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1.
Exp Ther Med ; 17(4): 2682-2688, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30930970

RESUMO

Delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) is a serious complication that occurs several days or weeks after carbon monoxide (CO) intoxication. This study identified computed tomography (CT) findings in the prediction of DEACMP development. Adults with CO poisoning admitted to Beijing Chaoyang Hospital, Shenyang Ninth People's Hospital, Shanxi Second People's Hospital and Shandong Provincial Hospital in China from January 2013 to January 2016 were retrospectively analyzed. Baseline demographic and clinical characteristics were extracted from the medical records. Brain CT imaging was carried out within 24 h of admission, and an integrated CT score was calculated to semi-quantify lesion severity. Patients were followed-up for 6 months. Baseline characteristics and CT findings were compared among patients who developed DEACMP (DEACMP group) and those who did not (non-DEACMP group). The receiver operating characteristic (ROC) curve analysis was used to examine the utility of integrated CT score for predicting DEACMP. Among the 123 patients included in the analysis, 27 (22.0%) developed DEACMP. The DEACMP and non-DEACMP groups did not differ with regard to age, sex and carboxyhemoglobin (COHb) level at admission. However, compared with the non-DEACMP group, the patients in the DEACMP group had longer onset time of symptoms and duration of exposure to CO, higher acute physiology and chronic health evaluation-II (APACHE-II) score, lower Glasgow Coma Scale (GCS) score, and there was a higher proportion of patients with severe symptoms and brain CT abnormalities (81.5 vs. 51.0%; P<0.05). Integrated CT score in the DEACMP group was significantly higher than that in the non-DEACMP group (73.63 vs. 51.39; P<0.01). ROC curve was used to analyze the utility of integrated CT score in the prediction of DEACMP. The area under the ROC curve was 0.700 (95% confidence interval, 0.584-0.817; P<0.01). In conclusion, brain integrated CT score has the potential to identify DEACMP in patients.

2.
Toxicon ; 161: 12-16, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30831147

RESUMO

The most frequently reported fatal Lepiota ingestions are due to L. brunneoincarnata. We present a case of L. brunneoincarnata poisoning with endoscopic nasobiliary drainage known to be the first in China. The patient suffered gastrointestinal symptoms 9 h post ingestion of mushrooms. The patient was hospitalized 4 days after eating the mushrooms with jaundice. The peak ALT, AST, APTT, TBIL and DBIL values of the patient were as follow: ALT, 2980 U/L (day 4 post ingestion); AST, 1910 U/L (day 4 post ingestion); APTT, 92.8 seconds (day 8 post ingestion), TBIL, 136 µmol/L (day 10 post ingestion), DBIL 74 µmol/L (day 10 post ingestion). UPLC-ESI-MS/MS was used to detect the peptide toxins in the mushroom and biological samples from the patient. We calculated that the patient may have ingested a total of 29.05 mg amatoxin from 300 g mushrooms, consisting of 19.91 mg α-amanitin, 9.1 mg ß-amanitin, and 0.044 mg γ-amanitin. Amatoxins could be detected in bile even on day 6 after ingestion of L. brunneoincarnata. With rehydration, endoscopic nasobiliary drainage and intravenous infusion of Legalon SIL, the patient recovered after serious hepatotoxicity developed.


Assuntos
Agaricales/química , Amanitinas/envenenamento , Intoxicação Alimentar por Cogumelos/metabolismo , Intoxicação Alimentar por Cogumelos/terapia , Amanitinas/sangue , Amanitinas/urina , China , Drenagem/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Intoxicação Alimentar por Cogumelos/sangue , Intoxicação Alimentar por Cogumelos/urina , Silimarina/uso terapêutico
3.
Toxins (Basel) ; 10(6)2018 05 25.
Artigo em Inglês | MEDLINE | ID: mdl-29799455

