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1.
Eur J Public Health ; 31(Supplement_4): iv36-iv39, 2021 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-34751365

RESUMO

Although the pandemic has caused substantial losses in economic prosperity and human lives, it has also some positive impacts on the environment. Restricted mobility, complete closure, less traffic and industry have led to improved air quality especially in urban settings. Not only is air pollution an important determinant of chronic diseases, such as heart and lung disorders, but it has also been shown that poor air quality increases the risk of COVID-19. In this article, we review some of the findings on changes in air quality during the pandemic, and its potential effects on health. We need to continue to monitor the effects of change in air quality, due to COVID-19 lockdown or other factors, but also keep all our efforts to improve air quality even faster and more persistent, bringing the pollution levels below what WHO recommends are safe to live with.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , COVID-19 , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/envenenamento , Poluição do Ar/efeitos adversos , Cidades , Controle de Doenças Transmissíveis , Monitoramento Ambiental , Humanos , Pandemias , Material Particulado/análise , Material Particulado/envenenamento , SARS-CoV-2
2.
Rev Infirm ; 70(275): 40-42, 2021 Nov.
Artigo em Francês | MEDLINE | ID: mdl-34752361

RESUMO

In order to prevent human and environmental risks related to the handling of cytotoxins and cytostatics, health care institutions are implementing precautionary measures. Information and training actions for health professionals, nurses, orderlies and pharmacy assistants are also part of the system. Example with a team in Lyon.


Assuntos
Citotoxinas , Equipe de Assistência ao Paciente , Citotoxinas/envenenamento , Atenção à Saúde , Instalações de Saúde , Pessoal de Saúde , Humanos , Exposição Ocupacional
3.
Epidemiol Infect ; 149: e178, 2021 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-34635196

RESUMO

In October 2019, public health surveillance systems in Scotland identified an increase in the number of reported infections of Shiga toxin-producing Escherichia coli (STEC) O26:H11 involving bloody diarrhoea. Ultimately, across the United Kingdom (UK) 32 cases of STEC O26:H11 stx1a were identified, with the median age of 27 years and 64% were male; six cases were hospitalised. Among food exposures there was an association with consuming pre-packed sandwiches purchased at outlets belonging to a national food chain franchise (food outlet A) [odds ratio (OR) = 183.89, P < 0.001]. The common ingredient identified as a component of the majority of the sandwiches sold at food outlet A was a mixed salad of Apollo and Iceberg lettuce and spinach leaves. Microbiological testing of food and environmental samples were negative for STEC O26:H11, although STEC O36:H19 was isolated from a mixed salad sample taken from premises owned by food outlet A. Contamination of fresh produce is often due to a transient event and detection of the aetiological agent in food that has a short-shelf life is challenging. Robust, statistically significant epidemiological analysis should be sufficient evidence to direct timely and targeted on-farm investigations. A shift in focus from testing the microbiological quality of the produce to investigating the processes and practices through the supply chain and sampling the farm environment is recommended.


Assuntos
Surtos de Doenças , Infecções por Escherichia coli/epidemiologia , Fast Foods/microbiologia , Doenças Transmitidas por Alimentos/epidemiologia , Escherichia coli Shiga Toxigênica/isolamento & purificação , Adulto , Diarreia/epidemiologia , Diarreia/microbiologia , Monitoramento Epidemiológico , Infecções por Escherichia coli/microbiologia , Fast Foods/envenenamento , Fast Foods/provisão & distribuição , Feminino , Doenças Transmitidas por Alimentos/microbiologia , Genoma Bacteriano/genética , Humanos , Masculino , Saladas/microbiologia , Saladas/envenenamento , Saladas/provisão & distribuição , Sorogrupo , Toxina Shiga/genética , Escherichia coli Shiga Toxigênica/genética , Reino Unido/epidemiologia
4.
Artigo em Chinês | MEDLINE | ID: mdl-34624949

