Pharmacological treatment of inhalation injury after nuclear or radiological incidents: The Chinese and German approach.

Inhalation injury is often associated with burns and significantly increases morbidity and mortality. The main toxic components of fire smoke are carbon monoxide, hydrogen cyanide, and irritants. In the case of an incident at a nuclear power plant or recycling facility associated with fire, smoke may also contain radioactive material. Medical treatments may vary in different countries, and in this paper, we discuss the similarities and differences in the treatments between China and Germany. Carbon monoxide poisoning is treated by 100% oxygen administration and, if available, hyperbaric oxygenation in China as well as in Germany. In addition, antidotes binding the cyanide ions and relieving the respiratory chain are important. Methemoglobin-forming agents (e.g., nitrites, dimethylaminophenol) or hydroxocobalamin (Vitamin B12) are options. The metabolic elimination of cyanide may be enhanced by sodium thiosulfate. In China, sodium nitrite with sodium thiosulfate is the most common combination. The use of dimethylaminophenol instead of sodium nitrite is typical for Germany, and hydroxocobalamin is considered the antidote of choice if available in cases of cyanide intoxications by fire smoke inhalation as it does not further reduce oxygen transport capacity. Systematic prophylactic use of corticosteroids to prevent toxic pulmonary edema is not recommended in China or Germany. Stable iodine is indicated in the case of radioiodine exposure and must be administered within several hours to be effective. The decorporation of metal radionuclides is possible with Ca (DTPA) or Prussian blue that should be given as soon as possible. These medications are used in both countries, but it seems that Ca (DTPA) is administered at lower dosages in China. Although the details of the treatment of inhalation injury and radionuclide(s) decorporation may vary, the general therapeutic strategy is very similar in China and Germany.

Antinutritional factors and hypocholesterolemic effect of wild apricot kernel (Prunus armeniaca L.) as affected by detoxification.

The present investigation was aimed to study the effect of detoxification on the nutrients and antinutrients of wild apricot kernel followed by its hypocholesterolemic effect in male Wistar albino rats. The results revealed a non-significant (p > 0.05) effect of detoxification on the proximate composition except total carbohydrates and protein content. However, detoxification led to a significant (p < 0.05) decrease in l-ascorbic acid (76.82%), ß-carotene (25.90%), dietary fiber constituents (10.51-28.92%), minerals (4.76-31.08%) and antinutritional factors (23.92-77.05%) (phenolics, tannins, trypsin inhibitor activity, saponins, phytic acid, alkaloids, flavonoids, oxalates) along with the complete removal (100%) of bitter and potentially toxic hydrocyanic acid (HCN). The quality parameters of kernel oil indicated no adverse effects of detoxification on free fatty acids, lipase activity, acid value and peroxide value, which remained well below the maximum permissible limit. Blood lipid profile demonstrated that the detoxified apricot kernel group exhibited significantly (p < 0.05) increased levels of HDL-cholesterol (48.79%) and triglycerides (15.09%), and decreased levels of total blood cholesterol (6.99%), LDL-C (22.95%) and VLDL-C (7.90%) compared to that of the raw (untreated) kernel group. Overall, it can be concluded that wild apricot kernel flour could be detoxified efficiently by employing a simple, safe, domestic and cost-effective method, which further has the potential for formulating protein supplements and value-added food products.

Perfil epidemiológico, sinais e sintomas respiratórios de indivíduos que inalaram fumaça tóxica no incêndio da boate Kiss, Santa Maria, RS, Brasil / Epidemiological profile, respiratory signs and symptoms of individuals who inhaled toxic smoke in Kiss nightclub fire, Santa Maria, RS, Brazil

Introdução: O incêndio ocorrido na Boate Kiss, na cidade de Santa Maria-RS, em 27 de janeiro de 2013, vitimou fatalmente 242 sujeitos asfixiados pela inalação de fumaça tóxica, deixando, aproximadamente, outros mil feridos. Objetivo: Analisar os sinais e sintomas respiratórios, em médio prazo, apresentados pelas pessoas que inalaram fumaça tóxica no incêndio. Métodos: Realizou-se este estudo transversal no ambulatório do Centro Integrado de Atenção às Vítimas de Acidentes, localizado no Hospital Universitário de Santa Maria, na cidade de Santa Maria-RS. Resultados: A amostra foi composta por 589 indivíduos (27,8±10,2 anos) que possuíam ou estavam cursando ensino superior. Os sinais e sintomas respiratórios mais prevalentes foram tosse produtiva, fadiga e opressão torácica. Conclusões: A persistência de sinais e sintomas respiratórios, após oito meses do episódio, representa um impacto à saúde das pessoas que inalaram a fumaça tóxica, havendo a necessidade de um monitoramento minucioso nos próximos anos.