RESUMO

Amatoxin poisoning induces delayed-onset acute liver failure, which are responsible for more than 90% of deaths in mushroom poisoning. It has been postulated from animal and human studies that biliary drainage interrupting enterohepatic amatoxin circulation may affect amatoxin poisoning. Dogs were randomly divided into four groups of six animals each. In 20 mg/kg and 60 mg/kg with biliary drainage groups, after accepting bile drainage operation, beagles were fed Amanita exitialis powder (20 or 60 mg/kg) in starch capsules. In control and bile drainage groups, the beagle dogs were fed with empty capsules. They were assessed for toxicity signs, biochemical and pathological changes, and peptide toxins in plasma, urine and bile. The data were directly compared with those from our published studies on Amanita exitialis-exposed beagles without biliary drainage. Amatoxins were rapidly absorbed and eliminated from plasma after Amanita exitialis ingestion. Amatoxins in 0⁻1-day urine accounted for more than 90% of the total urine excretion, and amatoxins in bile accounted for less than 20% of the total urine and bile excretion. The dogs with biliary drainage showed less severe toxicity signs and biochemical and pathological changes and much lower internal exposure than dogs without biliary drainage. Biliary drainage caused a more than 70% reduction in intestinal amatoxin absorption and could reduce amatoxin absorption from the gastrointestinal tract.


Assuntos
Amanita , Bile/metabolismo , Drenagem , Intoxicação Alimentar por Cogumelos/terapia , Amanita/química , Animais , Sistema Biliar/metabolismo , Cães , Masculino , Peptídeos/análise , Peptídeos/toxicidade , Toxinas Biológicas/análise , Toxinas Biológicas/toxicidade
4.
Toxicon ; 143: 59-67, 2018 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-29341897

RESUMO

In this study, the toxicology of A. exitialis, a lethal mushroom found in China, and the toxicokinetics of peptide toxins contained in it were evaluated. Beagles were fed A. exitialis powder (20 or 60 mg/kg) in starch capsules, after which they were assessed for signs of toxicity, as well as biochemical and pathological changes. Ultra-performance liquid chromatography-electrospray ionization-tandem mass spectrometry was used to assay the peptide toxins. The total peptide toxins in A. exitialis was 3482.6 ±â€¯124.94 mg/kg. The beagles showed signs of toxicity, such as vomiting and diarrhea, at 12-48 h following ingestion of A. exitialis. Furthermore, alanine transaminase and aspartate transaminase levels in plasma, as well as prothrombin time and activated partial thromboplastin time peaked at 36 h post A. exitialis ingestion. Furthermore, total bilirubin and alkaline phosphatase levels peaked at 48 h after A. exitialis ingestion. Three dogs that were administered 60 mg/kg A. exitialis died at 24-72 h after ingesting the capsules. Additionally, liver histopathological examinations showed hemorrhagic necrosis of hepatocytes. α-Amanitin, ß-amanitin, and phallacidin were rapidly absorbed and eliminated from plasma after A. exitialis was ingested. A long latency period (12-24 h post A. exitialis ingestion) was observed in the dogs before the onset of gastrointestinal symptoms. There was acute liver damage thereafter. Gastric lavage and enhanced plasma clearance methods such as hemodialysis, hemoperfusion, or plasma exchange may be ineffective in removing amatoxins from blood at 12 h post A. exitialis ingestion. Enhanced excretion of amatoxins in urine could be effective within 2 days after ingestion of A. exitialis because amatoxins in 0-2 d urine accounted for more than 90% of the total urine excretion.


Assuntos
Amanita/química , Cães , Proteínas Fúngicas/toxicidade , Intoxicação Alimentar por Cogumelos/patologia , Alanina Transaminase/sangue , Amanitinas/sangue , Animais , Aspartato Aminotransferases/sangue , Hepatopatias/etiologia , Hepatopatias/patologia , Masculino , Tempo de Tromboplastina Parcial/veterinária , Peptídeos Cíclicos/sangue , Tempo de Protrombina/veterinária , Toxicocinética
5.
Toxicon ; 133: 26-32, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28433521

RESUMO

Amanita subpallidorosea is a recently discovered lethal Amanita sect. Phalloideae species found in China that is clustered with A. virosa in the same clade based on molecular phylogenetic analysis. However, the cyclopeptide toxin contents of these lethal mushrooms remain poorly studied. In this study, the cyclopeptide toxins in A. subpallidorosea were reported for the first time and the cyclopeptide compositions of A. subpallidorosea and A. virosa species were systematically analyzed. Thirteen cyclopeptides and two unknown compounds were identified or observed from these two lethal mushrooms by high-performance liquid chromatography coupled with high-resolution mass spectrometry. Of the known cyclopeptides, the virotoxins alaviroidin, viroisin, and viroidin, which were previously thought to be restricted to A. virosa, were identified in A. subpallidorosea. The cyclopeptide compositions showed that there are diversities in the kinds and levels of amatoxins, phallotoxins, and virotoxins between A. subpallidorosea and A. virosa species, and that the amount of total toxins in the tested A. subpallidorosea is significantly higher than that in the tested A. virosa. Furthermore, consistency of the cyclopeptide toxins with the molecular phylogenetic relationships was demonstrated.


