Acute exposure to urea.

According to the best of our knowledge there are no reports in medical literature about massive and acute exposure to carbamide. We have described a man who has fallen into the wagon car full of granulated urea. A 34-year old male, without previous medical history, has fallen into train car full of carbamide. For about 10 minutes the patient was fully covered with granulate. After one year of follow-up the patient was still having symptoms of obturative respiratory insufficiency. Despite the fact that urea is thought as non toxic agent massive exposures to it, in some circumstances, may cause chronic respiratory problems.

Acute poisoning of silver gulls (Larus novaehollandiae) following urea fertilizer spillage.

Two episodes of accidental urea toxicosis are described in wild silver gulls (Larus novaehollandiae) following spillage of fertilizer grade urea at a commercial shipping facility near Perth, Western Australia. In both cases, urea spillage had been seen to contaminate freshwater wash-down pools on the wharves where ships were being unloaded and gulls were seen to be drinking and washing in the pools nearby the spillages. Affected birds were found moribund or dead. Necropsy and histopathological findings were non-specific and consisted of mild to moderate congestion of visceral organs and brain. Analysis of a water sample collected during Case 1 revealed a very high urea concentration of 4.124 mol/l (pH 5.5), and fluid from the proventriculus of two birds had urea concentrations of 382 and 308 mmol/l, respectively. Nine birds were examined during the second episode (Case 2) and, from heparinized heart blood samples collected (n = 5), the mean plasma urea (288 +/- 92.0 mmol/l), ammonia (43.9 +/- 34.2 mmol/l) and uric acid (7.45 +/- 1.99 mmol/l) concentrations were markedly elevated above the reference ranges for all bird species. Proventricular contents (n = 7) similarly contained high concentrations of urea (394 +/- 203 mmol/l) and ammonia (9.3 +/- 15 mmol/l). The probable mechanisms of urea and ammonia toxicity in these birds are discussed.

Ammonia toxicity from urea in a Brazilian dairy goat flock.

A flock of goats received a diet with 1% urea for at least 1 y. A new batch of concentrate was offered increasing the level of urea to 4.2%. Eighteen of 54 goats showed acute signs of ammonia toxicosis. Ten goats died within 60 min; 4 goats and a buck with convulsions recovered when treated by administration of vinegar and infusion of saline solution, diuretics, and atropine. Three goats with mild signs recovered within 1 h without treatment. The mean ammonia concentration and rumen pH content were 820 mg/L and 7.7, respectively. Generalized congestion, intense pulmonary edema, and slight tubular nephrosis were found in 3 goats on necropsy. The outbreak was self-limiting and no more cases occurred when the diet was removed.

Intoxicações em eqüinos no Brasil / Intoxications in horses in Brazil

Relatam-se algumas intoxicaçöes descritas em eqüídeos no Brasil. Dentre as intoxicaçöes por plantas, incluem-se: Senecio spp., Ateleia glazioviana, Crotalaria juncea, Equisetum spp., Pteridium aquilinum, Baccharis coridifolia, Senna occidentalis e Brachiara spp.. Mencionam-se, também, as micotoxicoses causadas por Fusarium moniliforme, Claviceps purpurea e aflatoxinas, e as intoxicaçöes por uréia, iodo, chumbo e inseticidas clorados.

[A fatal case due to intoxication with seven drugs detected by GC-MS and TDx methods].

A twenty-year-old woman was suspected to ingest large amounts of 4 kinds of over-the-counter analgesic and antipyretic drugs, and was found dead. Drugs and poisons were screened by TOXI-LAB drug detection system in the serum and urine, and analyzed by GC-MS and TDx system in the blood, urine, organ tissues and contents of stomach and small intestine. The concentrations (microgram/g) of bromisovalum, apronalide, ibuprofen, ethenzamide, acetaminophen and caffeine in the heart blood were 36.5, 7.58, 43.1, 16.9, 1.22 and 177, respectively. Salicylic acid concentration in the serum was 82.1 micrograms/ml. The concentrations of bromisovalum and caffeine are high enough to be lethal levels. Neither fatal pathological findings nor traumatic wounds were seen. The overdose of both bromisovalum and caffeine and synergistic, additive or combined effects of other 5 drugs above are considered to be her cause of death.

