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Sample records for acute organophosphate poisoning

  1. Unequal Efficacy of Pyridinium Oximes in Acute Organophosphate Poisoning

    PubMed Central

    Antonijevic, Biljana; Stojiljkovic, Milos P.

    2007-01-01

    The use of organophosphorus pesticides results in toxicity risk to non-target organisms. Organophosphorus compounds share a common mode of action, exerting their toxic effects primarily via acetylcholinesterase (AChE) inhibition. Consequently, acetylcholine accumulates in the synaptic clefts of muscles and nerves, leading to overstimulation of cholinergic receptors. Acute cholinergic crisis immediately follows exposure to organophosphate and includes signs and symptoms resulting from hyperstimulation of central and peripheral muscarinic and nicotinic receptors. The current view of the treatment of organophosphate poisoning includes three strategies, i.e. the use of an anticholinergic drug (e.g., atropine), cholinesterase-reactivating agents (e.g., oximes) and anticonvulsant drugs (e.g., benzodiazepines). Oximes, as a part of antidotal therapy, ensure the recovery of phosphylated enzymes via a process denoted as reactivation of inhibited AChE. However, both experimental results and clinical findings have demonstrated that different oximes are not equally effective against poisonings caused by structurally different organophosphorus compounds. Therefore, antidotal characteristics of conventionally used oximes can be evaluated regarding how close the certain substance is to the theoretical concept of the universal oxime. Pralidoxime (PAM-2), trimedoxime (TMB-4), obidoxime (LüH-6), HI-6 and HLö-7 have all been demonstrated to be very effective in experimental poisonings with sarin and VX. TMB-4 and LüH-6 may reactivate tabun-inhibited AChE, whereas HI-6 possesses the ability to reactivate the soman-inhibited enzyme. An oxime HLö-7 seems to be an efficient reactivator of AChE inhibited by any of the four organophosphorus warfare agents. According to the available literature, the oximes LüH-6 and TMB-4, although relatively toxic, are the most potent to induce reactivation of AChE inhibited by the majority of organophosphorus pesticides. Since there are no reports of

  2. Organophosphate Poisoning and Subsequent Acute Kidney Injury Risk: A Nationwide Population-Based Cohort Study.

    PubMed

    Lee, Feng-You; Chen, Wei-Kung; Lin, Cheng-Li; Lai, Ching-Yuan; Wu, Yung-Shun; Lin, I-Ching; Kao, Chia-Hung

    2015-11-01

    Small numbers of the papers have studied the association between organophosphate (OP) poisoning and the subsequent acute kidney injury (AKI). Therefore, we used the National Health Insurance Research Database (NHIRD) to study whether patients with OP poisoning are associated with a higher risk to have subsequent AKI.The retrospective cohort study comprised patients aged ≥20 years with OP poisoning and hospitalized diagnosis during 2000-2011 (N = 8924). Each OP poisoning patient was frequency-matched to 4 control patients based on age, sex, index year, and comorbidities of diabetes, hypertension, hyperlipidemia, chronic obstructive pulmonary disease, coronary artery disease, and stroke (N = 35,696). We conducted Cox proportional hazard regression analysis to estimate the effects of OP poisoning on AKI risk.The overall incidence of AKI was higher in the patients with OP poisoning than in the controls (4.85 vs 3.47/1000 person-years). After adjustment for age, sex, comorbidity, and interaction terms, patients with OP poisoning were associated with a 6.17-fold higher risk of AKI compared with the comparison cohort. Patients with highly severe OP poisoning were associated with a substantially increased risk of AKI.The study found OP poisoning is associated with increased risk of subsequent AKI. Future studies are encouraged to evaluate whether long-term effects exist and the best guideline to prevent the continuously impaired renal function. PMID:26632728

  3. Increased Risk of Dementia in Patients With Acute Organophosphate and Carbamate Poisoning

    PubMed Central

    Lin, Jiun-Nong; Lin, Cheng-Li; Lin, Ming-Chia; Lai, Chung-Hsu; Lin, Hsi-Hsun; Yang, Chih-Hui; Kao, Chia-Hung

    2015-01-01

    Abstract Organophosphate (OP) and carbamate (CM) are the most commonly used pesticides against insects. Little is known regarding the relationship between dementia and acute OP and CM poisoning. A nationwide population-based cohort study was conducted from the National Health Insurance Research Database in Taiwan. The incidence and relative risk of dementia were assessed in patients hospitalized for acute OP and CM poisoning from 2000 to 2011. The comparison cohort was matched with the poisoned cohort at a 4:1 ratio based on age, sex, and the year of hospitalization. During the follow-up period, the incidence of dementia was 29.4 per 10,000 person-years in the poisoned group, and represented a 1.98-fold increased risk of dementia compared with the control cohort (95% confidence interval, 1.59–2.47). This study provides evidence on the association between dementia and acute OP and CM poisoning. Regular follow-up of poisoned patients for dementia is suggested. PMID:26200627

  4. Organophosphate and carbamate poisoning.

    PubMed

    King, Andrew M; Aaron, Cynthia K

    2015-02-01

    Organophosphates (OPs) and carbamates have a wide variety of applications, most commonly as pesticides used to eradicate agricultural pests or control populations of disease-carrying vectors. Some OP and carbamates have therapeutic indications such as physostigmine. Certain organophosphorus compounds, known as nerve agents, have been employed in chemical warfare and terrorism incidents. Both classes inhibit acetylcholinesterase (AChE) enzymes, leading to excess acetylcholine accumulation at nerve terminals. In the setting of toxicity from either agent class, clinical syndromes result from excessive nicotinic and muscarinic neurostimulation. The toxic effects from OPs and carbamates differ with respect to reversibility, subacute, and chronic effects. Decontamination, meticulous supportive care, aggressive antimuscarinic therapy, seizure control, and administration of oximes are cornerstones of management. PMID:25455666

  5. An electrophysiological study of the intermediate syndrome of organophosphate poisoning.

    PubMed

    Lorenzoni, Paulo José; Gasparetto, Juliano; Kay, Cláudia Suemi Kamoi; Scola, Rosana Herminia; Werneck, Lineu César

    2010-09-01

    Acute organophosphate (OP) poisoning is commonly seen in emergency medicine. Neurologists must be alert to detect neuromuscular transmission failure and other neurological complications that follow OP poisoning. We report a 37-year-old male with acute OP poisoning to emphasize the electrophysiological abnormalities during the intermediate syndrome (IMS). Motor nerve conduction studies revealed that a single nerve stimulation evoked a repetitive compound muscle action potential, whereas repetitive nerve stimulation resulted in a combination of a decrement-increment pattern and a repetitive fade response. Thus, electrophysiological studies can be used to monitor patients with IMS, and these test results correlate well with clinical findings in acute OP poisoning. PMID:20483619

  6. Detoxification of Organophosphate Poisoning Using Nanoparticle Bioscavengers.

    PubMed

    Pang, Zhiqing; Hu, Che-Ming J; Fang, Ronnie H; Luk, Brian T; Gao, Weiwei; Wang, Fei; Chuluun, Erdembileg; Angsantikul, Pavimol; Thamphiwatana, Soracha; Lu, Weiyue; Jiang, Xinguo; Zhang, Liangfang

    2015-06-23

    Organophosphate poisoning is highly lethal as organophosphates, which are commonly found in insecticides and nerve agents, cause irreversible phosphorylation and inactivation of acetylcholinesterase (AChE), leading to neuromuscular disorders via accumulation of acetylcholine in the body. Direct interception of organophosphates in the systemic circulation thus provides a desirable strategy in treatment of the condition. Inspired by the presence of AChE on red blood cell (RBC) membranes, we explored a biomimetic nanoparticle consisting of a polymeric core surrounded by RBC membranes to serve as an anti-organophosphate agent. Through in vitro studies, we demonstrated that the biomimetic nanoparticles retain the enzymatic activity of membrane-bound AChE and are able to bind to a model organophosphate, dichlorvos, precluding its inhibitory effect on other enzymatic substrates. In a mouse model of organophosphate poisoning, the nanoparticles were shown to improve the AChE activity in the blood and markedly improved the survival of dichlorvos-challenged mice. PMID:26053868

  7. Detoxification of Organophosphate Poisoning Using Nanoparticle Bioscavengers

    PubMed Central

    Pang, Zhiqing; Hu, Che-Ming J.; Fang, Ronnie H.; Luk, Brian T.; Gao, Weiwei; Wang, Fei; Chuluun, Erdembileg; Angsantikul, Pavimol; Thamphiwatana, Soracha; Lu, Weiyue; Jiang, Xinguo; Zhang, Liangfang

    2016-01-01

    Organophosphate poisoning is highly lethal as organophosphates, which are commonly found in insecticides and nerve agents, cause irreversible phosphorylation and inactivation of acetylcholinesterase (AChE), leading to neuromuscular disorders via accumulation of acetylcholine in the body. Direct interception of organophosphates in the systemic circulation thus provides a desirable strategy in treatment of the condition. Inspired by the presence of acetylcholinesterase on red blood cell (RBC) membranes, we explored a biomimetic nanoparticle consisting of a polymeric core surrounded by RBC membranes to serve as an anti-organophosphate agent. Through in vitro studies, we demonstrated that the biomimetic nanoparticles retain the enzymatic activity of membrane-bound AChE and are able to bind to a model organophosphate, dichlorvos, precluding its inhibitory effect on other enzymatic substrates. In a mouse model of organophosphate poisoning, the nanoparticles were shown to improve the AChE activity in the blood and markedly improved the survival of dichlorvos-challenged mice. PMID:26053868

  8. Possible role for anisodamine in organophosphate poisoning.

    PubMed

    Eisenkraft, Arik; Falk, Avshalom

    2016-06-01

    In cases of organophosphate poisoning, patients are treated with a combination of antidotes. In addition to these poison-directed antidotes, patients may require extra oxygen and artificial ventilation; other modalities may also be needed due to the wide range of toxic effects. Anisodamine is a belladonna alkaloid, and like other drugs from this family is non subtype-selective muscarinic, and a nicotinic cholinoceptor antagonist, which has been employed in traditional Chinese medicine. As a muscarinic antagonist, it displays similar pharmacological effects to atropine and scopolamine. However, anisodamine is not only less potent than atropine and scopolamine but also less toxic. Current in vitro and animal model studies have demonstrated that anisodamine has protective effects in a variety of diseases. Organophosphate poisoning involves not only the central and peripheral nervous systems, but also the cardiac and respiratory systems, as well as activation of inflammatory processes and oxidative stress. Therefore, the anticholinergic and additional activities of anisodamine appear to be relevant and justify its consideration as an addition to the existing remedies. However, more research is needed, as at present data on the role of anisodamine in the management of organophosphate poisoning are limited. Here, we review the beneficial effects of anisodamine on processes relevant to organophosphate poisoning. PMID:27010563

  9. Amitraz: a mimicker of organophosphate poisoning.

    PubMed

    Dhooria, Sahajal; Behera, Digambar; Agarwal, Ritesh

    2015-01-01

    Amitraz is used as an ectoparasiticide for dogs and cattle. Human poisoning due to amitraz may be misdiagnosed as organophosphate/carbamate (OPC) toxicity, since amitraz poisoning shares several clinical features (miosis, bradycardia and hypotension) encountered with OPC poisoning. A 19-year-old man with an alleged history of suicidal ingestion of a pesticide presented with drowsiness and was found to have constricted pupils, hypotension and bradycardia. He was diagnosed as a case of OPC poisoning and was treated with atropine and pralidoxime prior to presentation to our centre. Absence of a hypersecretory state, and the presence of hyperglycaemia and hypothermia along with a normal serum cholinesterase level suggested an alternate possibility. Retrieval of the poison container confirmed the diagnosis of amitraz poisoning. The patient made a rapid recovery with supportive management. Clinician awareness is key to successful management of this poisoning, which carries a good prognosis. PMID:26430228

  10. Coronary artery bypass grafting in a patient with organophosphate poisoning.

    PubMed

    Pieris, Rajeeva R; Fernando, Ravindra

    2015-01-01

    A 43-year-old male, with no previous history of mental illness, was diagnosed with coronary heart disease, after which he became acutely depressed and attempted suicide by ingesting an organophosphate pesticide. He was admitted to an intensive care unit and treated with pralidoxime, atropine, and oxygen. His coronary occlusion pattern required early coronary artery bypass grafting (CABG) surgery. His family, apprehensive of a repeat suicidal attempt, requested surgery be performed as soon as possible. He recovered well from the OP poisoning and was mentally fit to express informed consent 2 weeks after admission. Seventeen days after poisoning, he underwent coronary artery bypass grafting and recovered uneventfully. Six years later, he remains in excellent health. We report this case because to the best of our knowledge there is no literature regarding CABG performed soon after organophosphate poisoning. PMID:26334855

  11. [Acute poisoning by pesticides in children].

    PubMed

    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. PMID:27266642

  12. From organophosphate poisoning to diabetes mellitus: The incretin effect.

    PubMed

    Rathish, D; Agampodi, S B; Jayasumana, M A C S; Siribaddana, S H

    2016-06-01

    Organophosphate (OP) poisoning induced disruption of glucose homeostasis is well established. OP poisoning leads to accumulation of acetylcholine (ACh) due to the inhibition of acetylcholinesterases (AChE). On the other hand the incidence of type 2 diabetes mellitus (T2DM) is shown to rise along with the use of pesticides in Southeast Asia. Attenuation of the 'incretin effect' is seen in T2DM. This effect is regulated by a complex loop of mechanism involving ACh driven muscarinic receptors. We hypothesize that OP poisoning leads to disruption of glucose homeostasis by attenuation of the incretin effect. Inhibition of the Glucagon Like Peptide-1 (GLP-1) secretion is our main focus of interest. Positive finding of the hypothesis will open possibility of using incretin based treatment modalities to treat or prevent acute OP induced disruption of glucose homeostasis. PMID:27142144

  13. Comparison of two pre-exposure treatment regimens in acute organophosphate (paraoxon) poisoning in rats: Tiapride vs. pyridostigmine

    SciTech Connect

    Petroianu, G.A. . E-mail: georg.petroianu@uaeu.ac.ae; Hasan, M.Y.; Nurulain, S.M.; Arafat, K.; Sheen, R.; Nagelkerke, N.

    2007-03-15

    Recently, the FDA approved the medical use of oral pyridostigmine as prophylactic treatment of possible nerve agent exposure: the concept is to block the cholinesterase transitorily using the carbamate (pyridostigmine) in order to deny access to the active site of the enzyme to the irreversible inhibitor (nerve agent) on subsequent exposure. We have shown previously that tiapride is in vitro a weak inhibitor of acetylcholinesterase and that in rats administration of tiapride before the organophosphate paraoxon significantly decreases mortality. The purpose of the present study was to compare tiapride- and pyridostigmine-based pretreatment strategies, either alone or in combination with pralidoxime reactivation, by using a prospective, non-blinded study in a rat model of acute high-dose paraoxon exposure. Groups 1-6 received 1 {mu}Mol paraoxon ({approx} LD{sub 75}) groups 2-6 received in addition: G{sub 2} 50 {mu}Mol tiapride 30 min before paraoxon; G{sub 3} 50 {mu}Mol tiapride 30 min before paraoxon and 50 {mu}Mol pralidoxime 1 min after paraoxon; G{sub 4} 1 {mu}Mol pyridostigmine 30 min before paraoxon; G{sub 5} 1 {mu}Mol pyridostigmine 30 min before paraoxon and 50 {mu}Mol pralidoxime 1 min after paraoxon; G{sub 6} 50 {mu}Mol pralidoxime 1 min after paraoxon; Mortality data were compared using Kaplan-Meier plots and logrank tests. Mortality is statistically significantly influenced by all treatment strategies. Tiapride pretreatment followed by pralidoxime treatment (G{sub 3}) is aux par with pyridostigmine pretreatment followed by pralidoxime treatment (G{sub 5}). Tiapride pretreatment only (G{sub 2}) is inferior to pyridostigmine pretreatment only (G{sub 4}). The best results are achieved with pyridostigmine pretreatment only or pralidoxime treatment only (G{sub 4} and G{sub 6})

  14. Organophosphate poisoning in a group of replacement heifers and dry cows.

    PubMed Central

    Khan, O

    2001-01-01

    Terbufos ingestion caused acute organophosphate poisoning in 67 Holstein heifers and dry cows, 7 months to 5 years old. Overall mortality was 31%, with attack rates of 4% and 48% for the dry cows and heifers, respectively. Less severely affected animals were treated with atropine sulfate for 7 days. PMID:11467187

  15. Reprint of 'Evaluating organophosphate poisoning in human serum with paper'.

    PubMed

    Yen, Tzung-Hai; Chen, Kuan-Hung; Hsu, Min-Yen; Fan, Shu-Ting; Huang, Yu-Fen; Chang, Chia-Ling; Wang, Yu-Ping; Cheng, Chao-Min

    2015-12-01

    This manuscript describes the development and clinical testing of a paper-based, metabolic assay designed for rapid, semi-quantitative measurement of organophosphate poisoning. Paper-based platforms, including point-of-care devices and 96-well plates, provided semi-quantitative information regarding the concentration of AchE (a biomarker for organophosphate poisoning). The paper-based 96-well-plate developed and implemented in this study was used to measure the level of organophosphate poisoning in three different clinical patients. Results were comparable to those obtained using conventional hospital methods currently considered the "gold standard". This diagnostic device offers several advantages over conventional methods, including short operating time (twice as fast as conventional methods), procedure simplicity, and reduced fabrication cost. With further commercialization efforts, the methods described in this manuscript could be applied to a wide range of potential diagnostic applications in the field. PMID:26459445

  16. Clinical features of organophosphate poisoning: A review of different classification systems and approaches

    PubMed Central

    Peter, John Victor; Sudarsan, Thomas Isiah; Moran, John L.

    2014-01-01

    Purpose: The typical toxidrome in organophosphate (OP) poisoning comprises of the Salivation, Lacrimation, Urination, Defecation, Gastric cramps, Emesis (SLUDGE) symptoms. However, several other manifestations are described. We review the spectrum of symptoms and signs in OP poisoning as well as the different approaches to clinical features in these patients. Materials and Methods: Articles were obtained by electronic search of PubMed® between 1966 and April 2014 using the search terms organophosphorus compounds or phosphoric acid esters AND poison or poisoning AND manifestations. Results: Of the 5026 articles on OP poisoning, 2584 articles pertained to human poisoning; 452 articles focusing on clinical manifestations in human OP poisoning were retrieved for detailed evaluation. In addition to the traditional approach of symptoms and signs of OP poisoning as peripheral (muscarinic, nicotinic) and central nervous system receptor stimulation, symptoms were alternatively approached using a time-based classification. In this, symptom onset was categorized as acute (within 24-h), delayed (24-h to 2-week) or late (beyond 2-week). Although most symptoms occur with minutes or hours following acute exposure, delayed onset symptoms occurring after a period of minimal or mild symptoms, may impact treatment and timing of the discharge following acute exposure. Symptoms and signs were also viewed as an organ specific as cardiovascular, respiratory or neurological manifestations. An organ specific approach enables focused management of individual organ dysfunction that may vary with different OP compounds. Conclusions: Different approaches to the symptoms and signs in OP poisoning may better our understanding of the underlying mechanism that in turn may assist with the management of acutely poisoned patients. PMID:25425841

  17. Massive acute arsenic poisonings.

    PubMed

    Lech, Teresa; Trela, Franciszek

    2005-07-16

    Arsenic poisonings are still important in the field of toxicology, though they are not as frequent as about 20-30 years ago. In this paper, the arsenic concentrations in ante- and post-mortem materials, and also forensic and anatomo-pathological aspects in three cases of massive acute poisoning with arsenic(III) oxide (two of them with unexplained criminalistic background, in which arsenic was taken for amphetamine and one suicide), are presented. Ante-mortem blood and urine arsenic concentrations ranged from 2.3 to 6.7 microg/ml, respectively. Post-mortem tissue total arsenic concentrations were also detected in large concentrations. In case 3, the contents of the duodenum contained as much as 30.1% arsenic(III) oxide. The high concentrations of arsenic detected in blood and tissues in all presented cases are particularly noteworthy in that they are very rarely detected at these concentrations in fatal arsenic poisonings. PMID:15939162

  18. Paralytic ileus as a complication of atropine therapy following severe organophosphate poisoning.

    PubMed

    Beards, S C; Kraus, P; Lipman, J

    1994-09-01

    A 32-year-old man presented with symptoms of severe organophosphate poisoning and required an atropine infusion for 5 weeks. We believe the development of a paralytic ileus occurred as a rare feature of atropine toxicity when other signs were masked by the underlying condition. The onset of a paralytic ileus coincided with a spontaneous increase in red cell cholinesterase levels and may be an early sign of recovery from organophosphate poisoning. PMID:7978137

  19. Pipazethate--acute childhood poisoning.

    PubMed

    da Silva, O A; Lopez, M

    1977-01-01

    A previously healthy child who who had accidentally ingested an unknown quantity of 20-mg tablets of pipazethate developed severe acute poisoning with neurologic, metabolic, and cardiovascular disturbances. She recovered with symptomatic and supportive therapy. PMID:589958

  20. [Acute salicylate poisoning].

    PubMed

    Reingardiene, Dagmara; Lazauskas, Robertas

    2006-01-01

    Although aspirin (acetylsalicylic acid) has become widely available without prescription, cases of self-poisoning due to overdose of salicylates are quite uncommon, with a low reported mortality. However, severe poisoning with these preparations is life threatening. Besides the aspirin, there are other sources of salicylate poisoning, such as an excessive application of topical agents, ingestion of salicylate containing ointments, use of keratolytic agents or agents containing methyl salicylate (e.g. oil of wintergreen). Most of these preparations are liquid, highly concentrated and lipid soluble, and, therefore, they are able to provoke a severe, rapid salicylate poisoning. On the basis of clinical and metabolic features or salicylate concentration in plasma it is very important to diagnose severe poisoning with salicylates in time and prescribe an adequate treatment. In the present review article various aspects of salicylate poisoning and its treatment are discussed: epidemiology, pharmacokinetics and pharmacodynamics of salicylates, clinical manifestations of their toxicity, management, enhanced elimination and prognosis. PMID:16467617

  1. Performance Assessment of the SOFA, APACHE II Scoring System, and SAPS II in Intensive Care Unit Organophosphate Poisoned Patients

    PubMed Central

    Kim, Yong Hwan; Yeo, Jung Hoon; Kang, Mun Ju; Cho, Kwang Won; Hwang, SeongYoun; Hong, Chong Kun; Lee, Young Hwan; Kim, Yang Weon

    2013-01-01

    This study assessed the ability of the Sequential Organ Failure Assessment (SOFA) and Acute Physiology, Chronic Health Evaluation (APACHE) II scoring systems, as well as the Simplified Acute Physiology Score (SAPS) II method to predict group mortality in intensive care unit (ICU) patients who were poisoned with organophosphate. The medical records of 149 organophosphate poisoned patients admitted to the ICU from September 2006 to December 2012 were retrospectively examined. The SOFA, APACHE II, and SAPS II were calculated based on initial laboratory data in the Emergency Department, and during the first 24 hr of ICU admission. The probability of death was calculated for each patient based on the SOFA score, APACHE II score, and SAPS II equations. The ability to predict group mortality by the SOFA score, APACHE II score, and SAPS II method was assessed using two by two decision matrices and receiver operating characteristic (ROC) curve analysis. A total of 131 patients (mean age, 61 yr) were enrolled. The sensitivities, specificities, and accuracies were 86.2%, 82.4%, and 83.2% for the SOFA score, respectively; 65.5%, 68.6%, and 67.9% for the APACHE II scoring system, respectively; and 86.2%, 77.5%, and 79.4% for the SAPS II, respectively. The areas under the curve in the ROC curve analysis for the SOFA score, APACHE II scoring system, and SAPS II were 0.896, 0.716, and 0.852, respectively. In conclusion, the SOFA, APACHE II, and SAPS II have different capability to discriminate and estimate early in-hospital mortality of organophosphate poisoned patients. The SOFA score is more useful in predicting mortality, and easier and simpler than the APACHE II and SAPS II. PMID:24339715

  2. Intranasal delivery of obidoxime to the brain prevents mortality and CNS damage from organophosphate poisoning.

    PubMed

    Krishnan, Jishnu K S; Arun, Peethambaran; Appu, Abhilash P; Vijayakumar, Nivetha; Figueiredo, Taíza H; Braga, Maria F M; Baskota, Sudikshya; Olsen, Cara H; Farkas, Natalia; Dagata, John; Frey, William H; Moffett, John R; Namboodiri, Aryan M A

    2016-03-01

    Intranasal delivery is an emerging method for bypassing the blood brain barrier (BBB) and targeting therapeutics to the CNS. Oximes are used to counteract the effects of organophosphate poisoning, but they do not readily cross the BBB. Therefore, they cannot effectively counteract the central neuropathologies caused by cholinergic over-activation when administered peripherally. For these reasons we examined intranasal administration of oximes in an animal model of severe organophosphate poisoning to determine their effectiveness in reducing mortality and seizure-induced neuronal degeneration. Using the paraoxon model of organophosphate poisoning, we administered the standard treatment (intramuscular pralidoxime plus atropine sulphate) to all animals and then compared the effectiveness of intranasal application of obidoxime (OBD) to saline in the control groups. Intranasally administered OBD was effective in partially reducing paraoxon-induced acetylcholinesterase inhibition in the brain and substantially reduced seizure severity and duration. Further, intranasal OBD completely prevented mortality, which was 41% in the animals given standard treatment plus intranasal saline. Fluoro-Jade-B staining revealed extensive neuronal degeneration in the surviving saline-treated animals 24h after paraoxon administration, whereas no detectable degenerating neurons were observed in any of the animals given intranasal OBD 30min before or 5min after paraoxon administration. These findings demonstrate that intranasally administered oximes bypass the BBB more effectively than those administered peripherally and provide an effective method for protecting the brain from organophosphates. The addition of intranasally administered oximes to the current treatment regimen for organophosphate poisoning would improve efficacy, reducing both brain damage and mortality. PMID:26751814

  3. [Acute phostoxin poisoning].

    PubMed

    Idali, B; Miguil, M; Moutawakkil, S; Bouaggad, A; Guartit, A; Abassi, O; Ben Aguida, M

    1995-04-01

    Phostoxin is a mixture of aluminium phosphide and ammonium carbonate. When exposed to water, it releases phosphorus hydrogen (PH3), a highly-poisonous gas. In Morocco, death rate from suicide due to self-administration of phostoxin pills is high. Clinical signs include abrupt digestive and nervous disorders. Pulmonary oedema or cardiogenic shock dominate early prognosis. Liver and renal damage is secondary. Prevention requires both legal constraints and regulation of sales. PMID:7761363

  4. NMDA antagonists exert distinct effects in experimental organophosphate or carbamate poisoning in mice

    SciTech Connect

    Dekundy, Andrzej . E-mail: andrzej.dekundy@merz.de; Kaminski, Rafal M.; Zielinska, Elzbieta; Turski, Waldemar A.

    2007-03-15

    Organophosphate (OP) and carbamate acetylcholinesterase (AChE) inhibitors produce seizures and lethality in mammals. Anticonvulsant and neuroprotective properties of N-methyl-D-aspartate (NMDA) antagonists encourage the investigation of their effects in AChE inhibitor-induced poisonings. In the present study, the effects of dizocilpine (MK-801, 1 mg/kg) or 3-((RS)-2-carboxypiperazin-4-yl)-propyl-1-phosphonic acid (CPP, 10 mg/kg), alone or combined with muscarinic antagonist atropine (1.8 mg/kg), on convulsant and lethal properties of an OP pesticide dichlorvos or a carbamate drug physostigmine, were studied in mice. Both dichlorvos and physostigmine induced dose-dependent seizure activity and lethality. Atropine did not prevent the occurrence of convulsions but decreased the lethal effects of both dichlorvos and physostigmine. MK-801 or CPP blocked or attenuated, respectively, dichlorvos-induced convulsions. Contrariwise, NMDA antagonists had no effect in physostigmine-induced seizures or lethality produced by dichlorvos or physostigmine. Concurrent pretreatment with atropine and either MK-801 or CPP blocked or alleviated seizures produced by dichlorvos, but not by physostigmine. Both MK-801 and CPP co-administered with atropine enhanced its antilethal effects in both dichlorvos and physostigmine poisoning. In both saline- and AChE inhibitor-treated mice, no interaction of the investigated antidotes with brain cholinesterase was found. The data indicate that both muscarinic ACh and NMDA receptor-mediated mechanisms contribute to the acute toxicity of AChE inhibitors, and NMDA receptors seem critical to OP-induced seizures.

  5. A comprehensive review on experimental and clinical findings in intermediate syndrome caused by organophosphate poisoning

    SciTech Connect

    Abdollahi, Mohammad Karami-Mohajeri, Somayyeh

    2012-02-01

    Acute organophosphate (OP) intoxication is important because of its high morbidity and mortality and occurrence of muscular paralysis associated by inhibition of acetylcholinesterase (AChE) activity at the neuromuscular junction. Cholinergic crisis, intermediate syndrome (IMS), and OP-induced delayed neuropathy (OPIDN) are the evidences that can be observed in OP intoxication. The main cause of morbidity due to OP poisoning is IMS that occurs 24–96 h after poisoning. Mechanisms underlying the IMS are not fully known. Although the electrophysiological aspects of delayed neuropathy are best characterized, the IMS remain very little studied. The aim of this study was to revisit current knowledge related to OP and the IMS. For this purpose, a systematic review without date limitation was performed. A total of 599 relevant articles were found and reviewed. Data were categorized according to experimental and clinical studies. Occurrences of persistent AChE inhibition, electromyography changes, muscle cell injury, and oxidative stress are the most important pieces of evidence for involvement of IMS in OP toxicity. Delayed AChE inhibition, muscle necrosis, down regulation or desensitization of postsynaptic ACh receptors, failure of postsynaptic ACh release, and oxidative stress-related myopathy are involved in IMS. Toxicokinetic factors, such as a high lipid-solubility, duration of AChE inhibition and metabolite excretion, evolution of alterations on repetitive nerve stimulation (RNS), type and frequency of muscle lesions can estimate the probability of the IMS. Plasma AChE of less than 200 units is a predictor and the 30 Hz RNS decremental response could be a useful marker for the IMS.

  6. Predicting Outcome in Acute Organophosphorus Poisoning with a Poison Severity Score or the Glasgow Coma Scale

    PubMed Central

    Davies, James O. J.; Eddleston, Michael; Buckley, Nick A.

    2008-01-01

    Background: Organophosphorus pesticide poisoning kills around 200,000 people each year, principally due to self poisoning in the Asia-Pacific region. Aim: We wished to assess whether patients at high risk of death could be identified accurately using clinical parameters soon after hospital admission. Design: We evaluated the usefulness of the International Program on Chemical Safety Poison Severity Score (IPCS PSS) and the Glasgow Coma Score (GCS) prospectively for predicting death in patients poisoned by organophosphorus pesticides. Methods: Data were collected as part of a multicentre cohort study in Sri Lanka. Study doctors saw all patients on admission, collecting data on pulse, blood pressure, pupil size, need for intubation, and GCS. Results: 1365 patients with a history of acute organophosphorus poisoning were included. Receiver operating characteristic (ROC) curves were calculated for the IPCS PSS and GCS on admission. The IPCS PSS and GCS had similar ROC area under the curves (AUC) and best cut points as determined by Youden's index (AUC/sensitivity/specificity 0.81/0.78/0.79 for IPCS PSS ≥ grade 2 and 0.84/0.79/0.79 for GCS ≤13). The predictive value varied with the pesticide ingested, being more accurate for dimethoate poisoning and less accurate for fenthion poisoning (GCS AUC 0.91 compared to 0.69). Conclusions: GCS and the IPCS PSS were similarly effective at predicting outcome. Patients presenting with a GCS ≤ 13 need intensive monitoring and treatment. However, the identity of the organophosphate must be taken into account since the half of all patients who died from fenthion poisoning only had mild symptoms at presentation. PMID:18319295

  7. Nosocomial poisoning associated with emergency department treatment of organophosphate toxicity--Georgia, 2000.

    PubMed

    Geller, R J; Singleton, K L; Tarantino, M L; Drenzek, C L; Toomey, K E

    2001-01-01

    Emergency department (ED) staff caring for patients contaminated with toxic chemicals are at risk for developing toxicity from secondary contamination. This report describes three cases of occupational illnesses associated with organophosphate toxicity caused by exposure to a contaminated patient and underscores the importance of using personal protection equipment (PPE) and establishing and following decontamination procedures in EDs and other areas of acute care hospitals. PMID:11327219

  8. Nosocomial poisoning associated with emergency department treatment of organophosphate toxicity--Georgia, 2000.

    PubMed

    2001-01-01

    Emergency department (ED) staff caring for patients contaminated with toxic chemicals are at risk for developing toxicity from secondary contamination. This report describes three cases of occupational illnesses associated with organophosphate toxicity caused by exposure to a contaminated patient and underscores the importance of using personal protection equipment (PPE) and establishing and following decontamination procedures in EDs and other areas of acute care hospitals. PMID:11198947

  9. Acute poisoning with Tricholoma equestre.

    PubMed

    Anand, Jacek Sein; Chwaluk, Paweł; Sut, Michał

    2009-01-01

    Four cases, including three adults and one child, suffering from acute poisoning with Tricholoma equestre were described. The patients had eaten from 100 to 400 grams of the mushroom within a few consecutive meals. After consuming about 1000 grams of Tricholoma equestre for 3-4 days, the subjects developed fatigue, muscle weakness, myalgia, and in two cases acute respiratory failure with the need of respiratorotherapy. Maximal serum CK was 48136 U/L in the adults and 306 U/L in children. Maximal serum levels of AST and ALT were 802 U/L and 446 U/L in adults and 39 U/L, and 56 U/L in a child. All routine biochemical tests were within normal range. No other causes of rhabdomyolysis such as parasitic or viral infections, immune diseases, trauma or exposure to medications were found. Patient, aged 72 yrs., who developed acute respiratory failure, died in the second day of hospitalization. In other patients all the above mentioned symptoms and biochemical abnormalities disappeared from 2 to 3 weeks of hospitalization. Physicians should be aware of the possibility of appearance of rhabdo-myolysis after repeated consumption of large quantities of Tricholoma equestre. PMID:19788144

  10. [Optic neuropathy in acute poisoning with methanol].

    PubMed

    Sekkat, A; Maillard, P; Dupeyron, G; Bensouda, J; Arne, J L; Bec, P

    1982-01-01

    The authors report four cases of methanol poisoning, two of which suffering acute bilateral optic neuropathy which secondarily leads to optic atrophy. The report the main clinical features of such a poisoning and the actual basis of its physiopathology and treatment. According to the four cases reported, they underline the importance of early diagnosis and specific treatment. PMID:7169508

  11. Profile of acute mixed organophosphorus poisoning.

    PubMed

    Thunga, Girish; Sam, Kishore Gnana; Khera, Kanav; Xavier, Vidya; Verma, Murlidhar

    2009-06-01

    Organophosphorus (OP) pesticide self-poisoning is a major clinical and public health problem across much of rural Asia and responsible for two thirds of suicidal deaths. However, clinical reports or evidence for the management of mixed poisoning are lacking. Patients are often treated based on the type of symptoms they exhibit, and there are no specific guidelines available to treat mixed poisoning. In this case series, we report 3 acute OP poisoning cases with mixed poisons such as organochlorine, fungicide, copper sulfate, and kerosene. All 3 patients were treated successfully, with a greater focus on OP poisoning with pralidoxime and atropine infusion along with standard decontamination procedures. Because patients developed complications due to the concomitant poisons ingested, they were later treated symptomatically, and in one case, D-penicillamine was administered as antidote for copper poisoning. Mixed poisoning especially with OP compounds makes the diagnosis difficult because the clinical symptoms of OP predominate, whereas damage produced by other pesticides is late to develop and often neglected. Common treatment procedures are focused mainly on the OP poisoning ignoring the complications of other concomitant pesticides ingested. Treating physicians should be prepared and consider the possibility of mixed poisoning prevalent in that region before initiating therapy. PMID:19497478

  12. Organophosphate poisoning.

    PubMed

    Gerald, Daniel R

    2002-11-01

    Stay safe! Certain scenes and scenarios invite a greater degree of caution. Wear protective gear (Level B for decon) and make sure the patient is hazmat-naked prior to decontamination. Use tincture of green soap or household dishwashing soap to decontaminate your patient. Maintain the patient's airway using oral/nasal airways; intubate if indicated. Give high-flow oxygen by nonrebreather oxygen mask or, if intubated, with a bagh-valve mask. Treat for shock by maintaining the patient's body temperature, keeping them supine if they will tolerate it, and gaining i.v. access. Administer oxygen, atropine, pralidoxime chloride and diazepam as required. Notify the ED and transport rapidly. If it is a terrorist incident, get your patient and get out. PMID:12440317

  13. The Long-Term Effects of Organophosphates Poisoning as a Risk Factor of CVDs: A Nationwide Population-Based Cohort Study

    PubMed Central

    Lin, Cheng-Li; Chang, Shih-Yu; Sung, Fung-Chang; Tai, Sally C. W.

    2015-01-01

    Background Organophosphorus pesticides are widely used throughout the world. Because of their ease of availability, organophosphorus compounds are commonly used for self-poisoning in developing countries. The acute effects of exposure to organophosphorus pesticides are well known, but the chronic effects are unclear. Recent studies suggest that abnormalities of the central and peripheral nervous systems persisted for up to 5 years after acute poisoning due to a single large dose of organophosphates (OPs). However, the long-term effects on cardiovascular diseases are poorly understood. Methodology/Principal Findings An OPs-exposed cohort (N = 7,561) and an age- and gender-matched control cohort (N = 30,244), both identified from the National Health Insurance Research Database, were compared. We utilized the multivariable Cox proportional model to estimate the risks of developing arrhythmia, coronary artery disease (CAD) and congestive heart failure (CHF). The patients with acute poisoning from OPs had higher incidence rates of arrhythmia (5.89 vs. 3.61 per 1,000 person-years), CAD (9.10 vs. 6.88 per 1,000 person-years), and CHF (3.89 vs. 2.98 per 1,000 person-years) compared with that of the non-OPs poisoning cohort, with a crude subhazard ratio (SHR) of 1.40, 1.13, and 1.12, respectively. Additionally, a significantly higher risk of arrhythmia was observed in the OPs poisoning cohort (adjusted SHR = 1.25) compared with the non-OPs poisoning cohort, particularly in male patients (adjusted SHR = 1.33) and those under 49 years of age (adjusted SHR = 3.16). After accounting for the competing risks of death, there was a higher risk of arrhythmia and CAD during a three year follow-up period (adjusted SHR = 1.50 for arrhythmia; adjusted SHR = 1.10 for CAD). We also found an adjusted SHR of 1.36 associated with developing CHF after 6 years of follow-up for OPs poisoning cohort. Conclusions Acute OPs poisoning may continuously impact human health through mechanisms that are

  14. Zebrafish Models for Human Acute Organophosphorus Poisoning

    PubMed Central

    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

    2015-01-01

    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. PMID:26489395

  15. Zebrafish Models for Human Acute Organophosphorus Poisoning.

    PubMed

    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

    2015-01-01

    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. PMID:26489395

  16. Pattern of acute poisonings in children below 15 years--a study from Mangalore, South India.

    PubMed

    Ram, Pradhum; Kanchan, Tanuj; Unnikrishnan, B

    2014-07-01

    Acute poisoning in children is a problem ubiquitous in distribution and is an important paediatric emergency. The present research was aimed to study the pattern and outcome of childhood poisoning under the age of 15 years at a tertiary care centre in South India to characterize the problem of acute paediatric poisoning among the children in different age group in the region. Medical records of all poisoning patients admitted during 2010 and 2011 were reviewed, and the information relating to the sociodemographic and clinical profile of the patients was recorded. Acute poisoning was reported in 81 children aged below 15 years during the study period. 50.6% were boys (n = 41) and 49.4% girls (n = 40). The mean age of the study sample was 6.8 years. Mean age was observed to be higher in females than males. The maximum number of cases were observed in the below 5 years age group (n = 45). A male predominance was evident in the below 5 years age group, while a female predominance in the age group between 10 and 15 years. Kerosene (n = 23, 28.4%) and organophosphate compounds (n = 16, 19.8%) were the most common agents responsible for poisoning in children. The majority of the poisoning cases were reported to the hospital within 12 h of the incident (n = 65, 83.3%). The mortality in paediatric poisoning was observed to be 7.4%. The majority of the children (n = 68, 84.0%) recovered, while seven patients had left the hospital against medical advice (8.6%). The study reports agrochemicals and hydrocarbons to be the most commonly implicated agents in paediatric poisoning. The cause of paediatric poisonings varies in different age groups and hence, preventive strategies should be planned accordingly. PMID:24931857

  17. Acute Poisoning in Children in Bahia, Brazil

    PubMed Central

    Rodrigues Mendonça, Dilton; Menezes, Marta Silva; Matos, Marcos Antônio Almeida; Rebouças, Daniel Santos; Filho, Jucelino Nery da Conceição; de Assis, Reginara Souza; Carneiro, Leila

    2016-01-01

    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%). PMID:27335994

  18. Acute Poisoning in Children in Bahia, Brazil.

    PubMed

    Rodrigues Mendonça, Dilton; Menezes, Marta Silva; Matos, Marcos Antônio Almeida; Rebouças, Daniel Santos; Filho, Jucelino Nery da Conceição; de Assis, Reginara Souza; Carneiro, Leila

    2016-01-01

    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%). PMID:27335994

  19. Acute renal dysfunction in acetaminophen poisoning.

    PubMed

    Mour, Girish; Feinfeld, Donald A; Caraccio, Thomas; McGuigan, Michael

    2005-01-01

    Although acetaminophen (APAP)-associated liver injury is well recognized, there are few reports describing APAP nephrotoxicity, and most of them are single cases. It has also been suggested that N-acetylcysteine (NAC), used to treat the hepatotoxicity, may be harmful to the kidneys. To examine this contention and to determine whether renal involvement in APAP poisoning is at all common, we analyzed the incidence and outcome of acute renal dysfunction in patients hospitalized for APAP overdose reported to our regional poison center over a year. Eleven APAP-poisoned patients had elevated liver function tests; nine of them had azotemia. Those with higher AST levels tended to be younger and to have lower APAP levels on admission. Two patients with acute renal injury died after admission. The other seven patients with renal dysfunction recovered in 2 to 7 days. Six of these received NAC; their mean serum creatinine fell from 3.2 +/- 2.0 versus 1.7 +/- 0.9 mg/dL (p < 0.05). We conclude that acute renal failure is not uncommon in APAP poisoning and appears to be unrelated to the degree of liver injury. NAC therapy did not seem to worsen nephrotoxicity. PMID:16060123

  20. Acute poisonings and sudden deaths in Crete: a five-year review (1991-1996).

    PubMed

    Christakis-Hampsas, M; Tutudakis, M; Tsatsakis, A M; Assithianakis, P; Alegakis, A; Katonis, P G; Michalodimitrakis, E N

    1998-08-01

    Fatal and non-fatal acute poisonings and other sudden deaths examined in the Toxicology Laboratory of University Hospital of Iraklion, Crete, from 1991 to 1996 mainly involved the abuse of drugs (heroin, flunitrazepam and other psychoactive substances), accidental poisonings or suicide attempts with pesticides (carbamates, organophosphates, paraquat), other chemicals (cyanide salts, paint thinner, chlorine), traffic accidents, drownings and violent deaths (gunshots). Many of the cases were related to poisonous gases or volatiles (carbon monoxide, methylbromide). Fatalities due to alcohol and methylene-dioxy-ethyl amphetamine were also examined. Amphetamine and alcohol-related deaths due to drowning were more recent. A significant number of cases were related to the accidental ingestion of alcohol, drugs or suicide attempts by children. Some of the cases were treated successfully in various Cretan hospitals, while others had fatal outcomes due to late hospital admission. PMID:9682411

  1. Acute endosulfan poisoning: a retrospective study.

    PubMed

    Moon, Jeong Mi; Chun, Byeong Jo

    2009-05-01

    Endosulfan is a widely used insecticide that is associated with a high fatality rate in humans when ingested accidentally or with the aim of suicide. However, the literature concerning human endosulfan exposure is limited to case reports. Thus, we sought to 1) describe the clinical features of patients with acute endosulfan poisoning and 2) identify independent factors to predict patients' outcome. Fifty-two patients who presented with acute endosulfan poisoning between January 2001 and January 2007 were enrolled in this retrospective study. Sixteen (30.7%) of the 52 patients died, and 48 patients experienced seizures. Endosulfan poisoning caused the hypotension and the abnormalities on electrocardiogram at presentation. Over half of the patients developed complications, such as rhabdomyolysis, hepatic toxicity, and hypotension. These complications resolved without sequelae in the survival group. Refractory status epilepticus was the most common cause of death in this series (75.0%). Amount ingested being greater than 35 g of endosulfan was the most found to be an independent variable that predicted patient mortality. Patients with this risk factor must be treated aggressively during the early stage of endosulfan poisoning. PMID:19755461

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

    PubMed Central

    Greene, S; Dargan, P; Jones, A

    2005-01-01

    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. PMID:15811881

  3. Acute Lead Poisoning In an Infant

    PubMed Central

    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 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. PMID:22400095

  4. Cortical blindness in acute carbon monoxide poisoning.

    PubMed

    Katafuchi, Y; Nishimi, T; Yamaguchi, Y; Matsuishi, T; Kimura, Y; Otaki, E; Yamashita, Y

    1985-01-01

    A 3-year-old boy had persistent cortical blindness following acute carbon monoxide poisoning. He was believed to have suffered anoxic brain damage due to incomplete combustion of the briquette-type solid fuel. Computed tomographic (CT) scan of the brain and visual evoked potentials (VEP) in the early stage were normal. However, on the 20th hospital day CT scan showed leukomalacia and VEP showed an absence of N1-, and P1-waves which was well correlated with the clinical feature at that time. PMID:4083389

  5. Acute arsenic poisoning in two siblings.

    PubMed

    Lai, Melisa W; Boyer, Edward W; Kleinman, Monica E; Rodig, Nancy M; Ewald, Michele Burns

    2005-07-01

    We report a case series of acute arsenic poisoning of 2 siblings, a 4-month-old male infant and his 2-year-old sister. Each child ingested solubilized inorganic arsenic from an outdated pesticide that was misidentified as spring water. The 4-month-old child ingested a dose of arsenic that was lethal despite extraordinary attempts at arsenic removal, including chelation therapy, extracorporeal membrane oxygenation, exchange transfusion, and hemodialysis. The 2-year-old fared well with conventional therapy. PMID:15995066

  6. Clinical Significance of National Patients Sample Analysis: Factors Affecting Mortality and Length of Stay of Organophosphate and Carbamate Poisoned Patients

    PubMed Central

    Kim, Kyoung-Ho; Lee, Jun Yeob; Yeo, Woon Hyung; Park, Ha Young; Park, Kyung Hye; Cho, Junho; Kim, Hyunjong; Kim, Gun Bea; Park, Deuk Hyun; Yoon, Yoo Sang; Kim, Yang Weon

    2013-01-01

    Objectives This study considered whether there could be a change of mortality and length of stay as a result of inter-hospital transfer, clinical department, and size of hospital for patients with organophosphates and carbamates poisoning via National Patients Sample data of the year 2009, which was obtained from Health Insurance Review and Assessment Services (HIRA). The utility and representativeness of the HIRA data as the source of prognosis analysis in poisoned patients were also evaluated. Methods Organophosphate and carbamate poisoned patients' mortality and length of stay were analyzed in relation to the initial and final treating hospitals and departments, as well as the presence of inter-hospital transfers. Results Among a total of 146 cases, there were 17 mortality cases, and the mean age was 56.8 ± 19.2 years. The median length of stay was 6 days. There was no inter-hospital or inter-departmental difference in length of stay. However, it significantly increased when inter-hospital transfer occurred (transferred 11 days vs. non-transferred 6 days; p = 0.037). Overall mortality rate was 11.6%. The mortality rate significantly increased when inter-hospital transfer occurred (transferred 23.5% vs. non-transferred 7.0%; p = 0.047), but there was no statistical difference in mortality on inter-hospital and inter-department comparison at the initial treating facility. However, at the final treating facility, there was a significant difference between tertiary and general hospitals (5.1% for tertiary hospitals and 17.3% for general hospitals; p = 0.024), although there was no significant inter-departmental difference. Conclusions We demonstrated that hospital, clinical department, length of stay, and mortality could be analyzed using insurance claim data of a specific disease group. Our results also indicated that length of stay and mortality according to inter-hospital transfer could be analyzed, which was previously unknown. PMID:24523992

  7. Acute Pancreatitis Caused By Mushroom Poisoning

    PubMed Central

    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

  8. [Neurologic disorders in acute dichloroethane poisoning].

    PubMed

    Akimov, G A; Buchko, V M; Kolesnichenko, I P

    1978-01-01

    The paper deals with a study of the nervous system in 121 patients with acute poisening with dichlorethane. Among the studied contingent there were 110 males and 11 females. According to the severity of the intoxication the patients were divided into 3 groups: mild--23 cases, moderate--11 cases, severe--87 cases. The following 6 neurological syndromes were distinguished: comatose, convulsive, atactic, extrapyramidal, psychotic and asthenic with vegetative-vascular insufficiency. Morphological studies detected the following: congestion plethora, vascular dystonia, microfoci hemorrhages, acute swelling of the nervous cells with signs of chromatolyses, shrunk cells, severe and ischemic change of the nervous cells. The treatment consisted in an accelerated elimination of dichlorethane from the organism and symptomatic therapy. The results of these studies demonstrated that in poisoning with dichlorethane there were diffuse, mainly dystrophic changes in the cells of the brain and spinal cord, which clinically may be expressed by symptoms of a lesion of many systems and may be qualified as toxic encephalomyelopathy. PMID:665065

  9. Acute carbon monoxide poisoning alters hemorheological parameters in human.

    PubMed

    Ozturk, Baris; Arihan, Okan; Coskun, Figen; Dikmenoglu-Falkmarken, Neslihan H

    2016-01-01

    Acute carbon monoxide (CO) poisoning seriously hinders oxygen delivery to tissues. This harmful effect of CO may be aggravated by accompanying changes in the viscosity of blood. We had previously reported increased plasma viscosity in people chronically exposed to CO. This study was planned to test our hypothesis that acute CO poisoning increases blood viscosity. For this purpose four main parameters contributing to blood viscosity - hematocrit, erythrocyte deformability, erythrocyte aggregation and plasma viscosity - were determined in patients with acute CO poisoning and compared with healthy controls. Plasma viscosity and erythrocyte aggregation tendency were lower in the CO group (p <  0.05). Erythrocyte deformability was also lower in CO group (p <  0.05). Our results indicate that acute CO poisoning has diverse effects on hemorheological parameters such as attenuating hematocrit value, plasma viscosity, erythrocyte aggregation tendency and erythrocyte deformability. PMID:25536918

  10. Carbon monoxide poisoning and nonoliguric acute renal failure.

    PubMed Central

    Bessoudo, R.; Gray, J.

