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2.
Clin Toxicol (Phila) ; 57(2): 104-111, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30073854

RESUMO

BACKGROUND: Consumption of yellow oleander (Cascabela thevetia) is a popular method of intentional self-harm in South India. OBJECTIVES: The objectives of this study were to identify the cardiac arrhythmias and electrolyte abnormalities in yellow oleander poisoning and to identify the association between electrolyte abnormalities, cardiac glycoside concentrations at admission and the severity of cardiotoxicity. This study was also designed to identify clinical and biochemical parameters at presentation which predict serious arrhythmias and determinants of mortality. MATERIALS AND METHODS: This was a prospective study among 192 patients who attended our Emergency department after consuming yellow oleander seeds. Patients were monitored with serial ECGs. Serious cardiac arrhythmias included sinus bradycardia <40/min, sinus arrest/exit block, second or third degree AV block, atrial tachyarrhythmias and ventricular tachyarrhythmias. Serum sodium, potassium, magnesium, total calcium and cardiac glycoside concentrations were measured at presentation for all 192 patients. Serial estimation of cardiac glycoside concentration was done in 43 patients who presented within 24 hours of consuming at least five seeds. RESULTS: At presentation, 46 patients had serious arrhythmias and on follow-up, 11 developed new-onset serious arrhythmia. Sinus bradycardia (27%) was the most common arrhythmia followed by second-degree AV block (17%); multiple arrhythmias were observed in 18%. Digoxin effect in ECG correlated significantly with hyperkalemia. Mortality rate was 5%. Serum sodium, total calcium and magnesium levels did not correlate with cardiotoxicity. Cardiac glycoside concentration was of relatively modest clinical utility to discriminate patients with serious dysrhythmias (AUC: 0.719, 95% CI: 0.63-0.81). Prolonged PR interval and digoxin effect in ECG were significantly associated with an increased likelihood of serious dysrhythmias. Increase in 0.4 number of seed intake increased the odds of mortality by 1.5 times when all other independent variables were kept constant. CONCLUSION: Cardiac glycoside concentration at the time of presentation predicted the development of new-onset serious arrhythmias. Although serum potassium correlated significantly with cardiac glycoside concentration at admission and overall serious dysrhythmias, it did not predict the development of new-onset serious arrhythmia. On the whole, serious dysrhythmias were significantly associated with higher number of seeds ingested, hypotension at admission, PR interval prolongation, presence of digoxin effect in ECG, hyperkalemia and higher cardiac glycoside concentration. The independent determinants of mortality were larger number of seeds ingested and hypotension at admission. Cardiac glycoside concentration and hyperkalemia failed to be independent markers of serious dysrhythmias as well as mortality.


Assuntos
Arritmias Cardíacas/etiologia , Glicosídeos Cardíacos/sangue , Intoxicação por Plantas/etiologia , Thevetia/envenenamento , Desequilíbrio Hidroeletrolítico/etiologia , Adolescente , Adulto , Eletrocardiografia , Serviço Hospitalar de Emergência , Feminino , Humanos , Índia , Masculino , Intoxicação por Plantas/sangue , Intoxicação por Plantas/fisiopatologia , Estudos Prospectivos , Sementes/envenenamento , Adulto Jovem
4.
Clin Toxicol (Phila) ; 56(9): 841-845, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29490507

RESUMO

INTRODUCTION: Steroidal alkaloids are found in plants of the genus Veratrum. Their toxicity manifests as gastrointestinal symptoms followed by a Bezold-Jarisch reflex: hypopnea, hypotension, and bradycardia. Some Veratrum steroidal alkaloids are also teratogens interfering with the hedgehog-2 signaling pathway, which causes cyclopsia and holoprosencephaly. We present a case of accidental poisoning from Veratrum parviflorum mistaken for the edible Allium tricoccum (ramps, wild leek). CASE HISTORY: A 27-year-old man and his 25-year-old wife presented to the emergency department with nausea, vomiting, hypotension, and bradycardia after foraging and ingesting plants that they believed to be a local native species of wild leek. METHODS: We collected and analyzed the implicated fresh plant material and both patients' serum/plasma. We used liquid chromatography-mass spectroscopy and high-resolution electrospray ionization time of flight tandem mass spectrometry to extract and characterize steroidal alkaloids from the foraged plant and patients' serum. RESULTS: Our V. parviflorum samples contained verazine, veratramine, veratridine, and cyclopamine. DISCUSSION: Steroidal alkaloids have been previously isolated from Veratrum viride and Veratrum album and toxicity has been reported mainly from V. album species. CONCLUSION: V. parviflorum toxicity manifests with gastrointestinal and cardiac symptoms. Treatment is symptomatic and supportive as with previous case reports of toxicity with other Veratrum species.


