Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.603
Filtrar
1.
Toxicol Appl Pharmacol ; 427: 115652, 2021 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-34298059

RESUMO

Exposure to phosphine (PH3) presents with a host of diverse, non-specific symptoms that span multiple organ systems and is characterized by a high mortality rate. While a comprehensive mechanism for PH3 poisoning remains inconclusive, prior studies have implicated cardiac failure and circulatory compromise as potential pathways central to PH3-induced mortality. In this study, milrinone (MLR), a phosphodiesterase-3 inhibitor used to treat cardiac failure, was investigated as a potential countermeasure for PH3 poisoning. Lethality, physiological responses, and behavioral changes were evaluated in telemetrized female rats pretreated with water (sham) or one of three doses of MLR (40, 200, or 600 µg/kg) and exposed to PH3 (660 ppm for 25-40 min; 16,500-26,400 ppm × min). Animals receiving prophylactic administration of 600 µg/kg of MLR had nominally improved survivability compared to sham animals, although median lethal concentration-time and time of death did not differ substantially between treatment groups. Changes in respiration and behavior induced by PH3 appeared largely unaffected by MLR pretreatment, regardless of dose. Conversely, MLR pretreatment alleviated some aspects of PH3-induced cardiac function impairment, with slight dose-dependent effects observed for cardiac contractility, mean arterial pressure, and QRS duration. Together, these results illustrate the importance of circulatory compromise in PH3 poisoning and highlight the potential viability of MLR as a potential countermeasure option or part of a countermeasure regimen when administered prophylactically at 600 µg/kg.


Assuntos
Débito Cardíaco/efeitos dos fármacos , Cardiotônicos/administração & dosagem , Inseticidas/envenenamento , Milrinona/administração & dosagem , Fosfinas/envenenamento , Mecânica Respiratória/efeitos dos fármacos , Animais , Débito Cardíaco/fisiologia , Relação Dose-Resposta a Droga , Avaliação Pré-Clínica de Medicamentos/métodos , Feminino , Exposição por Inalação/efeitos adversos , Dose Letal Mediana , Profilaxia Pré-Exposição/métodos , Ratos , Ratos Sprague-Dawley , Mecânica Respiratória/fisiologia , Taxa de Sobrevida/tendências
2.
Int J Cancer ; 149(10): 1768-1786, 2021 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-34270795

RESUMO

Evidence for the human health effects of pesticides is needed to inform risk assessment. We studied the relationship between occupational insecticide use and risk of non-Hodgkin lymphoma (NHL) by pooling data from nine case-control studies participating in the InterLymph Consortium, including 7909 cases and 8644 controls from North America, the European Union and Australia. Insecticide use was coded using self-report or expert assessment, for insecticide groups (eg, organophosphates, pyrethroids) and active ingredients (eg, malathion, permethrin). Associations with insecticides were estimated using logistic regression to produce odds ratios (ORs) and 95% confidence intervals (CI) for all NHL and NHL subtypes, with adjustment for study site, demographic factors and use of other pesticides. Occupational insecticide use, overall, was not associated with risk of NHL. Use of organophosphate insecticides was associated with increased risk of all NHL and the subtype follicular lymphoma, and an association was found with diazinon, in particular (ever use: OR = 2.05, 95%CI: 1.24-3.37). The carbamate insecticide, carbaryl, was associated with risk of all NHL, and the strongest associations were found with T-cell NHL for ever-use (OR = 2.44, 95%CI: 1.13-5.28) and longer duration (>8 years vs never: OR = 2.90, 95%CI: 1.02-8.25). There was no association of NHL with other broad groups of insecticides, including organochlorines and pyrethroids, and some inverse associations were estimated in relation to historical DDT use. Our findings contribute to the totality of evidence available to help inform risk decisions by public health and regulatory agencies of importance given continued, widespread use of organophosphate and carbamate insecticides.


