Organoleptic assessment and median lethal dose determination of oral aldicarb in rats.

Aldicarb, a carbamate pesticide, is an acetylcholinesterase inhibitor, with oral median lethal dose (LD50 ) estimates in rats ranging from 0.46 to 0.93 mg/kg. A three-phase approach was used to comprehensively assess aldicarb as an oral-ingestion hazard. First, the solubility of aldicarb in popular consumer beverages (bottled water, apple juice, and 2% milk) was assessed. Lethality was then assessed by administering aldicarb in bottled water via gavage. A probit model was fit to 24-h survival data and predicted a median lethal dose of 0.83 mg/kg (95% CI: 0.54-1.45 mg/kg; slope: 4.50). Finally, organoleptic properties (e.g., taste, smell, and texture) were assessed by allowing rats to voluntarily consume 3.0 mL of the above beverages as well as liquid eggs adulterated with aldicarb at various concentrations. This organoleptic assessment determined that aldicarb was readily consumed at lethal and supralethal doses. Overt toxic signs presented within 5 min post-ingestion, and all rats died within 20 min after consuming the highest concentration (0.542 mg/mL), regardless of amount consumed. Because rats have more developed chemoreceptive capabilities than humans, these results suggest that aldicarb may be consumed in toxic or even lethal concentrations by humans in a variety of beverages or foods.

Mioclonías generalizadas tras la ingesta de aldicarb como intento de autolisis / Generalized myoclonus after ingestion of aldicarb as suicide attempt

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Exhumation of Wistar rats experimentally exposed to the carbamate pesticides aldicarb and carbofuran: A pathological and toxicological study.

Exhumation is required for the investigation of suspicions deaths when a body is buried and is usually performed under court order. Exhumation of animals is not a routine practice in forensic pathology. In this study, 30 male 70-day-old Wistar rats were experimentally exposed to the carbamate pesticides aldicarb and carbofuran. Toxicological, macroscopic and microscopic examinations were performed. Groups of 3 animals (2 exposed and 1 control) were evaluated at 24h, 3days, 5days, 7days and 10days post-mortem. In histopathological examination, the brain, liver, lungs and kidneys were assessed, and for toxicological analysis, the gastric contents, liver, vitreous humor, skeletal muscle and larvae (when available) were collected. The pesticides were detected by HPLC and quantified in the analyzed matrices, and a possible delay in tissue putrefaction due to the pesticides was observed. This study has revealed that it is possible to exhume animals for investigations of possible poisoning by carbamates and has demonstrated that the exhumation of an animal in a suspected case of poisoning should not be ruled out. The increasing demand for investigations of suspicious animal deaths, e.g., in cases of poisoning, will likely lead to an increase in the use of this type of procedure in veterinary pathology.

Death by chumbinho: aldicarb intoxication-regarding a corpse in decomposition.

Chumbinho is the popular name given to carbamate aldicarb (Temik), an insecticide commonly used in agriculture and highly toxic (LD50 = 0.9 mg/kg oral in rats) that has been sold clandestinely in several regions of Brazil. Chumbinho is sold illegally as raticide and is available in a formulation of small black granules which are easily mixed with food for criminal purposes, its use often being attributed to accidents and suicides, hence the importance of its inclusion in the toxicology studies of suspicious deaths. With the corpse putrefaction, many pathological and toxicological anatomical parameters are damaged or lost. This study emphasizes the importance of the gastric content observation, which in this case has, despite the advanced putrefaction, recognized the presence of chumbinho and guide its toxicological confirmation.

Disulfiram inhibition of cyanide formation after acetonitrile poisoning.

