Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 21.018
Filtrar
1.
J Am Soc Nephrol ; 31(10): 2475-2489, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32963091

RESUMO

BACKGROUND: Although chloroquine, hydroxychloroquine, and quinine are used for a range of medical conditions, recent research suggested a potential role in treating COVID-19. The resultant increase in prescribing was accompanied by an increase in adverse events, including severe toxicity and death. The Extracorporeal Treatments in Poisoning (EXTRIP) workgroup sought to determine the effect of and indications for extracorporeal treatments in cases of poisoning with these drugs. METHODS: We conducted systematic reviews of the literature, screened studies, extracted data, and summarized findings following published EXTRIP methods. RESULTS: A total of 44 studies (three in vitro studies, two animal studies, 28 patient reports or patient series, and 11 pharmacokinetic studies) met inclusion criteria regarding the effect of extracorporeal treatments. Toxicokinetic or pharmacokinetic analysis was available for 61 patients (13 chloroquine, three hydroxychloroquine, and 45 quinine). Clinical data were available for analysis from 38 patients, including 12 with chloroquine toxicity, one with hydroxychloroquine toxicity, and 25 with quinine toxicity. All three drugs were classified as non-dialyzable (not amenable to clinically significant removal by extracorporeal treatments). The available data do not support using extracorporeal treatments in addition to standard care for patients severely poisoned with either chloroquine or quinine (strong recommendation, very low quality of evidence). Although hydroxychloroquine was assessed as being non-dialyzable, the clinical evidence was not sufficient to support a formal recommendation regarding the use of extracorporeal treatments for this drug. CONCLUSIONS: On the basis of our systematic review and analysis, the EXTRIP workgroup recommends against using extracorporeal methods to enhance elimination of these drugs in patients with severe chloroquine or quinine poisoning.


Assuntos
Cloroquina/envenenamento , Infecções por Coronavirus/tratamento farmacológico , Hidroxicloroquina/envenenamento , Pneumonia Viral/tratamento farmacológico , Guias de Prática Clínica como Assunto , Quinina/envenenamento , Diálise Renal/métodos , Cloroquina/uso terapêutico , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Hidroxicloroquina/uso terapêutico , Masculino , Avaliação de Resultados em Cuidados de Saúde , Pandemias/estatística & dados numéricos , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Envenenamento/terapia , Quinina/uso terapêutico , Diálise Renal/estatística & dados numéricos , Medição de Risco , Estados Unidos
2.
Emerg Med Clin North Am ; 38(4): 819-839, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32981620

RESUMO

Pediatric cardiac arrest is a relatively rare but devastating presentation in infants and children. In contrast to adult patients, in whom a primary cardiac dysrhythmia is the most likely cause of cardiac arrest, pediatric patients experience cardiovascular collapse most frequently after an initial respiratory arrest. Aggressive treatment in the precardiac arrest state should be initiated to prevent deterioration and should focus on support of oxygenation, ventilation, and hemodynamics, regardless of the presumed cause. Unfortunately, outcomes for pediatric cardiac arrest, whether in hospital or out of hospital, continue to be poor.


Assuntos
Parada Cardíaca/terapia , Ressuscitação/métodos , Manuseio das Vias Aéreas , Glicemia/análise , Criança , Maus-Tratos Infantis/terapia , Cardioversão Elétrica , Eletroencefalografia , Serviço Hospitalar de Emergência , Epinefrina/uso terapêutico , Oxigenação por Membrana Extracorpórea , Parada Cardíaca/etiologia , Cardiopatias Congênitas/terapia , Frequência Cardíaca , Humanos , Hipotermia/complicações , Hipotermia/terapia , Hipotermia Induzida , Pneumopatias/terapia , Pais , Exame Físico , Envenenamento/terapia , Avaliação de Processos em Cuidados de Saúde , Valores de Referência , Insuficiência Respiratória/terapia , Taxa Respiratória , Ordens quanto à Conduta (Ética Médica) , Sepse/terapia , Choque/etiologia , Choque/terapia , Vasoconstritores/uso terapêutico , Ferimentos e Lesões/terapia
3.
Emerg Med Clin North Am ; 38(4): 841-856, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32981621
4.
BMC Cardiovasc Disord ; 20(1): 415, 2020 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-32928149

