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1.
Lett Appl Microbiol ; 68(4): 313-320, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30790318

RESUMO

The aim of this study was the development of a novel and effective antibacterial formulation combining selected phytochemical compounds (quercetin, cuminaldehyde, indole-3-carbinol and vanillic acid) with ethylenediaminetetraacetic acid (EDTA), an aminopolycarboxylic acid. The antibacterial activity of the combinations was evaluated against Escherichia coli and Staphylococcus epidermidis in planktonic and sessile states as single and dual species. The compounds when applied individually demonstrated modest antibacterial activity. Nevertheless, synergy was observed when EDTA was combined with the selected phytochemicals, particularly with cuminaldehyde and indole-3-carbinol. These combinations were evaluated against single- and dual-species biofilms. An inactivation of 100% was obtained for almost all the biofilms, with E. coli biofilms showing the highest resistance. This study allowed the discovery of novel formulations of phytochemical compounds with antibacterial activity against E. coli and S. epidermidis single- and dual-species biofilms at concentrations close to the minimum bactericidal concentration. SIGNIFICANCE AND IMPACT OF THE STUDY: The synergistic combinations of EDTA and cuminaldehyde or indole-3-carbinol were effective against single- and dual-species E. coli and S. epidermidis planktonic cells and biofilms. The overall results highlight the role of phytochemical products as a green and sustainable source of antimicrobial potentiators to control bacteria in both planktonic and sessile states.


Assuntos
Biofilmes/crescimento & desenvolvimento , Ácido Edético/farmacologia , Escherichia coli/crescimento & desenvolvimento , Compostos Fitoquímicos/farmacologia , Staphylococcus epidermidis/crescimento & desenvolvimento , Antibacterianos/farmacologia , Benzaldeídos/farmacologia , Cimenos , Indóis/farmacologia , Testes de Sensibilidade Microbiana , Plâncton , Quercetina/farmacologia , Ácido Vanílico/farmacologia
2.
Phys Rev Lett ; 120(22): 227203, 2018 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-29906188

RESUMO

The temperature dependence of the excitation spectrum in NaOsO_{3} through its metal-to-insulator transition (MIT) at 410 K has been investigated using resonant inelastic x-ray scattering at the Os L_{3} edge. High-resolution (ΔE∼56 meV) measurements show that the well-defined, low-energy magnons in the insulating state weaken and dampen upon approaching the metallic state. Concomitantly, a broad continuum of excitations develops which is well described by the magnetic fluctuations of a nearly antiferromagnetic Fermi liquid. By revealing the continuous evolution of the magnetic quasiparticle spectrum as it changes its character from itinerant to localized, our results provide unprecedented insight into the nature of the MIT in NaOsO_{3} [J. G. Vale, S. Calder, C. Donnerer, D. Pincini, Y. G. Shi, Y. Tsujimoto, K. Yamaura, M. M. Sala, J. van den Brink, A. D. Christianson, and D. F. McMorrow, Phys. Rev. B 97, 184429 (2018)PRBMDO2469-995010.1103/PhysRevB.97.184429].

3.
Nat Mater ; 15(6): 601-5, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-27159018

RESUMO

Measuring how the magnetic correlations evolve in doped Mott insulators has greatly improved our understanding of the pseudogap, non-Fermi liquids and high-temperature superconductivity. Recently, photo-excitation has been used to induce similarly exotic states transiently. However, the lack of available probes of magnetic correlations in the time domain hinders our understanding of these photo-induced states and how they could be controlled. Here, we implement magnetic resonant inelastic X-ray scattering at a free-electron laser to directly determine the magnetic dynamics after photo-doping the Mott insulator Sr2IrO4. We find that the non-equilibrium state, 2 ps after the excitation, exhibits strongly suppressed long-range magnetic order, but hosts photo-carriers that induce strong, non-thermal magnetic correlations. These two-dimensional (2D) in-plane Néel correlations recover within a few picoseconds, whereas the three-dimensional (3D) long-range magnetic order restores on a fluence-dependent timescale of a few hundred picoseconds. The marked difference in these two timescales implies that the dimensionality of magnetic correlations is vital for our understanding of ultrafast magnetic dynamics.