    1978-01-01

    Carbon monoxide poisoning in a 37-year-old man was complicated by neurologic damage, skin changes, muscle necrosis and nonoliguric renal failure. The relation between nontraumatic rhabdomyolysis and acute renal failure in carbon monoxide poisoning is reviewed. Recognition of the acute renal failure in such cases is important, for this complication can be fatal; the prognosis is excellent, however, if proper medical management is provided. PMID:679099

  11. Escin attenuates cerebral edema induced by acute omethoate poisoning.

    PubMed

    Wang, Tian; Jiang, Na; Han, Bing; Liu, Wenbo; Liu, Tongshen; Fu, Fenghua; Zhao, Delu

    2011-06-01

    Organophosphorus exposure affects different organs such as skeletal muscles, the gastrointestinal tract, liver, lung, and brain. The present experiment aimed to evaluate the effect of escin on cerebral edema induced by acute omethoate poisoning. Sprague-Dawley rats were administered subcutaneously with omethoate at a single dose of 60 mg/kg followed by escin treatment. The results showed that escin reduced the brain water content and the amount of Evans blue in omethoate-poisoned animals. Treatment with escin decreased the levels of tumor necrosis factor-alpha (TNF-α), matrix metalloproteinase-9 (MMP-9), cyclooxygenase-2 (COX-2), and prostaglandin E₂ (PGE₂) in the brain. Escin also alleviated the histopathological change induced by acute omethoate poisoning. The findings demonstrated that escin can attenuate cerebral edema induced by acute omethoate poisoning, and the underlying mechanism was associated with ameliorating the permeability of the blood-brain barrier. PMID:21417632

  12. Application of high-performance thin-layer chromatography for the detection of organophosphorus insecticides in human serum after acute poisoning.

    PubMed

    Futagami, K; Narazaki, C; Kataoka, Y; Shuto, H; Oishi, R

    1997-12-19

    We developed a rapid and simple method for identifying 25 commonly used organophosphorus insecticides in human serum using high-performance thin-layer chromatography (HPTLC). These organophosphates were separated on plates with three different developing systems within 6-18 min and detected by means of ultraviolet radiation and coloring reactions with 4-(4-nitrobenzyl)pyridine-tetraethylenepentamine reagent (NT reagent) or palladium chloride reagent (PdCl2 reagent). Each organophosphate was accurately identified by means of the R(F) x 100 value and the spot color in three systems. The detection limits of dichlorvos, fenitrothion, malathion, methidathion, parathion and trichlorfon in serum by the liquid-liquid extraction method were 1.1, 0.12, 0.12, 0.05, 0.6 and 0.1 microg/ml, respectively. These sensitivities may be sufficient to detect those organophosphates in patient serum after acute poisoning. PMID:9518173

  13. Acute diquat poisoning with intracerebral bleeding

    PubMed Central

    Saeed, S; Wilks, M; Coupe, M

    2001-01-01

    A case of severe diquat poisoning complicated by the development of aggressive behaviour, oliguric renal failure, and intracerebral bleeding is described. The patient was successfully managed and made a complete recovery. In this paper special attention has been given to the major clinical differences between diquat and paraquat intoxication.


Keywords: poisoning; diquat; paraquat PMID:11320278

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

    PubMed Central

    Jensen, Hanne Klith; Konradsen, Flemming; Jørs, Erik; Petersen, Jørgen Holm; Dalsgaard, Anders

    2011-01-01

    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. PMID:21234245

  15. [Acute cyanide poisoning in an infant].

    PubMed

    Haasnoot, K; van Vught, A J; Meulenbelt, J; Bergman, L R

    1989-09-01

    An infant of 9 months was admitted to hospital in comatose condition; cyanide poisoning was suspected. This poisoning was caused by the desorption of hydrocyanic acid from building materials after the house had been fumigated with hydrocyanic acid under strict supervision and observed safety measures. Administration of 4-dimethyl-aminophenol, a methaemoglobin inducer, and sodium thiosulphate together with supportive measures, led to complete recovery of the infant, although the general hypotony persisted for a few weeks. PMID:2797290

  16. Acute Plant Poisoning and Antitoxin Antibodies

    PubMed Central

    Eddleston, Michael; Persson, Hans

    2007-01-01

    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, plants 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 anti-toxins are going to remain a dream in many of the areas where they are now urgently required. PMID:12807314

  17. Therapy against organophosphate poisoning: The importance of anticholinergic drugs with antiglutamatergic properties

    SciTech Connect

    Weissman, Ben Avi Raveh, Lily

    2008-10-15

    Potent cholinesterase inhibitors (e.g., soman, sarin), induce a wide range of deleterious effects including convulsions, behavioral impairments and ultimately, death. Due to the likelihood of various scenarios of military or terrorist attacks by these and other chemical weapons, research has to be aimed at finding optimal therapies. Early accumulation of acetylcholine in synaptic clefts was suggested to trigger an array of toxic events including an excessive release of glutamate, culminating in the activation of its receptors. Stimulation of the N-Methyl-D-Aspartate (NMDA) subtype of these receptors was associated with the neuronal injury that initiates organophosphate-induced brain damage. The notion of a stepwise mechanism yielded treatments based on a combination of an immediate administration of enzyme reactivators and anticholinergic drugs. This strategy dramatically increased survival rates but did not abolish convulsions and failed to prevent the ensuing cognitive dysfunction. Efforts to improve this paradigm by adding anticonvulsants or antiglutamatergic drugs with anti-epileptic characteristics produced dubious results. Under these conditions, benactyzine and caramiphen, agents with anticholinergic and antiglutamatergic properties, provided improved protection when introduced as adjunct agents to oximes, reversible cholinesterase inhibitors and/or specific antimuscarinic drugs such as atropine. In contrast, the specific antimuscarinic drug scopolamine failed to block soman-induced changes in glutamatergic and behavioral parameters even when given prophylactically. These findings along with a large number of additional reports led towards the conclusion that the therapeutic advantage of drugs such as benactyzine and caramiphen could derive from their ability to modulate central cholinergic and glutamate neurotransmission.

  18. Early Clinical Outcome of Acute Poisoning Cases Treated in Intensive Care Unit

    PubMed Central

    Sulaj, Zihni; Prifti, Edvin; Demiraj, Aurel; Strakosha, Arjana

    2015-01-01

    Introduction: A variety of factors have influenced the significant incidence of morbidity and mortality of acute poisoning and the timely recognition and properly management of critically ill poisoned patients is a key component. The aim of this study is to reveal the reasons for ICU admission of acutely poisoned patients, the main factors influencing the course and outcome of patients in relation with clinical approaches applied, available resources and infrastructure of treatment. Materials and Methods: This is a retrospective study based on most reachable variables extracted from patients’ medical records and ED registers of patients admitted at the medical ICU of “Mother Teresa” University Hospital in Tirana over two (2012-2013) years. Demography, time of exposure, etiology and circumstances of poisonings, assessment and treatment, reasons for ICU admission, course and outcome were duly obtained. Results: The number of ICU treated patients was 118, consisting in 47.4% (56) males and 52.5% (62) females which represented 10.2% of poisoned patients admitted during this two-year-period in ED and 9.2% of other etiology ICU admitted patients. Mean was 42.6 years for males, and 38 years for females. About 55.9% were urban residents and 44% rural ones. The elapsed time from toxic exposure to treatment initiation had varied between 2-6 hours, 44% arrived in the hospital <4 hours. The toxic exposures were intentional in 87.2% of cases, with a male:female ratio was 0.8:1. Agrochemicals such as Aluminum phosphide and organophosphates were involved in 77.1% of cases. Cardiovascular collapse and respiratory failure were the main clinical syndromes encountered. Mechanical ventilation was required in 31.4% of patients. The length of ICU stay was 2.73 (0.96) days and the mortality was 54.2%. Conclusion: This study evidenced that highly lethal toxicants used in poisoning acts such as agrochemicals, high rate of suicide, notwithstanding the infrastructure and resources

  19. Acute pesticide poisoning and pesticide registration in Central America

    SciTech Connect

    Wesseling, Catharina . E-mail: cwesseli@una.ac.cr; Corriols, Marianela; Bravo, Viria

    2005-09-01

    The International Code of Conduct on the Distribution and Use of Pesticides of the Food and Agriculture Organization (FAO) of the United Nations has been for 20 years the most acknowledged international initiative for reducing negative impact from pesticide use in developing countries. We analyzed pesticide use and poisoning in Central America, particularly in Costa Rica and Nicaragua, and evaluated whether registration decisions are based on such data, in accordance with the FAO Code. Extensive use of very hazardous pesticides continues in Central America and so do poisonings with organophosphates, carbamates, endosulfan and paraquat as the main causative agents. Central American governments do not carry out or commission scientific risk assessments. Instead, guidelines from international agencies are followed for risk management through the registration process. Documentation of pesticide poisonings during several decades never induced any decision to ban or restrict a pesticide. However, based on the official surveillance systems, in 2000, the ministers of health of the seven Central American countries agreed to ban or restrict twelve of these pesticides. Now, almost 4 years later, restrictions have been implemented in El Salvador and in Nicaragua public debate is ongoing. Chemical and agricultural industries do not withdraw problematic pesticides voluntarily. In conclusion, the registration processes in Central America do not comply satisfactorily with the FAO Code. However, international regulatory guidelines are important in developing countries, and international agencies should strongly extend its scope and influence, limiting industry involvement. Profound changes in international and national agricultural policies, steering towards sustainable agriculture based on non-chemical pest management, are the only way to reduce poisonings.

  20. Acute pesticide poisoning and pesticide registration in Central America.

    PubMed

    Wesseling, Catharina; Corriols, Marianela; Bravo, Viria

    2005-09-01

    The International Code of Conduct on the Distribution and Use of Pesticides of the Food and Agriculture Organization (FAO) of the United Nations has been for 20 years the most acknowledged international initiative for reducing negative impact from pesticide use in developing countries. We analyzed pesticide use and poisoning in Central America, particularly in Costa Rica and Nicaragua, and evaluated whether registration decisions are based on such data, in accordance with the FAO Code. Extensive use of very hazardous pesticides continues in Central America and so do poisonings with organophosphates, carbamates, endosulfan and paraquat as the main causative agents. Central American governments do not carry out or commission scientific risk assessments. Instead, guidelines from international agencies are followed for risk management through the registration process. Documentation of pesticide poisonings during several decades never induced any decision to ban or restrict a pesticide. However, based on the official surveillance systems, in 2000, the ministers of health of the seven Central American countries agreed to ban or restrict twelve of these pesticides. Now, almost 4 years later, restrictions have been implemented in El Salvador and in Nicaragua public debate is ongoing. Chemical and agricultural industries do not withdraw problematic pesticides voluntarily. In conclusion, the registration processes in Central America do not comply satisfactorily with the FAO Code. However, international regulatory guidelines are important in developing countries, and international agencies should strongly extend its scope and influence, limiting industry involvement. Profound changes in international and national agricultural policies, steering towards sustainable agriculture based on non-chemical pest management, are the only way to reduce poisonings. PMID:16153991

  1. Assessing the connection between organophosphate pesticide poisoning and mental health: A comparison of neuropsychological symptoms from clinical observations, animal models and epidemiological studies.

    PubMed

    Stallones, Lorann; Beseler, Cheryl L

    2016-01-01

    Psychiatry and psychology are beginning to recognize the importance of lead, mercury and heavy metals as causal partners in the development of mental disorders. Further, mental health researchers and clinicians are embracing the idea that the combined effects of genetics and environmental exposures can result in perturbations in brain neurochemistry leading to psychiatric disorders. The purpose of this review is to examine the biological foundations for the epidemiological observations previously identified by reviewing the toxicology literature and relating it to epidemiological studies addressing the role of poisoning with organophosphate pesticides (OPs) in neurobehavioral and neuropsychological disorders. The goal of this review is to raise awareness in the mental health community about the possibility that affective disorders might be the result of contributions from environmental and occupational pesticide poisoning. PMID:26654853

  2. Impacts of hypersaline acclimation on the acute toxicity of the organophosphate chlorpyrifos to salmonids.

    PubMed

    Maryoung, Lindley A; Lavado, Ramon; Schlenk, Daniel

    2014-07-01

    Acclimation to hypersaline conditions enhances the acute toxicity of certain thioether organophosphate and carbamate pesticides in some species of euryhaline fish. As the organophosphate chlorpyrifos is commonly detected in salmonid waterways, the impacts of hypersaline conditions on its toxicity were examined. In contrast to other previously examined pesticides, time to death by chlorpyrifos was more rapid in freshwater than in hypersaline water (16ppth). The median lethal time (LT50) after 100μg/L chlorpyrifos exposure was 49h (95% CI: 31-78) and 120h (95% CI: 89-162) for rainbow trout (Oncorhynchus mykiss) in freshwater and those acclimated to hypersaline conditions, respectively. Previous studies with hypersaline acclimated fish indicated induction of xenobiotic metabolizing enzymes that may detoxify chlorpyrifos. In the current study, chlorpyrifos metabolism was unaltered in liver and gill microsomes of freshwater and hypersaline acclimated fish. Acetylcholinesterase inhibition in brain and bioavailability of chlorpyrifos from the aqueous exposure media were also unchanged. In contrast, mRNA expression of neurological targets: calcium calmodulin dependent protein kinase II delta, chloride intracellular channel 4, and G protein alpha i1 were upregulated in saltwater acclimated fish, consistent with diminished neuronal signaling which may protect animals from cholinergic overload associated with acetylcholinesterase inhibition. These results indicate targets other than acetylcholinesterase may contribute to the altered toxicity of chlorpyrifos in salmonids under hypersaline conditions. PMID:24799192

  3. Acute renal failure following oxalic acid poisoning: a case report

    PubMed Central

    2012-01-01

    Oxalic acid poisoning is being recognized as an emerging epidemic in the rural communities of Sri Lanka as it is a component of locally produced household laundry detergents. Herein we describe a case of a 32 year old female, presenting after direct ingestion of oxalic acid. She then went on to develop significant metabolic acidosis and acute renal failure, requiring dialysis. Renal biopsy revealed acute tubulointerstitial nephritis associated with diffuse moderate acute tubular damage with refractile crystals in some of the tubules. The patient symptomatically improved with haemodialysis and renal functions subsequently returned to normal. PMID:22978510

  4. Acute Anticholinesterase Pesticide Poisoning Caused a Long-Term Mortality Increase

    PubMed Central

    Huang, Hung-Sheng; Hsu, Chien-Chin; Weng, Shih-Feng; Lin, Hung-Jung; Wang, Jhi-Joung; Su, Shih-Bin; Huang, Chien-Cheng; Guo, How-Ran

    2015-01-01

    Abstract Acute anticholinesterase pesticide (organophosphate and carbamate) poisoning (ACPP) often produces severe complications, and sometimes death. We investigated the long-term mortality of patients with ACPP because it is not sufficiently understood. In this retrospective nationwide population-based cohort study, 818 patients with ACPP and 16,360 healthy comparisons from 1999 to 2010 were selected from Taiwan's National Health Insurance Research Database. They were followed until 2011. Ninety-four (11.5%) ACPP patients and 793 (4.9%) comparisons died (P < 0.01) during follow-up. The incidence rate ratios (IRRs) of death were 2.5 times higher in ACPP patients than in comparisons (P < 0.01). The risk of death was particularly high in the first month after ACPP (IRR: 92.7; 95% confidence interval [CI]: 45.0–191.0) and still high for ∼6 months (IRR: 3.8; 95% CI: 1.9–7.4). After adjusting for age, gender, selected comorbidities, geographic area, and monthly income, the hazard ratio of death for ACPP patients was still 2.4 times higher than for comparisons. Older age (≥35 years), male gender, diabetes mellitus, coronary artery disease, hypertension, stroke, mental disorder, and lower monthly income also predicted death. ACPP significantly increased long-term mortality. In addition to early follow-up after acute treatment, comorbidity control and socioeconomic assistance are needed for patients with ACPP. PMID:26222853

  5. Acute Poisoning During Pregnancy: Observations from the Toxicology Investigators Consortium.

    PubMed

    Zelner, Irene; Matlow, Jeremy; Hutson, Janine R; Wax, Paul; Koren, Gideon; Brent, Jeffrey; Finkelstein, Yaron

    2015-09-01

    Acute poisonings during pregnancy pose a particular challenge to health care providers because of the potential for an immediate life threat or possible life-long implications for both the mother and fetus, including teratogenicity of the poison or its antidote. We describe recent consequential exposures among pregnant women in the USA. We identified all poisoning cases involving pregnant women that were catalogued by the medical toxicology services across the 37 sites of the Toxicology Investigators Consortium (ToxIC) Registry of the American College of Medical Toxicology between January 2010 and December 2012. Of 17,529 exposure cases reported in the ToxIC Registry, 103 (0.6 %) involved pregnant women, 80 % of whom were symptomatic and about a quarter displayed a specific toxidrome. The majority of cases (n = 53; 51.5 %) involved intentional exposures, most commonly to pharmaceutical agents, followed by unintentional pharmaceutical exposures (10 %) and withdrawal syndromes (9 %). Non-opioid analgesics were the most common class of agents encountered (31 %), followed by sedative-hypnotics/muscle relaxants (18 %), opioids (17 %), anti-convulsants (10 %), and anti-depressants (10 %). Over a third of cases involved exposure to multiple substances, and 32 % involved exposure to more than one drug class. The most commonly administered antidotes were N-acetylcysteine (23 %), sodium bicarbonate (10 %), flumazenil (4 %), and physostigmine (4 %). About half of acute poisoning cases among pregnant women presenting for emergency care involved intentional exposures, mostly with over-the-counter analgesics and psychoactive medications. Clinicians should be cognizant of the unique circumstances, maternal and fetal risks, and management principles of the acutely poisoned pregnant woman. PMID:25783189

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

    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

  9. Mechanism for the acute effects of organophosphate pesticides on the adult 5-HT system.

    PubMed

    Judge, Sarah J; Savy, Claire Y; Campbell, Matthew; Dodds, Rebecca; Gomes, Larissa Kruger; Laws, Grace; Watson, Anna; Blain, Peter G; Morris, Christopher M; Gartside, Sarah E

    2016-02-01

    The neurotransmitter serotonin (5-HT) is involved in mood disorder aetiology and it has been reported that (organophosphate) OP exposure affects 5-HT turnover. The aim of this study was to elucidate the mechanism underlying OP effects on the adult 5-HT system. First, acute in vivo administration of the OP diazinon (0, 1.3, 13 or 39 mg/kg i.p.) to male Hooded Lister rats inhibited the activity of the cholinergic enzyme acetylcholinesterase in blood and in the hippocampus, dorsal raphe nucleus (DRN), striatum and prefrontal cortex. Diazinon-induced cholinesterase inhibition was greatest in the DRN, the brain's major source of 5-HT neurones. Second, acute in vivo diazinon exposure (0 or 39 mg/kg i.p.) increased the basal firing rate of DRN neurones measured ex vivo in brain slices. The excitatory responses of DRN neurones to α1-adrenoceptor or AMPA/kainate receptor activation were not affected by in vivo diazinon exposure but the inhibitory response to 5-HT was attenuated, indicating 5-HT1A autoreceptor down-regulation. Finally, direct application of the diazinon metabolite diazinon oxon to naive rat brain slices increased the firing rate of DRN 5-HT neurones, as did chlorpyrifos-oxon, indicating the effect was not unique to diazinon. The oxon-induced augmentation of firing was blocked by the nicotinic acetylcholine receptor antagonist mecamylamine and the AMPA/kainate glutamate receptor antagonist DNQX. Together these data indicate that 1) acute OP exposure inhibits DRN cholinesterase, leading to acetylcholine accumulation, 2) the acetylcholine activates nicotinic receptors on 5-HT neurones and also on glutamatergic neurones, thus releasing glutamate and activating 5-HT neuronal AMPA/kainate receptors 3) the increase in 5-HT neuronal activity, and resulting 5-HT release, may lead to 5-HT1A autoreceptor down-regulation. This mechanism may be involved in the reported increase in risk of developing anxiety and depression following occupational OP exposure. PMID

  10. Acute lead poisoning in two users of illicit methamphetamine

    SciTech Connect

    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.

  11. Laser detoxication of acute poisonings with carbon monoxide

    NASA Astrophysics Data System (ADS)

    Provorov, Alexander S.; Salmin, Vladimir V.; Stavitskaya, Ekaterina Y.; Egorova, Alla B.

    2002-05-01

    A series of model experiments have been carried out. Those experiments have proved the fact of laser-induced photo dissociation of HbCO using Nd:YAG-laser with wavelength 533 nm at different conditions. Spontaneous reassociation of ligand to hemoproteid has been observed during the interpulse period. In order to prevent the reversibility of the reaction some oxidizing substances as well as trap-like functioning agents have been tested. The preliminary results allow us to propose the application of nonreversible laser- induced HbCO photodissotiation in the capacity of new physical method to treat acute carbon monoxide poisoning.

  12. Severe but reversible acute kidney injury resulting from Amanita punctata poisoning

    PubMed Central

    Kang, Eunjung; Cheong, Ka-Young; Lee, Min-Jeong; Kim, Seirhan; Shin, Gyu-Tae; Kim, Heungsoo; Park, In-Whee

    2015-01-01

    Mushroom-related poisoning can cause acute kidney injury. Here we report a case of acute kidney injury after ingestion of Amanita punctata, which is considered an edible mushroom. Gastrointestinal symptoms occurred within 24 hours from the mushroom intake and were followed by an asymptomatic period, acute kidney injury, and elevation of liver and pancreatic enzymes. Kidney function recovered with supportive care. Nephrotoxic mushroom poisoning should be considered as a cause of acute kidney injury. PMID:26779427

  13. Mechanism for the acute effects of organophosphate pesticides on the adult 5-HT system

    PubMed Central

    Judge, Sarah J.; Savy, Claire Y.; Campbell, Matthew; Dodds, Rebecca; Gomes, Larissa Kruger; Laws, Grace; Watson, Anna; Blain, Peter G.; Morris, Christopher M.; Gartside, Sarah E.

    2016-01-01

    The neurotransmitter serotonin (5-HT) is involved in mood disorder aetiology and it has been reported that (organophosphate) OP exposure affects 5-HT turnover. The aim of this study was to elucidate the mechanism underlying OP effects on the adult 5-HT system. First, acute in vivo administration of the OP diazinon (0, 1.3, 13 or 39 mg/kg i.p.) to male Hooded Lister rats inhibited the activity of the cholinergic enzyme acetylcholinesterase in blood and in the hippocampus, dorsal raphe nucleus (DRN), striatum and prefrontal cortex. Diazinon-induced cholinesterase inhibition was greatest in the DRN, the brain's major source of 5-HT neurones. Second, acute in vivo diazinon exposure (0 or 39 mg/kg i.p.) increased the basal firing rate of DRN neurones measured ex vivo in brain slices. The excitatory responses of DRN neurones to α1-adrenoceptor or AMPA/kainate receptor activation were not affected by in vivo diazinon exposure but the inhibitory response to 5-HT was attenuated, indicating 5-HT1A autoreceptor down-regulation. Finally, direct application of the diazinon metabolite diazinon oxon to naive rat brain slices increased the firing rate of DRN 5-HT neurones, as did chlorpyrifos-oxon, indicating the effect was not unique to diazinon. The oxon-induced augmentation of firing was blocked by the nicotinic acetylcholine receptor antagonist mecamylamine and the AMPA/kainate glutamate receptor antagonist DNQX. Together these data indicate that 1) acute OP exposure inhibits DRN cholinesterase, leading to acetylcholine accumulation, 2) the acetylcholine activates nicotinic receptors on 5-HT neurones and also on glutamatergic neurones, thus releasing glutamate and activating 5-HT neuronal AMPA/kainate receptors 3) the increase in 5-HT neuronal activity, and resulting 5-HT release, may lead to 5-HT1A autoreceptor down-regulation. This mechanism may be involved in the reported increase in risk of developing anxiety and depression following occupational OP exposure. PMID

  14. Patterns of Acute Poisoning in Childhood in Zagazig, Egypt: An Epidemiological Study

    PubMed Central

    Hassan, Basheir A.; Siam, Mohamed G.

    2014-01-01

    Background. Acute poisoning represents one of the most common medical emergencies in childhood. In view of paucity of literature on accidental poisoning among children in Egypt, this study was designed to describe the pattern of childhood poisoning in Zagazig University Hospitals. Patients and Methods. This retrospective study included 300 children up to 12 years with acute poisoning admitted to the Pediatric Department and Poisoning Treatment Unit, Zagazig University Hospitals, from January 2011 to August 2012. Complete epidemiological and clinical data were recorded and analyzed. Results. Three hundred of poisoned children were enrolled in this study. Children from 1 to 6 years were more liable to poisoning (81%). More boys than girls were poisoned at all age groups. The majority of all cases (99%) were due to accidental poisoning. Overall, 32% of the poisoned cases were living in Zagazig city while 68% were living in the rural areas. The presenting symptoms were classic in 60% of the cases. Pesticides, therapeutic drugs, and cleaning and disinfectant agents were the most frequent poisoning agents (28.7%, 22.7%, and 17.0%, resp.). In 86.0% of cases, observation with or without supportive measures together with decontamination and specific antidote therapy whenever needed was sufficient. Conclusion. Most of the poisonings were due to accidental ingestions by infants and young children. Pesticides and medications were the most commonly involved agents. PMID:27351009

  15. Poisoning

    MedlinePlus

    ... gas heater and any other gas-, oil- or wood-fueled appliances serviced regularly. Be sure these appliances ... on the skin, rinse it off with running water and remove any poisoned clothing. If the poison ...

  16. Acute dapsone poisoning in a 3-year-old child: Case report with review of literature

    PubMed Central

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

    2015-01-01

    Dapsone (DDS-diamino diphenyl sulphone) is a sulfone antibiotic being used for a variety of clinical conditions. Poisoning in children by DDS is rarely reported. Poisoning in acute cases will be frequently unrecognized due to relative lack of severe signs and symptoms. Methemoglobinemia is the major life-threatening situation associated with poisoning of DDS. Hence, any delay for medical attention can lead to increased rate of mortality. In this case, we describe acute DDS poisoning in a 3-year-old child and the successful management using intravenous methylene blue. PMID:26488029

  17. Pesticide poisoning.

    PubMed

    Goel, Ashish; Aggarwal, Praveen

    2007-01-01

    Acute poisoning with pesticides is a global public health problem and accounts for as many as 300,000 deaths worldwide every year. The majority of deaths occur due to exposure to organophosphates, organochlorines and aluminium phosphide. Organophosphate compounds inhibit acetylcholinesterase resulting in acute toxicity. Intermediate syndrome can develop in a number of patients and may lead to respiratory paralysis and death. Management consists of proper oxygenation, atropine in escalating doses and pralidoxime in high doses. It is Important to decontaminate the skin while taking precautions to avoid secondary contamination of health personnel. Organochlorine pesticides are toxic to the central nervous system and sensitize the myocardium to catecholamines. Treatment involves supportive care and avoiding exogenous sympathomimetic agents. Ingestion of paraquat causes severe inflammation of the throat, corrosive injury to the gastrointestinal tract, renal tubular necrosis, hepatic necrosis and pulmonary fibrosis. Administration of oxygen should be avoided as it produces more fibrosis. Use of immunosuppressive agents have improved outcome in patients with paraquat poisoning. Rodenticides include thallium, superwarfarins, barium carbonate and phosphides (aluminium and zinc phosphide). Alopecia is an atypical feature of thallium toxicity. Most exposures to superwarfarins are harmless but prolonged bleeding may occur. Barium carbonate Ingestion can cause severe hypokalaemia and respiratory muscle paralysis. Aluminium phosphide is a highly toxic agent with mortality ranging from 37% to 100%. It inhibits mitochondrial cytochrome c oxidase and leads to pulmonary and cardiac toxicity. Treatment is supportive with some studies suggesting a beneficial effect of magnesium sulphate. Pyrethroids and insect repellants (e.g. diethyltoluamide) are relatively harmless but can cause toxic effects to pulmonary and central nervous systems. Ethylene dibromide-a highly toxic, fumigant

  18. [Acute poisoning with selected hepatotoxic agents: biochemistry of toxic effect, clinical symptoms and treatment].

    PubMed

    Rusiński, Piotr; Kołaciński, Zbigniew

    2003-01-01

    The paper discusses etiopathogenesis, clinical symptoms and treatment in acute poisoning with hepatotoxic agents. The liver is a critical organ in acute poisoning with Amanita phalloides, carbon tetrachloride, iron compounds and isonicotinic acid hydrazide. Based on literature reports and own experience the authors present the current outlook on the specific treatment of acute poisoning with these xenobiotics. Special consideration was given to biochemical etiopathogenesis of hepatoxicity: oxidative stress, lipid peroxidation and impaired homeostasis of calcium ions and glutathione. Basic principles were also discussed of conservative treatment in hepatic encephalopathy due to toxic liver necrosis. PMID:14569886

  19. [Acute coronary syndrome with impaired left ventricular function in a carbon monoxide poisoning].

    PubMed

    Capilla, E; Pons, F; Poyet, R; Kerebel, S; Jego, C; Louge, P; Cellarier, G-R

    2016-02-01

    Carbon monoxide poisoning is the leading cause of death by poisoning in France. Neuropsychological symptoms are most common. We report on a patient with acute coronary syndrome and transient left ventricular dysfunction in carbon monoxide poisoning. Patient improved under hyperbaric oxygen therapy. Coronary angiography shows no significant lesion leading to myocardial stunning diagnose. Patients exposed to carbon monoxide must have systematic cardiac evaluation with electrocardiogram and dosage of biomarkers. PMID:25261170

  20. Resuscitative challenges in nerve agent poisoning.

    PubMed

    Ben Abraham, Ron; Weinbroum, Avi A

    2003-09-01

    The threat of weapons of mass destruction such as nerve agents has become real since last year. The medical community has established protocols for the rapid evacuation and decontamination of affected civilians. However, protocols for resuscitative measures or acute perioperative care in cases of life-saving surgical interventions in toxic-traumatized casualties are still lacking. The database concerning the effects of nerve agent poisoning in humans is limited, and is largely based on reports of unintentional exposures to pesticide organophosphate poisoning and similar chemical substances. In this review, we summarize the knowledge on the possible pharmacological interactions between nerve agents and acute care. PMID:12972890

  1. [Acute gamma-butyrolactone poisoning with withdrawal syndrome].

    PubMed

    Chwaluk, Paweł; Rejmak, Grazyna

    2011-01-01

    Gamma-butyrolactone (GBL) is a solvent that are part of many consumer products and in most countries can be legally purchased in the form of almost pure substance. After ingestion GBL is rapidly converted to gamma-hydroxybutyric acid (GHB). In recent years, GBL became a legal alternative to GHB, which is used widely since 1990s as a club drug and date rape drug. It is believed that abuse of GBL is not frequent in Europe, except for certain specific groups, mainly in urban centers in the west of the continent. We present a case of acute GBL poisoning with the withdrawal syndrome in 23-year-old man living in a rural area in eastern Poland. The patient was admitted to the Intensive Care Unit (ICU) because of coma of unknown origin. On admission erosions of the lips and mouth was seen. Ethyl alcohol was not present in blood sample, urine screening tests for drugs were negative. During his stay in the ICU patient required ventilatory support, was periodically agitated with muscular jerks and opisthotonos. The later medical history revealed that the patient from two years used GBL, which purchased as wheels cleaner. The tolerance developed, and the interruption of use of substance triggered symptoms of withdrawal. GBL abuse occurs in different social groups and is at risk for acute toxicity and the development of physical dependence. PMID:22010460

  2. Acute Anticholinesterase Pesticide Poisoning Caused a Long-Term Mortality Increase: A Nationwide Population-Based Cohort Study.

    PubMed

    Huang, Hung-Sheng; Hsu, Chien-Chin; Weng, Shih-Feng; Lin, Hung-Jung; Wang, Jhi-Joung; Su, Shih-Bin; Huang, Chien-Cheng; Guo, How-Ran

    2015-07-01

    Acute anticholinesterase pesticide (organophosphate and carbamate) poisoning (ACPP) often produces severe complications, and sometimes death. We investigated the long-term mortality of patients with ACPP because it is not sufficiently understood. In this retrospective nationwide population-based cohort study, 818 patients with ACPP and 16,360 healthy comparisons from 1999 to 2010 were selected from Taiwan's National Health Insurance Research Database. They were followed until 2011. Ninety-four (11.5%) ACPP patients and 793 (4.9%) comparisons died (P < 0.01) during follow-up. The incidence rate ratios (IRRs) of death were 2.5 times higher in ACPP patients than in comparisons (P < 0.01). The risk of death was particularly high in the first month after ACPP (IRR: 92.7; 95% confidence interval [CI]: 45.0-191.0) and still high for ~6 months (IRR: 3.8; 95% CI: 1.9-7.4). After adjusting for age, gender, selected comorbidities, geographic area, and monthly income, the hazard ratio of death for ACPP patients was still 2.4 times higher than for comparisons. Older age (≥35 years), male gender, diabetes mellitus, coronary artery disease, hypertension, stroke, mental disorder, and lower monthly income also predicted death. ACPP significantly increased long-term mortality. In addition to early follow-up after acute treatment, comorbidity control and socioeconomic assistance are needed for patients with ACPP. PMID:26222853

  3. Acute and chronic poisoning from residential exposures to elemental mercury--Michigan, 1989-1990

    SciTech Connect

    Not Available

    1991-06-14

    From May 1989 through November 1990, eight episodes of elemental mercury exposure in private residences or schools in the United States were reported to the Agency for Toxic Substances and Disease Registry (ATSDR). The case studies in this report document two of these episodes (both in Michigan) of residential mercury poisoning--one involving acute mercury exposure, and the other, chronic exposure to elemental mercury. These episodes illustrate the differing clinical and toxicologic manifestations of acute and chronic mercury poisoning.

  4. Metabolic changes in rat urine after acute paraquat poisoning and discriminated by support vector machine.

    PubMed

    Wen, Congcong; Wang, Zhiyi; Zhang, Meiling; Wang, Shuanghu; Geng, Peiwu; Sun, Fa; Chen, Mengchun; Lin, Guanyang; Hu, Lufeng; Ma, Jianshe; Wang, Xianqin

    2016-01-01

    Paraquat is quick-acting and non-selective, killing green plant tissue on contact; it is also toxic to human beings and animals. In this study, we developed a urine metabonomic method by gas chromatography-mass spectrometry to evaluate the effect of acute paraquat poisoning on rats. Pattern recognition analysis, including both partial least squares discriminate analysis and principal component analysis revealed that acute paraquat poisoning induced metabolic perturbations. Compared with the control group, the levels of benzeneacetic acid and hexadecanoic acid of the acute paraquat poisoning group (intragastric administration 36 mg/kg) increased, while the levels of butanedioic acid, pentanedioic acid, altronic acid decreased. Based on these urinary metabolomics data, support vector machine was applied to discriminate the metabolomic change of paraquat groups from the control group, which achieved 100% classification accuracy. In conclusion, metabonomic method combined with support vector machine can be used as a useful diagnostic tool in paraquat-poisoned rats. PMID:26419410

  5. Poisoning

    MedlinePlus

    ... Try to have the following information ready: The container or bottle from the medicine or poison The ... dangerous gases. Always store household chemicals in the container they came in. Don't reuse containers. Keep ...

  6. Poisoning

    MedlinePlus

    ... been swallowed, DO NOT give the person activated charcoal. DO NOT give children ipecac syrup. DO NOT ... poison from being absorbed, you may receive: Activated charcoal A tube through the nose into the stomach ...

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

    PubMed Central

    Guan, Li; Zhang, Yan-Lin; Li, Zong-Yang; Zhu, Ming-Xia; Yao, Wei-Juan; Zhao, Jin-Yuan

    2015-01-01

    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. PMID:25705671

  8. Characteristics of Children with Acute Carbon Monoxide Poisoning in Ankara: A Single Centre Experience

    PubMed Central

    Unsal Sac, Rukiye; Bostancı, İlknur; Şimşek, Yurda; Bilge Dallar, Yıldız

    2015-01-01

    The purpose of the study was to define characteristics of children with acute carbon monoxide poisoning. Eighty children hospitalized with acute carbon monoxide poisoning were recruited prospectively over a period of 12 months. Sociodemographic features, complaints and laboratory data were recorded. When the patient was discharged, necessary preventive measures to be taken were explained to parents. One month later, the parents were questioned during a control examination regarding the precautions that they took. The ages of the cases were between one month and 16 yr. Education levels were low in 86.2% of mothers and 52.6% of fathers. All families had low income and 48.8% did not have formal housing. The source of the acute carbon monoxide poisoning was stoves in 71.2% of cases and hot-water heaters in 28.8% of cases. Three or more people were poisoned at home in 85.1% of the cases. The most frequent symptoms of poisoning were headache and vertigo (58.8%). Median carboxyhemoglobin levels at admission to the hospital and discharge were measured as 19.5% and 1.1% (P < 0.001). When families were called for re-evaluation, it was determined that most of them had taken the necessary precautions after the poisoning incident (86.3%). This study determined that children with acute childhood carbon monoxide poisoning are usually from families with low socioeconomic and education levels. Education about prevention should be provided to all people who are at risk of carbon monoxide poisoning before a poisoning incident occurs. PMID:26713060

  9. Characteristics of Children with Acute Carbon Monoxide Poisoning in Ankara: A Single Centre Experience.

    PubMed

    Unsal Sac, Rukiye; Taşar, Medine Ayşin; Bostancı, İlknur; Şimşek, Yurda; Bilge Dallar, Yıldız

    2015-12-01

    The purpose of the study was to define characteristics of children with acute carbon monoxide poisoning. Eighty children hospitalized with acute carbon monoxide poisoning were recruited prospectively over a period of 12 months. Sociodemographic features, complaints and laboratory data were recorded. When the patient was discharged, necessary preventive measures to be taken were explained to parents. One month later, the parents were questioned during a control examination regarding the precautions that they took. The ages of the cases were between one month and 16 yr. Education levels were low in 86.2% of mothers and 52.6% of fathers. All families had low income and 48.8% did not have formal housing. The source of the acute carbon monoxide poisoning was stoves in 71.2% of cases and hot-water heaters in 28.8% of cases. Three or more people were poisoned at home in 85.1% of the cases. The most frequent symptoms of poisoning were headache and vertigo (58.8%). Median carboxyhemoglobin levels at admission to the hospital and discharge were measured as 19.5% and 1.1% (P < 0.001). When families were called for re-evaluation, it was determined that most of them had taken the necessary precautions after the poisoning incident (86.3%). This study determined that children with acute childhood carbon monoxide poisoning are usually from families with low socioeconomic and education levels. Education about prevention should be provided to all people who are at risk of carbon monoxide poisoning before a poisoning incident occurs. PMID:26713060

  10. A novel expression cassette delivers efficient production of exclusively tetrameric human butyrylcholinesterase with improved pharmacokinetics for protection against organophosphate poisoning.

    PubMed

    Terekhov, Stanislav; Smirnov, Ivan; Bobik, Tatiana; Shamborant, Olga; Zenkova, Marina; Chernolovskaya, Elena; Gladkikh, Danil; Murashev, Arkadii; Dyachenko, Igor; Palikov, Viktor; Palikova, Yulia; Knorre, Vera; Belogurov, Alexey; Ponomarenko, Natalie; Blackburn, G Michael; Masson, Patrick; Gabibov, Alexander

    2015-11-01

    Butyrylcholinesterase is a stoichiometric bioscavenger against poisoning by organophosphorus pesticides and nerve agents. The low level of expression and extremely rapid clearance of monomeric recombinant human butyrylcholinesterase (rhBChE) from bloodstream (t½≈2 min) limits its pharmaceutical application. Recently (Ilyushin at al., PNAS, 2013) we described a long-acting polysialylated recombinant butyrylcholinesterase (rhBChE-CAO), stable in the bloodstream, that protects mice against 4.2 LD50 of VR. Here we report a set of modifications of the initial rhBChE expression vector to improve stability of the enzyme in the bloodstream and increase its production in CHO cells by introducing in the expression cassette: (i) the sequence of the natural human PRAD-peptide in frame with rhBChE gene via "self-processing" viral F2A peptide under control of an hEF/HTLV promoter, and (ii) previously predicted in silico MAR 1-68 and MAR X-29 sequences. This provides fully tetrameric rhBChE (4rhBChE) at 70 mg/l, that displays improved pharmacokinetics (t½ = 32 ± 1.2 h, MRT = 43 ± 2 h). 3D Fluorescent visualization and distribution of (125)I-labeled enzyme reveals similar low level 4rhBChE and rhBChE-CAO accumulation in muscle, fat, and brain. Administered 4rhBChE was mainly catabolized in the liver and breakdown products were excreted in kidney. Injection of 1.2 LD50 and 1.1 LD50 of paraoxon to BALB/c and knockout BChE-/- mice pre-treated with 4rhBChE (50 mg/kg) resulted in 100% and 78% survival, respectively, without perturbation of long-term behavior. In contrast, 100% mortality of non-pre-treated mice was observed. The high expression level of 4rhBChE in CHO cells permits consideration of this new expression system for manufacturing BChE as a biopharmaceutical. PMID:26239905

  11. Hospital Performance Indicators and Their Associated Factors in Acute Child Poisoning at a Single Poison Center, Central Saudi Arabia.

    PubMed

    Alanazi, Menyfah Q; Al-Jeriasy, Majed I; Al-Assiri, Mohammed H; Afesh, Lara Y; Alhammad, Fahad; Salam, Mahmoud

    2015-12-01

    Admission rate and length of stay (LOS) are two hospital performance indicators that affect the quality of care, patients' satisfaction, bed turnover, and health cost expenditures. The aim of the study was to identify factors associated with higher admission rates and extended average LOS among acutely poisoned children at a single poison center, central Saudi Arabia.This is a cross-sectional, poison and medical chart review between 2009 and 2011. Exposures were child characteristics, that is, gender, age, body mass index (BMI), health history, and Canadian 5-level triage scale. Poison incident characteristics were, that is, type, exposure route, amount, form, home remedy, and arrival time to center. Admission status and LOS were obtained from records. Chronic poisoning, plant allergies, and venomous bites were excluded. Bivariate and regression analyses were applied. Significance at P < 0.05.Of the 315 eligible cases, (72%) were toddlers with equal gender distribution, (58%) had normal BMI, and (77%) were previously healthy. Poison substances were pharmaceutical drugs (63%) versus chemical products (37%). Main exposure route was oral (98%). Home remedy was observed in (21.9%), which were fluids, solutes, and/or gag-induced vomiting. Almost (52%) arrived to center >1 h. Triage levels: non-urgent cases (58%), less urgent (11%), urgent (18%), emergency (12%), resuscitative (1%). Admission rate was (20.6%) whereas av. LOS was 13 ± 22 h. After adjusting and controlling for confounders, older children (adj.OR = 1.19) and more critical triage levels (adj.OR = 1.35) were significantly associated with higher admission rates compared to younger children and less critical triage levels (adj.P = 0.006) and (adj.P = 0.042) respectively. Home remedy prior arrival was significantly associated with higher av. LOS (Beta = 9.48, t = 2.99), compared to those who directly visited the center, adj.P = 0.003.Hospital administrators are cautioned

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

    PubMed

    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. PMID:27258847

  13. Is there a relationship between admission blood glucose level following acute poisoning and clinical outcome?

    PubMed Central

    Sabzghabaee, Ali Mohammad; Eizadi-Mood, Nastaran; Gheshlaghi, Farzad; Adib, Nooshin; Safaeian, Leila

    2011-01-01

    Introduction The aim of this study was to investigate the relationship between the admission blood glucose level following acute poisoning, severity of acute poisoning and clinical outcome. Material and methods This prospective study was conducted on 345 deliberate self-poisoning patients. Standard demographic and clinical information; admission blood glucose level; poisoning severity score and outcome were recorded. Patients with a history of diabetes mellitus, receipt of pre-sampling intravenous dextrose solution or glucocorticoids, and poisoning with toxic agents which produce hyper- or hypoglycaemia were excluded. Results Mean age of the patients was 27.5 ±8.6 years. Females outnumbered males (57.9%). Oral ingestion of more than one drug (46.7%) and opiates (14.2%) were the main causes of poisoning. Blood glucose values ranged from 50 mg/dl to 396 mg/dl. Hyper- and hypoglycaemia were observed in 23.8% and 13.91% respectively. A total of 24.41% and 22.92% of the patients in hyper- and hypoglycaemic groups had grade 3 and 4 severity score in comparison with 4.18% in the normoglycaemic group. Development of complications and death were 14.64% and 10.42% in patients with hyper- and hypoglycaemia versus 3.73% in patients with normoglycaemia. A significant difference between normoglycaemic and hyperglycaemic patients in the severity of poisoning and clinical outcome was observed (P < 0.001). Conclusions Admission blood glucose levels may have a relationship with the severity of poisoning and clinical outcome following acute poisoning. PMID:22291737

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

    SciTech Connect

    Sevinc, A.; Savli, H.; Atmaca, H.

    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.

  15. Acute carbon monoxide poisoning: Emergency management and hyperbaric oxygen therapy

    SciTech Connect

    Severance, H.W.; Kolb, J.C.; Carlton, F.B.; Jorden, R.C.

    1989-10-01

    An ice storm in February 1989 resulted in numerous incidences of carbon monoxide poisoning in central Mississippi secondary to exposure to open fires in unventilated living spaces. Sixteen cases were treated during this period at the University of Mississippi Medical Center and 6 received Hyperbaric Oxygen therapy. These 6 cases and the mechanisms of CO poisoning are discussed and recommendations for emergency management are reviewed.10 references.

  16. The effect of stress on the acute neurotoxicity of the organophosphate insecticide chlorpyrifos

    SciTech Connect

    Hancock, Sandra; Ehrich, Marion; Hinckley, Jonathan; Pung, Thitiya; Jortner, Bernard S. . E-mail: bjortner@vt.edu

    2007-03-15

    A study was conducted to determine if multiple exposures to several stress paradigms might affect the anticholinesterase effect of subsequently administered organophosphate insecticide chlorpyrifos. Male Sprague-Dawley rats were subject to daily periods of restraint, swimming, a combination of the two, or neither of the two (controls) (n = 8/group) for 5 days per week over a six-week period. The most profound stress, as measured by reduced body weight gain and elevated levels of plasma corticosterone, was swimming. On day 39 of the study, shortly after the daily stress episode, one half of the rats in each group was dosed with 60 mg/kg chlorpyrifos subcutaneously. This had no effect on subsequent levels of plasma corticosterone. There were no stress-related differences in the degree of chlorpyrifos-induced inhibition of brain acetylcholinesterase in animals sacrificed on day 43.

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

    PubMed

    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. PMID:23902291

  18. Effect of acute paraquat poisoning on CYP450 isoforms activity in rats by cocktail method.

    PubMed

    Wang, Shuanghu; Wang, Zhiyi; Chen, Dongxin; Chen, Mengchun; Lin, Yingying; Liu, Zezheng; Zhang, Lijing; Wen, Congcong; Wang, Xianqin; Ma, Jianshe

    2015-01-01

    Paraquat is a highly effective contact herbicide that is marketed worldwide as a fantastical, non-selective compound for broadleaf weed control. As compared to most pesticides, paraquat is extremely toxic to humans and the lack of strategies to manage paraquat poisoning has resulted in high fatality rates. The rats were randomly divided into acute paraquat poisoning group and control group. The paraquat group rats were given 36 mg/kg paraquat by intragastric administration. The influence of acute paraquat poisoning on the activities of CYP450 isoforms CYP2B6, CYP1A2, CYP2C9, CYP2D6, CYP3A4 and CYP2C19 were evaluated by cocktail method, they were responded by the changes of pharmacokinetic parameters of bupropion, phenacetin, tolbutamide, metoprolol, midazolam and omeprazole. The six probe drugs were given to rats through intragastric administration, and the plasma concentrations were determined by UPLC-MS/MS. In the results of paraquat group compared to control group, there was statistical pharmacokinetic difference for bupropion, tolbutamide, metoprolol, midazolam and omeprazole. Acute paraquat poisoning may induce the activities of CYP2C19, and inhibit of CYP2B6, CYP2C9, CYP2D6 and CYP3A4 in rats. This may give advising for reasonable drug use after acute paraquat poisoning. PMID:26770539

  19. Effect of acute paraquat poisoning on CYP450 isoforms activity in rats by cocktail method

    PubMed Central

    Wang, Shuanghu; Wang, Zhiyi; Chen, Dongxin; Chen, Mengchun; Lin, Yingying; Liu, Zezheng; Zhang, Lijing; Wen, Congcong; Wang, Xianqin; Ma, Jianshe

    2015-01-01

    Paraquat is a highly effective contact herbicide that is marketed worldwide as a fantastical, non-selective compound for broadleaf weed control. As compared to most pesticides, paraquat is extremely toxic to humans and the lack of strategies to manage paraquat poisoning has resulted in high fatality rates. The rats were randomly divided into acute paraquat poisoning group and control group. The paraquat group rats were given 36 mg/kg paraquat by intragastric administration. The influence of acute paraquat poisoning on the activities of CYP450 isoforms CYP2B6, CYP1A2, CYP2C9, CYP2D6, CYP3A4 and CYP2C19 were evaluated by cocktail method, they were responded by the changes of pharmacokinetic parameters of bupropion, phenacetin, tolbutamide, metoprolol, midazolam and omeprazole. The six probe drugs were given to rats through intragastric administration, and the plasma concentrations were determined by UPLC-MS/MS. In the results of paraquat group compared to control group, there was statistical pharmacokinetic difference for bupropion, tolbutamide, metoprolol, midazolam and omeprazole. Acute paraquat poisoning may induce the activities of CYP2C19, and inhibit of CYP2B6, CYP2C9, CYP2D6 and CYP3A4 in rats. This may give advising for reasonable drug use after acute paraquat poisoning. PMID:26770539

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

    PubMed

    Dhanapriya, J; Gopalakrishnan, N; Arun, V; Dineshkumar, T; Sakthirajan, R; Balasubramaniyan, T; Haris, M

    2016-01-01

    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. PMID:27194836

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

    PubMed Central

    Dhanapriya, J.; Gopalakrishnan, N.; Arun, V.; Dineshkumar, T.; Sakthirajan, R.; Balasubramaniyan, T.; Haris, M.

    2016-01-01

    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. PMID:27194836

  2. Acute adult poisoning cases admitted to a university hospital in Tabriz, Iran.

    PubMed

    Islambulchilar, M; Islambulchilar, Z; Kargar-Maher, M H

    2009-04-01

    The aim of our study was to investigate the etiological and demographical characteristics of acute adult poisoning cases admitted to a university hospital in Tabriz, Iran. This retrospective study was performed on 1342 poisoning admissions to a university hospital from 2003 to 2005, by data collection from the medical records of patients. Poisonings were 5.40% of the total admissions. There was a predominance of female patients (55.7%) compared to male patients (44.3%) with a female-to-male ratio of 1.2:1. Most poisonings occurred in the age range of 11-20 years (38.9%). Drugs were the most common cause of poisonings (60.8%). Among the drug poisonings, benzodiazepines (40.31%) were the most frequent agents, followed by antidepressants (31.98%). The seasonal distribution in poisoning patients suggested a peak in spring (28%) and summer (27.5%). In 9.8% of cases accidental and in 90.2% intentional poisonings were evident. Most suicide attempts were made by women (58.51%) and unmarried people (51.4%).The mean duration of hospitalization was 3.02 +/- 2.8 days. There were 28 (2.3%) deaths; the majority (13 cases) was due to pesticides. This was a university hospital-based study, so these results may not be representative of the general population. Despite this drawback, these data still provide important information on the characteristics of the poisoning in this part of Iran. To prevent such poisonings, the community education about the danger of central nervous system-acting drugs and reducing the exposure period of people to pesticides are recommended. PMID:19734268

  3. 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

    PubMed Central

    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 < 0.001), which was available in all governmental hospitals but none of the private hospitals

  4. Comparative analysis of acute toxic poisoning in 2003 and 2011: analysis of 3 academic hospitals.

    PubMed

    Jang, Hak-Soo; Kim, Jung-Youn; Choi, Sung-Hyuk; Yoon, Young-Hoon; Moon, Sung-Woo; Hong, Yun-Sik; Lee, Sung-Woo

    2013-10-01

    Social factors may affect the available sources of toxic substances and causes of poisoning; and these factors may change over time. Additionally, understanding the characteristics of patients with acute toxic poisoning is important for treating such patients. Therefore, this study investigated the characteristics of patients with toxic poisoning. Patients visiting one of 3 hospitals in 2003 and 2011 were included in this study. Data on all patients who were admitted to the emergency departments with acute toxic poisoning were retrospectively obtained from medical records. Total 939 patients were analyzed. The average age of patients was 40.0 ± 20 yr, and 335 (36.9%) patients were men. Among the elements that did not change over time were the facts that suicide was the most common cause, that alcohol consumption was involved in roughly 1 of 4 cases, and that there were more women than men. Furthermore, acetaminophen and doxylamine remained the most common poisoning agents. In conclusion, the average patient age and psychotic drug poisoning has increased over time, and the use of lavage treatment has decreased. PMID:24133344

  5. A Case of Mushroom Poisoning with Russula subnigricans: Development of Rhabdomyolysis, Acute Kidney Injury, Cardiogenic Shock, and Death.