Assuntos
Antieméticos/uso terapêutico , Gastroenteropatias/tratamento farmacológico , Intoxicação por Plantas/tratamento farmacológico , Intoxicação por Plantas/fisiopatologia , Alcaloides de Veratrum/envenenamento , Veratrum/envenenamento , Vômito/tratamento farmacológico , Adulto , Feminino , Gastroenteropatias/etiologia , Georgia , Humanos , Masculino , Resultado do Tratamento , Vômito/etiologia
5.
Pesqui. vet. bras ; 37(12): 1357-1368, dez. 2017.
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-895398

RESUMO

This review updates information about neurotoxic plants affecting ruminants and equidae in Brazil. Currently in the country, there are at least 131 toxic plants belonging to 79 genera. Thirty one of these poisonous plants affect the nervous system. Swainsonine-containing plants (Ipomoea spp., Turbina cordata and Sida carpinifolia) cause numerous outbreaks of poisoning, mainly in goats, but cattle and horses are occasionally affected. The poisoning by Ipomoea asarifolia, a tremorgenic plant, is very common in sheep, goats and cattle in the Northeastern region and in the Marajo island. Poisoning by the pods of Prosopis juliflora are frequent in cattle in Northeastern Brazil; occasionally this poisoning affects goats and more rarely sheep. Some poisonings by plants, such as Hybanthus calceolaria, Ipomoea marcellia and Talisia esculenta in ruminants and Indigofera lespedezioides in horses were recently described and needs to be accurately investigated about its occurrence and importance. Other plants poisonings causing nervous signs in ruminants and equidae are less important, but should be considered for the differential diagnosis of neurologic diseases.(AU)


Esta revisão tem por objetivo atualizar as informações sobre plantas neurotóxicas que afetam ruminantes e equinos no Brasil. Atualmente sabe-se que existe no país pelo menos 131 plantas tóxicas pertencentes a 79 gêneros. Trinta e uma espécies afetam o sistema nervoso. As plantas quem contém swainsonina (Ipomoea spp., Turbina cordata and Sida carpinifolia) causam numerosos surtos de intoxicação, principalmente em caprinos, mas bovinos e cavalos são ocasionalmente afetados. A intoxicação por Ipomoea asarifolia, uma planta tremorgênica, é muito comum em ovinos, caprinos e bovinos na região Nordeste e na ilha de Marajó. A intoxicação pelas vagens de Prosopis juliflora é frequente em bovinos no Nordeste do Brasil; ocasionalmente são afetados caprinos e mais raramente ovinos. Algumas intoxicações por plantas, como Hybanthus calceolaria, Ipomoea marcellia e Talisia esculenta em ruminantes e Indigofera lespedezioides em equinos foram recentemente descritas e precisam ser investigadas com precisão sobre sua ocorrência e importância. Outras intoxicações por plantas que causam sinais nervosos em ruminantes e equídeos são menos importantes, todavia devem ser consideradas para o diagnóstico diferencial de doenças neurológicas.(AU)


Assuntos
Animais , Intoxicação por Plantas/fisiopatologia , Intoxicação por Plantas/veterinária , Plantas Tóxicas , Ruminantes , Agentes Neurotóxicos/análise , Cavalos , Sistema Nervoso , Brasil
6.
Indian J Med Res ; 143(6): 793-797, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27748304