RESUMO

Objective: To explore the value of soluble growth stimulation expression gene 2 protein (soluble suppression of tumorigenicity 2; sST2) and N terminal B type brain natriuretic peptide (N-terminal probrainnatriuretic peptide, NT-proBNP) in evaluating the short-term prognosis of acute organophosphorus pesticide poisoning. Methods: select 228 patients with acute organophosphorus pesticide poisoning in our hospital from October 2017 to March 2020. According to the grade of poisoning degree, it was divided into 82 cases in mild and moderate group and 146 cases in severe group. hs-cTnI、CK-MB、sST2、NT-proBNP、APACHE Ⅱ score and cholinesterase activity were detected 4 h、12 h、24 h after admission. ROC curve was used to evaluate sST2 and NT-proBNP to predict the prognosis of AOPP. Results: 4 hours after admission, there was no significant difference in the scores of hs-cTnI, APACHE Ⅱ, cholinesterase and CK-MB between the Severe Group and the mild and moderate Group (P<0.05) . At 12 and 24 hours after admission, the scores of hs-cTnI, CK-MB and APACHE Ⅱ in severe group were higher than those in mild and moderate group, and the changes of Cholinesterase were more significant than those in 12 hours after Admission (P<0.05) . 4 hours after admission, SST2 and NT-proBNP levels were significantly higher in severe group than those in mild and moderate Group (P<0.05) . The level of SST2 and NT-proBNP in the severe group was significantly higher than that in the mild and moderate group 12 and 24 hours after Admission (P<0.01) , and the level of SST2 and NT-proBNP was significantly higher than that in the mild group 12 hours after Admission (P<0.05) . Correlation analysis showed that 24 hours after admission, sST2, NT-proBNP were positively correlated with APACHE-Ⅱ scores (R=0.634, 0.723, P<0.01) . The area under sST2 combined with NT-proBNP was 0.891, higher than that under sST2 and NT-proBNP at 12 h after admission. The 24 h APACHE Ⅱ score after admission area under the curve was 0.838. Conclusion: sST2 and NT-proBNP combined detection can early predict the occurrence of recent complications in AOPP patients.


Assuntos
Proteína 1 Semelhante a Receptor de Interleucina-1 , Peptídeo Natriurético Encefálico , Praguicidas , Biomarcadores , Humanos , Compostos Organofosforados , Fragmentos de Peptídeos , Praguicidas/envenenamento , Prognóstico
6.
Pediatrics ; 148(5)2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34607934

RESUMO

BACKGROUND AND OBJECTIVES: In 2008, over-the-counter cough and cold medications (CCMs) underwent labeling changes in response to safety concerns, including fatalities, reported in children exposed to CCMs. The objective of this study is to describe fatalities associated with exposures to CCMs in children <12 years old that were detected by a safety surveillance system from 2008 to 2016. METHODS: Fatalities in children <12 years old that occurred between 2008 and 2016 associated with oral exposure to one or more CCMs were identified by the Pediatric Cough and Cold Safety Surveillance System. An expert panel reviewed all cases to determine the causal relationship between the exposure and death, if the intent of exposure was therapeutic, and if the dose was supratherapeutic. Other contributing factors related to the child's death were also identified as part of a root cause analysis. RESULTS: Of the 180 eligible fatalities captured during the study period, 40 were judged by the expert panel to be either related or potentially related to the CCM. Of these, the majority (n = 24; 60.0%) occurred in children <2 years old and involved nontherapeutic intent (n = 22; 55.0%). The most frequently involved index ingredient was diphenhydramine (n = 28; 70.0%). In 6 cases (n = 6; 15.0%), the CCM was administered to murder the child. In another 7 cases (n = 7; 17.5%), death followed the intentional use of the CCM to sedate the child. CONCLUSIONS: Pediatric fatalities associated with CCMs occurred primarily in young children after deliberate medication administration with nontherapeutic intent by a caregiver.