Assuntos
Irídio/química , Campos Magnéticos , Simulação de Dinâmica Molecular , Estrôncio/química , Supercondutividade
4.
Br J Clin Pharmacol ; 83(4): 855-862, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27785820

RESUMO

AIMS: Case reports and small case series suggest increased central nervous system (CNS) toxicity, especially convulsions, after overdose of mefenamic acid, compared with other nonsteroidal anti-inflammatory drugs (NSAIDs), although comparative epidemiological studies have not been conducted. The current study compared rates of CNS toxicity after overdose between mefenamic acid, ibuprofen, diclofenac and naproxen, as reported in telephone enquiries to the UK National Poisons Information Service (NPIS). METHODS: NPIS telephone enquiries related to the four NSAIDs, received between January 2007 and December 2013, were analysed, comparing the frequency of reported CNS toxicity (convulsions, altered conscious level, agitation or aggression, confusion or disorientation) using multivariable logistic regression. RESULTS: Of 22 937 patient-specific telephone enquiries, 10 398 did not involve co-ingestion of other substances (mefenamic acid 461, ibuprofen 8090, diclofenac 1300, naproxen 547). Patients taking mefenamic acid were younger and more commonly female than those using other NSAIDs. Those ingesting mefenamic acid were more likely to experience CNS toxicity than those ingesting the other NSAIDs combined [adjusted odds ratio (OR) 7.77, 95% confidence interval (CI) 5.68, 10.62], especially convulsions (adjusted OR 81.5, 95% CI 27.8, 238.8). Predictors of CNS toxicity included reported dose and age, but not gender. CONCLUSIONS: Mefenamic acid overdose is associated with a much larger and dose-related risk of CNS toxicity, especially convulsions, compared with overdose of other NSAIDs. The benefit-risk profile of mefenamic acid should now be re-evaluated in light of effective and less toxic alternatives.


Assuntos
Anti-Inflamatórios não Esteroides/intoxicação , Ácido Mefenâmico/intoxicação , Síndromes Neurotóxicas/etiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Anti-Inflamatórios não Esteroides/administração & dosagem , Criança , Pré-Escolar , Diclofenaco/administração & dosagem , Diclofenaco/intoxicação , Relação Dose-Resposta a Droga , Overdose de Drogas , Feminino , Humanos , Ibuprofeno/administração & dosagem , Ibuprofeno/intoxicação , Lactente , Recém-Nascido , Modelos Logísticos , Masculino , Ácido Mefenâmico/administração & dosagem , Pessoa de Meia-Idade , Análise Multivariada , Naproxeno/administração & dosagem , Naproxeno/intoxicação , Síndromes Neurotóxicas/epidemiologia , Centros de Controle de Intoxicações , Fatores Sexuais , Reino Unido/epidemiologia , Adulto Jovem
5.
Phys Rev Lett ; 117(3): 037201, 2016 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-27472131

RESUMO

Using resonant magnetic x-ray scattering we address the unresolved nature of the magnetic ground state and the low-energy effective Hamiltonian of Sm_{2}Ir_{2}O_{7}, a prototypical pyrochlore iridate with a finite temperature metal-insulator transition. Through a combination of elastic and inelastic measurements, we show that the magnetic ground state is an all-in-all-out (AIAO) antiferromagnet. The magnon dispersion indicates significant electronic correlations and can be well described by a minimal Hamiltonian that includes Heisenberg exchange [J=27.3(6) meV] and Dzyaloshinskii-Moriya interactions [D=4.9(3) meV], which provides a consistent description of the magnetic order and excitations. In establishing that Sm_{2}Ir_{2}O_{7} has the requisite inversion symmetry preserving AIAO magnetic ground state, our results support the notion that pyrochlore iridates may host correlated Weyl semimetals.

6.
Br J Surg ; 102(2): e151-7, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25627129

RESUMO

BACKGROUND: In the past 30 years surgical practice has changed considerably owing to the advent of minimally invasive surgery (MIS). This paper investigates the changing surgical landscape chronologically and quantitatively, examining the technologies that have played, and are forecast to play, the largest part in this shift in surgical practice. METHODS: Electronic patent and publication databases were searched over the interval 1980-2011 for ('minimally invasive' OR laparoscopic OR laparoscopy OR 'minimal access' OR 'key hole') AND (surgery OR surgical OR surgeon). The resulting patent codes were allocated into technology clusters. Technology clusters referred to repeatedly in the contemporary surgical literature were also included in the analysis. Growth curves of patents and publications for the resulting technology clusters were then plotted. RESULTS: The initial search revealed 27,920 patents and 95,420 publications meeting the search criteria. The clusters meeting the criteria for in-depth analysis were: instruments, image guidance, surgical robotics, sutures, single-incision laparoscopic surgery (SILS) and natural-orifice transluminal endoscopic surgery (NOTES). Three patterns of growth were observed among these technology clusters: an S-shape (instruments and sutures), a gradual exponential rise (surgical robotics and image guidance), and a rapid contemporaneous exponential rise (NOTES and SILS). CONCLUSION: Technological innovation in MIS has been largely stagnant since its initial inception nearly 30 years ago, with few novel technologies emerging. The present study adds objective data to the previous claims that SILS, a surgical technique currently adopted by very few, represents an important part of the future of MIS.


