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1.
Artigo em Chinês | MEDLINE | ID: mdl-34074079

RESUMO

Objective: To analyze the incidence characteristics of occupational chronic benzene poisoning under two diagnostic criteria. Methods: In March 2020, 126 patients who were divided into the old criteria group (74 cases) and the new criteria group (52 cases) were retrospectively analyzed. These patients were diagnosed with occupational chronic benzene poisoning, and were diagnosed in our hospital during the period of January 2009 to December 2019. The gender composition, age of onset, years of benzene exposure, industry distribution, work type, benzene concentration in working environment and diagnostic grade of the two groups of patients were analyzed and compared. The follow-up of 22 benzene poisoning observation subjects under the old criteria were retrospectively analyzed. Results: There were no statistically significant differences in gender composition, age of onset, years of benzene exposure, industry distribution and work type between the old criteria group and the new criteria group (P>0.05) . In the old criteria group and the new criteria group, 41.9% (31/74) and 17.3% (9/52) of the patients' workplace benzene concentration exceeded the maximum allowable concentration, respectively. The composition of different benzene concentration in the workplace between the two groups showed statistically significant (P<0.05) . In the old criteria group, the proportion of mild poisoning (79.7%, 59/74) was the majority, while in the new criteria group, the proportion of moderate and severe poisoning (51.9%, 27/52) were the majority, and there was statistically significance in the composition ratio of diagnostic grade between the two groups (P<0.05) . Under the old criteria, after folow-up of 22 cases of benzene poisoning observation subjects, we observed that 8 cases (36.4%) progressed to the level of chronic benzene poisoning. Conclusion: The revision of diagnostic criteria for benzene poisoning may affect the composition of diagnosis classification. Based on the rights and interests of workers, formulating more complete diagnostic criteria and system policies will be more conducive to the development of occupational benzene poisoning prevention and control.


Assuntos
Doenças Profissionais , Exposição Ocupacional , Envenenamento , Benzeno , Doença Crônica , Humanos , Incidência , Estudos Retrospectivos
2.
Artigo em Chinês | MEDLINE | ID: mdl-34074081

RESUMO

Objective: To further improve the awareness of the clinical feature of acute diquat poisoning. Methods: A retrospective analysis was performed on 4 cases of acute diquat poisoning with epileptoid seizure as the main clinical manifestation, which were admitted and diagnosed by the Characteristic Medical Center of Chinese People's Armed Police Force from January 1, 2017 to December 31, 2019. Take "Diquat" or "Deiquat" or "Reward" as keyword search for CNKI, Pubmed, and EMbase in both Chinese and English. The date of literature retrieval was from the database founding to December 31, 2019. Results: Of the 4 patients, 3 were male and 1 female, with an average age of 28 years (22-33 years) . The estimated dose was 8-20 g. All patients were treated with gastric lavage, catharsis, fluid replacement, blood perfusion, and in the early stage of treatment of epileptic seizures, the initial routine antiepileptic drugs had poor effect. Then propofol and midazolam were injected into the treatment. The epilepsy was relieved, but the condition deteriorated rapidly, and the patients died eventually. The literature search retrieved 3 patients in the 3 literatures included in the study were analyzed, and their clinical course was similar to that of 4 cases in the center. Necropsy was performedon all 3 patients, and the results were cerebral edema, diffuse cerebral edema, and hemorrhage around the basal ganglia. Conclusion: Acute diquat poisoning can cause epileptic seizures. Once it occurs, the disease progresses rapidly and the prognosis is poor. The combination of large dose of sedative drugs can be used to treat epilepsy in order to improve the prognosis.


