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1.
Forensic Sci Int ; 306: 110063, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31790891

RESUMO

Diagnosis of carbon monoxide (CO) poisonings has always been a challenging task due to the susceptibility to alterations of the optical state and degradation of blood samples during sampling, transport and storage, which highly affects the analysis with spectrophotometric methods. Methodological improvements are then required urgently because of increased reports of cases with discrepancies between results of the measured biomarker carboxyhemoglobin (COHb) and reported symptoms. Total blood CO (TBCO) measured chromatographically was thus proposed in a previous study as alternative biomarker to COHb. This approach was investigated in this study by comparing the two biomarkers and assessing the effects of various storage parameters (temperature, preservative, time, tube headspace (HS) volume, initial saturation level, freeze- and thaw- and reopening-cycles) over a period of one month. Results show that while for TBCO, concentrations are relatively stable over the observation period regardless of parameters such as temperature, time and HS volume, for COHb, concentrations are altered significantly during storage. Therefore, the use of TBCO as alternative biomarker for CO poisonings has been proposed, since it provides more valid results and is more stable even under non-optimal storage conditions. Additionally, it can be used to predict COHb in cases where sample degradation hinders optical measurement. Furthermore, a correction formula for COHb and TBCO is provided to be used in laboratories or circumstances where optimal storage or analysis is not possible, to obtain more accurate results.


Assuntos
Intoxicação por Monóxido de Carbono/diagnóstico , Monóxido de Carbono/sangue , Carboxihemoglobina/análise , Medicina Legal/métodos , Biomarcadores/sangue , Cromatografia Gasosa , Interpretação Estatística de Dados , Humanos , Oximetria , Manejo de Espécimes , Espectrofotometria
2.
Radiol Med ; 125(1): 80-86, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31529401

RESUMO

OBJECTIVE: To observe the structural changes of gray matter nuclei in patients with acute carbon monoxide intoxication by diffusion tensor imaging (DTI), quantify the degree of deep gray matter damage in the brain by adopting imaging technology and research the characteristics of the damage and its pertinence with memory and cognitive impairment. METHODS: Twenty-five patients with acute carbon monoxide intoxication and 25 healthy volunteers matched in sex and age were examined by routine head MRI and diffusion tensor imaging (DTI). Bilateral hippocampus, dater nucleus, thalamus, amygdala, globus pallidus and putamen were taken as regions of interest. The mean diffusion coefficient (MD), anisotropic fraction (FA) and appearance of deep gray matter nucleus in patients with acute carbon monoxide intoxication were analyzed. It found that the change of diffusion coefficient (ADC) and its clinical correlation with cognitive impairment were generated by carbon monoxide intoxication. RESULTS: Compared with the healthy control group, the FA values of bilateral globus pallidus, hippocampus, dater nucleus and putamen decreased, while the FA values of amygdala and thalamus had no statistical significance; the MD values and ADC values of hippocampus, globus pallidus and putamen increased, while the MD and ADC values of dater nucleus, thalamus and amygdala had no statistical significance, either. CONCLUSION: DTI is capable of sensitively reflecting the damage of gray matter nuclei caused by acute carbon monoxide intoxication and quantifying the degree of hypoxic brain damage in a certain extent, and may be related to cognitive impairment.


Assuntos
Lesões Encefálicas Difusas/diagnóstico por imagem , Intoxicação por Monóxido de Carbono/diagnóstico por imagem , Imagem de Tensor de Difusão/métodos , Substância Cinzenta/diagnóstico por imagem , Doença Aguda , Adulto , Idoso , Tonsila do Cerebelo/diagnóstico por imagem , Anisotropia , Estudos de Casos e Controles , Cognição , Feminino , Globo Pálido/diagnóstico por imagem , Hipocampo/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Testes de Estado Mental e Demência , Pessoa de Meia-Idade , Giro Para-Hipocampal/diagnóstico por imagem , Putamen/diagnóstico por imagem , Tálamo/diagnóstico por imagem , Vigília , Adulto Jovem
3.
Forensic Sci Int ; 306: 110093, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31816483