Assuntos
Invenções/estatística & dados numéricos , Procedimentos Cirúrgicos Minimamente Invasivos/tendências , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos/estatística & dados numéricos , Patentes como Assunto/estatística & dados numéricos , Editoração/estatística & dados numéricos , Terapias em Estudo/estatística & dados numéricos , Terapias em Estudo/tendências
7.
Emerg Med J ; 31(1): 45-7, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23349353

RESUMO

OBJECTIVE: To report the demographic and clinical characteristics of cases of methoxetamine toxicity reported to The National Poisons Information Service (NPIS) by healthcare professionals. To assess the pattern of enquiries from health professionals to the UK NPIS related to methoxetamine, including the period of the making of the UK first Temporary Class Drug Order (TCDO). METHODS: All telephone enquiries to and user sessions for TOXBASE, the NPIS on-line information resource, related to methoxetamine (and synonyms 'MXE', 'mket' and '2-(3-methoxyphenyl)-2-(ethylamino)cyclohexanone') were reviewed from 1 April 2010 to 1 August 2012. Data were compared for the 3 months before and after the TCDO. RESULTS: There were 47 telephone enquiries and 298 TOXBASE sessions regarding methoxetamine during the period of study. Comparing the 3 months before and after the TCDO, TOXBASE sessions for methoxetamine fell by 79% (from 151 to 32) and telephone enquiries by 80% (from 15 to 3). Clinical features reported by enquirers were consistent with case reports of analytically confirmed methoxetamine toxicity and typical toxidromes were of stimulant (36%), reduced consciousness (17%), dissociative (11%) and cerebellar (6.4%) types, but also particularly featured acute disturbances in mental heath (43%). CONCLUSIONS: Structured NPIS data may reveal trends in drugs of abuse use and toxicity when interpreted within their limitations. Since April 2012, there have been fewer enquiries to NPIS from clinicians, indicating reduced presentations with suspected methoxetamine toxicity to healthcare services. It is unclear if this is related to the TCDO made on 5 April 2012.


Assuntos
Cicloexanonas/toxicidade , Cicloexilaminas/toxicidade , Cicloexanonas/classificação , Cicloexilaminas/classificação , Bases de Dados Factuais , Serviços de Informação sobre Medicamentos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Telefone , Reino Unido
8.
Nat Commun ; 14(1): 6197, 2023 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-37794061

RESUMO

The layered-ruthenate family of materials possess an intricate interplay of structural, electronic and magnetic degrees of freedom that yields a plethora of delicately balanced ground states. This is exemplified by Ca3Ru2O7, which hosts a coupled transition in which the lattice parameters jump, the Fermi surface partially gaps and the spins undergo a 90∘ in-plane reorientation. Here, we show how the transition is driven by a lattice strain that tunes the electronic bandwidth. We apply uniaxial stress to single crystals of Ca3Ru2O7, using neutron and resonant x-ray scattering to simultaneously probe the structural and magnetic responses. These measurements demonstrate that the transition can be driven by externally induced strain, stimulating the development of a theoretical model in which an internal strain is generated self-consistently to lower the electronic energy. We understand the strain to act by modifying tilts and rotations of the RuO6 octahedra, which directly influences the nearest-neighbour hopping. Our results offer a blueprint for uncovering the driving force behind coupled phase transitions, as well as a route to controlling them.

9.
Eur J Neurol ; 17(1): 124-8, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19659750

RESUMO

BACKGROUND AND PURPOSE: The relative frequency of the different autosomal dominant cerebellar ataxia (ADCA) varies widely amongst different geographic locations. Here we describe a series of 45 ADCA families from Portugal. METHODS: Patients with progressive cerebellar dysfunction of autosomal dominant transmission underwent a clinical examination protocol and genetic testing for spinocerebellar ataxia (SCA)1 to Machado-Joseph disease (MJD)/SCA3, SCA6, SCA7, SCA10, SCA12, SCA17 and dentatorubral-pallidoluysian atrophy (DRPLA). We registered the clinical characteristics and frequency of each type of ataxia. RESULTS: MJD/SCA3 was the most frequent ADCA (26 families, 57.8% of all families), followed by DRPLA (5 families, 11.2%), SCA7 (2 families, 4.4%), SCA2 and SCA1 (1 family each, 2.2% each); 10 families (22.2%) had no molecular diagnosis. SCA1 and SCA7 patients had African ancestry. DRPLA patients had Portuguese ancestry and were characterized by prominent anticipation and a variable combination of epilepsy, extra-pyramidal symptoms and dementia. Ophtalmoparesis, slow saccades and retinopathy were most distinctive of SCA3, SCA2 and SCA7 cases, respectively. CONCLUSIONS: MJD/SCA3 was the most common ADCA in this group of families. The high frequency of DRPLA and presence of SCA1 and SCA7 cases was unexpected. The presence of these rarer ADCA types probably reflects migration phenomena, posing a challenge for differential diagnosis.


