations of which 31 were relevant. The rate of dermal absorption increases with the concentration of mercury and prior hydration of the skin. The degree of dermal absorption varies with the skin integrity and lipid solubility of the vehicle in the cosmetic products. Ingestion may occur after topical application around the mouth and hand-to-mouth contact. After absorption, inorganic mercury is distributed widely and elimination occurs primarily through the urine and feces. With long-term exposure, urinary excretion is the major route of elimination. The half-life is approximately 1-2 months. The kidneys are the major site of inorganic mercury deposition; renal damage includes reversible proteinuria, acute tubular necrosis and nephrotic syndrome. Gastrointestinal symptoms include a metallic taste, gingivostomatitis, nausea and hypersalivation. Although penetration of the blood-brain barrier by inorganic mercury is poor, prolonged exposure can result in central nervous system (CNS) accumulation and neurotoxicity. Inorganic mercury poisoning following the use of skin-lightening creams has been reported from Africa, Europe, USA, Mexico, Australia and Hong Kong. Nephrotic syndrome (mainly due to minimal change or membranous nephropathy) and neurotoxicity were the most common presenting features. As mercury-containing cosmetic products can contaminate the home, some close household contacts were also reported to have

  1. Occupational Metallic Mercury Poisoning in Gilders

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    M Vahabzadeh

    2016-04-01

    Full Text Available Occupational exposure to elemental mercury vapor usually occurs through inhalation during its utilizations. This leads to a variety of adverse health effects. In some Islamic cities, this type of poisoning may occur during gilding of shrines using elemental mercury with gold. Herein, we report on three male patients aged 20–53 years, who were diagnosed with occupational metallic mercury poisoning due to gilding of a shrine. All patients presented with neuro-psychiatric disorders such as anxiety, loss of memory and concentration, and sleep disorders with high urinary mercury concentrations of 326–760 μg/L upon referring, 3–10 days after cessation of elemental mercury exposure. Following chelating therapy, the patients recovered clinically and their mercury concentrations declined to non-toxic level (<25 μg/L. Health, environmental and labor authorities, as well as the gilders should be aware of the toxicity risk of exposure to metalic mercury during gilding in closed environments and act accordingly.

  2. Clinical studies on mercury poisoning in cattle

    Energy Technology Data Exchange (ETDEWEB)

    Sonoda, M.; Nakamura, R.; Too, K.; Matsuhashi, A.; Ishimoto, H.; Sasaki, R.; Ishida, K.; Takahashi, M.

    1956-01-01

    A sporadic outbreak of an unknown disease occurred among dairy cattle, from early February to late May 1955, in Japan. The characteristic symptoms of this disease were dyspnea and depilation; out of 29 cases, 8 died while 2 were slaughtered. Clinical studies have disclosed that the symptoms were similar to those found in cases of mercury poisoning as described by others. So the animals' feed was suspected of being the cause of the sickness. It was confirmed that the incident was due to poisoning resulting from ingestion of linseed meal treated with a mercurial fungicide. From the results of the testing anamnesis, it was found that 171 cattle were fed with the meal and 29 cases were affected. In veiw of the wide use of mercurial preparations for treating seed grains against fungi infection, a further experimental study was made on the effects of the feed and fungicide upon calves.

  3. Acute kidney injury and disseminated intravascular coagulation due to mercuric chloride poisoning

    Directory of Open Access Journals (Sweden)

    J Dhanapriya

    2016-01-01

    Full Text Available Mercury is a toxic heavy metal and occurs in organic and inorganic forms. Inorganic mercury includes elemental mercury and mercury salts. Mercury salts are usually white powder or crystals, and widely used in indigenous medicines and folk remedies in Asia. Inorganic mercury poisoning causes acute kidney injury (AKI and gastrointestinal manifestations and can be life-threatening. We describe a case with unknown substance poisoning who developed AKI and disseminated intravascular coagulation (DIC. Renal biopsy showed acute tubular necrosis. Later, the consumed substance was proven to be mercuric chloride. His renal failure improved over time, and his creatinine normalized after 2 months.

  4. Acute arsenic poisoning diagnosed late.

    Science.gov (United States)

    Shumy, Farzana; Anam, Ahmad Mursel; Kamruzzaman, A K M; Amin, Md Robed; Chowdhury, M A Jalil

    2016-04-01

    Acute arsenicosis, although having a 'historical' background, is not common in our times. This report describes a case of acute arsenic poisoning, missed initially due to its gastroenteritis-like presentation, but suspected and confirmed much later, when the patient sought medical help for delayed complications after about 2 months. © The Author(s) 2015.

  5. Carbon monoxide poisoning (acute)

    OpenAIRE

    Olson, Kent; Smollin, Craig

    2008-01-01

    The main symptoms of carbon monoxide poisoning are non-specific in nature and relate to effects on the brain and heart. The symptoms correlate poorly with serum carboxyhaemoglobin levels. People with comorbidity, the elderly or very young, and pregnant women are most susceptible.Carbon monoxide is produced by the incomplete combustion of carbon fuels, including inadequately ventilated heaters and car exhausts, or from chemicals such as methylene chloride paint stripper.Poisoning is conside...

  6. Carbon monoxide poisoning (acute)

    OpenAIRE

    Smollin, Craig; Olson, Kent

    2010-01-01

    The main symptoms of carbon monoxide poisoning are non-specific in nature and relate to effects on the brain and heart. The symptoms correlate poorly with serum carboxyhaemoglobin levels. People with comorbidity, elderly or very young people, and pregnant women are most susceptible.Carbon monoxide is produced by the incomplete combustion of carbon fuels, including inadequately ventilated heaters and car exhausts, or from chemicals such as methylene chloride paint stripper.Poisoning is cons...

  7. Acute renal failure following exposure to metallic mercury.

    Science.gov (United States)

    Katsuma, Ai; Hinoshita, Fumihiko; Masumoto, Shoichi; Hagiwara, Akiyoshi; Kimura, Akio

    2014-07-01

    Mercury exists in three forms: elemental, inorganic, and organic. Each form produces a unique profile of toxicity. Acute poisoning with inorganic salts is well-known, but few reports are available regarding oral elemental (metallic) mercury intoxication. Ingestion of metallic mercury is usually of no concern because of poor gastrointestinal absorption. We report a very rare case of acute renal failure (ARF) following ingestion of metallic mercury. A 67-year old man swallowed an unknown quantity of metallic mercury in a suicide attempt. He developed severe pneumonitis and ARF with anuria. The whole blood mercury concentration was extremely high (157.7 μg/dl). In this case, inhalation of vaporized mercury might have contributed to the significant systemic absorption, but chelating therapy was not performed because of severe renal failure. Hemodialysis was performed 13 times and discontinued 26 days after mercury ingestion. Consequently, the patient recovered normal renal function.

  8. Mercury

    Science.gov (United States)

    ... and treatments are needed. ELEMENTAL MERCURY Inhaled elemental mercury poisoning may be difficult to treat. The person may ... metals from the body INORGANIC MERCURY For inorganic mercury poisoning, treatment often begins with supportive care. The person ...

  9. Differential diagnosis between organic and inorganic mercury poisoning in human cases--the pathologic point of view.

    Science.gov (United States)

    Eto, K; Takizawa, Y; Akagi, H; Haraguchi, K; Asano, S; Takahata, N; Tokunaga, H

    1999-01-01

    Differences in pathology were found between acute and chronic exposure to methylmercury, mercury vapor, and inorganic mercury. Characteristic pathologic changes produced by organic mercury in the brain have previously been described in patients with Minamata disease. The brains of patients who presented with acute onset of symptoms and died within 2-mo showed loss of neurons with reactive proliferation of glial cells, microcavitation, vascular congestion, petechial hemorrhage, and edema in the cerebral cortices, predominantly in the calcarine, pre- and postcentral, and transverse temporal cortices and in the cerebellar cortex. The neuropathologic changes in the patients with acute onset of symptoms who survived for a long period (>10 yr) were also included neuronal loss with reactive proliferation of glial cells in similar anatomic locations. The neuropathologic changes in patients with inorganic mercury poisoning are quite different. Autopsies performed on 3 individuals with fatal cases of acute inorganic mercury poisoning who were exposed to mercury vapor for about 2 wk revealed diffuse organized pneumonia, renal cortical necrosis, disseminated intravascular coagulopathy, and infarctions in the brain and kidneys. In 2 other patients who worked in mercury mines for about 10 yr and who suffered from chronic inorganic poisoning, no specific lesions were demonstrated in the brain. However, the assay and the histochemistry of mercury revealed that inorganic mercury was present in the brain in all 3 groups irrespective of the brain lesions and the duration of clinical signs.

  10. Mercury poisoning in two 13-year-old twin sisters

    Directory of Open Access Journals (Sweden)

    Ezzat Khodashenas

    2015-01-01

    Full Text Available Mercury (Hg is a toxic agent that evaporates in room temperature and its inhalation may cause poisoning. Due to the nonspecific symptoms, diagnosis is difficult in special circumstances with no initial history of Hg exposure. We report two such cases of Hg poisoning. The patients were two sisters, presenting with pain in extremities, itchy rashes, sweating, salivation, weakness, and mood changes. They have used a compound that contains mercury, for treatment of pedicullosis three months before admission. This compound was purchased from a herbal shop and was applied locally on the scalps for 2 days. Their urinary mercury concentrations were 50 and 70 mg/L. They were successfully treated by D-penicillamine and gabapentin. In a patient with any kind of bone and joint pain, skin rash erythema and peripheral neuropathy, mercury poisoning should be considered as a differential diagnosis.

  11. A retrospective analysis of acute organophosphorus poisoning ...

    African Journals Online (AJOL)

    Objectives: We have herein reported our experience with the pattern of presentation of cases of acute organophosphorus (OP) poisoning cases in a tertiary care hospital. Materials and Methods:This retrospective study evaluated the hospital records of patients with acute OP poisoning. In a pre-structured proforma, data ...

  12. Mercury Poisoning Linked to Skin Products

    Science.gov (United States)

    ... products do not meet. Sellers and distributors who market mercury-containing skin whitening or lightening creams in ... Simone says. Some people – including pregnant women, nursing babies and young children – are especially vulnerable to mercury ...

  13. Rhabdomyolysis in 114 patients with acute poisonings

    Directory of Open Access Journals (Sweden)

    Seyed Reza Mousavi

    2015-01-01

    Full Text Available Background: Rhabdomyolysis is a clinical and biochemical syndrome, which is observed in some patients with acute chemical and/or pharmaceutical poisonings. We aimed to investigate rhabdomyolysis in patients with acute poisonings due to different chemicals, natural toxins or drug overdose. Materials and Methods: Following approval of the University medical research committee and obtaining informed consents from the patients or their relatives, all patients with acute poisonings who were treated between March 2009 and February 2010 in the Toxicologic Ward of Imam Reza Hospital and had serum creatine phosphokinase (CPK above 975 IU/L (as a definition for rhabdomyolysis were studied. Results: Of 3555 hospitalized poisoned patients, 114 patients had rhabdomyolysis with CPK of 5996 ± 892 IU/L (mean ± standard error. The most common intoxication to induce the rhabdomyolysis was opioid overdose (28%. Acute renal failure (ARF was diagnosed in 11 (8.7% patients. There was a linear correlation between CPK and creatinine (P < 0.001, which in turn had a significant correlation with death (P < 0.05. Conclusion: Patients with acute poisoning were at risk of rhabdomyolysis. Acute opioid poisoning was the most common cause of toxic rhabdomyolysis in the intoxicated patients, and ARF was the main complication.

  14. Mercury poisoning as a cause of intracranial hypertension.

    Science.gov (United States)

    Gençpınar, Pınar; Büyüktahtakın, Başak; İbişoğlu, Zeynep; Genç, Şakir; Yılmaz, Aygen; Mıhçı, Ercan

    2015-05-01

    Mercury poisoning is a rare but fatal toxicologic emergency. Neurologic manifestations involving the central nervous system are seen usually with chronic mercury intoxication. The most commonly seen complaints are headache, tremor, impaired cognitive skills, weakness, muscle atrophy, and paresthesia. Here, we present a male patient who was chronically exposed to elemental mercury and had papilledema and intracranial hypertension without parenchymal lesion in the central nervous system. A 12-year-old male patient was referred to our emergency room because of severe fatigue, generalized muscle pain and weakness, which was present for a month. Physical examination revealed painful extremities, decreased motor strength and the lack of deep tendon reflexes in lower extremities. He had mixed type polyneuropathy in his electromyography. Whole blood and 24-hour urinary mercury concentrations were high. A chelation therapy with succimer (dimercaptosuccinic acid) was started on the fourth day of his admission. On the seventh day of his admission, he developed headache and nausea, and bilateral papilledema and intracranial hypertension were detected on physical examination. Acetazolamide was started and after 1 month of treatment, the fundi examination was normal. The patient stayed in the hospital for 35 days and was then discharged with acetazolamide, vitamin B6, gabapentin, and followed as an outpatient. His clinical findings were relieving day by day. Although headache is the most common symptom in mercury poisoning, the clinician should evaluate the fundus in terms of intracranial hypertension. © The Author(s) 2014.

  15. Indirect sources of mercury poisoning in the Iraqi epidemic*

    Science.gov (United States)

    Bakir, F.; Al-Shahristani, H.; Al-Rawi, N. Y.; Khadouri, A.; Al-Mufti, A. W.

    1976-01-01

    Secondary sources of intoxication with methylmercury poisoning other than home-made bread were explored. Mercury levels in various food items were below 0.05 mg/kg. Over 30 000 specimens of meat and internal organs of sheep were analysed because of the strong suspicion that the animals had been fed treated barley. It was found that 6-12% of the specimens analysed contained more than 0.5 mg/kg of mercury. Consumption of meat did not appear to constitute a danger of intoxication during the outbreak. PMID:1086161

  16. Causes of rhabdomyolysis in acute poisonings

    Directory of Open Access Journals (Sweden)

    Janković Snežana R.

    2013-01-01

    Full Text Available Background/Aim. Rhabdomyolysis (RM is potentially lethal syndrome, but there are no enough published data on its frequency and characteristics in acute poisonings. The aim of this study was to determine the causes and severity of RM in acute poisonings. Methods. Patients hospital charts were retrospectively screened during a one-year period in order to identify patients with RM among 656 patients treated due to acute poisonings with different agents. All the patients with RM were selected. Entrance criterion was the value of creatine kinase (CK over 250 U/L. The severity of RM was assessed according to the Poison Severity Score. The patients were divided into three groups: the first one with mild RM (CK from 250 to 1,500 U/L, the second with moderate RM (CK from 1,500 to 10,000 U/L and the third with severe RM (CK greater than 10,000 U/L. Results. RM occurred in 125 (19% of the patients with acute poisonings. It was mainly mild (61%, or moderate (36%, and only in 3% of the patients was severe RM. The incidence of RM was the highest in poisonings with opiates (41%, pesticides (38%, neuroleptics (26%, anticonvulsants (26%, ethyl alcohol (20%, and gases (19%. Psychotropic agents were the most common causes of poisoning, and consequently of RM. Fatal outcomes were registered in 32 (25.60% of all RM patients. The incidence of fatal outcomes in poisonings with mild, moderate and severe RM was 19.73%, 31.11% and 75%, respectively. Conclusion. RM syndrome occurs at a relatively high rate in acute poisonings. Although agent’s toxicity is crucial for the outcome, severe RM and its complications may significantly influence the clinical course and prognosis of poisoning. Routine analysis of CK, as a relevant marker for RM may indicate the development of RM in acute poisoning and initiate prompt therapeutic measures in preventing acute renal failure as the most frequent consequence of extensive rhabdomyolysis.

  17. [The clinical analysis of mercury poisoning in 92 cases].

    Science.gov (United States)

    Liu, Xiao-ling; Wang, Han-bin; Sun, Cheng-wen; Xiong, Xi-shan; Chen, Zhi; Li, Zhao-sheng; Han, Bo; Yang, Gang

    2011-08-01

    To summarize the clinical features of mercury poisoning diagnosed by blood and urine tests for improving the diagnosis and treatment of the disease. Poisoning causes, clinical manifestations, diagnosis, treatment and prognosis were retrospectively reviewed in 92 in-patients with mercury poisoning in our hospital from January 2000 to April 2010. Of the 92 patients, 37 were male and 55 were female with an average age of 33.1 (2 - 65) years old. The mercury poisoning was caused by occupational exposure and non-occupational exposure, such as iatrogenic exposure, life exposure and wrong intake or suicidal intake of mercury-containing substances, mainly through respiratory tract, digestive tract and skin absorption. The most common clinical symptoms were as the followings: nervous system symptom, such as memory loss in 50 cases (54.3%), fatigue in 34 (37.0%), numb limb in 25 (27.2%), dizziness and headache in 22 (23.9%), cacesthesia in 20 (21.7%), fine tremor (finger tip, tongue tip, eyelids) in 15 (16.3%), insomnia and more dreams in 12 (13.0%); gastrointestinal symptoms: nausea in 16 (17.4%), abdominal pain in 14 (15.2%), stomatitis in 5 (5.4%); joint and muscle symptoms: muscle pain in 16 (17.4%), joint pain in 5 (5.4%); cardiovascular system: chest tightness, heart palpitations in 6 (6.5%); urinary system: edema in 9 (9.8%); other system: hidrosis in 20 (21.7%). After the treatment with sodium dimercaptopropane sulfonate (DMPS), the symptoms were gradually alleviated. Their gastrointestinal, cardiovascular symptoms were alleviated within 2 weeks; neurological symptoms were alleviated within 3 months; kidney damage showed a slower recovery and could be completely alleviated within 6 months. Because of its diverse clinical symptoms, the mercury poisoning was easy to misdiagnosis and missed diagnosis; therefore the awareness of the disease should be further enhanced. Leaving from the poisoning environment timely and giving appropriate treatment with DMPS will lead to a

  18. Acute Cyanide Poisoning from Jewelry Cleaning Solutions

    Directory of Open Access Journals (Sweden)

    Ines Bel Waer

    2015-05-01

    Full Text Available Cyanide is one of the most lethal and devastating poisons. It causes acute toxicity through smoke inhalation simultaneously with carbon monoxide, or by ingestion of cyanide salts that are commonly used in metallurgy and in jewelry or textile industries. Cyanide intoxication is an extremely rare event; in the present study, we report a case of cyanide poisoning involving a 25-year-old jeweler, who ingested a jewelry cleaning solution containing potassium cyanide in a suicide attempt.

  19. Acute Cyanide Poisoning from Jewelry Cleaning Solutions

    OpenAIRE

    Ines Bel Waer; Wafa Masri; Nedia Chaouali; Fathia Khlifi; Ines Gana; Anouar Nouioui; Dorra Ben Salah; Dorra Amira; Hayet Ghorbel; Abderrazzek Hedhili

    2015-01-01

    Cyanide is one of the most lethal and devastating poisons. It causes acute toxicity through smoke inhalation simultaneously with carbon monoxide, or by ingestion of cyanide salts that are commonly used in metallurgy and in jewelry or textile industries. Cyanide intoxication is an extremely rare event; in the present study, we report a case of cyanide poisoning involving a 25-year-old jeweler, who ingested a jewelry cleaning solution containing potassium cyanide in a suicide attempt.

  20. Gastric lavage in patients with acute poisoning

    OpenAIRE

    Montserrat Amigó Tadín

    2012-01-01

    Acute poisonings are a frequent complaint in emergency departments and therapy which prevents the absorption of toxic products taken orally is often indicated: one such option is gastric lavage. Gastric lavage is a digestive decontamination technique whose goal is to remove the maximum amount of poison from the stomach and prevent its absorption. The procedure involves inserting a gastric tube into the stomach through the mouth or nose; firstly to aspirate all the stomach contents and then to...

  1. Zebrafish Models for Human Acute Organophosphorus Poisoning.

    Science.gov (United States)

    Faria, Melissa; Garcia-Reyero, Natàlia; Padrós, Francesc; Babin, Patrick J; Sebastián, David; Cachot, Jérôme; Prats, Eva; Arick Ii, Mark; Rial, Eduardo; Knoll-Gellida, Anja; Mathieu, Guilaine; Le Bihanic, Florane; Escalon, B Lynn; Zorzano, Antonio; Soares, Amadeu M V M; Raldúa, Demetrio

    2015-10-22

    Terrorist use of organophosphorus-based nerve agents and toxic industrial chemicals against civilian populations constitutes a real threat, as demonstrated by the terrorist attacks in Japan in the 1990 s or, even more recently, in the Syrian civil war. Thus, development of more effective countermeasures against acute organophosphorus poisoning is urgently needed. Here, we have generated and validated zebrafish models for mild, moderate and severe acute organophosphorus poisoning by exposing zebrafish larvae to different concentrations of the prototypic organophosphorus compound chlorpyrifos-oxon. Our results show that zebrafish models mimic most of the pathophysiological mechanisms behind this toxidrome in humans, including acetylcholinesterase inhibition, N-methyl-D-aspartate receptor activation, and calcium dysregulation as well as inflammatory and immune responses. The suitability of the zebrafish larvae to in vivo high-throughput screenings of small molecule libraries makes these models a valuable tool for identifying new drugs for multifunctional drug therapy against acute organophosphorus poisoning.

  2. Hyperamylasaemia and acute pancreatitis in paracetamol poisoning

    DEFF Research Database (Denmark)

    Schmidt, L E; Dalhoff, K

    2004-01-01

    BACKGROUND: Hyperamylasaemia and even acute pancreatitis have been reported in patients with paracetamol poisoning. AIMS: To describe the incidence, clinical characteristics, and prognostic implications of hyperamylasaemia in paracetamol poisoning. PATIENTS: Six hundred and two patients transferred...... to a specialized unit with severe paracetamol poisoning and 212 unselected patients admitted from the local region. METHODS: Retrospective study based on hospital charts. The optimum threshold of serum amylase to discriminate non-survivors was identified. RESULTS: An elevated serum amylase (>100 U/L) occurred...... in 28 of the unselected patients (13%), in 218 of the transferred patients (36%), and in 118 of 148 patients (80%) with fulminant hepatic failure. Only 33 cases of paracetamol-associated acute pancreatitis were diagnosed. A threshold serum amylase of 150 U/L to discriminate non-survivors had sensitivity...

  3. Acute Poisoning with Methadone (Dolphin (Review

    Directory of Open Access Journals (Sweden)

    Georgy A. Livanov

    2017-01-01

    Full Text Available Most publications report on the use of methadone as a medication, however an increase of the illegal use of methadone has been demonstrated worldwide over the recent years, thus increasing the number of hospitalizations due to acute poisoning with this synthetic opioid. The aim of the present review was to summarize current data on the mechanisms of toxicity, selective toxicity, toxicokinetics and toxicodynamics of methadone (Dolphin. The involvement of CNS, respiratory, cardiovascular and urinary systems in acute poisoning with methadone was dis- cussed. The practice of use of methadone in many countries as a medicine for the replacement therapy for opiate addicts was analyzed. In addition, it was suggested that the results of the use of naloxone antidote therapy in acute opioid poisoning do not always clearly demonstrate its sufficient efficacy. Ways to improve of the intensive therapy of severe acute poisoning by methadone were substantiated; in addition to general critical care methods, treatment with a complex metabolic antihypoxant cytoflavin should be considered. 

  4. [Accidental mercury poisoning in a 12-year-old girl].

    Science.gov (United States)

    Alby-Laurent, F; Honoré-Goldman, N; Cavau, A; Bellon, N; Allali, S; Abadie, V

    2016-11-01

    Exposure to metallic mercury can cause severe accidental intoxications in children, whose clinical symptoms can vary depending on the route of administration, the dose, as well as the time and duration of the exposure. It has become unusual in France, yet it must be considered when taking a patient's medical history in cases of multisystemic involvement without a clear explanation. We report the case of a 12-year-old patient hospitalized because of a cough, poor general condition, chills, night sweats, psychomotor retardation, and skin lesions that had been developing for several weeks. The initial clinical examination also revealed sinus tachycardia, arterial hypertension, and abolition of osteotendinous reflexes. Complementary examination results were normal apart from a glomerular proteinuria without renal failure. When interviewing the mother, she reported that the child had played with mercury balls 3 months earlier. The suspicion of poisoning was confirmed by blood and urine analysis as well as renal biopsy showing an aspect of membranous glomerulonephritis with IgG and C3 depositions. An intoxication via a transdermal route being unlikely on healthy skin, the Regional Health Agency's survey concluded that chronic intoxication had occurred by inhalation of the mercury spread on the floor at the time of the exposure, which was then vacuum cleaned and released again by the contaminated vacuum cleaner. The patient's outcome was favorable within a few weeks after initiating DMSA chelation therapy. Mercury poisoning should be considered in cases of a multisystemic disorder without clear explanation, in order to intervene quickly and thus prevent irreversible renal and neurological consequences. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  5. Mercury poisoning dentistry: high-level indoor air mercury contamination at selected dental sites.

    Science.gov (United States)

    Khwaja, Mahmood A; Abbasi, Maryam Shabbir

    2014-01-01

    Mercury (Hg), also known as quick silver, is an essential constituent of dental amalgam. It is a toxic substance of global concern. Children are more at risk from mercury poisoning which affects their neurological development and brain. In the past, a number of studies at dental sites in many countries have been carried out and reported. The present report briefly describes and discusses our recent investigations carried out at 34 dental sites (teaching institutions, hospitals and private clinics) in Pakistan. It is evident from the data that at many sites the indoor mercury vapor levels exceed far above the permissible limit recommended for safe physical and mental health. At these sites, public in general and the medical, paramedical staff and vulnerable population in particular, are at most serious risk to health resulting from exposure to toxic and hazardous mercury. To minimize such risk, some of the recommendations are, best in-house environmental practices for occupational health and safety, mercury contaminated waste reduction at source, mercury specific legislation and ratification of Minamata convention on mercury by Pakistan and other world governments at the earliest time possible.

  6. Mercury poisoning associated with a Mexican beauty cream.

    Science.gov (United States)

    Weldon, M M; Smolinski, M S; Maroufi, A; Hasty, B W; Gilliss, D L; Boulanger, L L; Balluz, L S; Dutton, R J

    2000-07-01

    To describe demographic characteristics, patterns of use, and symptoms associated with mercury poisoning among persons who used a Mexican beauty cream containing mercurous chloride and to estimate the prevalence of cream use in Texas near the Mexico border. Case series and cross-sectional survey. Border communities of Arizona, California, New Mexico, and Texas. Persons who used the cream and contacted a health department in response to announcements about the cream and households that participated in the Survey of Health and Environmental Conditions in Texas Border Counties and Colonias, 1997. Urine mercury concentrations, self-reported symptoms, and prevalence of cream use among households. Of 330 cream users who contacted their health department, 96% were women, and 95% were Hispanic. The mean urine mercury concentration was 146.7 microg/L (reference range : 0-20 microg/L). In 5% of 2,194 randomly selected Texas households near the Mexico border, at least 1 person had used "Crema de Belleza-Manning" (Laboratorios Vida Natural, S.A., Tampico, Tamaulipas, Mexico) in the previous year. Most cream users had increased urine mercury concentrations. Cream use was common in Texas near the Mexico border. Physicians should consider toxicity in patients with neurologic symptoms of unclear cause and use public health departments when investigating unusual illnesses.

  7. Mercury poisoning associated with a Mexican beauty cream

    Science.gov (United States)

    Weldon, Minda M; Smolinski, Mark S; Maroufi, Azarnoush; Hasty, Brian W; Gilliss, Debra L; Boulanger, L Lucy; Balluz, Lina S; Dutton, Ronald J

    2000-01-01

    Objectives To describe demographic characteristics, patterns of use, and symptoms associated with mercury poisoning among persons who used aMexican beauty cream containing mercurous chloride and to estimate the prevalence of cream use in Texas near the Mexico border. Design Case series and cross-sectional survey. Setting Border communities ofArizona, California, New Mexico, and Texas. Participants Persons who used the cream and contacted a health department in response to announcements about the cream and households that participated in the Survey of Health andEnvironmental Conditions in Texas Border Counties and Colonias, 1997. Mainoutcome measures Urine mercury concentrations, self-reported symptoms, and prevalence of cream use among households. Results Of 330 cream users who contacted their health department, 96% were women, and 95% were Hispanic.The mean urine mercury concentration was 146.7 μg/L (reference range : 0-20μg/L). In 5% of 2,194 randomly selected Texas households near the Mexico border, at least 1 person had used “Crema de Belleza-Manning”(Laboratorios Vida Natural, S.A., Tampico, Tamaulipas, Mexico) in the previous year. Conclusions Most cream users had increased urine mercury concentrations. Cream use was common in Texas near the Mexico border.Physicians should consider toxicity in patients with neurologic symptoms of unclear cause and use public health departments when investigating unusual illnesses. PMID:10903281

  8. The role of chelation in the treatment of arsenic and mercury poisoning.

    Science.gov (United States)

    Kosnett, Michael J

    2013-12-01

    Chelation for heavy metal intoxication began more than 70 years ago with the development of British anti-lewisite (BAL; dimercaprol) in wartime Britain as a potential antidote the arsenical warfare agent lewisite (dichloro[2-chlorovinyl]arsine). DMPS (unithiol) and DMSA (succimer), dithiol water-soluble analogs of BAL, were developed in the Soviet Union and China in the late 1950s. These three agents have remained the mainstay of chelation treatment of arsenic and mercury intoxication for more than half a century. Animal experiments and in some instances human data indicate that the dithiol chelators enhance arsenic and mercury excretion. Controlled animal experiments support a therapeutic role for these chelators in the prompt treatment of acute poisoning by arsenic and inorganic mercury salts. Treatment should be initiated as rapidly as possible (within minutes to a few hours), as efficacy declines or disappears as the time interval between metal exposure and onset of chelation increases. DMPS and DMSA, which have a higher therapeutic index than BAL and do not redistribute arsenic or mercury to the brain, offer advantages in clinical practice. Although chelation following chronic exposure to inorganic arsenic and inorganic mercury may accelerate metal excretion and diminish metal burden in some organs, potential therapeutic efficacy in terms of decreased morbidity and mortality is largely unestablished in cases of chronic metal intoxication.

  9. Acute Lead Poisoning In an Infant

    OpenAIRE

    Madhusudhanan, M.; Lall, S.B.

    2007-01-01

    A case of acute lead poisoning in an infant without overt clinical manifestations of encephalopathy is reported for the first time in Oman. The case was diagnosed at Rustaq Hospital on the basis of (i) history by the mother of giving the child a traditional remedy for treating constipation (ii) X-ray of abdomen showing radio-opaque speckles and (iii) detection of high blood lead levels (83.3 µg/dL) at the toxicology laboratory of the poison control centre. The source of lead was confirmed by ...

  10. Acute Poisoning in Children in Bahia, Brazil

    Directory of Open Access Journals (Sweden)

    Dilton Rodrigues Mendonça MSc

    2016-02-01

    Full Text Available Acute poisoning is a frequent accident in childhood, particularly in children under 4 years of age. This was a descriptive study with data collected from standardized forms of the Poison Control Center and patient record charts. All the cases of acute poisoning in children aged 0 to 14 years during the period 2008 to 2012 were selected. The variables studied comprised characteristics of the events and toxic agents, clinical development, and outcome. A total of 657 cases of acute poisoning, with higher frequency in the age-group from 1 to 4 years (48.7% and male sex (53.4%, were recorded. The occurrences were accidental in 92% of the cases, and 5.8% were due to suicide attempts. Among the toxic agents, medications (28.5%, venomous animals (19.3%, nonvenomous animals (10%, household cleaning products (9.0%, and raticide agents (8.7% predominated. The majority of cases were characterized as light (73.5% and around 18% required hospitalization, and there was low lethality (0.5%.

  11. Elemental mercury poisoning caused by subcutaneous and intravenous injection: An unusual self-injury

    Directory of Open Access Journals (Sweden)

    Wale Jaywant

    2010-01-01

    Full Text Available Elemental mercury poisoning most commonly occurs through vapor inhalation as mercury is well absorbed through the lungs. Administering subcutaneous and intravenous elemental mercury is very uncommon but with only a few isolated case reports in the literature. We present an unusual case of elemental mercury poisoning in a 20-year-old young male who presented with chest pain, fever, and hemoptysis. He had injected himself subcutaneously with elemental mercury obtained from a sphygmomanometer. The typical radiographic findings in the chest, forearm, and abdomen are discussed, with a review of the literature.

  12. [Acute poisoning by pesticides in children].

    Science.gov (United States)

    Leveau, P

    2016-07-01

    Acute pesticide poisoning in children is rare but potentially serious. Some clinical patterns (toxidromes) are suggestive of the drug class: cholinergic crisis for organophosphate or carbamate insecticides; neurological syndrome for rodenticides; digestive and respiratory syndrome for herbicides. Treatment is symptomatic and only a few patients are treated with an antidote: atropine and pralidoxime for organophosphate insecticides, vitamin K for anticoagulant rodenticides. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  13. Accidental death from acute selenium poisoning.

    Science.gov (United States)

    See, Katharine A; Lavercombe, Peter S; Dillon, Jasmine; Ginsberg, Riesa

    2006-10-02

    We report a fatal case of acute selenium poisoning in a 75-year-old man. After reading on the Internet about a possible role of selenium in prostate cancer, the patient ingested 10 g of sodium selenite. Despite intensive care treatment, he suffered a cardiac arrest and died 6 hours after ingestion. This case illustrates the risks of failing to critically evaluate Internet information and exposes the myth that natural therapies are inherently safe.

  14. Acute poisoning: understanding 90% of cases in a nutshell.

    Science.gov (United States)

    Greene, S L; Dargan, P I; Jones, A L

    2005-04-01

    The acutely poisoned patient remains a common problem facing doctors working in acute medicine in the United Kingdom and worldwide. This review examines the initial management of the acutely poisoned patient. Aspects of general management are reviewed including immediate interventions, investigations, gastrointestinal decontamination techniques, use of antidotes, methods to increase poison elimination, and psychological assessment. More common and serious poisonings caused by paracetamol, salicylates, opioids, tricyclic antidepressants, selective serotonin reuptake inhibitors, benzodiazepines, non-steroidal anti-inflammatory drugs, and cocaine are discussed in detail. Specific aspects of common paediatric poisonings are reviewed.

  15. Acute Respiratory Failure in Acute Poisoning by Neutrotropic Substances

    Directory of Open Access Journals (Sweden)

    A. N. Lodyagin

    2008-01-01

    Full Text Available Objective: to evaluate the efficiency of methods for diagnosing and treating critically ill patients with acute respiratory failure (ARF in acute poisoning by neurotropic substances. Subjects and methods. Two hundred and thirty-three patients with acute severe intoxication with neurotropic poisons were examined. All the patients were admitted for toxic-hypoxic coma and ARF; in this connection all the patients underwent artificial ventilation (AV. The patients were divided into 3 groups: 1 those in whom the traditional treatments (AV, detoxifying therapy, and infusional and cardiotropic support could restore the basic parameters of vital functions, as judged from the recovered oxygenation index; these patients had no metabolic shifts; 2 those who had signs of pulmonary hyperhydration, low cardiac output and moderate metabolic disorders, as suggested by elevated lactate levels; 3 seriously ill patients in whom the interval between the time of poisoning to care delivery was more than 20 hours; the patients of this group had the most significant metabolic disorders. Results. Correction of ARF in critically ill patients with acute poisoning should include, in addition to the rational parameters of AV and detoxifying therapy, agents for targeted therapy for sequels of hypoxia and energy deficiency states. For maximally rapid and effective oxygen transport recovery, the addition of perfluorane to the complex therapy cardinally improves the results of treatment and reduces mortality rates. Conclusion. The complexity of the pathogenesis of ARF and its sequels is a ground for diagnosing and correcting not only ventilation disturbances, but also pulmonary microcirculatory disorders and metabolic disturbances. Key words: acute intoxication with neu-rotropic poisons, acute respiratory failure, pulmonary hyperhydration, hypoxia, metabolic disturbances.

  16. Acute lead poisoning in an infant.

    Science.gov (United States)

    Madhusudhanan, M; Lall, S B

    2007-10-01

    A case of acute lead poisoning in an infant without overt clinical manifestations of encephalopathy is reported for the first time in Oman. The case was diagnosed at Rustaq Hospital on the basis of (i) history by the mother of giving the child a traditional remedy for treating constipation (ii) X-ray of abdomen showing radio-opaque speckles and (iii) detection of high blood lead levels (83.3 µg/dL) at the toxicology laboratory of the poison control centre. The source of lead was confirmed by high content of inorganic lead (20.2%) found in the sample of the traditional remedy (bint al dahab). The blood lead levels significantly decreased, after the intravenous calcium edetate (EDTA) therapy was given to the baby. The case highlights that early detection and treatment of acute lead poisoning in children can prevent morbidity and sequelae associated with encephalopathy. It also indicated the need for awareness and prevention programme for parents on this issue.

  17. Gastric lavage in patients with acute poisoning

    Directory of Open Access Journals (Sweden)

    Montserrat Amigó Tadín

    2012-05-01

    Full Text Available Acute poisonings are a frequent complaint in emergency departments and therapy which prevents the absorption of toxic products taken orally is often indicated: one such option is gastric lavage. Gastric lavage is a digestive decontamination technique whose goal is to remove the maximum amount of poison from the stomach and prevent its absorption. The procedure involves inserting a gastric tube into the stomach through the mouth or nose; firstly to aspirate all the stomach contents and then to perform gastric washing manoeuvres. The effectiveness of gastric lavage is limited and involves a risk of iatrogenesis, and therefore the indications and contraindications should be carefully considered and the technique carried out meticulously to increase its effectiveness and reduce complications, primarily bronchoaspiration. Gastric lavage may be used in conjunction with other digestive decontamination techniques such as administration of activated charcoal. This gastric lavage protocol is based on a review of the literature on this procedure and is supported by the expertise of our research group in gastrointestinal decontamination techniques in patients with acute poisoning.

  18. Acute renal failure secondary to ingestion of ayurvedic medicine containing mercury

    Directory of Open Access Journals (Sweden)

    K Sathe

    2013-01-01

    Full Text Available Several traditional medicines contain potentially toxic heavy metals. Heavy metal poisoning is not an uncommon cause of renal damage, although the diagnosis can be easily missed. We report a case of chronic ingestion of an ayurvedic medicine containing mercury in a 2-year-old girl, resulting in anuric renal failure due to acute interstitial nephritis.

  19. Collective acute poisoning by nitrous gases

    Energy Technology Data Exchange (ETDEWEB)

    Touze, M.D.; Desjars, P.; Baron, D.; Tasseau, F.; Delajartre, A.Y.; Nicolas, F.

    1983-09-01

    A collective nitrous fumes poisoning (five cases) is reported. Two patients (case 3 and case 4) were comatose, in severe respiratory distress. Shock and slate blue cyanosis were noted. Physical examination and chest X ray revealed acute pulmonary edema-Methemoglobin levels were 71,3% (case 3) and 58% (case 4). Despite treatment both of them died from severe hypoxia resulting in cardiorespiratory arrest. Post-mortem examination was performed upon these four men. On admission the last one (case 5) was conscious, and in good hemodynamic condition. Acute pulmonary edema and cyanosis were present. Methemoglobin level was 37,3%. This patient recovered appropriate therapy. For case 1 and 2 acute anoxia due to methemoglobinemia seems to be cause of death. For cases 3 and 4 death is due to hypoxemia associated with pulmonary edema.

  20. Risk factors for acute pesticide poisoning in Sri Lanka

    DEFF Research Database (Denmark)

    van der Hoek, Wim; Konradsen, Flemming

    2005-01-01

    This report describes the characteristics of patients with acute pesticide poisoning in a rural area of Sri Lanka and, for intentional self-poisoning cases, explores the relative importance of the different determinants. Data were collected for 239 acute pesticide-poisoning cases, which were...... admitted to two rural hospitals in Sri Lanka. Sociodemographic characteristics, negative life events and agricultural practices of the intentional self-poisoning cases were compared with a control group. Most cases occurred among young adults and the large majority (84%) was because of intentional self...... shows that acute pesticide poisoning in Sri Lanka is determined by a combination of sociodemographic and psychological factors. Suggestions are given for interventions that could control the morbidity and mortality due to acute pesticide poisoning in developing countries....

  1. [Acute renal failure due to Cortinarius poisoning].

    Science.gov (United States)

    Bouhbouh, Souad; Haverkamp, Leonie; Kuyper, Thomas W; de Wolff, Frederik A; Barendregt, Jos N M

    2011-01-01

    Ingestion of certain Cortinarius species may lead to renal failure. In the Netherlands, this type of poisoning has not been previously described. A 58-year-old female presented with headache, vomiting and oliguria, preceded by a few days of burning, painful thirst and malaise. She had acute and irreversible renal failure of unknown cause. History revealed that two days before the onset of her symptoms, she had eaten a ragout prepared with mushrooms that were picked in a forest. A renal biopsy demonstrated interstitial nephritis with proximal tubular necrosis. In the leftovers of the ragout two fragments of Cortinarius mushroom, probably belonging to the complex of Cortinarius cinnamomeus (cinnamon webcap), were found. First signs and symptoms, and the course are compatible with those described in the literature on Cortinarius poisoning. Despite haemodialysis and administration of acetylcysteine and glucocorticoids, her renal function did not recover. This case is the first description of mushroom poisoning by a species of the genus Cortinarius in the Netherlands.

  2. Acute Pancreatitis Caused By Mushroom Poisoning

    Directory of Open Access Journals (Sweden)

    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.

  3. Acute Pancreatitis Caused By Mushroom Poisoning

    Science.gov (United States)

    Karahan, Samet; Erden, Abdulsamet; Cetinkaya, Ali; Avci, Deniz; Ortakoyluoglu, Adile Irfan; Karagoz, Hatice; Bulut, Kadir; Basak, Mustafa

    2016-01-01

    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. PMID:26835473

  4. Current approaches of the management of mercury poisoning: need of the hour

    Science.gov (United States)

    2014-01-01

    Mercury poisoning cases have been reported in many parts of the world, resulting in many deaths every year. Mercury compounds are classified in different chemical types such as elemental, inorganic and organic forms. Long term exposure to mercury compounds from different sources e.g. water, food, soil and air lead to toxic effects on cardiovascular, pulmonary, urinary, gastrointestinal, neurological systems and skin. Mercury level can be measured in plasma, urine, feces and hair samples. Urinary concentration is a good indicator of poisoning of elemental and inorganic mercury, but organic mercury (e.g. methyl mercury) can be detected easily in feces. Gold nanoparticles (AuNPs) are a rapid, cheap and sensitive method for detection of thymine bound mercuric ions. Silver nanoparticles are used as a sensitive detector of low concentration Hg2+ ions in homogeneous aqueous solutions. Besides supportive therapy, British anti lewisite, dimercaprol (BAL), 2,3-dimercaptosuccinic acid (DMSA. succimer) and dimercaptopropanesulfoxid acid (DMPS) are currently used as chelating agents in mercury poisoning. Natural biologic scavengers such as algae, azolla and other aquatic plants possess the ability to uptake mercury traces from the environment. PMID:24888360

  5. Current approaches of the management of mercury poisoning: need of the hour.

    Science.gov (United States)

    Rafati-Rahimzadeh, Mehrdad; Rafati-Rahimzadeh, Mehravar; Kazemi, Sohrab; Moghadamnia, Ali Akbar

    2014-06-02

    Mercury poisoning cases have been reported in many parts of the world, resulting in many deaths every year. Mercury compounds are classified in different chemical types such as elemental, inorganic and organic forms. Long term exposure to mercury compounds from different sources e.g. water, food, soil and air lead to toxic effects on cardiovascular, pulmonary, urinary, gastrointestinal, neurological systems and skin. Mercury level can be measured in plasma, urine, feces and hair samples. Urinary concentration is a good indicator of poisoning of elemental and inorganic mercury, but organic mercury (e.g. methyl mercury) can be detected easily in feces. Gold nanoparticles (AuNPs) are a rapid, cheap and sensitive method for detection of thymine bound mercuric ions. Silver nanoparticles are used as a sensitive detector of low concentration Hg2+ ions in homogeneous aqueous solutions. Besides supportive therapy, British anti lewisite, dimercaprol (BAL), 2,3-dimercaptosuccinic acid (DMSA. succimer) and dimercaptopropanesulfoxid acid (DMPS) are currently used as chelating agents in mercury poisoning. Natural biologic scavengers such as algae, azolla and other aquatic plants possess the ability to uptake mercury traces from the environment.

  6. Acute kidney injury following Paraquat poisoning in India.

    Science.gov (United States)

    Pavan, Malleshappa

    2013-01-01

    Paraquat is highly toxic to human and is widely used in agriculture as a contact herbicide. Paraquat poisoning is associated with high mortality varying from 35% to 50%. Six cases of paraquat poisoning were treated in our center. Acute kidney injury developed in all the cases and mortality was 66%. Respiratory and multiorgan failure are the main causes for mortality.

  7. Acute organo-phosphorus pesticide poisoning in North Karnataka ...

    African Journals Online (AJOL)

    Background: Pesticide poisoning is an important cause of morbidity and mortality in India. Objectives: To assess the oxidative damage, hemoglobin level and leukocyte count in acute organophosphorus pesticide poisoning. Methods: Plasma cholinesterase was assessed as a toxicity marker. Oxidative damage was ...

  8. Renal replacement therapy in acute poisonings--one center experience.

    Science.gov (United States)

    Mydlík, Miroslav; Derzsiová, Katarina; Frank, Katarina

    2013-01-01

    The authors described three groups of patients after acute poisonings. In the first group were 60 patients after carbon tetrachioride poisoning, the second group consisted of 81 patients after mushroom poisoning and 20 patients after ethylene glycol poisoning were in the third group. Besides two patients with rare poisonings after potassium dichromate and after paraquat poisoning were analysed. All groups of patients with the kidney damage were presented from the diagnostic, differential diagnostic, conservative, ntra- and extracorporeal elimination treatment point of view. In the group of patients suffering from acute carbon tetrachloride poisoning and with acute renal failure following therapy was used: conservative treatment, exchange blood transfusion--in 4 patients in hepatic coma, renal replacement therapy (peritoneal dialysis, haemodialysis, plasmapheresis). From the total number of 60 patients 58 survived and 2 patients died in liver coma. Survival of patients after mushroom poisoning depended on amount of oral use of mushroom (Amanita phalloides), on early admission in dialysis centre and on early beginning of renal replacement therapy within 24 hr after acute poisoning. Twenty four patients from 81 patients of this group died. Main clinical signs of ethylene glycol poisoning were various neurological symptoms (cramps, hemiparesis, coma), severe metabolic acidosis (pH = 7.06 +/- 0.14), leucocytosis (26.4 +/- 5.5x 10(9)/L) and the signs of acute toxic hepatitis and of acute renal failure. Calcium oxalic crystals in urine were present in 17 patients and leucocytosis was observed in every patient. In the first 4 patients we administered intravenously ethylalcohol as an antidotum and later in other patients we used ethylalcohol in dialysis solution. The concentration of ethylalcohol in dialysis solution was 100 mg%. Severe metabolic acidosis improved in 17 patients using bicarbonate haemodialysis and 3 patients died before the possibility to use bicarbonate

  9. Acute abdominal pain and constipation due to lead poisoning.

    Science.gov (United States)

    Mongolu, S; Sharp, P

    2013-01-01

    Although uncommon, lead poisoning should be considered as a differential diagnosis in cases of unexplained acute abdominal pain in both adults and children. We present the case of a 35-year-old Asian male who presented with abdominal pain and constipation secondary to lead poisoning. Initially, the source of lead exposure was not apparent; this was later found to be due to ingestion of an Ayurvedic herbal medicine for the treatment of infertility. Lead poisoning due to the ingestion of Ayurvedic remedies is well described. We discuss the diagnosis, pathophysiology and treatment of lead poisoning. This case illustrates one of the rarer medical causes of acute abdominal pain and emphasizes the need to take a thorough history (including specific questioning regarding the use of over-the-counter and traditional/ herbal remedies) in cases of suspected poisoning or drug toxicity.

  10. [The reporting system of acute pesticides poisoning and general situation of pesticides poisoning in China].

    Science.gov (United States)

    Chen, Shu-yang; Wang, Hong-fei; Yin, Yu

    2005-10-01

    To introduce the reporting system of acute pesticides poisoning and analyze epidemiologic characteristics of pesticides poisoning from reported cases in China. Case reports in the data base of reporting system for occupational diseases were computed by Excel for windows and statistical significance by SAS 6.12. A total of 108 372 cases were reported from 1997 to 2003. Among them, the incidence of occupational poisoning, and non-occupational poisoning accounted for 25.39%, and 74.61% respectively. The fatality rate was 6.86%. The average age was 36.83 years for all pesticides poisoning patients, and 15-59 years old patients accounted for 84.11%. Among 0-14 years old non-occupational poisoning patients, 0-4 years children accounted for 33.51%. Male patients were in the majority in occupational pesticides poisoning, female in non-occupational. Insecticides especially organophosphorus insecticides such as methamidophos, parathion, and omethoate comprised a higher proportion, accounting for 86.02% of the pesticides poisoning. More attention should be paid to pesticides poisoning by the government and medical workers engaged in public health.

  11. Acute Drug Poisoning in Tunisian Children: About 150 Cases

    Directory of Open Access Journals (Sweden)

    Hager Barakizou

    2016-04-01

    Full Text Available Background: Acute drug poisoning remains an important public health problem and represents the second most frequent accidental disease in children. In this study, we identified epidemiological and clinical features of children admitted for acute drug poisoning and related factors associated with suicidal poisoning. Methods: We conducted a retrospective study in the Department of Pediatrics, the Military Hospital, Tunis, over a period of 8 years (2008-2014. Children aged less than 16 yr and admitted for acute drug poisoning were included. Cases of drug addiction were excluded. Two groups were compared: accidental poisoning / suicidal poisoning. Results: We collected 150 cases. The ratio male / female was 1:1.2. The mean age was 4.3 yr. Poisoning was due to one drug in 82% of cases. Children were asymptomatic in 39% of cases, had digestive and neurologic symptoms respectively in 30% and 20% of cases, respectively. Psychotropics came in the first place (20% followed by paracetamol (16%. Two groups were identified: accidental poisoning (74 % and suicidal poisoning (26%. Four factors were significantly associated with suicidal poisoning: age ≥ 8 yr (P< 0.001, OR= 16.25, 95% IC : [6.44-40.95], female gender (P=0.011, OR= 5.4, 95% IC: [2.09-13.91], multiple drug intake (P < 0.001, OR= 9.42, 95% IC: [3.05-29.03] and use of psychotropics (P= 0.003, OR=4.81, 95%IC: [2.06-11.26] . Conclusion: Two groups had to be distinguished: accidental and suicidal drug poisoning. The identification of their characteristics and their predisposing factors is necessary in order to take appropriate preventive actions.

  12. Mercury poisoning associated with beauty cream--Texas, New Mexico, and California, 1995-1996.

    Science.gov (United States)

    1996-05-17

    The Texas Department of Health (TDH), New Mexico Department of Health (NMDH), and San Diego County Health Department (SDCHD) recently investigated three cases of mercury poisoning among persons who had used a beauty cream produced in Mexico. The investigations implicated the beauty cream as the source of the mercury. The cream, marketed as "Crema de Belleza--Manning," lists "calomel" (mercurous chloride) as an ingredient and was found to contain 6%-8% mercury by weight. This report summarizes the ongoing investigation of these and other possible cases.

  13. Occupational mercury vapour poisoning with a respiratory failure, pneumomediastinum and severe quadriparesis

    Directory of Open Access Journals (Sweden)

    Jakub Smiechowicz

    2017-02-01

    Full Text Available Objectives: Despite restrictions, mercury continues to pose a health concern. Mercury has the ability to deposit in most parts of the body and can cause a wide range of unspecific symptoms leading to diagnostic mistakes. Methods and results: We report the case of severe mercury vapour poisoning after occupational exposure in a chloralkali plant worker that resulted in life-threatening respiratory failure, pneumomediastinum and quadriparesis. Conclusions: Prolonged mechanical ventilation and treatment with penicillamine and spironolactone was used with successful outcome.

  14. Pattern of acute poisoning in Tehran-Iran in 2003.

    Science.gov (United States)

    Shadnia, Shahin; Esmaily, Hadi; Sasanian, Ghazal; Pajoumand, Abdolkarim; Hassanian-Moghaddam, Hosein; Abdollahi, Mohammad

    2007-09-01

    To characterize the poisoning cases admitted to the Loghman-Hakim Hospital Poison Center (a teaching reference hospital of poisoning) in Tehran, Iran. All admitted acutely poisoned patients from January to December 2003 were evaluated retrospectively. Information of socio-demographic characteristics, agents and cause of poisoning, and the mortality rate were collected from medical records of the hospital. During this period, 24 179 cases were referred to the emergency department that 10 206 of them were admitted. Of the admitted cases, 51% were male and 49% female. The majority (38%) of cases were in the age range of 21-30 years. Most (79%) of poisonings were intentional and 21% were unintentional. The most important agents of acute poisoning were drugs (69.13%) especially sedative-hypnotics followed by opioids (12.34%) and pesticides especially organophosphates (OPs) (6.21%). The mortality rate was 1.3% (318 patients). Death was mostly occurred by opioids (41.54%), followed by drugs (28%) and pesticides especially OPs (12%). The prevention and treatment of poisoning due to opioids, pesticides specially OPs and sedative-hypnotics drugs should merit high priority in the health care of the indigenous population of Tehran.

  15. Acute tramadol poisoning and its clinical and laboratory findings

    Directory of Open Access Journals (Sweden)

    Hamid Reza Rahimi

    2014-01-01

    Full Text Available 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, PCO 2 (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 PCO 2. Conclusion: Seizure and rise of PCO 2 were the most findings in this study.

  16. Acute methanol poisonings reported to the Drug and Poison Information Center in Izmir, Turkey.

    Science.gov (United States)

    Kalkan, Sule; Cevik, Arif Alper; Cavdar, Caner; Aygoren, Oguz; Akgun, Aylin; Ergun, Nurdan; Tuncok, Yesim

    2003-12-01

    The demographics, sources and outcomes of methanol poisoning have not been described in Turkey. Our study identified the profile of acute methanol exposures reported to Drug and Poison Information Center (DPIC) in Izmir, Turkey, from 1993 to 2002. Data analysis included patient demographics, sources of methanol, reason for the exposure, clinical effects and outcomes of methanol poisoning. The DPIC recorded 30,485 calls concerning poisoning; 996 (3.3%) alcohol poisonings were recorded and 113 (11.3%) of them were methanol poisonings. There were 91 (80.5%) males and 22 (19.5%) females with a mean age of 34.7+/-1.3 y (range 19-65) and 4.8+/-0.9 y (range 1-18) in adults and children, respectively. The sources of methanol were eu de cologne (72.6%), spirits (10.6%) and antifreeze (2.7%). Accidental poisoning occurred in all children between 0 and 12 y old, abuse (55.7%) and intentional poisoning (27.3%) were predominant in adults. Clinical signs in all cases were central nervous system symptoms (45.1%), metabolic acidosis (23.0%), visual symptoms (21.2%) and gastrointestinal symptoms (10.6%). Sixteen patients (14.1%) died, 63 (55.8%) had complete recovery and 1 (0.9%) had irreversible visual problems. Most patients with methanol poisoning may die or present serious morbidity without appropriate treatment in a health care facility. Methanol for producing cheap "eu de colognes" in Turkey is the principal reason for severe poisoning and deaths. Public education about colognes and legislative control of cologne production are important in preventing methanol poisoning.

  17. Mercury exposure: evaluation and intervention the inappropriate use of chelating agents in the diagnosis and treatment of putative mercury poisoning.

    Science.gov (United States)

    Risher, John F; Amler, Sherlita N

    2005-08-01

    Public awareness of the potential for mercury to cause health problems has increased dramatically in the last 15 years. It is now widely recognized that significant exposure to all forms of mercury (elemental/metallic and both inorganic and organic compounds) can result in a variety of adverse health effects, including neurological, renal, respiratory, immune, dermatologic, reproductive, and developmental sequellae. And while the various media have made the general population cognizant of the need to avoid unnecessary exposure to this naturally occurring element, there has also evolved a growing tendency to attribute unexplainable neurologic, as well as other, signs and symptoms to mercury, whether or not significant exposure to mercury has actually occurred. For the physician, making a diagnosis of mercury intoxication can be difficult, because many of the clinical signs and symptoms of mercury exposure can also be attributed to any number of causes, including undiagnosed neurological diseases, pharmacotherapy, vitamin or mineral deficiencies, and psychological stress. The physician must be able to recognize the clinical manifestations of mercury intoxication, and understand the importance of biological markers in making a definitive diagnosis of mercury poisoning. In a desire to treat the patient complaining of symptoms similar to some that can be caused by mercury, a growing number of physicians, particularly those in alternative medicine fields, result to chelation to "rid" the body of the mercury, believed to be the cause of the ailments. And although the use of chelation is increasing, controlled studies showing that this procedure actually improves outcome are lacking. If chelation therapy is considered to be indicated, the attending physician should communicate the risks of chelation to the patient before beginning treatment with metal-chelating drugs.

  18. [Acute lithium poisoning: epidemiology, clinical characteristics, and treatment].

    Science.gov (United States)

    Burguera Vion, Víctor; Montes, José Manuel; Del Rey, José Manuel; Rivera-Gorrín, Maite; Rodao, José María; Tenorio, Maite; Saiz-Ruiz, Jerónimo; Liaño, Fernando

    2017-02-01

    Lithium continues to be the treatment of choice for bipolar disorder. Acute lithium poisoning is a potentially serious event. We present a retrospective observational significative study of episodes of acute lithium poisoning during a 52- month period. Poisoning was defined by a blood lithium concentration of 1.5 mEq/L or higher. We analyzed treatment and epidemiologic and clinical characteristics of 70 episodes were identified (incidence density among treated patients, 1.76 per 100 patient-years). The most frequent cause of lithium poisoning was a concurrent medical condition (46%). Most poisonings were mild (74.2%), but neurologic involvement was identified in 40.3%. Electrocardiographic abnormalities were found in 8 cases. Acute renal failure, found in 23 patients (37.1%), was mild in most cases, although 11 patients required hemodialysis. We concluded that acute lithium poisoning is an uncommon complication, but risk needs to be lowered. Patients should be warned to avoid dosage errors and to take special care during concurrent illnesses and while taking other medications.

  19. The Chemical Nature of Mercury in Human Brain Following Poisoning or Environmental Exposure

    Science.gov (United States)

    2010-01-01

    Methylmercury is among the most potentially toxic species to which human populations are exposed, both at high levels through poisonings and at lower levels through consumption of fish and other seafood. However, the molecular mechanisms of methylmercury toxicity in humans remain poorly understood. We used synchrotron X-ray absorption spectroscopy (XAS) to study mercury chemical forms in human brain tissue. Individuals poisoned with high levels of methylmercury species showed elevated cortical selenium with significant proportions of nanoparticulate mercuric selenide plus some inorganic mercury and methylmercury bound to organic sulfur. Individuals with a lifetime of high fish consumption showed much lower levels of mercuric selenide and methylmercury cysteineate. Mercury exposure did not perturb organic selenium levels. These results elucidate a key detoxification pathway in the central nervous system and provide new insights into the appropriate methods for biological monitoring. PMID:22826746

  20. Acute plant poisoning and antitoxin antibodies.

    Science.gov (United States)

    Eddleston, Michael; Persson, Hans

    2003-01-01

    Plant poisoning is normally a problem of young children who unintentionally ingest small quantities of toxic plants with little resulting morbidity and few deaths. In some regions of the world, however, plant poisonings are important clinical problems causing much morbidity and mortality. While deaths do occur after unintentional poisoning with plants such as Atractylis gummifera (bird-lime or blue thistle) and Blighia sapida (ackee tree), the majority of deaths globally occur following intentional self-poisoning with plants such as Thevetia peruviana (yellow oleander) and Cerbera manghas (pink-eyed cerbera or sea mango). Antitoxins developed against colchicine and cardiac glycosides would be useful for plant poisonings--anti-digoxin Fab fragments have been shown to be highly effective in T. peruviana poisoning. Unfortunately, their great cost limits their use in the developing world where they would make a major difference in patient management. Therapy for some other plant poisonings might also benefit from the development of antitoxins. However, until issues of cost and supply are worked out, plant antitoxins are going to remain a dream in many of the areas where they are now urgently required.

  1. Calls to Florida Poison Control Centers about mercury: Trends over 2003-2013.

    Science.gov (United States)

    Gribble, Matthew O; Deshpande, Aniruddha; Stephan, Wendy B; Hunter, Candis M; Weisman, Richard S

    2017-11-01

    The aim of this analysis was to contrast trends in exposure-report calls and informational queries (a measure of public interest) about mercury to the Florida Poison Control Centers over 2003-2013. Poison-control specialists coded calls to Florida Poison Control Centers by substance of concern, caller demographics, and whether the call pertained to an exposure event or was an informational query. For the present study, call records regarding mercury were de-identified and provided along with daily total number of calls for statistical analysis. We fit Poisson models using generalized estimating equations to summarize changes across years in counts of daily calls to Florida Poison Control Centers, adjusting for month. In a second stage of analysis, we further adjusted for the total number of calls each day. We also conducted analyses stratified by age of the exposed. There was an overall decrease over 2003-2013 in the number of total calls about mercury [Ratio per year: 0.89, 95% CI: (0.88, 0.90)], and calls about mercury exposure [Ratio per year: 0.84, 95% CI: (0.83, 0.85)], but the number of informational queries about mercury increased over this time [Ratio per year: 1.15 (95% CI: 1.12, 1.18)]. After adjusting for the number of calls of that type each day (e.g., call volume), the associations remained similar: a ratio of 0.88 (95% CI: 0.87, 0.89) per year for total calls, 0.85 (0.83, 0.86) for exposure-related calls, and 1.17 (1.14, 1.21) for informational queries. Although, the number of exposure-related calls decreased, informational queries increased over 2003-2013. This might suggest an increased public interest in mercury health risks despite a decrease in reported exposures over this time period. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Our experience in the treatment of acute Amanita phalloides poisoning.

    Science.gov (United States)

    Iliev, Y; Andonova, S; Akabaliev, V

    1999-01-01

    The present study aimed at investigating phalloid mushroom poisoning and the toxicological aid services in Plovdiv region as this pathology shows in this country high mortality rate (40-100%) and increasing incidence; it is difficult to diagnose and is far from featuring adequately in the literature in our country. A caseload of 270 patients with mushroom poisoning from Plovdiv region, Bulgaria, admitted for treatment to the Clinic of Toxicology, Higher Medical Institute, Plovdiv, for the period 1991-1998 was studied. Of these 270 patients 25 (9.26%) had an acute phalloid poisoning. The following indicators were registered: gender, age, reported type of consumed mushrooms, time of appearance of the first complaints after the mushroom consumption, time of medical aid, disease outcome. The diagnosis and the applied treatment was based on our own diagnostic-therapeutic protocol for phalloid intoxication. All phalloid poisoning cases were accidental by character. The most frequently reported type of ingested mushroom was unidentified wild edible mushrooms. Of all the patients males were 56%, females--44% with mean age of 47.71 years (SD = 17.53). From 25 phalloid poisoning cases 15 survived (60%), 10 died (40%). The summer-fall seasonal pattern of phalloid poisoning occurrence was apparent. The mean duration of the latency period was 12 hours (SD--6.66). In 4 (16%) patients the disease exhibited an unusually early onset--up to 2 hours after the mushroom ingestion. The mean time period from the mushroom ingestion to the presentation in a medical institution for first medical aid was 32 hours (SD--21.69), for men--27.59 hours, for women--43.75 hours. Almost one third (32%) of the diseased presented for medical help more than 36 hours after the poisoning. The acute mushroom poisoning cases in adults comprise 7.01% of the total acute poisoning caseload. The phalloid poisoning accounts for 9.26% of the total number of patients with mushroom poisoning admitted for treatment

  3. Semiquantitative mercury determination in fish: a tool for poisoning prevention

    Directory of Open Access Journals (Sweden)

    YALLOUZ ALLEGRA V.