RESUMO

Studies on the mortalities of drug abusers in China are scarce. This study explores the deaths of methamphetamine, opioid, and ketamine abusers in Shanghai (2004-2017) and Wuhan (2005-2017). Chi-square/Fisher's exact tests were used to compare the differences in terms of region, gender, age, cause of death, and the method used in the last drug abuse. Poisson regression models were used to estimate the rate ratios ("RRs") and annual percentage changes ("APCs"). 314 heroin, 43 methamphetamine, and 4 ketamine abusers were included. Furthermore, simultaneously, 6 abusers used heroin and methamphetamine, and 7 abusers used methamphetamine and ketamine. Heroin-related deaths have declined in Shanghai (APC, -16.1; 95 % CI, -18.4 to -11.3) and Wuhan (APC, -16.0; 95 % CI, -18.9 to -10.6), whereas methamphetamine-related deaths have increased in Wuhan (APC, 12.8; 95 % CI, 0.0 to 29.2). On the whole, in the two cities, males were more frequently observed than females in heroin-related deaths (4.4, 230/52). However, the gender ratios for methamphetamine- (1.8, 34/19) and ketamine-related deaths (1.2, 6/5) were close to one. In view of the mortality rates of the drug abusers in most Chinese cities were still unclear, it is thus important to improve mortality surveillance of the drug abusers at the national level.


Assuntos
Analgésicos Opioides/envenenamento , Ketamina/envenenamento , Metanfetamina/envenenamento , Transtornos Relacionados ao Uso de Substâncias/mortalidade , Adolescente , Adulto , Distribuição por Idade , Analgésicos Opioides/efeitos adversos , Intoxicação por Monóxido de Carbono/mortalidade , China/epidemiologia , Feminino , Heroína/efeitos adversos , Heroína/envenenamento , Humanos , /envenenamento , Ketamina/efeitos adversos , Masculino , Metanfetamina/efeitos adversos , Pessoa de Meia-Idade , Distribuição por Sexo , Suicídio/estatística & dados numéricos , Adulto Jovem
4.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(12): 1296-1298, 2019 Dec 06.
Artigo em Chinês | MEDLINE | ID: mdl-31795589

RESUMO

The data were drawn from injury hospitalization surveillance system in Shandong province. From 2012 to 2018, 164 cases of acute occupational poisoning were reported from five surveillance counties (cities, districts), accounting for 6.11% (164/2 683) of total accidental poisoning cases. The annual average reported incidence of acute occupational poisoning hospitalization was 1.15/100 000. The number of male cases was 3.3 times that of females (126 vs 38). The poisoning cases mainly occurred between January to May in a year and 5-7 AM within a day. Those cases were mainly caused by irritating gases (92 cases, 56.10%) and asphyxiating gases (53 cases, 32.32%), of which chlorine (71 cases) and carbon monoxide (50 cases) were the main reasons. The average hospitalization medical cost of acute occupational poisoning cases was 7 278.81 RMB per case.


Assuntos
Acidentes de Trabalho , Intoxicação por Monóxido de Carbono/epidemiologia , Hospitalização , Ocupações/estatística & dados numéricos , China/epidemiologia , Cidades , Feminino , Hospitalização/economia , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Masculino , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/estatística & dados numéricos
5.
Medicine (Baltimore) ; 98(49): e18199, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31804341

RESUMO

BACKGROUND: Approximately 10% to 30% patients develop delayed encephalopathy after acute CO poisoning (DEACMP). No specific treatment is available and poor prognosis is a characteristic of this disease. We aimed to evaluate the efficacy and safety of all therapies that have been tried in randomized controlled trial (RCT) for DEACMP. METHODS: We conducted a systematic search of the Cochrane, Embase, PubMed, and Web of Science databases. RESULTS: Overall, 4 RCTs were identified in our study. Both hyperbaric oxygen (HBO) and mesenchymal stem cell (MSC) transplantation were effective in DEACMP, and MSC seemed to be superior to HBO. The addition of dexamethasone, N-butylphthalide, or XingZhi-YiNao granules into HBO, or butylphthalide into MSC could achieve better neurological recovery in DEACMP patients but did not significantly increase the incidence of adverse events. CONCLUSION: Several therapies have shown positive results in treating DEACMP and need to be proven by further studies.