Assuntos
Epilepsia , Envenenamento , Adulto , Diquat , Feminino , Lavagem Gástrica , Humanos , Masculino , Estudos Retrospectivos , Convulsões
3.
Artigo em Chinês | MEDLINE | ID: mdl-34074083

RESUMO

Objective: To analyze the diagnosis and treatment of a patient with glufosinate-ammonium poisoning after total gastrectomy. Methods: The clinical data of a patient with oral glufosinate-ammonium poisoning after total gastrectomy in the First Affiliated Hospital of Nanjing Medical University in August 2020 were analyzed. Results: After total gastrectomy, the patient took about 200 ml of glufosinate-ammonium orally, and the plasma glufosinate-ammonium concentration was 816.8 ng/ml 6.5 h after poisoning. After symptomatic treatment such as promoting poison excretion, rehydration, anti infection and protecting important organs, the patient improved and discharged. Conclusion: The clinical manifestations of patients with glufosinate-ammonium poisoning after total gastrectomy are still mainly neurological symptoms, with delayed effect. Whether total gastrectomy will affect the distribution and toxic effect of the poison still needs further exploration.


Assuntos
Herbicidas , Envenenamento , Aminobutiratos , Gastrectomia , Humanos
4.
Undersea Hyperb Med ; 48(2): 153-156, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33975405

RESUMO

Hydrogen sulfide (H2S) is a toxic gas produced via breakdown of organic matter. Hydrogen sulfide exposure can cause symptoms ranging in severity from mild effects (dizziness, headache, nausea) to severe lactic acidosis, respiratory failure, pulmonary edema, cardiac arrhythmias and death. Treatment modalities include oral countermeasures and 100% FiO2 with supportive therapy. However, case studies utilizing hyperbaric oxygen (HBO2) therapy have been reported with general benefit seen in severe cases of toxicity. In this report, cases of mild to moderate H2S toxicity occurred aboard a U.S. Navy ship, resulting in a mass casualty incident of more than 30 patients. Patient symptoms included dizziness, headaches, nausea, vomiting, and one patient with altered mental status. Most patients' symptoms resolved after several hours of supportive therapy, but six patients had symptoms refractory to 100% FiO2 at 1 atm. These six patients received HBO2 therapy with a USN Treatment Table 9 after consultation with the local emergency room and hyperbaric assets. Four separate chambers were utilized, including two chambers onboard USN ships and the local explosive ordnance disposal (EOD) chamber. Complete resolution of symptoms in all six patients was achieved within the first breathing period. Patients were monitored after treatment aboard the USN ship medical department. No patients required emergency department care. These cases demonstrate an expanded use of HBO2 to include moderate cases of H2S toxicity refractory to first-line therapy.


Assuntos
Poluentes Ocupacionais do Ar/envenenamento , Sulfeto de Hidrogênio/envenenamento , Oxigenação Hiperbárica/métodos , Incidentes com Feridos em Massa , Militares , Navios , Poluentes Ocupacionais do Ar/análise , Serviços Médicos de Emergência , Feminino , Humanos , Sulfeto de Hidrogênio/análise , Masculino , Envenenamento/terapia , Valores de Referência , Avaliação de Sintomas , Estados Unidos
5.
BMJ Open ; 11(5): e043037, 2021 05 19.
Artigo em Inglês | MEDLINE | ID: mdl-34011582

RESUMO

OBJECTIVES: To fill the existing research gap related to long-term costs of postacute care in methanol poisoning survivors, healthcare cost for 6 years after the outbreak has been modelled and estimated. DESIGN: In a prospective longitudinal cohort study, data collected from 55 survivors of the Czech methanol mass poisoning outbreak in 2012 were collected in four rounds (5 months, then 2, 4 and 6 years after the discharge) in the General University Hospital in Prague according to the same predefined study protocol. The collected data were used to inform the cost model. SETTING AND PARTICIPANTS: All 83 patients discharged from a hospital poisoning treatment after the 2012 methanol outbreak were informed about the study and invited to participate. Fifty-five patients (66%) gave their written informed consent and were followed until their death or the last follow-up 6 years later. The costs were modelled from the Czech healthcare service (general health insurance) perspective. MAIN OUTCOME MEASURES: Long-term national budget impact of the methanol poisoning outbreak, frequencies of sequelae and their average costs. RESULTS: The postacute cost analysis concentrated on visual and neurological sequelae that were shown to be dominant. Collected data were used to create process maps portraying gradual changes in long-term sequelae over time. Individual process maps were created for the central nervous system, peripheral nervous system, sequelae detected during eye examinations and sequelae concerning the visual evoked potentials. Based on the process maps the costs of the postacute outpatient care were estimated. CONCLUSIONS: In 2013-2019 the highest costs per patient related to postacute care were found in the first year; the average costs decreased afterwards, and remained almost constant for the rest of the studied period of time. These costs per patient ranged from CZK4142 in 2013 to CZK1845 in 2018, when they raised to CZK2519 in 2019 again.