    2002-01-01

    Full Text Available Human exposure to mercury intoxication through contaminated fish ingestion has been well studied, mainly among Japanese population. The Brazilian population, particulaly in the Amazon region, is now in focus due to findings of fish contamination. Major health impacts caused by mercury affect mostly people who have a regular fish diet. A continuous checking for mercury content in the most consumed fish could prevent human intoxication. A simple, non-instrumental method to allow a continuous checking of the mercury content in fish was developed. Based on this method, we are proposing a prevention action where community agents can be trained to perform fish analysis. Technical Schools and Universities located nearby the affected areas would be in charge of quality control programs for the fish analysis as well as for the selection, training and update for operators.

  4. Homeostatic Disorders in Acute Poisoning by Psychotropic Agents

    Directory of Open Access Journals (Sweden)

    M. V. Belova

    2007-01-01

    Full Text Available Objective: to determine the impact of the degree of oxidative stress on homeostatic parameters in critically ill patients with acute poisoning by psychotropic agents (PTA.Materials and methods. The components of lipid peroxidation (LPO and the antioxidative system (AOS, blood rheological and immunological parameters, and the markers of endogenous intoxication were studied in 43 patients with severe acute PTA intoxication before and during intensive detoxification therapy.Results. The first hours of poisoning were marked by LPO-AOS imbalance with a significant preponderance of peroxidation processes, by impaired blood viscous properties, the manifestations of secondary immunodeficiency and endogenous intoxication. There were changes in the study parameters during detoxification therapy and at the early somatogenic stage of the disease.Conclusion. In patients with acute poisoning-induced critical conditions, the degree of oxidative stress affects the time course of homeostatic changes and determines the severity of endotoxicosis at all stages of the disease. 

  5. Spectrum of Acute Pharmaceutical and Chemical Poisoning in Northern Bangladesh

    Directory of Open Access Journals (Sweden)

    Devendranath Sarkar

    2013-03-01

    Full Text Available Background: Acute poisoning is a major public health problem in Bangladesh. It is a common method for suicide. A clear picture regarding clinical presentation, most commonly used toxic agents, background factors and outcome of poisoned patients is necessary in every region. The aim of this study was to investigate frequency and outcome of acute pharmaceutical and chemical poisoning cases in Northern Bangladesh. Methods: This was a retrospective descriptive study on poisoned patients with 18 years of age and above who were admitted to Rangpur Medical College Hospital during 1st December 2011 to 30th November 2012. Results: During the study period, a total of 956 patients were investigated. Males slightly outnumbered females (51.6%. The majority of patients (92% were in the 18-40 year age-group. Regarding occupation, housewives were the most frequent (33.6% followed by farmers (31.7% and students (20.9%. Organophosphate compounds (OPC were the most commonly used toxic agents (73.5%. Most of poisoning cases occurred following suicidal attempts (88%. Familial disharmony was the main cause of suicidal attempts (92.3%. Univariate Analysis showed that age less than 40 years, being married, living in rural areas and educational attainment below secondary level were significantly associated with an increased risk of poisoning (P

  6. Management of acute organophosphorus pesticide poisoning

    Science.gov (United States)

    Eddleston, Michael; Buckley, Nick A; Eyer, Peter; Dawson, Andrew H

    2008-01-01

    Summary Organophosphorus pesticide self-poisoning is an important clinical problem in rural regions of the developing world, and kills an estimated 200 000 people every year. Unintentional poisoning kills far fewer people but is a problem in places where highly toxic organophosphorus pesticides are available. Medical management is difficult, with case fatality generally more than 15%. We describe the limited evidence that can guide therapy and the factors that should be considered when designing further clinical studies. 50 years after first use, we still do not know how the core treatments—atropine, oximes, and diazepam—should best be given. Important constraints in the collection of useful data have included the late recognition of great variability in activity and action of the individual pesticides, and the care needed cholinesterase assays for results to be comparable between studies. However, consensus suggests that early resuscitation with atropine, oxygen, respiratory support, and fluids is needed to improve oxygen delivery to tissues. The role of oximes is not completely clear; they might benefit only patients poisoned by specific pesticides or patients with moderate poisoning. Small studies suggest benefit from new treatments such as magnesium sulphate, but much larger trials are needed. Gastric lavage could have a role but should only be undertaken once the patient is stable. Randomised controlled trials are underway in rural Asia to assess the effectiveness of these therapies. However, some organophosphorus pesticides might prove very difficult to treat with current therapies, such that bans on particular pesticides could be the only method to substantially reduce the case fatality after poisoning. Improved medical management of organophosphorus poisoning should result in a reduction in worldwide deaths from suicide. PMID:17706760

  7. Pre-hospital treatment of acute poisonings in Oslo

    Directory of Open Access Journals (Sweden)

    Nore Anne K

    2008-11-01

    Full Text Available Abstract Background Poisoned patients are often treated in and discharged from pre-hospital health care settings. Studies of poisonings should therefore not only include hospitalized patients. Aims: To describe the acutely poisoned patients treated by ambulance personnel and in an outpatient clinic; compare patients transferred to a higher treatment level with those discharged without transfer; and study the one-week mortality after pre-hospital discharge. Methods A one-year multi-centre study with prospective inclusion of all acutely poisoned patients ≥ 16 years of age treated in ambulances, an outpatient clinic, and hospitals in Oslo. Results A total of 3757 health service contacts from 2997 poisoning episodes were recorded: 1860 were treated in ambulances, of which 15 died and 750 (40% were discharged without transfer; 956 were treated in outpatient clinic, of which 801 (84% were discharged without transfer; and 941 episodes were treated in hospitals. Patients discharged alive after ambulance treatment were mainly poisoned by opiates (70%, were frequently comatose (35%, had respiratory depression (37%, and many received naloxone (49%. The majority of the patients discharged from the outpatient clinic were poisoned by ethanol (55%, fewer were comatose (10%, and they rarely had respiratory depression (4%. Among the hospitalized, pharmaceutical poisonings were most common (58%, 23% were comatose, and 7% had respiratory depression. Male patients comprised 69% of the pre-hospital discharges, but only 46% of the hospitalized patients. Except for one patient, who died of a new heroin overdose two days following discharge from an ambulance, there were no deaths during the first week after the poisonings in the 90% of the pre-hospital discharged patients with known identity. Conclusion More than half of the poisoned patients treated in pre-hospital treatment settings were discharged without transfer to higher levels. These poisonings were more often

  8. Mercury poisoning through intravenous administration: Two case reports with literature review.

    Science.gov (United States)

    Lu, Qiuying; Liu, Zilong; Chen, Xiaorui

    2017-11-01

    Metallic mercury poisoning through intravenous injection is rare, especially for a homicide attempt. Diagnosis and treatment of the disease are challenging. A 34-year-old male presented with pyrexia, chill, fatigue, body aches, and pain of the dorsal aspect of right foot. Another case is that of a 29-year-old male who committed suicide by injecting himself metallic mercury 15 g intravenously and presented with dizzy, dyspnea, fatigue, sweatiness, and waist soreness. The patient's condition in case 1 was deteriorated after initial treatment. Imaging studies revealed multiple high-density spots throughout the body especially in the lungs. On further questioning, the patient's girlfriend acknowledged that she injected him about 40 g mercury intravenously 11 days ago. The diagnosis was then confirmed with a urinary mercury concentration of 4828 mg/L. Surgical excision, continuous blood purification, plasma exchange, alveolar lavage, and chelation were performed successively in case 1. Blood irrigation and chelation therapy were performed in case 2. The laboratory test results and organ function of the patient in case 1 gradually returned to normal. However, in case 2, the patient's dyspnea was getting worse and he finally died due to toxic encephalopathy and respiratory failure. Early diagnosis and appropriate treatment are critical for intravenous mercury poisoning. It should be concerned about the combined use of chelation agents and other treatments, such as surgical excision, hemodialysis and plasma exchange in clinical settings.

  9. Factors influencing acute alcohol poisoning in adolescents in Bulgaria.

    Science.gov (United States)

    Loukova, Anelia; Stankova, Eugene

    2011-01-01

    The aim of the current study is to analyze the social dimensions of acute alcohol poisoning in children. We have studied the patients at the age up to 18 years with acute alcohol poisoning hospitalized in the Children Toxicology Department of Emergency Hospital Pirogov, Sofia, Bulgaria, from January 1, 2007 to June 31,2008. All of them were at teen years--between 12 and 17 years old. Data on children were retrived from hospital medical records. We have used the inquiry method - specially created for the purpose of the survey questionnaire comprising 39 questions (location and the reason for drinking, type of alcoholic beverage, age at first drink, combination alcohol - illicit drug, type of family, education and employment of parents, frequency of alcohol consumption by parents, consecutiveness of the children in family, presence of siblings, presence of children in a single room, interests etc.). We have studied 137 Adolescents with acute alcohol poisoning. 77 are boys and 60 girls. The results demonstrate tendency of increase of the poisonings in weekends and in late afternoon and evening. No repeated hospitalization for acute alcohol poisoning in the study group for that period has been registered. The most frequent alcoholic beverage leading to intoxication was vodka (63.1 %). 64 % of the children come from complete families. Both parents have secondary education in 79.7 % and in 53.3 % both parents are employed. 60 % were the first born child in the family. The most frequent reason for alcohol consumption was meeting with friends. The research concerns one important medico-social problem--alcohol consumption among children. The increasing alcohol consumption leads to increasing number of acute alcohol poisonings and associated problems. The proposed preventive program may play in important role in decreasing the consequences of alcohol consumption among young people. It should be further developed and popularized among physicians.

  10. Cardiovascular Effects of Acute Organophosphate Poisoning

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    Shankar Laudari

    2014-06-01

    Conclusion:Cardiac effects of OP poisoning can be life-threatening. Prompt diagnosis, early supportive and definitive therapies with atropine and oximes along with vigilant monitoring of the patients for prominent cardiac effects such as QT prolongation, VT or VF during hospital stay can definitely save lives of the victims.

  11. A retrospective analysis of acute organophosphorus poisoning ...

    African Journals Online (AJOL)

    mortality that poses public health problem in developing countries, including India.[1-21] World .... patients, the paucity of health care, and the lack of facilities and antidotes.[13,14,42,48] The mortality .... poisoning: A Malaysian intensive care experience of one hundred cases. Med J Malaysia 1984;39:229-33. 26.

  12. Profile of acute poisoning in three health districts of Botswana

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    Mary Kasule

    2009-04-01

    Full Text Available Background: This study sought to characterise acute poisoning cases seen in three health districts of Botswana.Method: A retrospective review of patients’ records was conducted and included patients treated from January 2004 to December 2005. Data on the demographic status of the patients, information about the poisonous agent(s involved, and the circumstances and outcomes of the poisoning incidents were recorded on a pre-tested data collection form.Results: A total of 590 cases of acute poisoning were included in the analysis. The most affected age category was that of children aged less than six years, who constituted 33.4% of the cases. Most incidents were recorded in the urban district of Gaborone. Seventy-eight percent (78% of the incidents were accidental, with the remainder being intentional. The poisonous agents involved were pharmaceuticals (26.6%, natural toxins (25.6%, household products (14.6%, foods (14.4%, alcohol (6.9%, traditional medicines (4.7%, unspecified agents (3.2%, and agrochemicals (2.7%. The most common route of poison exposure was by oral (82.2%, followed by dermal contact (16.5%, while the inhalation of gases occurred in 1.2% of cases. An incidence rate of 4.7/1000, a case fatality rate of 3.8/100, and 1.5% of deaths were recorded over the two-year period.Conclusion: In conclusion, it can be stated that acute poisoning involved mainly young children and resulted in an incidence rate of 4.7/1000, a case fatality rate of 3.8/100, and 1.5% of deaths over the two-year period. There were differences based on age category, gender and residence of the victims, the types of toxic agents involved, as well as the circumstances and the outcomes of the poisoning incidents. Given the fact that pharmaceuticals, natural toxins, household products and foods were the agents most commonly involved, targeted interventions should take these differences into account in addressing the problem of acute poisoning.

  13. Acute organophosphorus compound poisoning in cattle: A case report

    African Journals Online (AJOL)

    A case of an acute organophosphorus compound, GOLDFLEECE poisoning involving 39 cattle at Abubakar Tafawa Balewa University, Bauchi is reported. The animals were overexposed to the compound following routine tick spray. Within 15 minutes after the spray of the compound, 26 animals were recumbent showing ...

  14. Occurrence of a Severe Acute Livestock Poisoning by Borehole ...

    African Journals Online (AJOL)

    This article reports on an outbreak of acute livestock poisoning by borehole water that occurred at Kargi in Marsabit District, Kenya in 2000. The borehole had been out of use for 3 years and after its rehabilitation, 7,000 animals died within a day after drinking the water. The most affected were shoats, cattle, camels and dogs ...

  15. Acute organo-phosphorus pesticide poisoning, oxidative damage ...

    African Journals Online (AJOL)

    Joseph Ayobabalola Hainan Medical University, China, Faculty of Medicine, University of Nis, Serbia; adjunct. University, Nigeria;. Chulalongkorn University, Bangkok Thailand. DOI: http://dx.doi.org/10.4314/ahs.v14i3.42. References. 1. Hundekari IA, Suryakar AN, Rathi DB. Acute organo-phosphorus pesticide poisoning in ...

  16. Accidental Potassium Bromate Poisoning Causing Acute Renal Failure

    OpenAIRE

    Adeleke SI; Asani MO

    2009-01-01

    Accidental poisoning is common in children. Potassium bromate is commonly used additive and raising agent in many edibles especially bread which is a staple food in Nigeria. This communication is that of an unusual case of acute renal failure following accidental ingestion of potassium bromate tablets.

  17. Accidental Potassium Bromate Poisoning Causing Acute Renal Failure

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    Adeleke SI

    2009-05-01

    Full Text Available Accidental poisoning is common in children. Potassium bromate is commonly used additive and raising agent in many edibles especially bread which is a staple food in Nigeria. This communication is that of an unusual case of acute renal failure following accidental ingestion of potassium bromate tablets

  18. [Prehospital management of acute childhood poisoning in Spain].

    Science.gov (United States)

    Salazar, June; Zubiaur, Oihane; Azkunaga, Beatriz; Molina, Juan Carlos; Mintegi, Santiago

    2017-06-01

    This objective was to analyze prehospital management of acute childhood poisonings. Poisonings treated in 59 pediatric emergency departments participating in the Toxicology Observation Project of the Spanish Society of Pediatric Emergency Medicine were registered prospectively between 2008 and 2014. We analyzed consultations made and treatments received before the patient arrived in the emergency department. A total of 902 poisonings were registered; in 870 cases (96.4%) cases whether or not a prehospital consultation had been made was on record. An emergency service of come type was contacted or visited in 312 cases (35.9%). Calls were most often made to the central emergency service (122 cases [14%]), primary care centers (100 cases [11.5%]), or the National Toxicology Institute (60 cases, [6.9%]). Choice of service to call or visit varied greatly according to type of poisoning. Prehospital treatment was more often received if a service had been contacted (26.3%) than if not (6.8%) (Pprehospital service had been contacted. About half the cases that consulted a poisoning service but did not receive treatment before coming to a hospital did receive treatment in the hospital emergency department. We conclude that a substantial percentage of patients who seek care for childhood poisoning from an emergency department have also consulted a prehospital service. Better prehospital management of such cases could facilitate earlier treatment when required and also preempt unnecessary trips to pediatric emergency departments.

  19. An unusual case of insecticide poisoning presenting as acute kidney injury

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    Manjusha Yadla

    2017-01-01

    Full Text Available Poisoning due to insecticides such as organophosphorus and super vasmol presenting as acute kidney injury (AKI is well-reported. Poisoning due to fipronil (phenylpyrazole is known to present with mild neurological and dermatological complaints. However, fipronil poisoning presenting as AKI and hepatic dysfunction is not known. Herein, we are presenting a case of fipronil poisoning presenting with severe AKI.

  20. Update: mercury poisoning associated with beauty cream--Arizona, California, New Mexico, and Texas, 1996.

    Science.gov (United States)

    1996-07-26

    During September 1995-May 1996, the Texas Department of Health (TDH), the New Mexico Department of Health (NMDH), and the San Diego County (California) Health Department investigated three cases of mercury poisoning associated with the use of a mercury-containing beauty cream produced in Mexico. The ongoing investigation has found this product in shops and flea markets in the United States located near the U.S.-Mexico border, and a U.S. distributor has been identified in Los Angeles. The cream, marketed as "Crema de Belleza--Manning" for skin cleansing and prevention of acne, listed "calomel" (mercurous chloride [Hg2Cl2]) as an ingredient and contained 6% to 10% mercury by weight. This report presents findings of a continuing investigation by these health departments, the Arizona Dept of Health Services (ADHS), California State Department of Health Services (CSDHS), the Food and Drug Administration (FDA), and CDC.

  1. Rhabdomyolysis among acute human poisoning cases.

    Science.gov (United States)

    Talaie, H; Pajouhmand, A; Abdollahi, M; Panahandeh, R; Emami, H; Hajinasrolah, S; Tghaddosinezhad, M

    2007-07-01

    Rhabdomyolysis is a clinical and biochemical syndrome occurring when skeletal muscle cells erupt and result in release of creatine phosphokinase (CPK), lactate dehydrogenase (LDH) and myoglobin into the interstitial space and plasma. Mechanical trauma, compression, excessive muscle activity and ischemia are frequent causes, but non-traumatic rhabdomyolysis is usually caused by a toxic reaction to drugs. In this study, 181 patients suspected of rhabdomyolysis were admitted to the poisoning center of Loghman-Hakim Hospital in Tehran during one year (September 2004 to September 2005) were studied. Patients were included on the basis of physical examination and blood analysis for CPK and LDH. Rhabdomyolysis was confirmed if CPK level has been greater than 975 U/L. Out of 181 patients, 64 were female and 117 were male with an age range between 13-78 years. One-hundred and forty-three (79%) patients had CPK greater than 975 U/L. In 6% of the cases, multiple drug poisoning were observed. Two patients (1.1%) had muscle pain, five patients (2.8%) had rigidity and five patients (2.8%) had muscle inflammation. One-hundred and nineteen patients (65.7%) were febrile. The most common cause of rhabdomyolysis was opium. Blood ALT showed an increase in 109 patients (60.9%), AST in 80 patients (44.7%), and LDH in 144 patients (79.6%). Fifty patients (28.2%) had higher blood direct bilirubin and 64 patients (36.4%) showed higher total bilirubin. Six percent of patients had been diagnosed as ARF by indication of creatinine greater than 1.4 mg/dL. Five percent of patients had hypernatremia and 1.1% of patients had hyperkalemia. It is concluded that rhabdomyolysis is a matter of concern in human poisonings and needs special approach to attend.

  2. Acute aluminium phosphide poisoning, what is new?

    Directory of Open Access Journals (Sweden)

    Yatendra Singh

    2014-01-01

    Full Text Available Aluminium phosphide (AlP is a cheap solid fumigant and a highly toxic pesticide that is commonly used for grain preservation. AlP has currently generated interest with increasing number of cases in the past four decades because of its increased use for agricultural and nonagricultural purposes, and also its easy availability in the markets has led to its increased misuse to commit suicide. Ingestion is usually suicidal in intent, uncommonly accidental and rarely homicidal. The poison affects all systems, shock, cardiac arrhythmias with varied ECG changes and gastrointestinal features being the most prominent. Diagnosis is made on the basis of clinical suspicion, a positive silver nitrate paper test to phosphine, and gastric aspirate and viscera biochemistry. Treatment includes early gastric lavage with potassium permanganate or a combination of coconut oil and sodium bicarbonate, administration of charcoal and palliative care. Specific therapy includes intravenous magnesium sulphate and oral coconut oil. Unfortunately, the lack of a specific antidote Results in very high mortality and the key to treatment lies in rapid decontamination and institution of resuscitative measures. This article aims to identify the salient features and mechanism of AlP poisoning along with its management strategies and prognostic variables.

  3. Acute Liver Failure Caused by Amanita phalloides Poisoning

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    Luca Santi

    2012-01-01

    Full Text Available Mushroom poisoning is a relatively rare cause of acute liver failure (ALF. The present paper analyzes the pathogenesis, clinical features, prognostic indicators, and therapeutic strategies of ALF secondary to ingestion of Amanita phalloides, which represents the most common and deadly cause of mushroom poisoning. Liver damage from Amanita phalloides is related to the amanitins, powerful toxins that inhibit RNA polymerase II resulting in a deficient protein synthesis and cell necrosis. After an asymptomatic lag phase, the clinical picture is characterized by gastrointestinal symptoms, followed by the liver and kidney involvement. Amatoxin poisoning may progress into ALF and eventually death if liver transplantation is not performed. The mortality rate after Amanita phalloides poisoning ranges from 10 to 20%. The management of amatoxin poisoning consists of preliminary medical care, supportive measures, detoxification therapies, and orthotopic liver transplantation. The clinical efficacy of any modality of treatment is difficult to demonstrate since randomized, controlled clinical trials have not been reported. The use of extracorporeal liver assist devices as well as auxiliary liver transplantation may represent additional therapeutic options.

  4. Acute Liver Failure Caused by Amanita phalloides Poisoning.

    Science.gov (United States)

    Santi, Luca; Maggioli, Caterina; Mastroroberto, Marianna; Tufoni, Manuel; Napoli, Lucia; Caraceni, Paolo

    2012-01-01

    Mushroom poisoning is a relatively rare cause of acute liver failure (ALF). The present paper analyzes the pathogenesis, clinical features, prognostic indicators, and therapeutic strategies of ALF secondary to ingestion of Amanita phalloides, which represents the most common and deadly cause of mushroom poisoning. Liver damage from Amanita phalloides is related to the amanitins, powerful toxins that inhibit RNA polymerase II resulting in a deficient protein synthesis and cell necrosis. After an asymptomatic lag phase, the clinical picture is characterized by gastrointestinal symptoms, followed by the liver and kidney involvement. Amatoxin poisoning may progress into ALF and eventually death if liver transplantation is not performed. The mortality rate after Amanita phalloides poisoning ranges from 10 to 20%. The management of amatoxin poisoning consists of preliminary medical care, supportive measures, detoxification therapies, and orthotopic liver transplantation. The clinical efficacy of any modality of treatment is difficult to demonstrate since randomized, controlled clinical trials have not been reported. The use of extracorporeal liver assist devices as well as auxiliary liver transplantation may represent additional therapeutic options.

  5. Ventricular bigeminy in acute organophorous poisoning – A rare ECG finding

    OpenAIRE

    Bharati Taksande; Bhawik Dhirawani

    2015-01-01

    India being a land of farmer, the pesticides are freely and easily available and therefore organophosphorous poisoning is one of the major health issues. Suicidal poisoning is more common than accidental poisoning. Cardiac manifestations of organophosphorous poisoning are well known. It results in various electrocardiographic changes from sinus tachycardia to ST elevation. We hereby present a rare ECG finding of ventricular bigeminy in a case of acute organophosphorous poisoning.

  6. Endotoxicosis as the Contents of Posresuscitative Disease in Acute Poisoning

    Directory of Open Access Journals (Sweden)

    Ye. A. Luzhnikov

    2007-01-01

    Full Text Available Objective: to study the specific features of the diagnosis and treatment of endothoxicosis as a manifestation of postresus-citative disease in acute exogenous poisoning.Subjects and methods. Clinical, laboratory, and statistical methods of the diagnosis of endotoxicosis complicating the course of acute poisoning by narcotics, psychopharmacological agents, and cauterants, as well as complex physicochemical detoxification were applied to 554 patients.Results. The study pathology has been ascertained to have 3 developmental stages — from functional (primary to developed and terminal clinical and laboratory manifestations as multiple organ dysfunctions. The best therapeutic results are achieved by effective therapeutic measures just in early-stage endotoxicosis, by substantially reducing the rates of death and pneumonia and the time of the latter’s resolution. The major contribution to the reduction in the rate of death due acute poisoning is associated with physicochemical detoxification that considerably lessens the influence of the intoxication factors of postresuscitative disease.Conclusion. When diagnosing endotoxicosis in patients with acute endogenous intoxication, it is necessary to keep in mind a whole spectrum of typical changes in endotoxicosis markers and homeostatic parameters: hematologi-cal, blood rheological, lipid peroxidation/antioxidative systems, which should be timely corrected by the basic efferent artificial detoxification techniques (hemosorption, hemodiafiltration, hemofiltration, by compulsorily employing physio-and chemohemotherapy (laser-ultraviolet hemotherapy, sodium hypochlorite infusion. 

  7. Lead, mercury, and arsenic poisoning due to topical use of traditional Chinese medicines.

    Science.gov (United States)

    Wu, Ming-Ling; Deng, Jou-Fang; Lin, Kon-Ping; Tsai, Wei-Jen

    2013-05-01

    Metal poisonings through a mucocutaneous route are reported rarely in the literature. We report 2 cases of heavy metal intoxication from inappropriate use of Chinese mineral medicines confirmed by toxicologic investigations. A 51-year-old man developed perianal gangrene and a high fever after a 2-week anal use of hong-dan herbal mixtures for anal fistula. He presented gastrointestinal and constitutional symptoms, followed by skin rash, anemia, hair loss, peripheral neuropathy, and muscle atrophy. Elevated urine arsenic and mercury confirmed the heavy metal poisonings. The hong-dan mixture contained lead tetraoxide, arsenic, and mercury. He was treated with 2,3-dimercapto-1-propanesulfonic acid, with partial improvement, but peripheral neuropathy persists 4 years later. A 75-year-old man developed anorexia, weight loss, headache, dizziness, nausea, vomiting, constipation, weakness, and anemia after a 3-month use of an herbal patch for chronic leg ulcer. His blood lead concentration was 226 μg/dL, and the lead content of the herbal patch was 517 mg/g. Chelation with ethylene diamine tetraacetic acid and dimercaptosuccinic acid was followed by clinical recovery. These cases documented serious systemic poisoning after the short-term use of traditional Chinese medicines containing heavy metals in damaged or infected tissue. Copyright © 2013. Published by Elsevier Inc.

  8. Chronic methyl mercury poisoning may trigger endemic pemphigus foliaceus "fogo selvagem".

    Science.gov (United States)

    Robledo, Mary Ann

    2012-01-01

    In endemic pemphigus foliaceus (EPF) or "fogo selvagem" the epidemiological evidence shows that all the described outbreaks occur on the banks of rivers where there is mercury contamination from alluvium gold mining and deforestation. Pathophysiological evidence shows a similarity to pemphigus induced by sulphydryl (SH-) drugs that act by denaturing cadherins at the desmosomal level, which are the pemphigus antigens. The sulfhydryl radical (SH-) call also thiol or mercaptans from the SH-drugs, act at the level of SH-groups of cystein as would the methyl mercury from the contaminated animals and fish in the diet of humans from endemic areas of pemphigus foliaceus. The methyl mercury would join the SH-groups from the cysteines amino acids from cadherin proteins in the skin. The autoimmune disease would only be triggered in genetically susceptible individuals with human leukocyte antigen HLA-DRB 1 haplotypes, just as Brown-Norway (BN) rats which are susceptible to develop Th2-dependent autoimmunity induced by metals. Immunological evidence from all the seroepidemiological studies could also be explained by binding mechanism of the methyl mercury to the SH-groups from the cysteines in the desmosomal cadherins proteins. The conclusion is that chronic methyl mercury poisoning is the most likely trigger of endemic pemphigus foliaceus "fogo selvagem". To reduce the contamination of methyl mercury in the animals of the polluted rivers is pertinent to the design of campaigns and education programs with the population. Implement reforestation and biological control measures like phytoremediation technologies using decontaminant plants to decrease the methylation, and the process of biomagnifications of the methyl mercury in the Latin-America EPF foci. Copyright © 2011 Elsevier Ltd. All rights reserved.

  9. Acute Severe Chromium Poisoning After Dermal Exposure to Hexavalent Chromium

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    Chun-Chi Lin

    2009-04-01

    Full Text Available Severe acute chromium poisoning related to dermal involvement has rarely been reported in the literature. We report a case of acute severe chromium poisoning through skin exposure as a result of a chemical burn of 15% of the body surface area and multiple organ failure after short-term exposure. Medical interventions, including mechanical ventilation, continuous venovenous hemofiltration, and plasmapheresis were performed. In addition, a chelating agent, dimercapto-propane sulfonic acid, was infused intravenously, combined with intravenous N-acetylcysteine and ascorbic acid as adjuvant therapy. The patient was discharged on day 33 without long-term sequelae. The consequence of transdermal exposure of hexavalent chromium should not be overlooked.

  10. Cases of Acute Poisoning in Southeast Anatolia of Turkey

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    Cahfer Güloğlu

    2004-01-01

    Full Text Available This study was conducted to determine the biological effects of acute poisoning, nature ofagents involved and pattern of poisoning during 2000 in Diyarbakır City in Southeast AnatolianRegion of Turkey.Data from hospital records of all admissions to Emergency Department (ED of Dicle UniversityHospital following acute poisoning collected retrospectively were analysed for the period January toDecember in 2000. Present study included 44 (25.9% male (M and 126 (74.1% female (F, a total170 consecutive patients. A M/F ratio was found as 1.0/3.5 in the study.Mean age of cases was 23.3±6.3 years old; 63 (37.1% of them were under age of 20 years oldand 147 (86.5% of them were under age of 30 years old. Cases of intoxication have admitted insummer season (93 of 170 patients, especially in April, May and July (24, 26 and 30 patients,respectively. Sixty-two (36.5% cases due to accidental, 108 (63.5% cases due to suicidal goal. Thecases of suicidal purposeful intoxications were mostly determined in females (77 cases, 71.3%,p<0.05, and singles (74 cases, 68.5%, p<0.05. There were only two deaths (1.2% among the 170admissions of acute poisonings during hospitaliztion. One of the deaths was due to pesticides; otherone was due to abuse of medical drug. According to physical examination, tachycardia (59, 34.7%,vomit history (55, 32.4%, and unconsciousness (42, 24.7% were frequently observed; however,hypersecretion (15, 8.8%, bradycardia (5, 2.9%, convulsion (8, 4.7%, and hipertension (2, 1.2%,were seen rarely. Cases who poisoned with pesticide compared other cases have had significantlyhigher rate of convulsion (6, 10.2%, miosis (6, 10.2%, and hypersecretion (12, 20.3% (p=0.018,p<0.0001 and p<0.0001, respectively.In our region, pesticides intoxication especially affected to young unmarried females, and mostof them resulted from suicidal purpose. The annual rate of poisoning-related ED visits and mortalitywere within the reported ranges, psychoactive agents being

  11. An unusual presentation of mad honey poisoning: acute myocardial infarction.

    Science.gov (United States)

    Akinci, Sinan; Arslan, Uğur; Karakurt, Kamber; Cengel, Atiye

    2008-09-26

    An unusual type of food poisoning is commonly seen in the Black Sea coast of Turkey due to grayanotoxin containing toxic honey so called "mad honey" ingestion. In cases of toxication bradycardia and rhythm disturbances are commonly observed. Herein, we present a case of a patient who was admitted to the hospital because of acute myocardial infarction with normal coronary arteries after "mad honey" ingestion.

  12. Optimization of Treatment Policy for Acute Carbon Monoxide Poisoning

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    R. N. Akalayev

    2012-01-01

    Full Text Available Objective: to evaluate the efficiency of combination use of hyperbaric oxygenation, succinate-containing solutions, and anti-edematous agents in patients with acute carbon monoxide poisoning. Subjects and methods. The results of treatment were analyzed in 32 patients admitted in 2009—2011 for severe acute carbon monoxide poisoning and a Glasgow coma score of 6—8. The patients were divided into 2 groups: 1 patients whose combination therapy involved hyperbaric oxygenation, Succinasol infusions, and L-lysine-aescinate injections; 2 those who received traditional therapy. All the patients underwent complex clinical, laboratory, and neurophysiologic examinations. Results. Just 24 hours after the combination use of Succinasol and L-lysine-aescinate, Group I patients were observed to have substantially reduced lactate, the content of the latter approached the normal value following 48 hours, which was much below the values in the control group. The similar pattern was observed when endogenous intoxication parameters were examined. During the performed therapy, the level of consciousness and that of intellect according to the MMSE and FAB scales were restored more rapidly in the study group patients than in Group 2. Conclusion. The combination use of hyperbaric oxygenation, the succinate-containing solution Succinasol, and the anti-edematous agent L-lysine-aescinate considerably enhances the efficiency of intensive therapy for acute carbon monoxide poisoning. Key words: carbon monoxide, toxic hypoxic encephalopathy, combination therapy, hyperbaric oxygenation, succinic acid, L-lysine-aescinate.

  13. Acute Renal Failure Due To Ethyleneglycol Poisoning

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    ihsan Ates

    2016-03-01

    Full Text Available Ethylene glycol is a colorless, odorless, sweet, water-soluble substance from the group of dihydric alcohols. As a result of taking ethylene-containing material for suicide purpose or as an accident, serious metabolic acidosis, central nervous system depression and oliguric acute renal failure occur. Early diagnosis and treatment can reduce mortality at a significant level. We present a case with severe metabolic acidosis, coma and acute renal failure due to ethylene glycol intoxication after drinking antifreeze accidentally. [J Contemp Med 2016; 6(1.000: 67-69

  14. Factors associated with self-reported symptoms of acute pesticide poisoning among farmers in northwestern Jamaica

    Science.gov (United States)

    Ncube, Ngqabutho M.; Fogo, Christopher; Bessler, Patricia; Jolly, Curtis M.; Jolly, Pauline E.

    2011-01-01

    Pesticide poisoning is a major public health concern in developing countries. We conducted a population survey among farmers in three parishes of northwestern Jamaica to determine the occurrence of acute pesticide poisoning and to identify factors associated with pesticide poisoning. Approximately 16% of 359 farmers who participated in the study reported one or more incidents of acute pesticide poisoning within the last two years. Only 25% of the farmers reported ever receiving training in pesticide handling or safety. The majority (68%) of farmers who reported pesticide poisoning never sought medical attention for poisoning. The factors found to be associated with pesticide poisoning in this study indicate that implementation of specific intervention strategies and education of farmers is needed in order to improve safe handling, use and disposal of pesticides and reduce incidents of acute pesticide poisoning. PMID:24484363

  15. Acute pesticide poisoning--a global public health problem

    DEFF Research Database (Denmark)

    Konradsen, Flemming

    2007-01-01

    Acute pesticide poisoning has become a major public health problem worldwide, following the intensification of agriculture and the promotion of agro-chemicals in low and middle income countries, with more than 300,000 deaths each year. The easy availability of highly toxic pesticides in the homes...... of farming communities has made pesticides the preferred means of suicide with an extremely high case fatality. Similarly, the extensive use of pesticides exposes the community to both long-term and acute occupational health problems. A concerted effort is urgently needed to address the situation....

  16. EEG spectral analysis and its clinical significance for patients with non-occupationalchronic mercury poisoning

    Directory of Open Access Journals (Sweden)

    Bin-bin SUN

    2015-03-01

    Full Text Available Objective To evaluate the features of EEG spectrum and its clinical significance for patients with non-occupational chronic mercury poisoning.  Methods Eighteen patients with chronic mercury poisoning were collected continuously as poisoning group at Affiliated Hospital of Academy of Military Medical Sciences from March 2012 to September 2013. At the same time, 12 age- and sex-matched healthy people were selected as control group. All patients underwent video EEG, and EEGLAB in Matlab 2013 software was used to analyze their EEG data. Relevant spectrum data of the 2 groups were compared and analyzed.  Results The frequency-energy curves of 12 normal subjects were similar to sine curve, with obvious energy peak at α band. The frequency-energy curves of 18 patients showed as follows: 5 cases had the peak at slow δ wave, and the energy curve decreased since δ band appeared, with α band peak disappearing. The curve of 10 cases had 2 peaks respectively at α and δ band, and δ peak was higher than α peak. The spectrum in other 3 cases was normal. The quantitative analysis of EEG revealed the proportion of δ band for the total energy. The proportion of δ band for total energy of the poisoning group in right middle temporal (P = 0.018 and left posterior temporal (P = 0.039 channel was significantly higher than that of the normal group, while the proportion of δ band in middle frontal (P = 0.003, right frontal (P = 0.016 and right anterior temporal (P = 0.024, left middle temporal (P = 0.036 and right posterior temporal (P = 0.031 was lower than that of the normal group. Conclusions EEG examination plays an important role in assessing the severity of brain injury for patients with non-occupational chronic mercury poisoning. Spectrum analysis is an intuitive and simple method, and can provide some help for clinical diagnosis and treatment. DOI: 10.3969/j.issn.1672-6731.2015.02.013

  17. Outpatient treatment of acute poisonings in Oslo: poisoning pattern, factors associated with hospitalization, and mortality

    Directory of Open Access Journals (Sweden)

    Lund Cathrine

    2012-01-01

    Full Text Available Abstract Background Most patients with acute poisoning are treated as outpatients worldwide. In Oslo, these patients are treated in a physician-led outpatient clinic with limited diagnostic and treatment resources, which reduces both the costs and emergency department overcrowding. We describe the poisoning patterns, treatment, mortality, factors associated with hospitalization and follow-up at this Emergency Medical Agency (EMA, "Oslo Legevakt", and we evaluate the safety of this current practice. Methods All acute poisonings in adults (> or = 16 years treated at the EMA during one year (April 2008 to April 2009 were included consecutively in an observational study design. The treating physicians completed a standardized form comprising information needed to address the study's aims. Multivariate logistic regression analysis was used to identify the factors associated with hospitalization. Results There were 2348 contacts for 1856 individuals; 1157 (62% were male, and the median age was 34 years. The most frequent main toxic agents were ethanol (43%, opioids (22% and CO or fire smoke (10%. The physicians classified 73% as accidental overdoses with substances of abuse taken for recreational purposes, 15% as other accidents (self-inflicted or other and 11% as suicide attempts. Most (91% patients were treated with observation only. The median observation time until discharge was 3.8 hours. No patient developed sequelae or died at the EMA. Seventeen per cent were hospitalized. Gamma-hydroxybutyric acid, respiratory depression, paracetamol, reduced consciousness and suicidal intention were factors associated with hospitalization. Forty-eight per cent were discharged without referral to follow-up. The one-month mortality was 0.6%. Of the nine deaths, five were by new accidental overdose with substances of abuse. Conclusions More than twice as many patients were treated at the EMA compared with all hospitals in Oslo. Despite more than a doubling of

  18. The Role of “Leakage” of Tubular Fluid in Anuria Due to Mercury Poisoning*

    Science.gov (United States)

    Bank, Norman; Mutz, Bertrand F.; Aynedjian, Hagop S.

    1967-01-01

    The role of “leakage” of tubular fluid in anuria produced by mercury poisoning was studied in rats by micropuncture techniques. After an initial brisk diuresis, almost all animals were completely anuric 24 hours after HgCl2 injection. Lissamine green injected intravenously in the early stage of anuria appeared in the beginning of the proximal tubule, but the color became progressively lighter as the dye traversed the proximal convolutions. The dye was barely visible in the terminal segments of the proximal tubule; it did not appear at all in the distal tubules. These observations suggest that the proximal epithelium had become abnormally permeable to Lissamine green. Tubular fluid to plasma inulin (TF/PIn) ratios and inulin clearance were measured in individual nephrons at three sites: early proximal tubule, late proximal tubule, and distal tubule. It was found that TF/PIn ratios were abnormally low in the late proximal and distal tubules. Inulin clearance was normal at the beginning of the proximal tubule but fell by more than 60% by the late proximal convolutions. Thus, the proximal tubule had also become permeable to inulin. We conclude from these observations that anuria in mercury poisoning can occur in the presence of a normal glomerular filtration rate. The absence of urine flow appears to be due to complete absorption of the filtrate through an excessively permeable tubular epithelium. The driving force affecting this fluid absorption is probably the colloid oncotic pressure of the peritubular capillary blood. Images PMID:6025476

  19. Mercury Poisoning in a Fisherman Working on a Pelagic Fishing Vessel Due to Excessive Tuna Consumption.

    Science.gov (United States)

    Ahn, Ji-Sung; Wook Kang, Kyung; Kang, Won-Yang; Lim, Hyeong-Min; Cho, Seunghyeon; Moon, Jai-Dong; Park, Won-Ju

    2017-11-01

    To report the case of a fisherman who developed chronic mercury poisoning due to excessive consumption of tuna while working on a pelagic fishing vessel. A 48-year-old male deep-sea fisherman developed paresthesia and pain in both legs while working at sea. He continued working for over 4 months on a pelagic fishing vessel but was eventually unable to function normally as his condition deteriorated. Upon arrival on land, he received specialist treatment, including imaging studies, for 2 months; however, the cause of the symptoms was not identified. An examination of his occupational history revealed that he had worked as a crew member on a pelagic fishing vessel catching tuna for the last 2 years and consumed tuna for two or more meals per day, every day. Two months after discontinuation of tuna consumption, he was tested for mercury. The result showed an elevated blood mercury level (BML) of 21.79 μg/L. Based on the half-life of mercury, the BML was evaluated as 38.70-53.20 μg/L when he was on board. Four months after discontinuing tuna consumption, his BML decreased to 14.18 μg/L, and the symptoms were almost ameliorated. The person responsible for preparing meals on a pelagic fishing ship should be aware that fish may contain high levels of heavy metals and should prepare meals for crew members according to the recommended levels. Crew members should also be aware that fish and shellfish may contain mercury, and hence, they should consume only an appropriate amount.

  20. Application of sodium carbonate prevents sulphur poisoning of catalysts in automated total mercury analysis

    Science.gov (United States)

    McLagan, David S.; Huang, Haiyong; Lei, Ying D.; Wania, Frank; Mitchell, Carl P. J.

    2017-07-01

    Analysis of high sulphur-containing samples for total mercury content using automated thermal decomposition, amalgamation, and atomic absorption spectroscopy instruments (USEPA Method 7473) leads to rapid and costly SO2 poisoning of catalysts. In an effort to overcome this issue, we tested whether the addition of powdered sodium carbonate (Na2CO3) to the catalyst and/or directly on top of sample material increases throughput of sulphur-impregnated (8-15 wt%) activated carbon samples per catalyst tube. Adding 5 g of Na2CO3 to the catalyst alone only marginally increases the functional lifetime of the catalyst (31 ± 4 g of activated carbon analyzed per catalyst tube) in relation to unaltered catalyst of the AMA254 total mercury analyzer (17 ± 4 g of activated carbon). Adding ≈ 0.2 g of Na2CO3 to samples substantially increases (81 ± 17 g of activated carbon) catalyst life over the unaltered catalyst. The greatest improvement is achieved by adding Na2CO3 to both catalyst and samples (200 ± 70 g of activated carbon), which significantly increases catalyst performance over all other treatments and enables an order of magnitude greater sample throughput than the unaltered samples and catalyst. It is likely that Na2CO3 efficiently sequesters SO2, even at high furnace temperatures to produce Na2SO4 and CO2, largely negating the poisonous impact of SO2 on the catalyst material. Increased corrosion of nickel sampling boats resulting from this methodological variation is easily resolved by substituting quartz boats. Overall, this variation enables an efficient and significantly more affordable means of employing automated atomic absorption spectrometry instruments for total mercury analysis of high-sulphur matrices.

  1. Acute arsenic poisoning: clinical, toxicological, histopathological, and forensic features.

    Science.gov (United States)

    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. © 2010 American Academy of Forensic Sciences.

  2. Acute lead poisoning in two users of illicit methamphetamine

    Energy Technology Data Exchange (ETDEWEB)

    Allcott, J.V. III; Barnhart, R.A.; Mooney, L.A.

    1987-07-31

    Acute lead poisoning can present a difficult diagnostic dilemma, with symptoms that mimic those of hepatitis, nephritis, and encephalopathy. The authors report two cases in intravenous methamphetamine users who presented with abnormal liver function values, low hematocrit values, basophilic stippling of red blood cells, and elevated blood lead levels. Both patients excreted large amounts of lead in their urine after treatment with edetic acid, followed by resolution of their symptoms. Lead contamination was proved in one drug sample. Basophilic stippling of the red blood cells was the one key laboratory result that led to the definitive diagnosis in both cases.

  3. [Acute inorganic lead poisoning in workers employed on building renovation].

    Science.gov (United States)

    Liberatori, Roberta; Romeo, R; Restieri, Rosetta; Sarrini, Daniela; Parducci, A D; Puccetti, Monica; Loi, F; Sartorelli, P

    2010-01-01

    Occupationally, there are a number of work processes that constitute a long-term risk as sources of exposure to lead. In these processes the presence of lead is not evident but represents a hidden risk of poisoning. Study of two cases of hidden exposure to lead that were discovered during renovation work on a historical building. Acute lead poisoning symptoms appeared in the 2 workers. The current protocol for treatment of lead poisoning was applied, which consisted in administration of a chelating agent (EDTA), with subsequent monitoring of indicators of dose (PbB. blood lead level, PbU: urinary lead level) and indicators of effect (erythrocyte Protoporphyrin IX, urinary delta-aminolevulinic acid (ALA-U), urinary coproporphyrins). The lead colic and anaemia appeared at PbB values (102 microg/dl e 104 microg/dl) that were higher than the PbB action value (40 microg/dl) and higher than the limit value (60 microg/dl). The gravity of the symptoms, the high number of persons potentially involved, the difficulty of reclamation and probable urban contamination, with relative consequences concerning particularly infants and women infertile age, are sufficient grounds to require effective legislative action and improvement in the services available at the hospitals involved.

  4. Successful Treatment of Acute Boron Poisoning Induced Neurotoxicity by Haemodialysis: A Case Report

    Directory of Open Access Journals (Sweden)

    Pradeep Hosagoudar

    2012-06-01

    Full Text Available Boric acid is commonly used as pesticide, disinfectant and wood preservative. Acute boron poisoning may manifest with vomiting, diarrhea, abdominal pain, headache, altered sensorium, seizure etc. Treatment of acute boron poisoning is conservative, no specific antidote is available.

  5. [Characterization of severe acute occupational poisoning accidents in China between 1989 and 2003].

    Science.gov (United States)

    Zhang, Min; Li, Tao; Wang, Huan-Qiang; Wang, Hong-Fei; Chen, Shu-Yang; Du, Xie-Yi; Zhang, Shuang; Qin, Jian

    2006-12-01

    To analyze severe acute occupational poisoning accidents reported in China between 1989 and 2003, and to study the characteristics of severe acute occupational poisoning accidents and provide scientific evidences for prevention and control strategies. The data from the national occupational poisoning case reporting system were analyzed with descriptive methods. (1) There were 506 acute severe occupational poisoning accidents for 15 years with 4 657 workers poisoned. The total poisoning rate was 54.8%, and the total mortality was 16.5%. The average poisoning age was (31.9 +/- 9.8) years old and the average death age was (33.7 +/- 10.3) years old. The poisoning accidents occurred more in men than in women. (2) There were more than 112 chemicals which caused these poisoning accidents. Most of the accidents caused by hydrogen sulfide, carbon monoxide, benzene and homologs, metal and metalloid and carbon dioxide, and the types of chemicals varied in different types of industries. (3) The accidents mainly occurred in chemical industry, manufacture, water disposal industry, mining and construction industry, and the risk was higher in some jobs than others, such as cleanout, machine maintenance and repair, production, mine and digging. The accidents occurred more frequently from April to August each year. (1) The control over the severe acute occupational poisoning is urgent. (2) The trend of the characteristics of severe acute occupational poisoning accidents is centralized in the high risk industries, poisons and jobs. (3) The characteristics of the accidents varied in different types of industries. (4) It is the key point to strengthen the supervision on poisoning.

  6. Acute poisoning in children; changes over the years, data of pediatric clinic department of toxicology

    Directory of Open Access Journals (Sweden)

    Alije Keka

    2014-01-01

    Conclusion: In our study drugs and house cleaning products are the most frequent agents causing accidental poisoning in children less than 5 years-old, this age of children is the most susceptible in terms of morbidity. Compared with the previous studies in Pediatric Clinic of Pristina, drugs are still the most frequent cause of acute poisoning in children; the number of poisoning with pesticides has fallen but has increased the number of poisoning with cleaning products. All preventive measures against poisoning should be taken including preventive strategies of education at national level especially in drug and household product storage.

  7. Chronic insomnia in workers poisoned by inorganic mercury: psychological and adaptive aspects

    Directory of Open Access Journals (Sweden)

    ROSSINI SUELI REGINA G.

    2000-01-01

    Full Text Available Insomnia is one of the symptoms of inorganic mercury poisoning (IMP. The objective of this study is to analyze the chief psychological aspects in the adjustment of workers with chronic insomnia associated with IMP. For this purpose the Preventive Clinical Interview and the Ryad Simon Operational Adaptive Diagnostic Scale (Escala Diagnóstica Adaptativa Operacionalizada-EDAO were utilized. Fifteen subjects with mean age of 40 years (10 males and 5 females were studied. Nine were diagnosed with High Adaptive Inefficacy, five with Moderate Inefficient Adaptation and only one with Mild Inefficient Adaptation. Impairment occurred in four adaptive sectors: affective relationship, social-cultural, productivity and organic. Adaptive efficiency indicated that in all the 15 subjects studied the adaptive solutions were frustrating and led to psychic suffering and/or environmental conflict confirming the severity of the involvement in chronic IMP.

  8. Severe acute caffeine poisoning due to intradermal injections: mesotherapy hazard.

    Science.gov (United States)

    Vukcević, Natasa Perković; Babić, Gordana; Segrt, Zoran; Ercegović, Gordana Vuković; Janković, Snezana; Aćimović, Ljubomir

    2012-08-01

    Caffeine is indicated in the treatment of migraine headaches, as well as neonatal apnea and bradycardia syndrome. In mild poisoning, the most prevalent symptoms are nausea, vomiting, diarrhea, tremor, anxiety and headache. In more severe cases, symptoms consist of heart rythym abnormalities, myocardial infarction and seizures. Due to its common lipolytic effect, caffeine is used in mesotherapy, usually in combination with drugs of similar effect. We presented a patient with acute iatrogenic caffeine poisoning. A 51-year-old woman, with preexisting hypertension and hypertensive cardiomyopathy was subjected to cosmetic treatment in order to remove fat by intradermal caffeine injections. During the treatment the patient felt sickness, an urge to vomit, and a pronounced deterioration of general condition. Upon examination, the patient exhibited somnolence, hypotension and nonsustained ventricular tachycardia, which was sufficient enough evidence for further hospitalization. On admission to the intensive care unit the patient was anxious with increased heart rate, normotensive, with cold, damp skin, and visible traces of injection sites with surrounding hematomas on the anterior abdominal wall. Paroxysmal supraventricular tachycardia (PSVT) on electrocardiographic monitoring was found. The laboratory analysis determined a lowered potassium level of 2.1 mmol/L (normal range 3,5 - 5.2 mmol/L), and a toxicological analysis (liquid chromatography with ultraviolet detection) proved a toxic concentration of caffeine in plasma - 85.03 mg/L (toxic concentration over 25 mg/L). On application of intensive therapy, antiarrhythmics, and substitution of potassium, as well as both symptomatic and supportive therapy, there was a significant recovery. The patient was discharged without any sequele within four days. A presented rare iatrogenic acute caffeine poisoning occured due to massive absorption of caffeine from the subcutaneous adipose tissue into the circulation when injected

  9. Severe acute caffeine poisoning due to intradermal injections: Mesotherapy hazard

    Directory of Open Access Journals (Sweden)

    Perković-Vukčević Nataša

    2012-01-01

    Full Text Available Introduction. Caffeine is indicated in the treatment of migraine headaches, as well as neonatal apnea and bradycardia syndrome. In mild poisoning, the most prevalent symptoms are nausea, vomiting, diarrhea, tremor, anxiety and headache. In more severe cases, symptoms consist of heart rythym abnormalities, myocardial infarction and seizures. Due to its common lipolytic effect, caffeine is used in mesotherapy, usually in combination with drugs of similar effect. We presented a patient with acute iatrogenic caffeine poisoning. Case report. A 51-year-old woman, with preexisting hypertension and hypertensive cardiomyopathy was subjected to cosmetic treatment in order to remove fat by intradermal caffeine injections. During the treatment the patient felt sickness, an urge to vomit, and a pronounced deterioration of general condition. Upon examination, the patient exhibited somnolence, hypotension and nonsustained ventricular tachycardia, which was sufficient enough evidence for further hospitalization. On admission to the intensive care unit the patient was anxious with increased heart rate, normotensive, with cold, damp skin, and visible traces of injection sites with surrounding hematomas on the anterior abdominal wall. Paroxysmal supraventricular tachycardia (PSVT on electrocardiographic monitoring was found. The laboratory analysis determined a lowered potassium level of 2.1 mmol/L (normal range 3,5 - 5.2 mmol/L, and a toxicological analysis (liquid chromatography with ultraviolet detection proved a toxic concentration of caffeine in plasma - 85.03 mg/L (toxic concentration over 25 mg/L. On application of intensive therapy, antiarrhythmics, and substitution of potassium, as well as both symptomatic and supportive therapy, there was a significant recovery. The patient was discharged without any sequele within four days. Conclusion. A presented rare iatrogenic acute caffeine poisoning occured due to massive absorption of caffeine from the

  10. [Effects of controlling specific dangerous pesticides on prevention of acute pesticide poisoning in rural area].

    Science.gov (United States)

    Zhang, Ping; Zhao, Jiang-xia; Chang, Xiu-li; Zhou, Zhi-jun

    2010-09-01

    To investigate the effects of controlling the specific dangerous pesticides on prevention of acute pesticide poisoning in rural area. The data of reported cases of pesticide poisoning were analyzed to find out the specific dangerous pesticide in acute pesticide poisoning. Then the occurrence of occupational pesticide poisoning and fatality of non-occupational pesticide poisoning were estimated under the hypothesis of removing the specific dangerous pesticides. The data indicated that parathion (including methyl parathion) was the specific dangerous pesticide inducing occupational pesticide poisoning. After removing the use of parathion, the hazard of pesticides which caused occupational pesticide poisoning would be significantly decreased (P pesticide which caused non-occupational pesticide poisoning, with its fatality up to 15.8%. If parathion was well controlled, the fatality of non-occupational pesticide poisoning would be declined from 9.4% to 7.4%. The analyses of related literatures also revealed the similar results. The occurrence of occupational pesticide poisoning and fatality of non-occupational pesticide poisoning may decrease if the most dangerous pesticides are well supervised.

  11. [An investigation of an accident of occupational acute hydrogen sulfide poisoning].

    Science.gov (United States)

    Zhang, Z C; Liu, J L; Jian, X D; Wang, K

    2017-07-20

    Objective: To investigate an accident of occupational acute hydrogen sulfide poisoning, and to analyze related clinical data. Methods: An investigation was performed for an accident of occupational acute hydrogen sulfide poisoning in a place in Shandong, China, in July 2016, and related clinical data were summarized. Results: This was a typical accident of occupational acute hydrogen sulfide poisoning, and a lack of occupational protection and illegal operation were the major causes of this accident. Of all five patients, four experienced coma, toxic encephalopathy, and respiratory failure and were cured at last, and one had cortical syndrome after long-term treatment and died of pulmonary infection seven months later. Conclusions: In case of occupational acute hydrogen sulfide poisoning, rescuers should help the persons who are poisoned reasonably and meanwhile ensure their own safety.

  12. MiR-92a and miR-486 are potential diagnostic biomarkers for mercury poisoning and jointly sustain NF-κB activity in mercury toxicity.

    Science.gov (United States)

    Ding, Enmin; Guo, Jun; Bai, Ying; Zhang, Hengdong; Liu, Xin; Cai, Wenyan; Zhong, Lixin; Zhu, Baoli

    2017-11-22

    Occupational and environmental exposure to mercury is a public health concern worldwide. Although the altered epigenetic regulatory features, such as microRNA, have been associated with mercury exposure, the underlying molecular mechanism is not well illuminated. This study aimed to confirm that hsa-miR-92a and hsa-miR-486 are novel diagnostic biomarkers of occupational mercury poisoning, and to explore the underlying mechanism of miR-92a and miR-486 in mercury toxicity. RT-qPCR assays and receiver operating characteristics curve analyses were conducted to confirm the diagnostic value of miR-92a and miR-486 as biomarkers of occupational mercury poisoning. Dual-luciferase assay was applied to confirm the target gene of miR-92a and miR-486 in vitro. Then, we established an in-vitro model where miR-92a and miR-486 were overexpressed or knocked down in HEK-293 and HUVEC cells. RT-qPCR and western blotting were used to analyze gene and protein expression levels. Cell apoptosis was determined by flow cytometry. Results show that miR-92a and miR-486 expression levels were up-regulated in workers exposed to occupational mercury. Upregulation of miR-92a and miR-486 may play a crucial role in mercury toxicity by jointly activating the NF-κB signaling pathway via targeting KLF4 and Cezanne, respectively.

  13. Electromyographic and laboratory findings in acute Solanum torvum poisoning.

    Science.gov (United States)

    Glover, Robert L; Connors, Nicholas J; Stefan, Cristiana; Wong, Ernest; Hoffman, Robert S; Nelson, Lewis S; Milstein, Mark; Smith, Silas W; Swerdlow, Michael

    2016-01-01

    Solanum torvum berries, known as susumber or turkey berries, are prepared as part of traditional Jamaican dishes usually served with cod and rice. Poisoning is rare. Although toxic compounds have never been definitively isolated, previous reports suggest toxicity results from inhibition of acetylcholinesterases. We present a case of susumber berry poisoning with detailed electromyographic studies and laboratory analysis. A 54-year-old woman presented to the Emergency Department (ED) complaining of vision, speech, and gait changes; emesis; and diffuse myalgias following consumption of susumber berries. The physical examination demonstrated an intact, lucid mental status, miosis, opsoclonus, severe dysarthria, dysmetria, mild extremity tenderness and weakness, and inability to ambulate. Her symptom constellation was interpreted as a stroke. Electromyography demonstrated a pattern of early full recruitment as well as myotonia during the period of acute toxicity. Additionally, solanaceous compounds, in particular solasonine and solanidine, were identified in leftover berries and the patient's serum. Store-bought commercial berries and subsequent serum samples were free of such toxic compounds. EMG studies, together with a laboratory analysis of berries or serum can assist in the differential diagnosis of stroke, and provide both a prognostic screening and confirmation of suspected glycoside toxicity.

  14. [Acute poisoning with anticholinesterase carbamate pesticides: methomyl-lannate®].

    Science.gov (United States)

    Chaouali, Nadia; Amira, Dorra; Zitouni, Eya; Gana, Ines; Nouioui, Anouer; Khelifi, Fathia; Belwaer, Ines; Masri, Wafa; Ghorbal, Hayet; Hedhili, Abderazzek

    2014-01-01

    The methomyl is increasingly involved in suicidal and autolytic attempts. Intoxication with carbamate (CM) compounds is still a frequent cause for admission in the Emergency department of the medical assistance center (MAC) in Tunis, Tunisia. The aim of this study was to describe the demographics, clinical features and hospital course of patients presenting with CM intoxication to the ED of MAC in Tunis, Tunisia. This was a retrospective study about 52 cases of acute poisoning by methomyl, compiled in the MAC from 1st January, 2009 to December 31, 2012. Intoxications were all oral, mostly intentional (33 cases: 65%) and in young patients (29 years old). Females outnumbered males by almost 2:1. The most frequent symptom was hypotension (41 cases: 80%), followed by miosis (39 cases: 75%), rhabdomyolysis (29 cases: 55%), vomiting (18 cases: 43%), bronchorrhea (14 cases: 27%), diarrhea (11 cases: 21%) and fasciculations (8 cases: 17%). Treatments included gastric lavage in 16 patients (32%), assisted ventilation in 8 cases (17%) and atropine in 44 patients (85%). Seven patients died during hospitalization. Pesticide poisoning is a significant public health problem and some preventive measures must be strictly enforced to limit this kind of intoxication.

  15. Pattern of Acute Poisoning Attending a Tertiary Care Hospital of Western Nepal

    Directory of Open Access Journals (Sweden)

    Raju Prasad Shakya

    2016-12-01

    Full Text Available Introduction: Poisoning with various substances is a major public health problem and a reason for significant morbidity and mortality throughout the globe. It is one of the most common presentation in an emergency department. This study was conducted to determine the sociodemographic, poisoning types, and mode of poisoning in cases attending a tertiary hospital of Western Nepal. Methods: A retrospective observational study of two years was conducted from July 2014 to June 2016. Demography details, name of poisonous substance, and reasons for poisoning were reviewed and analyzed using descriptive statistics. Results: A total of 65 cases of poisoning were recorded. The occurrence was more common in female (n=44, 67.7% than in male (n=21, 32.3% with a F:M ratio of 2.1:1.  Poisoning  was most  common in the age group of 11-20 years (32.3%. Most of the cases were students (37% followed by farmers (26%. The most commonly abused poisoning substance were organophosphorous compounds, zinc-phosphate,  and  kerosene in adults, adolescents, and children respectively. Oral route was the most common (99% route of administration. Suicidal attempt, as a mode of poisoning, accounted for 70.8% of total poisoning cases. Conclusion: Female and young people are at greater risk of acute poisoning. Insecticide was the most common agent and self administer poisoning was the most common mode of poisoning. The occurrence of poisoning and its morbidity and mortality can be reduced by developing and implementation of effective prevention strategies like restricting easy poison sales, establishing drug and poison information centers,  and community awareness programs.

  16. Acute ammonium dichromate poisoning in a 2 year-old child

    OpenAIRE

    Menon Narayanankutty Sunilkumar; Thekkuttuparambil Ananthanarayanan Ajith; Vadakut Krishnan Parvathy

    2014-01-01

    Hexavalent chromium compounds are most commonly used in printing, dyeing, plastics and rayon manufacturing. Poisoning in children by ammonium dichromate, an odorless and bright orange-red crystal, are rarely reported. Acute poisoning will result in death due to multi-organ failure. The target organs that are affected by this poison are the respiratory system, kidneys, liver, eyes and skin. On ingestion, initially there is a relative lack of severe symptoms and signs. Hence, the delay in seeki...

  17. Causes of Acute Poisoning Hospital admission in Shahid Beheshti Hospital of Yasuj, 2008

    Directory of Open Access Journals (Sweden)

    S Mohammad Hosseini

    2012-08-01

    Full Text Available Background & aim: About 7% of patient referred to hospital are various forms of poisoning. This study was performed to determine the major causes of acute poisoning leading to Hospitalization at Shahid Beheshti Hospital of Yasuj, Iran. Methods: This descriptive study was performed from August 2007 to July 2008 on 470 cases of poisonings referred to Shahid Beheshti hospital of Yasuj. Demographic characteristics, time of poisoning, poisoning factor, history of previous poisoning, history of psychiatric disease, medication and other therapeutic intervention based on questionnaires and interviews with patients or companions of patients were recorded. Data were analyzed by Chi-Square Test. Results: Majority of poisoned patients were single females, in the age range of 21-30 years, unemployed, lived in urban areas, and had at least a diploma. The majority of cases were intentional poisoning with a history of depression, previous poisoning and attempted suicide. Significant relationship were seen between poisoning, age, sex, and job, (p0.05. Conclusion: With respect to the results of this study, the majority of these poisonings occurred among young, single and unemployed females due to suicide and drug intoxication. Necessary actions should be done in drug usage and maintenance, taking action against non-prescription drugs and giving proper public education to families.

  18. acute poisoning in the community and its associated mortality at the ...

    African Journals Online (AJOL)

    SITWALA COMPUTERS

    exposure and iatrogenic poisoning resulting from drug interaction, incorrect prescribing and patients. 1 misunderstanding of their medication. Cases of acute poisoning take a heavy toll on ... reliable epidemiological data. The main aim of this study ..... level, and with stable cardio-respiratory function. Thus the majority of the ...