Assuntos
Ataxia Cerebelar/classificação , Ataxia Cerebelar/genética , Transtornos Cromossômicos/genética , Genes Dominantes/genética , Adolescente , Adulto , População Negra/genética , Ataxia Cerebelar/epidemiologia , Análise Mutacional de DNA , Feminino , Frequência do Gene/genética , Testes Genéticos , Genótipo , Humanos , Doença de Machado-Joseph/diagnóstico , Doença de Machado-Joseph/genética , Masculino , Epilepsias Mioclônicas Progressivas/diagnóstico , Epilepsias Mioclônicas Progressivas/genética , Portugal/epidemiologia , Portugal/etnologia , Prevalência , População Branca/genética , Adulto Jovem
10.
Hum Exp Toxicol ; 39(6): 828-833, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31975620

RESUMO

INTRODUCTION: Automatic dishwashing rinse aids are drying aids which contain non-ionic surfactants, usually ethoxylated alcohols, typically at concentrations of ≤30%. OBJECTIVE: To assess the reported toxicity of rinse aids. METHODS: Telephone enquiries to the UK National Poisons Information Service were analysed from January 2008 to June 2019. RESULTS: Ingestion: Ingestion was involved in 976 cases and produced gastrointestinal features, coughing and central nervous system depression, particularly in young children. In those in whom the amount ingested was known, the majority (56%) of children <18 years and of adults (57%) ingested <50 mL of rinse aid. Although moderate or severe exposures (Poisoning Severity Score (PSS) ≥ 2) were uncommon, they occurred significantly (p < 0.0008) more often in adults (9.0%) than in children (1.8%); however, three of the four adults with PSS ≥ 2 co-ingested other substances. Eye exposure: Ocular exposure was reported in 35 cases, of whom 29 developed features. Eye irritation (n = 10, 28.6%) and eye pain (n = 10, 28.6%) were reported most commonly, and three patients (8.6%) developed corneal abrasions (PSS 2). Dermal exposure: Thirty-four patients were exposed dermally, and six (17.6%) reported features, including rash, numbness, pruritus and burns (PSS 1). CONCLUSIONS: Overall, clinical features developed in 47% of patients exposed to rinse aids, but more severe features (PSS ≥ 2) were rare (<3%) following exposure by any route.


Assuntos
Produtos Domésticos/toxicidade , Irritantes/toxicidade , Tensoativos/toxicidade , Adulto , Queimaduras Químicas/etiologia , Criança , Pré-Escolar , Ingestão de Alimentos , Exantema/induzido quimicamente , Olho , Humanos , Exposição por Inalação , Dor/induzido quimicamente , Centros de Controle de Intoxicações , Prurido/induzido quimicamente , Pele , Reino Unido
11.
Hum Exp Toxicol ; 39(4): 433-439, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31797702

RESUMO

INTRODUCTION: Detergents used in automatic dishwashing machines are of two main types: traditional tablets that require removal from an external wrapper and newer soluble film tablets. OBJECTIVE: To determine the toxicity of automatic dishwashing tablets. METHODS: Telephone enquiries to the UK National Poisons Information Service were analysed for the period January 2008 to June 2019. RESULTS: Ingestion: Ingestion was involved in 798 traditional tablet exposures and 725 soluble film exposures. Clinical features (Poisoning Severity Score ≥ 1) developed in 22.2% of patients ingesting traditional tablets and in 28.8% ingesting soluble film tablets; moderate or severe toxicity was rare (<0.5% for both traditional and soluble film tablets). Children (≤5 years) significantly (p < 0.0001) more often developed features following ingestion of soluble film (n = 193, 28.2%) than traditional tablets (n = 134, 19.1%). In contrast, adults more often developed features following ingestion of traditional than soluble film tablets, although this difference was not statistically significant. Eye exposure: The eye was involved in only 26 of 1539 exposures; 17 of 26 exposures resulted in ocular features. The most commonly reported features were conjunctivitis, eye pain and blurred vision, although one patient sustained a corneal abrasion and developed loss of vision. Skin exposure: Thirty-four of 1539 exposures involved the skin but only 3 developed dermal features which were minor. CONCLUSIONS: Children (≤5 years) significantly more often developed features following ingestion of soluble film than traditional tablets, although the likelihood of a child developing features was relatively low (<30%) and features that did develop were almost always mild. In contrast, adults more often developed features following the ingestion of traditional than soluble film tablets. Overall, the eye was involved in only 1.7% of exposures and only one patient sustained a corneal abrasion.