CONTEXT: Cyanide poisoning may be caused by acetonitrile, a common industrial organic solvent and laboratory agent. OBJECTIVE: To describe the potential use of disulfiram in treating acetonitrile poisoning in a human clinical case and to further study its effect in human liver microsomes in vitro. CASE DETAILS: A 30-year-old man initially presented with a cholinergic toxic syndrome following ingestion of aldicarb. Toxicological analysis revealed coingestion of ethanol. He subsequently developed severe metabolic acidosis caused by the cyanogenic compound acetonitrile which was erroneously interpreted as acetone in the chromatogram. After three treatments with hydroxocobalamin (5 g i.v.) and sodium thiosulfate (12.5 g i.v.) on days 2, 3, and 5, he had transient improvement but recurrent lactic acidosis. Treatment with disulfiram was associated on day 7 with resolution of metabolic acidosis and slowing of the decrease in acetonitrile concentration. He recovered from acetonitrile toxicity completely. The time course of acetonitrile, thiocyanate, and cyanide concentrations suggested that disulfiram inhibited cyanide formation. RESULTS: In vitro experiments with human liver microsomes showed the cyanide concentration was significantly lower after incubation with acetonitrile and disulfiram than acetonitrile alone (a mean 60% reduction in cyanide level). DISCUSSION: Although disulfiram was given late in the course of the poisoning it is possible that it contributed to the recovery.

Poisoning of cats and dogs by the carbamate pesticides aldicarb and carbofuran.

The intentional and accidental poisoning of animals and people is a threat to public health and safety worldwide. Necropsies and histopathological examinations of 26 cats and 10 dogs poisoned by the carbamates aldicarb and carbofuran, confirmed by thin layer chromatography (TLC) and high performance liquid chromatography with diode-array detector (HPLC-DAD) were analysed, with variable post mortem interval and conservation of the carcass. Biological matrices were collected for toxicological and histopathological analyses. High performance liquid chromatography with diode-array detector (HPLC-DAD) was utilized to detect aldicarb and its metabolites, aldicarb sulphoxide and aldicarb sulphone, and carbofuran. The variable post mortem interval and the method of conservation of the carcass may be harmful to toxicological, necroscopic and histopathological analyses, that should be performed in order to provide reliable evidences to investigate possible poisoning of animals, which is cruel crime, and are usually linked to domestic or social conflict.

The pharmacokinetics and pharmacodynamics of severe aldicarb toxicity after overdose.

OBJECTIVE: To describe the clinical effects, pharmacokinetics, and pharmacodynamics of plasma and acetylcholinesterase in an aldicarb overdose. CASE REPORT: A 57-year-old female was found unconscious and incontinent of urine after ingesting aldicarb. She was bradycardic, hypotensive, hypersalivating, clammy, had small pupils, and generalized weakness. She was intubated, ventilated, and treated with large atropine doses (50 mg and 20 mg/h infusion) and adrenaline. She improved hemodynamically over 24 h, but remained comatose for another 24 h, before recovering without sequela. Aldicarb concentration at admission was 2.18 µg/ml and concentration-time data best fitted a two compartmental model with first order absorption and a time of ingestion 4.5 h preadmission. The half-life of distribution was 0.4 h and half-life of elimination, 13 h. Plasma cholinesterase concentration at admission was 0.3 kU/L (Reference range[RR]:4.3-10.6 kU/L) and red cell cholinesterase was 10 U/gHb (RR:38-66 U/gHb). The IC50 was 0.15 µg/ml and 0.26 µg/ml for plasma and red cell cholinesterase, respectively. DISCUSSION: Aldicarb poisoning causes rapid onset severe toxicity with muscarinic and nicotinic excess, seizures, and decreased consciousness. Cholinesterases rapidly recover once aldicarb concentrations decrease and precede clinical recovery.

Confirmed organophosphorus and carbamate pesticide poisonings in South African wildlife (2009-2014).

During a six-year period (from January 2009 to December 2014), specimens collected from 344 cases of suspected organophosphorus and carbamate pesticide poisonings in wildlife, including birds, were submitted to the Toxicology Laboratory (ARC-OVI) for analysis. A positive diagnosis was made in 135 (39%) of these cases. The majority of cases were from birds, which included Cape vultures (Gyps coprotheres) and African white-backed vultures (Gyps africanus) and bateleur eagles (Terathopius ecaudatus). In one incident 49 vultures were killed when a farmer intentionally laced carcasses with carbofuran in an attempt to control jackal predation. There were 22 incidents of poisoning in helmeted guineafowl (Numida meleagris). On nine different occasions blue cranes (Anthropoides paradiseus) were poisoned, in one incident 14 birds were reported to have been killed. Over the period of investigation, there were 20 cases of poisoning involving mammalian species, the majority being vervet monkeys (Chlorocebus pygerythrus). The carbamate pesticides were responsible for 57 incidents of poisoning. Aldicarb, carbofuran and methomyl were detected in 26, 18 and 12 cases respectively. The majority of organophosphorus pesticide poisonings were caused by diazinon (n = 19), monocrotophos (n = 13) and methamidophos (n = 10).