Assuntos
Antitussígenos/envenenamento , Medicamentos sem Prescrição/envenenamento , Antitussígenos/administração & dosagem , Bromofeniramina/envenenamento , Criança , Pré-Escolar , Clorfeniramina/envenenamento , Dextrometorfano/envenenamento , Difenidramina/administração & dosagem , Difenidramina/envenenamento , Doxilamina/envenenamento , Rotulagem de Medicamentos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/mortalidade , Feminino , Guaifenesina/envenenamento , Homicídio/estatística & dados numéricos , Humanos , Lactente , Masculino , Medicamentos sem Prescrição/administração & dosagem , Fenilefrina/envenenamento , Pseudoefedrina/envenenamento
7.
Artigo em Inglês | MEDLINE | ID: mdl-34501611

RESUMO

Studies suggest that acute pesticide poisonings (APP) may be linked with long-term neurological effects. To examine long-term neurological and psychological distress symptoms associated with having experienced an APP, we conducted a cross-sectional study of 300 conventional and organic smallholder farmers from Zarcero County, Costa Rica, May-August 2016. We collected self-reported data on sociodemographic characteristics, occupational history, pesticide exposure, APPs, neurological and psychological distress symptoms (using the Brief Symptom Inventory (BSI)). Adjusted logistic regression models were fit. A total of 14% of the farmers (98% male) reported experiencing at least one APP during their lifetime. Self-reported APP was associated with neurological symptoms during the 12 months prior to interview (e.g., fainting (Odds Ratio: 7.48, 95% Confidence Interval: 1.83, 30.74), shaking hands (3.50; 1.60, 7.60), numbness/tingling in hands or feet (3.23; 1.66, 6.32), insomnia (2.53; 1.34, 4.79), accelerated heartrate (2.42; 1.03, 5.47), dizziness (2.38; 1.19, 4.72), increased irritability/anger (2.37; 1.23, 4.55), low energy (2.33; 1.23, 4.46), and difficulty concentrating (2.01; 1.05, 3.85)). Farmers who reported an APP in the ten years prior to interview experienced increased odds of abnormal BSI scores for hostility (4.51; 1.16, 17.70) and paranoid ideation (3.76; 0.99, 18.18). Having experienced an APP may be associated with long-term neurological and psychological distress symptoms.


Assuntos
Fazendeiros , Exposição Ocupacional , Praguicidas , Angústia Psicológica , Costa Rica/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/análise , Praguicidas/envenenamento
8.
Forensic Sci Int ; 327: 110975, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34478894

RESUMO

Pholcodine is an opioid antitussive reputed for its low toxicity and absence of addictive effect. We report three cases of pholcodine intoxication with fatal outcome. Large concentrations of pholcodine were quantified by gas chromatography coupled to mass spectrometry (GC/MS) in peripheral postmortem blood (respectively 2890 ng/mL, 979 ng/mL and 12,280 ng/mL). Segmental hair analyses by GC/MS and detected pholcodine in three 1.5-2 cm segments (38-161 ng/mg, 8.54-41.6 ng/mg, and 0.26-2.66 ng/mg, respectively). These findings underline that pholcodine can be involved in fatal poisoning and raise the question of misuse or abuse and of taking account of this drug in opioid overdose prevention policies.


Assuntos
Antitussígenos/envenenamento , Codeína/análogos & derivados , Toxicologia Forense , Morfolinas/envenenamento , Antitussígenos/sangue , Antitussígenos/urina , Autopsia , Codeína/sangue , Codeína/envenenamento , Codeína/urina , Evolução Fatal , Feminino , Análise do Cabelo , Humanos , Pessoa de Meia-Idade , Morfolinas/sangue , Morfolinas/urina , Adulto Jovem
9.
J Forensic Sci ; 66(6): 2532-2538, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34405913