Assuntos
Detergentes/química , Detergentes/toxicidade , Olho/efeitos dos fármacos , Utensílios Domésticos , Intoxicação/etiologia , Pele/efeitos dos fármacos , Adolescente , Adulto , Pré-Escolar , Humanos , Pessoa de Meia-Idade , Centros de Controle de Intoxicações , Pós , Solubilidade , Propriedades de Superfície , Reino Unido , Adulto Jovem
12.
Clin Toxicol (Phila) ; 57(5): 303-311, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30689457

RESUMO

INTRODUCTION: Sodium hypochlorite is used as a bleaching and disinfecting agent and is commonly found in household bleach. OBJECTIVE: The objective is to review critically the epidemiology, mechanisms of toxicity, clinical features, diagnosis, and management of hypochlorite poisoning. METHODS: PubMed was searched from January 1950 to June 2018 using the terms "Hypochlorite", "Sodium Hypochlorite", "Sodium Oxychloride", "Hypochlorous Acid", "Bleach", "Chlorine Bleach", in combination with the keywords "poisoning", "poison", "toxicity", "ingestion", "adverse effects", "overdose", and "intoxication". In addition, bibliographies of identified articles were screened for additional relevant studies including non-indexed reports. Non-peer-reviewed sources were also included. These searches produced 110 citations which were considered relevant. EPIDEMIOLOGY: There is limited information regarding statistical trends on world-wide poisoning from sodium hypochlorite. In the United States of America, poison control center data have shown that enquiries regarding hypochlorite bleaches have ranged from 43,000 to 46,000 per year over the period 2012-2016. Mechanisms of toxicity: Hypochlorite's potential to cause toxicity is related to its oxidizing capacity and the pH of the solution. Toxicity arises from its corrosive activity upon contact with mucous membranes and skin. Features following ingestion: While small accidental ingestions are very unlikely to cause clinically significant toxicity, large ingestions may cause corrosive gastrointestinal injury and systemic effects, including metabolic acidosis, hypernatremia, and hyperchloremia. Features following dental exposure: Hypochlorite is used extensively by dentists for cleaning root canals and is safe if the solution remains within the root canal. Extrusions into the periapical area can result in severe pain with localized large and diffuse swelling and hemorrhage. Features following skin exposure: Prolonged or extensive exposure may cause skin irritation and damage to the skin or dermal hypersensitivity. Such exposures can result in either immediate or delayed-type skin reactions. High concentration solutions have caused severe chemical skin burns. Features following inhalation: Although there are only limited data, inhalation of hypochlorite alone is likely to lead to no more than mild irritation of the upper airways. Features following ocular exposure: Corneal injuries from ocular exposure are generally mild with burning discomfort and superficial disturbance of the corneal epithelium with recovery within 1 or 2 days. With higher concentration solutions, severe eye irritation can occur. DIAGNOSIS: The diagnosis can typically be made on the basis of a careful history, including details of the specific product used, its hypochlorite concentration, and the amount involved. As hypochlorite bleach produces a characteristic smell of chlorine, this may provide a diagnostic clue. In severe cases, corrosive injury is suggested on presentation because of hypersalivation, difficulty swallowing, retrosternal pain or hematemesis. MANAGEMENT: Symptom-directed supportive care is the mainstay of management. Gastrointestinal decontamination is not beneficial. Local corrosive injury is the major focus of treatment in severe cases. Fiberoptic endoscopy and CT thorax/abdomen are complimentary and have been shown to be useful in corrosive injuries in assessing the severity of injury, risk of mortality and risk of subsequent stricture formation and should be performed as soon as possible after ingestion. Dental periapical extrusion injuries should be left open for some minutes to allow bleeding through the tooth and to limit hematoma development in tissue spaces. Once the bleeding has ceased, the canal can be dressed with non-setting calcium hydroxide and sealed coronally. CONCLUSIONS: Accidental ingestion of household bleach is not normally of clinical significance. However, those who ingest a large amount of a dilute formulation or a high concentration preparation can develop severe, and rarely fatal, corrosive injury so prompt supportive care is essential as there is no specific antidote. Treatment primarily consists of symptom-directed supportive care.


