Case report of a fatal intoxication by Nucynta.

Tapentadol (Nucynta) is a centrally acting opioid analgesic prescribed for the treatment of moderate to severe acute pain. Its efficacy is believed to be due to µ-opioid receptor agonist activity and inhibition of norepinephrine reuptake resulting in increased norepinephrine concentrations. There is only one other case in the literature relating to the toxicity of this agent or report of a fatality. This case report documents a case in which tapentadol was identified as the cause of death. The tapentadol concentration found in the heart blood submitted in this case was more than 20 times the upper limit of the therapeutic range. Possible mechanisms of death include respiratory depression, central nervous system depression, and serotonin syndrome. Based on the scene investigation and autopsy findings in this case, the medical examiner determined that the cause of death was narcotic (Nucynta) intoxication and the manner of death was undetermined.

Bisphenol a exposure in Mexico City and risk of prematurity: a pilot nested case control study.

BACKGROUND: Presence of Bisphenol A (BPA) has been documented worldwide in a variety of human biological samples. There is growing evidence that low level BPA exposure may impact placental tissue development and thyroid function in humans. The aim of this present pilot study was to determine urinary concentrations of BPA during the last trimester of pregnancy among a small subset of women in Mexico City, Mexico and relate these concentrations to risk of delivering prematurely. METHODS: A nested case-control subset of 60 participants in the Early Life Exposure in Mexico to ENvironmental Toxicants (ELEMENT) study in Mexico City, Mexico were selected based on delivering less than or equal to 37 weeks of gestation and greater than 37 weeks of gestation. Third trimester archived spot urine samples were analyzed by online solid phase extraction coupled with high performance liquid chromatography isotope dilution tandem mass spectrometry. RESULTS: BPA was detected in 80.0% (N = 48) of the urine samples; total concentrations ranged from < 0.4 µg/L to 6.7 µg/L; uncorrected geometric mean was 1.52 µg/L. The adjusted odds ratio of delivering less than or equal to 37 weeks in relation to specific gravity adjusted third trimester BPA concentration was 1.91 (95%CI 0.93, 3.91, p-value = 0.08). When cases were further restricted to births occurring prior to the 37th week (n = 12), the odds ratio for specific-gravity adjusted BPA was larger and statistically significant (p < 0.05). CONCLUSIONS: This is the first study to document measurable levels of BPA in the urine of a population of Mexican women. This study also provides preliminary evidence, based on a single spot urine sample collected during the third trimester, that pregnant women who delivered less than or equal to 37 weeks of gestation and prematurely (< 37 weeks) had higher urinary concentrations of BPA compared to women delivering after 37 weeks.

Occupational and environmental exposure to tribromophenol used for wood surface protection in sawmills.

This study analyses the occupational and environmental conditions of sawmills where the lumber is protected from microorganism action by dipping it in 2,4,6 tribromophenol (TBP). Three processes were evaluated: hydraulic immersion, chain conveyor system and manual immersion. The biggest occupational exposure to TBP was registered in manual and chain conveyor systems. The average values in the workers' urine for TBP were 6.9 and 5.7 mg/g creatinine, respectively. For environmental exposure, the highest value in well waters was 25.1 microg/L and in soil was 4,602 mg/kg. It could be established that the hydraulic immersion system presents less occupational TBP exposure. Nevertheless, the hydraulic system, as well as the other two anti-stain alternatives, requires the introduction of pollution prevention efforts. To reduce the environmental exposure to TBP, the lumber-dipping tank area, the forklift traffic areas, and the storage areas need to be waterproofed. It is also necessary to implement a TBP solution recovery system to eliminate dripping from the lumber once it is removed from the fungicide dipping tanks.

Necrosis de coagulación por fenoles / Coagulation necrosis induced by phenols

Se presenta una paciente de edad pediátrica, con lesiones de quemaduras químicas debido a compuestos fenólicos concentrados, y repercusión sistémica. La histopatología mostró necrosis de coagulación. Se destaca la acción de los compuestos fenólicos en la piel, de acuerdo a su concentración. Las quemaduras ocurren como accidentes, la mayor parte de ellas laborales. Actualmente, la presencia de fenol industrial concentrado en los hogares permite que puedan ocurrir casos de intoxicación accidental, como en nuestra paciente. Creemos que difundirse el conocimiento de estos cuadros, debido a la creciente utilización de estos compuestos, que engrosarían el espectro de tóxicos caseros que pueden provocar accidentes

Necrosis de coagulación por fenoles / Coagulation necrosis induced by phenols

Se presenta una paciente de edad pediátrica, con lesiones de quemaduras químicas debido a compuestos fenólicos concentrados, y repercusión sistémica. La histopatología mostró necrosis de coagulación. Se destaca la acción de los compuestos fenólicos en la piel, de acuerdo a su concentración. Las quemaduras ocurren como accidentes, la mayor parte de ellas laborales. Actualmente, la presencia de fenol industrial concentrado en los hogares permite que puedan ocurrir casos de intoxicación accidental, como en nuestra paciente. Creemos que difundirse el conocimiento de estos cuadros, debido a la creciente utilización de estos compuestos, que engrosarían el espectro de tóxicos caseros que pueden provocar accidentes

Intoxicación aguda por fenoles / Acute phenol poisoning

Se describe el caso de una niña de 5 años intoxicada con una mezcla de fenole y cresoles de uso doméstico. Sus síntomas más destacados fueron convulsiones tónico clónicas generalizadas resistentes al diazepan e.v. (que obligaron a emplear pentobarbital en infusión e.v. y ventilación mecánica); hepatomegalia acentuada y evidencia histológica de necrosis hepática que se recuperó en el plazo aproximado de un mes