    PubMed

    Cho, Jong Tae; Han, Jin Hyung

    2016-07-01

    Mushroom exposures are increasing worldwide. The incidence and fatality of mushroom poisoning are reported to be increasing. Several new syndromes in mushroom poisoning have been described. Rhabdomyolytic mushroom poisoning is one of new syndromes. Russula subnigricans mushroom can cause delayed-onset rhabdomyolysis with acute kidney injury in the severely poisoned patient. There are few reports on the toxicity of R. subnigricans. This report represents the first record of R. subnigricans poisoning with rhabdomyolysis in Korea, describing a 51-year-old man who suffered from rhabdomyolysis, acute kidney injury, severe hypocalcemia, respiratory failure, ventricular tachycardia, cardiogenic shock, and death. Mushroom poisoning should be considered in the evaluation of rhabdomyolysis of unknown cause. Furthermore, R. subnigricans should be considered in the mushroom poisoning with rhabdomyolysis. PMID:27366018

  6. A Case of Mushroom Poisoning with Russula subnigricans: Development of Rhabdomyolysis, Acute Kidney Injury, Cardiogenic Shock, and Death

    PubMed Central

    2016-01-01

    Mushroom exposures are increasing worldwide. The incidence and fatality of mushroom poisoning are reported to be increasing. Several new syndromes in mushroom poisoning have been described. Rhabdomyolytic mushroom poisoning is one of new syndromes. Russula subnigricans mushroom can cause delayed-onset rhabdomyolysis with acute kidney injury in the severely poisoned patient. There are few reports on the toxicity of R. subnigricans. This report represents the first record of R. subnigricans poisoning with rhabdomyolysis in Korea, describing a 51-year-old man who suffered from rhabdomyolysis, acute kidney injury, severe hypocalcemia, respiratory failure, ventricular tachycardia, cardiogenic shock, and death. Mushroom poisoning should be considered in the evaluation of rhabdomyolysis of unknown cause. Furthermore, R. subnigricans should be considered in the mushroom poisoning with rhabdomyolysis. PMID:27366018

  7. Should hyperbaric oxygen be used to treat the pregnant patient for acute carbon monoxide poisoning

    SciTech Connect

    Van Hoesen, K.B.; Camporesi, E.M.; Moon, R.E.; Hage, M.L.; Piantadosi, C.A. )

    1989-02-17

    Carbon monoxide (CO) is the leading cause of death due to poisoning. Although uncommon, CO poisoning does occur during pregnancy and can result in fetal mortality and neurological malformations in fetuses who survive to term. Uncertainty arises regarding the use of hyperbaric oxygen (HBO) as a treatment for the pregnant patient because of possible adverse effects on the fetus that could be induced by oxygen at high partial pressures. While the dangers of hyperoxia to the fetus have been demonstrated in animal models, careful review of animal studies and human clinical experience indicates that the short duration of hyperoxic exposure attained during HBO therapy for CO poisoning can be tolerated by the fetus in all stages of pregnancy and reduces the risk of death or deformity to the mother and fetus. A case is presented of acute CO poisoning during pregnancy that was successfully treated with HBO. Recommendations are suggested for the use of HBO during pregnancy.

  8. A cost effectiveness analysis of the preferred antidotes for acute paracetamol poisoning patients in Sri Lanka

    PubMed Central

    2012-01-01

    Background Acute paracetamol poisoning is a rapidly increasing problem in Sri Lanka. The antidotes are expensive and yet no health economic evaluation has been done on the therapy for acute paracetamol poisoning in the developing world. The aim of this study is to determine the cost effectiveness of using N-acetylcysteine over methionine in the management of acute paracetamol poisoning in Sri Lanka. Methods Economic analysis was applied using public healthcare system payer perspective. Costs were obtained from a series of patients admitted to the National Hospital of Sri Lanka with a history of acute paracetamol overdose. Evidence on effectiveness was obtained from a systematic review of the literature. Death due to hepatotoxicity was used as the primary outcome of interest. Analysis and development of decision tree models was done using Tree Age Pro 2008. Results An affordable treatment threshold of Sri Lankan rupees 1,537,120/death prevented was set from the expected years of productive life gained and the average contribution to GDP. A cost-minimisation analysis was appropriate for patients presenting within 10 hours and methionine was the least costly antidote. For patients presenting 10-24 hours after poisoning, n-acetylcysteine was more effective and the incremental cost effectiveness ratio of Sri Lankan rupees 316,182/life saved was well under the threshold. One-way and multi-way sensitivity analysis also supported methionine for patients treated within 10 hours and n-acetylcysteine for patients treated within 10-24 hours as preferred antidotes. Conclusions Post ingestion time is an important determinant of preferred antidotal therapy for acute paracetamol poisoning patients in Sri Lanka. Using n-acetylcysteine in all patients is not cost effective. On economic grounds, methionine should become the preferred antidote for Sri Lankan patients treated within 10 hours of the acute ingestion and n-acetylcysteine should continue to be given to patients treated

  9. Oral administration of lactulose: a novel therapy for acute carbon monoxide poisoning via increasing intestinal hydrogen production.

    PubMed

    Fan, Dan-Feng; Hu, Hui-Jun; Sun, Xue-Jun; Meng, Xiang-En; Zhang, Yu; Pan, Shu-Yi

    2016-01-01

    It has been known that the pathophysiology of carbon monoxide (CO) poisoning is related to hypoxia, the increased production of reactive oxygen species (ROS) and oxidative stress. Studies have shown that the novel, safe and effective free radical scavenger, hydrogen, has neuroprotective effects in both acute CO poisoning and delayed neuropsychological sequelae in CO poisoning. Orally administered lactulose, which may be used by some intestinal bacteria as a food source to produce endogenous hydrogen, can ameliorate oxidative stress. Based on the available findings, we hypothesize that oral administration of lactulose may be a novel therapy for acute CO poisoning via increasing intestinal hydrogen production. PMID:27000012

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

    PubMed

    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 <9 were not intubated for ambulance transfer between rural and district hospitals. Delay in intubation leads to aspiration pneumonitis and pneumonia in 38%-45% of unconscious 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

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

    PubMed

    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. PMID:26786042

  12. Toxicoepidemiology of acute poisoning cases in a secondary care hospital in rural South India: A five-year analysis

    PubMed Central

    Indu, TH; Raja, D; Ponnusankar, S

    2015-01-01

    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. PMID:26119434

  13. Survey of acute pesticide poisoning among agricultural workers in four Asian countries*

    PubMed Central

    Jeyaratnam, J.; Lun, K. C.; Phoon, W. O.

    1987-01-01

    The study investigated the extent of acute pesticide poisoning in selected agricultural communities in Indonesia, Malaysia, Sri Lanka and Thailand, as well as the contributing factors, because it is believed that this type of poisoning is a major problem in developing countries, but not in the industrialized countries, despite their extensive use of pesticides. The study confirmed the existence of this problem, which was found to be due to inadequate knowledge of the safe practices in the use of pesticides among users and to the lack of suitable protective clothing for use by agricultural workers in hot and humid climates. PMID:3500805

  14. Fatality due to acute systemic fluoride poisoning following a hydrofluoric acid skin burn.

    PubMed

    Tepperman, P B

    1980-10-01

    Reports indicate that death due to hydrofluoric acid exposure is usually the result of inhalation of vapor causing pulmonary edema and fluoride poisoning. Absorption via the skin route of fluoride ion sufficient to cause serious systemic problems and even death has rarely been reported. A fatality resulting from a severe facial burn, which produced acute systemic fluoride poisoning with profound hypocalcemia and hypomagnesemia, is presented. The importance of proper personal protective equipment as well as the immediate initiation of first aid and appropriate medical measures, including the monitoring and replacement of serum calcium and magnesium, are emphasized. PMID:7431138

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

    PubMed

    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. PMID:25425845

  16. Oxidative stress in acute human poisoning with organophosphorus insecticides; a case control study.

    PubMed

    Ranjbar, Akram; Solhi, Hasan; Mashayekhi, Farideh Jalali; Susanabdi, Alireza; Rezaie, Ali; Abdollahi, Mohammad

    2005-07-01

    Free radicals play an important role in toxicity of pesticides and environmental chemicals. Organophosphorus insecticides (OPIs) may induce oxidative stress leading to generation of free radicals and alteration in antioxidant system. To complete the previous surveys, this study was conducted to evaluate the existence of oxidative stress, balance between total antioxidant capacity and oxygen free radicals in patients with acute OPI exposure. In this case control study, a total of 22 acute OPI poisoning patients were included and blood samples were analyzed for lipid peroxidation, total antioxidant capacity, total thiol groups, and cholinesterase levels. The results showed significant lipid peroxidation accompanied with decreased levels of total antioxidant capacity, total thiols, and cholinesterase activity. A significant correlation existed between cholinesterase depression and reduced total antioxidant capacity. It is concluded that oxygen free radicals and their related interactions like lipid peroxidation are present in acute OPI poisoning. Use of antioxidants may be beneficial in treatment of OPIs acute poisoning which remains to be elucidated by further clinical trials. PMID:21783573

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

    PubMed Central

    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

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

    PubMed Central

    Li, Hai-feng; Zhao, Shi-xing; Xing, Bao-peng; Sun, Ming-li

    2015-01-01

    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. PMID:25878598

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

    USGS Publications Warehouse

    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.

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

    PubMed

    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 < 0.0001) and month (P < 0.0001). Submissions were highest in 2009 (15.6%), 2001 (11.2%), and 2006 (9.9%). Most cases were observed during May, June, and July (62.3%). Cattle 6 months of age and younger were frequently poisoned (53.5%; P < 0.0001). Beef breeds were predominantly 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

  1. Hospital-based survey of pesticide poisoning in Japan, 1998--2002.

    PubMed

    Nagami, Hiroshi; Nishigaki, Yoshio; Matsushima, Shosui; Matsushita, Toshio; Asanuma, Shinji; Yajima, Nobuki; Usuda, Makoto; Hirosawa, Miwako

    2005-01-01

    Data concerning clinical cases of pesticide poisoning from 1998 to 2002 from the hospitals affiliated with the Japanese Association of Rural Medicine were analyzed. 346 cases of poisoning by agricultural chemicals were reported from 65 hospitals. Suicides accounted for 70% of pesticide poisoning cases, followed by accidental exposures during spraying work (16%) and accidental ingestion (8%). The majority of cases were acute or subacute systemic poisonings (90%), followed by acute dermatitis (5%) and chemical burns (3%). Organophosphate insecticide was the most frequent inducer of clinical cases (36%), followed by bipyridylium herbicide (20%) and carbamate insecticide (6%). The death rate from poisoning by the herbicide paraquat was more than 70% of clinical cases, even though it is a low-concentration product, whereas those from the alternative herbicides, glufosinate and glyphosate, were less than 10%. PMID:15875894

  2. Immunomodulation by poly-YE reduces organophosphate-induced brain damage.

    PubMed

    Finkelstein, Arseny; Kunis, Gilad; Berkutzki, Tamara; Ronen, Ayal; Krivoy, Amir; Yoles, Eti; Last, David; Mardor, Yael; Van Shura, Kerry; McFarland, Emylee; Capacio, Benedict A; Eisner, Claire; Gonzales, Mary; Gregorowicz, Danise; Eisenkraft, Arik; McDonough, John H; Schwartz, Michal

    2012-01-01

    Accidental organophosphate poisoning resulting from environmental or occupational exposure, as well as the deliberate use of nerve agents on the battlefield or by terrorists, remain major threats for multi-casualty events, with no effective therapies yet available. Even transient exposure to organophosphorous compounds may lead to brain damage associated with microglial activation and to long-lasting neurological and psychological deficits. Regulation of the microglial response by adaptive immunity was previously shown to reduce the consequences of acute insult to the central nervous system (CNS). Here, we tested whether an immunization-based treatment that affects the properties of T regulatory cells (Tregs) can reduce brain damage following organophosphate intoxication, as a supplement to the standard antidotal protocol. Rats were intoxicated by acute exposure to the nerve agent soman, or the organophosphate pesticide, paraoxon, and after 24 h were treated with the immunomodulator, poly-YE. A single injection of poly-YE resulted in a significant increase in neuronal survival and tissue preservation. The beneficial effect of poly-YE treatment was associated with specific recruitment of CD4(+) T cells into the brain, reduced microglial activation, and an increase in the levels of brain derived neurotrophic factor (BDNF) in the piriform cortex. These results suggest therapeutic intervention with poly-YE as an immunomodulatory supplementary approach against consequences of organophosphate-induced brain damage. PMID:21925261

  3. Evaluation of brain function in acute carbon monoxide poisoning with multimodality evoked potentials

    SciTech Connect

    He, Fengsheng; Liu, Xibao; Yang, Shi; Zhang, Shoulin ); Xu, Guanghua; Fang, Guangchai; Pan, Xiaowen )

    1993-02-01

    The median nerve somatosensory evoked potentials (SEP), pattern reversal visual evoked potentials (VEP), and brain stem auditory evoked potentials (BAEP) were studied in 109 healthy adults and in 88 patients with acute carbon monoxide (CO) poisoning. The upper limits for normal values of peak and interpeak latencies of multimodalities of evoked potentials in the reference group were established by a stepwise multiple regression analysis. SEP changes selectively affecting N32 and N60 were found in 78.8% of patients. There was prolonged PI00 latency of VEP in 58.2% of the cases examined. The prevalence of BAEP abnormalities in comatose patients (36%) was significantly higher than that (8.6%) in conscious patients. BAEP abnormalities were most frequently seen in comatose patients who had diminished brain stem reflexes (77.8%). It has been found that a consistent abnormality involving N2O and subsequent peaks in SEP, a remarkable prolongation of PI00 latency in VEP, or a prolongation of Ill-V interpeak latency in BAEP as well as the reoccurrence of evoked potential abnormalities after initial recovery all indicate unfavorable outcomes in patients with acute CO poisoning. The multimodality evoked potentials have proved to be sensitive indicators in the evaluation of brain dysfunction and in the prediction of prognosis of acute CO poisoning and the development of delayed encephalopathy. 16 refs., 4 figs., 6 tabs.

  4. Impact of Xuebijing and ulinastatin as assistance for hemoperfusion in treating acute paraquat poisoning

    PubMed Central

    Shi, Xiaofeng; Zhang, Yue; Wang, Yongqiang

    2015-01-01

    Objective: As the effect of Xuebijing as combined treatment in hemoperfusion (HP) toward acute paraquat (PQ) poisoning is not clear. We retrospectively analyzed 119 cases of acute paraquat poisoning in Tianjin first central hospital; the patients were divided into 3 groups based on treatment. Control (group A) patients underwent standard hemoperfusion with conventional treatment, while the experimental groups combined hemoperfusion with Xuebijing (group B) or ulinastatin (group C). Standard biomedical indicators, such as organ dysfunction and mortality were recorded and compiled, both in short (<7 days) and long (7-28 days) terms. Then, the effect of Xuebijing in combination to the standard (HP) treatment was evaluated by direct comparison. The results showed that using either Xuebijing or ulinastatin as additional treatment to standard HP significantly helped the overall outcomes, as evidenced by lower organ dysfunction and mortality. In addition, Xuebijing (group B) yielded a more pronounced improvement compared with ulinastatin (group C) in combination with HP (All P<0.05). Our findings indicated that both Xuebijing and ulinastatin provided positive impacts on HP treatment toward acute paraquat poisoning, with better outcomes observed with Xuebijing, which should be considered for more frequent use in clinical practice. PMID:26550361

  5. Acute poisoning from gamma-hydroxybutyrate in California.

    PubMed Central

    Chin, M. Y.; Kreutzer, R. A.; Dyer, J. E.

    1992-01-01

    We report a series of 5 representative patients in California who experienced adverse reactions from the illicitly marketed substance gamma-hydroxybutyrate (GHB). The drug is a putative neurotransmitter marketed as a growth hormone releaser for bodybuilders. The most commonly reported symptoms included abrupt drowsiness, dizziness, and a "high". Other effects were headache, nausea, vomiting, myoclonic jerking, and short-term coma. There have been no reported deaths. If product use is discontinued, full recovery with no long-term side effects is universal. No clear dose-response effect was observed; this may be attributable to differences in susceptibility, wide variations in doses taken by the same person, or the coingestion of other substances. Case interviews confirm that, despite being banned by the US Food and Drug Administration, GHB is still widely available in the underground drug market. Athletes and bodybuilders may take drugs for which there are claims of improved performance or body image. Physicians should be alert for signs of GHB poisoning in emergency department and clinic patients. PMID:1574880

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

    PubMed Central

    Radhakrishnan, H.; Gopi, M.; Arumugam, A.

    2014-01-01

    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. PMID:25484533

  7. Acute fatal poisoning cases due to furathiocarb ingestion.

    PubMed

    Lee, S K; Ameno, K; In, S W; Yang, W K; Koo, K S; Yoo, Y C; Kubota, T; Ameno, S; Ijiri, I

    1999-04-12

    Seven cases involving acute fatalities due to ingestion of furathiocarb, a carbamate insecticide, are presented. Furathiocarb was detected in the gastric contents using thin layer chromatography (TLC) and gas chromatography/mass spectrophotometry (GC/MS), and quantified in the blood using a gas chromatograph equipped with a nitrogen-phosphorus detector (NPD). The fatal levels of furathiocarb in the blood ranged from 0.1 to 21.6 micrograms/ml. PMID:10376339

  8. Autonomic Function following Acute Organophosphorus Poisoning: A Cohort Study

    PubMed Central

    Jayasinghe, Sudheera S.; Pathirana, Kithsiri D.

    2012-01-01

    Autonomic dysfunction after chronic low level exposure to organophosphorus (OP) pesticides has been consistently reported in the literature, but not following a single acute overdose. In order to study autonomic function after an acute OP overdose, sixty-six overdose patients were compared to 70 matched controls. Assessment of autonomic function was done by heart rate response to standing, deep breathing (HR-DB) and Valsalva manoeuvre; blood pressure (BP) response to standing and sustained hand grip; amplitude and latency of sympathetic skin response (SSR); pupil size and post-void urine volume. The patients were assessed one and six weeks after the exposure. The number of patients who showed abnormal autonomic function compared to standard cut-off values did not show statistically significantly difference from that of controls by Chi-Square test. When compared to the controls at one week the only significant differences consistent with autonomic dysfunction were change of diastolic BP 3 min after standing, HR-DB, SSR-Amplitude, SSR-Latency, post-void urine volume and size of the pupil. At 6 weeks significant recovery of autonomic function was observed and only HR-DB was decreased to a minor degree, −5 beats/min [95%CI 2–8]. This study provides good evidence for the lack of long term autonomic dysfunction following acute exposure to OP pesticides. PMID:22655091

  9. Central nervous system effects in acute thallium poisoning.

    PubMed

    Tsai, Yu-Tai; Huang, Chin-Chang; Kuo, Hung-Chou; Wang, Hsuan-Min; Shen, Wu-Shiun; Shih, Tung-Sheng; Chu, Nai-Shin

    2006-03-01

    We report the central nervous system manifestations, neuropsychological studies and brain magnetic resonance image (MRI) findings of two patients with acute thallium intoxication. Neurologically the patients suffered from confusion, disorientation, and hallucination in the acute stage, followed by anxiety, depression, lack of attention, and memory impairment, in addition to peripheral neuropathy. Neuropsychological tests revealed an impairment of memory function, including reversed digital span, memory registration, memory recall, memory recognition, similarity, proverb reasoning, and verbal fluency. High concentrations of thallium were found in the urine, blood, and drinking water of these two patients. Brain MRI showed lesions in the corpus striatum in one patient. During the follow-up periods, the clinical manifestations and neuropsychological studies showed a slowly progressive improvement, and a follow-up brain MRI 1.5 months later demonstrated a resolution of the lesions. We conclude that thallium intoxication might induce encephalopathy, and brain MRI studies demonstrated the acute-stage brain lesions in a severe intoxicated patient. In addition, neuropsychological tests also confirmed memory deficits, although the brain lesions in the corpus striatum might resolve. PMID:16337004

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

    PubMed Central

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

    2015-01-01

    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. PMID:26244924

  11. Initial Serum Ammonia as a Predictor of Neurologic Complications in Patients with Acute Glufosinate Poisoning

    PubMed Central

    Lee, Dong Keon; Youk, Hyun; Kim, Hyun; Kim, Oh Hyun; Go, Jin; Kim, Tae Hoon; Cha, KyoungChul; Lee, Kang Hyun; Hwang, Sung Oh

    2016-01-01

    Purpose Glufosinate poisoning can cause neurologic complications that may be difficult to treat due to delayed manifestation. Studies assessing possible predictors of complications are lacking. Although serum ammonia level is a potential predictor of severe neurotoxicity, it has only been assessed via case reports. Therefore, we investigated factors that predict neurologic complications in acute glufosinate-poisoned patients. Materials and Methods We conducted a retrospective review of 45 consecutive glufosinate-poisoning cases that were diagnosed in the emergency department (ED) of Wonju Severance Christian Hospital between May 2007 and July 2014. Patients with a Glasgow Coma Scale (GCS) score of <8, seizure, and/or amnesia were defined to a neurologic complication group. Results The neurologic complication group (29 patients, 64.4%) comprised patients with GCS<8 (27 patients, 60.0%), seizure (23 patients, 51.1%), and amnesia (5 patients, 11.1%). Non-neurologic complications included respiratory failure (14 patients, 31.1%), intubation and ventilator care (23 patients, 51.1%), shock (2 patients, 4.4%), pneumonia (16 patients, 35.6%), acute kidney injury (10 patients, 22.2%), and death (4 patients, 8.9%). Complications of GCS<8, seizure, respiratory failure, and intubation and ventilator care appeared during latent periods within 11 hrs, 34 hrs, 14 hrs, and 48 hrs, respectively. Initial serum ammonia was a predictor of neurologic complications [odds ratio 1.039, 95% confidence interval (1.001-1.078), p=0.046 and area under the curve 0.742]. Conclusion Neurologic complications developed in 64.4% of patients with acute glufosinate poisoning. The most common complication was GCS<8. Initial serum ammonia level, which can be readily assessed in the ED, was a predictor of neurologic complications. PMID:26632409

  12. Acute methoxetamine and amphetamine poisoning with fatal outcome: a case report.

    PubMed

    Wiergowski, Marek; Anand, Jacek Sein; Krzyżanowski, Maciej; Jankowski, Zbigniew

    2014-08-01

    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. PMID:25060403

  13. Hyperamylasemia as an Early Predictor of Mortality in Patients with Acute Paraquat Poisoning

    PubMed Central

    Liu, Shuai; Wang, Qiang; Zhou, Rong; Li, Changbin; Hu, Dayong; Xue, Wen; Wu, Tianfu; Mohan, Chandra; Peng, Ai

    2016-01-01

    Background Paraquat (PQ) is a non-selective and fast-acting contact herbicide which has been widely used in developing countries. Hyperamylasemia was reported in patients with PQ poisoning. This study investigated the predictive value and clinical characteristics of hyperamylasemia in patients with PQ poisoning. Material/Methods This study included 87 patients with acute PQ poisoning admitted from July 2012 to May 2015. Data were collected from medical records. Receiver operating characteristic (ROC) analysis was conducted to analyze the discriminatory potential of serum amylase with respect to 90-day mortality. Results Of 87 patients, 29 patients had elevated serum amylase. We found that serum amylase was significantly higher among patients with AKI than those with non-AKI (p<0.001), and was an independent predictor of mortality (hazard ratio [HR]=3.644; 95% [CI], 1.684–7.881; p=0.001). The area under the ROC curve for the serum amylase (area under curve [AUC]=0.796; 95% [CI], 0.690–0.903) had a better discriminatory potential than plasma PQ concentration (0.698;0.570–0.825) or urinary PQ concentration (0.647;0.514–0.781) in predicting 90-day mortality. Conclusions Hyperamylasemia is a valuable early predictor of 90-day mortality in PQ poisoning. PMID:27101346

  14. The characteristics of emergency department presentations related to acute herbicide or insecticide poisoning in South Korea between 2011 and 2014.

    PubMed

    Moon, Jeong Mi; Chun, Byeong Jo; Cho, Yong Soo

    2016-01-01

    The aim of this study was to examine epidemiologic data regarding acute herbicide or insecticide poisoning in adults from 2011 to 2014 at the national level in South Korea. Further, the association between governmental regulations involving pesticides and changes in pesticide poisoning occurrences over time was determined. Data were obtained from the emergency department (ED)-based Injury In-depth Surveillance system conducted by the Korea Center for Disease Control and Prevention (KCDC). Governmental regulations on pesticides were downloaded from the homepage of the Korea Rural Development Administration. Pesticides were classified according to guidelines provided by the World Health Organization (WHO) and by the respective Resistance Action Committee (RAC). Trends in the number of ED presentations and case fatality rate (CFR) due to pesticide poisoning were investigated. The overall CFR due to poisoning from herbicides or insecticides in adults in South Korea was 16.8% during 2011-2014. However, CFR significantly decreased over the 4-year period. The ED presentations of paraquat (PQ) poisoning fell significantly, whereas poisoning due to glyphosate, glufosinate, or combined herbicides increased markedly over the 4 years. Between 2011 and 2013, PQ was the most common pesticide poisoning, whereas glyphosate became the most frequent in 2014. PQ produced the highest rate of fatality followed by endosulfan. Although the frequency of PQ poisoning decreased, which may be attributed to governmental regulations, the CFR and incidence of pesticide poisoning in adults remain a public health concern that needs to be addressed. PMID:27267557

  15. Acute Self-Induced Poisoning With Sodium Ferrocyanide and Methanol Treated With Plasmapheresis and Continuous Renal Replacement Therapy Successfully

    PubMed Central

    Liu, Zhenning; Sun, Mingli; Zhao, Hongyu; Zhao, Min

    2015-01-01

    Abstract Self-induced poisoning with chemicals is one of the most commonly used suicide methods. Suicide attempts using massive pure sodium ferrocyanide and methanol are rare. This article discusses the management of acute intentional self-poisoning using sodium ferrocyanide and methanol. We present a case of acute self-induced poisoning using sodium ferrocyanide and methanol admitted to our hospital 2 hours after ingestion. He was deeply unconscious and unresponsive to painful stimuli. The laboratory findings showed acute kidney injury and severe metabolic acidosis. We took effective measures including endotracheal intubation and mechanical ventilation to ensure the vital signs were stable. Subsequently, we treated the patient using gastric lavage, bicarbonate, ethanol, plasmapheresis (plasma exchange), and continuous renal replacement therapy (CRRT) successfully. He gradually recovered from poisoning and was discharged without abnormalities on the 6th day. Follow-up for 3 months revealed no sequelae. Blood purification including plasmapheresis and CRRT is an effective method to scavenge toxicants from the body for acute self-poisoning with sodium ferrocyanide and methanol. Treatment strategies in the management of poisoning, multiple factors including the removal efficiency of toxin, the protection of vital organs, and the maintenance of homeostasis must be considered. PMID:26020397

  16. Acute animal and human poisonings from cyanotoxin exposure - A review of the literature.

    PubMed

    Wood, Roslyn

    2016-05-01

    Cyanobacterial blooms are a potential health hazard due to the ability of some species to produce toxins that are harmful to other living organisms. This review provides a comprehensive summary of anecdotal and case reports on acute poisonings in animals and humans attributable to cyanotoxin exposure in fresh- and brackish-waters. Approximately two-thirds of reported poisonings have occurred in Europe and the United States. Dogs and livestock account for the majority of reported cases involving animal exposure to cyanotoxins, while recreational activities are responsible for approximately half of reported incidents involving human exposure. Due to data limitations it is difficult to estimate the total number of animals and humans affected by cyanotoxins, however, some general observations regarding frequency and numbers affected are made. The review demonstrates that cyanotoxins have, and will likely to continue to have, potentially serious consequences for public health and animal welfare worldwide. PMID:26995270

  17. A CASE OF ACUTE WATER HEMLOCK (CICUTA MACULATA) POISONING AND DEATH IN CATTLE AFTER INGESTION OF GREEN SEED HEADS

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A case of acute water hemlock (Cicuta maculata) poisoning in cattle was reported. Nine cattle died acutely after grazing immature water hemlock seed. Chemical analysis and bioassay confirmation determined that the immature seeds contained the highly toxic long chain diols including cicutoxin, cicu...

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

    PubMed

    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. PMID:22010435

  19. Toxicokinetics of paraquat in Korean patients with acute poisoning

    PubMed Central

    Kim, Hak-Jae; Kim, Hyung-Ki; Lee, Hwayoung; Bae, Jun-Seok; Kown, Jun-Tack; Gil, Hyo-Wook

    2016-01-01

    To conduct a kinetic study of paraquat (PQ), we investigated 9 patients with acute PQ intoxication. All of them ingested more than 20 ml of undiluted PQ herbicide to commit suicide and arrived at our hospital early, not later than 7 h after PQ ingestion. The urine dithionite test for PQ in all of the nine patients was strongly positive at emergency room. Blood samples were obtained every 30 min for the first 2~3 h and then every 1 or 2 h, as long as the clinical progression was stable among the patients for 30 h after PQ ingestion. The area under the plasma concentration-time curve (AUCinf), which was extrapolated to infinity, was calculated using the trapezoidal rule. Toxicokinetic parameters, such as the terminal elimination half-life, apparent oral clearance, and apparent volume of distribution (Vd/F) were calculated. The maximum PQ concentration (Cmax) and the time to reach maximum PQ concentration (Tmax) were also obtained. Plasma PQ concentrations in nine patients were well described by a bi-exponential curve with a mean terminal elimination half-life of 13.1±6.8 h. Cmax and AUCinf were 20.8±25.7 mg/l and 172.5±160.3 h·mg/l, respectively. Apparent volume of distribution and apparent oral clearance were 50.9±61.3 l/kg and 173.4±111.2 l/h, respectively. There were a significant correlation (r =0.84; p<0.05) between the PQ amount ingested and Cmax. AUCinf also showed a significant correlation (r =0.83; p<0.05) with the PQ amount ingested. These correlations provide evidence that PQ has dose-linear toxicokinetic characteristics. PMID:26807021

  20. Impairment of striatal mitochondrial function by acute paraquat poisoning.

    PubMed

    Czerniczyniec, Analía; Lanza, E M; Karadayian, A G; Bustamante, J; Lores-Arnaiz, S

    2015-10-01

    Mitochondria are essential for survival. Their primary function is to support aerobic respiration and to provide energy for intracellular metabolic pathways. Paraquat is a redox cycling agent capable of generating reactive oxygen species. The aim of the present study was to evaluate changes in cortical and striatal mitochondrial function in an experimental model of acute paraquat toxicity and to compare if the brain areas and the molecular mechanisms involved were similar to those observed after chronic exposure. Sprague-Dawley rats received paraquat (25 mg/Kg i.p.) or saline and were sacrificed after 24 h. Paraquat treatment decreased complex I and IV activity by 37 and 21 % respectively in striatal mitochondria. Paraquat inhibited striatal state 4 and state 3 KCN-sensitive respiration by 80 % and 62 % respectively, indicating a direct effect on respiratory chain. An increase of 2.2 fold in state 4 and 2.3 fold in state 3 in KCN-insensitive respiration was observed in striatal mitochondria from paraquat animals, suggesting that paraquat redox cycling also consumed oxygen. Paraquat treatment increased hydrogen peroxide production (150 %), TBARS production (42 %) and cardiolipin oxidation/depletion (12 %) in striatal mitochondria. Also, changes in mitochondrial polarization was induced after paraquat treatment. However, no changes were observed in any of these parameters in cortical mitochondria from paraquat treated-animals. These results suggest that paraquat treatment induced a clear striatal mitochondrial dysfunction due to both paraquat redox cycling reactions and impairment of the mitochondrial electron transport, causing oxidative damage. As a consequence, mitochondrial dysfunction could probably lead to alterations in cellular bioenergetics. PMID:26350412

  1. Toxicokinetics of paraquat in Korean patients with acute poisoning.

    PubMed

    Kim, Hak-Jae; Kim, Hyung-Ki; Lee, Hwayoung; Bae, Jun-Seok; Kown, Jun-Tack; Gil, Hyo-Wook; Hong, Sae-Yong

    2016-01-01

    To conduct a kinetic study of paraquat (PQ), we investigated 9 patients with acute PQ intoxication. All of them ingested more than 20 ml of undiluted PQ herbicide to commit suicide and arrived at our hospital early, not later than 7 h after PQ ingestion. The urine dithionite test for PQ in all of the nine patients was strongly positive at emergency room. Blood samples were obtained every 30 min for the first 2~3 h and then every 1 or 2 h, as long as the clinical progression was stable among the patients for 30 h after PQ ingestion. The area under the plasma concentration-time curve (AUCinf), which was extrapolated to infinity, was calculated using the trapezoidal rule. Toxicokinetic parameters, such as the terminal elimination half-life, apparent oral clearance, and apparent volume of distribution (Vd/F) were calculated. The maximum PQ concentration (Cmax) and the time to reach maximum PQ concentration (Tmax) were also obtained. Plasma PQ concentrations in nine patients were well described by a bi-exponential curve with a mean terminal elimination half-life of 13.1±6.8 h. Cmax and AUCinf were 20.8±25.7 mg/l and 172.5±160.3 h·mg/l, respectively. Apparent volume of distribution and apparent oral clearance were 50.9±61.3 l/kg and 173.4±111.2 l/h, respectively. There were a significant correlation (r =0.84; p<0.05) between the PQ amount ingested and Cmax. AUCinf also showed a significant correlation (r =0.83; p<0.05) with the PQ amount ingested. These correlations provide evidence that PQ has dose-linear toxicokinetic characteristics. PMID:26807021

  2. Clinical outcomes and kinetics of propanil following acute self-poisoning: a prospective case series

    PubMed Central

    Roberts, Darren M; Heilmair, Renate; Buckley, Nick A; Dawson, Andrew H; Fahim, Mohamed; Eddleston, Michael; Eyer, Peter

    2009-01-01

    Background Propanil is an important cause of death from acute pesticide poisoning, of which methaemoglobinaemia is an important manifestation. However, there is limited information about the clinical toxicity and kinetics. The objective of this study is to describe the clinical outcomes and kinetics of propanil following acute intentional self-poisoning. Methods 431 patients with a history of propanil poisoning were admitted from 2002 until 2007 in a large, multi-centre prospective cohort study in rural hospitals in Sri Lanka. 40 of these patients ingested propanil with at least one other poison and were not considered further. The remaining 391 patients were classified using a simple grading system on the basis of clinical outcomes; methaemoglobinaemia could not be quantified due to limited resources. Blood samples were obtained on admission and a subset of patients provided multiple samples for kinetic analysis of propanil and the metabolite 3,4-dichloroaniline (DCA). Results There were 42 deaths (median time to death 1.5 days) giving a case fatality of 10.7%. Death occurred despite treatment in the context of cyanosis, sedation, hypotension and severe lactic acidosis consistent with methaemoglobinaemia. Treatment consisted primarily of methylene blue (1 mg/kg for one or two doses), exchange transfusion and supportive care when methaemoglobinaemia was diagnosed clinically. Admission plasma concentrations of propanil and DCA reflected the clinical outcome. The elimination half-life of propanil was 3.2 hours (95% confidence interval 2.6 to 4.1 hours) and the concentration of DCA was generally higher, more persistent and more variable than propanil. Conclusion Propanil is the most lethal herbicide in Sri Lanka after paraquat. Methylene blue was largely prescribed in low doses and administered as intermittent boluses which are expected to be suboptimal given the kinetics of methylene blue, propanil and the DCA metabolite. But in the absence of controlled studies the

  3. Acute lead poisoning in nursing home and psychiatric patients from the ingestion of lead-based ceramic glazes.

    PubMed

    Vance, M V; Curry, S C; Bradley, J M; Kunkel, D B; Gerkin, R D; Bond, G R

    1990-10-01

    To our knowledge, acute inorganic lead poisoning from single ingestions of lead compounds has been only rarely reported. During a 14-month period, we were contacted regarding eight instances of acute ingestions of liquid lead-based ceramic glazes by mentally impaired residents of nursing homes or psychiatric facilities participating in ceramic arts programs. While some ingestions did not cause toxic effects, some patients developed acute lead poisoning characterized by abdominal pain, anemia, and basophilic stippling of red blood cells. In the blood of several patients, lead concentrations were far above normal (4 to 9.5 mumol/L). Urinary lead excretions were tremendously elevated during chelation therapy, with one patient excreting 535.9 mumol/L of lead during a 6-day period, the largest lead excretion ever reported in a patient suffering from acute lead poisoning, to our knowledge. All patients recovered following supportive care and appropriate use of chelating agents. Lead-based glazes are commonly found in nursing homes and psychiatric facilities. We suspect that acute or chronic lead poisoning from the ingestion(s) of lead-based ceramic glazes may be an unrecognized but not uncommon problem among such residents. We urge physicians to take ingestions of lead-based glazes seriously and to consider the diagnosis of lead poisoning in nursing home and psychiatric patients who have participated in ceramic crafts programs. PMID:2222094

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

    PubMed

    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. PMID:25790716

  5. The Assessment of Electroencephalographic Changes and Memory Disturbances in Acute Intoxications with Industrial Poisons

    PubMed Central

    Chalupa, B.; Synková, J.; Ševčík, M.

    1960-01-01

    A report is given of the results of the electroencephalogram (EEG) and of an experimental memory examination in a group of 22 cases of acute carbon monoxide and solvents poisoning of varying severity. An abnormal EEG recording, most often in the form of theta activity 5-6 sec., was found in 12 patients; memory disturbances were found in 13 cases. There was correlation between the results of the two examinations as well as with the clinical classification of the degree of intoxication. The methods are suitable for the solving of various theoretical and practical questions in industrial toxicology. PMID:13692202

  6. Evidence for metal poisoning in acute deaths of large red drum (Scianeops ocellata)

    SciTech Connect

    Cardeihac, P.T.; Simpson, C.F.; White, F.H.; Thompson, N.P.; Carr, W.E.

    1981-12-01

    Two of the approximately 100 large, mature, red drum found dead or dying in Florida's Indian River and Mosquito Lagoon were examined. Determinations were made of serum electrolyte concentrations, total proteins, albumins, globulins, creatinine values, and enzyme activity. Concentrations of copper, zinc, arsenic, chromium, cadmium, mercury, lead, and selenium were determined by atomic aborption. The outstanding histological lesions were found in the gills of a moribund specimen. Results indicate that the acute episode was triggered by ingestion of copper, zinc, and arsenic. However, cadmium, mercury and chromium may have been contributory by binding with metallothionein and thus lowering tolerance to metal poisoning. (JMT)

  7. Stonefish poisoning.

    PubMed

    Lyon, Richard Mark

    2004-01-01

    Scuba diving is becoming an increasingly popular recreation. Divers are traveling further afield, often to remote dive locations. These locations are often home to poisonous marine creatures such as stonefish. A case of acute stonefish poisoning in a scuba diver is described, including his treatment, the difficulties encountered with his management and evacuation, and his subsequent return to full health. The proper management of stonefish poisoning is reviewed, and the implications for divers traveling to remote locations are given. PMID:15636379

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

    PubMed

    Zakharov, Sergey; Kotikova, Katerina; Vaneckova, Manuela; Seidl, Zdenek; Nurieva, Olga; Navratil, Tomas; Caganova, Blazena; Pelclova, Daniela

    2016-08-01

    The purpose was to study the prevalence and predisposing factors of brain lesions in survivors of acute methanol poisoning. Clinical data on 106 patients with methanol poisoning were collected during the Czech mass poisoning outbreak. Of 83 survivors, in 46 (55%) patients, follow-up examinations including magnetic resonance imaging of brain (MR) were performed 3-8 and 24-28 months after discharge from the hospital. Of 46 patients with a median age of 49 (interquartile range, 35-57) years, 24 (52%) patients had a total of 40 abnormal brain findings with haemorrhagic lesions detected in 15 (33%) and non-haemorrhagic lesions found in 9 (19%) patients. The patients with haemorrhagic brain lesions were more acidemic (lower arterial blood pH, higher base deficit) and had higher glycaemia and lactacidaemia on admission than those without haemorrhages (all p < 0.05). Thirteen of 32 (41%) of patients with systemic anticoagulation and 2 of 14 (14%) of patients without it had haemorrhagic lesions (p = 0.080). Bleeding complications during the treatment occurred in 4 of 15 (27%) patients, and 5 of 15 (33%) patients had conditions predisposing to haemorrhage in the group with haemorrhagic lesions. In three cases with a series of computer tomography (CT)/MR performed during hospitalization, the necrotic lesions in the brain remained non-haemorrhagic during hospitalization and haemorrhagic lesions were detected on the follow-up MR examinations only. No association between brain haemorrhages and systemic anticoagulation during dialysis was found: brain haemorrhages might occur in severely poisoned patients treated without systemic anticoagulation, whereas treatment with high doses of heparin might not lead to brain haemorrhages. PMID:26806851

  9. Acute Poisonings Admitted to a Tertiary Level Intensive Care Unit in Northern India: Patient Profile and Outcomes

    PubMed Central

    Mathai, Ashu Sara; Pannu, Aman; Arora, Rohit

    2015-01-01

    Background Poisoning is becoming a real health care burden for developing countries like India. An improved knowledge of the patterns of poisonings, as well as the clinical course and outcomes of these cases can help to formulate better preventive and management strategies. Aim To study the demographic and clinical profiles of patients admitted to the ICU with acute poisoning and to study the factors that predict their mortality. Materials and Methods Retrospective two years (September 1, 2010 to August 31, 2012) study of all consecutive patients admitted to the Intensive Care Unit (ICU) with acute poisoning at a tertiary care hospital in Northern India. Results Out of the 67 patients admitted to the ICU during the study period, the majority were young (median age 29 years) males (69%) who had consumed poison intentionally. Pesticides were the most commonly employed poison, notably organophosphorus compounds (22 patients, 32.8%) and aluminium phosphide (14 patients, 20.9%). While the overall mortality from all poisonings was low (18%), aluminium phosphide was highly toxic, with a mortality rate of 35%. The factors at ICU admission that were found to be associated with a significant risk of death were, high APACHE II and SOFA scores (p =0.0001 and p=0.006, respectively), as well as the need for mechanical ventilation and drugs for vasoactive support (p=0.012 and p= 0.0001, respectively). Conclusion Use of pesticides for intentional poisoning continues to be rampant in Northern India, with many patients presenting in a critical condition to tertiary level hospitals. Pesticide regulations laws, educational awareness, counseling and poison information centers will help to curtail this public health problem. PMID:26557594

  10. Neurotoxicity and reactive astrogliosis in the anterior cingulate cortex in acute ciguatera poisoning.

    PubMed

    Zhang, Xu; Cao, Bing; Wang, Jun; Liu, Jin; Tung, Vivian Oi Vian; Lam, Paul Kwan Sing; Chan, Leo Lai; Li, Ying

    2013-06-01

    Ciguatoxins (CTXs) cause long-term disturbance of cerebral functions. The primary mechanism of neurotoxicity is related to their interaction with voltage-gated sodium channels. However, until now, the neurological targets for CTXs in the brain of intact animals have not been described. In our study, 1 day following oral exposure to 0.26 ng/g of Pacific ciguatoxin 1 (P-CTX-1), we performed in vivo electrophysiological recordings in the rat anterior cingulate cortex (ACC) and identified the increase in spontaneous firings and enhanced responses to visceral noxious stimulation. Local field recordings characterized the P-CTX-1-induced synaptic potentiation and blockage of the induction of electrical stimulation-induced long-term potentiation in the medial thalamus (MT)-ACC pathway. Furthermore, intracerebroventricular administration of P-CTX-1 at doses of 1.0, 5.0, and 10 nM produced a dose-dependent increase in ACC neuronal firings and MT-ACC synaptic transmission. Further studies showed upregulated Na(+) channel expression in astrocytes under pathological conditions. We hypothesized that the astrocytes might have been activated in the ciguatera poisoning in vivo. Increases in glial fibrillary acid protein expression were detected in reactive astrocytes in the rat ACC. The activation of astroglia was further indicated by activation of the gap junction protein connexin 43 and upregulation of excitatory amino acid transporter 2 expression suggesting that glutamate was normally rapidly cleared from the synaptic cleft during acute ciguatera poisoning. However, neurotoxicity and reactive astrogliosis were not detected in the ACC after 7 days of P-CTX-1 exposure. The present results are the first characterization of P-CTX-1-invoked brain cortex neuronal excitotoxicity in vivo and supported the theme that neuron and astroglia signals might play roles in acute ciguatera poisoning. PMID:23494292

  11. Abnormal pancreatic enzymes and their prognostic role after acute paraquat poisoning

    PubMed Central

    Li, Yi; Wang, Meng; Gao, Yanxia; Yang, Wen; Xu, Qun; Eddleston, Michael; Li, Li; Yu, Xuezhong

    2015-01-01

    Ingestion of paraquat causes multi-organ failure. Prognosis is best estimated through measurement of blood paraquat concentrations but this facility is not available in most hospitals. We studied the prognostic significance of abnormal pancreatic enzymes for survival. Patients with acute paraquat poisoning were recruited. An extensive series of blood tests including serum amylase were serially checked. Patients were sorted according to their serum amylase activity (normal [<220 U/L], mildly elevated [220 to 660 U/L], elevated [>660 U/L]), and survival compared between groups. 177 patients were enrolled to the study, of whom 67 died and 110 survived. 122 (70.62%), 27 (15.25%) and 25 (14.13%) patients were in the normal, mildly elevated and elevated amylase activity groups, respectively. The case fatality in the elevated group was 100% compared to 17% in the normal group (P < 0.001). We found four independent factors for paraquat death prediction: amylase, PaCO2, leukocyte number, and neutrophil percentage. Models using pancreatic enzyme activity showed good prediction power. We have found that abnormal pancreatic enzymes are useful prognostic marker of death after acute paraquat poisoning. Including serum amylase activity into a prognostic model provides a good prognostication. PMID:26603772

  12. Acute Pancreatitis Caused By Mushroom Poisoning: A Report of Two Cases.

    PubMed

    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

  13. Organophosphate intermediate syndrome with neurological complications of extrapyramidal symptoms in clinical practice

    PubMed Central

    Detweiler, Mark B.

    2014-01-01

    Organophosphates (OPs) are ubiquitous in the world as domestic and industrial agricultural insecticides. Intentional poisoning as suicides attempts are clinical phenomena seen in emergency departments and clinics in agricultural areas. Intermediate syndrome with the neurological complication of extra pyramidal symptoms following acute OP ingestion may occur in pediatric and adult cases. While death is the most serious consequence of toxic OP doses, low levels of exposure and nonfatal doses may disrupt the neurobehavioral development of fetuses and children in addition to bring linked to testicular cancer and male and female infertility. These are disturbing. Chronic and acute toxicity from OPs are barriers to the health of our present and future generations. Symptoms and treatment of acute and chronic OP exposure are briefly referenced with inclusion of the intermediate syndrome. Suggestions for local and systemic reduction of the acute and long term consequences of OP ingestion are opined. PMID:25002781

  14. Organophosphate intermediate syndrome with neurological complications of extrapyramidal symptoms in clinical practice.

    PubMed

    Detweiler, Mark B

    2014-07-01

    Organophosphates (OPs) are ubiquitous in the world as domestic and industrial agricultural insecticides. Intentional poisoning as suicides attempts are clinical phenomena seen in emergency departments and clinics in agricultural areas. Intermediate syndrome with the neurological complication of extra pyramidal symptoms following acute OP ingestion may occur in pediatric and adult cases. While death is the most serious consequence of toxic OP doses, low levels of exposure and nonfatal doses may disrupt the neurobehavioral development of fetuses and children in addition to bring linked to testicular cancer and male and female infertility. These are disturbing. Chronic and acute toxicity from OPs are barriers to the health of our present and future generations. Symptoms and treatment of acute and chronic OP exposure are briefly referenced with inclusion of the intermediate syndrome. Suggestions for local and systemic reduction of the acute and long term consequences of OP ingestion are opined. PMID:25002781

  15. [Evaluation of the treat of acute poisoning with chemical compounds among adult inhabitants of Krakow in 1995].