Assuntos
Inseticidas/envenenamento , Linfoma não Hodgkin/diagnóstico , Doenças Profissionais/diagnóstico , Exposição Ocupacional/efeitos adversos , Saúde do Trabalhador/estatística & dados numéricos , Adulto , Idoso , Austrália , Estudos de Casos e Controles , União Europeia , Feminino , Humanos , Linfoma não Hodgkin/etiologia , Linfoma não Hodgkin/prevenção & controle , Masculino , Pessoa de Meia-Idade , América do Norte , Doenças Profissionais/etiologia , Doenças Profissionais/prevenção & controle , Exposição Ocupacional/análise , Razão de Chances , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , Fatores de Risco
3.
Sci Rep ; 11(1): 11573, 2021 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-34079008

RESUMO

Malathion, diethyl 2-[(dimethoxyphosphinothioyl)thio]butanedioate, is one of most widely used organophosphoryl pesticide, and it has been detected in several clinical cases of accidental exposure and suicide. It is reported that the observed malathion concentration in blood of persons who suffer from malathion poisoning is smaller than the expected concentration. Because malathion is bound to human serum albumin (HSA), recovery of malathion in the free form is insufficient. We detected malathion adducts in HSA by liquid chromatography quadrupole time-of-flight mass spectrometry (LC-Q/TOF-MS). The mass spectra showed that malathion was preferably bound to the lysine (K) and cysteinylproline (CP) residues of HSA. The K- and CP-adducts of malathion were increased in vitro with a dose-dependent fashion when its concentration was smaller than the lethal dose. Further, the K-adduct was also detected in post-mortem blood of an autopsied subject suffering from intentional malathion ingestion. These results suggest that the K-adduct seems to be available to use a biomarker of malathion poisoning, and the determination of the K-adduct could make possible to estimate the amount of malathion ingestion.


Assuntos
Inseticidas/envenenamento , Malation/toxicidade , Mudanças Depois da Morte , Albumina Sérica Humana/metabolismo , Cromatografia Líquida/métodos , Humanos , Inseticidas/farmacocinética , Malation/farmacocinética , Espectrometria de Massas/métodos , Reprodutibilidade dos Testes , Distribuição Tecidual
4.
PLoS Negl Trop Dis ; 15(5): e0009251, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33956803

RESUMO

BACKGROUND: The current body of research on insecticide use in Peru deals primarily with application of insecticides offered through Ministry of Health-led campaigns against vector-borne disease. However, there is a gap in the literature regarding the individual use, choice and perceptions of insecticides which may influence uptake of public health-based vector control initiatives and contribute to the thousands of deaths annually from acute pesticide poisoning in Peru. METHODS: Residents (n = 49) of the Alto Selva Alegre and CC districts of peri-urban Arequipa participated in seven focus group discussions (FGD). Using a FGD guide, two facilitators led the discussion and conducted a role-playing activity. this activity, participants insecticides (represented by printed photos of insecticides available locally) and pretended to "sell" the insecticides to other participants, including describing their qualities as though they were advertising the insecticide. The exercise was designed to elicit perceptions of currently available insecticides. The focus groups also included questions about participants' preferences, use and experiences related to insecticides outside the context of this activity. Focus group content was transcribed, and qualitative data were analyzed with Atlas.ti and coded using an inductive process to generate major themes related to use and choice of insecticides, and perceived risks associated with insecticide use. RESULTS: The perceived risks associated with insecticides included both short- and long-term health impacts, and safety for children emerged as a priority. However, in some cases insecticides were reportedly applied in high-risk ways including application of insecticides directly to children and bedding. Some participants attempted to reduce the risk of insecticide use with informal, potentially ineffective personal protective equipment and by timing application when household members were away. Valued insecticide characteristics, such as strength and effectiveness, were often associated with negative characteristics such as odor and health impacts. "Agropecuarios" (agricultural supply stores) were considered a trusted source of information about insecticides and their health risks. CONCLUSIONS: It is crucial to characterize misuse and perceptions of health impacts and risks of insecticides at the local level, as well as to find common themes and patterns across populations to inform national and regional programs to prevent acute insecticide poisoning and increase community participation in insecticide-based vector control campaigns. We detected risky practices and beliefs about personal protective equipment, risk indicators, and safety levels that could inform such preventive campaigns, as well as trusted information sources such as agricultural stores for partnerships in disseminating information.