RESUMO

Metomidate and etomidate belong to the non-barbiturate imidazole family of sedative-hypnotics and elicit little analgesic action when used alone. Metomidate, in particular, has little analgesic activity in humans and is, therefore, used for veterinary purposes. In 2019, a Korean woman in her twenties was found unconscious in a motel bath and eventually died. Etomidate, alprazolam, escitalopram, and metomidate were detected in the postmortem specimens. To our knowledge, this is the first case of human metomidate abuse reported in the Republic of Korea. In this research, a simple and reliable method was developed for the analysis of metomidate and etomidate in human blood samples using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Blood samples were deproteinized with acetonitrile, filtered, and analyzed by LC-MS/MS. Linear calibration curves were obtained with six concentrations ranging from 1 to 50 ng/ml for metomidate and 10 to 500 ng/ml for etomidate. The method was validated by assessing the selectivity, linearity, limit of detection (LOD), limit of quantitation (LOQ), intra- and inter-day precision and accuracy, matrix effect, and stability and successfully applied to the analysis of metomidate and etomidate in human blood samples. In a postmortem case, the concentrations of metomidate and etomidate were found to be 8 and 110 ng/ml in femoral blood and 6 and 210 ng/ml in cardiac blood, respectively.


Assuntos
Etomidato/análogos & derivados , Etomidato/sangue , Hipnóticos e Sedativos/sangue , Cromatografia Líquida , Etomidato/envenenamento , Feminino , Toxicologia Forense , Humanos , Hipnóticos e Sedativos/envenenamento , Transtornos Relacionados ao Uso de Substâncias , Espectrometria de Massas em Tandem , Adulto Jovem
10.
Br J Anaesth ; 127(5): 789-797, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34419240

RESUMO

BACKGROUND: Opioid-overdose deaths are associated with poisoning with prescription and illicit opioids in the USA. In contrast, opioid-related deaths (ORDs) in the UK often involve drugs and substances of misuse, and may not be associated with a high dose of prescribed opioids. This study aimed to investigate the association between prescribed opioid dose and ORDs in UK primary care. METHODS: This case-crossover study used the Clinical Practice Research Datalink and death registration between 2000 and 2015 to identify ORDs. Daily oral morphine equivalent (OMEQ) dose was measured within a 90 day focal window before ORD and three earlier reference windows. Conditional logistic regression models assessed the adjusted odds ratio (aOR) and 95% confidence interval (95% CI) comparing daily OMEQ dose greater than 120 mg in the focal window against the reference windows. RESULTS: Of the 232 ORDs, 62 (26.7%) were not prescribed opioids in the year before death. Of the remaining 170 cases, 50 (29.4%) were never prescribed a daily OMEQ dose greater than 50 mg. Daily OMEQ doses over 120 mg (aOR 2.20; 95% CI: 1.06-4.56), co-prescribing gabapentinoids (aOR 2.32; 95% CI: 1.01-5.33), or some antidepressants (aOR 3.03; 95% CI: 1.02-9.04) significantly increased the risk of ORD. CONCLUSIONS: Daily OMEQ dose greater than 120 mg and the concomitant use of psychotropic medicines were related to ORDs in the UK. Prescribers should cautiously avoid prescribing opioids with a daily OMEQ dose greater than 120 mg day-1 and the combination of opioids and gabapentinoids, even with low opioid doses.


Assuntos
Analgésicos Opioides/administração & dosagem , Overdose de Drogas/epidemiologia , Padrões de Prática Médica/estatística & dados numéricos , Psicotrópicos/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Analgésicos Opioides/envenenamento , Estudos de Coortes , Estudos Cross-Over , Relação Dose-Resposta a Droga , Overdose de Drogas/mortalidade , Inglaterra/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Risco , Adulto Jovem
11.
Artigo em Inglês | MEDLINE | ID: mdl-34428648