    PubMed

    Kamenczak, A; Pach, K; Kłys, M; Motyka, E

    1997-01-01

    The goal of this study is to evaluate the number and the reasons (poison and structure) of acute poisonings which occurred among Kraków adult inhabitants in the year 1995. Under analysis there were 3003 people treated at the Department of Clinical Toxicology and 210 poisoned who died at the place of accident prior to any treatment was conducted. The group of hospitalized persons consisted of 63.7% men and 36.3% women, and the group of people who died at the place of accident consisted of 89.5% men and of 10.5% women. The overall coefficient of poisonings during the year 1995 was 48.3; for men was 66.7 and 32.5 for women. A drugs (45.1%) followed by ethanol (42.8%) were the most common cause of acute poisonings. The mortality rate of the treated patients was low (0.7%), but while including those people who died at the place of accident prior to any treatment, the mortality rate rose up to 7.2%. That increase in the mortality rate was caused mainly by fatal cases due to ethanol and carbon monoxide poisonings. PMID:9333887

  16. Utility of the Measurement of Carboxyhemoglobin Level at the Site of Acute Carbon Monoxide Poisoning in Rural Areas

    PubMed Central

    Onodera, Makoto; Fujino, Yasuhisa; Kikuchi, Satoshi; Sato, Masayuki; Mori, Kiyofumi; Beppu, Takaaki; Inoue, Yoshihiro

    2016-01-01

    Objective. This study examined the hypothesis that correlations exist between the carbon monoxide exposure time and the carboxyhemoglobin concentration at the site of carbon monoxide poisoning, using a pulse carbon monoxide oximeter in rural areas or the carboxyhemoglobin concentration measured at a given medical institution. Background. In previous studies, no definitive relationships between the arterial blood carboxyhemoglobin level and the severity of carbon monoxide poisoning have been observed. Method. The subjects included patients treated for acute carbon monoxide poisoning in whom a medical emergency team was able to measure the carboxyhemoglobin level at the site of poisoning. We examined the relationship between the carboxyhemoglobin level at the site of poisoning and carbon monoxide exposure time and the relationships between the arterial blood carboxyhemoglobin level and carbon monoxide exposure time. Results. A total of 10 patients met the above criteria. The carboxyhemoglobin levels at the site of poisoning were significantly and positively correlated with the exposure time (rs = 0.710, p = 0.021), but the arterial blood carboxyhemoglobin levels were not correlated with the exposure time. Conclusion. In rural areas, the carboxyhemoglobin level measured at the site of carbon monoxide poisoning correlated with the exposure time. PMID:27239377

  17. Utility of the Measurement of Carboxyhemoglobin Level at the Site of Acute Carbon Monoxide Poisoning in Rural Areas.

    PubMed

    Onodera, Makoto; Fujino, Yasuhisa; Kikuchi, Satoshi; Sato, Masayuki; Mori, Kiyofumi; Beppu, Takaaki; Inoue, Yoshihiro

    2016-01-01

    Objective. This study examined the hypothesis that correlations exist between the carbon monoxide exposure time and the carboxyhemoglobin concentration at the site of carbon monoxide poisoning, using a pulse carbon monoxide oximeter in rural areas or the carboxyhemoglobin concentration measured at a given medical institution. Background. In previous studies, no definitive relationships between the arterial blood carboxyhemoglobin level and the severity of carbon monoxide poisoning have been observed. Method. The subjects included patients treated for acute carbon monoxide poisoning in whom a medical emergency team was able to measure the carboxyhemoglobin level at the site of poisoning. We examined the relationship between the carboxyhemoglobin level at the site of poisoning and carbon monoxide exposure time and the relationships between the arterial blood carboxyhemoglobin level and carbon monoxide exposure time. Results. A total of 10 patients met the above criteria. The carboxyhemoglobin levels at the site of poisoning were significantly and positively correlated with the exposure time (rs = 0.710, p = 0.021), but the arterial blood carboxyhemoglobin levels were not correlated with the exposure time. Conclusion. In rural areas, the carboxyhemoglobin level measured at the site of carbon monoxide poisoning correlated with the exposure time. PMID:27239377

  18. Determinants of lethality from suicidal pesticide poisoning in metropolitan HsinChu.

    PubMed

    Sheu, J J; Wang, J D; Wu, Y K

    1998-12-01

    Acute pesticide poisoning is a global health problem, especially in developing countries. Although Taiwan has quickly industrialized during the last several decades, pesticide use is still prevalent in the agricultural sector. We reviewed 187 consecutive hospitalized cases of the Provincial HsinChu Hospital from January 1989 through December 1995 to explore the determinants of acute pesticide poisoning in Metropolitan HsinChu. The annual incidence rate of acute pesticide poisoning was 3.2/100,000 with an overall fatality rate of 23% which was more severe than the rates found in developed countries. The major agents involved were organophosphates, and the major cause of poisoning was suicide. Alcohol abuse, history of major medical illnesses, and history of suicide were significantly associated with suicidal poisoning; quarrel was the immediate risk factor. Causes of poisoning (suicide vs non-suicide) and selection of the pesticides were major determinants of lethality. More stringent legislation and enforcement regarding the sale and distribution of extremely toxic pesticides are needed to reduce fatalities due to acute pesticide poisoning. PMID:9830692

  19. Pattern of acute poisoning in Al-Qassim region: a surveillance report from Saudi Arabia, 1999-2003.

    PubMed

    Moazzam, M; Al-Saigul, A M; Naguib, M; Al Alfi, M A

    2009-01-01

    We reviewed all registered cases of acute chemical poisoning reporting to the preventive medicine department in the Qassim Region of Saudi Arabia from 1999 to 2003. The number of cases increased from 66 to 114 during the study period. Mean age of patients was 17.7 years, and over 39% were children aged < or = 5 years. Pesticides were the most common chemical involved; paracetamol and other analgesics were also frequently reported. The oral route was the most frequent, while vomiting was the commonest symptom. Nine deaths were recorded, of which 4 were due to pesticide poisoning. In line with the global trend, acute chemical poisoning is growing as a major health issue in the Qassim Region. PMID:20187553

  20. Evaluation of Potential Oxidative Stress in Egyptian Patients with Acute Zinc Phosphide Poisoning and the Role of Vitamin C

    PubMed Central

    Sagah, Ghada A.; Oreby, Merfat M.; El-Gharbawy, Rehab M.; Ahmed Fathy, Amal S.

    2015-01-01

    Objective To evaluate potential oxidative stress in patients with acute phosphide poisoning and the effect of vitamin C. Methods Participants were females and divided into three groups; group I: healthy volunteers group II: healthy volunteers received vitamin C, group III: patients with acute phosphide poisoning received the supportive and symptomatic treatment and group IV: patients with acute phosphide poisoning received the supportive and symptomatic treatment in addition to vitamin C. All the participants were subjected to thorough history, clinical examination, ECG and laboratory investigations were carried on collected blood and gastric lavage samples on admission. Blood samples were divided into two parts, one for measurement of routine investigations and the second part was used for evaluation of malondialdehyde and total thiol levels before and after receiving the treatment regimen. Results Most of the cases in this study were among the age group of 15–25 years, females, single, secondary school education, from rural areas and suicidal. All vital signs were within normal range and the most common complaint was vomiting and abdominal pain. All cases in this study showed normal routine investigations. The mean MDA levels after receiving treatment decreased significantly in groups II and IV. The mean total thiol levels increased significantly after receiving treatment in groups II and IV. Conclusion It can be concluded that vitamin C has a potential benefit due to its antioxidant property on zinc phosphide induced-oxidative stress in acute zinc phosphide poisoned patients. PMID:26715917

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

    SciTech Connect

    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.

  2. Comparative assessment of blood and urine analyses in patients with acute poisonings by medical, narcotic substances and alcohol in clinical toxicology.

    PubMed

    Ostapenko, Yury Nikolaevich; Lisovik, Zhanna Andreevna; Belova, Maria Vladimirovna; Luzhnikov, Evgeny Alekseevich; Livanov, Alexandr Sergeevich

    2005-01-01

    Acute poisonings by medical, narcotic substances and alcohol are actual in Russia in the recent years. Comparison of analytic facilities of modern analytical techniques: chromatographic (HPLC, GC, GC-MS) and immuno-chemical (FPIA) in clinical toxicology for urgent diagnostics, assessment of the severity of acute poisoning and the efficacy of the treatment in patients with acute poisonings by psychotropic drugs, narcotics and alcohol have been done. The object of the study were serum, blood, urine of 611 patients with acute poisonings by amitriptyline, clozapine, carbamazepine, opiates and also alcohol. Threshold concentrations (threshold, critical and lethal) of the toxicants and their active metabolites which corresponded to different degrees of poisoning severity have been determined. The most comfortable and informative screening method for express diagnostics and assessment of severity of acute poisonings by psychotropic drugs and narcotics showed the HPLC with using automatic analyzers. FPIA using the automatic analyzer could be applied for screening studies, if group identification is enough. GC-FID method is advisable in case of poisoning by medical substances and narcotics in view of repeated investigation for assessment of the efficacy of the therapy. GC-MS could be advisable for confirming the results of other methods. GC-TCD possess high sensitivity and specificity and is optimal for express differential diagnostics and quantitative assessment of acute poisoning by ethanol and other alcohols. PMID:16225131

  3. Pioneering early Intensive Care Medicine by the 'Scandinavian Method' of treatment for severe acute barbiturate poisoning.

    PubMed

    Trubuhovich, R V

    2015-07-01

    Between the 1920s and the mid-1950s, barbiturates were the sedative-hypnotic agents most used in clinical practice. Their ready availability and narrow therapeutic margin accounted for disturbingly high rates of acute poisoning, whether suicidal or accidental. Until the late 1940s, medical treatment was relatively ineffective, with mortality subsequently high - not only from the effects of coma, respiratory depression and cardiovascular shock with renal impairment, but also from complications of the heavy use in the 1930s and 1940s of analeptic stimulating agents. Incidence of barbiturate intoxication increased substantially following World War II and this paper details development of what became known as the 'Scandinavian Method' of treatment, which contributed substantially to the earliest establishment of intensive care units and to the practice and methods of intensive care medicine. Three names stand out for the pioneering of this treatment. Successively, psychiatrist, Aage Kirkegaard, for introducing effective anti-shock fluid therapy; anaesthetist, Eric Nilsson, for introducing anaesthesiologic principles, including manual intermittent positive pressure ventilation into management; and, psychiatrist, Carl Clemmesen, for introducing centralisation of seriously poisoned patients in a dedicated unit. Clemmesen's Intoxication Unit opened at the Bispebjerg Hospital, Copenhagen, on 1 October 1949. ICU pioneer Bjørn Ibsen suggested it was the initial ICU, while noting that it supplied Intensive Therapy for one type of disorder only (as had HCA Lassen's Blegdam Hospital unit for Denmark's 1952 to 1953 polio epidemic). Treatment for barbiturate poisoning during the 1950s in some other Scandinavian hospitals will also be considered briefly. PMID:26126074

  4. Detoxification of organophosphate nerve agents by bacterial phosphotriesterase

    SciTech Connect

    Ghanem, Eman; Raushel, Frank M. . E-mail: raushel@tamu.edu

    2005-09-01

    Organophosphates have been widely used as insecticides and chemical warfare agents. The health risks associated with these agents have necessitated the need for better detoxification and bioremediation tools. Bacterial enzymes capable of hydrolyzing the lethal organophosphate nerve agents are of special interest. Phosphotriesterase (PTE) isolated from the soil bacteria Pseudomonas diminuta displays a significant rate enhancement and substrate promiscuity for the hydrolysis of organophosphate triesters. Directed evolution and rational redesign of the active site of PTE have led to the identification of new variants with enhanced catalytic efficiency and stereoselectivity toward the hydrolysis of organophosphate neurotoxins. PTE has been utilized to protect against organophosphate poisoning in vivo. Biotechnological applications of PTE for detection and decontamination of insecticides and chemical warfare agents are developing into useful tools. In this review, the catalytic properties and potential applications of this remarkable enzyme are discussed.

  5. Acute poisonings with chemical compounds among adolescent and adult inhabitants of Kraków in the year 1997.

    PubMed

    Sancewicz-Pach, K; Kamenczak, A; Klag, E; Kłys, M

    1999-01-01

    The pattern of adolescent and adult poisonings in Kraków is presented on the basis of the data collected by the Poison Information Centre of the Department of Clinical Toxicology Collegium Medicum of the Jagiellonian University in 1997. This analysis includes 3472 people treated at the Department of Clinical Toxicology and 118 poisoned people who were not given any treatment and died at the scene of the accident. The group of hospitalised persons consisted of 2359 (67.9%) men and 1113 (32.1%) women, and the group of people who died at the scene of the accident consisted of 97 (82.2%) men and of 21 (17.8%) women. The overall coefficient of poisonings in 1997 was 46.9; for men--67.8 and 28.3 for women. Ethanol (39.7%) followed by drugs (20.2%), drugs + ethanol (6.7%), carbon monoxide (6.2%) and drugs of abuse (4.4%) were the most common cause of acute poisonings. The mortality rate of the cases treated was low (0.43%), but while including those people who were not given any treatment and died at the scene of the accident, mostly due to ethanol, carbon monoxide, and drugs poisoning the fatality index rose up to 3.7%. PMID:10465990

  6. Household bleaches based on sodium hypochlorite: review of acute toxicology and poison control center experience.

    PubMed

    Racioppi, F; Daskaleros, P A; Besbelli, N; Borges, A; Deraemaeker, C; Magalini, S I; Martinez Arrieta, R; Pulce, C; Ruggerone, M L; Vlachos, P

    1994-09-01

    Bleaches based on solutions of sodium hypochlorite (NaOCl) are widely used in the household to disinfect and clean hard surfaces and to bleach the laundry. A review of both published and unpublished toxicological data is presented. In addition, the results of a survey of human accidents with hypochlorite bleaches by the Poison Control Centers of France, Italy, Belgium, Greece, Turkey, Spain and Portugal for the period 1989-1992 are presented. The data show that acute accidental exposure to household bleach in use or in foreseeable misuse situations results, in the great majority of the cases, in minor, transient adverse effects on health, with no permanent sequelae. Ingestion is the most frequent route of exposure, followed by inhalation of gases evolved by mixing sodium hypochlorite bleach with acid or alkaline products. All evidence presented confirms the normal safety profile of hypochlorite-based bleaches to be similar to that of other 'generally recognized as safe' household products. PMID:7927083

  7. Glutathione transferase activity and formation of macromolecular adducts in two cases of acute methyl bromide poisoning.

    PubMed Central

    Garnier, R; Rambourg-Schepens, M O; Müller, A; Hallier, E

    1996-01-01

    OBJECTIVES: To determine the activity of glutathione transferase and to measure the S-methylcysteine adducts in blood proteins, after acute inhalation exposure to methyl bromide. To examine the influence of the polymorphism of glutathione-S-transferase theta (GSTT1) on the neurotoxicity of methyl bromide. METHODS: Two workers acutely exposed to methyl bromide with inadequate respiratory protective devices were poisoned. Seven weeks after the accident, blood samples were drawn from both patients, for measurement of glutathione transferase activity in erythrocytes (conjugator status--that is, GSTT1 phenotype) and measurement of binding products of methyl bromide with blood proteins. Conjugator status was determined by a standard procedure. The binding product of methyl bromide, S-methylcysteine, was measured in globin and albumin. RESULTS: Duration and intensity of exposure were identical for both patients as they worked together with the same protective devices and with similar physical effort. However, one patient had very severe poisoning, whereas the other only developed mild neurotoxic symptoms. The first patient was a "conjugator" with normal glutathone transferase activity, whereas this activity was undetectable in the erythrocytes of the second patient, who consequently had higher concentrations of S-methylcysteine adduct in albumin (149 v 91 nmol/g protein) and in globin (77 v 30 nmol/g protein). CONCLUSIONS: Methyl bromide is genotoxic and neurotoxic. Its genotoxicity seems to be the consequence of the alkylating activity of the parent compound, and conjugation to glutathione has a protective effect. The data presented here suggest a different mechanism for methyl bromide neurotoxicity which could be related to the transformation of methylglutathione into toxic metabolites such as methanethiol and formaldehyde. If such metabolites are the ultimate toxic species, N-acetylcysteine treatment could have a toxifying rather than a detoxifying effect. PMID:8704864

  8. Frequency, Etiology and Several Sociodemographic Characteristics of Acute Poisoning in Children Treated in the Intensive Care Unit

    PubMed Central

    Azemi, Mehmedali; Berisha, Majlinda; Kolgeci, Selim; Bejiqi, Ramush

    2012-01-01

    Aim: The aim of this work has been to present the frequency, etiology and several other socio-demographic characteristics of acute poisoning in children. The treated patients and methods of work: The treated patients were children of all age groups hospitalized in the Pediatric Clinic of Prishtina during year 2009. The study was done retrospectively. The diagnosis was done on the basis of heteroanamnesis and in several cases on the basis of the anamnesis data of a child, routine laboratory tests and toxicologic analysis. Results: 66 (9.4%) poisoned children were treated in the Intensive Care Unit. The biggest number of patients, 37 (56.06%) of them, were male, and out of that number 36 (54.55%) cases were coming from rural areas. The biggest number of them 49 (74.98%) were over 2-6 years old. The poisoning was mostly caused through the digestive tract (ingestion), it happened with 55 cases (83.33%), 56 cases (84,80%) suffered from severe poisoning, whereas 59 cases (89,50%) suffered from accidental poisoning. Regarding the type of the substances that caused poisoning, the most frequent were drugs in 34 (51.50%) cases and pesticides in 20 (30.30%) cases. Among drugs, the most dominant were those belonging to a group of benzodiazepines (10 cases) and metoclopramide (4 cases). Among pesticides the most dominant one that caused poisoning was malation (5 cases), then paration and cipermetrina appeared in 3 cases each. The biggest number of cases, 64 (96.96%) of them, were treated, whereas 2 cases (3.40%) passed away. Conclusion: The practice proved that that our people are not well informed about the poisoning in general, therefore it is necessary that they be educated by the use of all media, written and electronic, as well as other methods of medical education. PMID:23678312

  9. [On the importance of a comprehensive study for diagnostics of death from acute ethanol poisoning and coronary heart disease].

    PubMed

    Porodenko, V A; Korkhmazov, V T

    2011-01-01

    Over 30 000 cases of acute poisoning with ethyl alcohol and its surrogates are recorded annually in this country. Differential diagnostics between fatal poisoning and death from coronary heart disease encounters serious difficulties. The authors report a comprehensive forensic chemical, morphometric, and pathomorphological study of the activity of ethanol-oxidizing enzyme systems in the internal organs. The results of histochemical examination provide a basis for the extension of diagnostic potential of the available methods and the enhancement of the objective value of expert reports. PMID:21866846

  10. Acute Pancreatitis, Hepatitis and Bone Erosion in Acute Yellow Phosphorous Compound Poisoning - A Rare Complication.

    PubMed

    Kamarthi, Prabhakar; Subramani, Parimala; Gopu, Arun Vardharaju; Prasad, Reddy; Srinivasa, Chandrakala

    2016-06-01

    We report a case of acute pancreatitis and hepatitis following ingestion of yellow phosphorous. The condition of the patient progressed to encephalopathy and bony erosion of the nasal septum. Fungal mass was observed in both the nasal cavities by endoscopy. Microbiological investigation revealed the identity of the fungus as Aspergillus flavus and Candida tropicalis. Patient improved with fluconazole treatment. PMID:27504287

  11. Acute Pancreatitis, Hepatitis and Bone Erosion in Acute Yellow Phosphorous Compound Poisoning – A Rare Complication

    PubMed Central

    Kamarthi, Prabhakar; Gopu, Arun Vardharaju; Prasad, Reddy; Srinivasa, Chandrakala

    2016-01-01

    We report a case of acute pancreatitis and hepatitis following ingestion of yellow phosphorous. The condition of the patient progressed to encephalopathy and bony erosion of the nasal septum. Fungal mass was observed in both the nasal cavities by endoscopy. Microbiological investigation revealed the identity of the fungus as Aspergillus flavus and Candida tropicalis. Patient improved with fluconazole treatment. PMID:27504287

  12. Combined administration of hyperbaric oxygen and hydroxocobalamin improves cerebral metabolism after acute cyanide poisoning in rats.

    PubMed

    Hansen, M B; Olsen, N V; Hyldegaard, O

    2013-11-01

    Hyperbaric oxygen therapy (HBOT) or intravenous hydroxocobalamin (OHCob) both abolish cyanide (CN)-induced surges in interstitial brain lactate and glucose concentrations. HBOT has been shown to induce a delayed increase in whole blood CN concentrations, whereas OHCob may act as an intravascular CN scavenger. Additionally, HBOT may prevent respiratory distress and restore blood pressure during CN intoxication, an effect not seen with OHCob administration. In this report, we evaluated the combined effects of HBOT and OHCob on interstitial lactate, glucose, and glycerol concentrations as well as lactate-to-pyruvate ratio in rat brain by means of microdialysis during acute CN poisoning. Anesthetized rats were allocated to three groups: 1) vehicle (1.2 ml isotonic NaCl intra-arterially); 2) potassium CN (5.4 mg/kg intra-arterially); 3) potassium CN, OHCob (100 mg/kg intra-arterially) and subsequent HBOT (284 kPa in 90 min). OHCob and HBOT significantly attenuated the acute surges in interstitial cerebral lactate, glucose, and glycerol concentrations compared with the intoxicated rats given no treatment. Furthermore, the combined treatment resulted in consistent low lactate, glucose, and glycerol concentrations, as well as in low lactate-to-pyruvate ratios compared with CN intoxicated controls. In rats receiving OHCob and HBOT, respiration improved and cyanosis disappeared, with subsequent stabilization of mean arterial blood pressure. The present findings indicate that a combined administration of OHCob and HBOT has a beneficial and persistent effect on the cerebral metabolism during CN intoxication. PMID:23970528

  13. Unrecognized delayed toxic lithium peak concentration in an acute poisoning with sustained release lithium product.

    PubMed

    Borrás-Blasco, Joaquín; Sirvent, Ana Esther; Navarro-Ruiz, Andrés; Murcia-López, Ana; Romero-Crespo, Isabel; Enriquez, Ricardo

    2007-03-01

    A 32-year-old female with a history of bipolar disorder was admitted after taking approximately 16 g of an extended-release lithium carbonate formulation in an attempted suicide. Five hours after consumption, the lithium serum level was 3.2 mEq/L. Fourteen hours after consumption, the lithium level was 5.1 mEq/L and the patient was asymptomatic. Due to a level > 4 mEq/L, the patient was transferred to a renal medicine service for hemodialysis. The lithium concentration 6 hours after the hemodialysis was 2.54 mEq/L. Thirty seven hours after the consumption (15 hours after hemodialysis), lithium levels increased up to 6.09 mEq/L. A second hemodialysis session was performed, which successfully reduced the serum lithium concentration to 1.86 mEq/L. Lithium levels 85 hours after the consumption were 0.61 mEq/L and the patient was transferred to the Psychiatry Department. Unrecognized delayed toxic peak lithium concentration may appear in an acute poisoning with a sustained release lithium product. Therefore, patients presenting with acute intoxication with extended release formulations should be managed with caution, and continued drug monitoring is suggested. PMID:17396741

  14. Single fibre electromyographic changes in man after organophosphate exposure.

    PubMed

    Baker, D J; Sedgwick, E M

    1996-05-01

    1. Neuromuscular (NM) changes resulting from organophosphate exposure are known to be complex. After severe acute poisoning recovery from initial depolarisation paralysis may be followed in a limited number of cases by onset of a non-depolarisation paralysis (the Intermediate Syndrome). It is not clear whether this block arises subclinically in all cases of poisoning as a sequel to the initial depolarisation. 2. Single fibre electromyography (SFEMG) is a sensitive clinical neurophysiological technique allowing detection of subclinical changes at the neuromuscular junction. In the study reported it has been used to examine changes in NM transmission in the forearm of fit volunteers exposed to a low level of sarin (isopropyl methyl phosphonofluoridate). 3. Small changes in SFEMG were seen at three hours and three days after an exposure sufficient to cause a reduction in red cell acetyl cholinesterase to 60% of normal. The SFEMG changes were not accompanied by any clinical neuromuscular symptoms or signs and returned to normal 2 years after exposure. 4. The results indicate that there are reversible subclinical changes compatible with the development of non-depolarising NM block without frank clinical expression. In the small population examined there were individual variations in response which may reflect differences in safety margin at the neuromuscular junction. PMID:8735458

  15. [Identification of urinary metabolites in a patient of acute poisoning by p-chloroaniline].

    PubMed

    Yoshida, T; Hirata, M; Tabuchi, T; Miyajima, K

    1991-11-01

    In order to clarify urinary metabolites of p-chloroaniline (p-CA), urine samples of a patient acutely poisoned with p-CA were analyzed by gas chromatography/mass spectrometry. Urinary metabolites were extracted with diethylether at pH 1.0 and pH 10 from urine samples hydrolyzed with acid and base and from intact urine samples. Aliquots of the ethereal extracts were injected into the gas chromatography, and p-CA and its metabolites were identified by comparing their mass spectra and retention times to those of standards. Six substances identified were as follows: p-CA, 2-amino-5-chlorophenol, 2,4-dichloroaniline, p-chloroformanilide and traces of p-chloroacetanilide and 4-chloro-2-hydroxyacetanilide. Since p-CA was mainly detected in the hydrolyzed urine samples, p-CA was considered to form conjugates in the urine. N-Acetylation reactions of p-CA were suggested to be weak in human, because extremely minute amounts of p-chloroacetanilide and 4-chloro-2-hydroxyacetanilide were detected in the urine. PMID:1770617

  16. Citrus peel extract attenuates acute cyanide poisoning-induced seizures and oxidative stress in rats.

    PubMed

    Abdel Moneim, Ahmed E

    2014-01-01

    The primary aimed of this study was to investigate the potential protective effects of methanolic extract of citrus peel (MECP) on acute cyanide (KCN) poisoning-induced seizures and oxidative stress in rats. The intraperitoneal LD50 value of KCN (6.3 mg/Kg bwt), based on 24 hrs mortality, was significantly increased by 9, 52 or 113% by oral administration of MECP (500 mg/Kg bwt) pre-administered for 1, 2 and 3 days, respectively, in rats in a time-dependent manner. Intraperitoneal injection of the sublethal dose of KCN (3 mg/Kg bwt) into rats increased, 24 hrs later, lipid peroxidation (LPO), nitric oxide (NO), glutamate levels and acetylcholinesterase (AChE) activity in hippocampus, striatum and cerebral cortex. KCN also decreased brain glutathione (GSH) level and superoxide dismutase (SOD) and catalase (CAT) activities in these animals. Pre-treatment of rats with MECP inhibited KCN-induced increases in LPO, NO, and glutamate levels and AChE activity as well as decreases in brain GSH level and SOD and CAT activities. In addition, KCN significantly decreased norepinephrine, dopamine and serotonin levels in different brain regions which were resolved by MECP. From the present results, it can be concluded that the neuroprotective effects of MECP against KCN-induced seizures and oxidative stress may be due to the inhibition of oxidative stress overproduction and maintenance of antioxidant defense mechanisms. PMID:24308563

  17. Evaluation of exhaled nitric oxide in acute paraquat poisoning: A pilot study

    PubMed Central

    Choi, Sang-cheon; Oh, Sungho; Min, Young-gi; Cha, Ju Young; Gil, Hyo-Wook; Hong, Sae-yong

    2014-01-01

    Background Fractional exhaled nitric oxide (FENO) is nitric oxide (NO) in the lower airway measured by oral exhalation. FENO can be a useful non-invasive marker for asthma. Paraquat-mediated lung injury can be reflective of an ROS-induced lung injury. We aimed to verify if FENO is a clinical parameter of ROS formation and responsiveness to medical therapies in acute paraquat intoxication. Material/Methods We recruited 12 patients admitted with acute paraquat poisoning. A portable and noninvasive device called NIOX MINO™ (Aerocrine AB, Solna, Sweden) was used to measure FENO. Measurements were made at the time of hospital admission and at 24, 48, 72, 96, and 120 h after paraquat ingestion. Results Six out of the total 12 recruited patients had general conditions (e.g. oral pain) that made it difficult for them to exhale with adequate force. Mean plasma paraquat level was 1.4±2.5 μg/mL. We found no direct correlation between the paraquat levels (both ingestion amount and plasma concentration) and FENO (initial, maximal, and minimal values). All the measured FENO values were no greater than 20 ppb for the 2 patients who died. FENO did not vary more than 20% from the baseline. Compared to the above findings, FENO measurements were found to be greater than 20 ppb for the patients who survived. FENO tends to reach its peak value at between 50 h and 80 h. Conclusions FENO did not predict mortality, and there was no increase of FENO in patients with severe paraquat intoxication. PMID:24487780

  18. Diagnosis & Treatment of Poisoning by Pesticides.

    ERIC Educational Resources Information Center

    Environmental Protection Agency, Washington, DC. Office of Pesticide Programs.

    This report succinctly discusses the steps necessary to diagnose and treat poisoning from pesticides, especially organophosphates, carbamates and chlorinated hydrocarbons. Immediate and continuing steps in the care of poisoning victims are outlined with supportive information on where to locate emergency assistance. (CS)

  19. Triage and clinical management of patients with acute pesticide self-poisoning presenting to small rural hospitals.

    PubMed

    Eddleston, Michael; Dawson, Andrew H

    2012-07-01

    Acute pesticide self-poisoning is the single most important cause of fatal self-harm worldwide, killing at least 250,000 people every year, the vast majority in rural Asia. However, for many years the problem was little studied and no systematic approach taken to reduce harm and prevent deaths. Eight years ago this changed when the World Health Organization (WHO) proposed an inter-sectoral public health campaign to improve patient management, prevention, knowledge of its epidemiology, and information dissemination. One aim was to improve the triage and acute care of pesticide self-poisoned patients presenting to small rural hospitals with few resources. To this end, a WHO meeting was held in Bangkok at the end of 2007 that developed a protocol for triage and early care that was published online. Unfortunately, this approach has not resulted in dissemination or uptake and, 4 years later, the guidance has not been widely read, critiqued, or used. In this commentary, we describe the basis for the guidance that was produced. We hope it will bring the work to a wider clinical toxicology audience, to ultimately improve management of pesticide poisoned patients, and to encourage clinicians to take part in this important campaign. Future attempts to improve clinical care in rural Asia will need to better understand and utilise methods for influencing policy makers and clinicians in target areas if practice is to be changed. PMID:22651884

  20. Reduced risk of acute poisoning in Australian cattle from used motor oils after introduction of lead-free petrol.

    PubMed

    Burren, B G; Reichmann, K G; McKenzie, R A

    2010-06-01

    Lead (Pb) poisoning of cattle has been relatively common in Australia and sump oil has been identified as an important cause of Pb toxicity for cattle because they seem to have a tendency to drink it. Lead-free petrol has been available in Australia since 1975, so the aim of this study was to assess the current risk to cattle from drinking used automotive oils. Sump or gear box oil was collected from 56 vehicles being serviced. The low levels of Pb found suggest that the removal of leaded petrol from the Australian market as a public health measure has benefited cattle by eliminating the risk of acute poisoning from used engine oil. PMID:20553575

  1. Neuropsychological and psychiatric functioning in sheep farmers exposed to low levels of organophosphate pesticides

    PubMed Central

    Ross, Sarah Jane Mackenzie; Brewin, Chris Ray; Curran, Helen Valerie; Furlong, Clement Eugene; Abraham-Smith, Kelly Michelle; Harrison, Virginia

    2011-01-01

    The study aim was to determine whether low level exposure to organophosphate pesticides (OPs) causes neuropsychological or psychiatric impairment. Methodological weaknesses of earlier studies were addressed by: recruiting participants who had retired on ill health grounds; excluding participants with a history of acute poisoning, medical or psychiatric conditions that might account for ill health; and exploring factors which may render some individuals more vulnerable to the effects of OPs than others. Performance on tests of cognition and mood of 127 exposed sheep farmers (67 working, 60 retired) was compared with 78 unexposed controls (38 working, 40 retired) and published test norms derived from a cross section of several thousand adults in the general population. Over 40% of the exposed cohort reported clinically significant levels of anxiety and depression compared to less than 23% of controls. Exposed subjects performed significantly worse than controls and standardisation samples on tests of memory, response speed, fine motor control, mental flexibility and strategy making, even after controlling for the effects of mood. The pattern was similar for both working and retired groups. The cognitive deficits identified cannot be attributed to mood disorder, malingering, a history of acute exposure or genetic vulnerability in terms of PON1192 polymorphisms. Results suggest a relationship may exist between low level exposure to organophosphates and impaired neurobehavioural functioning and these findings have implications for working practice and for other occupational groups exposed to OPs such as aviation workers and Gulf War veterans. PMID:20227490

  2. Lanolin poisoning

    MedlinePlus

    Wool wax poisoning; Wool alcohol poisoning; Glossylan poisoning; Golden dawn poisoning; Sparklelan poisoning ... a minor skin rash. Lanolin is similar to wax, so eating large amounts of it can cause ...

  3. Influence of pesticide regulation on acute poisoning deaths in Sri Lanka.

    PubMed Central

    Roberts, Darren M.; Karunarathna, Ayanthi; Buckley, Nick A.; Manuweera, Gamini; Sheriff, M. H. Rezvi; Eddleston, Michael

    2003-01-01

    OBJECTIVES: To assess in a developing Asian country the impact of pesticide regulation on the number of deaths from poisoning. These regulations, which were implemented in Sri Lanka from the 1970s, aimed to reduce the number of deaths - the majority from self-poisoning - by limiting the availability and use of highly toxic pesticides. METHODS: Information on legislative changes was obtained from the Ministry of Agriculture, national and district hospital admission data were obtained from the Sri Lanka Health Statistics Unit, and individual details of deaths by pesticide poisoning were obtained from a manual review of patients' notes and intensive care unit records in Anuradhapura. FINDINGS: Between 1986 and 2000, the total national number of admissions due to poisoning doubled, and admissions due to pesticide poisoning increased by more than 50%. At the same time, the case fatality proportion (CFP) fell for total poisonings and for poisonings due to pesticides. In 1991_92, 72% of pesticide-induced deaths in Anuradhapura were caused by organophosphorus (OP) and carbamate pesticides - in particular, the WHO class I OPs monocrotophos and methamidophos. From 1991, the import of these pesticides was reduced gradually until they were banned for routine use in January 1995, with a corresponding fall in deaths. Unfortunately, their place in agricultural practice was taken by the WHO class II organochlorine endosulfan, which led to a rise in deaths from status epilepticus - from one in 1994 to 50 in 1998. Endosulfan was banned in 1998, and over the following three years the number of endosulfan deaths fell to three. However, at the end of the decade, the number of deaths from pesticides was at a similar level to that of 1991, with WHO class II OPs causing the most deaths. Although these drugs are less toxic than class I OPs, the management of class II OPs remains difficult because they are, nevertheless, still highly toxic, and their toxicity is exacerbated by the paucity

  4. Acute kidney injury by cantharidin poisoning following a silly bet on an ugly beetle

    PubMed Central

    Cotovio, Patrícia; Silva, Cristina; Guedes Marques, Maria; Ferrer, Francisco; Costa, Fátima; Carreira, Armando; Campos, Mário

    2013-01-01

    Cantharidin is a poisonous substance secreted by blister beetles, including the ‘Spanish fly’. Historically, cantharidin was used as an aphrodisiac, vesicant and abortifacient. Symptoms of poisoning include gastrointestinal and genitourinary mucosal irritation along with renal dysfunction. We present the case of a reckless 23-year-old soldier who accepted the challenge of eating a beetle (Berberomeloe majalis). Six hours later he was admitted to the emergency room with abdominal pain, dysuria, gross haematuria with clots, hypotension, fever and renal insufficiency. With intravenous fluid therapy, he recovered clinically. Laboratory parameters returned to normal within 1 week. PMID:26019851

  5. Prevention of organophosphate-induced chronic epilepsy by early benzodiazepine treatment.

    PubMed

    Shrot, Shai; Ramaty, Erez; Biala, Yoav; Bar-Klein, Guy; Daninos, Moshe; Kamintsky, Lyn; Makarovsky, Igor; Statlender, Liran; Rosman, Yossi; Krivoy, Amir; Lavon, Ophir; Kassirer, Michael; Friedman, Alon; Yaari, Yoel

    2014-09-01

    Poisoning with organophosphates (OPs) may induce status epilepticus (SE), leading to severe brain damage. Our objectives were to investigate whether OP-induced SE leads to the emergence of spontaneous recurrent seizures (SRSs), the hallmark of chronic epilepsy, and if so, to assess the efficacy of benzodiazepine therapy following SE onset in preventing the epileptogenesis. We also explored early changes in hippocampal pyramidal cells excitability in this model. Adult rats were poisoned with the paraoxon (450μg/kg) and immediately treated with atropine (3mg/kg) and obidoxime (20mg/kg) to reduce acute mortality due to peripheral acetylcholinesterase inhibition. Electrical brain activity was assessed for two weeks during weeks 4-6 after poisoning using telemetric electrocorticographic intracranial recordings. All OP-poisoned animals developed SE, which could be suppressed by midazolam. Most (88%) rats which were not treated with midazolam developed SRSs, indicating that they have become chronically epileptic. Application of midazolam 1min following SE onset had a significant antiepileptogenic effect (only 11% of the rats became epileptic; p=0.001 compared to non-midazolam-treated rats). Applying midazolam 30min after SE onset did not significantly prevent chronic epilepsy. The electrophysiological properties of CA1 pyramidal cells, assessed electrophysiologically in hippocampal slices, were not altered by OP-induced SE. Thus we show for the first time that a single episode of OP-induced SE in rats leads to the acquisition of chronic epilepsy, and that this epileptogenic outcome can be largely prevented by immediate, but not delayed, administration of midazolam. Extrapolating these results to humans would suggest that midazolam should be provided together with atropine and an oxime in the immediate pharmacological treatment of OP poisoning. PMID:24881594

  6. [Pesticide poisoning].

    PubMed

    Ferrer, A

    2003-01-01

    Pesticides are one of the families of chemical products most widely used by man. They have been used above all to combat pests because of their effect on harvests and as vectors of transmissible diseases. Pesticides can be classified according to their use (insecticides, fungicides, herbicides, raticides em leader ) or by their chemical family (organochlorates, organophosphates, carbamates, pyrethroids, Bipyridilium compounds, inorganic salts em leader ). All of them are biocides, which normally implies a high toxicity for humans, which has been a cause for concern since the mid-XX century due to the widespread and indiscriminate use of these products. Exposure to pesticides can have effects that are acute, chronic and long-term. Some organochlorate compounds (such as DDT) were the first to be used in massive fumigations to fight malaria and have had to be banned because of their capacity for bioaccumulation and environmental persistence. The danger represented by the widespread presence of these agents has been demonstrated in numerous episodes of human toxic epidemics, producers of a high morbidity/mortality, described for nearly all chemical families: organochlorate insecticides and fungicides, organophosphate and carbamate insecticides, organomercurial fungicides and inorganic salts. These episodes have above all been caused through the ingestion of foodstuffs and in the occupational field. Other causes of health concern are their carcinogenic capacity and occasional reproductive alterations. The principal characteristics of some of the most relevant families are presented. PMID:12813483

  7. Correlations among copeptin, ischemia-modified albumin, and the extent of myocardial injury in patients with acute carbon monoxide poisoning.

    PubMed

    Li, J; Wang, J S; Xie, Z X; Wang, W Z; Wang, L; Ma, G Y; Li, Y Q; Wang, P

    2015-01-01

    This study evaluated the relationships among copeptin, ischemia-modified albumin (IMA), and extent of myocardial injury in patients with acute carbon monoxide poisoning (ACOP). A total of 110 patients with different degrees of ACOP were selected as the poisoning group, and 30 healthy individuals as the control group. The levels of troponin I (cTnI), IMA, and copeptin were detected. Based on the presence of complications, the patients were assigned to the complication (26 patients) or non-complication (84 patients) group. Levels of cTnI, IMA, and copeptin were compared among the control, complication, and non-complication groups. Compared with the control group, in the 2 h after admission, the IMA levels decreased and copeptin levels increased in the poisoning group; these changes were more significant in patients with severe ACOP than in those with mild ACOP, and the difference was statistically significant (P < 0.05). There were no differences in the IMA and copeptin levels between the groups 7 days after admission; the cTnI levels increased more significantly in patients with severe ACOP than in patients with mild and moderate ACOP, and the differences were statistically significant (P < 0.05). In the complication group, at 7 days after admission, the IMA levels decreased whereas the copeptin and cTnI levels were significantly higher than in the non-complication group, with a statistically significant difference (P < 0.05). IMA was negatively correlated with copeptin. IMA and copeptin detection is clinically useful in the early diagnosis and prognosis of ACOP-related myocardial injury and in guiding early clinical drug application. PMID:26345979

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

    PubMed

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

    2016-01-01

    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. PMID:27414166

  9. Acute Cyanide Poisoning: Hydroxocobalamin and Sodium Thiosulfate Treatments with Two Outcomes following One Exposure Event

    PubMed Central

    Meillier, Andrew; Heller, Cara

    2015-01-01

    Cyanide is rapidly reacting and causes arrest of aerobic metabolism. The symptoms are diffuse and lethal and require high clinical suspicion. Remediation of symptoms and mortality is highly dependent on quick treatment with a cyanide antidote. Presently, there are two widely accepted antidotes: sodium thiosulfate and hydroxocobalamin. These treatments act on different components of cyanide's metabolism. Here, we present two cases resulting from the same source of cyanide poisoning and the use of both antidotes separately used with differing outcomes. PMID:26543483

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

    PubMed Central

    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

  11. Phosphorus poisoning in waterfowl

    USGS Publications Warehouse

    Coburn, D.R.; DeWitt, J.B.; Derby, J.V., Jr.; Ediger, E.

    1950-01-01

    Black ducks and mallards were found to be highly susceptible to phosphorus poisoning. 3 mg. of white phosphorus per kg. of body weight given in a single dose resulted in death of a black duck in 6 hours. Pathologic changes in both acute and chronic poisoning were studied. Data are presented showing that diagnosis can be made accurately by chemical analysis of stored tissues in cases of phosphorus poisoning.

  12. Clinical presentation, treatment and outcome of paraphenylene-diamine induced acute kidney injury following hair dye poisoning: a cohort study

    PubMed Central

    Shigidi, Mazin; Mohammed, Osama; Ibrahim, Mohammed; Taha, Elshafie

    2014-01-01

    Introduction In Africa and Asia hair dye is applied together with henna to decorate the hands and feet. Paraphenylene-diamine (PPD), a highly toxic constituent of hair dye can lead to acute kidney injury (AKI). Methods A cohort study was conducted during the period from April 2012 to March 2013 in Khartoum Teaching Hospital, Sudan. It targeted adults presenting acutely with an evident history and clinical features of hair dye poisoning, together with AKI as per the RIFLE criteria. Analysis of data was done using SPSS. Results 30 adults were included, their mean age was 25.6 ± 4.2 years, 93.3% were females. Exposure to PPD was suicidal in 86.7%. The mean duration to onset of renal symptoms was 34.8 ± 7.6 hours, maximum median serum creatinine was 8.6 ± 2.3 mg/dl, 86.7% had loss of kidney function as per the RIFLE classification and required dialysis. Initial renal recovery was seen after a mean duration of 9.8 ± 2.2 days. One patient died, 3.3%; all others, 96.7%, recovered normal kidney function. The amount of ingested PPD correlated significantly to the severity of symptoms, number of dialysis sessions required and time for renal recovery with P values < 0.05. Conclusion Hair dye poisoning was associated with prolonged hospital stay, requirement of dialysis and increased morbidity. The severity of symptoms directly correlates to the dose of PPD ingested, with the kidney damage being reversible in almost all survivors. PMID:25810799

  13. Recognition and Management of Pesticide Poisonings. Third Edition.

    ERIC Educational Resources Information Center

    Morgan, Donald P.

    This manual aids health professionals in recognizing and treating pesticide poisonings. Suggested treatments are appropriate for implementation in the small hospitals and clinics which usually receive the victims of pesticide poisoning. Classes of compounds covered include: (1) organophosphate cholinesterase-inhibiting pesticides; (2) carbamate…

  14. Djenkol bean poisoning (djenkolism): an unusual cause of acute renal failure.

    PubMed

    Segasothy, M; Swaminathan, M; Kong, N C; Bennett, W M

    1995-01-01

    This report describes a patient with acute renal failure that resulted from the ingestion of djenkol beans. Features of acute djenkolism include nausea, vomiting, bilateral loin pain, gross hematuria, and oliguria. The blood urea level was 16.2 mmol/L and the serum creatinine was 460 mumol/L. Phase contrast microscopy of the urinary sediment indicated that the hematuria was nonglomerular. Ultrasound of the kidneys showed slightly enlarged kidneys with no features of obstruction. Renal biopsy showed acute tubular necrosis similar to the single animal study reported in the literature. With conservative therapy, which included rehydration with normal saline and alkalinization of the urine with sodium bicarbonate, the acute renal failure resolved. Based on its chemistry, djenkol bean-associated acute renal failure may be analogous to acute uric acid nephropathy. PMID:7810535

  15. An in vivo zebrafish screen identifies organophosphate antidotes with diverse mechanisms of action.

    PubMed

    Jin, Shan; Sarkar, Kumar S; Jin, Youngnam N; Liu, Yan; Kokel, David; Van Ham, Tjakko J; Roberts, Lee D; Gerszten, Robert E; Macrae, Calum A; Peterson, Randall T

    2013-01-01

    Organophosphates are a class of highly toxic chemicals that includes many pesticides and chemical weapons. Exposure to organophosphates, either through accidents or acts of terrorism, poses a significant risk to human health and safety. Existing antidotes, in use for over 50 years, have modest efficacy and undesirable toxicities. Therefore, discovering new organophosphate antidotes is a high priority. Early life stage zebrafish exposed to organophosphates exhibit several phenotypes that parallel the human response to organophosphates, including behavioral deficits, paralysis, and eventual death. Here, we have developed a high-throughput zebrafish screen in a 96-well plate format to find new antidotes that counteract organophosphate-induced lethality. In a pilot screen of 1200 known drugs, we identified 16 compounds that suppress organophosphate toxicity in zebrafish. Several in vitro assays coupled with liquid chromatography/tandem mass spectrometry-based metabolite profiling enabled determination of mechanisms of action for several of the antidotes, including reversible acetylcholinesterase inhibition, cholinergic receptor antagonism, and inhibition of bioactivation. Therefore, the in vivo screen is capable of discovering organophosphate antidotes that intervene in distinct pathways. These findings suggest that zebrafish screens might be a broadly applicable approach for discovering compounds that counteract the toxic effects of accidental or malicious poisonous exposures. PMID:22960781

  16. Acute poisoning following ingestion of medicines: initial management. How to treat life-threatening complications and to evaluate the risk of delayed effects and psychological distress.

    PubMed

    2010-12-01

    Acute poisoning following ingestion of medications, both intentional and unintentional, is frequent and more or less severe. It is often unclear whether a toxic dose has been ingested. This review examines the initial management of patients with suspected acute poisoning, based on a review of the literature using the standard Prescrire methodology. We examined clinical practice guidelines, which are mostly based on observational, pharmacological and toxicological data, as well as empirical data. Few comparative trials are available. In life-threatening situations, the first priority is to call an emergency response mobile unit and to implement life-support techniques, i.e., resuscitation for cardiorespiratory arrest; respiratory support if necessary; and the left lateral head-down position and glucose injection if the patient is unconscious. Prompt, initial measures may also include: anticonvulsant injection for status epilepticus (diazepam, for example); a sedative for extreme agitation (diazepam or clorazepate if there is no risk of respiratory depression; otherwise haloperidol); atropine for severe bradycardia; elevating the legs for hypotension; and naloxone in case of respiratory depression due to opioids. Drug poisoning can be life-threatening.The extent of the risk should be assessed by questioning the patient and close contacts, examining the immediate environment, and carrying out a clinical examination to identify a major toxic condition. The severity of poisoning is assessed by gathering all information about the patient, the drug(s) ingested, the circumstances of ingestion, and any other substances ingested at the same time. A poison control centre may be called to assist with diagnosis, to predict the clinical consequences, and to guide patient management. Activated charcoal can reduce the gastrointestinal absorption of some drugs. It should be given as soon as possible, preferably within 2 hours after ingestion of a drug known to be adsorbed by

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

    PubMed

    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. PMID:12298423

  18. Severe oral and intravenous insecticide mixture poisoning with diabetic ketoacidosis: a case report

    PubMed Central

    2014-01-01

    Background The widespread use of pesticides in public health protection and agricultural pest control has caused severe environmental pollution and health hazards, especially in developing countries, including cases of severe acute and chronic human poisoning. Diabetic ketoacidosis is an uncommon manifestation of acute pesticide poisoning. Suicidal pesticide poisoning by injection is also an unusual way to take poison. We report a severe pesticide mixture poisoning case with diabetic ketoacidosis in an adult with improved outcome after supportive treatment and large doses of atropine. Case presentation A 30-year-old unmarried Moroccan Arab male with a previous history of active polysubstance abuse and behavior disorders had ingested and self injected intravenously into his forearm an unknown amount of a mixture of chlorpyrifos and cypermethrin. He developed muscarinic and nicotinic symptoms with hypothermia, inflammation in the site of the pesticide injection without necrosis. Red blood cell cholinesterase and plasma cholinesterase were very low (<10%). By day 3, the patient developed stroke with hypotension (80/50 mmHg) and tachycardia (143 pulses /min). Laboratory tests showed severe hyperglycemia (4.49 g/dL), hypokaliemia (2.4 mEq/L), glycosuria, ketonuria and low bicarbonate levels (12 mEq/L) with improvement after intensive medical treatment and treatment by atropine. Conclusion Suicidal poisonings with self-injection of insecticide were rarely reported but could be associated with severe local and systemic complications. The oxidative stress caused by pyrethroids and organophosphates poisoning could explain the occurrence of hyperglycemia and ketoacidosis. PMID:25078103

  19. TWO ACUTE HUMAN POISONING CASES RESULTING FROM EXPOSURE TO DIAZINON TRANSFORMATION PRODUCTS IN EGYPT

    EPA Science Inventory

    Two spraymen working in public health occupations in Alexandria, Egypt, experienced acute toxicity resulting from exposure to diazinon. Symptomatology was similar to that previously reported for exposure to parathion or other organophosphorus insecticides. Plasma and red blood ce...

  20. Multiple-dose activated charcoal in acute self-poisoning: a randomised controlled trial

    PubMed Central

    Eddleston, Michael; Juszczak, Edmund; Buckley, Nick A; Senarathna, Lalith; Mohamed, Fahim; Dissanayake, Wasantha; Hittarage, Ariyasena; Azher, Shifa; Jeganathan, K; Jayamanne, Shaluka; Sheriff, MH Rezvi; Warrell, David A

    2008-01-01

    Summary Background The case-fatality for intentional self-poisoning in the rural developing world is 10–50-fold higher than that in industrialised countries, mostly because of the use of highly toxic pesticides and plants. We therefore aimed to assess whether routine treatment with multiple-dose activated charcoal, to interrupt enterovascular or enterohepatic circulations, offers benefit compared with no charcoal in such an environment. Methods We did an open-label, parallel group, randomised, controlled trial of six 50 g doses of activated charcoal at 4-h intervals versus no charcoal versus one 50 g dose of activated charcoal in three Sri Lankan hospitals. 4632 patients were randomised to receive no charcoal (n=1554), one dose of charcoal (n=1545), or six doses of charcoal (n=1533); outcomes were available for 4629 patients. 2338 (51%) individuals had ingested pesticides, whereas 1647 (36%) had ingested yellow oleander (Thevetia peruviana) seeds. Mortality was the primary outcome measure. Analysis was by intention to treat. The trial is registered with controlled-trials.com as ISRCTN02920054. Findings Mortality did not differ between the groups. 97 (6·3%) of 1531 participants in the multiple-dose group died, compared with 105 (6·8%) of 1554 in the no charcoal group (adjusted odds ratio 0·96, 95% CI 0·70–1·33). No differences were noted for patients who took particular poisons, were severely ill on admission, or who presented early. Interpretation We cannot recommend the routine use of multiple-dose activated charcoal in rural Asia Pacific; although further studies of early charcoal administration might be useful, effective affordable treatments are urgently needed. PMID:18280328

  1. Limitations and challenges in treatment of acute chemical warfare agent poisoning.

    PubMed

    Thiermann, Horst; Worek, Franz; Kehe, Kai

    2013-12-01

    Recent news from Syria on a possible use of chemical warfare agents made the headlines. Furthermore, the motivation of terrorists to cause maximal harm shifts these agents into the public focus. For incidents with mass casualties appropriate medical countermeasures must be available. At present, the most important threats arise from nerve agents and sulfur mustard. At first, self-protection and protection of medical units from contamination is of utmost importance. Volatile nerve agent exposure, e.g. sarin, results in fast development of cholinergic crisis. Immediate clinical diagnosis can be confirmed on-site by assessment of acetylcholinesterase activity. Treatment with autoinjectors that are filled with 2mg atropine and an oxime (at present obidoxime, pralidoxime, TMB-4 or HI-6) are not effective against all nerve agents. A more aggressive atropinisation has to be considered and more effective oximes (if possible with a broad spectrum or a combination of different oximes) as well as alternative strategies to cope with high acetylcholine levels at synaptic sites should be developed. A further gap exists for the treatment of patients with sustained cholinergic crisis that has to be expected after exposure to persistent nerve agents, e.g. VX. The requirement for long-lasting artificial ventilation can be reduced with an oxime therapy that is optimized by using the cholinesterase status for guidance or by measures (e.g. scavengers) that are able to reduce the poison load substantially in the patients. For sulfur mustard poisoning no specific antidote is available until now. Symptomatic measures as used for treatment of burns are recommended together with surgical or laser debridement. Thus, huge amounts of resources are expected to be consumed as wound healing is impaired. Possible depots of sulfur mustard in tissues may aggravate the situation. More basic knowledge is necessary to improve substantially therapeutic options. The use of stem cells may provide a new

  2. Acute and chronic methyl mercury poisoning impairs rat adrenal and testicular function

    SciTech Connect

    Burton, G.V.; Meikle, A.W.

