Acute arsenic exposure secondary to deliberate self-poisoning with sheep dip.

A 53-year-old male patient presented to a regional hospital Emergency Department approximately 2 h post an intentional ingestion of Coopers Instant Wetting Powder Sheep Dip (66% arsenic trioxide, 23% sulphur and 0.42% rotenone), mixed in 600 mL water, as a suicide attempt. On arrival to the Emergency Department, the patient had nausea, vomiting and diarrhoea. Seven hours post ingestion, hypotension developed (BP 90/60 mmHg) and intravenous fluids were commenced. He later developed QTc prolongation. He was treated with 2,3-Dimercapto-1-propanesulfonic acid (DMPS) and N-acetylcysteine and improved without development of neurology. Further investigation of NAC efficacy in humans in the setting of acute arsenic poisoning is required and the optimal duration of treatment and dosing needs to be established. This case highlights an uncommon poisoning which presented to the Emergency Department, the acute symptoms of arsenic toxicity and considerations for management.

Intestinal perforation associated with chlorine dioxide ingestion: an adult chronic consumer during COVID-19 pandemic.

COVID-19 pandemic is one of the most devastating worldwide crises in recent years. During this pandemic, people have been exposed to products that have not been proven to be safe and effective against COVID-19. We present an adult chronic consumer of chlorine dioxide, in which a fatal outcome is described. This case demonstrates that for people searching products to protect themselves from COVID-19, unregulated access to industrial disinfectants represents a dangerous alternative. To date, there is no scientific evidence to uphold the use of chlorine dioxide or chlorine derivatives as preventive or therapeutic agents against COVID-19. Researchers and general population must take into consideration the fatal possible consequences of not following communications and warnings from health authorities and government institutions.

The impact of chicory (Cichoriumintybus L.) on hemodynamic functions and oxidative stress in cardiac toxicity induced by lead oxide nanoparticles in male rats.

BACKGROUND: A common environmental pollutant, lead can induce toxicity in several organ systems. A range of industrial and/or household materials and products contain lead, and food/liquid ingestion and inhalation are the mechanisms through which lead is introduced into the human body. OBJECTIVE: Since knowledge about the cardiac toxicity of acute lead nanoparticles is limited, this work sought to shed more light on the issue by investigating the therapeutic effects of chicory extract based on rat models to elevate cardiac functions and oxidative stress. METHODS: Four research groups were used, each consisting of ten albino rats of male sex and adult age. The groups were: control group, chicory group, lead oxide nanoparticle group, and lead oxide nanoparticle + chicory group. RESULTS: Compared to the control and chicory groups, the lead oxide nanoparticle group displayed a notable increase in heart functions and oxidative stress markers as well as alterations in cardiac histological structure. On the other hand, cardiac function modifications were counteracted through four-week administration of lead oxide nanoparticles alongside chicory. CONCLUSION: Heart damage caused by lead oxide nanoparticles may be attenuated by chicory through scavenging of free radicals.

Spatial distribution, risk and potential sources of lead in soils in the vicinity of a historic industrial site.

Because of measures taken by local and national government agencies to control releases of metals, former industrial sites in China that are contaminated with lead (Pb) in soils have been abandoned. Compared with historic sites themselves, little attention has been paid to contamination with Pb in areas surrounding these sites. In this study, a method by integrating sequential extraction and isotopic fingerprinting was proposed to reveal the key fractions of Pb contaminants in soils, trace their sources and determine the subject of liability for remediation. Topsoils from near a historic site, where lead oxide was produced, were found to be contaminated. Concentrations of Pb in soils were inversely proportional to distances from the industrial site and depth in soils. The predominant form of Pb was the Fe/Mn-oxide-bound fraction (FM3), which accounted for from 53.39% to 82.07% of total concentrations of Pb. Concentrations of Pb in vegetables produced on contaminated soils exceeded those allowed in food for consumption by humans. An assessment of hazards and risks posed by consumption of vegetables grown on these soils indicated relatively high potential for adverse effects on local residents around the closed plant. By use of isotopic finger printing for Pb, the abandoned factory was determined to be the most likely source of Pb in topsoils, especially fraction FM3. To mitigate exposures of people to Pb via consumption of locally produced food, recommended strategies should target legacy sources of Pb to soils in the vicinity of this historic industrial site.