RESUMO

BACKGROUND: Methanol is widely used in industry; however, methanol poisoning is not common. In this regard, a number of outbreaks have been recently reported due to inappropriate processing of alcoholic beverages. Shiraz, a city located in the southern part of Iran, faced one of such outbreaks in 2020 during COVID-19 pandemic. There is no sufficient literature on the electrocardiographic findings in methanol toxicity. This study aimed to address this gap in the literature. METHOD: A total of 356 cases with methanol toxicity referred to Shiraz University of Medical Science Tertiary Hospitals (Faghihi and Namazi) in March and April, 2020. The clinical findings of blindness and impaired level of consciousness, lab data such as arterial blood gas, electrolytes, and creatinine, and the most common findings from ECGs were collected. RESULTS: The most common ECG findings were J point elevation (68.8%), presence of U wave (59.2%), QTc prolongation (53.2% in males and 28.6% in females), and fragmented QRS (33.7%). An outstanding finding in this study was the presence of myocardial infarction in 5.3% of the cases. This finding, to the best of our knowledge, has only been reported in a few case reports. Brugada pattern (8.1%) and Osborn wave (3.7%) were the other interesting findings. In multivariate analysis, when confounding factors were adjusted, myocardial infarction, atrioventricular conduction disturbances, sinus tachycardia, and the prolonged QTC > 500 msecond were four independent factors correlated with methanol toxicity severity measured with arterial blood PH on arterial blood gas measurements, with odds ratios of 12.82, 4.46, 2.32 and 3.15 (P < 0.05 for all), respectively. CONCLUSION: Electrocardiographic variations during methanol intoxication are remarkable and well-correlated with poisoning severity. Myocardial infarction was an egregious and yet a common concerning finding in this sample, which need to be ruled out in methanol toxicity.


Assuntos
Bloqueio Atrioventricular/induzido quimicamente , Cegueira/induzido quimicamente , Transtornos da Consciência/induzido quimicamente , Síndrome do QT Longo/induzido quimicamente , Metanol/envenenamento , Infarto do Miocárdio/induzido quimicamente , Solventes/envenenamento , Taquicardia Sinusal/induzido quimicamente , Adolescente , Adulto , Idoso , Bebidas Alcoólicas , Bloqueio Atrioventricular/sangue , Bloqueio Atrioventricular/fisiopatologia , Betacoronavirus , Cegueira/sangue , Cegueira/fisiopatologia , Gasometria , Síndrome de Brugada/sangue , Síndrome de Brugada/induzido quimicamente , Síndrome de Brugada/fisiopatologia , Transtornos da Consciência/sangue , Transtornos da Consciência/fisiopatologia , Infecções por Coronavirus , Eletrocardiografia , Feminino , Contaminação de Alimentos , Humanos , Concentração de Íons de Hidrogênio , Irã (Geográfico) , Síndrome do QT Longo/sangue , Síndrome do QT Longo/fisiopatologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Infarto do Miocárdio/sangue , Infarto do Miocárdio/fisiopatologia , Pandemias , Pneumonia Viral , Envenenamento/sangue , Envenenamento/fisiopatologia , Fatores Sexuais , Taquicardia Sinusal/sangue , Taquicardia Sinusal/fisiopatologia , Adulto Jovem
6.
Rev Environ Health ; 35(3): 239-243, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32877367

RESUMO

Two types of analytical multi-level approach to analyse symptoms after exposure to poisons were performed using numerical data extracted from reports received by the JAPAN POISON INFORMATION CENTER on the number "Poisoning 110" during 1998-2017. In the first approach, data collected in 2017, 2012, 2007 and 2002 were used, while in the second approach, all data collected during 1999-2017 were used. In the first approach, according to the odds ratio, the order of causative agents was industrial drugs>home drugs>general drugs and in the second approach, it was industrial drugs>foods/natural poisoning>agricultural drugs. However, in the first approach, the order based on the 95% confidence interval (CI) and profile likelihood was general drugs>home drugs>industrial drugs and in the second approach, the order based on 95% CI, profile likelihood and Wald value was agricultural drugs>foods/natural poisoning>industrial drugs. These multi-prospects were developed using a multilevel approach and the most optimized model was selected from the number of numerical data and the adaptability of fit of the multi-level logistic regression models in this report.