  19. Patterns of acute poisoning with pesticides in the paediatric age group.

    Science.gov (United States)

    Dayasiri, Kavinda Chandimal; Jayamanne, Shaluka F; Jayasinghe, Chamilka Y

    2017-12-01

    Pesticides are identified as one of the dangerous poisons globally in children and are associated with increased short- and long-term morbidity. Pesticide poisoning is the most common method of self-poisoning among adults in rural Sri Lanka, and the clinical management is associated with significant healthcare costs to the country. There is however little data published on acute pesticide poisoning among children in rural Sri Lanka. The current study aimed to comprehensively evaluate clinical profiles, harmful first aid measures, emergency clinical management, complications and outcomes related to acute pesticide poisoning among children in the rural community of Sri Lanka. This multicenter study was conducted in the North Central Province of Sri Lanka involving all children with acute pesticide poisoning and who were between 9 months and 12 years of age. Data were collected over 7 years (2007-2014), and children from 36 hospitals were recruited. Data collection was carried out by pretested, multi-structured, interviewer-administered questionnaires to identify clinical profiles of children, harmful first aid measures, emergency clinical management, reasons for delayed management, complications and outcomes of pesticide poisoning events. Among 1621 children with acute poisoning, 9.5% (155) comprised children with acute pesticide poisoning. Male children outnumbered female children, and the majority of children were less than 5 years. Most common pesticides implicated in poisoning of children were organophosphates and carbamates. Gastrointestinal and neurological symptoms were predominant clinical features. Limited transport and lack of concern regarding urgency among caregivers were leading reasons for delayed management. Most common location for poisoning was cultivation lands. Harmful first aid measures were practiced in 32.4%. 7.1% had intentional pesticide poisoning. The case fatality rate of all pesticide poisonings in the study was 1.9%. 58.1% of patients

  20. Characteristics of Acute Poisoning at Two Referral Hospitals in ...

    African Journals Online (AJOL)

    Poisoning by household chemicals, particularly paraffin, affected mainly children under 12, while poisoning by pharmaceuticals involved mainly teenagers. With regard to outcomes, three of the female victims died, representing a case fatality rate of 2.6%. One death was due to paraffin poisoning and two to traditional ...

  1. [Clinical manifestation and influential factors in patients with acute arsenic poisoning].

    Science.gov (United States)

    Liu, Wei-Wei; Yang, Zhi-Qian; Zhang, Cheng; Zhang, Yi-Li; Jiang, Wen-Zhong; Wu, Yi-Xing; Liu, Yi-Min; Gu, Li-Cheng

    2008-11-01

    To investigate the clinical characteristics of acute arsenic poisoning and its influential factors. Clinical data of 47 cases of arsenic poisoning were collected and analyzed. Two cases of observation, 40 cases of mild acute poisoning, and 5 severe acute poisoning were investigated in this group. Myocardial enzyme activity was correlated with age and urine arsenic concentrations. Myocardial enzyme, the liver ALT, total bilirubin (TBil) and indirect bilirubin (IBil) were negatively correlated with vomiting frequency, with statistical significance (P arsenic concentration was correlated with vomiting frequency and amount of soup drunk, with statistically significant difference (P arsenic concentrations, cardiac enzymes and liver enzyme concentration. Acute arsenic poisoning can lead to multiple organ damage. The damage is relevant with amount of arsenic intake, vomiting, diarrhea and urinary frequency arsenic concentration. So early use of gastric lavage, vomiting, poison discharges, and adequate application of effective antidote (Na-DMPS) as soon as possible, symptomatic treatment and the reinforced monitoring, are the rescue key for patients with acute arsenic poisoning.

  2. [The characteristics and trends of acute pesticide poisoning of Shaoxing in 2006 to 2011].

    Science.gov (United States)

    Jiang, Guo-qin; Lian, Ling-jun; Wang, Chun-hui; Li, Ming; Wang, Ji-gang; Pan, Nan-yan; Wang, Sha-sha

    2013-07-01

    To describe the epidemiological characteristics of acute pesticide poisoning in Shaoxing, China during 2006-2011 and to provide a reference for the prevention and control of pesticide poisoning. The data on pesticide poisoning in Shaoxing during 2006-2011 were obtained from the China Information System for Disease Control and Prevention and were then analyzed. A total of 2024 cases of acute pesticide poisoning were reported in Shaoxing during 2006-2011, and 44 cases were missed, accounting for 2.1% (44/2068) of all cases. Among the 2024 cases, 119 (5.9%) died; the fatality rates of productive poisoning and unproductive poisoning were 1.0% (3/289) and 6.7% (116/1735), respectively. The reported cases included 1038 (51.3%) females and 986 (48.7%) males, and there were no significant differences in the ratio between male and female cases of acute pesticide poisoning from 2006 to 2011 (χ2 = 9.16, P = 0.10). The 2024 cases had a mean age of 47.0±18.7 years; the male cases had a significantly higher mean age than the female cases (50.7±19.0 vs 43.4±17.8 years, t = 9.01, P poisoning, and 1735 (85.7%) suffered unproductive poisoning. In the 986 male cases, 219 (22.2%) suffered productive poisoning; in the 1038 female cases, 968 (93.3%) suffered unproductive poisoning. The pesticides that caused poisoning included insecticide (86.7%, 1754/2024), herbicide (5.1%, 104/2024), rodenticide (3.6%, 72/2024), and bactericide, mixed preparation, biochemical pesticides, and other four categories of pesticides (4.6%, 94/2024); of the 1754 cases caused by insecticide, 1455 (83.0%) were attributed to organophosphorus insecticide. The incidence of unproductive acute pesticide poisoning is high in Shaoxing, and it mainly affects females. Most cases of acute pesticide poisoning are aged 30∼60 years. Insecticide is the main cause of poisoning. It is necessary to enhance health knowledge popularization and safety management of pesticides.

  3. Features and Prognostic Factors for Elderly With Acute Poisoning in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Yu-Hui Hu

    2010-02-01

    Conclusion: Our results demonstrated that elderly patients with acute poisoning had a mortality rate of 9.6%. Suicide attempts resulted in more serious complications. The risk factors for mortality were herbicide intoxication, hypotension and respiratory failure.

  4. Lead Poisoning Can Be Easily Misdiagnosed as Acute Porphyria and Nonspecific Abdominal Pain

    OpenAIRE

    Ming-Ta Tsai; Shi-Yu Huang; Shih-Yu Cheng

    2017-01-01

    Lead poisoning (LP) is less commonly encountered in emergency departments (ED). However, lead exposure still occurs, and new sources of poisoning have emerged. LP often goes unrecognized due to a low index of suspicion and nonspecific symptoms. We present a case of a 48-year-old man who had recurring abdominal pain with anemia that was misdiagnosed. His condition was initially diagnosed as nonspecific abdominal pain and acute porphyria. Acute porphyria-like symptoms with a positive urine porp...

  5. Study of Acute Alcohol Poisoning in Children Admitted to a Emergency Hospital Pirogov in Sofia, Bulgaria

    OpenAIRE

    Loukova, Anelia

    2011-01-01

    Aim: The aim of the current study is to analyze the medical and social dimensions of acute alcohol poisoning in children with regard of improving prevention of addictive habitis and develop effective preventative strategies for reducing underage alcohol consumption.Material and Methods: We have studied the patients at the age up to 18 years with acute alcohol poisoning hospitalized in the Children Toxicology Department of Emergency Hospital Pirogov, Sofia, Bulgaria, from January 1, 2007 to Ju...

  6. Toxicokinetics and correlation of carbamazepine salivary and serum concentrations in acute poisonings

    Directory of Open Access Journals (Sweden)

    Đorđević Snežana

    2012-01-01

    Full Text Available Background/Aim. Saliva is a body fluid which, like serum, can be used for determination of concentrations of certain drugs, both in pharmacotherapy as well as in acute poisonings. The aim of this study was to determine carbamazepine concentrations in both saliva and serum in acute poisoning in order to show if there is a correlation between the obtained values, as well as to monitor toxicokinetics of carbamazepine in body fluides. Methods. Saliva and serum samples were obtained from 26 patients treated with carbamazepine and 20 patients acutely poisoned by the drug immediately after their admission in the Emergency Toxicology Unit. Determination of salivary and serum carbamazepine concentrations was performed by the validated high pressure liquid chromatographyultraviolet (HPLC-UV method. Results. A significant correlation of salivary and serum carbamazepine concentrations in both therapeutic application and acute poisoning (r = 0.9481 and 0.9117, respectively was confirmed. In acute poisonings the mean ratio between salivary and serum concentrations of carbamazepine (0.43 was similar to the mean ratio after its administration in therapeutic doses (0.39, but there were high inter-individual variations in carbamazepine concentrations in the acutely poisoned patients, as a consequence of different ingested doses of the drug. In acute poisoning the halftime of carbamazepine in saliva and serum was 12.57 h and 6.76 h, respectively. Conclusion. Our results suggest a possible use of saliva as an alternative biological material for determination of carbamazepine concentrations in therapeutic application and acute poisoning as well, and a possible extrapolation of the results obtained in saliva to serum concentrations of carbamazepine.

  7. Neurological Effects of Acute Carbon Monoxide Poisoning in Children

    Directory of Open Access Journals (Sweden)

    Coskun YARAR

    2009-11-01

    Full Text Available Carbon monoxide poisoning (COP is one of the most common causes of mortality and morbidity due to poisoning in all over the world. Although the incidence of COP has not been known exactly in the childhood, almost one-third of CO exposures occurred in children. The data regarding COP in children are inconclusive. Children may be more vulnerable to CO exposure than adults as a result of their high respiration and metabolic rates, high oxygen metabolism, and immature central nervous system. Recent researches proposed new theories about neurological effects of CO toxicity. The clinical presentations associated acute COP may be various and nonspecific. Unrecognized CO exposure may lead to significant morbidity and mortality. CO exposed children often become symptomatic earlier, and recover more rapidly, than similarly CO exposed adults. Mild clinical signs and symptoms associated with COP are headache, dizziness, weakness, lethargy, and myalgia; however, severe signs and symptoms such as blurred vision, syncope, convulsion, coma, cardiopulmonary arrest and death can also accompany with COP. Neurologic manifestations can include altered mental status at different degrees, neck stiffness, tremor, ataxia, and positive Babinski's sign. Delayed neurologic sequels (DNS of COP might be seen in children like adults. DNS symptoms and signs in children include memory problems, mental retardation, mutism, fecal and urinary incontinence, motor deficits, facial palsy, psychosis, chronic headache, seizures, and epilepsy. After CO exposure children must be cared to detect and treat DNS. Although hyperbaric oxygen therapy (HBOT is reported to prevent development of DNS, its indications, application duration and procedures are controversial in both of the children and adults. Although their predictive values are limited, exposing to CO more than eight hours and suffering from CO-induced coma, cardiac arrest, lactic acidosis, high COHb levels, and pathologic findings

  8. [The role of liver transplantation in the treatment of acute liver failure following Amanita phalloides poisoning].

    Science.gov (United States)

    Beckurts, K T; Hölscher, A H; Heidecke, C D; Zilker, T R; Natrath, W; Siewert, J R

    1997-03-21

    To formulate the indications for liver transplantation in the treatment of acute liver failure after Amanita phalloides poisoning and to determine the results of this treatment. In 1994 twelve patients with acute Amanita phalloides poisoning were treated in the intensive care unit of our hospital's toxicology department. Three of them developed irreversible signs of poisoning and were given orthotopic liver transplants. The findings and course of this group of patients were analysed retrospectively and prognostic criteria defined on the basis of this personal experience and published data. Amanita phalloides poisoning differs from other causes of acute liver failure in several respects. The following criteria make it possible reliably to distinguish a lethal from a non-lethal course: a Quick value 1.4 mg%, even after correcting water and electrolyte abnormalities, serum bilirubin > 4.6 mg%, and progressive encephalopathy indicate a lethal course. Two of three patients survived severe poisoning by being given a liver transplant. Renal failure, pancreatitis and bone marrow suppression, in addition to liver failure, were signs relevant to treatment decisions. Liver transplantation is the procedure of choice in the treatment of acute Amanita phalloides poisoning, if the criteria for a probably lethal course under conservative treatment have been met. This should be taken into account when poisoned patients are to be transferred to a centre for treatment.

  9. [Changes in the nervous system due to occupational metallic mercury poisoning].

    Science.gov (United States)

    Langauer-Lewowicka, H; Zajac-Nedza, M

    1997-01-01

    At the Institute of Occupational Medicine and Environmental Health, during 12 years, chronic mercury intoxication was diagnosed in 34 persons. There were male workers tending technological processes in which Hg was used as a catalyst (synthesis of acetic aldehyde and obtaining chlorine). The length of professional exposure was 13-34 years (mean 20.6). The patients were removed from the contact with Hg after Hg intoxication case was confirmed. During the following 11 years, 24 of them were reexamined in the clinical department 2-4 times. The clinical picture of the poisoning consisted mainly of neurasthenic, cerebellar (30 persons), psychoorganic symptoms (20 persons) and behavioural changes (irritability, aggressive states). Headaches, sleep and recent memory disturbances, progressive behavioral changes, dizziness, were the most frequent complaints. The authors stressed the irreversibility of central nervous disorders despite cessession of the exposure to Hg. The degree of cerebellar intensity changes did not handicap examined patients. This is especially important to show the difference between the above described clinical picture of Hg intoxication and multiple sclerosis.

  10. A Narrative Review of Acute Adult Poisoning in Iran

    Directory of Open Access Journals (Sweden)

    Samira Alinejad

    2017-07-01

    Full Text Available Poisoning is a frequent cause of referral to medical emergencies and a major health problem around the world, especially in developing countries. We aimed to review the epidemiology and pattern of adult poisoning in Iran in order to facilitate the early diagnosis and management of poisoning. The pattern of poisoning is different in various parts of Iran. Pharmaceutical compounds were the most common cause of poisoning in most parts of Iran. Pesticide-related toxicities were more common in northern agricultural regions, whereas bites and stings were seen more commonly in southern Iran. Carbon monoxide poisoning was common in cities with many motor vehicles such as Tehran and in colder climates such as in northern and western regions due to inadequately vented gas appliances such as stoves and heaters. Majoon Birjandi (containing cannabis is a unique substance used in eastern Iran. Poisoning by opioids, tramadol, and pesticides (organophosphate and aluminum phosphide has remained a common hazard in Iran. Poisoning-associated morbidity and mortality rates vary by region and have changed over time due to the introduction of new drugs and chemicals. Early diagnosis and proper treatment may be lifesaving; thus, understanding the general pattern of poisoning in different regions is important.

  11. Clinical Profile of Acute Accidental Poisoning Among Children- A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Tabassum Khatoon

    2017-12-01

    Full Text Available Acute toxicity is a frequent but avoidable cause of morbidity and mortality in children especially in developing countries, including India. Present study assesses their pattern with relation to different age groupings. This retrospective study was conducted among all hospitalised paediatric victims of acute accidental poisoning at the King George Medical University; Lucknow during 2010 -11. Their history, baseline characteristics, clinical course and outcome was studied. Most children were male of less than three years with 4% overall mortality. Kerosene oil was implicated in most cases. Childhood poisoning is commonest during 1-3 years with a male preponderance. Household poisons; especially kerosene oil was responsible for most cases which was consumed accidentally. Parents must be educated and warned to keep these toxic ingredients safely in suitable containers and out of reach of their beloved children. Keywords: Forensic Science, Paediatric, Acute Poisoning, Kerosene, Outcome.

  12. Acute poisoning in a children's hospital: a 2-year experience.

    Science.gov (United States)

    Fazen, L E; Lovejoy, F H; Crone, R K

    1986-02-01

    In a 2-year retrospective review, 90 patients were treated in a children's hospital for acute overdoses. In 90%, the history was the most important indicator of poisoning. On physical examination, 64% of patients were found to have altered sensorium, and 69% of cases were confirmed with a routine qualitative toxicology screening test. Accidental overdoses were most frequently due to ingestion of petroleum distillates, digoxin, carbamazepine, and theophylline. Suicidal patients ingested alcohol, barbiturates, tricyclic antidepressants, benzodiazepines, and aspirin. The majority of children with accidental overdoses received medical attention within 2 hours, but suicidal patients presented significantly later. Appropriate treatment with gastric lavage or emesis was used for 85% of patients on an emergency basis prior to admission. The inpatient therapy is based on continued gastrointestinal decontamination, basic organ system support, and monitoring for toxic effects and complications of therapy. Specific antidotes were available for only 10% of patients. In this study, 50% of patients were able to be discharged to their homes after one day of hospitalization. Pediatric patients treated in the intensive care unit incur less morbidity than adults in a similar setting. Adolescents who attempt suicide and are treated in the intensive care unit are likely to take prescription drugs in a similar manner as their adult counterparts.

  13. Successful Treatment of Acute Lethal Dose of Acrylamide Poisoning

    Directory of Open Access Journals (Sweden)

    Ali Banagozar Mohammadi

    2015-03-01

    Full Text Available Background: Acrylamide (C3H5NO is a vinyl monomer. This water-soluble crystalline solid is a colorless, odorless agent which is used in scientific laboratories and some industries. Acrylamide has cellular oxidative effects. Acute or chronic poisoning with this agent happens as a result of skin, respiratory, or oral contacts. Clinical manifestations depend on the dose, duration, and frequency of contact. Management of these patients consists of conservative and palliative therapies to reduce the oxidative effects. Case: The case was a 29-year-old girl with a Master of Sciences degree in genetics who worked in a university research center with previous history of depression. She had ingested 100cc of 30% Acrylamide solution for intentional suicide attempt. The patient was successfully managed using N-acetyl cysteine, vitamin C, and melatonin. Conclusion: Early diagnosis and appropriate treatment with recommended agents together with supportive therapies can save the life of patients exposed to potentially lethal doses of acrylamide, although intentional or accidental.

  14. A case report of massive acute boric acid poisoning.

    Science.gov (United States)

    Corradi, Francesco; Brusasco, Claudia; Palermo, Salvatore; Belvederi, Giulio

    2010-02-01

    Boric acid comes as colourless, odourless white powder and, if ingested, has potential fatal effects including metabolic acidosis, acute renal failure and shock. An 82-year-old male was brought to the emergency room 3 h after unintentional ingestion of a large amount of boric acid. Clinical course was monitored by collecting data at admittance, 12 h after admission, every 24 h for 5 days and again 1 week after admission. During the first 132 h, serum and urinary concentrations of boric acid were measured. Serum boric acid levels decreased from 1800 to 530 microg/ml after haemodialysis and from 530 to 30 microg/ml during the forced diuresis period. During dialysis, boric acid clearance averaged 235 ml/min with an extraction ratio of 70%. The overall patient's condition steadily improved over 84 h after admission. In conclusion, early treatment with forced diuresis and haemodialysis may be considered for boric acid poisoning, even if signs of renal dysfunction are not apparent, to prevent severe renal damage and its complications.

  15. Salvianolic Acids Attenuate Rat Hippocampal Injury after Acute CO Poisoning by Improving Blood Flow Properties

    Directory of Open Access Journals (Sweden)

    Li Guan

    2015-01-01

    Full Text Available Carbon monoxide (CO poisoning causes the major injury and death due to poisoning worldwide. The most severe damage via CO poisoning is brain injury and mortality. Delayed encephalopathy after acute CO poisoning (DEACMP occurs in forty percent of the survivors of acute CO exposure. But the pathological cause for DEACMP is not well understood. And the corresponding therapy is not well developed. In order to investigate the effects of salvianolic acid (SA on brain injury caused by CO exposure from the view point of hemorheology, we employed a rat model and studied the dynamic of blood changes in the hemorheological and coagulative properties over acute CO exposure. Compared with the groups of CO and 20% mannitol + CO treatments, the severe hippocampal injury caused by acute CO exposure was prevented by SA treatment. These protective effects were associated with the retaining level of hematocrit (Hct, plasma viscosity, fibrinogen, whole blood viscosities and malondialdehyde (MDA levels in red blood cells (RBCs. These results indicated that SA treatment could significantly improve the deformation of erythrocytes and prevent the damage caused by CO poisoning. Meanwhile, hemorheological indexes are good indicators for monitoring the pathological dynamic after acute CO poisoning.

  16. Acute Cardiac Toxicity of Nerium Oleander/Indicum Poisoning (Kaner) Poisoning

    OpenAIRE

    Khan, Ibraheem; Kant, Chandra; Sanwaria, Anil; Meena, Lokesh

    2010-01-01

    We present a case of oleander leaf extract poisoning manifested by vomiting, lightheadedness, and heart block. Practicing physicians should understand the potential lethal properties of oleander and its availability throughout the world.

  17. Acute cardiac toxicity of nerium oleander/indicum poisoning (kaner) poisoning.

    Science.gov (United States)

    Khan, Ibraheem; Kant, Chandra; Sanwaria, Anil; Meena, Lokesh

    2010-10-01

    We present a case of oleander leaf extract poisoning manifested by vomiting, lightheadedness, and heart block. Practicing physicians should understand the potential lethal properties of oleander and its availability throughout the world.

  18. Emergency Room of the Hospital associated with the University of Salerno: acute poisoning registered from April 2009 to September 2011

    Directory of Open Access Journals (Sweden)

    N. M. Vitola

    2012-07-01

    Full Text Available An ever growing number of patients go to the emergency room (ER for toxic exposure to various causal agents. Yet, the actual number of acute poisoning still remains unknown and the epidemic data are only partly available. Cases of acute poisoning in the ER of Salerno Hospital from April 2009 to September 2011 (30 months’ period are reported. Data are divided according to the criteria of gender, age, aetiologic agent, place and reasons of poisoning, and risk evaluation. Out of the total 220,165 patients, the acute poisoning cases were 1,347 (0.61%. Among these, 189 (14.1% patients were admitted to hospital while 3 (0.2% died. Alcool acute poisonings are the most frequent (43.6%, followed by drugs poisonings (30.6%. Acute poisonings are more common among males (59.9% and in people aged 20-50 years. Out of all the acute poisoning cases, 27.8% requested a consult to the Anti-Poisoning Centre. The results aim at contributing to the epidemic research for acute poisoning in ER.

  19. [Acute renal failure as a sequela of mushroom poisoning with Cortinarius speciocissimus].

    Science.gov (United States)

    Münstermann, Susanne; Heinicke, Hans-Jürgen; Kayser, Marten; Nüsslein, Hubert

    2002-02-15

    Poisoning with the mushroom Cortinarius speciocissimus is a rare event. Within 2-17 days after ingestion unspecific symptoms appear. Characteristically, this state is soon followed by irreversible kidney damage which finally requires chronic hemodialysis. A 46-year-old man was admitted with nausea, vomiting and acute anuria 9 days after he had eaten Cortinarius speciocissimus. Hemodialysis had to be started. Kidney biopsy revealed an interstitial nephritis. This finding corresponds to earlier case reports about intoxication with orellanine, the poison of Cortinarius speciocissimus. 6 months later the kidney function had not recovered leaving the patient to chronic hemodialysis. The prognosis of poisoning with that mushroom is poor. The amount of ingested poison is crucial. Monitoring of kidney function is mandatory when poisoning is suspected. Therapy is directed to symptoms. Usually dialysis has to be commenced. To rule out other causes for kidney damage, a kidney biopsy is required.

  20. Acute lead poisoning in western Canadian cattle - A 16-year retrospective study of diagnostic case records.

    Science.gov (United States)

    Cowan, Vanessa; Blakley, Barry

    2016-04-01

    This study describes the epidemiology of acute lead poisoning in western Canadian cattle over the 16-year period of 1998 to 2013 and reports background bovine tissue lead concentrations. Case records from Prairie Diagnostic Services, Western College of Veterinary Medicine, identified 525 cases of acute lead toxicity over the investigational period. Poisonings were influenced by year (P poisoned (53.5%; P poisoned. Mean toxic lead concentrations (mg/kg wet weight) in the blood, liver, and kidney were 1.30 ± 1.70 (n = 301), 33.5 ± 80.5 (n = 172), and 56.3 ± 39.7 (n = 61). Mean normal lead concentrations in the blood, liver, and kidney were 0.036 ± 0.003 mg/kg (n= 1081), 0.16 ± 0.63 mg/kg (n = 382), and 0.41 ± 0.62 mg/kg (n = 64).

  1. [Radiographic and computed tomographic manifestations of chest in patients with acute chlorine gas poisoning].

    Science.gov (United States)

    Liu, Zhen-juan; Huang, De-jian; Wang, Zhong-qiu; Wang, Zheng-ge; Chang, Shuang-hui; Wu, Zheng-can

    2010-10-26

    To investigate the radiographic and computerized tomographic features of chest in patients with acute chlorine poisoning and its diagnostic value. Twenty-eight cases of chlorine poisoning were reviewed. And their radiographic and computerized tomographic features were compared and analyzed. Radiographic findings: among 28 patients, 9 cases were normal and 2 cases had no abnormalities on the first chest X-ray and became abnormal one or two days later. And there were abnormal findings in first chest X-ray in 17 patients:acute tracheal inflammation of peribronchitis (n = 3), acute chemical bronchopneumonia (n = 6) and diffuse interstitial and central pulmonary edema (n = 8). CT manifestations: At Days 1-3, the patients of mild poisoning had scattered patchy dense shadow; those of moderate to severe poisoning showed multiple patchy or diffuse infiltration (ground-glass opacity). And partial consolidation, air bronchogram and pleural effusion could be observed. At Days 4-10, the manifestations of mild poisoning were largely absorbed; those of moderate to severe poisoning manifested the absorption of diffuse or multiple patchy effusion and a fading of shadow. And the size of lung consolidation became smaller than before. At Day 10 after onset, 4 patients completely recovered. At Days 30-40, 6 cases showed traces of fibrous shadow and one case showed small punctiform opacities in both lungs. And at Day 42, there was slight ground-glass change. Acute chlorine gas poisoning in varying degrees may manifest acute bronchial pneumonia and acute pulmonary edema. During treatment, a series of chest X-ray examinations will help to follow the changes of disease. And CT examination can offer a more accurate evaluation of lung lesions.

  2. [Peripheral circulatory support in acute poisoning: 10 years' experience].

    Science.gov (United States)

    Baud, Frédéric; Lamhaut, Lionel; Jouffoy, Romain; Carli, Pierre

    2016-01-01

    Extracorporeal life support (ECLS) has become a common technique for treating refractory cardiogenic shock and cardiac arrest induced by drug overdose. The aim of this paper is to present our group's 10-year experience (2002-2012) using ECLS to treat drug-induced, refractory cardiogenic shock and cardiac arrest. We review 112 consecutive cases of acute poisoning requiring arteriovenous ECLS. We provided ECLS with a Rotaflow pump (Jostra-Maquette). In 71 cases (63%) the patient presented with refractory cardiac arrest; 41 (37%) presented with refractory cardiogenic shock. The dose ingested was very high in all cases. Survival was strongly related to presentation (cardiogenic shock vs cardiac arrest) and the type of drug taken. Survival was highest after overdoses of β-blockers and antiarrhythmic drugs and lowest after overdoses of chloroquine, colchicine, or verapamil. Survival rates were very low in the subgroup of patients presenting with cardiac arrest who had taken hypnotics or sedatives, suggesting that the heart stopped more because of anoxia than because of a direct cardiotoxic effect. In contrast, in cardiotoxic drug-induced cardiac arrest, the survival rate of 10% was significantly higher than the rate in non cardiotoxic arrests. Survival rates in drug-induced cardiogenic shock ranged from 45% to 100%. We conclude that ECLS should be considered for the management of cardiotoxic drug overdose. Close cardiovascular monitoring should be initiated if a patient has taken a particularly high dose of a cardiotoxic drug. Severe cardiotoxicity is rare but life threatening. The use of ECLS in these cases should be based on clinical criteria. Early use of ECLS in drug-induced cardiogenic shock significantly improves survival. Delays in applying ECLS in severe drug-induced cardiotoxicity-diagnosed based on type of drug, dose, and hemodynamic effects-can lead to cardiac arrest and a worse outcome.

  3. Acute pesticide poisoning outcomes: a nationwide study in Taiwan.

    Science.gov (United States)

    Chen, Chieh-Fan; Lin, Hsing-Lin; Chou, Huei-Yin; Hsu, Wen-Chi; Shi, Hon-Yi

    2015-03-01

    This study presents the findings of a nationwide study of acute pesticide poisoning (APP) outcomes, including outcome predictors such as physician and hospital volume and associated factors. This study of data contained in the Taiwan National Health Insurance Research Database analysed 27 046 patients who had been hospitalised for APP from January 1996 to December 2007. Patient characteristics were then compared among quartiles. The primary outcome measures were length of stay (LOS) and hospital treatment cost. Effect size (ES) was compared among three equally divided periods, and multiple regression models were used to identify outcome predictors. The overall prevalence of APP per 100 000 patients decreased from 12.43 in 1996 to 6.87 in 2007. The LOS for APP treatment was negatively associated with physician volume during the study period. Both LOS and hospital treatment cost were lowest in the high hospital volume subgroup. Comparisons of LOS and hospital treatment cost among the three periods showed that high-volume hospitals and high-volume physicians had better ESs compared to low-volume hospitals and low-volume physicians. Age and number of co-morbidities had significant positive associations with LOS, while admission year, male gender, hospital level, hospital volume and physician volume had significant negative associations with LOS (p<0.05). Hospital treatment cost and hospital level correlated positively with admission year, number of co-morbidities and LOS but correlated negatively with hospital volume and physician volume (p<0.05). In APP patients, treatment by a high-volume physician can reduce LOS and treatment cost. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  4. Acute Datura Stramonium poisoning in East of Iran - a case series.

    Science.gov (United States)

    Amini, Mahnaz; Khosrojerdi, Hamid; Afshari, Reza

    2012-01-01

    Datura Stramonium (DS) is a common weed along roadsides, in cornfields and pastures and in waste areas. It belongs to the family Solanaceae and its toxic components are tropane belladonna alkaloids. It has been used voluntarily by teenagers for its hallucinogenic effect. The plant is named in Iran as Tatoore. Symptoms and signs of acute D. Stramonium poisoning usually are similar to anticholinergic syndrome. This study is done in order to clarify the status of this poisoning in our region. This study is a case series on all patients admitted to Imam Reza Hospital, Mashhad, Iran, with acute D. Stramonium poisoning between 2008 and 2011. We observed their symptoms, signs, routine laboratory test results and treatment used to control their symptoms. There were 19 patients included in our study. Children were poisoned more commonly than teenagers and poisoning in adults was rare. All of the children ingested the plant accidentally. The most presenting symptom was irritability and the most common sign was sinus tachycardia. There was not any presentation of seizure or coma. Most of the symptoms were controlled by parenteral benzodiazepines and there were no need to use of cholinergic agents such as physostigmine. Our study showed most of D. Stramonium poisoned population in our region are children. We suggest decreasing accessibility to the plant in order to decrease the incidence of its poisoning.

  5. Acute Datura Stramonium poisoning in East of Iran - a case series

    Directory of Open Access Journals (Sweden)

    Mahnaz Amini

    2012-03-01

    Full Text Available Objectives: Datura Stramonium (DS is a common weed along roadsides, in cornfields and pastures and in waste areas. It belongs to the family Solanaceae and its toxic components are tropane belladonna alkaloids. It has been used voluntarily by teenagers for its hallucinogenic effect. The plant is named in Iran as Tatoore. Symptoms and signs of acute D. Stramonium poisoning usually are similar to anticholinergic syndrome. This study is done in order to clarify the status of this poisoning in our region. Materials and Methods: This study is a case series on all patients admitted to Imam Reza Hospital, Mashhad, Iran, with acute D. Stramonium poisoning between 2008 and 2011. We observed their symptoms, signs, routine laboratory test results and treatment used to control their symptoms. Results: There were 19 patients included in our study. Children were poisoned more commonly than teenagers and poisoning in adults was rare. All of the children ingested the plant accidentally. The most presenting symptom was irritability and the most common sign was sinus tachycardia. There was not any presentation of seizure or coma. Most of the symptoms were controlled by parenteral benzodiazepines and there were no need to use of cholinergic agents such as physostigmine. Conclusion: Our study showed most of D. Stramonium poisoned population in our region are children. We suggest decreasing accessibility to the plant in order to decrease the incidence of its poisoning.

  6. Analysis of 8000 hospital admissions for acute poisoning in a rural area of Sri Lanka

    DEFF Research Database (Denmark)

    van der Hoek, Wim; Konradsen, Flemming

    2006-01-01

    BACKGROUND: Acute poisoning, especially deliberate self-poisoning with agricultural pesticides, is an emerging global public health problem, but reliable incidence estimates are lacking. Only a few previous studies have assessed the impact of regulatory or other preventive measures. OBJECTIVE...... of the 1990s. The decline in mortality was attributed to regulatory controls for the group of highly hazardous organophosphorus compounds implemented in 1995 and for the organochlorine endosulfan in 1998. CONCLUSIONS: Regulatory control of highly toxic pesticides provides important health benefits, especially...

  7. An interesting cause of pulmonary emboli: Acute carbon monoxide poisoning

    Energy Technology Data Exchange (ETDEWEB)

    Sevinc, A.; Savli, H.; Atmaca, H. [Gaziantep University, Gaziantep (Turkey). School of Medicine

    2005-07-01

    Carbon monoxide poisoning, a public health problem of considerable significance, is a relatively frequent event today, resulting in thousands of hospitalizations annually. A 70-year-old lady was seen in the emergency department with a provisional diagnosis of carbon monoxide poisoning. The previous night, she slept in a tightly closed room heated with coal ember. She was found unconscious in the morning with poor ventilation. She had a rare presentation of popliteal vein thrombosis, pulmonary emboli, and possible tissue necrosis with carbon monoxide poisoning. Oxygen treatment with low-molecular-weight heparin (nadroparine) and warfarin therapy resulted in an improvement in both popliteal and pulmonary circulations. In conclusion, the presence of pulmonary emboli should be sought in patients with carbon monoxide poisoning.

  8. Acute Liver Failure Caused by Amanita phalloides Poisoning

    National Research Council Canada - National Science Library

    Santi, Luca; Maggioli, Caterina; Mastroroberto, Marianna; Tufoni, Manuel; Napoli, Lucia; Caraceni, Paolo

    2012-01-01

    ... and deadly cause of mushroom poisoning. Liver damage from Amanita phalloides is related to the amanitins, powerful toxins that inhibit RNA polymerase II resulting in a deficient protein synthesis and cell necrosis...

  9. Neurological Effects of Acute Carbon Monoxide Poisoning in Children

    OpenAIRE

    YARAR, Coskun

    2009-01-01

    Carbon monoxide poisoning (COP) is one of the most common causes of mortality and morbidity due to poisoning in all over the world. Although the incidence of COP has not been known exactly in the childhood, almost one-third of CO exposures occurred in children. The data regarding COP in children are inconclusive. Children may be more vulnerable to CO exposure than adults as a result of their high respiration and metabolic rates, high oxygen metabolism, and immature central nervous system. Rec...

  10. ACUTE POISONING WITH BENZODIAZEPINES AND OTHER HYPNOTICS: ETIOLOGIC CAUSE, SEX/AGE DISTRIBUTION AND CLINICAL OUTCOME

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    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.

  11. Medical treatment of acute poisoning with organophosphorus and carbamate pesticides.

    Science.gov (United States)

    Jokanović, Milan

    2009-10-28

    Organophosphorus compounds (OPs) are used as pesticides and developed as warfare nerve agents such as tabun, soman, sarin, VX and others. Exposure to even small amounts of an OP can be fatal and death is usually caused by respiratory failure. The mechanism of OP poisoning involves inhibition of acetylcholinesterase (AChE) leading to inactivation of the enzyme which has an important role in neurotransmission. AChE inhibition results in the accumulation of acetylcholine at cholinergic receptor sites, producing continuous stimulation of cholinergic fibers throughout the nervous systems. During more than five decades, pyridinium oximes have been developed as therapeutic agents used in the medical treatment of poisoning with OP. They act by reactivation of AChE inhibited by OP. However, they differ in their activity in poisoning with pesticides and warfare nerve agents and there is still no universal broad-spectrum oxime capable of protecting against all known OP. In spite of enormous efforts devoted to development of new pyridinium oximes as potential antidotes against poisoning with OP only four compounds so far have found its application in human medicine. Presently, a combination of an antimuscarinic agent, e.g. atropine, AChE reactivator such as one of the recommended pyridinium oximes (pralidoxime, trimedoxime, obidoxime and HI-6) and diazepam are used for the treatment of OP poisoning in humans. In this article the available data related to medical treatment of poisoning with OP pesticides are reviewed and the current recommendations are presented.

  12. Profile of Acute Poisoning Cases Treated in a Tertiary Care Hospital: a Study in Navi Mumbai

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    Amit Patil

    2014-03-01

    Full Text Available Background: Periodic epidemiological studies are necessary to understand the pattern of poisoning in each region. This study was designed to evaluate the pattern of acute poisoning cases treated in a tertiary care hospital in Navi Mumbai, India. Methods: This cross sectional study was conducted at Dr. D. Y. Patil Medical College, Hospital and Research Centre during July 2012 to July 2013. All cases of poisoning admitted to the hospital were included in this study. The patients’ data were obtained from medical records and were documented on a pre-structured proforma. Results: A total of 74 cases of acute poisoning were studied, of which 51.4% were men. Most of the patients aged 20 to 29 years (44.6%. In majority of cases, the route of exposure to poison was oral (86.5%. Most of the patients reside in urban areas (52.7%. Most of the patients were Hindus (85.1% followed by Muslims (14.9%. The exposure mostly occurred between 6:00 pm to 12:00 am (30% of cases. The majority of poisonings (44.6% was due to consumption of household products followed by pesticides (14.9% and pharmaceutical agents (13.5%. Neurologic manifestations were the most common clinical findings (64.8% followed by gastrointestinal manifestations (37%. All patients were treated successfully with no mortality. There was a significant correlation between gender and intention of poisoning (P < 0.001, as the suicidal attempts were higher in women (69.4%. Moreover, a significant relationship existed between marital status and intention of poisoning (P = 0.016 as the suicidal poisonings were most common among married individuals (45.7%.  Conclusion:The trend in poisoning is never static. Household products were identified as the main cause of poisoning in urban areas of India. Educational programs with more emphasis on preventive measures are necessary to create awareness among the general public.   How to cite this article: Patil A, Peddawad R, Verma VCS, Gandhi H. Profile of Acute

  13. Correction of Oxygen Transport and Metabolic Disturbances in Acute Poisoning by Neurotropic Substances

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    G. A. Livanov

    2007-01-01

    Full Text Available Objective: to examine the capacities of pharmacological correction of impairments in oxygen-transporting systems and metabolic processes with perfluorane and cytoflavin in critically ill patients with acute intoxication with neurotropic poisons.Subjects and methods. Metabolic sequels of severe hypoxia, free radical processes, and endogenous intoxications were studied in 62 patients with the severest acute intoxication with neurotropic poisons.Results. The studies have established that hypoxia and metabolic changes lead to the development of endotoxicosis. Intensifying endotoxicosis in turn enhances hypoxic lesion. Thus, the major task of intensive care is to restore oxygen delivery and to diminish metabolic disturbances and endotoxicosis. Ways of correcting hypoxia and metabolic disturbances are considered in the severe forms of acute poisoning

  14. An unusual case of reversible acute kidney injury due to chlorine dioxide poisoning.

    Science.gov (United States)

    Bathina, Gangadhar; Yadla, Manjusha; Burri, Srikanth; Enganti, Rama; Prasad Ch, Rajendra; Deshpande, Pradeep; Ch, Ramesh; Prayaga, Aruna; Uppin, Megha

    2013-09-01

    Chlorine dioxide is a commonly used water disinfectant. Toxicity of chlorine dioxide and its metabolites is rare. In experimental studies, it was shown that acute and chronic toxicity were associated with insignificant hematological changes. Acute kidney injury due to chlorine dioxide was not reported. Two cases of renal toxicity due to its metabolites, chlorate and chlorite were reported. Herein, we report a case of chlorine dioxide poisoning presenting with acute kidney injury.

  15. Successful Treatment of Severe Metabolic Acidosis Due to Acute Aluminum Phosphide Poisoning With Peritoneal Dialysis: a Report of 2 Cases.

    Science.gov (United States)

    Bashardoust, Bahman; Farzaneh, Esmaeil; Habibzadeh, Afshin; Seyyed Sadeghi, Mir Salim

    2017-03-01

    Aluminum phosphide poisoning is common in our region. It can cause severe metabolic acidosis and persistent hypotension, which lead to cardiogenic shock and subsequently mortality. Oliguric or anuric acute kidney injury is seen in almost all patients with aluminum phosphide poisoning. Renal replacement therapies are recommended in these patients to improve metabolic acidosis and increase the rate of survival. We report 2 cases of severe acute aluminum phosphide poisoning treated successfully with peritoneal dialysis.

  16. Awareness, among primary health care physicians, of acute cyanide poisoning being a possible consequence of fire accidents

    OpenAIRE

    Sood, R S; Khandalkar, S; Sood, A.

    2016-01-01

    Objectives: To discern the degree of awareness amongst the primary health care physicians about the fact that cyanide poisoning is a possible consequence of fire accidents.Methods: Using an anonymous questionnaire, thirty allopath primary health care physicians were tested for awareness of acute cyanide poisoning being a possible consequence of fire accidents.Results: Only one (3%) of the physicians was aware of the possibility of Acute cyanide poisoning due to fire accidents.Conclusions: We ...

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

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    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.

  18. Acute liver failure caused by mushroom poisoning: a case report and review of the literature

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    Erden A

    2013-11-01

    Full Text Available Abdulsamet Erden,1 Kübra Esmeray,1 Hatice Karagöz,1 Samet Karahan,1 Hasan Hüseyin Gümüsçü,1 Mustafa Basak,1 Ali Çetinkaya,1 Deniz Avci,1 Orhan Kürsat Poyrazoğlu2 1Internal Medicine Department, 2Gastroenterology Department, Kayseri Training and Research Hospital, Kayseri, Turkey Abstract: It is estimated that there are over 5,000 species of mushrooms worldwide. Some of them are edible and some are poisonous due to containing significant toxins. In more than 95% of mushroom toxicity cases, poisoning occurs as a result of misidentification of the mushroom by an amateur mushroom hunter. The severity of mushroom poisoning may vary, depending on the geographic location where the mushroom is grown, growth conditions, the amount of toxin delivered, and the genetic characteristics of the mushroom. Amanita phalloides is the most common and fatal cause of mushroom poisoning. This mushroom contains amanitins, which are powerful hepatotoxins that inhibit RNA polymerase II in liver. Mushroom poisoning is a relatively rare cause of acute liver failure. A 63-year-old male patient was admitted to the emergency room with weakness, nausea, vomiting, and diarrhea. He reported ingesting several wild mushrooms about 36 hours earlier. In this article we report a case of lethal Amanita phalloides intoxication from stored mushrooms. Keywords: acute liver failure, Amanita phalloides, mushroom, poisoning

  19. Cost-effectiveness of hospital treatment and outcomes of acute methanol poisoning during the Czech Republic mass poisoning outbreak.

    Science.gov (United States)

    Rulisek, Jan; Balik, Martin; Polak, Ferdinand; Waldauf, Petr; Pelclova, Daniela; Belohlavek, Jan; Zakharov, Sergey

    2017-06-01

    During an outbreak of mass methanol poisoning in the Czech Republic in 2012-2014, we compared the total hospital costs and one-year medical costs in the patients treated with different antidotes (fomepizole versus ethanol) and modalities of hemodialysis (intermittent hemodialysis, IHD, versus continuous renal replacement therapy, CRRT). Cross-sectional study in 106 patients with confirmed diagnosis treated in 30 ICU settings. For each patient, the following data were analyzed: admission laboratory data, GCS, PSS, ICU length of stay, organ failures, treatment, outcome, and total hospital costs. Of 83 survivors, in 54 (65%) patients the follow-up examination, quality of life measurement with SF36 questionnaire two years after discharge, and one-year medical costs analysis were performed. The median total hospital costs were 7200 (IQR 1500-10,900) euros and the median one-year medical costs were 1447 (IQR 133-1163) euros in the study population. The total hospital costs were higher in the patients treated with fomepizole comparing to ethanol: 12,890 (IQR 6910-16,210) versus 5590 (IQR 1430-6940) euros (p0.05). The total hospital costs in the patients with acute methanol poisoning were more than three times higher in the patients treated with fomepizole than in the patients treated with ethanol after adjustment for the severity of poisoning. The dialysis modality did not affect the total hospital costs, but the trend to lower costs was present in IHD-group. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Toxicological Investigation of Acute Cyanide Poisoning Cases: Report of Four Cases

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    Humera Shafi

    2015-12-01

    Full Text Available Cyanide is a deadly poison. Acute cyanide poisoning in humans is rare and is predominantly caused by smoke inhalation from fires and much more rarely by intentional ingestion of cyanide salts as in suicide or homicide attempts. The main objective of this report is to emphasize the need to consider cyanide poisoning, even if it is rare, in differential diagnosis while evaluating cases of sudden death and the significance of gastric content analysis in acute poisoning cases. The authors reported four cases of lethal cyanide poisoning. Autopsy specimens were submitted to the author’s laboratory for analysis. A presumptive test for cyanide using Vitamin B12 indicated the presence of cyanide. Confirmation and quantification of cyanide was performed using headspace gas chromatograph coupled to flame ionization detector technique. The toxicological analysis revealed lethal hydrogen cyanide concentrations in all postmortem specimens ranging from 24 to 2600 mg/L in gastric contents, 70 to 282 mg/kg in liver specimens, 11 to 12 mg/kg in a mixture of viscera (liver, spleen, kidney and 15 mg/L in blood. The cause of deaths in the reported cases was acute respiratory failure and cardiac arrest following cyanide intoxication.

  1. Secondary poisoning of cadmium, copper and mercury: implications for the Maximum Permissible Concentrations and Negligible Concentrations in water, sediment and soil

    NARCIS (Netherlands)

    Smit CE; Wezel AP van; Jager T; Traas TP; CSR

    2000-01-01

    The impact of secondary poisoning on the Maximum Permissible Concentrations (MPCs) and Negligible Concentrations (NCs) of cadmium, copper and mercury in water, sediment and soil have been evaluated. Field data on accumulation of these elements by fish, mussels and earthworms were used to derive

  2. Reversible brain damage following acute organic solvents' poisoning determined by magnetic resonance

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    Dujmović Irena

    2005-01-01

    Full Text Available Introduction. Acute exposure to the effects of volatile solvents is characterized by the abrupt onset of symptoms and signs of poisoning, and relatively fast recovery in the majority of cases. Case report. We report a 24-year-old patient with an acute, accidental poisoning with a mixture of volatile organic solvents (most probably toluene, styrene and xylene, which led to the development of upward gaze paresis, diplopia, hemiparesis, ataxic gate, and the late onset truncal ataxia episodes. After 6 weeks, he recovered completely, while his extensive brain MRI lesions in the caudate nuclei, laterobasal putaminal regions, bilateral anterior insular cortex, central midbrain tegmental area withdrew completely after 4 months. Conclusion. Acute toxic encephalopathy should be a part of the differential diagnosis in any patient with acute neurobehavioral and neurological deficit.

  3. [The effects of ethanol on the evolution of the acute benzodiazepine poisoning].

    Science.gov (United States)

    Puha, Gabriela; Hurjui, J; Lupuşoru, Cătălina Elena; Sorodoc, L

    2011-01-01

    The depressing effects on the nervous central system (NCS) induced by benzodiazepines and ethanol are similar. The complications are rare in the benzodiazepine poisoning, but are a lot more frequent in association with other depressing drugs for the NCS (especially alcohol). We analyzed retrospectively patients with benzodiazepine poisoning admitted in the Internal Medicine Clinic - Toxicology during 2003 - 2009.The study attempted a complex evaluation of the consequences of acute and chronic alcoholism on the evolution of acute benzodiazepinepoisoning and the description of the clinic evolution and paraclinical particularities of the patients under investigation. 343 patients with benzodiazepine poisoning were admitted, 150 were tested through measurement of alcohol level, leading to values between 1 - 415 mg/dl. Chronic alcoholism in personal pathological antecedents of the patients determined a relative risk of intoxication 1.46 times higher. The hospitalization period varied from 1 to 8 days for patients with chronic alcoholism and from 1 to 14 days for patients with acute alcoholism, a statistically important difference. During the period under investigation, from the total of patients admitted for acute benzodiazepine poisoning, 2 deaths were registered. Of the two deaths, one patient showed ethanol coingestion.

  4. [Dynamics of blood gases and acid-base balance in patients with carbon monoxide acute poisoning].

    Science.gov (United States)

    Polozova, E V; Shilov, V V; Bogachova, A S; Davydova, E V

    2015-01-01

    Evaluation of blood gases and acid-base balance covered patients with carbon monoxide acute poisoning, in accordance with inhalation trauma presence. Evidence is that thermochemical injury of respiratory tract induced severe acid-base dysbalance remaining decompensated for a long time despite the treatment.

  5. Acute pesticide poisoning among female and male cotton growers in India

    NARCIS (Netherlands)

    Mancini, F.; Bruggen, van A.H.C.; Jiggins, J.L.S.; Ambatipudi, A.C.; Murphy, H.

    2005-01-01

    A season-long assessment of acute pesticide poisoning among farmers was conducted in three villages in India. Fifty female cotton growers reported the adverse effects experienced after exposures to pesticides by themselves and by their male relatives (n = 47). The study documented the serious

  6. An Unusual Case of Acute Psychosis With Obsessive-Compulsive Features Following Arsenic Poisoning.

    Science.gov (United States)

    Wu, Hanjing E; Abdel-Gawad, Noha M; Gharbaoui, Yasmine; Teixeira, Antonio L; Pigott, Teresa A

    2017-09-01

    Arsenic exposure, particularly the chronic type, can lead to poisoning with manifestations presenting in multiple organ systems. However, acute psychosis is not a commonly described manifestation of arsenic exposure. In this report, we present the case of a patient who developed acute psychosis with hallucinations, disorganized thinking, and obsessive-compulsive symptoms following chronic occupational arsenic exposure. The patient was treated with the combination of an antipsychotic and an antidepressant and he responded well with significant improvement in both the acute psychosis and obsessive-compulsive symptoms. The authors concluded that patients can develop atypical symptoms, including acute psychosis, following arsenic poisoning. In the case described in this report, the patient also presented with a new onset of obsessive-compulsive symptoms. Given this rare manifestation of arsenic poisoning for which there is no clearly defined treatment regimen, this case suggests that the use of a combination of an antipsychotic and an antidepressant may be considered in the rare event of psychosis with obsessive-compulsive features following arsenic poisoning.

  7. Evaluation of cardiac autonomic function using heart rate variability in children with acute carbon monoxide poisoning.

    Science.gov (United States)

    Vural, Cagdas; Dinleyici, Ener Cagri; Kosger, Pelin; Bolluk, Ozge; Kilic, Zubeyir; Ucar, Birsen

    2017-11-01

    Introduction Carbon monoxide poisoning may cause myocardial toxicity and cardiac autonomic dysfunction, which may contribute to the development of life-threatening arrhythmias. We investigated the potential association between acute carbon monoxide exposure and cardiac autonomic function measured by heart rate variability. The present study included 40 children aged 1-17 years who were admitted to the Pediatric Intensive Care Unit with acute carbon monoxide poisoning and 40 healthy age- and sex-matched controls. Carboxyhaemoglobin and cardiac enzymes were measured at admission. Electrocardiography was performed on admission and discharge, and 24-hour Holter electrocardiography was digitally recorded. Heart rate variability was analysed at both time points - 24-hour recordings - and frequency domains - from the first 5 minutes of intensive care unit admission. Time domain and frequency indices such as high-frequency spectral power and low-frequency spectral power were similar between patient and control groups (p>0.05). The ratio of low-frequency spectral power to high-frequency spectral power was significantly lower in the carbon monoxide poisoning group (pcarbon monoxide poisoning group (pcarbon monoxide poisoning group compared with controls on discharge (p<0.05). The frequency domain indices, especially the ratio of low-frequency spectral power to high-frequency spectral power, are useful for the evaluation of the cardiac autonomic function. The decreased low-frequency spectral power-to-high-frequency spectral power ratio reflects a balance of the autonomic nervous system, which shifted to parasympathetic components.

  8. Mercury Exposure and Children’s Health

    Science.gov (United States)

    Bose-O’Reilly, Stephan; McCarty, Kathleen M.; Steckling, Nadine; Lettmeier, Beate

    2011-01-01

    Acute or chronic mercury exposure can cause adverse effects during any period of development. Mercury is a highly toxic element; there is no known safe level of exposure. Ideally, neither children nor adults should have any mercury in their bodies because it provides no physiological benefit. Prenatal and postnatal mercury exposures occur frequently in many different ways. Pediatricians, nurses, and other health care providers should understand the scope of mercury exposures and health problems among children and be prepared to handle mercury exposures in medical practice. Prevention is the key to reducing mercury poisoning. Mercury exists in different chemical forms: elemental (or metallic), inorganic, and organic (methylmercury and ethyl mercury). Mercury exposure can cause acute and chronic intoxication at low levels of exposure. Mercury is neuro-, nephro-, and immunotoxic. The development of the child in utero and early in life is at particular risk. Mercury is ubiquitous and persistent. Mercury is a global pollutant, bio-accumulating, mainly through the aquatic food chain, resulting in a serious health hazard for children. This article provides an extensive review of mercury exposure and children’s health. PMID:20816346

  9. N-acetylcysteine in Acute Organophosphorus Pesticide Poisoning: A Randomized, Clinical Trial.

    Science.gov (United States)

    El-Ebiary, Ahmad A; Elsharkawy, Rasha E; Soliman, Nema A; Soliman, Mohammed A; Hashem, Ahmed A

    2016-08-01

    Organophosphorus poisoning is a major global health problem with hundreds of thousands of deaths each year. Research interest in N-acetylcysteine has grown among increasing evidence of the role of oxidative stress in organophosphorus poisoning. We aimed to assess the safety and efficacy of N-acetylcysteine as an adjuvant treatment in patients with acute organophosphorus poisoning. This was a randomized, controlled, parallel-group trial on 30 patients suffering from acute organophosphorus poisoning, who were admitted to the Poison Control Center of Tanta University Emergency Hospital, Tanta, Egypt, between April and September 2014. Interventions included oral N-acetylcysteine (600 mg three times daily for 3 days) as an added treatment to the conventional measures versus only the conventional treatment. Outcome measures included mortality, total dose of atropine administered, duration of hospitalization and the need for ICU admission and/or mechanical ventilation. A total of 46 patients were screened and 30 were randomized. No significant difference was found between both groups regarding demographic characteristics and the nature or severity of baseline clinical manifestations. No major adverse effects to N-acetylcysteine therapy were reported. Malondialdehyde significantly decreased and reduced glutathione significantly increased only in the NAC-treated patients. The patients on NAC therapy required less atropine doses than those who received only the conventional treatment; however, the length of hospital stay showed no significant difference between both groups. The study concluded that the use of N-acetylcysteine as an added treatment was apparently safe, and it reduced atropine requirements in patients with acute organophosphorus pesticide poisoning. © 2016 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

  10. Translational toxicological research: investigating and preventing acute lung injury in organophosphorus insecticide poisoning.

    Science.gov (United States)

    Hulse, Elspeth J; Clutton, R E; Drummond, G; Eddleston, M

    2014-06-01

    Poisoning through ingestion of organophosphorus (OP) insecticide is a leading cause of suicide globally. Severe poisoning with OP compounds creates an unconscious, paralysed patient with respiratory failure. These symptoms make pulmonary aspiration of stomach contents highly likely, potentially causing an acute lung injury. To explore this hypothesis, we created a Gottingen minipig pulmonary aspiration model (n=26) to investigate the mechanism and severity of lung injury created through pulmonary instillation of 0.5 mL/kg mixtures of porcine gastric juice (GJ), OP and/or its solvent. Early results show that aspiration of OP and GJ causes pulmonary neutrophil sequestration, alveolar haemorrhage and interstitial oedema, with disruption of the alveolar-capillary membrane. Further measurements will include quantitative CT imaging, histopathology scoring, acute lung injury biomarkers and respiratory function. In order to test the validity of the minipig model, a pilot study in Sri Lanka has been devised to observe signs of lung injury in human patients who have ingested OP insecticide with or without clinical evidence of pulmonary aspiration. Lung injury will be assessed with PaO2/FIO2 ratios and physiological dead space measurement. Blood, bronchoalveolar lavage and urine will be taken at 24 and 48 h after poisoning and at 3-4 h in surgical control patients to measure acute lung injury biomarkers. An unpublished toxicology study from Sri Lanka, 2011-2012, showed that over 40% of unconscious poisoned patients with a GCS poisoned patients. We hypothesise that non-drug assisted placement of supraglottic airways may be a good tool for use in unconscious poisoned patients requiring transfer from small rural hospitals in Asia. They could confer better airway protection than no airway intervention and reduce both morbidity and mortality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. Total mercury in fruiting bodies and underlying soil substrate of Poison Pax Paxillus involutus (Batsch Ex. Fr.) Fr. from various sites in Poland

    Science.gov (United States)

    Brzostowski, A.; Falandysz, J.

    2003-05-01

    The total mercury concentrations were quantified in the caps, stalks and underlying soil substrate of Poison Pax Paxillus involutus collected from 19 spatially distant sites in Poland in 1994-2001 to examine the status of mercury pollution, bioconcentration features as well as bioindication potential of this mushroom species. The mushroom and soil samples were collected from the Mierzeja Wiślana Landscape Park, Wdzydzki Landscape Park, Zaborski Landscape Park, Augustów Forests, Borecka Forests, Wieluńska Upland, Darżlubska Forest, Tucholskie Forest and the counties of Gubin. Kościerzyna, Morag, Koszalin, Gdańsk, Bydgoszcz, Kętrzyn, Żuromin, Włocławek, and Starachowice. The mean concentrations of mercury varied, depending on the sampling site, between 15±9 and 410±200 ng/g dry matter for caps and between 14±26 and 200±130 ng/g dry matter for stalks, The mean soil mercury concentrations varied between 8.8±4.5 and 95±84 ng/g. The mean mercury concentration cap to stalk quotients varied between O.6±0.2 and 1.9±1.5, with exception of the site Morag with 4.4±7.2. The mean values of bioconcentration factor of mercury in caps and stalks of Poison Pax varied in relatively narrow range between 0.7 and 10, and 0.5 and 8.5, respectively.

  12. Early Biochemical Effects of an Organic Mercury Fungicide on Infants: ``Dose Makes the Poison''

    Science.gov (United States)

    Gotelli, Carlos A.; Astolfi, Emilio; Cox, Christopher; Cernichiari, Elsa; Clarkson, Thomas W.

    1985-02-01

    Phenylmercury absorbed through the skin from contaminated diapers affected urinary excretion in infants in Buenos Aires. The effects were reversible and quantitatively related to the concentration of urinary mercury. Excretion of γ -glutamyl transpeptidase, an enzyme in the brush borders of renal tubular cells, increased in a dose-dependent manner when mercury excretion exceeded a ``threshold'' value. Urine volume also increased but at a higher threshold with respect to mercury. The results support the threshold concept of the systemic toxicity of metals. γ -Glutamyl transpeptidase is a useful and sensitive marker for preclinical effects of toxic metals.

  13. Water Balance Estimation in Patients with Acute Poisonings due to Psychotropic Agents

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    K. K. Ilyashenko

    2010-01-01

    Full Text Available Objective: to develop a procedure for an integrated assessment of changes in body hydration, by using the polyseg-mental bioimpedance analysis (PBIA of the body’s water sectors. Subjects and methods. The volumes of cellular and extracellular fluids in various body regions were estimated in 85 patients with acute poisonings by psychotropic agents, by employing the PBIA over time within three days and when the impact of various treatment options on them was evaluated. An ABC-01 MEDASS device with ABC043 software was applied. Results. The study ascertained that the changes in the volumes of extracellular and cellular fluids in the upper trunk, namely progressive extracellular fluid accumulation, are the most informative parameters for disease prognosis. On this basis, the authors proposed a formula to calculate the integral hydration index (IHI and showed its informative value when used in patients with acute poisonings due to psychotropic agents during remedial measures. Conclusion. The IHI developed on the basis of estimation of abnormal cellular and extracellular fluid volumes in patients with poisonings by psychotropic agents is sensitive and striking in the evaluation of water imbalance in patients under resuscitation and allows the detected disorders to be efficiently corrected. Key words: acute poisonings, water balance, extracellular and cellular fluid, index, hydration index.

  14. Lead Poisoning Can Be Easily Misdiagnosed as Acute Porphyria and Nonspecific Abdominal Pain.

    Science.gov (United States)

    Tsai, Ming-Ta; Huang, Shi-Yu; Cheng, Shih-Yu

    2017-01-01

    Lead poisoning (LP) is less commonly encountered in emergency departments (ED). However, lead exposure still occurs, and new sources of poisoning have emerged. LP often goes unrecognized due to a low index of suspicion and nonspecific symptoms. We present a case of a 48-year-old man who had recurring abdominal pain with anemia that was misdiagnosed. His condition was initially diagnosed as nonspecific abdominal pain and acute porphyria. Acute porphyria-like symptoms with a positive urine porphyrin test result led to the misdiagnosis; testing for heme precursors in urine is the key to the differential diagnosis between LP and acute porphyria. The final definitive diagnosis of lead toxicity was confirmed based on high blood lead levels after detailed medical history taking. The lead poisoning was caused by traditional Chinese herbal pills. The abdominal pain disappeared after a course of chelating treatment. The triad for the diagnosis of lead poisoning should be a history of medicine intake, anemia with basophilic stippling, and recurrent abdominal pain.

  15. Clonidine as an adjuvant in the management of acute poisoning by anticholinesterase pesticides.

    Science.gov (United States)

    El-Ebiary, A A; Gad, S A; Wahdan, A A; El-Mehallawi, I H

    2016-04-01

    Anticholinesterase pesticides are widely used in agriculture and domestic settings throughout the world, and they are responsible for great morbidity and mortality. In Egypt and other developing countries, there is a pressing need for new affordable antidotes to treat anticholinesterase pesticide poisoning. Hence, this study was conducted to evaluate the safety and effectiveness of moderate doses of clonidine in the management of adult patients with acute anticholinesterase pesticide poisoning. This study was an open-label, phase II pilot clinical trial. Sixty patients with acute anticholinesterase pesticide poisoning gave consent to participate in the study. They were divided into 2 equal groups, with 30 patients in each group. Group I received clonidine plus the routine treatment, while group II received only the routine treatment. Patients were subjected to full history taking, and their vital and clinical data were recorded. Serum cholinesterase levels and routine laboratory investigations were measured. The different outcomes of the patients were assessed. The baseline characteristics of both groups were similar. Thirteen (43.3%) patients developed significant hypotension during clonidine treatment. The clinical outcomes (including mortality, need for assisted ventilation, length of hospital stay, and total doses of atropine) showed no significant differences between the two groups. The use of clonidine in acute anticholinesterase pesticide poisoning may be associated with a high incidence of hypotension requiring intervention. The clinical outcomes may not significantly improve in clonidine-treated patients. © The Author(s) 2015.

  16. Lead Poisoning Can Be Easily Misdiagnosed as Acute Porphyria and Nonspecific Abdominal Pain

    Directory of Open Access Journals (Sweden)

    Ming-Ta Tsai

    2017-01-01

    Full Text Available Lead poisoning (LP is less commonly encountered in emergency departments (ED. However, lead exposure still occurs, and new sources of poisoning have emerged. LP often goes unrecognized due to a low index of suspicion and nonspecific symptoms. We present a case of a 48-year-old man who had recurring abdominal pain with anemia that was misdiagnosed. His condition was initially diagnosed as nonspecific abdominal pain and acute porphyria. Acute porphyria-like symptoms with a positive urine porphyrin test result led to the misdiagnosis; testing for heme precursors in urine is the key to the differential diagnosis between LP and acute porphyria. The final definitive diagnosis of lead toxicity was confirmed based on high blood lead levels after detailed medical history taking. The lead poisoning was caused by traditional Chinese herbal pills. The abdominal pain disappeared after a course of chelating treatment. The triad for the diagnosis of lead poisoning should be a history of medicine intake, anemia with basophilic stippling, and recurrent abdominal pain.

