Science.gov

Sample records for acute paracetamol poisoning

  1. 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

  2. Paracetamol poisoning: beyond the nomogram.

    PubMed

    Bateman, D Nicholas

    2015-07-01

    Paracetamol poisoning is the commonest overdose seen in the UK. The management of patients with paracetamol poisoning has been little changed for the past 40 years, with a weight related dose of antidote (acetylcysteine) and treatment based on nomograms relating paracetamol concentration to time from ingestion. In 2012 the UK Commission on Human Medicines recommended a revision of the nomogram, following the death of a young woman, lowering the treatment threshold for all patients. As a result many more patients were treated. This has resulted in a large increase in admissions and in the proportion suffering adverse reactions to the antidote acetylcysteine since, interestingly, higher paracetamol concentrations inhibit anaphylactoid reactions to the antidote. New approaches to assessing the toxicity of paracetamol are now emerging using new biomarkers in blood. This article discusses new approaches to risk assessment and treatment for paracetamol overdose based on recent research in this area. PMID:26099917

  3. Paracetamol poisoning: beyond the nomogram

    PubMed Central

    Bateman, D Nicholas

    2015-01-01

    Paracetamol poisoning is the commonest overdose seen in the UK. The management of patients with paracetamol poisoning has been little changed for the past 40 years, with a weight related dose of antidote (acetylcysteine) and treatment based on nomograms relating paracetamol concentration to time from ingestion. In 2012 the UK Commission on Human Medicines recommended a revision of the nomogram, following the death of a young woman, lowering the treatment threshold for all patients. As a result many more patients were treated. This has resulted in a large increase in admissions and in the proportion suffering adverse reactions to the antidote acetylcysteine since, interestingly, higher paracetamol concentrations inhibit anaphylactoid reactions to the antidote. New approaches to assessing the toxicity of paracetamol are now emerging using new biomarkers in blood. This article discusses new approaches to risk assessment and treatment for paracetamol overdose based on recent research in this area. PMID:26099917

  4. The protective effect of pomegranate juice in paracetamol-induced acute hepatotoxicity in rats

    PubMed Central

    Çalışkan, Duygu; Koca, Tuğba; Doğuç, Duygu Kumbul; Özgöçmen, Meltem; Akçam, Mustafa

    2016-01-01

    Aim: Being the most commonly used antipyretic and analgesic, paracetamol is one of the most common causes of childhood poisoning in the world and maintains its importance also in our country. Paracetamol poisoning is one of the most common causes of liver failure. This study aimed to investigate if pomegranate juice had protective effect in acute liver toxicity related with paracetamol. Material and Methods: A total of 36 Wistar-Albino rats were divided into four groups as the paracetamol group (3 000 mg/kg paracetamol), the pomegranate juice + paracetamol group (1.5 mL pomegranate juice plus 3 000 mg/kg paracetamol), the pomegranate juice group (1.5 mL pomegranate juice) and the control group (1.5 mL distilled water). Pomegranate juice and distilled water were administered for eight days. Paracetamol was administered on day 8. The level of thiobarbituric acid reactive substances, as an oxidative marker, was measured in the blood and liver tissue on day 9. In addition, liver tissues were evaluated histologically (in terms of increased connective tissue, granular degeneration, mononuclear cell infiltration, necrotic cells and vascular congestion). Results: The liver tissue and blood thiobarbituric acid reactive substances levels were found to be significantly lower in the pomegranate juice + paracetamol group compared to the paracetamol group (p<0.05). Histologically, structural changes related with damage were observed in both the paracetamol group and pomegranate juice + paracetamol group. The extent of damage was statistically significantly lower in the pomegranate juice + paracetamol group (p<0.001). Conclusions: Our results related with oxidative and histologic evaluation showed that pomegranate juice might have a preventive effect in paracetamol-induced acute liver damage. PMID:27489463

  5. 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

  6. Paracetamol poisoning in the north east of England: presentation, early management and outcome.

    PubMed

    Thomas, S H; Horner, J E; Chew, K; Connolly, J; Dorani, B; Bevan, L; Bhattacharyya, S; Bramble, M G; Han, K H; Rodgers, A; Sen, B; Tesfayohannes, B; Wynne, H; Bateman, D N

    1997-09-01

    1. Paracetamol is increasingly involved in self-poisoning in the United Kingdom and remains a common cause of fatal poisoning. 2. To document the epidemiology and early management of paracetamol poisoning data were collected on consecutive patients with suspected paracetamol poisoning presenting to 6 hospitals in the North East of England over 12 weeks in 1994. 3. There were 400 presentations (attendance rate 1.14/10(3) population/yr) involving 343 persons (45% male). Paracetamol concentrations at 4 h correlated weakly with reported paracetamol dose (R = 0.49, P < 0.0001) and were similar comparing those treated and not treated by gastric decontamination. 4. In 38 (9%) cases paracetamol concentrations were above the appropriate nomogram treatment line, including 3% and 20% of patients who reported ingesting less than and more than 12 g respectively. In 21 patients acetylcysteine treatment was deferred until admission to the ward, the mean delay involved was 2.8 h. 5. One patient died, from arrhythmias caused by co-ingested dothiepin. 6. Paracetamol poisoning is common. Most cases do not have potentially toxic plasma paracetamol concentrations, but those who do often present late and antidotal treatment may be delayed inappropriately. PMID:9306135

  7. 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

  8. 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

  9. [Paracetamol poisoning in infants aged less than six months: dosage errors].

    PubMed

    Fernández Landaluce, A; Mintegi Raso, S; Martínez González, M J

    2004-02-01

    In infants under 6 months of age, paracetamol overdose is usually due to dose confusion by caretakers. Recently, liquid formulations of this drug have been commercialized in larger,60-ml bottles. The syringe to measure the syrup in these new formulations is also bigger (5 cc versus 1.2-2 cc). We present six cases of 2-4-month-old infants mistakenly given an overdose of paracetamol, each from this new 60-ml formulation. These patients are especially susceptible to poisoning because of liver immaturity and require more aggressive management. To prevent this kind of poisoning, correct and clear information must be given to caregivers about drug dosage. PMID:14757024

  10. [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

  11. [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

  12. Paracetamol.

    PubMed Central

    Meredith, T. J.; Goulding, R.

    1980-01-01

    Paracetamol is an analgesic and antipyretic agent which was first marketed for use as a drug in the U.K. in 1956. It has since become popular with the medical profession and the general public as an alternative to aspirin. PMID:7003571

  13. 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

  14. [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

  15. 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

  16. Assessing the Effect of Leptin on Liver Damage in Case of Hepatic Injury Associated with Paracetamol Poisoning

    PubMed Central

    Polat, Murat; Cerrah, Serkan; Albayrak, Bulent; Ipek, Serkan; Yilmaz, Omer

    2015-01-01

    Background Aim. In case of high-dose acetaminophen intake, the active metabolite can not bind to the glutathione, thereby inducing cellular necrosis through binding to the cytosol proteins. This trial was performed to histologically and biochemically investigate whether leptin was protective against liver damage induced by paracetamol at toxic doses. Material and Method. In our trial, 30 female rats, divided into 5 groups, were used. IP leptin administration was performed after an hour in the group of rats, in which paracetamol poisoning was induced. The groups were as follows: Group 1: the control group, Group 2: 20 µg/kg leptin, Group 3: 2 g/kg paracetamol, Group 4: 2 g/kg paracetamol + 10 µg/kg leptin, and Group 5: 2 g/kg paracetamol + 20 µg/kg leptin. Results. The most significant increase was observed in the PARA 2 g/kg group, while the best improvement among the treatment groups occurred in the PARA 2 g/kg + LEP 10 µg/kg group (p < 0.05). While the most significant glutathione (GSH) reduction was observed in the PARA 2 g/kg group, the best improvement was in the PARA 2 g/kg + LEP 10 µg/kg group (p < 0.05). Conclusion. Liver damage occurring upon paracetamol poisoning manifests with hepatocyte breakdown occurring as a result of inflammation and oxidative stress. Leptin can prevent this damage thanks to its antioxidant and anti-inflammatory efficacy. PMID:26697061

  17. Assessing the Effect of Leptin on Liver Damage in Case of Hepatic Injury Associated with Paracetamol Poisoning.

    PubMed

    Polat, Murat; Cerrah, Serkan; Albayrak, Bulent; Ipek, Serkan; Arabul, Mahmut; Aslan, Fatih; Yilmaz, Omer

    2015-01-01

    Background Aim. In case of high-dose acetaminophen intake, the active metabolite can not bind to the glutathione, thereby inducing cellular necrosis through binding to the cytosol proteins. This trial was performed to histologically and biochemically investigate whether leptin was protective against liver damage induced by paracetamol at toxic doses. Material and Method. In our trial, 30 female rats, divided into 5 groups, were used. IP leptin administration was performed after an hour in the group of rats, in which paracetamol poisoning was induced. The groups were as follows: Group 1: the control group, Group 2: 20 µg/kg leptin, Group 3: 2 g/kg paracetamol, Group 4: 2 g/kg paracetamol + 10 µg/kg leptin, and Group 5: 2 g/kg paracetamol + 20 µg/kg leptin. Results. The most significant increase was observed in the PARA 2 g/kg group, while the best improvement among the treatment groups occurred in the PARA 2 g/kg + LEP 10 µg/kg group (p < 0.05). While the most significant glutathione (GSH) reduction was observed in the PARA 2 g/kg group, the best improvement was in the PARA 2 g/kg + LEP 10 µg/kg group (p < 0.05). Conclusion. Liver damage occurring upon paracetamol poisoning manifests with hepatocyte breakdown occurring as a result of inflammation and oxidative stress. Leptin can prevent this damage thanks to its antioxidant and anti-inflammatory efficacy. PMID:26697061

  18. 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

  19. 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

  20. Efficacy of Intravenous Paracetamol Versus Intravenous Morphine in Acute Limb Trauma

    PubMed Central

    Jalili, Mohammad; Mozaffarpour Noori, Ali; Sedaghat, Mojtaba; Safaie, Arash

    2016-01-01

    Background: Efficient pain management is one of the most important components of care in the field of emergency medicine. Objectives: This study was conducted to compare intravenous paracetamol and intravenous morphine sulfate for acute pain reduction in patients with limb trauma. Patients and Methods: In a randomized double-blinded clinical trial, all patients (aged 18 years and older) with acute limb trauma and a pain score of greater than 3/10 in the emergency department were recruited; they received either 1 g intravenous paracetamol or 0.1 mg/kg intravenous morphine sulfate over 15 minutes. The primary outcome was the pain score measured on a numerical rating scale at 0, 15 and 30 minutes after commencing drug administration. The requirement for rescue analgesia and the frequency of adverse reactions were also recorded. Results: Sixty patients randomly received either IV paracetamol (n = 30) or IV morphine (n = 30). The mean reduction in numerical rating scale pain intensity scores at 30 minutes was 3.86 (± 1.61) for paracetamol, and 2.16 (± 1.39) for morphine. However, pain relief was significantly higher in the paracetamol group compared to the morphine group (P < 0.001). Four patients in the paracetamol group and 15 patients in the morphine group needed rescue analgesia and the difference was significant (P = 0.05). Conclusions: Intravenous paracetamol appears to provide better analgesia than intravenous morphine in acute limb trauma. Further larger studies are required. PMID:27218042

  1. [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

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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

  7. Hepatoprotective and Antioxidant Activity of Dunaliella salina in Paracetamol-induced Acute Toxicity in Rats

    PubMed Central

    Madkour, Fedekar F.; Abdel-Daim, M. M.

    2013-01-01

    Paracetamol has a reasonable safety profile when taken in therapeutic doses. However, it could induce hepatotoxicity and even more severe fatal acute hepatic damage when taken in an overdose. The green alga, Dunaliella salina was investigated for hepatoprotective and antioxidant activity against paracetamol-induced liver damage in rats. Male albino Wistar rats overdosed with paracetamol showed liver damage and oxidative stress as indicated by significantly (P<0.05) increased serum levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total and direct bilirubin, malondialdehyde, cholesterol and nitric oxide. At the same time, there were decreased activities of serum superoxide dismutase and total antioxidant capacity compared with the control group. Treatment with D. salina methanol extract at doses of 500 and 1000 mg/kg body weight or silymarin could significantly (P<0.05) decrease the liver damage marker enzymes, total and direct bilirubin, malondialdehyde, cholesterol and nitric oxide levels and increase the activities of superoxide dismutase and total antioxidant capacity in serum when compared with paracetamol intoxicated group. Liver histopathology also showed that D. salina reduced the centrilobular necrosis, congestion and inflammatory cell infiltration evoked by paracetamol overdose. These results suggest that D. salina exhibits a potent hepatoprotective effect on paracetamol-induced liver damage in rats, which may be due to both the increase of antioxidant enzymes activity and inhibition of lipid peroxidation. PMID:24591738

  8. 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

  9. 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

  10. 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

  11. Paracetamol (acetaminophen) with or without an antiemetic for acute migraine headaches in adults

    PubMed Central

    Derry, Sheena; Moore, R Andrew; McQuay, Henry J

    2014-01-01

    Background Migraine is a common, disabling condition and a burden for the individual, health services and society. Many sufferers choose not to, or are unable to, seek professional help and rely on over-the-counter analgesics. Co-therapy with an antiemetic should help to reduce nausea and vomiting commonly associated with migraine. Objectives To determine the efficacy and tolerability of paracetamol (acetaminophen), alone or in combination with an antiemetic, compared to placebo and other active interventions in the treatment of acute migraine in adults. Search methods We searched Cochrane CENTRAL, MEDLINE, EMBASE and the Oxford Pain Relief Database for studies through 4 October 2010. Selection criteria We included randomised, double-blind, placebo- or active-controlled studies using self-administered paracetamol to treat a migraine headache episode, with at least 10 participants per treatment arm. Data collection and analysis Two review authors independently assessed trial quality and extracted data. Numbers of participants achieving each outcome were used to calculate relative risk and numbers needed to treat (NNT) or harm (NNH) compared to placebo or other active treatment. Main results Ten studies (2769 participants, 4062 attacks) compared paracetamol 1000 mg, alone or in combination with an antiemetic, with placebo or other active comparators, mainly sumatriptan 100 mg. For all efficacy outcomes paracetamol was superior to placebo, with NNTs of 12, 5.2 and 5.0 for 2-hour pain-free and 1- and 2-hour headache relief, respectively, when medication was taken for moderate to severe pain. Nausea, photophobia and phonophobia were reduced more with paracetamol than with placebo at 2 hours (NNTs of 7 to 11); more individuals were free of any functional disability at 2 hours with paracetamol (NNT 10); and fewer participants needed rescue medication over 6 hours (NNT 6). Paracetamol 1000 mg plus metoclopramide 10 mg was not significantly different from oral sumatriptan

  12. 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

  13. Effect of the UK’s revised paracetamol poisoning management guidelines on admissions, adverse reactions and costs of treatment

    PubMed Central

    Bateman, D Nicholas; Carroll, Robert; Pettie, Janice; Yamamoto, Takahiro; Elamin, Muhammad E M O; Peart, Lucy; Dow, Margaret; Coyle, Judy; Cranfield, Kristina R; Hook, Christopher; Sandilands, Euan A; Veiraiah, Aravindan; Webb, David; Gray, Alasdair; Dargan, Paul I; Wood, David M; Thomas, Simon H L; Dear, James W; Eddleston, Michael

    2014-01-01

    Aims In September 2012 the UK’s Commission on Human Medicines (CHM) recommended changes in the management of paracetamol poisoning: use of a single ‘100 mg l−1’ nomogram treatment line, ceasing risk assessment, treating all staggered/uncertain ingestions and increasing the duration of the initial acetylcysteine (NAC) infusion from 15 to 60 min. We evaluated the effect of this on presentation, admission, treatment, adverse reactions and costs of paracetamol poisoning. Methods Data were prospectively collected from adult patients presenting to three large UK hospitals from 3 September 2011 to 3 September 2013 (year before and after change). Infusion duration effect on vomiting and anaphylactoid reactions was examined in one centre. A cost analysis from an NHS perspective was performed for 90 000 patients/annum with paracetamol overdose. Results There were increases in the numbers presenting to hospital (before 1703, after 1854; increase 8.9% [95% CI 1.9, 16.2], P = 0.011); admitted (1060/1703 [62.2%] vs. 1285/1854 [69.3%]; increase 7.1% [4.0, 10.2], P < 0.001) and proportion treated (626/1703 [36.8%] vs. 926/1854 [50.0%]; increase: 13.2% [95% CI 10.0, 16.4], P < 0.001). Increasing initial NAC infusion did not change the proportion of treated patients developing adverse reactions (15 min 87/323 [26.9%], 60 min 145/514 [28.2%]; increase: 1.3% [95% CI –4.9, 7.5], P = 0.682). Across the UK the estimated cost impact is £8.3 million (6.4 million–10.2 million) annually, with a cost-per-life saved of £17.4 million (13.4 million–21.5 million). Conclusions The changes introduced by the CHM in September 2012 have increased the numbers of patients admitted to hospital and treated with acetylcysteine without reducing adverse reactions. A safety and cost-benefit review of the CHM guidance is warranted, including novel treatment protocols and biomarkers in the assessment of poisoning. PMID:24666324

  14. Acute liver failure in a term neonate after repeated paracetamol administration

    PubMed Central

    Bucaretchi, Fábio; Fernandes, Carla Borrasca; Branco, Maíra Migliari; Capitani, Eduardo Mello De; Hyslop, Stephen; Caldas, Jamil Pedro S.; Moreno, Carolina Araújo; Porta, Gilda

    2014-01-01

    Objective: Severe hepatotoxicity caused by paracetamol is rare in neonates. We report a case of paracetamol-induced acute liver failure in a term neonate. Case description: A 26-day-old boy was admitted with intestinal bleeding, shock signs, slight liver enlargement, coagulopathy, metabolic acidosis (pH=7.21; bicarbonate: 7.1mEq/L), hypoglycemia (18mg/dL), increased serum aminotransferase activity (AST=4,039IU/L; ALT=1,087IU/L) and hyperbilirubinemia (total: 9.57mg/dL; direct: 6.18mg/dL) after receiving oral paracetamol (10mg/kg/dose every 4 hours) for three consecutive days (total dose around 180mg/kg; serum concentration 36-48 hours after the last dose of 77µg/ mL). Apart from supportive measures, the patient was successfully treated with intravenous N-acetylcysteine infusion during 11 consecutive days, and was discharged on day 34. The follow-up revealed full recovery of clinical and of laboratory findings of hepatic function. Comments: The paracetamol pharmacokinetics and pharmacodynamics in neonates and infants differ substantially from those in older children and adults. Despite the reduced rates of metabolism by the P-450 CYP2E1 enzyme system and the increased ability to synthesize glutathione - which provides greater resistance after overdoses -, it is possible to produce hepatotoxic metabolites (N-acetyl-p-benzoquinone) that cause hepatocellular damage, if glutathione sources are depleted. Paracetamol clearance is reduced and the half-life of elimination is prolonged. Therefore, a particular dosing regimen should be followed due to the toxicity risk of cumulative doses. This report highlights the risk for severe hepatotoxicity in neonates after paracetamol multiple doses for more than two to three days. PMID:24676202

  15. [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

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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

    activated charcoal, provided the patient is fully conscious and capable of swallowing safely. Gastric lavage carries a risk of serious adverse effects. It is only justified in the rare cases in which the patient's life is at risk following ingestion of a drug that is not adsorbed by activated charcoal. Ipecac syrup should not be used under any circumstances. Purging and gastric lavage are not part of initial management. Few antidotes are suitable for use in the early stages of poisoning. Acetylcysteine can be used for some cases of paracetamol poisoning, and naloxone for some types of opioid poisoning. Paracetamol poisoning can cause life-threatening hepatocellular necrosis. Activated charcoal should be administered as soon as possible. Acetylcysteine protects the liver when administered within 24 hours after paracetamol ingestion. Paracetamol serum assay can be useful for guiding patient management. In practice, acetylcysteine should be given when access to emergency medical intervention is not feasible within 8 to 10 hours after paracetamol ingestion. Intravenous naloxone is useful for respiratory depression due to opioid poisoning, but its duration of action is often shorter than that of opioids, making continuous monitoring necessary. Hospital monitoring is warranted in case of potentially severe poisoning; this includes patients at increased risk, patients having taken a potentially lethal substance at a toxic or unknown dose. Some pharmacological substances and formulations can have delayed effects. In case of self-poisoning, the risk of short-term relapse should be evaluated, even when the patient's condition is not life-threatening. Hospital admission should be proposed, or sometimes imposed, until the acute risk of suicide has subsided. In practice, when faced with acute drug poisoning, the first step is to implement life-support measures, to gather and communicate prognostic information and details of any treatments to the ambulance crew or hospital team. PMID

  1. [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

  2. 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

  3. [Accidental ingestions of paracetamol in the form of EFFERALGAN pediatric syrup: experience of the Marseille Anti-poison Center during 1998].