Assuntos
Centros de Controle de Intoxicações/estatística & dados numéricos , Envenenamento/etiologia , Venenos/efeitos adversos , Humanos , Japão , Envenenamento/classificação
7.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 32(7): 846-849, 2020 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-32788021

RESUMO

OBJECTIVE: To explore the clinical value of "hydration therapy" in the treatment of severe acute paraquat poisoning (APP). METHODS: A prospective historical control observation was conducted. Fifty-eight patients with severe APP admitted to Shouguang People's Hospital Affiliated to Weifang Medical College from February 2014 to June 2019 were enrolled. Twenty-six patients admitted before May 10th, 2016 were enrolled in the standard treatment group. After being admitted to intensive care unit (ICU) from the department of emergency, patients in the standard treatment group were immediately given standard treatment such as repeated gastric lavage, catharsis, adsorption of poison by activated carbon or montmorillonite powder, drug treatment and blood purification. From May 10th, 2016, 32 patients were enrolled in the intensive treatment group. On the basis of standard treatment, "hydration therapy" was carried out, that was, 0.9% NaCl and/or 5% glucose injection were used for continuous intravenous infusion throughout the day, so as to ensure that the total amount of fluid infusion per day reached 200 mL/kg within 48-72 hours after ICU admission. At the same time, furosemide was used to strengthen diuresis to ensure the balance of water and electrolyte. If heart failure or acute pulmonary interstitial edema occurred during the treatment, "hydration therapy" should be stopped immediately. Six months after treatment, all patients were followed up. The patients with normal activity, no complaints of discomfort and no damage of heart, lung, liver, kidney and other organs were regarded as cured. The therapeutic effect of "hydration therapy" was evaluated. RESULTS: There was no significant difference in gender, age, dosage or time from taking poison to ICU between the two groups. In the intensive treatment group, 32 patients did not appear heart failure during continuous rehydration treatment. Follow-up after 6 months showed that the overall cure rate in the intensive treatment group was significantly higher than that in the standard treatment group [59.4% (19/32) vs. 19.2% (5/26), P < 0.05]. In the 6-month follow-up, there was no significant difference in age or time from taking poison to ICU between the two groups, but the dosage in the intensive treatment group was significantly higher than that in the standard treatment group (mL: 54.06±26.03 vs. 23.00±4.47, P < 0.05). After 6 months of follow-up, chest CT showed that the lesions of pulmonary fibrosis of cured patients in both group gradually reduced with time, not completely progressive and irreversible. CONCLUSIONS: "Hydration therapy" with intensive diuresis can significantly improve the rescue success rate of patients with severe APP.


Assuntos
Paraquat/envenenamento , Envenenamento/terapia , Hidratação , Humanos , Unidades de Terapia Intensiva , Pulmão , Estudos Prospectivos , Fibrose Pulmonar
9.
Pediatrics ; 146(2)2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32732262

RESUMO

OBJECTIVES: Acute nystagmus (AN) is an uncommon neurologic sign in children presenting to pediatric emergency departments. We described the epidemiology, clinical features, and underlying causes of AN in a large cohort of children, aiming at identifying features associated with higher risk of severe underlying urgent conditions (UCs). METHODS: Clinical records of all patients aged 0 to 18 years presenting for AN to the pediatric emergency departments of 9 Italian hospitals in an 8-year period were retrospectively reviewed. Clinical and demographic features and the underlying causes were analyzed. A logistic regression model was applied to detect predictive variables associated with a higher risk of UCs. RESULTS: A total of 206 patients with AN were included (male-to-female ratio: 1.01; mean age: 8 years 11 months). The most frequently associated symptoms were headache (43.2%) and vertigo (42.2%). Ataxia (17.5%) and strabismus (13.1%) were the most common neurologic signs. Migraine (25.7%) and vestibular disorders (14.1%) were the most common causes of AN. Idiopathic infantile nystagmus was the most common cause in infants <1 year of age. UCs accounted for 18.9% of all cases, mostly represented by brain tumors (8.3%). Accordant with the logistic model, cranial nerve deficits, ataxia, or strabismus were strongly associated with an underlying UC. Presence of vertigo or attribution of a nonurgent triage code was associated with a reduced risk of UCs. CONCLUSIONS: AN should be considered an alarming finding in children given the risk of severe UCs. Cranial nerve palsy, ataxia, and strabismus should be considered red flags during the assessment of a child with AN.


