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3.
APMIS ; 127(10): 671-680, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31344276

RESUMO

Regardless of the communal impact of Shiga toxins, till today neither a specific treatment nor licensed vaccine is available. Lactococcus lactis (L. lactis), generally regarded as safe organism, is well known to provide a valuable approach regarding the oral delivery of vaccines. This study was undertaken to evaluate the protective efficacy of Stx2a1 expressed in nisin-inducible L. lactis, against Shiga toxins (Stx1, Stx2) in mouse model. Oral immunization of BALB/c mice with LL-Stx2a1 elicited significant serum antibody titer with elevated fecal and serum IgA, along with minimized intestinal and kidney damage resulting in survival of immunized animals at 84% and 100% when challenged with 10 × LD50 of Escherichia coli O157 and Shigella dysenteriae toxins, respectively. HeLa cells incubated with immune sera and toxin mixture revealed high neutralizing capacity with 90% cell survivability against both the toxins. Mice immunized passively with both toxins and antibody mixture survived the observation period of 15 days, and the controls administered with sham sera and toxins were succumbed to death within 3 days. Our results revealed protective efficacy and toxin neutralization ability of LL-Stx2a1, proposing it as an oral vaccine candidate against Shiga toxicity mediated by E. coli O157 and S. dysenteriae.


Assuntos
Vacinas Bacterianas/administração & dosagem , Vacinas Bacterianas/imunologia , Escherichia coli O157/imunologia , Envenenamento/prevenção & controle , Toxina Shiga/imunologia , Toxina Shiga/toxicidade , Shigella dysenteriae/imunologia , Administração Oral , Animais , Anticorpos Antibacterianos/administração & dosagem , Anticorpos Antibacterianos/sangue , Anticorpos Neutralizantes/administração & dosagem , Anticorpos Neutralizantes/sangue , Antitoxinas/administração & dosagem , Antitoxinas/sangue , Vacinas Bacterianas/genética , Sobrevivência Celular/efeitos dos fármacos , Modelos Animais de Doenças , Portadores de Fármacos/administração & dosagem , Escherichia coli O157/genética , Vetores Genéticos/administração & dosagem , Células HeLa , Humanos , Lactococcus lactis/genética , Camundongos , Camundongos Endogâmicos BALB C , Toxina Shiga/genética , Shigella dysenteriae/genética , Análise de Sobrevida , Resultado do Tratamento , Vacinas Sintéticas/administração & dosagem , Vacinas Sintéticas/genética , Vacinas Sintéticas/imunologia
4.
Pediatrics ; 144(1)2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31160344

RESUMO

OBJECTIVES: To investigate exposures to liquid laundry detergent packets among children <6 years old in the United States and to evaluate the impact of the American Society for Testing and Materials voluntary product safety standard. METHODS: Data from the National Poison Data System involving exposures to liquid laundry detergent packets from 2012 to 2017 were analyzed. RESULTS: From January 2012 to December 2017, there were 72 947 single and polysubstance exposures to liquid laundry detergent packets. Most exposures (91.7%) were documented among children <6 years old. The annual number and rate of exposures for children <6 years old increased by 110.4% and 111.9%, respectively, from 2012 to 2015. From 2015 to 2017, the number and rate of exposures in this age group decreased by 18.0%. Among individuals ≥6 years old, the annual number and rate of exposures increased by 292.7% and 276.7%, respectively, from 2012 to 2017. Annual hospital admissions among children <6 years old increased by 63.4% from 2012 to 2015 and declined by 55.5% from 2015 to 2017. Serious outcomes among children <6 years old increased by 78.5% from 2012 to 2015 and declined by 32.9% from 2015 to 2017. CONCLUSIONS: The number, rate, and severity of liquid laundry detergent packet exposures have decreased modestly in recent years among children <6 years old, likely attributable, in part, to the voluntary product safety standard and public awareness efforts. Exposures among older children and adults are increasing. Opportunities exist to strengthen the current product safety standard to further reduce exposures.


Assuntos
Qualidade de Produtos para o Consumidor , Detergentes/envenenamento , Lavanderia , Acidentes Domésticos/prevenção & controle , Criança , Pré-Escolar , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Envenenamento/epidemiologia , Envenenamento/prevenção & controle , Rotulagem de Produtos , Embalagem de Produtos , Estados Unidos/epidemiologia
9.
Suicide Life Threat Behav ; 49(3): 635-642, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-29693268