RESUMO

BACKGROUND & OBJECTIVES: Ingestion of Cleistanthus collinus causes hypokalemia and cardiac arrhythmias leading to mortality in most cases. We undertook this retrospective study to evaluate the clinical presentation and predictors of outcome in critically ill patients admitted with C. collinus poisoning. METHODS: The case records of 56 patients admitted to the medical intensive care unit (MICU) of a tertiary care teaching hospital in south India (2000-2014) with C. collinus poisoning were retrospectively analysed. RESULTS: The mean age of patients was 36.7±13.3 yr; there were 30 males. Salient clinical manifestations included hypokalemia (58%), neutrophilic leucocytosis (48.2%), acute kidney injury (AKI) (42.9%), acute respiratory failure requiring mechanical ventilation (AcRFMv) (32.1%), shock (21.4%); cardiac arrhythmias and neuromuscular weakness (19.6% each); 21 patients (37.5%) had adverse outcome. Longer time-lapsed from consumption to reaching emergency room [median (interquartile range)] (hours) [49 (22-97) vs. 28 (7-56), p =0.0380 ]; higher acute physiology and chronic health evaluation II (APACHE II) score at presentation [14 (8.25-14.75) vs. 2 (0-6) P<0.001]; and presence of the following [odds ratio (95% confidence intervals)] at initial presentation: shock [37.40 (4.29-325.98), P=0.001]; AcRFMv [26.67 (5.86-121.39), P<0.001]; elevated alanine aminotransferase [5.71 (1.30-25.03), p0 =0.021]; metabolic acidosis [5.48 (1.68-17.89), P=0.005]; acute kidney injury (AKI) [5 (1.55-16.06), P=0.007]; hyponatremia [4.67 (1.25-17.44), P=0.022]; and neutrophilic leucocytosis [3.80 (1.02-14.21), P=0.047] predicted death. A significant (P<0.001) increasing trend in mortality was observed with increasing International Program on Chemical Safety Poisoning Severity Score (IPCS-CSS) grade. INTERPRETATION & CONCLUSIONS: C. collinus is a lethal poison associated with high mortality for which there is no specific antidote. Careful search and meticulous monitoring of the predictors of death and initiating appropriate corrective measures can be life saving.


Assuntos
Lesão Renal Aguda/fisiopatologia , Arritmias Cardíacas/fisiopatologia , Euphorbiaceae/toxicidade , Hipopotassemia/fisiopatologia , Intoxicação por Plantas/fisiopatologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Índia , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Centros de Atenção Terciária
7.
Clin Toxicol (Phila) ; 54(9): 878-880, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27436403

RESUMO

INTRODUCTION: Common yew (Taxus baccata) is a common decorative evergreen shrub with potentially fatal toxicity hallmarked by seizure, arrhythmia and cardiovascular collapse if ingested. Taxine B has been identified as one of the most cardiotoxic taxine alkaloids in Taxus spp, and another alkaloid, 3,5-dimethoxyphenol (3,5-DMP), is used as a marker of ingestion. We present a fatal case of ingestion of yew with perimortem serum and gastric taxine B, and 3,5-DMP concentrations. CASE PRESENTATION: A 22-year-old woman was brought to the emergency department (ED) from a nearby botanical garden after she was found apneic and pulseless after a witnessed generalized tonic clonic seizure. The patient was found to have a wide complex rhythm with persistent cardiovascular collapse and expired despite maximal supportive care in the ED. A baggie of plant material was found on the patient, identified as Taxus baccata. Perimortem serum and gastric samples were analyzed to quantify serum and gastric taxine B and 3,5-DMP concentrations. RESULTS: Perimortem serum showed a 3,5-DMP concentration of 86.9 ng/mL, and taxine B of 80.9 ug/mL. CONCLUSION: We report a perimortem serum and gastric taxine B and 3,5-DMP concentrations in a fatal case of T. baccata toxicity.