Assuntos
Nistagmo Patológico/etiologia , Ataxia/complicações , Ataxia/diagnóstico , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/diagnóstico , Infecções do Sistema Nervoso Central/complicações , Infecções do Sistema Nervoso Central/diagnóstico , Criança , Pré-Escolar , Estudos de Coortes , Doenças dos Nervos Cranianos/complicações , Doenças dos Nervos Cranianos/diagnóstico , Doenças Desmielinizantes/complicações , Doenças Desmielinizantes/diagnóstico , Tontura/etiologia , Serviço Hospitalar de Emergência , Feminino , Cefaleia/etiologia , Humanos , Hipertensão Intracraniana/complicações , Hipertensão Intracraniana/diagnóstico , Itália , Masculino , Transtornos de Enxaqueca/complicações , Transtornos de Enxaqueca/diagnóstico , Náusea/etiologia , Envenenamento/complicações , Envenenamento/diagnóstico , Estudos Retrospectivos , Estrabismo/etiologia , Vertigem/etiologia , Doenças Vestibulares/complicações , Doenças Vestibulares/diagnóstico , Vômito/etiologia
10.
Medicine (Baltimore) ; 99(31): e21351, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756123

RESUMO

Paraquat (PQ) poisoning is associated with high mortality rate. Therefore, an accurate method for predicting the survival of patients with PQ poisoning is required. This study evaluated the value of serum anion gap (AG) at admission in predicting the survival of such patients.Cases of patients with PQ poisoning admitted to Cangzhou Central Hospital between May 2012 and March 2019 were retrospectively analyzed. The patients were classified into survival and nonsurvival groups on the basis of their 90-day prognosis. Correlation analysis, Cox regression analysis, and receiver operating characteristic and Kaplan-Meier curve analyses were performed to assess the value of AG in predicting the 90-day survival of patients with PQ poisoning.Only 44 of the 108 patients with PQ poisoning survived; thus, the 90-day survival was 40.74%. AG levels at admission were significantly higher in nonsurvivors (26.53 ±â€Š4.93 mmol/L) than in survivors (20.88 ±â€Š2.74 mmol/L) (P < .001) and negatively correlated with 90-day survival (r = -0.557; P < .001). Cox regression analysis revealed that AG at admission is an independent prognostic marker of the 90-day survival of patients with PQ poisoning. AG level at admission had an area under the receiver operating characteristic curve of 0.836 (95% confidence interval: 0.763-0.909) and an optimal cut-off value of 25.5 mmol/L (59.4% sensitivity and 95.5% specificity).AG level at admission may serve as a candidate marker for predicting the survival of patients with PQ poisoning.


Assuntos
Desequilíbrio Ácido-Base/sangue , Herbicidas/envenenamento , Paraquat/envenenamento , Envenenamento/mortalidade , Adulto , Biomarcadores/sangue , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Envenenamento/diagnóstico , Valor Preditivo dos Testes , Modelos de Riscos Proporcionais , Estudos Retrospectivos
11.
MMWR Morb Mortal Wkly Rep ; 69(32): 1070-1073, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32790662