Intoxicação aguda por agrotóxicos anticolinesterásicos na cidade do Recife, Pernambuco, 2007-2010 / Acute anticholinesterase pesticide poisoning in Recife, Pernambuco State, Brazil, 2007-2010 / Intoxicación aguda por agrotóxicos anticolinesterásicos en la ciudad de Recife, Pernambuco, 2007-2010

Objetivo: descrever as características epidemiológicas e a distribuição espacial dos casos de intoxicações agudas por agrotóxicos anticolinesterásicos na cidade do Recife, estado de Pernambuco, Brasil, no período 2007-2010. Métodos: estudo descritivo das notificações registradas no Sistema de Informação de Agravos de Notificação (Sinan), para levantamento do perfil epidemiológico e geoprocessamento. Resultados: foram identificados 549 casos de intoxicações agudas por agrotóxicos anticolinesterásicos, sendo as maiores frequências observadas no sexo feminino (60,3 por cento), na faixa etária de 15 a 29 anos (42,3 por cento) e naqueles de cor ou raça parda (95,3 por cento); o "chumbinho" representou o principal agente tóxico envolvido (92,2 por cento) e o principal motivo das intoxicações foi a tentativa de suicídio (79,4 por cento). Conclusão: a intoxicação por agrotóxicos anticolinesterásicos acometeu principalmente mulheres, jovens e pardos; o achado de que a grande maioria dos casos estava relacionada a tentativa de suicídio indica a necessidade de ações de prevenção focadas na população detectada como vulnerável.

Objective: to describe the epidemiological characteristics and spatial distribution of acute anticholinesterase pesticide poisoning cases in the city of Recife Pernambuco State, Brazil, 2007-2010. Methods: this was a descriptive study of cases reported on the Notifiable Diseases Database (Sinan) to obtain their epidemiologic profile and perform geoprocessing. Results: 549 cases were identified. The highest frequencies occurred among females (60.3 percent), the 15-29 age group (42.3 percent) and brown-skinned individuals (95.3 percent). "Rat poison" was the main poisoning agent found (92.2 percent) and attempted suicide was the main reason for poisoning (79.4 percent). Conclusion: anticholinesterase pesticide poisoning is a serious public health problem with a high proportion of cases concentrated in youth, women and brown-skinned people. The finding that the vast majority of cases were related to attempted suicide indicates the need for prevention actions focusing vulnerable populations.

Objetivo: describir las características epidemiológicas y la distribución espacial de los casos de intoxicaciones agudas por agrotóxicos anticolinesterásicos en la ciudad de Recife, estado de Pernambuco, Brasil, en el período 2007-2010.Métodos: estudio descriptivo de las notificaciones registradas en el Sistema de Información de Agravamientos de Notificación (Sinan), para analizar el perfil epidemiológico y el geoprocesamiento.Resultados: se identificaron 549 casos de intoxicaciones agudas por agrotóxicos anticolinesterásicos, siendo observadas las mayores frecuencias en el sexo femenino (60,3%), en la franja de edad de 15 a 29 años (42,3%) y en las personas de color o raza parda (95,3%); el rodenticida ("chumbinho") fue el principal agente tóxico involucrado (92,2%) y el principal motivo de las intoxicaciones fue el intento de suicidio (79,4%). Conclusion: la intoxicación por agrotóxicos anticolinesterásicos acometió principalmente a mujeres, jóvenes y a pardos; el hallazgo de que en la gran mayoría de los casos estaba relacionada al intento de suicidio indica la necesidad de acciones de prevención dirigidas a la población detectada como vulnerable.

[Acute voluntary poisoning by carbamate]. / Intoxication aiguë volontaire par un carbamate.