  17. Acute ammonium dichromate poisoning in a 2 year-old child.

    Science.gov (United States)

    Sunilkumar, Menon Narayanankutty; Ajith, Thekkuttuparambil Ananthanarayanan; Parvathy, Vadakut Krishnan

    2014-11-01

    Hexavalent chromium compounds are most commonly used in printing, dyeing, plastics and rayon manufacturing. Poisoning in children by ammonium dichromate, an odorless and bright orange-red crystal, are rarely reported. Acute poisoning will result in death due to multi-organ failure. The target organs that are affected by this poison are the respiratory system, kidneys, liver, eyes and skin. On ingestion, initially there is a relative lack of severe symptoms and signs. Hence, the delay in seeking medical attention could lead to the increased rate of mortality. In this case study, we report the ingestion of ammonium dichromate by a child. Despite appropriate management, such as hepatic supportive measures and plasma transfusion, the toxicity progressed to multi-organ failure and death.

  18. Acute liver failure caused by mushroom poisoning: a case report and review of the literature

    Science.gov (United States)

    Erden, Abdulsamet; Esmeray, Kübra; Karagöz, Hatice; Karahan, Samet; Gümüşçü, Hasan Hüseyin; Başak, Mustafa; Çetinkaya, Ali; Avcı, Deniz; Poyrazoğlu, Orhan Kürşat

    2013-01-01

    It is estimated that there are over 5,000 species of mushrooms worldwide. Some of them are edible and some are poisonous due to containing significant toxins. In more than 95% of mushroom toxicity cases, poisoning occurs as a result of misidentification of the mushroom by an amateur mushroom hunter. The severity of mushroom poisoning may vary, depending on the geographic location where the mushroom is grown, growth conditions, the amount of toxin delivered, and the genetic characteristics of the mushroom. Amanita phalloides is the most common and fatal cause of mushroom poisoning. This mushroom contains amanitins, which are powerful hepatotoxins that inhibit RNA polymerase II in liver. Mushroom poisoning is a relatively rare cause of acute liver failure. A 63-year-old male patient was admitted to the emergency room with weakness, nausea, vomiting, and diarrhea. He reported ingesting several wild mushrooms about 36 hours earlier. In this article we report a case of lethal Amanita phalloides intoxication from stored mushrooms. PMID:24294010

  19. Acute Pesticide Poisoning in Children: Hospital Review in Selected Hospitals of Tanzania

    Directory of Open Access Journals (Sweden)

    Elikana Lekei

    2017-01-01

    Full Text Available Background. Acute pesticide poisoning (APP is a serious problem worldwide. Because the burden of childhood APP is unknown in Tanzania, this study describes the distribution, circumstances, and patterns of APP involving children under 18 years in Tanzania. Methodology. A 12-month prospective study was conducted in 10 Tanzanian healthcare facilities in 2006 using a data collection tool for surveillance. Results. Of 53 childhood poisoning cases identified, 56.6% were female. The most common poisoning circumstances were accidents (49.1% and suicide (30.2%. The most vulnerable children were 16-17 years old (30.2%. Suicide was significantly more common in females (PRR females/males = 1.66; 95% CI = 1.03–2.68 and accidental cases were more common in children aged 10 years or younger. Suicide was concentrated in children over 10 years, comprising 53% of cases in this age group. Organophosphates (OPs, zinc phosphide, and endosulfan were common amongst reported poisoning agents. The annual APP incidence rate was 1.61/100,000. Conclusion. APP is common among children in this region of Tanzania. Prevention of suicide in older children should address mental health issues and control access to toxic pesticides. Prevention of accidents in younger children requires safer storage and hygiene measures. Diverse interventions are needed to reduce pesticide poisoning among children in Tanzania.

  20. Ulinastatin suppresses endoplasmic reticulum stress and apoptosis in the hippocampus of rats with acute paraquat poisoning

    Directory of Open Access Journals (Sweden)

    Hai-feng Li

    2015-01-01

    Full Text Available Lung injury is the main manifestation of paraquat poisoning. Few studies have addressed brain damage after paraquat poisoning. Ulinastatin is a protease inhibitor that can effectively stabilize lysosomal membranes, prevent cell damage, and reduce the production of free radicals. This study assumed that ulinastatin would exert these effects on brain tissues that had been poisoned with paraquat. Rat models of paraquat poisoning were intraperitoneally injected with ulinastatin. Simultaneously, rats in the control group were administered normal saline. Hematoxylin-eosin staining showed that most hippocampal cells were contracted and nucleoli had disappeared in the paraquat group. Fewer cells in the hippocampus were concentrated and nucleoli had disappeared in the ulinastatin group. Western blot assay showed that expressions of GRP78 and cleaved-caspase-3 were significantly lower in the ulinastatin group than in the paraquat group. Immunohistochemical findings showed that CHOP immunoreactivity was significantly lower in the ulinastatin group than in the paraquat group. Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling staining showed that the number of apoptotic cells was reduced in the paraquat and ulinastatin groups. These data confirmed that endoplasmic reticular stress can be induced by acute paraquat poisoning. Ulinastatin can effectively inhibit this stress as well as cell apoptosis, thereby exerting a neuroprotective effect.

  1. Acute liver failure caused by mushroom poisoning: a case report and review of the literature.

    Science.gov (United States)

    Erden, Abdulsamet; Esmeray, Kübra; Karagöz, Hatice; Karahan, Samet; Gümüşçü, Hasan Hüseyin; Başak, Mustafa; Cetinkaya, Ali; Avcı, Deniz; Poyrazoğlu, Orhan Kürşat

    2013-01-01

    It is estimated that there are over 5,000 species of mushrooms worldwide. Some of them are edible and some are poisonous due to containing significant toxins. In more than 95% of mushroom toxicity cases, poisoning occurs as a result of misidentification of the mushroom by an amateur mushroom hunter. The severity of mushroom poisoning may vary, depending on the geographic location where the mushroom is grown, growth conditions, the amount of toxin delivered, and the genetic characteristics of the mushroom. Amanita phalloides is the most common and fatal cause of mushroom poisoning. This mushroom contains amanitins, which are powerful hepatotoxins that inhibit RNA polymerase II in liver. Mushroom poisoning is a relatively rare cause of acute liver failure. A 63-year-old male patient was admitted to the emergency room with weakness, nausea, vomiting, and diarrhea. He reported ingesting several wild mushrooms about 36 hours earlier. In this article we report a case of lethal Amanita phalloides intoxication from stored mushrooms.

  2. [Epidemiological study of acute poisoning cases treated at a Galician hospital between 2005 and 2008].

    Science.gov (United States)

    de Miguel-Bouzas, José Carlos; Castro-Tubío, Eva; Bermejo-Barrera, Ana María; Fernández-Gómez, Purificación; Estévez-Núñez, Juan Carlos; Tabernero-Duque, María Jesús

    2012-01-01

    A descriptive retrospective study of acute intoxication cases registered at the Complexo Hospitalario de Pontevedra (CHOP) between January 2005 and December 2008 was performed to find out the number and types of poisoning cases treated, their distribution according to patient's sex and age, chronology, type of toxic agents involved, intentionality, history, symptoms, clinical development, treatment and toxicological analysis used for diagnosis. Data were recorded using Clinica and IANUS software and consulting all paper records of patients with symptoms of poisoning. Data from a total of 1893 patients with a mean age of 35.6 ± 17.6 years (66% men) were included. Highest rates of poisoning were recorded on Saturdays and Sundays during the summer months (June, July and August). Drugs of abuse were the most common toxic agents (70.4%), ethyl alcohol accounting for 61% of these cases, which often involved males and with people with high degrees of dependency. In second place was poisoning resulting from the abuse of medical drugs, more commonly associated with females, and involving benzodiazepines in 73.2% of cases. The majority of these intoxications were intentional, and suicide attempts accounted for 18.8%. The problems most commonly resulting from the poisoning were neurological, and mortality rate was just 0.2%.

  3. Mercury

    Science.gov (United States)

    Mercury is an element that is found in air, water and soil. It has several forms. Metallic mercury is a shiny, silver-white, odorless liquid. If ... with other elements to form powders or crystals. Mercury is in many products. Metallic mercury is used ...

  4. Anticholinesterase poisoning of birds: Field monitoring and diagnosis of acute poisoning

    Science.gov (United States)

    Hill, E.F.; Fleming, W.J.

    1982-01-01

    Organophosphorus and carbamate pesticides are cholinesterase (ChE) inhibiting chemicals that have been responsible for avian die-offs. Identification of chemicals implicated in these die-offs is difficult and sometimes conclusions are solely circumstantial. However, when marked depression (inhibition) of brain ChE activity accompanies organophosphorus or carbamate residues in body tissues or ingesta, cause-effect diagnosis is enhanced. To achieve this end, normal brain ChE activity is estimated for controls of the affected species and then die-off specimens are individually evaluated for evidence of ChE inhibition. This approach to evaluation of antiChE poisoning may also be used to monitor exposure of vertebrates to field application of organophosphorus or carbamate pesticides. Problems associated with this kind of evaluation, and the main topic of this report, include variability of brain ChE activity among species, postmortem influences of ambient conditions (storage or field) on ChE activity, and differential patterns of ChE activity when inhibited by organophosphorus or carbamate compounds. Other topics discussed are the ChE assay procedure, example case reports and interpretation, and research needed for improving the diagnostic utility of ChE activity in a field situation.

  5. Using bosentan to treat paraquat poisoning-induced acute lung injury in rats.

    Directory of Open Access Journals (Sweden)

    Zhongchen Zhang

    Full Text Available BACKGROUND: Paraquat poisoning is well known for causing multiple organ function failure (MODS and high mortality. Acute lung injury and advanced pulmonary fibrosis are the most serious complications. Bosentan is a dual endothelin receptor antagonist. It plays an important role in treating PF. There is no related literature on the use of bosentan therapy for paraquat poisoning. OBJECTIVE: To study the use of bosentan to treat acute lung injury and pulmonary fibrosis as induced by paraquat. METHOD: A total of 120 adult Wister male rats were randomly assigned to three groups: the paraquat poisoning group (rats were intragastrically administered with paraquat at 50 mg/kg body weight once at the beginning; the bosentan therapy group (rats were administered bosentan at 100 mg/kg body weight by intragastric administration half an hour after paraquat was administered, then the same dose was administered once a day; and a control group (rats were administered intragastric physiological saline. On the 3rd, 7th, 14th, and 21st days following paraquat exposure, rats were sacrificed, and samples of lung tissue and venous blood were collected. The levels of transforming growth factor-β1 (TGF-β1, endothelin-1 (ET-1, and hydroxyproline (HYP in the plasma and lung homogenate were determined. Optical and electronic microscopes were used to examine pathological changes. RESULT: The TGF-β1, ET-1, and HYP of the paraquat poisoning group were significantly higher than in the control group, and they were significantly lower in the 21st day therapy group than in the paraquat poisoning group on the same day. Under the optical and electronic microscopes, lung tissue damage was observed to be more severe but was then reduced after bosentan was administered. CONCLUSION: Bosentan can reduce inflammation factor release. It has a therapeutic effect on acute lung injury as induced by paraquat.

  6. Pharmacotherapy to protect the neuromuscular junction after acute organophosphorus pesticide poisoning.

    Science.gov (United States)

    Bird, Steven B; Krajacic, Predrag; Sawamoto, Keigo; Bunya, Naofumi; Loro, Emanuele; Khurana, Tejvir S

    2016-06-01

    Organophosphorus (OP) pesticide poisoning is a leading cause of morbidity and mortality in the developing world, affecting an estimated three million people annually. Much of the morbidity is directly related to muscle weakness, which develops 1-4 days after poisoning. This muscle weakness, termed the intermediate syndrome (IMS), leads to respiratory, bulbar, and proximal limb weakness and frequently necessitates the use of mechanical ventilation. While not entirely understood, the IMS is most likely due to persistently elevated acetylcholine (ACh), which activates nicotinic ACh receptors at the neuromuscular junction (NMJ). Thus, the NMJ is potentially a target-rich area for the development of new therapies for acute OP poisoning. In this manuscript, we discuss what is known about the IMS and studies investigating the use of nicotinic ACh receptor antagonists to prevent or mitigate NMJ dysfunction after acute OP poisoning. © 2016 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals Inc. on behalf of The New York Academy of Sciences.

  7. Long-term visual damage after acute methanol poisonings: Longitudinal cross-sectional study in 50 patients

    Czech Academy of Sciences Publication Activity Database

    Zakharov, S.; Pelclová, D.; Diblík, P.; Urban, P.; Kuthan, P.; Nurieva, O.; Kotíková, K.; Navrátil, Tomáš; Komarc, M.; Běláček, J.; Seidl, Z.; Vaněčková, M.; Hubáček, J. A.; Bezdíček, O.; Klempíř, J.; Yurchenko, M.; Růžička, E.; Miovský, M.; Janíková, B.; Hovda, K. E.

    2015-01-01

    Roč. 53, č. 9 (2015), s. 884-892 ISSN 1556-3650 Institutional support: RVO:61388955 Keywords : acute methanol poisoning * hospital treatment * treatment outcome Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 2.886, year: 2015

  8. Acute Lantana camara poisoning in a Boer goat kid : case report

    Directory of Open Access Journals (Sweden)

    A. Ide

    1998-07-01

    Full Text Available Acute Lantana camara poisoning in a Boer goat kid is described. The animal was part of a flock of boer goats that was introduced from the Kalahari thornveld, where the plant does not occur, to an area where the plant grew abundantly. At necropsy, the animal was severely icteric, dehydrated and constipated, with hepatosis, distention of the gall-bladder and nephrosis, but no skin lesions. Histopathological findings of the liver confirmed moderate hepatosis with single-cell necrosis and bile stasis. The pathology is consistent with that described in acute Lantana poisoning in cattle, sheep and goats. The absence of photosensitisation may be attributed to relatively mild liver damage, or the rapid course of this toxicosis.

  9. Survival without peripheral neuropathy after massive acute arsenic poisoning: Treated by 2,3-dimercaptopropane-1-sulphonate.

    Science.gov (United States)

    Lu, P-H; Tseng, J-C; Chen, C-K; Chen, C-H

    2017-08-01

    Massive acute arsenic poisoning is rare yet potentially life-threatening. 2,3-dimercaptopropane-1-sulphonate (DMPS) appears to have the appropriate chelating property. However, clinical experience on the use of DMPS in massive arsenic poisoning is limited. A 37-year-old woman attempted suicide by ingesting 37.5 g of arsenic trioxide. DMPS was promptly initiated based on history and clinical symptoms. The patient recovered completely, with no complications or side effects of the therapy. TDMPS is useful for the treatment of massive acute arsenic poisoning. © 2017 John Wiley & Sons Ltd.

  10. Acute kidney injury following rhabdomyolysis and sepsis after non-poisonous desert monitor bite.

    Science.gov (United States)

    Gupta, Poonam; Verma, Pradeep Kumar

    2017-10-01

    The desert monitor, Varanus griseus, is a species of desert monitor lizard found in North-Western India. They are believed to be non-poisonous. We report a case of Indian desert monitor bite leading to acute renal failure following rhabdomyolysis and severe sepsis. Prompt diagnosis and treatment resulted in the favourable outcome. This is author's intent to highlight the complication that may occur after Indian desert monitor bite.

  11. A phase II clinical trial to assess the safety of clonidine in acute organophosphorus pesticide poisoning

    Directory of Open Access Journals (Sweden)

    Karunatilake Harindra

    2009-08-01

    Full Text Available Abstract Background An estimated 2–3 million people are acutely poisoned by organophosphorus pesticides each year, mostly in the developing world. There is a pressing need for new affordable antidotes and clonidine has been shown to be effective in animal studies. Our aim was to determine the safety of clonidine given as an antidote in adult patients presenting with signs or symptoms of acute organophosphate ingestion. Methods This study was a dose finding, open-label, multicentre, phase II trial. Forty eight patients with acute organophosphate poisoning were randomized to receive either clonidine or placebo: Four to receive placebo and twelve to receive clonidine at each dose level. The first dose level was an initial loading dose of 0.15 mg followed by an infusion of 0.5 mg of clonidine over 24 hours. The initial loading dose was increased to 0.3 mg, 0.45 and 0.6 mg. at all dosing levels however the subsequent infusion remained at 0.5 mg of clonidine over 24 hours. Results The baseline characteristics of both groups were similar. The trial was stopped after completion of the 3rd dosing level. At the 1st and 2nd dosing level there were no reported adverse drug reactions. At the 3rd dosing level 5 patients (42% developed significant hypotension during clonidine treatment that responded to intravenous fluids. There were no statistical differences in ventilation rate, pre and post GCS, and mortality rates over all levels. Conclusion Our findings suggest use of moderate doses of clonidine in acute organophosphate poisoning can be used without causing frequent clinical problems but that higher doses are associated with a high incidence of hypotension requiring intervention. Further studies are needed to study the efficacy of clonidine as an antidote in organophosphate poisoning. Trial registration Current Controlled Trial ISRCTN89917816.

  12. Oxidative stress induced by chlorpromazine in patients treated and acutely poisoned with the drug

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    Dejanović Bratislav

    2016-01-01

    Full Text Available Background/Aim. Although chlorpromazine (CPZ is an antipsychotic drug widely used in clinical practice for a long time, its mechanism of action has not been entirely defined. An extremely difficult managing of patients acutely poisoned with CPZ is additional reason for detailed studying its toxicity mechanisms. In this clinical study, we investigated whether the oxidative stress (OS mediates CPZ toxic effects in the exposed patients. Methods. The patients were organized into 3 groups: the T-group - hospitalized patients receiving therapeutic doses of 75-150 mg CPZ/day; the overdosed group, divided into two subgroups: the group M and the group S - mildly (CPZ serum concentration: 0.21 ± 0.05 mg/L and severely (CPZ serum concentration: 2.66 ± 0.25 mg/L poisoned patients, respectively, and the group C (control group of healthy volunteers. Oxidative stress parameters [total antioxidative status (TAS and malondialdehyde (MDA in plasma] and superoxide dismutase (SOD activity in erythrocytes were measured spectrophotometrically, and CPZ concentrations in serum were monitored chromatographically. One set of measurements was performed in the group C and T, whereas two sets of measurements (after 24 hours and 48 hours were done in the poisoned patients, groups M and S. Results. A decrease of TAS and increase of SOD activity were obtained in both subgroups of the poisoned patients, compared to the controls and the group receiving therapeutic doses of CPZ. A significant increase of MDA was achieved in severely poisoned patients, compared to all other groups. Conclusion. Changed oxidative stress parameters in patients poisoned with chlorpromazine indicate involvement of oxidative stress in the toxicity mechanism(s of chlorpromazine. [Military Medical Academy, Project No. МФВМА/6/15-17

  13. Effect and Management of acute dichlovos poisoning in Wistar Rats ...

    African Journals Online (AJOL)

    Dichlorvos; organophosphorus pesticide is among the most widely used pesticides for insect control. In Nigeria and most other developing countries it is used indiscriminately by people with little or no knowledge of its toxic effects as a household and agricultural insecticide. The acute effect and antidotal therapy of ...

  14. Acute kidney injury from Paraquat poisoning: a case report. | Slater ...

    African Journals Online (AJOL)

    We report a fatal case of a16 year old girl who presented with dysphagia, cough and dyspnoea following ingestion of paraquat. She subsequently developed acute kidney injury (AKI) that resolved but she succumbed to respiratory complications despite use of antibiotics, corticosteroids and haemodialysis. Key words: ...

  15. Successful usage of intravenous lipid emulsion in treatment of acute verapamil poisoning: A case report

    Directory of Open Access Journals (Sweden)

    Vuković-Ercegović Gordana

    2017-01-01

    Full Text Available Introduction. During the last few years, intravenous lipid emulsions have been effectively used in treatment of acute poisonings with lipophilic substances, including verapamil. Case report. A 37-year-old women presented 1 hour after ingestion of 2.8 g verapamil with hypotension and complete heart block. Because of the applied standard therapy failure and further patients impairment, Intralipid® 20% was used. Sinus rhythm was restored, arterial blood pressure increased and verapamile concentrations, both total and free decreased. Conclusion. Intravenous lipid emulsion can be important in treatment of severe acute intoxication and cardiotoxicity caused by verapamil.

  16. Prediction and validation of hemodialysis duration in acute methanol poisoning.

    Science.gov (United States)

    Lachance, Philippe; Mac-Way, Fabrice; Desmeules, Simon; De Serres, Sacha A; Julien, Anne-Sophie; Douville, Pierre; Ghannoum, Marc; Agharazii, Mohsen

    2015-11-01

    The duration of hemodialysis (HD) in methanol poisoning (MP) is dependent on the methanol concentration, the operational parameters used during HD, and the presence and severity of metabolic acidosis. However, methanol assays are not easily available, potentially leading to undue extension or premature termination of treatment. Here we provide a prediction model for the duration of high-efficiency HD in MP. In a retrospective cohort study, we identified 71 episodes of MP in 55 individuals who were treated with alcohol dehydrogenase inhibition and HD. Four patients had residual visual abnormality at discharge and only one patient died. In 46 unique episodes of MP with high-efficiency HD the mean methanol elimination half-life (T1/2) during HD was 108 min in women, significantly different from the 129 min in men. In a training set of 28 patients with MP, using the 90th percentile of gender-specific elimination T1/2 (147 min in men and 141 min in women) and a target methanol concentration of 4 mmol/l allowed all cases to reach a safe methanol of under 6 mmol/l. The prediction model was confirmed in a validation set of 18 patients with MP. High-efficiency HD time in hours can be estimated using 3.390 × (Ln (MCi/4)) for women and 3.534 × (Ln (MCi/4)) for men, where MCi is the initial methanol concentration in mmol/l, provided that metabolic acidosis is corrected.

  17. Lipid emulsions in the treatment of acute poisoning: a systematic review of human and animal studies.

    Science.gov (United States)

    Jamaty, Chloé; Bailey, Benoit; Larocque, Alexandre; Notebaert, Eric; Sanogo, Karine; Chauny, Jean-Marc

    2010-01-01

    To assess the evidence regarding the efficacy and safety of intravenous fat emulsion (IFE) in the management of poisoned patients. We performed a systematic review of the literature with no time or language restriction. The electronic databases were searched from their inception until June 1, 2009 (Medline, EMBASE, ISI web of science, Biological abstract, LILACS, ChemIndex, Toxnet, and Proquest). We also examined the references of identified articles and the gray literature. The target interventions eligible for inclusion were administration of any IFE before, during, or after poisoning in human or animals. All types of studies were reviewed. Eligibility for inclusion and study quality scores, based on criteria by Jadad and the STROBE statement, were evaluated by independent investigators. The primary outcome was mortality. Secondary outcomes included neurologic, hemodynamic, and electrocardiographic variables, as well as adverse effects. Of the 938 publications identified by the search strategies, 74 met the inclusion criteria. We identified 23 animal trials, 50 human, and 1 animal case reports. Overall, the quality of evidence was weak and significant heterogeneity prevented data pooling. Available data suggest some benefits of IFE in bupivacaine, verapamil, chlorpromazine, and some tricyclic antidepressants and beta-blockers toxicity. No trial assessed the safety of IFE in the treatment of acute poisoning. The evidence for the efficacy of IFE in reducing mortality and improving hemodynamic, electrocardiographic, and neurological parameters in the poisoned patients is solely based on animal studies and human case reports. The safety of IFE has not been established.

  18. Acute collective gas poisoning at work in a manure storage tank.

    Science.gov (United States)

    Żaba, Czesław; Marcinkowski, Jerzy T; Wojtyła, Andrzej; Tężyk, Artur; Tobolski, Jarosław; Zaba, Zbigniew

    2011-01-01

    Cases of deaths in manure or septic tanks are rare in legal-medical practice, more frequently as unfortunate occupational accidents. Poisoning with toxic gases, especially with hydrogen sulfide, is reported as the cause of death, while the exhaustion of oxygen in the air is omitted with the simultaneous excess of carbon dioxide. In such cases, determination of the direct cause of death constitutes a big problem because post-mortem examination does not reveal the specific changes. A case of acute collective poisoning by gases in a manure storage tank is presented of 5 agricultural workers, 2 of whom died. While explaining the cause of poisoning and deaths, toxicological blood tests were performed in the victims of the accident, as well as gases inside the manure storage tank. The post-mortem examinations and toxicological blood tests performed did not allow determination of the direct cause of death. Toxicological tests of gases from inside the manure tank showed a very low concentration of oxygen, with a simultaneous very high concentration of carbon dioxide, and a considerable level of hydrogen sulfide. The cause of fainting of three and deaths of two workers was not the poisoning with hydrogen sulfide, but oxygen deficiency in the air of the tank.

  19. Acute methoxetamine and amphetamine poisoning with fatal outcome: A case report

    Directory of Open Access Journals (Sweden)

    Marek Wiergowski

    2014-08-01

    Full Text Available Methoxetamine (MXE is a psychoactive substance distributed mostly via the Internet and is not liable to legal regulation in Poland. MXE has a toxicity profile similar to that of ketamine but longer-lasting effects. The paper describes a case of acute poisoning that resulted from recreational use of MXE and amphetamine and ended in death. In mid-July 2012, a 31-year old man was admitted to the clinical toxicology unit in Gdańsk because of poisoning with an unknown psychoactive substance. The patient was transported to the emergency department (ED at 5:15 a.m. in a very poor general condition, in a deep coma, with acute respiratory failure, hyperthermia (> 39°C and generalized seizures. Laboratory tests showed marked leukocytosis, signs of massive rhabdomyolysis, hepatic failure and beginning of acute renal failure. Despite intensive therapy, the patient died 4 weeks after the poisoning in the course of multi-organ dysfunction syndrome. Chemical and toxicological studies of serum and urine samples collected on the poisoning day at 1:40 p.m. confirmed that amphetamine and MXE had been taken earlier that day. Concentration of amphetamine in the serum (0.06 μg/ml was within the non-toxic range, while MXE (0.32 μg/ml was within the toxic range of concentrations. Amphetamine was also detected in the patient's hair, which suggested a possibility of its use within the last dozen weeks or so. The serious clinical course of intoxication and co-existence of amphetamine and MXE in the patient's blood and urine suggest the possibility of adverse interactions between them.

  20. Ammonium dichromate poisoning: A rare cause of acute kidney injury

    Directory of Open Access Journals (Sweden)

    H Radhakrishnan

    2014-01-01

    Full Text Available Ammonium dichromate is an inorganic compound frequently used in screen and color printing. Being a strong oxidizing agent, it causes oxygen free radical injury resulting in organ failure. We report a 25-year-old female who presented with acute kidney injury after consumption of ammonium dichromate. She was managed successfully with hemodialysis and supportive measures. This case is reported to highlight the toxicity of ammonium dichromate.

  1. Mercury

    NARCIS (Netherlands)

    de Vries, Irma|info:eu-repo/dai/nl/41398625X

    2017-01-01

    Mercury is a naturally occurring metal that exists in several physical and chemical forms. Inorganic mercury refers to compounds formed after the combining of mercury with elements such as chlorine, sulfur, or oxygen. After combining with carbon by covalent linkage, the compounds formed are called

  2. [Imaging diagnosis of 95 cases of moderate and severe acute carbon monoxide poisoning].

    Science.gov (United States)

    Hao, N N; Tian, C; Lian, K X; Han, T; Jin, S

    2017-06-20

    Objective: To explore the difference of radiological imaging features of delayed encephalopathy after carbon monoxide poisoning (DECMP) and acute carbon monoxide poisoning (ACMP) , and the correlation between the imaging findings and clinical prognosis of the disease. Methods: The correlation between imaging findings and clinical manifestations and prognosis of 95 patients with moderate and severe acute carbon monoxide poisoning were retrospectively analyzed. In the above 95 cases, there were 62 cases of ACMP and 33 cases of DEACMP. All patients underwent conventional CT, MRI and magnetic resonance diffusion tensor imaging (DTI) . Circular regions of interest (ROI) measurement was used for analysis of average diffusion coefficient (ADC) value and fractional anisotropy (FA) value of the MRI and DTI imaging manifestations in different brain regions. Results: The main clinical manifestation of moderate acute carbon monoxide poisoning was consciousness disorder and fatigue; Severe poisoning patients showed deep coma as the main clinical manifestations; The most prominent clinical manifestations of DEACMP were mental disorders and neurological impairment in the extrapyramidal system. A total of 95 cases with moderate or severe CO poisoning showed unilateral or bilateral cerebral cortex, bilateral basal ganglia (white ball) , cerebral white matter around bilateral ventricles or bilateral centrum semiovale, around bilateral ventricles cerebral white matter around bilateral ventricles and bilateral centrum semiovale, cerebral cortex and subcortical involvement. CT showed normal or low density shadow.MRI showed that the lesion T(1)WI presented slightly low or equal signal, T(2)WI and FLAIR sequences showed equal, a slightly higher or high signal; DWI sequence showed slightly higher or high signal. ADC value and FA value in different brain white matter regions of DEACMP group was significantly lower than those of ACMP group (P<0.05) , especially for those around semi oval

  3. Detection of Mercury in Human Organs and Hair in a Case of a Homicidal Poisoning of a Woman Autopsied 6 Years After Death.

    Science.gov (United States)

    Lech, Teresa

    2015-09-01

    In the described case of the death of a 53-year-old woman, no toxicological examination was performed directly after death (only an anatomopathological autopsy), although symptoms of serious gastrointestinal disturbances had been present (the woman had been hospitalized twice in the course of several months). It was assumed that the cause of death was myocardial infarction. Five years later, some new circumstances came to light which suggested that somebody could have administered some poison (metals, cyanides) to the woman. Toxicological analysis of postmortem samples from the corpse, exhumed 6 years after death by order of the public prosecutor's office, revealed high tissue mercury contents in biological material (cold vapor atomic absorption spectrometry): small intestine, 1516 ng/g; large intestine, 487 ng/g; liver, 1201 ng/g; heart muscle, 1023 ng/g; and scalp hair, 227 ng/g. In samples of soil from places near the coffin, negligible traces of mercury were found (0.5-1.5 ng/g); contamination by mercury from the environment was ruled out. The presented case is a rare example of recognition of mercury poisoning on the basis of the results of analysis of biological material from an exhumed cadaver.

  4. Effects of acute organophosphate poisoning on pituitary target gland hormones at admission, discharge and three months after poisoning: A hospital based pilot study

    Directory of Open Access Journals (Sweden)

    Pinaki Dutta

    2015-01-01

    Full Text Available Background: Organophosphate compound (OPC poisoning is common in the developing countries such as India. The acute and later effects of OPC poisoning on pituitary and target gland hormones is largely unknown. Materials and Methods: This prospective study was conducted at Postgraduate Institute of Medical Education and Research between January 2012 and March 2013. Fourteen patients (8 males, age 18-50 years with acute OPC poisoning were included in the study based on the history and clinical features, documented decreased in plasma cholinesterase activity or presence of the OPC in gastric lavage/blood samples. The hormonal parameters were done at baseline, at the time of discharge and at three months of follow-up. Results: A total of 14 patients out of 46 with the mean age of 30.1 ± 10.3 years were finally eligible for the study. Hormonal alterations at admission were similar to sick euhormonal syndrome. Overall 7 of them had nine hormonal deficits at three months of follow up, 4 having sub normal basal cortisol level and two each had low testosterone and growth hormone and only one had thyroxine deficiency. Conclusion: Acute organophosphate poisoning results in endocrine dysfunction akin to sick euhormonal syndrome. However, in a small subset of patients, varying level of hormonal insufficiency may occur either at admission or later. These observations need re-validation in a larger group of patients with specific OPC.

  5. Duration of an induced resistance of sheep to acute poisoning by Crotalaria retusa seeds

    Directory of Open Access Journals (Sweden)

    Lisanka Angelo Maia

    2014-06-01

    Full Text Available The aim of this study was to determine the duration of the resistance after the end of the ingestion of non-toxic doses of Crotalaria retusa seeds. Ten sheep were divided into 3 groups of 3 animals each and a control group with 1 sheep. To induce resistance, sheep in groups 1, 2 and 3 received 20 daily doses of 2g kg-1 of C. retusa seeds, followed by 7 daily doses of 4g kg-1. To determine the duration of resistance the sheep in groups 1, 2 and 3 were challenged orally, 3, 7 and 15 days, respectively, after receiving the last dose of 4g kg-1, with a single dose of 5g kg-1. Sheep of groups 1 and 2 did not develop overt signs of poisoning. Two sheep of group 3, challenged 15 days after the end of the resistance induction period, showed signs of acute poisoning and died. These results suggest that the induced resistance of sheep to acute poisoning by C. retusa seeds is of short duration, from 7 to 15 days.

  6. Acute pesticide poisoning among children in South Korea: findings from National Health Insurance claims data, 2006-2009.

    Science.gov (United States)

    Lee, Won Jin; Ko, Yousun; Cha, Eun Shil

    2014-02-01

    The aim of this study was to estimate the incidence of acute pesticide poisoning among children in South Korea and describe the related epidemiologic characteristics. We evaluated the age-standardized rates of incidence of pesticide poisoning among children in South Korea from 2006 through 2009 using National Health Insurance claims data. A total of 1232 children aged 0-14 years were identified from the acute pesticide poisoning cases reported across South Korea during the study period. The annual average age-standardized rate of incidence from acute pesticide poisoning was 3.6 per 100 000. The majority of the cases were identified in the categories of the 1-4-year-old age-group (56.5%), outpatients (80.0%), single-day visit to a hospital (70.4%) and summer occurrence (43.3%). Acute pesticide poisoning is prevalent among children in South Korea; therefore, intervention efforts are needed to reduce the cases of pesticide poisoning among children.

  7. [Clinical symptoms and circumastances of acute poisonings with fly agaric (Amanita muscaria) and panther cap (Amanita pantherina)].

    Science.gov (United States)

    Łukasik-Głebocka, Magdalena; Druzdz, Artur; Naskret, Maciej

    2011-01-01

    Mushroom poisonings in Poland are quite common, especially in summer and autumn, but fly agaric (Amanita muscaria) and panther cap (Amanita pantherina) are rather rare cause of these intoxications. Fly agaric is a cause of deliberate poisoning, whereas panther cap poisoning also happens accidentally. The main toxins of these two mushrooms are ibotenic acid (pantherine, agarine), muscimol, muscazone and muscaridine. The other bioactive substances are stizolobic and stizolobinic acids and aminodicarboxyethylthiopropanoic acids. All these compounds are responsible for diverse picture of intoxication. An analysis of patients with Amanita muscaria and Amanita pantherina poisoning hospitalized in the Poznan Departament of Toxicology revealed that symptoms occurred after 30 minutes to 2 hours with vomiting, hallucinations, restlessness, increased psychomotor drive and central nervous system depression. Other antycholinergic symptoms like tachycardia and increased blood pressure, mydriasis, dry and red skin were seen only in a few cases. Acute respiratory failure was the most dangerous symptom observed in the course of poisoning.

  8. Reducing acute poisoning in developing countries--options for restricting the availability of pesticides

    DEFF Research Database (Denmark)

    Konradsen, Flemming; van der Hoek, Wim; Cole, Donald C

    2003-01-01

    Hundreds of thousands of people are dying around the world each year from the effects of the use, or misuse, of pesticides. This paper reviews the different options to reduce availability of the most hazardous chemicals, focusing on issues in developing countries. Emphasis is placed on the fatal ......, alcohol or drug addiction, emotional distress, depression, physical illness, social isolation or financial hardship. These should be addressed through preventive health programmes and community development efforts....... poisoning cases and hence the focus on self-harm cases. Overall, it is argued here that restricting access to the most hazardous pesticides would be of paramount importance to reduce the number of severe acute poisoning cases and case-fatalities and would provide greater opportunities for preventive...

  9. Morphologic Evidence to Support the Role of Tubular Leakage as a Cause of Anuria Induced by Mercury Poisoning

    Science.gov (United States)

    Wada, Takao; Aizawa, Koh; Kan, Keika; Kitamoto, Kiyoshi; Kuroda, Shigeomi; Ogawa, Masaru; Kato, Eiichi

    1974-01-01

    The qualitative Hanssen technic was used to study the mechanism of anuria produced in rabbits by mercury poisoning. Twenty-four to 30 hours after intravenous injection of a low dose of HgCl2, the animals were almost completely anuric. Sodium ferrocyanide injected intravenously was visualized as Prussian blue in essentially all glomeruli in anuric kidneys, and the amount of the dye in the glomerular tufts was almost the same as in control kidneys. Thus there was no evidence for a severe reduction in glomerular capillary blood flow. Besides, the distribution of Prussian blue in tubular lumina indicated that the anuria occurred in the presence of a significant glomerular filtration. Tubular walls of the anuric kidneys showed an abnormally increased permeability to sodium ferrocyanide. These findings suggested that the anuria during this stage was caused more by tubular leakage than by intrarenal vasoconstriction and subsequent cessation of glomerular filtration. ImagesFig 3Fig 4Fig 5Fig 6Fig 7Fig 8Fig 9Fig 10Fig 1Fig 2 PMID:4447127

  10. Acute lead poisoning in western Canadian cattle — A 16-year retrospective study of diagnostic case records

    Science.gov (United States)

    Cowan, Vanessa; Blakley, Barry

    2016-01-01

    This study describes the epidemiology of acute lead poisoning in western Canadian cattle over the 16-year period of 1998 to 2013 and reports background bovine tissue lead concentrations. Case records from Prairie Diagnostic Services, Western College of Veterinary Medicine, identified 525 cases of acute lead toxicity over the investigational period. Poisonings were influenced by year (P poisoned (53.5%; P poisoned. Mean toxic lead concentrations (mg/kg wet weight) in the blood, liver, and kidney were 1.30 ± 1.70 (n = 301), 33.5 ± 80.5 (n = 172), and 56.3 ± 39.7 (n = 61). Mean normal lead concentrations in the blood, liver, and kidney were 0.036 ± 0.003 mg/kg (n= 1081), 0.16 ± 0.63 mg/kg (n = 382), and 0.41 ± 0.62 mg/kg (n = 64). PMID:27041761

  11. Risk Factors for Acute Unintentional Poisoning among Children Aged 1–5 Years in the Rural Community of Sri Lanka

    Directory of Open Access Journals (Sweden)

    M. B. Kavinda Chandimal Dayasiri

    2017-01-01

    Full Text Available Background. Acute poisoning in children is a major preventable cause of morbidity and mortality in both developed and developing countries. However, there is a wide variation in patterns of poisoning and related risk factors across different geographic regions globally. This hospital based case-control study identifies the risk factors of acute unintentional poisoning among children aged 1−5 years of the rural community in a developing Asian country. Methods. This hospital based case-control study included 600 children. Each group comprised three hundred children and all children were recruited at Anuradhapura Teaching Hospital, Sri Lanka, over two years (from February 2012 to January 2014. The two groups were compared to identify the effect of 23 proposed risk factors for unintentional poisoning using multivariate analysis in a binary logistic regression model. Results. Multivariate analysis identified eight risk factors which were significantly associated with unintentional poisoning. The strongest risk factors were inadequate supervision (95% CI: 15.4–52.6, employed mother (95% CI: 2.9–17.5, parental concern of lack of family support (95% CI: 3.65–83.3, and unsafe storage of household poisons (95% CI: 1.5–4.9. Conclusions. Since inadequate supervision, unsafe storage, and unsafe environment are the strongest risk factors for childhood unintentional poisoning, the effect of community education to enhance vigilance, safe storage, and assurance of safe environment should be evaluated.

  12. Acute Compartment Syndrome Which Causes Rhabdomyolysis by Carbon Monoxide Poisoning and Sciatic Nerve Injury Associated with It: A Case Report

    OpenAIRE

    Ji, Jung-woo

    2017-01-01

    Rhabdomyolysis is most frequently caused by soft tissue injury with trauma to the extremities. Non-traumatic rhabdomyolysis may be caused by alcohol or drug abuse, infection, collagen disease, or intensive exercise, but incidence is low. In particular, rhabdomyolysis resulting from carbon monoxide poisoning is especially rare. If caught before death, carbon monoxide poisoning has been shown to cause severe muscle necrosis and severe muscle damage leading to acute renal failure. In cases of ca...

  13. [A case of favourable outcome of severe acute intoxication with an animal poison after a bite by the monocled cobra].

    Science.gov (United States)

    Livanov, G A; Batotsyrenkov, B V; Lodiagin, A N; Andrianov, A Iu; Kuznetsov, O A; Loladze, A T; Baranov, D V

    2014-01-01

    This paper reports a case of severe acute intoxication with an animal poison after a bite by the monocled cobra. Combined treatment including artificial lung ventilation, infusion-detoxication and desensitizing (hormonal) therapy, hemosorption, correction of metabolic disorders with cytoflavin, antibacterial therapy had positive effect on the patient's condition and ensured the favourable outcome ofpotentially lethal poisoning without the use ofa specific anti-snake venom serum.

  14. [Acute lead poisoning: a singular case of hemolytic anemia and lead colic].

    Science.gov (United States)

    Corradi, M; Goldoni, M; Sabbadini, F; Mutti, A

    2011-01-01

    Acute lead poisoning due to food intake is exceptional in adults and often associated with mental illness to describe a case report of acute lead intoxication with haemolytic anemia and lead colic. A 41-year old male patient was admitted to hospital for abdominal pain and persistent constipation. Abdominal X-ray showed a radiopaque mass in the caecum and progressive anaemia was observed The patient was discharged with a diagnosis of bowel obstruction. Due to persistence of the symptoms he was again hospitalized; abdominal X-ray showed diffuse radiopaque particles in the colon and haemoglobin (hb) had dropped to 8.7 g/dl. Blood levels of lead and zinc protoporphryin were 106.7 microg/dl and 6.6 microg/gHb, respectively. The timely start of chelating therapy led to a rapid return to normal peripheral blood counts and a decline in blood lead levels. Although acute lead poisoning due to intake with food is exceptional in adults and often associated with mental illness, in this case, it was not possible to clarify the route and vehicle of ingestion of the toxic. Lead body burden was shown as a caecal mass, probably as a result of ingesting a single bolus of lead dust which, considering the size and density of the mass, was estimated as weighing several grammes. This acute lead intake induced an acute haemolysis due to enhanced fragility of the erythrocyte membrane. In the course of acute lead intoxication, the critical organ is not the bone marrow, but rather the red blood cell, leading to haemolysis and anaemia.

  15. On the mechanisms underlying poisoning-induced rhabdomyolysis and acute renal failure.

    Science.gov (United States)

    Talaie, Haleh; Emam-Hadi, Mohammad; Panahandeh, Reyhaneh; Hassanian-Moghaddam, Hosein; Abdollahi, Mohammad

    2008-01-01

    ABSTRACT The clinical syndrome of rhabdomyolysis is caused by injury of skeletal muscles resulting in release of intracellular muscle constituents. Drug poisoning is one of the causes of severe rhabdomyolysis. Severe electrolyte disorders and acute renal failure may occur in rhabdomyolysis, leading to life-threatening situations. Early initiation of renal replacement therapy can help improve outcome. In the present retrospective study, medical records of 181 patients suspected of rhabdomyolysis from Loghman-Hakim Hospital in the period of 2004 to 2005 were reviewed. A creatinine phosphokinase (CPK) value of greater than five times normal (>/=975 IU/L) was the basis for confirmation of a rhabdomyolysis diagnosis. An increased serum creatinine level of more than 30% was the basis for acute renal failure diagnosis. Out of 156 patients, 100 were male with an age range of 13 to 78 years. One hundred and two (92%) patients had CPK >975 U/L, and 36 patients (28.6%) had a 30% or more increase in their creatinine level during their admission days. Mean fluid intake was the same in patients with renal failure and those without renal failure. In 8.3% of the cases, multiple drug poisoning was observed. The most common compound overdose associated with rhabdomyolysis was opium. It is concluded that fluid therapy alone is not adequate in the management of acute renal failure in rhabdomyolysis. Therefore, other etiological factors are involved that remain to be elucidated by further studies.

  16. Potentialities of Program Analysis of Probable Outcome in Patients with Acute Poisoning by Mushrooms

    Directory of Open Access Journals (Sweden)

    V. I. Cherniy

    2006-01-01

    Full Text Available The authors have developed a method for predicting a probable outcome in patients with acute poisoning by mushrooms, by examining the data of routine laboratory studies and dynamic interphase tensiometry and rheometry of sera from patients. Sixty-eight patients with acute mushroom intoxication were followed up. According to the outcome of the disease, they were divided into two groups: A survivors and B (deceased. In the sera of the deceased, the time of T monolayer relaxation and the angle of L1 tensiogram slope were 2.5 greater and PN3-PN4 and L2/L1 were 6 and 3.7 times less, respectively, than those in the survivors. Based on these data, by using the discriminant analysis, the authors have derived a classification rule that permits prediction of the outcome of the disease with a high degree of probability, by examining the results of dynamic interphase tensiometry and the data of routine laboratory studies of blood samples from patients with acute poisoning by mushrooms. The derived rule is of high significance (p<0.05.

  17. Quantitative Romberg's test in acute carbon monoxide poisoning treated by hyperbaric oxygen

    DEFF Research Database (Denmark)

    Bidstrup, Daniel; Jansen, Erik Christian; Hyldegaard, Ole

    2017-01-01

    OBJECTIVE: The aim of this study was to evaluate whether monitoring of acute carbon monoxide-poisoned (COP) patients by means of quantitative Romberg's test (QR-test) during a hyperbaric oxygen (HBO₂) therapy regimen could be a useful supplement in the evaluation of neurological status. METHODS: We...... LMM, sway prior to HBO₂ therapy was set as the fixed effect and change in sway after HBO₂ therapy was set as the response variable. Patient, treatment number, weight and age were set as random effects for all LMMs. RESULTS: From the LMMs we found that larger values of sway prior to HBO₂ produced...

  18. Effects of Acute Carbon Monoxide Poisoning on ECG and Echocardiographic Parameters in Children.

    Science.gov (United States)

    Ozyurt, Abdullah; Karpuz, Derya; Yucel, Aydin; Tosun, Mehtap Durukan; Kibar, Ayse Esin; Hallioglu, Olgu

    2017-07-01

    The aim of the current study is to investigate the effects of CO (carbon monoxide) on the cardiovascular system via electrocardiographic, echocardiographic and biochemical findings in children. This prospective study included 22 children with CO poisoning and 24 healthy children as a control group. The CO-intoxicated children were evaluated via electrocardiography and echocardiography 1 h after admission to the emergency department and daily until their discharge from the hospital. Blood gasses, complete blood account, troponin I and creatinine kinase-MB(CK-MB) were assessed daily. Tpeak-end (p:0.001), QTc durations (p:0.02), Tpeak-end dispersion (p:0.001) and Tpeak-end/QT ratio (p:0.001) of CO-intoxicated patients were significantly higher than those in the control group. Mitral E duration (p:0.001), mitral E/A ratio (p:0.001) and left ventricle contractile fraction (p:0.023) at admission were significantly lower, and left ventricle myocardial performance index was higher (p:0.001) in the CO poisoning group. Troponin I and CK-MB levels were higher at admission in 6 (27 %) and 4 (18 %) patients, respectively. The heart is the most critical organ in pediatric CO poisoning. These children present subclinical systolic and diastolic left ventricle dysfunction even in mild cases. Although, in children with acute CO-intoxication ventricular repolarization is impaired, it seems to be reversible like other findings.

  19. Acute Poisoning with Dapsone and Olanzapine: Severe Methemoglobinemia and Coma with a Favourable Outcome.

    Science.gov (United States)

    Iliev, Yanko T; Zagorov, Marin Y; Grudeva-Popova, Janet G

    2015-01-01

    Dapsone is a drug commonly used in the treatment of leprosy. In Europe it is rarely prescribed, mostly for the treatment of skin diseases such as dermatitis herpetiformis. Poisoning with dapsone is rare and reports of such cases are of interest for toxicological practice. We describe the only acute dapsone poisoning in a caseload series of 21,000 intoxications treated in the Clinical Toxicology Clinic at St George University Hospital in Plovdiv, Bulgaria between 1999 and 2013. We report on a 36-year-old woman who attempted deliberate self-poisoning with an ingestion of approximately 4.5 g of dapsone and 0.3 g of olanzapine. On admission, the patient was in a state of severe intoxication and comatose. On admission to hospital 9 hours after the ingestion, the methemoglobin level was 51.7%. The patient recovered 8 days later. She received complex treatment including intubation, ventilation, repeated gastric lavage, hemodialysis, blood exchange transfusion and antidote treatment with methylene blue. She was discharged in good clinical condition with minimal organ damage such as mild toxic hepatitis.

  20. Acute Compartment Syndrome Which Causes Rhabdomyolysis by Carbon Monoxide Poisoning and Sciatic Nerve Injury Associated with It: A Case Report.

    Science.gov (United States)

    Ji, Jung-Woo

    2017-09-01

    Rhabdomyolysis is most frequently caused by soft tissue injury with trauma to the extremities. Non-traumatic rhabdomyolysis may be caused by alcohol or drug abuse, infection, collagen disease, or intensive exercise, but incidence is low. In particular, rhabdomyolysis resulting from carbon monoxide poisoning is especially rare. If caught before death, carbon monoxide poisoning has been shown to cause severe muscle necrosis and severe muscle damage leading to acute renal failure. In cases of carbon-monoxide-induced rhabdomyolsis leading to acute compartment syndrome in the buttocks and sciatic nerve injury are rare. We have experience treating patients with acute compartment syndrome due to rhabdomyolysis following carbon monoxide poisoning. We report the characteristic features of muscle necrosis observed during a decompression operation and magnetic resonance imaging findings with a one-year follow-up in addition to a review of the literature.

  1. Brain temperature measured by {sup 1}H-magnetic resonance spectroscopy in acute and subacute carbon monoxide poisoning

    Energy Technology Data Exchange (ETDEWEB)

    Fujiwara, Shunrou; Nishimoto, Hideaki; Murakami, Toshiyuki; Ogawa, Akira; Ogasawara, Kuniaki [Iwate Medical University, Department of Neurosurgery, Morioka, Iwate (Japan); Yoshioka, Yoshichika [Osaka University, Laboratory of Biofunctional Imaging, WPI Immunology Frontier Research Center, Osaka (Japan); Matsuda, Tsuyoshi [MR Applications and Workflow Asia Pacific, GE Healthcare Japan, Tokyo (Japan); Beppu, Takaaki [Iwate Medical University, Department of Neurosurgery, Morioka, Iwate (Japan); Iwate Medical University, Department of Hyperbaric Medicine, Iwate (Japan)

    2016-01-15

    Brain temperature (BT) is associated with the balance between cerebral blood flow and metabolism according to the ''heat-removal'' theory. The present study investigated whether BT is abnormally altered in acute and subacute CO-poisoned patients by using {sup 1}H-magnetic resonance spectroscopy (MRS). Eight adult CO-poisoned patients underwent 3-T magnetic resonance imaging in the acute and subacute phases after CO exposure. MRS was performed on deep cerebral white matter in the centrum semiovale, and MRS-based BT was estimated by the chemical shift difference between water and the N-acetyl aspartate signal. We defined the mean BT + 1.96 standard deviations of the BT in 15 healthy controls as the cutoff value for abnormal BT increases (p < 0.05) in CO-poisoned patients. BT of CO-poisoned patients in both the acute and subacute phases was significantly higher than that of the healthy control group. However, BT in the subacute phase was significantly lower than in the acute phase. On the other hand, no significant difference in body temperature was observed between acute and subacute CO-poisoned patients. BT weakly correlated with body temperature, but this correlation was not statistically significant (rho = 0.304, p = 0.2909). The present results suggest that BT in CO-poisoned patients is abnormally high in the acute phase and remains abnormal in the subacute phase. BT alteration in these patients may be associated with brain perfusion and metabolism rather than other factors such as systemic inflammation and body temperature. (orig.)

  2. [A prospective study on acute poisonings presenting to the Emergency Department at Landspitali University Hospital in Iceland 2012].

    Science.gov (United States)

    Gudjonsdottir, Gudborg Audur; Thordardottir, Anna Maria; Kristinsson, Jakob

    2017-01-01

    The purpose of the study was to assess the incidence and type of toxic exposures presenting to the Emergency Department (ED) at Landspitali University Hospital in Iceland over one year and compare the results to another study performed eleven years before. The study was prospective and included all visits due to acute poisoning to the ED between January 1, and December 31, 2012. A total of 977 toxic exposures were documented. Females were 554 (57%) and males 423 (43%). The age range was from 2 months to 96 years old. More than half of the patients were under 30 years old. The majority of exposures occurred in private homes and ingestion was the most common route of exposure. Deliberate poisonings accounted for 66% of all the poisonings and 76% had drugs and/or alcohol as their main cause. Exposures to chemicals other than drugs were usually unintentional and 31% of them were occupational exposures. 80% of patients received treatment and were discharged from the ED, 20% were admitted to other departments, thereof 21% to ICU. Two patients died (0.2%). A slight but statistically unsignificant increase in incidence was observed. Females outnumbered males. Self-poisonings by ingestion of drugs and/or alcohol accounted for the majority of cases. The age range was wide, but the incidence was higher with young people. Mortality was low. Key words: toxicology, acute poisoning, epidemiology, self-poisoning. Correspondence: Gudborg Audur Gudjonsdottir, gudborgg@gmail.com.

  3. Toxicological Investigation of Acute Cyanide Poisoning of a 29-year-old Man: A Case Report

    Directory of Open Access Journals (Sweden)

    Martin Anazodo Nnoli

    2016-07-01

    Full Text Available Background: Cyanide poisoning is frequently lethal, Because of the early onset of severe symptoms and difficulty in the diagnosis. Case: The case was a 29-year-old boy who collapsed suddenly after taking a bottle of beer in a bar. Samples, such as peripheral blood, stomach contents, bile fluid, urine and mouth swabs, were prepared using standard autopsy procedure and were subjected to analysis for cyanide using visible spectrophotometric method. The cyanide contents in samples, included stomach content (260 ppm, bile fluid (272 ppm, blood (256 ppm, and mouth swab (265 ppm. Conclusion: The cause of death was acute myocardial infarction following acute poisoning from ingestion of cyanide salts. Its lethality was related to the rapid onset of toxicity, non-specific nature of the symptoms, and failure to consider the diagnosis. Regarding the absence of pathognomonic symptoms for its toxicity, delay in acquiring a full history and unexplained sudden collapse or acidosis which worsen the prognosis, cyanide intoxication needs to be expeditiously diagnosed and managed.

  4. Alternative drugs go global: possible lead and/ or mercury intoxication from imported natural health products and a need for scientifically evaluated poisoning monitoring from environmental exposures.

    Science.gov (United States)

    Budnik, Lygia Therese; Baur, Xaver; Harth, Volker; Hahn, Axel

    2016-01-01

    With increases in globalization, cultural remedies from Chinese, Ayurvedic, Arab and other traditions have become more available to international consumers, offering unfamiliar "Natural Health Products" (NHP), used as alternative medicine or supplementary medicine. Contamination with toxic ingredients including lead, mercury, arsenic, and other toxic elements has been documented in several of these products from various parts of the globe, particularly from some parts of Asia and the Orient. We have been following this development in the last 6 years and have analyzed n = 20 such products (60 analyses) from patients with intoxication symptoms in a pilot study, showing alarming high concentrations of mercury and/or lead (the first one in "therapeutic" doses). 82 % of the studied NHP contained lead concentrations above the EU limit for dietary supplements. 62 % of the samples exceeded the limit values for mercury. Elevated blood lead and mercury levels in patients along with clinical intoxication symptoms corroborate the causal assumption of intoxication (s). We present one detailed clinical case report of severe lead and mercury intoxications and give an overview about blood concentration related symptoms and signs of n = 41 case reports of mercury intoxications of the German monitoring BfR-DocCenter. For NHP there is evidence on a distinct toxicological risk with alarming low awareness for a possible intoxication which prevents potentially life-saving diagnostic steps in affected cases. In many cases patients do not communicate the events to their physicians or the local health authority so that case reports (e.g. the BfR-DocCentre) are missing. Thus, there is an urgent need to raise awareness and to initiate more suitable monitory systems (e.g. National Monitoring of Poisonings) and control practice protecting the public.

  5. [Cases of acute pesticide poisoning in Colonia Puerto Pirapó, Itapúa, Paraguay, February, 2014].

    Science.gov (United States)

    Pedrozo, María Esther; Ocampos, Sandra; Galeano, Rosa; Ojeda, Andrea; Cabello, Agueda; De Assis, Dalva

    2017-06-01

    In Paraguay, pesticides are the causative agent in 13.7% of poisonings, especially organophosphorus compounds. Such poisoning produces the inhibition of acetylcholinesterase generating three possible clinical conditions: acute poisoning, intermediate syndrome or late neurotoxicity. We present 15 cases of acute poisoning, ten women and five men from a rural community between 5 and 67 years of age, whose symptoms began after using water contaminated by pesticides from the community network. The most common symptoms were nausea and vomiting, followed by abdominal pain, headache, fever, itching, red eyes and sweating. Five patients underwent blood tests for blood count, renal and liver function and serum cholinesterase, with results within the reference values; just one patient had high liver enzymes.In two samples from the community water supply network the active compound detected was profenophos. It is essential to train primary health care personnel to identify cases of acute pesticide poisoning in a timely manner to provide appropriate treatment, especially in rural areas. Additionally, it is necessary that responsible institutions monitor compliance with environmental regulations in these areas to avoid such incidents.

  6. Mercury

    Science.gov (United States)

    ... the dose, the duration, how you are exposed, personal traits and habits, and whether other chemicals are ... National Priorities List sites identified by the Environmental Protection ... inadequate human cancer data available for all forms of mercury. Mercuric chloride ...

  7. A case report of zinc phosphide poisoning: complicated by acute renal failure and tubulo interstitial nephritis.

    Science.gov (United States)

    Yogendranathan, Nilukshana; Herath, H M M T B; Sivasundaram, Thenuka; Constantine, R; Kulatunga, Aruna

    2017-05-25

    Run Rat® is a rodenticide widely used against small mammals. It comprises of a minimum of 32% zinc phosphide which is highly toxic in acute exposures to humans. It may be consumed accidentally or intentionally. It enters the body via skin, respiratory and gastrointestinal tracts. Zinc phosphide is hydrolyzed by the gastric acid and is transformed into phosphine gas. Phosphine is a respiratory toxin that inhibits cytochrome C oxidase system resulting in renal failure and liver failure. A 35 year old Sri Lankan female presented following ingestion of 2.5 g of Run Rat®, which is a branded preparation of zinc phosphide, resulting in 61 mg/kg poison load. She developed severe acute kidney injury with acute tubular necrosis, subnephrotic ranged proteinuria and tubulointerstitial nephritis for which she underwent haemodialysis three times along with other measures of resuscitation. She also developed elevated liver enzymes with hyperblirubinaemia, hypoalbuminaemia, acute pancreatitis and mild myocarditis. She improved with supportive therapy over a period of 3 weeks. Run Rat® is a commonly used rodenticide and the toxic effects are mediated through conversion of phosphide to phosphine gas. The majority of the deaths had occurred in the first 12 to 24 h and the main causes identified are refractory hypotension and arrhythmias. The late deaths (beyond 24 h) had been commonly due to adult respiratory distress syndrome, liver and renal failure. The outcome is poorer with delayed presentation, development of coagulopathy, hyperglycaemia and multiorgan failure with elevated liver enzymes. In our patient, Zinc phosphide poisoning caused severe acute kidney injury, abnormal liver profile, pancreatitis and possible myocarditis. The patient improved with repeated haemodialysis. The renal biopsy revealed acute tubulointerstitial nephritis with acute tubular necrosis. In tropical countries, the rural population engaged in agriculture has easier access to the compound, as it

  8. Acute toxicity and bio-accumulation of mercury and copper in ...

    African Journals Online (AJOL)

    The acute toxicity of Mercury and Copper on C. africanus and T. fuscatus and the bio-accumulation potentials of the metals were investigated in laboratory experiments employing standard bio–assay techniques. On the basis of LC50 values, both metals had similar magnitudes of toxicity against C. africanus. However ...

  9. Amanita poisonings resulting in acute, reversible renal failure: new cases, new toxic Amanita mushrooms.

    Science.gov (United States)

    Kirchmair, Martin; Carrilho, Patrícia; Pfab, Rudi; Haberl, Bettina; Felgueiras, Joana; Carvalho, Fernanda; Cardoso, José; Melo, Ireneia; Vinhas, José; Neuhauser, Sigrid

    2012-04-01

    Renal failure as a consequence of eating mushrooms has been reported repeatedly after ingestion of webcaps of the Cortinarius orellanus group. But mushrooms of the genus Amanita can also cause renal failure: Amanita smithiana (North America) and Amanita proxima (Mediterranean area). Here, we discuss poisonings caused by other white amanitas. A German and--independently--two Portuguese patients reported the ingestion of completely white mushrooms with ring. Similar to intoxications with A. smithiana or A. proxima, the clinical picture was characterized by nausea and vomiting 10-12 h after ingestion, severe acute renal failure and mild hepatitis. Renal biopsy showed acute interstitial nephritis and tubular necrosis. Two patients were given temporary haemodialysis. All have fully recovered their renal function. Poisonings caused by mushrooms containing the toxin of A. smithiana were suspected. We tested 20 Amanita species for the presence of this toxin. Thin layer chromatography was applied to detect A. smithiana nephrotoxin in herbarium specimens using authentic material of A. smithiana as reference. A. smithiana toxin could be detected in Amanita boudieri, Amanita gracilior and in Amanita echinocephala. A. boudieri was collected by the Portuguese patients. A. echinocephala is the only nephrotoxic Amanita growing North of the Alps and is suspected to be the cause of renal failure in the German patient. No A. smithiana toxin was detectable in the nephrotoxic A. proxima. A. boudieri, A. gracilior and A. echinocephala are nephrotoxic. These intoxications are clinically similar to that of A. smithiana, with acute reversible renal failure and mild hepatitis but are different in their clinical picture from Orellanus syndrome characterized by a delayed onset of severe and often irreversible renal failure.

  10. [Biological and toxic effects of ethanol: diagnostics and treatment of acute poisonings].

    Science.gov (United States)

    Kołaciński, Zbigniew; Rusiński, Piotr

    2003-01-01

    Ethyl alcohol (ethanol) is readily absorbed from all parts of the gastrointestinal tract due to its hydrophilic potential. The biological effects in humans refer to practically every organ and system. The basic enzyme involved in its oxidation is alcohol dehydrogenase. Another important metabolic pathway is the Microsomal Ethanol-Oxidizing System (MEOS). Toxic effect on basic cell functions is produced both by ethanol and acetic aldehyde, its oxidation product which accounts for most of the acute and delayed effects of ethanol toxicity. In acute ethanol intoxication's the CNS symptoms are the first to manifest. Ethanol affects the CNS functions mainly through stimulating opiate and benzodiazepine receptors and a number of neurotransmitters. However, the attempts to diminish the toxic effects of ethanol on CNS by blocking the affected receptors have proved to be ineffective. In acute poisoning a basic essential is to sustain vital functions by following the principles of intensive care. Each case of acute ethanol intoxication must be subject to neurological examination for possible cerebro-cranial traumas. The diagnostics and treatment procedures should take account of the possible symptoms: convulsions, respiratory and cardiac failure, hypoglycemia, hypothermia, and severe gastric dysfunction. Vital signs monitoring and control of acid-base and water-electrolyte balance are a must. The toxic properties of ethanol metabolites can be particularly hazardous to patients treated with disulfiram. The patients who develop "antabuse response" should be given immediately iron and vitamin C intravenously.