Assuntos
Alcaloides/sangue , Floroglucinol/análogos & derivados , Intoxicação por Plantas/fisiopatologia , Taxoides/sangue , Taxus/envenenamento , Alcaloides/metabolismo , Serviço Hospitalar de Emergência , Evolução Fatal , Feminino , Humanos , Floroglucinol/sangue , Floroglucinol/metabolismo , Convulsões/etiologia , Taxoides/metabolismo , Adulto Jovem
8.
J Trop Pediatr ; 62(6): 487-489, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27240665

RESUMO

Cleistanthus collinus, also known as Oduvanthalai in Tamil, is the most commonly encountered plant poison in southern India. The leaves are used for poisoning humans (suicide or homicide) and animals (cattle and fish) and as an abortifacient, especially in rural south India. Although this poisoning is commonly reported in adults, data regarding the use of N-acetylcysteine in pediatric poisoning is lacking. We report two previously healthy male siblings of pediatric age group who ingested the liquid extracted from crushed leaves of this plant given to them by their mother as a means of deliberate harm. Both patients developed distal renal tubular acidosis, with hypokalemia. The younger sibling also developed myocardial toxicity. Other significant findings noted include hypocalcemia, hypomagnesemia and elevated liver enzymes. Both patients received supportive care along with N-acetylcysteine infusion, and showed complete recovery within 10 days.


Assuntos
Acetilcisteína/administração & dosagem , Lesão Renal Aguda/induzido quimicamente , Glicosídeos/envenenamento , Túbulos Renais/fisiopatologia , Extratos Vegetais/envenenamento , Intoxicação por Plantas/fisiopatologia , Criança , Humanos , Concentração de Íons de Hidrogênio , Hipopotassemia/induzido quimicamente , Masculino , Tentativa de Suicídio , Resultado do Tratamento , Vômito/induzido quimicamente
9.
Toxicon ; 118: 91-4, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27125469

RESUMO

In the semiarid region of Brazil, in areas with vegetation composed mainly of Poincianella pyramidalis, several cases of congenital malformation and reproductive losses were observed in goats and sheep from 2012 to 2014. To determine the teratogenic effect of P. pyramidalis, two groups of eight goats each were used. Goats from Group 1 received fresh P. pyramidalis, harvested daily, as the only roughage during the whole breeding and pregnancy period. Goats in Group 2 (control) received Cynodon dactylon (tifton) hay free choice. Ultrasound examination for pregnancy diagnosis was performed every 28 days. Four goats from Group 1 were pregnant on day 28 but not on day 56, suggesting embryonic death or abortion. Another goat from Group 1 died at day 70 of pregnancy, and the fetuses exhibited micrognathia. The other three goats bore six kids, three of which showed bone malformations in the limbs, spine, ribs, sternum, and head, including arthrogryposis, scoliosis and micrognathia. One kid also showed hypoplasia of the left pulmonary lobes. In the control group, all goats bore a total of 13 kids and none of them exhibited malformations. These results demonstrated that P. pyramidalis causes congenital malformations and other reproductive losses in goats.


Assuntos
Anormalidades Induzidas por Medicamentos/veterinária , Aborto Animal/induzido quimicamente , Caesalpinia/toxicidade , Reabsorção do Feto/veterinária , Doenças das Cabras/induzido quimicamente , Doenças das Cabras/etiologia , Intoxicação por Plantas/veterinária , Complicações na Gravidez/veterinária , Animais , Artrogripose/induzido quimicamente , Artrogripose/veterinária , Brasil , Cynodon , Feminino , Reabsorção do Feto/induzido quimicamente , Doenças das Cabras/fisiopatologia , Cabras , Micrognatismo/induzido quimicamente , Micrognatismo/veterinária , Componentes Aéreos da Planta/toxicidade , Intoxicação por Plantas/fisiopatologia , Gravidez , Complicações na Gravidez/fisiopatologia , Escoliose/induzido quimicamente , Escoliose/veterinária
12.
Toxicon ; 99: 125-9, 2015 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-25817002