Acute poisoning by organophosphate or carbamate is important to recognize since it can cause severe complications such as cardiorespiratory failure, coma, and even death in the absence of early management. Pharmacologically, the mode of action of these substances is based on an inhibition of cholinesterases; the clinical presentation therefore consists of a cholinergic syndrome. The typical clinical picture can be confirmed by the dosage of plasma cholinesterases. On a therapeutic viewpoint, atropine remains the antidote of choice. In high doses, it is the only molecule with a demonstrated effect for the specific treatment of such poisonings. Pralidoxime is clearly recommended in case of poisoning by an organophosphate, but is more discussed when carbamates are involved. The observation of a case of voluntary poisoning by a powerful carbamate, aldicarbe, offers s the opportunity to review the key elements of this type of poisoning. The rather loose inaugural presentation and the initial absence of diagnosis, underline the value of an adequate premature symptomatic care.

Aldicarb: a case series of watermelon-borne carbamate toxicity.

Improper use of pesticides on food plants can result in significant toxicity. In spite of regulations, enforcement, and prior episodes of poisonings, poisonings from misapplication of pesticides continues to occur. The objective of this study was to present a case series of toxicity resulting from ingestion of watermelon inappropriately treated with the carbamate insecticide aldicarb. A restrospective review of medical records, impounding the suspected watermelons, and chemical analysis of the watermelon samples using liquid chromatography and mass spectroscopy were carried out. Seven farm workers shared a watermelon and presented to a rural emergency department with symptoms of cholinergic poisoning. They were treated empirically with atropine and pralidoxime. The farmer denied use of insecticides other than rat poison on the watermelon patch. Chemical analyst verified aldicarb in the watermelon samples from the field, but none in control samples. Despite government regulations, application of restricted pesticides such as aldicarb continues to occur and cause significant poisonings.

Perfil do paciente com intoxicação exógena por "chumbinho" na abordagem inicial em serviço de emergência / Profile of a patient with exogenous intoxication by "BBs" in the initial approach at an emergency service / Perfil del paciente con intoxicación exógena por raticidas en el abordaje inicial en servicio de emergencia

Objetivou-se com este trabalho conhecer o perfil do paciente intoxicado por chumbinho admitido na emergência, descrevendo a abordagem inicial e o seu desfecho do mesmo, após o tratamento. Trata-se de um estudo descritivo, realizado por meio de pesquisa em prontuários de pacientes atendidos na emergência de um hospital no município de Fortaleza. As maiores ocorrências aconteceram com homens (52,8%), na zona urbana (95,7%), entre faixa etária de 18 a 28 anos (55,7%), em tentativas de autoextermínio (61,4%). No atendimento inicial, foram realizados monitorização dos sinais vitais, oximetria de pulso, passagem de sonda nasogástrica, lavagem gástrica, intubação endotraqueal, aspiração, oxigenoterapia, administração de carvão ativado e atropinização. A maioria dos casos precisou de internação (98,6%), destes, 68,5% tiveram cura confirmada. Em geral, os registros apresentavam-se incompletos, demonstrando a necessidade de preenchimento sistematizado. Conclui-se que a conduta adequada dos profissionais de saúde influenciará significativamente na inativação do toxicante, prevenindo complicações e mortalidade.

The objective of this study was to identify the profile of patients intoxicated with BBs (lead projectiles) admitted at an emergency room, describing the initial approach and the outcome after treatment. This descriptive study was performed by means of a search using the medical files of patients seen at the emergency room of a hospital in Fortaleza. Most occurrences involved men (52.8%), in the urban area (95.7%), aged between 18 and 28 years (55.7%), who had attempted self-extermination (61.4%). The initial care included monitoring vital signs, pulse oximetry, inserting a nasogastric tube, gastric lavage, endotracheal intubation, aspiration, oxygen therapy, administering activated charcoal, and atropinization. Most cases required patient admission (98.6%), 68.5% of which were cured. In general, records were incomplete, suggesting the need for a systematized completion. In conclusion, the adequate conduct of healthcare professionals will have a significant effect on the inactivation of the toxicant, thus avoiding complications and death.