RESUMO

A selective and sensitive analytical method for the determination of selected catechins (catechin, epicatechin, gallocatechin, epigallocatechin) and pyrogallol in biological matrices by HPLC-MS/MS was developed. The utilized sample preparation technique was a two-stage liquid-liquid extraction using ethyl acetate. The HPLC-system was equipped with a Phenomenex Luna Pentafluorophenyl Column (150 × 2 mm, 5 µm) and operated with an acetonitrile-water gradient as a mobile phase system. Detection was performed with a 3200 Q Trap mass spectrometer. For analysis the mass spectrometer was used in the MRM-mode with negative ionization. The method validation was performed with serum as matrix. The selectivity of the method as well as the linearity of calibration was successfully proven for all analytes. The limits of quantification were between 5.3 and 11.2 ng/mL and the recovery rates were above 50 % for all analytes. Results from the samples of three deer poisoning cases demonstrated that the developed HPLC-MS/MS method is applicable to real biological samples.


Assuntos
Catequina/análogos & derivados , Cervos/metabolismo , Animais , Animais de Zoológico/metabolismo , Catequina/análise , Catequina/farmacocinética , Catequina/envenenamento , Cromatografia Líquida de Alta Pressão/métodos , Alemanha , Limite de Detecção , Modelos Lineares , Extração Líquido-Líquido/métodos , Quercus , Reprodutibilidade dos Testes , Espectrometria de Massas em Tandem/métodos , Distribuição Tecidual
12.
Epidemiol Prev ; 45(3): 155-163, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34212696

RESUMO

BACKGROUND: the exposure to a coal-fired power plant has been shown to increase mortality both for cardiovascular and respiratory causes among an exposed cohort in comparison with a cohort of unexposed. Hazard ratios between 1.30 and 1.90 were found for cardiovascular and respiratory mortality. OBJECTIVES: to estimate the individual life shortening among the exposed due to power plant emissions. DESIGN: survival for cardiovascular and respiratory disease in the exposed vs unexposed groups was estimated by the Kaplan-Meier method. For each gender and exposure, a fictitious cohort with a cumulative 30-year follow up was built combining three subcohorts of age at entry of 55-64, 65-74, and 75-84 years, with 10 years of follow up each. Survivals at 10 years in the 55-64-year subcohort were used as initial risks for 65-74-year subcohort; then, survivals at 10 years of the 65-74-year subcohort were used as initial risk in the 75-84-year subcohort. Eventually, 30-years cumulative follow up cohorts were obtained by gender and exposure. Individual life-shortening in people exposed was estimated as time from death of an exposed subject to the subsequent time when the unexposed cohort reached the same risk of the exposed subject at that time of the death. Here, it is proposed a method to take into account causes other than those considered. SETTING AND PARTICIPANTS: 144,018 subjects aged 55-74 years at entry of both genders belonging to the open cohort of residents of 12 municipalities (including Savona) from 2001 to 2013 in the area where the coal-fired power plant of Vado-Quiliano (Liguria Region, Northern Italy) is located. MAIN OUTCOME MEASURES: individual life shortening. RESULTS: after 5 years of follow up, the individual life shortening due to cardiorespiratory causes varied between 972 and 1,822 days for males and from 612 and 1,578 days among females. Taking into account other causes of death, reduces slightly (3% for males of 75 years at death) the estimate of life shortening found in this study. The comparison between the cohorts requires that the exposed and unexposed groups are comparable, except for the exposure, and that causes other than those considered are taken into account. Socioeconomic status had been found to have little effect on cause-specific death risk indicating that, at least in terms of socioeconomic status, the exposed and unexposed groups were similar. Taking into account causes other than those considered slightly reduced the found estimates (3% at age 75 in males). According to the proposal, the life-shortening for the considered causes is easy to calculate and provides an individual indicator of damage. Inferring from group statistics individual estimates could be the most controversial point of this approach. The proposed estimates are the most credible estimate of individual damage for each occurred death among the exposed people. CONCLUSIONS: an increased hazard ratio for a wide series of causes is equivalent to a life shortening among the exposed. A method to produce reasonable estimates of life-shortening is proposed as the effect of exposure at individual level. This approach is simple and do not require sophisticated statistical tools. It appears a promising approach for other settings.