Introduction: The fire occurred at Kiss nightclub in the city of Santa Maria-RS, on January 27, 2013, fatally killed 242 people, asphyxiated by inhalation of toxic smoke and approximately another one thousand were injured. Objective: To evaluate respiratory signs and symptoms in the medium term, shown by individuals who inhaled of toxic smoke in fire. Methods: Cross-sectional study was conducted in the clinic of the Integrated Center for Attention to Victims, located at the Hospital Universitário de Santa Maria, in Santa Maria-RS. Results: The sample consisted of 589 subjects (27.8 ± 10.2 years) who had or were attending higher education. The most common signs and respiratory symptoms were productive cough, fatigue and chest tightness. Conclusions: The persistence of signs and respiratory symptoms, after eight months of the episode, is an impact on the health of individuals who inhaled of toxic smoke. Thus, there is the need for careful monitoring in the coming years.

Investigation of hydrogen cyanide generation from the cyanoacrylate fuming process used for latent fingermark detection.

Cyanoacrylate fuming is one of the most common techniques employed for the detection of latent fingermarks on non-porous surfaces such as plastic and glass. The technique is generally applied by exposing items of interest to the vapours generated by heating a suitable quantity of commercial cyanoacrylate adhesive. In this study, the potential for highly toxic hydrogen cyanide (HCN) to be generated from the overheating of cyanoacrylate was investigated. Two commercial cyanoacrylate adhesives and two quantitative methods for the determination of HCN were employed: (i) the sodium picrate method; and (ii) the picrate-resorcinol method. (13)C nuclear magnetic resonance (NMR) analysis was used to confirm the presence of cyanide. In addition, the thermal decomposition of cyanoacrylate was studied using simultaneous thermogravimetric and differential thermal analysis (TGA-DTA). It was determined that detectable and quantifiable amounts of HCN were generated from the thermal decomposition of cyanoacrylate monomer and polymer at temperatures as low as 200 °C. Using an optimised picrate-resorcinol method, it was shown that around 10 µg of HCN could be generated from the heating of 1g of cyanoacrylate monomer at 200 °C. For one of the adhesives tested, this increased to above 100 µg of HCN when 1g of cyanoacrylate monomer was heated at 280 °C. Recommendations are provided that, if followed, should ensure that the cyanoacrylate fuming process can be safely applied with minimal risk to the operator.

Lesiones pulmonares por inhalación / No disponible

No disponible

[Study of hydrogen cyanide activity in various working environment in gold-mining industry].

The study concerned an influence of saline content of liquid phase of crushed ore and presence or absence of solution blending on the process of cyanic hydrogen release in air of working area gold-mining industry.

Cyanide-induced alterations to the biophysical conformations of the isolated fish liver.

The purpose of this study is to examine the applicability of an infared spectroscopic methodology for the study of an environmental problem. The effect of cyanide concentrations on the biophysical conformation of the fish liver homogenate was determined by using an attenuated total reflectance (ATR)/Fourier transform infrared (FT-IR) microspectroscopy. Alive male model fish, Tilapia Zillii, was used. The liver from fish was isolated and homogenized in pH 8.0 Tris buffer solution. The results indicate that the IR peak intensity increased markedly in the C-H stretching range (3000-2800 cm-1), ester C = O stretching of lipids (1743 cm-1) and carbohydrate bands (1195-950 cm-1), but decreased in the amide I at 1649 cm-1 and the free asymmetric stretching band of phosphate at 1261 cm-1 with the increase of KCN concentrations. The marked release of hepatic enzymes and glutathione into homogenate induced by cyanide might account for the higher IR spectral peak intensity of fish liver tissue after treatment with KCN. The cyanide was also found to induce the protein structure of fish liver homogenate from alpha-helical conformation to beta-conformation.

Former poison gas workers and cancer: incidence and inhibition of tumor formation by treatment with biological response modifier N-CWS.

Mustard gas is known to have mutagenic and carcinogenic effects on animal and human cells. In this report, 1,632 male Japanese who worked in poison gas factories at some time between the years 1927 and 1945 were studied to determine comparative risk for development of cancer, the reference population being data on Japanese males overall. The standardized mortality ratio (SMR) for lung cancer in workers directly and indirectly involved in the production of mustard gas was significantly elevated. In addition, SMR for lung cancer in worker who had worked for more than 5 years was also significantly elevated. Thus, poison gas workers who had engaged in the production of mustard gas or related work for more than 5 years are a high-risk group for lung cancer. Under the cancer preventive program, Nocardia rubra cell-wall skeleton (N-CWS) was administered to 146 former poison gas workers. During a 4.5 year observation period, development of cancers was found in 7 treated workers and 17 untreated controls. After elimination of the influence of smoking level, a significant suppression of development of cancers was noted in the N-CWS-treated workers as compared to the untreated controls. Although the molecular mechanisms of carcinogenesis in former poison gas workers remains unclear, our study proposes the possible effect of biological response modifiers in the prevention of cancer development in high-risk human subjects.