Assuntos
Uso Indevido de Medicamentos/efeitos adversos , Inseticidas/farmacologia , Inseticidas/envenenamento , Controle de Mosquitos/métodos , Doenças Transmitidas por Vetores/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Vetores Artrópodes/efeitos dos fármacos , Feminino , Grupos Focais/estatística & dados numéricos , Avaliação do Impacto na Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Peru , Risco , Adulto Jovem
5.
Clin Toxicol (Phila) ; 59(4): 347-350, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32959700

RESUMO

BACKGROUND: Self-poisoning with imidacloprid has been previously shown to have low toxicity in humans. Since 2007 newer formulations of Imidacloprid with unknown solvents have been introduced and the potential clinical consequences of these products have not been described. METHODS: Clinical and demographic data were prospectively collected from admissions following oral ingestion of imidacloprid from seven hospitals in Sri Lanka. Data was collected from 2002 to 2007 in an already published study. We compared this data on poisonings collected from 2010 to 2016 following the introduction of new formulations of imidacloprid. RESULTS: From 2002-2007, there were 56 patients with ingestion to imidacloprid compared to 67 patients post 2010 The median time to presentation prior to 2007 was 4 h (IQR 2.3-6.0 hrs) and post 2010 was only 2.0 hr (IQR 1.5 to 3.1 hrs). The median amount ingested was 15 ml (IQR 10.0-50.0mls) prior to 2007 and 27.5mls (IQR 5.0-71.8mls) post 2010. In both studies most patients developed non-specific symptoms including nausea, vomiting, epigastric pain and headache. However, prior to 2007 only 1.9% of the cohort required mechanical ventilation due to respiratory failure and there were no reported deaths. In contrast, post 2010; deaths occurred in 3.0% of the cohort and 6.0% required mechanical ventilation for respiratory failure. The cause of mortality was due to one case of cardiorespiratory failure and the other due to a prolonged admission complicated with lobar pneumonia leading to decompensated liver failure on the background of undiagnosed liver cirrhosis. CONCLUSION: Although acute exposure to imidacloprid is usually associated with mild non-specific symptoms, since the introduction of new formulations of imidacloprid, the toxic profile has changed with reported cases of death as well as an increase in cases requiring mechanical ventilation. The change in toxicity could be due to the solvents used in the newer formulations but also due to higher dose of imidacloprid described in our latter cohort. Further research into these solvents needs to be done and continued toxicovigilance is required.


Assuntos
Inseticidas/envenenamento , Neonicotinoides/envenenamento , Nitrocompostos/envenenamento , Administração Oral , Humanos , Inseticidas/administração & dosagem , Inseticidas/toxicidade , Masculino , Pessoa de Meia-Idade , Neonicotinoides/administração & dosagem , Neonicotinoides/toxicidade , Nitrocompostos/administração & dosagem , Nitrocompostos/toxicidade , Estudos Prospectivos , Respiração Artificial , Insuficiência Respiratória/induzido quimicamente , Insuficiência Respiratória/terapia , Sri Lanka
6.
Toxicol Ind Health ; 36(12): 946-950, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33094704

RESUMO

Cases of abamectin poisoning have been reported previously, but cases of severe brain dysfunction after poisoning are rarely reported, and abnormal electroencephalograms (EEGs) have not been reported. We report a case of a 46-year-old female who intentionally drank 400 mL of 5% abamectin pesticide. We describe in detail the clinical and EEG characteristics of the patient. The patient was discharged in good condition after 10 days. The study indicates that serious brain dysfunction and abnormal EEG caused by abamectin poisoning are treatable. Despite poor clinical and EEG findings at the outset, recovery is still possible. This is the first report on EEG after abamectin poisoning.


Assuntos
Eletroencefalografia/efeitos dos fármacos , Inseticidas/envenenamento , Ivermectina/análogos & derivados , Feminino , Humanos , Ivermectina/envenenamento , Pessoa de Meia-Idade
8.
BMC Vet Res ; 16(1): 318, 2020 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-32867767

RESUMO

BACKGROUND: Carbofuran is a widely used broad-spectrum pesticide that, despite strict regulation and being banned for more than a decade, is still encountered in cases of intentional poisoning in dogs and wildlife. The objective of the study was to provide a complete and detailed description of the pathological, histological and toxicological findings of 7 cases of intentional carbofuran poisoning in dogs. RESULTS: In this retrospective study, 7 cases of carbofuran intoxication recorded from July 2015 to June 2017 were analyzed. Following complete history recording, all cases were examined by complete necropsy and histopathology. Carbofuran intoxication was confirmed in all cases by gas chromatography. The postmortem examination revealed extensive hemorrhaging and congestion located mainly within the respiratory, nervous and cardiovascular systems, accompanied by degeneration and necrosis within the lungs, heart, and kidneys. CONCLUSIONS: Although carbamates have been banned in the European Union, carbamate poisoning is still frequently encountered, especially in wild animals. This paper will contribute to a better understanding of the occurrence and pathogenesis of acute carbofuran exposure in dogs and contribute some peculiar pathological features of this type of poisoning to the current literature.