    PubMed

    de Haro, L; Tichadou, L; Prost, N; Perringue, C; Drouet, G; Rodor, F; Valli, M; Arditti, J

    1999-01-01

    In 1998, 77 cases of accidental ingestion of paracetamol paediatric syrup (Efferalgan) in children were notified to the Marseille Poison Centre. In a quarter of them, the alleged dose taken was greater than the toxic dose. Ingestion was mainly due to the child opening the bottle. The proximate marketing of a product with a child-proof top, which should allow the number of accidents to be reduced. Doctors and pharmacists should be informed rapidly, so that they can warn the families who still have the old type of bottle. PMID:10709457

  4. 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

  5. Target biomarker profile for the clinical management of paracetamol overdose.

    PubMed

    Vliegenthart, A D Bastiaan; Antoine, Daniel J; Dear, James W

    2015-09-01

    Paracetamol (acetaminophen) overdose is one of the most common causes of acute liver injury in the Western world. To improve patient care and reduce pressure on already stretched health care providers new biomarkers are needed that identify or exclude liver injury soon after an overdose of paracetamol is ingested. This review highlights the current state of paracetamol poisoning management and how novel biomarkers could improve patient care and save healthcare providers money. Based on the widely used concept of defining a target product profile, a target biomarker profile is proposed that identifies desirable and acceptable key properties for a biomarker in development to enable the improved treatment of this patient population. The current biomarker candidates, with improved hepatic specificity and based on the fundamental mechanistic basis of paracetamol-induced liver injury, are reviewed and their performance compared with our target profile. PMID:26076366

  6. 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

  7. 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

  8. Paracetamol with and without codeine in acute pain: a quantitative systematic review.

    PubMed

    Moore, A; Collins, S; Carroll, D; McQuay, H

    1997-04-01

    In order to assess the analgesia obtained from single oral doses of paracetamol alone and in combination with codeine in postoperative pain, we conducted a systematic review of randomised controlled trials. We found 31 trials of paracetamol against placebo with 2515 patients, 19 trials of paracetamol plus codeine against placebo with 1204 patients and 13 trials of paracetamol plus codeine against the same dose of paracetamol with 874 patients. Pain relief information was extracted, and converted into dichotomous information (number of patients with at least 50% pain relief). Wide variations in responses to placebo (0-72%) and active drug (3-89%) were observed. In postoperative pain states paracetamol 1000 mg alone against placebo had an number-needed-to-treat (NNT) of 3.6 (3.0-4.4) and paracetamol 600/650 mg alone an NNT of 5.0 (4.1-6.9). Paracetamol 600/650 mg plus codeine 60 mg against placebo had a better NNT of 3.1 (2.6-3.8), with no overlap of 95% confidence intervals with paracetamol 600/650 mg alone. In direct comparisons of paracetamol plus codeine with paracetamol alone the additional analgesic effect of 60 mg of codeine added to paracetamol was 12 extra patients in every 100 achieving at least 50% pain relief. In indirect comparisons of each with placebo it was 14 extra patients per 100. This was an NNT for adding codeine 60 mg of 9.1 (5.8-24). The results confirm that paracetamol is an effective analgesic, and that codeine 60 mg added to paracetamol produces worthwhile additional pain relief even in single oral doses. PMID:9150293

  9. The Effect of Paracetamol on Core Body Temperature in Acute Traumatic Brain Injury: A Randomised, Controlled Clinical Trial

    PubMed Central

    Saxena, Manoj K.; Taylor, Colman; Billot, Laurent; Bompoint, Severine; Gowardman, John; Roberts, Jason A.; Lipman, Jeffery; Myburgh, John

    2015-01-01

    Background Strategies to prevent pyrexia in patients with acute neurological injury may reduce secondary neuronal damage. The aim of this study was to determine the safety and efficacy of the routine administration of 6 grams/day of intravenous paracetamol in reducing body temperature following severe traumatic brain injury, compared to placebo. Methods A multicentre, randomised, blind, placebo-controlled clinical trial in adult patients with traumatic brain injury (TBI). Patients were randomised to receive an intravenous infusion of either 1g of paracetamol or 0.9% sodium chloride (saline) every 4 hours for 72 hours. The primary outcome was the mean difference in core temperature during the study intervention period. Results Forty-one patients were included in this study: 21 were allocated to paracetamol and 20 to saline. The median (interquartile range) number of doses of study drug was 18 (17–18) in the paracetamol group and 18 (16–18) in the saline group (P = 0.85). From randomisation until 4 hours after the last dose of study treatment, there were 2798 temperature measurements (median 73 [67–76] per patient). The mean ± standard deviation temperature was 37.4±0.5°C in the paracetamol group and 37.7±0.4°C in the saline group (absolute difference -0.3°C; 95% confidence interval -0.6 to 0.0; P = 0.09). There were no significant differences in the use of physical cooling, or episodes of hypotension or hepatic abnormalities, between the two groups. Conclusion The routine administration of 6g/day of intravenous paracetamol did not significantly reduce core body temperature in patients with TBI. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12609000444280 PMID:26678710

  10. 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

  11. 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.

  12. 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.

  13. 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

  14. Lycium barbarum extract provides effective protection against paracetamol-induced acute hepatotoxicity in rats

    PubMed Central

    Gündüz, Ercan; Dursun, Recep; Zengin, Yılmaz; İçer, Mustafa; Durgun, Hasan Mansur; Kanıcı, Ayşe; Kaplan, İbrahim; Alabalık, Ulaş; Gürbüz, Hüseyin; Güloğlu, Cahfer

    2015-01-01

    The aim of the present study was to investigate the hepatoprotective and antioxidant effects of Lycium barbarum (LB) extract against paracetamol-induced acute oxidative stress and hepatotoxicity in rats. The subjects were divided into 6 groups of 8 rats each. The rats in the LB group were administered a dose of 100 mg/kg LB extract dissolved in saline via the intraperitoneal route for 7 days. Subsequently, after last dose of LB, PCT was given in a single dose of 1 g/kg diluted in saline via the oral route. Twenty-four hours later, blood samples were drawn from all of the subjects for serum Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Total antioxidant status (TAS) and Total oxidant status (TOS) tests, and liver tissue samples were obtained for histopathological evaluation. The mean TAS level of the group that was subjected to PCT intoxication was significantly lower than those of the other groups. Additionally, the mean TOS, Oxidative stress index (OSI), ALT and AST values were significantly higher in this group. Though the mean TAS level in the PCT + LB group was significantly higher than that of the PCT group, the TOS, OSI, ALT, and AST levels were significantly lower. When the PCT + LB group and the PCT only group were compared in terms of liver damage during the histopathological evaluation, a statistically significant difference was observed in Grade I and Grade III damage (P=0.013 and P=0.038, respectively). We conclude that Lycium barbarum extract leads to a significant improvement in PCT-induced acute hepatotoxicity in terms of the histopathological results, serum oxidative stress parameters, and serum liver function marker enzymes. PMID:26221346

  15. 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

  16. 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 ...

  17. 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

  18. 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

  19. [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

  20. [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

  1. Tramadol/paracetamol.

    PubMed

    McClellan, Karen; Scott, Lesley J

    2003-01-01

    The orally administered fixed combination tablet of tramadol (centrally-acting opiate) plus paracetamol (acetaminophen; nonopiate, nonsalicylate analgesic) [37.5/325 mg] provides effective analgesia in patients with moderate to severe acute pain and those with chronic painful conditions characterised by intermittent exacerbations of pain. Two tramadol/paracetamol 37.5/325 mg tablets provided greater relief of dental pain over an 8-hour period than either agent alone, with a faster onset of action than tramadol alone and a longer duration of action than either agent as monotherapy. In patients with postoperative dental pain, two tramadol/paracetamol tablets (37.5/325 mg) provided similar analgesia to hydrocodone/paracetamol 10/650 mg over an 8-hour period. The addition of one or two tramadol/paracetamol 37.5/32 5mg tablets (up to four times daily) for 5 days to existing NSAID or cyclo-oxygenase-2 inhibitor analgesic therapy provided effective pain relief in patients with osteoarthritis flare pain. Tramadol/paracetamol 37.5/325 mg provided similar efficacy to that of codeine/paracetamol 30/300 mg in patients with chronic back pain in a 4-week, randomised, double-blind trial (a maximum of 10 tablets or capsules per day of the active drug). PMID:12749738

  2. [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

  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. 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

  9. 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

  10. 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

  11. 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

  12. Acute tubulointerstitial nephritis-uveitis (TINU) syndrome developed secondary to paracetamol and codeine phosphate use: two case reports.

    PubMed

    Alaygut, Demet; Torun Bayram, Meral; Ünlü, Mehtat; Soylu, Alper; Türkmen, Mehmet; Kavukçu, Salih

    2014-01-01

    Tubulointerstitial nephritis (TIN) refers to a group of heterogeneous diseases affecting the interstitial compartment of the kidney. It might be primary or can develop secondary to many urinary systemic diseases. Primary TIN develops mainly following drug usage, exposure to toxins, and also infections and humoral and cell-mediated immune reactions. In some patients, signs of systemic inflammatory reactions can be the first presenting symptoms. Histopathological evaluation reveals mononuclear cells and lymphocytes in the interstitium and tubuli. Acute and chronic TIN can resolve after elimination of the culprit destructive factors, as drugs, toxins and immune reaction. Combination of tubulointerstitial inflammation and uveitis is termed as tubulointerstitial nephritis-uveitis (TINU) syndrome. Uveitis might occur before, after, and also concomitantly with TIN. Herein, two adolescent cases of TIN and TINU, seemingly developed secondary to paracetamol and codeine phosphate use, are presented. PMID:24827955

  13. 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

  14. 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

  15. The combination of non-selective NSAID 400 mg and paracetamol 1000 mg is more effective than each drug alone for treatment of acute pain. A systematic review.

    PubMed

    Alexander, Louise; Hall, Emma; Eriksson, Lars; Rohlin, Madeleine

    2014-01-01

    The aim was to evaluate the evidence on outcomes of the combination of non-selective NSAID/ paracetamol compared to either drug alone, to relieve acute pain following oral surgery in adult patients. A systematic review of available literature was performed. The first step comprised searches in three electronic databases. Original studies written in English were searched. As a second step, the reference lists of included publications were searched for additional publications. Abstracts were retrieved if the title contained information on postoperative pain, NSAID, and paracetamol in combination with oral surgery. Two reviewers selected publications on the basis of predetermined inclusion criteria. Data were extracted using one protocol and the quality of each study was assessed using another protocol. The initial search in PubMed resulted in 138 abstracts and in the Cochrane library a further four. The search in the Web of Science resulted in no additional abstract. Five RCTs fulfilled the inclusion criteria. Pain relief from the combination of non-selective NSAID with paracetamol was significantly better than with paracetamol alone as well as with NSAID alone. Nausea, vomiting, headache, and dizziness were among the most common adverse events in all treatment groups. Most of the adverse events were of mild to moderate severity. Two studies reported no significant differences in adverse events between the treatment groups. According to one study the adverse events were significantly lower for the combination ibuprofen 400 mg/paracetamol 1000 mg compared to ibuprofen 400 mg alone. The need for rescue drugs in the different groups varied between the studies. Since the studies reported a significantly better postoperative pain relief with the combination of non-selective NSAIDs/paracetamol compared to each drug alone, this combination might be considered the treatment of choice, as long as side effects of NSAIDs are observed. PMID:26995806

  16. 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

  17. 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.

  18. 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.

  19. 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

  20. 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

  1. 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

  2. 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

  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. 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

  5. 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

  6. 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

  7. 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

  8. Critical role of c‐jun (NH2) terminal kinase in paracetamol‐ induced acute liver failure

    PubMed Central

    Henderson, Neil C; Pollock, Katharine J; Frew, John; Mackinnon, Alison C; Flavell, Richard A; Davis, Roger J; Sethi, Tariq; Simpson, Kenneth J

    2007-01-01

    Background Acute hepatic failure secondary to paracetamol poisoning is associated with high mortality. C‐jun (NH2) terminal kinase (JNK) is a member of the mitogen‐activated protein kinase family and is a key intracellular signalling molecule involved in controlling the fate of cells. Aim To examine the role of JNK in paracetamol‐induced acute liver failure (ALF). Methods A previously developed mouse model of paracetamol poisoning was used to examine the role of JNK in paracetamol‐induced ALF. Results Paracetamol‐induced hepatic JNK activation both in human and murine paracetamol hepatotoxicity and in our murine model preceded the onset of hepatocyte death. JNK inhibition in vivo (using two JNK inhibitors with different mechanisms of action) markedly reduced mortality in murine paracetamol hepatotoxicity, with a significant reduction in hepatic necrosis and apoptosis. In addition, delayed administration of the JNK inhibitor was more effective than N‐acetylcysteine after paracetamol poisoning in mice. JNK inhibition was not protective in acute carbon tetrachloride‐mediated or anti‐Fas antibody‐mediated hepatic injury, suggesting specificity for the role of JNK in paracetamol hepatotoxicity. Furthermore, disruption of the JNK1 or JNK2 genes did not protect against paracetamol‐induced hepatic damage. Pharmacological JNK inhibition had no effect on paracetamol metabolism, but markedly inhibited hepatic tumour necrosis foctor α (TNF α) production after paracetamol poisoning. Conclusions These data demonstrated a central role for JNK in the pathogenesis of paracetamol‐induced liver failure, thereby identifying JNK as an important therapeutic target in the treatment of paracetamol hepatotoxicity. PMID:17185352

  9. 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

  10. 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

  11. 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.

  12. 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

  13. 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.

  14. 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

  15. Novel analgesic combination of tramadol, paracetamol, caffeine and taurine in the management of moderate to moderately severe acute low back pain

    PubMed Central

    Madhusudhan, Santhosh Kumar

    2013-01-01

    Background Acute low back pain is one the leading cause of doctor's visit in our country with innumerable medication for treatment. Finding an ideal analgesic medication with better efficacy and least adverse effects is always a challenging task to the treating doctor. Methods In this study we compared the efficacy and safety profile of a fixed dose combination of novel analgesic tramadol 37.5 mg/paracetamol 325 mg/caffeine 30 mg/taurine 250 mg with commonly used tramadol 37.5 mg/paracetamol 325 mg tablet in the treatment of moderate to moderately severe acute low back pain. Patients attending 50 clinics throughout India were enrolled in either of the above group and were asked to take one tablet every 6th hour for five consecutive days. The pain evaluation in both groups was done with verbal pain relief scale and pain intensity scale at end of treatment. Results Proportion of patients in novel combination group compared to tramadol/paracetamol only group responding to treatment based on treatment satisfaction (good and excellent) and mean pain intensity (no pain or mild pain), were 81% Vs 45%, (p < 0.001) and 83% Vs 66% (p < 0.001) respectively. Common expected adverse drug reaction like nausea, vomiting and dizziness occurred with far less frequency in patients under novel combination group. Conclusion We conclude that significantly more patients in novel combination drug group compared to tramadol/paracetamol only group had a superior analgesic effect with lesser adverse reactions. PMID:24396231

  16. 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

  17. 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

  18. 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

  19. 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

  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 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

  2. 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

  3. 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

  4. 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

  5. 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.

  6. 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

  7. 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.

  8. 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

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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

  17. Efficacy and safety profile of combination of tramadol-diclofenac versus tramadol-paracetamol in patients with acute musculoskeletal conditions, postoperative pain, and acute flare of osteoarthritis and rheumatoid arthritis: a Phase III, 5-day open-label study

    PubMed Central

    Chandanwale, Ajay S; Sundar, Subramanian; Latchoumibady, Kaliaperumal; Biswas, Swati; Gabhane, Mukesh; Naik, Manoj; Patel, Kamlesh

    2014-01-01

    Objective We aimed to evaluate the safety and efficacy of a fixed-dose combination (FDC) of tramadol and diclofenac versus a standard approved FDC of tramadol and paracetamol, in patients with acute moderate to severe pain. Methods A total of 204 patients with moderate to severe pain due to acute musculoskeletal conditions (n=52), acute flare of osteoarthritis (n=52), acute flare of rheumatoid arthritis (n=50), or postoperative pain (n=50) were enrolled in the study at baseline. Each disease category was then randomized to receive either of two treatments for 5 days: group A received an FDC of immediate-release tramadol hydrochloride (50 mg) and sustained-release diclofenac sodium (75 mg) (one tablet, twice daily), and group B received an FDC of tramadol hydrochloride (37.5 mg) and paracetamol (325 mg) (two tablets every 4–6 hours, up to a maximum of eight tablets daily). The primary efficacy end points were reductions in pain intensity from baseline at day 3 and day 5 as assessed by a Visual Analog Scale (VAS) score. Results Group A showed a significant reduction in the VAS score for overall pain from baseline on day 3 (P=0.001) and day 5 (P<0.0001) as compared with group B. The combination of tramadol-diclofenac resulted in few mild to moderate adverse events (nausea, vomiting, epigastric pain, and gastritis), which required minimal management, without any treatment discontinuation. The number of adverse events in group A was nine (8.82%) compared with 22 (21.78%) in group B, after 5 days of treatment. Conclusion An FDC of tramadol-diclofenac showed a significantly greater reduction in pain intensity and was well tolerated compared with tramadol-paracetamol, resulting in better analgesia in patients suffering from moderate to severe pain due to acute musculoskeletal conditions, postoperative pain following orthopedic surgery, or acute flare of osteoarthritis and rheumatoid arthritis. PMID:25152629

  18. Paracetamol + tramadol: new preparation. No advance.

    PubMed

    2003-12-01

    (1) First-line treatment for both acute and chronic pain is paracetamol or, if necessary, ibuprofen, a nonsteroidal antiinflammatory drug. If relief is inadequate, the best option is a combination of paracetamol with codeine (a weak opiate). (2) A fixed-dose combination of paracetamol (325 mg) and tramadol (37.5 mg), a weak opiate, arrived on the French market in May 2003. (3) In the acute setting, three trials in a total of 1197 patients showed that a single dose of the paracetamol 650 mg + tramadol 75 mg combination after dental surgery was no more effective than ibuprofen 400 mg. Compared with each drug used alone, the paracetamol + tramadol combination prolongs the analgesic effect but does not increase its intensity. (4) A trial after gynaecological surgery and another trial after orthopaedic surgery showed that a single dose of paracetamol 975 mg + tramadol 112.5 mg had similar efficacy to tramadol alone at 112.5 mg. (5) In the chronic setting, we found no trials comparing the paracetamol + tramadol combination with each drug used alone. A comparative double-blind trial in 462 patients with low back pain or osteoarthritic pain showed no difference in efficacy between paracetamol 325 mg + tramadol 37.5 mg and paracetamol 300 mg + codeine 30 mg. (6) The main adverse effects of the paracetamol + tramadol combination are the same as other weak opiates: nausea, vomiting, dizziness, headache, drowsiness and constipation. Tramadol carries a higher risk of drug interactions than codeine. (7) In practice, the paracetamol + tramadol combination offers patients no advantages relative to standard analgesics. PMID:14986689

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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

  4. 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...

  5. 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

  6. [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

  7. 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

  8. 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

  9. 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

  10. 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

  11. 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

  12. [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

  13. 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

  14. 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)

  15. 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

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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

  1. [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

  2. 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

  3. 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

  4. 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

  5. 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.