  11. Leukotriene-mediated neuroinflammation, toxic brain damage, and neurodegeneration in acute methanol poisoning.

    Science.gov (United States)

    Zakharov, Sergey; Kotikova, Katerina; Nurieva, Olga; Hlusicka, Jiri; Kacer, Petr; Urban, Pavel; Vaneckova, Manuela; Seidl, Zdenek; Diblik, Pavel; Kuthan, Pavel; Navratil, Tomas; Pelclova, Daniela

    2017-04-01

    The role of neuroinflammation in methanol-induced toxic brain damage has not been studied. We studied acute concentrations and the dynamics of leukotrienes (LT) in serum in hospitalized patients with acute methanol poisoning and in survivors. Series of acute cysteinyl-LT and LTB4 concentration measurements were performed in 28/101 hospitalized patients (mean observation time: 88 ± 20 h). In 36 survivors, control LT measurements were performed 2 years after discharge. The acute maximum (Cmax) LT concentrations were higher than concentrations in survivors: Cmax for LTC4 was 80.7 ± 5.6 versus 47.9 ± 4.5 pg/mL; for LTD4, 51.0 ± 6.6 versus 23.1 ± 2.1 pg/mL; for LTE4, 64.2 ± 6.0 versus 26.2 ± 3.9 pg/mL; for LTB4, 59.8 ± 6.2 versus 27.2 ± 1.4 pg/mL (all p  0.05). The mean decrease in LT concentration was 30.9 ± 9.0 pg/mL for LTC4, 26.3 ± 8.6 pg/mL for LTD4, 37.3 ± 6.4 pg/mL for LTE4, and 32.0 ± 8.8 pg/mL for LTB4. Our findings suggest that leukotriene-mediated neuroinflammation may play an important role in the mechanisms of toxic brain damage in acute methanol poisoning in humans. Acute elevation of LT concentrations was moderate, transitory, and was not followed by chronic neuroinflammation in survivors.

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

    Directory of Open Access Journals (Sweden)

    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

  13. Pesticide use and self-reported symptoms of acute pesticide poisoning among aquatic farmers in Phnom Penh, Cambodia

    DEFF Research Database (Denmark)

    Jensen, Hanne Klith; Konradsen, Flemming; Jørs, Erik

    2011-01-01

    in Boeung Cheung Ek (BCE) Lake, Phnom Penh, Cambodia. The study showed that 50% of the pesticides used belonged to WHO class I + II and personal protection among the farmers were inadequate. A majority of the farmers (88%) had experienced symptoms of acute pesticide poisoning, and this was significantly...

  14. Acute lead poisoning with eosinophilic meningoencephalitis in calves on a farm receiving land application of sewage sludge

    Energy Technology Data Exchange (ETDEWEB)

    Dorn, C.R.; Tuomari, D.; Reddy, C.; Logan, T.J.

    1986-03-01

    A total of 3 cases of acute lead poisoning in calves was confirmed by atomic absorption spectrophotometric analysis of biological samples, presence of an acute lead exposure source, clinical signs of impaired vision in one case and eosinophilic meningoencephalitis in another case. One of two other calves which died approximately 2 months earlier had nervous signs and it is likely that they also had lead poisoning. Dams of two of the cases did not have elevated lead levels. Municipal sewage sludge had been applied to most fields on the farm during the preceding 5 year period. There had been approximately a doubling of the lead content in the soil; however, the foodstuffs produced on the farm had low lead concentrations. The extremely high lead levels in the abomasal contents and feces of calves eliminated sludge as the source of the lead in this acute poisoning episode. The contents of oil filters, accessible to calves but not to adult cattle, had lead levels as high as 26,922 micrograms/g and was the most likely lead source responsible for this lead intoxication. It appears that the manifestation of eosinophilic meningoencephalitis in lead poisoning cases may occur in young calves as well as in cows and in acute as well as in chronic intoxications.

  15. Reducing the Incidence of Acute Pesticide Poisoning by Educating Farmers on Integrated Pest Management in South India

    NARCIS (Netherlands)

    Mancini, F.; Jiggins, J.L.S.; O'Malley, M.

    2009-01-01

    Sixty-five farmers reported on pesticide use and the signs and symptoms of acute pesticide poisoning when using two different plant protection strategies: in 2003 using chemical controls and in 2004 using an approach to Integrated Pest Management (IPM) based on an ecological analysis of the field

  16. Paraquat poisoning: an experimental model of dose-dependent acute lung injury due to surfactant dysfunction

    Directory of Open Access Journals (Sweden)

    M.F.R. Silva

    1998-03-01

    Full Text Available Since the most characteristic feature of paraquat poisoning is lung damage, a prospective controlled study was performed on excised rat lungs in order to estimate the intensity of lesion after different doses. Twenty-five male, 2-3-month-old non-SPF Wistar rats, divided into 5 groups, received paraquat dichloride in a single intraperitoneal injection (0, 1, 5, 25, or 50 mg/kg body weight 24 h before the experiment. Static pressure-volume (PV curves were performed in air- and saline-filled lungs; an estimator of surface tension and tissue works was computed by integrating the area of both curves and reported as work/ml of volume displacement. Paraquat induced a dose-dependent increase of inspiratory surface tension work that reached a significant two-fold order of magnitude for 25 and 50 mg/kg body weight (P<0.05, ANOVA, sparing lung tissue. This kind of lesion was probably due to functional abnormalities of the surfactant system, as was shown by the increase in the hysteresis of the paraquat groups at the highest doses. Hence, paraquat poisoning provides a suitable model of acute lung injury with alveolar instability that can be easily used in experimental protocols of mechanical ventilation

  17. Hypersensitivity Reaction and Acute Respiratory Distress Syndrome in Pyrethroid Poisoning and Role of Steroid Therapy

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    Jisa George

    2015-06-01

    Full Text Available Background: Pyrethroids are generally of low toxicity to humans, but in suicidal poisonings which are usually associated with ingestion of high doses, they lead to severe systemic effects. Case Report: A 30-year old woman presented to emergency department with a history of intentional ingestion of about 15 mL of prallethrin around 3 days earlier. She complained of shortness of breath along with chest pain for the last 2 days. She reported no vomiting or stomach pain prior to presentation to hospital. On chest auscultation, breath sounds were mildly decreased in bilateral infrascapular areas with generalized crepitation. Arterial blood gas analysis revealed respiratory alkalosis. Chest X ray and computed tomography of thorax revealed widespread confluent areas of consolidation with interlobular septal thickening involving bilateral parahilar regions suggestive of acute respiratory distress syndrome (ARDS. The patient did not respond to broad spectrum antibiotic coverage, diuretics and oxygen inhalation. Intravenous methylprednisolone (2 mg/kg/day divided 6 hourly was started and slowly tapered off during the next days. The patient discharged after 3 weeks in good health. Discussion: As pyrethroids can affect sodium channels, the osmotic gradient of alveolar epithelium probably disrupts and therefore, alveolar infiltrations gradually spread over lungs. In addition, there is a possibility of hypersensitivity reactions to pyrethroids, which can cause progressive inflammation and involve respiratory tract in severe cases. Conclusion: Pyrethroid poisoning can lead to ARDS. Steroid therapy may help such patients tide over the pulmonary crisis.

  18. Sodium Nitrite and Sodium Thiosulfate Are Effective Against Acute Cyanide Poisoning When Administered by Intramuscular Injection.

    Science.gov (United States)

    Bebarta, Vikhyat S; Brittain, Matthew; Chan, Adriano; Garrett, Norma; Yoon, David; Burney, Tanya; Mukai, David; Babin, Michael; Pilz, Renate B; Mahon, Sari B; Brenner, Matthew; Boss, Gerry R

    2017-06-01

    The 2 antidotes for acute cyanide poisoning in the United States must be administered by intravenous injection. In the out-of-hospital setting, intravenous injection is not practical, particularly for mass casualties, and intramuscular injection would be preferred. The purpose of this study is to determine whether sodium nitrite and sodium thiosulfate are effective cyanide antidotes when administered by intramuscular injection. We used a randomized, nonblinded, parallel-group study design in 3 mammalian models: cyanide gas inhalation in mice, with treatment postexposure; intravenous sodium cyanide infusion in rabbits, with severe hypotension as the trigger for treatment; and intravenous potassium cyanide infusion in pigs, with apnea as the trigger for treatment. The drugs were administered by intramuscular injection, and all 3 models were lethal in the absence of therapy. We found that sodium nitrite and sodium thiosulfate individually rescued 100% of the mice, and that the combination of the 2 drugs rescued 73% of the rabbits and 80% of the pigs. In all 3 species, survival in treated animals was significantly better than in control animals (log rank test, Pcyanide poisoning in 3 clinically relevant animal models of out-of-hospital emergency care. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  19. Toxicological Investigation of Acute Carbon Monoxide Poisoning in Four Occupants of a Fuming Sport Utility Vehicle

    Directory of Open Access Journals (Sweden)

    Martin Nnoli

    2014-11-01

    Full Text Available Background: This toxicological investigation involves a report on the death of four occupants of a sport utility vehicle on one of the major busy Federal roads of Nigeria where they were held for up to three hours in a traffic jam while the car was steaming. Methods: Autopsy was executed using the standard procedure and toxicological analysis was done using simple spectrophotometric method to establish the level of carboxyhaemoglobin (HbCO in peripheral blood in the four occupants. Results: The autopsy report indicated generalized cyanosis, sub-conjuctival hemorrhages, marked laryngo-trachea edema with severe hyperemia with frothy fluid discharges characteristic of carbon monoxide poisoning. Toxicological report of the level of HbCO in part per million (ppm in the peripheral blood of the four occupants was A= 650 ppm; B= 500 ppm; C= 480 ppm, and D= 495 ppm against the maximum permissible level of 50 ppm. Conclusion: The sudden death of the four occupants was due to excessive inhalation of the carbon monoxide gas from the exhaust fumes leaking into the cabin of the car. The poor road network, numerous potholes, and traffic jam in most of roads in Nigeria could have exacerbated a leaky exhaust of the smoky second hand SUV car leading to the acute carbon monoxide poisoning.

  20. Rhabdomyolysis following Acute Extended-Release Quetiapine Poisoning: A Case Report

    Directory of Open Access Journals (Sweden)

    Antonios Liolios

    2012-01-01

    Full Text Available Background. During the past few years, there have been a number of case reports concerning rhabdomyolysis following quetiapine poisoning; however, there has been none concerning the medication in its extended-release form. Methods. We present the case report of a 48-year-old man presenting a major depressive disorder and borderline personality disorder, who after voluntary intoxication with 12000 mg of quetiapine extended-release developed signs of acute rhabdomyolysis. Results. The rhabdomyolysis was confirmed by the laboratory and the clinical findings, with elevated levels of creatinine, creatine phosphokinase, and CRP. Discussion. We would like to pinpoint the importance of this complication and our concern of prescribing it for psychiatric patients with chronic somatic comorbidities.

  1. Long-term visual damage after acute methanol poisonings: Longitudinal cross-sectional study in 50 patients.

    Science.gov (United States)

    Zakharov, Sergey; Pelclova, Daniela; Diblik, Pavel; Urban, Pavel; Kuthan, Pavel; Nurieva, Olga; Kotikova, Katerina; Navratil, Tomas; Komarc, Martin; Belacek, Jaromir; Seidl, Zdenek; Vaneckova, Manuela; Hubacek, Jaroslav A; Bezdicek, Ondrej; Klempir, Jiri; Yurchenko, Maksim; Ruzicka, Evzen; Miovsky, Michal; Janikova, Barbara; Hovda, Knut Erik

    2015-11-01

    Visual disturbances due to the toxic effect of formic acid in acute methanol poisonings are generally transient. The subjective symptoms of visual toxicity may resolve within few weeks and fundoscopic signs of acute optic neuropathy subside within 1-2 months; therefore, the prevalence of long-term visual sequelae in the population of survivors of poisonings may be underestimated. To study the prevalence and character of long-term visual sequelae of acute methanol poisonings based on the data from the Czech mass methanol outbreak in 2012. A total of 50 patients with confirmed methanol poisoning were included in this longitudinal cross-sectional study, median age: 48 (range, 23-73) years. The following tests were performed: optical coherence tomography or OCT with evaluation of the retinal nerve fibers layer (RNFL), visual evoked potentials (VEP), magnetic resonance imaging (MRI) of brain, complete ocular examination (visual acuity/field, color vision, contrast sensitivity, and fundus), neurological examinations, and biochemical tests. Of 50 patients, 7/50 (14%) were discharged with diagnosed visual sequelae and 6/50 (12%) were discharged with both visual and central nervous system sequelae of poisoning. On the follow-up examination, 20/50 (40%) of the patients had long-term visual sequelae, with 8% of blindness. A total of 38% of the patients had abnormal (28% borderline) findings on RNFL, and 40% had abnormal (18% borderline) VEP. Among the patients discharged without detected visual sequelae, 8/37 (22%) had abnormal RNFL and VEP. Patients with visual sequelae had brain lesions more often (70% vs. 27%, p methanol, ethanol, HCO3-, formate, pH, anion gap, and base deficit (all p methanol poisonings in general.

  2. Mercury

    CERN Document Server

    Balogh, André; Steiger, Rudolf

    2008-01-01

    Mercury, the planet closest to the Sun, is different in several respects from the other three terrestrial planets. In appearance, it resembles the heavily cratered surface of the Moon, but its density is high, it has a magnetic field and magnetosphere, but no atmosphere or ionosphere. This book reviews the progress made in Mercury studies since the flybys by Mariner 10 in 1974-75, based on the continued research using the Mariner 10 archive, on observations from Earth, and on increasingly realistic models of its interior evolution.

  3. Intoxicación aguda por plaguicidas Acute poisoning from pesticides

    Directory of Open Access Journals (Sweden)

    Jaime Jesús Durán-Nah

    2000-02-01

    Full Text Available OBJETIVO: Describir la epidemiología de la intoxicación aguda por plaguicidas (IAP en el Hospital General O'Horán de Mérida, Yucatán, México. MATERIAL Y MÉTODOS: Se revisaron los expedientes de 33 pacientes ³ 13 años, tratados en una unidad de cuidados intensivos (UCI, entre 1994 y 1998. Se recopilaron variables demográficas y clínicas relevantes, y se aplicó estadística descriptiva. RESULTADOS: En la población estudiada predominó el sexo masculino (82% del medio rural (70%, y la edad media fue de 34 ± 15.8 años. El intento de suicidio fue causa frecuente de IAP (79%, y en 33% de los casos la intoxicación se produjo por la utilización de organofosforados. La mortalidad fue de 12%. CONCLUSIONES: La IAP fue baja entre los sujetos del medio rural, por lo que los resultados de este estudio parecen no reflejar la realidad del problema. Es importante añadir que los plaguicidas son utilizados con relativa frecuencia para el intento de suicidio.OBJECTIVE: To describe the epidemiologic pattern of acute pesticide poisoning (APP in a general hospital in Merida, Yucatan, Mexico. MATERIAL AND METHODS: From 1994 to 1998, 33 patients 13 years of age or older with diagnosis of APP were studied. Descriptive statistics were used to analyze information. RESULTS: Males were frequently affected (82%, specially those coming from rural areas (60%. The mean age of the group was 34 ± 15.8 years. In 79% of the cases, pesticides were used to commit suicide and 33% of poisoning cases were due to organophospate pesticides. The mortality rate was 12%. CONCLUSIONS: In this small sample, acute poisoning from pesticides in the agricultural setting may be underestimated, since it was less frequent than in the general population. APP was more commonly used by indigent people to commit suicide.

  4. Pesticide Use and Self-Reported Symptoms of Acute Pesticide Poisoning among Aquatic Farmers in Phnom Penh, Cambodia

    Directory of Open Access Journals (Sweden)

    Hanne Klith Jensen

    2011-01-01

    Full Text Available Organophosphates and carbamates (OPs/CMs are known for their acetylcholinesterase inhibiting character. A cross-sectional study of pesticide handling practices and self-perceived symptoms of acute pesticide poisoning was conducted using questionnaire-based interviews with 89 pesticide sprayers in Boeung Cheung Ek (BCE Lake, Phnom Penh, Cambodia. The study showed that 50% of the pesticides used belonged to WHO class I + II and personal protection among the farmers were inadequate. A majority of the farmers (88% had experienced symptoms of acute pesticide poisoning, and this was significantly associated with the number of hours spent spraying with OPs/CMs (OR = 1.14, CI 95%: 1.02–1.28. The higher educated farmers reduced their risk of poisoning by 55% for each extra personal protective measure they adapted (OR = 0.45, CI 95%: 0.22–0.91. These findings suggest that improving safe pesticide management practices among the farmers and enforcing the effective banning of the most toxic pesticides will considerably reduce the number of acute pesticide poisoning episodes.

  5. Triage vital signs predict in-hospital mortality among emergency department patients with acute poisoning: a case control study

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    Yu Jiun-Hao

    2012-08-01

    Full Text Available Abstract Background To document the relationship between triage vital signs and in-hospital mortality among emergency department (ED patients with acute poisoning. Methods Poisoning patients who admitted to our emergency department during the study period were enrolled. Patient’s demographic data were collected and odds ratios (OR of triage vital signs to in-hospital mortality were assessed. Receiver operating characteristic curve was used to determine the proper cut-off value of vital signs that predict in-hospital mortality. Logistic regression analysis was performed to test the association of in-hospital mortality and vital signs after adjusting for different variables. Results 997 acute poisoning patients were enrolled, with 70 fatal cases (6.7%. A J-shaped relationship was found between triage vital signs and in-hospital mortality. ED triage vital signs exceed cut-off values independently predict in-hospital mortality after adjusting for variables were as follow: body temperature 37°C, p 150 mmHg, p 120 bpm, p 20 per minute, p = 0.38, OR: 1.4. Conclusions Triage vital signs could predict in-hospital mortality among ED patients with acute poisoning. A J-curve relationship was found between triage vital signs and in-hospital mortality. ED physicians should take note of the extreme initial vital signs in these patients.

  6. Acute Datura Stramonium poisoning in East of Iran - a case series

    Directory of Open Access Journals (Sweden)

    Mahnaz Amini

    2012-03-01

    Conclusion: Our study showed most of D. Stramonium poisoned population in our region are children. We suggest decreasing accessibility to the plant in order to decrease the incidence of its poisoning

  7. A 3-year survey of acute poisoning exposures in infants reported in ...

    African Journals Online (AJOL)

    minis tered by a carer, but children are inquisitive by nature, and as infants become mobile (8 12 ... Most poisoning exposures in infants are not serious and can be safely managed at home after contacting a poison centre. Identification and documentation of ..... Host and environment factors for exposure to poisons: A ...

  8. Reduced Levels of Serum Potassium and Plasma Cholinesterase in Acute Organophosphate Poisoning: Possible Predictive Markers

    Directory of Open Access Journals (Sweden)

    Devanur Prasad

    2014-06-01

    Conclusion: For severe clinical features of OP poisoning, serum [K+] and PChE level are greatly reduced. Hence, these biochemical findings can be proposed as OP poisoning predictive markers. Clinicians and medical toxicologists should consider hypokalemia associated with reduced PChE level as alarming signs of poor prognosis in OP poisoned patients.

  9. Acute Poisoning in Elderly; a Five-Year Study (2008-2013 in Hamadan, Iran

    Directory of Open Access Journals (Sweden)

    Saeed Afzali

    2015-12-01

    Conclusion: Deliberate self-harm and poisoning with opioids especially methadone showed a high prevalence in elderly poisoned patients in Hamadan, Iran.  It seems that drug trafficking control, addiction rehabilitation therapies and suicide prevention programs for elderly can be helpful in poisoning reduction in this age group in this part of the country.

  10. Use of the molecular adsorbent recirculating system (MARS™) for the management of acute poisoning with or without liver failure.

    Science.gov (United States)

    Wittebole, Xavier; Hantson, Philippe

    2011-11-01

    There is an increasing interest in recent developments in bioartificial and non-bioartificial devices, so called extracorporeal liver assist devices, which are now used widely not only to increase drug elimination, but also to enhance the removal of endogenous substances in acute liver failure. Most of the non-bioartificial techniques are based on the principle of albumin dialysis. The objective is to remove albumin-bound substances that could play a role in the pathophysiology of acute liver failure by dialysing blood against an albumin-containing solution across a high flux permeable membrane. The most widely used device is the Molecular Adsorbent Recirculating System (MARS™). The relevant English and French literature was identified through Medline using the terms, 'molecular adsorbent recirculating system', 'MARS', 'acute liver failure', 'acute poisoning', 'intoxication'. This search identified 139 papers of which 48 reported on a toxic cause for the use of MARS™. Of these 48 papers, 39 specified the substance (eighteen different substances were identified); two papers reported on the same group of patients. BIOARTIFICIAL AND NON-BIOARTIFICIAL SYSTEMS: Bioartificial systems based on porcine hepatocytes incorporated in the extracorporeal circuit are no longer in use due to the possibility of porcine retroviral transmission to humans. Historically, experience with such devices was limited to a few cases of paracetamol poisoning. In contrast, an abundant literature exists for the non-bioartificial systems based on albumin dialysis. The MARS™ has been used more widely than other techniques, such as the one using fractionated plasma separation and adsorption (Prometheus™). All the extracorporeal liver assist devices are able to some extent to remove biological substances (ammonia, urea, creatinine, bilirubin, bile acids, amino acids, cytokines, vasoactive agents) but the real impact on the patient's clinical course has still to be determined. Improvement in

  11. Changes in monoclonal HLA-DR antigen expression in acute organophosphorus pesticide-poisoned patients.

    Science.gov (United States)

    Xia, Chenyun; Wang, Mi; Liang, Qi; Yun, Ling'an; Kang, Housheng; Fan, Lei; Wang, Dongsheng; Zhang, Guoyuan

    2014-01-01

    The aim of this study was to investigate changes in human leukocyte antigen (HLA)-DR expression of peripheral blood mononuclear cells (MNCs) in patients with acute organophosphorus pesticide poisoning (AOPP). HLA-DR antigen expression of peripheral blood MNCs was examined in 75 patients with AOPP, including 36 patients without multiple organ dysfunction syndrome (non-MODS) and 39 patients with multiple organ dysfunction syndrome (MODS), as well as in 30 healthy individuals using flow cytometry assay. The associations between HLA-DR antigen expression and certain parameters were analyzed, including acute physiology and chronic health evaluation II (APACHE II) score, serum cholinesterase (ChE) activity, cardiac troponin I (cTnI), cardiac enzymes, and liver and kidney function. The mean fluorescence intensity (MCF) of HLA-DR expression in the AOPP group (21.59±5.36) was significantly lower than that in the control group (27.85±4.86) (PDR expression in patients with AOPP was significantly decreased compared with that in healthy individuals; HLA-DR expression may therefore be a good indicator for evaluating AOPP, MODS disease severity, immune function, efficacy of prognosis and prognosis. Examination of HLA-DR antigen expression may be of crucial clinical value.

  12. The spectrum of intermediate syndrome following acute organophosphate poisoning: a prospective cohort study from Sri Lanka.

    Directory of Open Access Journals (Sweden)

    Pradeepa Jayawardane

    2008-07-01

    Full Text Available Intermediate syndrome (IMS is a major cause of death from respiratory failure following acute organophosphate poisoning. The objective of this study was to determine repetitive nerve stimulation (RNS predictors of IMS that would assist in patient management and clinical research.Seventy-eight consenting symptomatic patients with organophosphate poisoning were assessed prospectively with daily physical examination and RNS. RNS was done on the right and left median and ulnar nerves at 1, 3, 10, 15, 20, and 30 Hz. The study was conducted as a prospective observational cohort study in the Central Province, Sri Lanka. IMS was diagnosed in ten out of 78 patients using a priori clinical diagnostic criteria, and five of them developed respiratory failure. All ten patients showed progressive RNS changes correlating with the severity of IMS. A decrement-increment was observed at intermediate and high frequencies preceding the onset of clinical signs of IMS. As the patient developed clinical signs of IMS, decrement-increment was progressively noted at low and intermediate frequencies and a combination of decrement-increment and repetitive fade or severe decrement was noted at high frequencies. Severe decrement preceded respiratory failure in four patients. Thirty patients developed forme fruste IMS with less severe weakness not progressing to respiratory failure whose RNS was characterized by decrement-increment or a combination of decrement-increment and repetitive fade but never severe decrements.Characteristic changes in RNS, preceding the development of IMS, help to identify a subgroup of patients at high risk of developing respiratory failure. The forme fruste IMS with the characteristic early changes on RNS indicates that IMS is a spectrum disorder. RNS changes are objective and precede the diagnosis and complications of IMS. Thus they may be useful in clinical management and research.

  13. Evidence of the direct adsorption of mercury in human hair during occupational exposure to mercury vapour.

    Science.gov (United States)

    Queipo Abad, Silvia; Rodríguez-González, Pablo; García Alonso, J Ignacio

    2016-07-01

    We have found clear evidence of direct adsorption of mercury in human hair after the occupational exposure to mercury vapour. We have performed both longitudinal analysis of human hair by laser ablation ICP-MS and speciation analysis by gas chromatography ICP-MS in single hair strands of 5 individuals which were occupationally exposed to high levels of mercury vapour and showed acute mercury poisoning symptoms. Hair samples, between 3.5 and 11cm long depending on the individual, were taken ca. three months after exposure. Single point laser ablation samples of 50μm diameter were taken at 1mm intervals starting from the root of the hairs. Sulfur-34 was used as internal standard. The ratio (202)Hg/(34)S showed a distinct pattern of mercury concentration with much lower levels of mercury near the root of the hair and high levels of mercury near the end of the hair. In all cases a big jump in the concentration of mercury in hair occurred at a given distance from the root, between 32 and 42mm depending on the individual, with a high and almost constant concentration of mercury for longer distances to the root. When we took into account the rate of hair growth in humans, 9-15mm/month, the jump in mercury concentration agreed approximately with the dates when the contamination occurred with the new growing hair showing much lower mercury concentration. In some cases the concentration of mercury at the tip of the hair was ca. 1000 times higher than that near the root. Additionally, speciation studies confirmed that mercury in all hair samples was present as inorganic mercury. The only explanation for these results was the direct adsorption of mercury vapour in hair at the time of exposure. Copyright © 2016 Elsevier GmbH. All rights reserved.

  14. Gastric Lavage in Acute Organophosphorus Pesticide poisoning (GLAOP – a randomised controlled trial of multiple vs. single gastric lavage in unselected acute organophosphorus pesticide poisoning

    Directory of Open Access Journals (Sweden)

    Cao YuPing

    2006-10-01

    Full Text Available Abstract Background Organophosphorus (OP pesticide poisoning is the most common form of pesticide poisoning in many Asian countries. Guidelines in western countries for management of poisoning indicate that gastric lavage should be performed only if two criteria are met: within one hour of poison ingestion and substantial ingested amount. But the evidence on which these guidelines are based is from medicine overdoses in developed countries and may be irrelevant to OP poisoning in Asia. Chinese clinical experience suggests that OP remains in the stomach for several hours or even days after ingestion. Thus, there may be reasons for doing single or multiple gastric lavages for OP poisoning. There have been no randomised controlled trials (RCTs to assess this practice of multiple lavages. Since it is currently standard therapy in China, we cannot perform a RCT of no lavage vs. a single lavage vs. multiple lavages. We will compare a single gastric lavage with three gastric lavages as the first stage to assess the role of gastric lavage in OP poisoning. Methods/Design We have designed an RCT assessing the effectiveness of multiple gastric lavages in adult OP self-poisoning patients admitted to three Chinese hospitals within 12 hrs of ingestion. Patients will be randomised to standard treatment plus either a single gastric lavage on admission or three gastric lavages at four hour intervals. The primary outcome is in-hospital mortality. Analysis will be on an intention-to-treat basis. On the basis of the historical incidence of OP at the study sites, we expect to enroll 908 patients over three years. This projected sample size provides sufficient power to evaluate the death rate; and a variety of other exposure and outcome variables, including particular OPs and ingestion time. Changes of OP level will be analyzed in order to provide some toxic kinetic data. Discussion the GLAOP study is a novel, prospective cohort study that will explore to the toxic

  15. [Impact of quality-indicator-based measures to improve the treatment of acute poisoning in pediatric emergency patients].

    Science.gov (United States)

    Martínez Sánchez, Lidia; Trenchs Sainz de la Maza, Victoria; Azkunaga Santibáñez, Beatriz; Nogué-Xarau, Santiago; Ferrer Bosch, Nuria; García González, Elsa; Luaces I Cubells, Carles

    2016-02-01

    To analyze the impact of quality-indicator-based measures for improving quality of care for acute poisoning in pediatric emergency departments. Recent assessments of quality indicators were compared with benchmark targets and with results from previous studies. The first study evaluated 6 basic indicators in the pediatric emergency departments of members of to the working group on poisoning of the Spanish Society of Pediatric Emergency Medicine (GTI-SEUP). The second study evaluated 20 indicators in a single emergency department of GTI-SEUP members. Based on the results of those studies, the departments implemented the following corrective measures: creation of a team for gastric lavage follow-up, preparation of a new GTI-SEUP manual on poisoning, implementation of a protocol for poisoning incidents, and creation of specific poisoning-related fields for computerized patient records. The benchmark targets were reached on 4 quality indicators in the first study. Improvements were seen in the availability of protocols, as indicators exceeded the target in all the pediatric emergency departments (vs 29.2% of the departments in an earlier study, P indicators. Improvements were seen in compliance with incident reporting to the police (recently, 44.4% vs 19.2% previously, P = .036), case registration in the minimum basic data set (51.0% vs 1.9%, P trend toward increased administration of activated carbon within 2 hours (93.1% vs 83.5%, P = .099). No other significant improvements were seen. The corrective measures led to improvements in some quality indicators. There is still room for improvement in these emergency departamens' care of pediatric poisoning.

  16. Searching for the Cases of Acute Organophosphorus Pesticides Poisoning by JOIS

    Science.gov (United States)

    Futagami, Kojiro; Fujii, Toshiyuki; Horioka, Masayoshi; Asakura, Hajime; Fukagawa, Mitsuro

    Cholinesterase reactivator PAM (Pralidoxime) is used in the treatment of organophosphates poisoning with anticholinergic agent atropine. However, some reports demonstrated recently that PAM has inefficacy in some cases of so-called low toxicity organophosphates poisoning. So, to atempt to discuss the efficacy of PAM in clinical treatment, we searched for the case reports of these poisoning by JOIS. In this time, we compared with the specificity of each data bases and presented some examples in this on-line information retrieval.

  17. Acute poisonings during pregnancy and in other non-pregnant women in emergency departments of four government hospitals, Addis Ababa, Ethiopia: 2010-2015.

    Science.gov (United States)

    Eyasu, Mebrahtu; Dida, Tolesa; Worku, Yoseph; Worku, Solomon; Shafie, Mensur

    2017-10-01

    To characterise acute poisonings in pregnant and non-pregnant women treated at emergency departments of government hospitals in Addis Ababa, Ethiopia, between 2010 and 2015. All data for acutely poisoned women were retrospectively collected from patient medical charts at the emergency departments of Saint Paul's Hospital Millennium Medical College, Ras Desta Memorial Hospital, Yekatit 12 Hospital Medical College and Zewditu Memorial Hospital. Data were collected by extraction questionnaire and analysed using SPSSv. 20 statistical software. During the study period, 998 cases of acutely poisoned women were listed in the hospital registries. Of these, complete data for inclusion in the study were available for 592. 36.3% of the study participants were in the age group of 20-24, with a mean (±SD) age of 23.03 (±6.3) years. 80.9% were from Addis Ababa; 4.6% were pregnant. The mean arrival time of all cases was 4.14 h. 85.5% of all study cases were due to intentional self-poisoning, of whom 42.1% were discharged without complications. The most common poisons were bleach and organophosphates; 25.9% of pregnant cases and 32.6% of non-pregnant cases were poisoned by bleach; and 18.5% of pregnant cases and 18.9% of non-pregnant cases had organophosphate poisoning. 0.7% had a history of poisoning; all were non-pregnant women. The common route of poison exposure was oral, and the case fatality rate of organophosphate poisoning in pregnant and non-pregnant women was 20 and 1.87%, respectively. The pre-hospital intervention for the majority of the women was milk, in 12.0% of cases. Acute poisoning remains a public health problem in our community. Bleach is the most common poisons. Our present findings indicate the necessity of educational programmes on preventable reasons of acute poisonings and their outcomes on pregnant and non-pregnant women. © 2017 John Wiley & Sons Ltd.

  18. [Acute alcohol poisonings among patients in Toxicology Unit, Nofer Institute of Occupational Medicine in the period of time 2007-2012].

    Science.gov (United States)

    Rogaczewska, Anna; Kobza-Sindlewska, Katarzyna; Krakowiak, Anna; Piekarska-Wijatkowska, Anna

    2014-01-01

    The purpose of the research was to present the analysis of acute alcohol poisonings (ethanol, methanol, ethylene glycol, isopropanol) in Toxicology Unit (TU), Nofer Institute of Occupational Medicine (NIOM), Lódź, Poland. To further analysis were chosen all cases, whose were coded according to the International Statistical Classification of Diseases and Related Health Problems 10th Revision. There were 10,936 acute poisonings in the analyzed period of time 2007-2012 years, 3,088 of them referred to alcohol poisonings (28%). The largest group of patients included cases with ethanol intoxication (2,883 subjects), the second and third one-cases with methanol and ethylene glycol poisonings (99 and 98 respectively), 8 cases were poisoned with isopropanol. The largest group of patients includes cases at age less than 30 years. Patients at age above 60 years formed the lowest group among the total number of poisonings. Most of the admitted cases were men (2,417 patients) and cases hospitalized due to ethanol abuseladdiction (93%). Ethylene glycol poisonings constituted the leading cause of deaths (10 subjects). The study shows, that intoxications with alcohols are a big problem in NIOM and the number of alcohol poisonings markedly increased in the years 2007-2012.

  19. Hospital-based surveillance for acute pesticide poisoning caused by neurotoxic and other pesticides in Tanzania.

    Science.gov (United States)

    Lekei, Elikana; Ngowi, Aiwerasia V; London, Leslie

    2014-12-01

    Acute pesticide poisoning (APP), particularly with neurotoxic agents, is often under-reported in developing countries. This study aimed to estimate the burden of APP in Tanzania due to neurotoxic and other pesticides in order to propose a surveillance system. The study reviewed hospital admission data for APP retrospectively (2000-2005) in 30 facilities in four regions of Tanzania. A prospective follow-up over 12 months in 2006 focused on 10 facilities with the highest reporting of APP. The majority of known poisoning agents were organophosphates or WHO class I and II pesticides. APP involving suicide was significantly more likely to be fatal in both retrospective (PRR fatal/non-fatal=3.8; 95% CI=1.8-8.0) and in prospective (PRR=8.7; 95% CI=1.1-65) studies. There was a significant association between suicide and gender (PRR female/male=1.5; 95% CI=1.1-2.0) in the prospective study. Occupational circumstances as a cause of APP, which was relatively small in both studies (8.5% in the retrospective and 10.2% in the prospective study) was less common amongst men compared to women (6.1% for males versus 12.0% for females) in the retrospective study but almost equal in prospective study (10.2% for males versus 10.1% for females). Contrasting retrospective to prospective studies, the annual incidence rate almost tripled (from 1.43 to 4.05 per 100,000) and mortality rate doubled (from 0.11 to 0.22 per 100,000). Case fatality declined accordingly from 7.8% to 5.6% in prospective study. The study revealed a substantial improvement in the completeness of data with prospective data collection. Missing data for circumstances and agents declined by 24.1% and 9.9%, respectively. Despite this improvement, routine reporting could only generate 33-50% of the information needed for a notification of banned or severely restricted chemicals under the Prior Informed Consent (PIC) convention. The two to threefold increase in rates with prospective data collection suggests significant

  20. Coagulation disorders secondary to acute liver failure in Amanita phalloides poisoning: a case report.

    Science.gov (United States)

    Soysal, Dilek; Cevik, Cetin; Saklamaz, Aras; Yetimalar, Yeşim; Unsal, Belkis

    2006-09-01

    Amanita mushroom poisoning is a serious occurrence. Physicians need to recognize the syndrome promptly and institute effective treatment as soon as possible in order to avoid the often fatal complications. We report a case of a young man with mushroom poisoning of the genus Amanita with a clinical spectrum that ranged from hepatic failure and coagulation disorders to an outcome with a partial recovery. The aim of this report was to emphasize the clinical outcomes and treatment regimens in this type of mushroom poisoning seen with increasing frequency in our region.

  1. Coagulation disorders secondary to acute liver failure in Amanita phalloides poisoning: a case report

    National Research Council Canada - National Science Library

    Soysal, Dilek; Cevik, Cetin; Saklamaz, Aras; Yetimalar, Yeşim; Unsal, Belkis

    2006-01-01

    Amanita mushroom poisoning is a serious occurrence. Physicians need to recognize the syndrome promptly and institute effective treatment as soon as possible in order to avoid the often fatal complications...

  2. Acute Human Self-Poisoning with Imidacloprid Compound: A Neonicotinoid Insecticide

    OpenAIRE

    Fahim Mohamed; Indika Gawarammana; Robertson, Thomas A.; Roberts, Michael S.; Chathura Palangasinghe; Shukry Zawahir; Shaluka Jayamanne; Jaganathan Kandasamy; Michael Eddleston; Buckley, Nick A; Dawson, Andrew H.; Roberts, Darren M

    2009-01-01

    Background Deliberate self-poisoning with older pesticides such as organophosphorus compounds are commonly fatal and a serious public health problem in the developing world. The clinical consequences of self-poisoning with newer pesticides are not well described. Such information may help to improve clinical management and inform pesticide regulators of their relative toxicity. This study reports the clinical outcomes and toxicokinetics of the neonicotinoid insecticide imidacloprid following ...

  3. Factors associated with acute pesticide poisoning among farmers in Northwestern Jamaica

    OpenAIRE

    Jolly, Pauline; Ncube, N.; Bessler, Patricia; Fogo, Christopher; Jolly, Curtis M.

    2010-01-01

    The safe production and marketing of food is a major step towards food security. However, many farmers put themselves at risk from pesticide poisoning during the production process. The unsafe use of pesticides is a major problem, especially in Caribbean Common Market (CARICOM) countries where the most persistent and hazardous pesticides are used by farmers with limited training. Excessive and improper use of pesticides is one of the major causes of chemical poisoning in the CARICOM area. In ...

  4. [Role of acute alcohol poisoning and craniocerebral trauma in the mechanism of death caused by subarachnoid hemorrhage].

    Science.gov (United States)

    Tang, Yi-kun; Shi, Meng; Ou, Gui-sheng; Zhao, Hu

    2014-10-01

    To investigate the relation between the expression of tPA, MMP-2, MMP-9 and AEG-1 in the human brain tissue and the ethanol concentration under the acute alcohol poison, and to analyze the role of alcohol and trauma in the mechanism of death of subarachnoid hemorrhage. Fifteen real cases were collected in this study. The brain tissues were researched by histological examination and the concentration of ethanol in heart blood were detected. The tPA, MMP-2, MMP-9 and AEG-1 in brainstem, brain and cerebellum were observed respectively by immunohistochemistry. In alcohol poisoning groups with or without trauma, the acute alcohol toxicity resulted in the swelling of brain tissues. The tPA, MMP-2, MMP-9 and AEG-1 of brainstem, brain and cerebellum showed high expression in alcohol victims, and the tPA in cerebellum showed no difference. The expression of the MMP-2, MMP-9 and AEG-1 showed good relation with the ethanol concentration in blood (P 0.6). The expressions of tPA, MMP-2, MMP-9 and AEG-1 are significant higher in alcohol victims, and expressions of MMP-2 and MMP-9 and AEG-1 have positive correlation with the alcohol concentration. The alcohol has acute toxicity to brain cells.

  5. Hair analysis for drug abuse. XIV. Identification of substances causing acute poisoning using hair root. I. Methamphetamine.

    Science.gov (United States)

    Nakahara, Y; Kikura, R; Yasuhara, M; Mukai, T

    1997-01-17

    A hair root was evaluated as a specimen for proving acute methamphetamine (MA) poisonings using an animal model and fatal cases of MA intoxicaton. First of all, male pigmented hairy rats (n = 5) were administered with acute poisonous doses (20, 40 and 60 mg/kg) of MA and the hair roots were plucked out with a hair nipper 5 min and 0.5, 1, 2, 6 and 24 h after i.p. injection. The hair root samples were, directly or after washing with detergent, extracted with methanol/5 N HCl (20:1) under vortex mixing at room temperature for 14 h. After evaporation, the residue was derivatized with pentafluoropropionic anhydride and analyzed with GC/MS. From all samples including a 5-min sample, MA was detected at high concentrations (approximately 150 ng/mg) with a small amount of amphetamine (AP). Many animals died within 120 min of administration, but the concentrations in the hair roots increased up to 120 min and then slowly decreased until 24 h. Although MA was definitely detected anytime in the hair roots, almost no MA was found in 24-h plasma. In comparison of the drug levels in hair roots between the washed group and the unwashed group, the levels of the washed group were as a whole 4-5-fold higher than those of the unwashed group. These differences show that most of the drug incorporated into hair root is still not immobilized in the early stage. The ratios of the MA remainder in the washed samples increased with the elapse of time in all cases. However, the slope of the curves definitely dropped after the death of rats, probably due to the stopping of the hair growth and the incorporation of drug into the hair shaft. The ratios of AP/MA after death became a plateau probably due to the stoppage of the activity of metabolism after death, while those before death had increased over time. We analyzed the specimens of hair root of four men who died mainly due to acute poisonings with MA. Consequently, MA in the hair roots was detected at high concentrations, 30.5-134.6 ng

  6. Effectiveness of Continuous Veno-Venous Hemofiltration and Intermittent Hemodialysis in the Treatment of Severe Acute Phenobarbital Poisoning

    Directory of Open Access Journals (Sweden)

    Le Quang Thuan

    2013-03-01

    Full Text Available Background: Phenobarbital poisoning is common in Vietnam. The aim of this study was to compare the effectiveness of continuous veno-venous hemofiltration (CVVH and hemodialysis (HD on clinical outcomes in the treatment of severe acute phenobarbital poisoning. Methods: This was a retrospective observational historically controlled study. 42 patients with severe phenobarbital poisoning were enrolled. 21 patients were treated with HD and 21 with CVVH. Both groups received similar supportive therapies consisting of mechanical ventilation, forced alkaline diuresis and multiple-dose activated charcoal. Results: Following one course of treatment with HD (4 hours or CVVH (~19.5 hours the mean (SD blood phenobarbital concentration (BPC had decreased to 3.9 (2.5 and 3.2 (2.3 mg/dL respectively (P=0.232. Mean percentage decrease in BPC after HD and CVVH were 62.7 (12.4 and 61.5 (22.0 % respectively, showing no significant difference (P=0.782. Mean duration of coma and mechanical ventilation in CVVH group was 31.9 (26.6 and 39.7 (27.9 hours, significantly shorter than those in HD group with 66.1 (32.5 and 66.7 (32.2 hours (P=0.002; 0.001 respectively. Conclusion: One course of treatment with CVVH and HD decreased the BPC to a similar extent but this was not associated with similar clinical outcomes. Although, CVVH was not associated with rapid fall in blood phenobarbital level, it clearly had clinical advantages by shortening the duration of coma and mechanical ventilation and with lack of coma recurrence in severe phenobarbital poisoning.

  7. [The relationship between lactate clearance rate and delayed encephalopathy after acute carbon monoxide poisoning].

    Science.gov (United States)

    Wang, Wei-zhan; Ma, Guo-ying; Zhao, Ling-jun; Li, Jing; Wang, Pu; Li, Ya-qin; Xiao, Qing-mian; Liu, Yong-jian

    2013-10-01

    To study the relationship between lactate clearance rate (LCR) and prognosis after acute carbon monoxide poisoning in patients with delayed encephalopathy (DEACMP). Data from 354 patients with acute severe carbon monoxide poisoning (ASCOP) were retrospectively analyzed. The patients were divided into hyperlactacidemia group (arterial lactic acid > 2 mmol/L, n=263) and low lactic acidosis group (arterial lactate ≤2 mmol/L, n=91) according to the blood lactic acid level at admission. Arterial blood (1 mL) was collected from all patients before and 6, 24, 72 hours after treatment at ambient air, and arterial blood lactic acid was determined, and LCR was calculated. The initial level of blood lactic acid and LCR at 6, 24, 72 hours were compared between two groups. At the same time, the patients with hyperlactacidemia were divided into high LCR group (LCR more than 10%, n=101) and low LCR group (LCR less than or equal to 10%, n=162) according to 6-hour LCR, and the incidence of DEACMP was compared between two groups. The relationship between LCR and the incidence of DEACMP was analyzed with Spearman linear correlation analysis. The risk factors associated with DEACMP were analyzed with logistic regression analysis. The initial level of blood lactic acid (2.73±0.57 mmol/L vs. 1.69±0.20 mmol/L, t=5.327, P=0.001) and LCR at 6, 24, 72 hours [6 hours: (9.0±2.4)% vs. (1.2±0.6)%, t=9.468, P=0.001; 24 hours: (8.6±3.7)% vs. (1.2±0.4)%, t=4.889, P=0.001; 72 hours: (14.0±3.9)% vs. (1.7±1.0)%, t=5.211, P=0.001] in hyperlactacidemia group were significantly higher than those in low lactic acidosis group. The initial level of blood lactic acid in high LCR group was significantly lower than that in low LCR group (2.41±0.23 mmol/L vs. 2.92±0.63 mmol/L, t=2.429, P=0.023), and LCR at 6 hours and 24 hours were significantly higher than those in low LCR group [6 hours: (11.0±1.2)% vs. (8.0±2.1)%, t=4.487, P=0.001; 24 hours: (12.2±3.0)% vs. (6.3±1.8)%, t=6.264, P=0.001]. But

  8. REHABILITATION OF PATIENTS WITH ENCEPHALOPATHY CAUSED BY ACUTE CHEMICAL AGENTS POISONING. P300 OF AUDITORY EVENT RELATED POTENTIALS AND ELECTROENCEPHALOGRAPHY

    Directory of Open Access Journals (Sweden)

    I. U. Berezina

    2014-01-01

    Full Text Available RELEVANCE. Patients with encephalopathy due to acute chemical agents poisoning have some brain functioning changes and a cognitive impairment during the rehabilitation program. These changes require correction of appropriate diagnostic protocol and treatment.AIM. The aim of this study was to estimate changes of electroencephalography (EEG and the P3 component of the event related potential (P300 ERP that are observed in patients with encephalopathy due to acute chemical agents poisoning during stage of rehabilitation.MATERIAL AND METHODS. The study was included 25 patients (age 37 (32; 51 poisoned different kind of neurotoxic substances (drugs, ethanol and complicated by toxic and hypoxic encephalopathy. They have got the treatment of encephalopathy by mexidol intravenously, mesodiencephalic modulation (MDM and hyperbaric oxygen therapy (HBOT. All patients were recoded EEG (electroencephalograph of “MBN” company, Russia and P300 ERP (“Neuron-Spectrum-5/EP” of “Neurosoft”, Russia according to the international recommendations of clinical neurophysiologists. Neuropsychological testing was used for the assessment of cognitive functions.RESULTS. There were some disturbances in primary electroencephalograms of all subjects. The follow-up EEG recording showed the main group of patients who had got the treatment (mexidol, MDM, HBOT had more often (11 patients the EEG improvements compared to the controls (1 patient. The main group had more rarely the EEG impairments compared to the control group. 6 patients of main group and 3 patients of controls did not have EEG changes during the follow-up EEG recordings. All controls and 17 patients of the main group patients had different cognitive disturbances. After the treatment 15 patients of the main group had improved on neuropsychological tests (MMSE, Munsterberg test, Schulte table, Number Connecting Test. They also had a decrease in the N200, P300 peak latency and an increase in the N200, P300

  9. [Methods for the prevention and treatment of toxico-hypoxic encephalopathy in patients with acute severe poisoning].

    Science.gov (United States)

    2011-01-01

    The study included 147 patients with toxico-hypoxic encephalopathy resulting from acute poisoning. It was shown that intensive therapy with cytoflavin (20 ml in 400 ml of 5% glucose solution twice daily for 7 days) reduced severity of hypoxic brain lesions and suppression of CNS as apparent from the improvement of its bioelectric activity. The recovery of CNS regulatory action on the life-sustaining systems of the body promoted normalization of the respiratory component of oxygen transport. The improvement of the patients' conditions in the acute phase contributed to accelerated recovery of cognitive-amnestic functions and social adaptation. Cytoflavin therapy improved the clinical picture of toxico-hypoxic encephalopathy due to the reduction in the duration of the comatose state from 45.3 +/- 8.2 to 27.7 +/- 6.9 hr and the decrease in the frequency of secondary pulmonary complications from 72.7 to 35.9%.

  10. [Acute dextromethorphan poisoning based on the records of the Department of Toxicology and Internal Diseases in Poznan].

    Science.gov (United States)

    Łukasik-Głebocka, Magdalena; Sommerfeld, Karina

    2009-01-01

    The recreational usage of dextrometorphan, the popular antitussive medicine, has become alarming in Poland. The euphoric and hallucinogenic activity of this drug manifests after high doses, usually ranging from 225 to 1500 mg that may lead to acute poisoning. Currently, dextrometh-orphan is considered as addictive substance. In this article we describe the symptoms of acute dextrometorphan poisoning that have been observed in 11 patients, aged between 16 and 31 years that have been treated in the Department of Toxicology and Internal Diseases Raszeja Hospital in Poznan. In the course of intoxication the most frequent symptom was balance disturbation (12.50%), impaired motoric coordination (11.36%), confusion (11.36%) and papillary dilation (11.36%). Agitation (9.09%), tachycardia (7.95%), hallucinations (6.82%), disartria (5.68%) and hypertension (4.55%) were less common. The doses of dextromethorphan ranged from 4.28 to 16.67 mg/kg. All the patients were treated symptomatically. They recovered without sequelae and were discharged after 1-3 days of hospitalization.

  11. Oxidative Distress and Its Correction with Reamberin in Patients With Acute Poisoning by a Mixture of Psychotropic Substances

    Directory of Open Access Journals (Sweden)

    G. A. Livanov

    2013-01-01

    Full Text Available Objective: to determine the impact of reamberin incorporation into intensive care on the antioxidant defense system and the activity of lipid peroxidation in patients with toxic-hypoxic encephalopathy. Subjects and methods. The investigation enrolled 84 patients with acute severe poisoning by a mixture of psychotropic substances (hypnotics, neuroleptics, antidepressants, 1,4-benzodiazepine derivatives, ethanol. Oxygen balance parameters (oxygen consumption, oxygen utilization quotient, and arteriovenous oxygen difference were calculated. The antiradical defense system was evaluated determining the levels of reduced glutathione and free sulfhydryl groups of proteins activity of the antiradical enzymes glutathione peroxidase, glutathione-S-transferase, and catalase in red blood cells. Lipid peroxidation rate in red blood cells was determined by measuring the concentration of malondialdehyde. Results. The incorporation of reamberin into intensive care was found to be accompanied by a reduction in tissue hypoxia, more rapid recovery of the antioxidant defense system, and a decrease in the activity of lipid peroxidation processes. Сorrection of metabolic disturbances in its turn leads to the improved clinical course of acute poisoning, which manifests itself as a reduction in the duration of coma, the length of stay in the intensive care unit, and mortality. Conclusion. The reduction in the severity of metabolic disturbances associated with the development of hypoxia and free radical disorders leads to substantial improvement of the clinical course and outcomes of toxic-hypoxic encephalopathy. Key words: toxic-hypoxic encephalopathy, hypoxia, antioxidant system, lipid peroxida-tion, reamberin.

  12. Effect of environmental exposure to mercury on the functioning of the human body

    Directory of Open Access Journals (Sweden)

    Maciej Cyran

    2013-09-01

    Full Text Available Mercury is classified as a heavy metal and thus is commonly referred to as a death metal due to its high toxicity. In the environment it occurs in metallic form or in combination with other compounds. Amidst the sources of exposure to mercury, the most important environmental sources are dental amalgam and mercury vapor from the production of chlorine which is the most important source of occupational exposure. Mercury is easily soluble in fats, so it penetrates through biological membranes. Both - acute and chronic mercury poisoning causes characteristic clinical symptoms. There are several connections between exposure to this metal and toxic effects on the nervous system, cardiovascular system, endocrine system and kidneys. Thus mercury damages the structure of many organs and impairs their function

  13. Serum biochemical markers of central nerve system damage in children with acute elemental mercury intoxicatıon.

    Science.gov (United States)

    Yılmaz, F M; Yılmaz, H; Tutkun, E; Uysal, S; Carman, K B; Dılber, C; Ercan, M

    2014-01-01

    Acute mercury intoxication among children can occur through unintentional exposure, and neurotoxicity is one of the main findings in acute exposures. In this study, we aimed to study the central nerve system markers, namely neuron-specific enolase (NSE), S100B, and glutamate receptor (GRIA 1) levels and discuss the mechanisms of central nerve system damage and whether these parameters could be used as markers of acute elemental mercury intoxication neurotoxicity. This is a case-control study which includes 169 children with acute elemental mercury intoxication, who were exposed to mercury in the school laboratory from a broken jar, and 45 sex- and age-matched controls without mercury exposure. Patient group were divided into three subgroups according to the neurological examination performed during the admission. Neuropathy Group included the children with neurological symptoms including peripheral neuropathy and decreased muscle strength (n = 39) (with or without dilated pupils). Dilated Pupil Group included the children who had mid-dilated/dilated pupils (n = 52). Asymptomatic Exposure Group included the children who did not have any neurological symptoms (n = 78). Serum NSE, S100B, GRIA 1, blood, and urine mercury levels were determined. NSE, S100B, GRIA 1, and blood mercury levels were significantly higher in exposed group than the nonexposed subjects (Median values NSE 22.4 ng/mL, 17.2 ng/mL; S100B 0.09 ng/mL, 0.08 ng/mL; GRIA 1 70.6 pg/mL, 54.1 pg/mL, and blood mercury 15.2 μg/L, 0.23 μg/L for exposed and nonexposed groups, respectively). GRIA 1 levels found to differ between exposed and nonexposed groups and it has also been found to be increased in the subgroups with positive neurological findings compared to that in neurological finding negative groups. S100B levels were found to be increased in exposed and having neurological symptom groups. There was not a significant difference between exposed-not having neurological symptom patients and control group

  14. Vulnerability associated with "symptoms similar to those of mercury poisoning" in communities from Xingu River, Amazon basin.

    Science.gov (United States)

    Da Silva-Junior, Flávio Mnaoel Rodrigues; Oleinski, Ritta M; Azevedo, Antonia E S; Monroe, Kátia C M C; Dos Santos, Marina; Da Silveira, Tatiane Britto; De Oliveira, Adrianne Maria Netto; Soares, Maria Cristina Flores; Pereira, Tatiana Da Silva

    2017-06-03

    The Brazilian Amazon is known to be a region with high levels of mercury (Hg) in the environment and studies point to an association between high levels of natural mercury in the mother rock and the vast number of clandestine gold mines. Other studies already report the contamination of fish in this region, as well as high levels of Hg in biological material from environmentally exposed populations. On the other hand, this is one of the least developed regions of the planet and it is necessary to understand the vulnerability factors in these populations that may be intoxicated by this element. The purpose of the present study was to investigate the vulnerability factors in communities from Xingu River-Amazon basin probably exposed to Hg. A cross-selection study in two cities localized in Xingu River was conducted, and the sample contained was 268 individuals. sociodemographic questions, lifestyle, diet habits and health conditions were collated. The majority of the sample was female, between 30 and 59 years old, had less than 3 years of educational level and lived in the local of study more than 240 months. There was regular fish consumption (95.9%), principally carnivorous species (80.5%). The visual problem has a highest prevalence (43.3%) between the health problems and about the symptoms of Hg intoxication, memory loss (42.9%), weakness (35.1%), fatigue (34.3%), mood changes (28.7%) and difficulties in concentration (27.2%) was most reported. The female sex, age over 60, educational level below 3 years of study, did not had flush toilet, smoke and least one chronic non-communicable disease represent higher probability to had symptoms of Hg intoxication. Lack of access to health services, low education level and income evidence the susceptibility of this community to diseases and injuries. The vulnerable groups identified in this study should be a priority in public health and environmental health policies.

  15. A 3-year survey of acute poisoning exposures in infants reported in ...

    African Journals Online (AJOL)

    Pharmaceuticals were involved in 185 cases (16.8%) followed by biological exposures (e.g. snake and spider bites, scorpion stings, plant and mushroom poisonings) (n=109, 9.9%). Most infants (n=987, 89.6%) presented with no or only minor symptoms. In neonates, 17 (37.0%) presented with moderate to severe toxicity.

  16. Is prevention of acute pesticide poisoning effective and efficient, with Locally Adapted Personal Protective Equipment?

    DEFF Research Database (Denmark)

    Varma, Anshu; Neupane, Dinesh; Ellekilde Bonde, Jens Peter

    2016-01-01

    BACKGROUND: Farmers' risk of pesticide poisoning can be reduced with personal protective equipment but in low-income countries farmers' use of such equipment is limited. OBJECTIVE: To examine the effectiveness and efficiency of Locally Adapted Personal Protective Equipment to reduce organophospha...

  17. A Yearlong Epidemiologic Study on Unintentional Acute Carbon Monoxide Poisoning in Fars Province, Southwest Iran

    Directory of Open Access Journals (Sweden)

    Alireza Mirahmadizadeh

    2016-03-01

    Conclusion: Generally, the incidence and fatality rate of CO poisoning in the current study were comparable to those of the world statistics, but higher than in developed counties. Attention and emphasis on the safety of gas heaters, stoves, and other gas-powered appliances in residential places should be enforced.

  18. Acute poisoning in the community and its associated mortality at the ...

    African Journals Online (AJOL)

    Of the cases where due to self-poisoning with intent to cause selfharm. The reasons for self-harm behaviour were given in 115 cases, and 71 (62%) of these were due to interpersonal conflicts arising from disharmony in relationships. The rest were due to various psychological disorders including depressive illness.

  19. Acute poisoning in cattle due to ingestion of rattlebox weed in ...

    African Journals Online (AJOL)

    A case of poisoning due to ingestion of Crotalaria cylindrocapa otherwise referred to as rattlebox weed in cattle was investigated and reported in this paper. High morbidity and low mortality rates were recorded in the affected cattle. Clinical signs observed were; hypersalivation, weakness, ataxia, inappetance , recumbency ...

  20. Food Poisoning

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Food Poisoning KidsHealth / For Kids / Food Poisoning What's in ... find out how to avoid it. What Is Food Poisoning? Food poisoning comes from eating foods that ...

  1. Pralidoxime in acute organophosphorus insecticide poisoning--a randomised controlled trial.

    Directory of Open Access Journals (Sweden)

    Michael Eddleston

    2009-06-01

    Full Text Available Poisoning with organophosphorus (OP insecticides is a major global public health problem, causing an estimated 200,000 deaths each year. Although the World Health Organization recommends use of pralidoxime, this antidote's effectiveness remains unclear. We aimed to determine whether the addition of pralidoxime chloride to atropine and supportive care offers benefit.We performed a double-blind randomised placebo-controlled trial of pralidoxime chloride (2 g loading dose over 20 min, followed by a constant infusion of 0.5 g/h for up to 7 d versus saline in patients with organophosphorus insecticide self-poisoning. Mortality was the primary outcome; secondary outcomes included intubation, duration of intubation, and time to death. We measured baseline markers of exposure and pharmacodynamic markers of response to aid interpretation of clinical outcomes. Two hundred thirty-five patients were randomised to receive pralidoxime (121 or saline placebo (114. Pralidoxime produced substantial and moderate red cell acetylcholinesterase reactivation in patients poisoned by diethyl and dimethyl compounds, respectively. Mortality was nonsignificantly higher in patients receiving pralidoxime: 30/121 (24.8% receiving pralidoxime died, compared with 18/114 (15.8% receiving placebo (adjusted hazard ratio [HR] 1.69, 95% confidence interval [CI] 0.88-3.26, p = 0.12. Incorporating the baseline amount of acetylcholinesterase already aged and plasma OP concentration into the analysis increased the HR for patients receiving pralidoxime compared to placebo, further decreasing the likelihood that pralidoxime is beneficial. The need for intubation was similar in both groups (pralidoxime 26/121 [21.5%], placebo 24/114 [21.1%], adjusted HR 1.27 [95% CI 0.71-2.29]. To reduce confounding due to ingestion of different insecticides, we further analysed patients with confirmed chlorpyrifos or dimethoate poisoning alone, finding no evidence of benefit.Despite clear reactivation of

  2. Notes from the Field: Acute Sulfuryl Fluoride Poisoning in a Family - Florida, August 2015.

    Science.gov (United States)

    Mulay, Prakash R; Clark, Grethel; Jackson, William L; Calvert, Geoffrey M

    2016-07-15

    On August 19, 2015, the Florida Department of Health (FDOH) was notified by the Florida Poison Information Center Network and a local hospital of possible sulfuryl fluoride poisonings affecting a family in Martin County, in southeastern Florida. Sulfuryl fluoride is a highly toxic (toxicity category I) gas fumigant used for termite control of homes and buildings.* FDOH personnel in Martin County commenced an investigation and identified a family of five (a grandmother, mother, father, son, and daughter) exposed to sulfuryl fluoride after their house was fumigated. The Florida Department of Agriculture and Consumer Services (FDACS), and the U.S. Environmental Protection Agency (EPA) Criminal Investigation Division also conducted an investigation after being notified by FDOH. Medical records were reviewed, and the father was interviewed by FDOH.

  3. Reversible cerebral periventricular white matter changes with corpus callosum involvement in acute toluene-poisoning.

    Science.gov (United States)

    Lin, Chih-Ming; Liu, Chi-Kuang

    2015-01-01

    Substance poisoning, such as toluene intoxication, has seldom been reported in the relevant literature. The documented cerebral neuroimaging has mostly described reversible symmetrical white matter changes in both the cerebral and cerebellar hemispheres. This paper presents 2 patients with toluene poisoning, whose brain magnetic resonance imaging studies showed a similar picture that included extra involvement over the corpus callosum; however, such corpus callosum involvement has never been mentioned and is quite rare in the literature. We discussed the underlying neuropathological pathways in this article. Hopefully, these cases will provide first-line clinicians with some valuable information with regard to toluene intoxication and clinical neuroimaging presentations. Copyright © 2014 by the American Society of Neuroimaging.

  4. Recommendations for the role of extracorporeal treatments in the management of acute methanol poisoning

    DEFF Research Database (Denmark)

    Roberts, Darren M; Yates, Christopher; Megarbane, Bruno

    2015-01-01

    of biomarkers of exposure and toxicity. In the absence of severe poisoning, the decision to use extracorporeal treatment is determined by balancing the cost and complications of extracorporeal treatment to that of fomepizole or ethanol. Given regional differences in cost and availability of fomepizole......OBJECTIVE: Methanol poisoning can induce death and disability. Treatment includes the administration of antidotes (ethanol or fomepizole and folic/folinic acid) and consideration of extracorporeal treatment for correction of acidemia and/or enhanced elimination. The Extracorporeal Treatments...... of fomepizole therapy, 2) greater than 600 mg/L or 18.7 mmol/L in the context of ethanol treatment, 3) greater than 500 mg/L or 15.6 mmol/L in the absence of an alcohol dehydrogenase blocker; in the absence of a methanol concentration, the osmolal/osmolar gap may be informative; or, in the context of impaired...