Assuntos
Carbofurano/envenenamento , Doenças do Cão/induzido quimicamente , Inseticidas/envenenamento , Animais , Autopsia/veterinária , Doenças do Cão/mortalidade , Doenças do Cão/patologia , Cães , Estudos Retrospectivos
9.
Artigo em Chinês | MEDLINE | ID: mdl-32746578

RESUMO

To analyze the clinical data of a case of acute emamectin·chlorfenapyr poisoning in Guangzhou 12th People's Hospital in 2019. The patient developed high fever and night sweats, and gradually became unconscious. The patient died after 5 days of treatment. The toxicity and mortality of emamectin·chlorfenapyr were high. For acute poisoning patients, in addition to conventional symptomatic treatment, early blood purification treatment should be actively carried out.


Assuntos
Dissacarídeos/envenenamento , Inseticidas/envenenamento , Ivermectina/análogos & derivados , Envenenamento/diagnóstico , Piretrinas/envenenamento , Humanos , Ivermectina/envenenamento
10.
Ann N Y Acad Sci ; 1480(1): 136-145, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32761625

RESUMO

Aldicarb, a carbamate pesticide, is an acetylcholinesterase inhibitor, with oral median lethal dose (LD50 ) estimates in rats ranging from 0.46 to 0.93 mg/kg. A three-phase approach was used to comprehensively assess aldicarb as an oral-ingestion hazard. First, the solubility of aldicarb in popular consumer beverages (bottled water, apple juice, and 2% milk) was assessed. Lethality was then assessed by administering aldicarb in bottled water via gavage. A probit model was fit to 24-h survival data and predicted a median lethal dose of 0.83 mg/kg (95% CI: 0.54-1.45 mg/kg; slope: 4.50). Finally, organoleptic properties (e.g., taste, smell, and texture) were assessed by allowing rats to voluntarily consume 3.0 mL of the above beverages as well as liquid eggs adulterated with aldicarb at various concentrations. This organoleptic assessment determined that aldicarb was readily consumed at lethal and supralethal doses. Overt toxic signs presented within 5 min post-ingestion, and all rats died within 20 min after consuming the highest concentration (0.542 mg/mL), regardless of amount consumed. Because rats have more developed chemoreceptive capabilities than humans, these results suggest that aldicarb may be consumed in toxic or even lethal concentrations by humans in a variety of beverages or foods.


Assuntos
Aldicarb/envenenamento , Inibidores da Colinesterase/envenenamento , Inseticidas/envenenamento , Modelos Biológicos , Animais , Humanos , Dose Letal Mediana , Masculino , Ratos , Ratos Sprague-Dawley
11.
Pesqui. vet. bras ; 40(3): 155-157, Mar. 2020.
Artigo em Inglês | ID: biblio-1135605

RESUMO

An approach for the diagnosis of an abamectin outbreak in calves in the field is described and discussed. In a Midwestern Brazilian property, nine out of a 52 newborn calves were affected and died, making up for morbidity, mortality, and lethality ratios of 17.3%, 17.3%, and 100%, respectively. Major clinical signs included tremors in various muscle groups, inability to stand, and difficult, wheezing breathing. Each affected calf had been treated subcutaneously with abamectin (0.4mg/kg/body weight). No lesions were found at necropsy or at histological examination. Major diseases of newborn calves were included in the differential diagnosis.(AU)


Uma abordagem para o diagnóstico de um surto de abamectina em bezerros a campo é descrita e discutida. Numa propriedade do Centro-Oeste brasileiro, nove de um lote de 52 bezerros de 3 dias de idade foram afetados e morreram, perfazendo quocientes de morbidade, mortalidade e letalidade, respectivamente, de 17,3%, 17,3% e 100%. Os principais sinais clínicos incluíam tremores em vários grupos musculares, incapacidade em se manter em pé, e respiração difícil e estertorosa. Cada bezerro afetado havia sido tratado por via subcutânea com abamectina, na dose de 0,4mg/kg/peso corporal. Não foram encontradas lesões na necropsia, nem no exame histológico. As principais doenças de bezerros recém-nascidos foram incluídas no diagnóstico diferencial.(AU)


Assuntos
Animais , Bovinos , Síndromes Neurotóxicas/diagnóstico , Síndromes Neurotóxicas/veterinária , Acaricidas/envenenamento , Inseticidas/envenenamento , Anti-Helmínticos/envenenamento
12.
Rev Saude Publica ; 54: 09, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31967278