Assuntos
Metanol , Envenenamento , Surtos de Doenças , Potenciais Evocados Visuais , Custos de Cuidados de Saúde , Humanos , Estudos Longitudinais , Envenenamento/epidemiologia , Estudos Prospectivos , Cuidados Semi-Intensivos , Sobreviventes
6.
BMJ Case Rep ; 14(4)2021 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-33883110

RESUMO

A 16-year-old girl presented with grade 3 hepatic encephalopathy (HE) following suicide attempt after consuming a lethal dose of yellow phosphorus containing rodenticide. Although she was a candidate for liver transplantation, it could not be done. In the absence of a specific antidote for yellow phosphorus poisoning, the patient was managed conservatively. In addition, low volume-therapeutic plasma exchange (LV-TPE) was initiated, which resulted in a dramatic improvement in HE. Although liver transplantation is the definitive treatment, this case has shown that TPE has a promising role as a 'bridge to recovery' in situations where transplantation is not feasible. We describe our experience with the above-mentioned case, along with the sequence of clinical recovery and the trend in biochemical parameters during follow-up. The patient made a full recovery and is doing well.


Assuntos
Falência Hepática Aguda , Envenenamento , Rodenticidas , Adolescente , Feminino , Humanos , Falência Hepática Aguda/terapia , Fósforo , Troca Plasmática , Plasmaferese
7.
Pan Afr Med J ; 38: 42, 2021.
Artigo em Francês | MEDLINE | ID: mdl-33854671

RESUMO

Introduction: intentional poisoning is a major public health problem in both developed and developing countries. The purpose of this study is to describe the epidemiological features of criminal intoxication in Morocco. Method: we conducted a retrospective study of all cases of criminal intoxication identified by the Morocco Poison Control and Pharmacovigilance Centre (MPCPC) between 1980 and 2014. Results: during the study period, 611 cases of criminal poisoning were recorded, reflecting a rate of 2.1% of all intentional poisoning reported during the same period. The average age of intoxicated patients was 26.4±14.3 years. More than a quarter of the subjects were children under the age of 15 (28.6%). According to the study results, 55.9% were male, with a sex-ratio (M/F) of 1.3. The majority of cases (89.4%) occurred in urban areas. Collective intoxications were reported in 24.4% of cases. The most frequently used products were pesticides (19.1%) and plants (19%). Patients developed different symptoms based on the toxic substances used, the amount ingested and the time elapsed before treatment. A range of digestive, neurological, respiratory and cardiovascular disorders were reported. Out of 440 patients with outcome data available, 27 died. The remainder of patients survived with or without sequelae. Conclusion: criminal poisoning is a major issue. The number of cases is probably underestimated due to a large number of undiagnosed or unreported cases.


Assuntos
Crime , Farmacovigilância , Envenenamento/epidemiologia , Venenos/administração & dosagem , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Praguicidas/envenenamento , Intoxicação por Plantas/epidemiologia , Centros de Controle de Intoxicações/estatística & dados numéricos , Estudos Retrospectivos , Adulto Jovem
8.
Artigo em Inglês | MEDLINE | ID: mdl-33808312