Assuntos
Carbono , Doenças Cardiovasculares , Exposição Ambiental , Centrais Elétricas , Doenças Respiratórias , Idoso , Idoso de 80 Anos ou mais , Carbono/envenenamento , Doenças Cardiovasculares/mortalidade , Causas de Morte , Cidades/epidemiologia , Exposição Ambiental/efeitos adversos , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Doenças Respiratórias/mortalidade
13.
Forensic Sci Int ; 325: 110893, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34273605

RESUMO

Toxicology investigation on human's buried dead bodies is a rare and challenging task in the forensic field. As requested by the Judicial Authority, this work aimed to verify testimonial evidence that emerged during a criminal investigation involving multiple murder cases. The statements indicated an improper medical administration of one or more alleged drugs (propofol, morphine, diazepam, and midazolam) which presumably caused the deaths. Since the supposed crimes took place several years before, the task of the present work was to obtain results to support the charges. The analyses involved 18 biological samples taken from four exhumed bodies, three of which were female and one male, each buried in a different date and mode. Each sample was treated with specific purification and extraction techniques (LLE - SPE) after the addition of the deuterated analogs of the searched analytes (propofol-d17, morphine-d3, diazepam-d5, midazolam-d4) as internal standards. Afterwards, the extracts were subjected to qualitative analysis by gas chromatography-mass spectrometry-Electron Impact (GC/MS - EI), both in full scan and SIM mode. Propofol, morphine, and diazepam were identified in the corpses. It supports testimonials that were administered just before the deaths occurred.


Assuntos
Diazepam/análise , Homicídio , Midazolam/análise , Morfina/análise , Propofol/análise , Idoso , Idoso de 80 Anos ou mais , Cadáver , Diazepam/envenenamento , Exumação , Feminino , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Rim/química , Fígado/química , Masculino , Midazolam/envenenamento , Morfina/envenenamento , Propofol/envenenamento , Bexiga Urinária/química
15.
Sci Rep ; 11(1): 14710, 2021 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-34282204

RESUMO

The population of bumble bees and other pollinators has considerably declined worldwide, probably, due to the toxic effect of pesticides used in agriculture. Inexpensive and available antidotes can be one of the solutions for the problem of pesticide toxicity for pollinators. We studied the properties of the thiazine dye Methylene blue (MB) as an antidote against the toxic action of pesticides in the bumble bee mitochondria and found that MB stimulated mitochondrial respiration mediated by Complex I of the electron transport chain (ETC) and increased respiration of the mitochondria treated with mitochondria-targeted (chlorfenapyr, hydramethylnon, pyridaben, tolfenpyrad, and fenazaquin) and non-mitochondrial (deltamethrin, metribuzin, and penconazole) pesticides. MB also restored the mitochondrial membrane potential dissipated by the pesticides affecting the ETC. The mechanism of MB action is most probably related to its ability to shunt electron flow in the mitochondrial ETC.


Assuntos
Abelhas , Azul de Metileno/farmacologia , Mitocôndrias/efeitos dos fármacos , Praguicidas/envenenamento , Agricultura , Animais , Antídotos/farmacologia , Abelhas/efeitos dos fármacos , Abelhas/metabolismo , Citoproteção/efeitos dos fármacos , Metabolismo Energético/efeitos dos fármacos , Masculino , Potencial da Membrana Mitocondrial/efeitos dos fármacos , Mitocôndrias/metabolismo , Polinização/efeitos dos fármacos , Polinização/fisiologia , Piretrinas/envenenamento
16.
J Forensic Sci ; 66(6): 2527-2531, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34291457