Urea poisoning in suckler cows.

Accidental urea intoxication resulted in the death of 17 of 29 suckler cows within six hours after the contamination of their drinking water with urea fertiliser. The other cows showed no lasting ill effects and neither their three-month-old calves nor the stock bull were affected. The urea concentration in the water was 86 mmol/litre, and the concentrations of ammonia nitrogen in the rumen fluid of two of the cows which were examined after death were 1825 and 957 mg/litre. The clinical signs and post mortem findings are described.

Nonprotein nitrogen-induced ammonia toxicosis and ammoniated feed toxicity syndrome.

In spite of all the reports and work done, the ammoniated feed toxicity syndrome still is quite a mystery. Given its enigmatic cause, prevention is our only current means of control. The data that is recorded from each new episode, however, may help to piece together the exact mechanism so that one day it can be understood and treated.

Acute and chronic intoxication with carbromal preparations.

An important number of acute intoxications can be ascribed to the abuse of, until now, non-prescription carbromal preparations. Prolonged use of these drugs also leads to chronic intoxication with bromide accumulation. The clinical features and treatment of three suicidal Obral overdoses and of two patients presenting with bromism are presented. Laboratory findings, from admission to recovery, consist of qualitative TLC and quantitative HPLC drug assays in body fluids and the determination in plasma of the two competing ions chloride and bromide. The high frequency of acute intoxications and carbromal induced bromism stresses the need to bring these preparations under prescription.

Bromism after prolonged use of carbromal.

Most of the brominated monoureide and bromide salt containing drugs are obtainable in Belgium without prescription. Apart from the regularly encountered suicidal attempts, these drugs can also, without the intention of the patient, cause bromism . We report two cases of patients recently admitted because of bromism after prolonged use of Carbromal . Bromism now has become a rather unfamiliar condition. Therefore diagnostic and therapeutic aspects are briefly discussed. Because we dispose now, for the same indications, of more efficient and much less toxic drugs, we suggest that drugs containing a significant amount of brominated monoureides or bromide salts should be removed from the market.

Ovine blood chemistry values measured during ammonia toxicosis.

Venous blood values were determined on 19 Southdown sheep (9 adult ewes and 10 wether lambs). Principal sheep were given 12.5 ml of 3.3M urea solution/kg of body weight, which produced acute ammonia toxicosis. Whole blood ammonium-nitrogen was determined by ion exchange; venous blood gases and pH were measured with a pH blood gas analyzer; and 23 serum chemical analyses were obtained with a sequential multiple autoanalyzer computer. Analysis of variance for the data revealed significant changes for 20 values. The values are presented and discussed with regard to those that changed beyond acceptable limits (whole blood ammonium-nitrogen, venous blood pH, serum glucose, serum lactate dehydrogenase, serum alkaline phosphatase, serum creatine kinase, serum urea nitrogen, serum inorganic phosphorus, serum sodium, and serum potassium), those that changed within acceptable limits (PVo2, PVco2, serum triglycerides, serum free fatty acids, plasma volatile fatty acids, serum aspartate aminotransferase, serum total protein, serum albumin, serum creatinine, urea nitrogen-creatinine ratio, serum uric acid, serum cholesterol, serum low-density lipoproteins, serum calcium, serum iron and serum chloride), and those with no change (total and direct serum bilirubin and albumin-globulin ratio). Metabolic consequences of ammonia toxicosis are considered with regard to energy, lipid , protein, and acid-base and electrolyte balances. Blood values having possible laboratory diagnosis value and considerations for therapeutic adjustment are discussed.

Suspected ammonium nitrate fertiliser poisoning in cattle.

The occurrence of a suspected mixed ammonia and nitrate fertiliser poisoning that led to acute illness and fatalities in cattle is described. The circumstances leading to the incident included the method of application of the fertiliser, low rainfall and the absence of subsequent irrigation of the fertilised pastures. The clinical and gross post mortem findings, principally dehydration and fluid distension of the rumen, were not pathognomonic. The complex of nitrate, nitrite and ammonia toxicity is discussed.