Assuntos
Encefalopatias/etiologia , Encefalopatias/terapia , Intoxicação por Monóxido de Carbono/complicações , Benzofuranos/uso terapêutico , Dexametasona/uso terapêutico , Medicamentos de Ervas Chinesas/uso terapêutico , Humanos , Oxigenação Hiperbárica/métodos , Transplante de Células-Tronco Mesenquimais/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo
7.
BMC Med Genet ; 20(1): 197, 2019 12 16.
Artigo em Inglês | MEDLINE | ID: mdl-31842790

RESUMO

BACKGROUND: We explored the association of leucine-rich repeats and calponin homology domain containing 1 (LRCH1) gene polymorphisms with genetic susceptibility to delayed encephalopathy after acute carbon monoxide poisoning (DEACMP), which might provide a theoretical basis for the pathogenesis, diagnosis, and prognosis research of DEACMP. METHODS: Four single nucleotide polymorphisms, rs1539177 (G/A), rs17068697 (G/A), rs9534475 (A/C), and rs2236592 (T/C), of LRCH1, selected as candidate genes through genome-wide association analysis, were genotyped in 661 patients (DEACMP group: 235 cases; ACMP group: 426 cases) using Sequenom Massarray®. The association analysis of four SNPs and LRCH1 was performed under different genetic models. RESULTS: LRCH1 polymorphisms (rs1539177, rs17068697, rs9534475) under additive and dominant genetic models were significantly associated with an increased risk of DEACMP, but no significant association under allele and recessive models was found. The LRCH1 rs2236592 polymorphism was susceptible to DEACMP only under the dominant model (TT/TC + CC, OR = 1.616, 95% CI: 1.092-2.390, P = 0.015784). In addition, the A allele gene of rs9534475 polymorphism in LRCH1 might increase the risk for DEACMP (OR = 1.273, 95% CI: 1.013-1.601, P = 0.038445). CONCLUSIONS: We found a significant association between the four LRCH1 polymorphisms and DEACMP. The allelic A of rs9534475 polymorphism in LRCH1 might be a risk factor for DEACMP.


Assuntos
Encefalopatias/etiologia , Encefalopatias/genética , Intoxicação por Monóxido de Carbono/complicações , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Proteínas dos Microfilamentos/genética , Polimorfismo de Nucleotídeo Único , Doença Aguda , Idoso , Alelos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
8.
Undersea Hyperb Med ; 46(5): 655-658, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31683364

RESUMO

Background: Carboxyhemoglobin (COHb) levels are obtained when there is suspicion for carbon monoxide (CO) exposure. Serial COHb levels are sometimes obtained despite the well-established half-life of COHb with oxygen supplementation. We sought to evaluate the trends and characteristics associated with obtaining serial carboxyhemoglobin levels. Methods: A retrospective review was performed at an academic medical center for all inpatient and emergency department cases with either single COHb or serial COHb levels from 1 April 2010 through 31 March 2015. Data collected included age, gender, pregnancy status, smoking history, encounter month, admission status, oxygen administration, fire or burn history, vital signs, presenting symptoms, hyperbaric oxygen (HBO2) therapy use, initial pH, troponin, lactate, and COHb levels. The time and change in values between serial levels were also obtained. Results: 624 cases were identified, with 106 (17%) having multiple carboxyhemoglobin levels. A mean of 2.6 (range 2 - 9) serial COHb levels were obtained. The average initial COHb was 8.9%. Subsequent serial levels were obtained on average at 353, 663 and 1,095 minutes and averaged 2.8%, 1.8% and 1.1% respectively. Serial COHb levels were obtained more commonly in burn patients, those admitted to the ICU and those who had HBO2 therapy. Four patients had an increase in COHb level on serial testing. The largest increase of these was from 2.0% to 3.9%. Conclusion: Serial COHb levels were not infrequent in this study. No clinically significant increase in COHb was identified by serial testing. Further studies should examine the clinical utility of such practices.