RESUMO

OBJECTIVE: To evaluate the attributes of Primary Health Care (PHC) for rural workers; to analyze sociodemographic conditions, history of poisoning and hospitalizations for pesticides and use of personal protective equipment; and to verify exposure to pesticides by determining bioindicators. METHODS: Cross-sectional, descriptive-analytical study with a sample of 1,027 rural workers living in municipalities belonging to a regional health department in Southern Minas Gerais, whose PHC is governed by the Family Health Strategy model. We used the adult version of the Primary Care Assessment Tool (PCATool Brazil) and a structured questionnaire to collect socioeconomic data, history of poisoning and hospitalization for pesticides and use of personal protective equipment. Blood samples were collected to measure biomarkers of pesticide exposure and signs of renal and hepatic sequelae. RESULTS: Low education was prevalent, as well as the intense contact of workers with pesticides. Frequent use of personal protective equipment was higher among men, as was the history of poisoning and hospitalizations for pesticides. Rates of 20% poisoning, 15% liver disease and 2% nephropathy were detected. Signs of hepatotoxicity were more frequent in men. Gender differences were all statistically significant. Regarding PHC, only the attribute "degree of affiliation" had a high score. None of the poisoning cases detected in the study were previously diagnosed. CONCLUSIONS: Despite the high coverage of the Family Health Strategy, occupational risk and its consequences have not been detected by health services, which do not seem oriented to primary care, even lacking their essential attributes. There is a need for immediate and effective adaptation of public policies regarding the health of rural workers, with adequate training of teams and review of the portfolio of PHC services offered.


Assuntos
Doenças dos Trabalhadores Agrícolas/induzido quimicamente , Exposição Ocupacional/estatística & dados numéricos , Praguicidas/toxicidade , Atenção Primária à Saúde/estatística & dados numéricos , Adulto , Doenças dos Trabalhadores Agrícolas/epidemiologia , Brasil/epidemiologia , Estudos Transversais , Saúde da Família , Feminino , Humanos , Inseticidas/envenenamento , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Equipamento de Proteção Individual , Fatores de Risco , Saúde da População Rural , População Rural , Fatores Socioeconômicos , Inquéritos e Questionários
13.
Clin Toxicol (Phila) ; 58(5): 397-405, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31452424

RESUMO

Objectives: Current therapeutic options for organophosphorus (OP) insecticide self-poisoning including atropine and oximes are inadequate and case fatality may exceed 20%. An OP hydrolase enzyme, OpdA, has been used for environmental cleansing of OP insecticides and prevented death in rat and non-human primate models of OP insecticide poisoning if given very quickly after exposure. We here tested OpdA's ability to break down OP insecticides in human serum and in clinically relevant minipig models of OP insecticide poisoning.Methods: Human serum was spiked with seven diverse WHO Class II OP insecticides (chlorpyrifos, quinalphos, diazinon, dimethoate, fenthion, phenthoate, and profenofos) and the effect of OpdA on degradation measured. The pharmacodynamic and clinical effects of OpdA treatment were studied in Gottingen minipigs orally poisoned with agricultural formulations of dimethoate EC40 or methyl parathion EC60; pharmacodynamic effects were also assessed in profenofos EC50-poisoned pigs.Results: OpdA effectively hydrolysed OP insecticides in human serum, with rates varying from 856 (SD 44) down to 0.107 (SD 0.01) moles of substrate hydrolysed/mole of enzyme/sec (kcat) for quinalphos and phenthoate, respectively, although at rates 2-3 log orders less than found in vitro in buffered solution. It showed clinical benefit in minipig models, reducing the dose of noradrenaline required to sustain an adequate mean arterial pressure after dimethoate (mean 0.149 [SD 0.10] µg/kg/h vs. 1.07 [SD 0.77] µg/kg/h, p < .0001) and methyl parathion (mean 0.077 [SD 0.08] µg/kg/h vs. 0.707 [SD 0.49] µg/kg/h, p < .0001) poisoning. OpdA reduced blood OP insecticide concentration and acetylcholinesterase inhibition after poisoning by dimethoate, methyl parathion, and profenofos insecticides.Conclusions: In vitro incubation of OpdA in human serum showed hydrolysis of diverse OP insecticides, although at lower rates than found in buffer solutions. This activity results in clinical and pharmacodynamic efficacy in vivo against several OP insecticides. These results support the testing of OpdA in further animal models before considering human trials to determine whether it may become an urgently required novel therapeutic agent for OP insecticide self-poisoning.