RESUMO

Alcohol-based hand sanitizer is a liquid, gel, or foam that contains ethanol or isopropanol used to disinfect hands. Hand hygiene is an important component of the U.S. response to the emergence of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19). If soap and water are not readily available, CDC recommends the use of alcohol-based hand sanitizer products that contain at least 60% ethyl alcohol (ethanol) or 70% isopropyl alcohol (isopropanol) in community settings (1); in health care settings, CDC recommendations specify that alcohol-based hand sanitizer products should contain 60%-95% alcohol (≥60% ethanol or ≥70% isopropanol) (2). According to the Food and Drug Administration (FDA), which regulates alcohol-based hand sanitizers as an over-the-counter drug, methanol (methyl alcohol) is not an acceptable ingredient. Cases of ethanol toxicity following ingestion of alcohol-based hand sanitizer products have been reported in persons with alcohol use disorder (3,4). On June 30, 2020, CDC received notification from public health partners in Arizona and New Mexico of cases of methanol poisoning associated with ingestion of alcohol-based hand sanitizers. The case reports followed an FDA consumer alert issued on June 19, 2020, warning about specific hand sanitizers that contain methanol. Whereas early clinical effects of methanol and ethanol poisoning are similar (e.g., headache, blurred vision, nausea, vomiting, abdominal pain, loss of coordination, and decreased level of consciousness), persons with methanol poisoning might develop severe anion-gap metabolic acidosis, seizures, and blindness. If left untreated methanol poisoning can be fatal (5). Survivors of methanol poisoning might have permanent visual impairment, including complete vision loss; data suggest that vision loss results from the direct toxic effect of formate, a toxic anion metabolite of methanol, on the optic nerve (6). CDC and state partners established a case definition of alcohol-based hand sanitizer-associated methanol poisoning and reviewed 62 poison center call records from May 1 through June 30, 2020, to characterize reported cases. Medical records were reviewed to abstract details missing from poison center call records. During this period, 15 adult patients met the case definition, including persons who were American Indian/Alaska Native (AI/AN). All had ingested an alcohol-based hand sanitizer and were subsequently admitted to a hospital. Four patients died and three were discharged with vision impairment. Persons should never ingest alcohol-based hand sanitizer, avoid use of specific imported products found to contain methanol, and continue to monitor FDA guidance (7). Clinicians should maintain a high index of suspicion for methanol poisoning when evaluating adult or pediatric patients with reported swallowing of an alcohol-based hand sanitizer product or with symptoms, signs, and laboratory findings (e.g., elevated anion-gap metabolic acidosis) compatible with methanol poisoning. Treatment of methanol poisoning includes supportive care, correction of acidosis, administration of an alcohol dehydrogenase inhibitor (e.g., fomepizole), and frequently, hemodialysis.


Assuntos
Higienizadores de Mão/envenenamento , Metanol/envenenamento , Adulto , Idoso , Arizona/epidemiologia , Ingestão de Alimentos , Feminino , Higienizadores de Mão/química , Humanos , Masculino , Metanol/análise , Pessoa de Meia-Idade , New Mexico/epidemiologia , Envenenamento/epidemiologia , Envenenamento/mortalidade , Adulto Jovem
12.
Environ Sci Pollut Res Int ; 27(30): 38064-38071, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32621194

RESUMO

In Brazil, the increased use of pesticides has caused several consequences such as mortality of non-target species, contamination of aquatic environments, and changes in biodiversity. Regarding humans, such products could increase the cases of poisoning, the number of different types of cancer, and also neurodegenerative and autoimmune diseases, especially in workers who occupationally handle pesticides. Therefore, this study aimed to evaluate the number of agricultural poisonings from 2007 to 2017 and if there is a correlation between harvested areas, and to analyze the possible factors that contribute to poisonings. Our results demonstrated an increase in poisonings by 8% and a correlation with the growth of the harvested area. We emphasize that other factors are also determinant for the increase of poisonings such as the absence or inappropriate use of personal protective equipment (PPE), the toxicity of mixtures, the mishandling, and the lack of information on how to use and spray such products. Among the circumstances about poisoning, we presented suicide attempts and accidental causes. We found that the area planted and harvested is also associated with the amount of poisoning; however, several other behavioral factors are also determinant for the growth of agricultural poisoning in Brazil.


Assuntos
Doenças dos Trabalhadores Agrícolas , Exposição Ocupacional , Praguicidas , Envenenamento , Agricultura , Brasil , Humanos
14.
Alcohol ; 88: 29-32, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32693023

RESUMO

The coronavirus disease 2019 (COVID-19) spread rapidly worldwide and led to the deaths of thousands of people. To date, there is not any vaccine or specific antiviral medicine that can prevent or treat this virus. This caused panic among people who try their best to prevent being infected. In Iran, methanol poisoning was reported and led to the death of hundreds of people in several provinces. The incident occurred after a rumor circulated in the country that drinking alcohol (ethanol) can cure or prevent being infected by COVID-19.


