Retrospective assessment of acute poisoning incidents by nonpharmaceutical agents in Jordan: Data from Pharmacy One™ Poison Call Center, 2014 to 2018-Part I.

The Pharmacy One™ Poising Call Center (P1 PCC), located in Amman, Jordan, was created to address deficiencies identified by the pharmacy service, including in the management of poisoning cases. The aims of this study were to analyze the patterns of poisoning cases reported to the P1 PCC and to describe the role of the P1 PCC pharmacist in ensuring preparedness and managing the response to poisoning cases. In addition, the information from these interventions was used to survey human poisoning in Jordan. This is a retrospective descriptive study of acute poisoning incidents in the Jordanian population, as recorded by the P1 PCC during the period 2014-2018. Inquiries received by the P1 PCC were recorded on a predesigned form. The year, patient demographics, toxic agent involved, and circumstances of the poisoning event were all fully documented utilizing Oracle and Excel spreadsheets. A total of 1992 poisoning incidents were reported to the P1PCC, predominately (68.59%) via 911 phone calls. Reports were predominantly from males (1.67:1). Children were the second most common age group after adolescents (22.62% and 42.49%, respectively). The most frequent causative nonpharmaceutical agents were household products (17%) in preschool children and animal bites (20%) in adolescents. Most of the poisoning incidents (74.63%) occurred at home. Unintentional poisoning (54.12%), with mild medical outcomes (61.45%), accounted for most of the poisoning incidents caused by exposure to household products. These data may represent the most recent picture of poisoning incidents in Jordan. Emergency medical services were provided by experienced pharmacy practitioners at the P1 PCC, to respond to emergency needs in the community in a professional manner. Therefore, the need for unnecessary hospitalization and the cost of ambulance dispatch were minimized, which are highly valuable outcomes.

Meat quality assessment from young goats fed for long periods with castor de-oiled cake.

Diet can influence both the qualitative and quantitative traits of ruminant meat. This study evaluated the effects of castor de-oiled cake on the meat of mixed-breed male goat kids. After 165days of diet treatment, no alterations (p>0.05) were observed in the in vivo performance, anatomic components, dissection and proximate composition of the Longissimus dorsi muscle, as well as in the color and pH of the carcasses. However, diet had an effect (p<0.05) on energy metabolites, fatty acid profile, and expression of certain proteins of the Longissimus dorsi muscle. To conclude, this study showed that the establishment of castor de-oiled cake diet for a long period to goats led to alterations in meat quality, without compromising its consumption qualities.

Assessment of mycotoxin exposure in the Belgian population using biomarkers: aim, design and methods of the BIOMYCO study.

Mycotoxins are harmful food contaminants. Currently, human exposure assessment to these toxins is often based on calculations combining mycotoxin occurrence data in food with population data on food consumption. Because of limitations inherent to that approach, biomarkers have been proposed as a suitable alternative whereby a more accurate assessment of exposure at the individual level can be performed. The BIOMYCO study is designed to assess human mycotoxin exposure using urinary biomarkers of exposure. Over the different seasons of 2013 and 2014, morning urine is gathered in a representative part of the Belgian population according to a designed study protocol, whereby 140 children (3-12 years old) and 278 adults (19-65 years old) are selected based on random cluster sampling stratified for sex, age and geographical areas. Every participant completes a food frequency questionnaire to assess the consumption of relevant foodstuffs (n = 43) of both the day before the urine collection and the previous month. Validated multi-toxin LC-MS/MS methods are used to analyse aflatoxins, fumonisins, ochratoxin A, trichothecenes, zearalenone and their metabolites in morning urine. The study protocol is approved by the ethical committee of the Ghent University Hospital. Within this paper, study design and methods are described. The BIOMYCO study is the first study whereby a multi-toxin approach is applied for mycotoxin exposure assessment in adults and children on a large scale. Moreover, it is the first study that will describe the exposure to an elaborated set of mycotoxins in the Belgian population. In first instance, descriptive analysis will be performed, describing the exposure to mycotoxins for the child and adult group. Exposure of different subgroups will be compared. Furthermore, correlations between the mycotoxin concentrations measured and the food consumption reported will be estimated to explore whether the mycotoxin exposure could be explained by the consumption of certain foods.

T-2 and HT-2 toxins in cereals and cereal-based products in South Korea.