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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

  11. 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

  12. [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

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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

  19. [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

  20. 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

  1. 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

  2. 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

  3. Can paracetamol (acetaminophen) be administered to patients with liver impairment?

    PubMed

    Hayward, Kelly L; Powell, Elizabeth E; Irvine, Katharine M; Martin, Jennifer H

    2016-02-01

    Although 60 years have passed since it became widely available on the therapeutic market, paracetamol dosage in patients with liver disease remains a controversial subject. Fulminant hepatic failure has been a well documented consequence of paracetamol overdose since its introduction, while short and long term use have both been associated with elevation of liver transaminases, a surrogate marker for acute liver injury. From these reports it has been assumed that paracetamol use should be restricted or the dosage reduced in patients with chronic liver disease. We review the factors that have been purported to increase risk of hepatocellular injury from paracetamol and the pharmacokinetic alterations in different pathologies of chronic liver disease which may affect this risk. We postulate that inadvertent under-dosing may result in concentrations too low to enable efficacy. Specific research to improve the evidence base for prescribing paracetamol in patients with different aetiologies of chronic liver disease is needed. PMID:26460177

  4. The PanAM study: a multi-center, double-blinded, randomized, non-inferiority study of paracetamol versus non-steroidal anti-inflammatory drugs in treating acute musculoskeletal trauma

    PubMed Central

    2013-01-01

    Background Acute musculoskeletal trauma, including strains, sprains or contusions, occur frequently. Pain management is a crucial component of treatment. However, there is no convincing evidence which drug is superior in managing pain in these patients. The aim of the PanAM Study is to compare analgesic efficacy of three strategies of pain management: paracetamol, diclofenac, or a combination of both in patients with acute musculoskeletal trauma. Methods/design The PanAM Study is a multi-center, double blind randomized controlled trial with non-inferiority design. Included are adult patients presenting to an academic, urban Emergency Department or to a General Practice with acute, blunt, traumatic limb injury. In total, 547 patients will be included using a predefined list of exclusion criteria, to be allocated by randomization to treatment with paracetamol + placebo diclofenac, diclofenac + placebo paracetamol or paracetamol + diclofenac. The hypothesis is that paracetamol will not be inferior to treatment with diclofenac, or the combination of both. Primary outcome will be between-group differences in decrease in pain, measured with Numerical Rating Scales at baseline and at 90 minutes after study drug administration. Secondary outcomes are Numerical Rating Scales at 30 and 60 minutes and measured frequently during three consecutive days after discharge; occurrence of adverse effects; patient satisfaction and an analysis of quality of life and cost-effectiveness. Recruitment started July 2013 and is expected to last a year. Discussion With this multi-center randomized clinical trial we will investigate whether treatment with paracetamol alone is not inferior to diclofenac alone or a combination of both drugs in adult patients with acute musculoskeletal trauma. The main relevance of the trial is to demonstrate the benefits and risks of three commonly used treatment regimens for musculoskeletal trauma. Data that lead to the prevention of severe Non

  5. 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

  6. To compare the efficacy and safety of fixed dose combination of thiocolchicoside and aceclofenac versus chlorzoxazone, aceclofenac and paracetamol in patients with acute lower backache associated with muscle spasm

    PubMed Central

    Kumar, Sanjeev; Rani, Seema; Siwach, Ramchander; Verma, Prem

    2014-01-01

    Background: The fixed dose combinations (FDCs) of muscle relaxants, non-steroidal anti-inflammatory drugs and paracetamol are commonly prescribed in the treatment of acute lower backache. Aim: The present study was undertaken with the aim of comparing the efficacy and safety of FDCs of thiocolchicoside and aceclofenac versus chlorzoxazone, aceclofenac and paracetamol in patients with acute lower backache associated with muscle spasm. Materials and Methods: A total of 100 patients between ages range from 18 and 55 years having low back pain of ≤7 days duration were randomly divided into two groups. Group A was prescribed thiocolchicoside (4 mg) + aceclofenac (100 mg) while Group B was prescribed chlorzoxazone (500 mg) + aceclofenac (100 mg) + paracetamol (325 mg) orally twice daily for 7 days. Severity of pain at rest and on movement was recorded using visual analogue scale. Muscle spasm was evaluated by hand-to-floor distance and Lasegue's maneuver. Readings were noted on day 1 (baseline), day 3 and day 7. Results: There was statistically significant reduction in severity of pain and muscle spasm on day 3 and day 7 in both groups. There was no statistically significant difference in pain relief and muscle spasm among the treatment groups but clinically showed better improvement in the Group A. The adverse drug reactions occurring during study showed a statistically significant better safety profile in the Group A than Group B. Conclusion: These findings confirm that FDC of thiocolchicoside and aceclofenac is a preferred option for patients with lower backache pain associated with muscle spasm. PMID:25143885

  7. Intravenous paracetamol (acetaminophen).

    PubMed

    Duggan, Sean T; Scott, Lesley J

    2009-01-01

    Intravenous paracetamol (rINN)/intravenous acetaminophen (USAN) is an analgesic and antipyretic agent, recommended worldwide as a first-line agent for the treatment of pain and fever in adults and children. In double-blind clinical trials, single or multiple doses of intravenous paracetamol 1 g generally provided significantly better analgesic efficacy than placebo treatment (as determined by primary efficacy endpoints) in adult patients who had undergone dental, orthopaedic or gynaecological surgery. Furthermore, where evaluated, intravenous paracetamol 1 g generally showed similar analgesic efficacy to a bioequivalent dose of propacetamol, and a reduced need for opioid rescue medication. In paediatric surgical patients, recommended doses of intravenous paracetamol 15 mg/kg were not significantly different from propacetamol 30 mg/kg for the treatment of pain, and showed equivocal analgesic efficacy compared with intramuscular pethidine 1 mg/kg in several randomized, active comparator-controlled studies. In a randomized, noninferiority study in paediatric patients with an infection-induced fever, intravenous paracetamol 15 mg/kg treatment was shown to be no less effective than propacetamol 30 mg/kg in terms of antipyretic efficacy. Intravenous paracetamol was well tolerated in clinical trials, having a tolerability profile similar to placebo. Additionally, adverse reactions emerging from the use of the intravenous formulation of paracetamol are extremely rare (<1/10 000). [table: see text]. PMID:19192939

  8. 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 ...

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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.

  16. 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

  17. 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

  18. 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

  19. 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

  20. The Effect of Adding Magnesium Sulfate to Lidocaine Compared with Paracetamol in Prevention of Acute Pain in Hand Surgery Patients Under Intravenous Regional Anesthesia (IVRA)

    PubMed Central

    Mirkheshti, Alireza; Aryani, Mohammad Reza; Shojaei, Poujia; Dabbagh, Ali

    2012-01-01

    Introduction: This study was done to compare the analgesic effects of “magnesium plus lidocaine”, “paracetamol plus lidocaine”, and “placebo plus lidocaine” on block characteristics for intravenous regional anesthesia (IVRA) in patients undergoing upper extremity orthopedic surgery. Methods: In a double-blind, placebo-controlled randomized clinical trial, 90 patients were selected and entered randomly into three study groups after applying the inclusion and exclusion criteria. Time to start of the sensory and motor block were measured separately and also the duration of these two block types were measured. Post-op pain assessment was measured using a numeric rating scale. Venous samples were checked and compared regarding blood gas and pH measurements. Results: The time from drug injection to sensory block onset was the shortest in the magnesium plus lidocaine group; the time from drug injection to the time of motor block onset was the shortest in the lidocaine plus magnesium group; the duration of the motor block was the longest in the lidocaine plus magnesium group. Discussion: Addition of magnesium lidocaine in patients undergoing upper extremity orthopedic operations using IVRA decreases significantly the time gap between drug administration and the start of the block; also, this drug combination increases the IVRA block length, while paracetamol does not have such a significant effect. PMID:23024850

  1. 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...

  2. 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

  3. 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

  4. 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.

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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

  11. 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 ...

  12. 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. ...

  13. 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 ...

  14. 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 ...

  15. Single dose oral paracetamol (acetaminophen) for postoperative pain in adults

    PubMed Central

    Toms, Laurence; McQuay, Henry J; Derry, Sheena; Moore, R Andrew

    2014-01-01

    Background This is an updated version of the original Cochrane review published in Issue 1, 2004 - this original review had been split from a previous title on ‘Single dose paracetamol (acetaminophen) with and without codeine for postoperative pain’. The last version of this review concluded that paracetamol is an effective analgesic for postoperative pain, but additional trials have since been published. This review sought to evaluate the efficacy and safety of paracetamol using current data, and to compare the findings with other analgesics evaluated in the same way. Objectives To assess the efficacy of single dose oral paracetamol for the treatment of acute postoperative pain. Search methods We searched The Cochrane Library, MEDLINE, EMBASE, the Oxford Pain Relief Database and reference lists of articles to update an existing version of the review in July 2008. Selection criteria Randomised, double-blind, placebo-controlled clinical trials of paracetamol for acute postoperative pain in adults. Data collection and analysis Two review authors independently assessed trial quality and extracted data. Area under the “pain relief versus time” curve was used to derive the proportion of participants with paracetamol or placebo experiencing at least 50% pain relief over four to six hours, using validated equations. Number-needed-to-treat-to-benefit (NNT) was calculated, with 95% confidence intervals (CI). The proportion of participants using rescue analgesia over a specified time period, and time to use, were sought as measures of duration of analgesia. Information on adverse events and withdrawals was also collected. Main results Fifty-one studies, with 5762 participants, were included: 3277 participants were treated with a single oral dose of paracetamol and 2425 with placebo. About half of participants treated with paracetamol at standard doses achieved at least 50% pain relief over four to six hours, compared with about 20% treated with placebo. NNTs for at

  16. 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

  17. 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.

  18. 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

  19. 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

  20. The epidemiology of childhood poisonings in Cyprus.

    PubMed

    Koliou, Maria; Ioannou, Chrystalla; Andreou, Kyriaki; Petridou, Alexandra; Soteriades, Elpidoforos Soterakis

    2010-07-01

    Information on childhood poisonings in Cyprus is limited. Our objective was to examine the epidemiology of poisonings among children in Cyprus. All children up to 15 years of age admitted for poisoning to the Archbishop Makarios Hospital in Nicosia, Cyprus between 2005 and 2008 were included in our study. All hospital poisoning records were reviewed. A total of 257 children were admitted for poisoning. The mean age of children was 3.1 years, of which 83.7% were below the age of 5 years old, while 53% were boys. The poisoning hospitalizations accounted for about 3% of all admissions to the pediatric department during the study period (4 years). The annual cumulative incidence of childhood poisoning hospitalizations was 116 per 100,000 children. Medications accounted for 46.1% of all poisonings, the most frequent cause being paracetamol (9.8%), cardiovascular medications (5.3%), antitussive medications (4.5%), and other painkillers (4.1%). Another 37.6% of hospitalizations involved household products such as household cleaning products (11.8%), petroleum products (11.0%), and rodenticides (5.7%). Among children who ingested petroleum distillates, 55.6% developed clinical symptomatology. The vast majority of cases were accidental (93.8%). Suicidal cases involved children 8-14 years old, mainly girls, and the most frequent poisoning ingested was paracetamol (46.7%). Poisoning hospitalizations represent an important cause of morbidity among children in Cyprus. Preventive strategies should include the education of caregivers on the handling of medications and household products as well as legislation requiring child-resistant packaging for all medications and household products including petroleum distillates. PMID:20016913

  1. 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

  2. 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

  3. 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

  4. The modern pharmacology of paracetamol: therapeutic actions, mechanism of action, metabolism, toxicity and recent pharmacological findings.

    PubMed

    Graham, Garry G; Davies, Michael J; Day, Richard O; Mohamudally, Anthoulla; Scott, Kieran F

    2013-06-01

    Paracetamol is used worldwide for its analgesic and antipyretic actions. It has a spectrum of action similar to that of NSAIDs and resembles particularly the COX-2 selective inhibitors. Paracetamol is, on average, a weaker analgesic than NSAIDs or COX-2 selective inhibitors but is often preferred because of its better tolerance. Despite the similarities to NSAIDs, the mode of action of paracetamol has been uncertain, but it is now generally accepted that it inhibits COX-1 and COX-2 through metabolism by the peroxidase function of these isoenzymes. This results in inhibition of phenoxyl radical formation from a critical tyrosine residue essential for the cyclooxygenase activity of COX-1 and COX-2 and prostaglandin (PG) synthesis. Paracetamol shows selectivity for inhibition of the synthesis of PGs and related factors when low levels of arachidonic acid and peroxides are available but conversely, it has little activity at substantial levels of arachidonic acid and peroxides. The result is that paracetamol does not suppress the severe inflammation of rheumatoid arthritis and acute gout but does inhibit the lesser inflammation resulting from extraction of teeth and is also active in a variety of inflammatory tests in experimental animals. Paracetamol often appears to have COX-2 selectivity. The apparent COX-2 selectivity of action of paracetamol is shown by its poor anti-platelet activity and good gastrointestinal tolerance. Unlike both non-selective NSAIDs and selective COX-2 inhibitors, paracetamol inhibits other peroxidase enzymes including myeloperoxidase. Inhibition of myeloperoxidase involves paracetamol oxidation and concomitant decreased formation of halogenating oxidants (e.g. hypochlorous acid, hypobromous acid) that may be associated with multiple inflammatory pathologies including atherosclerosis and rheumatic diseases. Paracetamol may, therefore, slow the development of these diseases. Paracetamol, NSAIDs and selective COX-2 inhibitors all have central and

  5. Paracetamol hepatotoxicity and microsomal function.

    PubMed

    Kaushal, R; Dave, K R; Katyare, S S

    1999-03-01

    The effect of paracetamol-induced hepatotoxicity in rats (650 mg/kg) on microsomal function was examined. Paracetamol treatment resulted in lowered Na(+),K(+)-ATPase activity in the microsomes with decrease in V(max) of the low affinity high V(max) component II. However, the temperature kinetics was not influenced significantly. The total phospholipid and cholesterol contents as well as lipid peroxidation in the microsomes were unchanged. However, content of acidic phospholipids: phosphatidylserine and phosphatidylinositol decreased by 50% with a reciprocal increase in the sphingomyelin content; the lysophosphoglyceride content increased by 12-fold. The microsomal membrane appeared to be more fluidized following paracetamol treatment. Paracetamol treatment also resulted in a significant reduction in the sulfhydryl groups content. PMID:21781911

  6. 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

  7. 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

  8. Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults

    PubMed Central

    Toms, Laurence; Derry, Sheena; Moore, R Andrew; McQuay, Henry J

    2014-01-01

    Background This is an updated version of the Cochrane review published in Issue 4, 1998. Combining drugs from different classes with different modes of action may offer opportunity to optimise efficacy and tolerability, using lower doses of each drug to achieve the same degree of pain relief. Previously we concluded that addition of codeine to paracetamol provided additional pain relief, but at expense of additional adverse events. New studies have been published since. This review sought to evaluate efficacy and safety of paracetamol plus codeine using current data, and compare findings with other analgesics evaluated similarly. Objectives Assess efficacy of single dose oral paracetamol plus codeine in acute postoperative pain, increase in efficacy due to the codeine component, and associated adverse events. Search methods We searched CENTRAL, MEDLINE, EMBASE, the Oxford Pain Relief Database in October 2008 for this update. Selection criteria Randomised, double-blind, placebo-controlled trials of paracetamol plus codeine, compared with placebo or the same dose of paracetamol alone, for relief of acute postoperative pain in adults. Data collection and analysis Two authors assessed trial quality and extracted data. The area under the “pain relief versus time” curve was used to derive proportion of participants with paracetamol plus codeine and placebo or paracetamol alone experiencing least 50% pain relief over four-to-six hours, using validated equations. Number-needed-to-treat-to-benefit (NNT) was calculated using 95% confidence intervals (CIs). Proportion of participants using rescue analgesia over a specified time period, and time to use of rescue analgesia, were sought as additional measures of efficacy. Information on adverse events and withdrawals were collected. Main results Twenty-six studies, with 2295 participants, were included comparing paracetamol plus codeine with placebo. Significant dose response was seen for the outcome of at least 50% pain

  9. 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

  10. Intravenous paracetamol is highly effective in pain treatment after tonsillectomy in adults.

    PubMed

    Atef, Ahmed; Fawaz, Ahmed Aly

    2008-03-01

    Tonsillectomy in adults is associated with significant postoperative pain. Intravenous paracetamol injection (Perfalgan) is marketed for the management of acute pain. This prospective placebo-controlled study was performed to evaluate the analgesic efficacy and safety of intravenous paracetamol in 76 adult patients undergoing elective standard bipolar diathermy tonsillectomy. After tonsillectomy was performed under general anesthesia, the patients were randomized to receive either intravenous paracetamol 1 g (Perfalgan) (n = 38) or 0.9% normal saline as a placebo (n = 38) at 6-h intervals. No other analgesic medication was permitted for postoperative pain during the study. Need for rescue analgesic during the first 24 h after surgery as well as all adverse events were recorded. The intravenous paracetamol group differed significantly from the placebo group regarding pain relief and median time to pethidine rescue. Intravenous paracetamol significantly reduced pethidine consumption over the 24-h period. The worst pain after surgery was also more severe in the placebo group than that in the paracetamol group. There was no significant difference between groups in the incidence of adverse events. Intravenous paracetamol administered regularly in adult patients with moderate to severe pain after tonsillectomy provided rapid and effective analgesia and was well tolerated. PMID:17891409

  11. 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

  12. 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

  13. 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

  14. 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 ...

  15. 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. ...

  16. 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. ...

  17. 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- ...

  18. 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 ...

  19. 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. ...

  20. 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, ...

  1. 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)

  2. 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

  3. 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

  4. The Role of RAAS Inhibition by Aliskiren on Paracetamol-Induced Hepatotoxicity Model in Rats.

    PubMed

    Karcioglu, Saliha Sena; Palabiyik, Saziye Sezin; Bayir, Yasin; Karakus, Emre; Mercantepe, Tolga; Halici, Zekai; Albayrak, Abdulmecit

    2016-03-01

    Paracetamol is one of the most popular and widely used analgesic and antipyretic agents, but an overdose can cause hepatotoxicity and lead to acute liver failure. Aliskiren directly inhibits renin which downregulates the renin-angiotensin-aldosterone system (RAAS). Recent findings suggest that RAAS system takes part in the pathogenesis of liver fibrosis. We aimed to reveal the relationship between hepatotoxicity and the RAAS by examining paracetamol induced hepatotoxicity. Rats were separated into five groups as follows: control, 100 mg/kg aliskiren (p.o.), 2 g/kg paracetamol (per os (p.o.)), 2 g/kg paracetamol + 50mg/kg aliskiren (p.o.), and 2 g/kg paracetamol + 100 mg/kg aliskiren(p.o.). Samples were analyzed at the biochemical, molecular, and histopathological levels. Paracetamol toxicity increased alanine aminotransferases (ALT), aspartate aminotransferases (AST), renin, and angiotensin II levels in the serum samples. In addition, the SOD activity and glutathione (GSH) levels decreased while Lipid Peroxidation (MDA) levels increased in the livers of the rats treated with paracetamol. Paracetamol toxicity caused a significant increase in TNF-α and TGF-β. Both aliskiren doses showed an improvement in ALT, AST, oxidative parameters, angiotensin II, and inflammatory cytokines. Only renin levels increased in aliskiren treatment groups due to its pharmacological effect. A histopathological examination of the liver showed that aliskiren administration ameliorated the paracetamol-induced liver damage. In immunohistochemical staining, the expression of TNF-α in the cytoplasm of the hepatocytes was increased in the paracetamol group but not in other treatment groups when compared to the control group. In light of these observations, we suggest that the therapeutic administration of aliskiren prevented oxidative stress and cytokine changes and also protected liver tissues during paracetamol toxicity by inhibiting the RAAS. PMID:26280784

  5. 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

  6. Hepatoprotective effects of ethanolic extract of Cnidoscolus aconitifolius on paracetamol-induced hepatic damage in rats.

    PubMed

    Oyagbemi, A A; Odetola, A A

    2010-02-15

    The study was designed to evaluate the possible hepatoprotective effect of Cnidoscolus aconitifolius on paracetamol poisoning in rats. Twenty five male Wistar rats were used in this study. They were divided into 5 groups of 5 rats. Groups I and II received normal saline (0.9% physiological saline). Animal in groups III-V were administered Cnidoscolus aconitifolius at 100, 500 and 1,000 mg kg(-1), respectively for 7 days. All animal in groups II-V were given paracetamol at 3 g kg(-1) by gastric gavage on days 8 and 9. Animals were sacrificed by cervical dislocation on day 10 after an overnight fast. Paracetamol overdose caused significant (p<0.05) increase in the plasma Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Alkaline phosphatase (ALP), Blood Urea Nitrogen (BUN), triglycerides (TAG) with total cholesterol (TC) and Low Density Lipoprotein (LDL-cholesterol) and significant (p<0.05) decrease Total Protein (TP) and High Density Lipoprotein (HDL-cholesterol) in rats treated with paracetamol alone when compared with rats pre-treated with extract of Cnidoscolus aconitifolius. Pre-treatment with ethanolic extract of Cnidoscolus aconitifolius led to significant (p<0.05) decrease in serum ALT, ALP, AST, LDL and BUN when compared with the paracetamol treated rats in dose-dependent manner. The extract also similarly caused significant (p<0.05) increase in HDL values compared with paracetamol treated group. In conclusion, the results of this study demonstrated that Cnidoscolus aconitifolius can ameliorate paracetamol-induced hepatotoxicity. Significant hepato-protective activity was observed in rats treated with the dose of 1000 mg kg(-1) b.wt. PMID:20437682

  7. N-Acetyl cysteine does not prevent liver toxicity from chronic low-dose plus subacute high-dose paracetamol exposure in young or old mice.