RESUMO

The International Health Regulations (2005) promote national capacity in core institutions so that countries can better detect, respond to and recover from public health emergencies. In accordance with the 'all hazards' approach to public health risk, this systematic review examines poisoning and toxic exposures in Myanmar. A systematic literature search was undertaken to find articles pertaining to poisoning in Myanmar published between 1998 and 2020. A number of poisoning risks are identified in this review, including snakebites, heavy metals, drugs of abuse, agrochemicals and traditional medicine. Patterns of poisoning presented in the literature diverge from poisoning priorities reported in other lower-middle income countries in the region. The experience of professionals working in a Yangon-based poison treatment unit also indicate that frequently observed poisoning as a result of pharmaceuticals, methanol, and petroleum products was absent from the literature. Other notable gaps in the available research include assessments of the public health burden of poisoning through self-harm, household exposures to chemicals, paediatric risk and women's occupational risk of poisoning. There is a limited amount of research available on poisoning outcomes and routes of exposure in Myanmar. Further investigation and research are warranted to provide a more complete assessment of poisoning risk and incidence.


Assuntos
Envenenamento , Saúde Pública , Criança , Feminino , Humanos , Renda , Metanol , Mianmar/epidemiologia , Envenenamento/epidemiologia
9.
Toxicon ; 196: 25-31, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33798604

RESUMO

An epidemiological study on animal poisoning due to plants and zootoxins has been carried out by the Poison Control Centre of Milan (CAV) in collaboration with the University of Milan (Italy). During the period January 2015-March 2019, the CAV received 932 calls on animal poisonings, 12.66% (n = 118) of which were related to plants and zootoxins. Among these, 95 enquiries (80.51%) concerned exposures to plants and 23 (19.49%) to zootoxins. The dog was the species most frequently involved (67.80% of the calls, n = 80), followed by the cat (26.27%, n = 31). As for the plants, several poisoning episodes were related to glycoside-, alkaloid-, oxalate- and diterpenoid-containing species. Cycas revoluta, Euphorbia pulcherrima and Hydrangea macrophylla were the most often reported plants. The outcome has been reported for half of the episodes (51.58%, n = 49) and it was fatal for 3 animals (6.12%). Regarding the zootoxins, the majority of the enquiries were related to asp viper (Vipera aspis), but exposures to pine processionary moth (Thaumetopoea pityocampa), common toad (Bufo), fire salamander (Salamandra), and jellyfish (phylum Cnidaria) were also reported. The outcome was known in 65.22% of the cases with just one fatal episode. This epidemiological investigation depicts an interesting overview on the issue of plant and zootoxin exposures in domestic animals, highlighting the relevance of these agents as causes of animal poisoning and providing useful information for prevention and diagnosis.


Assuntos
Animais Domésticos , Envenenamento/veterinária , Animais , Gatos , Cnidários , Cycas , Cães , Itália/epidemiologia , Centros de Controle de Intoxicações
10.
Artigo em Chinês | MEDLINE | ID: mdl-33910289

RESUMO

Objective: To understand the present situation, law and characteristics of pesticide poisoning in Tianjin, and provide scientific basis for the formulation of pesticide poisoning control strategy. Methods: In August 2019, the related pesticide poisoning report card was derived from the China Disease Prevention and Control Information System. A total of 864 pesticide poisoning cases from 2009 to 2018 in Tianjin were studied, and the data were processed by SPSS 24.0, statistical analysis was performed by 2-test. Results: from 2009 to 2018, a total of 56 pesticide poisoning deaths were reported in Tianjin, with a case fatality rate of 6.48% (56/864) , including 166 cases of productive pesticide poisoning (19.21%) and 698 cases of non-productive pesticide poisoning (80.79%) , the difference of case fatality rate was statistically significant (χ(2)=11.72, P<0.05) . With the most cases of pesticide poisoning (144 cases) in 2012 and the least (48 cases) in 2018. The cases were mainly distributed in Jizhou (312 cases) , Baodi District (247 cases) and Jinnan district (140 cases) , with a total of 699 cases (80.90%) . The time was mainly from May to August, in which non-productive pesticide poisoning occurred in each month, the concentration of productive pesticide poisoning occurred from April to August in spring and summer, and reached its peak in July and August. The age range from 35 to 44 years old was the most (188 cases, 21.76%) , and the age below 15 years old was the least (8 cases, 0.93%) . Pesticide was the most common drug type (551 cases, 63.77%) . Conclusion: The departments concerned should strengthen the education and supervision of pesticide safety, improve the farmers'awareness of harm and self-protection, so as to reduce and prevent the occurrence of pesticide poisoning in this city.