A total of 214 samples, consisting of brown rice, barley, mixed grains, corn, wheat and wheat flour were analysed for T-2 and HT-2 toxins using high-performance liquid chromatography with fluorescence detection. Recovery and repeatability were 79.9%-107.5% and 4.9%-14.5% for T-2, and 74.0%-106.1% and 5.0%-17.9% for HT-2, respectively. T-2 toxin was detected in 11 (5.1%) of all samples. The highest incidence was found in corn (21.7%) followed by mixed grains and brown rice. Mean of all samples was 1.5-4.1 µg kg⁻¹, the maximum level being 41.5 µg kg⁻¹ in corn. HT-2 toxin was detected in 126 (58.9%) of all samples, and the mean values were 26.4-59.2 µg kg⁻¹. The estimated daily intakes for the sum of T-2 and HT-2 toxins were 2.56, 3.22, 2.53, 0.03, 0.01 and 2.45 ng (kg bw)⁻¹ day⁻¹ in brown rice, barley, mixed grains, corn, wheat and wheat flour, respectively.

Fusariotoxins in Russian Federation 2005-2010 grain harvests.

Monitoring results of food grain contamination with fusariotoxins-deoxynivalenol (DON), zearalenone (ZEN), fumonisins (FB1&FB2), T-2 and HT-2 toxins-are presented. Harvests of 2005-2010 in different regions of Russia were investigated. The occurrence of DON in wheat was 8%, barley 9%, oats 4%, rye 2% and maize 2%. The highest frequency of ZEN contamination was found in oats, the lowest in wheat. Calculated average daily intake of DON varied from 0.066 to 0.096 µg/kg body weight, the highest being found in the Southern region, but substantially lower than the provisional maximum tolerable daily intake. The results of enzyme-linked immunosorbent assay and high-performance liquid chromatography-mass spectrometry analysis demonstrated the presence of T-2 toxin in 14% and HT-2 toxin in 17% of all samples. The maximum level of T-2 toxin was exceeded only in one sample of barley. Relatively high frequency and levels of FB1&FB2 contamination were found in maize.

Lead, cadmium, arsenic, mercury and copper levels in Chinese Yunnan Pu'er tea.

The Yunnan region of China produces a distinctive variety of Pu'er tea, which is consequently labeled as a Chinese geographic indication product. In this study, the safety of Chinese Yunnan Pu'er tea with regard to heavy metal content was evaluated in 30 different brands of Pu'er tea, including 150 commercial samples. Metal levels in the Pu'er tea samples followed the order: copper (12-22 µg/g) > lead (0.26-3.2 µg/g) > arsenic (0.035-0.24 µg/g) > cadmium (0.0059-0.085 µg/g) > mercury (<0.010 µg/g). Mercury was not detected in 17 of the brands of Pu'er tea. Metal-to-metal correlation studies showed that there were no significant correlation between metal pairs. Based on current safety standards, the low levels of metals detected in these Pu'er tea samples mean they are safe for human consumption.

Deoxynivalenol and zearalenone in Fusarium-contaminated wheat in Mexico City.

Fusarium spp. invasion causes head blight, a destructive disease in the world's main wheat-growing areas, and deoxynivalenol (DON) and zearalenone (ZEA) contamination in cereal-based products. No data are available on the relationship between Fusarium spp. on commercial wheat samples in Mexico City and the presence of mycotoxins. A total of 30 wheat samples were subject to a PCR method involving genes of the trichothecene and zearalenone biosynthesis pathways to detect the presence of Fusarium. Detection and quantification of DON and ZEA was performed using liquid chromatography coupled to UV detection. PCR indicated the presence of the Tri5 and PKS4 genes in 16.7 and 23.3% of samples, respectively. DON and ZEA contamination was found in 51.2 and 71.4% of samples, respectively, where a positive amplification was obtained. This work presents up-to-date information on mycotoxin contamination in Mexico, where improved contamination/exposure data and firm control/monitoring measures are needed.

Research toward the development of a biologically based dose response assessment for inorganic arsenic carcinogenicity: a progress report.