RESUMO

There are limited data on the medical severity of suicide attempts by intentional self-poisoning (ISP) associated with ingestion of differing classes of medications and meager data on specific agents. The purpose of the study was to address these gaps. This was an analysis of a consecutive series of ISP cases ages 13 to 65 treated at a U.S. university medical center (N = 671). The outcome, poisoning severity, was dichotomized as "moderate-severe" and "low" (reference) based on a standard measure. Class of medication (e.g., opiate) and specific agents ingested were the predictors of interest. Covariates were age, sex, and the ingestion of multiple classes of medications. Data were analyzed using multivariate logistic regression models. At the class level, ingestion of opiate was uniquely associated with increased risk for moderate-severe ISP at a statistically significant level, adjusted odds ratio (95% CI) = 2.97 (1.69, 5.21), p = .0002. Several specific agents were also associated with moderate-severe ISP. Along with the key role of opiate medications in unintentional overdose morbidity and mortality, opiate medications may also play an important and largely unrecognized role in medically serious suicidal behavior. Results also underscore the variability in toxicity of specific agents within drug classes.


Assuntos
Preparações Farmacêuticas/classificação , Envenenamento , Tentativa de Suicídio , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Envenenamento/diagnóstico , Envenenamento/etiologia , Envenenamento/mortalidade , Envenenamento/prevenção & controle , Índice de Gravidade de Doença , Tentativa de Suicídio/prevenção & controle , Tentativa de Suicídio/estatística & dados numéricos , Estados Unidos/epidemiologia
12.
Environ Health Prev Med ; 23(1): 27, 2018 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-29945568

RESUMO

BACKGROUND: Acetylcholinesterase inhibitor insecticides (AChEIIs) were used extensively in the agrarian region of Anuradhapura for the past few decades. As a result, the region faced a heightened risk of toxicity. Carbaryl, carbofuran, chlorpyrifos, dimethoate, and fenthion were the five hazardous AChEIIs banned from Anuradhapura in 2014. Assessment of post-ban trends in acute poisoning will reveal the impact of the ban. Data on availability and sales of remaining AChEIIs will guide towards preventive measures against related toxicities. METHODS: Cross-sectional surveys were conducted at Anuradhapura district of Sri Lanka. Details related to acute AChEII poisoning were sorted from the Teaching Hospital Anuradhapura. Main insecticide vendors in Anuradhapura were surveyed to find information on availability and sales of AChEIIs. Chi-square for goodness of fit was performed for trends in acute poisoning and sales. RESULTS: Hospital admissions related to acute AChEII poisoning have declined from 554 in 2013 to 272 in 2017. Deaths related to acute AChEII poisoning have declined from 27 in 2013 to 13 in 2017. Sales of all five banned AChEIIs had reduced by 100%. Sales of the remaining AChEIIs were declining, except for acephate, phenthoate, and profenofos. However, one of the top selling, most frequently abused carbosulfan, had the highest risk of toxicity. Chi-square for goodness of fit showed a significance (P < 0.001) between the trends of hospital admissions for acute AChEII poisoning and the sales related to AChEIIs. CONCLUSIONS: Hospital admissions related to acute poisoning was declining along with the overall sales of remaining AChEIIs, during the post-AChEII ban period. Nevertheless, future vigilance is needed on the remaining AChEIIs to predict and prevent related toxicities.


Assuntos
Agricultura/legislação & jurisprudência , Inibidores da Colinesterase/envenenamento , Comércio/tendências , Política de Saúde/legislação & jurisprudência , Hospitalização/tendências , Inseticidas/envenenamento , Envenenamento/epidemiologia , Inibidores da Colinesterase/classificação , Inibidores da Colinesterase/provisão & distribução , Comércio/estatística & dados numéricos , Estudos Transversais , Países em Desenvolvimento , Feminino , Regulamentação Governamental , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Inseticidas/classificação , Inseticidas/provisão & distribução , Masculino , Envenenamento/mortalidade , Envenenamento/prevenção & controle , Fatores de Risco , Sri Lanka/epidemiologia
15.
Med. clín (Ed. impr.) ; 150(1): 16-19, ene. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-169654

RESUMO

Antecedentes y objetivo: Los antídotos pueden tener un papel relevante en el tratamiento de las intoxicaciones y el tiempo hasta su administración puede condicionar la supervivencia del paciente. Pacientes y método: Estudio realizado mediante cuestionario a principios del año 2015 en 70 hospitales de Cataluña que atienden urgencias. La disponibilidad cualitativa para cada antídoto se consideró adecuada cuando estaba presente en al menos el 80% de los hospitales. La disponibilidad cuantitativa se consideró adecuada cuando se disponía de la cantidad recomendada en al menos el 80% de los hospitales del nivel oportuno. Resultados: Para hospitales de menor complejidad, el porcentaje de antídotos con disponibilidad cualitativa y cuantitativa adecuada fue del 66,7 y 42,9%. En hospitales de mayor complejidad, las disponibilidades cualitativas y cuantitativas fueron adecuadas en un 64,5 y 38,7% de los antídotos. No se observaron diferencias significativas entre las diferentes regiones sanitarias, pero hubo una correlación positiva (p<0,05) entre las urgencias atendidas por los hospitales y el porcentaje de disponibilidad cualitativa adecuada. Conclusiones: La disponibilidad de antídotos en los hospitales de Cataluña es en general baja y muestra diferencias en función de la región sanitaria y de la complejidad asistencial de los hospitales (AU)