  5. Relevance of Plasma Cholinesterase to Clinical Findings in Acute Organophosphorous Poisoning

    Directory of Open Access Journals (Sweden)

    Devanur R.M.M. Prasad

    2013-03-01

    Full Text Available Background: Organophosphorus (OP poisoning is a major public health problem in developing world. OP pesticides inhibit carboxylic esterase enzymes including plasma cholinesterase (PChE. Clinical manifestations following OP poisoning can be associated with the extent of decrease of PChE. This study was designed to investigate the relevance of PChE level to clinical manifestations in OP poisoning and to evaluate usefulness of PChE in predicting clinical outcomes. Methods: This was a cross-sectional study which was conducted at Jawaharlal Nehru Medical College, Karnataka from 1st October 2009 to 30th September 2010. Seventy-six OP poisoned patients were enrolled and their clinical manifestations were recorded. 5-ml samples of intravenous blood were collected from each patient (on first day and fifth day of treatment under strict aseptic precaution and the PChE level was measured. Results: In total, mean age of patients were 25.5 (range: 21-30 years. Majority of patients were males (65.7 %, from rural areas (86.84 % and agricultural workers (25%. Main clinical findings at the time of admission were congested conjunctiva (87%, pin point pupil (83%, lacrimation (80%, vomiting (78%, non-reactive pupil (75%, respiratory distress (60% and abdominal pain (37%. Mean (SD PChE at 6 hours post-exposure was 3672.4 (4200.1 IU/L. At presentation, cyanosis, muscle weakness, convulsion, respiratory distress and fasciculation were related to cases with >75%reduction of PChE, while,  constricted and non-reactive pupil, lacrimation and congested conjunctivae were related to cases with 50-75% reduction and abdominal pain, dryness of conjunctiva, vomiting and diarrhea were related to

  6. The effect of acute carbon monoxide poisoning on micronuclei frequency and proliferation in human peripheral blood lymphocytes (case-control study).

    Science.gov (United States)

    Ślęzak, Monika; Skalniak, Anna; Groszek, Barbara; Piątkowsk, Jakub; Pach, Dorota

    2014-01-01

    Carbon monoxide (CO) exposure is still one of the leading causes of unintentional poisonings. Although its neurological sequels have been extensively studied, the knowledge about cytogenetic conse- quences still remains very limited. The aim of this study was to estimate the genotoxic potential of carbon monoxide in the course of acute poisoning. The examined group consisted of 73 patients treated because of accidental acute CO poisoning, and 22 healthy control individuals. Poisoning severity was estimated on the basis of neurological symptoms at admission, age, duration of exposure, carboxyhemoglobin (COHb) level and blood lactate concentration. The cytochalasine-B (cytokinesis blocker) micronucleus assay (CBMN) was used to analyze the cytogenetic alterations in lymphocytes from peripheral blood of the patients. Intoxicated patients displayed higher numbers of micronuclei (MN) than controls. The frequency of MN depended on the age of patients, loss of consciousness, neurological symptoms at admission, and the level of carboxyhemoglobin, but did not correlate with lactate level. We also observed differences in cell responses depending on the gender. Our results confirm the presence of cytogenetic changes after carbon monoxide poisoning. Based on these data we conclude, that CO might have genotoxic potential.

  7. Legalon® SIL: The Antidote of Choice in Patients with Acute Hepatotoxicity from Amatoxin Poisoning

    Science.gov (United States)

    Mengs, Ulrich; Pohl, Ralf -Torsten; Mitchell, Todd

    2012-01-01

    More than 90% of all fatal mushroom poisonings worldwide are due to amatoxin containing species that grow abundantly in Europe, South Asia, and the Indian subcontinent. Many cases have also been reported in North America. Initial symptoms of abdominal cramps, vomiting, and a severe cholera-like diarrhea generally do not manifest until at least six to eight hours following ingestion and can be followed by renal and hepatic failure. Outcomes range from complete recovery to fulminant organ failure and death which can sometimes be averted by liver transplant. There are no controlled clinical studies available due to ethical reasons, but uncontrolled trials and case reports describe successful treatment with intravenous silibinin (Legalon® SIL). In nearly 1,500 documented cases, the overall mortality in patients treated with Legalon® SIL is less than 10% in comparison to more than 20% when using penicillin or a combination of silibinin and penicillin. Silibinin, a proven antioxidative and anti-inflammatory acting flavonolignan isolated from milk thistle extracts, has been shown to interact with specific hepatic transport proteins blocking cellular amatoxin re-uptake and thus interrupting enterohepatic circulation of the toxin. The addition of intravenous silibinin to aggressive intravenous fluid management serves to arrest and allow reversal of the manifestation of fulminant hepatic failure, even in severely poisoned patients. These findings together with the available clinical experience justify the use of silibinin as Legalon® SIL in Amanita poisoning cases. PMID:22352731

  8. Prognostic value of long QT interval in acute and severe organophosphate poisoning.

    Science.gov (United States)

    Shadnia, Shahin; Okazi, Arash; Akhlaghi, Navid; Sasanian, Ghazal; Abdollahi, Mohammad

    2009-12-01

    Suicidal poisoning with organophosphorus (OP) pesticides is common, particularly from rural areas. This highlights the importance of determining an OP poisoning prognosis to decide how aggressive treatment should be. There are reports suggesting a relationship between prolonged corrected QT (QTC) interval and the severity of poisoning. We aimed to evaluate the prognostic utility of this clinical tool in OP poisoning (OPP) patients. Patients with the primary diagnosis of OPP who were admitted to the intensive care unit (ICU) of Loghman-Hakim Hospital Poison Centre (LHHPC) were the subjects of this prospective study. Cholinesterase (CE) activity and the QTC interval was determined for each patient using the Bazett formula and considering <440 msec as normal. Comparative outcomes of the study were duration of both hospitalization and mechanical ventilation, serum CE activity on admission and its daily level, total amount of atropine administered, analysis of the QT and QTC intervals in the primary ECG on admission and at the end of hospitalization, and rate of mortality. The study included 42 patients with a diagnosis of OPP. The mean age of the patients was 32, ranged from 12 to 81 years old. The mortality rate was 37.5%. There was no significant difference between two groups (prolonged and normal QTC intervals) according to gender and age (p=.491 and p=.133, respectively). The CE level for long and normal QTC interval groups was 3.90+/-0.33 kU/L vs. 4.41+/-0.23 kU/L, respectively. The mortality rate in the long QTC group was significantly higher than that of the normal QTC group (p=.044). Moreover, the average period of hospitalization in patients with prolonged QTC interval was higher than the other group (p=.02). The average atropine required to control the muscarinic signs and symptoms such as salivation, bronchorrehea, and miosis in patients with prolonged QTC interval was 38.60 mg; in patients with normal QTC interval it was 20.02 mg (p=.013). QTC interval

  9. Acute liver failure due to zinc phosphide containing rodenticide poisoning: Clinical features and prognostic indicators of need for liver transplantation.

    Science.gov (United States)

    Saraf, Vivek; Pande, Supriya; Gopalakrishnan, Unnikrishnan; Balakrishnan, Dinesh; Menon, Ramachandran N; Sudheer, O V; Dhar, Puneet; Sudhindran, S

    2015-07-01

    Zinc phosphide (ZnP) containing rodenticide poisoning is a recognized cause of acute liver failure (ALF) in India. When standard conservative measures fail, the sole option is liver transplantation. Records of 41 patients admitted to a single centre with ZnP-induced ALF were reviewed to identify prognostic indicators for requirement of liver transplantation. Patients were analyzed in two groups: group I (n = 22) consisted of patients who either underwent a liver transplant (n = 14) or died without a transplant (n = 8); group II (n = 19) comprised those who survived without liver transplantation. International normalized ratio (INR) in group I was 9 compared to 3 in group II (p Liver Disease (MELD) score in group I was 41 compared to 24 in group II (p liver transplantation.

  10. The effects of intravenous aminophylline on level of consciousness in acute intentional benzodiazepines poisoning in comparison to flumazenil.

    Science.gov (United States)

    Aghabiklooei, A; Sangsefidi, J

    2017-03-01

    Acute intentional benzodiazepine poisoning is marked by a significant loss of consciousness, aspiration pneumonia, and increased rates of mortality and morbidity, especially in older patients with underlying heart or lung disease. These patients may need flumazenil to reverse the respiratory effects of benzodiazepines. The positive effects of aminophylline on respiration and neonatal apnea improvement have been shown previously. However, its possible effects on increasing the level of consciousness have never been evaluated. In a placebo-controlled study, we assessed the effectiveness of aminophylline on increasing the level of consciousness. Time to full awakening was significantly shorter in those who received aminophylline (72 min vs. 881 min, p = 0.001), compared to those who received a placebo. When "flumazenil" is contraindicated or unavailable, intravenous aminophylline can be used as a second choice.

  11. Cost to government health-care services of treating acute self-poisonings in a rural district in Sri Lanka

    DEFF Research Database (Denmark)

    Wickramasinghe, Kanchana; Steele, Paul; Dawson, Andrew

    2009-01-01

    OBJECTIVE: To estimate the direct financial costs to the Sri Lanka Ministry of Health of treating patients after self-poisoning, particularly from pesticides, in a single district. METHODS: Data on staff, drug, laboratory and other inputs for each patient admitted for self-poisoning were......-poisonings. Based on the total treatment cost per self-poisoned patient estimated in this study, the cost of treating self-poisoned patients in all of Sri Lanka in 2004 was estimated at US$ 866,304. CONCLUSION: The cost of treating pesticide self-poisonings may be reduced by promoting the use of less toxic...

  12. A quick inexpensive laboratory method in acute paracetamol poisoning could improve risk assessment, management and resource utilization

    Science.gov (United States)

    Senarathna, S.M.D.K. Ganga; Ranganathan, Shalini S.; Buckley, Nick; Soysa, S.S.S.B.D. Preethi; Fernandopulle, B. M. Rohini

    2012-01-01

    Objectives: Acute paracetamol poisoning is an emerging problem in Sri Lanka. Management guidelines recommend ingested dose and serum paracetamol concentrations to assess the risk. Our aim was to determine the usefulness of the patient's history of an ingested dose of >150 mg/kg and paracetamol concentration obtained by a simple colorimetric method to assess risk in patients with acute paracetamol poisoning. Materials and Methods: Serum paracetamol concentrations were determined in 100 patients with a history of paracetamol overdose using High Performance Liquid Chromatography (HPLC); (reference method). The results were compared to those obtained with a colorimetric method. The utility of risk assessment by reported dose ingested and colorimetric analysis were compared. Results: The area under the receiver operating characteristic curve for the history of ingested dose was 0.578 and there was no dose cut-off providing useful risk categorization. Both analytical methods had less than 5% intra- and inter-batch variation and were accurate on spiked samples. The time from blood collection to result was six times faster and ten times cheaper for colorimetry (30 minutes, US$2) than for HPLC (180 minutes, US$20). The correlation coefficient between the paracetamol levels by the two methods was 0.85. The agreement on clinical risk categorization on the standard nomogram was also good (Kappa = 0.62, sensitivity 81%, specificity 89%). Conclusions: History of dose ingested alone greatly over-estimated the number of patients who need antidotes and it was a poor predictor of risk. Paracetamol concentrations by colorimetry are rapid and inexpensive. The use of these would greatly improve the assessment of risk and greatly reduce unnecessary expenditure on antidotes. PMID:23087506

  13. Outcome of patients in acute poisoning with ethylene glycol--factors which may have influence on evolution.

    Science.gov (United States)

    Tanasescu, A; Macovei, R A; Tudosie, M S

    2014-01-01

    acidosis was present up to 55,55% (10 of the 18 patients) in the blood gas analysis on admission, with pH on admission between 6.9 and 7.27, with anion gap ranging between 16.3 mmol/l and 32.6 mmol/l (normal range 8-16 mmol/l). Ten patients also had an increased level of urea and creatinine with a level between 1.24 to 6.85 mg/dl for creatinine (normal range 0.5-1.2 mg/dl) and 49 to 98 mg/dl for urea (normal range 15-43 mg/dl) and developed acute kidney injury that required regular HD sessions. Mechanical ventilation was required for 7 of the 18 patients (38.88%). Five patients died (27.77%). Although metabolic acidosis was corrected under hemodialysis, there were patients who had multiple organ failure and systems: acute respiratory failure requiring ventilator support, acute renal failure requiring dialysis daily sessions, altered state of consciousness. The early diagnostic and exclusion of the other diseases and other poisoning led to a specific treatment of the intoxication. The time from the ingestion of ethylene glycol and the early establishment of therapy is very important for a favorable evolution and can prevent substantial mortality.

  14. A review of pitfalls and progress in chelation treatment of metal poisonings

    DEFF Research Database (Denmark)

    Andersen, Ole; Aaseth, Jan

    2016-01-01

    of ethylenediamminetetraacetic acid (CaEDTA) but not dimercaptosuccinic acid (DMSA) increased the brain uptake of Pb. In oral Cd or Hg poisoning, early oral administration of DMSA or dimercaptopropane sulfonate (DMPS) increased survival and reduced intestinal metal uptake. Oral administration of Prussian Blue or resins...... to clinical settings. Intramuscular administration of dimercaptopropanol (BAL) has until now been used in acute arsenic, lead, and mercury poisonings, but repeated BAL administration increased the brain uptake of As, Pb and Hg in experimental animals. Also, diethyl dithiocarbamate (DDC) has been used...... as antidote in acute experimental animal parenteral Cd poisoning, and both DDC and tetraethylthiuram disulfide (TTD, disulfiram, Antabuse) have been used in nickel allergic patients. However, even one dose of DDC given immediately after oral Cd or Ni increased their brain uptake considerably. The calcium salt...

  15. Toxicology in the Old Testament. Did the High Priest Alcimus die of acute aconitine poisoning?

    Science.gov (United States)

    Moog, Ferdinand P; Karenberg, Axel

    2002-01-01

    The Bible contains several interesting contributions to the history of neurology, as is the case of the High Priest Alkimos, who died suddenly in 159 BC. He was regarded as a stereotypical stroke victim for a long time. The reports on his death in the Septauginta and the later 'Jewish Antiquities' of Flavius Josephus present some typical symptoms of stroke (collapse, loss of speech and death within a short time), but they also describe severe pains, which are very unusual among patients with stroke. Similar symptoms can be found in the case of the Roman emperor Claudius, who was poisoned by his spouse Agrippina. It was thought that she used aconitine, an ingredient of the monkshood plant (Aconitum napellus L.), which imitates an apoplectic insult, but also causes vehement pains. It was therefore possible that something similar had happened to Alkimos, as aconitine was a common poison in ancient times and the surroundings of his death may confirm the suspicion. Reigning during a time of great upheaval, Alkimos was able to maintain his high office chiefly because of the help of the Seleucides. He has just begun construction work on the temple of Jerusalem, an order, which was regarded as a sacrilege by his foes. This impression was enhanced by his subsequent illness which could be considered as a divine punishment.

  16. [Paracetamol: therapeutic action, pathogenesis and treatment of acute poisonings complicated by severe liver damage].

    Science.gov (United States)

    Kołaciński, Zbigniew; Rusiński, Piotr

    2003-01-01

    The biosynthesis of prostaglandins proceeds in the presence of fatty acid cycloxygenases (COX-1, COX-2). COX-1 is responsible for the synthesis of prostaglandins indispensable for normal homeostasis, while COX-2 regulates local expression of pro-inflammatory prostaglandins. Paracetamol is a selective inhibitor of COX-2 thus having an analgesic and antipyretic potential. The drug is metabolised primarily in the liver. About 5% of the dose transforms into N-acetylo-p-benzoquinoneimine (NAPQI), a highly active compound. Ingestion of a single paracetamol dose higher than 8 g leads to a depletion of hepatic glutathione reserves and a loss of the detoxifying property of the liver. As a result, hepatic necrosis develops. The specific antidote is N-acetylcysteine (NAC). If applied within 10-15 h since the poisoning it enables complete survival. The efficacy of specific treatment decreases after 24 h but blood paracetamol is an indication for NAC therapy. The surviving patients with advanced paracetamol poisoning require long-lasting conservative treatment with ornithine and phospholipids as well as a light diet.

  17. Availability of treatment resources for the management of acute toxic exposures and poisonings in emergency departments among various types of hospitals in Palestine: a cross-sectional study

    Science.gov (United States)

    2014-01-01

    Background Poisoning exposures continue to be a significant cause of morbidity and mortality worldwide. The lack of facilities, treatment resources, and antidotes in hospitals may affect the treatments provided and outcomes. This study aimed to determine the availability of gastrointestinal (GI) decontamination, stabilisation, elimination enhancement resources, and antidotes for the management of acute toxic exposures and poisonings in emergency departments (EDs) among various types of governmental and private hospitals in Palestine. Methods A cross-sectional study using semi-structured questionnaire was performed. Data were collected based on hospital resources; GI decontamination, stabilisation, elimination enhancement resources and antidotes from Palestinian hospitals. Results Eighteen hospitals (94.7%) have responded. Among them, paracetamol poisoning was the most frequently reported cases by EDs (mean frequency score = 7.6 ± 2.1), followed by bee stings (mean = 6.9 ± 2.7) and organophosphate poisoning (mean = 6.7 ± 2.7). The availabilities of most resources related to GI decontamination items varied substantially with hospital type, but these differences were not statistical significant. The availability of stabilisation resources was not significantly different between hospitals types. For the availability of techniques used to enhance the elimination of toxic substances, there were variations between the hospitals types. However, these differences were not statistical significant, except for haemodialysis (p = 0.003) which was more available in governmental hospitals. For the availability of antidotes, none of the hospitals had sufficient stock of all antidotes listed. In relation to hospital type, there was variability in the availability of antidotes, but this did not reach statistical significance, except for deferoxamine (p Palestine for the management of acute toxic exposure and poisoning. The implementation of a minimum

  18. Survival pattern in patients with acute organophosphate poisoning on mechanical ventilation: A retrospective intensive care unit-based study in a tertiary care teaching hospital.

    Science.gov (United States)

    Ahmed, Syed M; Das, Bikramjit; Nadeem, Abu; Samal, Rajiv K

    2014-01-01

    Organophosphorus (OP) compound poisoning is one of the most common poisonings in India. The aim of the study was to study the outcomes and predictors of mortality in patients with acute OP poisoning requiring mechanical ventilation. A retrospective study was conducted in the intensive care unit and 117 patients were included. Diagnosis was performed from the history taken either from the patient or from the patient's relatives. Demographic data, month of the year, mode of poisoning, common age group, duration of mechanical ventilation, time of starting pralidoxime (PAM), and mortality were recorded. Chi square test, Pearson correlation test, and multivariate binary logistic regression analysis was used. Data are presented as mean ± SD. 91.86% (79/86) of cases were suicidal and remaining cases were accidental. Duration of mechanical ventilation varied from less than 48 hours to more than 7 days. Mortality rate was 33.3%, 7.2%, and 100% in those who required mechanical ventilation for more than 7 days, 5 to 7 days, and 2 to 4 days, respectively. Lag time was less than 6 hrs in 13 patients and all of them survived. 17.1% and 28.1% patients died in whom PAM was started 6 to 12 hrs and 13 to 24 hrs after poisoning, respectively. There was statistically significant positive correlation between lag time of starting of PAM with duration of mechanical ventilation and total dose of PAM (P ventilation were independent predictors of death. Overall mortality rate was 18.6%. Mortality from OP compound poisoning is directly proportionate to the severity of poisoning, delay in starting PAM, and duration of mechanical ventilation. Death is not dependent on a single factor, rather contributory to these factors working simultaneously.

  19. Poisoning cases and their management in emergency centres of government hospitals in northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Getnet Mequanint Adinew

    2017-06-01

    Discussion: Young females comprise a group at increased risk for suicidal poisonings. As a developing nation, pesticide and bleaching agents remain a significant cause of acute poisonings in Ethiopia. Intentional poisoning remains the most significant identified cause of poisoning overall.

  20. Knowledge and Practices Relating to Acute Pesticide Poisoning Among Health Care Providers in Selected Regions of Tanzania

    Directory of Open Access Journals (Sweden)

    Elikana Lekei

    2017-02-01

    Full Text Available Background: Acute pesticide poisoning (APP is commonly underdiagnosed in Tanzania. Studies in developing countries suggest that a lack of diagnostic skills among health care providers (HCPs undermines surveillance for APP. This study aimed at characterizing experience and skills of Tanzanian HCPs regarding APP diagnosis and management. Methodology: The population included HCPs responsible for managing APP in Kilimanjaro and Arusha regions (n = 91. The resulting sample included 66 respondents (response rate: 73%. The data were collected in 2005 using a standardized questionnaire. Results: Half of all respondents (50% reported handling at least 1 APP case with 15% reporting handling more than 5 cases in the past. Reported experience of handling an APP case was marginally higher in respondents who reported ⩾4 years of work experience in the health sector compared with those with <4 years of work experience (odds ratio = 1.32; 95% confidence interval = 0.9-1.5. Most of the respondents had high knowledge of exposure routes, reporting awareness of oral (98.5%, inhalational (93.9%, and dermal (77% routes. The study revealed low awareness of pesticide classification by chemical groups (29% or World Health Organization hazard (0% and weak knowledge on pesticide label instructions (55%. Organophosphates accounted for 35% of the pesticide products reported by respondents as being responsible for poisoning. Some treatment options were incorrectly reported as first aid options, and some reported first aid options were wrong or inappropriate. Conclusions: The study revealed that HCPs in northern Tanzania lack adequate skills to diagnose and manage APP. For effective surveillance of APP, there is a need to include training on hazards, classification, diagnosis, and health effects in the training programmes for all HCPs in Tanzania.

  1. Acute poisoning due to ingestion of Datura stramonium - a case report.

    Science.gov (United States)

    Trancă, Sebastian Daniel; Szabo, Robert; Cociş, Mihaela

    2017-04-01

    Datura stramonium (DS) is a widespread annual plant, containing atropine, hyoscyamine, and scopolamine, which can produce poisoning with a severe anticholinergic syndrome. Teenagers ingest the roots, seeds or the entire plant to obtain its hallucinogenic and euphoric effects. We presented the case of a 22 year old male who was admitted to the Emergency Room in a coma after consuming Datura stramonium, 2 hours earlier. The patient presented with fever, tachycardia with right bundle branch block, and urinary retention. Rapid sequence induction and intubation was performed immediately, with sedation and assisted-control mechanical ventilation, after being transferred to the Intensive Care Unit. The patient received activated charcoal, in repeated doses, external and internal cooling was applied, and an infusion of neostigmine was started. The biological assessment revealed rhabdomyolysis and prevention of renal failure was initiated. After a proper neurological evaluation, 36 hours after using Datura stramonium, the patient was extubated and transferred to the Psychiatric ward for further assessment and care.

  2. Acute Methanol Poisoning: Prevalence and Predisposing Factors of Haemorrhagic and Non-Haemorrhagic Brain Lesions

    Czech Academy of Sciences Publication Activity Database

    Zakharov, S.; Kotíková, K.; Vaněčková, M.; Seidl, Z.; Nurieva, O.; Navrátil, Tomáš; Caganová, B.; Pelclová, D.

    2016-01-01

    Roč. 119, č. 2 (2016), s. 228-238 ISSN 1742-7835 Institutional support: RVO:61388955 Keywords : ACUTE OPTIC NEUROPATHY * FORMATE CONCENTRATIONS * PROGNOSTIC-FACTORS Subject RIV: CG - Electrochemistry Impact factor: 3.176, year: 2016

  3. Chelating capacity and the adverse effects of two treatments (N-acetylcysteine and D-penicillamine in patients with mercury poisoning in Segovia, a municipality at the northeastern part of Antioquia, Colombia

    Directory of Open Access Journals (Sweden)

    Fanny Cuesta González

    2008-02-01

    Full Text Available

    OBJECTIVE: to compare the chelating capacity and the adverse effects of treatments with either Nacetylcysteine or D-penicillamine in patients with mercury poisoning in Segovia, a municipality at the northeastern part of Antioquia, Colombia.

    METHODS: 50 patients with toxic levels of mercury were enrolled in a 10 days open label, randomized comparison of either D-penicillamine (750 mg/day or Nacetilcysteine (1.8 g/day. Patients were followed on a daily basis to assess the elimination of mercury in urine and the frequency of adverse effects of each treatment.

    RESULTS: 32 patients completed 10 days of drug treatment. Averages of mercury elimination in 24 hours urine, before and after treatment with D-penicillamine and N-acetylcysteine, were not different (211.96 mcg ± 190 and 262.15 mcg ± 305 and 232.85 mcg ± 248 and 218.65 mcg ± 240, respectively, P > 0.05 for all comparisons. Evaluation of the frequency of adverse effects showed a significant difference between the two groups: D-penicillamine (50% and N-acetylcysteine (11% p = 0.0079.

    CONCLUSION: this study

  4. Organophosphorus pesticide poisoning : cases and developments

    NARCIS (Netherlands)

    Aardema, H.; Ligtenberg, J. J. M.; Peters-Polman, O. M.; Tulleken, J. E.; Zijlstra, J. G.; Meertens, John H. J. M.

    Self-poisoning with organophosphate pesticides is a major health problem world-wide. Through the inhibition of acetylcholinesterase, organophosphorus poisoning is characterised by the clinical picture of acute cholinergic crisis. Other manifestations are the intermediate neurotoxic syndrome and

  5. Efficiency of acidemia correction on intermittent versus continuous hemodialysis in acute methanol poisoning.

    Science.gov (United States)

    Zakharov, Sergey; Pelclova, Daniela; Navratil, Tomas; Belacek, Jaromir; Latta, Jiri; Pisar, Michal; Rulisek, Jan; Leps, Jiri; Zidek, Pavel; Kucera, Cyril; Bocek, Robert; Mazur, Miroslav; Belik, Zdenek; Chalupa, Josef; Talafa, Viktor; Kodras, Kamil; Nalos, Daniel; Sedlak, Ctirad; Senkyrik, Michal; Smid, Jan; Salek, Tomas; Roberts, Darren M; Hovda, Knut Erik

    2017-02-01

    Acidemia is a marker of prognosis in methanol poisoning, as well as compounding formate-induced cytotoxicity. Prompt correction of acidemia is a key treatment of methanol toxicity and methods to optimize this are poorly defined. We studied the efficiency of acidemia correction by intermittent hemodialysis (IHD) and continuous renal replacement therapy (CRRT) in a mass outbreak of methanol poisoning. The study was designed as observational cohort study. The mean time for an increase of 1 mmol/L HCO3-, 0.01 unit arterial blood pH, and the total time for correction of HCO3- were determined in IHD- and CRRT-treated patients. Data were obtained from 18 patients treated with IHD and 13 patients treated with CRRT. At baseline, CRRT group was more acidemic than IHD group (mean arterial pH 6.79 ± 0.10 versus 7.05 ± 0.10; p = 0.001). No association was found between the rate of acidemia correction and age, weight, serum methanol, lactate, formate, and glucose on admission. The time to HCO3- correction correlated with arterial blood pH (r= -0.511; p = 0.003) and creatinine (r = 0.415; p = 0.020). There was association between the time to HCO3- correction and dialysate/effluent and blood flow rates (r= -0.738; p < 0.001 and r= -0.602; p < 0.001, correspondingly). The mean time for HCO3- to increase by 1 mmol/L was 12 ± 2 min for IHD versus 34 ± 8 min for CRRT (p < 0.001), and the mean time for arterial blood pH to increase 0.01 was 7 ± 1 mins for IHD versus 11 ± 4 min for CRRT (p = 0.024). The mean increase in HCO3- was 5.67 ± 0.90 mmol/L/h for IHD versus 2.17 ± 0.74 mmol/L/h for CRRT (p < 0.001). Our study supports the superiority of IHD over CRRT in terms of the rate of acidemia correction.

  6. [The assessment of factors affecting acute ethanol poisonings clinical status in 1974-1975, 1984-1985 and 2011-2013].

    Science.gov (United States)

    Hydzik, Piotr; Paź, Ewelina; Szkolnicka, Beata; Pach, Janusz

    2015-01-01

    The aim of the study was an evaluation of clinical factors affecting relationship between ethanol concentration and clinical status in case of acute ethanol poisoning in the 70s and the 80s of the 20th century and 2011-2013 y. Ethanol blood concentration was a criterion of ethanol dose, grade of coma was a decisive factor of toxic effect. 112 patients treated at the Department of Clinical Toxicology Jagiellonian University Medical College in 1974-1975 y, 232 treated in 1984-1985 y and 663 treated in 2011-2013 y because of acute ethanol poisoning were analyzed. The degree of coma was evaluated according to Matthew's scale. Ethanol plasma concentration in each case was measured. The lowest ethanol blood concentrations in the youngest (60 y) groups were noted also the highest in group of adults (30-49 y). The three-gradual relationship between ethanol plasma level and degree of toxic coma was distinguished. However, the average of ethanol blood concentration were statistically significant in every degree of coma in 2011-2013 y. A statistically significant increase in number of patients in 0 coma grade with severe withdrawal symptoms, alcohol psychosis or epilepsy were noted, also decrease of patient in IV degree of coma. The increase ethanol tolerance in the group of acute ethanol poisoned patients shows their ethanol addiction.

  7. Environmental and health aspects of lighting: Mercury

    Energy Technology Data Exchange (ETDEWEB)

    Clear, R.; Berman, S.

    1993-07-01

    Most discharge lamps, including fluorescent lamps, metal halide lamps, and high pressure sodium lamps, contain Mercury, a toxic chemical. Lighting professionals need to be able to respond to questions about the direct hazards of Mercury from accidentally breaking lamps, and the potential environmental hazards of lamp operation and disposal. We calculated the exposures that could occur from an accidental breakage of lamps. Acute poisoning appears almost impossible. Under some circumstances a sealed environment, such as a space station, could be contaminated enough to make it unhealthy for long-term occupation. Mercury becomes a potential environmental hazard after it becomes methylated. Mercury is methylated in aquatic environments, where it may accumulate in fish, eventually rendering them toxic to people and other animals. Lighting causes Mercury to enter the environment directly from lamp disposal, and indirectly from power plant emissions. The environmental tradeoffs between incandescent and discharge lamps depend upon the amounts released by these two sources, their local concentrations, and their probabilities of being methylated. Indirect environmental effects of lighting also include the release of other heavy metals (Cadmium, Lead and Arsenic), and other air pollutants and carbon dioxide that are emitted by fossil fuel power plants. For a given light output, the level of power plant emissions depends upon the efficacy of the light source, and is thus much larger for incandescent lamps than for fluorescent or discharge lamps. As disposal and control technologies change the relative direct and indirect emissions from discharge and incandescent lamps will change.

  8. Inconceivable Hypokalemia: A Case Report of Acute Severe Barium Chloride Poisoning

    Directory of Open Access Journals (Sweden)

    Haibo Tao

    2016-01-01

    Full Text Available Barium is a heavy divalent alkaline earth metal that has been known as a muscle poison. Barium can cause human toxicity, which may lead to significant hypokalemia and have serious consequences. This paper reports a case of unprecedented barium intoxication in which the patient, who suffered from depression, swallowed at least 3.0 g barium chloride to commit suicide. On admission, the patient presented with nausea, vomiting, stomach burning feeling, dizziness, and weakness. Emergency biochemical testing showed that the patient was suffering from severe hypokalemia (K+ 1.7 mmol/L. His electrocardiogram (ECG prompted atrioventricular blocking, ventricular tachycardia, prolongation of PR interval, ST segment depression with U waves, and T wave inversion. Intravenous potassium supplements were given immediately to correct hypokalemia and regular monitoring of vital signs and fluid balance was arranged. After all-out rescue of our hospital personnel, the condition of the patient is currently stable and he is gradually recovering. This case exemplifies the weaknesses of the management of toxic substances and the lack of mental health education for young people. We hope to get more attention for the supervision of toxic substances and the healthy development of young people.

  9. Acute poisoning due to ingestion of Datura stramonium – a case report

    Science.gov (United States)

    Trancă, Sebastian Daniel; Szabo, Robert; Cociş, Mihaela

    2017-01-01

    Datura stramonium (DS) is a widespread annual plant, containing atropine, hyoscyamine, and scopolamine, which can produce poisoning with a severe anticholinergic syndrome. Teenagers ingest the roots, seeds or the entire plant to obtain its hallucinogenic and euphoric effects. We presented the case of a 22 year old male who was admitted to the Emergency Room in a coma after consuming Datura stramonium, 2 hours earlier. The patient presented with fever, tachycardia with right bundle branch block, and urinary retention. Rapid sequence induction and intubation was performed immediately, with sedation and assisted-control mechanical ventilation, after being transferred to the Intensive Care Unit. The patient received activated charcoal, in repeated doses, external and internal cooling was applied, and an infusion of neostigmine was started. The biological assessment revealed rhabdomyolysis and prevention of renal failure was initiated. After a proper neurological evaluation, 36 hours after using Datura stramonium, the patient was extubated and transferred to the Psychiatric ward for further assessment and care. PMID:28913501

  10. Confirmation of acute nitrate poisoning differentiating from anthrax in three Indian indigenous cattle

    Directory of Open Access Journals (Sweden)

    Kumaresan Nagarajan

    2015-03-01

    Full Text Available This article reports cases of nitrate poisoning in Indian indigenous cattle breeds comprising two Gir cows aging 4 years each, and one Barugur cow at 1.5 years of age. The cattle with case history of sudden death and oozing of partially clotted blood from the anal opening were brought to the Central University Laboratory (CUL, Center for Animal Health Studies (CAHS, Tamil Nadu Veterinary and Animal Sciences University (TANUVAS for diagnostic investigation with a suspicion of anthrax. According to anamnesis, all the animals were clinically normal and did not reveal any abnormality on the previous day. The animals were fed with recently harvested sorghum leaves and stalks. Smears examined for anthrax were found negative. Biological test (mice inoculation for anthrax was also negative. Gross lesions on necropsy examination of the carcases were suggestive of nitrate intoxication. Finally, nitrate intoxication of these cattle was confirmed by chemical and toxicological analysis of fodder, rumen content, aqueous humor, liver, kidney and urine.

  11. [Study of blood concentration analysis for formate in acute methanol poisoning].

    Science.gov (United States)

    Morikawa, Go; Okazawa, Katsuko; Shimizu, Takahiro; Otagiri, Sayoko; Fuwa, Fumiko; Nakagawa, Saori; Yamato, Susumu

    2015-09-01

    A 53-year-old woman ingested about 300 mL of 95% methanol. After immediate ethanol antagonist therapy and hemodialysis, she recovered completely. Few days later, the plasma concentration of methanol and formate was measured. A gas chromatography was used for the plasma methanol concentration measurement, and a colorimetric method was used for plasma formate concentration measurement (Formate Colorimetric Assay Kit; BioVision, California, USA). Patient's plasma methanol concentration before hemodialysis was 676.9 mg/dL and plasma formate concentration was 16.9 mg/dL. By removing blood methanol and formate using hemodialysis before formate accumulations in the body, the patient was discharged without any sequelae. We were able to obtain correlation between a gas chromatography and colorimetric method without gas chromatography-mass spectrometry, with good correlation coefficients. The sensitivity was sufficient for analyzing blood sample. Monitoring formate concentration is useful in determining the treatment and evaluating the prognosis of methanol poisoning. We suggest that this colorimetric method is useful in a facility with no access to a gas chromatography in order to measure a plasma formate concentration.

  12. [Simulation of parameters of alcohol-oxidizing enzyme systems and pathomorphological characteristics in situations of acute ethanol poisoning and ischemic heart disease].

    Science.gov (United States)

    Porodenko, V A; Korkhmazov, V T

    2011-01-01

    Morphometric characteristics and forensic chemical information used in diagnostics of acute ethanol intoxication and coronary heart disease in conjunction with macro- and microscopic pathomorphological signs of the changes in the heart, liver, and kidneys provide data that may suggest the presence of pathology but do not permit to reliably identify it. In this context, evaluation of activities of alcohol-oxidizing enzyme systems acquires clinical significance. The analysis of correlations between quantitative parameters supplemented by the construction of binary models allows to objectively interpret the conclusions about the cause of death in each concrete case of acute ethanol poisoning and coronary heart disease.

  13. Effects of different blood purification methods on serum cytokine levels and prognosis in patients with acute severe organophosphorus pesticide poisoning.

    Science.gov (United States)

    Liu, Lunzhi; Ding, Guohua

    2015-04-01

    The aim of the present study was to investigate the impact of three different blood purification methods, hemoperfusion (HP), continuous blood purification (CBP), and on-line high-volume hemodiafiltration (OL-HDF), on the survival rate of patients with acute severe organophosphorus pesticide poisoning (ASOPP), as well as on major pro-inflammatory (interleukin [IL]-1, IL-6, tumor necrosis factor-α [TNF-α]) and anti-inflammatory (IL-10) cytokines in the serum. Eighty-one ASOPP patients were randomly divided into three groups: HP (N = 23), HP + CBP (N = 26), HP + OL-HD (N = 32). Serum IL-1, IL-6, TNF-α, and IL-10 levels were assessed by ELISA before treatment and at 24 and 48 h post-treatment and survival rates were determined. Patient survival rate was significantly higher in OL-HDF and CBP treated patients compared with HP group (P  0.05). Compared with the HP method, CBP or OL-HDF combined with HP can rapidly clear inflammatory cytokines, reduce systemic inflammatory response syndrome, and improve the survival of ASOPP patients. Compared with CBP, OL-HDF is an economical and effective method to treat ASOPP with less technical difficulty and more suitability for rural areas and primary hospitals. © 2014 The Authors. Therapeutic Apheresis and Dialysis © 2014 International Society for Apheresis.

  14. Impacts of stress, self-efficacy, and optimism on suicide ideation among rehabilitation patients with acute pesticide poisoning.

    Science.gov (United States)

    Feng, Jun; Li, Shusheng; Chen, Huawen

    2015-01-01

    The high incidence of pesticide ingestion as a means to commit suicide is a critical public health problem. An important predictor of suicidal behavior is suicide ideation, which is related to stress. However, studies on how to defend against stress-induced suicidal thoughts are limited. This study explores the impact of stress on suicidal ideation by investigating the mediating effect of self-efficacy and dispositional optimism. Direct and indirect (via self-efficacy and dispositional optimism) effects of stress on suicidal ideation were investigated among 296 patients with acute pesticide poisoning from four general hospitals. For this purpose, structural equation modeling (SEM) and bootstrap method were used. Results obtained using SEM and bootstrap method show that stress has a direct effect on suicide ideation. Furthermore, self-efficacy and dispositional optimism partially weakened the relationship between stress and suicidal ideation. The final model shows a significant relationship between stress and suicidal ideation through self-efficacy or dispositional optimism. The findings extended prior studies and provide enlightenment on how self-efficacy and optimism prevents stress-induced suicidal thoughts.

  15. Carbon monoxide poisoning

    OpenAIRE

    Dolan, Michael C.

    1985-01-01

    Carbon monoxide poisoning is a significant cause of illness and death. Its protean symptoms probably lead to a gross underestimation of its true incidence. Low levels of carbon monoxide aggravate chronic cardiopulmonary problems, and high levels are associated with cardiac arrhythmias and cerebral edema. Patients who survive acute poisoning are at risk of delayed neurologic sequelae. The measurement of carboxyhemoglobin levels does not reveal the tissue levels of carbon monoxide but is useful...

  16. [Acute poisoning with weight-loss dietary supplement falsely suggesting the use of amphetamine].

    Science.gov (United States)

    Łukasik-Głebocka, Magdalena; Sommerfeld, Karina; Tezyk, Artur; Zielińska-Psuja, Barbara

    2013-01-01

    poisoning. Definitive confirmation of such intoxication requires the use of the reference methods.

  17. Hydroxyethyl Starch Could Save a Patient With Acute Aluminum Phosphide Poisoning

    Directory of Open Access Journals (Sweden)

    Sayed Mahdi Marashi

    2016-07-01

    Full Text Available A 40-year-old male patient with suicidal ingestion of one tablet of aluminium phosphide was referred to the department of toxicology emergency of Baharloo Hospital, Tehran, Iran. The garlic odor was smelled from the patient and abdominal pain and continuous vomiting as well as agitation and heartburn were the first signs and symptoms. Systolic and diastolic blood pressures at the arrival time were 95 and 67 mmHg, respectively. Gastric lavage with potassium permanganate (1:10,000, and 2 vials of sodium bicarbonate through a nasogastric tube was started for the patient and the management was continued with free intravenous infusion of 1 liter of NaCl 0.9% serum plus NaHCO3, hydrocortisone acetate (200 mg, calcium gluconate (1 g and magnesium sulfate (1 g. Regarding the large intravenous fluid therapy and vasoconstrictor administering (norepinephrine started by 5 µg/min and continued till 15 µg/min, there were no signs of response and the systolic blood pressure was 49 mmHg. At this time, hydroxyethyl starch (HES (6% hetastarch 600/0.75 in 0.9% sodium chloride with a dose of 600 cc in 6 hours was started for the patient. At the end of therapy with HES, the patient was stable with systolic and diastolic blood pressure of 110 and 77 mmHg, respectively. He was discharged on the 6th day after the psychological consultation, with normal clinical and paraclinical examinations. This is the first report of using HES in the management of AlP poisoning and its benefit to survive the patient.

  18. Mercury pOIsonIng

    African Journals Online (AJOL)

    rise to a variety of neurological signs, which include erethism and tremor. Erethism is characterised by shyness, irritability, marked outbursts of manic behaviour; hallucinations, insomnia, and difficulty in concentration, which may be associated with vasomotor instability such as excess perspiration, blushing and sialorrhoea.

  19. [Pecularities of correction of alcohol affctions of liver in patients with acute ethanol poisoning in the setting of consequence of toxic effect of ethanol].

    Science.gov (United States)

    Shilov, V V; batotsyrenov, B V; Vasil'ev, S A; Shikalova, I A; Kuznetsov, O A

    2012-06-01

    The aim of this work was to test the usage of infusion of hepatoprotector "remaxol" in intensive therapy of acute ethanol poisoning accompanied with severe alcohol affections of the lever. In the result of the examination and treatment of 130 patients it was established that severe alcohol poisonings registered on alcohol abused patients with toxic hepatopathy, are always accompanied with serious metabolic violations. In the process of a comparative valuation of the using of heptral (ademethionin) and remaxol in the intensive therapy of alcohol poisonings it has been revealed that the using of remaxol led to improvement of the clinic of that poisonings, what had been registered as a decrease of frequency and duration of an alcohol delirium from 33,9% to 10,8%, a decrease of frequency of secondary lung complication from 18,5 to 3,1%, a decrease of a duration of treatment in intensive care unit from 7,3 +/- 0,6 to 5,6 +/- 0,3 and a hospital treatment duration from 11,8 +/- 0,5 to 9,0 +/- 0,3 days. Biochemical investigation has shown that using as heptral, as remaxol led to improvement of lever damages due to alcohol. However remaxol compared with heptral was better in the treatment of metabolic violations.

  20. DNA pooling base genome-wide association study identifies variants at NRXN3 associated with delayed encephalopathy after acute carbon monoxide poisoning.

    Directory of Open Access Journals (Sweden)

    Wenqiang Li

    Full Text Available Delayed encephalopathy after acute carbon monoxide poisoning (DEACMP is more characteristic of anoxic encephalopathy than of other types of anoxia. Those who have the same poisoning degree and are of similar age and gender have a greater risk of getting DEACMP. This has made it clear that there are obvious personal differences. Genetic factors may play a very important role. The authors performed a genome-wide association study involving pooling of DNA obtained from 175 patients and 244 matched acute carbon monoxide poisoning without delayed encephalopathy controls. The Illumina HumanHap 660 Chip array was used for DNA pools. Allele frequencies of all SNPs were compared between delayed encephalopathy after acute carbon monoxide poisoning and control groups and ranked. A total of 123 SNPs gave an OR >1.4. Of these, 46 mapped in or close to known genes. Forty-eight SNPs located in 19 genes were associated with DEACMP after correction for 5% FDR in the genome-wide association of pooled DNA. Two SNPs (rs11845632 and rs2196447 locate in the Neurexin 3 gene were selected for individual genotyping in all samples and another cohort consisted of 234 and 271 controls. There were significant differences in the genotype and allele frequencies of rs11845632 and rs2196447 between the DEACMP group and controls group (all P-values <0.05. This study describes a positive association between Neurexin 3 and controls in the Han Chinese population, and provides genetic evidence to support the susceptibility of DEACMP, which may be the resulting interaction of environmental and genetic factors.

  1. ICP OES and CV AAS in determination of mercury in an unusual fatal case of long-term exposure to elemental mercury in a teenager.

    Science.gov (United States)

    Lech, Teresa

    2014-04-01

    In this work, a case of deliberate self-poisoning is presented. A 14-year-old girl suddenly died during one of the several hospitalizations. Abdominal computer tomography showed a large number of metallic particles in the large intestine. Analysis of blood and internal organs for mercury and other toxic metals carried out by inductively coupled plasma optical emission spectrometry (ICP OES) revealed high concentrations of mercury in kidneys and liver (64,200 and 2470ng/g, respectively), less in stomach (90ng/g), and none in blood. Using cold vapor-atomic absorption spectrometry (CV AAS), high levels of mercury were confirmed in all examined materials, including blood (87ng/g), and additionally in hair. The results of analysis obtained by two techniques revealed that the exposure to mercury was considerable (some time later, it was stated that the mercury originated from thermometers that had been broken over the course of about 1 year, because of Münchausen syndrome). CV AAS is a more sensitive technique, particularly for blood samples (negative results using ICP OES), and tissue samples - with LOQ: 0.63ng/g of Hg (CV AAS) vis-à-vis 70ng/g of Hg (ICP OES). However, ICP OES may be used as a screening technique for autopsy material in acute poisoning by a heavy metal, even one as volatile as mercury. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. Acute oxalate poisoning attributable to ingestion of curly dock (Rumex crispus) in sheep.

    Science.gov (United States)

    Panciera, R J; Martin, T; Burrows, G E; Taylor, D S; Rice, L E

    1990-06-15

    Ten of 100 mature ewes were afflicted with acute oxalate toxicosis within 40 hours after being temporarily penned in a lot that contained considerable growing Rumex crispus (curly dock). Clinical signs of toxicosis included excess salivation, tremors, ataxia, and recumbency. Affected ewes were markedly hypocalcemic and azotemic. Oxalate crystals were not observed in urine. Gross postmortem lesions were minimal and nondiagnostic in 2 ewes that died peracutely, but perirenal edema and renal tubular degeneration were clearly observable in ewes euthanatized on the third day of toxicosis. Diagnosis of oxalate toxicosis was confirmed by histopathologic findings. Samples of Rumex spp contained 6.6 to 11.1% oxalic acid on a dry-weight basis, a concentration comparable with that in other oxalate-containing plants that have caused acute oxalate toxicosis.

  3. Intravenous cobinamide versus hydroxocobalamin for acute treatment of severe cyanide poisoning in a swine (Sus scrofa) model.

    Science.gov (United States)

    Bebarta, Vikhyat S; Tanen, David A; Boudreau, Susan; Castaneda, Maria; Zarzabal, Lee A; Vargas, Toni; Boss, Gerry R

    2014-12-01

    Hydroxocobalamin is a Food and Drug Administration-approved antidote for cyanide poisoning. Cobinamide is a potential antidote that contains 2 cyanide-binding sites. To our knowledge, no study has directly compared hydroxocobalamin with cobinamide in a severe, cyanide-toxic large-animal model. Our objective is to compare the time to return of spontaneous breathing in swine with acute cyanide-induced apnea treated with intravenous hydroxocobalamin, intravenous cobinamide, or saline solution (control). Thirty-three swine (45 to 55 kg) were intubated, anesthetized, and instrumented (continuous mean arterial pressure and cardiac output monitoring). Anesthesia was adjusted to allow spontaneous breathing with FiO2 of 21% during the experiment. Cyanide was continuously infused intravenously until apnea occurred and lasted for 1 minute (time zero). Animals were then randomly assigned to receive intravenous hydroxocobalamin (65 mg/kg), cobinamide (12.5 mg/kg), or saline solution and monitored for 60 minutes. A sample size of 11 animals per group was selected according to obtaining a power of 80%, an α of .05, and an SD of 0.17 in mean time to detect a 20% difference in time to spontaneous breathing. We assessed differences in time to death among groups, using Kaplan-Meier estimation methods, and compared serum lactate, blood pH, cardiac output, mean arterial pressure, respiratory rate, and minute ventilation time curves with repeated-measures ANOVA. Baseline weights and vital signs were similar among groups. The time to apnea and cyanide dose required to achieve apnea were similar. At time zero, mean cyanide blood and lactate concentrations and reduction in mean arterial pressure from baseline were similar. In the saline solution group, 2 of 11 animals survived compared with 10 of 11 in the hydroxocobalamin and cobinamide groups (Pcyanide concentrations became undetectable at the end of the study in both antidote-treated groups, and no statistically significant differences

  4. Methanol poisoning: characteristic MRI findings.

    Science.gov (United States)

    Jain, Nirdesh; Himanshu, Dandu; Verma, Shailendra Prasad; Parihar, Anit

    2013-01-01

    Acute methanol intoxication is not an unusual poisoning. It can have serious neurological sequelae. We emphasize how neuroimaging can help in distinguishing methanol poisoning from other causes of acute unconsciousness in alcoholic patients such as hypoglycemic brain damage and carbon monoxide poisoning or head injury, which are frequently observed in alcoholic patients and are also responsible for altered sensorium. The most important findings in MR brain imaging in methanol poisoning have been bilateral putaminal hemorrhagic necrosis. Other less common findings are subcortical and deep white matter lesions, cerebral and cerebellar cortical lesions, and midbrain lesions, cerebral and intraventricular hemorrhage, and even enhancement of necrotic lesions, we found almost the entire spectrum of MRI findings in this patient with methanol poisoning. Neurological sequelae can entail the course and prognosis in methanol poisoning. The patient died because of ventilator-associated pneumonia that developed in the course of prolonged hospitalization.

  5. Prognosis for children with acute liver failure due to Amanita phalloides poisoning

    Science.gov (United States)

    Wachulski, Marcin F.; Kamińska-Gocał, Diana; Dądalski, Maciej; Socha, Piotr; Mulawka, Jan J.

    2011-10-01

    The primary objective of this article is to find new effective methods of diagnosis of urgent liver transplantation after Amanita phalloides intoxication amongst pediatric patients. The research was carried out using a medical database of pediatric patients who suffered from acute liver failure after amatoxin consumption. After data preprocessing and attribute selection steps, a two-phase experiment was conducted, which incorporated a wide variety of data mining algorithms. The results deliver two equivalent classification models with simple decision structure and reasonable quality of surgery prediction.

  6. Gallium poisoning: a rare case report.

    Science.gov (United States)

    Ivanoff, Chris S; Ivanoff, Athena E; Hottel, Timothy L

    2012-02-01

    The authors present a case of a college student who suffered acute gallium poisoning as a result of accidental exposure to gallium halide complexes. This is extremely rare and has never been reported in the literature. Acute symptoms after the incident, which initially presented as dermatitis and appeared relatively not life-threatening, rapidly progressed to dangerous episodes of tachycardia, tremors, dyspnea, vertigo, and unexpected black-outs. Had there been effective emergency medical care protocols, diagnostic testing, treatment and antidotes, the latent manifestations of irreversible cardiomyopathy may have been prevented. Given how quickly exposure led to morbidity, this article aims to raise an awareness of the toxic potential of gallium. This has particular relevance for workers involved in the production of semiconductors where there is a potential for accidental exposure to gallium by-products during device processing. It may also have implications for dentists who use gallium alloys to replace mercury containing amalgam. In the absence of threshold limit values and exposure limits for humans, as well as emergency medical guidelines for treatment of poisoning, the case calls on the National Institute for Occupational Safety and Health and the Occupational Safety and Health Administration to establish guidelines and medical management protocols specific for gallium. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. Food poisoning.

    Science.gov (United States)

    Lawrence, David T; Dobmeier, Stephen G; Bechtel, Laura K; Holstege, Christopher P

    2007-05-01

    Food poisoning is encountered throughout the world. Many of the toxins responsible for specific food poisoning syndromes are no longer limited to isolated geographic locations. With increased travel and the ease of transporting food products, it is likely that a patient may present to any emergency department with the clinical effects of food poisoning. Recognizing specific food poisoning syndromes allows emergency health care providers not only to initiate appropriate treatment rapidly but also to notify health departments early and thereby prevent further poisoning cases. This article reviews several potential food-borne poisons and describes each agent's mechanism of toxicity, expected clinical presentation, and currently accepted treatment.

  8. Mercury hazards from gold mining to humans, plants, and animals

    Science.gov (United States)

    Eisler, R.

    2004-01-01

    Mercury contamination of the environment from historical and ongoing mining practices that rely on mercury amalgamation for gold extraction is widespread. Contamination was particularly severe in the immediate vicinity of gold extraction and refining operations; however, mercury--especially in the form of water-soluble methylmercury--may be transported to pristine areas by rainwater, water currents, deforestation, volatilization, and other vectors. Examples of gold mining-associated mercury pollution are shown for Canada, the United States, Africa, China, the Philippines, Siberia, and South America. In parts of Brazil, for example, mercury concentrations in all abiotic materials, plants, and animals--including endangered species of mammals and reptiles--collected near ongoing mercury-amalgamation gold mining sites were far in excess of allowable mercury levels promulgated by regulatory agencies for the protection of human health and natural resources. Although health authorities in Brazil are unable to detect conclusive evidence of human mercury intoxication, the potential exists in the absence of mitigation for epidemic mercury poisoning of the mining population and environs. In the United States, environmental mercury contamination is mostly from historical gold mining practices, and portions of Nevada remain sufficiently mercury-contaminated to pose a hazard to reproduction of carnivorous fishes and fish-eating birds. Concentrations of total mercury lethal to sensitive representative natural resources range from 0.1 to 2.0 ug/L of medium for aquatic organisms; from 2200 to 31,000 ug/kg body weight (acute oral) and 4000 to 40,000 ug/kg (dietary) for birds; and from 100 to 500 ug/kg body weight (daily dose) and 1000 to 5000 ug/kg diet for mammals. Significant adverse sublethal effects were observed among selected aquatic species at water concentrations of 0.03 to 0.1 ug Hg/L. For some birds, adverse effects--mainly on reproduction--have been associated with total

  9. Serum Electrolyte, Acid-Base Balance, and Enzyme Changes in Acute Halogeton Glomeratus Poisoning in Sheep

    Science.gov (United States)

    James, L. F.

    1968-01-01

    Fourteen sheep were used on an acute halogeton toxicity feeding experiment. Seven sheep were fed a lethal dose of Halogeton glomeratus, an oxalate-producing plant, 7 served as controls. Various serum and tissue electrolytes and enzymes were measured. Sesum calcium decreased while magnesium and phosphorus increased. Although a severe hypocalcemia resulted from the feeding of halogeton tetany was not observed. Blood pH, pCO2 and pO2 measurements demonstrated that alkalosis did not develop. Serum glutamic pyruvic transaminase, serum glutamic oxalacetic transaminase, and lactic dehydrogenase all increased. Succinic dehydrogenase was inhibited in the rumen wall but not in other tissues according to the methods used. This finding, as well as other work cited, indicates a possible interference with carbohydrate metabolism. PMID:4234785

  10. [Rhabdomyolysis during acute poisoning with drugs and narcotics. Experience with 7 clinical cases].

    Science.gov (United States)

    Zele, I; De Tommaso, I; Melandri, R; Barakat, B; Pezzilli, R; Re, G; Fontana, G

    1992-12-01

    Numerous and extremely varied conditions (intense muscular activity, ischemia, metabolic and genetic disorders, infections, immunological diseases and toxic causes) may play a role in the genesis of non-traumatic rhabdomyolysis. Over the past years there has been an increased number of reports of forms due to drug or narcotic intoxication. Seven cases of rhabdomyolysis are reported in patients admitted to emergency wards in a state of coma due to heroin overdose (4 cases), cocaine overdose (1 case), carbamazepin (1 case), and tricyclic anti-depressives (1 case). In all cases it was possible to hypothesise a multifactorial pathogenesis of the disease in which other factors, such as acidosis, hypoxia, hypothermia and compression of the muscle mass during coma, were associated with the direct toxic damage caused by the drug. The most frequent complication was acute renal failure. One case of myocardial involvement with non-Q infarction characteristics was also observed.

  11. Serum electrolyte, acid-base balance, and enzyme changes in acute halogeton glomeratus poisoning in sheep.

    Science.gov (United States)

    James, L F

    1968-10-01

    Fourteen sheep were used on an acute halogeton toxicity feeding experiment. Seven sheep were fed a lethal dose of Halogeton glomeratus, an oxalate-producing plant, 7 served as controls. Various serum and tissue electrolytes and enzymes were measured. Sesum calcium decreased while magnesium and phosphorus increased. Although a severe hypocalcemia resulted from the feeding of halogeton tetany was not observed. Blood pH, pCO(2) and pO(2) measurements demonstrated that alkalosis did not develop. Serum glutamic pyruvic transaminase, serum glutamic oxalacetic transaminase, and lactic dehydrogenase all increased. Succinic dehydrogenase was inhibited in the rumen wall but not in other tissues according to the methods used. This finding, as well as other work cited, indicates a possible interference with carbohydrate metabolism.

  12. Clinical and laboratory features of acute sulfur dioxide inhalation poisoning: two-year follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Rabinovitch, S.; Greyson, N.D.; Weiser, W.; Hoffstein, V.

    1989-02-01

    We present clinical and laboratory results (including nuclear imaging) obtained over a period of two years in two nonsmoking miners who were exposed to high concentrations of sulfur dioxide (SO/sub 2/) after a mine explosion. Within 3 wk of the accident, both miners had evidence of severe airways obstruction, hypoxemia, markedly reduced exercise tolerance, ventilation-perfusion mismatch, and evidence of active inflammation as documented by positive gallium lung scan. Serial ventilation-perfusion scans over the first 12 months showed progressive improvement without returning to normal. After the initial recovery, there has been no significant change over the subsequent two years postinjury. Pulmonary function and exercise tests also displayed a similar pattern of initial improvement. We conclude that (1) acute exposure to high concentrations of SO/sub 2/ results in severe airways obstruction, (2) pulmonary function abnormalities are partially reversible, and (3) most of the improvement occurs within 12 months after the initial injury.

  13. Acute intentional self-poisoning with a herbicide product containing fenoxaprop-P-ethyl, ethoxysulfuron and isoxadifen ethyl. A prospective observational study

    Science.gov (United States)

    ZAWAHIR, SHUKRY; ROBERTS, DARREN M.; PALANGASINGHE, CHATHURA; MOHAMED, FAHIM; EDDLESTON, MICHAEL; DAWSON, ANDREW H.; BUCKLEY, NICK A.; REN, LINGLING; MEDLEY, GREGORY A.; GAWARAMMANA, INDIKA

    2011-01-01

    BACKGROUND Herbicides are commonly ingested for self-harm; however, relatively little has been published on poisoning with herbicides other than paraquat and glyphosate. We report here a case series of patients with acute exposure to a combination herbicide (brand name Tiller Gold or Whip Super) containing the selective phenoxy herbicide fenoxaprop-P-ethyl, the sulfonylurea herbicide ethoxysulfuron and the safener isoxadifen ethyl. METHOD Clinical data on all patients presenting with Tiller Gold or Whip Super poisoning to two General Hospital in Sri Lanka from 2002-2008 were collected prospectively until discharge. RESULTS Eighty-six patients with a history of Tiller Gold or Whip Super ingestion were included. The median time to presentation was 4 hours post-ingestion (IQR 2 to 10 hrs) and the median volume ingested was 22.5ml (IQR: 20-60; n=64). Most patients demonstrated limited clinical signs of poisoning and none required mechanical ventilation or intensive care treatment. The main clinical features were an epigastric burning sensation and vomiting; however, most of those who vomited had received gastric lavage or forced emesis. Eight patients had a reduced level of consciousness on admission (GCS 9 -14) that resolved without intervention over several hours. Only symptomatic and supportive care was required. The median hospital stay was 1 day (IQR: 1 to 2) and the case fatality was zero (95% CI: zero to 4.2%). This low case fatality compared favorably with the case fatality of other common herbicides in our cohort: paraquat >40%, propanil >10%, 4-chloro-2-methylphenoxyacetic acid (MCPA) > 5% and glyphosate >2%. CONCLUSION This combination herbicide product appears to be safe in patients with acute self-poisoning, particularly in comparison with other herbicides, and causing few clinical features PMID:19663557

  14. Ultrastructural lesions in the myocardium and kidneys of rabbits in experimental acute Amorimia exotropica poisoning

    Directory of Open Access Journals (Sweden)

    Mauro P. Soares

    2016-03-01

    Full Text Available Abstract: Amorimia exotropica is an important plant associated with sudden death in cattle in Southern Brazil. In order to understand the mechanisms by which A. exotropica causes acute lesions in the heart and kidney of intoxicated animals, an experiment was conducted to determine the histopathology and ultrastructure of myocardial and renal lesions of intoxicated rabbits. After receiving 18g/kg of dried plant, six rabbits died suddenly. At necropsy, the liver was swollen and no other macroscopic lesions were observed. Histologically, centrolobular and midzonal hepatocytes were vacuolated. These vacuoles were strong PAS stained positive, suggesting that they corresponded to glycogen accumulations. In some regions of the ventricular septum and ventricles were found vacuoles of different sizes and the kidneys of two rabbits showed vacuolar degeneration on distal convoluted tubules. Ultrastructurally, the myocardium had cardiomyocytes swelling with separation of myofibrils bundles and rupture and disorganization of the sarcomeres. The mitochondria displayed swelling, disorganization, disruption of the mitochondrial cristae, and electron-dense matrix. Some mitochondria exhibited eccentric projections of their membranes with disruption of both outer and inner membranes. The sarcoplasmic reticulum had no alterations, whereas the T-tubule system was occasionally dilated and ruptured. The kidneys had mitochondrial swelling with disorganization and disruption of the mitochondrial cristae. The vacuoles result from the swelling of the endoplasmatic reticulum and usually were located between two basolateral infoldings and mitochondria, occurring preferentially around the nucleus. The myocytes and T system damages induced by A. exotropica result in acute heart failure and death. Furthermore, this mechanism of cardiotoxicity may be common to all plant containing monofluoroacetate.

  15. Role of biomarkers of nephrotoxic acute kidney injury in deliberate poisoning and envenomation in less developed countries

    Science.gov (United States)

    Mohamed, Fahim; Endre, Zoltan H; Buckley, Nicholas A

    2015-01-01

    Acute kidney injury (AKI) has diverse causes and is associated with increased mortality and morbidity. In less developed countries (LDC), nephrotoxic AKI (ToxAKI) is common and mainly due to deliberate ingestion of nephrotoxic pesticides, toxic plants or to snake envenomation. ToxAKI shares some pathophysiological pathways with the much more intensively studied ischaemic AKI, but in contrast to ischaemic AKI, most victims are young, previously healthy adults. Diagnosis of AKI is currently based on a rise in serum creatinine. However this may delay diagnosis because of the kinetics of creatinine. Baseline creatinine values are also rarely available in LDC. Novel renal injury biomarkers offer a way forward because they usually increase more rapidly in AKI and are normally regarded as absent or very low in concentration, thereby reducing the need for a baseline estimate. This should increase sensitivity and speed of diagnosis. Specificity should also be increased for urine biomarkers since many originate from the renal tubular epithelium. Earlier diagnosis of ToxAKI should allow earlier initiation of appropriate therapy. However, translation of novel biomarkers of ToxAKI into clinical practice requires better understanding of non-renal factors in poisoning that alter biomarkers and the influence of dose of nephrotoxin on biomarker performance. Further issues are establishing LDC population-based normal ranges and assessing sampling and analytical parameters for low resource settings. The potential role of renal biomarkers in exploring ToxAKI aetiologies for chronic kidney disease of unknown origin (CKDu) is a high research priority in LDC. Therefore, developing more sensitive biomarkers for early diagnosis of nephrotoxicity is a critical step to making progress against AKI and CKDu in the developing world. PMID:26099916

  16. Speciation analysis of arsenic compounds in the serum and urine of a patient with acute arsine poisoning

    Directory of Open Access Journals (Sweden)

    Yamanaka K.