Assuntos
Intoxicação por Monóxido de Carbono/sangue , Carboxihemoglobina/análise , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Monitorização Transcutânea dos Gases Sanguíneos/instrumentação , Queimaduras/sangue , Intoxicação por Monóxido de Carbono/diagnóstico , Criança , Cuidados Críticos , Feminino , Humanos , Oxigenação Hiperbárica , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo , Adulto Jovem
9.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi ; 37(10): 789-792, 2019 Oct 20.
Artigo em Chinês | MEDLINE | ID: mdl-31726514

RESUMO

Objective: To analyze the epidemiological characteristics of occupational diseases in Gansu Province, China in 2010-2017, and to provide a scientific basis for the prevention and control of occupational diseases. Methods: The cluster sampling method was adopted to make statistical analysis of 1339 cases of occupational disease reported by "occupational disease and occupational health information monitoring system" in Gansu province from 2010 to 2017, to investigate the diseases, regions and industries of occupational diseases in June 2018. Results: A total of 1339 cases of occupational diseases (39 types, 8 classes) were diagnosed and reposed in 2010-2017. The three most frequent diseases were pneumoconiosis (87.53%, 1172/1339), occupational poisonings (5.83%, 78/1339), and occupational ear, nose, and throat (ENT) diseases (3.14%, 42/1339). The cases of silicosis accounted for 54.61% (640/1172) of all cases of pneumoconiosis, the second was coalworker pneumoconiosis, which accounted for 38.57% (452/1172). In the cases of occupational poisonings, 32.05% (25/78) suffered from carbon monoxide poisoning. Patients with occupational diseases were reported in 14 districts of Gansu, mostly in Lanzhou (27.52%, 347/1261), Jinchang (16.57%, 209/1261), and Baiyin (14.20%, 179/1261). The reported cases are mainly concentrated in mining (71.56%, 468/654) and manufacturing (21.87%, 143/654), the types of state-owned economy (55.63%, 692/1244) and private economy (33.68%, 419/1244), large (43.41%, 540/1244) and small enterprises (35.21%, 438/1244) in 2010-2017 in Gansu. Conclusion: The pneumoconiosis caused by silicious and coal dust and the occupational poisonings caused by carbon monoxide seem to be the main occupational hazards in Gansu province. Occupational diseases occur in all districts of Guangzhou and in various industries. The state-owned economy and private sector, large and small enterprises should be the focuses of occupational health supervision.


Assuntos
Doenças Profissionais/epidemiologia , Pneumoconiose/epidemiologia , Envenenamento/epidemiologia , Intoxicação por Monóxido de Carbono/epidemiologia , China/epidemiologia , Estudos Epidemiológicos , Humanos , Incidência
10.
Med Sci Monit ; 25: 7684-7693, 2019 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-31606731

RESUMO

BACKGROUND Hyperbaric oxygen (HBO) is used in patients with carbon monoxide (CO) poisoning to prevent the occurrence of delayed neurological sequelae. However, inconsistent results were obtained regarding the treatment effects of HBO. Therefore, the current meta-analysis was conducted based on published randomized controlled trials (RCTs) to determine the effect of HBO on neurologic sequelae and all-cause mortality in patients with CO poisoning. MATERIAL AND METHODS Electronic databases MedLine, EmBase, and the Cochrane Library were searched for relevant RCTs from inception to March 1, 2019. The pooled relative risks (RRs) and weighted mean differences (WMDs) with corresponding 95% confidence intervals (CIs) were calculated to evaluate the outcomes by using a random-effects model. Sensitivity, subgroup, and publication bias analyses were also conducted. RESULTS Seven RCTs, including 9 cohorts and a total of 2023 patients with CO poisoning, were enrolled in this study. The summary results revealed that HBO showed an association with lower risk of memory impairment compared to patients receiving normobaric oxygen (NBO), whereas 2 sessions of HBO showed an association with higher risk of memory impairment compared to those who received 1 session of HBO. Moreover, HBO was associated with increased neuropsychologic scores of block design and trail making when compared with NBO. No other significant differences regarding the treatment effects of HBO were observed. CONCLUSIONS These results indicate that HBO therapy significantly reduces the risk of memory impairment compared to NBO, but 2 sessions of HBO might not be better for memory impairment than 1 session of HBO.


