Acute mercury poisoning among children in two provinces of Turkey.

Elemental mercury exposure occurs frequently and is potentially a toxic, particularly in children. Children are often attracted to elemental mercury because of its color, density, and tendency to form beads. Clinical manifestations of elemental mercury intoxication vary depending on its form, concentration, route of ingestion, and the duration of exposure. We present data on 179 pediatric cases of elemental mercury poisoning from exposure to mercury in schools in two different provinces of Turkey. Of all patients, 160 children had both touched/played with the mercury and inhaled its vapors, while 26 children had only inhaled the mercury vapor, two children reported having tasted the mercury. The median duration of exposure was 5 min (min 1-max 100), and 11 (6 %) children were exposed to the mercury for more than 24 h at home. More than half of the children (51.9 %) were asymptomatic at admission. Headache was the most common presenting complaint. The results of physical and neurological examinations were normal in 80 (44.6 %) children. Mid-dilated/dilated pupils were the most common neurological abnormality, and this sign was present in 90 (50.2 %) children. Mercury levels were measured in 24-h urine samples daily, and it was shown that the median urinary level of mercury was 29.80 µg/L (min, 2.40 µg/L; max, 4,687 µg/L). A positive correlation was also found between the duration of exposure and urinary mercury levels (r = 0.23, p = 0.001). All patients were followed up for 6 months. On the first follow-up visit performed 1 month after discharge, the neurological examinations of all patients were normal except for those patients with peripheral neuropathy and visual field defects. On the last follow-up visit at the sixth month, only two children still experienced visual field defects. In conclusion, this study is one of the largest case series of mercury intoxication of students in schools. Elemental mercury exposure can be potentially toxic, and its symptomatology is variable, particularly in children. Therefore, school staff and children should be aware of the risk of mercury toxicity. Pediatricians also need to warn parents and children about the hazards of playing with any chemical.

A clinical and epidemiological study on spider bites in Turkey.

OBJECTIVE: To classify and characterize spider bites among inquiries to the National Poison Information Center (NPIC) between 1995 and 2004, in terms of the epidemiology and clinical symptomatology. METHODS: Clinical and epidemiological data were obtained from the NPIC's patient records. The following information was recorded for each spider bite: demographics, circumstances of the bite, and local and systemic effects. RESULTS: A total of 82 cases were reported. The accidents were mostly seen during August. The gender distribution was 59.76% male, 37.20% female, and 2.44% unknown and the 20-29 age group presented more spider bites. Most of the cases were in the Central Anatolia, Marmara, Mediterranean, and Black Sea regions. Local symptoms were observed in 60.87% of the cases, including local pain, edema, redness, itching, debris, burning, and numbness. Systemic symptoms were observed such as nausea, vomiting, abdominal pain, lethargy, anxiety, weakness, somnolence, dyspnea, hypertension, hypotension, and hyperthermia. CONCLUSIONS: In conclusion, these findings emphasize the presence of medically important spider species in Turkey. All patients and especially pediatric patients should be admitted to the hospital. Identification of spider species may be considered a useful clinical and epidemiological tool in determining the incidence and risk of spider bites.

Scorpion stings in Turkey: epidemiological and clinical aspects between the years 1995 and 2004.

The most important health-threatening scorpions found in Turkey are; Androctonus crassicauda, Leiurus quinquestriatus, Mesobuthus gibbosus and M. eupeus species, all of which belong to the Buthidae family. The epidemiological and clinical findings of scorpion stings in Turkey were evaluated between the years 1995 and 2004 based on data recorded in the National Poison Information Center (NPIC). A total of 930 cases were recorded. The cases mostly occurred in the month of July. The gender distribution was 50.22% female and 45.48% male. It was shown that the 20-29 age group presented more scorpion stings. Most of the stings occurred in Central Anatolia and Marmara regions of Turkey. Patients at the hospital showed signs of localized (pain, hyperemia, edema and numbness) and systemic effects (hyperthermia, nausea and vomiting, tachycardia, shivering and lethargy) but no lethality was notified. According to records, 33% of the poisoned patients were treated with antivenin in healthcare facilities.

Androctonus crassicauda (Olivier 1807) scorpionism in the Sanliurfa provinces of Turkey.

In this study, the epidemiology and clinical findings of scorpion stings in the Sanliurfa province of Turkey was evaluated between May and September 2003. Data obtained from questionnaires was evaluated and the identification of scorpions collected from the region was carried out in the laboratory. It was determined that of the species of scorpions only Androctonus crassicauda was collected. This species plays the major role in 50.8% of scorpionism cases. This study also showed that intoxications caused by A. crassicauda in southeast Anatolia region were seen in the summer during the hot months especially in August. Females and people above 15 years of age were the most affected and they had been stung on the extremities. In clinical evaluations, it was found that 17.7% of the cases showed systemic effects and no deaths were reported. Also parasympathetic effects were more common in comparison to sympathetic effects.

Juniper tar poisoning.

Juniper tar (cade oil) is distilled from the branches and wood of Juniperus oxycedrus. It contains etheric oils, triterpene and phenols, and is used for many purposes in folk medicine. A case is reported of a previously healthy man who ingested a spoonful of home-made extract of Juniperus oxycedrus. The poisoning caused fever, severe hypotension, renal failure, hepatotoxicity, and severe cutaneous burns on the face. After supportive and symptomatic treatment, the patient improved and was discharged in a good condition on the eleventh day.