Assuntos
Amanita/química , Peptídeos Cíclicos/química , Amanita/classificação , Amanitinas/química , Cromatografia Líquida de Alta Pressão , Espectrometria de Massas , Peptídeos Cíclicos/classificação , Filogenia
6.
Toxins (Basel) ; 8(5)2016 05 04.
Artigo em Inglês | MEDLINE | ID: mdl-27153089

RESUMO

Amatoxins and phallotoxins are toxic cyclopeptides found in the genus Amanita and are among the predominant causes of fatal food poisoning in China. In the treatment of Amanita mushroom poisoning, an early and definite diagnosis is necessary for a successful outcome, which has prompted the development of protocols for the fast and confirmatory determination of amatoxins and phallotoxins in human biological fluids. For this purpose, a simple, rapid and sensitive multiresidue UPLC-MS/MS method for the simultaneous determination of α-amanitin, ß-amanitin, γ-amanitin, phalloidin (PHD) and phallacidin (PCD) in human plasma, serum and urine was developed and validated. The diluted plasma, serum and urine samples were directly purified with a novel PRiME technique on a 96-well µElution plate platform, which allowed high-throughput sample processing and low reagent consumption. After purification, a UPLC-MS/MS analysis was performed using positive electrospray ionization (ESI+) in multiple reaction monitoring (MRM) mode. This method fulfilled the requirements of a validation test, with good results for the limit of detection (LOD), lower limit of quantification (LLOQ), accuracy, intra- and inter-assay precision, recovery and matrix effects. All of the analytes were confirmed and quantified in authentic plasma, serum and urine samples obtained from cases of poisoning using this method. Using the PRiME µElution technique for quantification reduces labor and time costs and represents a suitable method for routine toxicological and clinical emergency analysis.


Assuntos
Intoxicação Alimentar por Cogumelos/sangue , Intoxicação Alimentar por Cogumelos/urina , Peptídeos Cíclicos/sangue , Peptídeos Cíclicos/urina , Cromatografia Líquida de Alta Pressão , Humanos , Limite de Detecção , Espectrometria de Massas por Ionização por Electrospray , Espectrometria de Massas em Tandem
7.
Chemosphere ; 147: 404-11, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26774306

RESUMO

Rapid development of industrialization and urbanization results in serious environmental contamination by metal(loid)s, which would consequently cause deleterious health effects to the exposed people through multi-pathways. Therefore, total health risk assessment for the population in urban environment is very important. Unfortunately, few studies to date investigate the cumulative health risks of metal(loid)s through aggregative pathways in Children who are often susceptible population. 12 metal(loid)s including Lead(Pb), Cadmium(Cd), Arsenic(As), Chromium(Cr), Zinc(Zn), Copper(Cu), Nickel(Ni), Manganese(Mn), Cobalt(Co), Selenium(Se), Antimony(Se) and Vanadium(V), were analyzed in PM10, drinking water, food, soil and indoor dust in this study. The cumulative and aggregative risks of these metal(loid)s among the local children were then evaluated on a field sampling and questionnaire-survey basis. The results showed that the environments were heavily polluted by metal(loid)s. For most metal(loid)s, food ingestion accounted for more than 80% of the total daily exposure dose. The non-cancer risks were up to 30 times higher than the acceptable level due to the food ingestion via Pb, Cr, Cu, Zn, As, Se, Cd and Sb, and the PM10 inhalation via Cr and Mn. While, the cancer risks were mainly attributed to Cr via food ingestion and As via food and dust ingestion, and approximately 100 times of the maximum acceptable level of 1.0 × 10(-4). The study highlights the cumulative and aggregative exposure assessment, instead of pollutant investigation to evaluate the potential health risks and emphasizes concerns to improve indoor hygienic and environmental quality and to decrease the potential harmful health effects of children living in urban area.