Assuntos
Arildialquilfosfatase/sangue , Arildialquilfosfatase/uso terapêutico , Inseticidas/envenenamento , Intoxicação por Organofosfatos/tratamento farmacológico , Animais , Modelos Animais de Doenças , Humanos , Metil Paration/toxicidade , Suínos , Porco Miniatura
14.
Clin Toxicol (Phila) ; 58(4): 254-261, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31364415

RESUMO

Background: A common manifestation of organophosphorus insecticide self-poisoning is prolonged respiratory failure due to neuromuscular junction dysfunction and likely nicotinic receptor overstimulation. We aimed at collecting preliminary data on whether addition of the competitive nicotinic antagonist rocuronium to standard early therapy might be clinically feasible and associated with reduced duration of ventilation.Methods: A pilot three-arm dose-response phase II trial was set up to compare bolus doses of rocuronium bromide titrated to produce initial >95% or 50% inhibition of neuromuscular function, measured using acceleromyography, plus standard treatment, versus standard treatment alone. After attaining inhibition, patients receiving bolus rocuronium then received rocuronium infusions for a maximum of 120 h. Primary outcome was duration of intubation; secondary outcome was case fatality. Plasma butyrylcholinesterase activity was measured throughout the inpatient stay. Blood was analysed to confirm the organophosphorus insecticide ingested.Results: Forty-five patients were randomised to receive: rocuronium to initially attain 95% inhibition (Roc>95, n = 15), rocuronium to initially attain 50% inhibition (Roc50, n = 14), or no rocuronium (control, n = 16). The most commonly ingested pesticide was profenofos (29/45, 64.4%). Butyrylcholinesterase activity remained severely inhibited for the duration of the study for most patients. Case fatality was 9/45 (20%) and similar across study arms: control 3/16 (18.8%), Roc50 4/14 (28.6%) and Roc>95 2/15 (13.3%) (p = .5842). When excluding patients who died, median [IQR] duration of intubation was significantly longer in the Roc50 (259.5 [176-385] h) and Roc>95 (226.8 [186-355] h) groups compared to controls (88.5 [47-160] h, p = .0162 and p = .0016, respectively).Conclusions: In this pilot dose-response study, we found no evidence that rocuronium in addition to standard therapy reduced the duration of intubation. It is possible that it worsened neuromuscular junction function. Further clinical research, including testing of shorter duration regimens, needs to be performed before nicotinic antagonists can be used in the clinical management of OP poisoning.


Assuntos
Inseticidas/envenenamento , Intoxicação por Organofosfatos/complicações , Respiração Artificial/estatística & dados numéricos , Insuficiência Respiratória/induzido quimicamente , Rocurônio/administração & dosagem , Adulto , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fármacos Neuromusculares não Despolarizantes/administração & dosagem , Intoxicação por Organofosfatos/terapia , Projetos Piloto , Insuficiência Respiratória/terapia , Comportamento Autodestrutivo/complicações , Fatores de Tempo , Adulto Jovem
17.
Clin Toxicol (Phila) ; 58(2): 136-138, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31092066

RESUMO

Introduction: Imidacloprid is a commonly used neonicotinoid insecticide in Thailand. Limited reports suggest it may be associated with liver injury.Case series: A retrospective poison center case series identified 128 cases of imidacloprid ingestion from 2010-2016, of which four developed liver injury.Results: Three patients ingested soluble liquid concentrates and one ingested water-dispersible granules of imidacloprid. The estimated doses of ingestion ranged from 2-35 g. One patient developed cholestatic liver injury, two developed hepatocellular liver injury, and the remaining patient, who ingested the highest dose, developed a mixed pattern of liver injury. Median onset of liver injury was 5.5 days.Discussion: In prior case reports and animal studies, these cases suggest imidacloprid toxicity is associated with liver injury that may be delayed. This is consistent with our finding. The cases also demonstrated a possible dose-response relationship of imidacloprid ingestion with severity and type of liver injury. All findings suggested that imidacloprid might contribute to liver injury.Conclusion: We report four cases of liver injury, which are possibly related to ingestion of imidacloprid. In management, consideration should be given to repeating liver tests as an outpatient if initial tests are normal, with counseling on the possibility of delayed liver injury.