RESUMO

BACKGROUND: Toxalbumins are natural plant toxins purported to be highly toxic. The purpose was to evaluate toxalbumin exposures reported to U.S. poison centers to determine plants involved and their toxicities. METHODS: A retrospective review of National Poison Data System data on acute toxalbumin exposures with known outcomes from 2000 through 2011 was performed. RESULTS: There were 1164 exposures. The majority involved one route (1135; 97.5%), mostly ingestions (904; 79.7%) or dermal (166; 14.3%). Most patients developed no effects (694; 59.6%) or minor effects (374; 32.1%). Moderate or major effects occurred in 8.3% with 66.6% ingestions and 23.9% dermal. There were no deaths. Exposures to the plants Ricinus communis and Robinia pseudoacacia were most common (33.8% and 32.9%, respectively), with gastrointestinal effects from R. communis (vomiting 19.6%, diarrhea 8.9%, nausea 7.9%) and dermal effects from R. pseudoacacia (puncture 28.7%, dermal irritation/pain 27.9%, and edema 13.3%). CONCLUSIONS: While toxalbumin plant exposures were generally well-tolerated, continued evaluation of risk is warranted since plants were primarily identified by the public. Major effects occurred in under 1% of cases overall, and not at all following unintentional ingestions. These findings should help allay concerns that unintentional ingestions of toxalbumin plants by young children will cause serious toxicity and possibly death.


Assuntos
Semente de Rícino/toxicidade , Lectinas de Plantas/toxicidade , Intoxicação por Plantas/etiologia , Ricina/toxicidade , Robinia/toxicidade , Toxinas Biológicas/toxicidade , Doença Aguda , Adulto , Doenças Assintomáticas/epidemiologia , Doenças Assintomáticas/terapia , Criança , Bases de Dados Factuais , Dermatite de Contato/epidemiologia , Dermatite de Contato/etiologia , Dermatite de Contato/fisiopatologia , Dermatite de Contato/terapia , Feminino , Gastroenterite/etiologia , Humanos , Masculino , Neurotoxinas/toxicidade , Intoxicação por Plantas/epidemiologia , Intoxicação por Plantas/fisiopatologia , Intoxicação por Plantas/terapia , Centros de Controle de Intoxicações , Estudos Retrospectivos , Estados Unidos/epidemiologia
13.
Toxicon ; 99: 36-43, 2015 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-25772859

RESUMO

Larkspurs (Delphinium spp.) are poisonous plants on rangelands throughout the Western United States and Canada. Larkspur-induced poisoning in cattle is due to norditerpene alkaloids that are represented by two main structural groups of norditerpene alkaloids, the N-(methylsuccinimido) anthranoyllycoctonine type (MSAL-type) and the non-MSAL type. Information on the alkaloid composition and resulting toxicity in mice and cattle is lacking for a number of Delphinium species, including Delphinium stachydeum. The objective of this study was to determine the alkaloid composition of D. stachydeum and to characterize its relative toxicity in mice and cattle compared to two reference species Delphinium barbeyi and Delphinium occidentale. D. stachydeum contains the non-MSAL-type alkaloids but not the MSAL-type alkaloids. D. stachydeum was less toxic than D. barbeyi and D. occidentale in the mouse model. D. stachydeum was less toxic than the MSAL-containing D. barbeyi but much more toxic than the non-MSAL-containing D. occidentale in cattle as measured by heart rate and time of exercise. These results indicate that predictions of Delphinium toxicity can't be accurately made based solely on results from the mouse model or the absence of the MSAL-type alkaloids in the plant.


Assuntos
Alcaloides/toxicidade , Doenças dos Bovinos/fisiopatologia , Delphinium/toxicidade , Componentes Aéreos da Planta/toxicidade , Extratos Vegetais/toxicidade , Intoxicação por Plantas/veterinária , Toxinas Biológicas/toxicidade , Alcaloides/análise , Alcaloides/química , Alcaloides/isolamento & purificação , Animais , Bovinos , Doenças dos Bovinos/etiologia , Delphinium/química , Delphinium/crescimento & desenvolvimento , Diterpenos/análise , Diterpenos/química , Diterpenos/isolamento & purificação , Diterpenos/toxicidade , Humanos , Coxeadura Animal/etiologia , Dose Letal Mediana , Masculino , Camundongos , Debilidade Muscular/etiologia , Nevada , Oregon , Componentes Aéreos da Planta/química , Componentes Aéreos da Planta/crescimento & desenvolvimento , Extratos Vegetais/química , Extratos Vegetais/isolamento & purificação , Intoxicação por Plantas/etiologia , Intoxicação por Plantas/fisiopatologia , Especificidade da Espécie , Taquicardia/etiologia , Toxinas Biológicas/análise , Toxinas Biológicas/química , Toxinas Biológicas/isolamento & purificação , Tremor/etiologia , Utah
14.
J Med Toxicol ; 11(1): 141-3, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25252802

