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2.
Toxicon ; 191: 69-82, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33359388

RESUMO

The Mediterranean region is, by far, a prime travel destination, having hosted more than 330 million tourists in 2016, mostly for seaside holidays. A greatly increased influx of thermophilic Red Sea species, introduced through the Suez Canal in a process referred to as Lessepsian invasion (in honor of Ferdinand de Lesseps who instigated the building of the Suez Canal), have raised awareness among scientists, medical personnel, and the public, of health risks caused by some venomous and poisonous marine species. The main species of concern are the poisonous Lagocephalus sceleratus, and the venomous Plotosus lineatus, Siganus luridus, Siganus rivulatus, Pterois miles, Synancea verrucosa, Rhopilema nomadica, Macrorhynchia philippina and Diadema setosum. Recognizing that the main factors that drive the introduction and dispersal of Red Sea biota in the Mediterranean, i.e., Suez Canal enlargements and warming seawater, are set to increase, and international tourist arrivals are forecasted to increase as well, to 500 million in 2030, an increase in intoxications and envenomations by alien marine species is to be expected and prepared for.


Assuntos
Organismos Aquáticos , Espécies Introduzidas , Toxinas Biológicas , Animais , Peixes-Gato , Ecossistema , Humanos , Oceano Índico , Mar Mediterrâneo , Perciformes , Tetraodontiformes
6.
Toxicon ; 108: 97-103, 2015 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-26454165

RESUMO

INTRODUCTION: Immunotherapy is the gold standard treatment for patients bitten by European vipers in France; it significantly decreases morbidity, frequency and severity of complications and length of stay. A national prospective study was performed by all Poison Control Centers (PCC) to validate the emergency protocol for viper envenomations. METHODS: This prospective study included all cases of viper bites in France, treated or not with Viperfav(®) in 2013. RESULTS: In 2013, 277 cases of viper bites were collected: ratio M/F 2.1; mean aged 43 years (<15 years 25% 15-65 63% > 65 12%). The final severity was divided into 68 grades 0, 58 grades I, 62 grades IIA, 71 grades IIB and 18 grades III. One death was reported. Five patients had neurological signs. For the 114 patients who received Viperfav(®), all systemic signs disappeared in 5 h and in 24 h for biological and neurological signs. No severe anaphylactic reaction with Viperfav(®) was reported. Late Viperfav(®) administration increased the risk of functional impairment 15 days after the bite (OR = 3.21 p = 0.043). The administration of Low Molecular Weight Heparin (LMWH) increased the frequency of functional impairment to 15 days after the bite (OR = 6.38 p = 0.064), although Viperfav(®) was given in the first 18 h. DISCUSSION: This study confirms the efficiency, safety and recommendation of an early administration of a single dose of Viperfav(®), LMWH should not be used. It also shows the extension of neurotoxic venom of vipers in France.


Assuntos
Mordeduras de Serpentes/epidemiologia , Viperidae , Adolescente , Adulto , Idoso , Animais , Antivenenos/efeitos adversos , Antivenenos/uso terapêutico , Feminino , França/epidemiologia , Humanos , Imunoterapia/efeitos adversos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Mordeduras de Serpentes/terapia
7.
Bull Soc Pathol Exot ; 108(2): 139-43, 2015 Mar.
Artigo em Francês | MEDLINE | ID: mdl-25925815

RESUMO

Jatropha curcas L. is an inedible plant belonging to the Euphorbiaceae family that is growing in subtropical zones of all continents. We report a series of 24 cases of poisoning with J. curcas seeds or fruits reported to poison centers in Paris and Marseille between December 2000 and June 2014. Fifteen adults and 9 children ingested J. curcas seeds or fruits. All patients experienced gastrointestinal disorders, within the first hours following ingestion: nausea, vomiting, diarrhea and abdominal pain. Laboratory investigations performed in 10 patients revealed minor abnormalities: CK elevation (8 cases), dehydration (5 cases) with moderate elevation of serum creatinine levels (3 cases), and mildly increased serum bilirubin (8 cases). Complete remission of all clinical signs was observed within 48 hours in the 20 cases for which the outcome was known. Previously published cases of J. curcas poisoning were very similar to ours: As in our series, gastrointestinal disorders were always present. They were sometimes associated with neurological or cardiovascular signs, and hepatic or renal disorders; these were generally interpreted as complications of severe gastroenteritis, although direct toxic effects could not be formally excluded. In most cases, simple supportive measures were sufficient to ensure complete recovery within 24-48 hours. J Curcas poisoning incidence is certainly increasing because the plant is cultivated to produce biodiesel and is now largely present in most subtropical countries. As a consequence, local health professionals should be informed of the toxic properties of this plant.