Assuntos
Desinfetantes/intoxicação , Oxidantes/intoxicação , Intoxicação , Hipoclorito de Sódio/intoxicação , Clareadores Dentários/intoxicação , Acidose/induzido quimicamente , Acidose/epidemiologia , Animais , Desinfetantes/química , Oftalmopatias/induzido quimicamente , Oftalmopatias/epidemiologia , Humanos , Hipernatremia/induzido quimicamente , Hipernatremia/diagnóstico , Hipernatremia/epidemiologia , Exposição por Inalação/efeitos adversos , Oxidantes/química , Intoxicação/diagnóstico , Intoxicação/epidemiologia , Intoxicação/terapia , Prognóstico , Doenças Respiratórias/induzido quimicamente , Doenças Respiratórias/epidemiologia , Medição de Risco , Dermatopatias/induzido quimicamente , Dermatopatias/epidemiologia , Hipoclorito de Sódio/química , Clareadores Dentários/química
13.
Clin Toxicol (Phila) ; 57(11): 1053-1063, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31130018

RESUMO

Introduction: Liquid laundry detergent capsules (also called single-use detergent sacs; laundry pods; laundry packets) have become an increasingly popular household product worldwide. Objectives: To review the composition and mechanisms of toxicity of liquid laundry detergent, capsules, and the circumstances, routes, clinical features (and impact of packaging changes) and management of exposure. Methods: The databases PubMed and EMBASE were searched using the terms: "detergent" and "capsule", "pod", "pac" or "sac" combined with "poison", "ingest", "expos" but not "animal" or "in vitro" or "bacteria". The searches yielded 289 articles, of which 186 were excluded: 38 duplicates, 133 not relevant, 10 abstracts which had been published as a paper and 5 non-English language articles. The bibliographies of relevant articles were hand-searched which yielded 14 additional citations. Searching of abstracts from scientific meetings produced five additional citations. A total of 122 publications were relevant to the objectives of the review. Capsules and composition: Capsules typically contain anionic surfactants (20-35%), non-ionic surfactants (10-20%), propylene glycol (8-20%) and ethanol (2-5%) within a water-soluble polyvinyl alcohol membrane. Mechanisms of toxicity: Non-ionic surfactants are the primary mechanism, though anionic surfactants, ethanol and propylene glycol may also contribute. Circumstances of exposure: The majority (60%) of children are exposed when the capsule is removed from its original container. Routes of exposure: Ingestion is the most common (>85%); ocular (<15%) and dermal (<8%) exposure account for the remainder. Features following ingestion: Features develop in around half of all exposures, though >90% are minor. In those with features, vomiting occurs in some 50%; coughing and drowsiness are reported in <5%. Respiratory depression (<0.5%), central nervous system depression (<0.1%) esophageal or gastric injury (<0.5%), metabolic acidosis and hyperlactatemia (<0.05%) have been reported rarely. Of 17 deaths reported, 13 were adults and nine were suffering from cognitive impairment. Features following ocular exposure: Conjunctivitis, eye irritation and/or eye pain are commonly experienced; corneal injury is less common but complete recovery typically occurs within one week. Features following dermal exposure: Clinically important dermal toxicity seldom occurs, though skin burns can develop in <5% of cases when skin contact is prolonged. Impact of packaging changes on features: The implementation of packaging changes resulted in a fall in the number of exposures and their severity in the United States and in the number in Italy. Management-ingestion: Gut decontamination is not recommended, though small amounts of fluid can be administered orally to rinse out the mouth. Symptomatic and supportive care should be offered to all patients that develop features of toxicity. Supplemental oxygen should be administered for hypoxemia, and bronchodilators for laryngospasm/bronchospasm. Intubation and assisted ventilation may be required if CNS and respiratory depression develop. A chest radiograph should be performed if respiratory features develop. In patients with swallowing difficulties, drooling or oropharyngeal burns, endoscopy should be performed; if substantial mucosal damage is present MRI should be considered. In addition, intravenous fluids will be required if prolonged vomiting or diarrhea occur and acid-base disturbances should be corrected. Management-eye exposure: Thorough irrigation of the eye with sodium chloride 0.9% is required. Instillation of a local anesthetic will reduce discomfort and help more thorough decontamination. Due to the potential for corneal injury, fluorescein should be instilled. If ocular injury is present, the patient should be referred to an ophthalmologist. Management-skin exposure: Skin should be irrigated thoroughly with soap and water, and burns should be treated as a thermal burn. Conclusions: Accidental ingestion usually produces no or only minor features. Very rarely respiratory depression, central nervous system depression, esophageal or gastric injury, hyperlactatemia and metabolic acidosis occur. Ocular exposure results in corneal injury infrequently and skin burns can develop uncommonly following prolonged dermal contact. Of 17 deaths reported, 13 were adults and nine were suffering from cognitive impairment.


