Colchicum autumnale intoxications: experience of the Poisons Information Centre, Austria 2002-2018.

INTRODUCTION: Colchicine toxicity can occur when individuals unintentionally pick meadow saffron (Colchicum autumnale) instead of Allium ursinum. This study aimed to assess the severity of poisoning based on readily available clinical laboratory parameters evaluated within the first 24 hours of ingestion. METHODS: Data from the Austrian Poisons Information Centre from 2002 to 2018 were evaluated for Colchicum autumnale poisoning and follow-up, including patients' clinical conditions, laboratory values, and serum colchicine concentrations. RESULTS: Over the period of 17 years, 174 human cases of suspected Colchicum autumnale poisoning were reported to the Austrian Poisons Information Centre, including 163 cases of unintentional exposure (113 cases <15 years; 50 cases ≥ 15 years old). Follow-up was possible in seven of these cases; two of the patients died. Laboratory tests within the first 24 hours showed increased activities of lactate dehydrogenase (258-1974 U/L), aspartate aminotransferase (71-217 U/L), and creatine kinase (164-559 U/L) in five cases. One patient who consumed a small amount did not have any relevant laboratory changes. In another patient, the first blood sample was taken after 20 hours, which showed elevated aspartate aminotransferase (109 U/L) and lactate dehydrogenase (650 U/L) activities. Blood samples after 26.5 hours showed elevated creatine kinase (277 U/L) activity. Three patients had an elevated troponin concentration within the first 24 to 26.5 hours; one of them died. In five of these seven cases, toxicological analyses confirmed colchicine intoxication (serum colchicine concentration 2.0 - 6.5 µg/L). CONCLUSIONS: When the ingestion of Colchicum autumnale is suspected in patients with gastrointestinal symptoms, elevated activities of lactate dehydrogenase, aspartate aminotransferase, and creatine kinase within the first 24 hours, careful monitoring is required. Serum creatinine and troponin concentrations, together with haematological parameters, should be measured to allow better clinical assessment. As only a small number of patients have been reported, further detailed case reports are needed to better predict the prognosis of intoxications with Colchicum autumnale.

Initial Evidence for Positive Effects of a Psychological Preparation Program for MRI "iMReady" in Children with Neurofibromatosis Type I and Brain Tumors-How to Meet the Patients' Needs Best.

To provide an effective alternative to sedation during MRI examinations in pediatric cancer and NF1 patients, the aims of the present study were to (1) exploratively evaluate a behavioral MRI training program, to (2) investigate potential moderators, as well as to (3) assess the patients' well-being over the course of the intervention. A total of n = 87 patients of the neuro-oncology unit (mean age: 6.83 years) underwent a two-step MRI preparation program, including training inside the scanner, and were recorded using a process-oriented screening. In addition to the retrospective analysis of all data, a subset of 17 patients were also analyzed prospectively. Overall, 80% of the children receiving MRI preparation underwent the MRI scan without sedation, making the success rate almost five times higher than that of a group of 18 children that opted out of the training program. Memory, attentional difficulties, and hyperactivity were significant neuropsychological moderators for successful scanning. The training was associated with favorable psychological well-being. These findings suggest that our MRI preparation could present an alternative to sedation of young patients undergoing MRI examinations as well as a promising tool for improving patients' treatment-related well-being.

MAGAM II - prospective observational multicentre poisons centres study on eye exposures caused by cleaning products.

Objective: Local effects on the eye following cleaning product exposures are frequently reported. According to EU chemicals legislation many cleaning products are labelled with Hazard Phrase 318 indicating risk of irreversible eye damage. The objectives of this study were to identify cleaning products with potential for irreversible eye damage by collecting human exposure data from poisons centres (PC), and to clarify to what degree exact product identification is possible during a PC telephone call. Methods: MAGAM II was a multicentre binational prospective observational PC study. All human eye exposures to detergents or maintenance products reported to nine PCs taking calls from the public and medical professionals during an 18-month period were included. The severity of eye effects was rated according to the WHO Poisoning Severity Score. Results: Five hundred and eighty-six cases were included. Product identification by name leading to formula information was successful in 533 cases (91%). Follow-up was successful in 528 exposures. Irrigation was performed in 94% of cases. Duration of symptoms was ≥24 hours in 73 patients (25%). 33 (6%) patients developed moderate eye injury. Healing was reported in all cases. The percentage of moderate cases was highest in the group of drain cleaners (25%), toilet cleaners (18%) and oven cleaners (15%). Products intended for professional use caused relatively more moderate eye injuries than products also intended for consumer use. Conclusion: MAGAM II has shown that PCs are able to identify formulas in sufficiently high quality as needed for product-directed toxicovigilance. The results underline the potential of PC exposure case data for product safety monitoring. The results indicate that irreversible eye damage is very rare after cleaning product exposure.