    2013-04-01

    Full Text Available Arsine is one of the most potent hemolytic agents. It is important to clarify arsine metabolism as well as its chemical interactions with biological components. The aim of the present study was to clarify arsine metabolism by arsenic speciation analysis in serum and urine from an acute poisoning patient with hematuria, anemia, and renal and liver dysfunction. Speciation analysis of arsenics in serum and urine was performed using HPLC-ICP-MS. The total arsenic (T-As concentration in serum was 244.8 μg/l at admission and 97.1 μg/l at discharge. In the speciation analysis, four kinds of As compounds derived from arsine metabolism were detected in serum and urine. The concentration of arsenite (AsIII, arsenate (AsV, monomethylarsonic acid (MMA, and dimethylarsinic acid (DMA in serum at admission were 45.8, 5.2, 17.9 and 9.3 μg/l, respectively. The concentrations of AsIII, AsV, and MMA decreased with biological half time (BHT of 30.1, 43.0, and 96.3 h, respectively. Only DMA was increased at discharge. The urinary AsIII, AsV, MMA and DMA concentrations were 223.0, 12.1, 317.5 and 1053.5 μg/l at discharge, and decreased with BHT of 15.1, 20.8, 14.7, and 16.0 d, respectively. The results indicate that arsine was quickly metabolized to AsIII and subsequently up to DMA, with the result that the toxic effects of inorganic arsenic were added to those of arsine toxicity.

  17. Removal of Elemental Mercury from a Gas Stream Facilitated by a Non-Thermal Plasma Device

    Energy Technology Data Exchange (ETDEWEB)

    Charles Mones

    2006-12-01

    Mercury generated from anthropogenic sources presents a difficult environmental problem. In comparison to other toxic metals, mercury has a low vaporization temperature. Mercury and mercury compounds are highly toxic, and organic forms such as methyl mercury can be bio-accumulated. Exposure pathways include inhalation and transport to surface waters. Mercury poisoning can result in both acute and chronic effects. Most commonly, chronic exposure to mercury vapor affects the central nervous system and brain, resulting in neurological damage. The CRE technology employs a series of non-thermal, plasma-jet devices to provide a method for elemental mercury removal from a gas phase by targeting relevant chemical reactions. The technology couples the known chemistry of converting elemental mercury to ionic compounds by mercury-chlorine-oxygen reactions with the generation of highly reactive species in a non-thermal, atmospheric, plasma device. The generation of highly reactive metastable species in a non-thermal plasma device is well known. The introduction of plasma using a jet-injection device provides a means to contact highly reactive species with elemental mercury in a manner to overcome the kinetic and mass-transfer limitations encountered by previous researchers. To demonstrate this technology, WRI has constructed a plasma test facility that includes plasma reactors capable of using up to four plasma jets, flow control instrumentation, an integrated control panel to operate the facility, a mercury generation system that employs a temperature controlled oven and permeation tube, combustible and mercury gas analyzers, and a ductless fume hood designed to capture fugitive mercury emissions. Continental Research and Engineering (CR&E) and Western Research Institute (WRI) successfully demonstrated that non-thermal plasma containing oxygen and chlorine-oxygen reagents could completely convert elemental mercury to an ionic form. These results demonstrate potential the

  18. Ethanol poisoning

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002644.htm Ethanol poisoning To use the sharing features on this page, please enable JavaScript. Ethanol poisoning is caused by drinking too much alcohol. ...

  19. Alcohol Poisoning

    Science.gov (United States)

    ... unconscious or can't be awakened is at risk of dying. Alcohol poisoning is an emergency If you suspect that ... a short period of time, the greater your risk of alcohol poisoning. One drink is defined as: 12 ounces ( ...

  20. Poison Prevention

    Science.gov (United States)

    ... the Word Shop AAP Find a Pediatrician Safety & Prevention Immunizations All Around At Home At Play On ... Listen Español Text Size Email Print Share Poison Prevention Page Content Article Body Post the Poison Help ...

  1. Poisonous Plants

    Science.gov (United States)

    ... Publications and Products Programs Contact NIOSH NIOSH POISONOUS PLANTS Recommend on Facebook Tweet Share Compartir Photo courtesy ... U.S. Department of Agriculture Many native and exotic plants are poisonous to humans when ingested or if ...

  2. Starch poisoning

    Science.gov (United States)

    Cooking starch poisoning; Laundry starch poisoning ... Cooking and laundry starch are both made from vegetable products, most commonly: Corn Potatoes Rice Wheat Both are usually considered nonpoisonous (nontoxic), but ...

  3. Cologne poisoning

    Science.gov (United States)

    ... ingredients in cologne can be poisonous: Ethyl alcohol (ethanol) Isopropyl alcohol (isopropanol) There may be other poisonous ... D, Hovda KE. Methanol, ethylene glycol, and other toxic alcohols. In: Shannon MW, Borron SW, Burns MJ, ...

  4. Methanol poisoning

    Science.gov (United States)

    ... reverse the effect of the poison (fomepizole or ethanol) Tube through the nose to remove remaining poison, ... Elsevier Churchill Livingstone; 2015:chap 29. White SR. Toxic alcohols. In: Marx JA, Hockberger RS, Walls RM, ...

  5. Copper poisoning

    Science.gov (United States)

    ... Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 75. Holland MG. Pulmonary toxicology. ... Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 9. Jones AL, Dargan PI. ...

  6. Insecticide poisoning

    Science.gov (United States)

    ... Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 76. Borron SW. Pyrethins, repellants, ... Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 77. Cannon RD, Ruha A- ...

  7. Toxicoepidemiology of acute poisoning cases in a secondary care hospital in rural South India: A five-year analysis

    Directory of Open Access Journals (Sweden)

    T H Indu

    2015-01-01

    Full Text Available Objective: To ascertain the trend of poisoning cases admitted to the Government District Headquarters Hospital, a secondary care center in Udhagamandalam, Nilgiris District, Tamil Nadu, India, over a five-year period. Materials and Methods: The number of cases that presented to the hospital annually (incidence, mortality, and case fatality rates, socio-demographic pattern, and the nature of the poison were noted. Results: A total of 1860 poisoning cases (80 deaths were reported during the period from October 2008 to September 2013. The incidence of poisoning was found to increase every year. The average incidence was 1.60 per 1000 population, while the average case fatality rate and mortality rates were 40.51 and 0.07, respectively. A total of 1148 (62% were males. The majority of cases were seen in the 21-30 age group (41.24%. The poisonings were largely deliberate self-harm (n = 1,755; 94.35%, followed by accidental (n = 85; 4.57%. Agrochemicals were the main choice of poisoning agents and among these, organophosphates were the major cause. Conclusion: The data generated can help policy makers take decisions on the sale and availability of pesticides in this region.

  8. Epidemiological Study of Acute Poisoning in Children Referred to Bu-Ali Hospital of Ardabil, 2007-2011

    Directory of Open Access Journals (Sweden)

    Esmaeil Farzaneh

    2014-04-01

    Full Text Available Background & Objectives : Poisoning is a common cause of hospital emergency visits in many countries. Incidence of poisoning is different based on cultural and economic characteristics. The aim of this study was to investigate the epidemiology of poisoning in pediatrics.   Methods: This cross sectional study was performed on 336 patients under 13 years of age referring to Bu-Ali hospital during five years (2007-2011. Variables such as age, sex, residency place, hospitalized duration, cause of the poisoning, clinical signs, treatment and outcome were obtained by a checklist. Collected data analyzed by statistical methods in SPSS v16.   Results : Among the subjects, 197 patients (58.6% were male. The average age of the children was 4.1 years and the most common age range was 1 to 4 years with (210 patients, 62.5%. The mean duration of hospitalization of children was 1.7 day (SD= 0.2, 77.7 % of the children were living in the city and the summer was accounted as a common season in which the patients referred to the hospital (32.7 %. The most used materials were drugs with 60.71% and in 86.6% of patients the cause of poisoning was accidental.   Conclusion : Results showed that the most common cause of poisoning among children are drugs and methadone was the most commonly abused substance. It requires that parents should be trained about keeping their children away from drugs somewhere.

  9. [Characteristics of the pharmacological treatment of toxic liver damage in patients with an alcohol abused syndrome and an acute severe ethanol poison].

    Science.gov (United States)

    Shilov, V V; Shikalova, I A; Vasil'ev, S A; Loladze, A T; Batotsyrenov, B V

    2012-01-01

    The examination of 130 patients with an alcohol abused syndrome and a severe ethanol poison have revealed that ethanol action are accompanied by significant metabolic disturbances. The comparative evaluation of the inclusion of heptral and remaxol in the treatment has shown that remaxol improves the clinical course of mentioned disorders decreasing the frequency and duration of alcohol delirium. Patients treated with this drug spent less time in acute care and their treatment duration was shorter. Remaxol reduces more effectively the severity of metabolic disorders.

  10. [The impact of L-carnitine administration on the serum level of myocardium injury markers in patients with acute carbon monoxide poisoning].

    Science.gov (United States)

    Sun, Zhong-ji; Yang, Chao-bin; Wang, Hui; Li, Ying

    2011-12-01

    To examine the serum level of myocardial injury markers in patients with carbon monoxide (CO) poisoning, the correlation between these markers and the severity of the disease, and the therapeutic effects of L-carnitine administration. 69 patients, chosen from 309 cases of acute carbon monoxide poisoning (ACOP) for abnormally high level of serum myocardial injury markers (myoglobin, Mb; MB isoenzyme of creatine kinase, CK-MB; cardiac troponin-I, cTnI) at the time of admission, were randomly divided into control group (n = 34) and observation group (n = 35). The patients in control group were given Xingnaojing (20 ml/d i.v. drip), and the observation group Xingnaojing (20 ml/d)+L-carnitine (2 g/d i.v. drip), in addition to the conventional oxygen supply and symptom-focused therapy. The plasma concentration of carboxyhemoglobin (HbCO, as index for CO poisoning severity), Mb, CK-MB, and cTnI in these patients were further examined 24 hours, 72 hours and 1 week after the treatment, for difference between the two groups, and the correlation between the serum level of HbCO and the myocardial injury markers. At the time of admission, the incidence of abnormal findings in myocardial injury markers were 2.5% (5/204), 46.8% (36/77) and 100.0% (28/28) in patients with mild (HbCO: 10% ~ 19%), moderate (20% ~ 39%) and severe (≥40%) CO poisoning, respectively. The incidence of abnormal findings in injury markers was significantly correlated to the HbCO concentration (x(2)=170.3549, P 0.05] between the control and observation group. However, it was found in: Mb (24 hours: 74.0 ± 36.5 vs. 97.1 ± 35.8, 72 hours: 40.1 ± 6.8 vs. 69.0 ± 11.2), cTnI (24 hours: 1.9 ± 0.5 vs. 2.3 ± 0.7, 72 hours: 1.2 ± 0.3 vs. 1.8 ± 0.4) both 24 hours and 72 hours after the treatment, and CK-MB, 24 hours after treatment (10.6 ± 4.1 vs. 13.0 ± 3.9) with the values in observation group significantly lower (P incidence of abnormal findings in serum myocardial injury markers was positively

  11. [Mercury (and...) through the centuries].

    Science.gov (United States)

    Kłys, Małgorzata

    2010-01-01

    Mercury has a long history, fascinating in its many aspects. Through the centuries--from ancient times to the present day--the metal in its various forms, also known under the name "quicksilver", accompanied the man and was used for diversified purposes. Today, mercury is employed in manufacturing thermometers, barometers, vacuum pumps and explosives. It is also used in silver and gold mining processes. Mercury compounds play a significant role in dentistry, pharmaceutical industry and crop protection. The contemporary use of mercury markedly decreases, but historically speaking, the archives abound in materials that document facts and events occurring over generations and the immense intellectual effort aiming at discovering the true properties and mechanisms of mercury activity. Mercury toxicity, manifested in destruction of biological membranes and binding of the element with proteins, what disturbs biochemical processes occurring in the body, was discovered only after many centuries of the metal exerting its effect on the lives of individuals and communities. For centuries, mercury was present in the work of alchemists, who searched for the universal essence or quintessence and the so-called philosopher's stone. In the early modern era, between the 16th and 19th centuries, mercury was used to manufacture mirrors. Mercury compounds were employed as a medication against syphilis, which plagued mankind for more than four hundred years--from the Middle Ages till mid 20th century, when the discovery of penicillin became the turning point. This extremely toxic therapy resulted in much suffering, individual tragedies, chronic poisonings leading to fatalities and dramatic sudden deaths. In the last fifty years, there even occurred attempts of mentally imbalanced individuals at injecting themselves with metallic mercury, also as a performance-enhancing drug. Instances of mass mercury poisoning occurred many times in the past in consequence of eating food products

  12. Development of a Prediction Model for Diagnosis of Acute Poisoning in Patients with Altered Mental Status and Absent History of Alcohol/Drug Ingestion.

    Science.gov (United States)

    Camilleri, Robert

    2017-11-01

    Diagnosis of acute poisoning in patients with altered mental status and absent history is a challenging diagnostic problem in clinical practice. The aims of the study were to develop a simple clinical tool to stratify risk of acute poisoning in patients with altered mental states and no history of alcohol/drug ingestion, and develop a prediction model using initial observations from which a simple risk score could be derived. The study was carried out on non-trauma patients aged 15 years and older admitted with altered mental states and no history of alcohol or drug ingestion. Univariate analysis and logistic regression were carried out and a score was derived and validated. There were 607 patients included, with mean age of 60.3 years and 54% were male. The regression model performed moderately well on both the training and validation sets with areas under the receiver operating characteristic curve of 0.834 and 0.844, respectively. The risk score correlated with the regression model (R2 = 0.969). At cutoff thresholds of 20% for the model and 2 for the score, sensitivity and specificity of the regression model (67.6% and 85.6%) and the score (67.6% and 85.4%) were moderate, while positive predictive values were low (43.4%) and negative predictive values were high (94.2%) for both the regression model and the score. A prediction model with a derived risk score was developed with a high negative predictive value and may have potential in assessing risk of poisoning in altered mental status and may have value in a prehospital environment or at triage. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Combined application of dexamethasone and hyperbaric oxygen therapy yields better efficacy for patients with delayed encephalopathy after acute carbon monoxide poisoning.

    Science.gov (United States)

    Xiang, Wenping; Xue, Hui; Wang, Baojun; Li, Yuechun; Zhang, Jun; Jiang, Changchun; Liang, Furu; Pang, Jiangxia; Yu, Lehua

    2017-01-01

    Delayed encephalopathy after acute carbon monoxide (CO) poisoning (DEACMP) commonly occurs after recovering from acute CO poisoning. This study was performed to assess the efficacy of the combined application of dexamethasone and hyperbaric oxygen (HBO) therapy in patients with DEACMP. A total of 120 patients with DEACMP were recruited and randomly assigned into the experimental group (receiving dexamethasone 5 mg/day or 10 mg/day plus HBO therapy) and control group (HBO therapy as monotherapy). Meanwhile, the conventional treatments were provided for all the patients. We used the Mini-Mental State Examination (MMSE) scale to assess the cognitive function, the National Institutes of Health Stroke Scale (NIHSS) to assess the neurological function and the remission rate (RR) to assess the clinical efficacy. Myelin basic protein (MBP) in the cerebrospinal fluid (CSF) was also measured. After 4 weeks of treatment, compared to the control group, the experimental group had a significantly higher remission rate ( P =0.032), a significantly higher average MMSE score ( P =0.037) and a significantly lower average NIHSS score ( P =0.002). Meanwhile, there was a trend toward better improvement with dexamethasone 10 mg/day, and the level of MBP in the CSF of patients was significantly lower in the experimental group than in the control group ( P incidence of adverse events. These results indicate that the combined application of dexamethasone and HBO therapy could yield better efficacy for patients with DEACMP and should be viewed as a potential new therapy.

  14. Study protocol: a randomised controlled trial of multiple and single dose activated charcoal for acute self-poisoning

    Directory of Open Access Journals (Sweden)

    Mohammed Fahim

    2007-05-01

    Full Text Available Abstract Background The case fatality for intentional self-poisoning in rural Asia is 10–30 times higher than in the West, mostly due to the use of highly toxic poisons. Activated charcoal is a widely available intervention that may – if given early – bind to poisons in the stomach and prevent their absorption. Current guidelines recommend giving a single dose of charcoal (SDAC if patients arrive within an hour of ingestion. Multiple doses (MDAC may increase poison elimination at a later time by interrupting any enterohepatic or enterovascular circulations. The effectiveness of SDAC or MDAC is unknown. Since most patients present to hospital after one hour, we considered MDAC to have a higher likelihood of clinical benefit and set up a study to compare MDAC with no charcoal. A third arm of SDAC was added to help determine whether any benefit noted from MDAC resulted from the first dose or all doses. Methods/design We set up a randomised controlled trial assessing the effectiveness of superactivated charcoal in unselected adult self-poisoning patients admitted to the adult medical wards of three Sri Lankan secondary hospitals. Patients were randomised to standard treatment or standard treatment plus either a single 50 g dose of superactivated charcoal dissolved in 300 ml of water or six doses every four hours. All patients with a history of poison ingestion were approached concerning the study and written informed consent taken from each patient, or their relative (for unconscious patients or those 72 hrs post-ingestion, and previous recruitment. The primary outcome was in-hospital mortality; secondary outcomes included the occurrence of serious complications (need for intubation, time requiring assisted ventilation, fits, cardiac dysrhythmias. Analysis will be on an intention-to-treat basis; the effects of reported time to treatment after poisoning and status on admission will also be assessed. Discussion This trial will provide important

  15. Hemlock (Conium Maculatum) Poisoning In A Child

    OpenAIRE

    KONCA, Capan; Kahramaner, Zelal; Bosnak, Mehmet; Kocamaz, Halil

    2016-01-01

    SUMMARY Poison hemlock (Conium maculatum) is a plant that is poisonous for humans and animals. Accidental ingestion of the plant may result in central nervous system depression, respiratory failure, acute rhabdomyolysis, acute renal failure and even death. The main treatment of hemlock poisoning is supportive care. The case of a 6-year-old girl who was admitted to the emergency department with complaints of burning sensation in mouth, hypersalivation, tremor in hands and ataxia after ingestio...

  16. Hemlock (Conium Maculatum) Poisoning In A Child

    OpenAIRE

    KONCA, Capan; Kahramaner, Zelal; Bosnak, Mehmet; Kocamaz, Halil

    2014-01-01

    Poison hemlock (Conium maculatum) is a plant that is poisonous for humans and animals. Accidental ingestion of the plant may result in central nervous system depression, respiratory failure, acute rhabdomyolysis, acute renal failure and even death. The main treatment of hemlock poisoning is supportive care. The case of a 6-year-old girl who was admitted to the emergency department with complaints of burning sensation in mouth, hypersalivation, tremor in hands and ataxia after ingestion of poi...

  17. Toxicological responses to acute mercury exposure for three species of Manila clam Ruditapes philippinarum by NMR-based metabolomics.

    Science.gov (United States)

    Liu, Xiaoli; Zhang, Linbao; You, Liping; Cong, Ming; Zhao, Jianmin; Wu, Huifeng; Li, Chenghua; Liu, Dongyan; Yu, Junbao

    2011-03-01

    The Manila clam (Ruditapes philippinarum) has been considered a good sentinel species for metal pollution monitoring in estuarine tidal flats. Along the Bohai coast of China, there are dominantly distributed three species of clams (White, Liangdao Red and Zebra in Yantai population) endowed with distinct tolerances to environmental stressors. In this study, adductor muscle samples were collected from both control and acute mercury exposed White, Liangdao Red and Zebra clams, and the extracts were analyzed by NMR-based metabolomics to compare the metabolic profiles and responses to the acute mercury exposure to determine the most sensitive clam species capable of acting as abioindicator for heavy metal pollution monitoring. The major abundant metabolites in the White clam sample were branched-chain amino acids (leucine, isoleucine and valine), lactate, arginine, aspartate, acetylcholine, homarine and ATP/ADP, while the metabolite profile of Zebra clam sample comprised high levels of glutamine, acetoacetate, betaine, taurine and one unidentified metabolite. For the Liangdao Red clam sample, the metabolite profile relatively exhibited high amount of branched-chain amino acids, arginine, glutamate, succinate, acetylcholine, homarine and two unassigned metabolites. After 48h exposure of 20μgL(-1) Hg(2+), the metabolic profiles showed significant differences between three clam species, which included increased lactate, succinate, taurine, acetylcholine, betaine and homarine and decreased alanine, arginine, glutamine, glutamate, acetoacetate, glycine and ATP/ADP in White clam samples, and elevated succinate, taurine and acetylcholine, and declined glutamine, glycine, and aspartate in Liangdao Red clam samples, while the increased branched-chain amino acids, lactate, succinate, acetylcholine and homarine, and reduced alanine, acetoacetate, glycine and taurine were observed in the Zebra clam samples. Overall, our findings showed that White clams could be a preferable

  18. Diagnosis of acute poisoning

    African Journals Online (AJOL)

    Chantel

    for wood or paper). Newspaper. Talc (not inhaled). Golf ball (core may cause ... medicines). Phenolphthalein laxatives (Brooklax). Chalk (calcium carbonate). Hydrogen pero xide (medicinal 3%). Plasticine. V aseline. Charcoal. Play-Doh. V.

  19. Food Poisoning

    Science.gov (United States)

    1983-05-16

    enterotoxemia and other bacterial enterotoxemias due to contamination of food by preformed toxins, botulism, mushroom poisoning and "other poisons of...Preformed Toxins of Bacterial Origin Enterotoxemia Protein toxins produced during the growth of Staphylococcal aureus in food cause the most common...NUMBER 2. GOVT ACCESSION NO. 3. RECIPIENT’S CATALOG NUMBER 4. TITLE (and Subttl*e) 5. TYPE OF REPORT & PERIOD COVERED Food Poisoning AD A 1 2 A- S

  20. Drug Utilization Study on Acute Poisoning Cases Treated at a Tertiary Care Hospital in Western Part of India

    Directory of Open Access Journals (Sweden)

    Pratik D. Asari

    2016-03-01

    Conclusion: Use of antimicrobial medicines for poisoned patients was too high and irrational.  Due to high incidence of snakebites, hospital stockpiles should be regularly checked for availability of antivenom. Educational programs with emphasis on preventive measures for toxic exposures are necessary to create awareness among the general public.

  1. A CLINICAL STUDY OF 100 CASES OF ACUTE OLEANDER SEED POISONING IN KANYAKUMARI GOVERNMENT MEDICAL COLLEGE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Sankar Selvaraj

    2016-10-01

    Full Text Available BACKGROUND Yellow oleander (Cascabela thevetia is a poisonous plant that is widely found in India. All parts of the C. thevetia plant are toxic to humans as they contain cardiac glycosides. MATERIALS AND METHODS 100 patients with alleged history of yellow oleander seed poisoning who came to Kanyakumari Government Medical College Hospital during the period of 2013-16 were enrolled in this study. Patients presenting with multiple poison consumption and those with previous history of heart disease were excluded from the study. A detailed history of the number of seeds consumed, the time of consumption, detailed clinical assessment, routine blood investigations and a 12-lead ECG were recorded. ECG was recorded at the time of admission and every 12th hourly to detect any cardiac arrhythmias. RESULTS Most symptomatic patients had conduction defects affecting the SA node, the AV node or both. Patients showing cardiac arrhythmias had significantly higher mean serum potassium concentrations ranging from 4.5-5.2 mEq/L. Yellow oleander seed poisoning is common among young females (56%. There is a poor correlation between the number of seeds ingested and the severity of cardiotoxicity. Arrhythmias has occurred after ingestion of one or two seeds; some patients are asymptomatic even after consuming five or more seeds without requiring specialised treatments. This could be explained on the basis that crushed seeds are more dangerous than whole seeds. CONCLUSION Most of these young previously healthy patients had conduction defects affecting the SA or AV nodes. Relatively, few had the atrial tachyarrhythmias or ventricular ectopic beats that are typical of digoxin poisoning. Yellow oleander induced arrhythmias were associated with high serum potassium levels when compared to patient without arrhythmias.

  2. Mercury Exposure in a Riverside Amazon Population, Brazil: A Study of the Ototoxicity of Methylmercury

    Directory of Open Access Journals (Sweden)

    Hoshino, Ana

    2015-02-01

    Full Text Available Introduction Mercury poisoning causes hearing loss in humans and animals. Acute and long-term exposures produce irreversible peripheral and central auditory system damage, and mercury in its various forms of presentation in the environment is ototoxic. Objective We investigated the otoacoustic emissions responses in a riverside population exposed to environmental mercury by analyzing the inhibitory effect of the medial olivocochlear system (MOCS on transient otoacoustic emissions (TEOAE. Methods The purpose of the research was to evaluate the entire community independently of variables of sex and age. All of the participants were born and lived in a riverside community. After otolaryngologic evaluation, participants were received tympanometry, evaluation of contralateral acoustic reflexes, pure tone audiometry, and recording of TEOAEs with nonlinear click stimulation. Hair samples were collect to measure mercury levels. Results There was no significant correlation between the inhibitory effect of the MOCS, age, and the level of mercury in the hair. Conclusions The pathophysiological effects of chronic exposure may be subtle and nonspecific and can have a long period of latency; therefore, it will be important to monitor the effects of mercury exposure in the central auditory system of the Amazon population over time. Longitudinal studies should be performed to determine whether the inhibitory effect of the MOCS on otoacoustic emissions can be an evaluation method and diagnostic tool in populations exposed to mercury.

  3. Pesticide Poisoning of Honeybees: A Review of Symptoms, Incident Classification, and Causes of Poisoning

    OpenAIRE

    Kiljanek Tomasz; Niewiadowska Alicja; Posyniak Andrzej

    2016-01-01

    During the 2000s, the problem of pesticide poisoning of honeybees seemed to be almost solved. The number of cases has decreased in comparison to the 1970s. The problem of acute honeybee poisoning, however, has not disappeared, but instead has transformed into a problem of poisoning from ‘traditional’ pesticides like organophosphorus pesticides or pyrethroids, to poisoning from additional sources of ‘modern’ systemic neonicotinoids and fipronil. In this article, the biological activity of pest...

  4. Mushroom poisoning.

    Science.gov (United States)

    Erguven, M; Yilmaz, O; Deveci, M; Aksu, N; Dursun, F; Pelit, M; Cebeci, N

    2007-09-01

    We aimed to review characteristics of mushrooms and mushroom poisoning and compare clinical picture, laboratory data, treatment modalities and prognostic factors in children with amanita intoxication and non-amanita mushroom poisoning. We analyzed 39 pediatric patients through 1994-2004, retrospectively from the patient files and evaluated the patients in two groups as patients with amanita intoxication and patients with non-amanita mushroom poisoning. All of the cases were admitted to the hospital in autumn. Twenty three (59%) of the patients were female and 16 (41%) were male. Mean age of the patients was 8.05 +/- 2.10 years. Amanita phalloides toxin was detected in the serum in 8 patients. Eleven (28%) of the cases were strongly suggestive of amanita poisoning but alpha amanitin level could not be studied. The average time of appearance of symptoms after mushroom consumption, duration of symptoms, hospital stay, serum AST, ALT, PT and creatinine levels were significantly higher in patients with amanita poisoning (pamanita poisoning (30%), totally 7 patients died of hepatic coma. The average time of admission to hospital, mean AST, ALT, creatinine and PT values at 3rd day were significantly higher in patients who died of hepatic coma. Prognosis was better in case of early admittance to hospital in patients with amanita poisoning. Early diagnosis and treatment in mushroom poisoning can be life saving. Public awareness is very important in prevention of intoxication as well as encouraging early admission to hospitals.

  5. Benzodiazepine poisoning in elderly.

    Science.gov (United States)

    Vukcević, Natasa Perković; Ercegović, Gordana Vuković; Segrt, Zoran; Djordjević, Snezana; Stosić, Jasmina Jović

    2016-03-01

    Benzodiazepines are among the most frequently ingested drugs in self-poisonings. Elderly may be at greater risk compared with younger individuals due to impaired metabolism and increased sensitivity to benzodiazepines. The aim of this study was to assess toxicity of benzodiazepines in elderly attempted suicide. A retrospective study of consecutive presentations to hospital after self-poisoning with benzodiazepines was done. Collected data consisted of patient's characteristics (age, gender), benzodiazepine ingested with its blood concentrations at admission, clinical findings including vital signs and Glasgow coma score, routine blood chemistry, complications of poisoning, details of management, length of hospital stay and outcome. According the age, patients are classified as young (15-40-year old), middle aged (41-65-year old) and elderly (older than 65). During a 2-year observational period 387 patients were admitted because of pure benzodiazepine poisoning. The most frequently ingested drug was bromazepam, the second was diazepam. The incidence of coma was significantly higher, and the length of hospital stay significantly longer in elderly. Respiratory failure and aspiration pneumonia occurred more frequently in old age. Also, flumazenil was more frequently required in the group of elderly patients. Massive benzodiazepines overdose in elderly may be associated with a significant morbidity, including deep coma with aspiration pneumonia, respiratory failure, and even death. Flumazenil is indicated more often to reduce CNS depression and prevent complications of prolonged unconsciousness, but supportive treatment and proper airway management of comatose patients is the mainstay of the treatment of acute benzodiazepine poisoning.

  6. The role of clinical laboratories in lead exposure: from diagnosis of acute poisonings to neonatal screening? A report on two cases

    Directory of Open Access Journals (Sweden)

    Elena García-González

    2016-12-01

    Full Text Available The role of clinical laboratories in lead exposure has traditionally focused on the diagnosis of poisonings that pose a risk to human health. However, the last decades of the twentieth century saw an increase in public awareness of lead exposure, which prompted the banning of both lead-containing paint and petrol. As a result, acute lead poisonings are increasingly rare in industrialized countries. However, this is always a latent danger that clinicians should be aware of. As an example of this we describe two cases that we recently diagnosed at our laboratory.Even more worrying is confirming the harmful effects of lead on children, even at concentrations hitherto considered safe. This has renewed interest in the determination of this element in clinical laboratories in order to find and control all those pregnant women and children who might have blood lead levels above a suitable threshold value, which is currently set at 50 μg L-1 for both populations. If this situation becomes the norm, the role of clinical laboratories with respect to lead determination will undergo a major change. This possibility is discussed in this paper, together with a pilot program developed at our hospital for such purpose.

  7. Association of blood lead level with neurological features in 972 children affected by an acute severe lead poisoning outbreak in Zamfara State, northern Nigeria.

    Science.gov (United States)

    Greig, Jane; Thurtle, Natalie; Cooney, Lauren; Ariti, Cono; Ahmed, Abdulkadir Ola; Ashagre, Teshome; Ayela, Anthony; Chukwumalu, Kingsley; Criado-Perez, Alison; Gómez-Restrepo, Camilo; Meredith, Caitlin; Neri, Antonio; Stellmach, Darryl; Sani-Gwarzo, Nasir; Nasidi, Abdulsalami; Shanks, Leslie; Dargan, Paul I

    2014-01-01

    In 2010, Médecins Sans Frontières (MSF) investigated reports of high mortality in young children in Zamfara State, Nigeria, leading to confirmation of villages with widespread acute severe lead poisoning. In a retrospective analysis, we aimed to determine venous blood lead level (VBLL) thresholds and risk factors for encephalopathy using MSF programmatic data from the first year of the outbreak response. We included children aged ≤5 years with VBLL ≥45 µg/dL before any chelation and recorded neurological status. Odds ratios (OR) for neurological features were estimated; the final model was adjusted for age and baseline VBLL, using random effects for village of residence. 972 children met inclusion criteria: 885 (91%) had no neurological features; 34 (4%) had severe features; 47 (5%) had reported recent seizures; and six (1%) had other neurological abnormalities. The geometric mean VBLLs for all groups with neurological features were >100 µg/dL vs 65.9 µg/dL for those without neurological features. The adjusted OR for neurological features increased with increasing VBLL: from 2.75, 95%CI 1.27-5.98 (80-99.9 µg/dL) to 22.95, 95%CI 10.54-49.96 (≥120 µg/dL). Neurological features were associated with younger age (OR 4.77 [95% CI 2.50-9.11] for 1-lead poisoning in prioritising therapy and developing chelation protocols.

  8. [Comparative evaluation of clinical efficacy of drugs remaxol and ademetionine in patients with acute ethanol poisoning complicated by the toxic damage of the liver].

    Science.gov (United States)

    Shilov, V V; Shikalova, I A; Batotsyrenov, B V; Andrianov, A Iu; Vasil'ev, S A; Loladze, A T

    2012-04-01

    As a result of survey in process of treatment of 100 patients with severe acute poisoning of ethanol on the background of the toxic damage of the liver set that the severity of poisoning depends on the duration abuse of alcohol (Binge drinking). Inclusion in the intensive care infusion hepatoprotector remaxol compared with ademetionine leads to a faster dynamics of improvement of the patients condition, evaluated by the scale assessing the severity APACHE II. Also found, Use of remaxol can reduce development of complications such is alcoholic delirium on the background of long-term abuse of alcohol in percentage from 31.9% to 16%, as well as reduces the time of stay of patients in the departments of the resuscitation and intensive care unit from 7,3±0,6 to 5,6±0,3 days and duration of treatment of patients in the hospital from 11,8±1,1 to 9,0±0,4 days.

  9. Hemlock (Conium Maculatum) Poisoning In A Child.

    Science.gov (United States)

    Konca, Capan; Kahramaner, Zelal; Bosnak, Mehmet; Kocamaz, Halil

    2014-03-01

    Poison hemlock (Conium maculatum) is a plant that is poisonous for humans and animals. Accidental ingestion of the plant may result in central nervous system depression, respiratory failure, acute rhabdomyolysis, acute renal failure and even death. The main treatment of hemlock poisoning is supportive care. The case of a 6-year-old girl who was admitted to the emergency department with complaints of burning sensation in mouth, hypersalivation, tremor in hands and ataxia after ingestion of poison hemlock is presented here with clinical and laboratory features. In this case, we aim to report that accidental ingestion of plants resembling vegetables that are consumed daily can lead to serious complications and even death.

  10. How Does Mercury Get into Fish?

    National Research Council Canada - National Science Library

    Cherie Winner

    2010-01-01

    ... poisoned by methyl-mercury dumped from a chemical plant into Minamata Bay, Japan. The biggest single source is the burning of fossil fuels, especially coal, which releases 160 tons of mercury a year into the air in the United States alone...

  11. Is prevention of acute pesticide poisoning effective and efficient, with Locally Adapted Personal Protective Equipment? A randomized crossover study among farmers in Chitwan, Nepal

    DEFF Research Database (Denmark)

    Varma, Anshu; Neupane, Dinesh; Bonde, Jens Peter Ellekilde

    2016-01-01

    . Based on the farmers' working behavior, compounds used, intensity and exposure duration we conclude that Locally Adapted Personal Protective Equipment does not provide additional protection during usual work practices. However, our Locally Adapted Personal Protective Equipment might offer protection...... exposure among farmers. Methods: In a crossover study, 45 male farmers from Chitwan, Nepal, were randomly allocated to work as usual applying organophosphate pesticides wearing Locally Adapted Personal Protective Equipment or Daily Practice Clothing. For seven days before each experiment, each farmer...... the expectation that our farmers in Chitwan, Nepal working with Locally Adapted Personal Protective Equipment would have fewer acute organophosphate poisoning symptoms, higher plasma cholinesterase (U/mL) and find it more efficient to work with the equipment than farmers working with their Daily Practice Clothing...

  12. The toxicology of mercury.

    Science.gov (United States)

    Clarkson, T W

    1997-01-01

    The major physical forms of mercury to which humans are exposed are mercury vapor, Hg0, and methylmercury compounds, Ch3HgX. Mercury vapor emitted from both natural and anthropogenic sources is globally distributed in the atmosphere. It is returned as a water-soluble form in precipitation and finds its way into bodies of fresh and ocean water. Land run-off also accounts for further input into lakes and oceans. Inorganic mercury, present in water sediments, is subject to bacterial conversion to methylmercury compounds that are bioaccumulated in the aquatic food chain to reach the highest concentration in predatory fish. Human exposure to mercury vapor is from dental amalgam and industries using mercury. Methylmercury compounds are found exclusively in seafood and freshwater fish. The health effects of mercury vapor have been known since ancient times. Severe exposure results in a triad of symptoms, erethism, tremor, and gingivitis. Today, we are concerned with more subtle effects such as preclinical changes in kidney function and behavioral and cognitive changes associated with effects on the central nervous system. Methylmercury is a neurological poison affecting primarily brain tissue. In adults, brain damage is focal affecting the function of such areas as the cerebellum (ataxia) and the visual cortex (constricted visual fields). Methylmercury also at high doses can cause severe damage to the developing brain. Today the chief concern is with the more subtle effects arising from prenatal exposure such as delayed development and cognitive changes in children.

  13. Transdermal carbamate poisoning – a case of misuse

    Directory of Open Access Journals (Sweden)

    Lalit Kumar Rajbanshi

    2017-01-01

    Full Text Available Acute pesticide poisoning is a common mode of intentional self harm. Oral ingestion is the usual mode of poisoning. However, inhalation, accidental or occupational transdermal exposure leading to acute or chronic poisoning can be the other route of poisoning. It has been seen that the purpose of poising is suicidal intensity in most of the cases. We report an unusual case where the victim had acute pesticide poisoning through transdermal route that was intended for non suicidal purpose. The patient was managed successfully with immediate decontamination and adequate antidote.

  14. Fluctuations in serum ethanol concentration in the treatment of acute methanol poisoning: a prospective study of 21 patients.

    Science.gov (United States)

    Zakharov, Sergey; Navratil, Tomas; Salek, Tomas; Kurcova, Ivana; Pelclova, Daniela

    2015-12-01

    During the 2012 outbreak of mass methanol poisonings in the Czech Republic, ethanol, in the main, was used as an antidote. The complex pharmacokinetics of ethanol made it difficult to maintain the requisite 1000-1500 mg/L serum ethanol levels (S-EtOH). The aim of this study was to measure the fluctuations in S-EtOH during the treatment. A prospective case series in 21 patients, median age 52 (27-79 years), 13 males and 8 females. Serum ethanol, methanol and formate were measured every 2-6 hours during the treatment. Follow-up clinical examination was carried out in 15/18 survivors. The majority of patients (17/21) were late presenters and on admission, almost half (10/21) had suffered a severe grade of intoxication according to the Poisoning Severity Score (PSS). The mean observation time was 90±20 h. The mean period of consistent maintenance of S-EtOH within the recommended therapeutic range lasted 28±7% of the total observation time. For 29±8% of the time, S-EtOH was >1500 mg/L with "peaks" of up to 3500 mg/L. For 44±10% of the observation time, S-EtOH was toxic serum levels of methanol >200 mg/L or formate >20 mg/L lasted 20±10% and 18±11% of the time of observation, respectively. Complications occurred in 14 (67%) of cases including significant fluctuations of S-EtOH in 9; aspiration pneumonia in 3 and delirium tremens in 2 cases. Other complications included sepsis, bleeding, acidosis rebound, intolerance and set clotting. The outcomes were: 11 survivors free of health impairment, 7 with sequelae and 3 deaths. There was no significant difference in mean duration of sub-therapeutic and supra-therapeutic concentrations of serum ethanol in patients who survived without sequelae and those with poor outcome (P > 0.05). Administration of ethanol according to the present guidelines of the AACT/EAPCCT is effective and relatively safe in the treatment of methanol poisoning during a mass outbreak(31). Physicians have to be most aware of fluctuations in serum

  15. Menthol poisoning

    Science.gov (United States)

    Menthol is used to add peppermint flavor to candy and other products. It is also used in certain skin lotions and ointments. This article discusses menthol poisoning from swallowing pure menthol. This article is ...

  16. Chlorine poisoning

    Science.gov (United States)

    Chlorine is a chemical that prevents bacteria from growing. Chlorine poisoning occurs when someone swallows or breathes in (inhales) chlorine. This article is for information only. Do NOT use it to ...

  17. Acetone poisoning

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002480.htm Acetone poisoning To use the sharing features on this page, please enable JavaScript. Acetone is a chemical used in many household products. ...

  18. Paradichlorobenzene poisoning

    Science.gov (United States)

    ... amounts are usually swallowed. References Holland MG. Occupational toxicology. In: Shannon MW, Borron SW, Burns MJ, eds. ... and the A.D.A.M. Editorial team. Pesticides Read more Poisoning Read more NIH MedlinePlus Magazine ...

  19. Gasoline poisoning

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002806.htm Gasoline poisoning To use the sharing features on this ... This article discusses the harmful effects from swallowing gasoline or breathing in its fumes. This article is ...

  20. Detergent poisoning

    Science.gov (United States)

    ... acids, including benzalkonium chloride Simple soap Symptoms Detergent poisoning can cause symptoms in many parts of the body. BLOOD Severe change in acid level of blood (pH balance), which leads to damage in all of the body organs ...

  1. Refrigerant poisoning

    Science.gov (United States)

    ... Severe abdominal pain Vomiting Burns of the food pipe (esophagus) Vomiting blood Blood in the stool HEART ... effect of the poison Washing of the skin (irrigation), perhaps every few hours for several days Skin ...

  2. Yew poisoning

    Science.gov (United States)

    ... poison is in most parts of the yew plant, but the highest amount is in the seeds. ... or irregular or fast heartbeat Blue-colored lips Breathing difficulty ... Muscle weakness Nausea and vomiting Stomach pain Diarrhea

  3. Hypotension in Severe Dimethoate Self-Poisoning

    OpenAIRE

    Davies, James; Roberts, Darren; Eyer, Peter; Buckley, Nick; Eddleston, Michael

    2008-01-01

    Introduction Acute self-poisoning with the organophosphorus (OP) pesticide dimethoate has a human case fatality three-fold higher than poisoning with chlorpyrifos despite similar animal toxicity. The typical clinical presentation of severe dimethoate poisoning is quite distinct from that of chlorpyrifos and other OP pesticides: many patients present with hypotension that progresses to shock and death within 12?48 h post-ingestion. The pathophysiology of this syndrome is not clear. Case report...

  4. Determinantes nas intoxicações medicamentosas agudas na zona urbana de um município do Sul do Brasil Causes of acute poisoning with medication in a southern Brazilian city

    Directory of Open Access Journals (Sweden)

    Fabiana Burdini Margonato

    2008-02-01

    Full Text Available As intoxicações medicamentosas no Brasil resultam entre diversos fatores os relacionados a uma frágil política de medicamentos em nosso país. Assim, o objetivo deste estudo foi analisar variáveis sócio-econômicas, tipos de indicação, formas de aquisição e armazenamento de medicamentos das pessoas acometidas por intoxicações medicamentosas agudas não-intencionais. Os dados foram coletados durante visitas domiciliares aos pacientes com registro de intoxicação medicamentosa aguda não-intencional pelo Centro de Controle de Intoxicações de Maringá, Paraná, em 2004. Foram estudadas variáveis relacionadas ao intoxicado, à intoxicação, ao medicamento e armazenamento doméstico de medicamentos. Dentre as 97 intoxicações registradas no período, foram entrevistadas 72 famílias, sendo a maioria de menores de 10 anos (73,6%, sexo masculino (54,2%, estratos econômicos C e D (63,9%. Muitos entrevistados referiram não ter recebido informações sobre o medicamento (76,5%. Houve associação significativa entre pessoas dos estratos econômicos C e D e armazenamento inadequado de medicamentos (p Acute poisoning with medicines in Brazil has various causes, including a deficient national drug policy. The current study thus aimed to analyze socioeconomic variables, prescription characteristics, and forms of purchase or acquisition and storing of medicines by victims of acute unintentional poisoning. The data were collected during home visits to patients with a record of acute unintentional drug poisoning according to the Poison Control Center in Maringá, Paraná State, in 2004. The variables were related to the victim, the poisoning event, the product, and its household storage. For the 97 poisonings recorded during the study period, 72 families were interviewed, with the majority of the victims under 10 years of age (73.6%, males (54.2%, and from lower-income groups (63.9%. Many interviewees reported not having received information

  5. [Current dietary exposure to mercury during pregnancy and childhood, and public health recommendations].

    Science.gov (United States)

    Llop, Sabrina; Ibarlucea, Jesús; Sunyer, Jordi; Ballester, Ferran

    2013-01-01

    Exposure to high levels of mercury during vulnerable periods (such as pregnancy and childhood) may have serious consequences for cognitive development, as observed after acute poisoning episodes in Japan and Irak. The main source of mercury exposure in the general population is consumption of certain types of fish. There is growing concern about the possible neurotoxic effects of mercury, especially in younger children in populations where fish intake is moderate to high. The scientific evidence to date is inconclusive. In Spain, the Childhood and Environment (Infancia y Medio Ambiente [INMA]) project has provided information on levels of prenatal exposure to mercury among 1800 newborns from Valencia, Sabadell, Asturias and Guipúzcoa. In general, levels were high, being above the World Health Organization's recommended dose in 24% of children and above the recommended levels of the U.S. Environmental Protection Agency in 64%. However, the results did not indicate a significant association between prenatal mercury exposure and delayed cognitive development during the second year of life. Various agencies have developed recommendations on fish consumption for pregnant women and children, due to the presence of mercury. These recommendations should be strengthened, since there is general consensus among all regional and national public administrations that fish is an essential source of nutrients for development in the early stages of life. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

  6. An abrupt extinction in the Middle Permian (Capitanian) of the Boreal Realm with a causal link to anoxia, acidification and mercury poisoning

    Science.gov (United States)

    Bond, David; Wignall, Paul; Joachimski, Michael; Sun, Yadong; Savov, Ivan; Grasby, Stephen; Beauchamp, Benoit; Blomeier, Dierk

    2016-04-01

    The controversial Capitanian (Middle Permian, 262 Ma) extinction event is mostly known from equatorial latitudes and consequently its global extent is poorly resolved. We demonstrate that there were two, severe extinctions amongst brachiopods in northern Boreal latitudes (Spitsbergen), in the Middle to Late Permian, separated by a recovery phase. New age dating of the Kapp Starostin Formation of Spitsbergen using strontium and carbon isotopic trends suggests that the first crisis occurred in the Capitanian. This age assignment indicates that this Middle Permian extinction is manifest at higher latitudes. Redox proxies (pyrite framboids and trace metals) show that the Boreal crisis coincided with an intensification of oxygen depletion, implicating anoxia in the extinction scenario. The highly toxic metal mercury becomes enriched in strata at the Middle Permian extinction level implicating death-by-toxicity (and a possible link to volcanism). Finally, the near-total loss of carbonates across the Boreal Realm in the Middle to Late Permian also suggests a role for acidification. New in prep. data from Ellesmere Island, Arctic Canada (samples collected July 2015) tentatively suggests that this potent "three strikes and you're out" extinction mechanism was a Boreal-wide phenomenon. The Late Permian recovery interval saw the appearance of new brachiopod and bivalve taxa alongside survivors, and an increased mollusk dominance, resulting in an assemblage reminiscent of younger Mesozoic assemblages. The subsequent end-Permian mass extinction terminated this Late Permian radiation.

  7. Methemoglobinemia in aluminum phosphide poisoning.

    Science.gov (United States)

    Shadnia, Shahin; Soltaninejad, Kambiz; Hassanian-Moghadam, Hossein; Sadeghi, Anahaita; Rahimzadeh, Hormat; Zamani, Nasim; Ghasemi-Toussi, Alireza; Abdollahi, Mohammad

    2011-03-01

    Acute aluminum phosphide (AlP) poisoning is one of the most common causes of acute pesticide poisoning in Iran. Hydrogen phosphide or phosphine gas is produced following reaction of AlP with water even at ambient humidity. Methemoglobinemia is a rare finding following phosphine poisoning. In this paper, two cases of fatal AlP poisoning complicated by methemoglobinemia are reported. Two patients presented following suicidal ingestion of AlP tablets. In the Emergency Department (ED), they received gastric lavage with sodium bicarbonate and potassium permanganate. Both of them received supportive care. In each case, hematuria and hemolysis were significant events. The patients also showed a decrease in O(2) saturation in spite of high FIO(2). Methemoglobin levels of 40% and 30% were detected by co-oximetry. Neither patient responded to treatment (ascorbic acid in one case, methylene blue in the other). Both patients died due to systemic effects of phosphine poisoning. Hemolysis and methemoglobinemia may complicate the course of phosphine poisoning that seems resistant to methylene blue and ascorbic acid. Therefore, other treatments including hyperbaric oxygen therapy and exchange blood transfusion should be considered.

  8. Environmental Mercury and Its Toxic Effects

    Directory of Open Access Journals (Sweden)

    Kevin M. Rice

    2014-03-01

    Full Text Available Mercury exists naturally and as a man-made contaminant. The release of processed mercury can lead to a progressive increase in the amount of atmospheric mercury, which enters the atmospheric-soil-water distribution cycles where it can remain in circulation for years. Mercury poisoning is the result of exposure to mercury or mercury compounds resulting in various toxic effects depend on its chemical form and route of exposure. The major route of human exposure to methylmercury (MeHg is largely through eating contaminated fish, seafood, and wildlife which have been exposed to mercury through ingestion of contaminated lower organisms. MeHg toxicity is associated with nervous system damage in adults and impaired neurological development in infants and children. Ingested mercury may undergo bioaccumulation leading to progressive increases in body burdens. This review addresses the systemic pathophysiology of individual organ systems associated with mercury poisoning. Mercury has profound cellular, cardiovascular, hematological, pulmonary, renal, immunological, neurological, endocrine, reproductive, and embryonic toxicological effects.

  9. Environmental mercury and its toxic effects.

    Science.gov (United States)

    Rice, Kevin M; Walker, Ernest M; Wu, Miaozong; Gillette, Chris; Blough, Eric R

    2014-03-01

    Mercury exists naturally and as a man-made contaminant. The release of processed mercury can lead to a progressive increase in the amount of atmospheric mercury, which enters the atmospheric-soil-water distribution cycles where it can remain in circulation for years. Mercury poisoning is the result of exposure to mercury or mercury compounds resulting in various toxic effects depend on its chemical form and route of exposure. The major route of human exposure to methylmercury (MeHg) is largely through eating contaminated fish, seafood, and wildlife which have been exposed to mercury through ingestion of contaminated lower organisms. MeHg toxicity is associated with nervous system damage in adults and impaired neurological development in infants and children. Ingested mercury may undergo bioaccumulation leading to progressive increases in body burdens. This review addresses the systemic pathophysiology of individual organ systems associated with mercury poisoning. Mercury has profound cellular, cardiovascular, hematological, pulmonary, renal, immunological, neurological, endocrine, reproductive, and embryonic toxicological effects.

  10. Combined application of dexamethasone and hyperbaric oxygen therapy yields better efficacy for patients with delayed encephalopathy after acute carbon monoxide poisoning

    Directory of Open Access Journals (Sweden)

    Xiang W

    2017-02-01

    Full Text Available Wenping Xiang,1 Hui Xue,2 Baojun Wang,2 Yuechun Li,2 Jun Zhang,2 Changchun Jiang,2 Furu Liang,2 Jiangxia Pang,2 Lehua Yu1 1Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 2Department of Neurology, Baotou Central Hospital, Baotou, Inner Mongolia, People’s Republic of China Background: Delayed encephalopathy after acute carbon monoxide (CO poisoning (DEACMP commonly occurs after recovering from acute CO poisoning. This study was performed to assess the efficacy of the combined application of dexamethasone and hyperbaric oxygen (HBO therapy in patients with DEACMP.Patients and methods: A total of 120 patients with DEACMP were recruited and randomly assigned into the experimental group (receiving dexamethasone 5 mg/day or 10 mg/day plus HBO therapy and control group (HBO therapy as monotherapy. Meanwhile, the conventional treatments were provided for all the patients. We used the Mini-Mental State Examination (MMSE scale to assess the cognitive function, the National Institutes of Health Stroke Scale (NIHSS to assess the neurological function and the remission rate (RR to assess the clinical efficacy. Myelin basic protein (MBP in the cerebrospinal fluid (CSF was also measured.Results: After 4 weeks of treatment, compared to the control group, the experimental group had a significantly higher remission rate (P=0.032, a significantly higher average MMSE score (P=0.037 and a significantly lower average NIHSS score (P=0.002. Meanwhile, there was a trend toward better improvement with dexamethasone 10 mg/day, and the level of MBP in the CSF of patients was significantly lower in the experimental group than in the control group (P<0.0001. The addition of dexamethasone did not significantly increase the incidence of adverse events.Conclusion: These results indicate that the combined application of dexamethasone and HBO therapy could yield better efficacy for patients with DEACMP and

  11. Benzodiazepine poisoning in elderly

    Directory of Open Access Journals (Sweden)

    Perković-Vukčević Nataša

    2016-01-01

    Full Text Available Background/Aim. Benzodiazepines are among the most frequently ingested drugs in self-poisonings. Elderly may be at greater risk compared with younger individuals due to impaired metabolism and increased sensitivity to benzodiazepines. The aim of this study was to assess toxicity of benzodiazepines in elderly attempted suicide. Methods. A retrospective study of consecutive presentations to hospital after self-poisoning with benzodiazepines was done. Collected data consisted of patient's characteristics (age, gender, benzodiazepine ingested with its blood concentrations at admission, clinical findings including vital signs and Glasgow coma score, routine blood chemistry, complications of poisoning, details of management, length of hospital stay and outcome. According the age, patients are classified as young (15-40-year old, middle aged (41-65-year old and elderly (older than 65. Results. During a 2-year observational period 387 patients were admitted because of pure benzodiazepine poisoning. The most frequently ingested drug was bromazepam, the second was diazepam. The incidence of coma was significantly higher, and the length of hospital stay significantly longer in elderly. Respiratory failure and aspiration pneumonia occurred more frequently in old age. Also, flumazenil was more frequently required in the group of elderly patients. Conclusion. Massive benzodiazepines overdose in elderly may be associated with a significant morbidity, including deep coma with aspiration pneumonia, respiratory failure, and even death. Flumazenil is indicated more often to reduce CNS depression and prevent complications of prolonged unconsciousness, but supportive treatment and proper airway management of comatose patients is the mainstay of the treatment of acute benzodiazepine poisoning.

  12. [Use of activated charcoal in acute poisonings: clinical safety and factors associated with adverse reactions in 575 cases].

    Science.gov (United States)

    Amigó, Montserrat; Nogué, Santiago; Miró, Oscar

    2010-07-17

    To identify the pattern of use of activated charcoal in the treatment of poisonings, and to evaluate the prevalence and severity of adverse reactions and define the risk factors associated with them. Observational, prospective 7-year study. Patients receiving activated charcoal for gut decontamination were included. Epidemiological, toxicological, therapeutic and evolutionary variables were studied. The dependent variable was the appearance of secondary effects related to the use of charcoal. A total of 575 patients were included. The mean age was 37.8 (14.8) years and 65.7% were women. Activated charcoal was administered orally in 88% of the patients and by gastric tube after lavage in 12%, and 2.4% of patients received charcoal before hospital arrival. Adverse reactions occurred in 41 cases (7.1%) and included nausea or vomiting (36 patients), bronchoaspiration (6 patients) and pneumonia (2 patients). Spontaneous vomiting before administration of charcoal (p < 0.001), pre-hospital administration of charcoal (p < 0.05), repeated doses (p < 0.01) and the need for symptomatic measures to treat intoxicated patients (p < 0.05) were independent risk factors for adverse reactions, whereas age ≥ 40 years (p < 0.05) and intoxication with benzodiazepines (p < 0.01) were independently associated with a smaller risk of adverse reactions. The mean emergency department stay was 10.2 (18.6) hours, and was significantly longer (p < 0.05) in patients suffering adverse reactions. A total of 75.4% of patients were discharged to home, 20.5% required psychiatric admission and 3.9% were admitted due to the clinical consequences of the poisoning. The prevalence of non-psychiatric admission to general hospital or intensive care was greater in patients suffering adverse reactions. No patient died. Adverse reactions to charcoal are infrequent and rarely severe, but are associated with a greater emergency department stay and a trend to greater hospital admission. Predisposing factors are

  13. Mercury Toxicity and Contamination of Households from the Use of Skin Creams Adulterated with Mercurous Chloride (Calomel)

    OpenAIRE

    Lori Copan; Jeff Fowles; Tracy Barreau; Nancy McGee

    2015-01-01

    Inorganic mercury, in the form of mercurous chloride, or calomel, is intentionally added to some cosmetic products sold through informal channels in Mexico and the US for skin lightening and acne treatment. These products have led to multiple cases of mercury poisoning but few investigations have addressed the contamination of cream users’ homes. We report on several cases of mercury poisoning among three Mexican-American families in California from use of mercury-containing skin creams. Each...

  14. Use of sodium polystyrene sulfonate in an acute-on-chronic lithium poisoned patient: A case report

    Directory of Open Access Journals (Sweden)

    Chakroun-Walha Olfa

    2016-03-01

    Full Text Available A 35-year-old woman with an acute-on-chronic lithium overdose received multiple oral doses of sodium polystyrene sulfonate totaling 120 g over a 24-h period. During the 72 h after the institution of therapy, the serum lithium level decreased from 3.80 to 0.42 mEq/L. Multiple doses of sodium polystyrene sulfonate may be useful in lowering the serum lithium level in severely ill patients with acute renal failure, and can substitute hemodialysis.

  15. [Arsenic poisoning: a special gastroenteritis...].

    Science.gov (United States)

    Ganster, F; Kuteifan, K; Mootien, Y; Harry, P; Guiot, P

    2009-06-01

    Arsenic (As) intoxication is nowadays extremely rare. Two cases of acute and chronic As criminal poisoning leading to death of a couple of retired people, are reported. Clinical presentation was simulating a gastro-enteritidis with fast evolution to refractory shock. Toxicological analysis confirmed this diagnostic, with respectively blood As concentrations at 579 and 21 765 microg/l for our two patients.

  16. Lead poisoning in children: a case report.

    Science.gov (United States)

    Jouhadi, Zineb; Bensabbahia, Dalal; Chafiq, Fouad; Oukkache, Bouchra; Guebessi, Nisrine Bennani; Abdellah, El Abidi; Najib, Jilali

    2016-01-01

    Lead colic is a rare cause of abdominal pain. The diagnosis of lead poisoning is most often mentioned in at risk populations (children, psychotic). We report the case of a 2 year old child that was presented for acute abdomen. Abdominal plain radiograph showed multiple intra-colonic metallic particles and suggested lead poisoning diagnosis. Anamnesis found a notion of pica and consumption of peeling paint. Elevated blood lead levels (BLL) confirmed the diagnosis. The lead poisoning is a public health problem especially in children, but its manifestation by a lead colic is rare and could simulate an acute abdomen table.

  17. Severity and prognosis of acute organophosphorus pesticide poisoning are indicated by C-reactive protein and copeptin levels and APACHE II score.

    Science.gov (United States)

    Wu, Xinkuan; Xie, Wei; Cheng, Yuelei; Guan, Qinglong

    2016-03-01

    The aim of the present study was to investigate the plasma levels of C-reactive protein (CRP) and copeptin, in addition to the acute physiology and chronic health evaluation II (APACHE II) scores, in patients with acute organophosphorus pesticide poisoning (AOPP). A total of 100 patients with AOPP were included and divided into mild, moderate and severe groups according to AOPP diagnosis and classification standards. Blood samples were collected from all patients on days 1, 3 and 7 following AOPP. The concentrations of CRP and copeptin in the plasma were determined using enzyme-linked immunosorbent assay. All AOPP patients underwent APACHE II scoring and the diagnostic value of these scores was analyzed using receiver operating characteristic curves (ROCs). On days 1, 3 and 7 after AOPP, the levels of CRP and copeptin were increased in correlation with the increase in AOPP severity, and were significantly higher compared with the control groups. Furthermore, elevated CRP and copeptin plasma levels were detected in patients with severe AOPP on day 7, whereas these levels were reduced in patients with mild or moderate AOPP. APACHE II scores, blood lactate level, acetylcholine esterase level, twitch disappearance time, reactivating agent dose and inability to raise the head were the high-risk factors that affected the prognosis of AOPP. Patients with plasma CRP and copeptin levels higher than median values had worse prognoses. The areas under curve for ROCs were 0.89, 0.75 and 0.72 for CRP levels, copeptin levels and APACHE II scores, respectively. In addition, the plasma contents of CRP and copeptin are increased according to the severity of AOPP. Therefore, the results of the present study suggest that CRP and copeptin levels and APACHE II scores may be used for the determination of AOPP severity and the prediction of AOPP prognosis.

  18. The evaluation of total mercury and arsenic in skin bleaching creams commonly used in Trinidad and Tobago and their potential risk to the people of the Caribbean

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    Terry Mohammed

    2017-10-01

    Full Text Available Background. Skin lightening is very popular among women and some men of the Caribbean, and its popularity appears to be growing. The lightening of skin colour is done to produce a lighter complexion which is believed to increase attractiveness, social standing and improves one’s potential of being successful. Design and Methods. Fifteen (15 common skin lightening creams found in pharmacies and cosmetic retailers throughout Trinidad and Tobago were evaluated for Mercury by Cold Vapor Atomic Absorption Spectrophotometry (CVAAS and Arsenic by Hydride Generation Atomic Absorption Spectrophotometry (HGAAS. The results obtained were compared to global standards and previous research. Results. Fourteen (14 of the fifteen samples analysed contained Mercury in the range of 0.473 μg/g to 0.766 μg/g. One sample had a Mercury content of 14,507.74±490.75 μg/g which was over 14,000 times higher than the USFDA limit for mercury in cosmetics of 1 μg/g. All samples contained Arsenic in the range 1.016 μg/g to 6.612 μg/g, which exceeds the EU limit for cosmetics of 0 μg/g. Conclusions. All the samples analysed contained significant amounts of Mercury and Arsenic and none of them can be considered safe for prolonged human use. The samples that contained Mercury levels which were lower than the USFDA limit contained Arsenic levels which exceeded the EU standard of 0 μg/g in cosmetics. The popularity of these skin lightening creams in the Caribbean region places the population at elevated risk of chronic Mercury and Arsenic poisoning and possibly acute Mercury Poisoning.

  19. The evaluation of total mercury and arsenic in skin bleaching creams commonly used in Trinidad and Tobago and their potential risk to the people of the Caribbean.

    Science.gov (United States)

    Mohammed, Terry; Mohammed, Elisabeth; Bascombe, Shermel

    2017-12-13

    Background. Skin lightening is very popular among women and some men of the Caribbean, and its popularity appears to be growing. The lightening of skin colour is done to produce a lighter complexion which is believed to increase attractiveness, social standing and improves one's potential of being successful. Design and Methods. Fifteen (15) common skin lightening creams found in pharmacies and cosmetic retailers throughout Trinidad and Tobago were evaluated for Mercury by Cold Vapor Atomic Absorption Spectrophotometry (CVAAS) and Arsenic by Hydride Generation Atomic Absorption Spectrophotometry (HGAAS). The results obtained were compared to global standards and previous research. Results. Fourteen (14) of the fifteen samples analysed contained Mercury in the range of 0.473 μg/g to 0.766 μg/g. One sample had a Mercury content of 14,507.74±490.75 μg/g which was over 14,000 times higher than the USFDA limit for mercury in cosmetics of 1 μg/g. All samples contained Arsenic in the range 1.016 μg/g to 6.612 μg/g, which exceeds the EU limit for cosmetics of 0 μg/g. Conclusions. All the samples analysed contained significant amounts of Mercury and Arsenic and none of them can be considered safe for prolonged human use. The samples that contained Mercury levels which were lower than the USFDA limit contained Arsenic levels which exceeded the EU standard of 0 μg/g in cosmetics. The popularity of these skin lightening creams in the Caribbean region places the population at elevated risk of chronic Mercury and Arsenic poisoning and possibly acute Mercury Poisoning.