Assuntos
Detergentes/química , Detergentes/toxicidade , Acidose/induzido quimicamente , Cápsulas/química , Pré-Escolar , Detergentes/intoxicação , Ingestão de Alimentos , Europa (Continente) , Humanos , Intubação , América do Norte , Intoxicação/mortalidade , Intoxicação/terapia , Convulsões/induzido quimicamente , Tensoativos/química , Tensoativos/toxicidade
14.
Clin Toxicol (Phila) ; 57(12): 1146-1153, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30892959

RESUMO

Introduction: Liquid laundry detergent capsules contain concentrated liquid laundry detergent in a water-soluble polyvinyl alcohol membrane.Objective: To review 4652 exposures reported to the United Kingdom National Poisons Information Service (NPIS) and to assess the impact of regulatory changes on potential toxicity.Methods: Telephone enquiries to the NPIS and returned questionnaires for these products were analyzed for the period January 2008 to December 2018.Results: Data on 4652 exposures were reported by telephone or questionnaire, of which 95.4% involved children aged ≤5 years. Overall, 1738 of 4594 patients remained asymptomatic (Poisoning Severity Score [PSS] 0), 2729 developed minor (PSS 1) features, 107 suffered moderate features (PSS 2), 19 were graded as severe (PSS 3) and one died. Ingestion was involved in most exposures (n = 4175): vomiting occurred in 46.5%, coughing occurred in 4.3% and central nervous system depression in 3.2%. Nine (0.2%) children were intubated and ventilated. The eye was exposed in 646 cases: 371 (59.8%) suffered conjunctivitis or eye irritation and 21 (3.4%) had keratitis/corneal damage, which persisted in one patient for 9 d. The skin was involved in 364 cases; in 127 (35.5%) minor dermal features developed including erythema, irritation and rash. The most commonly reported features in the 127 cases with PSS ≥2 were vomiting (n = 75), stridor (n = 34), CNS depression (n = 22), keratitis/corneal damage (n = 21), coughing (n = 18), conjunctivitis (n = 13), hypersalivation (n = 12), foaming from the mouth (n = 11) and hypoxemia (n = 11). However, respiratory features (stridor, hypoxemia, bronchospasm, respiratory distress, dyspnea, pulmonary aspiration and tachypnea) were the reason for grading 56 of 127 cases as PSS ≥2.Conclusions: This large data set of 4652 exposures is reassuring in that 97.2% of exposures resulted in no or only minor features, only 107 patients suffered moderate features (PSS 2) and 19 severe (PSS 3) features; one patient died.


Assuntos
Detergentes/intoxicação , Produtos Domésticos/intoxicação , Centros de Controle de Intoxicações/estatística & dados numéricos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Humanos , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Inquéritos e Questionários , Reino Unido/epidemiologia , Adulto Jovem
15.
J Phys Condens Matter ; 31(18): 185803, 2019 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-30721882

RESUMO

X-ray magnetic critical scattering measurements and specific heat measurements were performed on the perovskite iridate [Formula: see text]. We find that the magnetic interactions close to the Néel temperature [Formula: see text] are three-dimensional. This contrasts with previous studies which suggest two-dimensional behaviour like Sr2IrO4. Violation of the Harris criterion ([Formula: see text]) means that weak disorder becomes relevant. This leads a rounding of the antiferromagnetic phase transition at [Formula: see text], and modifies the critical exponents relative to the clean system. Specifically, we determine that the critical behaviour of [Formula: see text] is representative of the diluted 3D Ising universality class.

16.
J Med Biogr ; : 967772018754646, 2018 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-29392961

RESUMO

This paper will review Winston Churchill's severe respiratory illness in March 1886 when he developed pneumonia of the right lung as an 11-year-old boy. Winston was treated supportively with 'nourishment, stimulants [probably alcohol] and close watching' at his school by the 'celebrated' family physician, Dr Robson Roose, with the assistance of Dr Joseph Rutter. Roose was exemplary in his commitment to his young patient and assiduous in informing Lord Randolph Churchill of his son's clinical progress by letter.