Assuntos
Doença Hepática Induzida por Substâncias e Drogas/etiologia , Inseticidas/envenenamento , Neonicotinoides/envenenamento , Nitrocompostos/envenenamento , Centros de Controle de Intoxicações , Adulto , Idoso , Doença Hepática Induzida por Substâncias e Drogas/diagnóstico , Doença Hepática Induzida por Substâncias e Drogas/epidemiologia , Doença Hepática Induzida por Substâncias e Drogas/terapia , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Centros de Controle de Intoxicações/estatística & dados numéricos , Estudos Retrospectivos , Resultado do Tratamento
18.
Artigo em Inglês | LILACS | ID: biblio-1058888

RESUMO

ABSTRACT OBJECTIVE To evaluate the attributes of Primary Health Care (PHC) for rural workers; to analyze sociodemographic conditions, history of poisoning and hospitalizations for pesticides and use of personal protective equipment; and to verify exposure to pesticides by determining bioindicators. METHODS Cross-sectional, descriptive-analytical study with a sample of 1,027 rural workers living in municipalities belonging to a regional health department in Southern Minas Gerais, whose PHC is governed by the Family Health Strategy model. We used the adult version of the Primary Care Assessment Tool (PCATool Brazil) and a structured questionnaire to collect socioeconomic data, history of poisoning and hospitalization for pesticides and use of personal protective equipment. Blood samples were collected to measure biomarkers of pesticide exposure and signs of renal and hepatic sequelae. RESULTS Low education was prevalent, as well as the intense contact of workers with pesticides. Frequent use of personal protective equipment was higher among men, as was the history of poisoning and hospitalizations for pesticides. Rates of 20% poisoning, 15% liver disease and 2% nephropathy were detected. Signs of hepatotoxicity were more frequent in men. Gender differences were all statistically significant. Regarding PHC, only the attribute "degree of affiliation" had a high score. None of the poisoning cases detected in the study were previously diagnosed. CONCLUSIONS Despite the high coverage of the Family Health Strategy, occupational risk and its consequences have not been detected by health services, which do not seem oriented to primary care, even lacking their essential attributes. There is a need for immediate and effective adaptation of public policies regarding the health of rural workers, with adequate training of teams and review of the portfolio of PHC services offered.


ABSTRACT OBJETIVO Avaliar os atributos da atenção primária à saúde (APS) na assistência à saúde de trabalhadores rurais; analisar condições sociodemográficas, histórico de intoxicação e internações por agrotóxicos e uso de equipamentos de proteção individual; e verificar a exposição aos praguicidas pela determinação de bioindicadores. MÉTODOS Estudo transversal, descritivo-analítico, com amostra de 1.027 trabalhadores rurais residentes em municípios pertencentes a uma superintendência regional de saúde do sul de Minas Gerais, cuja APS é regida pelo modelo da Estratégia Saúde da Família. Utilizou-se o Instrumento de Avaliação da Atenção Primária (PCATool Brasil) versão adulto e um questionário estruturado para coleta de dados socioeconômicos, histórico de intoxicação e internação por agrotóxicos e uso de equipamentos de proteção individual. Foram coletadas amostras sanguíneas para dosagem de biomarcadores de exposição a praguicidas e de sinais de sequelas renais e hepáticas. RESULTADOS A baixa escolaridade foi prevalente, bem como o contato intenso dos trabalhadores com praguicidas. O uso frequente de equipamentos de proteção individual foi maior entre os homens, assim como o histórico de intoxicação e de internações por agrotóxicos. Detectaram-se índices de 20% de intoxicação, 15% de hepatopatia e 2% de nefropatia. Os sinais de hepatotoxicidade foram mais frequentes em homens. As diferenças entre sexos foram todas estatisticamente significantes. Com relação à APS, apenas o atributo "grau de afiliação" apresentou escore elevado. Nenhum dos casos de intoxicação detectados no estudo tinha diagnóstico prévio. CONCLUSÕES A despeito de uma alta cobertura da Estratégia Saúde da Família, o risco ocupacional e suas consequências não têm sido detectados pelos serviços de saúde, que se apresentam como não orientados à atenção primária, carecendo mesmo de seus atributos essenciais. Percebe-se a necessidade de adequação imediata e efetiva das políticas públicas no que concerne à saúde do trabalhador rural, com adequada capacitação das equipes e revisão da carteira de serviços da APS ofertados.