    1980-05-01

    Animals poisoned with methyl mercury (CH/sub 3/Hg) exhibit stress intolerance and decreased sexual activity, which suggest both adrenal and testicular dysfunction. Adrenal and testicular function was studied in male rats after treatment with CH/sub 3/Hg. In animals treated chronically, the adrenal glands were markedly hyperplastic with enlargement of the zona fasciculata. The mean basal serum levels of corticosterone were similar in experimental (17.8 ..mu..g/dl) and control (16.8 ..mu..g/dl) groups. However, with ether stress, experimental animals had a subnormal response, and the mean serum levels of corticosterone increased to only 23.9 ..mu../dl compared to 40.6 ..mu..g/dl in the controls. Exogenous ACTH stimulation produced a mean level of 19.0 ..mu..g/dl in the CH/sub 3/Hg-treated animals and 49.7 ..mu..g/dl in the controls. In vitro studies demonstrated a defect in the conversion of cholesterol to pregnenolone. A profound impairment in swimming was partially reversed with glucocorticoid therapy. In animals treated with CH/sub 3/Hg, serum testosterone was lower than normal in the basal state. Human chorionic gonadotropin stimulation increased the mean serum concentration of testosterone to 23.4 ng/ml in controls, but it was only 4.50 ng/ml in experimental animals. The data indicate that CH/sub 3/Hg poisoning impairs adrenal and testicular steroid hormone secretion, which accounts in part for the diminished stress tolerance and decreased sexual activity observed in CH/sub 3/Hg-intoxicated animals.

  3. A Randomized Controlled Trial of Puncturing and Bloodletting at Twelve Hand Jing Points to Treat Acute Carbon Monoxide Poisoning as Adjunct to First Aid Treatment: A Study Protocol.

    PubMed

    Yue, Ying; Pan, Xingfang; Zhang, Sai; Jin, Jun; Wang, Wei; Wang, Dongqiang; Han, Dexin; Wang, Guirong; Hu, Qunliang; Kang, Jingqing; Ding, Shasha; Yang, Yi; Bu, Huaien; Guo, Yi

    2015-01-01

    Background. Acute carbon monoxide poisoning (ACOP) is a significant cause of morbidity and mortality in many countries. Twelve Hand Jing Points (THJP) have been believed to be effective to treat all kinds of emergency calls in traditional Chinese medicine (TCM) for more than 3000 years. This randomized controlled trial (RCT) is designed to evaluate the effectiveness of THJP in curing acute carbon monoxide poisoning in first aid treatment. This paper reports the protocol of the trial. Methods/Design. This RCT is a multicenter, randomized, controlled study undergoing in China. The compliant patients are divided into the bloodletting group and standard of care group. With first aid treatments given to both of the groups, the bloodletting group is bleeding at THJP upon being hospitalized. Primary outcomes and secondary outcomes will be measured and compared between these two groups. Before treatment, immediately after treatment, and 30 minutes, 1 hour, and 4 hours after treatment, patients' basic vital signs and state of consciousness were observed. Before treatment and 1 and 4 hours after treatment, carboxyhemoglobin concentration in venous blood samples was detected. Discussion. The objective of this study is to provide convincing evidence to clarify the efficacy and safety of THJP for early treatment of acute carbon monoxide poisoning. PMID:26339271

  4. A Randomized Controlled Trial of Puncturing and Bloodletting at Twelve Hand Jing Points to Treat Acute Carbon Monoxide Poisoning as Adjunct to First Aid Treatment: A Study Protocol

    PubMed Central

    Yue, Ying; Pan, Xingfang; Zhang, Sai; Jin, Jun; Wang, Wei; Wang, Dongqiang; Han, Dexin; Wang, Guirong; Hu, Qunliang; Kang, Jingqing; Ding, Shasha; Yang, Yi; Bu, Huaien; Guo, Yi

    2015-01-01

    Background. Acute carbon monoxide poisoning (ACOP) is a significant cause of morbidity and mortality in many countries. Twelve Hand Jing Points (THJP) have been believed to be effective to treat all kinds of emergency calls in traditional Chinese medicine (TCM) for more than 3000 years. This randomized controlled trial (RCT) is designed to evaluate the effectiveness of THJP in curing acute carbon monoxide poisoning in first aid treatment. This paper reports the protocol of the trial. Methods/Design. This RCT is a multicenter, randomized, controlled study undergoing in China. The compliant patients are divided into the bloodletting group and standard of care group. With first aid treatments given to both of the groups, the bloodletting group is bleeding at THJP upon being hospitalized. Primary outcomes and secondary outcomes will be measured and compared between these two groups. Before treatment, immediately after treatment, and 30 minutes, 1 hour, and 4 hours after treatment, patients' basic vital signs and state of consciousness were observed. Before treatment and 1 and 4 hours after treatment, carboxyhemoglobin concentration in venous blood samples was detected. Discussion. The objective of this study is to provide convincing evidence to clarify the efficacy and safety of THJP for early treatment of acute carbon monoxide poisoning. PMID:26339271

  5. Ischemic colitis associated with acute carbon monoxide poisoning--a case report.

    PubMed

    Weaver, Lindell K; Deru, Kayla

    2016-01-01

    Carbon monoxide (CO) poisoning is common, but it has rarely been reported to cause ischemic colitis. In this case, a 34-year-old female with depression presented to an emergency department after a period of unconsciousness, with urinary and bowel incontinence, following exposure to car exhaust. Her carboxyhemoglobin level was 23%. She had metabolic acidosis. She was transferred to our facility for hyperbaric oxygen treatment, where she had intractable nausea/vomiting with abdominal pain and bright-red bleeding per rectum. She exhibited lower abdominal tenderness and hypoactive bowel sounds. Vital signs were: temperature 36.8 degrees C; blood pressure 137/ 86 mmHg; heart rate 114 beats/minute; respiratory rate 28 breaths/minute. The patient's electrocardiogram showed sinus tachycardia with T-wave inversions in leads I, aVL and V3-V6. The troponin I level peaked at 3.7 ng/ml. Echocardiogram showed a reduced ejection fraction of 30%-35%, with akinesis in the posterior lateral and distal anterior distributions. Computed tomography of the abdomen revealed diffuse colonic mural thickening, supporting mesenteric ischemia. Sigmoidoscopy showed edematous friable pale mucosa from rectum to distal sigmoid colon. Hyperbaric oxygen was deferred based on the patient's status. Over three days, the initial hematochezia progressed to melena and then resolved. Adenosine cardiac stress MRI was normal. She was transferred to the psychiatry service and discharged four days later. Four years later, she has no gastrointestinal, cardiac or cognitive problems. PMID:27265995

  6. Toxicokinetics, including saturable protein binding, of 4-chloro-2-methyl phenoxyacetic acid (MCPA) in patients with acute poisoning.

    PubMed

    Roberts, Darren M; Dawson, Andrew H; Senarathna, Lalith; Mohamed, Fahim; Cheng, Ron; Eaglesham, Geoffrey; Buckley, Nick A

    2011-03-25

    Human data on protein binding and dose-dependent changes in toxicokinetics for MCPA are very limited. 128 blood samples were obtained in 49 patients with acute MCPA poisoning and total and unbound concentrations of MCPA were determined. The Scatchard plot was biphasic suggesting protein binding to two sites. The free MCPA concentration increased when the total concentration exceeded 239mg/L (95% confidence interval 198-274mg/L). Nonlinear regression using a two-site binding hyperbola model estimated saturation of the high affinity binding site at 115mg/L (95%CI 0-304). Further analyses using global fitting of serial data and adjusting for the concentration of albumin predicted similar concentrations for saturable binding (184mg/L and 167mg/L, respectively) without narrowing the 95%CI. In 25 patients, the plasma concentration-time curves for both bound and unbound MCPA were approximately log-linear which may suggest first order elimination, although sampling was infrequent so zero order elimination cannot be excluded. Using a cut-off concentration of 200mg/L, the half-life of MCPA at higher concentrations was 25.5h (95%CI 15.0-83.0h; n=16 patients) compared to 16.8h (95%CI 13.6-22.2h; n=10 patients) at lower concentrations. MCPA is subject to saturable protein binding but the influence on half-life appears marginal. PMID:21256202

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

    PubMed

    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 < 0.001). Encephalopathy occurred only in group I. Model for End-Stage Liver Disease (MELD) score in group I was 41 compared to 24 in group II (p < 0.001). MELD score of 36 (sensitivity of 86.7 %, specificity of 90 %) or a combination of INR of 6 and encephalopathy (sensitivity of 100 %, specificity of 83 %) were the best indicators of mortality. Such patients should undergo urgent liver transplantation. PMID:26310868

  8. Impacts of Stress, Self-Efficacy, and Optimism on Suicide Ideation among Rehabilitation Patients with Acute Pesticide Poisoning

    PubMed Central

    Feng, Jun; Li, Shusheng; Chen, Huawen

    2015-01-01

    Background 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. Objective This study explores the impact of stress on suicidal ideation by investigating the mediating effect of self-efficacy and dispositional optimism. Methods 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 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. Conclusion 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. PMID:25679994

  9. Lead Poisoning

    MedlinePlus

    ... Experiments Stories Lessons Topics Games Activities Lessons MENU Lead Poisoning Kids Homepage Topics Pollution Lead Poisoning What is ... you can avoid contact with it! Sources of Lead Poisoning HOUSE PAINTS: Before1950, lead-based paint was used ...

  10. Lead Poisoning

    MedlinePlus

    Lead Poisoning What is it and who is affected? Lead is a highly toxic substance, exposure to which ... and children can suffer from the effects of lead poisoning, but childhood lead poisoning is much more frequent. ...

  11. Mushroom Poisoning

    MedlinePlus

    ... poisoning, call your doctor or the Poison Control Center. Call 911 immediately if the person is unconscious, not breathing or convulsing. The phone number for the Poison Control Center is 1-800-222-1222. This number is ...

  12. Deodorant poisoning

    MedlinePlus

    ... if known) Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

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

    PubMed

    Marashi, Sayed Mahdi; Nasri Nasrabadi, Zeynab; Jafarzadeh, Mostafa; Mohammadi, Sogand

    2016-07-01

    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. PMID:27424021

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

    NASA Astrophysics Data System (ADS)

    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.

  15. Intravenous Cobinamide Versus Hydroxocobalamin for Acute Treatment of Severe Cyanide Poisoning in a Swine (Sus scrofa) Model

    PubMed Central

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

    2015-01-01

    Study objective 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). Methods 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. Results 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 (P<.001 between the 2 treated groups and the saline solution group). Time to return of spontaneous breathing

  16. Acute thiopurine overdose: analysis of reports to a National Poison Centre 1995-2013.

    PubMed

    Gregoriano, Claudia; Ceschi, Alessandro; Rauber-Lüthy, Christine; Kupferschmidt, Hugo; Banner, Nicholas R; Krähenbühl, Stephan; Taegtmeyer, Anne B

    2014-01-01

    Literature regarding acute human toxicity of thiopurines is limited to a handful of case reports. Our objectives were to describe all cases of overdose with thiopurines reported to the Swiss Toxicological Information Centre between 1995-2013. A retrospective analysis was performed to determine circumstances, magnitude, management and outcome of overdose with these substances. A total of 40 cases (14 paediatric) were reported (azathioprine, n = 35; 6-mercaptopurine, n = 5). Of these, 25 were with suicidal intent, 12 were accidental and 3 were iatrogenic errors. The magnitude of overdose ranged from 1.5 to 43 (median 8) times the usual dose in adults. Twelve cases (30%) had attributable symptoms. The majority of these were minor and included gastrointestinal complaints and liver function test and blood count abnormalities. Symptoms were experienced by patients who took at least 1.5-times their usual daily thiopurine dose. Overdoses over two or more consecutive days, even if of modest size, were less well tolerated. One case of azathioprine and allopurinol co-ingestion over consecutive days led to agranulocytosis. Decontamination measures were undertaken in 11 cases (10 activated charcoal, 1 gastric lavage) and these developed fewer symptoms than untreated patients. This study shows that acute overdoses with thiopurines have a favourable outcome in the majority of cases and provides preliminary evidence that gastrointestinal decontamination with activated charcoal may reduce symptom development after overdose of these substances if patients present to medical services soon after ingestion. PMID:24489721

  17. Use of OpdA, an Organophosphorus (OP) Hydrolase, Prevents Lethality in an African Green Monkey Model of Acute OP Poisoning

    PubMed Central

    Jackson, Colin J; Carville, Angela; Ward, Jeanine; Mansfield, Keith; Ollis, David L.; Khurana, Tejvir; Bird, Steven B.

    2014-01-01

    Organophosphorus (OP) pesticides are a diverse class of acetylcholinesterase (AChE) inhibitors that are responsible for tremendous morbidity and mortality worldwide, killing approximately 300,000 people annually. Enzymatic hydrolysis of OPs is a potential therapy for acute poisoning. OpdA, an OP hydrolase isolated from Agrobacterium radiobacter, has been shown to decrease lethality in rodent models of OP poisoning. This study investigated the effects of OpdA on AChE activity, plasma concentrations of OP, and signs of toxicity after administration of dichlorvos to nonhuman primates. A dose of 75 mg/kg dichlorvos given orally caused apnea within 10 minutes with a progressive decrease in heart rate. Blood AChE activity decreased to zero within ten minutes. Respirations and AChE activity did not recover. The mean dichlorvos concentration rose to a peak of 0.66 μg/ml. Treated monkeys received 1.2 mg/kg OpdA iv immediately after poisoning with dichlorvos. In Opda-treated animals, heart and respiratory rates were unchanged from baseline over a 240-minute observation period. AChE activity slowly declined, but remained above 25% of baseline for the entire duration. Dichlorvos concentrations reached a mean peak of 0.19 μg/ml at 40 minutes after poisoning and decreased to a mean of 0.05 μg/ml at 240 minutes. These results show that OpdA hydrolyzes dichlorvos in an African Green Monkey model of lethal poisoning, delays AChE inhibition, and prevents lethality. PMID:24447378

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

    PubMed Central

    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

  19. Antagonism of Acute Sulfide Poisoning in Mice by Nitrite Anion without Methemoglobinemia.

    PubMed

    Cronican, Andrea A; Frawley, Kristin L; Ahmed, Humza; Pearce, Linda L; Peterson, Jim

    2015-07-20

    There are currently no FDA-approved antidotes for H2S/sulfide intoxication. Sodium nitrite, if given prophylactically to Swiss Webster mice, was shown to be highly protective against the acute toxic effects of sodium hydrosulfide (∼LD40 dose) with both agents administered by intraperitoneal injections. However, sodium nitrite administered after the toxicant dose did not detectably ameliorate sulfide toxicity in this fast-delivery, single-shot experimental paradigm. Nitrite anion was shown to rapidly produce NO in the bloodstream, as judged by the appearance of EPR signals attributable to nitrosylhemoglobin and methemoglobin, together amounting to less than 5% of the total hemoglobin present. Sulfide-intoxicated mice were neither helped by the supplemental administration of 100% oxygen nor were there any detrimental effects. Compared to cyanide-intoxicated mice, animals surviving sulfide intoxication exhibited very short knockdown times (if any) and full recovery was extremely fast (∼15 min) irrespective of whether sodium nitrite was administered. Behavioral experiments testing the ability of mice to maintain balance on a rotating cylinder showed no motor impairment up to 24 h post sulfide exposure. It is argued that antagonism of sulfide inhibition of cytochrome c oxidase by NO is the crucial antidotal activity of nitrite rather than formation of methemoglobin. PMID:25951111

  20. Evaluation of efficacy of resin hemoperfusion in patients with acute 2,4-dinitrophenol poisoning by dynamic monitoring of plasma toxin concentration

    PubMed Central

    Zhao, Xue-hong; Jiang, Jiu-kun; Lu, Yuan-qiang

    2015-01-01

    Objective: The intoxications caused by 2,4-dinitrophenol (2,4-DNP), even death, have been frequently reported in recent years. This study aims to investigate the dynamic changes of plasma toxin concentration and explore the clinical value of resin hemoperfusion (HP) in the treatment of patients with acute 2,4-DNP poisoning. Methods: We reported 16 cases of acute 2,4-DNP poisoning through occupational exposure due to ignoring the risk of poisoning. The blood samples were collected from the 14 survivors. According to the different treatments of resin HP, the survivors were divided into routine HP (n=5) and intensive HP (n=9) groups. Ultra high performance liquid chromatography/tandem mass spectroscopy (UPLC-MS/MS) was used to detect the 2,4-DNP concentration in plasma in this study. Results: The 14 survivors recovered very well after treatment. The initial plasma 2,4-DNP concentrations (C 1) of survivors ranged from 0.25 to 41.88 µg/ml (mean (12.56±13.93) µg/ml). A positive correlation existed between initial plasma 2,4-DNP concentration (C 1) and temperature. The elimination of 2,4-DNP was slow and persistent, and the total clearance rates of plasma toxin from the 1st to 3rd day (R 3), the 3rd to 7th day (R 3–7), and the 1st to 7th day (R 7), were only (53.03±14.04)%, (55.25±10.50)%, and (78.29±10.22)%, respectively. The plasma toxin was cleared up to 25 d after poisoning in most of the patients. The R 3, R 3–7, and R 7 in the intensive HP group were all apparently higher than those in the routine HP group, with statistical significance (P<0.05). Simultaneously, the elimination half-life (t 1/2) of 2,4-DNP in the intensive HP group was apparently shorter than that in the routine HP group, with statistical significance (P<0.05). Conclusions: The clinicians should be aware of this slow and persistent process in the elimination of plasma 2,4-DNP. Higher initial plasma toxin concentration resulted in a more severe fever for the patient. According to the

  1. Non-accidental chlorpyrifos poisoning-an unusual cause of profound unconsciousness.

    PubMed

    Lee, Jiun-Chang; Lin, Kuang-Lin; Lin, Jainn-Jim; Hsia, Shao-Hsuan; Wu, Chang-Teng

    2010-04-01

    Chlorpyrifos is an organophosphorus anticholinesterase insecticide, and organophosphate intoxication can induce symptoms such as miosis, urination, diarrhea, diaphoresis, lacrimation, excitation of central nervous system, salivation, and consciousness disturbance (MUDDLES). Although accidental poisoning of children with drugs and chemicals is a common cause for consciousness disturbance in children, the possibility of deliberate poisoning is rarely considered. We report on a healthy 5-year 6-month-old boy with recurrent organophosphate intoxication. Reports of chlorpyrifos intoxication in children are quite rare. This case report demonstrates decision-making process and how to disclose deliberate chlorpyrifos poisoning of the toddler by the stepmother, another example of Munchausen syndrome by proxy. PMID:19763618

  2. HPLC measurement of chlorophenoxy herbicides, bromoxynil, and ioxynil, in biological specimens to aid diagnosis of acute poisoning.

    PubMed

    Flanagan, R J; Ruprah, M

    1989-07-01

    A simple high-performance liquid-chromatographic assay for eight chlorophenoxy (2,4-D and related compounds) and two benzonitrile (bromoxynil and ioxynil) herbicides has been developed to aid in the diagnosis of acute poisoning. Sample (whole blood, plasma/serum, urine, or tissue homogenate) or standard (100 microL) is vortex-mixed (ca. 5 s) with 20 microL of internal standard solution [1.00 g/L 2,4,5-TP in 0.02 mol/L Tris buffer, pH 9.6:methanol (1 + 1)]. Dilute (0.2 mL/L) hydrochloric acid in methanol, 200 microL, is added and the mixture is again vortex-mixed (30 s). After centrifugation (9950 X g, 2 min) a 10-20 microL portion of the supernate is analyzed on a 250 X 5 mm (i.d.) Spherisorb S5 Phenyl column, with aqueous potassium dihydrogen orthophosphate (50 mmol/L, pH 3.5) and acetonitrile (3 to 1 by vol) at a flow-rate of 1.8 mL/min as eluent. The method is capable of resolving the chlorophenoxy/benzonitrile mixtures (2,4-D/MCPP, 2,4-D/DCPP, 2,4-D/ioxynil, 2,4-D/MCPP/DCPP, 2,4-D/2,4,5-T, and MCPP/ioxynil) encountered in the U.K. The limit of detection (at 240 nm) is 20 mg/L (10 mg/L for bromoxynil and ioxynil). Intra-assay and interassay CVs were less than 5% and less than 8%, respectively, for all analytes. Plasma:whole blood distribution ratios ranged from ca. 1.7 for 2,4-DB to ca. 2.0 for 2,4-D, emphasizing that results of whole-blood measurements must be multiplied by a factor of ca. 2 for comparison with plasma/serum data. PMID:2758576

  3. Pharmacokinetics of digoxin cross-reacting substances in patients with acute yellow oleander (Thevetia peruviana) poisoning, including the effect of activated charcoal.

    PubMed Central

    Roberts, Darren M; Southcott, Emma; Potter, Julia M; Roberts, Michael S; Eddleston, Michael; Buckley, Nick A

    2008-01-01

    Intentional self-poisonings with seeds from the yellow oleander tree (Thevetia peruviana) are widely reported. Activated charcoal has been suggested to benefit patients with yellow oleander poisoning by reducing absorption and/or facilitating elimination. Two recent randomised controlled trials (RCTs) assessing the efficacy of activated charcoal reported conflicting outcomes in terms of mortality. The effect of activated charcoal on the pharmacokinetics of Thevetia cardenolides has not been assessed. This information may be useful for determining whether further studies are necessary. Serial blood samples were obtained from patients enrolled in a RCT assessing the relative efficacy of single dose (SDAC) and multiple doses (MDAC) of activated charcoal compared to no activated charcoal (NoAC). The concentration of Thevetia cardenolides was estimated using a digoxin immunoassay. The effect of activated charcoal on cardenolide pharmacokinetics was compared between treatment groups using the AUC24, the 24h Mean Residence Time (MRT24), and regression lines obtained from serial concentration points adjusted for exposure. Erratic and prolonged absorption patterns were noted in each patient group. The apparent terminal half-life was highly variable, with a median time of 42.9h. There was a reduction in MRT24 and the apparent terminal half-life estimated from linear regression in patients administered activated charcoal compared to the control group (NoAC). This effect was approximately equal in patients administered MDAC or SDAC. Activated charcoal appears to favourably influence the pharmacokinetic profile of Thevetia cardenolides in patients with acute self-poisoning, which may have clinical benefits. Given the conflicting clinical outcomes noted in previous RCTs, this mechanistic data supports the need for further studies to determine whether a subgroup of patients (eg. those presenting soon after poisoning) will benefit from activated charcoal. PMID:17164695

  4. Compartment Syndrome Resulting from Carbon Monoxide Poisoning.

    PubMed

    Serbest, Sancar; Belhan, Oktay; Gürger, Murat; Tosun, Haci Bayram

    2015-12-01

    Every year, especially in the cooler Fall and Winter months, hundreds of people die because of carbon monoxide poisoning. This occurs usually as an accident. It is a significant cause of poisoning worldwide. We present a case of compartment syndrome in both lower extremities with accompanying acute renal failure and systemic capillary leakage syndrome because of carbon monoxide poisoning. PMID:26588033

  5. Starch poisoning

    MedlinePlus

    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 ...

  6. Ethanol poisoning

    MedlinePlus

    ... 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. ...

  7. Cologne poisoning

    MedlinePlus

    ... Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 100. Jacobsen D, Hovda KE. ... Poisoning and Drug Overdose. 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 32. Mycyk MB. Toxic alcohols. ...

  8. Insecticide poisoning

    MedlinePlus

    ... 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- ...

  9. Poisonous Plants

    MedlinePlus

    ... 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 ...

  10. Copper poisoning

    MedlinePlus

    ... 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. ...

  11. Merbromin poisoning

    MedlinePlus

    ... Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 71. Linakis JG, Skarbek-Borowska S. ... Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 18. Rusyniak DE, Arroyo A, ...

  12. Foxglove poisoning

    MedlinePlus

    Foxglove poisoning most often occurs from sucking the flowers or eating the seeds, stems, or leaves of ... The poisonous substances are found in: Flowers, leaves, stems, and seeds of the foxglove plant Heart medicine (digitalis glycoside)

  13. Poisons and fever.

    PubMed

    Gordon, C J; Rowsey, P J

    1998-02-01

    1. Dysfunction of the thermoregulatory system is one of many pathologies documented in experimental animals and humans exposed to toxic chemicals. The mechanism of action responsible for many types of poison-induced fevers is not understood. Some elevations in body temperature are attributed to the peripheral actions of some poisons that stimulate metabolic rate and cause a forced hyperthermia. Exposure to organophosphate (OP) pesticides and certain metal fumes appears to cause a prolonged, regulated elevation in body temperature (Tb). 2. Activation of cyclo-oxygenase (COX) and the production of prostaglandin (PG)E2 in central nervous system (CNS) thermoregulatory centres is required to elicit a fever. Activating the COX-PGE2 pathway by a poison may occur by one of three mechanisms: (i) induction of cell-mediated immune responses and the subsequent release of cytokines; (ii) induction of lipid peroxidation in the CNS; and (iii) direct neurochemical activation. 3. Radiotelemetric monitoring of core temperature in unstressed rodents has led to an experimental animal model of poison-induced fever. Rats administered the OP agents chlorpyrifos and diisopropyl fluorophosphate display an initial hypothermic response lasting approximately 24 h, followed by an elevation in diurnal core temperature for 24-72 h after exposure. The hyperthermia is apparently a result of the activation of the COX-PGE2 pathway because it is blocked by the anti-pyretic sodium salicylate. Overall, the delayed hyperthermia resulting from OP exposure involves activation of thermoregulatory pathways that may be similar to infection-mediated fever. PMID:9493505

  14. Paraquat Poisoning: A Case Report

    PubMed Central

    Singh, Veer Bahadur; Meena, Babu Lal; Gaur, Subhash; Singla, Rahul

    2016-01-01

    Paraquat is commonly used herbicide by farmers in North West Rajasthan. Despite its easy availability, poisoning of its not common. Fatal dose of paraquat is so small that >10 ml poison can damage lungs permanently. Diagnosis is often difficult without proper history, absence of specific clinical feature and lack of diagnostic test. Inhalation exposures represent one of the most important routes of poisoning. We are reporting a case of inhaled paraquat poisoning with complication of irreversible acute kidney, liver and lung injury. PMID:27042505

  15. Ischemia-modified albumin levels in the prediction of acute critical neurological findings in carbon monoxide poisoning.

    PubMed

    Daş, Murat; Çevik, Yunsur; Erel, Özcan; Çorbacioğlu, Şeref Kerem

    2016-04-01

    The aim of the study was to determine whether serum ischemia-modified albumin (IMA) levels in patients with carbon monoxide (CO) poisoning were higher compared with a control group of healthy volunteers. In addition, the study sought to determine if there was a correlation between serum IMA levels and carboxyhemoglobin (COHB) levels and other critical neurological findings (CNFs). In this prospective study, the IMA levels of 100 patients with CO poisoning and 50 control individuals were compared. In addition, the IMA and COHB levels were analyzed according to absence or presence CNFs in patients with CO poisoning. The levels of IMA (mg/dL) on admittance, and during the 1(st) hour and 3(rd) hour, in patients with CO poisoning (49.90 ± 35.43, 30.21 ± 14.81, and 21.87 ± 6.03) were significantly higher, compared with the control individuals (17.30 ± 2.88). The levels of IMA in the 6(th) hour were not higher compared with control individuals. The levels of IMA on admittance, and during the 1(st) hour, 3(rd) hour, and 6(th) hour, and COHB (%) levels in patients who had CNFs were higher compared with IMA levels and COHB levels in patients who had no CNFs (p < 0.001). However, when the multivariate model was created, it was observed that IMA level on admittance was a poor indicator for prediction of CNFs (odds ratio = 1.05; 95% confidence interval, 1.01-1.08). We therefore concluded that serum IMA levels could be helpful in the diagnosis of CO poisoning. However, we believe that IMA levels cannot be used to predict which patients will develop CNFs due to CO poisoning. PMID:27185603

  16. Neurobehavioral function and organophosphate insecticide use among pesticide applicators in the Agricultural Health Study.

    PubMed

    Starks, Sarah E; Gerr, Fred; Kamel, Freya; Lynch, Charles F; Jones, Michael P; Alavanja, Michael C; Sandler, Dale P; Hoppin, Jane A

    2012-01-01

    Although persistent decrements in cognitive function have been observed among persons who have recovered from clinically overt organophosphate (OP) pesticide poisoning, little is known about the cognitive effects of chronic OP exposures that do not result in acute poisoning. To examine associations between long-term pesticide use and neurobehavioral (NB) function, NB tests were administered to licensed pesticide applicators enrolled in the Agricultural Health Study (AHS) in Iowa and North Carolina. Between 2006 and 2008, 701 male participants completed nine NB tests to assess memory, motor speed and coordination, sustained attention, verbal learning and visual scanning and processing. Data on ever-use and lifetime days of use of 16 OP pesticides were obtained from AHS interviews conducted before testing between 1993 and 2007 and during the NB visit. The mean age of participants was 61 years (SD=12). Associations between pesticide use and NB test performance were estimated with linear regression controlling for age and outcome-specific covariates. NB test performance was associated with lifetime days of use of some pesticides. Ethoprop was significantly associated with reduced performance on a test of motor speed and visual scanning. Malathion was significantly associated with poor performance on a test of visual scanning and processing. Conversely, we observed significantly better test performance for five OP pesticides. Specifically, chlorpyrifos, coumaphos, parathion, phorate, and tetrachlorvinphos were associated with better verbal learning and memory; coumaphos was associated with better performance on a test of motor speed and visual scanning; and parathion was associated with better performance on a test of sustained attention. Several associations varied by state. Overall, we found no consistent evidence of an association between OP pesticide use and adverse NB test performance among this older sample of pesticide applicators. Potential reasons for these

  17. Organophosphate-induced delayed neurotoxicity of triarylphosphates.

    PubMed

    Weiner, M L; Jortner, B S

    1999-08-01

    This paper reviews the characteristics of organophosphate-induced delayed neurotoxicity, its mechanism, lesions, species sensitivities and structure activity-relationships as they relate to the class of compounds known as triaryl phosphates. The triaryl phosphates have been widely used in commerce for over thirty years as flame retardants in fluids and plastics. Concern has been raised regarding their potential to cause organophosphate-induced delayed neurotoxicity (OPIDN), due to structural similarities to the potent neurotoxicant, tri-ortho cresyl phosphate (TOCP). Based on research on many pure isomers, Johnson (1975a, 1975b) found that certain structural features are required for a triaryl phosphate to react with the enzyme, neuropathy target enzyme (NTE), in a manner which induces OPIDN. Results of acute hen OPIDN studies, the experimental model of choice, support his findings as regards the structure-activity relationships for commercial triaryl phosphates. Thus, standard acute hen OPIDN studies on triphenyl phosphate and butylated triaryl phosphates fail to demonstrate a potential to elicit OPIDN by these products after a single dose. Studies on the mixed isopropyl phenyl phosphates indicate that, while some are neurotoxic, they are much less potent than tricresyl phosphate (TCP) and TOCP in the induction of OPIDN. Most commercial isopropylated triaryl phosphates lacked the potential to induce acute OPIDN using a limit dose of 2000 mg/kg. Although in early studies these compounds appeared to be neurotoxic, they were generally tested at excessively high doses, often exceeding 10,000 mg/kg in acute hen OPIDN studies. In contrast to the isopropylated and butylated triaryl phosphate products, TCP, and especially its ortho substituted isomer, TOCP, were found to be neurotoxic in both acute and subchronic hen OPIDN studies. Recent advances in the synthesis of commercial TCP products have resulted in products with reduced neurotoxic potential (McCormick et al, 1993

  18. Super vasomol hair dye poisoning.

    PubMed

    Kumar, Praveen A S; Talari, Keerthi; Dutta, T K

    2012-01-01

    Hair dye poisoning is not rare but is an emerging poisoning in India. The main component of hair dye causing toxicity is paraphenylenediamine (PPD). Acute poisoning by PPD causes characteristic severe angioedema of the upper airway accompanied by a swollen, dry, hard, and protruding tongue. Systemic intoxication results in multisystem involvement and can cause rhabdomyolysis, acute renal failure (ARF). PPD consumption is an uncommon cause of ARF. There is no specific antidote for PPD and treatment is mainly supportive. We report a case of suicidal ingestion of hair dye that presented with cervicofascial edema and later developed rhabdomyolysis and ARF. Our patient improved with dialysis and symptomatic management. PMID:22736909

  19. Characterization of Phosphohydrolases Using Organophosphates

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The ease of organophosphate mineralization resulting in release of inorganic phosphorus (Pi) for plant uptake largely depends on the stereochemical structure of the compound, the types and sources of enzymes involved, and certain environmental factors. We determined the kinetic parameters (Vmax, Km,...

  20. Carbon monoxide poisoning

    PubMed Central

    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 in determining therapy. Treatment includes the monitoring and management of cardiac arrhythmias and oxygenation. Hyperbaric oxygenation is beneficial, but there are currently no definite criteria for its use. PMID:4027805

  1. Outsmarting Poison Ivy and Other Poisonous Plants

    MedlinePlus

    ... Consumer Updates Outsmarting Poison Ivy and Other Poisonous Plants Share Tweet Linkedin Pin it More sharing options ... hang in loose clusters. back to top Poison Plant Rashes Aren’t Contagious Poison ivy and other ...

  2. Boric Acid Poisoning

    PubMed Central

    Wong, L. C.; Heimbach, M. D.; Truscott, D. R.; Duncan, B. D.

    1964-01-01

    Boric acid poisoning in 11 infants, occurring in the newborn nursery as a result of the accidental and inadvertent use of 2.5% boric acid in the preparation of the formulae, is reported. Five of the infants died. All except two exhibited the classical symptomatology of acute boric acid poisoning, namely, diarrhea, vomiting, erythema, exfoliation, desquamation of the skin, and marked central nervous system irritation. Early manifestations of poisoning were nonspecific, and one patient died before skin manifestations were noted. Peritoneal dialysis, instituted in nine cases, was found to be the most effective method of treatment. It is recommended that boric acid, which is of doubtful therapeutic value, should be completely removed from hospitals, dispensaries and pharmacopoeias. ImagesFig. 1Fig. 2 PMID:14166459

  3. Sodium carbonate poisoning

    MedlinePlus

    Sal soda poisoning; Soda ash poisoning; Disodium salt poisoning; Carbonic acid poisoning; Washing soda poisoning ... have symptoms. In this rare situation, long-term effects, even death, are possible if you do not ...

  4. Methanol poisoning

    MedlinePlus

    ... with has an exposure, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

  5. Bee poison

    MedlinePlus

    ... is caused by a sting from a bee, wasp , or yellow jacket. This article is for information ... anywhere in the United States. Poisonous Ingredient Bee, wasp, and yellow jacket stings contain a substance called ...

  6. Food poisoning

    MedlinePlus

    ... growing or shipping can contain animal or human waste. Food may be handled in an unsafe way during preparation in grocery stores, restaurants, or homes. Food poisoning can occur after eating or drinking: ...

  7. Refrigerant poisoning

    MedlinePlus

    A refrigerant is a chemical that makes things cold. This article discusses poisoning from sniffing or swallowing such chemicals. ... occurs when people intentionally sniff a type of refrigerant called Freon. This article is for information only. ...

  8. Mistletoe poisoning

    MedlinePlus

    Symptoms of mistletoe poisoning can affect many parts of the body. EYES, EARS, NOSE, MOUTH, AND THROAT Blurred vision STOMACH AND INTESTINES Diarrhea Nausea and vomiting Stomach pain HEART AND BLOOD Weakness NERVOUS SYSTEM Drowsiness

  9. Detergent poisoning

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/002777.htm Detergent poisoning To use the sharing features on this page, please enable JavaScript. Detergents are powerful cleaning products that may contain strong ...

  10. Lead poisoning

    MedlinePlus

    ... swallows a lead object or breathes in lead dust, some of the poison can stay in the ... a health problem. Lead is everywhere, including dirt, dust, new toys, and old house paint. Unfortunately, you ...

  11. Lacquer poisoning

    MedlinePlus

    Poisoning from lacquers is due to hydrocarbons, which are substances that contain only hydrogen and carbon. ... Lee DC. Hydrocarbons. In: Marx JA, Hockberger RS, Walls RM, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, ...

  12. Gasoline poisoning

    MedlinePlus

    The poisonous ingredients in gasoline are chemicals called hydrocarbons, which are substances that contain only hydrogen and ... Lee DC. Hydrocarbons. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ...

  13. Pokeweed poisoning

    MedlinePlus

    ... highest amounts of poison are found in the roots, leaves, and stems. Small amounts are in the ... is no guarantee that they are safe. The roots should never be eaten. Symptoms most often appear ...

  14. Naphthalene poisoning

    MedlinePlus

    ... K. General approach to the poisoned patient. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical ... 147. Levine MD, Zane R. Chemical injuries. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical ...

  15. Ammonia poisoning

    MedlinePlus

    ... K. General approach to the poisoned patient. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical ... 147. Levine MD, Zane R. Chemical injuries. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical ...

  16. Depilatory poisoning

    MedlinePlus

    ... Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 100. Pfau PR, Hancock SM. ... Gastrointestinal and Liver Disease . 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 27. Wax PM, Young A. ...

  17. Aftershave poisoning

    MedlinePlus

    ... Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Mosby; 2014:chap 185. Jacobsen D, Hovda KE. ... Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 32. White SR. Toxic alcohols. ...

  18. Iodine poisoning

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/002658.htm Iodine poisoning To use the sharing features on this page, please enable JavaScript. Iodine is a naturally occurring chemical. Small amounts are ...

  19. Lanolin poisoning

    MedlinePlus

    Lanolin is an oily substance taken from sheep's wool. Lanolin poisoning occurs when someone swallows a product that contains lanolin. This article is for information only. Do NOT use it to treat or ...

  20. Menthol poisoning

    MedlinePlus

    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 ...

  1. Diazinon poisoning

    MedlinePlus

    ... care unit and getting long-term therapy. Some effects of the poison may last for weeks or months, or even longer. ... RD, Ruha A-M. Insecticides, herbicides, and rodenticides. In: Adams JG. Emergency Medicine . 2nd ...

  2. Shellac poisoning

    MedlinePlus

    These substances are found in: Paint remover Shellac Wood finishing products Other products may also contain these ... a vein (IV) Medicine (antidote) to reverse the effect of the poison Surgery to remove burned skin ...

  3. Antifreeze poisoning

    MedlinePlus

    The poisonous ingredients in antifreeze are: Ethylene glycol Methanol Propylene glycol ... For ethylene glycol: Death may occur within the first 24 hours. If the patient survives, there may be little ...

  4. Gasoline poisoning

    MedlinePlus

    This article discusses the harmful effects from swallowing gasoline or breathing in its fumes. This article is ... The poisonous ingredients in gasoline are chemicals called ... only hydrogen and carbon. Examples are benzene and methane.

  5. Ink poisoning

    MedlinePlus

    Mirkin DB. Benzene and related aromatic hydrocarbons. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: ...

  6. Paraffin poisoning

    MedlinePlus

    ... patient. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 147. Shannon MW. Emergency management of poisoning. In: Shannon MW, ed. Haddad and ...

  7. Yew poisoning

    MedlinePlus

    ... poisoning occurs when someone eats pieces of this plant. This article is for information only. DO NOT use it ... information: Person's age, weight, and condition Name and part of the plant that was swallowed, if known Time it was ...

  8. Mistletoe poisoning

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/002883.htm Mistletoe poisoning To use the sharing features on this page, please enable JavaScript. Mistletoe is an evergreen plant with white berries. Mistletoe ...

  9. Case histories of organophosphate pesticides killing birds of prey in the United States

    USGS Publications Warehouse

    Henny, C.J.; Kolbe, E.J.; Hill, E.F.; Blus, L.J.

    1985-01-01

    Since 1982 when secondary. poisoning of Red-tailed Hawks (Buteo jamaicensis) was documented following the recommended use of famphur on cattle, the Patuxent Wildlife Research Center has tested for organophosphate (OP) poisoning in selected birds of prey found dead. This report documents the circumstances for a number of. cases where birds of prey were killed by OP pesticides in the United States. Many of the cases were brought to our attention by the U S. Fish and Wildlife Service Division of Law Enforcement The cases may be divided into three categories: misuse, approved use, and unknown. Now that we are looking for OP poisoning of birds of prey, we are finding it more frequently than previously suspected.

  10. Role of paraoxonase 1 (PON1) in organophosphate metabolism: Implications in neurodegenerative diseases

    SciTech Connect

    Androutsopoulos, Vasilis P.; Kanavouras, Konstantinos; Tsatsakis, Aristidis M.

    2011-11-15

    Organophosphate pesticides are a class of compounds that are widely used in agricultural and rural areas. Paraoxonase 1 (PON1) is a phase-I enzyme that is involved in the hydrolysis of organophosphate esters. Environmental poisoning by organophosphate compounds has been the main driving force of previous research on PON1 enzymes. Recent discoveries in animal models have revealed the important role of the enzyme in lipid metabolism. However although PON1 function is well established in experimental models, the contribution of PON1 in neurodegenerative diseases remains unclear. In this minireview we summarize the involvement of PON1 genotypes in the occurrence of Parkinson's disease, Alzheimer's disease and amyotrophic lateral sclerosis. A brief overview of latest epidemiological studies, regarding the two most important PON1 coding region polymorphisms PON1-L55M and PON1-Q192R is presented. Positive and negative associations of PON1 with disease occurrence are reported. Notably the MM and RR alleles contribute a risk enhancing effect for the development of some neurodegenerative diseases, which may be explained by the reduced lipoprotein free radical scavenging activity that may give rise to neuronal damage, through distinct mechanism. Conflicting findings that fail to support this postulate may represent the human population ethnic heterogeneity, different sample size and environmental parameters affecting PON1 status. We conclude that further epidemiological studies are required in order to address the exact contribution of PON1 genome in combination with organophosphate exposure in populations with neurodegenerative diseases.

  11. The nation's first poison control center: taking a stand against accidental childhood poisoning in Chicago.

    PubMed

    Burda, A M; Burda, N M

    1997-04-01

    Prior to the 1950's, there existed no formal system for poison prevention or treatment in the US. Estimates place the number of pediatric poisoning fatalities at over 400/y at that time. After World War II, urbanization and modern technological methods brought forth over 250,000 different brand name products on the market. Health care professionals presented with cases of acute poisoning usually had little knowledge of what ingredients were contained in these new products, making it difficult to treat these patients. In the 1930's, pharmacist Louis Gdalman established a poison information service at St Luke's hospital. Because of Gdalman's training in pharmacy and chemistry, physicians throughout Chicago and the US called on him in search of assistance. In the late 1940's, Gdalman began recording information on small cards, and developed a standard data collection from. By the 1950's he had established an extensive library on the management of acute and chronic poisonings. In 1948, a national effort to reduce the number of accidents in children was started by the American Academy of Pediatrics, and a committee was formed in Chicago to address this public safety need. In November, 1953, the poison center at Presbyterian-St Luke's Hospital was formally recognized, and the poison program model spread nationwide. As the number of poison centers grew, coordination was achieved through the National Clearing House for Poison Control Centers, founded in 1957, and the American Association of Poison Control Centers, created in 1958. By 1970, the number of poison centers in the US was reported to be 597. The need for large and better centers led to regional poison control centers. Other outgrowths were the formation of the National Poison Prevention Week Council, the enactment of the Poison Prevention Packaging Act, development of "Mr. Yuk" and other symbols, and formation of the National Animal Poison Control Center. As a result, the number of children dying from accidental

  12. Successful Use of Hydroxocobalamin and Sodium Thiosulfate in Acute Cyanide Poisoning: A Case Report with Follow-up.

    PubMed

    Zakharov, Sergey; Vaneckova, Manuela; Seidl, Zdenek; Diblik, Pavel; Kuthan, Pavel; Urban, Pavel; Navratil, Tomas; Pelclova, Daniela

    2015-09-01

    Hydroxocobalamin is an effective first-line antidote used mainly in monotherapy of cyanide poisonings, while the opinions are different on the effects of its combination with sodium thiosulfate. A 58-year-old male committed a suicide attempt by ingesting of 1200-1500 mg of potassium cyanide; he was unconscious for 1-1.5 min. after ingestion with the episode of generalized seizures. On admission to the ICU, the patient was acidotic (pH 7.28; HCO3 14.0 mmol/L, base excess -12.7 mmol/L, saturation O2 0.999) with high serum lactate (12.5 mmol/L). Hydroxocobalamin was administered 1.5 hr after ingestion in two subsequent intravenous infusions at a total dose of 7.5 g. The infusion was followed by continuous intravenous administration of 1 mL/hr/kg of 10% sodium thiosulfate at a total dose of 12 g. No complications and adverse reactions were registered. Serum lactate decreased to 0.6 mmol/L the same day, and arterial blood gases became normal (pH 7.49; HCO3 27.2 mmol/L, base excess 2.2 mmol/L, saturation O2 0.994). The follow-up examination 5 months later revealed no damage of basal ganglia and cerebellum on magnetic resonance imaging. The neurological examination revealed no pathological findings. On the ocular coherence tomography, the retinal nerve fibres layer was normal. In visual evoked potentials, there was a normal evoked complex on the left eye and minor decrease in amplitude on the right eye. Combination of hydroxocobalamin and sodium thiosulfate can have a positive effect on the survival without long-term neurological and visual sequelae in the cases of massive cyanide poisonings due to the possibility of a potentiation or synergism of hydroxocobalamin effects by sodium thiosulfate. This synergism can be explained by the different time-points of action of two antidotes: the initial and immediate effect of hydroxocobalamin, followed by the delayed, but more persistent effect of sodium thiosulfate. PMID:25645744

  13. A study of effectiveness of fresh frozen plasma in organophosphorous compound poisoning in reducing length of Intensive Care Unit stay and in reducing need for tracheostomy

    PubMed Central

    Dayananda, V. P.; Bhaskara, B.; Pateel, G.N.P.

    2016-01-01

    Background: The main stay of treatment in organophophosphorous [OP] poisoning is with atropine, oximes and supportive therapy. Despite the therapy, no improvement in mortality and morbidity. Fresh frozen plasma [FFP] a source of serum cholinesterase act as bio-scavenger to neutralise organophosphate toxins to improve the patients out come. Methods: The prospective study was conducted in 80 patients with acute OP poisoning. Patients with moderate to severe grade of OP poisoning with serum cholinesterase level <1000 IU/L were included in the study. Study group received atropine and oximes along with FFP given as 4 units first day, 3units on 2nd day, 2 units on 3rd day. Control group was given atropine and oximes only. Serum cholinesterase enzymes level, consumption of atropine per day, number of days on ventilator, length of ICU stay, and need for tracheostomy were assessed. Results: There was a significant increase in the serum cholinesterase levels after FFP infusion in the study group in comparison to the control group. Mean duration of Intensive Care Unit [ICU] stay was 8.35±4.3 in the study group and 12.45±4.13 in the control group. 06 patients in the control group succumbed whereas there were no fatalities in the study group. Conclusion: Daily reducing dose of FFP therapy for 3 consecutive days has beneficial effect in acute OP poisoning by increasing serum cholinesterase enzymes in blood with reduction in total dose of atropine consumption per day. It also reduces the ICU stay with zero mortality in OP poisoning. PMID:27212759

  14. Age and criminal poisonings.

    PubMed

    Stankova, Evgenia; Gesheva, Margarita; Hubenova, Aneta

    2005-01-01

    We present a series of 8 cases of acute combined poisonings, occurred in an identical way in patients over 70 years of age for a period of 6 months. The way of exposure, characteristic of the clinical presentation, complications and the outcome of the intoxications, as well as the therapeutic approach is described. In all of the cases combined drug intoxication with benzodiazepines and opiates have been proved. The impact of the combination of two toxic substances: the first causing rapid and brief suppression of the consciousness and the second, causing prolonged continuation of the already suppressed consciousness, on the clinical course is discussed. The similarities in the circumstances of the exposure, clinical course of the poisonings, the identified toxic substances, lead to the consideration of criminal characteristic of the poisonings. The contact with the corresponding authorities brought off the disclosure of a group of criminals, committed the intentional intoxications with the aim of robbery. Age, with all its various characteristics, has been discussed as a factor for occurrence of criminal poisonings. PMID:16225098

  15. Poisoning - fish and shellfish

    MedlinePlus

    Fish poisoning; Dinoflagellate poisoning; Seafood contamination; Paralytic shellfish poisoning; Ciguatera poisoning ... algae and algae-like organisms called dinoflagellates. Small fish that eat the algae become contaminated. If larger ...

  16. Photographic fixative poisoning

    MedlinePlus

    Photographic developer poisoning; Hydroquinone poisoning; Quinone poisoning; Sulfite poisoning ... Hydroquinones Quinones Sodium thiosulfate Sodium sulfite/bisulfite Boric acid Photographic fixative can also break down (decompose) to form sulfur dioxide gas.

  17. Hyperbaric programs in the United States: Locations and capabilities of treating decompression sickness, arterial gas embolisms, and acute carbon monoxide poisoning: survey results.

    PubMed

    Chin, Walter; Jacoby, Laura; Simon, Olivia; Talati, Nisha; Wegrzyn, Gracelene; Jacoby, Rachelle; Proano, Jacob; Sprau, Susan E; Markovitz, Gerald; Hsu, Rita; Joo, Ellie

    2016-01-01

    Hyperbaric oxygen therapy is the primary treatment for arterial gas embolism, decompression sickness and acute carbon monoxide poisoning. Though there has been a proliferation of hyperbaric centers throughout the United States, a scarcity of centers equipped to treat emergency indications makes transport of patients necessary. To locate and characterize hyperbaric chambers capable of treating emergency cases, a survey of centers throughout the entire United States was conducted. Using Google, Yahoo, HyperbaricLink and the UHMS directory, a database for United States chambers was created. Four researchers called clinicians from the database to administer the survey. All centers were contacted for response until four calls went unreturned or a center declined to be included. The survey assessed chamber readiness to respond to high-acuity patients, including staff availability, use of medical equipment such as ventilators and intravenous infusion devices, and responding yes to treating hyperbaric emergencies within a 12-month period. Only 43 (11.9%, N = 361) centers had equipment, intravenous infusion pumps and ventilators, and staff necessary to treat high-acuity patients. Considering that a primary purpose of hyperbaric oxygen therapy is the treatment of arterial gas embolism and decompression sickness, more hyperbaric centers nationwide should be able to accommodate these emergency cases quickly and safely. PMID:27000011

  18. Severity and prognosis of acute organophosphorus pesticide poisoning are indicated by C-reactive protein and copeptin levels and APACHE II score

    PubMed Central

    WU, XINKUAN; XIE, WEI; CHENG, YUELEI; GUAN, QINGLONG

    2016-01-01

    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. PMID:26997996

  19. Poison ivy dermatitis. Nuances in treatment.

    PubMed

    Williford, P M; Sheretz, E F

    1994-02-01

    Acute allergic contact dermatitis due to poison ivy or poison oak is a common presenting complaint in the practices of many primary care physicians. While the clinical features are well described, reported treatment regimens vary in both topical and systemic therapies. We review herein the variability of presenting morphologic features of the disease and common treatment regimens, with attention given to complications of therapy. We also comment on the correct botanical designation, incidence, and immune mechanisms of the disease state and review measures to avoid allergic contact dermatitis due to poison ivy and poison oak. PMID:7994440

  20. [Poisoning by bee sting].