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

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

Subchronic arsenism-induced oxidative stress and inflammation contribute to apoptosis through mitochondrial and death receptor dependent pathways in chicken immune organs.

In many organ dysfunctions, arsenic and its compounds are well known to induce apoptosis by the mitochondria and death receptor apoptotic pathways in liver and airway. However, it is less reported that which signaling pathways contribute to excessive apoptosis of chicken immune organs, a major target of toxic metals biotransformation, which suffer from subchronic arsenism. In this study, we investigated whether the mitochondria or death receptor apoptotic pathways activated in the immune organs (spleen, thymus and bursa of Fabricius) of one-day-old male Hy-line chickens exposed to arsenic trioxide (As2O3), which were fed on diets supplemented with 0, 0.625, 1.25 and 2.5 mg/kg BW of As2O3 for 30, 60 and 90 days. We found that (1) Oxidative damage and inflammatory response were confirmed in the immune organs of chickens fed on As2O3 diet. (2) Subchronic arsenism induced typical apoptotic changes in ultrastructure. (3) TdT-mediated dUTP Nick-End Labeling (TUNEL) showed that the number of apoptotic cells significantly increased under subchronic arsenism. (4) As2O3-induced apoptosis of immune organs involved in mitochondrial pathway (decrease of B-cell lymphoma-2 (Bcl-2) and increase of protein 53 (p53), Bcl-2 Associated X Protein (Bax), caspase-9, caspase-3) and death receptor pathway (increase of factor associated suicide (Fas) and caspase-8). In conclusion, this work is the first to demonstrate that the activation of mitochondria and death receptor apoptosis pathways can lead to excessive apoptosis in immune organs of chickens, which suffer from subchronic arsenism, meanwhile, oxidative stress as well as subsequent inflammatory is a crucial driver of apoptosis.

Fowler's Solution and the Evolution of the Use of Arsenic in Modern Medicine.

While arsenic has been used medicinally and as a poison for thousands of years, Fowler's solution, an arsenic compound, has had a fascinating history in medicine during the past 200 years. The use of Fowler's solution was first described and published as a treatment for malaria and syphilis in the late 1700s. Many clinical applications for Fowler's solutions have been studied and utilized over the years, but toxicities have limited its utility. Even so, arsenic trioxide, chemically related to Fowler's solution, was approved by the US Food and Drug Administration for treating acute promyelocytic leukemia. The history of Fowler's solution, its applications and uses, and benefits and risks are discussed.

[Acute arsenic poisoning]. / Intoxication aiguë à l'arsenic.

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

Nanotoxicity: oxidative stress mediated toxicity of metal and metal oxide nanoparticles.

Metal and metal oxide nanoparticles are often used as industrial catalysts or to improve product's functional properties. Recent advanced nanotechnology have been expected to be used in various fields, ranging from sensors, environmental remediation to biomedicine, medical biology and imaging, etc. However, the growing use of nanoparticles has led to their release into environment and increased levels of these particles at nearby sites or the surroundings of their manufacturing factories become obvious. The toxicity of metal and metal oxide nanoparticles on humans, animals, and certainly to the environment has become a major concern to our community. However, controversies still remain with respect to the toxic effects and the mechanisms of these nanoparticles. The scientific community now feels that an understanding of the toxic effects is necessary to handle these nanoparticles and their use. A new discipline, named nanotoxicology, has therefore been developed that basically refers to the study of the interactions of nanoparticles with biological systems and also measures the toxicity level related to human health. Nanoparticles usually generate reactive oxygen species to a greater extent than micro-sized particles resulting in increased pro-inflammatory reactions and oxidative stress via intracellular signaling pathways. In this review, we mainly focus on the routes of exposure of some metal and metal oxide nanoparticles and how these nanoparticles affect us or broadly the cells of our organs. We would also like to discuss the responsible mechanism(s) of the nanoparticle-induced reactive oxygen species mediated organ pathophysiology. A brief introduction of the characterization and application of these nanoparticles has also been included in the article.

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

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.

Acute arsenic self-poisoning for suicidal purpose in a dentist: a case report.