Cancer risk assessments for inorganic arsenic have been based on human epidemiological data, assuming a linear dose response below the range of observation of tumors. Part of the reason for the continued use of the linear approach in arsenic risk assessments is the lack of an adequate biologically based dose response (BBDR) model that could provide a quantitative basis for an alternative nonlinear approach. This paper describes elements of an ongoing collaborative research effort between the CIIT Centers for Health Research, the U.S. Environmental Protection Agency, ENVIRON International, and EPRI to develop BBDR modeling approaches that could be used to inform a nonlinear cancer dose response assessment for inorganic arsenic. These efforts are focused on: (1) the refinement of physiologically based pharmacokinetic (PBPK) models of the kinetics of inorganic arsenic and its metabolites in the mouse and human; (2) the investigation of mathematical solutions for multi-stage cancer models involving multiple pathways of cell transformation; (3) the review and evaluation of the literature on the dose response for the genomic effects of arsenic; and (4) the collection of data on the dose response for genomic changes in the urinary bladder (a human target tissue for arsenic carcinogenesis) associated with in vivo drinking water exposures in the mouse as well as in vitro exposures of both mouse and human cells. An approach is proposed for conducting a biologically based margin of exposure risk assessment for inorganic arsenic using the in vitro dose response for the expression of genes associated with the obligatory precursor events for arsenic tumorigenesis.

The use of human experience data in the EU risk assessment process.

The incorporation of human experience data (HD) into the risk assessment process is encouraged by various authorities with the aim of improving the robustness of the subsequent findings. HD, however, can present in many forms, ranging from epidemiological studies to the accumulated experiences from poison centers. This diversity of the human experience, combined with the manner in which it may (or may not) present, creates several challenges for risk assessors if they are to give available HD due weight in the RA process. An evaluation was made of how HD has been cited and used within the 64 human health RAs published by the EU to the end of 2005. In all RAs, HD had been cited to some degree. But there was no consistency between how cited data had subsequently been taken forward and used in the evaluation of different endpoints, either between the RAs authored by the same or different EU Member States. The lack of any accepted guidance for addressing the role that HD can play within the RA process appears to lead to this situation. Recommendations are provided on the scope and focus such guidance could usefully be expected to take.

Research approaches to address uncertainties in the risk assessment of arsenic in drinking water.

Inorganic arsenic (iAs), an environmental drinking water contaminant, is a human toxicant and carcinogen. The public health community has developed recommendations and regulations that limit human exposure to iAs in drinking water. Although there is a vast amount of information available to regulators on the exposure, disposition and the health-related effects of iAs, there is still critical information about the toxicology of this metalloid that is needed. This necessary information includes identification of the chemical species of arsenic that is (are) the active toxicant(s), the mode(s) of action for its various toxicities and information on potentially susceptible populations. Because of these unknown factors, the risk assessment of iAs still incorporates default assumptions, leading to uncertainties in the overall assessment. The characteristics of a scientifically defensible risk assessment for iAs are that it must: (1) quantitatively link exposure and target tissue dose of active metabolites to key events in the mode of action for major health effects and (2) identify sources of variation in susceptibility to arsenic-induced health effects and quantitatively evaluate their impact wherever possible. Integration of research to address these goals will better protect the health of iAs-exposed populations.

Poder, Hierarquia e Reciprocidade: saúde e harmonia entre os Baniwa do Alto Rio Negro / Power, Hierarchy and Reciprocity: health and harmony among the Baniwa from the Upper Rio Negro

Resultado de ampla pesquisa na qual a autora apresenta os diversos aspectos que compõem o complexo mundo baniwa, a importância que a doença ocupa nele, suas especificidades, sua cultura, seu modo estóico de vida, suas inter-relações com outros grupos étnicos do Alto Rio Negro, Amazonas. Nos permite mergulhar e melhor compreender o 'caleidoscópio de problemas vividos hoje pelos povos indígenas' no Brasil em diversas áreas. Sociopoliticamente de alta relevância, revela a distância entre as necessidades desse povo e os serviços de saúde para eles disponibilizados, pautados por um tendência à uniformização e baixa sensibilidade às diferenças culturais. Transcende o contexto rionegrino, sendo relevante para o universo indígena como um todo. Academicamente instigante e politicamente perspicaz, inaugura nova coleção em grande estilo.

Utilization of data obtained in pilot acute experiments for practical hygienic assessment of a chemical substance.

A large number of the chemical substances and preparations (compositions) that are incorporated into the national economy cannot be subjected to long-term and detailed testing for toxicity and safety. There are simple methods on the acute experimental level which can serve as a basis for working out the necessary prophylactic measures in introducing new substances into the industry. Determination of LD50 upon intragastric administration, intravenous administration (model of rapid penetration into the organism), static inhalatory treatment under saturated concentration, determination of the primary local effect of the skin and mucous membranes, together with careful observation of the behaviour of the experimental animals, signs of their intoxication and their death, as well as comparison of the physico-chemical properties of the substance and its already familiar structural analogues may serve as the ground for predicting the biological significance of the new substance even at longer terms of contact with the organism and making toxicological and hygienic assessments under concrete technological conditions.