    PubMed

    de Roodt, Adolfo R; Salomón, Oscar D; Orduna, Tomás A; Robles Ortiz, Luis E; Paniagua Solís, Jorge F; Alagón Cano, Alejandro

    2005-01-01

    Among the human pathologies produced by venomous animals, bee stings constitute the largest number of accidents in several countries, exceeding the mortality rate caused by other venomous animals such as snakes, spiders or scorpions. The clinical picture after the bee sting may include anaphylaxis or poisoning. The latter is produced by massive attacks and is a serious problem that may put the patient's life at risk. People that are poisoned display hemolysis, rhabdomiolysis and acute renal failure that together with other systemic failures can bring about death. The knowledge of the physiopathological mechanisms involved in the massive attack of bees is crucial for health care professionals as to date we do not have antivenoms with proven clinical efficacy. In this review we include the bee's biological aspects, venom composition and its relation with the occurrence and severity of accidents as well as epidemiological data that can be useful for this type of accidents. PMID:16025987

  1. Cholestatic presentation of yellow phosphorus poisoning.

    PubMed

    Lakshmi, C P; Goel, Amit; Basu, Debdatta

    2014-01-01

    Yellow phosphorus, a component of certain pesticide pastes and fireworks, is well known to cause hepatotoxicity. Poisoning with yellow phosphorus classically manifests with acute hepatitis leading to acute liver failure which may need liver transplantation. We present a case of yellow phosphorus poisoning in which a patient presented with florid clinical features of cholestasis highlighting the fact that cholestasis can rarely be a presenting feature of yellow phosphorus hepatotoxicity. PMID:24554916

  2. Association of Blood Lead Level with Neurological Features in 972 Children Affected by an Acute Severe Lead Poisoning Outbreak in Zamfara State, Northern Nigeria

    PubMed Central

    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

    Background 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. Methods and Findings 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–<2 years and 2.69 [95%CI 1.15–6.26] for 2–<3 years, both vs 3–5 years). Severe neurological features were seen at VBLL <105 µg/dL only in those with malaria. Interpretation Increasing VBLL (from ≥80 µg/dL) and age 1–<3 years were strongly associated with neurological features; in those tested for malaria, a positive test was also strongly associated. These factors will help clinicians managing children with lead poisoning in prioritising therapy and developing chelation protocols. PMID:24740291

  3. Poison Ivy

    MedlinePlus

    ... poison ivy”. The plant is found around the world, but it usually doesn’t grow in the desert or in high elevations. It usually grows in clusters in the woods, up in trees, and on the ground. Every part of the ...

  4. Lead poisoning

    SciTech Connect

    Rekus, J.F.

    1992-08-01

    Construction workers who weld, cut or blast structural steel coated with lead-based paint are at significant risk of lead poisoning. Although technology to control these exposures may not have existed when the lead standard was promulgated, it is available today. Employers who do not take steps to protect their employees from lead exposure may be cited and fined severely for their failure.

  5. Poison Prevention

    MedlinePlus

    ... Word Shop AAP Find a Pediatrician Safety & Prevention ... Content Article Body Post the Poison Help number 1-800-222-1222 on the emergency list next to every phone in your home and in your cell phone. A toddler or preschooler who vomits may ...

  6. Acetone poisoning

    MedlinePlus

    ... JavaScript. Acetone is a chemical used in many household products. This article discusses poisoning from swallowing acetone-based ... A.M. Editorial team. Related MedlinePlus Health Topics Household Products Browse the Encyclopedia A.D.A.M., Inc. ...

  7. Malathion poisoning

    MedlinePlus

    ... care unit and getting long-term therapy. Some effects of the poison may last for weeks or months, or even longer. ... Cannon RD, Ruha A-M. Insecticides, herbicides, and rodenticides. ... Agency for Toxic Substances and Disease Registry (ATSDR); 2003.

  8. Poison Ivy

    MedlinePlus

    ... ground. It is usually found in groups of many plants and looks like weeds growing from 6 inches ... or anything else that may have touched the plant (like camping, sporting, fishing or hunting gear). If you develop a poison ivy rash, it will go away on its own in 1 to 3 ...

  9. Yew poisoning

    MedlinePlus

    ... is found in various kinds of the yew plant. The poison is in most parts of the yew plant, but the highest amount ... information: Person's age, weight, and condition Name and part of the plant that was swallowed, if known Time it was ...

  10. Paradichlorobenzene poisoning

    MedlinePlus

    ... level of alertness). Before Calling Emergency Have this information ready: Person's age, weight, and condition (for example, is the person awake or alert?) Name of the product Time it was swallowed Amount swallowed However, DO NOT delay calling ... Poison Control Your local ...

  11. Nicotine poisoning

    MedlinePlus

    ... 15 minutes. Before Calling Emergency Determine the following information: The person's age, weight, and condition Name of product (as well as the ingredients and strength, if known) When it was swallowed or inhaled The amount swallowed or ... Poison Control Your local ...

  12. The Dose Makes the Poison.

    ERIC Educational Resources Information Center

    Ottoboni, Alice

    1992-01-01

    A Toxicologist discusses common misconception that all chemicals are poisonous to people and the environment and how these misconceptions are perpetuated. Describes what makes a chemical toxic. Defines related concepts including dose, acute and chronic toxicity, and natural verses synthetic chemicals. (MCO)

  13. Acute Poisonings from Synthetic Cannabinoids - 50 U.S. Toxicology Investigators Consortium Registry Sites, 2010-2015.

    PubMed

    Riederer, Anne M; Campleman, Sharan L; Carlson, Robert G; Boyer, Edward W; Manini, Alex F; Wax, Paul M; Brent, Jeffrey A

    2016-01-01

    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. PMID:27413997

  14. Glyphosate poisoning.

    PubMed

    Bradberry, Sally M; Proudfoot, Alex T; Vale, J Allister

    2004-01-01

    Glyphosate is used extensively as a non-selective herbicide by both professional applicators and consumers and its use is likely to increase further as it is one of the first herbicides against which crops have been genetically modified to increase their tolerance. Commercial glyphosate-based formulations most commonly range from concentrates containing 41% or more glyphosate to 1% glyphosate formulations marketed for domestic use. They generally consist of an aqueous mixture of the isopropylamine (IPA) salt of glyphosate, a surfactant, and various minor components including anti-foaming and colour agents, biocides and inorganic ions to produce pH adjustment. The mechanisms of toxicity of glyphosate formulations are complicated. Not only is glyphosate used as five different salts but commercial formulations of it contain surfactants, which vary in nature and concentration. As a result, human poisoning with this herbicide is not with the active ingredient alone but with complex and variable mixtures. Therefore, It is difficult to separate the toxicity of glyphosate from that of the formulation as a whole or to determine the contribution of surfactants to overall toxicity. Experimental studies suggest that the toxicity of the surfactant, polyoxyethyleneamine (POEA), is greater than the toxicity of glyphosate alone and commercial formulations alone. There is insufficient evidence to conclude that glyphosate preparations containing POEA are more toxic than those containing alternative surfactants. Although surfactants probably contribute to the acute toxicity of glyphosate formulations, the weight of evidence is against surfactants potentiating the toxicity of glyphosate. Accidental ingestion of glyphosate formulations is generally associated with only mild, transient, gastrointestinal features. Most reported cases have followed the deliberate ingestion of the concentrated formulation of Roundup (The use of trade names is for product identification purposes only and

  15. Endrin-food-poisoning

    PubMed Central

    Weeks, D. E.

    1967-01-01

    Between 3 June and 15 July 1967 four explosive outbreaks of acute poisoning with the insecticide endrin occurred in Doha in Qatar and Hofuf in Saudi Arabia. Altogether 874 persons were hospitalized and 26 died. It is estimated that many others were poisoned whose symptoms were not so severe as to cause them to seek medical care or to enter hospital. The author describes the course of the outbreaks and the measures taken to ascertain their cause and prevent their extension and recurrence. It was found that the victims had eaten bread made from flour contaminated with endrin. In two different ships, both of them loaded and off-loaded at different ports, flour and endrin had been stowed in the same hold, with the endrin above the flour. In both ships the endrin containers had leaked and penetrated the sacks of flour which was later used to make bread. These two unconnected but nearly simultaneous mass poisonings emphasize the importance of regulating the carriage of insecticides and other toxic chemicals in such a way as to prevent the contamination of foodstuffs and similar substances during transport; both the World Health Organization and the Inter-Governmental Maritime Consultative Organization are working towards the establishment of regulations and practices to that end. PMID:5301732

  16. A systematic review of aluminium phosphide poisoning.

    PubMed

    Mehrpour, Omid; Jafarzadeh, Mostafa; Abdollahi, Mohammad

    2012-03-01

    Every year, about 300,000 people die because of pesticide poisoning worldwide. The most common pesticide agents are organophosphates and phosphides, aluminium phosphide (AlP) in particular. AlP is known as a suicide poison that can easily be bought and has no effective antidote. Its toxicity results from the release of phosphine gas as the tablet gets into contact with moisture. Phosphine gas primarily affects the heart, lungs, gastrointestinal tract, and kidneys. Poisoning signs and symptoms include nausea, vomiting, restlessness, abdominal pain, palpitation, refractory shock, cardiac arrhythmias, pulmonary oedema, dyspnoea, cyanosis, and sensory alterations. Diagnosis is based on clinical suspicion, positive silver nitrate paper test to phosphine, and gastric aspirate and viscera biochemistry. Treatment includes early gastric lavage with potassium permanganate or a combination with coconut oil and sodium bicarbonate, administration of charcoal, and palliative care. Specific therapy includes intravenous magnesium sulphate and oral coconut oil. Moreover, acidosis can be treated with early intravenous administration of sodium bicarbonate, cardiogenic shock with fluid, vasopresor, and refractory cardiogenic shock with intra-aortic baloon pump or digoxin. Trimetazidine may also have a useful role in the treatment, because it can stop ventricular ectopic beats and bigeminy and preserve oxidative metabolism. This article reviews the epidemiological, toxicological, and clinical/pathological aspects of AlP poisoning and its management. PMID:22450207

  17. Chinese dumpling scare hits Japan--a case of methamidophos food poisoning.

    PubMed

    Sumi, Yuka; Oode, Yasumasa; Tanaka, Hiroshi

    2008-10-01

    An outbreak of food poisoning that affected at least ten people in various regions of Japan was traced to exposure to Chinese dumplings contaminated with the organophosphate insecticide Methamidophos. We experienced the most serious case, a five years old girl, who suffered coma. She presented with features of cholinergic overactivity and her serum cholinesterase activity was 9 U/l. We started intravenous treatment with pralidoxime iodide, atropine sulfate, and midazolam. Her symptoms improved gradually and she was discharged on day 25 without any sequelae. Though poisoning attributed to organophosphate insecticides has become less common in recent years, it is even more important to diagnose the problem rapidly based on the characteristic symptoms and to start specific treatment at the earliest possible stage after poisoning. PMID:18827448

  18. Mercuric chloride poisoning

    MedlinePlus

    ... Mercuric chloride is a very poisonous form of mercury. It is a type of mercury salt. There are different types of mercury poisonings . This article discusses poisoning from swallowing mercuric ...

  19. Ink remover poisoning

    MedlinePlus

    ... be very poisonous if swallowed in large doses) Wood alcohol (methanol, which is very poisonous) ... Immediate kidney dialysis Medicine (antidote) to reverse the effect of the poison Tube through the mouth into ...

  20. Plant fertilizer poisoning

    MedlinePlus

    Household plant food poisoning; Plant food - household - poisoning ... Belson M. Ammonia and nitrogen oxides. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ...

  1. Shaving cream poisoning

    MedlinePlus

    ... if known) Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  2. Rhubarb leaves poisoning

    MedlinePlus

    ... if known Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  3. Lip moisturizer poisoning

    MedlinePlus

    ... The time it was swallowed The amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  4. Hair tonic poisoning

    MedlinePlus

    ... if known) Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  5. Mass Spectrometric Analyses of Organophosphate Insecticide Oxon Protein Adducts

    PubMed Central

    Thompson, Charles M.; Prins, John M.; George, Kathleen M.

    2010-01-01

    Objective Organophosphate (OP) insecticides continue to be used to control insect pests. Acute and chronic exposures to OP insecticides have been documented to cause adverse health effects, but few OP-adducted proteins have been correlated with these illnesses at the molecular level. Our aim was to review the literature covering the current state of the art in mass spectrometry (MS) used to identify OP protein biomarkers. Data sources and extraction We identified general and specific research reports related to OP insecticides, OP toxicity, OP structure, and protein MS by searching PubMed and Chemical Abstracts for articles published before December 2008. Data synthesis A number of OP-based insecticides share common structural elements that result in predictable OP–protein adducts. The resultant OP–protein adducts show an increase in molecular mass that can be identified by MS and correlated with the OP agent. Customized OP-containing probes have also been used to tag and identify protein targets that can be identified by MS. Conclusions MS is a useful and emerging tool for the identification of proteins that are modified by activated organophosphate insecticides. MS can characterize the structure of the OP adduct and also the specific amino acid residue that forms the key bond with the OP. Each protein that is modified in a unique way by an OP represents a unique molecular biomarker that with further research can lead to new correlations with exposure. PMID:20056576

  6. Prognostic Factors in Cholinesterase Inhibitor Poisoning

    PubMed Central

    Sun, In O; Yoon, Hyun Ju; Lee, Kwang Young

    2015-01-01

    Background Organophosphates and carbamates are insecticides that are associated with high human mortality. The purpose of this study is to investigate the prognostic factors affecting survival in patients with cholinesterase inhibitor (CI) poisoning. Material/Methods This study included 92 patients with CI poisoning in the period from January 2005 to August 2013. We divided these patients into 2 groups (survivors vs. non-survivors), compared their clinical characteristics, and analyzed the predictors of survival. Results The mean age of the included patients was 56 years (range, 16–88). The patients included 57 (62%) men and 35 (38%) women. When we compared clinical characteristics between the survivor group (n=81, 88%) and non-survivor group (n=11, 12%), there were no differences in renal function, pancreatic enzymes, or serum cholinesterase level, except for serum bicarbonate level and APACHE II score. The serum bicarbonate level was lower in non-survivors than in survivors (12.45±2.84 vs. 18.36±4.73, P<0.01). The serum APACHE II score was higher in non-survivors than in survivors (24.36±5.22 vs. 12.07±6.67, P<0.01). The development of pneumonia during hospitalization was higher in non-survivors than in survivors (n=9, 82% vs. n=31, 38%, P<0.01). In multiple logistic regression analysis, serum bicarbonate concentration, APACHE II score, and pneumonia during hospitalization were the important prognostic factors in patients with CI poisoning. Conclusions Serum bicarbonate and APACHE II score are useful prognostic factors in patients with CI poisoning. Furthermore, pneumonia during hospitalization was also important in predicting prognosis in patients with CI poisoning. Therefore, prevention and active treatment of pneumonia is important in the management of patients with CI poisoning. PMID:26411989

  7. Lead Poisoning Prevention Tips

    MedlinePlus

    ... CDC.gov . Lead Home Calendar of Events National Lead Poisoning Prevention Week Archived Materials CDC's Childhood Lead Poisoning Prevention Program Advisory Committee (ACCLPP) Current Activities Blood ...

  8. Protecting Yourself from Poisonous Plants

    MedlinePlus

    ... 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 ...

  9. House of Poison: Poisons in the Home.

    ERIC Educational Resources Information Center

    Keller, Rosanne

    One of a series of instructional materials produced by the Literacy Council of Alaska, this booklet provides information about common household poisons. Using a simplified vocabulary and shorter sentences, it provides statistics concerning accidental poisonings; a list of the places poisons are usually found in the home; steps to make the home…

  10. Lead poisoning in the world and Iran.

    PubMed

    Azizi, M H; Azizi, F

    2010-04-01

    Lead is a relatively ubiquitous heavy metal with particular features such as resistance to corrosion, high malleability and wide variety of industrial applications. In medicine, however, it is considered as a slow-acting toxic substance affecting multiple body systems, specifically functioning as a potent neurotoxin in the central nervous system. Lead poisoning may be acute or chronic and can be due to occupational or environmental exposures. The history of lead poisoning dates back to ancient times. The present paper briefly describes the worldwide historical accounts of lead poisoning with a special focus on Iran. PMID:23022790

  11. Prevention of Food Poisoning.

    ERIC Educational Resources Information Center

    Army Quartermaster School, Ft. Lee, VA.

    The programed text provides a single lesson, four-hour, correspondence subcourse on the prevention of food poisoning. It covers the following areas: a definition of food poisoning; chemical food poisoning; biological food poisoning; causes and prevention of trichinosis; six factors controlling bacteria growth; bacterial infection; prevention of…

  12. Organophosphate nerve agent toxicity in Hydra attenuata.

    PubMed

    Lum, Karin T; Huebner, Henry J; Li, Yingchun; Phillips, Timothy D; Raushel, Frank M

    2003-08-01

    The toxicity for analogues of sarin (GB), soman (GD), and VX was evaluated using Hydra attenuata as a model organism. The organophosphate nerve agent analogue simulants used in this investigation included the following: isopropyl p-nitrophenyl methylphosphonate (for GB); pinacolyl p-nitrophenyl methylphosphonate (for GD); and diisopropyl S-(2-diisopropylaminoethyl)phosphorothioate, diethyl S-(2-diisopropylaminoethyl)phosphorothioate, and diethyl S-(2-trimethylaminoethyl)phosphorothioate (for VX). The toxicity of each organophosphate nerve agent was assessed quantitatively by measuring the minimal effective concentration within 92 h in H. attenuata. There is a positive correlation between the molecular hydrophobicity of the compound and its ability to cause toxicity. Results from this study indicate the potential for application of this assay in the field of organophosphate chemical warfare agent detection, as well as for the prediction of toxicity of structurally similar organophosphate compounds. The minimal effective concentration for two of the VX analogues was 2 orders of magnitude more toxic than the analogue for GD and 4 orders of magnitude more toxic than the analogue for GB. PMID:12924922

  13. [Cholinesterase inhibitor poisoning: a complicated medical challenge].

    PubMed

    Lavon, Ophir; Sagi, Ram

    2013-07-01

    Exposure to insecticides, mainly cholinesterase inhibitors, is a global problem with substantial morbidity and mortality. Risk of intoxication is increased in rural areas where there is high availability and proximity of insecticides to families and children. Neglected storage and inadequate practice lead to dangerous exposure. Strict regulations and appropriate safety measures are needed for the prevention of exposure to insecticides. Broad toxicological knowledge is necessary in order to treat organophosphate and carbamate poisoned patients. Diagnosis is not trivial, since the identity of the poison is not always apparent. Multiple exposures including organic solvents are possible. The clinical presenting can be confusing. Measurement of cholinesterase activity is mandatory in establishing the diagnosis. Prompt treatment with proper antidotes and respiratory support is indicated. Early administration of anticonvulsants may mitigate central neurologic complications. Monitoring neurologic and cardiac function is advised for rapid identification of complications and prognosis evaluation. Meticulous preparedness of health care providers for insecticide poisoning is needed from the pre-hospital phase to emergency departments and the different hospital wards. PMID:23957084

  14. High lethality and minimal variation after acute self-poisoning with carbamate insecticides in Sri Lanka – implications for global suicide prevention

    PubMed Central

    Lamb, Thomas; Selvarajah, Liza R.; Mohamed, Fahim; Jayamanne, Shaluka; Gawarammana, Indika; Mostafa, Ahmed; Buckley, Nicholas A.; Roberts, Michael S.; Eddleston, Michael

    2016-01-01

    Abstract Background: Highly hazardous organophosphorus (OP) insecticides are responsible for most pesticide poisoning deaths. As they are removed from agricultural practice, they are often replaced by carbamate insecticides of perceived lower toxicity. However, relatively little is known about poisoning with these insecticides. Methods: We prospectively studied 1288 patients self-poisoned with carbamate insecticides admitted to six Sri Lankan hospitals. Clinical outcomes were recorded for each patient and plasma carbamate concentration measured in a sample to confirm the carbamate ingested. Findings: Patients had ingested 3% carbofuran powder (719), carbosulfan EC25 liquid (25% w/v, 389), or fenobucarb EC50 liquid (50% w/v, 127) formulations, carbamate insecticides of WHO Toxicity Classes Ib, II, and II, respectively. Intubation and ventilation was required for 183 (14.2%) patients while 71 (5.5%) died. Compared with carbofuran, poisoning with carbosulfan or fenobucarb was associated with significantly higher risk of death [carbofuran 2.2%; carbosulfan 11.1%, OR 5.5 (95% CI 3.0–9.8); fenobucarb 6.3%, OR 3.0 (1.2–7.1)] and intubation [carbofuran 6.1%; carbosulfan 27.0%, OR 5.7 (3.9–8.3); fenobucarb 18.9%, OR 3.6 (2.1–6.1)]. The clinical presentation and cause of death did not differ markedly between carbamates. Median time to death was similar: carbofuran 42.3 h (IQR 5.5–67.3), carbosulfan 21.3 h (11.5–71.3), and fenobucarb 25.3 h (17.3–72.1) (p = 0.99); no patients showed delayed onset of toxicity akin to the intermediate syndrome seen after OP insecticide poisoning. For survivors, median duration of intubation was 67.8 h (IQR 27.5–118.8) with no difference in duration between carbamates. Reduced GCS at presentation was associated with worse outcome although some patients with carbosulfan died after presentation with normal GCS. Conclusions: We did not find carbamate insecticide self-poisoning to vary markedly according to the carbamate

  15. Survey on Hypothermia and Hyperthermia in Poisoned Patients in a Unique Referral Hospital, Tehran, Iran

    PubMed Central

    Mozafari, Naser; Talaie, Haleh; Shoaei, Simin Dokht; Hashemian, Morteza; Mahdavinejad, Arezou

    2016-01-01

    Background Body temperature is a critical criterion of health. Drugs and a variety of poisons can affect body temperature in poisoned patients, causing hyperthermia and hyperpyrexia. Objectives Our previous study’s findings in patients poisoned with organophosphate led us to the goal of this study: obtaining the initial tympanic temperature in patients poisoned by a variety of toxins. Materials and Methods A cross-sectional study reviewed the records of poisoned patients who were admitted to the toxicological intensive care unit (TICU) at Loghman Hakim hospital poison center (LHHPC) from February 2014 to February 2015. The data collected included gender, age, type of poisoning, the season during which poisoning occurred, vital signs, initial tympanic temperature (first four hours), presence of seizures, white blood cell (WBC) count, creatinine phosphokinase (CPK), length of stay and patient outcome. We determined the mean (SD) for normally distributed continuous variables, the median and interquartile range for non-normally distributed continuous variables, and the absolute and relative frequency (%) for categorical variables. All were determined using SPSS version 16. Results Data were collected from 310 eligible patients. The mean patient age was 32.65 (with a standard deviation of 14.40). Of the patients in the study, 183 (59%) were male. Intentional poisoning in an attempted suicide was documented in 253 (81.6%) patients. The most prevalent poisoning agent was aluminum phosphate (18.70%), followed by methadone (10%) and opium (10%). Seventy percent of the patients (n = 217) were diagnosed and classified with fever or hyperthermia. A temperature ≥ 40°C was detected in just three cases. The highest mean temperature was found in patients poisoned with amphetamine, organophosphate and tramadol. Patients with alcohol and phenobarbital poisoning were included in the sample, but these patients were not diagnosed with hypothermia. WBC ≥ 10,000 cells/mL and CPK

  16. Recent advances in the treatment of organophosphorous poisonings.

    PubMed

    Balali-Mood, Mahdi; Saber, Hamidreza

    2012-06-01

    Organophosphorous compounds have been employed as pesticides and chemical warfare nerve agents. Toxicity of organophosphorous compounds is a result of excessive cholinergic stimulation through inhibition of acetyl cholinesterase. Clinical manifestations include cholinergic syndromes, central nervous system and cardiovascular disorders. Organophosphorous pesticide poisonings are common in developing worlds including Iran and Sri Lanka. Nerve agents were used during the Iraq-Iran war in 1983-1988 and in a terrorist attack in Japan in 1994-1995. Following decontamination, depending on the severity of intoxication the administration of atropine to counteract muscarinic over-stimulation, and an oxime to reactivate acetyl cholinesterase are indicated. Supportive and intensive care therapy including diazepam to control convulsions and mechanical respiration may be required. Recent investigations have revealed that intravenous infusion of sodium bicarbonate to produce mild to moderate alkalinization is effective. Gacyclidine; an antiglutamatergic compound, was also proved to be beneficial in conjunction with atropine, pralidoxime, and diazepam in nerve agent poisoning. Intravenous magnesium sulfate decreased hospitalization duration and improved outcomes in patients with organophosphorous poisoning. Bio-scavengers including fresh frozen plasma or albumin have recently been suggested as a useful therapy through clearing of free organophosphates. Hemofiltration and antioxidants are also suggested for organophosphorous poisoning. Recombinant bacterial phosphotriesterases and hydrolases that are able to transfer organophosphorous-degrading enzymes are very promising in delayed treatment of organophosphorous poisoning. Recently, encapsulation of drugs or enzymes in nanocarriers has also been proposed. Given the signs and symptoms of organophosphorous poisoning, health professionals should remain updated about the recent advances in treatment of organophosphorous poisoning

  17. Renal Failure Prevalence in Poisoned Patients

    PubMed Central

    Arefi, Mohammad; Taghaddosinejad, Fakhroddin; Salamaty, Peyman; Soroosh, Davood; Ashraf, Hami; Ebrahimi, Mohsen

    2014-01-01

    Background: Renal failure is an important adverse effect of drug poisoning. Determining the prevalence and etiology of this serious side effect could help us find appropriate strategies for the prevention of renal failure in most affected patients. Objectives: The present study is aimed to identify drugs that induce renal failure and also to find the prevalence of renal failure in patients referred to emergency departments with the chief complaint of drug poisoning, in order to plan better therapeutic strategies to minimize the mortality associated with drug poisoning induced renal failure. Patients and Methods: This cross-sectional study surveyed 1500 poisoned patients referred to the Emergency Department of Baharloo Hospital in Tehran during 2010. Demographic data including age and gender as well as clinical data including type of medication, duration of hospital stay, and presence of renal failure were recorded. Mann-Whitney U test and chi-squared statistics were used to analyze the results. Results: A total number of 435 patients were poisoned with several drugs, 118 patients were intoxicated with sedative-hypnotic drugs, 279 patients were exposed to opium, and 478 patients were administered to other drugs. The method of intoxication included oral 84.3%, injective 9%, inhalation 4.3% and finally a combination of methods 2.3%. Laboratory results revealed that 134 cases had renal failure and 242 had rhabdomyolysis. The incidence of rhabdomyolysis and renal failure increased significantly with age, and also with time of admission to the hospital. Renal failure was reported in 25.1% of patients exposed to opium, vs. 18.2% of patients poisoned with aluminum phosphide, 16.7% of those with organophosphate, 8% with multiple drugs, 6.7% with alcohol, heavy metals and acids, and 1.7% with sedative hypnotics. Conclusions: Based on the findings of this study, there is a high probability of renal failure for patients poisoned with drugs such as opium, aluminum phosphide

  18. Incidence of animal poisoning cases in the Czech Republic: current situation

    PubMed Central

    Modrá, Helena; Svobodová, Zdeňka

    2009-01-01

    This article reports the most frequent cases of poisoning in farm animals, horses, cats, dogs, wild animals, fish and honey-bees in the Czech Republic. At present, there are fewer cases of acute poisoning caused by high doses of toxic substances but there are more and more cases of chronic poisoning as a consequence of environmental pollution. PMID:21217846

  19. Ciguatera Fish Poisoning

    MedlinePlus

    ... By Syndrome Life Cycle Impacts Human Health Wildlife Ecosystems Socioeconomic Freshwater Regions Distribution - U.S. Distribution - World Maps ... Paralytic Shellfish Poisoning Cyanobacteria Medical Community ... Fish Poisoning Causative organisms: Gambierdiscus ...

  20. Face powder poisoning

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/002700.htm Face powder poisoning To use the sharing features on this page, please enable JavaScript. Face powder poisoning occurs when someone swallows or breathes ...

  1. Hydrochloric acid poisoning

    MedlinePlus

    Hydrochloric acid is a clear, poisonous liquid. It is highly corrosive, which means it immediately causes severe damage, ... discusses poisoning due to swallowing or breathing in hydrochloric acid. This article is for information only. Do NOT ...

  2. Hand lotion poisoning

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/002708.htm Hand lotion poisoning To use the sharing features on this page, please enable JavaScript. Hand lotion poisoning occurs when someone swallows hand lotion or ...

  3. Hydrochloric acid poisoning

    MedlinePlus

    Hydrochloric acid is a clear, poisonous liquid. It is highly corrosive, which means it immediately causes severe damage, such ... poisoning due to swallowing or breathing in hydrochloric acid. This article is for information only. Do NOT ...

  4. Poisoning first aid

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/007579.htm Poisoning first aid To use the sharing features on this page, ... or burns Stupor Unconsciousness Unusual breath odor Weakness First Aid Seek immediate medical help. For poisoning by swallowing: ...

  5. Hair bleach poisoning

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/002702.htm Hair bleach poisoning To use the sharing features on this page, please enable JavaScript. Hair bleach poisoning occurs when someone swallows hair bleach or ...

  6. Plant fertilizer poisoning

    MedlinePlus

    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. ...

  7. Bracken fern poisoning

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Bracken fern (Pteridium aquilinum) is found throughout the world and enzootic hematuria, bright blindness, and bracken staggers. This chapter reviews the plant, the various poisoning syndrome that it produces, the current strategies to prevent poisoning, and recommended treatments....

  8. Black nightshade poisoning

    MedlinePlus

    Black nightshade poisoning occurs when someone eats pieces of the black nightshade plant. This article is for information only. ... Poisons are found in the black nightshade plant, especially in the unripened fruit and leaves.

  9. Blue nightshade poisoning

    MedlinePlus

    Blue nightshade poisoning occurs when someone eats parts of the blue nightshade plant. This article is for information only. DO NOT use it to treat or manage an actual poison exposure. If you or someone you ...

  10. Hair straightener poisoning

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/002706.htm Hair straightener poisoning To use the sharing features on this page, please enable JavaScript. Hair straightener poisoning occurs when someone swallows products that ...

  11. Bubble bath soap poisoning

    MedlinePlus

    ... 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. ...

  12. Lead Poisoning in Childhood.

    ERIC Educational Resources Information Center

    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…

  13. Lead Poisoning (For Parents)

    MedlinePlus

    ... Story" 5 Things to Know About Zika & Pregnancy Lead Poisoning KidsHealth > For Parents > Lead Poisoning Print A A ... Family en español La intoxicación por plomo About Lead Poisoning If you have young kids, it's important to ...

  14. Lead Poisoning in Children.

    ERIC Educational Resources Information Center

    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)

  15. Lead poisoning: An overview

    NASA Technical Reports Server (NTRS)

    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.

  16. Carbamate poisoning: treatment recommendations in the setting of a mass casualties event.

    PubMed

    Rosman, Yossi; Makarovsky, Igor; Bentur, Yedidia; Shrot, Shai; Dushnistky, Tsvika; Krivoy, Amir

    2009-11-01

    The threat of using chemical compounds by terrorists as weapons of mass casualties has been a rising concern in recent years. Carbamates, a group of reversible acetylcholinesterase inhibitors, could be potentially involved in such toxic mass casualty events because they can cause cholinergic crisis that could lead to fatality, similar to that of organophosphate poisoning. The medical management of carbamate poisoning consists of supportive measures and specific antidotal treatment, that is, the anticholinergic compound atropine. The administration of oximes, acetylcholinesterase reactivators, in carbamate poisoning is controversial because of the potential toxicity of oximes in conjunction with carbamate especially in the case of the carbamate--"carbaryl" poisoning. However, recent data suggest that this concern may be unwarranted. In this article, we review the current data regarding the pros and cons of using oximes against carbamates poisoning in a mass casualties event scenario. We also propose a new decision-making algorithm for the medical first responders in a mass casualties event suspected to be caused by a cholinergic substance (organophosphate or carbamate). According to this algorithm, treatment should consist of atropine and oxime regardless of the exact toxic compound involved. We speculate that in a mass casualties event, the benefits of using oximes outweigh the low level of potential risk. PMID:19931761

  17. Poisoning: Effective Clinical Intervention

    PubMed Central

    Turner, T. J.

    1982-01-01

    Poisoning accounts for 40-60% of suicides, is the commonest medical emergency in small children, and an important source of occupational injury. Prevention of unintentional poisoning involves primarily education of parents. In intervention, the patient—not the poison—must be treated. Self-poisoners require supportive but firm handling. Treatment is directed towards prevention of further absorption, removal of absorbed poison, symptomatic or supportive therapy, and administration of systemic antidotes. Careful attention should be paid to the physician's legal responsibilities in cases of poisoning. Imagesp2032-a PMID:21286544

  18. Marijuana poisoning.

    PubMed

    Fitzgerald, Kevin T; Bronstein, Alvin C; Newquist, Kristin L

    2013-02-01

    , tremors, hypothermia, and bradycardia. Higher dosages may additionally cause nystagmus, agitation, tachypnea, tachycardia, ataxia, hyperexcitability, and seizures. Treatment of marijuana ingestion in animals is largely supportive. Vital signs including temperature and heart rate and rhythm must be continually monitored. Stomach content and urine can be tested for cannabinoids. Gas chromatography and mass spectrometry can be utilized for THC detection but usually may take several days and are not practical for initiation of therapy. Human urine drug-screening tests can be unreliable for confirmation of marijuana toxicosis in dogs owing to the interference of a large number of the metabolites in canine urine. False negatives may also arise if testing occurs too recently following THC ingestion. Thus, the use of human urine drug-screening tests in dogs remains controversial. No specific antidote presently exists for THC poisoning. Sedation with benzodiazepines may be necessary if dogs are severely agitated. Intravenous fluids may be employed to counter prolonged vomiting and to help control body temperature. Recently, the use of intralipid therapy to bind the highly lipophilic THC has been utilized to help reduce clinical signs. The majority of dogs experiencing intoxication after marijuana ingestion recover completely without sequellae. Differential diagnoses of canine THC toxicosis include human pharmaceuticals with central nervous system stimulatory effects, drugs with central nervous system depressant effects, macrolide parasiticides, xylitol, and hallucinogenic mushrooms. PMID:23796481

  19. Conservative Care in Successful Treatment of Abamectin Poisoning

    PubMed Central

    Aminiahidashti, Hamed; Jamali, Seyed Reza; Heidari Gorji, Ali Morad

    2014-01-01

    Human intoxication with abamectin is an uncommon but potentially fatal cause of pesticide poisoning. In this study a 42-year-old man was intoxicated with 3600 mg abamectin orally. On admission patient was fully alert with the smell of the poison from the mouth. Vital signs were normal and conjunctiva was hyperemic. Conservative cares such as gastric lavage was performed and charcoal was administered. After 2.5 hours, the patient gradually developed altered mental status as drowsiness, hypotension, tachycardia and dermal erythema. He was treated with H1 and H2 blockers and vasoactive agents and after 2 days was discharged in good condition. In comparison with organophosphates, abamectin intoxication has less risk in humans. However, consumption of large amounts in human can be fatal. Altered mental status could be considered as the first sign of abamectin intoxication. Normal level of consciousness is the best indicator of improvement of the condition. Conservative treatment is recommended. PMID:25948975

  20. Conservative care in successful treatment of abamectin poisoning.

    PubMed

    Aminiahidashti, Hamed; Jamali, Seyed Reza; Heidari Gorji, Ali Morad

    2014-01-01

    Human intoxication with abamectin is an uncommon but potentially fatal cause of pesticide poisoning. In this study a 42-year-old man was intoxicated with 3600 mg abamectin orally. On admission patient was fully alert with the smell of the poison from the mouth. Vital signs were normal and conjunctiva was hyperemic. Conservative cares such as gastric lavage was performed and charcoal was administered. After 2.5 hours, the patient gradually developed altered mental status as drowsiness, hypotension, tachycardia and dermal erythema. He was treated with H1 and H2 blockers and vasoactive agents and after 2 days was discharged in good condition. In comparison with organophosphates, abamectin intoxication has less risk in humans. However, consumption of large amounts in human can be fatal. Altered mental status could be considered as the first sign of abamectin intoxication. Normal level of consciousness is the best indicator of improvement of the condition. Conservative treatment is recommended. PMID:25948975

  1. Multiple Small Intestine Perforations after Organophosphorous Poisoning: A Case Report.

    PubMed

    Mahajan, Rubina Khullar; Rajan, Sudha Jasmine; Peter, John Victor; Suryawanshi, Mayur Keshav

    2016-03-01

    Organophosphate poisoning has significant gastrointestinal manifestations including vomiting, diarrhea, cramps and increased salivation. We report an uncommon gastrointestinal complication of multiple small intestinal perforations following organophosphorus poisoning. A 28-year old male presented after ingesting dichlorvos mixed with alcohol. Following the initial cholinergic symptoms, the patient developed severe shock with fever, attributed to aspiration pneumonia. Despite appropriate antibiotics, shock was persistent. Over the next 24-hours, he developed abdominal distension, loose stools and high nasogastric aspirates. Computed tomography showed pneumoperitonium. Exploratory laparotomy revealed six perforations in the jejunum and ileum. The involved portion of the bowel was resected and re-anastomosed, following which only 80-cm of small bowel was left. Postoperatively, shock resolved over 72-hours. However, over the next few days, patient developed features of anastomotic leak. Since only a small portion of the small bowel was preserved, a conservative approach was adopted. He deteriorated further and finally succumbed to the illness. PMID:27134898

  2. Multiple Small Intestine Perforations after Organophosphorous Poisoning: A Case Report

    PubMed Central

    Rajan, Sudha Jasmine; Peter, John Victor; Suryawanshi, Mayur Keshav

    2016-01-01

    Organophosphate poisoning has significant gastrointestinal manifestations including vomiting, diarrhea, cramps and increased salivation. We report an uncommon gastrointestinal complication of multiple small intestinal perforations following organophosphorus poisoning. A 28-year old male presented after ingesting dichlorvos mixed with alcohol. Following the initial cholinergic symptoms, the patient developed severe shock with fever, attributed to aspiration pneumonia. Despite appropriate antibiotics, shock was persistent. Over the next 24-hours, he developed abdominal distension, loose stools and high nasogastric aspirates. Computed tomography showed pneumoperitonium. Exploratory laparotomy revealed six perforations in the jejunum and ileum. The involved portion of the bowel was resected and re-anastomosed, following which only 80-cm of small bowel was left. Postoperatively, shock resolved over 72-hours. However, over the next few days, patient developed features of anastomotic leak. Since only a small portion of the small bowel was preserved, a conservative approach was adopted. He deteriorated further and finally succumbed to the illness. PMID:27134898

  3. ANDROGEN RECEPTOR ANTAGONISM BY THE ORGANOPHOSPHATE INSECTICIDE FENITROTHION

    EPA Science Inventory

    Androgen receptor antagonism by the organophosphate insecticide fenitrothion. Tamura, H., Maness, S.C., Reischmann, K. Dorman, D.C., Gray, L.E., and Gaido, K.W. (2000). Toxicol. Sci.

    Organophosphate insecticides represent one of the most widely used classes of pesticide...

  4. Paraquat Poisoning: Analysis of an Uncommon Cause of Fatal Poisoning from Manipal, South India

    PubMed Central

    Kanchan, Tanuj; Bakkannavar, Shankar M.; Acharya, Preetham R.

    2015-01-01

    Background: Morbidity and mortality related to acute poisoning is a serious health concern worldwide. Paraquat is known to be responsible for a number of acute poisonings in south India. Aim: The study aims at presenting the various aspects of paraquat poisoning that include patient profile, clinical presentation, end-organ complications, and observations at autopsy. Materials and Methods: The present registry-based retrospective research was conducted in a tertiary care teaching hospital in south India. All the confirmed cases of paraquat poisoning were included in the present study. The postmortem and hospital records of these patients were retrieved and relevant information was collected and analyzed. Results: Paraquat poisonings constituted 14.4% of the total poisoning fatalities during the study period. Equal number of males and females were observed in the present study. The victims were aged between 17 and 65 years (mean ± SD = 30.2 ± 13.1 years). Manner of death was suicidal in 92.9% cases. Common presenting symptoms after ingestion of paraquat included vomiting, followed by difficulty in breathing. In the present series, overall survival post paraquat consumption ranged between 10 h and 25 days. Half of the victims died within 2 days of consumption of poison. The underlying cause of death included acute renal failure (ARF), adult respiratory distress syndrome (ARDS), multiorgan failure (MOF), acute liver failure, etc., In all the cases, brain was congested and edematous, and visceral organs showed marked congestion at autopsy. Lungs were congested with marked edema in 10 cases. Conclusion: It is recommended that the availability of this highly toxic substance be restricted so as to prevent its misuse as a method of suicide. PMID:26862257

  5. Arsine poisoning

    SciTech Connect

    Kleinfeld, M.J.

    1980-12-01

    A 31-year-old patient was admitted to the hospital beause 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.

  6. [Seafood poisonings. Part II. Fish poisonings].

    PubMed

    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. PMID:23243919

  7. Organophosphate pesticide method development and presence of chlorpyrifos in the feet of nearctic-neotropical migratory songbirds from Canada that over-winter in Central America agricultural areas.

    PubMed

    Alharbi, Hattan A; Letcher, Robert J; Mineau, Pierre; Chen, Da; Chu, Shaogang

    2016-02-01

    Recent modeling analysis suggests that numerous birds may be at risk of acute poisoning in insecticide-treated fields. Although the majority of avian field studies on pesticides have focused on treated seed, granule, insect or vegetation (oral exposure) ingestion, dermal exposure is an important exposure route when birds come into contact with deposited pesticides on foliage and other surfaces. Some nearctic-neotropical migratory songbirds are likely exposed to pesticides on their non-breeding habitats and include treated crops, plantations or farmlands. In the present study, we developed a method for four environmentally-relevant organophosphate (OP) pesticides (fenthion, fenamiphos, chlorpyrifos and diazinon) in the feet of migratory songbirds (i.e. Common yellowthroat, Gray catbird, Indigo bunting, America redstart, Northern waterthrush, Northern parula, and an additional 12 species of warblers). A total of 190 specimens of the 18 species of songbirds were sampled from available window-killed birds (spring of 2007 and 2011) in downtown Toronto, Canada. The species that were available most likely over-wintered in Mexican/Central American crops such as citrus, coffee and cacao. The feet of the dead birds were sampled and where OP foot exposure likely occurred during over-wintering foraging on pesticide-treated crops. Chlorpyrifos was the only measurable OP (pg mg feet weight(-1)) and in the 2011-collected feet of Black throated blue warbler (0.5), Tennessee warbler (1.0), Northern parula (1.2), Northern waterthrush (0.6), Common yellowthroat (1.0) and the Blue winged warbler (0.9). Dermal contact with OP pesticides during over-wintering in agricultural areas resulted in low levels of chlorpyrifos and long time retention on the feet of a subset of songbirds. PMID:26421621

  8. Oxalic acid poisoning

    MedlinePlus

    Symptoms of oxalic acid poisoning include: Abdominal pain Burns and blisters where the acid contacted the skin Collapse Convulsions Mouth pain Shock Throat pain Tremors (unintentional trembling) Vomiting

  9. Hair dye poisoning

    MedlinePlus

    Hair tint poisoning ... Different types of hair dye contain different harmful ingredients. The harmful ingredients in permanent dyes are: Naphthylamine Other aromatic amino compounds Phenylenediamines Toluene ...

  10. Poison Ivy, Oak, and Sumac

    MedlinePlus

    ... U.S.) is a delayed allergic reaction. Brushing the plant on the skin results in blisters and slightly ... of poison ivy, poison oak, and poison sumac plants. People typically have itchy bumps (papules) and blisters ( ...

  11. Grass and weed killer poisoning

    MedlinePlus

    Weedoff poisoning; Roundup poisoning ... Glyphosate is the poisonous ingredient in some weed killers. ... Glyphosate is in weed killers with these brand names: Roundup Bronco Glifonox Kleen-up Rodeo Weedoff Other ...

  12. Unintentional poisoning with drugs in a Mexican pediatric population.

    PubMed

    Olguin, Hugo Juárez; Garduño, Lina Barranco; Pérez, Janett Flores; Pérez, Carmen Flores

    2011-01-01

    In Mexico, more than 70 % of acute pediatric poisoning is caused by medicines. The age groups at greatest risk of drug poisoning are those between 2 to 5 years and 14 to 18 years; although in this last group, drug ingestion is usually intentional. The purpose of our study was to determine the frequency of unintentional drug poisoning in the pediatric population attended in a tertiary care hospital in Mexico, and to review the rescue procedures applied in specific cases. A retrospective and descriptive study was performed through revision of clinical records, obtained from patients attended at the National Pediatrics Institute from January 1995 to June 2005. One hundred and thirty nine (139) records, 62 females and 77 males, median age 2 years with clinical diagnosis of drug poisoning were reviewed. Poisoning was confirmed in 23.7% of the cases by determination of drug plasma concentration. The most frequent causes of drug poisoning were analgesics (42.3 %), from which 60 % corresponded to acetylsalicylic acid and 40 % to acetaminophen; antiepileptics (22.9 %), anxiolytics (17.9 %) and other drugs (16.3 %). From our results, we concluded that self-medication was unlikely due to the early age of patients, unless ingestion of the drug was accidental. No case needed more than 24 h of hospitalization, and no patient died due to poisoning. Specific cause of poisoning was that, at early ages, doses must be administered according to the infant's weight, which poses a risk of poisoning. PMID:21471606

  13. Fatal parathion poisoning in Sierra Leone

    PubMed Central

    Etzel, R. A.; Forthal, D. N.; Hill, R. H.; Demby, A.

    1987-01-01

    In May and June 1986, 49 persons in Sierra Leone were acutely poisoned by the organothiophosphate insecticide, parathion. Fourteen people died. Illness occurred in three episodes at two different locations that were 44 km apart. A study of 21 cases and 22 household controls was undertaken to explore which factors were associated with the development of the symptoms. Cases were more likely than controls to have eaten bread in the 4 hours before becoming ill (odds ratio, 12.7; 95% confidence interval, 2.4-83.8). Scrapings of residue from the floor of the truck that had brought the wheat flour from the mill to the general store where the baker purchased it were positive for parathion, suggesting that the flour had been contaminated during transport. Pesticide poisoning is a common problem in the developing world, and public health measures such as restricting the use of parathion may help to prevent fatal poisonings. PMID:3501344

  14. GC-MS analysis of the designer drug α-pyrrolidinovalerophenone and its metabolites in urine and blood in an acute poisoning case.

    PubMed

    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. PMID:26775198

  15. Suspected Pesticide Poisoning

    PubMed Central

    Sellar, Christine; Ferguson, Joyce A.

    1991-01-01

    Of 1125 calls to a regional poison control center about suspected pesticide poisonings, more than half concerned children younger than 6 years, most of whom had ingested small amounts and required no treatment other than drinking fluids. Adults represented a small proportion of victims, but were more likely to have consumed moderate or large quantities, to have symptoms, and to need referral. PMID:21228985

  16. Lead Poisoning in Children.

    ERIC Educational Resources Information Center

    Lin-Fu, Jane S.

    This publication is a guide to help social and health workers plan a preventive campaign against lead poisoning, a cause of mental retardation other neurological handicaps, and death among children. The main victims are 1- to 6-year-olds living in areas where deteriorating housing prevails. Among the causes of lead poisoning are: ingestion of…

  17. Poisoning - fish and shellfish

    MedlinePlus

    ... contaminated waters. Scombroid poisoning usually occurs from large, dark meat fish such as tuna, mackerel, mahi mahi, and albacore. Because this poison develops after a fish is caught and dies, it does not matter where the fish is caught. The main factor ...

  18. Hydrofluoric acid poisoning

    MedlinePlus

    ... with has an exposure, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

  19. Diethylene glycol poisoning from transcutaneous absorption.

    PubMed

    Devoti, Elisabetta; Marta, Elisabetta; Belotti, Elena; Bregoli, Laura; Liut, Francesca; Maiorca, Paolo; Mazzucotelli, Valentina; Cancarini, Giovanni

    2015-04-01

    A case of transcutaneous diethylene glycol poisoning with severe acute kidney injury, but a positive outcome, is described. A man without significant medical history was admitted to our hospital due to anuria, gastrointestinal symptoms, and hypertension. Ultrasonography excluded vascular damage and postrenal obstruction. Laboratory tests showed acute kidney injury and metabolic acidosis with increased anion gap; hemodialysis therapy was started. The brother of the patient reported that the patient had been smearing his skin with brake fluid containing diethylene glycol to treat a "dermatitis." Only supportive therapy was given due to the lack of a specific antidote. Continuous venovenous hemofiltration was performed. The kidney biopsy showed acute toxic proximal tubulonecrosis, without deposition of oxalate crystals. His neurologic condition worsened dramatically; supportive care was continued. Over time, acute kidney injury and neurologic damage gradually improved; 33 days after admission, he went to a rehabilitation unit for 5 months, with complete clinical recovery. Historically, diethylene glycol has been the cause of large-scale poisonings from ingestion of contaminated drugs. The clinical evolution is unpredictable. Treatment is not well defined; early hemodialysis treatment reduces levels of toxic metabolites, and fomepizole could be useful in cases with an early diagnosis. A comparison of the characteristics of diethylene glycol versus ethylene glycol poisoning is given. PMID:25445099

  20. 1H Nuclear Magnetic Resonance (NMR) Metabolomic Study of Chronic Organophosphate Exposure in Rats

    PubMed Central

    Alam, Todd M.; Neerathilingam, Muniasamy; Alam, M. Kathleen; Volk, David E.; Ansari, G. A. Shakeel; Sarkar, Swapna; Luxon, Bruce A.

    2012-01-01

    1H NMR spectroscopy and chemometric analysis were used to characterize rat urine obtained after chronic exposure to either tributyl phosphate (TBP) or triphenyl phosphate (TPP). In this study, the daily dose exposure was 1.5 mg/kg body weight for TBP, or 2.0 mg/kg body weight for TPP, administered over a 15-week period. Orthogonal signal correction (OSC) -filtered partial least square discriminant analysis (OSC-PLSDA) was used to predict and classify exposure to these organophosphates. During the development of the model, the classification error was evaluated as a function of the number of latent variables. NMR spectral regions and corresponding metabolites important for determination of exposure type were identified using variable importance in projection (VIP) coefficients obtained from the OSC-PLSDA analysis. As expected, the model for classification of chronic (1.5–2.0 mg/kg body weight daily) TBP or TPP exposure was not as strong as the previously reported model developed for identifying acute (15–20 mg/kg body weight) exposure. The set of majorly impacted metabolites identified for chronic TBP or TPP exposure was slightly different than those metabolites previously identified for acute exposure. These metabolites were then mapped to different metabolite pathways and ranked, allowing the metabolic response to chronic organophosphate exposure to be addressed. PMID:24957643

  1. EFFECTS OF ORGANOPHOSPHATES ON THE VISUAL SYSTEM OF RATS

    EPA Science Inventory

    The possibility that exposure to organophosphate insecticides can lead to ocular damage is suggested by Japanese studies and indicating that exposed humans developed chronic ocular degeneration, in addition to showing more commonly accepted effects of cholinesterase inhibiting co...

  2. The influence of tomato processing on residues of organochlorine and organophosphate insecticides and their associated dietary risk.