Assuntos
Praguicidas , Envenenamento , Adulto , China/epidemiologia , Cidades , Humanos , Envenenamento/epidemiologia , Projetos de Pesquisa , Estações do Ano
13.
BMC Psychiatry ; 21(1): 148, 2021 03 10.
Artigo em Inglês | MEDLINE | ID: mdl-33691646

RESUMO

BACKGROUND: Poisoning and deaths by organo-phosphorous (OP) compounds are one of the major causes of death in developing and poor countries, and a common admission in the emergency ward and the ICU. OP compounds act by irreversibly binding to pseudocholinesterase enzyme and hence prolong the apnea in patients being given suxamethonium. We present a unusual case of OP poisoning (OPP) in which prolonged apnea ensued in a patient of severe depression following MECT (modified electroconvulsive therapy) in which suxamethonium was used as muscle relaxant, in whom we were cautious of the side-effect of prior organophosphorus poisoning. Since the cases of OPP are very high worldwide, a thorough knowledge of the interaction of the action of the drug and the receptors on which it acts takes pride of place. This article highlights the nuances in the field of psychiatry and anaesthesia in diagnosis and management of prolonged apnea after ECT. CASE PRESENTATION: A 53/F patient consumed OP 38 days prior to MECT. Since existing literature recommend a delay of 4 weeks and a subminimal dose of suxamethonium to prevent prolonged apnea, both these points were taken into consideration. Despite 38 days post exposure to OP, and a dose of succinylcholine of < 0.3 mg/kg, the patient remained apneic for 3 h. Suxamethionum apnea was managed with elective ventilation. After recovery, patient had no residual effect. Subsequently her pseudocholinesterase levels were done which were found to be very low. CONCLUSION: This case is being presented to emphasize that behaviour of post synaptic receptors cannot be relied upon after OP poisoning and pseudocholinesterase levels needs to be mandatorily checked, irrespective of duration post-exposure. In strong suspects dibucaine number and fluoride number also needs to be estimated.


Assuntos
Eletroconvulsoterapia , Intoxicação por Organofosfatos , Envenenamento , Apneia/induzido quimicamente , Apneia/terapia , Feminino , Humanos , Fármacos Neuromusculares Despolarizantes , Intoxicação por Organofosfatos/complicações , Intoxicação por Organofosfatos/terapia , Succinilcolina/efeitos adversos
14.
Artigo em Alemão | MEDLINE | ID: mdl-33688973

RESUMO

BACKGROUND AND OBJECTIVE: Since 1963, the poison control center in Berlin has been the central helpline for the Berlin and Brandenburg population on the subject of poisoning. Furthermore, the institution performs a vital function in the field of poisoning prevention. The aim of this paper is to describe the development of the volume of consultations and their content from 1999 to 2018. Differences in the urban and rural origin of the callers as well as in the private or professional background of the inquiries are considered. The results will serve to improve prevention work. METHODS: The case data of the poison control center (1999-2018) were evaluated and analyzed using descriptive statistical methods. Correlations between the categories "origin of call" (urban or rural area), "background" (private or professional), and "noxious agent" were analyzed using the Pearson's chi-squared test. RESULTS: The annual volume of consultations tended to increase. In particular, the increases are mainly related to inquiries regarding exposures of adults and seniors. The most frequent topics were poisoning with medications and products used in daily life. Inquiries about illegal drugs increased the most (average annual growth rate 6.3%). Inquiring persons with a private background can be helped directly in most cases (86.8%), so medical treatment is rarely recommended. Private persons call more frequently from urban areas, while calls from medical staff predominate in rural areas. Calls about pesticides, mushrooms, animals, and plants were more common in rural areas. Calls about food, foreign bodies, stimulants (alcoholic, caffeinated, and nicotine-containing foods/consumables), or illegal drugs, on the other hand, were received more frequently from urban areas.