RESUMO

Oleander poisoning typically results in cardiac arrhythmias, hyperkalemia, and gastrointestinal irritation, and can be fatal. Oleander extracts have also been studied experimentally as hypoglycemic agents. Here, we describe a dog with confirmed oleander toxicosis presenting with classical symptoms and also hypoglycemia. After excluding other likely causes of hypoglycemia, the finding was attributed to oleander toxicosis, which has not been previously reported in dogs. A 7-year-old female spayed Maltese was presented to the emergency service after ingesting oleander leaves. Toxicosis was confirmed by measurement of digoxin using a competitive binding immunoassay, patient level 0.7 ng/mL (0.9 nmol/L) 24-h post-ingestion. Clinical symptoms included vomiting, cardiac arrhythmia, mild hyperkalemia, and hypoglycemia. Treatment was successful with aggressive supportive care, and the dog was discharged from the hospital after 48 h and made a full recovery. This case reviews the presentation and treatment of oleander toxicity but also highlights possible effects of oleander on blood sugar in dogs. Hypoglycemia in this dog, attributed to oleander poisoning, is interesting as it supports experimental research into hypoglycemic properties of oleander extracts.


Assuntos
Doenças do Cão/induzido quimicamente , Hipoglicemia/veterinária , Nerium/toxicidade , Folhas de Planta/toxicidade , Intoxicação por Plantas/veterinária , Animais , Animais Endogâmicos , Terapia Combinada/veterinária , Reações Cruzadas , Digoxina/sangue , Doenças do Cão/sangue , Doenças do Cão/fisiopatologia , Doenças do Cão/terapia , Cães , Tratamento de Emergência/veterinária , Feminino , Hospitais Veterinários , Hipoglicemia/induzido quimicamente , Hipoglicemia/etiologia , Imunoensaio/veterinária , Intoxicação por Plantas/sangue , Intoxicação por Plantas/fisiopatologia , Intoxicação por Plantas/terapia , Resultado do Tratamento
16.
Clin Toxicol (Phila) ; 52(4): 265-8, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24579983

RESUMO

CONTEXT: Ingestions of the seed of the castor bean plant (Ricinus communis) carries the risk of toxicity from ricin, a potent inhibitor of protein synthesis. OBJECTIVE: We sought to describe characteristics of castor bean seed exposures reported to a state-wide poison control system. METHODS: This was an observational case series. A state-wide poison control system's database was reviewed for exposures to castor bean plant seeds from 2001 to 2011. Case notes were reviewed and data collected, when available, included age, gender, circumstances surrounding exposure, number of castor beans consumed, whether beans were chewed or crushed, symptoms described, laboratory values (aspartate aminotransferase [AST], alanine aminotransferase [ALT], prothrombin time [PT] and international normalized ratio [INR]), duration of follow-up, treatment, and patient outcomes. RESULTS: Eighty-four cases were identified. Ingestions were unintentional in 50 cases (59%) cases and intentional in 34 (40%) cases. A median of 10 seeds (range: 1-20) were ingested in intentional cases versus 1 seed (range: 1-40) in unintentional cases. In 49 (58%) of cases the seeds were reported to have been chewed or crushed. Gastrointestinal symptoms were the most commonly reported symptoms. Vomiting (n = 39), nausea (n = 24), diarrhea (n = 17), and abdominal pain (n = 16) predominated. One patient developed hematochezia and vomiting after reportedly ingesting and intravenously injecting castor bean seeds. Laboratory values were documented in 17 (20%) cases. Only one abnormality was noted; an asymptomatic patient one week following ingestion had AST/ALT of 93 U/L and 164 U/L, respectively. Ricinine was confirmed in the urine of two patients. Twenty-three (27%) cases received activated charcoal. Seventy-two (86%) of cases were calls from health care facilities or referred to health care facilities by the poison control center. Twenty-two (26%) cases were admitted for a median of 2 days (range: 1-10). Admitted cases ingested a median of 8.5 seeds (range: 1-20). Intentional ingestions were followed for median of 37.5 h (range: 0.5-285.5) while unintentional cases were followed for 14 h (range: 1-182). No delayed symptoms, serious outcomes, or deaths were reported. DISCUSSION: Due to the presence of ricin, there is concern for serious outcomes after ingestions of the seeds of the castor bean plant. In this study GI symptoms were most commonly reported but serious morbidity or mortality was not present. The true risk of castor bean plant seed ingestions should continue to be re-evaluated. CONCLUSION: In this retrospective review, gastrointestinal symptoms were the most common symptoms described after reported exposures to castor bean seeds. These exposures were not associated with serious morbidity, mortality, or delayed symptoms.