    PubMed

    Reiler, Emilie; Jørs, Erik; Bælum, Jesper; Huici, Omar; Alvarez Caero, Maria Mercedes; Cedergreen, Nina

    2015-09-15

    Due to the increasing food demand, the use of pesticides in agriculture is increasing. Particularly in low income countries poor training among farmers, combined with the use of obsolete pesticides may result in a high risk for the consumers. In this study six organochlorines and five organophosphates were analyzed in 54 samples of tomatoes from small scale farmers in Bolivia. The analyses were done on unprocessed, stored, washed and peeled tomatoes. The cumulated risk associated with consumption of the tomatoes after different storage times and processing treatments was evaluated using the Hazard Index (HI) for acute risk assessment. All 11 pesticides were detected in the analyses although several of them are obsolete and included in the Stockholm convention ratified by Bolivia. The organochlorines were found in the μg pesticide/kg tomato range and below the HI, while the organophosphates were present in the mg pesticide/kg tomato range and most often above the HI. The low organochlorine concentrations were not significantly affected by time or treatment, but storage significantly decreased the concentrations of organophosphates. Washing decreased the initial concentrations to between 53% (malathion) down to 2% (ethyl parathion), while peeling had a larger effect reducing the initial concentrations to between 33% (malathion) and 0.7% (chlorpyriphos). Both the acute and chronic cumulative risk assessment of organophosphates showed a dietary risk for unprocessed tomatoes three days after harvest. For children, also the consumption of washed tomatoes constituted a dietary risk. To reduce the dietary risk of pesticide residues in Bolivia, there is an urgent need of farmer education and introduction of less hazardous pesticides as well as resources for surveillance and enforcement of legislation in order to ensure public health. PMID:25965039

  3. Look Out! It's Poison Ivy!

    ERIC Educational Resources Information Center

    Darlington, Elizabeth, Day

    1986-01-01

    Provides background information on poison ivy and offers suggestions for instructional activities. Includes illustrations of the varieties of poison ivy leaf forms and poison ivy look-alikes. Highlights interesting facts and cases associated with poison ivy and its relatives. (ML)

  4. [EFFECT OF 4-METHYLPYRAZOLE ON IMMUNE RESPONSE, FUNCTION OF Th1 AND Th2 LYMPHOCYTES, AND CYTOKINE CONCENTRATION IN RAT BLOOD AFTER ACUTE METHANOL POISONING].

    PubMed

    Zabrodskii, P F; Maslyakov, V V; Gromov, M S

    2016-01-01

    It was established in experiments on noninbred albino rats that the acute intoxication with methanol (1.0 LD50) decreased cellular and humoral immune responses, Th2-lymphocyte activity (to a greater extent as compared to the function of Th1 cells), reduced the blood concentration of immunoregulatory (IFN-g, IL-2, IL-4) and proinflammatory (TNF, IL-1b, IL-6) cytokines on the average by 36.5% (p < 0.05), and did not affect the content of anti-inflammatory cytokines (IL-10, IL-13). Methanol antidote 4-methylpyrazole (non-competitive inhibitor of alcohol dehydrogenase) administered upon acute intoxication with methanol at a dose of 1.0 DL50 partially reduces the intoxication-induced suppression of humoral and cellular immune response, activity of T-helper cells, and production of IL-4 and restores blood levels of TNF, IL-1b, IFN-γ, IL-4, IL-2, IL-6 to the control values. PMID:27455577

  5. Protein tyrosine adduct in humans self-poisoned by chlorpyrifos

    SciTech Connect

    Li, Bin; Eyer, Peter; Eddleston, Michael; Jiang, Wei; Schopfer, Lawrence M.; Lockridge, Oksana

    2013-06-15

    Studies of human cases of self-inflicted poisoning suggest that chlorpyrifos oxon reacts not only with acetylcholinesterase and butyrylcholinesterase but also with other blood proteins. A favored candidate is albumin because in vitro and animal studies have identified tyrosine 411 of albumin as a site covalently modified by organophosphorus poisons. Our goal was to test this proposal in humans by determining whether plasma from humans poisoned by chlorpyrifos has adducts on tyrosine. Plasma samples from 5 self-poisoned humans were drawn at various time intervals after ingestion of chlorpyrifos for a total of 34 samples. All 34 samples were analyzed for plasma levels of chlorpyrifos and chlorpyrifos oxon (CPO) as a function of time post-ingestion. Eleven samples were analyzed for the presence of diethoxyphosphorylated tyrosine by mass spectrometry. Six samples yielded diethoxyphosphorylated tyrosine in pronase digests. Blood collected as late as 5 days after chlorpyrifos ingestion was positive for CPO-tyrosine, consistent with the 20-day half-life of albumin. High plasma CPO levels did not predict detectable levels of CPO-tyrosine. CPO-tyrosine was identified in pralidoxime treated patients as well as in patients not treated with pralidoxime, indicating that pralidoxime does not reverse CPO binding to tyrosine in humans. Plasma butyrylcholinesterase was a more sensitive biomarker of exposure than adducts on tyrosine. In conclusion, chlorpyrifos oxon makes a stable covalent adduct on the tyrosine residue of blood proteins in humans who ingested chlorpyrifos. - Highlights: • Chlorpyrifos-poisoned patients have adducts on protein tyrosine. • Diethoxyphosphate-tyrosine does not lose an alkyl group. • Proteins in addition to AChE and BChE are modified by organophosphates.

  6. Sodium hypochlorite poisoning

    MedlinePlus

    ... poisoning, especially if the product is mixed with ammonia. This article is for information only. Do NOT ... hypochlorite, which may cause severe injury. NEVER mix ammonia with sodium hypochlorite (bleach or bleach-containing products). ...

  7. Trisodium phosphate poisoning

    MedlinePlus

    ... For swallowed poison, the person may receive: Endoscopy. Camera is placed down the throat to see burns ... the nose or mouth into the lungs Bronchoscopy. Camera is placed down the throat to see burns ...

  8. Poison Control Centers

    MedlinePlus

    ... except Maricopa County Mail donation to: College of Pharmacy, Development Office PO Box 210202, Tucson, AZ 85721 ... ly/1HDxdHb Tucson, AZ 85721 Online http://www.pharmacy.arizona.edu/outreach/poison/ Email: boesen at pharmacy ...

  9. Sodium bisulfate poisoning

    MedlinePlus

    ... in large amounts. This article discusses poisoning from swallowing sodium bisulfate. This article is for information only. ... Symptoms from swallowing more than a tablespoon of this acid may include: Burning pain in the mouth Chest pain from burns ...

  10. Carbon monoxide poisoning

    MedlinePlus

    ... any major gas-burning appliances (such as a furnace or water heater). Many carbon monoxide poisonings occur in the winter months when furnaces, gas fireplaces, and portable heaters are being used ...

  11. Hand lotion poisoning

    MedlinePlus

    Hand lotion poisoning occurs when someone swallows hand lotion or hand cream. This article is for information only. DO ... These ingredients in hand lotion or cream can be harmful if swallowed: Dimethicone Mineral oil Paraffins (waxes) Petrolatum Various alcohols

  12. Mineral spirits poisoning

    MedlinePlus

    ... substances may be found in: Mineral spirits ( Stoddard solvent ) Some paints Some floor and furniture waxes and ... for recovery. Swallowing such poisons can have severe effects on many parts of the body. The ultimate ...

  13. Potassium carbonate poisoning

    MedlinePlus

    Potassium carbonate is a white powder used to make soap, glass, and other items. This article discusses poisoning from swallowing or breathing in potassium carbonate. This article is for information only. Do ...

  14. Pine oil poisoning

    MedlinePlus

    ... K. General approach to the poisoned patient. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical ... Mosby; 2013:chap 147. Lee DC. Hydrocarbons. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical ...

  15. Bug spray poisoning

    MedlinePlus

    ... effective bug sprays contain pyrethrins. Pyrethrins are a pesticide made from the chrysanthemum flower. It is generally ... Borron SW. Pyrethrins, repellants, and other pesticides. In: Shannon ... of Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: ...

  16. Ethylene glycol poisoning

    MedlinePlus

    ... kidneys. The poisoning causes disturbances in the body's chemistry, including metabolic acidosis . The disturbances may be severe ... other tests such as: Arterial blood gas analysis Chemistry panel and liver function studies Chest x-ray ( ...

  17. Acid soldering flux poisoning

    MedlinePlus

    ... Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 158. Mirkin DB. Benzene and ... Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 94. Wax PM, Yarema M. ...

  18. Window cleaner poisoning

    MedlinePlus

    ... Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 32. Mycyk MB. Toxic alcohols. ... JG, ed. Emergency Medicine . 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 151. White SR. Toxic alcohols. ...

  19. Ammonium hydroxide poisoning

    MedlinePlus

    ... Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 97. Harchelroad FP Jr, Rottinghaus ... Textbook of Critical Care . 6th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 187. Wax PM, Yarema M. ...

  20. Wart remover poisoning

    MedlinePlus

    ... Poisoning and Drug Overdose. 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 48. Nelson LS, Ford MD. ... eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 110. Seger DL, Murray L. ...

  1. Plastic resin hardener poisoning

    MedlinePlus

    ... Elsevier Saunders; 2012:chap 41. Holland MG. Occupational toxicology. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. ...

  2. Tips to Prevent Poisonings

    MedlinePlus

    ... local take back programs in your community . Household Chemicals and Carbon Monoxide Always read the label before using a product that may be poisonous. Keep chemical products in their original bottles or containers. Do ...

  3. Turpentine oil poisoning

    MedlinePlus

    Turpentine oil comes from a substance in pine trees. Turpentine oil poisoning occurs when someone swallows turpentine oil or breathes in the fumes. Breathing these fumes on purpose is sometimes called "huffing" ...

  4. Face powder poisoning

    MedlinePlus

    Face powder poisoning occurs when someone swallows or breathes in this substance. This article is for information ... The ingredients in face powder that can be harmful are: Baking soda Talcum powder Many other types of powder

  5. Mineral spirits poisoning

    MedlinePlus

    Mineral spirits are liquid chemicals used to thin paint and as a degreaser. Mineral spirits poisoning occurs ... be found in: Mineral spirits ( Stoddard solvent ) Some paints Some floor and furniture waxes and polishes Some ...

  6. Rhubarb leaves poisoning

    MedlinePlus

    ... Field R, Panter KE, et al. Selected poisonous plants affecting animal and human health. In: Haschek WAM, Rousseaux CG, Wallig MA, eds. Haschek and Rousseaux's Handbook of Toxicologic Pathology . 3rd ed. Philadelphia, PA: Elsevier; 2013:chap 40.

  7. Cold wave lotion poisoning

    MedlinePlus

    ... 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 ...

  8. Black nightshade poisoning

    MedlinePlus

    ... when someone eats pieces of the black nightshade plant. This article is for information only. DO NOT ... Poisons are found in the black nightshade plant, especially in the unripened fruit and leaves.

  9. Automatic dishwasher soap poisoning

    MedlinePlus

    ... OJ, et al., eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide . 7th ed. New York, NY: McGraw-Hill Medical; 2011:chap 211. Kulig K. General approach to the poisoned patient. In: Marx J, ed. ...

  10. Swimming pool cleaner poisoning

    MedlinePlus

    Swimming pool cleaner poisoning occurs when someone swallows this type of cleaner, touches it, or breathes in ... The harmful substances in swimming pool cleaner are: Bromine ... copper Chlorine Soda ash Sodium bicarbonate Various mild acids

  11. Drain cleaner poisoning

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/002779.htm Drain cleaner poisoning To use the sharing features on this page, please enable JavaScript. Drain cleaners contain very dangerous chemicals that can be ...

  12. Poison Ivy Dermatitis

    MedlinePlus

    ... familiar skin rash. No one is born with sensitivity to Poison ivy, but if exposed enough most ... sensitized at some time and remain allergic. A sensitivity can change at any time. There's no way ...

  13. Boric acid poisoning

    MedlinePlus

    ... boric acid poisoning usually occurs when someone swallows powdered roach-killing products that contain the chemical. Chronic ... vein (IV) Medicines to treat symptoms Note: Activated charcoal does not effectively treat (absorb) boric acid. For ...

  14. Hair spray poisoning

    MedlinePlus

    Hair spray poisoning occurs when someone breathes in (inhales) hair spray or sprays it down their throat or ... The harmful ingredients in hair spray are: Carboxymethylcellulose ... Polyvinyl alcohol Propylene glycol Polyvinylpyrrolidone

  15. Potassium carbonate poisoning

    MedlinePlus

    ... dishwasher soaps Some forms of potash (material from wood ashes that is used in fertilizers) Some home ... chance for recovery. Swallowing poisons can have severe effects on many parts of the body. Damage to ...

  16. Sodium carbonate poisoning

    MedlinePlus

    Sodium carbonate (known as washing soda or soda ash) is a chemical found in many household and ... products. This article focuses on poisoning due to sodium carbonate. This article is for information only. Do ...

  17. Window cleaner poisoning

    MedlinePlus

    Jacobsen D, Hovda KE. Methanol, ethylene glycol, and other toxic alcohols. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, ...

  18. Metal cleaner poisoning

    MedlinePlus

    Metal cleaners are very strong chemical products that contain acids. This article discusses poisoning from swallowing or ... Metal cleaners contain organic compounds called hydrocarbons, including: 1,2-butylene oxide Boric acid Cocoyl sarcosine Dicarboxylic ...

  19. Toluene and xylene poisoning

    MedlinePlus

    ... used in: Fingernail polish Glues and adhesives Lacquers Octane booster in gasoline Paints Paint thinners Printing and ... anywhere in the United States.This national hotline number will let you talk to experts in poisoning. ...

  20. Trisodium phosphate poisoning

    MedlinePlus

    ... removal of burned skin) Washing of the skin (irrigation). Perhaps every few hours for several days. Ointments ... For eye exposure, the person may receive: Extensive irrigation to flush out the poison Medicines

  1. Occupational cyanide poisoning

    PubMed Central

    Amizet, Loic; Pruvot, Gauthier; Remy, Sophie; Kfoury, Michel

    2011-01-01

    Cyanide poisoning has existed for centuries. In most cases, cyanide is combined with other toxic substances; for example with carbon monoxide in fire smoke. Cases of pure cyanide poisoning are rare, and usually due to accidental exposure. Their treatment is based on oxygenation and the infusion of hydroxocobalamin. The seriousness of this type of poisoning calls for a rapid and specific response, which demonstrates the usefulness of non-hospital based medical treatment. The authors report here the case of a man who was the victim of occupational poisoning with sodium cyanide and who was treated at the workplace by fire-fighters and the Service Mobile d’Urgence et Reanimation emergency ambulance service. PMID:22674698

  2. The Poisons Project.

    ERIC Educational Resources Information Center

    Crawford, Barbara A.

    1998-01-01

    Details a project in which students explore and study the poisons in their environment by asking and finding answers to their own research questions. Includes some suggestions for involving students successfully in inquiry-based learning. (DDR)

  3. Jerusalem cherry poisoning

    MedlinePlus

    ... poisoning occurs when someone eats pieces of this plant. This article is for information only. DO NOT use it ... information: Person's age, weight, and condition Name and part of the plant that was swallowed, if known Time it was ...

  4. Caulking compound poisoning

    MedlinePlus

    Caulking compounds are substances used to seal cracks and holes around windows and other openings. Caulking compound poisoning occurs when someone swallows these substances. This is for information only and not for use in the ...

  5. Pyopneumothorax Following Kerosene Poisoning

    PubMed Central

    Chaudhary, Shyam Chand; Sawlani, Kamal Kumar; Yathish, B. E.; Singh, Ambukeshwar; Kumar, Suresh; Parihar, Anit

    2014-01-01

    Kerosene poisoning is a common poisoning in India especially in childhood, and clinical spectrum can range from meager chemical pneumonitis to grave complications such as hypoxia, pneumothorax, pneumomediastinum, and emphysema. Pyopneumothorax that may require aggressive management in the form of thoracotomy has not been reported in literature. We hereby report a 22-year young female who had developed series of respiratory complications including pyopneumothorax following ingestion of kerosene with suicidal intent and was treated successfully. PMID:24748745

  6. Carbon monoxide poisoning.

    PubMed

    Kao, Louise W; Nañagas, Kristine A

    2005-11-01

    CO is an ubiquitous poison with many sources of exposure. CO poisoning produces diverse signs and symptoms that are often subtle and may be easily misdiagnosed. Failure to diagnose CO poisoning may result insignificant morbidity and mortality and permit continued exposure to a dangerous environment. Treatment of CO poisoning begins with inhalation of supplemental oxygen and aggressive supportive care. HBOT accelerates dissociation of CO from hemoglobin and may also prevent DNS. Absolute indications forHBOT for CO poisoning remain controversial, although most authors would agree that HBOT is indicated in patients who are comatose or neurologically abnormal, have a history of LOC with their exposure, or have cardiac dysfunction. Pregnancy with an elevated CO-Hgb level(>15%-20%) is also widely, considered an indication for treatment.HBOT may be considered in patients who have persistent symptoms despite NBO, metabolic acidosis, abnormalities on neuropsychometric testing, or significantly elevated levels. The ideal regimen of oxygen therapy has yet to be determined, and significant controversy exists regarding HBOTtreatment protocols. Often the local medical toxicologist, poison control center, or hyperbaric unit may assist the treating physician with decisions regarding therapy. PMID:16227059

  7. [The protective effect of pantothenic acid derivatives and changes in the system of acetyl CoA metabolism in acute ethanol poisoning].

    PubMed

    Moiseenok, A G; Dorofeev, B F; Omel'ianchik, S N

    1988-01-01

    Calcium pantothenate (CaP), calcium 4'-phosphopantothenate (CaPP), pantethine, panthenol, sulfopantetheine and CoA decrease acute toxicity of acetaldehyde in mice. All studied compounds diminish duration of the narcotic action of ethanol--ET (3.5 g/kg intraperitoneally) in mice and rats. In the latter this effect is realized at the expense of "long sleeping" and "middle sleeping" animals. CaP (150 mg/kg subcutaneously) and CaPP (100 mg/kg subcutaneously) prevent hypothermia and a decrease of oxygen consumption in rats induced by ET administration. Combined administration of ET, CaP and CaPP leads to a characteristic increase of acid-soluble CoA fractions in the rat liver and a relative decrease of acetyl CoA synthetase and N-acetyltransferase reactions. The antitoxic effect of preparations of pantothenic acid is not mediated by CoA-dependent reactions of detoxication, but most probably is due to intensification of ET oxidation and perhaps to its elimination from the organism. PMID:2905277

  8. Recombinant human butyrylcholinesterase from milk of transgenic animals to protect against organophosphate poisoning.

    PubMed

    Huang, Yue-Jin; Huang, Yue; Baldassarre, Hernan; Wang, Bin; Lazaris, Anthoula; Leduc, Martin; Bilodeau, Annie S; Bellemare, Annie; Côté, Mélanie; Herskovits, Peter; Touati, Madjid; Turcotte, Carl; Valeanu, Loredana; Lemée, Nicolas; Wilgus, Harvey; Bégin, Isabelle; Bhatia, Bhim; Rao, Khalid; Neveu, Nathalie; Brochu, Eric; Pierson, Janice; Hockley, Duncan K; Cerasoli, Douglas M; Lenz, David E; Karatzas, Costas N; Langermann, Solomon

    2007-08-21

    Dangerous organophosphorus (OP) compounds have been used as insecticides in agriculture and in chemical warfare. Because exposure to OP could create a danger for humans in the future, butyrylcholinesterase (BChE) has been developed for prophylaxis to these chemicals. Because it is impractical to obtain sufficient quantities of plasma BChE to treat humans exposed to OP agents, the production of recombinant BChE (rBChE) in milk of transgenic animals was investigated. Transgenic mice and goats were generated with human BChE cDNA under control of the goat beta-casein promoter. Milk from transgenic animals contained 0.1-5 g/liter of active rBChE. The plasma half-life of PEGylated, goat-derived, purified rBChE in guinea pigs was 7-fold longer than non-PEGylated dimers. The rBChE from transgenic mice was inhibited by nerve agents at a 1:1 molar ratio. Transgenic goats produced active rBChE in milk sufficient for prophylaxis of humans at risk for exposure to OP agents. PMID:17660298

  9. Scenario of organophosphate pollution and toxicity in India: A review.

    PubMed

    Kumar, Shardendu; Kaushik, Garima; Villarreal-Chiu, Juan Francisco

    2016-05-01

    The present study on organophosphate deals with the reports on pollution and toxicity cases throughout India. The use of pesticides was introduced in India during the 1960s which are now being used on a large scale and represents the common feature of Indian agriculture. Use of organophosphates as a pesticide came as an alternative to chlorinated hydrocarbons due to their easy degradability. Although these xenobiotics degrade under natural condition, their residues have been detected in soil, sediments, and water due to their non-regulated usage practice. The over-reliance on pesticides has not only threatened our environment but contaminations of organophosphate residues have been also detected in certain agricultural products like tea, sugars, vegetables, and fruits throughout India. This paper highlights many of the cases where different organophosphates have been detected exceeding their respective MRL values. Some organophosphates detected are so hazardous that even WHO has listed them in class 1a and class 1b hazardous group. Presence of their residues in blood, milk, honey, and tissues of human and animals revealed their excessive use and bioaccumulating capabilities. Their intentional or unintentional uptake is causing thousands of deaths and severity each year. Most of the toxicity cases presented here are due to their uptake during a suicidal attempt. This shows how easily these harmful substances are available in the market. PMID:26916265

  10. MS 04-044: demographic features of drug and chemical poisoning in northern Malaysia.

    PubMed

    Fathelrahman, Ahmed Ibrahim; Ab Rahman, Ab Fatah; Mohd Zain, Zaininah

    2005-01-01

    Acute poisoning is a significant health problem all over the world. In Malaysia, nationwide data on poisoning pattern is scarce and incomplete. The objectives of our study were to determine the pattern of acute drug and chemical poisoning at Penang General Hospital (PGH), in the northern region of Malaysia, and to compare poisoning characteristics between different ethnic groups. The study was a retrospective case review of all poisoned patients admitted to PGH during the years 2000-2002. We collected data concerning demographic parameters of patients, information about the agent(s) implicated, and circumstances surrounding the event. There were 493 poisoning incidents. Nearly two-thirds of the poisoned cases involved female patients. The predominant mode of poisoning was intentional (51.5%). The age group 15.1-30 years ranked at the top, constituting 55.2% of all cases. Drugs were the predominant agents implicated. Among cases associated with drugs, paracetamol was the main causative agent (44.7%). Chinese patients constituted 37.7% of all poisoning cases, followed by the Indians (31.6%) and Malays (26.6%). Between ethnic groups, Indian patients were found to have the highest rate of poisoning admission of 75.2 per 100,000 persons. PMID:15822759

  11. Carbon monoxide poisoning.

    PubMed

    Kao, Louise W; Nañagas, Kristine A

    2004-11-01

    CO is an insidious poison with many sources of exposure. CO poisoning produces diverse signs and symptoms, which often are subtle and can be misdiagnosed easily. Failure to diagnose CO poisoning may result insignificant morbidity and mortality and allow continued exposure to a dangerous environment. In the ED, a high index of suspicion must be maintained for occult CO exposure. Headache, particularly when associated with certain environments, and flulike illness in the wintertime with symptomatic cohabitants should raise the index of suspicion in the ED significantly for occult CO poisoning. Emergency treatment of CO poisoning begins with inhalation of supplemental oxygen and aggressive supportive care. HBOT accelerates dissociation of CO from hemoglobin and may prevent DNS. Absolute indications for HBOT for CO poisoning remain controversial, although most would agree that HBOT is indicated in patients who are comatose, are neurologically abnormal, have a history of loss of consciousness with their exposure, or have cardiac dysfunction. Pregnancy with an elevated CO-Hgb level (>15-20%) also is widely considered an indication for treatment. HBOT may be considered in patients who have persistent symptoms despite NBO, metabolic acidosis, abnormalities on neuropsychometric testing, or significantly elevated levels. The ideal regimen of oxygen therapy has yet to be determined, and significant controversy exists regarding HBOT protocols. The emergency physician may be confronted with the difficult decision regarding disposition and even transfer to a hyperbaric facility. Often the local medical toxicologist, poison control center, or hyperbaric unit can assist the emergency physician with the decision-making process. PMID:15474779

  12. Right bundle branch block: an uncommon cardiotoxic manifestation of hair dye poisoning-a case report.

    PubMed

    Balasubramanian, Deepak; Subramanian, Saravanan; Thangaraju, Pugazhenthan; Shanmugam, Kani

    2014-01-01

    Hair dye poisoning has been rising in incidence in the recent years. Apart from the commoner manifestations of upper airway edema, rhabdomyolysis and acute renal failure, cardiac toxicity, convulsions and sudden cardiac death are relatively rare complications. We discuss a case of hair dye poisoning manifesting as oropharyngeal edema along with cardiac complication. The patient survived. PMID:24596762

  13. Organophosphate pesticide concentrations in coral tissues of Indonesian coastal waters.

    PubMed

    Sabdono, Agus; Kang, Suil; Hur, Hor-Gil; Grossart, Hans-Peter; Simon, Meinhard; Radjasa, Ocky Kama

    2007-06-01

    In this study we evaluated the persistence of diazinon, chlorpyrifos, profenofos, parathion, malathion and ethion in dead coral tissues of Indonesian coastal waters (Java, Bali, Sulawesi and Komodo). Comparison of the residue levels in coral tissues showed that the highest presence of organophosphate concentrations was detected in a coral sample collected from Java coastal waters. While medium amounts of a contaminant diazinon can still lead to detectable in Bali and Sulawesi coastal waters. Prominent contamination of organophosphate was not found in a sample collected from Komodo. Neither parathion nor malathion were detected in any of the samples. This result implies that the geographical variations of organophosphate compounds are determined by the possible usage of these chemicals around coastal waters at the present or in the past. There is need for further work to identify sources and fate of pesticide contaminants, as well as to improve monitoring of pesticide use. PMID:19086563

  14. Effects of trophic poisoning with methylmercury on the appetitive elements of the agonistic sequence in fighting-fish (Betta splendens).

    PubMed

    Gouveia, Amauri; de Oliveira, Caio Maximino; Romão, Cynthia Ferreira; de Brito, Thiago Marques; Ventura, Dora Fix

    2007-11-01

    The aggressive display in Betta splendens is particularly prominent, and vital to its adaptation to the environment. Methylmercury is an organic variation of Hg that presents particularly pronounced neuro-behavioral effects. The present experiments aim to test the effect of acute and chronic poisoning with methylmercury on the display in Bettas. The animals were poisoned by trophic means in both experiments (16 ug/kg in acute poisoning; 16 ug/kg/day for chronic poisoning), and tested in agonistic pairs. The total frequency of the display was recorded, analyzing the topography of the agonistic response. The methylmercury seems to present a dose- and detoxification-dependent effect on these responses, with a more pronounced effect on motivity in acute poisoning and on emotionality in the chronic poisoning. It is possible that this effect could be mediated by alteration in the mono-amino-oxidase systems. PMID:17992970

  15. Organophosphorus poisoning: victim specific analysis of mortality and morbidity.

    PubMed

    Dash, Shreemanta Kumar; Mohanty, Manoj Kumar; Mohanty, Sachidananda; Patnaik, Kiran Kumar

    2008-07-01

    The aim of this study was to evaluate the pattern of acute organophosphorous (OP) poisoning cases including death, duration of hospitalization and time lapse before arrival at hospital. All OP poisoning cases admitted to the Emergency Department of MKCG Medical College Hospital and other fatal cases received at the mortuary between September 1999 and August 2001 were prospectively studied. Males outnumbered females and most OP poisoning occurred in the 21-30 year age group. In 68 (97.1%) cases the motive was suicide and more than 80% were from rural areas. Nearly one-third of cases occurred during the summer and in the later part of the day. Married females and unmarried males were most frequently affected. Most of the married females were housewives and the males were students or farmers. Fifty-four per cent of cases were admitted for treatment within three hours with a mean time lapse of 6.2 hours. The mean hospital stay for all OP poisoning cases was 5.1 days. Twenty-nine out of 66 admitted OP poisoning cases were fatal. There is a high incidence of OP poisoning with mortality in the region. OP compounds are readily available at low cost in the market. A time of stress and frustration can lead to their use as a common poison with which to commit suicide. PMID:18754212

  16. Most common poisonings and their management--data from Tbilisi.

    PubMed

    Kobidze, T S; Gerzmava, O Kh; Areshidze, T Kh; Tsintsadze, M A; Dikhamindzhiia, O B

    2009-01-01

    The purpose of the present study was to evaluate the toxicological aid and efficiency of preventive measures and methods in treatment of acute exogenous intoxications in hospitals in Tbilisi in 1990-2005. Structure of poisoning accidents in Tbilisi, its trends in last decade is analyzed and explained. The data were obtained in Georgian National Center for Disease Control and Medical statistics in Tbilisi. The study revealed that total number of hospitalizations due to acute poisoning in Tbilisi exceeded the number of hospitalizations due to acute myocardial infarction. In 1992-1994 Georgia was in severe social-economic crisis: the cases of acute poisoning increased and the number of hospitalizations had been reduced with concomitant longer hospital stay (in 1992--10.7 hospital days; in 1993-1994--13.7 hospital days), and higher mortality (in 1992--4%; in 1993--5.5%; 1994--5.2%). Low hospitalization rates in 1992-1994 should be explained by late patient referral to hospitals. Longer hospital stay was available due to free hospital care at that time. In 1995 with termination of free medical care number of hospitalized patients with acute intoxication raised annually; hospital stay shortened and mortality rate decreased. In 2003 mortality was reduced by 0.74% in Tbilisi. The prevalence of acute alcoholic intoxication incidence was noticed. Therefore hospital stay decreases. High prevalence of acute alcoholic intoxication was explained by the growth of alcohol consumption; lack of quality control of beverage production resulting in huge amount of unconditioned and counterfeit substances in the market, etc. As to poisonings due to medical substances 42% of cases were intoxications with anticonvulsants, sedative and psychotropic preparations; 17% with cardiovascular drugs; and 10% with narcotic substances. It was found, that poisoning incidence and their outcome significantly depend on social-economical conditions in Georgia. Measures to improve toxicology care in the

  17. Oil-based paint poisoning

    MedlinePlus

    Paint - oil based - poisoning ... Hydrocarbons are the primary poisonous ingredient in oil paints. Some oil paints have heavy metals such as lead, mercury, cobalt, and barium added as pigment. These heavy metals can cause additional ...

  18. Cow dung powder poisoning.

    PubMed

    Sherfudeen, Khaja Mohideen; Kaliannan, Senthil Kumar; Dammalapati, Pavan Kumar

    2015-11-01

    Cow dung, which has germicidal property, was used in ancient days to clean living premises in South India. Nowadays, people are using commercially available synthetic cow dung powder. It is locally known as "saani powder" in Tamil Nadu. It is freely available in homes and is sometimes accidentally consumed by children. It is available in two colors - yellow and green. Cow dung powder poisoning is common in districts of Tamil Nadu such as Coimbatore, Tirupur, and Erode. We report two cases of yellow cow dung powder poisoning from our hospital. PMID:26730123

  19. Risk factors for accidental poisoning in urban Malaysian children.

    PubMed

    Azizi, B H; Zulkifli, H I; Kasim, M S

    1993-01-01

    In a case control study, 70 children consecutively hospitalized for acute ingestion of poisons were compared with 140 other hospitalized children matched for age. Children aged less than 3 years and boys were most often the victims. Univariate analysis identified Indian race, having a parent younger than 21 years, residing at present address for less than 1 year and living in a household with more than five occupants as significant risk factors. Experience of a recent stressful event in the family barely failed to reach the level of significance. Logistic regression analysis confirmed that Indian race, having a parent younger than 21 years and residing less than 1 year at the present address were independent predictors of acute poisoning. Positive interactions were noted between Indian race and duration of residence and between parental age and duration of residence. Knowledge of risk factors and their interactions may be useful in planning preventive measures against childhood poisoning. PMID:7687115

  20. Interethnic variability of plasma paraoxonase (PON1) activity towards organophosphates and PON1 polymorphisms among Asian populations--a short review.

    PubMed

    Mohamed Ali, Safiyya; Chia, Sin Eng

    2008-08-01

    Organophosphate (OP) poisoning is a progressively worrying phenomenon as worldwide pesticide production and consumption has doubled. On average, WHO estimates that 3% of agricultural workers in developing Asian countries suffer an episode of pesticide poisoning every year. Furthermore, the threat of OP usage in terrorism is existent, as seen by the subway tragedy in Tokyo in 1995 where sarin was used. Despite these alarming facts, there is currently no global system to track poisonings related to pesticide use. Human serum paraoxonase (PON1) is the enzyme that hydrolyses OP compounds. Serum PON1 levels and activity vary widely among different ethnic populations. Two commonly studied polymorphisms of PON1 are PON1Q192R and PON1L55M. PON1R192 hydrolyses paraoxon faster than PON1Q192 but hydrolyses diazoxon, sarin and soman eight times slower, and vice versa. PON1M55 has lower plasma levels of PON1 than PON1L55. As the prevalence of the different alleles and genotypic distribution vary between the Asian populations we studied, we propose the necessity to study PON1 polymorphisms and its role in OP toxicity in Asian populations. This would help safeguard the proper care of agricultural workers who might be affected by OP poisoning, and alert relevant anti biological terrorism agencies on possible risks involved in the event of an OP attack and provide effective counter measures. PMID:18716378

  1. Chronological Variations of Children Poisoning Causes in Zahedan, South of Iran

    PubMed Central

    Sadeghi-Bojd, Simin; Khajeh, Ali

    2014-01-01

    Background: Poisoning is a common pediatric emergency among children and adolescents in the Emergency Department of Zahedan University of Medical Sciences hospital. Objectives: The aim of this study was comparing the characteristics and variations of pediatric poisoning between two retrospective studies (1998 and 2008). We hypothesized that the epidemiology of pediatric patients admitted for poisoning is related to variations of environmental agents and drug usage. Patients and Methods: Records of 170 patients from 1998 and 147 from 2008 with acute poisoning were retrospectively evaluated and compared. Results: Poisoning mostly occurred in children younger than five years old via oral route (72.94%-87%) and by single exposure (94.12%-96.6%). It was also noted that 86.8%-90% of cases were accidentally poisoned. Drugs were the most common poisoning agents in both studies (52.94% and 37.41%, respectively) and analgesics-antipyretics were the most common poisoning drugs. Drug poisoning was more common among children under five years old in both the studies. Neurological signs including lethargy and coma were the main presenting signs. About 80%-95% of cases were referred to the hospital within three hours of poisoning and supportive-symptomatic therapy was provided to them; charcoal/naloxone was administered for most of the patients (26.2% in 2008 and 21% in 1998). Mortality rate due to drug poisoning was 3-4 cases in both studies; but, non-drug poisoning mortality rate was higher. Conclusions: Preventable accidental poisoning is a significant cause of morbidity in children in developing countries. The study provided information on evolving trends and the need for increasing awareness about potential toxins as well as appropriate storage of toxins in the house to reduce the occurrence of accidental poisoning. PMID:25632384

  2. ORGANOPHOSPHATE PESTICIDE DEGRADATION UNDER DRINKING WATER TREATMENT CONDITIONS

    EPA Science Inventory

    Chlorpyrifos (CP) was used as a model compound to develop experimental methods and prototype modeling tools to forecast the fate of organophosphate (OP) pesticides under drinking water treatment conditions. CP was found to rapidly oxidize to chlorpyrifos oxon (CPO) in the presen...

  3. ORGANOPHOSPHATE PESTICIDE EXPOSURES - WHERE ARE THE HIGH RISK CHILDREN?

    EPA Science Inventory

    Methods to identify children at high-risk for organophosphate (OP) pesticide exposure are difficult to develop because biological markers reflect only recent "snapshots" of exposure due to the short half-life of OP compounds (generally about 24 hours). We conducted a series of p...

  4. MICROCHIP ENZYMATIC ASSAY OF ORGANOPHOSPHATE NERVE AGENTS. (R830900)

    EPA Science Inventory

    An on-chip enzymatic assay for screening organophosphate (OP) nerve agents, based on a pre-column reaction of organophosphorus hydrolase (OPH), electrophoretic separation of the phosphonic acid products, and their contactless-conductivity detection, is described. Factors affec...

  5. ORGANOPHOSPHATE PESTICIDE DEGRADATION PATHWAYS DURING DRINKING WATER TREATMENT

    EPA Science Inventory

    Free chlorine has been found to react with organophosphate (OP) pesticides resulting in the more toxic oxon products. We will discuss OP pesticide degradation pathways and modeling in the presence of chlorine and chloramines, as well as present a relationship between structure a...

  6. ORGANOPHOSPHORUS HYDROLASE-BASED ASSAY FOR ORGANOPHOSPHATE PESTICIDES

    EPA Science Inventory

    We report a rapid and versatile Organophosphorus hydrolase (OPH)-based method for measurement of organophosphates. This assay is based on a substrate-dependent change in pH at the local vicinity of the enzyme. The pH change is monitored using fluorescein isothiocyanate (FITC), ...

  7. Hair dye poisoning

    MedlinePlus

    ... temporary dyes are: Arsenic Bismuth Denatured alcohol Lead ( lead poisoning ) Mercury Pyrogallol Silver Hair dyes may contain other ... infection. Continued exposure to lead or mercury can lead to permanent brain and nervous system damage. Alternative ... References Lee DC. Hydrocarbons. In: Marx JA, Hockberger ...

  8. Lead Poisoning in Children.

    ERIC Educational Resources Information Center

    Boeckx, Roger L.

    1986-01-01

    Urban children are exposed to lead through the air they breathe, the water they drink, and the food and nonfood substances they ingest. The history, diagnosis, and treatment of lead poisoning in these children are discussed. Includes information on the toxicology of lead and the various risk classes. (JN)

  9. Tainted Water, Poison Paint.

    ERIC Educational Resources Information Center

    Natale, Jo Anna

    1991-01-01

    Recent research shows lead poisoning is more widespread and even more dangerous to infants and young children than previously thought. A bill proposed in Congress would require schools and day-care centers to test for lead. Summarizes lead's health hazards and how to test drinking water. (MLF)

  10. Lead Poisoning in Children.

    ERIC Educational Resources Information Center

    Lin-Fu, Jane S.

    Designed as a public information pamphlet, the text discusses the problem of lead poisoning in children. The preventable nature of the problem is stressed as well as needed action on the part of the public, physicians and other health workers, and the legislators. The pamphlet emphasizes that each of these areas is essential in preventing death or…

  11. Methyl Bromide Poisoning

    PubMed Central

    Rathus, E. M.; Landy, P. J.

    1961-01-01

    Seven cases of methyl bromide poisoning which occurred amongst workers engaged on a fumigation project are described. The methods adopted for investigation of the environmental situation are discussed and the measurement of blood bromide levels on random samples of workers is suggested as an index of the effectiveness of equipment and working methods. PMID:13739738

  12. Caladium plant poisoning

    MedlinePlus

    ... a protein found in the plant Note: All parts of the plants are poisonous if large amounts are eaten. ... Symptoms from eating parts of the plant or from the plant touching the eye include: Burning in the mouth or throat Damage to the outer clear ...

  13. Puffer fish poisoning.

    PubMed Central

    Field, J

    1998-01-01

    Regarded by many as a delicacy, puffer fish (Lagocephalus scleratus) is a lethal source of food poisoning with a high mortality. It contains tetrodotoxin which can cause death by muscular paralysis, respiratory depression, and circulatory failure. A case of mild intoxication is reported and the literature reviewed. Images p336-a PMID:9785165

  14. Methylmercury Poisoning in Iraq

    ERIC Educational Resources Information Center

    Bakir, F.; And Others

    1973-01-01

    Discusses incidence of methylmercury poisoning throughout the world with increasing industrial and agricultural use of mercury compounds. Describes recent epidemic in Iraq resulting from use of wheat treated with methylmercurial fungicide. New data are presented on the toxicity of methylmercury and its metabolic fate in the human body. (JR)

  15. Paraphenylenediamine Containing Hair Dye: An Emerging Household Poisoning.

    PubMed

    Patra, Ambika Prasad; Shaha, Kusa Kumar; Rayamane, Anand P; Dash, Shreemanta Kumar; Mohanty, Manoj Kumar; Mohanty, Sachidananda

    2015-09-01

    Paraphenylenediamine poisoning is among one of the emerging causes of poisoning in Asian countries, because it is a constituent of hair dye formulations and is easily available in market at low cost. Hair dyes are rampantly used in Asian households compared with the western world. Locally, hair dye constituents may have allergic adverse effects, and acute systemic poisoning presents with characteristic angioedema, upper airway obstruction, rhabdomyolysis, methemoglobinemia, myoglobinuria, and acute renal failure. This study reports about the death of a 24-year-old Indian housewife who committed suicide by taking hair dye emulsion. She had an argument with her husband, and because of fit of rage, took a bowlful (80 mL) of hair dye emulsion kept prepared for the use by husband. She developed angioedema, cervical swelling, and rhabdomyolysis and died of acute renal failure within 24 hours. Toxicological analysis of viscera and blood revealed varying levels of paraphenylenediamine. Histopathological samples of kidney showed features of acute tubular necrosis and myoglobin casts in renal tubules. The aim of the study is to create awareness about the adverse effects of the hair dye, its poisoning outcome, and possible preventive measures. PMID:26056768

  16. Histopathological alterations, biochemical responses and acetylcholinesterase levels in Clarias gariepinus as biomarkers of exposure to organophosphates pesticides.

    PubMed

    Doherty, V F; Ladipo, M K; Aneyo, I A; Adeola, A; Odulele, W Y

    2016-05-01

    Organophosphate pesticides, commonly used in large scale farming, have been found to be major contaminants in aquatic environment. Clarias gariepinus was exposed to acute and sublethal concentrations of phostoxin and DD Force to evaluate single and joint action toxicity of the organophosphates. Effects of phostoxin and DD force on antioxidant enzymes, fish organs and acetylcholinesterase levels in fingerlings and juveniles of C. gariepinus were also investigated. The lethal concentrations (96 h LC50) for phostoxin and DD Force were 0.631 and 1.759 mg/l, respectively. The results obtained from the bioassay showed that phostoxin was 2.8× more toxic than DD Force after exposure of C. gariepinus. Joint action toxicity evaluations of phostoxin and DD Force showed that the interaction between the chemicals was synergistic (RTU >1). The biochemical responses in the exposed fish differed significantly (P < 0.05) from the control fish. The result of acetylcholinesterase study revealed significant difference between acetylcholinesterase levels in the exposed fish and control, with reduction in the acetylcholineterase level in fish exposed to sublethal concentrations of phostoxin and DD Force. Haematological studies revealed an increase in WBC, RBC, PCV and platelets in the exposed fish. Histopathology of the gills showed shortened primary lamellae, loss of secondary lamellae and loss of ceratobrachial bones. In the acute toxicity studies, respiratory stress, erratic swimming and instant death of fish were observed in the exposed fish. This study reveals that changes in histopathology and acetylcholinesterase level are good biomarkers and can be successfully used to detect exposure to organophosphates pesticides in fish. PMID:27121169

  17. Efficacy of an organophosphate mixture against an organophosphate-resistant strain of Rhipicephalus (Boophilus) microplus (Acari: Ixodidae)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The efficacy of an organophosphate (OP) mixture acaricide, Ravap®, was evaluated as a whole-body spray treatment applied at 0.15 and 0.3% active ingredient (AI) to cattle infested with all parasitic stages of a highly OP-resistant strain of Rhipicephalus (Boophilus) microplus (Canestrini). Laborator...

  18. Intentional and unintentional poisoning in Pakistan: a pilot study using the Emergency Departments surveillance project

    PubMed Central

    2015-01-01

    Background Acute poisoning is one of the most common reasons for emergency department visits around the world. In Pakistan, the epidemiological data on poisoning is limited due to an under developed poison information surveillance system. We aim to describe the characteristics associated with intentional and unintentional poisoning in Pakistan presenting to emergency departments. Methods The data was extracted from the Pakistan National Emergency Department Surveillance (Pak-NEDS) which was an active surveillance conducted between November 2010 and March 2011. All patients, regardless of age, who presented with poisoning to any of Pakistan's seven major tertiary care centers' emergency departments, were included. Information about patient demographics, type of poisoning agent, reason for poisoning and outcomes were collected using a standard questionnaire. Results Acute poisoning contributed to 1.2% (n = 233) of patients with intentional and unintentional injuries presenting to EDs of participating centers. Of these, 68% were male, 54% were aged 19 to 44 and 19% were children and adolescents (<18 years). Types of poisoning included chemical/gas (43.8%), drug/medicine (27%), alcohol (16.7%) and food/plant (6%). In half of all patients the poisoning was intentional. A total of 11.6% of the patients were admitted and 6.6% died. Conclusion Poisoning causes more morbidity and mortality in young adults in Pakistan compared to other age groups, half of which is intentional. Improving mental health, regulatory control for hazardous chemicals and better access to care through poison information centers and emergency departments will potentially help control the problem. PMID:26691609

  19. Acute oral marijuana poisoning in the dog.

    PubMed

    Godbold, J C; Hawkins, B J; Woodward, M G

    1979-11-15

    Ingestion of marijuana by three dogs in unrelated incidents resulted in depression-type toxicosis in each case. The most evident clinical signs were central nervous system depression and ataxia. Emesis and hypothermia were noted in two of the cases. Symptomatic and supportive treatment was accompanied by clinical improvement. In two cases, recovery was slow, with clinical signs apparent for 36 to 48 hours after onset. In the third case, clinical signs were apparent for only 3 hours. PMID:521354

  20. Oxime-mediated in vitro reactivation kinetic analysis of organophosphates-inhibited human and electric eel acetylcholinesterase.

    PubMed

    Sahu, Arvind Kumar; Sharma, Rahul; Gupta, Bhanushree; Musilek, Kamil; Kuca, Kamil; Acharya, Jyotiranjan; Ghosh, Kallol K

    2016-06-01

    Organophosphate (OP)-based pesticides and nerve agents are highly toxic compounds which interrupt the catalytic mechanism of acetylcholinesterase (AChE) by phosphorylating the hydroxyl moiety of serine residue. The inhibited enzyme can be reactivated by the nucleophilic action of oxime reactivators. To analyze the effect of different AChE sources on reactivation efficacy of reactivators, several in vivo studies have carried out using variety of AChE sources like pig, rat and monkey. Investigations on species differences provide a better insight for the development of new reactivators. Hence, present study was mainly targeted on comparative analysis of the reactivation of electric eel and human AChE inhibited by different OP. A series of butene-linked bis-pyridinium mono oximes which vary in functional groups present at the second pyridinium ring have been examined against sarin, VX, tabun and ethyl-paraoxon-poisoned AChE. In case of tabun-inhibited AChEs, tested oximes were better than reference oximes. For VX-poisoned human AChE, reactivator K251 (kr2;1.51 mM (-) (1 )min (-) (1)) showed good reactivation efficacy with standard oximes. Studies stipulated that butene-linked oximes consisting of different functional moieties are good reactivators and found to have better efficacy to reactivate nerve agent-inhibited human AChE in comparison to eel AChE. PMID:27101948

  1. Cost of accidental carbon monoxide poisoning: A preventable expense.

    PubMed

    Hampson, Neil B

    2016-06-01

    Carbon monoxide (CO) poisoning is common in the United States, accounting for hundreds of deaths and thousands of emergency department visits annually. It is believed that most accidental CO poisoning is preventable through public education, warning labels on consumer products, and uniform use of residential CO alarms. However, cost effectiveness of these prevention strategies has not been demonstrated in the United States to date. It was the objective of this study to estimate societal cost of accidental CO poisoning and evaluate the cost-effectiveness of universal installation of residential CO alarms. Published studies and data from the English language literature were used in to estimate direct hospital costs and lost earnings resulting from accidental CO poisoning. The study was performed in the US in 2015. Approximately 6600 individuals are estimated to sustain long-term cognitive sequela annually, with total loss in earnings of approximately $925 million, 334 individuals die from accidental, non-fire related CO poisoning with an average loss of 26 years of productivity accounting for $355 million, and 2800 are hospitalized with acute medical care costs of $33 million. Available data indicate that accidental CO poisoning in the US conservatively costs society over $1.3 billion, resulting from direct hospital costs and lost earnings. Further, it demonstrates a positive cost-benefit ratio for the uniform use of residential CO alarms. PMID:26844181

  2. Cost of accidental carbon monoxide poisoning: A preventable expense

    PubMed Central

    Hampson, Neil B.

    2015-01-01

    Carbon monoxide (CO) poisoning is common in the United States, accounting for hundreds of deaths and thousands of emergency department visits annually. It is believed that most accidental CO poisoning is preventable through public education, warning labels on consumer products, and uniform use of residential CO alarms. However, cost effectiveness of these prevention strategies has not been demonstrated in the United States to date. It was the objective of this study to estimate societal cost of accidental CO poisoning and evaluate the cost-effectiveness of universal installation of residential CO alarms. Published studies and data from the English language literature were used in to estimate direct hospital costs and lost earnings resulting from accidental CO poisoning. The study was performed in the US in 2015. Approximately 6600 individuals are estimated to sustain long-term cognitive sequela annually, with total loss in earnings of approximately $925 million, 334 individuals die from accidental, non-fire related CO poisoning with an average loss of 26 years of productivity accounting for $355 million, and 2800 are hospitalized with acute medical care costs of $33 million. Available data indicate that accidental CO poisoning in the US conservatively costs society over $1.3 billion, resulting from direct hospital costs and lost earnings. Further, it demonstrates a positive cost-benefit ratio for the uniform use of residential CO alarms. PMID:26844181

  3. Midazolam as an anticonvulsant antidote for organophosphate intoxication− A pharmacotherapeutic appraisal

    PubMed Central

    Reddy, Sandesh D.; Reddy, Doodipala Samba

    2015-01-01

    SUMMARY Objective This review summarizes the therapeutic potential of midazolam as an anticonvulsant antidote for organophosphate (OP) intoxication. Methods Benzodiazepines are widely used for acute seizures and status epilepticus (SE), a neurological emergency of persistent seizures that can lead to severe neuronal damage or death. Midazolam is a benzodiazepine hypnotic with a rapid onset and short duration of action. Results Midazolam is considered the new drug of choice for persistent acute seizures and SE, including those caused by neurotoxic OPs and nerve agents. Midazolam is a positive allosteric modulator of synaptic GABA-A receptors in the brain. It potentiates GABAergic inhibition and thereby controls hyperexcitability and seizures. Midazolam is administered intravenously or intramuscularly to control acute seizures and SE. Due to its favorable pharmacokinetic features, midazolam is being considered as a replacement anticonvulsant for diazepam in the antidote kit for nerve agents. Clinical studies such as the recent RAMPART trial have confirmed the anticonvulsant efficacy of midazolam in SE in prehospital settings. Significance In experimental models, midazolam is effective when given at the onset of seizures caused by nerve agents. However, benzodiazepines are less effective at terminating seizures when given 30 min or later after OP exposure or seizure onset likely because of internalization or down-regulation of synaptic, but not extrasynaptic, GABA-A receptors, which can lead to diminished potency and seizure recurrence. PMID:26032507

  4. [Poisoning by spiders of Loxosceles genus].

    PubMed

    De Roodt, Adolfo R; Salomón, Oscar D; Lloveras, Susana C; Orduna, Tomás A

    2002-01-01

    Despite the great number of spiders in the world, only a small group of them is capable of producing death in humans. In Argentina, there are only three of the four genera of spiders considered of high risk to humans: Latrodectus is present in rural areas, Phoneutria is restricted to small regions while Loxosceles is distributed throughout the country. Accidents by Loxosceles represent around 4% of the total number produced by venomous animals in Argentina. The bite is accidental and may produce considerable local necrosis with scar formation and ulcers of slow and difficult healing that may require surgical repair. Some bitten people may suffer from intravascular hemolysis, disseminated coagulation and acute renal insufficiency leading to death. Despite the great number of studies performed on Loxosceles venoms, at present, the physiopathological course of poisoning is not clear and there is not common criteria for its treatment. In this review, biological and epidemiological data of this spider are described as well as the venom composition and the possible participation of its components in the poisoning. These data provide biological and biochemical tools to understand the course of poisoning and to have better criteria for the treatment and prevention of these accidents and their complications. PMID:11965857

  5. [Accidental methyl alcohol poisoning].