Assuntos
Corpos Estranhos , Drogas Ilícitas , Envenenamento , Adulto , Animais , Berlim , Alemanha/epidemiologia , Humanos , Centros de Controle de Intoxicações , Envenenamento/epidemiologia
15.
Med. U.P.B ; 40(1): 28-34, 03/03/2021. tab
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1177489

RESUMO

Objetivo: La incidencia de intoxicaciones en el servicio de urgencias viene en aumento en Colombia. En el abordaje inicial se solicitan paraclínicos de rutina, en ocasiones sin una correlación entre el xenobiótico, la fisiopatología y el riesgo clínico. El objetivo de esta investigación es describir el uso de las ayudas diagnósticas en el paciente intoxicado en el servicio de urgencias de un hospital de alta complejidad. Metodología: Estudio descriptivo transversal con disponibilidad de datos para el periodo 2014-2016. Se recopiló información de los registros de las historias clínica de los pacientes que acudieron al servicio de urgencias con diagnósticos relacionados con intoxicaciones. Resultados: El 55.4% de la población fue de sexo femenino, el 54.5% eran menores de 25 años y la mayoría pertenencia al área urbana (77.7%). La intencionalidad en el 68.9% fue suicida. Se reportó el toxídrome en el 17.6% de los casos, donde el sedante fue el más común (9.2%). Las sustancias más usadas fueron los psicofármacos (22.8%), siendo los antidepresivos tricíclicos más comunes con un 10.9%; seguidos de los plaguicidas (19.1%), donde los organofosforados fueron los más comunes (8.8%). Las ayudas diagnósticas más solicitadas fueron el hemograma en un 94.3% de los casos, seguido de la creatinina en un 90.2%. El electrocardiograma se realizó en el 49.7% de los casos y los tóxicos en orina en el 7.8%. Conclusión: Se evidencia un uso rutinario de ayudas diagnósticas en el servicio de urgencias; se requieren estudios adicionales que evalúen la pertinencia de ayudas diagnósticas en este escenario.


Objective: The incidence of poisoning in the emergency department is increasing in Colombia. In the initial approach, paraclinical routines are requested, sometimes without a correlation between xenobiotic, pathophysiology and clinical risk. The objective of this research is to describe the use of diagnostic aids in poisoned patients in the emergency department of a high-complexity hospital. Methodology: Descriptive cross-sectional study with retrospective data availability for the 2014-2016 period. Information was collected from the medical records of patients who came to the emergency department with diagnoses related to poisoning. Results: 55.4 % of the population was female, 54.5 % were under the age of 25, the majority belonging to the urban area (77%). The intentionality in 68.9% of them was suicidal. Toxidrome was reported in 17.6% of cases, the sedative being the most common (9.2%). Psychotropic drugs were the most commonly used substances (22.8%), the tricyclic anti-depressant being the most used with 10.9%, followed by pesticides with 19.1%, among which organophosphates were the most common (8.8%). The most requested diagnostic aids were the hemogram in 94.3% of the cases, followed by creatinine in 90.2%. The electrocardiogram was performed in 49.7% of the cases and the toxic in urine in 7.8%. Conclusions: A routine use of diagnostic aids is evidenced in the emergency department. Therefore, additional studies are required to evaluate the relevance of diagnostic aids in this setting.


