Cade oil poisoning: about a case.

Throughout Morocco, cade oil is used in folk medicine for many purposes, in particular for atopic dermatosis. It is also used as a wormer. Cade oil poisoning of newborns and infants thus often has an iatrogenic origin, resulting especially from the ingestion of a significant amount or from a prolonged and extensive cutaneous application. Thus, this oil, used for therapeutic purposes, is responsible for a non-negligible number of cases of poisoning, some fatal. We report a case of poisoning after cutaneous application of cade oil in a 2-month-old infant. The outcome was fatal. This report calls attention to the real possibility of this event and emphasizes the interest of preventing it by promoting information to families in Morocco.

Juniper tar (cade oil) poisoning in new born after a cutaneous application.

Juniper tar (cade oil) is distilled from the branches and wood of Juniperus oxycedrus. It contains etheric oils, triterpene and phenols, used for many purposes in folk medicine. The authors report a case of a previously healthy new born treated with a topical application of Juniperus oxycedrus for atopic dermatosis The poisoning caused convulsions, collapsus, acute pulmonary oedema, renal failure and hepatotoxicity. The newborn survived after supportive and symptomatic treatment, and discharged in a good condition on the eleventh day of hospitalisation in intensive care unit.

A cross-sectional investigation of biomarkers of risk after a decade of smoking.

Two groups of 20 healthy volunteers with cigarettes of different tar yield were compared with a group of 20 never smokers over 24 h for several biomarkers. All groups were of similar mean ages and the smokers had smoked for a homogeneous period of approximately 10 yr. The groups were assessed using routine medical parameters as well as biomarkers of recent smoke exposure and other biomarkers that were under evaluation as possible markers of risk for smoking-associated diseases. All biomarkers of exposure-carbon monoxide, nicotine plus its five major metabolites, and 4-(methylnitrosamine)-1-(3-pyridyl)-1-butanol (NNAL)-were significantly elevated in smokers. For biomarkers of potential risk evaluated in the blood, white cells and immunoglobulin (Ig) G showed a decrease related to smoking status (p < .01). Interleukin 6 levels were higher in smoker groups compared to never smokers, with a significant increasing trend across the groups (p < .05). Among the urinary biomarkers studied, 11-deydro-thromboxane B2, 2,3-dinor-thromboxane B2, and thymidine glycol showed significant increasing trends across the groups (p < .01). The results suggest that after the first decade or less of smoking, changes in inflammatory, immunological, and cardiovascular function can be observed. However, further studies on larger groups will be required to better understand the kinetics of these subtle effects observed early in smokers and their relationship with the potential risk of subsequent smoking-associated disease.

More on the regulation of tobacco smoke: how we got here and where next.

The modern cigarette is unnecessarily dangerous. Despite being lower in tar yield, and consequently in squamo-carcinogenic polyaromatic hydrocarbons such as benzo[a]pyrene, the nitrosamine yields are often higher than they need to be. Also, reductions in tar levels have not led to the consequential reductions in mortality that were anticipated several decades ago. The modern cigarette is also smoother, easier to smoke and to learn how to smoke, highly addictive and facilitates compensatory smoking. Compensatory smoking leads to excess inhalation of carcinogens and toxins in the hunt for nicotine. Its labelling is misleading in that supposedly low-yielding cigarettes may, due to compensation occurring as a result of cigarette design, lead to inhalation of much higher amounts of nicotine, carcinogens and toxins than the smoker is led to expect. Regulation of the product is needed to provide the persistent smoker with a cigarette lower in risk, accurately labelled, providing a relatively consistent and known dose of nicotine, and less likely to facilitate compensatory smoking. This will not produce a safe cigarette but should result in a reduction in harm if seriously implemented.