Assuntos
Arsênico/análise , Exposição Ambiental/análise , Metais/análise , Poluição do Ar em Ambientes Fechados/análise , Criança , Pré-Escolar , China , Cidades , Água Potável/análise , Poeira/análise , Feminino , Contaminação de Alimentos/análise , Humanos , Masculino , Material Particulado/análise , Medição de Risco , Poluentes do Solo/análise , Poluentes Químicos da Água/análise
8.
Environ Pollut ; 200: 16-23, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25686884

RESUMO

Manufacture of lead-acid batteries is of widespread interest because of its emissions of heavy metals and metalloids into environment, harming environmental quality and consequently causing detrimental effects on human health. In this study, exposure pathways and health risks of children to heavy metal(loid)s (Pb, Cd, As, etc) were investigated based on field sampling and questionnaire. Pb was one of the most abundant elements in children's blood, with an elevated blood lead level of 12.45 µg dL(-1). Soil/dust and food were heavily polluted by targeted metal(loid)s. Food ingestion accounted for more than 80% of the total exposure for most metal(loid)s. The non-cancer risks to children were 3-10 times higher than the acceptable level of 1, while the cancer risks were 5-200 times higher than the maximum acceptable level of 1.0 × 10(-4). The study emphasized the significance of effective environmental management, particularly to ensure food security near battery facilities.


Assuntos
Fontes de Energia Elétrica , Exposição Ambiental/estatística & dados numéricos , Metaloides/análise , Poluentes do Solo/análise , Criança , China , Poeira/análise , Poluição Ambiental/estatística & dados numéricos , Humanos , Resíduos Industriais/análise , Resíduos Industriais/estatística & dados numéricos , Chumbo , Metais/análise , Medição de Risco , Solo
9.
Environ Pollut ; 199: 18-25, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25617855

RESUMO

As a highly toxic heavy metal, the pollution and exposure risks of lead are of widespread concern for human health. However, the collection of blood samples for use as an indicator of lead pollution is not always feasible in most cohort or longitudinal studies, especially those involving children health. To evaluate the potential use of urinary lead as an indicator of exposure levels and source apportionment, accompanying with environmental media samples, lead concentrations and isotopic measurements (expressed as (207)Pb/(206)Pb, (208)Pb/(206)Pb and (204)Pb/(206)Pb) were investigated and compared between blood and urine from children living in the vicinities of a typical coking plant and lead-acid battery factory. The results showed urinary lead might not be a preferable proxy for estimating blood lead levels. Fortunately, urinary lead isotopic measurements could be used as an alternative for identifying the sources of children's lead exposure, which coincided well with the blood lead isotope ratio analysis.


Assuntos
Exposição Ambiental/análise , Poluição Ambiental/estatística & dados numéricos , Intoxicação por Chumbo/urina , Chumbo/urina , Criança , Coque , Exposição Ambiental/estatística & dados numéricos , Poluição Ambiental/análise , Humanos , Isótopos/análise , Chumbo/análise
10.
Artigo em Chinês | MEDLINE | ID: mdl-26887270

RESUMO

OBJECTIVE: To investigate toxicokinetic parameters impacted by hemoperfusion after oral chlorpyrifos exposure, to investigate the adsorption effect of hemoperhusion for chlorpyrifos poisoning. METHODS: 12 rabbits were divided into two groups after oral exposure with chlorpyrifos 300 mg/kg body weight. Control group: without hemoperfusion; hemoperfusion group: hemoperfusion starts 0.5 h after chlorpyrifos exposure and lasts for 2h. Blood samples were collected at different times, concentrations of chlorpyrifos were tested by GC, then, toxicokinetic parameterswere calculated and analysis by DAS3.0. RESULTS: In hemoperfusion group, peak time was (7.19±3.74) h, peak concentrations was (1.37±0.56) mg/L, clearance rate was (13.93±10.27) L/h/kg, apparent volume of distribution was (418.18±147.15) L/kg The difference of these parameter were statistically significant compared with control group (P<0.05). CONCLUSION: Hmoperfusion will decrease the inner exposure and load dose of rabbits with chlorpyrifos poisoning.