Se objetivó conocer el perfil del paciente admitido en emergencias intoxicado por raticidas y describir su abordaje inicial una vez admitido y el desenlace luego del tratamiento. Estudio descriptivo realizado mediante investigación de historias clínicas de pacientes atendidos en sector de emergencias de hospital del municipio de Fortaleza. Prevalecieron hombres (52,8%), de zona urbana (95,7%), faja etaria de 18 a 28 años (55,7%), en tentativa de suicidio (61,4%). En la atención inicial, se realizó monitoreo de signos vitales y oximetría de pulso, pasaje de sonda nasogástrica, lavaje estomacal, entubado endotraqueal, aspiración, oxigenoterapia, administración de carbón activado y atropinización. La mayoría requirió internación (98,6%); de ellos, 68,5% alcanzaron curación confirmada. Generalmente, los registros se presentaban incompletos, mostrando la necesidad de rellenado sistematizado. Se concluye en que la conducta adecuada de los profesionales de salud influirá significativamente en la inactivación del tóxico, previniendo complicaciones y mortalidad.

Poisoning by illegal rodenticides containing acetylcholinesterase inhibitors (chumbinho): a prospective case series.

OBJECTIVE: To describe a prospective case series of poisonings caused by ingestion of illegal rodenticides containing acetylcholinesterase inhibitors, mainly "chumbinho," followed-up by the Campinas PCC for a period of 1 year. CASE SERIES: Seventy-six cases were included, of which 53.9% were males. Age ranged from 2 to 74 years (median = 36 years). The main circumstances leading to poisoning were intentional (suicide attempts 92.1%; homicide attempts 5.3%), and 65.8% were admitted less than 2 hours after ingestion. Most of the patients (96.1%) showed cholinergic muscarinic manifestations, particularly salivation (86.8%), myosis (77.6%), sweating (50%), and bronchorrhea (35.5%). Atropine was used in 82.9% of patients (median = 2 days), intubation and mechanical ventilation in 46.1% (median = 3 days), and the median length of the hospital stay was 4 days. Plasma samples obtained upon admission in 59 cases revealed (LC-MS/MS): aldicarb (55), carbofuran (2), aldicarb and carbofuran (1), no active component (1). In most of the plasma and urine samples collected upon admission, the highest concentrations (ng/mL) obtained were for the active metabolite aldicarb sulphoxide (plasma, median = 831, IIQ = 99.2-2885; urine, median = 9800, IIQ = 2000-15000) than aldicarb (plasma, median = 237, IIQ = 35.7-851; urine, median = 584, IIQ = 166-1230), indicating rapid metabolism. The excretion of aldicarb and its metabolites was rapid since these compounds were rarely detected in plasma samples 48 hours after admission. Sequential cholinesterase analysis in 14 patients revealed almost complete reactivation in the first 48 hours post-admission, compatible for poisoning by carbamates. Based on the Poisoning Severity Score, the cases were classified as asymptomatic (5.3%), minor (11.8%), moderate (35.5%), severe (43.4%), and fatal (3.9%). CONCLUSIONS: Most poisonings involved aldicarb and resulted from suicide attempts; the poisonings were generally severe, with a mortality of 3.9%. Aldicarb was rapidly absorbed, metabolized, and excreted.

Casos de intoxicação envolvendo as substâncias químicas mais notificadas: álcool e aldicarb no estado do Rio de Janeiro durante o período de 1998 a 2005 / Cases of poisoning involving chemicals notified more - alcohol and aldicarb - in the state of Rio de Janeiro during the period 1998-2005

Esta pesquisa objetivou identificar os fatores de risco associados ascircunstâncias envolvendo alcoolemia no município do Rio de Janeiro no período de 1998 a 2005. As variáveis utilizadas para os casos considerados como positivos com quantificação de álcool no sangue levando-se em consideração o limite estabelecido pelo Código de Trânsito Brasileiro vigente no período (...) foram Índice de Desenvolvimento Humano (IDH) do ano de 2000, as ocorrências registradas pelo Instituto Médico Legal, idade média e média de concentração de álcool das vítimas. Avariável média de concentração de álcool foi significativa (...) explicando 38 por cento da variação dos casos de Afogamento, assim como o IDH (p = 0,008) explicou 29 por cento davariação dos casos com Vítimas de projétil de arma de fogo. Foram obtidas relações inversas, para a variável IDH quando associada com as circunstâncias que se referiam à violência (Agressão, Vítima de projétil de arma de fogo e enforcamento). Podemos inferir, portanto, que os casos de morte por estas circunstâncias de violência aumentam quando os Índices de Desenvolvimento Humano são mais baixos. Além disso, nossos achados indicaram que os municipios não banhados pelo mar apresentaram os maiores índices de Afogamento corroborando com a literatura.