Assuntos
Intoxicação por Monóxido de Carbono/mortalidade , Intoxicação por Monóxido de Carbono/terapia , Oxigenação Hiperbárica , Transtornos da Memória/complicações , Ensaios Clínicos Controlados Aleatórios como Assunto , Adulto , Comportamento , Intoxicação por Monóxido de Carbono/complicações , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Viés de Publicação
12.
Emergencias (Sant Vicenç dels Horts) ; 31(5): 304-310, oct. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184119

RESUMO

Objetivo. Investigar la calidad asistencial en los episodios de exposición a monóxido de carbono (CO) asistidos por unidades prehospitalarias mediante indicadores de calidad (IC) y las variables relacionadas con el uso del pulsicooxímetro para medir de forma incruenta el porcentaje de saturación de la hemoglobina con CO (SpCO). Método. Estudio de cohorte de los episodios de exposición a CO atendidos por las unidades de soporte vital avanza-do (SVA) del Sistema de Emergencias Médicas de Cataluña. Se seleccionaron 11 IC y se diseñó un análisis multivariante para investigar las variables relacionadas con el uso del pulsicooxímetro.Resultados. Se recogieron 1.676 episodios de exposición a CO. En 1.108 (66,1%) se registró la SpCO con pulsicooxímetro, siendo SpCO > 10% en 358 (32,3%). De los 11 IC, cinco no alcanzaron el estándar recomendado. El análisis multivariante mostró un menor uso del pulsicooxímetro cuando había asociación con otro tóxico, OR 0,34 (IC 95% 0,11-1,00) y cuando la primera asistencia era realizada por SVA médico, OR 0,43 (IC 95% 0,31-0,59). Hubo mayor uso del pulsicooxímetro ante la presencia de antecedentes psiquiátricos OR 3,01 (IC 95% 1,27-7,17), la cefalea OR 2,13 (IC 95% 1,22-3,72) y el uso de oxigenoterapia OR 10,33 (5,46-19,53). Conclusión. En la asistencia prehospitalaria de los episodios de exposición al CO existe una falta de cumplimiento de algunos IC. Hay variables relacionadas con la infrautilización del pulsicooxímetro, con puntos de mejora


Objective. To describe health care quality indicators in cases of carbon monoxide (CO) exposure attended by prehospital services and to explore factors associated with the use of pulse CO-oximetry (SpCO) for the noninvasive estimation of CO saturation of arterial blood. Method. Cohort study of patients exposed to CO and transported by advanced life support units of the Emergency Medical Services of Catalonia between January 2015 and December 2017. We selected 11 applicable quality indicators and used multivariate analysis to explore factors associated with the recording of SpCO. Results. We studied 1676 cases of CO exposure. SpCO was recorded in 1108 cases (66.1%). CO saturation exceeded 10% in 358 patients (32.3%). Adherence was deficient in 5 of the 11 applicable quality indicators. Multivariate analysis showed less use of pulse CO-oximetry when another toxic exposure was present (odds ratio [OR], 0.34; 95% CI, 0.11-1.00) and when the first responder was from the advanced life support service (OR, 0.43; 95% CI, 0.31-0.59). SpCO was used more in the presence of a history of mental health problems (OR, 3.01; 95% CI,1.27-7.17), headache (OR, 2.13; 95% CI, 1.2-3.72), and along with use of oxygen therapy (OR, 10.33; 95% CI, 5.46-19.53). Conclusion. Prehospital attendance of episodes of CO exposure is marked by failure to comply with some health care quality indicators. We detected factors associated with under use of SpCO as well as areas to target for improvement


Assuntos
Humanos , Adulto , Indicadores de Qualidade em Assistência à Saúde/estatística & dados numéricos , Serviços Médicos de Emergência/métodos , Assistência Pré-Hospitalar/organização & administração , Intoxicação por Monóxido de Carbono/diagnóstico , Indicadores de Qualidade em Assistência à Saúde/organização & administração , Assistência Pré-Hospitalar/normas , Melhoria de Qualidade/organização & administração , Exposição Ambiental , Estudos Transversais , Estudos de Coortes , Razão de Chances
13.
Artigo em Alemão | MEDLINE | ID: mdl-31562538