Assuntos
Clorpirifos/toxicidade , Hemoperfusão , Toxicocinética , Animais , Clorpirifos/farmacocinética , Taxa de Depuração Metabólica , Coelhos
11.
Environ Int ; 73: 158-66, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25124751

RESUMO

Lead exposure in the environment is a major hazard affecting human health, particularly for children. The blood lead levels in the local children living around the largest coking area in China were measured, and the source of blood lead and the main pathways of lead exposure were investigated based on lead isotopic ratios ((207)Pb/(206)Pb and (208)Pb/(206)Pb) in blood and in a variety of media, including food, airborne particulate matter, soil, dust and drinking water. The children's blood lead level was 5.25 (1.59 to 34.36 as range) µg dL(-1), lower than the threshold in the current criteria of China defined by the US Centers for Disease Control (10 µg dL(-1)). The isotopic ratios in the blood were 2.111±0.018 for (208)Pb/(206)Pb and 0.864±0.005 for (207)Pb/(206)Pb, similar to those of vegetables, wheat, drinking water, airborne particulate matter, but different from those of vehicle emission and soil/dust, suggesting that the formers were the main pathway of lead exposure among the children. The exposure pathway analysis based on the isotopic ratios and the human health risk assessment showed that dietary intake of food and drinking water contributed 93.67% of total exposed lead. The study further indicated that the coal used in the coking plant is the dominant pollution source of lead in children's blood.


Assuntos
Coque , Poluentes Ambientais/sangue , Chumbo/sangue , Criança , China , Carvão Mineral/análise , Poluentes Ambientais/análise , Poluição Ambiental , Feminino , Humanos , Isótopos/análise , Isótopos/sangue , Chumbo/análise , Masculino
12.
Artigo em Chinês | MEDLINE | ID: mdl-24754949

RESUMO

OBJECTIVE: To observe the effect of different doses of acetamide on the histopathology in the cerebral cortex of rats with tetramine (TET) poisoning and to provide a basis for the treatment of fluoroacetamide poisoning with acetamide. METHODS: Eighty clean Sprague-Dawley rats were randomly divided into five groups: saline control group,dimethylsulfoxide water solution control group,TET poisoning group, acetamide (2.88 g/kg/d) treatment group, and acetamide (5.68 g/kg/d) treatment group, with 16 rats in each group. Rats in the poisoning group and treatment groups were poisoned with TET by intragastric administration after fasting; then, saline was injected intramuscularly into rats of the poisoning group, and different doses of acetamide were injected intramuscularly into rats of treatment groups; the course of treatment was 5 d. At 3 h, 12 h, 48 h, and 7 d after treatment, the cerebral cortex was harvested from rats in each group, and the histopathological changes in the cerebral cortex were evaluated under light and electron microscopes. RESULTS: The light microscopy showed that the TET poisoning group had hypoxia changes in the cerebral cortex, which worsened over time; the treatment groups had reduced hypoxia changes, and the acetamide (2.88 g/kg/d) treatment group had more reduction than the acetamide (5.68 g/kg/d) treatment group. The electron microscopy showed that the apoptosis of neuronal cells were the main pathological changes in the TET poisoning group; the treatment groups had reduced apoptotic changes, and the acetamide (2.88 g/kg/d) treatment group had more reduction than the acetamide (5.68 g/kg/d) treatment group. CONCLUSION: No pathological changes associated with the synergistic toxic effect of acetamide and TET are found in the cerebral cortex. Acetamide (2.88 g/kg/d) could reduce central nervous lesions, but the efficacy is not improved after increasing the dose. For patients who cannot be identified with TET or fluoroacetamide poisoning, acetamide could be considered for treatment.