Acute aldicarb toxicity in dogs: 15 cases (2001-2009).

OBJECTIVE: To describe the common clinical signs, laboratory abnormalities, treatment, and prognosis associated with acute aldicarb toxicosis in dogs. DESIGN: Retrospective observational study from 2001 to 2009. SETTING: Urban referral hospital. ANIMALS: Fifteen client-owned dogs. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The most common clinical signs associated with acute aldicarb toxicosis were vomiting, ptyalism, diarrhea, and tremors. Of the 15 dogs, 11 were admitted to the hospital for treatment, 2 were euthanized at presentation and 2 were discharged against medical advice following minimal treatment and lost to follow-up. Laboratory abnormalities included lactic acidosis and hyperglycemia in 12 and 9 patients, respectively. Treatment of hospitalized dogs included induction of emesis with apomorphine (4 dogs), activated charcoal (5), IV fluids (11), atropine (7), methocarbamol (3), diazepam (1), pralidoxime (1) and diphenhydramine (1). Ten of 11 hospitalized dogs survived to discharge; 1 was euthanized following a respiratory arrest after 36 hours of hospitalization. One patient received mechanical ventilation and treatment for pneumonia before discharge from the hospital. The median duration of hospitalization was 22 hours (range 12-168 h). CONCLUSIONS: Acute aldicarb toxicosis carries a good prognosis for survival and hospital discharge with treatment. Supportive care should be considered for at least 18-24 hours to monitor for response to therapy and development of respiratory failure.

Treatment rationale for dogs poisoned with aldicarb (carbamate pesticide).

The treatment rationale for dogs poisoned by aldicarb is reviewed from a pharmacological perspective. The illegal use of aldicarb to maliciously poison dogs is a major problem in some parts of the world. In South Africa, it is probably the most common canine poisoning treated by companion animal veterinarians. Aldicarb poisoning is an emergency and veterinarians need to be able to diagnose it and start with effective treatment immediately to ensure a reasonable prognosis. Successful treatment depends on the timely use of an anti-muscarinic drug (e.g. atropine). Additional supportive treatment options, including fluid therapy, diphenhydramine, benzodiazepines and the prevention of further absorption (activated charcoal) should also be considered. Possible complications after treatment are also briefly discussed.

Intoxicação exógena por chumbinho como forma de autoextermínio no Estado de Goiás, 2003 - 2007 / Exogenous intoxication by chumbinho (lead) as a form of self-extermination in the State of Goiás (Brazil), 2003 - 2007 / Intoxicación exógena por raticida (chumbinho) como forma de auto exterminio en el estado de Goiás, 2003 - 2007

A intoxicação exógena por chumbinho é considerada importante causa de morbidade e mortalidade no Brasil devido ao fácil acesso, baixo custo e por sua eficácia frente às tentativas de suicídio, tornando-se um problema de Saúde Pública. No Estado de Goiás não existem levantamentos sobre esse tipo de intoxicação, causadas intencionalmente, designando esta investigação. Trata-se de um estudo descritivo, retrospectivo documental com abordagem quantitativa, com o objetivo de estabelecer o perfil das vitimas com tentativas de autoextermínio no Estado de Goiás no período de 2003 a 2007. Das 537 fichas registradas 296 eram casos de intoxicação exógena intencional por chumbinho. As maiores ocorrências foram, nos anos de 2006 (33,44%) e 2007 (28,4%), na zona urbana com (90,88%), o sexo feminino com (52,36%), e a faixa etária entre 19 a 25 anos com (26,35%). Permaneceram internados por mais de 24 horas 76,35% dos casos, sendo que 79,07% dos casos obtiveram cura e 5,74% evoluíram para óbito. Conclui-se, portanto, a necessidade de o enfermeiro efetivar a educação em saúde na comunidade, alertando para os riscos do uso inadequado do ?chumbinho?, ainda, deve haver maior conscientização por parte destes profissionais no preenchimento da ficha de notificação compulsória.