Objetivo: A incidência de intoxicações no setor de emergência está aumentando na Colômbia. Na abordagem inicial, são solicitadas paraclínicas de rotina, às vezes sem correlação entre o xenobiótico, a fisiopatologia e o risco clínico. O objetivo desta pesquisa é descrever a utilização de meios auxiliares de diagnóstico em pacientes intoxicados no pronto-socorro de um hospital de alta complexidade. Metodologia: Estudo transversal descritivo com disponibilidade de dados para o período 2014-2016. As informações foram coletadas nos prontuários dos pacientes que compareceram ao pronto-socorro com diagnóstico de intoxicação. Resultados: 55,4% da população era do sexo feminino, 54,5% tinham menos de 25 anos e a maioria pertencia à zona urbana (77,7%). A intencionalidade em 68,9% foi suicida. Toxidromia foi relatada em 17,6% dos casos, sendo o sedativo o mais comum (9,2%). As substâncias mais utilizadas foram os psicotrópicos (22,8%), sendo os antidepressivos tricíclicos mais comuns com 10,9%; seguido por agrotóxicos (19,1%), onde os organo-fosforados foram os mais comuns (8,8%). Os meios diagnósticos mais solicitados foram o hemograma em 94,3% dos casos, seguido da creatinina em 90,2%. O eletrocardiograma foi realizado em 49,7% dos casos e a urina tóxica em 7,8%. Conclusão: Evidencia-se o uso rotineiro de meios auxiliares de diagnóstico no pronto-socorro; Estudos adicionais são necessários para avaliar a relevância dos auxiliares de diagnóstico neste cenário.


Assuntos
Envenenamento , Praguicidas , Organofosfatos , Psicotrópicos , Urina , Substâncias Tóxicas , Eletrocardiografia , Emergências , Serviços Médicos de Emergência , Antidepressivos Tricíclicos
16.
Biomed Res Int ; 2021: 6621894, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33604379

RESUMO

Objective: To evaluate the efficiency of a radiomics model in predicting the prognosis of patients with acute paraquat poisoning (APP). Materials and Methods: Chest computed tomography images and clinical data of 80 patients with APP were obtained from November 2014 to October 2017, which were randomly assigned to a primary group and a validation group by a ratio of 7 : 3, and then the radiomics features were extracted from the whole lung. Principal component analysis (PCA) and least absolute shrinkage and selection operator (LASSO) regression were used to select the features and establish the radiomics signature (Rad-score). Multivariate logistic regression analysis was used to establish a radiomics prediction model incorporating the Rad-score and clinical risk factors; the model was represented by nomogram. The performance of the nomogram was confirmed by its discrimination and calibration. Result: The area under the ROC curve of operation was 0.942 and 0.865, respectively, in the primary and validation datasets. The sensitivity and specificity were 0.864 and 0.914 and 0.778 and 0.929, and the prediction accuracy rates were 89.5% and 87%, respectively. Predictors included in the individualized predictive nomograms include the Rad-score, blood paraquat concentration, creatine kinase, and serum creatinine. The AUC of the nomogram was 0.973 and 0.944 in the primary and validation datasets, and the sensitivity and specificity were 0.943 and 0.955, respectively, in the primary dataset and 0.889 and 0.929 in the validation dataset, and the prediction accuracy was 94.7% and 91.3%, respectively. Conclusion: The radiomics nomogram incorporates the radiomics signature and hematological laboratory data, which can be conveniently used to facilitate the individualized prediction of the prognosis of APP patients.


Assuntos
Paraquat/envenenamento , Envenenamento/diagnóstico por imagem , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nomogramas , Envenenamento/epidemiologia , Envenenamento/patologia , Prognóstico , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Adulto Jovem
17.
BMC Pediatr ; 21(1): 98, 2021 02 26.
Artigo em Inglês | MEDLINE | ID: mdl-33637060

RESUMO

BACKGROUND: Organophosphates are one of the most common agents of poisoning in developing countries including Egypt. Due to lack of data about characteristics of organophosphates poisoning in our localities, we aimed to evaluate its clinical pattern and factors affecting outcome. METHODS: It was a cross-sectional study conducted in South valley University hospital between January 2019 and December 2019. It included all children ≤16 years of age presented with organophosphates poisoning. Diagnosis was performed from the history taken from the patient's relatives and presenting symptoms. Demographic data, mode and route of poisoning, time from exposure to presentation, clinical symptomatology, grading and routine investigations were evaluated in addition to treatment taken and outcome. RESULTS: During the study period, 108 children; mean age was 7.95 ± 4.11 years (range 1. 5-16 years) presented with organophosphorous poisoning. Sixty five (60%) cases were females and 43 (40%) were males. Unintentional acts (87%) were detected more than suicidal (13%) and inhalation route (63.8%) more than ingestion (36. 2%). Miosis was the most frequent clinical sign (100%) followed by respiratory distress (77.7%). Regarding time of presentation to emergency department, 43 (40%) cases were presented within 6 h while others presented more than 6 h post-exposure. Mechanical ventilation (MV) was needed for 14 (13%) cases and 6 (5.5%) cases died due to respiratory failure. Duration of hospital stay, mean time interval from toxic exposure to hospital presentation, leucocytosis, need for MV and cumulative dose of pralidoxime were significantly higher in non survivors than survivors while Pao2 (partial arterial oxygen) and GCS (Glasgow coma scale) were significantly lower. CONCLUSION: This study concluded that time consumed till presentation to hospital, low GCS, need for MV, leucocytosis, decreased PaO2 and increased cumulative dose of pralidoxime were independent risk factors of mortality.