Assuntos
Acetamidas/farmacologia , Hidrocarbonetos Aromáticos com Pontes/toxicidade , Córtex Cerebral/patologia , Animais , Córtex Cerebral/efeitos dos fármacos , Modelos Animais de Doenças , Masculino , Ratos , Ratos Sprague-Dawley
13.
Sci Total Environ ; 472: 1001-9, 2014 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-24345860

RESUMO

Coking influences environmental quality and poses high risks to human health as large amounts of heavy metals and metalloids are emitted into the environment from coal during the coking process. Health risks depend heavily on multi-pathway and element-specific exposures, which have, unfortunately, been rarely studied. In this study, children's health risks and exposure levels to As, Se, and heavy metals (Pb, Cd, Cr, Ni, Co, Zn, Cu, Mn, V and Sb) in the water, soil, dust, air and locally produced food were studied based on field sampling and questionnaire-based surveys around the largest coking area in China. Human blood samples were collected and analyzed to indicate the exposure levels. The non-carcinogenic risks to children mainly resulted from Cr, Mn, Pb, As and Sb, the levels of which were 3 to 10 times higher than the acceptable levels (1.0×10(-6)). The carcinogenic risks to children were 30 to 200 times higher than the safe level (1.0×10(-6)-1.0×10(-4)), which could be attributed to Cr, As and Ni pollution. The estimated risks mainly came from the pathway involving the ingestion of locally produced food, accounting for more than 85% in total for most elements. For As, the food ingestion and air inhalation exposure pathways both contributed approximately 50%, respectively. The high risks in this study highlight the attention paid to the health of children who live in the vicinity of coking activities and the importance of site-specific multi-pathway health risk assessments and food safety to protect potentially exposed children.


Assuntos
Coque , Exposição Ambiental/análise , Poluentes Ambientais/análise , Poluição Ambiental/análise , Metais Pesados/análise , Arsênico/análise , Criança , China , Poeira/análise , Exposição Ambiental/estatística & dados numéricos , Poluição Ambiental/estatística & dados numéricos , Feminino , Humanos , Chumbo/análise , Masculino , Medição de Risco , Selênio/análise , Solo/química
14.
Artigo em Chinês | MEDLINE | ID: mdl-22931872

RESUMO

OBJECTIVE: To evaluate the therapeutic effects of epidermal growth factor (EGF) combined with plasma cryoprecipitate (CRYO) on the corneal injury induced by paraquat (PQ). METHODS: According to the "Toxicological test methods of pesticides for registration" (GB 15670-1995), the conjunctival sacs of 18 health New Zealand rabbits were exposed to 100 µl 20% PQ, which were randomly divided into EGF, CRYO and EGF plus CRYO groups. The routine treatments (normal saline washing and antibiotic eyedrops) were administrated to the injured eyes of 3 groups, at the same time the left eyes of 3 groups were treated with EGF, CRYO and EGF plus CRYO, respectively. The injury of conjunctival, iris and corneal, fluorescent stranded and pathology changes of corneal were observed. The injury score was calculated and the recovery time of corneal injury was recorded. RESULTS: The recovery time of corneal injury in EGF and EGF plus CRYO groups were 19.50 ± 3.08 and 18.67 ± 2.73 days, respectively which were significantly lower than those (27.33 ± 2.58 and 26.83 ± 3.13 days) in corresponding routine treatment controls (P < 0.05). CONCLUSION: EGF and EGF plus CRYO could be used to treat the corneal injury induced by paraquat.


Assuntos
Córnea/efeitos dos fármacos , Fator de Crescimento Epidérmico/uso terapêutico , Traumatismos Oculares/tratamento farmacológico , Fator VIII/uso terapêutico , Fibrinogênio/uso terapêutico , Cicatrização/efeitos dos fármacos , Animais , Transfusão de Sangue Autóloga , Lesões da Córnea , Traumatismos Oculares/induzido quimicamente , Soluções Oftálmicas , Paraquat/efeitos adversos , Plasma , Coelhos , Resultado do Tratamento
15.
Clin Toxicol (Phila) ; 50(1): 65-9, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22175787