The exogenous intoxication by "chumbinho"(lead) is considered an important cause of morbidity and mortality in Brazil because of the easy access, low cost and its effectiveness against the attempts of suicide becoming a public health problem. In the State of Goiás, there is no surveys on this type of intoxication caused intentionally designating this investigation. That´s a descriptive study, retrospective documentary with a quantitative approach, aiming to establish the profile of victims in attempts to self-extermination in the State of Goiás from 2003 to 2007. Of the 537 recorded files 296 were recorded cases of intentional intoxication by exogenous lead, the highest occurrences were in 2006 (33.44%) and in 2007 (28.4%), in the urban area was (90.88%), women (52.36%) and from 19 to 25 years old (26.35%). Remained hospitalized for more than 24 hours 76.35% of the cases, while 79.07% of the cases were cured and 5.74% died. So it concludes the need for the nurses to carry out health education in the community warning all of the risks of inappropriate use of the lead ("chumbinho") And still, should be a greater awareness by these professionals in the form how they fill in the compulsory notification.

La intoxicación con raticida es considerada importante causa de morbilidad y mortalidad en Brasil debido al fácil acceso, bajo costo y por su eficacia en los intentos de suicidio, volviéndose un problema de salud pública. En el Estado de Goiás no existen informes acerca de ese tipo de intoxicación, causadas intencionalmente, designando esta investigación. Se trata de un estudio descriptivo, retrospectivo documental con abordaje cuantitativo, con el objetivo de establecer el perfil de las víctimas con intentos de auto exterminio en el Estado de Goiás en el periodo de 2003 hasta 2007. De las 537 fichas registradas 296 eran casos de intoxicación exógena intencional con raticida (?chumbinho?), las mayores ocurrencias fueron en los años de 2006 (33,44%); y 2007 (28,4%), entre noviembre y febrero (38,4%), en el área urbana con (90,88%), el sexo femenino con (52,36%), y la faja etaria entre 19 y 25 años con (26,35%). Permanecieron internados por más de 24 horas 76,35% de los casos, siendo que 79,07% de los casos lograron curarse y 5,74% llegaron al óbito. Se concluye, entonces, la necesidad del enfermero efectuar la educación en salud en la comunidad alertando para los riesgos del uso inadecuado del dicho raticida. Aún debe haber una mayor información por parte de estos profesionales en el acto de rellenar la ficha de notificación obligatoria.

Dichlorvos, chlorpyrifos oxon and Aldicarb adducts of butyrylcholinesterase, detected by mass spectrometry in human plasma following deliberate overdose.

The goal of this study was to develop a method to detect pesticide adducts in tryptic digests of butyrylcholinesterase in human plasma from patients poisoned by pesticides. Adducts to butyrylcholinesterase in human serum may serve as biomarkers of pesticide exposure because organophosphorus and carbamate pesticides make a covalent bond with the active site serine of butyrylcholinesterase. Serum samples from five attempted suicides (with dichlorvos, Aldicarb, Baygon and an unknown pesticide) and from one patient who accidentally inhaled dichlorvos were analyzed. Butyrylcholinesterase was purified from 2 ml serum by ion exchange chromatography at pH 4, followed by procainamide affinity chromatography at pH 7. The purified butyrylcholinesterase was denatured, digested with trypsin and the modified peptide isolated by HPLC. The purified peptide was analyzed by multiple reaction monitoring in a QTRAP 4000 mass spectrometer. This method successfully identified the pesticide-adducted butyrylcholinesterase peptide in four patients whose butyrylcholinesterase was inhibited 60-84%, but not in two patients whose inhibition levels were 8 and 22%. It is expected that low inhibition levels will require analysis of larger serum plasma volumes. In conclusion, a mass spectrometry method for identification of exposure to live toxic pesticides has been developed, based on identification of pesticide adducts on the active site serine of human butyrylcholinesterase.