Assuntos
Intoxicação por Organofosfatos , Envenenamento , Criança , Estudos Transversais , Egito/epidemiologia , Feminino , Humanos , Lactente , Masculino , Intoxicação por Organofosfatos/diagnóstico , Respiração Artificial , Estudos Retrospectivos
18.
Artigo em Chinês | MEDLINE | ID: mdl-33535341

RESUMO

Objective: To analyze the epidemiological characteristics of acute occupational poisoning in Yunnan province, so as to provide basis for formulating prevention and control measures of acute occupational poisoning in Yunnan province. Methods: In December 2019, the information of acute occupational poisoning events reported in Yunnan province from 2004 to 2019 was collected, and the epidemiological distribution, event classification, industry characteristics, poison types and poisoning causes were analyzed. Results: A total of 47 acute occupational poisoning incidents were reported in Yunnan province from 2004 to 2019, with 562 poisoning cases and 51 deaths (case fatality rate of 9.07%) . The regions with the largest number of reported incidents were Kunming and Qujing, with 12 incidents (25.53%) and 10 incidents (21.28%) respectively; The majority of incidents was relatively large (31 incidents, 65.96%) , and the industry was mainly distributed in the chemical industry (19 incidents, 40.43%) and metallurgy (15 incidents, 31.91%) . The most poisonous poisons were carbon monoxide (10 incidents, 21.28%) and arsine (9 incidents, 19.15%) . The main causes of poisoning included not using personal protective equipment or poor equipment (25 incidents, 53.19%) , failure to formulate or violate safety operating procedures (15 incidents, 31.91%) . Conclusion: Acute occupational poisoning incidents occur from time to time in Yunnan province, and the fatality rate is high. Therefore, it is necessary to strengthen the supervision of key areas and industries.


Assuntos
Indústria Química , Envenenamento , China/epidemiologia , Humanos , Metalurgia , Equipamento de Proteção Individual , Envenenamento/epidemiologia
19.
Lakartidningen ; 1182021 02 19.
Artigo em Sueco | MEDLINE | ID: mdl-33616194

RESUMO

A woman in her sixties presented at the Emergency department with nausea, flank pain and profuse vomiting. She had an anion-gap metabolic acidosis, elevated liver enzymes and a pronounced renal failure with creatinine 1997 µmol/L (22,6 mg/dl). She was admitted and treated with haemodialysis. On hospital day 5 a bilateral facial palsy, blindness and a moderate generalized weakness rapidly developed. The patient now revealed that she had consumed about 2 dl of brake fluid with a high content of diethylene glycol about a week before hospital admission. Diethylene glycol poisoning typically causes irreversible kidney failure and demyelinating nerve damage in severe cases. The early and debilitating metabolic acidosis seen in ethylene glycol poisoning seems to be absent in diethylene glycol poisoning and patients often present late. This is the first known Swedish case of symptomatic diethylene glycol poisoning. Internationally, during the last century, several mass poisonings have been caused by diethylene glycol contaminated pharmaceutical products.


Assuntos
Acidose , Envenenamento , Acidose/induzido quimicamente , Creatinina , Etilenoglicóis , Feminino , Humanos , Suécia
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