RESUMO

BACKGROUND: Every year, hospitals in Germany treat roughly 450,000 people in the aftermath of poisoning incidents. To reduce the number of poisoning accidents, it is essential to inform the public about poisoning risks and the possibilities for prevention. OBJECTIVES: The goal was to examine risk perception of poisonings in order to derive insights into adequate communication activities from the results. As a special focus topic, the risk of carbon monoxide poisoning was chosen. METHOD: Telephone interviews were conducted with 1,012 persons aged 14 or over in Germany. They were asked about their awareness, perception, and knowledge of poisoning risks, particularly carbon monoxide. RESULTS: Most people are aware of risks such as accidental intoxications caused by alcohol, carbon monoxide, or mushrooms. Other risks that could be especially dangerous for children, like coin cell batteries, lamp oils, or liquids in e­cigarettes, are less known. Of the interviewees, 82% had already heard of poisoning incidents in connection to carbon monoxide and 41% estimated the risk of accidental carbon monoxide poisoning as rather or very high. However, only 15% had already installed a carbon monoxide detector. Although people are mostly aware of the main causes and identifiers of carbon monoxide poisoning, more than one third still believe that carbon monoxide can be identified by its odor, smoke, or the smoke alarm signal. In addition, there is a special need for information about the risks of carbon monoxide intoxication through indoor shisha smoking and indoor storage of wood pellets. CONCLUSION: The results offer first insights into the target groups and possible dissemination paths for future risk communication activities.


Assuntos
Intoxicação por Monóxido de Carbono , Sistemas Eletrônicos de Liberação de Nicotina , Acidentes , Adolescente , Monóxido de Carbono , Criança , Alemanha , Humanos
14.
Undersea Hyperb Med ; 46(4): 495-501, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31509905

RESUMO

Objective: Government programs have attempted to impact a recognized elevated risk for carbon monoxide (CO) poisoning among minority racial and ethnic groups. This study sought to describe U.S. mortality due to unintentional, non-fire-related CO poisoning, examining the distribution and trends by race and ethnicity. Methods: CDC Wonder was used to extract and analyze data on all U.S. resident deaths from unintentional CO poisoning from 2000-2017, categorizing them by year, race, ethnic origin and gender. Results: The absolute number of unintentional CO deaths decreased from about 450 to 380 per year during the period studied, a number near totally accounted for by the decrease in deaths occurring among non-Hispanic/Latino whites. The number of deaths among the remainder of the population did not significantly change. However, greater growth in minority populations resulted in a similar decline in the mortality rate between non-Hispanic/Latino whites and the combined minority population. The decline in combined minority death rate resulted from a decrease in the Hispanic/Latino white rate. Death rate did not decline in the black or African American population. Conclusions: All minority groups continue to display a disproportionate number of unintentional non-fire-related CO poisoning deaths compared to non-Hispanic/Latino whites. The decrease in U.S. deaths from unintentional non-fire-related carbon monoxide poisoning from 2000-2017 is accounted for by a decrease in non-Hispanic/Latino white deaths. While numbers of such deaths among minority groups have not changed since 2000, increases in the size of minority populations have resulted in a declining crude death rate for Hispanic/Latino whites.


Assuntos
Intoxicação por Monóxido de Carbono/etnologia , Intoxicação por Monóxido de Carbono/mortalidade , Grupos de Populações Continentais/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Masculino , Mortalidade/tendências , Estados Unidos/epidemiologia
15.
Mo Med ; 116(3): 184-187, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31527937

RESUMO

Hyperbaric oxygen therapies may have grown out of emergencies such as those for Decompression Sickness (DCS), but more commonly in the U.S., hyperbaric oxygen is used for much more elective problems. Wound healing applications lead this trend. Nationally many more hyperbaric centers exist to treat elective problems adjunctively, and this is a concise review of these indications as well as pointing out where even elective centers might be able to broaden their practices.