Assuntos
Doenças Transmitidas por Alimentos/epidemiologia , Jatropha/envenenamento , Centros de Controle de Intoxicações , Adolescente , Adulto , Criança , Pré-Escolar , Comores/epidemiologia , Feminino , França/epidemiologia , Frutas/envenenamento , Humanos , Masculino , Pessoa de Meia-Idade , Nova Caledônia/epidemiologia , Paris/epidemiologia , Centros de Controle de Intoxicações/estatística & dados numéricos , Reunião/epidemiologia , Gestão de Riscos/estatística & dados numéricos , Adulto Jovem
8.
Arch Pediatr ; 21(11): 1213-5, 2014 Nov.
Artigo em Francês | MEDLINE | ID: mdl-25284732

RESUMO

Clonidine poisoning's clinical feature is well documented in the medical literature, but the minimal toxic dose has not yet been established. The effectiveness of naloxone is also controversial. The authors describe a clonidine overdose in a 9-year-old boy (25 kg) during a growth hormone test: he received tenfold the prescribed clonidine dose (0.23 mg instead of 0.023 mg) with 6.2 mg betaxolol. About 40 min later, he became drowsy and then complained of low blood pressure, bradycardia, and myosis. By maintaining the Trendelenburg position, administering fluids as well as salbutamol and naloxone (three doses of 0.2 mg were required), he recovered and was discharged from the hospital on day 2. The minimal clonidine toxic dose, the clinical picture, and the effectiveness of naloxone administration are discussed in this paper.


Assuntos
Agonistas de Receptores Adrenérgicos alfa 2/envenenamento , Anti-Hipertensivos/envenenamento , Clonidina/envenenamento , Overdose de Drogas/diagnóstico , Albuterol/administração & dosagem , Betaxolol/administração & dosagem , Betaxolol/envenenamento , Pressão Sanguínea/efeitos dos fármacos , Criança , Clonidina/administração & dosagem , Terapia Combinada , Relação Dose-Resposta a Droga , Overdose de Drogas/tratamento farmacológico , Quimioterapia Combinada , Frequência Cardíaca/efeitos dos fármacos , Humanos , Masculino , Erros de Medicação , Naloxona/administração & dosagem
9.
Clin Toxicol (Phila) ; 52(6): 625-8, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24940644

RESUMO

CONTEXT: Shiitake (Lentinula edodes) is an edible mushroom which was initially grown in Japan and China and is now sold on the European market. Flagellate erythema may arise following shiitake consumption and was first described in Japan in 1974. OBJECTIVE: This paper reports a French shiitake dermatitis case series. METHODS: The findings of retrospective study of shiitake dermatitis cases, reported to French Poison Control Centres (PCC) from January 2000 to December 2013, are reported. RESULTS: Among 32 exposed patients, 15 presented flagellate urticarial lesions after raw shiitake consumption. The first case of this series was reported in 2006 and the last nine cases were reported as of 2012. After shared meals, no symptoms were reported among guests, who preferred cooked shiitake to the raw mushroom. In this series, rashes appeared 12 h to 5 days (median: 24 h) after raw shiitake ingestion. Linear and itchy urticarial lesions formed on the trunk, arms, and legs within a few hours and persisted for 3-21 days. In four cases, rash and pruritus were either triggered or worsened by sun exposure. Eleven patients received corticosteroids, antihistamines, or both. All patients completely recovered. CONCLUSION: Due to the rapidly increasing consumption of exotic food in Western countries, it is no surprise that cases of shiitake dermatitis are now appearing in Europe. The mechanism of shiitake dermatitis is thought to be toxic and due to lentinan, a polysaccharide component of the mushroom. There is no specific validated treatment for shiitake dermatitis. Health professionals and the general population should be aware of both the risk associated with raw shiitake consumption and of the good prognosis of this very spectacular and uncomfortable toxic dermatitis.