RESUMO

Complex planned suicide is characterized by the simultaneous use of two or more methods to ensure that death occurs even if one method fails. The authors present an original combination of two self-killing methods. A 42-year-old cardiologist, with a major depressive syndrome and several suicide attempts, as well as cocaine addiction, was found dead at his home with a femoral catheter inserted in the right femoral artery. The autopsy concluded that death was due to major hemorrhagic process in a context of suicide. Toxicological analyses, performed in peripheral blood by gas chromatography coupled to mass spectrometry and by liquid chromatography-diode array detection, revealed the presence of ethanol (0.13 g/L), cocaine, and metabolites (cocaine: 432 µg/L, benzoylecgonine: 3286 µg/L, ecgonine methyl ester: 1195 µg/L, cocaethylene: 41 µg/L), a potentially lethal concentration of citalopram (1.03 mg/L), toxic concentrations of hydroxyzine (0.11 mg/L), bromazepam (2.06 mg/L), and lidocaine (7.30 mg/L). At the end of these analyses, the death was reclassified as planned complex suicide combining drug intoxication and catheterization of the femoral artery. The authors discuss the main aspects of this case and stress the importance of meticulous analysis of all available evidence: witness reports, victim's medical history and occupation, findings of at-the-scene examination, autopsy, and toxicological analyses, in order to exclude homicide and to understand the sequence of events that led to death.


Assuntos
Antidepressivos de Segunda Geração/efeitos da radiação , Cateterismo , Citalopram/envenenamento , Artéria Femoral , Suicídio Consumado , Adulto , Antidepressivos de Segunda Geração/sangue , Antidepressivos de Segunda Geração/envenenamento , Cromatografia Líquida , Citalopram/sangue , Cocaína/sangue , Transtornos Relacionados ao Uso de Cocaína/complicações , Transtorno Depressivo Maior , Overdose de Drogas , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Masculino , Entorpecentes/sangue
18.
Int J Mol Sci ; 22(9)2021 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-34063051

RESUMO

Botulism has been known for about three centuries, and since its discovery, botulinum toxin has been considered one of the most powerful toxins. However, throughout the 20th century, several medical applications have been discovered, among which the treatment of spasticity stands out. Botulinum toxin is the only pharmacological treatment recommended for spasticity of strokes and cerebral palsy. Although its use as an adjuvant treatment against spasticity in spinal cord injuries is not even approved, botulinum toxin is being used against such injuries. This article describes the advances that have been made throughout history leading to the therapeutic use of botulinum toxin and, in particular, its application to the treatment of spasticity in spinal cord injury.


Assuntos
Toxinas Botulínicas/envenenamento , Toxinas Botulínicas/uso terapêutico , Espasticidade Muscular/complicações , Espasticidade Muscular/tratamento farmacológico , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/tratamento farmacológico , Animais , Humanos , Dose Máxima Tolerável , Neurotoxinas/envenenamento
19.
J Forensic Sci ; 66(5): 2024-2028, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34117775

RESUMO

Autopsy findings in intravenous drug addicts are quite variable and may involve a number of organ systems. Reports of the macroscopic identification at autopsy of components of tablets that have been crushed and injected are, however, exceedingly rare. The case of 34-year-old man who died of zolpidem toxicity on a background of pulmonary hypertension attributed to intravenous injections of crushed tablets is described. A very unusual finding was very fine white stippling on the cut surfaces of both the liver and spleen which was shown on energy-dispersive x-ray spectroscopy (EDS) to be titanium dioxide most likely from the coating of the zolpidem tablets. This case is significant in demonstrating titanium dioxide accumulation within organs at both macroscopic and microscopic levels, with confirmation of exposure by EDS analysis. The clinical significance of exposure to such high levels of titanium dioxide is unclear.


Assuntos
Fígado/patologia , Baço/patologia , Titânio/análise , Adulto , Usuários de Drogas , Humanos , Hipertensão Pulmonar/complicações , Fígado/química , Masculino , Medicamentos Indutores do Sono/envenenamento , Espectrometria por Raios X , Baço/química , Abuso de Substâncias por Via Intravenosa , Comprimidos , Zolpidem/envenenamento
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