Assuntos
Comunicação , Infecções por Coronavirus/prevenção & controle , Etanol/uso terapêutico , Metanol/envenenamento , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Envenenamento/mortalidade , Solventes/envenenamento , Adolescente , Adulto , Idoso , Consumo de Bebidas Alcoólicas , Bebidas Alcoólicas , Betacoronavirus , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Surtos de Doenças , Contaminação de Medicamentos , Feminino , Contaminação de Alimentos , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/epidemiologia , Envenenamento/epidemiologia , Envenenamento/etiologia , Solventes/uso terapêutico , Adulto Jovem
15.
PLoS One ; 15(7): e0234150, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32614830

RESUMO

To investigate a Florida manatee (Trichechus manatus latirostris) mortality event following a red tide bloom in Southwest Florida, an RNA sequencing experiment was conducted. Gene expression changes in white blood cells were assessed in manatees rescued from a red tide affected area (n = 4) and a control group (n = 7) using RNA sequencing. The genes with the largest fold changes were compared between the two groups to identify molecular pathways related to cellular and disease processes. In total, 591 genes (false discovery rate <0.05) were differentially expressed in the red tide group. Of these, 158 were upregulated and 433 were downregulated. This suggests major changes in white blood cell composition following an exposure to red tide. The most highly upregulated gene, Osteoclast associated 2C immunoglobulin-like receptor (OSCAR), was upregulated 12-fold. This gene is involved in initiating the immune response and maintaining a role in adaptive and innate immunity. The most highly downregulated gene, Piccolo presynaptic cytomatrix protein (PCLO), was downregulated by a factor of 977-fold. This gene is associated with cognitive functioning and neurotransmitter release. Downregulation of this gene in other studies was associated with neuronal loss and neuron synapse dysfunction. Among the cellular pathways that were most affected, immune response, including inflammation, wounds and injuries, cell proliferation, and apoptosis were the most predominant. The pathway with the most differentially expressed genes was the immune response pathway with 98 genes involved, many of them downregulated. Assessing the changes in gene expression associated with red tide exposure enhances our understanding of manatee immune response to the red tide toxins and will aid in the development of red tide biomarkers.


Assuntos
Perfilação da Expressão Gênica , Proliferação Nociva de Algas , Trichechus manatus/fisiologia , Animais , Buffy Coat/citologia , Florida , Ontologia Genética , Sistema Imunitário , Leucócitos/metabolismo , Toxinas Marinhas/envenenamento , Redes e Vias Metabólicas/genética , Neurotoxinas/envenenamento , Oxocinas/envenenamento , Envenenamento/sangue , Envenenamento/reabilitação , Envenenamento/veterinária , RNA Mensageiro/biossíntese , RNA Mensageiro/sangue , Transcriptoma , Trichechus manatus/sangue , Trichechus manatus/genética , Trichechus manatus/imunologia
17.
J Zoo Wildl Med ; 51(2): 407-415, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32549572

RESUMO

Over a period of 5 mo, seven out of eight American white pelicans (Pelecanus erythrorhynchos) housed on a spring-fed pond at a zoo died or were euthanized. Clinical signs included inability to stand, anorexia, and weight loss. Clinicopathologic findings included heterophilic leukocytosis and elevated creatine kinase and aspartate aminotransferase. Histopathologic findings on all pelicans demonstrated severe, chronic, diffuse rhabdomyofiber degeneration and necrosis, making vitamin E deficiency a differential diagnosis despite routine supplementation. Based on tissue and pond water assays for the cyanobacterial toxin, microcystin, toxicosis is suspected as the inciting cause of death in these cases. We hypothesize that vitamin E exhaustion and resultant rhabdomyodegeneration and cardiomyopathy were sequelae to this toxicosis.


Assuntos
Doenças das Aves/diagnóstico , Aves , Microcistinas/envenenamento , Necrose/veterinária , Envenenamento/mortalidade , Envenenamento/veterinária , Alabama/epidemiologia , Animais , Doenças das Aves/microbiologia , Doenças das Aves/mortalidade , Diagnóstico Diferencial , Feminino , Masculino , Necrose/diagnóstico , Necrose/microbiologia , Necrose/mortalidade , Envenenamento/complicações , Envenenamento/diagnóstico
18.
J Zoo Wildl Med ; 51(2): 416-425, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32549573