Assuntos
Dermatite/etiologia , Intoxicação Alimentar por Cogumelos/epidemiologia , Cogumelos Shiitake , Adulto , Idoso de 80 Anos ou mais , Dermatite/diagnóstico , Dermatite/patologia , Feminino , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Intoxicação Alimentar por Cogumelos/diagnóstico , Intoxicação Alimentar por Cogumelos/patologia , Centros de Controle de Intoxicações , Estudos Retrospectivos , Pele/patologia
11.
Ann Dermatol Venereol ; 139(12): 824-7, 2012 Dec.
Artigo em Francês | MEDLINE | ID: mdl-23237281

RESUMO

BACKGROUND: Emla(®) cream, a mixture of two local anaesthetics (prilocaine 2.5%, lidocaine 2.5%) has a good benefit-risk profile. However, methaemoglobinaemia can occur, especially when the cream is applied in excessive amounts or over long periods. PATIENTS AND METHODS: The authors report a case of seizure and respiratory disturbances (MetHb=20.1%) after excessive application of Emla(®) (30g) for curettage of molluscum contagiosum in a young girl with eczema. The patient's clinical condition improved after withdrawal of the cream and administration of methylene blue, and she returned home on day two. DISCUSSION: This new case of methaemoglobinaemia in a child following application of Emla(®) cream highlights the importance of strict compliance with the instructions for use of this medicinal product.


Assuntos
Anestésicos Combinados/efeitos adversos , Lidocaína/efeitos adversos , Metemoglobinemia/induzido quimicamente , Prilocaína/efeitos adversos , Pré-Escolar , Formas de Dosagem , Overdose de Drogas , Feminino , Humanos , Combinação Lidocaína e Prilocaína
12.
Ann Fr Anesth Reanim ; 31(5): 466-8, 2012 May.
Artigo em Francês | MEDLINE | ID: mdl-22465651

RESUMO

Amanita proxima is one species of white mushroom which can induce poisonings called in France "proximien" syndrome. The clinical feature of "proximien" syndrome is mainly characterized by early digestive troubles, mild hepatic cytolysis and late renal impairment. A cardiac insult has never been reported in such a circumstance. The authors describe herein two cases of white mushroom poisoning occurred in the Mediterranean French coast with a typical clinical feature of "proximien" syndrome plus secondary development of severe cardiac alterations. The outcome was good for the two patients thanks to symptomatic treatment. The cases reported here suggest that A. proxima have a potential severe cardiac toxicity leading to include early and precise cardiac examination in the management of patients poisoned by these mushrooms.


Assuntos
Amanita , Insuficiência Cardíaca/induzido quimicamente , Intoxicação Alimentar por Cogumelos/fisiopatologia , Agonistas Adrenérgicos beta/uso terapêutico , Adulto , Diuréticos , Dobutamina/uso terapêutico , Eletrocardiografia , Feminino , Furosemida/uso terapêutico , Insuficiência Cardíaca/diagnóstico por imagem , Insuficiência Cardíaca/fisiopatologia , Hemodiafiltração , Hemodinâmica/fisiologia , Humanos , Síndrome do QT Longo/induzido quimicamente , Masculino , Pessoa de Meia-Idade , Intoxicação Alimentar por Cogumelos/diagnóstico por imagem , Náusea/induzido quimicamente , Ressuscitação , Choque Cardiogênico/induzido quimicamente , Choque Cardiogênico/terapia , Ultrassonografia , Disfunção Ventricular Esquerda/induzido quimicamente , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/fisiopatologia
15.
Arch Pediatr ; 18(12): 1290-3, 2011 Dec.
Artigo em Francês | MEDLINE | ID: mdl-21982976

RESUMO

Mushroom intoxication due to Amanita proxima poisoning is characterized by moderate gastrointestinal symptoms, followed by severe acute renal failure and sometimes by hepatic cytolysis. This syndrome was described in the 1990s in the southeast of France; we report here the first pediatric case, requiring dialysis but achieving complete recovery. The mother of this 11-year-old boy, who had eaten the same mushrooms but in smaller quantities, had only biological renal and hepatic involvement.