RESUMO

OBJECTIVE: To describe the clinical features and management of thallium poisoning in patients with delayed hospital admission. METHODS: Fourteen patients (median age 36 years) were admitted 9-19 days after ingesting food poisoned with thallium. Clinical and laboratory data, including blood and urine thallium concentrations, were collected. Patients were treated with oral Prussian blue, a chelating agent sodium dimercaptosulfonate, and hemodialysis. RESULTS: All patients experienced a triad of symptoms of acute gastrointestinal upset, painful combined polyneuropathy, and hair loss after consuming poisoned food. Fatigue and skin pigmentation were observed in all patients. Abnormal liver function tests were found in 6 (42.9%) and delirium and coma were identified in 4 (28.6%). Two weeks after the poisoning, the blood and urine thallium concentration ranged from 219.0 to 1414.4 µg/L (median: 535.3) and 956.5 to 11285.0 µg/L (median: 7460.0), respectively. One patient (7.1%) with a previous history of pulmonary fibrosis died of respiratory failure in hospital. Symptoms were improved and blood or urine thallium levels were normalized in the remaining 13 patients before discharge. After a 6.5 ± 1-month follow-up, 1 patient (7.1%) developed deep venous thrombosis in the left lower limb. In another patient (7.1%), numbness in the lower limbs remained. CONCLUSION: Acute thallium poisoning is commonly manifested by gastrointestinal upset, painful polyneuropathy, and significant hair loss. Treatment strategies included Prussian blue and hemodialysis, which were associated with a good outcome in this case series.


Assuntos
Doenças Transmitidas por Alimentos/terapia , Tálio/envenenamento , Adolescente , Adulto , Idoso , Antídotos/uso terapêutico , Criança , Pré-Escolar , Diagnóstico Tardio/efeitos adversos , Feminino , Ferrocianetos/uso terapêutico , Contaminação de Alimentos , Doenças Transmitidas por Alimentos/diagnóstico , Doenças Transmitidas por Alimentos/etiologia , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tálio/sangue , Tálio/urina , Fatores de Tempo , Resultado do Tratamento
16.
Zhonghua Yu Fang Yi Xue Za Zhi ; 43(2): 146-50, 2009 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-19534909

RESUMO

OBJECTIVE: To analyze the capacity of personal protection on poison emergency items in Chinese disease control and prevention institutes. METHODS: Evaluation analysis based on data obtained from investigating personal protection equipments and professional knowledge quizzing about personal protection in poisoning control of 57 different level centers for disease control and prevention selected from China by a multi-stage stratified sampling. RESULTS: All 80.70% of the institutes possessed the protection equipments, provincial, municipal, county level institutes were 100.00%, 95.24%, 66.67%, respectively, with significant statistical difference (H = 7.94, P < 0.05). The average level of the type of individual protective equipments in disease control and prevention institutes was (5.42 +/- 4.00) kinds, the average points in category of provincial, municipal, county level institutes were (11.33 +/- 3.67), (6.52 +/- 3.16), (3.47 +/- 3.10) kinds, being statistically significant (F = 17.30, P < 0.05); type difference counts of disease control and prevention institutes in economic development, secondary, less-developed regions were (6.41 +/- 4.03), (3.55 +/- 3.35), (6.45 +/- 4.07) kinds, with statistical significance (F = 3.70, P < 0.05). Protection equipments chiefly possessed were latex gloves, gauze masks and C-protective clothing. Protective clothing and respiratory protective equipments were insufficient evidently. The average points in testing personal protection basic knowledge were (71.39 +/- 12.52) points; there were no differences between different institutes with different economic regions, levels, technical posts and title degrees. CONCLUSION: Certain advances have been achieved in recent years in personal protection capacity of institutes for disease control and prevention, but far from the actual demands, and maybe no enough effective response on emergency occurred.


Assuntos
Emergências , Envenenamento/prevenção & controle , Roupa de Proteção , China , Humanos , Exposição Ocupacional
17.
Zhonghua Yu Fang Yi Xue Za Zhi ; 42(3): 199-201, 2008 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-18788587

RESUMO

OBJECTIVE: To establish a comprehensive,easily approached, operated, and searched internet poison databank as to providing professional poison data and knowledge of effective treatment for those consented such as medical staff, and emergency response team in the shortest time. METHODS: We established a computer poison databank, by adopting B/S structure, using SQL Server databank, and explore technology, in which all information may easily be explored and obtained by users. RESULTS: The database integrated the information in relating to the substances identifiers, physical and chemical properties, toxicology data, clinical manifestation while intoxication, emergency response guides, effective treatment, anything related to the special antidotes, preventive measures, poison analysis, and manufacturers of chemicals, pharmaceuticals, herbs, pesticides, animal, plant, bacteria, fungi, productions and toxins. Otherwise some information about poison control organizations and experts, literatures about poison case reports, poison incidents, were also involved in the system, which can also provide a shortcut, convenient, and exact search. CONCLUSIONS: The databank might be easily used on several fields, providing important information with acute poison incidents disposal and clinic treatment.