17.
J Endourol ; 21(8): 923-5, 2007 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-17867955

RESUMO

We present the first report of a pseudoaneurysm of an accessory internal pudendal artery after transperitoneal robotic radical prostatectomy. The vesicourethral anastomosis was performed using two continuous 3-0 Monocryl sutures tied at the six o'clock position. As the anastomotic suture was placed at 11 o'clock, lateral to the dorsal venous complex, there was a small amount of pulsatile bleeding that ceased when the suture was completed and tied. The lesion presented as hematuria beginning on the fourth day. On the 14(th) day, the pseudoaneurysm was diagnosed by CT angiography and treated by embolization with eight 3-mm/30-mm micro coils after superselective catheterization. There were no complications or further hematuria.


Assuntos
Falso Aneurisma , Embolização Terapêutica , Hemorragia Pós-Operatória , Prostatectomia/efeitos adversos , Neoplasias da Próstata/cirurgia , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/terapia , Angiografia , Humanos , Artéria Ilíaca , Masculino , Pessoa de Meia-Idade , Hemorragia Pós-Operatória/diagnóstico por imagem , Hemorragia Pós-Operatória/etiologia , Hemorragia Pós-Operatória/terapia , Prostatectomia/métodos , Robótica , Fatores de Tempo
18.
Waste Manag ; 27(12): 1877-83, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17187975

RESUMO

Treatment of municipal solid waste (MSW) landfill leachate generally results in low percentages of nutrient removal due to the high concentration and accumulation of refractory compounds. For this reason, individual physical, chemical and biological processes have been used for the treatment of raw landfill leachate and sometimes for the mixture of domestic wastewater and landfill leachate. In this work, the possibility of treating landfill leachate was tested in a bench-scale pilot plant by a two-step method combining adsorption and coagulation-flocculation. Zeolite synthesized from coal fly ash, a by-product of coal-fired power stations, was used in this study both as a decantation aid reagent and as an adsorbent of COD and NH4-N. The coagulation-flocculation step was performed by the use of aluminium sulphate and a polyelectrolyte (ACTIPOL A-401). The leachate was collected directly from a storage unit of the organic fraction of MSW, before it was composted. For this reason the raw leachate was diluted before treatment. The sludge was recirculated to enhance the removal efficiency of nutrients as well as to optimize flocculant saving and to decrease sludge production. The results showed that it is possible to remove 43%, 53% and 82% of COD, NH4-N, and suspended solids, respectively. Therefore, this method may be an alternative for ammonium removal, as well as a suitable pre- or post-treatment step, in combination with other processes in order to meet regulatory limits.


Assuntos
Compostos de Alúmen/química , Carbono/química , Eletrólitos/química , Material Particulado/química , Eliminação de Resíduos/métodos , Zeolitas/química , Cinza de Carvão , Projetos Piloto , Esgotos/química
19.
J R Soc Med ; 110(12): 483-492, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29171780

RESUMO

While staying in the White House over Christmas 1941, Churchill developed chest pain on trying to open a window in his bedroom. Sir Charles Wilson, his personal physician, diagnosed a 'heart attack' (myocardial infarction). Wilson, for political and personal reasons, decided not to inform his patient of the diagnosis or obtain assistance from US medical colleagues. On Churchill's return to London, Wilson sought a second opinion from Dr John Parkinson who did not support the diagnosis of coronary thrombosis (myocardial infarction) and reassured Churchill accordingly.


Assuntos
Infarto do Miocárdio/história , Pessoas Famosas , História do Século XX , Humanos , Masculino , Médicos , Estados Unidos
20.
J R Coll Physicians Edinb ; 47(4): 388-394, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29537415

RESUMO

This paper reviews Churchill's illnesses in February 1943 and August/September 1944 when he developed pneumonia; on the first occasion this followed a cold and sore throat. Churchill was managed at home by Sir Charles Wilson (later Lord Moran) with the assistance of two nurses and the expert advice of Dr Geoffrey Marshall, Brigadier Lionel Whitby and Colonel Robert Drew. A sulphonamide (sulphathiazole on the first occasion) was prescribed for both illnesses. Churchill recovered, and despite his illnesses continued to direct the affairs of State from his bed. On the second occasion, Churchill's illness was not made public.


Assuntos
Pessoas Famosas , Equipe de Assistência ao Paciente/história , Pneumonia/história , Inglaterra , História do Século XX , Humanos , Masculino , Pneumonia/terapia
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