Arsenic is a classical poison that has been historically used since ancient times for homicidal purposes. More recently, episodes of deliberate or unintentional arsenic self-poisoning have been increasingly reported. We describe here a case of a 77-year old male patient with a history of major depression, who attempted suicide by ingestion of 4 g of arsenic trioxide. The man, a dentist by profession, used arsenic preparations for pulp devitalization. The patient was admitted to our hospital 5 h after arsenic ingestion with nausea and vomiting. Plain radiograph of the abdomen showed radio-opaque material in the stomach and small intestine. Nasogastric lavage, activated charcoal, and chelators were used to remove arsenic. On day 3, endoscopy disclosed the presence of gastritis and superficial ulcers. The patient developed significant anemia (Hb: 8.7 g/dL on day 7) without significant signs of hemolysis. He gradually recovered from anemia within 5 months. The patient did not suffer any adverse outcome in spite of having ingesting 4 g of arsenic, approximately 20 times the lethal dose.

Survival after a massive overdose of arsenic trioxide.

Arsenic poisoning remains a therapeutic challenge, and outcomes are often poor. An 18-year-old man deliberately ingested termiticide containing a massive dose of arsenic trioxide. Arsenic concentration was 6.3 micromol/L in serum on ICU Day 1, and 253 micromol/L in the first 24-hour urine sample, with a urinary arsenic/creatinine ratio of 84 200 micromol/mol. He was treated with the chelating agent meso-2,3-dimercaptosuccinic acid (DMSA) (replaced by dimercaprol on Days 2-5) and required intensive support for multisystem organ failure, but recovered slowly. Nine weeks after the ingestion the only ongoing clinical issue was persistent but slowly improving peripheral neuropathy.

Acute arsenic trioxide ant bait ingestion by toddlers.

INTRODUCTION: Arsenic trioxide is available for home use in ant baits. Potential arsenic toxicity from unintentional pediatric ingestion is not well studied. The goal of this study is to describe the clinical course and urinary arsenic concentrations of children who ingested ant bait containing arsenic trioxide (0.46%). METHODS: This is a case series of pre-school children who unintentionally ingested arsenic trioxide ant bait gel bars in the home reported to two U.S. poison control centers from January 2003 to July 2007. RESULTS: Six children (age range, 8 months to 4 years) ingested varying portions of ant bait gel bars containing arsenic trioxide (0.46%). All vomited shortly after exposure. The initial, pre-chelation urine total arsenic concentrations ranged from 1,858 to 13,981 mcg/L. All children had resolution of symptoms and received chelation with succimer. Follow-up urine arsenic concentrations were in the normal range 14-35 days after chelation and no further clinical toxicity was noted. CONCLUSIONS: Children who ingest all or part of a household ant bait gel bar that contains relatively low concentration of arsenic trioxide can develop markedly elevated urine arsenic concentrations with minor initial symptoms. Prompt chelation with succimer is recommended for children with these exposures and continued until urine arsenic concentrations are normal.

Toxic remedy: a case of a 3-year-old child with lead colic treated with lead monoxide (greta).

This article reports the case of a 3-year-old male with an elevated blood lead level. The child had a history of consuming imported lead-contaminated candies resulting in abdominal pains for which he was given a Hispanic folk remedy, called greta, by his mother. The home remedy aggravated the child's symptoms which prompted medical consultation. Analysis of the powdered folk remedy revealed a lead concentration of 140 000 ppm. This case highlights the complexities associated with identifying unfamiliar sources of lead poisoning, and their potential relationships to cultural practices.

[Two different clinical cases of acute arsenic trioxide intoxication]. / Dwa przypadki ostrego zatrucia arszenikiem o róznym przebiegu klinicznym.

This paper describes two different cases of acute suicidal arsenic trioxide intoxication. Case no 1. A 38-year-old man, alcohol abuser, who ingested 4-5 g dental paste, which corresponds to 2.2-2.7 g of pure arsenic trioxide, developed gastritis with vomiting and abdominal pain, but without diarrhea. No cardiovascular collapse or renal failure were observed. The patient developed also symptoms of central nervous system injury (minor left paresis) and transient hepatic impairment. A head CT revealed no pathological changes in the brain. Hepatic disturbance recovered in a few days and the patient could be discharged on the 12 day. Case no 2. A 57-year-old man, who ingested few grams of pure arsenic developed vomiting, abdominal pain and severe diarrhea. Cardiovascular collapse as a result of intravascular volume depletion, vasodilatation and myocardial dysfunction was observed. The patient died on the first day of hospitalization. In both cases treatment included gastric lavage, BAL therapy, haemodialysis and supportive measures.