Assuntos
Animais Venenosos , Sistemas de Gerenciamento de Base de Dados , Plantas , Animais , Bancos de Espécimes Biológicos , Bases de Dados Factuais , Software
18.
Biomed Environ Sci ; 21(3): 253-6, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18714825

RESUMO

OBJECTIVE: This study analyzed patterns of suicide and suicide attempts by poisoning as reported through a national poison control system for the purpose of improving intervention and prevention. METHODS: During the period of 2000 to 2006, 6440 cases of poisoning suicide were reported to the telephone consultation service system of The National Center for Poisoning Control (Chinese Center for Disease Control and Prevention). Among these records, 4728 cases had completed data for this analysis in terms of age, sex, trend of time and location, and type of poisons. RESULTS: There were 60.6% female cases with the age from 10 to 90 years old. The age of cases from 20 to 39 years accounted for 54.5% of all age groups. Both the numbers and percentage in record related to poisoning consultation of oral poisoning suicide showed an increasing tendency during the 7 years. In particular, there was a drastic increase from 2004 to 2006. In addition, the high frequency of cases occurred from May to October. Hebei, Shandong, Henan, and Anhui Provinces had the highest number of cases. Pesticide poisonings were the most common method in these cases of consultation for suicide and suicide attempts. CONCLUSION: This study describes epidemiological characteristics in the oral poisoning suicide cases and provides scientific basis for suicide prevention interventions.


Assuntos
Centros de Controle de Intoxicações/estatística & dados numéricos , Envenenamento/epidemiologia , Tentativa de Suicídio/tendências , Suicídio/tendências , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , China/epidemiologia , Feminino , Geografia , Humanos , Masculino , Pessoa de Meia-Idade , Praguicidas/envenenamento , Fatores Sexuais , Suicídio/estatística & dados numéricos , Tentativa de Suicídio/estatística & dados numéricos , Adulto Jovem
20.
Zhonghua Yu Fang Yi Xue Za Zhi ; 39(2): 91-4, 2005 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-15842825

RESUMO

OBJECTIVE: To explore toxicokinetics of tetramethylene disulphotetramine (TETS) in rabbit and the effects on toxicokinetics of TETS after activated charcoal by gavage. METHODS: Eight rabbits were exposed through gavage and vein respectively, the blood samples were collected from the center artery in ear of rabbit at an arranged time. Four rabbits were exposed after being intubated into urethra and common bile duct. The samples of bile and urine were collected at arranged times. After being exposed by gavage, activated charcoal (1 g/kg) was administrated in the activated charcoal group and the distilled water (1 g/kg) administrated to the controls. The samples of blood were collected from the center artery in ear of rabbit at arranged times. The contents of TETS in samples were determined by GC/NPD method. Analysed by the 3p87 soft, toxicokinetics parameters of TETS were acquired. RESULTS: TETS was eliminated very slowly in rabbit. The plasma half time in elimination phase (Tke1/2) of TETS was 56.9 hours in vein exposure group and 262.5 hours in oral exposure group respectively. The plasma clearance (CL) of it was only 15.4 ml.kg(-1).h(-1) in oral exposure group and 24.1 ml.kg(-1).h(-1) in vein exposure group. TETS was eliminated from urine in rabbit. The eliminated amount of it from urine was more 5 times than from bile. All parameters of toxicokinetics of TETS were significantly different between the activated charcoal group and the control. Compared to the control, Tke1/2 of TETS in the activated charcoal group was equal to 55%, CL was increased over 3-fold, area under the curve was equal to 30%. CONCLUSION: TETS was a poison eliminated very slowly in body. The eliminated amount of it from urine was more than from bile. The excretion of TETS could be quickened after activated charcoal by gavage.


Assuntos
Hidrocarbonetos Aromáticos com Pontes/farmacocinética , Carvão Vegetal/administração & dosagem , Animais , Antídotos/administração & dosagem , Bile/metabolismo , Hidrocarbonetos Aromáticos com Pontes/sangue , Hidrocarbonetos Aromáticos com Pontes/urina , Feminino , Masculino , Taxa de Depuração Metabólica/efeitos dos fármacos , Coelhos
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