[Evaluation of magnesium, zinc, copper and calcium levels in workers exposed to organic solvents, hydrogen cyanide and harmful physical factors]. / Ocena stezen magnezu, cynku, miedzi i wapnia u pracowników narazonych na dzialanie rozpuszczalników organicznych, cyjanowodoru iszkodliwych czynników fizycznych.

UNLABELLED: The aim of the work was to assess te effect of chronic occupational exposure to organic solvents, hydrogen cyanide, and harmful physical factors (noise, vibration and electromagnetic fields) on intra- and extracellular concentration of magnesium, zinc, copper and calcium. The study converted 83 persons (25 males and 57 females), aged 20-58 years (median: 37.8 +/- 8.64), employed in the MERA PAFAL SA Factory of Measuring Equipment, Swidnica, for 0.42 +/- 34 years (median: 11.84 +/- 9.28). The subjects were divided into four groups: Group A-25 persons exposed to organic solvents; Group B-24 persons exposed to hydrogen cyanide; Group C-19 persons exposed to noise and vibration; and Group D-8 persons exposed to electromagnetic fields. Blood samples (10 ml) were collected from each person. Intra- and extracellular concentrations of magnesium, zinc, copper and calcium were estimated. CONCLUSIONS: exposure to 1) organic solvents induces depletion of calcium and zinc from the body and intracellular cumulation of magnesium; 2) to hydrogen cyanide induces depletion of intracellular zinc and intracellular cumulation of magnesium and zinc; 3) to noise and vibration induces depletion of calcium, zinc and copper and intracellular cumulation of magnesium; and 4) electromagnetic fields does not induce any significant changes in ionic concentrations.

Clinical smoke inhalation injury: systemic effects.

Exposure to asphyxiant gases is a ubiquitous feature of the fire environment, particularly in structural (or closed-space) fires. The clinician evaluating the smoke-inhalation patient must keep in mind the manifold actions of systemic toxicants upon an individual whose pulmonary gas exchange may be compromised and whose circulatory and metabolic status may be stressed by burns, hypo- or hypervolemia, and intercurrent disease. Also to be considered is the likelihood of exposure to multiple toxicants whose physiologic effects may be synergistic and whose therapeutic demands may be conflicting. As newer therapeutic regimens and rapid laboratory tests become available, the clinician should be prepared to evaluate their strengths and limitations for the complex task of evaluating and treating smoke-inhalation patients.

Smoking and wound healing.

The association between cigarette smoking and delayed wound healing is well recognized in clinical practice, although extensive controlled studies have yet to be performed. The documented effects of the toxic constituents of cigarette smoke--particularly nicotine, carbon monoxide, and hydrogen cyanide--suggest potential mechanisms by which smoking may undermine expeditious wound repair. Nicotine is a vasoconstrictor that reduces nutritional blood flow to the skin, resulting in tissue ischemia and impaired healing of injured tissue. Nicotine also increases platelet adhesiveness, raising the risk of thrombotic microvascular occlusion and tissue ischemia. In addition, proliferation of red blood cells, fibroblasts, and macrophages is reduced by nicotine. Carbon monoxide diminishes oxygen transport and metabolism, whereas hydrogen cyanide inhibits the enzyme systems necessary for oxidative metabolism and oxygen transport at the cellular level. Slower healing has been observed clinically in smokers with wounds resulting from trauma, disease, or surgical procedures. The reduced capacity for wound repair is a particular concern in patients undergoing plastic or reconstructive surgery. Compared with nonsmokers, smokers have a higher incidence of unsatisfactory healing after face-lift surgery, as well as a greater degree of complications following breast surgery. Smokers should be advised to stop smoking prior to elective surgery or when recovering from wounds resulting from trauma, disease, or emergent surgery.

Anti-nutritional and toxic factors in food legumes: a review.

A comprehensive review on the presence of certain important anti-nutritional and toxic factors in food legumes has been conducted. These substances include proteolytic inhibitors, phytohemagglutinins, lathyrogens, cyanogenetic compounds, compounds causing favism, factors affecting digestibility and saponins. These factors are shown to be widely present in leguminous foods which are important constituents of the diet of a large section of the world's population, and particularly, of people in the developing countries.

[Pathology in firemen]. / Sulla patologia dei Vigili del Fuoco.

Fire fighters' respiratory organs, circulatory system and muscular system are often exposed to considerable risks. In fact in addition to the most obvious external stress causes (heat, humidity, O2 decrement, CO2 increment, emotional stress) these workers use heavy equipments and carry people or things. Furthermore always present is the risk of poisoning by inhalation of toxic combustion gas of the fire atmosphere.