Assuntos
Injúria Renal Aguda/etiologia , Injúria Renal Aguda/terapia , Amanita , Intoxicação Alimentar por Cogumelos/complicações , Intoxicação Alimentar por Cogumelos/terapia , Diálise Renal , Injúria Renal Aguda/induzido quimicamente , Criança , Humanos , Hepatopatias/sangue , Hepatopatias/etiologia , Testes de Função Hepática , Masculino , Intoxicação Alimentar por Cogumelos/diagnóstico , Resultado do Tratamento
17.
Med Trop (Mars) ; 71(3): 292-4, 2011 Jun.
Artigo em Francês | MEDLINE | ID: mdl-21870562

RESUMO

Henna (Lawsonia inermis) is a shrub bearing leaves that are crushed and used for cosmetic purposes in Asia and Africa. In several countries, henna decoction is ingested as a traditional drug to induce abortion. One component of Henna, known as Lawsone, can induce hemolysis in G6PD-deficient patients after cutaneous exposure or ingestion. The purpose of this report is to describe a case of severe hemolytic anemia after voluntary ingestion of Henna decoction to induce abortion. This complication led to diagnosis of partial moderate G6PD-deficiency in the 17-year-old patient living in Mayotte in the Indian Ocean. This report emphasizes the life-threatening hazards associated with some plant extracts used as traditional medicines.


Assuntos
Anemia Hemolítica/induzido quimicamente , Deficiência de Glucosefosfato Desidrogenase/complicações , Lawsonia (Planta)/efeitos adversos , Folhas de Planta/efeitos adversos , Aborto Induzido , Adolescente , Comores , Feminino , Humanos , Gravidez
19.
Dis Esophagus ; 23(7): E39-41, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20840467

RESUMO

Currently, most of esophageal diverticula arise as the result of a pulsion effect. Some esophageal motor disorders increase the intraluminal pressure and after some time, the diverticula grow through a weak point of esophageal wall. In these cases, the surgical treatment of choice is the myotomy associated with diverticulopexy or diverticulectomy. Adding a fundoplication is accepted to avoid the consequences of gastroesophageal reflux after myotomy in the epiphrenic diverticula surgery. There are other causes of esophageal diverticula that change the resistance of esophageal wall. Cutis laxa, a congenital or acquired connective disease, is a strange one. In our patient, a good result was reached modifying the standard technique accord to its ethiopathogenic mechanism.


Assuntos
Cútis Laxa/complicações , Divertículo de Zenker/complicações , Divertículo de Zenker/cirurgia , Adolescente , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Humanos , Masculino
20.
Br J Surg ; 97(5): 714-8, 2010 May.
Artigo em Inglês | MEDLINE | ID: mdl-20187171

RESUMO

BACKGROUND: This study assessed the feasibility of a protocol-driven written clinical pathway for multidisciplinary postoperative management after oesophagectomy for oesophageal neoplasia, and examined whether the application of such a protocol could shorten hospital stay and reduce postoperative morbidity and mortality. METHODS: Consecutive patients undergoing transthoracic oesophagectomy for oesophageal neoplasia were divided into those treated between 2003 and 2008 to whom a clinical pathway was applied for postoperative management (group 1), and a control group treated between 1998 and 2002 when no clinical pathway was applied (group 2). RESULTS: There were 74 patients in each group. Morbidity rates were similar in the two groups: 31 per cent in group 1 and 38 per cent in group 2. There were more pulmonary complications in group 2 (23 versus 14 per cent; P = 0.025). One patient (1 per cent) in group 1 and four (5 per cent) in group 2 died after surgery (P = 0.010). The median (range) length of hospital stay was 9 (5-98) days for group 1 and 13 (8-106) days in group 2 (P = 0.012). CONCLUSION: Use of a written clinical pathway in patients undergoing oesophageal resection significantly reduced pulmonary complications, postoperative mortality and hospital stay.


Assuntos
Procedimentos Clínicos/normas , Neoplasias Esofágicas/cirurgia , Esofagectomia/métodos , Adolescente , Adulto , Idoso , Estudos de Viabilidade , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Cuidados Pós-Operatórios/métodos , Resultado do Tratamento , Adulto Jovem
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