Assuntos
Semente de Rícino/toxicidade , Intoxicação por Plantas/epidemiologia , Intoxicação por Plantas/terapia , Ricina/toxicidade , Sementes/toxicidade , Acidentes , Adolescente , Adulto , Idoso , Antídotos/uso terapêutico , Carvão Vegetal/uso terapêutico , Criança , Pré-Escolar , Serviços Médicos de Emergência , Feminino , Humanos , Kansas/epidemiologia , Masculino , Náusea/etiologia , Intoxicação por Plantas/etiologia , Intoxicação por Plantas/fisiopatologia , Centros de Controle de Intoxicações , Estudos Retrospectivos , Vômito/etiologia
19.
Pesqui. vet. bras ; 33(1): 47-51, Jan. 2013. ilus
Artigo em Português | LILACS | ID: lil-668091

RESUMO

São descritos surtos de intoxicação espontânea por Cestrum intermedium em bovinos leiteiros do Município de Salgado Filho, sudoeste do Estado do Paraná, com morte de dezesseis bovinos de um total de 72 de quatro pequenas propriedades. O histórico obtido nessas propriedades incluía curso clínico agudo, com morte em menos de 24 horas. Em todas foram observadas elevada lotação por área com escassa pastagem disponível e grande quantidade de plantas arbustivas identificadas como C. intermedium e com sinais de terem sido consumidas pelos animais. Dois bovinos foram necropsiados e os achados mais importantes foram congestão de mucosas conjuntivais e vulvovestibular; hemorragias e evidenciação do padrão lobular no fígado; hemorragia, congestão e edema pulmonares; congestão esplênica e encefálica, além de hemorragias multifocais no coração. Amostras de tecidos desses bovinos foram avaliadas, com alterações histológicas importantes no fígado, caracterizadas por necrose acentuada de hepatócitos e hemorragia, indicativas de hepatopatia tóxica aguda e, no encéfalo, foram observadas alterações astrocitárias em substância branca de cérebro e cerebelo e na substância cinzenta do cerebelo, caracterizadas por tumefação celular com citoplasma amplo e eosinofílico, núcleo picnótico, ora excêntrico. Essas alterações astrocitárias foram evidenciadas pela técnica de imuno-histoquímica (IHQ), com imunomarcação fortemente positiva para os anticorpos anti-proteína S100 (anti-S100) e anti-proteína glial fibrilar ácida (anti-GFAP). O trabalho visa enfatizar em lesões encefálicas relacionadas à hepatotoxicidade aguda em bovinos.


Assuntos
Animais , Feminino , Bovinos , Bovinos , Cestrum/envenenamento , Intoxicação por Plantas/fisiopatologia , Intoxicação por Plantas/veterinária , Autopsia/veterinária , Imuno-Histoquímica , Fígado
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