  20. Mercury hazards from gold mining to humans, plants, and animals.

    Science.gov (United States)

    Eisler, Ronald

    2004-01-01

    Mercury contamination of the environment from historical and ongoing mining practices that rely on mercury amalgamation for gold extraction is widespread. Contamination was particularly severe in the immediate vicinity of gold extraction and refining operations; however, mercury, especially in the form of water-soluble methylmercury, may be transported to pristine areas by rainwater, water currents, deforestation, volatilization, and other vectors. Examples of gold mining-associated mercury pollution have been shown for Canada, the U.S., Africa, China, the Philippines, Siberia, and South America. In parts of Brazil, for example, mercury concentrations in all abiotic materials, plants, and animals, including endangered species of mammals and reptiles, collected near ongoing mercury amalgamation gold mining sites were far in excess of allowable mercury levels promulgated by regulatory agencies for the protection of human health and natural resources. Although health authorities in Brazil are unable to detect conclusive evidence of human mercury intoxication, the potential exists in the absence of mitigation for epidemic mercury poisoning of the mining population and environs. In the U.S., environmental mercury contamination is mostly from historical gold mining practices, and portions of Nevada remain sufficiently mercury contaminated to pose a hazard to reproduction of carnivorous fishes and fish-eating birds. Concentrations of total mercury lethal to sensitive representative natural resources range from 0.1 to 2.0 microg/L of medium for aquatic organisms; from 2,200 to 31,000 microg/kg BW (acute oral) and from 4,000 to 40,000 microg/kg (dietary) for birds; and from 100 to 500 microg/kg BW (daily dose) and from 1,000 to 5,000 microg/kg diet for mammals. Significant adverse sublethal effects were observed among selected aquatic species at water concentrations of 0.03-0.1 microg Hg/L. For some birds, adverse effects, mainly on reproduction, have been associated with

  1. Plastic casting resin poisoning

    Science.gov (United States)

    Epoxy poisoning; Resin poisoning ... Epoxy and resin can be poisonous if they are swallowed or their fumes are breathed in. ... Plastic casting resins are found in various plastic casting resin products.

  2. Poison Control Centers

    Science.gov (United States)

    ... 1222 immediately. Name State American Association of Poison Control Centers Address AAPCC Central Office NOT A POISON ... not for emergency use. Arkansas ASPCA Animal Poison Control Center Address 1717 S. Philo Road, Suite 36 Urbana, ...

  3. Protecting Yourself from Poisonous Plants

    Science.gov (United States)

    ... NIOSH NIOSH Fast Facts: Protecting Yourself from Poisonous Plants Language: English Español (Spanish) Kreyol Haitien (Hatian Creole) ... outdoors is at risk of exposure to poisonous plants, such as poison ivy, poison oak, and poison ...

  4. Acute Poisonings from Synthetic Cannabinoids - 50 U.S. Toxicology Investigators Consortium Registry Sites, 2010-2015.

    Science.gov (United States)

    Riederer, Anne M; Campleman, Sharan L; Carlson, Robert G; Boyer, Edward W; Manini, Alex F; Wax, Paul M; Brent, Jeffrey A

    2016-07-15

    Recent reports suggest that acute intoxications by synthetic cannabinoids are increasing in the United States (1,2). Synthetic cannabinoids, which were research compounds in the 1980s, are now produced overseas; the first shipment recognized to contain synthetic cannabinoids was seized at a U.S. border in 2008 (3). Fifteen synthetic cannabinoids are Schedule I controlled substances (3), but enforcement is hampered by the continual introduction of new chemical compounds (1,3). Studies of synthetic cannabinoids indicate higher cannabinoid receptor binding affinities, effects two to 100 times more potent than Δ(9)-tetrahydrocannabinol (the principal psychoactive constituent of cannabis), noncannabinoid receptor binding, and genotoxicity (4,5). Acute synthetic cannabinoid exposure reportedly causes a range of mild to severe neuropsychiatric, cardiovascular, renal, and other effects (4,6,7); chronic use might lead to psychosis (6,8). During 2010-2015, physicians in the Toxicology Investigators Consortium (ToxIC) treated 456 patients for synthetic cannabinoid intoxications; 277 of the 456 patients reported synthetic cannabinoids as the sole toxicologic agent. Among these 277 patients, the most common clinical signs of intoxication were neurologic (agitation, central nervous system depression/coma, and delirium/toxic psychosis). Relative to all cases logged by 50 different sites in the ToxIC Case Registry, there was a statistically significant association between reporting year and the annual proportion of synthetic cannabinoid cases. In 2015, reported cases of synthetic cannabinoid intoxication increased at several ToxIC sites, corroborating reported upward trends in the numbers of such cases (1,2) and underscoring the need for prevention.

  5. Pesticide Poisoning of Honeybees: A Review of Symptoms, Incident Classification, and Causes of Poisoning

    Directory of Open Access Journals (Sweden)

    Kiljanek Tomasz

    2016-12-01

    Full Text Available During the 2000s, the problem of pesticide poisoning of honeybees seemed to be almost solved. The number of cases has decreased in comparison to the 1970s. The problem of acute honeybee poisoning, however, has not disappeared, but instead has transformed into a problem of poisoning from ‘traditional’ pesticides like organophosphorus pesticides or pyrethroids, to poisoning from additional sources of ‘modern’ systemic neonicotinoids and fipronil. In this article, the biological activity of pesticides was reviewed. The poisoning symptoms, incident definitions, and monitoring systems, as well as the interpretation of the analytical results, were also reviewed. The range of pesticides, and the detected concentrations of pesticides in poisoned honeybee samples, were reviewed. And, for the first time, cases of poisoning related to neonicotinoids were reviewed. The latter especially is of practical importance and could be helpful to analysts and investigators of honeybee poisoning incidents. It is assumed that secondary poisoning induced by plant collected materials contaminated with systemic pesticides occurs. Food stored in a hive and contaminated with systemic pesticides consumed continuously by the same generation of winter bees, may result in sub-lethal intoxication. This leads to abnormal behaviour identified during acute intoxication. The final result is that the bees discontinue their social role in the honeybee colony super organism, and colony collapse disorder (CCD takes place. The process described above refers primarily to robust and strong colonies that were able to collect plenty of food due to effective plant protection.

  6. Comprehensive characterization of neurochemicals in three zebrafish chemical models of human acute organophosphorus poisoning using liquid chromatography-tandem mass spectrometry.

    Science.gov (United States)

    Gómez-Canela, Cristian; Tornero-Cañadas, Daniel; Prats, Eva; Piña, Benjamí; Tauler, Romà; Raldúa, Demetrio

    2018-02-01

    There is a growing interest in biological models to investigate the effect of neurotransmitter dysregulation on the structure and function of the central nervous system (CNS) at different stages of development. Zebrafish, a vertebrate model increasingly used in neurobiology and neurotoxicology, shares the common neurotransmitter systems with mammals, including glutamate, GABA, glycine, dopamine, norepinephrine, epinephrine, serotonin, acetylcholine, and histamine. In this study, we have evaluated the performance of liquid chromatography-tandem mass spectrometry (LC-MS/MS) for the multiresidue determination of neurotransmitters and related metabolites. In a first step, ionization conditions were tested in positive electrospray mode and optimum fragmentation patterns were determined to optimize two selected reaction monitoring (SRM) transitions. Chromatographic conditions were optimized considering the chemical structure and chromatographic behavior of the analyzed compounds. The best performance was obtained with a Synergy Polar-RP column, which allowed the separation of the 38 compounds in 30 min. In addition, the performance of LC-MS/MS was studied in terms of linearity, sensitivity, intra- and inter-day precision, and overall robustness. The developed analytical method was able to quantify 27 of these neurochemicals in zebrafish chemical models for mild (P1), moderate (P2), and severe (P3) acute organophosphorus poisoning (OPP). The results show a general depression of synaptic-related neurochemicals, including the excitatory and inhibitory amino acids, as well as altered phospholipid metabolism, with specific neurochemical profiles associated to the different grades of severity. These results confirmed that the developed analytical method is a new tool for neurotoxicology research using the zebrafish model.

  7. Mercury, Vaccines, and Autism

    Science.gov (United States)

    Baker, Jeffrey P.

    2008-01-01

    The controversy regarding the once widely used mercury-containing preservative thimerosal in childhood vaccines has raised many historical questions that have not been adequately explored. Why was this preservative incorporated in the first place? Was there any real evidence that it caused harm? And how did thimerosal become linked in the public mind to the “autism epidemic”? I examine the origins of the thimerosal controversy and their legacy for the debate that has followed. More specifically, I explore the parallel histories of three factors that converged to create the crisis: vaccine preservatives, mercury poisoning, and autism. An understanding of this history provides important lessons for physicians and policymakers seeking to preserve the public’s trust in the nation’s vaccine system. PMID:18172138

  8. Epidemiological study of acute food poisoning recorded at Imam Khomeini Hospital of Kermanshah during 4 years period (2008-2011

    Directory of Open Access Journals (Sweden)

    K Sharafi

    2014-11-01

    Full Text Available Foodborne diseases remain as one of the world’s major health problem that often poses severe and immediate danger. Epidemiological studies have essential role in identifying the contamination sources, transmission routes and prevalence rates of foodborne diseases, as well as establishing the prevention/control strategies. The aim of this study was to conduct an epidemiological survey on acute foodborne diseases recorded at Imam Khomeini Hospital of Kermanshah during 4 years (2008-2011. For this, the information of patients was extracted using 165 medical files. Using Chi-Square test, the relationship between the occurrence of foodborne diseases and different variables was determined. Considering the season, gender and age of the patients, it was revealed that most incidences of foodborne diseases were observed in spring, male patients and age group of 15 to 30 years. The incidence trend of foodborne diseases was increased from 2008 to 2011. Moreover, there were a significant relationship among incidence of foodborne diseases with season, month, gender and age group (P < 0.01. According to the results it is crucial that the responsible authorities bring about the public educations to increase the public awareness using radio, TV shows, newspapers, and etc.

  9. Mortality Analysis of Patients with Paraquat Poisoning Treated at Two University Hospitals in Shiraz, Iran

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    Fazel Goudarzi

    2014-12-01

    Conlcusion: PQ poisoning is associated with high mortality requiring an immediate assessment of patients and prediction of prognosis. Renal and hepatic failure in addition to respiratory distress can be the strongest risk factors for poor prognosis in acute PQ poisoning.

  10. Hemlock (Conium Maculatum Poisoning In A Child

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    Capan KONCA

    2014-03-01

    Full Text Available Poison hemlock (Conium maculatum is a plant that is poisonous for humans and animals. Accidental ingestion of the plant may result in central nervous system depression, respiratory failure, acute rhabdomyolysis, acute renal failure and even death. The main treatment of hemlock poisoning is supportive care. The case of a 6-year-old girl who was admitted to the emergency department with complaints of burning sensation in mouth, hypersalivation, tremor in hands and ataxia after ingestion of poison hemlock is presented here with clinical and laboratory features. In this case, we aim to report that accidental ingestion of plants resembling vegetables that are consumed daily can lead to serious complications and even death.

  11. Mercury and Your Health

    Science.gov (United States)

    ... the Risk of Exposure to Mercury Learn About Mercury What is Mercury What is Metallic mercury? Toxicological Profile ToxFAQs Mercury Resources CDC’s National Biomonitoring Program Factsheet on Mercury ...

  12. [Mushroom poisonings: syndromic diagnosis and treatment].

    Science.gov (United States)

    Kaufmann, Peter

    2007-01-01

    The major syndromes of mushroom poisoning can be divided by presentation timing: Early syndromes (symptom onset 6 hrs after ingestion) are life-threatening due to liver- and renal failure. Patients who are jaundiced after an acute gastrointestinal episode, are suspected to be poisoned with Amatoxins. Patients with flank pain, hematuria, polyuria or oliguria in the absence of jaundice are suspected to have an intoxication with Cortinarius mushrooms. In both cases an intensive care management is indicated.

  13. Aconite poisoning.

    Science.gov (United States)

    Chan, Thomas Y K

    2009-04-01

    Aconitine and related alkaloids found in the Aconitum species are highly toxic cardiotoxins and neurotoxins. The wild plant (especially the roots and root tubers) is extremely toxic. Severe aconite poisoning can occur after accidental ingestion of the wild plant or consumption of an herbal decoction made from aconite roots. In traditional Chinese medicine, aconite roots are used only after processing to reduce the toxic alkaloid content. Soaking and boiling during processing or decoction preparation will hydrolyze aconite alkaloids into less toxic and non-toxic derivatives. However, the use of a larger than recommended dose and inadequate processing increases the risk of poisoning. A Medline search (1963-February 2009) was conducted. Key articles with information on the use of aconite roots in traditional medicine, active (toxic) ingredients, mechanisms of toxicity, toxicokinetics of Aconitum alkaloids, and clinical features and management of aconite poisoning were reviewed. The cardiotoxicity and neurotoxicity of aconitine and related alkaloids are due to their actions on the voltage-sensitive sodium channels of the cell membranes of excitable tissues, including the myocardium, nerves, and muscles. Aconitine and mesaconitine bind with high affinity to the open state of the voltage-sensitive sodium channels at site 2, thereby causing a persistent activation of the sodium channels, which become refractory to excitation. The electrophysiological mechanism of arrhythmia induction is triggered activity due to delayed after-depolarization and early after-depolarization. The arrhythmogenic properties of aconitine are in part due to its cholinolytic (anticholinergic) effects mediated by the vagus nerve. Aconitine has a positive inotropic effect by prolonging sodium influx during the action potential. It has hypotensive and bradycardic actions due to activation of the ventromedial nucleus of the hypothalamus. Through its action on voltage-sensitive sodium channels in the

  14. The study of etiological and demographic characteristics of acute household accidental poisoning in children - a consecutive case series study from Pakistan

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    Manzar Nabeel

    2010-05-01

    Full Text Available Abstract Background To determine the agents of poisoning and demographic distribution of children brought to Civil Hospital Karachi (CHK with a history of accidental poison intake and to examine the factors associated with it. Methods This hospital based descriptive study of first 100 patients from both sexes who presented to Pediatric department, CHK from 1st January 2006 till 31st December 2008 with exposure to a known poisonous agent and fulfilling other inclusion criteria were included in the study. Data regarding their demographic profile and potential risk factors was collected on a well structured proforma, cases were followed until discharge or expiry. Data was analyzed using frequencies, proportions, group means, median and standard deviations. Results The male to female ratio in our study was 1.2:1, with kerosene (50% being the most common household agent followed by medicines (38%, insecticides (7% and bathroom cleaners (5%. Factors such as mother's education level, number of siblings and storage place of poison correlated significantly with the cases of accidental poisoning. Most of the children (70% presented within 3 hours of ingestion. Dyspnea was the most common symptom observed. The mortality rate in our study was 3%. Conclusions Children belonging to age group 2-3 years are the most susceptible both in terms of morbidity and mortality. Preventive strategies need to be adopted at a national level to spread awareness among parents.

  15. Recent Advances in the Clinical Management of Lead Poisoning.

    Directory of Open Access Journals (Sweden)

    Sina Kianoush

    2015-06-01

    Full Text Available Lead poisoning is a historic universal disease. Acute or chronic lead exposure may cause reversible or even permanent damages in human beings. Environmental lead exposure is a global health concern in children. Occupational lead poisoning is still a health issue, particularly in developing countries. During the last decades, new methods and medications have been advocated for the prevention and treatment of lead poisoning. This review deals mainly with recent developments in the management of lead poisoning. Sources of lead exposure are introduced, and methods for the primary prevention of lead poisoning are discussed. Details for the screening of adults and children are also explained to serve as a practical guideline for the secondary prevention. Standard chelation therapy in different groups and up-to-date less toxic new medications for the treatment of lead poisoning are finally discussed. Our published clinical research on the therapeutic effects of garlic tablets in mild to moderate occupational lead poisoning will also be discussed.

  16. Recent Advances in the Clinical Management of Lead Poisoning.

    Science.gov (United States)

    Kianoush, Sina; Sadeghi, Mahmood; Balali-Mood, Mahdi

    2015-01-01

    Lead poisoning is a historic universal disease. Acute or chronic lead exposure may cause reversible or even permanent damages in human beings. Environmental lead exposure is a global health concern in children. Occupational lead poisoning is still a health issue, particularly in developing countries. During the last decades, new methods and medications have been advocated for the prevention and treatment of lead poisoning. This review deals mainly with recent developments in the management of lead poisoning. Sources of lead exposure are introduced, and methods for the primary prevention of lead poisoning are discussed. Details for the screening of adults and children are also explained to serve as a practical guideline for the secondary prevention. Standard chelation therapy in different groups and up-to-date less toxic new medications for the treatment of lead poisoning are finally discussed. Our published clinical research on the therapeutic effects of garlic tablets in mild to moderate occupational lead poisoning will also be discussed.

  17. Original Article. Protection studies of new bis quaternary 2-(hydroxyimino-N-(pyridin-3yl acetamide derivatives (HNK-series oximes against acute poisoning by dichlorvos (DDVP in Swiss albino mice

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    Kumar Pravin

    2016-12-01

    Full Text Available The available antidotal therapy against acute poisoning by organophosphates involves the use of atropine alone or in combination with one of the oximes, e.g. 2-PAM, Obidoxime, TMB-4 or HI-6. Each of these oximes has some limitation, raising the question of the universal antidotal efficacy against poisoning by all OPs/nerve agents. In the present study, newly synthesized bis quaternary 2-(hydroxyimino-N-(pyridin-3yl acetamide derivatives (HNK-series oximes were evaluated for their antidotal efficacy against DDVP intoxicated Swiss mice, in terms of the Protection Index (PI and AChE reactivation in brain and serum. The inhibition concentration (IC50 was determined in brain and serum after optimizing the time point for maximum inhibition (60 min post DDVP exposure. AChE reactivation efficacy of the HNK series was evaluated at IC50 and compared with 2-PAM. HNK-102 showed a ~2 times better Protection Index (PI as compared to 2-PAM against DDVP toxicity. IC50 at 60 min DDVP post exposure was found to be approximately one fifth and one half of the LD50 dose for brain and serum AChE, respectively. Out of three HNK oximes, HNK-102 & 106 at 0.20 LD50 dose significantly reactivated DDVP intoxicated brain AChE (p<0.05 as compared to 2-PAM at double IC50 dose of DDVP. In light of double PI and higher AChE reactivation, HNK 102 was found to be a better oxime than 2-PAM in the treatment of acute poisoning by DDVP.

  18. Cleistanthus collinus poisoning

    Directory of Open Access Journals (Sweden)

    Anugrah Chrispal

    2012-01-01

    Full Text Available Cleistanthus collinus, a toxic shrub, is used for deliberate self-harm in rural South India. MEDLINE (PUBMED and Google were searched for published papers using the search/ MeSH terms "Cleistanthus collinus," "Euphorbiaceae," "Diphyllin," "Cleistanthin A," Cleistanthin B" and "Oduvanthalai." Non-indexed journals and abstracts were searched by tracing citations in published papers. The toxic principles in the leaf include arylnaphthalene lignan lactones - Diphyllin and its glycoside derivatives Cleistanthin A and B. Toxin effect in animal models demonstrate neuromuscular blockade with muscle weakness, distal renal tubular acidosis (dRTA and type 2 respiratory failure with conflicting evidence of cardiac involvement. Studies suggest a likely inhibition of thiol/thiol enzymes by the lignan-lactones, depletion of glutathione and ATPases in tissues. V-type H+ ATPase inhibition in the renal tubule has been demonstrated. Mortality occurs in up to 40% of C. collinus poisonings. Human toxicity results in renal tubular dysfunction, commonly dRTA, with resultant hypokalemia and normal anion gap metabolic acidosis. Aggressive management of these metabolic derangements is crucial. Acute respiratory distress syndrome (ARDS is seen in severe cases. Cardiac rhythm abnormalities have been demonstrated in a number of clinical studies, though the role of temporary cardiac pacemakers in reducing mortality is uncertain. Consumption of decoctions of C. collinus leaves, hypokalemia, renal failure, severe metabolic acidosis, ARDS and cardiac arrhythmias occur in severe poisonings and predict mortality. Further study is essential to delineate mechanisms of organ injury and interventions, including antidotes, which will reduce mortality.

  19. Status and trends in poisonings in Denmark 2007-2009

    DEFF Research Database (Denmark)

    Dalhoff, Kim Peder; Bøgevig, Søren; Høgberg, Lotte Christine Groth

    2011-01-01

    INTRODUCTION: The Danish Poison Information Centre (DPIC) provides information to the public and health care professionals on acute poisonings. The DPIC received 41,000 enquiries during the first three years of its existence as an open 24h telephone service. The aim of this data register study...... national poison centres, we predict a doubling in enquiries during the next ten years, mainly from the public....

  20. Status and trends in poisonings in Denmark 2007-2009

    DEFF Research Database (Denmark)

    Bøgevig, Søren; Høgberg, Lotte Christine Groth; Dalhoff, Kim Peder

    2011-01-01

    The Danish Poison Information Centre (DPIC) provides information to the public and health care professionals on acute poisonings. The DPIC received 41,000 enquiries during the first three years of its existence as an open 24h telephone service. The aim of this data register study was to classify ...... all substance exposures, to gain knowledge of the status and trends in poisonings (toxico-surveillance) and to evaluate the development in the number of contacts....

  1. Mercury Hair Concentration among Primary School Children in Malaysia

    Directory of Open Access Journals (Sweden)

    Nurul Izzah Abdul Samad

    2017-12-01

    Full Text Available The main concern regarding mercury exposure is the adverse health effect on the developing nervous system. The objective of this cross-sectional study was to determine hair mercury levels and their association with socio-demographic characteristics, complaints about mercury poisoning symptoms and the fish consumption pattern among children in Malaysia. A cross-sectional study was conducted among 215 school children aged 11 years old. Hair was collected from the children and the total mercury was analyzed using oxygen combustion–gold amalgamation atomic absorption spectrophotometry. Anthropometric data, a fish consumption questionnaire and mercury poisoning symptoms were collected during a personal interview. The mean hair mercury level among primary school children was 0.63 ± 0.59 µg/g with the geometric mean of 0.47 µg/g. A total of 14% of respondents had hair mercury levels above 1 µg/g. A multiple binary logistic regression analysis outlined that fish consumption of at least one meal per week increased the likelihood of having a high mercury level (odds ratio (OR 3.7, 95% confidence interval (CI 1.3–10.4. This study confirms the existence of a mercury burden among Malaysian children and the level is high compared to other regional studies. This study provides important baseline data regarding the mercury level among children in Malaysia.

  2. Is prevention of acute pesticide poisoning effective and efficient, with Locally Adapted Personal Protective Equipment? A randomized crossover study among farmers in Chitwan, Nepal

    DEFF Research Database (Denmark)

    Varma, Anshu; Neupane, Dinesh; Bonde, Jens Peter Ellekilde

    2016-01-01

    Background: Farmers' risk of pesticide poisoning can be reduced with personal protective equipment but in low-income countries farmers' use of such equipment is limited. Objective: To examine the effectiveness and efficiency of Locally Adapted Personal Protective Equipment to reduce organophospha...

  3. [Mushroom poisoning in Portugal].

    Science.gov (United States)

    Brandão, José Luís; Pinheiro, J; Pinho, D; Correia da Silva, D; Fernandes, E; Fragoso, G; Costa, M I; Silva, A

    2011-12-01

    The renewed interest in mycology has been reflected in growing use of wild mushrooms in culinary, driven by its nutritional, organoleptic and commercial value. However, the international scientific literature describes several syndromes of poisoning by mushrooms. We live, therefore, a paradigm conducive to an increase of mycetism, whose diagnosis requires a high level of suspicion and knowledge of clinical profiles. In Portugal, the real dimension of this problem is unknown. Although some mycetisms, such as the hepatotoxic syndrome, have high morbidity and mortality, their relative incidences are unknown. Add up to the shortage of international scientific literature, often outdated and inappropriate to clinical practice. In this context, this article provides an updated epidemiological and clinical perspective emphasizing a narrative and descriptive information on the forms of presentation, differential diagnosis and therapeutic approach, with the ultimate goal of the elaboration of a national diagram-oriented approach to decision-making diagnosis. We analyzed all the clinical records of patients admitted into ten hospitals between 1990 and 2008, notified with the code 988.1 of GDH (acute poisoning by mushrooms). There were registered demographic data, way of presentation, time between ingestion and onset of symptoms, the annual distribution, clinical profile, clinical and analytical treatment performed and complications. We identified 93 cases of acute poisoning by mushrooms, with equal gender distribution and inclusion of individuals of all age groups (from 1 to 85 years), but with greater representation from 21 to 50 years. There was a bimodal seasonal pattern, with a higher peak between September and December and a second in the spring. The hepatotoxic profile presentation corresponded to 63.4% and 31.7% of the cases to gastroenteritis syndrome. The mortality in cases of hepatotoxicity was 11.8%. The developmental profile of the rate of prothrombin time (PT

  4. Rhubarb leaves poisoning

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/002876.htm Rhubarb leaves poisoning To use the sharing features on this page, please enable JavaScript. Rhubarb leaves poisoning occurs when someone eats pieces of leaves ...

  5. Bubble bath soap poisoning

    Science.gov (United States)

    ... medlineplus.gov/ency/article/002762.htm Bubble bath soap poisoning To use the sharing features on this page, please enable JavaScript. Bubble bath soap poisoning occurs when someone swallows bubble bath soap. ...

  6. Poisoning - fish and shellfish

    Science.gov (United States)

    ... poisonings are heat stable, so no amount of cooking will prevent you from becoming poisoned if you ... R. Blaser MJ, eds. Mandell, Douglas and Bennett's Principles and Practice of Infectious Disease, Updated Edition . 8th ...

  7. Poisoning first aid

    Science.gov (United States)

    ... containers, even if they are labeled. Most nonfood substances are poisonous if taken in large doses. If you are concerned that industrial poisons might be polluting nearby land or water, report your concerns to ...

  8. Hair dye poisoning

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/002703.htm Hair dye poisoning To use the sharing features on this page, please enable JavaScript. Hair dye poisoning occurs when someone swallows dye or tint ...

  9. Plant fertilizer poisoning

    Science.gov (United States)

    Plant fertilizers and household plant foods are used to improve plant growth. Poisoning can occur if someone swallows these products. Plant fertilizers are mildly poisonous if small amounts are swallowed. ...

  10. Bug spray poisoning

    Science.gov (United States)

    ... that mosquitos spread. Some of these are malaria, dengue fever, and West Nile virus. Other less effective ... you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. ...

  11. Basic Information about Mercury

    Science.gov (United States)

    ... Your Environment Contact Us Share Basic Information about Mercury On this page: What is mercury? Emissions of ... Consumer products that traditionally contain mercury What is Mercury? Mercury is a naturally-occurring chemical element found ...

  12. [Toxic nephropathy secondary to occupational exposure to metallic mercury].

    Science.gov (United States)

    Voitzuk, Ana; Greco, Vanina; Caputo, Daniel; Alvarez, Estela

    2014-01-01

    Toxic nephrophaties secondary to occupational exposure to metals have been widely studied, including membranous nephropathy by mercury, which is rare. Occupational poisoning by mercury is frequent, neurological symptoms are the main form of clinical presentation. Secondary renal involvement in chronic exposure to metallic mercury can cause glomerular disease by deposit of immune-complexes. Membranous glomerulopathy and minimal change disease are the most frequently reported forms. Here we describe the case of a patient with occupational exposure to metallic mercury, where nephrotic syndrome due to membranous glomerulonephritis responded favorably to both chelation and immunosuppressive therapy.

  13. [Development and application of poison databank and poisonous animal and plants sample databank].

    Science.gov (United States)

    Yin, Yu; Jiang, Shao-Feng; Cai, Jun; Luo, Tao; Xie, Li-Jing; Zhou, Jing; Sun, Cheng-Ye

    2008-03-01

    To establish a comprehensive,easily approached, operated, and searched internet poison databank as to providing professional poison data and knowledge of effective treatment for those consented such as medical staff, and emergency response team in the shortest time. We established a computer poison databank, by adopting B/S structure, using SQL Server databank, and explore technology, in which all information may easily be explored and obtained by users. The database integrated the information in relating to the substances identifiers, physical and chemical properties, toxicology data, clinical manifestation while intoxication, emergency response guides, effective treatment, anything related to the special antidotes, preventive measures, poison analysis, and manufacturers of chemicals, pharmaceuticals, herbs, pesticides, animal, plant, bacteria, fungi, productions and toxins. Otherwise some information about poison control organizations and experts, literatures about poison case reports, poison incidents, were also involved in the system, which can also provide a shortcut, convenient, and exact search. The databank might be easily used on several fields, providing important information with acute poison incidents disposal and clinic treatment.

  14. EDITORIAL POISONING PATTERN Human poisoning with ...

    African Journals Online (AJOL)

    pharm-chem

    Bioaccumulation of methylmercury then occurred in fish which were eventually eaten by humans. Thallium poisoning is characterized by alopecia often seen one to two weeks later when the patient is about to be discharged from hospital. Thus, in chronic poisoning, it is difficult to establish definitive cause-effect relationship.

  15. Carbon Monoxide Poisoning from Portable Electrical Generators.

    Science.gov (United States)

    Hampson, Neil B; Dunn, Susan L

    2015-08-01

    Portable electrical generators have been responsible for over 800 accidental carbon monoxide (CO) poisoning deaths in the United States from 1999-2012. Because mortality figures are typically the only data reported with regard to the adverse effects of generators, we describe a nonfatal segment of the poisoned population to further emphasize the significance of the problem. Unidentifiable information about patients treated in the United States with hyperbaric oxygen for acute CO poisoning was prospectively reported by participating centers. Those patients poisoned by portable generators were selected for analysis. Of 1604 patients reported from August 1, 2008 to July 31, 2011, there were 264 accidentally poisoned by portable generators. Exposures occurred in 151 incidents in 33 states. In 99 incidents, poisoning occurred in a residence. Average patient age was 37 ± 20 years (range 1 to 90+ years). Of those poisoned, 146 (55%) were non-Hispanic white, 57 (22%) were black, 52 (20%) were Hispanic white, 4 (2%) were Asian, and 4 (2%) were Native American. English was spoken by 96%. The most common symptoms included headache (62%), dizziness (52%), and loss of consciousness (50%). Blood carboxyhemoglobin levels averaged 22.7 ± 9.0% (range 2.3-48.3%). Thirty-six patients demonstrated evidence of cardiac ischemia. Acute, severe CO poisoning from portable electric generators is common in the United States, likely affecting an estimated 4000 individuals annually, occurring predominantly in residential settings, and affecting English language-speaking individuals. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Lead Poisoning (For Parents)

    Science.gov (United States)

    ... Needs a Kidney Transplant Vision Facts and Myths Lead Poisoning KidsHealth > For Parents > Lead Poisoning Print A ... Family en español La intoxicación por plomo About Lead Poisoning If you have young kids, it's important ...

  17. Poison Ivy Rash

    Science.gov (United States)

    ... leaves and can grow as a bush or tree. Unlike poison ivy and poison oak, it doesn't grow in a three-leaf-per-stem pattern. Poison ivy rash is a type of allergic contact dermatitis caused by an oily resin called urushiol. It's found in the leaves, stems ...

  18. Lead Poisoning in Childhood.

    Science.gov (United States)

    Pueschel, Siegfried M., Ed.; Linakis, James G., Ed.; Anderson, Angela C., Ed.

    The magnitude of childhood lead poisoning has been inexplicably neglected by modern medicine and by legislators. However, since the 1970s, increased attention has been focused on lead poisoning, and advances have been made in several areas, including understanding of the neurodevelopmental and behavioral ramifications of lead poisoning, and…

  19. Lead poisoning: An overview

    Science.gov (United States)

    Gendel, Neil

    1993-01-01

    A problem that should be of great concern to all of us is the lead poisoning of children. First, I would like to present a short overview concerning the reasons everyone should care about lead poisoning, then discuss the history of lead poisoning, what is happening today across the country, and the future.

  20. Lead Poisoning in Children.

    Science.gov (United States)

    Drummond, A. H., Jr.

    1981-01-01

    Early symptoms of lead poisoning in children are often overlooked. Lead poisoning has its greatest effects on the brain and nervous system. The obvious long-term solution to the lead poisoning problem is removal of harmful forms of the metal from the environment. (JN)

  1. Poisoning of domestic animals with heavy metals

    Directory of Open Access Journals (Sweden)

    Velev Romel

    2009-01-01

    Full Text Available The term heavy metal refers to a metal that has a relatively high density and is toxic for animal and human organism at low concentrations. Heavy metals are natural components of the Earth's crust. They cannot be degraded or destroyed. To a small extent they enter animal organism via food, drinking water and air. Some heavy metals (e.g cooper, iron, chromium, zinc are essential in very low concentrations for the survival of all forms of life. These are described as essential trace elements. However, when they are present in greater quantities, like the heavy metals lead, cadmium and mercury which are already toxic in very low concentrations, they can cause metabolic anomalies or poisoning. Heavy metal poisoning of domestic animals could result, for instance, from drinking-water contamination, high ambient air concentrations near emission sources, or intake via the food chain. Heavy metals are dangerous because they tend to bioaccumulate in a biological organism over time. Manifestation of toxicity of individual heavy metals varies considerably, depending on dose and time of exposure, species, gender and environmental and nutritional factors. Large differences exist between the effects of a single exposure to a high concentration, and chronic exposures to lower doses. The aim of this work is to present the source of poisoning and toxicity of some heavy metals (lead, mercury, cadmium, thallium, arsenic, as well as new data about effects of those heavy metals on the health of domestic animals. .

  2. Teenagers with Jimson weed (Datura stramonium) poisoning.

    Science.gov (United States)

    Spina, Sean P; Taddei, Anthony

    2007-11-01

    We report 2 cases of teenagers who were poisoned with Jimson weed (Datura stramonium) and presented to the emergency department with a severe acute anticholinergic toxidrome after ingestion of several hundred seeds. The patients presented with visual hallucinations, disorientation, incomprehensible and nonsensical speech, and dilated sluggish pupils. Both patients required restraints for combativeness until adequate sedation with lorazepam and haloperidol was achieved. Jimson weed is found in southern Canada and the United States and can cause acute anticholinergic poisoning and death in humans and animals. The treatment of choice for anticholinergic poisoning is mainly supportive care and gastrointestinal decontamination with activated charcoal. Jimson weed intoxication should be considered in cases of patients presenting with unexplained peripheral and central anticholinergic symptoms including delirium, agitation and seizures, especially among younger patients and partygoers. It is important that health care professionals recognize that Jimson weed is a toxic, indigenous, "wild" growing plant, subject to misuse and potentially serious intoxication requiring hospitalization.

  3. Appendectomy due to lead poisoning: a case-report

    Directory of Open Access Journals (Sweden)

    Aghilinejad M

    2008-10-01

    Full Text Available Abstract Background Lead poisoning is a common occupational health hazard in developing countries and many misdiagnoses and malpractices may occur due to unawareness of lead poisoning symptoms. Case presentation We report a case of occupational lead poisoning in an adult battery worker with abdominal colic who initially underwent appendectomy with removal of normal appendix. Later on he was diagnosed with lead poisoning and was treated appropriately with lead chelator (CaNa2EDTA. Conclusion Lead poisoning is frequently overlooked as the differential diagnosis of acute abdomen which may result in unnecessary surgery. Appropriate occupational history taking is helpful in making a correct diagnosis. Occupational lead poisoning is a preventable disorder and a serious challenge for the health and labor authorities in developing countries.

  4. EPIDEMIOLOGICAL STUDY OF POISONING CASES IN COASTAL ANDHRA PRADESH

    OpenAIRE

    Anand; Ashok Chakravarthy

    2014-01-01

    Acute poisoning is one of the common causes of admission in emergency department of various hospitals. This is a common socio medical problem. Green revolution has increased the production of food grain but the wide spread use of organophosphorus compounds has increased incidence of its poisoning to the human kind by accidental or suicidal. Around one hundred fifty six patient admitted in Konaseema Institute of Medical Science and General Hospital with diagnosis of acute p...

  5. Pesticide poisoning: a major health problem in Sri Lanka

    DEFF Research Database (Denmark)

    Hoek, Wim van der; Konradsen, F; Athukorala, K

    1998-01-01

    Acute pesticide poisoning is a major public health problem in Sri Lanka. In several agricultural districts, it precedes all other causes of death in government hospitals. Most of the acute poisoning cases are intentional (suicide) and occur among young adults, mainly males. Poisoning due...... to occupational exposure is also common, but less well documented. In an irrigation area in Sri Lanka a very high incidence of serious pesticide poisoning was observed, with 68% due to intentional ingestion of liquid pesticides. It is argued that the easy availability and widespread use of highly hazardous...... that promote the safe use of pesticides through education and training of farmers will be ineffective in Sri Lanka because knowledge is already high and most poisoning cases are intentional. Instead, enforcement of legislation to restrict availability of the most hazardous pesticides would result...

  6. Hearing Loss due to Carbon Monoxide Poisoning

    DEFF Research Database (Denmark)

    Mehrparvar, Amir Houshang; Davari, Mohammad Hossein; Mollasadeghi, Abolfazl

    2013-01-01

    Carbon monoxide poisoning is one of the rare causes of hearing loss which may cause reversible or irreversible, unilateral or bilateral hearing loss after acute or chronic exposure. In this report, we present a case of bilateral sensorineural hearing loss in a secondary smelting workshop worker a...

  7. Morbilidad por intoxicaciones agudas en el Hospital Pediátrico de Cienfuegos durante el quinquenio 1996-2000 Morbidity from acute poisonings at the Pediatric Hospital of Cienfuegos from 1996 to 2000

    Directory of Open Access Journals (Sweden)

    Antonio Masot Rangel

    2004-09-01

    Full Text Available Se realizó un estudio descriptivo, retrospectivo, tipo serie de casos, sobre los pacientes menores de 15 años egresados del Hospital Pediátrico de Cienfuegos, con el diagnóstico de intoxicación aguda, con el objetivo de determinar el comportamiento de algunas variables clínicas y epidemiológicas. El universo de estudio lo conformaron los 609 pacientes egresados con este diagnóstico durante el quinquenio 1996-2000. En todos los casos fueron analizadas las siguientes variables: edad, sexo, origen de la intoxicación, lugar de ocurrencia, agente etiológico, vía de entrada, nivel de atención donde recibió primera asistencia médica y complicaciones; obtenidas de las historias clínicas. El 53 % de las intoxicaciones agudas ocurrió en las edades comprendidas hasta 4 años; en este grupo, el 58,2 % perteneció al sexo masculino, mientras que a partir de los 10 años se observó un franco predominio del sexo femenino (78,3 %. Las intoxicaciones accidentales ocurrieron en el 77,8 % del total de pacientes, pero a partir de los 10 años predominó el origen intencional (67,3 %, resultados que fueron estadísticamente significativos. Se comprobó relación entre la edad de la intoxicación, el sexo y el origen intencional o accidental del evento, en la población estudiada.A descriptive, retrospective and serial study was conducted among patients under 15 discharged from the Pediatric Hospital of Cienfuegos with the diagnosis of acute poisoning aimed at determining the behavior of some clinical and epidemiological variables. The sample was composed of 609 patients discharged with this diagnosis from 1996 to 2000. The following variables were taken from the medical histories and analized in all cases: age, sex, origin of the poisoning, place of occurrence, etiological agent, route, level of medical attention received and complications. 53 % of the acute poisonings took place at ages up to 4 years old. In this group, 58.2 % were males. Among

  8. EDITORIAL POISONING PATTERN Human poisoning with ...

    African Journals Online (AJOL)

    pharm-chem

    Thus, in chronic poisoning, it is difficult to establish definitive cause-effect ... This is the most stressful period when young people are trying to come into terms ... Typical examples of "Police cases" include suicide, suspected homicide, death.

  9. [Seafood poisonings. Part II. Fish poisonings].

    Science.gov (United States)

    Ciszowski, Krzysztof; Mietka-Ciszowska, Aneta

    2012-01-01

    Fish plays a significant role in human life, mainly as part of a balanced healthy diet and a good source of many of nutrients. However, contact with fish may be harmful or even life-threatening to man. Toxic effects, that fish exerts toward men (ichthyotoxism), result from envenomations by poison. ous fish equipped in venom apparatus (ichthyoacanthotoxism), direct contact with venom produced by skin glandules (ichthyocrinotoxism), or consuming fish containing toxins for nutritional purposes (ichthyosarcotoxism). In the present review, different fish-borne food poisonings are presented including their etiology, pathogenesis, symptomatology and treatment. In fact, the majority of fish poisonings are intoxications with toxins primary produced by bacteria, cyanobacteria and algae. These are consumed and accumulated in the food chain by herbivorous and predatory fish, that in turn may be a cause of poisonings in humans.

  10. Arsine poisoning.

    Science.gov (United States)

    Kleinfeld, M J

    1980-12-01

    A 31-year-old patient was admitted to the hospital because of dark red urine which on examination was found to be due to extracellular hemoglobin. The cause of the hemoglobinuria was exposure to arsine gas from a cylinder thought to be empty. The worker's exposure time was approximately one to two minutes. The degree of hemolytic anemia required only one unit of packed red cells. The patient was hydrated intravenously to avoid acute tubular necrosis. The arsenic content in the urine taken was 0.72 mg/L on the day of admission and dropped to 0.1 mg/L on the fourth day of hospitalization. The patient was discharged eight days after admission, when clinical and hematological status had improved sufficiently. Occupational history revealed that protective procedures employed in the handling of the cylinders containing the arsine gas were inadequate. It was found that the valve on one of the cylinders was half-opened and leaking and that the dust caps, which were attached to the outside of the valves of the cylinders, were present on some and not on others and, where present, had been hand-tightened and not wrench-tightened. Moreover, the cylinders although specified to be empty, were not, according to regulations requiring pressure to be less than 25 pounds gauge or 45 absolute.

  11. Extracorporeal treatment for theophylline poisoning

    DEFF Research Database (Denmark)

    Ghannoum, Marc; Wiegand, Timothy J; Liu, Kathleen D

    2015-01-01

    pharmacokinetic studies, yielding a low-to-very-low quality of evidence for all recommendations. Data on 143 patients were reviewed, including 10 deaths. The workgroup concluded that theophylline is dialyzable (level of evidence = A) and made the following recommendations: ECTR is recommended in severe...... theophylline poisoning (1C). Specific recommendations for ECTR include a theophylline concentration [theophylline] > 100 mg/L (555 μmol/L) in acute exposure (1C), the presence of seizures (1D), life-threatening dysrhythmias (1D) or shock (1D), a rising [theophylline] despite optimal therapy (1D), and clinical...

  12. Childhood lead poisoning: an overview.

    Science.gov (United States)

    Hon, K L; Fung, C K; Leung, A Kc

    2017-12-01

    Childhood lead poisoning is a major public health concern in many countries. In 2015, the Hong Kong SAR Government and its citizens faced a major public health crisis due to the presence of lead in the drinking water of a number of public housing estates. Fortunately, no child was diagnosed with lead poisoning that required treatment with chelation. Lead is a ubiquitous, naturally occurring material that exists in air, dust, soil, and water. It is also widely present in industrial products including petrol, paints, ceramics, food cans, candies, cosmetics, traditional remedies, batteries, solder, stained glass, crystal vessels, ammunition, ceramic glazes, jewellry, and toys. It can also be found in human milk. There is no safe blood lead level and it may be impossible to completely eliminate lead from any city. Hence routine measurement of blood lead levels is not considered useful. Acute poisoning, especially with encephalopathy, deserves immediate medical treatment in hospital. Chelation therapy is recommended if blood lead level is 45 μg/dL or higher. For blood levels between 20 and 45 μg/dL, treatment is indicated if the child is symptomatic. For blood levels below 20 μg/dL in otherwise asymptomatic children, the principle of treatment is to provide long-term neurodevelopmental follow-up and counselling. In all cases, immediate removal of the source of lead exposure is vital. Even low levels of lead exposure can significantly impair learning, educational attainment, and neurodevelopment.

  13. Mercury toxicity and antioxidants: Part 1: role of glutathione and alpha-lipoic acid in the treatment of mercury toxicity.

    Science.gov (United States)

    Patrick, Lyn

    2002-12-01

    Mercury exposure is the second-most common cause of toxic metal poisoning. Public health concern over mercury exposure, due to contamination of fish with methylmercury and the elemental mercury content of dental amalgams, has long been a topic of political and medical debate. Although the toxicology of mercury is complex, there is evidence for antioxidant protection in the prevention of neurological and renal damage caused by mercury toxicity. Alpha-lipoic acid, a coenzyme of pyruvate and alpha-ketoglutarate dehydrogenase, has been used in Germany as an antioxidant and approved treatment for diabetic polyneuropathy for 40 years. Research has attempted to identify the role of antioxidants, glutathione and alpha-lipoic acid specifically, in both mitigation of heavy metal toxicity and direct chelation of heavy metals. This review of the literature will assess the role of glutathione and alpha-lipoic acid in the treatment of mercury toxicity.

  14. Acrodynia: exposure to mercury from fluorescent light bulbs

    Energy Technology Data Exchange (ETDEWEB)

    Tunnessen, W.W. Jr.; McMahon, K.J.; Baser, M.

    1987-05-01

    Medical attention was sought for a 23-month-old toddler because of anorexia, weight loss, irritability, profuse sweating, peeling and redness of his fingers and toes, and a miliarial rash. The diagnosis was mercury poisoning, and an investigation of his environment disclosed that he had been exposed to mercury from broken fluorescent light bulbs. Acrodynia resulting from fluorescent bulbs has not been previously reported.

  15. Mercury residues in tissues of dead and surviving birds fed methylmercury

    Science.gov (United States)

    Finley, M.T.; Stickel, W.H.; Christensen, R.E.

    1979-01-01

    Concentrations of mercury in passerine birds fed diets containing 40 ppm methylmercury were similar in tissues of birds that died from mercury poisoning and in those that were sacrificed after half the group had died. Residues were higher in tissues of birds that died, but the differences were not statistically significant. Residue levels were highest in livers, followed by kidneys and brains. Levels of mercury were similar in breast muscle, carcass, and whole body. Mercury levels were highest in redwinged blackbirds, lowest in grackles, and intermediate in starlings and cowbirds. Mercury concentrations exceeded 20 ppm in all tissues of all species and were similar to levels reported in wild birds known to have died of mercury poisoning.

  16. Mercury and Pregnancy

    Science.gov (United States)

    ... Home > Pregnancy > Is it safe? > Mercury and pregnancy Mercury and pregnancy E-mail to a friend Please ... vision problems. How can you be exposed to mercury? Mercury has several forms: It can be a ...

  17. Fatal poisonings in Oslo: a one-year observational study

    Directory of Open Access Journals (Sweden)

    Heyerdahl Fridtjof

    2010-06-01

    Full Text Available Abstract Background Acute poisonings are common and are treated at different levels of the health care system. Since most fatal poisonings occur outside hospital, these must be included when studying characteristics of such deaths. The pattern of toxic agents differs between fatal and non-fatal poisonings. By including all poisoning episodes, cause-fatality rates can be calculated. Methods Fatal and non-fatal acute poisonings in subjects aged ≥16 years in Oslo (428 198 inhabitants were included consecutively in an observational multi-centre study including the ambulance services, the Oslo Emergency Ward (outpatient clinic, and hospitals, as well as medico-legal autopsies from 1st April 2003 to 31st March 2004. Characteristics of fatal poisonings were examined, and a comparison of toxic agents was made between fatal and non-fatal acute poisoning. Results In Oslo, during the one-year period studied, 103 subjects aged ≥16 years died of acute poisoning. The annual mortality rate was 24 per 100 000. The male-female ratio was 2:1, and the mean age was 44 years (range 19-86 years. In 92 cases (89%, death occurred outside hospital. The main toxic agents were opiates or opioids (65% of cases, followed by ethanol (9%, tricyclic anti-depressants (TCAs (4%, benzodiazepines (4%, and zopiclone (4%. Seventy-one (69% were evaluated as accidental deaths and 32 (31% as suicides. In 70% of all cases, and in 34% of suicides, the deceased was classified as drug or alcohol dependent. When compared with the 2981 non-fatal acute poisonings registered during the study period, the case fatality rate was 3% (95% C.I., 0.03-0.04. Methanol, TCAs, and antihistamines had the highest case fatality rates; 33% (95% C.I., 0.008-0.91, 14% (95% C.I., 0.04-0.33, and 10% (95% C.I., 0.02-0.27, respectively. Conclusions Three per cent of all acute poisonings were fatal, and nine out of ten deaths by acute poisonings occurred outside hospital. Two-thirds were evaluated as accidental

  18. Mercury Toxicity: A Family Case Report

    OpenAIRE

    Rahşan Yıldırım; Fuat Erdem; Mehmet Gündoğdu; Yusuf Bilen; Ebru Koca; Yalçın Yıllıkoğlu; Yaşar Nuri Şahin

    2012-01-01

    Background: Increased levels of environmental pollution have exposed mankind to foreign matters. In this article, five individuals within the age range of 20 and 54 from the same family, who were poisoned from liquid form mercury, are presented. Case Report: The first case presented to our clinic with cough, fever, night sweat.The patient with clinical findings of neutropenia, anemia and pneumonia who rapidly developed ARDS and died on the fourth day of hospitalization. Her WBC count: 0.4...

  19. Aconite poisoning in camouflage.

    Science.gov (United States)

    Poon, W T; Lai, C K; Ching, C K; Tse, K Y; So, Y C; Chan, Y C; Hau, L M; Mak, T W L; Chan, A Y W

    2006-12-01

    The Toxicology Reference Laboratory has confirmed 10 cases of aconite poisoning from March 2004 to May 2006. In four of these 10 cases, the aconite herb was not listed in the written prescription. We report these four cases to highlight the problem of 'hidden' aconite poisoning.

  20. DRUG POISONING IN SLOVENIA

    Directory of Open Access Journals (Sweden)

    Miran Brvar

    2008-01-01

    Poisoning by drugs for the nervous system, particularly benzodiazepines, is the most commonform of poisoning by drugs in Slovenia. It would be necessary to report all acutelypoisoned patients to the Register of Intoxications, since we need data about all poisoningin Slovenia to improve their prophylaxis and treatment

  1. Poison ivy - oak - sumac

    Science.gov (United States)

    ... sharing features on this page, please enable JavaScript. Poison ivy, oak, or sumac poisoning is an allergic reaction that results from touching the sap of these plants. The sap may be on the plant, in the ashes of burned plants, on an animal, or on other objects that came in contact ...

  2. Survival and reproductive success of black ducks fed methyl mercury

    Science.gov (United States)

    Finley, M.T.; Stendell, R.C.

    1978-01-01

    A diet containing 3 ppm mercury was fed to black ducks (Anas rubripes) for periods of 28 weeks during two consecutive breeding seasons. Clutch size, egg production, number of eggs incubated, hatchability and survival of ducklings were lower during both years in hens fed mercury. Reduced hatchability and poor duckling survival were the most harmful effects. During 2 years, 13 pairs of breeders fed mercury produced only 16 ducklings that survived 1 week compared with 73 ducklings from 13 pairs of controls. Mercury residues in eggs, embryos and ducklings averaged about 30% lower during the second breeding season compared with first year results. Third eggs laid by treated hens contained a mean of 6?14 and 3?86 ppm mercury during the first and second years. Whole embryos that failed to hatch contained means of 9?62 and 6?08 ppm mercury during the first and second years. Brains of dead ducklings contained between 3?25 and 6?98 ppm mercury and exhibited lesions characteristic of mercury poisoning. Relative tissue mercury levels for treated adult breeders were: feathers > liver > kidney > breast muscle > brain. Mercury levels in males and females did not differ.

  3. [Abdominal pain as a presentation by lead poisoning. Case report].

    Science.gov (United States)

    Mottiera, Daniel M; Cargnel, Elda

    2017-04-01

    Acute lead poisoning is not a common pathology seen in the pediatrician's office. Lead poisoning symptoms can be digestive or neurological, and they can be confused with other pathologies. That is the reason why it should be considered and, in case of doubt, complementary studies to confirm lead poisoning should be requested. This is the case of a nine-year-old child that comes to the office with a strong abdominal pain and vomiting, and after a close physical examination and a detailed anamnesis, a suspicious diagnosis of "acute" lead poisoning is obtained. Therefore, the infant is hospitalized, and after taking a venous sampling to confirm the lead level, a chelation therapy is performed under the toxicology expert's supervision. Sociedad Argentina de Pediatría.

  4. Artisanal Mining of Gold with Mercury in Ghana

    African Journals Online (AJOL)

    USER

    The main pathway of human exposure to this toxic metal is through the consumption of Hg contaminated fish as illustrated by the mass Hg poisoning in Minamata Bay and Agano River in Japan (D'Itri & D'Itri, 1977; Takizawa,1979) during the 1950s and 1960s. Gold mining with mercury. The mining sector has been identified ...

  5. Mortality and morbidity of poisonings in the Nordic countries in 2002.

    Science.gov (United States)

    Andrew, Erik; Irestedt, Birgitta; Hurri, Tommi; Jacobsen, Peter; Gudjonsdottir, Gudborg

    2008-04-01

    To map and compare mortality and morbidity of poisonings in Denmark, Finland, Iceland, Norway, and Sweden in 2002 and to establish a common understanding of methods and procedures among the National Poisons Information Centres (NPIC) in order to create a Nordic toxico-epidemiological platform. Morbidity was for this study defined as acute poisonings treated in hospitals given the ICD-10 codes T36-T65 and F10-F19. The figures were extracted from the National Patient/Hospital Registers. Acute poisonings listed as main as well as side diagnoses were included. Deaths recorded as acute poisoning (using the same ICD-10 codes) were collected from the National Death Cause Registers. Annual mortality of acute poisonings per 100,000 inhabitants (rate) was 16.6 in Finland and between 8.6 and 11.1 in the other Nordic countries. Morbidity rates varied between 150 and 255 per 100,000 inhabitants. The death rate due to acute poisoning was 50% higher in Finland compared to the rate in the other Nordic countries. The variable data between countries obtained for morbidity of acute poisonings need further elucidations to verify if the differences are real and not only due to heterogeneous procedures and practice for data collection and recording.

  6. Outsmarting Poison Ivy and Other Poisonous Plants

    Science.gov (United States)

    ... and cannot further spread the rash. Tips for Prevention Learn what poison ivy, oak, and sumac plants ... View FDA photos on Flickr FDA Archive Combination Products Advisory ... Popular Content Home Latest Recalls Report an Adverse Event MedWatch Safety Alerts News ...

  7. Emergency management and treatment of the poisoned small animal patient.

    Science.gov (United States)

    Lee, Justine A

    2013-07-01

    This article reviews management of the acutely poisoned veterinary patient, including initial telephone triage, appropriate communication and history gathering from the pet owner, decontamination methods (including the use of appropriate emetic agents and dosing of activated charcoal), and general treatment of the poisoned patient. Symptomatic and supportive care of the poisoned patient includes the use of fluid therapy, gastrointestinal support (eg, antacids), central nervous system support (eg, muscle relaxants, anticonvulsants), sedatives/reversal agents (eg, phenothiazines, naloxone, flumazenil), hepatoprotectants, and miscellaneous antidotal therapy. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. AN EPIDEMIOLOGICAL STUDY OF POISONING IN A TERTIARY CARE HOSPITAL

    OpenAIRE

    Stephen; Sahajanand; Rangalakshmi; Kasim

    2015-01-01

    AIMS : The aim of this retrospective study was to analyze the rate and chara cteristics of acute poisoning cases admitted to adult intensive care unit ( ICU ) in a tertiary care medical college hospital. We report clinical features , demographic data , laboratory results , mortality rate , and the results of our treatment in cases who ca me with the history of poisoning. METHODS: The study was done in patients admitted with his...

  9. GC-MS analysis of the designer drug α-pyrrolidinovalerophenone and its metabolites in urine and blood in an acute poisoning case.

    Science.gov (United States)

    Grapp, Marcel; Sauer, Christoph; Vidal, Christian; Müller, Dieter

    2016-02-01

    α-Pyrrolidinovalerophenone (α-PVP) is a synthetic cathinone belonging to the group of "second generation" pyrrolidinophenones that becomes more and more popular as a designer psychostimulant. Here we provide toxicological analytical support for a severe poisoning with α-PVP. Serum and urine samples that were sent to our laboratory were subjected to a general unknown screening procedure. The procedure includes immunoassay-based screening of drugs of abuse in serum and systematic toxicological analysis of urine and serum after neutral and basic liquid-liquid extraction followed by gas chromatography-mass spectrometry (GC-MS). Whereas the immunoassay delivered negative results, analyzing the urine sample by GC-MS in full scan mode disclosed the presence of α-PVP and its metabolites α-(2″-oxo-pyrrolidino)valerophenone (2″-oxo-α-PVP) and 1-phenyl-2-(pyrrolidin-1-yl)pentan-1-ol (OH-α-PVP). In the acetylated urine sample we found additionally N,N-bis-dealkyl-PVP. In serum, α-PVP could be detected after solid phase extraction and a concentration of 29ng/mL was determined. Other forensic relevant substances were not detected. The presented data can explain the psychotic symptoms and behavioural pattern of the subject after abuse of α-PVP, leading to a clinical condition similar to excited delirium syndrome. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Absorption and excretion of mercury in man. VI. Significance of mercury in urine

    Energy Technology Data Exchange (ETDEWEB)

    Jacobs, M.B.; Ladd, A.C.; Goldwater, L.J.

    1964-10-01

    The recent literature dealing with mercury in urine of humans has been reviewed and some new data have been developed. On a group basis, there appears to be good correlation between levels of mercury exposure and levels of urinary excretion. This relationship does not always hold for an individual. There is no clear-cut evidence that workers presumed to have unchanged conditions of exposure will show either an increase or decrease in urinary mercury as duration of exposure increases. Levels of mercury in the urine show little or no correlation with manifestation of poisoning. There appears to be no level above which symptoms cannot occur. The empirical use of arbitrary levels in control programs may result in the imposition of unnecessary restrictions. Present evidence suggests that mercury can be found in 20% of ''normal'' urines. Concentrations up to 100..mu..g/liter or more have been found but rarely is the figure greater than 50..mu..g/liter. Wide fluctuations in the hourly and daily excretion of mercury in urine are common in exposed persons. Present knowledge does not justify the application of specific gravity corrections to mercury in urine.

  11. Aluminium phosphide induced acute kidney injury

    Directory of Open Access Journals (Sweden)

    Quaiser Saif

    2015-01-01

    Full Text Available Aluminium phosphide is one of the most common agricultural poisons being consumed in north India. Consumption of a fresh tablet is lethal as no antidote is available. Acute intoxication primarily presents with cardiovascular collapse due to myocardial toxicity. We report here a case of acute severe poisoning along with cardiovascular collapse and oliguria. The patient developed acute kidney injury during the illness (a rare entity in aluminium phosphide poisoning, which completely resolved following prompt conservative treatment.

  12. Histamine fish poisoning

    Directory of Open Access Journals (Sweden)

    M. Nosić

    2010-01-01

    Full Text Available Histamine fish poisoning is a chemical intoxication associated with intake of fishes with high histamine content. Histamine is developed in fish tissue post mortem due to bacterial decarboxilation of free amino-acid histidine. This paper deals with causes of histamine development in fish meat and with histamine influence on human health. Prevention of histamine fish poisoning would also be discussed. The case histories of histamine food poisoning in our country and in the world would be described. Histamine levels used in Regulation would be presented.

  13. The use of self-reported symptoms as a proxy for acute organophosphate poisoning after exposure to chlorpyrifos 50% plus cypermethrin 5% among Nepali farmers

    DEFF Research Database (Denmark)

    Kofod, Dea Haagensen; Jørs, Erik; Varma, Anshu

    2016-01-01

    in response to occupational acute organophosphate exposure. Methods: We performed a randomized, double-blind, placebo-controlled, crossover trial among 42 Nepali commercial vegetable farmers. The farmers were randomly assigned (ratio 1:1) to a 2-h organophosphate (chlorpyrifos 50% plus cypermethrin 5...

  14. Childhood pesticide poisoning in Zhejiang, China: a retrospective analysis from 2006 to 2015.

    Science.gov (United States)

    Yimaer, Aziguli; Chen, Guangdi; Zhang, Meibian; Zhou, Lifang; Fang, Xinglin; Jiang, Wei

    2017-06-28

    Pesticide poisoning in children has been a serious public health issue around the world, especially in the developing countries where agriculture is still one of the largest economic sectors. The purpose of this study was to analyze epidemiological characteristics of acute pesticide poisoning in children from Zhejiang province, China. The pesticide poisoning cases for children were retrieved from Occupational Disease Surveillance and Reporting System, Zhejiang Provincial Center for Disease Control and Prevention, China. The incident cases, deaths, and fatality rate of child pesticide poisoning from 2006 through 2015 were calculated. During the study period, totally 2952 children were poisoned by pesticides, with 66 deaths, resulting in a fatality rate of 2.24%. Among them, there were 1607 male cases with 28 deaths, and 1345 female cases with 38 deaths. Most of the cases occurred in preschool children (1349) and adolescent age group (1269). Organophosphate and carbamate insecticides were the cause of most poisonings (1130), leading to 34 deaths. The highest fatality rate (3.13%) was due to poisoning by herbicides and fungicides, causing 14 deaths out of 448 cases. Poisoning occurred mostly in rural areas (78%). And most pesticide poisoning occurred in the summer (896) and fall (811), while fewest poisoning cases in the winter (483) but with the highest fatality rate (3.52%). This study shows that pesticide poisoning of children is a major health problem in Zhejiang, suggesting preventive strategies should be conducted to control childhood pesticide poisoning.

  15. Pathology of arylmercurial poisoning in swine

    Energy Technology Data Exchange (ETDEWEB)

    Tryphonas, L.; Nielsen, N.O.

    1980-07-01

    To produce arylmercurial poisoning, phenyl-mercuric chloride (PMC) was administered daily to 30 healthy five week-old piglets for periods of up to 90 days. The dosage used ranged from 0.19 to 4.56 mg of mercury (Hg)/kg. Levels exceeding 2.28 mg Hg/kg daily were moderately toxic. The disease occurring in this intoxication resulted from injury to the kidneys and large intestine. Fetid diarrhea and failure to gain weight were consistent clinical signs. The primary gross lesions were necrotic typhlitis and colitis, and nephrosis. Degeneration and necrosis were found in affected organs. Regeneration was prominent in the proximal convoluted tubules. Tissue analysis for mercury suggested that only certain target organs, such as kidney and colon, accumulated significantly high levels of mercury. This, presumably, resulted from rapid metabolism of the compound and excretion of mercuric ion in the kidney and colon. The net effect was to spare other tissues, and to injure the excretory organs when the dose level was sufficiently high. 12 references, 9 figures, 5 tables.

  16. Photographic fixative poisoning

    Science.gov (United States)

    Photographic fixatives are chemicals used to develop photographs. This article discusses poisoning from swallowing such chemicals. This article is for information only. DO NOT use it to treat or manage an ...

  17. Asphalt cement poisoning

    Science.gov (United States)

    ... petroleum material that hardens when it cools. Asphalt cement poisoning occurs when someone swallows asphalt. If hot ... found in: Road paving materials Roofing materials Tile cements Asphalt may also be used for other purposes.

  18. Overview of Poisoning

    Science.gov (United States)

    ... Newspaper Paint (water color or water-based) Perfumes Petroleum jelly Plant food (household) Polyethylene glycols, such as ... reduces the severity of poisonings, particularly with acetaminophen , aspirin , or ibuprofen . The identifying marks printed on pills ...

  19. Cold wave lotion poisoning

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002693.htm Cold wave lotion poisoning To use the sharing features on this page, please enable JavaScript. Cold wave lotion is a hair care product used ...

  20. Cedar leaf oil poisoning

    Science.gov (United States)

    Cedar leaf oil is made from some types of cedar trees. Cedar leaf oil poisoning occurs when someone swallows this substance. ... The substance in cedar leaf oil that can be harmful is thujone (a hydrocarbon).