Assuntos
Humanos , Masculino , Feminino , Adulto , Praguicidas/toxicidade , Atenção Primária à Saúde/estatística & dados numéricos , Exposição Ocupacional/estatística & dados numéricos , Doenças dos Trabalhadores Agrícolas/induzido quimicamente , População Rural , Fatores Socioeconômicos , Brasil/epidemiologia , Saúde da População Rural , Saúde da Família , Estudos Transversais , Inquéritos e Questionários , Fatores de Risco , Exposição Ocupacional/efeitos adversos , Doenças dos Trabalhadores Agrícolas/epidemiologia , Equipamento de Proteção Individual , Inseticidas/envenenamento , Pessoa de Meia-Idade
19.
BMJ Case Rep ; 12(11)2019 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-31753823

RESUMO

A 54-year-old man with a history of schizophrenia presented to the emergency room for weakness with associated lacrimosis, drooling, nausea, emesis, diarrhoea, diplopia and burning sensation on his skin that began 6 hours after spraying five cans of Raid on his carpet. He was noted to have miotic pupils and hyperactive bowel sounds. Given the clinical presentation, the patient was diagnosed with organophosphate (OP) toxicity. After being admitted, he developed symptoms associated with his OP toxicity and was successfully treated with atropine and pralidoxime. Most Raid products contain pyrethroids; however, both OPs and pyrethroids are available in commercial pesticides and patients may misidentify ingestions. There are limited data reporting the toxicity of pyrethroid overdose in humans and to guide its subsequent treatment. It is crucial to keep a low threshold for diagnosing and treating patients with acute onset of symptoms suspicious for an OP or pyrethroid toxidrome.


Assuntos
Produtos Domésticos/envenenamento , Inseticidas/envenenamento , Intoxicação por Organofosfatos/diagnóstico , Piretrinas/envenenamento , Antídotos/uso terapêutico , Atropina/uso terapêutico , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Intoxicação por Organofosfatos/tratamento farmacológico , Compostos de Pralidoxima/uso terapêutico
20.
Vet J ; 251: 105349, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31492383

RESUMO

Organophosphates (OP) and carbamates are commonly used insecticides and important intoxication sources of humans and animals. Nevertheless, large scale studies of these intoxications in dogs are unavailable. The medical records of dogs presented to a veterinary hospital were reviewed retrospectively. The study included 102 dogs definitely diagnosed with acute OP or carbamate intoxication. The most common presenting clinical signs included muscle tremor, hypersalivation, miosis, weakness, vomiting and diarrhea. Hypersalivation, muscle tremor and tachypnea were significantly (P < 0.05) associated with survival to discharge; while weakness, mental dullness, anorexia, pale mucous membranes and paddling were significantly associated with death. Common laboratory abnormalities included decreased butyrylcholine esterase activity, acidemia, increased total plasma protein, leukocytosis, hypochloridemia, hyperbilirubinemia, increased creatinine and alanine transaminase (ALT), aspartate transaminase (AST) and creatine kinase activities, and prolonged activated partial thromboplastin time (aPTT). Compared to the survivors, the non-survivors showed significantly: higher frequencies of thrombocytopenia, hypocarbemia, prolonged prothrombin time (PT), hypernatremia, hyperkalemia, hypocholesterolemia, hypoproteinemia, hypertriglyceridemia, increased ALT activity and increased urea concentration; lower median concentrations of venous blood bicarbonate, serum chloride and total CO2; and higher medians of PT, serum total bilirubin and urea concentrations, and ALT and AST activities. Intoxicated dogs were commonly treated with diphenhydramine, atropine-sulfate, antibiotics, diazepam and pralidoxime, while some (19.2%) required general anesthesia and mechanical ventilation. The survival rate of dogs treated by gastric lavage was higher (P = 0.041) compared to that of the remaining dogs. Development of respiratory failure and mechanical ventilation requirement were significantly associated (P < 0.001) with death. The mortality rate was 17%.


Assuntos
Carbamatos/envenenamento , Doenças do Cão/induzido quimicamente , Inseticidas/envenenamento , Intoxicação por Organofosfatos/veterinária , Envenenamento/veterinária , Animais , Cães , Lavagem Gástrica/veterinária , Intoxicação por Organofosfatos/diagnóstico , Intoxicação por Organofosfatos/terapia , Envenenamento/diagnóstico , Envenenamento/terapia , Respiração Artificial/veterinária , Insuficiência Respiratória/terapia , Insuficiência Respiratória/veterinária , Estudos Retrospectivos , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...