Background and objective: Antidotes may have a relevant role in acute intoxication management and the time until its administration can influence patient survival. Patients and method: Study conducted by a questionnaire sent in early 2015 to 70 hospitals in Catalonia providing emergency services. Qualitative availability on each antidote was considered adequate when present in at least 80% of hospitals. The quantitative availability was considered adequate when at least 80% of hospitals had the number of units of antidote recommended. Results: Lower complexity hospitals (level A) showed a percentage of adequate qualitative and quantitative availability of 66.7 and 42.9% respectively. In higher complexity hospitals (level B) qualitative and quantitative availability was adequate in 64.5 and 38.7% of the antidotes respectively. Data showed no differences between the different health regions as well as a positive correlation (p<.05) between the number of emergencies attended and the percentage of adequate qualitative availability. Conclusions: The availability of antidotes in Catalonia hospitals is generally low and shows differences across health regions and depending on level of complexity (AU)


Assuntos
Humanos , Antídotos/provisão & distribução , Hospitais/normas , Serviços Médicos de Emergência/tendências , Kit Médico de Emergência , Envenenamento/epidemiologia , Envenenamento/prevenção & controle , Administração Hospitalar/normas , Inquéritos e Questionários , Aprovisionamento , Estudos Transversais/métodos
16.
Inj Prev ; 24(1): 41-47, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28385953

RESUMO

BACKGROUND: Toddler-aged children are vulnerable to unintentional injuries, especially those in low-income families. OBJECTIVE: To examine the effectiveness of an intervention grounded in social cognitive theory (SCT) on the reduction of home safety problems among low-income families with toddlers. METHODS: 277 low-income mother-toddler dyads were randomised into a safety promotion intervention (n=91) or an attention-control group (n=186). Mothers in the safety promotion intervention group received an eight-session, group-delivered safety intervention targeting fire prevention, fall prevention, poison control and car seat use, through health education, goal-setting and social support. Data collectors observed participants' homes and completed a nine-item checklist of home safety problems at study enrolment (baseline), 6 and 12 months after baseline. A total score was summed, with high scores indicating more problems. Linear mixed models compared the changes over time in home safety problems between intervention and control groups. RESULTS: The intent-to-treat analysis indicated that the safety promotion intervention group significantly reduced safety problems to a greater degree than the attention-control group at the 12-month follow-up (between-group difference in change over time ß=-0.54, 95% CI -0.05 to -1.03, p=0.035), with no significant differences at the 6-month follow-up. CONCLUSIONS: A safety promotion intervention built on principles of SCT has the potential to promote toddlers' home safety environment. Future studies should examine additional strategies to determine whether better penetration/compliance can produce more clinically important improvement in home safety practices. TRIAL REGISTRATION NUMBER: NCT02615158; post-results.


Assuntos
Acidentes por Quedas/prevenção & controle , Acidentes Domésticos/prevenção & controle , Fogo/prevenção & controle , Educação em Saúde/organização & administração , Pais/educação , Envenenamento/prevenção & controle , Adulto , Sistemas de Proteção para Crianças , Pré-Escolar , Feminino , Primeiros Socorros , Humanos , Lactente , Equipamentos para Lactente , Masculino , Inquéritos Nutricionais , Poder Familiar , Avaliação de Programas e Projetos de Saúde , Equipamentos de Proteção
17.
Pest Manag Sci ; 74(1): 181-188, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28762643

RESUMO

BACKGROUND: An acute and orally delivered toxic bait containing micro-encapsulated sodium nitrite (MESN), is under development to provide a novel and humane technology to help curtail damage caused by invasive wild pigs (Sus scrofa). We evaluated potential secondary risks for non-target species by: testing whether four different types of micro-encapsulation coatings could reduce vomiting by invasive wild pigs, testing the levels of residual sodium nitrite (SN) in tissues of invasive wild pigs, testing the environmental persistence of SN in vomitus, and conducting a risk assessment for scavengers. RESULTS: Micro-encapsulation coatings did not affect the frequency of vomiting. We identified no risk of secondary poisoning for non-target scavengers that consume muscle, eyes, and livers of invasive wild pig carcasses because residual SN from the toxic bait was not detected in those tissues. The risk of secondary poisoning from consuming vomitus appeared low because ∼90% of the SN was metabolized or broken down prior to vomiting, and continued to degrade after being exposed to the environment. Secondary poisoning could occur for common scavengers that consume approximately ≥15% of their daily dietary requirements of digestive tract tissues or undigested bait from carcasses of invasive wild pigs in a rapid, single-feeding event. The likelihood of this occurring in a natural setting is unknown. The digestive tracts of poisoned invasive wild pigs contained an average of ∼4.35 mg/g of residual SN. CONCLUSION: Data from this study suggest no risks of secondary poisoning for non-target species (including humans) that consume muscle, liver, or eyes of invasive wild pigs poisoned with a MESN toxic bait. More species-specific testing for scavengers that consume digestive tract tissues and undigested bait is needed to reduce uncertainty about these potential risks. © 2017 Society of Chemical Industry.