    PubMed

    Xiao, J H

    1990-05-01

    An accidental poisoning due to drinking methyl alcohol in Chaoyang county is reported, analysing the accident. The poison came from the "retail white spirit" which was contaminated with methyl alcohol. Twenty-nine persons drank the wine, fourteen of them died, two of them became blind. After drinking this "retail white spirit" the drinkers showed symptoms of vertigo, headache, weakness, vomiting, night sweat, dyspnea and blurring of vision etc. within 6-120 hours. On examining the remaining spirit, we found the content of methyl alcohol to be between 16.6 and 40.69 g/100 ml. Some of the patients' urine and blood also contained methyl alcohol. We reckoned that each one of the twenty patients had taken more than 27 g of methyl alcohol and each of the ten dead drank more than 40 ml of the alcohol. PMID:2253526

  6. Homicidal arsenic poisoning.

    PubMed

    Duncan, Andrew; Taylor, Andrew; Leese, Elizabeth; Allen, Sam; Morton, Jackie; McAdam, Julie

    2015-07-01

    The case of a 50-year-old man who died mysteriously after being admitted to hospital is reported. He had raised the possibility of being poisoned prior to his death. A Coroner's post-mortem did not reveal the cause of death but this was subsequently established by post-mortem trace element analysis of liver, urine, blood and hair all of which revealed very high arsenic concentrations. PMID:25344454

  7. Lead Poison Detection

    NASA Technical Reports Server (NTRS)

    1976-01-01

    With NASA contracts, Whittaker Corporations Space Science division has developed an electro-optical instrument to mass screen for lead poisoning. Device is portable and detects protoporphyrin in whole blood. Free corpuscular porphyrins occur as an early effect of lead ingestion. Also detects lead in urine used to confirm blood tests. Test is inexpensive and can be applied by relatively unskilled personnel. Similar Whittaker fluorometry device called "drug screen" can measure morphine and quinine in urine much faster and cheaper than other methods.

  8. Managing aluminum phosphide poisonings

    PubMed Central

    Gurjar, Mohan; Baronia, Arvind K; Azim, Afzal; Sharma, Kalpana

    2011-01-01

    Aluminum phosphide (AlP) is a cheap, effective and commonly used pesticide. However, unfortunately, it is now one of the most common causes of poisoning among agricultural pesticides. It liberates lethal phosphine gas when it comes in contact either with atmospheric moisture or with hydrochloric acid in the stomach. The mechanism of toxicity includes cellular hypoxia due to the effect on mitochondria, inhibition of cytochrome C oxidase and formation of highly reactive hydroxyl radicals. The signs and symptoms are nonspecific and instantaneous. The toxicity of AlP particularly affects the cardiac and vascular tissues, which manifest as profound and refractory hypotension, congestive heart failure and electrocardiographic abnormalities. The diagnosis of AlP usually depends on clinical suspicion or history, but can be made easily by the simple silver nitrate test on gastric content or on breath. Due to no known specific antidote, management remains primarily supportive care. Early arrival, resuscitation, diagnosis, decrease the exposure of poison (by gastric lavage with KMnO4, coconut oil), intensive monitoring and supportive therapy may result in good outcome. Prompt and adequate cardiovascular support is important and core in the management to attain adequate tissue perfusion, oxygenation and physiologic metabolic milieu compatible with life until the tissue poison levels are reduced and spontaneous circulation is restored. In most of the studies, poor prognostic factors were presence of acidosis and shock. The overall outcome improved in the last decade due to better and advanced intensive care management. PMID:21887030

  9. Managing aluminum phosphide poisonings.

    PubMed

    Gurjar, Mohan; Baronia, Arvind K; Azim, Afzal; Sharma, Kalpana

    2011-07-01

    Aluminum phosphide (AlP) is a cheap, effective and commonly used pesticide. However, unfortunately, it is now one of the most common causes of poisoning among agricultural pesticides. It liberates lethal phosphine gas when it comes in contact either with atmospheric moisture or with hydrochloric acid in the stomach. The mechanism of toxicity includes cellular hypoxia due to the effect on mitochondria, inhibition of cytochrome C oxidase and formation of highly reactive hydroxyl radicals. The signs and symptoms are nonspecific and instantaneous. The toxicity of AlP particularly affects the cardiac and vascular tissues, which manifest as profound and refractory hypotension, congestive heart failure and electrocardiographic abnormalities. The diagnosis of AlP usually depends on clinical suspicion or history, but can be made easily by the simple silver nitrate test on gastric content or on breath. Due to no known specific antidote, management remains primarily supportive care. Early arrival, resuscitation, diagnosis, decrease the exposure of poison (by gastric lavage with KMnO(4), coconut oil), intensive monitoring and supportive therapy may result in good outcome. Prompt and adequate cardiovascular support is important and core in the management to attain adequate tissue perfusion, oxygenation and physiologic metabolic milieu compatible with life until the tissue poison levels are reduced and spontaneous circulation is restored. In most of the studies, poor prognostic factors were presence of acidosis and shock. The overall outcome improved in the last decade due to better and advanced intensive care management. PMID:21887030

  10. OXYGEN POISONING IN MAMMALS.

    PubMed

    Binger, C A; Faulkner, J M; Moore, R L

    1927-04-30

    1. Oxygen in concentrations of over 70 per cent of an atmosphere is poisonous to dogs, rabbits, guinea pigs and mice. 2. The poisonous effects manifest themselves in drowsiness, anorexia, loss of weight, increasing dyspnea, cyanosis and death from oxygen want. 3. The cause of oxygen want is a destructive lesion of the lungs. 4. The lesion may be characterized grossly as an hemorrhagic edema. Microscopically there is to be seen in varying degrees of intensity (a) capillary engorgement with hemorrhage, (b) the presence of interstitial and intraalveolar serum, (c) hypertrophy and desquamation of alveolar cells, (d) interstitial and alveolar infiltration of mononuclear cells. 5. The type of tissue reaction is not characteristic of an infectious process and no organisms have been recovered at autopsy from the heart's blood or from lung puncture. 6. The poisonous effects of inhalations of oxygen-rich mixtures do not appear to be related to impurities in the oxygen, nor are they related to faulty ventilation, excessive moisture or increased carbon dioxide in the atmosphere of the chambers in which the experimental animals were confined. PMID:19869294

  11. Syncope Associated with Carbon Monoxide Poisoning due to Narghile Smoking.

    PubMed

    Ozkan, Seda; Ozturk, Tayfun; Ozmen, Yavuz; Durukan, Polat

    2013-01-01

    Narghile smoking is a traditional method of tobacco use, and it has been practiced extensively for 400 years. Traditionally, narghile smoking is a matter of culture mainly in Middle East, Asia, and Africa. In recent years, its use as a social activity has increased worldwide, especially among young people. Narghile smoking is an unusual cause of carbon monoxide poisoning. Narghile smoking, compared to cigarette smoking, can result in more smoke exposure and greater levels of carbon monoxide. We present an acute syncope case of a 19-year-old male patient who had carbon monoxide poisoning after narghile smoking. PMID:23585971

  12. [Cases of poisoning in Germany. Disease entity, documentation, and aspects of the event].

    PubMed

    Hahn, A; Begemann, K; Stürer, A

    2014-06-01

    Cases of poisoning account for a distinct share of accidents in Germany, which is particularly high for accidents involving children. Cases of poisoning resulting from suicidal intent or abuse are not counted as accidents. Compared to other cases of disease and accidents, the numerical documentation of cases of poisoning is inadequate. Presently, there is no institution in Germany that could make available representative and meaningful data on the current state of poisoning. Owing to intensive scientific cooperation between the poison information centers (funded by the federal states) and the Poison and Product Documentation Center at the Federal Institute for Risk Assessment (BfR DocCenter) as well as to international cooperation, harmonized and standardized tools have been developed for the appropriate documentation and reporting of procedures to account for poisoning accidents. The first evaluation for 2005-2012 based on published and processed figures for the Federal Republic of Germany yielded the following results: Of approximately 230,000 telephone inquiries received in 2012, about 207,000 involved exposure of humans to different noxae. An annual increase of 3-5 % was recorded. For 2011, analyses of subsets processed by means of standardized methods yielded the following results: Medicines were involved in about 39 % of the cases recorded (of these, medicinal products for humans in 99 %); chemical/physicochemical agents in about 26 % (of these, cleaning and maintenance products in 46 %); products of daily use in about 14 % (of these, cosmetics in 40 %); and plants in about 10 %. More than 90 % of cases were acute poisoning and less than 5 %, chronic poisoning. Regarding the degree of severity of poisoning, an asymptomatic course was reported for 44 % of the cases; minor manifestations were experienced in 30 %, moderate ones in 6 %, and severe manifestations in 2 % of the cases recorded. Fatal cases were rare (< 0.1 %). The

  13. Prallethrin poisoning: A diagnostic dilemma

    PubMed Central

    Chandra, Alka; Dixit, Madhu B.; Banavaliker, Jayant N.

    2013-01-01

    Pyrethroid insecticides are very widely used in agriculture and household due to their high effectiveness and low toxicity in humans. Despite their extensive worldwide use, there are a few reports of human pyrethroid poisoning. The poisoning has a varied presentation and its symptoms overlap with those of other compounds, which can lead to misdiagnosis. We present a case of poisoning with prallethrin, a pyrethroid compound, commonly available as All-Out. PMID:23494161

  14. Chemical and Biological Summer Poisons

    PubMed Central

    Lees, Ronald E. M.

    1972-01-01

    Summer has its own special poisoning hazards for the vacationer, gardener or outdoorsman. Because of the comparative variety of accidental human poisonings from contact with these seasonal toxic substances, either artificial or natural, many family physicians are unfamiliar with their effects. Some of us, unfortunately, will be called upon to deal with them over the next few months. This article highlights some of the hazards, outlines their toxicology and summarizes the treatment of the poisoned patient. PMID:20468771

  15. Potassium Permanganate Poisoning: A Nonfatal Outcome

    PubMed Central

    Eteiwi, Suzan M.; Al-Eyadah, Abdallah A.; Al-Sarihin, Khaldon K.; Al-Omari, Ahmad A.; Al-Asaad, Rania A.; Haddad, Fares H.

    2015-01-01

    Acute poisoning by potassium permanganate is a rare condition with high morbidity and mortality. Diagnosis of the condition relies on a history of exposure or ingestion and a high degree of clinical suspicion. Oxygen desaturation and the presence of methemoglobin are also helpful indicators. Since no specific antidote is available, treatment is mainly supportive. Few cases have been reported in the literature following potassium permanganate ingestion, whether intentional or accidental, and most of the patients in these cases had unfavorable outcomes, which was not the case in our patient. Our patient, a 73-year-old male, purchased potassium permanganate over the counter mistaking it for magnesium salt, which he frequently used as a laxative. Several hours after he ingested it, he was admitted to the endocrine department at King Hussein Medical Center, Jordan, with acute rapidly evolving shortness of breath. During hospitalization, his liver function tests deteriorated. Since he was diagnosed early and managed promptly he had a favorable outcome. PMID:26366264

  16. Potassium Permanganate Poisoning: A Nonfatal Outcome.

    PubMed

    Eteiwi, Suzan M; Al-Eyadah, Abdallah A; Al-Sarihin, Khaldon K; Al-Omari, Ahmad A; Al-Asaad, Rania A; Haddad, Fares H

    2015-07-01

    Acute poisoning by potassium permanganate is a rare condition with high morbidity and mortality. Diagnosis of the condition relies on a history of exposure or ingestion and a high degree of clinical suspicion. Oxygen desaturation and the presence of methemoglobin are also helpful indicators. Since no specific antidote is available, treatment is mainly supportive. Few cases have been reported in the literature following potassium permanganate ingestion, whether intentional or accidental, and most of the patients in these cases had unfavorable outcomes, which was not the case in our patient. Our patient, a 73-year-old male, purchased potassium permanganate over the counter mistaking it for magnesium salt, which he frequently used as a laxative. Several hours after he ingested it, he was admitted to the endocrine department at King Hussein Medical Center, Jordan, with acute rapidly evolving shortness of breath. During hospitalization, his liver function tests deteriorated. Since he was diagnosed early and managed promptly he had a favorable outcome. PMID:26366264

  17. Piezoelectric Biosensors for Organophosphate and Carbamate Pesticides: A Review

    PubMed Central

    Marrazza, Giovanna

    2014-01-01

    Due to the great amount of pesticides currently being used, there is an increased interest for developing biosensors for their detection. Among all the physical transducers, piezoelectric systems have emerged as the most attractive due to their simplicity, low instrumentation costs, possibility for real-time and label-free detection and generally high sensitivity. This paper presents an overview of biosensors based on the quartz crystal microbalance, which have been reported in the literature for organophosphate and carbamate pesticide analysis. PMID:25587424

  18. PESTICIDE POISONINGS REPORTED BY FLORIDA CITRUS FIELDWORKERS

    EPA Science Inventory

    In a 1981 survey of 1811 Florida citrus fieldworkers, 25 pesticide related poisoning incidents involving 29 fieldworkers were reported. Suspected poisonings were categorized into possible and confirmed poisonings, and from these reports it was possible to project an estimated 438...

  19. Household Safety: Preventing Poisoning (For Parents)

    MedlinePlus

    ... How Do I Get My Child Tested for Lead Poisoning? What You Need to Know in an Emergency ... Aid: Poisoning First-Aid Kit Emergency Contact Sheet Lead Poisoning Childproofing and Preventing Household Accidents Babysitting: Dealing With ...

  20. [Fatal poisoning in the Department of Toxicology in Poznarn in 2008-2012--preliminary analysis].

    PubMed

    Łukasik-Głebocka, Magdalena; Adamek, Robert

    2013-01-01

    This paper presents the results of a preliminary analysis of deaths from acute poisoning, which occurred in the Department of Toxicology in Poznań in 2008-2012. During this period, recorded 31 cases of fatal poisoning, representing 0.38% of all treated cases. In subsequent years the percentage of poisoning deaths ranged from 0.25 to 0.49%. Throughout the period leading cause of fatal poisoning were drugs (38.71%) and non-consumptive alcohols (methanol or ethylene glycol) (38.71%). In subsequent years, however, a decrease in the percentage of drug poisoning (from 75 to 0%) and an increase in the percentage of nonconsumptive alcohol poisoning (from 0% to 100%) were observed. In fatal cases were diagnosed among others olanzapine, carbamazepine, pseudoephedrine, tramadol, benzodiazepines, clozapine, morphine and benzodiazepines, insulin, verapamil, carbon monoxide and smoke fire, cyanide, Amanita phalloides, ethanol and a mixture of drugs with ethanol poisoning. The most common fatal poisoning occurred in people addicted (45.16%), mainly in alcohol dependence syndrome (35.48%). Suicidal poisoning was the cause of 32.26% of the deaths, while accidental of 19.35%. In nine cases, the procedure of diagnosis of death from irreversible cessation of brain stem function was performed in order to qualify donors of organs for transplantation or to terminate the therapy. One of the dead was liver and kidneys, and two were kidneys donors. PMID:24466679

  1. Fe2O3 nanoparticles for airborne organophosphate detection

    NASA Astrophysics Data System (ADS)

    Phillips, Joshua; Soliz, Jennifer; Hauser, Adam

    Dire need for early detection of organophosphates (OP) exists in both civilian (pesticide/herbicide buildup) and military (G/V nerve agents) spheres. Nanoparticle materials are excellent candidates for the detection and/or decontamination of hazardous materials, owing to their large surface to volume ratios and tailored surface functionality. Within this category, metal oxides include structures that are stable with the range of normal environmental conditions (temperature, humidity), but have strong, specific reaction mechanisms (hydrolysis, oxidation, catalysis, stoichiometric reaction) with toxic compounds. In this talk, we will present on the suitability of Fe2O3 nanoparticles as airborne organophosphate detectors. 23 nm particles were exposed to a series of organophosphate compounds (dimethyl methylphosphonate, dimethyl chlorophosphonate, diisopropyl methylphosphonate), and studied by x-ray magnetic circular dichroism and x-ray absorption spectroscopy to confirm the stoichiometric Fe2O3 to FeO mechanism and determine magnetic sensor feasibility. AC Impedance Spectroscopy shows both high sensitivity and selectivity via frequency dependence in both impedance and resistivity, suggesting some feasibility for impedimetric devices. We acknowledge funding under Army Research Office STIR Award #W911F-15-1-0104. J.R.S. acknowledges funding from the Defense Threat Reduction Agency under Projects BA13PHM210 and BA07PRO104. J.R.S. also acknowledges funding under a NRC fellowship.

  2. Prevalence of tinnitus in workers exposed to noise and organophosphates

    PubMed Central

    Delecrode, Camila Ribas; de Freitas, Thais Domingues; Frizzo, Ana Claúdia Figueiredo; Cardoso, Ana Claúdia Vieira

    2012-01-01

    Summary Introduction: Research on the workplace has emphasized the effects of noise exposure on workers' hearing, but has not considered the effects of agrochemicals. Aim: To evaluate and correlate the hearing level and tinnitus of workers exposed simultaneously to noise and organophosphates in their workplace and to measure tinnitus distress on their quality of life. Method: A retrospective clinical study. We evaluated 82 organophosphate sprinklers from the São Paulo State Regional Superintendence who were active in the fight against dengue and who were exposed to noise and organophosphates. We performed pure tone audiometry and applied the translated THI (Tinnitus Handicap Inventory) questionnaire. Results: Of the sample, 28.05% reported current tinnitus or had presented tinnitus, and the workers with tinnitus had an increased incidence of abnormal audiometry. The average hearing threshold for the 4–8-kHz frequency range of the workers with current tinnitus was higher than that of the others, and was most affected at the 4-kHz frequency. The THI score ranged 0–84, with an average score of 13.1. Twelve (52.17%) workers had THI scores consistent with discrete handicap. Conclusion: There is an increased incidence of abnormal pure tone audiometry in workers with tinnitus, and its impact on the workers' quality of life was discrete. The correlation between average hearing threshold and tinnitus distress was weak. PMID:25991953

  3. An unusual case of organophosphate intoxication of a worker in a plastic bottle recycling plant: an important reminder.

    PubMed Central

    Wang, C L; Chuang, H Y; Chang, C Y; Liu, S T; Wu, M T; Ho, C K

    2000-01-01

    A young man was sent to our emergency unit because he had suffered from vomiting and cold sweating for 2 days. At the time he was admitted, he had no acute abdominal pains or gastrointestinal symptoms, and a physical examination revealed nothing but a faster heart rate and moist, flushing skin. The patient had worked for 6 years at a plastic bottle-recycling factory, but none of his co-workers had the same symptoms. Nevertheless, because the plant also recycled pesticide bottles, we suspected organophosphate pesticide intoxication. The patient's plasma acetylcholinesterase level was checked, revealing 1498.6 microU/L (normal range: 2,000-5, 000) on the first day and 1,379 microU/L on the second day. Upon questioning, the patient recalled that one of his shoe soles had been damaged and that his foot had been wet from walking all day in rain collected on the factory floor on the day that his symptoms first occurred. We conducted a study in the change of preshift and postshift acetylcholinesterase levels among six of his co-workers on a rainy day. We used the Wilcoxon signed rank test to compare the preshift and postshift plasma acetylcholinesterase levels; no significant difference was revealed (p = 0.600), leaving contamination via the damaged shoe sole suspect. We reviewed the literature on organophosphate intoxication; pesticide bottle-recycling factories were reported to be at a low risk of organophosphate toxicity in the working environment. However, because the potential risk of intoxication is still present, protective equipment such as clothing, gloves, and water-proof shoes should be worn, and employees should be educated on the potential risks. PMID:11102304

  4. Treatment of toxicodendron dermatitis (poison ivy and poison oak).

    PubMed

    Guin, J D

    2001-04-01

    Toxicodendron dermatitis results from a reaction to an oil soluble oleoresin that is present in many parts of the poison ivy and poison oak plants. Prophylactic measures include avoidance, protective clothing, barrier creams and hyposensitization. Treatments include washing the area immediately with a solvent suitable for lipids and the use of anti-inflammatory agents, especially corticosteroids. PMID:11376396

  5. The power of poison: pesticide poisoning of Africa's wildlife.

    PubMed

    Ogada, Darcy L

    2014-08-01

    Poisons have long been used to kill wildlife throughout the world. An evolution has occurred from the use of plant- and animal-based toxins to synthetic pesticides to kill wildlife, a method that is silent, cheap, easy, and effective. The use of pesticides to poison wildlife began in southern Africa, and predator populations were widely targeted and eliminated. A steep increase has recently been observed in the intensity of wildlife poisonings, with corresponding population declines. However, the majority of poisonings go unreported. Under national laws, it is illegal to hunt wildlife using poisons in 83% of African countries. Pesticide regulations are inadequate, and enforcement of existing legislation is poor. Few countries have forensic field protocols, and most lack storage and testing facilities. Methods used to poison wildlife include baiting carcasses, soaking grains in pesticide solution, mixing pesticides to form salt licks, and tainting waterholes. Carbofuran is the most widely abused pesticide in Africa. Common reasons for poisoning are control of damage-causing animals, harvesting fish and bushmeat, harvesting animals for traditional medicine, poaching for wildlife products, and killing wildlife sentinels (e.g., vultures because their aerial circling alerts authorities to poachers' activities). Populations of scavengers, particularly vultures, have been decimated by poisoning. Recommendations include banning pesticides, improving pesticide regulations and controlling distribution, better enforcement and stiffer penalties for offenders, increasing international support and awareness, and developing regional pesticide centers. PMID:24716788

  6. [Suicidal salicylate intoxications and unintentional percutaneous poisoning with salicylic ointment].

    PubMed

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

    2003-01-01

    Suicidal salicylate poisonings are presented in 49 patients, 33 women and 16 men, aged from 18 to 71 (mean 37) years. Mixed poisonings with multiple agents were four times more frequent, had more severe clinical course and demanded longer hospitalisation than acute intoxications with salicylates alone. Four patient were over 65 years old (8.2%). Difficult economic situation of geriatric population in Poland had no effect on frequency of suicidal attempts in the studied cohort. There were no fatalities in the studied group. There were two unintentional systemic poisonings due to topical administration of the 10% salicylic acid ointment for wide spread skin lesions (more than 80% of body surface) in two patients with exudative psoriasis. PMID:14569910

  7. OCCUPATIONAL CARBAMATE POISONING IN THAILAND.

    PubMed

    Tongpoo, Achara; Sriapha, Charuwan; Wongvisawakorn, Sunun; Rittilert, Panee; Trakulsrichai, Satariya; Wananukul, Winai

    2015-07-01

    Carbamate insecticide is a leading cause of poisoning in Thailand. The objective of this study was to characterize the clinical manifestations and modes of occupational exposure in carbamate poisoning cases. We retrospectively studied all the cases of carbamate poisoning due to occupational exposure recorded in the Ramathibodi Poison Center Toxic Exposure Surveillance system during 2005 to 2010. Demographic data, clinical manifestations and severity were analyzed statistically. During the study period, 3,183 cases were identified, of which 170 (5.3%) were deemed to be due to occupational exposure. Ninety-six cases (56.5%) and 35 cases (20.6%) were poisoned by carbofuran and methomyl, respectively. Carbofuran is sold as a 3% grain and applied by sowing; methomyl is sold as a liquid and is applied by spraying. The majority of poisoned patients did not wear personal protective equipment (PPE) while applying the carbamates. The clinical manifestations of occupational carbofuran poisoning recorded were nausea and vomiting (82.3%), headaches (56.3%) and miosis (19.8%). The clinical manifestations of methomyl poisoning were nausea and vomiting (74.3%), headaches (57.1%) and palpitations (11.4%). Most patients in both groups had mild symptoms. Only one case in each group required endotracheal intubation and mechanical ventilation support. There were no deaths and the lengths of hospitalization ranged from 2 hours to 2 days. Occupational carbamate poisoning cases in our series were mostly mild and the patients recovered quickly. There were only rare cases of serious symptoms. Lack of knowledge and inadequate PPE were the major factors contributing to occupational poisoning. Educating agricultural workers about correct precautions and pesticide use could minimize this type of poisoning. PMID:26867400

  8. Neuregulin-1 is Neuroprotective in a Rat Model of Organophosphate-Induced Delayed Neuronal Injury

    PubMed Central

    Li, Yonggang; Lein, Pamela J.; Liu, Cuimei; Bruun, Donald A.; Giulivi, Cecilia; Ford, Gregory; Tewolde, Teclemichael; Ross-Inta, Catherine; Ford, Byron D.

    2012-01-01

    Current medical countermeasures against organophosphate (OP) nerve agents are effective in reducing mortality, but do not sufficiently protect the CNS from delayed brain damage and persistent neurological symptoms. In this study, we examined the efficacy of neuregulin-1 (NRG-1) in protecting against delayed neuronal cell death following acute intoxication with the OP diisopropylfluorophosphate (DFP). Adult male Sprague Dawley rats were pretreated with pyridostigmine (0.1 mg/kg BW, i.m.) and atropine methylnitrate (20 mg/kg BW, i.m.) prior to DFP (9 mg/kg BW, i.p.) intoxication to increase survival and reduce peripheral signs of cholinergic toxicity but not prevent DFP-induced seizures or delayed neuronal injury. Pretreatment with NRG-1 did not protect against seizures in rats exposed to DFP. However, neuronal injury was significantly reduced in most brain regions by pretreatment with NRG-1 isoforms NRG-EGF (3.2 μg/kg BW, i.a) or NRG-GGF2 (48 μg/kg BW, i.a.) as determined by FluroJade-B labeling in multiple brain regions at 24 h post-DFP injection. NRG-1 also blocked apoptosis and oxidative stress-mediated protein damage in the brains of DFP-intoxicated rats. Administration of NRG-1 at 1 h after DFP injection similarly provided significant neuroprotection against delayed neuronal injury. These findings identify NRG-1 as a promising adjuvant therapy to current medical countermeasures for enhancing neuroprotection against acute OP intoxication. PMID:22583949

  9. Poisonous snakebite in Utah.

    PubMed

    Plowman, D M; Reynolds, T L; Joyce, S M

    1995-12-01

    A retrospective study was done of poisonous snakebite in Utah to determine the current epidemiology and scope of treatment, reviewing emergency department logs and other sources statewide for a 69-month period. Of 61 cases of poisonous snakebite identified, 13 occurred in snake hobbyists or venom laboratory personnel and were considered nonaccidental, and 48 were inflicted by native noncaptive snakes. These bites were considered accidental, and all were presumed to be from rattlesnakes. Nearly three fourths of the victims were male, ranging in age from 2 to 56 years (mean, 22 years). Most accidental bites occurred in areas of high human populations, during the summer months, in the afternoon or evening hours, and during recreational activities. Of the 48 bites, 11 (23%) were provoked. Two thirds of bites were on the upper extremities, and a third were on the lower extremities. More than half of the victims had no first-aid treatment recorded. Of those who did receive first aid, many were subjected to possibly harmful treatments, including tourniquets and ice application. The median time to a hospital was 68 minutes, with a range of 15 to 440 minutes. Swelling and discoloration were the most common signs and pain and paresthesia the most common symptoms. Half the bites resulted in minimal or no envenomation, 17 (35%) produced moderate envenomation, and 6 (12%) severe envenomation. Most patients with moderate or severe envenomation received antivenin, but the dosages given were usually less than recommended dosages. Five patients received surgical treatment based on clinical findings. One child died in a snake-handling incident. Long-term morbidity was unknown due to lack of follow-up. The Utah Poison Control Center was poorly utilized as a reporting and informational resource. PMID:8553638

  10. Herbicide poisoning: A diagnostic challenge

    PubMed Central

    Ghosh, Supradip; Singh, Amandeep; Dewan, Himanshu; Walia, Gunwant; Bansal, Abhishek

    2012-01-01

    Despite widespread availability, reports of herbicide poisoning from India are not common. Diagnosis is often difficult in the absence of proper history, non-specific clinical features and lack of diagnostic tests. A case of Paraquat poisoning is reported where diagnosis could be established only after the recovery of the patient. The literature is reviewed. PMID:22557836

  11. Identifying Plant Poisoning in Livestock

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Poisonous plant intoxication is a common and often deadly problem that annually costs the livestock industry more than $340 million in the western United States alone. Despite the cost or frequency, definitively identifying or diagnosing poisoning by plants in livestock is challenging. The purpos...

  12. Poison control center - emergency number

    MedlinePlus

    For a POISON EMERGENCY call: 1-800-222-1222 ANYWHERE IN THE UNITED STATES This national hotline number will let you talk to ... ncbi.nlm.nih.gov/pubmed/12630734 . Shannon MW. Emergency management of poisoning. In: Shannon MW, Borron SW, ...

  13. Acute respiratory distress syndrome due to overdose desferrioxamine: report of a child.

    PubMed

    Atas, B; Caksen, H; Tuncer, O; Oner, A F; Kirimi, E; Akbayram, S

    2005-03-01

    In this article, we present an 18-month-old girl with acute iron poisoning who died from acute respiratory distress syndrome due to overdose of desferrioxamine. Our purpose is to emphasize the importance of close follow-up children with acute iron poisoning for desferrioxamine toxicity. PMID:16250288

  14. Fatal Honey Poisoning Caused by Tripterygium wilfordii Hook F in Southwest China: A Case Series.

    PubMed

    Zhang, Qiang; Chen, Xinguang; Chen, Shunan; Liu, Zhitao; Wan, Rong; Li, Juanjuan

    2016-06-01

    Mad honey poisoning has been reported in many countries, and it seldom results in death. We describe a rare case series of fatal honey poisoning caused by Tripterygium wilfordii Hook F (TwHF) in Southwest China. Three male construction workers were delivered to the emergency department with symptoms of food poisoning after ingestion of wild raw honey. Laboratory results showed that the 3 patients were at different degrees of renal damage, and 1 patient with severe symptoms died of acute renal failure 1 day after admission. Pollen analysis indicated that the suspected honey was heavily contaminated with TwHF pollen. Early diagnosis and prompt treatment are crucial for such poisoning. Pollen analysis is a practical approach to help diagnosis in remote areas where such honey poisoning occurs. PMID:27132027

  15. Scombroid Poisoning: A Practical Approach.

    PubMed

    Guergué-Díaz de Cerio, O; Barrutia-Borque, A; Gardeazabal-García, J

    2016-09-01

    Scombroid poisoning is a common cause of food poisoning worldwide. It is caused by ingestion of oily fish contaminated with bacteria that trigger the formation of high concentrations of histamine. Scombroid poisoning manifests mainly as a skin complaint (flushing that spreads downward and/or an erythematous urticarial rash affecting the face and upper trunk). Although the clinical course is usually self-limiting and benign, vascular compromise, bronchospasm, and arrhythmias have been described. It is important to establish a differential diagnosis that includes conditions such as fish allergy. Oral antihistamines are the mainstay of treatment. Scombroid poisoning is best prevented by refrigerating fish properly. The practical review of scombroid poisoning provided here is intended for dermatologists. PMID:27133773

  16. Organochlorine poisoning of herons

    USGS Publications Warehouse

    Ohlendorf, H.M.; Swineford, D.M.; Locke, L.N.

    1979-01-01

    Over a period of years interested individuals have submitted many dead or moribund herons of various species to our laboratory to learn whether the birds had been affected by diseases or organochlorine poisoning. Residue concentrations in carcasses of birds and mammals are considered the best measure of sublethal exposure, whereas residues in brains are best to use for diagnosing death by most organochlorine chemicals.... The purpose of the present paper is to document the occurrence and concentration of organochlorine residues in the brains of herons from various areas in the United States. By comparing these residue concentrations with laboratory-determined diagnostic lethal levels, we conclude that some herons were killed by organochlorine poisoning; others were at least seriously endangered by the residues they carried. Complete results of carcass analyses for these and other herons, as well as further details? on residues in brains, will be reported elsewhere. Overall, we analyzed carcasses or brains of more than 70 herons found dead or moribund and 36 others taken in planned collections. Residue levels in carcasses of many herons were not high enough to warrant analysis of brains. In the present paper we compare carcass and brain residues of dieldrin in 23 herons of which both carcass and brain were analyzed.

  17. Enhancing enzyme stability by construction of polymer-enzyme conjugate micelles for decontamination of organophosphate agents.

    PubMed

    Suthiwangcharoen, Nisaraporn; Nagarajan, Ramanathan

    2014-04-14

    Enhancing the stability of enzymes under different working environments is essential if the potential of enzyme-based applications is to be realized for nanomedicine, sensing and molecular diagnostics, and chemical and biological decontamination. In this study, we focus on the enzyme, organophosphorus hydrolase (OPH), which has shown great promise for the nontoxic and noncorrosive decontamination of organophosphate agents (OPs) as well as for therapeutics as a catalytic bioscavanger against nerve gas poisoning. We describe a facile approach to stabilize OPH using covalent conjugation with the amphiphilic block copolymer, Pluronic F127, leading to the formation of F127-OPH conjugate micelles, with the OPH on the micelle corona. SDS-PAGE and MALDI-TOF confirmed the successful conjugation, and transmission electron microscopy (TEM) and dynamic light scattering (DLS) revealed ∼100 nm size micelles. The conjugates showed significantly enhanced stability and higher activity compared to the unconjugated OPH when tested (i) in aqueous solutions at room temperature, (ii) in aqueous solutions at higher temperatures, (iii) after multiple freeze/thaw treatments, (iv) after lyophilization, and (v) in the presence of organic solvents. The F127-OPH conjugates also decontaminated paraoxon (introduced as a chemical agent simulant) on a polystyrene film surface and on a CARC (Chemical Agent Resistant Coating) test panel more rapidly and to a larger extent compared to free OPH. We speculate that, in the F127-OPH conjugates (both in the micellar form as well as in the unaggregated conjugate), the polypropylene oxide block of the copolymer interacts with the surface of the OPH and this confinement of the OPH reduces the potential for enzyme denaturation and provides robustness to OPH at different working environments. The use of such polymer-enzyme conjugate micelles with improved enzyme stability opens up new opportunities for numerous civilian and Warfighter applications. PMID

  18. A guinea pig hippocampal slice model of organophosphate-induced seizure activity.

    PubMed

    Harrison, Patrick K; Sheridan, Robert D; Green, A Chris; Scott, Iain R; Tattersall, John E H

    2004-08-01

    Extracellular recording techniques have been used in the guinea pig hippocampal slice preparation to investigate the electrophysiological actions of the organophosphate (OP) anticholinesterase soman. When applied at a concentration of 100 nM, soman induced epileptiform activity in the CA1 region in approximately 75% of slices. This effect was mimicked by the anticholinesterases paraoxon (1 and 3 microM), physostigmine (30 microM), and neostigmine (30 microM), thus providing indirect evidence that the epileptiform response was mediated by elevated acetylcholine levels. Soman-induced bursting was inhibited by the muscarinic receptor antagonists atropine (concentrations tested, 0.1-10 microM), telenzepine (0.03-3 microM), AF-DX116 [11-(2-[(diethylamino)methyl]-1-piperidinyl acetyl)-5,11-dihydro-6H-pyrido 92.b-b) (1,4)-benzodiazepin-6-one] (0.3-300 microM), and biperiden (0.1-10 microM) and by the benzodiazepine anticonvulsants diazepam (3-30 microM) and midazolam (3-30 microM), but it was not inhibited by the nicotinic antagonists mecamylamine (30 microM) and methyllycaconitine (300 nM). In contrast to soman-induced epileptiform activity, bursting induced by the K(+) channel blocker 4-aminopyridine (30 microM), the adenosine A1 receptor antagonist 8-cyclopentyl-1,3-dipropylxanthine (30 nM) or perfusion with low Mg(2+) buffer was insensitive to atropine (10 microM). The ability of muscarinic antagonists and benzodiazepines to inhibit soman-induced epileptiform activity is in accordance with the in vivo pharmacology of soman-induced seizures and suggests that the guinea pig hippocampal slice preparation may provide a useful tool for the evaluation of novel anticonvulsant therapies for the treatment of seizures related to OP poisoning. PMID:15031302

  19. Unusual Complications of Quinalphos Poisoning

    PubMed Central

    Viswanathan, Stalin

    2013-01-01

    This 40-year-old man was treated for suicidal quinalphos 25%EC consumption. He developed intermediate syndrome with normal response to repetitive nerve stimulation, pancreatitis with high enzyme elevations, and normal computed tomography and excreted black, brown, and orange urine sequentially over the first nine days of hospitalization. The last complication has not been previously reported with any organophosphate compound. He finally succumbed to complication of ventilator associated pneumonia related septic shock and ventricular tachycardia. PMID:23762661

  20. Lead Poisoning From a Ceramic Jug Presenting as Recurrent Abdominal Pain and Jaundice.

    PubMed

    Mohamed, Mahmod; Ugarte-Torres, Alejandra; Groshaus, Horacio; Rioux, Kevin; Yarema, Mark

    2016-01-01

    Lead poisoning may present with non-specific symptoms that may result in unnecessary investigations. We report a case of acute lead poisoning in a previously healthy 28-year-old man who presented with recurrent abdominal pain, jaundice, constipation, and weight loss. An extensive diagnostic work-up was completed with inconclusive results. A detailed history revealed an unusual source of lead exposure. Chelation therapy resulted in substantial clinical and biochemical improvement. PMID:26958573

  1. Lead Poisoning From a Ceramic Jug Presenting as Recurrent Abdominal Pain and Jaundice

    PubMed Central

    Ugarte-Torres, Alejandra; Groshaus, Horacio; Rioux, Kevin; Yarema, Mark

    2016-01-01

    Lead poisoning may present with non-specific symptoms that may result in unnecessary investigations. We report a case of acute lead poisoning in a previously healthy 28-year-old man who presented with recurrent abdominal pain, jaundice, constipation, and weight loss. An extensive diagnostic work-up was completed with inconclusive results. A detailed history revealed an unusual source of lead exposure. Chelation therapy resulted in substantial clinical and biochemical improvement. PMID:26958573

  2. BEHAVIORAL AND NEUROCHEMICAL EFFECTS OF ACUTE CHLORPYRIFOS IN RATS: TOLERANCE TO PROLONGED INHIBITION OF CHOLINESTERASE

    EPA Science Inventory

    Chlorpyrifos (CPF), a commercially prevalent organophosphate (OP) pesticide, inhibits blood and brain cholinesterase for up to 10 weeks after acute s.c. injection in rats. his prolonged inhibition suggested that acute CPF may affect muscarinic receptors and behavior as does repea...

  3. Sodium hypochlorite poisoning

    MedlinePlus

    ... hypochlorite is found in: Chemical used to add chlorine to swimming pools Disinfectants Some bleaching solutions Water ... Short term respiratory effects of acute exposure to chlorine due to a swimming pool accident. Occup Environ ...

  4. Occupational poison ivy and oak dermatitis.

    PubMed

    Epstein, W L

    1994-07-01

    Among the growing and diverse groups of outdoor and environmental workers, poison ivy and poison oak continue to be the major cause of occupational contact dermatitis. This article reviews the practical and theoretic means to prevent poison ivy and poison oak dermatitis in workers occupationally exposed to these weeds. PMID:7923948

  5. American Association of Poison Control Centers

    MedlinePlus

    ... View all alerts right left National Poison Prevention Week is March 20-26! Be a part of ... is poison-proof. Read more › National Poison Prevention Week The U.S. Congress established National Poison Prevention Week ...

  6. Fatal aluminium phosphide poisoning

    PubMed Central

    Mittal, Sachin; Rani, Yashoda

    2015-01-01

    Aluminium phosphide (AlP) is a cheap solid fumigant and a highly toxic pesticide which is commonly used for grain preservation. AlP has currently aroused interest with a rising number of cases in the past four decades due to increased use for agricultural and non-agricultural purposes. Its easy availability in the markets has increased also its misuse for committing suicide. Phosphine inhibits cellular oxygen utilization and can induce lipid peroxidation. Poisoning with AlP has often occurred in attempts to commit suicide, and that more often in adults than in teenagers. This is a case of suicidal consumption of aluminium phosphide by a 32-year-old young medical anesthetist. Toxicological analyses detected aluminium phosphide. We believe that free access of celphos tablets in grain markets should be prohibited by law. PMID:27486362

  7. Chronic organophosphate-induced neuropsychiatric disorder: a case report

    PubMed Central

    Ghimire, Shree Ram; Parajuli, Sarita

    2016-01-01

    Chronic organophosphate (OP)-induced neuropsychiatric disorder is a rare condition following prolonged exposure to OP compounds. Due to the lack of valid diagnostic tools and criteria, very few cases are seen in clinical practice and are often misdiagnosed. Misdiagnosis can lead to inappropriate treatment that may increase the risk of morbidity or suicidality. In this paper, we present the case of a 35-year-old male who needed support in breathing from a mechanical ventilator and developed neuropsychiatric behavioral problems following ingestion of OP compounds, which lead to suicidality. The patient was treated by the psychiatric team with antipsychotic and antidepressants and improved following the regular use of medication. PMID:26893566

  8. Using Poison Center Exposure Calls to Predict Methadone Poisoning Deaths

    PubMed Central

    Dasgupta, Nabarun; Davis, Jonathan; Jonsson Funk, Michele; Dart, Richard

    2012-01-01

    Purpose There are more drug overdose deaths in the Untied States than motor vehicle fatalities. Yet the US vital statistics reporting system is of limited value because the data are delayed by four years. Poison centers report data within an hour of the event, but previous studies suggested a small proportion of poisoning deaths are reported to poison centers (PC). In an era of improved electronic surveillance capabilities, exposure calls to PCs may be an alternate indicator of trends in overdose mortality. Methods We used PC call counts for methadone that were reported to the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS®) System in 2006 and 2007. US death certificate data were used to identify deaths due to methadone. Linear regression was used to quantify the relationship of deaths and poison center calls. Results Compared to decedents, poison center callers tended to be younger, more often female, at home and less likely to require medical attention. A strong association was found with PC calls and methadone mortality (b = 0.88, se = 0.42, t = 9.5, df = 1, p<0.0001, R2 = 0.77). These findings were robust to large changes in a sensitivity analysis assessing the impact of underreporting of methadone overdose deaths. Conclusions Our results suggest that calls to poison centers for methadone are correlated with poisoning mortality as identified on death certificates. Calls received by poison centers may be used for timely surveillance of mortality due to methadone. In the midst of the prescription opioid overdose epidemic, electronic surveillance tools that report in real-time are powerful public health tools. PMID:22829925

  9. Can poison control data be used for pharmaceutical poisoning surveillance?

    PubMed Central

    Olsen, Cody S; Dean, J Michael; Olson, Lenora M; Cook, Lawrence J; Keenan, Heather T

    2011-01-01

    Objective To determine the association between the frequencies of pharmaceutical exposures reported to a poison control center (PCC) and those seen in the emergency department (ED). Design A statewide population-based retrospective comparison of frequencies of ED pharmaceutical poisonings with frequencies of pharmaceutical exposures reported to a regional PCC. ED poisonings, identified by International Classification of Diseases, Version 9 (ICD-9) codes, were grouped into substance categories. Using a reproducible algorithm facilitated by probabilistic linkage, codes from the PCC classification system were mapped into the same categories. A readily identifiable subset of PCC calls was selected for comparison. Measurements Correlations between frequencies of quarterly exposures by substance categories were calculated using Pearson correlation coefficients and partial correlation coefficients with adjustment for seasonality. Results PCC reported exposures correlated with ED poisonings in nine of 10 categories. Partial correlation coefficients (rp) indicated strong associations (rp>0.8) for three substance categories that underwent large changes in their incidences (opiates, benzodiazepines, and muscle relaxants). Six substance categories were moderately correlated (rp>0.6). One category, salicylates, showed no association. Limitations Imperfect overlap between ICD-9 and PCC codes may have led to miscategorization. Substances without changes in exposure frequency have inadequate variability to detect association using this method. Conclusion PCC data are able to effectively identify trends in poisonings seen in EDs and may be useful as part of a pharmaceutical poisoning surveillance system. The authors developed an algorithm-driven technique for mapping American Association of Poison Control Centers codes to ICD-9 codes and identified a useful subset of poison control exposures for analysis. PMID:21422101

  10. [Acute intoxication with nutmeg used as a recreational purpose--a case report].

    PubMed

    Sein Anand, Jacek; Barwina, Małgorzata; Waldman, Wojciech

    2013-01-01

    We present a case of acute nutmeg poisoning used for recreational purposes. Poisoning had a stormy clinical course with symptoms of gastrointestinal, cardiovascular and nervous system. The widespread availability of nutmeg suggests that real number of these poisonings may be underestimated in our country. PMID:24466724

  11. A fatal case of Taxus poisoning

    PubMed Central

    TRANCA, SEBASTIAN; PETRISOR, CRISTINA LAURA

    2013-01-01

    Context Taxine-derived alkaloids, taxane-derived substances, and glycosides seem to be responsible for the toxicity of Taxus spp. by blocking microtubule, sodium and calcium channels causing conduction abnormalities. Cases with Taxus baccata acute intoxication have rarely been reported. Case details We report the case of a 43-year-old man who ingested, for suicidal purposes, common (or European) yew leaves (Taxus baccata) and presented severe hypokalemia, ventricular arrhythmias with hemodynamic instability accompanied by severe multiple organ dysfunction syndrome, including respiratory insufficiency, renal failure, acid-base imbalance with severe hypokalemia, hepatic dysfunction and coma, which led to death 12 hours after Taxus baccata ingestion. Conclusion In this particular case, the cardiac electrical instability was definitely maintained by several causes, including severe hypokalemia, which has not been previously reported as related to Taxus poisoning. The metabolic acidosis associated with severe hypokalemia definitely contributed to the complex arrhythmias. The occurrence of severe hypokalemia needs further attention in cases with Taxus poisoning as its immediate treatment might increase survival chances. PMID:26527962

  12. Poison ivy - oak - sumac rash

    MedlinePlus

    ... rash is caused by skin contact with the oils (resin) of certain plants. The oils most often enter the skin rapidly. POISON IVY ... blisters. Therefore, once a person has washed the oil off the skin, the rash does not often ...

  13. Oil-based paint poisoning

    MedlinePlus

    Hydrocarbons are the primary poisonous ingredient in oil paints. Some oil paints have heavy metals such as ... Gummin DD. Hydrocarbons. In: Nelson LS, Lewin NA, Howland MA, et al., eds. Goldfrank's Toxicologic Emergencies . 9th ed. New York, NY: ...

  14. Grass and weed killer poisoning

    MedlinePlus

    ... fluids (through a vein) Medicines to reverse the effects of the poison and treat symptoms Tube placed down the nose and into the stomach (sometimes) Washing of the skin (irrigation), perhaps every few hours for several days

  15. Piperonyl butoxide with pyrethrins poisoning

    MedlinePlus

    Borron, SW. Pyrethrins, repellants, and other pesticides. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: ...

  16. Poison control center - emergency number

    MedlinePlus

    ... ANYWHERE IN THE UNITED STATES This national hotline number will let you talk to experts in poisoning. ... centers in the United States use this national number. You should call if you have any questions ...

  17. The therapeutic use of localized cooling in the treatment of VX poisoning.

    PubMed

    Sawyer, T W; Mikler, J; Worek, F; Reiter, G; Thiermann, H; Tenn, C; Weatherby, K; Bohnert, S

    2011-07-01

    The organophosphate (OP) nerve agent VX is a weaponized chemical warfare agent that has also been used by terrorists against civilians. This contact poison produces characteristic signs of OP poisoning, including miosis, salivation, mastication, dysrhythmias and respiratory distress prior to death. Although successful treatment of OP poisoning can be obtained through decontamination and/or oxime reactivation of agent-inhibited cholinesterase, medical countermeasures that increase the therapeutic window for these measures would be of benefit. An anaesthetized swine model was utilized to examine the effects of lethal VX exposure to the skin, followed by cooling the exposure site prior to decontamination or treatment. The cooling was simply accomplished by using crushed ice in grip-seal plastic bags applied to the exposure sites. Cooling of skin exposed to lethal doses of VX significantly increased the window of opportunity for successful decontamination using the Reactive Skin Decontaminant Lotion(®) (RSDL(®)) or treatment with the oxime antidotes HI-6 and 2PAM. Analyses of blood VX levels showed that cooling acted to slow or prevent the entry of VX into the bloodstream from the skin. If the exposure site is known, the simple and non-invasive application of cooling provides a safe means with which to dramatically increase the therapeutic window in which decontamination and/or antidote treatment against VX are life-saving. PMID:21530621

  18. Lead poisoning in China: a health and human rights crisis.

    PubMed

    Cohen, Jane E; Amon, Joseph J

    2012-01-01

    Acute and chronic lead poisoning is occurring throughout China and is a major cause of childhood morbidity. The Chinese government's emphasis on industrial development and poverty reduction has, over the past three decades, decreased by 500 million the number of people surviving on less than one dollar per day, but has caused significant environmental degradation that threatens public health. Drawing upon in-depth interviews conducted in 2009 and 2010 with families affected by lead poisoning, environmental activists, journalists, government and civil society organization officials in Shaanxi, Henan, Hunan, and Yunnan provinces, as well as a review of scientific and Chinese media, and health and environmental legal and policy analysis, we examine the intersection of civil, political, economic, and social rights related to access to information, screening, treatment, and remediation related to lead poisoning. In-depth interviews in each province uncovered: censorship and intimidation of journalists, environmental activists, and parents seeking information about sources and prevention of lead poisoning; denial of screening for lead poisoning, often based upon arbitrary eligibility criteria; and inadequate and inappropriate treatment being promoted and provided by health facilities. Over the past decade, the Chinese government has prioritized health care and invested billions of dollars towards universal health coverage, and strengthened environmental to address industrial pollution and guarantee access to information on the environment. Yet, despite these reforms, information remains constrained and citizens seeking information and redress are sometimes arrested, in violation of Chinese and international law. Local government officials and national environmental policies continue to prioritize economic development over environmental protection. To effectively address lead poisoning requires an emphasis on prevention, and to combat industrial pollution requires

  19. Respiratory Complications of Organophosphorus Nerve Agent and Insecticide Poisoning. Implications for Respiratory and Critical Care

    PubMed Central

    Hulse, Elspeth J.; Davies, James O. J.; Simpson, A. John; Sciuto, Alfred M.

    2014-01-01

    Organophosphorus (OP) compound poisoning is a major global public health problem. Acute OP insecticide self-poisoning kills over 200,000 people every year, the majority from self-harm in rural Asia. Highly toxic OP nerve agents (e.g., sarin) are a significant current terrorist threat, as shown by attacks in Damascus during 2013. These anticholinesterase compounds are classically considered to cause an acute cholinergic syndrome with decreased consciousness, respiratory failure, and, in the case of insecticides, a delayed intermediate syndrome that requires prolonged ventilation. Acute respiratory failure, by central and peripheral mechanisms, is the primary cause of death in most cases. However, preclinical and clinical research over the last two decades has indicated a more complex picture of respiratory complications after OP insecticide poisoning, including onset of delayed neuromuscular junction dysfunction during the cholinergic syndrome, aspiration causing pneumonia and acute respiratory distress syndrome, and the involvement of solvents in OP toxicity. The treatment of OP poisoning has not changed over the last 50 years. However, a better understanding of the multiple respiratory complications of OP poisoning offers additional therapeutic opportunities. PMID:25419614

  20. Effect of stress at dosing on organophosphate and heavy metal toxicity

    SciTech Connect

    Jortner, Bernard S.

    2008-11-15

    This paper reviews recent studies assessing the effect of well-defined, severe, transient stress at dosing on two classical models of toxicity. These are the acute (anticholinesterase) toxicity seen following exposure to the organophosphate insecticide chlorpyrifos, and the nephrotoxicity elicited by the heavy metal depleted uranium, in rats. Stress was induced by periods of restraint and forced swimming in days to weeks preceding toxicant exposure. Forced swimming was far more stressful, as measured by marked, if transient, elevation of plasma corticosterone. This form of stress was administered immediately prior to administration of chlorpyrifos or depleted uranium. Chlorpyrifos (single 60 mg/kg subcutaneously) elicited marked inhibition of brain acetylcholinesterase 4-day post-dosing. Depleted uranium (single intramuscular doses of 0.1, 0.3 or 1.0 mg/kg uranium) elicited dose-dependent increase in kidney concentration of the metal, with associated injury to proximal tubular epithelium and increases in serum blood urea nitrogen and creatinine during the 30-day post-dosing period. Stress at dosing had no effect on these toxicologic endpoints.