Assuntos
Intoxicação por Monóxido de Carbono/terapia , Estado Terminal/terapia , Oxigenação Hiperbárica/instrumentação , Cicatrização , Lesões por Esmagamento/terapia , Doença da Descompressão/terapia , Humanos , Osteomielite/terapia
16.
Pediatr Cardiol ; 40(8): 1638-1644, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31485699

RESUMO

Troponin is a marker that displays cardiac injury quickly and accurately. In adults, troponin elevation is usually associated with coronary artery disease and requires urgent cardiac catheterization. In healthy children, myocardial injury is rare and may develop due to many different causes. Therefore, troponin elevation in children and adolescents does not usually require emergency cardiac catheterization. The aim of this study is to assess the most common causes of troponin elevation in children and adolescents and to show which diagnostic tests are helpful in assessing pediatric patients with elevated troponin. Patients who had been diagnosed with troponin I elevation (> 0.06 ng/ml) at Dr. Sami Ulus Maternity, Children's Health and Disease Training and Research Hospital between 2007 and 2018 were retrospectively evaluated. Patients undergoing cardiac surgery and those with severe congenital heart disease were excluded from the study. The medical records of the patients were examined and age, gender, diagnostic tests, and diagnosis were evaluated. During the study period, the records of 972 patients were obtained. 213 patients were excluded from the study because of heart surgery, congenital heart disease, and neonatal asphyxia or sepsis. Of the remaining 759 patients, 58% were male, 42% were female, and the median age was 4 years (3 days to 17 years). The most frequent causes are myopericarditis (n: 164), drug intoxications (n: 85), carbon monoxide poisoning (n: 74), perimyocarditis (n: 65), and intensive inhalation ß agonist use in acute asthma and lower respiratory tract infections (n: 70). Patients diagnosed with myocarditis and myopericarditis were admitted with a complaint of chest pain, and the diagnosis was made by history, physical examination, ECG, and echocardiographic findings. Unlike adults, troponin I elevation may be associated with many cardiac and non-cardiac pathologies in children. The most common pathologies in cardiac etiology are myopericarditis and perimyocarditis and can be diagnosed by history, physical examination, ECG, and echocardiography. Cardiac catheterization is not necessary except for rare cardiac pathologies and does not alter the prognosis.


Assuntos
Miocardite/sangue , Troponina I/sangue , Adolescente , Biomarcadores/sangue , Intoxicação por Monóxido de Carbono/sangue , Intoxicação por Monóxido de Carbono/diagnóstico , Estudos de Casos e Controles , Criança , Pré-Escolar , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/sangue , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/diagnóstico , Ecocardiografia , Eletrocardiografia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Miocardite/diagnóstico , Estudos Retrospectivos
17.
Hum Exp Toxicol ; 38(11): 1235-1243, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31423839

RESUMO

OBJECTIVE: In this study, we aimed to investigate oxidative stress and antioxidant parameter levels in patients with carbon monoxide (CO) poisoning. METHODS: The study was conducted prospectively between March 1, 2015 and April 30, 2016 in the pediatric emergency department. Eligible patients included children aged 0-18 years old with a diagnosis of CO poisoning. To determination of oxidative stress and antioxidant parameter levels, venous blood with heparinized and urine samples were drawn during the admission and after normobaric oxygen (NBO) and hyperbaric oxygen (HBO) treatment. RESULTS: Forty-seven children with CO poisoning for study group and 29 patients as control group were included to the study. Sixteen patients treated with HBO. Basal plasma malondialdehyde levels were found to be significantly higher in the CO poisoning group when compared with the control group (p = 0.019). There is no significant difference in oxidative stress and antioxidant parameter levels except erythrocyte catalase enzyme levels in patients treated with NBO when comparing before and after NBO treatment (p > 0.05). Decreasing of basal erythrocyte catalase enzyme levels were found statistically significant after NBO treatment (p = 0.04). There was no significant difference in oxidative stress and antioxidant parameter levels in patients treated with HBO before and after therapy (p > 0.05). CONCLUSIONS: CO poisoning is associated with increased lipid peroxidation in children immediately after the poisoning. However, both treatment modalities including NBO or HBO do not have a significant effect on oxidative stress or antioxidant parameter levels.