Assuntos
Animais Selvagens , Controle de Pragas/instrumentação , Envenenamento/prevenção & controle , Nitrito de Sódio/toxicidade , Sus scrofa , Animais , Feminino , Masculino , Nitrito de Sódio/metabolismo , Vômito/induzido quimicamente , Vômito/prevenção & controle
18.
Inj Prev ; 24(1): 5-11, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28188147

RESUMO

OBJECTIVE: To analyse paediatric exposures to pod and traditional laundry detergents in Italy and changes in exposure trends. METHODS: Analyses of a series of patients aged <5 years and exposed to laundry detergents between September 2010 and June 2015, identified by the National Poison Control in Milan. RESULTS: In comparison with patients exposed to traditional laundry detergents (n=1150), a higher proportion of those exposed to pods (n=1649) were managed in hospital (68% vs 42%), had clinical effects (75% vs 22%) and moderate/high severity outcomes (13% vs <1%). Exposure rates were stable over time for traditional detergents (average 0.65 cases/day), but an abrupt decline in major company pods was seen in December 2012, 4 months after the introduction of opaque outer packaging (from 1.03 to 0.36 cases/day and from 1.88 to 0.86 cases/million units sold). The odds of clinical effects was higher for exposure to pods than for traditional detergents (OR=10.8; 95% CI 9.0 to 12.9). Among patients exposed to pods, the odds of moderate/high severity outcomes was four times higher for children aged <1 years than for the other age groups (OR=3.9; 95% CI 2.2 to 7.0). Ten children exposed to laundry detergent pods had high severity outcomes while no children exposed to traditional laundry detergents developed high severity effects. CONCLUSIONS: The study confirms that exposure to laundry detergent pods is more dangerous than exposure to traditional detergents. In Italy, 4 months after the introduction of opaque outer packaging by a major company, product-specific exposure rates decreased sharply, suggesting that reducing visibility of laundry detergent pods may be an effective preventive measure. Further efforts are needed to improve safety.


Assuntos
Prevenção de Acidentes , Acidentes Domésticos/prevenção & controle , Acidentes Domésticos/estatística & dados numéricos , Detergentes/envenenamento , Exposição Ambiental/estatística & dados numéricos , Lavanderia , Envenenamento/prevenção & controle , Cuidadores/educação , Pré-Escolar , Qualidade de Produtos para o Consumidor/legislação & jurisprudência , Qualidade de Produtos para o Consumidor/normas , Ingestão de Alimentos , Exposição Ambiental/prevenção & controle , Feminino , Guias como Assunto , Humanos , Lactente , Itália/epidemiologia , Masculino , Vigilância da População , Embalagem de Produtos/legislação & jurisprudência , Estudos Retrospectivos
19.
Environ Sci Pollut Res Int ; 25(2): 1706-1712, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29101695

RESUMO

A study was carried out to determine the incidents of illegal poisoning of griffon vulture (Gyps fulvus), Egyptian vulture (Neophron percnopterus), black vulture (Aegypius monachus), and bearded vulture (Gypaetus barbatus) in the southern Balkan Peninsula between 1982 and 2017. A total of 38 poisoning cases affecting 224 vultures were analyzed to identify their causes and the primary target species for poisoning. Nine different compounds were used in these incidents and the most frequently applied were strychnine, carbamate, and organophosphoros compounds. The poison used to kill gray wolf had the most significant collateral damage to the vulture populations in comparison to the other investigated reasons. It was the primary cause of 60% of all registered vulture poisoning events in the southern Balkan Peninsula during the last 36 years. Establishing permanent feeding sites for vultures in areas with wolves appears to be an effective way to minimize the risk of poisoning. There is a pressing need for the development of an appropriate conservation practice taking into consideration relationships among the main and casual target species for poisoning as an essential element in conjunction with the human activities.


Assuntos
Falconiformes , Mortalidade , Envenenamento/mortalidade , Venenos/toxicidade , Animais , Península Balcânica , Conservação dos Recursos Naturais/legislação & jurisprudência , Comportamento Criminoso , Humanos , Envenenamento/etiologia , Envenenamento/prevenção & controle , Venenos/classificação , Lobos
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