    PubMed

    Kane, Alice Elizabeth; Huizer-Pajkos, Aniko; Mach, John; McKenzie, Catriona; Mitchell, Sarah Jayne; de Cabo, Rafael; Jones, Brett; Cogger, Victoria; Le Couteur, David G; Hilmer, Sarah Nicole

    2016-06-01

    Paracetamol is an analgesic commonly used by people of all ages, which is well documented to cause severe hepatotoxicity with acute overexposures. The risk of hepatotoxicity from nonacute paracetamol exposures is less extensively studied, and this is the exposure most common in older adults. Evidence on the effectiveness of N-acetyl cysteine (NAC) for nonacute paracetamol exposures, in any age group, is lacking. This study aimed to examine the effect of long-term exposure to therapeutic doses of paracetamol and subacute paracetamol overexposure, in young and old mice, and to investigate whether NAC was effective at preventing paracetamol hepatotoxicity induced by these exposures. Young and old male C57BL/6 mice were fed a paracetamol-containing (1.33 g/kg food) or control diet for 6 weeks. Mice were then dosed orally eight times over 3 days with additional paracetamol (250 mg/kg) or saline, followed by either one or two doses of oral NAC (1200 mg/kg) or saline. Chronic low-dose paracetamol exposure did not cause hepatotoxicity in young or old mice, measured by serum alanine aminotransferase (ALT) elevation, and confirmed by histology and a DNA fragmentation assay. Subacute paracetamol exposure caused significant hepatotoxicity in young and old mice, measured by biochemistry (ALT) and histology. Neither a single nor double dose of NAC protected against this toxicity from subacute paracetamol in young or old mice. This finding has important clinical implications for treating toxicity due to different paracetamol exposure types in patients of all ages, and implies a need to develop new treatments for subacute paracetamol toxicity. PMID:26821200

  8. 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

  9. 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

  10. Retro-orbital blood acquisition facilitates circulating microRNA measurement in zebrafish with paracetamol hepatotoxicity

    PubMed Central

    Vliegenthart, A D B; Lewis, P Starkey; Tucker, C S; Del Pozo, J; Rider, S; Antoine, D J; Dubost, V; Westphal, M; Moulin, P; Bailey, M A; Moggs, J G; Goldring, C E; Park, B K; Dear, J W

    2014-01-01

    Paracetamol is the commonest cause of acute liver failure in the Western world and biomarkers are needed that report early hepatotoxicity. The liver enriched microRNA, miR-122, is a promising biomarker currently being qualified in humans. For biomarker development and drug toxicity screening the zebrafish has advantages over rodents, however, blood acquisition in this model remains technically challenging. We developed a method for collecting blood from the adult zebrafish by retro-orbital (RO) bleeding and compared it to the commonly used ‘lateral incision’ (LI) method. The RO technique was more reliable in terms of the blood yield and minimum amount per fish. This new RO technique was used in a zebrafish model of paracetamol toxicity. Paracetamol induced dose-dependent increases in liver cell necrosis, serum ALT activity and mortality. In situ hybridization localised expression of miR-122 to the cytoplasm of zebrafish hepatocytes. After collection by RO bleeding, serum miR-122 could be measured and this microRNA was substantially increased by paracetamol 24 hours after exposure, an increase that was prevented by delayed (3 hours post start of paracetamol exposure) treatment with acetylcysteine. In summary, collection of blood by RO bleeding facilitated measurement of miR-122 in a zebrafish model of paracetamol hepatotoxicity. The zebrafish represents a new species for measurement of circulating microRNA biomarkers that are translational and can bridge between fish and humans. PMID:24625211

  11. 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 ...

  12. 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

  13. 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 ...

  14. [Acetaminophen (paracetamol) causing renal failure: report on 3 pediatric cases].

    PubMed

    Le Vaillant, J; Pellerin, L; Brouard, J; Eckart, P

    2013-06-01

    Renal failure secondary to acetaminophen poisoning is rare and occurs in approximately 1-2 % of patients with acetaminophen overdose. The pathophysiology is still being debated, and renal acetaminophen toxicity consists of acute tubular necrosis, without complication if treated promptly. Renal involvement can sometimes occur without prior liver disease, and early renal manifestations usually occur between the 2nd and 7th day after the acute acetaminophen poisoning. While therapy is exclusively symptomatic, sometimes serious metabolic complications can be observed. The monitoring of renal function should therefore be considered as an integral part of the management of children with acute, severe acetaminophen intoxication. We report 3 cases of adolescents who presented with acute renal failure as a result of voluntary drug intoxication with acetaminophen. One of these 3 girls developed severe renal injury without elevated hepatic transaminases. None of the 3 girls' renal function required hemodialysis, but one of the 3 patients had metabolic complications after her acetaminophen poisoning. PMID:23628119

  15. 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.

  16. Plasma glutathione S-transferase and F protein are more sensitive than alanine aminotransferase as markers of paracetamol (acetaminophen)-induced liver damage.

    PubMed

    Beckett, G J; Foster, G R; Hussey, A J; Oliveira, D B; Donovan, J W; Prescott, L F; Proudfoot, A T

    1989-11-01

    Concentrations of glutathione S-transferase (GST; glutathione transferase; EC 2.5.1.18) B1 subunits, F protein, and the activity of alanine aminotransferase (ALT; EC 2.6.1.2) were measured in sequential plasma samples taken from nine patients with self-administered paracetamol (acetaminophen) poisoning. GST exceeded the reference interval in all patients at the time of admission, and F protein was increased in seven. In contrast, abnormal activities of ALT in plasma were found in only one of the nine on admission, a patient admitted 12 h after poisoning. Subsequent to admission nine, eight, and five patients, respectively, had abnormal concentrations of GST, F protein, and ALT. When expressed as multiples of the upper reference limit, the highest values for GST measured in each patient always far exceeded the greatest abnormalities in ALT; this was true for F protein in only five patients. Patients in whom the concentration of GST exceeded 10 micrograms/L on admission subsequently went on to develop moderate or severe liver damage, despite treatment with N-acetylcysteine. F protein and ALT measurements on admission were not as efficient as GST at predicting the clinical outcome of the patients. We conclude that GST and F protein offer clear advantages over ALT for detecting minor degrees of acute liver dysfunction, particularly when only centrilobular damage may be involved. PMID:2582614

  17. Aspirin, paracetamol, and haematemesis and melaena.

    PubMed Central

    Coggon, D; Langman, M J; Spiegelhalter, D

    1982-01-01

    Aspirin and paracetamol consumption have been compared in 346 matched pairs of patients with haematemesis and melaena, and control individuals in the general community. Both aspirin and paracetamol intake were more common in patients than in controls, but the association for aspirin was stronger and was apparent with both recent and habitual intake, whereas for paracetamol the association was not detectable for habitual intake. The results for paracetamol suggests that patients with bleeding take analgesic drugs in part because of symptoms associated with bleeding, and such intake is not necessarily causal of bleeding. Failure to control investigations to take account of this point has exaggerated the possible risks of aspirin consumption. PMID:7076011

  18. Photodegradation of Paracetamol in Nitrate Solution

    SciTech Connect

    Meng Cui; Qu Ruijuan; Liang Jinyan; Yang Xi

    2010-11-24

    The photodegradation of paracetamol in nitrate solution under simulated solar irradiation has been investigated. The degradation rates were compared by varying environmental parameters including concentrations of nitrate ion, humic substance and pH values. The quantifications of paracetamol were conducted by HPLC method. The results demonstrate that the photodegradation of paracetamol followed first-order kinetics. The photoproducts and intermediates of paracetamol in the presence of nitrate ions were identified by extensive GC-MS method. The photodegradation pathways involving. OH radicals as reactive species were proposed.

  19. Photodegradation of Paracetamol in Nitrate Solution

    NASA Astrophysics Data System (ADS)

    Meng, Cui; Qu, Ruijuan; Liang, Jinyan; Yang, Xi

    2010-11-01

    The photodegradation of paracetamol in nitrate solution under simulated solar irradiation has been investigated. The degradation rates were compared by varying environmental parameters including concentrations of nitrate ion, humic substance and pH values. The quantifications of paracetamol were conducted by HPLC method. The results demonstrate that the photodegradation of paracetamol followed first-order kinetics. The photoproducts and intermediates of paracetamol in the presence of nitrate ions were identified by extensive GC-MS method. The photodegradation pathways involving. OH radicals as reactive species were proposed.

  20. Sorption of paracetamol onto biomaterials.

    PubMed

    Ferchichi, Maroua; Dhaouadi, Hatem

    2016-01-01

    Pharmaceutical residues released into the environment are posing more and more public health problems. It is worthwhile to study the retention of pharmaceuticals residues by adsorption on solid supports. Batch sorption experiments are intended to identify the adsorption isotherms of the pharmaceutically active ingredient on the biomaterials. The results obtained in this study have shown that the retention possibilities of these compounds by bio-adsorbents (clay and sand) are not significant. The negligible sorption for these media is explained by the low hydrophobicity of paracetamol (Log K(ow) = 0.46). The retention of paracetamol on the dehydrated sewage sludge and on Posidonia oceanica showed a relatively significant adsorption with a maximal quantity of 0.956 mg g(-1) and 1.638 mg g(-1) for the dehydrate sludge and P. oceanica, respectively. On the other hand, the study of paracetamol retention on the powdered activated carbon showed a high adsorption capacity of about 515.27 mg g(-1). Isotherm data show a good fit with Langmuir's model. An infrared analysis is carried out. It shows identical bands before and after adsorption, with some modifications. PMID:27387007

  1. 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 ...

  2. 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: ...

  3. 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. ...

  4. 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

  5. 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 ...

  6. 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 ...

  7. 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, ...

  8. 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 ...

  9. 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 ...

  10. 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 ...

  11. 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 ...

  12. 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. ...

  13. 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. ...

  14. 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 ...

  15. 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 ...

  16. 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 ...

  17. 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 ...

  18. 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 ...

  19. 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 ...

  20. 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.

  1. 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: ...

  2. 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 ...

  3. 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 ...

  4. 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 ...

  5. The Alzheimer Pandemic: Is Paracetamol to Blame?

    PubMed Central

    Jones, Günther Robert Norman

    2013-01-01

    Historical Background: The clinical recognition of a form of dementia closely resembling Alzheimer's disease dates from around 1800. The role of analgesics derived from coal-tar in the spread of the pandemic is traced in terms of the introduction of phenacetin (PN) in 1887; its nephrotoxicity; the observation of lesions characteristic of the disease by Fischer and Alzheimer; the discovery of paracetamol (PA) as the major metabolite of PN; the linking of kidney injury and dementia with high PN usage; and the failure of PN replacement by PA to halt and reverse the exponential, inexorable rise in the incidence of Alzheimer-type dementia. Fischer observed his first case before Alzheimer; it is proposed to rename the syndrome Fischer-Alzheimer disease (F-AD). Disease development: PA-metabolising enzymes are localised in the synaptic areas of the frontal cortex and hippocampus, where F-AD lesions arise. The initiating chemical lesions in liver poisoning comprise covalent binding of a highly reactive product of PA metabolism to proteins; similar events are believed to occur in brain, where alterations in the antigenic profiles of cerebral proteins activate the microglia. β-Amyloid forms, and, like PA itself, induces nitric oxide synthase. Peroxynitrite modifies cerebral proteins by nitrating tyrosine residues, further challenging the microglia and exacerbating the amyloid cascade. Spontaneous reinnervation, N-acetyl cysteine administration and tyrosine supplementation may attenuate the early stages of F-AD development. Conclusion: F-AD is primarily a man-made condition with PA as its principal risk factor. PMID:24350947

  6. Previous administration of naltrexone did not change synergism between paracetamol and tramadol in mice.

    PubMed

    Miranda, Hugo F; Noriega, Viviana; Prieto, Juan Carlos

    2012-07-01

    In the treatment of acute and chronic pain the most frequently used drugs are nonsteroidal anti-inflammatory drugs (NSAIDs), e.g., paracetamol; opioids, e.g., tramadol, and a group of drugs called coanalgesics or adjuvants (e.g., antidepressants, anticonvulsants). The aim of this work was to determine the nature of the interaction induced by intraperitoneal or intrathecal coadministration of paracetamol and tramadol. The type of interaction was evaluated by means of isobolographic analysis, using the acetic acid writhing test as an algesiometer in mice. In addition, the involvement of opioid receptors in the interaction was studied using naltrexone, a non-selective opioid receptor antagonist. The administration of paracetamol or tramadol induced a dose-dependent antinociceptive activity in the assay. The dose-response curves were characterized by equal efficacy but different potencies, being i.t. paracetamol 11.84 times more potent than i.p. paracetamol, and i.t. tramadol 3.54 times more potent than the i.p. tramadol. The isobolographic analysis indicates a synergistic interaction between the coadministration of i.p. or i.t. paracetamol with tramadol. The interaction index values were similar for the i.p. and i.t. coadministration with values of 0.414 and 0.364, respectively. The different mechanisms of action of paracetamol and tramadol strongly explain the analgesic synergism between them, in agreement with the general theory of drug interaction. This synergic interaction was not modified by the non selective opioid antagonist, naltrexone. This association could be of clinical significance in the treatment of pain with a reduction of doses and adverse effects. PMID:22465615

  7. 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

  8. 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

  9. Paracetamol absorption from a feeding jejunostomy.

    PubMed

    Nelson, E B; Abernethy, D R; Greenblatt, D J; Ameer, B

    1986-07-01

    Disposition of paracetamol oral elixir was determined in two male patients after administration via feeding jejunostomy and compared with four male controls who received the same dose by mouth. Area under the plasma concentration-time curve, elimination half-life, and time to maximum concentration were similar in both groups after 650 mg paracetamol elixir. The absolute amounts and ratio of paracetamol glucuronide to sulphate, the major urinary metabolites after therapeutic paracetamol doses, were similar after jejunal administration as compared to oral administration. Paracetamol is absorbed and biotransformed in a similar manner after either jejunal or oral administration. Therefore, it may be administered effectively via jejunostomy tube in patients who require this route of administration. PMID:3091054

  10. 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

  11. 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 ...

  12. 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.

  13. Acetaminophen/paracetamol: A history of errors, failures and false decisions.

    PubMed

    Brune, K; Renner, B; Tiegs, G

    2015-08-01

    Acetaminophen/paracetamol is the most widely used drug of the world. At the same time, it is probably one of the most dangerous compounds in medical use, causing hundreds of deaths in all industrialized countries due to acute liver failure (ALF). Publications of the last 130 years found in the usual databases were analyzed. Personal contacts existed to renowned researchers having contributed to the medical use of paracetamol and its precursors as H.U. Zollinger, S. Moeschlin, U. Dubach, J. Axelrod and others. Further information is found in earlier reviews by Eichengrün, Rodnan and Benedek, Sneader, Brune; comp. references. The history of the discovery of paracetamol starts with an error (active against worms), continues with a false assumption (paracetamol is safer than phenacetin), describes the first side-effect 'epidemy' (phenacetin nephropathy, drug-induced interstitial nephritis) and ends with the discovery of second-generation problems due to the unavoidable production of a highly toxic metabolite of paracetamol N-acetyl-p-benzoquinone imine (NAPQI) that may cause not only ALF and kidney damage but also impaired development of the fetus and the newborn child. It appears timely to reassess the risk/benefit ratio of this compound. PMID:25429980

  14. 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

  15. 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

  16. Single-dose intravenous paracetamol or propacetamol for prevention or treatment of postoperative pain: a systematic review and meta-analysis.

    PubMed

    McNicol, E D; Tzortzopoulou, A; Cepeda, M S; Francia, M B D; Farhat, T; Schumann, R

    2011-06-01

    Paracetamol is the most commonly prescribed analgesic for the treatment of acute pain. The efficacy and safety of i.v. formulations of paracetamol is unclear. We performed a systematic search (multiple databases, bibliographies, any language, to May 2010) for single-dose, randomized, controlled clinical trials of propacetamol or i.v. paracetamol for acute postoperative pain in adults or children. Thirty-six studies involving 3896 patients were included. For the primary outcome, 37% of patients (240/367) receiving propacetamol or i.v. paracetamol experienced at least 50% pain relief over 4 h compared with 16% (68/527) receiving placebo (number needed to treat=4.0; 95% confidence interval, 3.5-4.8). The proportion of patients in propacetamol or i.v. paracetamol groups experiencing at least 50% pain relief diminished over 6 h. Patients receiving propacetamol or paracetamol required 30% less opioid over 4 h and 16% less opioid over 6 h than those receiving placebo. However, this did not translate to a reduction in opioid-induced adverse events (AEs). Similar comparisons between propacetamol or i.v. paracetamol and active comparators were either not statistically significant, not clinically significant, or both. AEs occurred at similar rates with propacetamol or i.v. paracetamol and placebo. However, pain on infusion occurred more frequently in those receiving propacetamol compared with placebo (23% vs 1%). A single dose of either propacetamol or i.v. paracetamol provides around 4 h of effective analgesia for about 37% of patients with acute postoperative pain. Both formulations are associated with few AEs, although patients receiving propacetamol have a higher incidence of pain on infusion. PMID:21558067

  17. 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

  18. [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

  19. 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

  20. 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

  1. A systematic review of paracetamol for non-specific low back pain

    PubMed Central

    Davies, Reece A.; Hancock, Mark J.

    2008-01-01

    The objective of this study was to assess the efficacy of paracetamol (acetaminophen) in the treatment of pain and disability in patients with non-specific low back pain. We conducted a systematic review of randomized controlled trials to assess the efficacy of paracetamol in the treatment of pain and disability in patients with non-specific low back pain. A search for randomized controlled trials was conducted using the Medline, Embase and CINAHL databases. Trials were eligible if they were randomized controlled trials comparing paracetamol to no treatment, placebo or another treatment in patients with non-specific low back pain. Two of the authors independently assessed trials for methodological quality on the PEDro Scale and extracted data. Continuous pain and disability data were converted to a common 0–10 scale; ordinal data were dichotomized (e.g., no pain, pain). The data was analyzed using the MIX version 1.61 meta-analysis software. Out of 205 unique articles found in the searches, 7 eligible trials were identified. The trials enrolled a total of 676 participants with 5 investigating acute low back pain, 1 investigating chronic low back pain and 1 investigating both. No trial provided data comparing paracetamol to placebo and only one trial compared paracetamol to no treatment. In general the trials were small (only 1 trial had >25 subjects per group) and of low methodological quality (only 2 had a score above 6 on the quality scale). All but one of the trials provided imprecise estimates of the effects of treatment with confidence intervals spanning clinically important beneficial and also harmful effects of paracetamol. No trial reported a statistically significant difference in favor of paracetamol. There is insufficient evidence to assess the efficacy of paracetamol in patients with low back pain. There is a clear need for large, high quality randomized controlled trials evaluating paracetamol, to provide reliable evidence of paracetamol

  2. Weight a minute - iatrogenic paracetamol toxicity is preventable by utilisation of well-designed drug charts

    PubMed Central

    Khan, Amad; Flavin, Kathryn; Tsang, Jason

    2014-01-01

    Iatrogenic Paracetamol toxicity is a potentially life-threatening yet avoidable cause of acute liver failure. Unfortunately, several cases have recently been reported nationally (1,2). The impetus behind our project was a recent case of iatrogenic Paracetamol induced hepatotoxicity within our trust, a London-based District General Hospital. According to the British National Formulary, for adults weighing 10–50kg the intravenous (IV) dose is 15mg/kg every 4-6hours (max. 60mg/kg daily), not the usual 1 gram QDS oral dose which is applied irrespective of weight (3). We audited 100 adult patients in April 2013 and re-audited in July 2013. Both of the randomly selected samples consisted of an equal number of surgical and medical patients, with an equal gender ratio. Data of interest included whether patients were on IV Paracetamol, appropriately dosed; if and when patients had been weighed during admission; and whether the WHO pain ladder of analgesia was followed. Identified shortcomings included patient weight on admission not being recorded, and IV Paracetamol dose adjustment not being made in patients <50kg. 3 months were spent raising awareness of the importance to record patient weights and to dose-adjust IV Paracetamol when indicated. Patients weighed on admission improved from 37% to 68% (p<0.0001) and those on the inappropriate dose of Paracetamol fell from 18 (25% of the patients on Paracetamol) to 5 (5.75% of the patients on Paracetamol) p=0.0013. There was a marked improvement in the number of patients with the weight written on their drug chart from 27% to 53% post-intervention. (p=0.0003) In conclusion, every patient should be weighed on admission. In order to prevent potential hepatotoxicity, staff should document patient weights on the drug charts and be aware of the fact that patients who weigh <50 kg should be on a 15 mg/kg/dose of IV Paracetamol, not 1 gram QDS. PMID:26734252

  3. Intravenous paracetamol in patients with renal colic.

    PubMed

    Morgan, Sara

    2011-02-01

    Non-steroidal anti-inflammatory drugs and opioids have been the mainstay of pain relief in patients with renal colic, but both have side effects. Research on the efficacy of intravenous (IV) paracetamol shows that it is comparable to morphine, diclofenac and ketoralac. This article discusses the role of IV paracetamol for patients with this condition. It examines the effectiveness, mechanism of action and pharmacokinetics of IV paracetamol, and suggests that non-clinical prescribers can use the method to relieve patients' pain quickly. PMID:21384782

  4. 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 ...

  5. 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.

  6. 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 ...

  7. 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. ...

  8. 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.

  9. 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 ...

  10. 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 ...

  11. 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 ...

  12. 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 ...

  13. 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)

  14. 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

  15. 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

  16. 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

  17. [Photodegradation of paracetamol in carbonate solution].

    PubMed

    Gao, Ying; Yang, Xi; Liu, Yu

    2008-03-01

    The photodegradation of paracetamol in the solution of carbonate with comparably environmental concentration was studied through kinetics method. Experiments were carried out to compare the different photodegradation effects of paracetamol in the solution of carbonate radical and hydroxyl radical. The effects of such factors, pH, nitrate, humic matters, chloride sodium, calcium and magnesium were also analyzed. The products of the photodegradation were identified with GC/MS, and the degradation mechanism of paracetamol was discussed. The results indicate that, the scondary reaction rate constant (k(a)) between paracetamol and carbonate radical is 5.0 x 10(7) L (mol s)(-1), which is lower than that with hydroxyl radical [k(b) = 8.1 x 10(9) L (mol s)(-1)]. But in natural aqueous system, the stable concentration of carbonate radical is much higher than that of hydroxyl. Therefore, the effect of carbonate radical on paracetamol approximately equals to that of hydroxyl radical. The degradation rate of paracetamol increases when the system was changed with higher pH, adding of nitrate, chloride sodium, calcium and magnesium which increase the rigidity of the water, while decreases when the SRFA is present. PMID:18649521

  18. 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

  19. 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})

  20. Perioperative analgesic effects of intravenous paracetamol: Preemptive versus preventive analgesia in elective cesarean section

    PubMed Central

    Hassan, Hossam Ibrahim Eldesuky Ali

    2014-01-01

    Background: Cesarean section (CS) is the one of the most common surgical procedure in women. There is preoperative stress effect before the delivery of the baby as (intubation and skin incision). There is acute postoperative pain, which may be progressed to chronic pain. All these perioperative stress effects need for various approach of treatment, which including systemic and neuraxial analgesia. The different analgesia modalities may affect and impair early interaction between mother and infant. Preemptive intravenous (I.V.) paracetamol (before induction) may reduce stress response before the delivery of the baby, intraoperative opioids and postoperative pain. Objectives: The aim of this study to compare between the administration of I.V. paracetamol as: Preemptive analgesia (preoperative) and preventive analgesia (at the end of surgery) as regards of hemodynamic, pain control, duration of analgesia, cumulative doses of intraoperative opioids and their related side-effects and to compare between two different protocols of postoperative analgesia and their cumulative doses. Patients and Methods: Sixty patients undergoing elective CS were randomly enrolled in this study and divided into two groups of 30 patients each. Group I: i.V. paracetamol 1 g (100 ml) was given 30 min before induction of anesthesia. Group II: i.V. paracetamol 1 g (100 ml) was given 30 min before the end of surgery. Heart rate, systolic blood pressure, diastolic blood pressure, and peripheral oxygen saturation were recorded. Postoperative pain was assessed by visual analog score. Postoperative pethidine was given by two different protocols: group I: 0.5 mg/kg was divided into 0.25 mg/kg intramuscular and 0.25 mg/kg I.V. Group II was given pethidine 0.5 mg/kg I.V. Doses of intraoperative fentanyl, postoperative pethidine, duration of paracetamol analgesic time, time to next analgesia, and side-effects of opioid were noted and compared. Result: Preemptive group had hemodynamic stability

  1. 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 ...

  2. 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 ...

  3. 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 ...

  4. 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 ...

  5. 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 ...

  6. 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 ...

  7. 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 ...

  8. 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 ...

  9. Effects of iron on the pharmacokinetics of paracetamol in saliva.

    PubMed

    Issa, Mahmoud Mohamed; Nejem, R'afat Mahmoud; Shanab, Alaa Abu

    2013-12-15

    Paracetamol has been reported to chelate with iron. It was found that no in vitro reaction between ferrous ion and paracetamol. Other studies found that there is an aerobic (in the gastrointestinal tract) oxidation of ferrous ion to ferric ion caused in iron-paracetamol in vivo reactions. The objective of this study was to determine if iron interacts with paracetamol and reduces paracetamol absorption. A randomized, double-blind, cross-over study design was used to assess the in vivo interaction of paracetamol and ferrous ion. Paracetamol (1.0 g) was co-ignested alone or with (300 mg) ferrous sulphate by ten healthy male volunteers, using saliva drug levels as a parameter. Concomitant administration of ferrous sulphate and paracetamol, decreased AUC8 from 42.88 +/- 3.8-34.25 +/- 2.8 microg h mL(-1) (p = 0.04) and Cmax from 18.75 +/- 1.9 to 15.9 +/- 1.7 microg mL(-1) (p = 0.11), while no change in tmax (p = 0.5) was originated. A significant difference was found in the paracetamol pharmacokinetic parameter oral clearance (C1/F) (p = 0.02) and slightly increased in volume of distribution (V(d)/F) (p = 0.10). Co-administration of iron and paracetamol results in decreased paracetamol absorption due to an interaction between iron and paracetamol. PMID:24517028

  10. 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 ...

  11. 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…

  12. Radiolysis of paracetamol in dilute aqueous solution

    NASA Astrophysics Data System (ADS)

    Szabó, László; Tóth, Tünde; Homlok, Renáta; Takács, Erzsébet; Wojnárovits, László

    2012-09-01

    Using radiolytic experiments hydroxyl radical (main reactant in advanced oxidation processes) was shown to effectively destroy paracetamol molecules. The basic reaction is attachment to the ring. The hydroxy-cyclohexadienyl radical produced in the further reactions may transform to hydroxylated paracetamol derivatives or to quinone type molecules and acetamide. The initial efficiency of aromatic ring destruction in the absence of dissolved O2 is c.a. 10%. The efficiency is 2-3 times higher in the presence of O2 due to its reaction with intermediate hydroxy-cyclohexadienyl radical and the subsequent ring destruction reactions through peroxi radical. Upon irradiation the toxicity of solutions at low doses increases with the dose and then at higher doses it decreases. This is due to formation of compounds with higher toxicity than paracetamol (e.g. acetamide, hidroquinone). These products, however, are highly sensitive to irradiation and degrade easily.

  13. Pharmacokinetics of paracetamol after cardiac surgery.

    PubMed Central

    Hopkins, C S; Underhill, S; Booker, P D

    1990-01-01

    Plasma concentration was measured after rectal and nasogastric administration of paracetamol 15 mg/kg to 28 febrile children aged between 9 days to 7 years who had undergone cardiac surgery. After equivalent doses, rectal administration in neonates and children on the first postoperative day was found to produce plasma concentrations below the therapeutic range with higher concentrations after nasogastric paracetamol on the second postoperative day. There was less variance in plasma paracetamol concentrations in neonates. Both plasma elimination half life and area under the plasma concentration time curve were significantly increased in neonates after suppository dosing compared with older children. There was no difference in antipyretic effect between the two routes of administration, but this was much lower than that previously reported in febrile children. PMID:2221970

  14. 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

  15. Chromatography as Method for Analytical Confirmation of Paracetamol in Postmortem Material Together with Psychoactive Substances

    PubMed Central

    Biscevic-Tokic, Jasmina; Tokic, Nedim; Ibrahimpasic, Elma

    2015-01-01

    for determining the drug, and the drug substance. Used GC-MS instrument was an Agilent 7890A with helium as the carrier gas. Results: The analysis of blood samples, urine, bile and stomach contents, obtained after the autopsy of deceased persons, by using gas chromatography with mass spectrometry, in analytical manner confirmed the fact that paracetamol is a very common component of psychoactive substances poisoning. In our assay of samples we detected psychoactive substances (heroin, codeine, morphine, sertraline, diazepam), and almost all were found in the combination with paracetamol, indicating the poor quality of illicit drugs sold on the market. Discussion: Paracetamol (Acetaminophen) is a very common component in mixtures of street drugs. Such mixtures almost anyone can afford, but the very quality of these drugs has become extremely low, because it does not sell the pure substance, but is mixed with various medications. According to research Pantazia et al. the heroin mixture proportion of the heroin is very small so a lot of that mixture has only 3% of heroin, a large number of cases can be only 1% of pure heroin. Most of the time it replaces caffeine and paracetamol. According to the Risser et al. reason why acetaminophen component is present in these mixtures is because it can be purchased without a prescription, it is cheap, well tolerated by most people and shows no side effects. Conclusion: When we talk about illegal drugs, we must emphasize the fact that there is no quality control, or the composition of the drug. The composition of the drug purchased on the black market is still unknown to potential user. While reaching the final drug users it pass through many hands, and at each step something is added to increase earnings. Most often present additives or impurities in narcotic drugs that are added are caffeine, ephedrine, acetaminophen, acetylsalicylic acid (aspirin) and additives such as powders, cement and chalk. PMID:26635443

  16. 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…

  17. Aceclofenac and paracetamol in episiotomal pain.

    PubMed

    Yscla, A

    1988-01-01

    The analgesic efficacy and safety of a single oral dose of 100 mg of aceclofenac was compared in a double-blind study with a single dose of 650 mg of paracetamol in patients with severe episiotomal pain. The patients were questioned after 30 min and then at hourly intervals for 6 h after medication. A standard format (Huskisson's test) was used to investigate the intensity of the pain throughout the study. The statistically significant results show that the analgesic effect of aceclofenac is superior to that of paracetamol. The tolerance of both compounds is excellent. PMID:3071451

  18. Effect of migraine attacks on paracetamol absorption.

    PubMed Central

    Tokola, R A; Neuvonen, P J

    1984-01-01

    The absorption of effervescent paracetamol (1000 mg) was investigated in nine female patients during a migraine attack and in the same patients when headache free. Migraine attack decreased (P less than 0.05) the areas under the serum paracetamol concentration-time curves (AUC) of 0-2 h, 0-4 h and 0-6 h and the peak serum concentration. The severity of nausea correlated significantly with the decrease in the AUC values. Our results support findings of delayed gastric emptying in migraine attacks. Both a delay and an impairment of drug absorption may follow. PMID:6529526

  19. Poisoning due to Chinese proprietary medicines.

    PubMed

    Chan, T Y; Lee, K K; Chan, A Y; Critchley, J A

    1995-05-01

    1. To determine the toxic potentials of those Chinese proprietary medicines (CPM) which are commonly used for self-poisoning by adults in Hong Kong, all patients admitted to four of the eight general medical wards at the Prince of Wales Hospital between January 1988 and December 1993 were retrospectively studied. 2. There were 54 women and 17 men with their age ranging from 15 to 86 years. Twenty-three subjects (32%) also took alcohol, chemicals or drugs. Of the 51 subjects (72%) who had taken topical medicaments, 22 had no symptoms while 28 had minor features of gastrointestinal irritation (n = 26), mild (n = 2) or severe (n = 1) salicylate poisoning. Of the 17 subjects (24%) who had taken CPM tablets/capsules, nine had mild symptoms including nausea/vomiting and drowsiness. The three remaining patients (4%) who had ingested liquid CPM preparations were asymptomatic. Elevated plasma salicylate or paracetamol concentrations (> 0.1 mmol l-1) were found in some patients who had taken topical medicaments and CPM tablets/capsules, respectively. All the 71 patients completely recovered. 3. Most of the CPM used for self-poisoning in Hong Kong were of low to moderate toxicity except for those containing wintergreen oil (methyl salicylate). PMID:7612306

  20. Paracetamol serum concentrations in preterm infants treated with paracetamol intravenously: a case series

    PubMed Central

    2012-01-01

    Introduction Until now, studies on paracetamol given intravenously have mainly been performed with the pro-drug propacetamol or with paracetamol in preterm babies above 32 weeks of gestation. Studies in these babies indicate that intravenous paracetamol is tolerated well, however studies on the efficacy of intravenous paracetamol are lacking. There are no pharmacokinetic data on the administration of multiple doses of paracetamol in preterm babies with a gestational age below 32 weeks. Case presentation We present a case series of nine Caucasian preterm babies, six boys and three girls, with a mean gestational age of 28.6 weeks (range 25.9 to 31.6 weeks). Case one, a girl with a gestational age of 25 weeks and six days, presented with necrotizing enterocolitis. In the second case, a female baby with a gestational age of 26 weeks and two days presented with hematoma. In case three, a female baby with a gestation of 26 weeks and one day developed intraventricular hemorrhage. In case four, a male baby with a gestational age of 31 weeks and four days presented with pain after vacuum delivery. Case five, a female baby born after a gestation of 29 weeks and six days presented with hematoma. In case six, a male baby with a gestation of 30 weeks and six days presented with hematoma. In case seven, a male baby, born with a gestational age of 30 weeks and six days, presented with caput succedaneum and hematoma. In case eight, a male baby, born after a gestation of 28 weeks and four days, developed abdominal distention. Case nine, a female baby, born with a gestational age of 27 weeks and three days presented with hematoma. These babies were treated with intravenous paracetamol 15 mg/kg every six hours. Serum concentrations and aspartate transaminase were determined after prolonged administration. Pain scores were assessed using the Premature Infant Pain Profile. Conclusion Paracetamol serum concentrations ranged from 8 to 64 mg/L after eight to 12 doses of intravenous

  1. The Effects of Paracetamol, Ketorolac, and Paracetamol Plus Morphine on Pain Control after Thyroidectomy

    PubMed Central

    Lee, Sun Yeul; Lee, Eun Ha; Han, Kyu Cheol; Ko, Young Kwon

    2010-01-01

    Background The aim of this study was to compare the efficacy of ketorolac, paracetamol, and paracetamol plus morphine on pain relief after thyroidectomy. Methods Eighty patients were randomly allocated to one of the 4 groups: normal saline (group C), ketorolac 30 mg (group K), paracetamol 1 g (group P), and paracetamol 700 mg plus morphine 3 mg (group PM). Each regimen was administered intravenously (IV) 30 min. before the end of surgery. If pain was not relieved, patients received an IV bolus of pethidine hydrochloride 25 mg. Pain intensity using a visual analogue scale (VAS) was recorded at 0.5, 1, 2, 4, and 6 hr after the end of surgery. Results VAS at 0.5 and 1 hr after the end of surgery were significantly lower in group K, group P, and group PM than in group C (P < 0.05). The number of patients receiving pethidine hydrochloride at 0.5 and 1 hr after the end of surgery was significantly lower in group K, group P, and group PM than in group C (P < 0.05). There was no significant difference among the groups in the incidences of adverse events associated with study medications and patient satisfaction (P > 0.05). Conclusions Paracetamol 1 g IV possesses a similar analgesic efficacy to ketorolac 30 mg IV after thyroidectomy. Paracetamol may represent an alternative to ketorolac for pain prevention after mildly to moderately painful surgery in situations where the use of NSAIDs is unsuitable. PMID:20556214

  2. Effect of radiation on solid paracetamol: ESR identification and dosimetric features of gamma-irradiated paracetamol

    NASA Astrophysics Data System (ADS)

    Polat, M.; Korkmaz, M.

    2006-01-01

    In the present work, electron spin resonance (ESR) identification of gamma-irradiated paracetamol and its potential use as a normal and/or accidental dosimetric material were investigated in the dose range of 2.5-25 kGy. Both unirradiated paracetamol and mechanically ground vermidon samples exhibited a weak single resonance line at g = 2.0049 +/- 0.0006 and had Delta H-pp = 0.6 +/- 0.02 mT. Gamma irradiation produced an increase in signal intensity with a small hyperfine splitting in both paracetamol and vermidon and many weak resonance lines on both sides of a central line in the case of vermidon. Dose-response curves associated with central line of paracetamol and vermidon were found to follow polynomial and linear function, respectively. Simulation calculations based on the room temperature ESR intensity data of the paracetamol sample irradiated at 10 kGy were performed to determine the structure and spectral parameters of the radiation-induced radical species involved in the formation of the experimental ESR spectrum of paracetamol.

  3. 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

  4. Development of a ‘patient information leaflet’ for use following assessment of patients with reported or suspected paracetamol overdose in the UK

    PubMed Central

    Potter, Thomas; Chan, Wui Ling; Archer, John R H; Barrett, Jessica; Dargan, Paul I; Wood, David M

    2014-01-01

    The aim of this study was to design an information leaflet for patients with paracetamol overdose based on Medicines and Healthcare products Regulatory Agency guidance and to assess its readability. A two-sided one page information leaflet was designed for patients being discharged from hospital after a paracetamol overdose. Patients presenting with an acute paracetamol overdose, irrespective of whether they were treated or not, were recruited to read the leaflet and then answer a brief structured questionnaire based on the leaflet. The readability of the information leaflet was assessed using the Flesch reading ease score. Thirty patients (15 male, 12 female, 3 not recorded; mean age 38 ± 13.0 years) were recruited, wherein 100% of patients reported the language used was understandable, 96.6% knew which symptoms would require urgent medical review after discharge and 100% of patients knew the liver was affected by paracetamol. The Flesch reading ease score was 67.6 (out of a maximum of 100), equivalent to a UK reading age of 10–11years old. Our information leaflet for all patients being discharged after paracetamol overdose was well received by patients, provided them with the required knowledge and had an appropriate reading age based on UK literacy rates. We would recommend that this leaflet could be used as a template on a national level, localized to individual hospitals, to improve patient knowledge of paracetamol toxicity, and facilitate early medical review in the event of deterioration following discharge from the hospital. PMID:25505616

  5. 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

  6. Paracetamol removal in subsurface flow constructed wetlands

    NASA Astrophysics Data System (ADS)

    Ranieri, Ezio; Verlicchi, Paola; Young, Thomas M.

    2011-07-01

    SummaryIn this study two pilot scale Horizontal Subsurface Flow Constructed Wetlands (HSFCWs) near Lecce, Italy, planted with different macrophytes ( Phragmites australis and Typha latifolia) and an unplanted control were assessed for their effectiveness in removing paracetamol. Residence time distributions (RTDs) for the two beds indicated that the Typha bed was characterized by a void volume fraction (porosity) of 0.16 and exhibited more ideal plug flow behavior (Pe = 29.7) than the Phragmites bed (Pe = 26.7), which had similar porosity. The measured hydraulic residence times in the planted beds were 35.8 and 36.7 h when the flow was equal to 1 m 3/d. The Phragmites bed exhibited a range of paracetamol removals from 51.7% for a Hydraulic Loading Rate (HLR) of 240 mm/d to 87% with 120 mm/d HLR and 99.9% with 30 mm/d. The Typha bed showed a similar behavior with percentages of removal slightly lower, ranging from 46.7% (HLR of 240 mm/d) to >99.9% (hydraulic loading rate of 30 mm/d). At the same HLR values the unplanted bed removed between 51.3% and 97.6% of the paracetamol. In all three treatments the paracetamol removal was higher with flow of 1 m 3/d and an area of approx. 7.5 m 2 (half bed) than in the case of flow equal to 0.5 m 3/d with a surface treatment of approx. 3.75 m 2. A first order model for paracetamol removal was evaluated and half lives of 5.16 to 10.2 h were obtained.

  7. [Comparative, randomized, parallel clinical study of the effectiveness and safety of aceclofenac vs. paracetamol in the treatment of viral pharyngoamygdalitis].

    PubMed

    Conti, M

    1997-03-01

    The purpose of this open, controlled, and randomized study was to evaluate the effectiveness of aceclofenac compared with paracetamol in improving the signs and symptoms of viral pharyngoamygdalitis and to evaluate the safety of both drugs. Thirty outpatients (age range 18-65 years) with acute viral pharyngoamygdalitis received either aceclofenac 100 mg/12 h or paracetamol 650 mg/ 12 h per os. Patients were evaluated at baseline and on days 1, 3, and 7 after beginning treatment. The parameters of effectiveness evaluated were: severity of pharyngoamygdalitis, spontaneous pharyngeal pain, saliva swallowing, and duration of pharyngeal pain. The results showed that the aceclofenac group had a significant decrease in the severity of pharyngoamygdalitis and spontaneous pharyngeal pain after day 1 of treatment (p < 0.001), but the paracetamol group showed no improvement in these parameters until day 3 of treatment (p < 0.001). There were no adverse reactions in either group. Therefore, patients treated with aceclofenac showed an earlier improvement in the signs and symptoms of acute viral pharyngoamygdalitis than those treated with paracetamol. PMID:9198464

  8. 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

  9. 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 ...

  10. 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 ...

  11. 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 ...

  12. 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 ...

  13. 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 ...

  14. 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: ...

  15. 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 ...

  16. 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. ...

  17. 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....

  18. 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.

  19. 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 ...

  20. 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 ...

  1. 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. ...

  2. Acetaminophen-induced acute liver injury in mice.

    PubMed

    Mossanen, J C; Tacke, F

    2015-04-01

    The induction of acute hepatic damage by acetaminophen (N-acetyl-p-aminophenol [APAP]), also termed paracetamol, is one of the most commonly used experimental models of acute liver injury in mice. The specific values of this model are the highly reproducible, dose-dependent hepatotoxicity of APAP and its outstanding translational importance, because acetaminophen overdose is one of the most frequent reasons for acute liver failure (ALF) in humans. However, preparation of concentrated APAP working solutions, application routes, fasting period and variability due to sex, genetic background or barrier environment represent important considerations to be taken into account before implementing this model. This standard operating procedure (SOP) provides a detailed protocol for APAP preparation and application in mice, aimed at facilitating comparability between research groups as well as minimizing animal numbers and distress. The mouse model of acetaminophen poisoning therefore helps to unravel the pathogenesis of APAP-induced toxicity or subsequent immune responses in order to explore new therapeutic interventions for improving the prognosis of ALF in patients. PMID:25835736

  3. Presentation of poisoned patients to accident and emergency departments in the north of England.

    PubMed

    Thomas, S H; Bevan, L; Bhattacharyya, S; Bramble, M G; Chew, K; Connolly, J; Dorani, B; Han, K H; Horner, J E; Rodgers, A; Sen, B; Tesfayohannes, B; Wynne, H; Bateman, D N

    1996-06-01

    1. A 12 week prospective survey of all patients of any age with confirmed or suspected poisoning presenting to six accident and emergency departments in the North East of England was performed to establish the local incidence and patterns of presentation of poisoning. 2. 945 episodes of poisoning involving 852 patients were recorded representing approximately 1.2% of all A&E presentations and suggesting an annual attendance rate of 2.7 per 1000 persons per year. 3. Attendance rates varied threefold between hospitals and were similar in males and females overall; between the ages of five and 14 attendances were more common in females (1.9 vs 0.6/10(3)/y) while between 0 and 4 y (3.1 vs 2.4) and 25 and 34 y (3.9 vs 2.9/10(3)/y) they were more common in males. 4. The median interval between poisoning and presentation was 2 h (mean 4.1 h) and only 19% of cases presented within 1 h. Presentation was most common between Friday evening and Tuesday morning and in the late afternoon and evening. 5. 6% of the patients presented more than once with poisoning during the study period and 37% had a past history of deliberate self-harm. The most common poisons involved were paracetamol (43%), opioids (15%) and benzodiazepines (15%). 6. The study illustrates the frequency of presentations of poisoning to A&E departments. The high rate of poisoning in young men and the increasing use of paracetamol are particular causes for concern. PMID:8793528

  4. Evidence on the use of paracetamol in febrile children.

    PubMed Central

    Russell, Fiona M.; Shann, Frank; Curtis, Nigel; Mulholland, Kim

    2003-01-01

    Antipyretics, including acetaminophen (paracetamol), are prescribed commonly in children with pyrexia, despite minimal evidence of a clinical benefit. A literature review was performed by searching Medline and the Cochrane databases for research papers on the efficacy of paracetamol in febrile illnesses in children and adverse outcomes related to the use of paracetamol. No studies showed any clear benefit for the use of paracetamol in therapeutic doses in febrile children with viral or bacterial infections or with malaria. Some studies suggested that fever may have a beneficial role in infection, although no definitive prospective studies in children have been done to prove this. The use of paracetamol in therapeutic doses generally is safe, although hepatotoxicity has occurred with recommended dosages in children. In developing countries where malnutrition is common, data on the safety of paracetamol are lacking. The cost of paracetamol for poor families is substantial. No evidence shows that it is beneficial to treat febrile children with paracetamol. Treatment should be given only to children who are in obvious discomfort and those with conditions known to be painful. The role of paracetamol in children with severe malaria or sepsis and in malnourished, febrile children needs to be clarified. PMID:12856055

  5. Anaphylaxis following intravenous paracetamol: the problem is the solution.

    PubMed

    Jain, S S; Green, S; Rose, M

    2015-11-01

    Paracetamol is a ubiquitous analgesic and antipyretic that is widely administered, including by anaesthetists. Immediate hypersensitivity reactions to intravenous paracetamol are particularly rare. We report two cases involving four separate episodes of anaphylaxis to intravenous paracetamol in different perioperative settings without a past history of intolerance to the oral form. The allergological investigations are described, during which it became evident that both patients were allergic to an excipient (mannitol) present in the formulation and that neither was allergic to the principal agent (paracetamol). The importance of referral and investigation of perioperative drug reactions is underscored by these two cases. PMID:26603804

  6. Effect of short surgical procedures on salivary paracetamol elimination.

    PubMed Central

    Ray, K; Adithan, C; Bapna, J S; Kangle, P R; Ray, K; Ramakrishnan, S

    1985-01-01

    The effect of short surgical procedures on paracetamol elimination was studied in seven male patients undergoing surgery with epidural anaesthesia. Five healthy volunteers who did not undergo surgery served as a control group. Paracetamol concentration was measured in saliva at various intervals 1 day before and after surgery. Paracetamol half-life (t1/2,z) decreased and metabolic clearance rate (CL) increased after surgery as compared to preoperative values. The results suggest that surgical stress may enhance the hepatic metabolism of paracetamol. PMID:4041337

  7. 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…

  8. 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 ...

  9. 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)

  10. 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.

  11. 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

  12. 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

  13. Protective effect of Triphala Rasayana against paracetamol-induced hepato–renal toxicity in mice

    PubMed Central

    Singh, Dewasya Pratap; Mani, Dayanandan

    2015-01-01

    Background: Paracetamol, a widely used analgesic and antipyretic, is known to cause liver and renal injury in humans when administered in higher and repeated doses that cause acute liver injury. Triphala is a well-known Ayurvedic Rasayana formulation that is prescribed for balancing of Vata, Pitta and Kapha. Traditionally, it is used for the treatment of liver and kidney diseases. Objective: The present study was undertaken to examine the protective effect of Triphala extract against paracetamol-induced hepato–renal injury in Swiss albino mice. Materials and Methods: Swiss albino mice (weight 20–25 g) were used in this study. The mice were divided into five groups of six animals each. The aqueous extract of Triphala was given orally at two different doses (100 and 300 mg/kg body weight) for seven consecutive days, followed by a single intraperitoneal injection of paracetamol (500 mg/kg body weight) to induce hepato–renal toxicity. Serum levels of liver enzymes, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), bilirubin, creatinine, urea and uric acid were measured as indices of liver and renal injury. All the statistical analyses were performed with the help of one-way analysis of variance (ANOVA) followed by Student–Newman–Keuls test as post hoc test. Results were considered statistically significant when P < 0.05. Results: Pre-treatment with Triphala extract at 100 mg/kg and 300 mg/kg body weight exhibited a significant (P < 0.01) hepatoprotective activity. The protective effect of Triphala extract at 300 mg/kg body weight appears more effective than 100 mg/kg body weight. Conclusion: The present study gives an evidence of the protective role of Triphala extract against paracetamol-induced hepato–renal toxicity and validates its traditional claim in the Ayurveda system. PMID:26604553

  14. Covariates of intravenous paracetamol pharmacokinetics in adults

    PubMed Central

    2014-01-01

    Background Pharmacokinetic estimates for intravenous paracetamol in individual adult cohorts are different to a certain extent, and understanding the covariates of these differences may guide dose individualization. In order to assess covariate effects of intravenous paracetamol disposition in adults, pharmacokinetic data on discrete studies were pooled. Methods This pooled analysis was based on 7 studies, resulting in 2755 time-concentration observations in 189 adults (mean age 46 SD 23 years; weight 73 SD 13 kg) given intravenous paracetamol. The effects of size, age, pregnancy and other clinical settings (intensive care, high dependency, orthopaedic or abdominal surgery) on clearance and volume of distribution were explored using non-linear mixed effects models. Results Paracetamol disposition was best described using normal fat mass (NFM) with allometric scaling as a size descriptor. A three-compartment linear disposition model revealed that the population parameter estimates (between subject variability,%) were central volume (V1) 24.6 (55.5%) L/70 kg with peripheral volumes of distribution V2 23.1 (49.6%) L/70 kg and V3 30.6 (78.9%) L/70 kg. Clearance (CL) was 16.7 (24.6%) L/h/70 kg and inter-compartment clearances were Q2 67.3 (25.7%) L/h/70 kg and Q3 2.04 (71.3%) L/h/70 kg. Clearance and V2 decreased only slightly with age. Sex differences in clearance were minor and of no significance. Clearance, relative to median values, was increased during pregnancy (FPREG = 1.14) and decreased during abdominal surgery (FABDCL = 0.715). Patients undergoing orthopaedic surgery had a reduced V2 (FORTHOV = 0.649), while those in intensive care had increased V2 (FICV = 1.51). Conclusions Size and age are important covariates for paracetamol pharmacokinetics explaining approximately 40% of clearance and V2 variability. Dose individualization in adult subpopulations would achieve little benefit in the scenarios explored. PMID:25342929

  15. 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

  16. [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

  17. 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.

  18. [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

  19. Corona discharge ionization of paracetamol molecule: Peak assignment

    NASA Astrophysics Data System (ADS)

    Bahrami, H.; Farrokhpour, H.

    2015-01-01

    Ionization of paracetamol was investigated using ion mobility spectrometry equipped with a corona discharge ionization source. The measurements were performed in the positive ion mode and three peaks were observed in the ion mobility spectrum. Experimental evidence and theoretical calculations were used to correlate the peaks to related ionic species of paracetamol. Two peaks were attributed to protonated isomers of paracetamol and the other peak was attributed to paracetamol fragment ions formed by dissociation of the N-C bond after protonation of the nitrogen atom. It was observed that three sites of paracetamol compete for protonation and their relative intensities, depending on the sample concentration. The ratio of ion products could be predicted from the internal proton affinity of the protonation sites at each concentration.

  20. Corona discharge ionization of paracetamol molecule: peak assignment.

    PubMed

    Bahrami, H; Farrokhpour, H

    2015-01-25

    Ionization of paracetamol was investigated using ion mobility spectrometry equipped with a corona discharge ionization source. The measurements were performed in the positive ion mode and three peaks were observed in the ion mobility spectrum. Experimental evidence and theoretical calculations were used to correlate the peaks to related ionic species of paracetamol. Two peaks were attributed to protonated isomers of paracetamol and the other peak was attributed to paracetamol fragment ions formed by dissociation of the N-C bond after protonation of the nitrogen atom. It was observed that three sites of paracetamol compete for protonation and their relative intensities, depending on the sample concentration. The ratio of ion products could be predicted from the internal proton affinity of the protonation sites at each concentration. PMID:25128677

  1. Effect of low-dose dexketoprofen trometamol and paracetamol on postoperative complications after impacted third molar surgery on healthy volunteers: A pilot study

    PubMed Central

    Durmus, Ercan; Kiresi, Demet

    2014-01-01

    Objectives: The aim of the present study was to investigate the analgesic and anti-inflammatory effects of dexketoprofen trometamol (DT) and paracetamol on deep acute somatic pain and inflammation in patients undergoing impacted third molar surgery. This study was planned to present benefits that we could obtain with low burden of drug. Study Design: Effects of drugs, which were administered preemptively before the procedure, on pain, mouth-opening limitation, and swelling were assessed by visual analogue scale (VAS), magnetic resonance imaging (MRI), and mouth-opening measurement. Following surgery, time intervals when the patients first need to receive the drug were measured. Results: The VAS scores of the patients were lower in the side treated with DT than that in the paracetamol treated side. There was no significant difference between the groups in terms of mouth-opening limitation. MRI recordings revealed that swelling was lower in the side treated with paracetamol than DT treated side. Conclusions: Administration of the drugs before surgery contributed to the postoperative patient comfort. The analgesic activity of 12.5 mg dose of DT was similar to, even better than, the analgesic activity of 500 mg dose of paracetamol; however, DT had insufficient anti-inflammatory efficacy. Key words:Dexketoprofen trometamol, paracetamol, magnetic resonance imaging. PMID:25129247

  2. The effect of sunitinib on the plasma exposure of intravenous paracetamol and its major metabolite: paracetamol glucuronide.

    PubMed

    Karbownik, Agnieszka; Szałek, Edyta; Sobańska, Katarzyna; Połom, Wojciech; Grabowski, Tomasz; Biczysko-Murawa, Anna; Matuszewski, Marcin; Wolc, Anna; Grześkowiak, Edmund

    2015-06-01

    The study aimed to examine the effect of sunitinib on the plasma exposure of intravenous paracetamol and its major metabolite, paracetamol glucuronide. Both drugs share metabolic pathways in the liver, and the drug interactions between sunitinib and paracetamol administered in higher doses were reported. These interactions resulted in hepatotoxicity. The adult New Zealand male rabbits were divided into three groups (6 animals each): rabbits receiving sunitinib and paracetamol (SUN + PC), rabbits receiving sunitinib (SUN), and a control group receiving paracetamol (PC). Sunitinib was administered orally (25 mg) and paracetamol was administrated intravenously (35 mg/kg). Blood samples for sunitinib and SU12662 assays were collected up to 96 h after drug administration and for paracetamol and paracetamol glucuronide up to 300 min after drug administration. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), and bilirubin were analysed before and after drug administration. A number of pharmacokinetic parameters were analysed. There were no differences in the levels of AST, ALT, and bilirubin among the groups at either time point. Significantly higher values of AUC0-t , AUC0-∞ , and C max and lower clearance and volume of distribution of paracetamol were observed in group PC vs. group SUN + PC (p < 0.01). The maximum plasma concentration of paracetamol glucuronide tended to be higher in group PC 213.27 μg/mL (90 % CI 1.06, 1.25; p = 0.0267). Statistically significant differences were revealed for paracetamol glucuronide mean residence time (MRT); MRT was higher in group SUN + PC than in group PC (p = 0.0375). The mean t max of paracetamol glucuronide was similar in both groups: SUN + PC and group PC (15 and 20 min, respectively). The mean t max of sunitinib was different in groups SUN + PC and SUN (10.0 and 7.0, respectively; p = 0.0134). At the studied doses, neither of the drugs, whether administered alone or together, had

  3. Randomized comparative trial of efficacy of paracetamol, ibuprofen and paracetamol-ibuprofen combination for treatment of febrile children

    PubMed Central

    Vyas, Falgun Indravadan; Rana, Devang Ashwinkumar; Patel, Piyush M.; Patel, Varsha Jitendra; Bhavsar, Rekha H.

    2014-01-01

    Objective: Paracetamol and ibuprofen are widely used for fever in children as monotherapy and as combined therapy. None of the treatments is proven clearly superior to others. Hence, the study was planned to compare the efficacy of paracetamol, ibuprofen and paracetamol-ibuprofen combination for treatment of febrile children. Materials and Methods: This was an investigator blind, randomized, comparative, parallel clinical trial conducted in 99 febrile children, 6 months to 12 years of age, allocated to three groups. First group received paracetamol 15 mg/kg, second group received ibuprofen 10 mg/kg and third group received both paracetamol and ibuprofen, all as a single dose by the oral route. Patients were followed-up at intervals of 1, 2, 3 and 4 h post dose by tympanic thermometry. Results: Mean tympanic temperature after 4 h of drug administration was significantly lower in the combination group compared with paracetamol group (P < 0.05); however, the difference was not clinically significant (<1°C). The rate of fall of temperature was highest in the combination group. Number of afebrile children any time post dose until 4 h was highest in the combination group. Difference between combination and paracetamol was significant for the 1st h (P = 0.04). Highest fall of temperature was noted in the 1st h of drug administration in all the groups. No serious adverse events were observed in any of the groups. Conclusion: Paracetamol and ibuprofen combination caused quicker temperature reduction than either paracetamol or ibuprofen alone. If quicker reduction of body temperature is the desired goal of therapy, the use of combination of paracetamol + ibuprofen may be advocated. PMID:24551584

  4. Ozone photolysis of paracetamol in aqueous solution.

    PubMed

    Neamţu, Mariana; Bobu, Maria; Kettrup, Antonius; Siminiceanu, Ilie

    2013-01-01

    The degradation of a paracetamol (N-acetil-para-aminofenol) aqueous solution (C (0) P = 5 mmol L(-1)) is studied in a bench-scale setup by means of simple ozonation (O3) and ozonation catalyzed with UV light (O3/UV) in order to quantify the influence of UV light on the degradation process. The results have shown that under the adopted experimental conditions (25°C, applied ozone dose = 9.8 mg L(-1) and gas flow rate of 20 L h(-1)) both oxidative systems are capable of removing the substrate with mineralization degrees up to 51% for ozonation and 53% for O3/UV. HPICE chromatography allowed the detection of nitrate ions and maleic and oxalic acids as ultimate carboxylic acids. The experimental data have been interpreted through 5 indicators: the conversion of paracetamol (XP ), the conversion degree of TOC (XTOC ), the apparent rate constant (kap ), the Hatta number (Ha) and the enhancement factor (E). The main advantage of photo-ozonation compared to simple ozonation was a more advanced conversion (79% vs. 92% after 90 min). The paracetamol decay follows a pseudo-first-order reaction with a superior rate constant (higher by 54%) for the UV catalyzed system in comparison with direct ozonation. Mineralization is slightly accelerated (+4%) in the O3/UV system, due to the additional production of hydroxyl radicals induced by the UV light and a higher Hatta number (+24%). Nevertheless, the process was still in the slow reaction kinetic regime (Ha < 0.3), and the enhancement factor was not significantly increased. The results are useful for the design and scale-up of the gas-liquid processes. PMID:23647117

  5. 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

  6. 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 ...

  7. [Consumption of, overdose and fatal poisoning with analgesics in Denmark 1979-1986].

    PubMed

    Ott, P; Hansen, P B; Dalhoff, K P; Loft, S H; Poulsen, H E

    1990-01-22

    During 1978-1987 the annual sale of analgetics increased by 28% to 164 millions defined daily doses (mDDD) per year. Paracetamol changed status to over-the-counter drug by 1.1.1984 as did combinations of acetylicsalicylic acid and codein 14.5.1984. The consumption of paracetamol increased rapidly to 47 mDDD/-year, the mortality steadily decreasing to 0.07 deaths/mDDD in 1986. The consumption of salicylics decreased from 113 to 94 mDDD, of which the salicylic/codein combination constituted an increasing fraction. The mortality of salicylics increased from 0.05 death/mDDD in 1983 to 0.27/mDDD in 1986. Opoids except dextropropoxyphene increased three times during the period, while the risk of fatal poisoning decreased from 10 to 5 deaths/mDDD. Dextropropoxyphene consumption was stable 1978-86 while mortality doubled from 59 to 121 per year. After a National Board of Health initiative, 66 dextropropoxyphene deaths were seen in 1987. Paracetamol mortality was 10 times lower than in England and Wales, where a dextropropoxyphene/paracetamole combination (not available in Denmark) was often involved. From a toxicological point of view over the counter status for combinations of strong and weak analgetics are not desirable. PMID:2301074

  8. 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 ( ...

  9. 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 ...

  10. 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

  11. Aniline Is Rapidly Converted Into Paracetamol Impairing Male Reproductive Development.

    PubMed

    Holm, Jacob Bak; Chalmey, Clementine; Modick, Hendrik; Jensen, Lars Skovgaard; Dierkes, Georg; Weiss, Tobias; Jensen, Benjamin Anderschou Holbech; Nørregård, Mette Marie; Borkowski, Kamil; Styrishave, Bjarne; Martin Koch, Holger; Mazaud-Guittot, Severine; Jegou, Bernard; Kristiansen, Karsten; Kristensen, David Møbjerg

    2015-11-01

    Industrial use of aniline is increasing worldwide with production estimated to surpass 5.6 million metric tons in 2016. Exposure to aniline occurs via air, diet, and water augmenting the risk of exposing a large number of individuals. Early observations suggest that aniline is metabolized to paracetamol/acetaminophen, likely explaining the omnipresence of low concentrations of paracetamol in European populations. This is of concern as recent studies implicate paracetamol as a disrupter of reproduction. Here, we show through steroidogenic profiling that exposure to aniline led to increased levels of the Δ4 steroids, suggesting that the activity of CYP21 was decreased. By contrast, paracetamol decreased levels of androgens likely through inhibition of CYP17A1 activity. We confirm that aniline in vivo is rapidly converted to paracetamol by the liver. Intrauterine exposure to aniline and paracetamol in environmental and pharmaceutical relevant doses resulted in shortening of the anogenital distance in mice, a sensitive marker of fetal androgen levels that in humans is associated with reproductive malformations and later life reproductive disorders. In conclusion, our results provide evidence for a scenario where aniline, through its conversion into antiandrogenic paracetamol, impairs male reproductive development. PMID:26259604

  12. 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

  13. 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

  14. Intercalation of paracetamol into the hydrotalcite-like host

    SciTech Connect

    Kovanda, Frantisek; Maryskova, Zuzana; Kovar, Petr

    2011-12-15

    Hydrotalcite-like compounds are often used as host structures for intercalation of various anionic species. The product intercalated with the nonionic, water-soluble pharmaceuticals paracetamol, N-(4-hydroxyphenyl)acetamide, was prepared by rehydration of the Mg-Al mixed oxide obtained by calcination of hydrotalcite-like precursor at 500 Degree-Sign C. The successful intercalation of paracetamol molecules into the interlayer space was confirmed by powder X-ray diffraction and infrared spectroscopy measurements. Molecular simulations showed that the phenolic hydroxyl groups of paracetamol interact with hydroxide sheets of the host via the hydroxyl groups of the positively charged sites of Al-containing octahedra; the interlayer water molecules are located mostly near the hydroxide sheets. The arrangement of paracetamol molecules in the interlayer is rather disordered and interactions between neighboring molecules cause their tilting towards the hydroxide sheets. Dissolution tests in various media showed slower release of paracetamol intercalated in the hydrotalcite-like host in comparison with tablets containing the powdered pharmaceuticals. - Graphical abstract: Molecular simulations showed disordered arrangement of paracetamol molecules in the interlayer; most of the interlayer water molecules are located near the hydroxide sheets. Black-Small-Square Highlights: Black-Right-Pointing-Pointer Paracetamol was intercalated in Mg-Al hydrotalcite-like host by rehydration/reconstruction procedure. Black-Right-Pointing-Pointer Paracetamol phenolic groups interact with positively charged sites in hydroxide sheets. Black-Right-Pointing-Pointer Molecular simulations showed disordered arrangement of guest molecules in the interlayer. Black-Right-Pointing-Pointer Slower release of paracetamol intercalated in the hydrotalcite-like host was observed.

  15. Bullous Fixed Drug Eruption Probably Induced by Paracetamol

    PubMed Central

    Agarwala, Manoj Kumar; Mukhopadhyay, Sramana; Sekhar, M Raja; Peter, CV Dincy

    2016-01-01

    We report a case of a 42-year-old male who presented with second episode of bullous eruptions after ingestion of paracetamol. There were no systemic complaints. The temporal correlation with the drug, history of a similar episode and the quick improvement led us to a diagnosis of bullous fixed drug due to paracetamol. Applying Naranjo's algorithm, a causality score of 8 was obtained and was categorized as probable reaction to paracetamol. Clinicians should be vigilant of the possible adverse reactions to drugs with robust safety profiles. Drug alert cards could play an important role in preventing recurrences. PMID:26951737

  16. Paracetamol (acetaminophen): a blessing or a hidden curse?

    PubMed

    Whitehouse, M W; Butters, D E

    2014-02-01

    This Journal has recently published a splendid review of all you need to know about paracetamol (Graham et al. 2013), an analgesic widely used in the long-term management of arthritis. It clearly presents the science and hard facts. This commentary, by contrast, discusses some aspects of the metapharmacology of paracetamol; particularly by asking questions of how we might extract more benefit and suffer less adverse reactions when using this analgesic in the context of non-transient inflammation. As both a drug and a toxin, paracetamol exemplifies how beneficial and/or deleterious responses may be conditioned by circumstances (disease stress, nutritional status, fasting, etc.). PMID:24072615

  17. 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

  18. 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…

  19. 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 ...

  20. 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.

  1. 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

  2. Comparison of preoperative rectal paracetamol with paracetamol - diclofenac combination for postoperative analgesia in pediatric surgeries under general anesthesia

    PubMed Central

    Yallapragada, Srivishnu Vardhan; Shenoy, Thrivikram

    2016-01-01

    Context: Traditionally, pain in children is a topic that has received only minimal attention. However, in the recent times, considerable progress has been made in the field of neonatal and pediatric pharmacology. The concept of preemptive analgesia is important in combating postoperative pain in children. In this study, we sought to compare the effectiveness of preemptive analgesia provided by paracetamol alone and by its combination with diclofenac when administered per rectum. Aims: To compare the efficacy of preoperative rectal paracetamol with paracetamol - diclofenac combination for postoperative analgesia in pediatric surgeries under general anesthesia. Settings and Design: Prospective randomized double-blind study. Subjects and Methods: Sixty children scheduled for various surgeries under general anesthesia were randomly allocated into two Groups A and B, with 30 in each. Children in Group A received paracetamol suppository 20 mg/kg and those in Group B received paracetamol 20 mg/kg + diclofenac 2 mg/kg as suppository immediately after tracheal intubation. All the children were assessed for 24 h from the time of extubation. The pain was measured using numerical rating scale in children above 7 years and face-legs-activity-cry-consolability scale in children below 7 years. The time interval between extubation and the administration of the first dose of rescue analgesic was taken as the duration of postoperative analgesia. Statistical Analysis Used: Descriptive and inferential statistical methods were used to analyze the data. Results: The duration of postoperative analgesia was significantly longer in paracetamol + diclofenac group (21.13 ± 2.68 h) as compared to paracetamol alone group (10.18 ± 2.39 h). Conclusions: The combination of paracetamol and diclofenac administered per rectum preoperatively is more effective than paracetamol alone in providing postoperative analgesia in children. PMID:27212765

  3. Paracetamol induced Steven-Johnson syndrome: A rare case report

    PubMed Central

    Rajput, Rajan; Sagari, Shitalkumar; Durgavanshi, Astha; Kanwar, Alpana

    2015-01-01

    In the contemporary era, use of drugs is the dominant paradigm of health care. The most quotidian drug used for fever and pain is paracetamol. Although adverse reactions to paracetamol in India are rare, at times they can cause life-threatening situations. Stevens-Johnson syndrome (SJS) is one such potentially lethal adverse drug reaction. The most reported cases of analgesic-induced SJS were due to oxicams or propionic acid derivatives. There are very few detailed reports of SJS due to the use of paracetamol. We report a case of SJS, which occurred due to the use of paracetamol. The clinical features of this condition and multidisciplinary management of the patient are described in brief. PMID:26604588

  4. Clinical Pharmacology of Paracetamol in Neonates: A Review

    PubMed Central

    Pacifici, Gian Maria; Allegaert, Karel

    2014-01-01

    Paracetamol is commonly used to control mild-to-moderate pain or to reduce opioid exposure as part of multimodal analgesia, and is the only compound recommended to treat fever in neonates. Paracetamol clearance is lower in neonates than in children and adults. After metabolic conversion, paracetamol is subsequently eliminated by the renal route. The main metabolic conversions are conjugation with glucuronic acid and with sulphate. In the urine of neonates sulphated paracetamol concentration is higher than the glucuronidated paracetamol level, suggesting that sulfation prevails over glucuronidation in neonates. A loading dose of 20 mg/kg followed by 10 mg/kg every 6 hours of intravenous paracetamol is suggested to achieve a compartment concentration of 11 mg/L in late preterm and term neonates. Aiming for the same target concentration, oral doses are similar with rectal administration of 25 to 30 mg/kg/d in preterm neonates of 30 weeks’ gestation, 45 mg/kg/d in preterm infants of 34 weeks’ gestation, and 60 mg/kg/d in term neonates are suggested. The above-mentioned paracetamol doses for these indications (pain, fever) are well tolerated in neonates, but do not result in a significant increase in liver enzymes, and do not affect blood pressure and have limited effects on heart rate. In contrast, the higher doses suggested in extreme preterm neonates to induce closure of the patent ductus arteriosus have not yet been sufficiently evaluated regarding efficacy or safety. Moreover, focussed pharmacovigilance to explore the potential causal association between paracetamol exposure during perinatal life and infancy and subsequent atopy is warranted. PMID:25709719

  5. 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)

  6. [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

  7. EFFECT OF PARACETAMOL ON MELANIZATION PROCESS IN HUMAN EPIDERMAL MELANOCYTES.

    PubMed

    Wrześniok, Dorota; Oprzondek, Martyna; Hechmann, Anna; Beberok, Artur; Otreba, Michał; Buszman, Ewa

    2016-01-01

    Paracetamol (acetaminophen) is commonly used as a drug of choice for treatment of pain and fever. Unlike non-steroidal anti-inflammatory drugs (NSAIDs) it does not cause gastrointestinal damage or untoward cardiorenal effects, however cutaneous adverse effects have been reported. It is known that paracetamol binds to melanin biopolymers, but the relation between the affinity of this drug to melanin and its toxicity is not documented. The aim of this work was to examine the impact of paracetamol on melanogenesis in cultured human normal epidermal melanocytes (HEMn-DP). The effect of paracetamol on cell viability was determined by WST-1 assay, melanin content and tyrosinase activity were measured spectrophotometrically. It has been demonstrated that paracetamol induced concentration-dependent loss in melanocytes viability. The value of EC50 was found to be - 20.0 mM. The analyzed drug inhibited melanin biosynthesis in a concentration-dependent manner by decreasing the melanin content as well as the tyrosinase activity. The demonstrated inhibitory effect of paracetamol on melanization process in normal epidermal melanocytes in vitro may explain the potential role of melanin biopolymer in the mechanisms of undesirable side effects of this drug in vivo, as a result of its accumulation in pigmented tissues. PMID:27476283

  8. Spectrophotometric determination of paracetamol with microwave assisted alkaline hydrolysis

    NASA Astrophysics Data System (ADS)

    Xu, Chunli; Li, Baoxin

    2004-07-01

    A novel and rapid spectrophotometric method for the determination of paracetamol is proposed in this paper. The proposed method is based on the microwave assisted alkaline hydrolysis of paracetamol to p-aminophenol that reacts with S 2- in the presence of Fe 3+ as oxidant to produce a methylene blue-like dye having an absorptivity maximum at 540 nm. The experiment showed that paracetamol could be hydrolysed quantitatively to p-aminophenol in only 1.5 min under radiation power 640 W using a microwave in NaOH medium. The system obeys Beer's law in the range of 0-3.0×10 -4 mol l -1 paracetamol. The molar absorptivity and Sandell's sensitivity were found to be 3.2×10 3 l mol -1 cm -1 and 0.047 μg cm -2, respectively. The relative standard deviation ( n=11) was 1.7% for 8.0×10 -5 mol l -1 paracetamol. The method has been applied successfully to analysis of paracetamol in pharmaceutical preparation.

  9. Prenatal Paracetamol Exposure and Wheezing in Childhood: Causation or Confounding?

    PubMed Central

    Migliore, Enrica; Zugna, Daniela; Galassi, Claudia; Merletti, Franco; Gagliardi, Luigi; Rasero, Laura; Trevisan, Morena; Rusconi, Franca; Richiardi, Lorenzo

    2015-01-01

    Background Several studies have reported an increased risk of wheezing in the children of mothers who used paracetamol during pregnancy. We evaluated to what extent this association is explained by confounding. Methods We investigated the association between maternal paracetamol use in the first and third trimester of pregnancy and ever wheezing or recurrent wheezing/asthma in infants in the NINFEA cohort study. Risks ratios (RR) and 95% confidence intervals (CI) were estimated after adjustment for confounders, including maternal infections and antibiotic use during pregnancy. Results The prevalence of maternal paracetamol use was 30.6% during the first and 36.7% during the third trimester of pregnancy. The prevalence of ever wheezing and recurrent wheezing/asthma was 16.9% and 5.6%, respectively. After full adjustment, the RR for ever wheezing decreased from 1.25 [1.07–1.47] to 1.10 [0.94–1.30] in the first, and from 1.26 [1.08–1.47] to 1.10 [0.93–1.29] in the third trimester. A similar pattern was observed for recurrent wheezing/asthma. Duration of maternal paracetamol use was not associated with either outcome. Further analyses on paracetamol use for three non-infectious disorders (sciatica, migraine, and headache) revealed no increased risk of wheezing in children. Conclusion The association between maternal paracetamol use during pregnancy and infant wheezing is mainly, if not completely explained by confounding. PMID:26305473

  10. Paracetamol overdose: the liver unit perspective.

    PubMed

    Iqbal, M; Cash, W J; Sarwar, S; McCormick, P A

    2012-09-01

    Liver failure resulting from deliberate or accidental paracetamol overdose continues to be an important reason for referral to liver transplant centres. Severe hepatic dysfunction often appears 72-96 h after overdose. Liver injury can be prevented by timely administration of the specific antidote, N-acetylcysteine. Unfortunately, administration of N-acetylcysteine is frequently delayed due to late presentation or late administration. While N-acetylcysteine works best if given within 8 h of overdose, it is beneficial at any time period and should always be given if there is concern about significant overdose, irrespective of interval from time of ingestion. Early discussion with liver transplant unit is suggested if there is any doubt or evidence of liver failure. PMID:22072400

  11. 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). ...

  12. 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 ...

  13. 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 ...

  14. 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 ...

  15. 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 ...

  16. 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

  17. 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 ...

  18. 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 ...

  19. 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 ...

  20. 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: ...

  1. 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 ( ...

  2. 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. ...

  3. 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. ...

  4. 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. ...

  5. 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. ...

  6. 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. ...

  7. 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 ...

  8. 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" ...

  9. 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

  10. 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 ...

  11. 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.

  12. 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 ...

  13. 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.

  14. 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. ...

  15. 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

  16. 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 ...

  17. 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 ...

  18. 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 ...

  19. 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

  20. 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 ...

  1. 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 ...

  2. 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, ...

  3. 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 ...

  4. 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. ...

  5. 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

  6. 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

  7. 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)

  8. 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 ...

  9. 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 ...

  10. 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

  11. 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

  12. [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

  13. 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

  14. 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

  15. [Paracetamol (perfalgane) as analgesic component of medicinal sedation].

    PubMed

    Mustafaeva, M N; Mizikov, V M

    2011-01-01

    This article reviews the possibility of the use of paracetamol (perfalgane) as an analgesic component of medical sedation. The actuality of the problem is the choice effective pharmacological means of protection from peri-operative pain. The theoretical advantages of paracetamol in the scheme of sedoanalgesia are exquisite. We describe a personal experience of efficacy assessment and safety of paracetamol as an analgesic component of the methodology of drug sedation for bronchoscopy in the early postoperative period. We compare analgesia by the means of paracetamol 1000 mg (IV) and tramadol 100 mg (IV). The sedative agent in both groups was midazolam. It turned out, that despite the high efficacy of tramadol as a component of sedoanalgesia, the quality of anialgesia when using perfalagane is almost 5 times higher, both due to the significant number of good results, and to reduced number of adverse events. Use of paracetamol (Perfalgane) instead of tramadol for medical sedation during fibrotracheoscopy in patients in the early postoperative period leads to better quality of analgesia, thus avoiding such undesirable phenomena as hypersedation, respiratory depression, dizziness, and nausea. PMID:21688656

  16. Paracetamol and analgesic nephropathy: Are you kidneying me?

    PubMed Central

    Waddington, Freya; Naunton, Mark; Thomas, Jackson

    2015-01-01

    Introduction Analgesic nephropathy is a disease resulting from the frequent use of combinations of analgesic medications over many years, leading to significant impairment of renal function. The observation of a large number of cases of renal failure in patients abusing analgesic mixtures containing phenacetin led to the initial recognition of the nephrotoxicity from the use of analgesics. Phenacetin was subsequently exclusively blamed for this disease. However, the role of a single analgesic as a sole cause of analgesic nephropathy was challenged, and a number of researchers have since attempted to determine the extent of involvement of other analgesics including nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, and paracetamol. Case presentation We present the case of an 83-year-old woman with a history of NSAID-induced nephropathy with poor pain control and reluctance to use paracetamol. We attempt to briefly review the evidence of paracetamol being implicated in the development of analgesic-induced nephropathy. Conclusion There is a lack of concrete data regarding causative analgesics, including paracetamol. Patients should therefore not be withheld paracetamol, an effective and commonly recommended agent, for fear of worsening renal function. PMID:25548527

  17. Molecular dynamics simulation of paracetamol molecules ordering around glycogen

    NASA Astrophysics Data System (ADS)

    Lim, Wilber; Feng, Yuan Ping; Liu, X. Y.

    2005-05-01

    By the use of classical atomistic molecular dynamics simulations, we demonstrate that paracetamol molecules exist in a highly ordered phase in the presence of a glycogen substrate at 317K whereas the paracetamol fluid exists in an isotropic phase in the absence of the glycogen substrate at the same temperature. This result further validates the studies made on polysaccharide regarding its abilities to promote nucleation of paracetamol via liquid preordering. As little is known regarding liquid ordering induced by a polymeric substrate, we seek to explore the ordering mechanism from an energy perspective. This is accomplished using conformation mappings. Our analysis shows that the conformation space accessible to the paracetamol molecule at 317K in the vicinity of glycogen is smaller than the one in the absence of glycogen. An investigation on the orientation of the dipole moments of the glycogen monomers and paracetamol molecules were carried out as well. From the investigations, we show that dipolar interactions play an important role in the ordering process. These studies bear significance to the understanding of the ordering process as well as the promotion and effective control of the nucleation rate.

  18. Intercalation of paracetamol into the hydrotalcite-like host

    NASA Astrophysics Data System (ADS)

    Kovanda, František; Maryšková, Zuzana; Kovář, Petr

    2011-12-01

    Hydrotalcite-like compounds are often used as host structures for intercalation of various anionic species. The product intercalated with the nonionic, water-soluble pharmaceuticals paracetamol, N-(4-hydroxyphenyl)acetamide, was prepared by rehydration of the Mg-Al mixed oxide obtained by calcination of hydrotalcite-like precursor at 500 °C. The successful intercalation of paracetamol molecules into the interlayer space was confirmed by powder X-ray diffraction and infrared spectroscopy measurements. Molecular simulations showed that the phenolic hydroxyl groups of paracetamol interact with hydroxide sheets of the host via the hydroxyl groups of the positively charged sites of Al-containing octahedra; the interlayer water molecules are located mostly near the hydroxide sheets. The arrangement of paracetamol molecules in the interlayer is rather disordered and interactions between neighboring molecules cause their tilting towards the hydroxide sheets. Dissolution tests in various media showed slower release of paracetamol intercalated in the hydrotalcite-like host in comparison with tablets containing the powdered pharmaceuticals.

  19. 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

  20. 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

  1. 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

  2. Non-steroidal anti-inflammatory drugs and paracetamol in self-therapy of various disorders in students of different fields of study.

    PubMed

    Wiliński, Jerzy; Lechowicz, Marta; Kameczura, Tomasz; Głowacki, Mikołaj; Kameczura, Anna; Chrapusta, Anna; Wiliński, Bogdan

    2015-01-01

    Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol are most commonly the first-line pharmacotherapy in combating different pain and inflammatory disorders and fever. Unfortunately, those drugs might have serious side effects, especially when they are used in an inappropriate way. The aim of the study was to explore various aspects of NSAIDs and paracetamol use in the self-therapy of miscellaneous disorders in young adults. The questionnaire-based survey comprised 250 consecutive students aged 22.1 ± 1.9 years (189 women) of diverse fields of study. The drugs were applied in clinical conditions in which they should be avoided including asthma attack (1.2%), vomiting (2.4%), malaise and depression (3.6%), in autumn and winter as a preventive measure against infections (14.0%), heart-burn (2.0%) and during food poisoning (16.0%). As many as 6.0% of the students claimed that studied medications are ultimately free of adverse reactions. Men more frequently than women used NSAIDs and paracetamol during alcohol consumption (49.2% vs 30.7%, p = 0.009, respectively) but less often were aware that there are maximum doses of medications which should not be exceeded (57.4% vs 76.7%, p = 0.003, respectively). The students of medical-related degree courses (n = 82) compared with individuals of other subjects (n = 168) declared they more often have the custom of always reading medications' leaflets (46.3% vs 31.0%, p = 0.017, respectively). Side effects of medicines were reported by 65 participants - 26.0%. In conclusion, students' knowledge about NSAIDs and paracetamol is low. Participants do not search for information on drug related endangerments, the medication group choice for the given disorder is often inappropriate and the drugs are applied in conditions in which they are contraindicated. PMID:26839243

  3. Paracetamol as a Post Prandial Marker for Gastric Emptying, A Food-Drug Interaction on Absorption

    PubMed Central

    Bartholomé, R.; Salden, B.; Vrolijk, M. F.; Troost, F. J.; Masclee, A.; Bast, A.; Haenen, G. R.

    2015-01-01

    The use of paracetamol as tool to determine gastric emptying was evaluated in a cross over study. Twelve healthy volunteers were included and each of them consumed two low and two high caloric meals. Paracetamol was mixed with a liquid meal and administered by a nasogastric feeding tube. The post prandial paracetamol plasma concentration time curve in all participants and the paracetamol concentration in the stomach content in six participants were determined. It was found that after paracetamol has left the stomach, based on analysis of the stomach content, there was still a substantial rise in the plasma paracetamol concentration time curve. Moreover, the difference in gastric emptying between high and low caloric meals was missed using the plasma paracetamol concentration time curve. The latter curves indicate that (i) part of the paracetamol may leave the stomach much quicker than the meal and (ii) part of the paracetamol may be relatively slowly absorbed in the duodenum. This can be explained by the partition of the homogenous paracetamol-meal mixture in the stomach in an aqueous phase and a solid bolus. The aqueous phase leaves the stomach quickly and the paracetamol in this phase is quickly absorbed in the duodenum, giving rise to the relatively steep increase of the paracetamol concentration in the plasma. The bolus leaves the stomach relatively slowly, and encapsulation by the bolus results in relatively slow uptake of paracetamol from the bolus in the duodenum. These findings implicate that paracetamol is not an accurate post prandial marker for gastric emptying. The paracetamol concentration time curve rather illustrates the food-drug interaction on absorption, which is not only governed by gastric emptying. Trial Registration ClinicalTrials.gov NCT01335503 Nederlands Trial Register NTR2780 PMID:26352940

  4. 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 ...

  5. Acetaminophen (paracetamol) oral absorption and clinical influences.

    PubMed

    Raffa, Robert B; Pergolizzi, Joseph V; Taylor, Robert; Decker, John F; Patrick, Jeffrey T

    2014-09-01

    Acetaminophen (paracetamol) is a widely used nonopioid, non-NSAID analgesic that is effective against a variety of pain types, but the consequences of overdose can be severe. Because acetaminophen is so widely available as a single agent and is increasingly being formulated in fixed-ratio combination analgesic products for the potential additive or synergistic analgesic effect and/or reduced adverse effects, accidental cumulative overdose is an emergent concern. This has rekindled interest in the sites, processes, and pharmacokinetics of acetaminophen oral absorption and the clinical factors that can influence these. The absorption of oral acetaminophen occurs primarily along the small intestine by passive diffusion. Therefore, the rate-limiting step is the rate of gastric emptying into the intestines. Several clinical factors can affect absorption per se or the rate of gastric emptying, such as diet, concomitant medication, surgery, pregnancy, and others. Although acetaminophen does not have the abuse potential of opioids or the gastrointestinal bleeding or organ adverse effects of NSAIDs, excess amounts can produce serious hepatic injury. Thus, an understanding of the sites and features of acetaminophen absorption--and how they might be influenced by factors encountered in clinical practice--is important for pain management using this agent. It can also provide insight for design of formulations that would be less susceptible to clinical variables. PMID:26013309

  6. Molecular mobility of the paracetamol amorphous form.

    PubMed

    di Martino, P; Palmieri, G F; Martelli, S

    2000-08-01

    The purpose of this paper is to study the molecular mobility of paracetamol molecules in their amorphous state below the glass transition temperature (Tg) in order to evaluate the thermodynamic driving force which allows the amorphous form to recrystallize under different polymorphic modifications. Samples were aged at temperatures of -15, 0, 6, and 12 degrees C for periods of time from 1 h to a maximum of 360 h. The extent of physical aging was measured by a DSC study of enthalpy recovery in the glass transition region. The onset temperature of glass transition was also determined (Tg). Enthalpy recovery (deltaH) and change in heat capacity (deltaCp) were used to calculate the mean molecular relaxation time constant (tau) using the empirical Kohlausch-Williams-Watts (KWW) equation. Enthalpy recovery and onset glass transition temperature increased gradually with aging and aging temperatures. Structural equilibrium was reached experimentally only at an aging temperature of 12 degrees C (Tg-10 degrees C), according to the deltaH(infinity) results. The experimental model used is appropriate only at lower aging temperatures, while at higher ones the complexity of the system increases and molecular polymorphic arrangement could be involved. When structural equilibrium is experimentally reached, molecules can be arranged in their lowest energy state, and the polymorphic form I formation is the one preferred. PMID:10959571

  7. Measurement of antipyretic activity of ibuprofen and paracetamol in children.

    PubMed

    Sheth, U K; Gupta, K; Paul, T; Pispati, P K

    1980-01-01

    The antipyretic activity of ibuprofen (Brufen) and paracetamol (Crocin) was compared in 22 children with pyrexia who received either ibuprofen or paracetamol in syrup form. Both axillary and rectal temperatures were recorded prior to drug administration and 1/2, 1, 2, 3, 4, 5, 6, 8, and 12 hours after dosing. Analysis of the results in terms of rate of temperature decrease and degree and duration of decrease in temperature indicated that both drugs produced significant reduction in temperature and in the rate of temperature decrease. The maximum effect of the two drugs was similar. However, ibuprofen was more effective than paracetamol at 6 and 8 hours after administration, and its duration of action was longer. The associated antipyretic and antiinflammatory features of ibuprofen could provide an advantage in the control of exudative forms of upper respiratory tract infections. PMID:6971880

  8. Pharmacokinetics of paracetamol (acetaminophen) after intravenous and oral administration.

    PubMed

    Rawlins, M D; Henderson, D B; Hijab, A R

    1977-04-20

    Plasma paracetamol concentrations were measured in 6 volunteers after single intravenous (1000 mg) and oral (500 mg, 1000 mg and 2000 mg) doses of the drug. Paracetamol levels declined multiphasically with a mean clearance after intravenous administration of 352 +/- 40 ml/min. A two-compartment open model appeared to describe the decline adequately. Comparison of the areas under the plasma concentration-time curves (AUC) indicated that oral bioavailability increased from 0.63 +/- 0.02 after 500 mg, to 0.89 +/- 0.04 and 0.87 +/- 0.08 after 1000 mg and 2000 mg, respectively. As a consequence of the incomplete bioavailability of paracetamol, as well as its multicompartmental distribution, accurate estimates of its distribution volume and clearance cannot be obtained if the drug is given orally. However, an estimate of its total plasma clearance may be derived from the AUC after a 500 mg oral dose. PMID:862649

  9. 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

  10. 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

  11. 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

  12. 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 ...

  13. 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)

  14. 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)

  15. 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…

  16. 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

  17. 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 ...

  18. 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

  19. 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)

  20. 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

  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. 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

  3. 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

  4. 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

  5. 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

  6. Incorrect Prescription of Intravenous Paracetamol in a Pediatric Patient

    PubMed Central

    Örün, E; Polat, A; Andan, H; Çizmeci, N; Tufan, N

    2013-01-01

    Intravenous (IV) paracetamol is widely used for the treatment of pain and fever, when there is a clinical indication for an IV route. A 16-month-old girl weighing 12 kg had undergone anterior open reduction for developmental dysplasia of the hip. Twenty-four hours after the operation, IV paracetamol (Perfalgan® 10 mg/ml) infusion was started for the postoperative pain management. After 12 hours’ infusion, she has developed nausea, vomiting and agitation. The liver function tests were found to be more than 10-fold elevated on the laboratory results. When the medication order was checked, it was shown that she had been administered paracetamol 5 times at a dose of 42 mg/kg (total: 2.5 g/30 hours or 168 mg/kg/24 hours). The patient was started on N-acetyl cysteine (NAC) therapy immediately. She was asymptomatic at the 36th hour of the NAC treatment and the liver function tests completely recovered over 15 days. Since the errors in the calculation of the dosage of IV paracetamol may lead to serious complications or even death, physicians should be careful not to miscalculate when preferring the IV form of the drug. PMID:23935350

  7. Incorrect prescription of intravenous paracetamol in a pediatric patient.

    PubMed

    Orün, E; Polat, A; Andan, H; Cizmeci, N; Tufan, N

    2013-01-01

    Intravenous (IV) paracetamol is widely used for the treatment of pain and fever, when there is a clinical indication for an IV route. A 16-month-old girl weighing 12 kg had undergone anterior open reduction for developmental dysplasia of the hip. Twenty-four hours after the operation, IV paracetamol (Perfalgan® 10 mg/ml) infusion was started for the postoperative pain management. After 12 hours' infusion, she has developed nausea, vomiting and agitation. The liver function tests were found to be more than 10-fold elevated on the laboratory results. When the medication order was checked, it was shown that she had been administered paracetamol 5 times at a dose of 42 mg/kg (total: 2.5 g/30 hours or 168 mg/kg/24 hours). The patient was started on N-acetyl cysteine (NAC) therapy immediately. She was asymptomatic at the 36th hour of the NAC treatment and the liver function tests completely recovered over 15 days. Since the errors in the calculation of the dosage of IV paracetamol may lead to serious complications or even death, physicians should be careful not to miscalculate when preferring the IV form of the drug. PMID:23935350

  8. Biochemical effects of the pharmaceutical drug paracetamol on Anguilla anguilla.

    PubMed

    Nunes, Bruno; Verde, Maria Francisca; Soares, Amadeu M V M

    2015-08-01

    The ever-increasing presence of pharmaceutical drugs in the environment is a motif of concern, and human-use drugs are of particular importance. This is the case of paracetamol, a widely employed drug in human therapeutics, as analgesic and antipyretic, whose toxicity on aquatic organisms is still not fully characterized. The present study aimed to assess the toxic deleterious effects of paracetamol on European eel, Anguila anguilla, by using a comprehensive battery of antioxidant biomarkers (activities of enzymes such as catalase (CAT) and glutathione S-transferases (GSTs)), and the quantification of oxidative damage (measurement of levels of lipid peroxidation (thiobarbituric acid reactive substances (TBARS) assay)). Other biochemical effects elicited by this substance were also quantified, in terms of anaerobic respiration (activity of lactate dehydrogenase, LDH) and neurotoxicity (acetylcholinesterase, AChE, activity). The obtained results showed the occurrence of an oxidative base response, and paracetamol also seemed to inhibit AChE, showing that this drug can also elicit neurotoxicity. The lack of response by both CAT and LDH show that, despite the occurrence of toxicity, eels have detoxification mechanisms that are effective to cope with paracetamol, preventing additional deleterious alterations, including in the main pathway by which they obtain energy. PMID:25827650

  9. Paracetamol: mechanism of action, applications and safety concern.

    PubMed

    Jóźwiak-Bebenista, Marta; Nowak, Jerzy Z

    2014-01-01

    Paracetamol/acetaminophen is one of the most popular and most commonly used analgesic and antipyretic drugs around the world, available without a prescription, both in mono- and multi-component preparations. It is the drug of choice in patients that cannot be treated with non-steroidal anti-inflammatory drugs (NSAID), such as people with bronchial asthma, peptic ulcer disease, hemophilia, salicylate-sensitized people, children under 12 years of age, pregnant or breastfeeding women. It is recommended as a first-line treatment of pain associated with osteoarthritis. The mechanism of action is complex and includes the effects of both the peripheral (COX inhibition), and central (COX, serotonergic descending neuronal pathway, L-arginine/NO pathway, cannabinoid system) antinociception processes and "redox" mechanism. Paracetamol is well tolerated drug and produces few side effects from the gastrointestinal tract, however, despite that, every year, has seen a steadily increasing number of registered cases of paracetamol-induced liver intoxication all over the world. Given the growing problem of the safety of acetaminophen is questioned the validity of the sale of the drug without a prescription. This work, in conjunction with the latest reports on the mechanism of action of paracetamol, trying to point out that it is not a panacea devoid of side effects, and indeed, especially when is taken regularly and in large doses (> 4 g/day), there is a risk of serious side effects. PMID:24779190

  10. Growth of large single crystals of the orthorhombic paracetamol

    NASA Astrophysics Data System (ADS)

    Mikhailenko, M. A.

    2004-05-01

    A new procedure for the growth of large (cm-range) single crystals of the metastable orthorhombic (s.g. Pcab) polymorph of paracetamol is described. The crystals were grown by very slow cooling of hot water solutions under the conditions, when the multiple nucleation was prevented. The samples were characterized by DSC and X-ray diffraction.

  11. 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

  12. 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

  13. Diclofenac or paracetamol for analgesia in paediatric myringotomy outpatients.

    PubMed

    Tay, C L M; Tan, S

    2002-02-01

    This prospective, randomized, double-blind study compared the analgesic efficacy of oral diclofenac resinate 0.5 mg.kg(-1) with paracetamol 15 mg/kg(-1) for control of postoperative pain in paediatric patients for outpatient bilateral myringotomy and tube insertion. Paracetamol, the most commonly used oral analgesic for paediatric patients, was compared with a new palatable syrup formulation of diclofenac. Sixty-three ASA 1 orA SA 2 children aged one year and above were randomly assigned to receive diclofenac (Group A) or paracetamol (Group B). The study drug was given 30 to 60 minutes before induction of anaesthesia. Anaesthesia was induced with either inhalational sevoflurane or intravenous thiopentone. All subjects received intravenous fentanyl 1 microg/kg(-1) intraoperatively. Postoperative pain was assessed by a blinded observer using the CHEOPS score on eye-opening, and then at 10, 30 and 60 minutes. Children with a CHEOPS score > 7 received further fentanyl 1 microg x kg(-1). The number of cases requiring this "rescue" analgesia was recorded. Both groups were comparable in demographics, induction technique, duration of anaesthesia and time between premedication and induction of anaesthesia. Overall, CHEOPS scores were low for both groups at all times and did not differ between the groups at any time. Twenty per cent of the diclofenac group and 27% of the paracetamol group required rescue analgesia (not statistically significant). The efficacy of diclofenac 0.5 mg x kg(-1) and paracetamol 15 mg x kg(-1) as oral analgesic premedication for BMT was comparable in children receiving an anaesthetic which included intraoperative administration of fentanyl 1 microg x kg(-1). PMID:11939442

  14. [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

  15. [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

  16. The influence of morphine on the absorption of paracetamol from various formulations in subjects in the supine position, as assessed by TDx measurement of salivary paracetamol concentrations.

    PubMed

    Kennedy, Julia M; Tyers, Nicola M; Davey, Andrew K

    2003-10-01

    The aim of this study was to determine the influence of the type of paracetamol formulation on the rate of absorption when subjects are in the supine position, with or without taking concomitant morphine. Two groups of healthy volunteers were used, who were in the fasting state and remained in the supine position during the study. One group took 1,500 mg of paracetamol on three occasions as conventional tablets, dispersible tablets or a suspension in a randomized crossover design. Seventeen saliva samples per subject were obtained (time zero to 360 min post-dose), which were then centrifuged and kept at -20 degrees C prior to analysis. The second group repeated the study following four doses of morphine syrup (10 mg 4 hourly) in the 12 h preceding paracetamol ingestion. In this phase of the study, paracetamol absorption from suspension was not investigated. A TDx assay was used to determine salivary paracetamol concentrations. The tmax for conventional tablets when taken concomitantly with morphine was 160 (+/- 81) min compared to 51 (+/- 58) min for subjects not taking morphine. For dispersible tablets the tmax in the morphine group was 14 (+/- 9) min compared to 15 (+/- 12) min without morphine. The results suggest that patients who are confined to bed and taking morphine will have an unacceptably long delay between taking conventional paracetamol tablets and the paracetamol reaching therapeutic plasma concentrations. Conversely, there is little effect on the absorption of dispersible paracetamol under the same conditions. PMID:14607015

  17. 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

  18. 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.

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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

  4. [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

  5. Comparison of a gas chromatographic and colorimetric method for the determination of plasma paracetamol.

    PubMed

    Chambers, R E; Jones, K

    1976-07-01

    Plasma paracetamol levels have generally been determined either by gas chromatography (Stewart and Willis, 1975), which relies on complex equipment, or by spectrophotometry (Knepil, 1974), which can be time-consuming. The introduction by Glynn and Kendal (1975) of a simple colorimetric method based on the reaction of paracetamol with nitrous acid to give 2-nitro-4-acetamidophenol appears to have overcome these disadvantages, thereby providing a suitable procedure for the rapid measurement of plasma paracetamol in cases of overdose. The method was reported to be specific for paracetamol, no interference being caused either by the sulphate and glucuronide conjugates of paracetamol or by a large number of other commonly found drugs. This communication presents the results of a study in which plasma paracetamol levels determined by the colorimetric method were compared with those determined by an established gas chromatographic technique. PMID:952476

  6. Hypernatremia secondary to soluble paracetamol use in an elderly man: a case report

    PubMed Central

    Khanna, Arun

    2009-01-01

    Introduction Soluble (effervescent) paracetamol is routinely given to elderly patients for convenience. A daily dose of 4 gm in this soluble formulation can contain up to 8.7 gm of sodium chloride, which exceeds the threshold recommended by the World Health Organization. Hypernatremia secondary to soluble paracetamol has rarely been reported. We describe an elderly patient who developed hypernatremia shortly after taking soluble paracetamol. Case presentation A confused 89-year-old man with back pain secondary to metastatic prostatic carcinoma was prescribed soluble paracetamol. Ten days later, his serum sodium concentration had increased from 142 mmol/L to 165 mmol/L. Soluble paracetamol was withdrawn shortly before he died, and was believed to have contributed to his hypernatremia. Conclusion Hypernatremia is associated with high morbidity and mortality. Clinicians should be aware of the high sodium chloride content in soluble paracetamol, which can precipitate hypernatremia in elderly patients with impaired renal function. PMID:19829847

  7. A graphene-based electrochemical sensor for sensitive detection of paracetamol

    SciTech Connect

    Kang, Xinhuang; Wang, Jun; Wu, Hong; Liu, Jun; Aksay, Ilhan A.; Lin, Yuehe

    2010-05-15

    An electrochemical sensor based on the electrocatalytic activity of functionalized graphene for sensitive detection of paracetamol is presented. The electrochemical behaviors of paracetamol on graphene-modified glassy carbon electrodes (GCEs) were investigated by cyclic voltammetry and square-wave voltammetry. The results showed that the graphene-modified electrode exhibited excellent electrocatalytic activity to paracetamol. A quasi-reversible redox process of paracetamol at the modified electrode was obtained, and the over-potential of paracetamol decreased significantly compared with that at the bare GCE. Such electrocatalytic behavior of graphene is attributed to its unique physical and chemical properties, e.g., subtle electronic characteristics, attractive π–π interaction, and strong adsorptive capability. The sensor shows great promise for simple, sensitive, and quantitative detection of paracetamol.

  8. 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

  9. 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

  10. Design and evaluation of herbal hepatoprotective formulation against paracetamol induced liver toxicity

    PubMed Central

    Gupta, Arti; Sheth, Navin R.; Pandey, Sonia; Shah, Dinesh R.; Yadav, Jitendra S.

    2014-01-01

    Aim To isolate and identify the quercetin from polyherbal hepatoprotective formulation. Polyherbal formulations were developed by using five bioactive fractionated extracts of Butea monosperma, Bauhinia variegata and Ocimum gratissimum for treatment of liver disorders by exploiting the knowledge of traditional system of medicine and evaluated for hepatoprotective activity using acute liver toxicity model of paracetamol induced liver damage in rats. Methods Major active fractions were isolated by solvent fractionation and quantified by HPTLC method. Two polyherbal tablet formulations were developed by the wet granulation method using microcrystalline cellulose, aerosil and other excipients and subjected for physicochemical evaluation to assess physical stability followed by pharmacological screening. The prepared tablets were finally subjected to stability testing to assess its shelf-life. The rats were monitored for change in liver morphology, biochemical parameters like serum glutamate pyruvate transaminase (SGPT), serum glutamate oxaloacetate transaminase (SGOT), alkaline phosphatase (ALP) and total bilirubin for polyherbal tablet formulation at 50 mg/kg and polyherbal tablet formulation at 100 mg/kg. Results Active principle was isolated, quantified by HPTLC and characterized with IR. Both formulations showed significant hepatoprotective activity. The histological studies were also support the biochemical parameters. From the results of biochemical analysis and histopathological studies, it can be accomplished that polyherbal tablet formulation at 100 mg/kg can be effectively formulated into a suitable dosage form with added benefit of no side effects for control and cure of chronic ailments like liver disorders. A comparative histopathological study of liver exhibited almost normal architecture as compared to toxicant group. Conclusion Biochemical marker showed improved results for polyherbal tablet formulation at 100 mg/kg. Polyherbal tablet formulation

  11. 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

  12. 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

  13. 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...

  14. 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 ...

  15. [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

  16. Intrauterine Exposure to Paracetamol and Aniline Impairs Female Reproductive Development by Reducing Follicle Reserves and Fertility.

    PubMed

    Holm, Jacob Bak; Mazaud-Guittot, Severine; Danneskiold-Samsøe, Niels Banhos; Chalmey, Clementine; Jensen, Benjamin; Nørregård, Mette Marie; Hansen, Cecilie Hurup; Styrishave, Bjarne; Svingen, Terje; Vinggaard, Anne Marie; Koch, Holger Martin; Bowles, Josephine; Koopman, Peter; Jégou, Bernard; Kristiansen, Karsten; Kristensen, David Møbjerg

    2016-03-01

    Studies report that fetal exposure to paracetamol/acetaminophen by maternal consumption can interfere with male reproductive development. Moreover, recent biomonitoring data report widespread presence of paracetamol in German and Danish populations, suggesting exposure via secondary (nonpharmaceutical) sources, such as metabolic conversion from the ubiquitous industrial compound aniline. In this study, we investigated the extent to which paracetamol and aniline can interfere with female reproductive development. Intrauterine exposure to paracetamol by gavage of pregnant dams resulted in shortening of the anogenital distance in adult offspring, suggesting that fetal hormone signaling had been disturbed. Female offspring of paracetamol-exposed mothers had ovaries with diminished follicle reserve and reduced fertility. Fetal gonads of exposed animals had also reduced gonocyte numbers, suggesting that the reduced follicle count in adults could be due to early disruption of germ cell development. However, ex vivo cultures of ovaries from 12.5 days post coitum fetuses showed no decrease in proliferation or expression following exposure to paracetamol. This suggests that the effect of paracetamol occurs prior to this developmental stage. Accordingly, using embryonic stem cells as a proxy for primordial germ cells we show that paracetamol is an inhibitor of cellular proliferation, but without cytotoxic effects. Collectively, our data show that intrauterine exposure to paracetamol at levels commonly observed in pregnant women, as well as its precursor aniline, may block primordial germ cell proliferation, ultimately leading to reduced follicle reserves and compromised reproductive capacity later in life. PMID:26732887

  17. Haemodynamic effects of parenteral vs. enteral paracetamol in critically ill patients: a randomised controlled trial.

    PubMed

    Kelly, S J; Moran, J L; Williams, P J; Burns, K; Rowland, A; Miners, J O; Peake, S L

    2016-10-01

    Paracetamol is a commonly used drug in the intensive care unit. There have been reports in the literature of an association with significant hypotension, a potentially important interaction for labile critically ill patients. Route of administration may influence the incidence of hypotension. This single-centre, prospective, open-label, randomised, parallel-arm, active-control trial was designed to determine the incidence of hypotension following the administration of paracetamol to critically ill patients. Fifty adult patients receiving paracetamol for analgesia or pyrexia were randomly assigned to receive either the parenteral or enteral formulation of the drug. Paracetamol concentrations were measured at baseline and at multiple time points over 24 h. The maximal plasma paracetamol concentration was significantly different between routes; 156 vs. 73 micromol.l(-1) [p = 0.0005] following the first dose of parenteral or enteral paracetamol, respectively. Sixteen hypotensive events occurred in 12 patients: parenteral n = 12; enteral n = 4. The incident rate ratio for parenteral vs. enteral paracetamol was 2.94 (95% CI 0.97-8.92; p = 0.06). The incidence of hypotension associated with paracetamol administration is higher than previously reported and tends to be more frequent with parenteral paracetamol. PMID:27611038

  18. Cholestyramine as an antidote against paracetamol-induced hepato- and nephrotoxicity in the rat.

    PubMed

    Siegers, C P; Möller-Hartmann, W

    1989-05-01

    Besides hepatotoxicity, paracetamol may exert nephrotoxic effects in experimental animals and man. The present study in rats shows that cholestyramine given 4 and 24 h after paracetamol provided protection against both hepato- and nephrotoxicity; this was evidenced by reduced increments in plasma enzyme activities (SDH, GPT), indicating liver damage, and diminished retention of plasma and creatinine, indicating renal failure. The recovery of paracetamol and its conjugates in urine was markedly reduced by cholestyramine at 24-48 h after treatment. The protective effects of cholestyramine are explained by adsorption of paracetamol and conjugates in the intestine undergoing biliary excretion and enterohepatic circulation. PMID:2741180

  19. 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

  20. 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