Assuntos
Intoxicação por Monóxido de Carbono/sangue , Intoxicação por Monóxido de Carbono/terapia , Estresse Oxidativo , Oxigenoterapia , Adolescente , Carboxihemoglobina/análise , Catalase/sangue , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Peroxidação de Lipídeos , Masculino , Malondialdeído/sangue , Superóxido Dismutase/sangue
18.
Zhongguo Zhen Jiu ; 39(7): 697-702, 2019 Jul 12.
Artigo em Chinês | MEDLINE | ID: mdl-31286729

RESUMO

OBJECTIVE: Quantitative assessment of white blood flow in semi-oval center of patients with delayed neuropathological sequelae (DNS) after carbon monoxide poisoning treated with acupuncture combined with hyperbaric oxygen (HBO) based on magnetic resonance multi-inversion time arterial spin labeling imaging (mTI-ASL), and to evaluate its efficacy indirectly. METHODS: Twenty-six patients with clinically diagnosed DNS were randomly divided into an observation group (13 cases) and a control group (13 cases). The conventional therapy combined with HBO were given in the control group. In the observation group,on the base of the treatment, Xingnao Kaiqiao acupuncture was applied, the main acupoints were Shuigou (GV 26), Neiguan (PC 6), Baihui (GV 20), Shangxing (GV 23), Yintang (GV 29), Sanyinjiao (SP 6) on the affected side, Sishencong (EX-HN 1), Fenglong (ST 40), Lianquan (CV 23) and Jinjin (EX-HN12) for slurred speech, Jianyu (LI 15), Waiguan (TE 5) and Shousanli (LI 10) for upper limb pain, Huantiao (GB 30), Yanglingquan (GB 34), Yinlingquan (SP 9) for lower limb pain, the treatment was given once every day, 5 days as one course, with an interval of 2 days between the course. The treatment for 6 courses was required. The conventional head MR scan, mTI-ASL and diffusion tensor imaging (DTI) scans before and 1 week after treatment were adopted, Matlab (R2014b), Mricron and Syngo.via software were adopted to measure the cerebral blood flow (CBF) and anisotropy (FA) values of the semi-oval center. The correlation between the parameters was evaluated by Pearson method. And the simple intelligent mental state examination scale (MMSE) was uesd to assess cognitive function. RESULTS: After treatment, the CBF, MMSE scores in both groups and FA values in the observation group were higher than those before treatment (P<0.05). After treatment, the CBF, FA and MMSE scores in the observation group were significantly higher than those in the control group (P<0.05). There was a positive correlation between CBF, FA and MMSE scores (P<0.05), and the correlation between CBF and MMSE was the best (r =0.822). CONCLUSION: Acupuncture combined with hyperbaric oxygen can significantly improved early white matter hypoperfusion and improved cognitive function score in patients with DNS. The curative effect is better than that of hyperbaric oxygen therapy alone. The mTI-ASL imaging can quantitatively evaluate its curative effect.


Assuntos
Terapia por Acupuntura , Intoxicação por Monóxido de Carbono , Oxigenação Hiperbárica , Imagem de Tensor de Difusão , Humanos
19.
Dev Period Med ; 23(2): 142-148, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31280252

RESUMO

Hyperbaric oxygen therapy (HBOT), which is a centuries-old treatment, has now increasingly often been used in the pediatric population. The basic indications for HBOT are well-known disease entities, i.e. carbon monoxide poisoning or decompression sickness. Due to the immunomodulatory properties of hyperbaric oxygen, attempts are made to use HBOT in the treatment of atopic dermatitis or inflammatory bowel diseases. The close cooperation between pediatricians and hyperbaric medicine teams is very important to obtain optimal results. The aim of this article is to present the mechanism of hyperbaric oxygen activity, and its influence on selected disease entities. The paper outlines new perspectives for HBOT in the pediatric population.


Assuntos
Medicina Baseada em Evidências , Oxigenação Hiperbárica , Adolescente , Infecções Bacterianas/terapia , Intoxicação por Monóxido de Carbono/terapia , Criança , Pré-Escolar , Doença da Descompressão/terapia , Dermatite Atópica/terapia , Humanos , Lactente , Recém-Nascido , Doenças Inflamatórias Intestinais/terapia , Pediatria
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