RESUMO

Moxidectin is a commonly used lipophilic anthelmintic with activity against a wide range of nematodes. It is labeled for use in cattle by oral, topical, and subcutaneous routes. In semi-free ranging conditions, many anthelmintics are remotely administered intramuscularly due to an inability to administer by other routes without restraint. During 2015-2016, three animals including a roan (Hippotragus equinus), sable (Hippotragus niger), and Arabian oryx (Oryx leucoryx) treated with moxidectin developed clinical signs consistent with toxicosis. The primary sign was severe neurologic depression within 12 to 24 hr. Based on recommendations in domestic cases, animals were treated with intravenous lipid therapy and supportive care while diagnostic testing was performed. All three initially improved prior to succumbing to secondary problems associated with prolonged recumbency. Moxidectin has been administered remotely on 97 occasions in eight different exotic ruminant species at Fossil Rim, with only the above three cases showing clinical signs of toxicosis. Two potential causes in these cases include poor body condition leading to a smaller volume of distribution, thus allowing higher concentrations to overwhelm the blood-brain barrier, or a genetic defect similar to some herding dog breeds. Given that cases were seen in three different species at an overall low incidence within a given species, a genetic defect is considered unlikely. The animals affected did have significantly lower body condition score than conspecifics, and it is considered likely that this predisposed these animals to toxicosis. Therefore, caution should be used when administering moxidectin intramuscularly in animals in poor body condition.


Assuntos
Antílopes , Antiparasitários/toxicidade , Macrolídeos/toxicidade , Envenenamento/veterinária , Animais , Animais de Zoológico , Evolução Fatal , Feminino , Masculino , Envenenamento/etiologia , Texas
19.
Emergencias (Sant Vicenç dels Horts) ; 32(3): 185-187, jun. 2020.
Artigo em Espanhol | IBECS | ID: ibc-189731

RESUMO

OBJETIVO: La suspensión líquida de carbón activado (CA) contiene como excipiente 600 mg/mL de sacarosa. Se eva¬lúa el impacto glucémico de la administración de CA en pacientes con intoxicación medicamentosa aguda (IMA). MÉTODO: Se identificaron pacientes con IMA y determinación de la glucemia antes y después de haber recibido CA. Se compararon estos cambios de glucemia con los generados por el desayuno en un grupo control de no intoxicados. RESULTADOS: Se incluyeron 55 IMA. En el 82% de los casos la glucemia aumentó tras administrar CA. La media de las glucemias previas al carbón fue de 98,2 mg/dL y a la hora posterior de 124,2 mg/dL (p < 0,001). El cambio glucémico no condicionó eventos clínicos adversos. En el grupo control (n = 23) la glucemia aumentó en el 82,6% de los casos. La media de las glucemias antes del desayuno fue de 117,1 mg/dL y la posterior de 152,0 mg/dL (p < 0,001). CONCLUSIÓN: La administración de CA induce un aumento estadísticamente significativo de la glucemia, pero sin rele¬vancia clínica y equiparable al producido por un desayuno


OBJECTIVE: Activated charcoal in suspension contains 600 mg/mL of sucrose. We aimed to assess the impact of an activated charcoal suspension on blood glucose levels in patients with acute medication poisoning. METHODS: We identified drug patients whose blood glucose levels were measured before and after administration of activated charcoal to treat poisoning. The impact on blood glucose level was compared to changes after breakfast in a control group not receiving treatment for poisoning. RESULTS: Fifty-five poisoned patients were included. Eighty-two percent had higher blood glucose levels after activated charcoal administration. The mean glucose levels before and 1 hour after treatment were 98.2 mg/dL and 124.2 mg/dL, respectively (P<.001). The increase did not translate to adverse clinical events. Glucose levels increased in 82.6% of the 23 patients in the control group. Mean glucose levels before breakfast and 1 hour later were 117.1 mg/dL and 152.0 mg/dL (P<.001). CONCLUSION: Activated charcoal induces an increase in blood glucose level that is statistically but not clinically significant. The increase is comparable to the increase after breakfast


Assuntos
Humanos , Masculino , Feminino , Adulto , Índice Glicêmico/efeitos dos fármacos , Carvão Vegetal/toxicidade , Envenenamento/diagnóstico , Envenenamento/tratamento farmacológico , Carvão Vegetal/metabolismo , Carvão Vegetal/administração & dosagem , Sacarose/administração & dosagem , Serviços Médicos de Emergência
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA