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1.
Hum Exp Toxicol ; 43: 9603271241249965, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38662433

RESUMO

BACKGROUND: The mechanism of emamectin benzoate (EMB-a macrocyclic lactone insecticide like abamectin) action involves the disruption of glutamate-gated chloride channels and GABA receptors in insects, leading to paralysis and death. EMB overdose can breach the blood-brain barrier, resulting in severe poisoning and altered consciousness. AIM: Review EMB poisoning presentations in patients and reevaluate clinical manifestations. MATERIALS AND METHODS: This retrospective study reviewed (August 31, 2008-August 31, 2023) medical university hospital records. We analyzed symptoms, patient characteristics, vital signs, Glasgow Coma Scale scores, laboratory findings, and outcomes. RESULTS: Ten patients (males: 6, females: 4, median age = 64.5 years) experienced EMB poisoning. Common symptoms included sore throat, gastrointestinal distress, dyspnea, and altered consciousness; two patients showed laryngeal corrosive injuries. Management involved activated charcoal administration, gastric lavage, and intensive care unit admission. DISCUSSION: Sore throat and corrosive injuries were distinctive presentations of EMB poisoning, warranting vigilance. Potential mechanisms of corrosive injury include skin and eye irritation effects of EMB, the solvents of which might exert corrosive action. CONCLUSION: EMB poisoning manifests as diverse symptoms, including sore throat, gastrointestinal symptoms, central nervous system depression, and potential aspiration pneumonia. Recognizing and promptly managing EMB poisoning are crucial for enhancing patient outcomes and minimizing complications.


Assuntos
Ivermectina , Ivermectina/análogos & derivados , Humanos , Ivermectina/intoxicação , Ivermectina/toxicidade , Feminino , Pessoa de Meia-Idade , Masculino , Estudos Retrospectivos , Idoso , Inseticidas/intoxicação , Inseticidas/toxicidade , Adulto , Idoso de 80 Anos ou mais
2.
Toxins (Basel) ; 14(2)2022 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-35202149

RESUMO

The cobra (genus Naja (N.)) is one of the most common venomous snakes. Due to its frequency and deadly complications of muscle paralysis, local necrosis, and chronic musculoskeletal disability, it should not be ignored. The pathology of devastating tissue destruction, even though specific antivenoms exist, is not fully clear. Here, we attempted to dig in envenomed tissues to study the clinical toxicology of cobra venom. Four cases of N. atra snake envenomation, in which the subjects developed advanced tissue injury, were involved in this study. We used enzyme-ligand sandwich immunoassay (ELISA) to assay the whole venom, cytotoxin A3 and short-chain neurotoxin (sNTX) in blood, bullae, wound discharge, and debrided tissue. We found that persistently high concentrations of venom and toxins, especially cytotoxin A3, were detected in bullae, wound discharge fluid and necrotic tissue of these patients even after large doses of specific antivenom treatment, and wide excision and advanced debridement could largely remove these toxins, lessen the size of necrosis, and promote wound healing. We also found that the point-of-care apparatus, ICT-Cobra kit, might be used to promptly monitor the wound condition and as one of the indicators of surgical intervention in cases of cobra envenomation in Taiwan.


Assuntos
Citotoxinas/análise , Venenos Elapídicos/análise , Neurotoxinas/análise , Mordeduras de Serpentes , Idoso , Idoso de 80 Anos ou mais , Animais , Antivenenos/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Naja naja , Projetos Piloto , Mordeduras de Serpentes/tratamento farmacológico
3.
PLoS One ; 15(12): e0243922, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33373373

RESUMO

Habits such as smoking and alcohol drinking and existing esophageal malfunction are considered the main risk factors for esophageal carcinogenesis. Caustic ingestion of acidic or alkaline agents or strong irritants can induce severe esophageal corrosive injury and increase esophageal cancer risk. We studied the relationship between esophageal carcinoma and acute detergent or pesticide poisoning by using nationwide health insurance data. Methodology/Principle findings: We compared a pesticide/detergent intoxication cohort (N = 21,840) and an age- and gender-matched control cohort (N = 21,840) identified from the National Health Insurance Research Database between 2000 and 2011. We used the multivariable Cox proportional model to determine esophageal carcinoma risk. The overall incidence density of esophageal cancer was 1.66 per 10,000 person-years in the comparison cohort and 4.36 per 10,000 person-years in the pesticide/detergent intoxication cohort. The corresponding adjusted hazard ratio (HR) for esophageal cancer was 2.33 (95% confidence interval [CI] = 1.41-3.86) in the pesticide/detergent intoxication cohort compared with the control cohort. Patients with corrosive and detergent intoxication did not have a higher risk of esophageal cancer (adjusted HR = 0.98, 95% CI = 0.29-3.33) than those without pesticide/detergent intoxication. However, patients with pesticide intoxication had a significantly higher risk of esophageal cancer (adjusted HR = 2.52, 95% CI = 1.52-4.18) than those without pesticide/detergent intoxication. Conclusion: In the present study, after adjusting for conventional risk factors, we observed that pesticide intoxication could exert substantial effects through increased esophageal cancer risk. However, patients with detergent intoxication may not have an increased risk of esophageal cancer.


Assuntos
Carcinoma/epidemiologia , Cáusticos/intoxicação , Neoplasias Esofágicas/epidemiologia , Praguicidas/intoxicação , Adulto , Idoso , Carcinoma/induzido quimicamente , Carcinoma/patologia , Estudos de Coortes , Detergentes/intoxicação , Ingestão de Alimentos/efeitos dos fármacos , Neoplasias Esofágicas/induzido quimicamente , Neoplasias Esofágicas/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Fatores de Risco
4.
Am J Emerg Med ; 38(6): 1296.e1-1296.e3, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31956048

RESUMO

A 64-year-old woman presented with coma, seizure, and lactic acidosis after ingesting 80 yam bean seeds. This rotenone-containing seeds cause cellular asphyxia via blockage of the mitochondrial electron transport. Subsequent oxidative stress results in the formation of lipid peroxidation (LPO). Rotenone analysis via liquid chromatography mass spectrometry revealed the following: 31,590 ng/mL in cooked yam bean seed and 100 ng/mL in the blood. We attempted to use N-acetylcysteine to alleviate oxidative stress and documented the continuous decline in the plasma concentration of LPO.


Assuntos
Pachyrhizus/efeitos adversos , Rotenona/análise , Acidose Láctica/complicações , Acidose Láctica/etiologia , Coma/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Estresse Oxidativo/efeitos dos fármacos , Rotenona/efeitos adversos , Rotenona/sangue , Convulsões/etiologia
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