Urea as a source of cheap non-protein nitrogen is used to adulterate fish and meat meals which are basic components of broiler diets. The present study was carried out to elucidate the effects of urea on weight gain, ...Urea as a source of cheap non-protein nitrogen is used to adulterate fish and meat meals which are basic components of broiler diets. The present study was carried out to elucidate the effects of urea on weight gain, and hematological and biochemical profiles. A total of 48 broiler chicks were randomly allotted into 4 groups, designated Groups 1, 2, 3 and 4 of 12 birds each. Birds in Groups 2, 3 and 4 were fed on diets containing urea at the levels of 1%, 2.5% and 4%, respectively. Birds in Group 1 served as control and were not exposed to urea. Experimentation period was for 3 weeks and experiment was terminated when birds were 42 days of age. Body weight of all intoxicated birds at the various intervals was significantly decreased in comparison with that of the untreated control. Compared with control, all intoxicated broilers manifested significant (P ≤ 0.05) decrease in all hematological parameters involving erythrocytic and total leucocytic counts, Hemoglobin (Hb) and Packed Cell Volume (PCV) on a dose- and time-pattern. In comparison with the control levels, biochemical profile of the intoxicated birds disclosed significant decrease in blood glucose level and significant increase in serum uric acid, urea, Alkaline Phosphatase (ALP) and Lactate Dehydrogenase (LDH) levels. Based upon the present data, it was concluded that the addition of urea to broiler diets bears serious sequences concerning the general health condition, performance, weight gain, and hematological and biochemical profiles.展开更多
Paraquat, is a Bipy herbicide have been widely used in last decade in China. Because of its high human toxicity and mortality characteristics, paraquat has been gained considerable attention in recent years. In order ...Paraquat, is a Bipy herbicide have been widely used in last decade in China. Because of its high human toxicity and mortality characteristics, paraquat has been gained considerable attention in recent years. In order to evaluate the epidemic status of paraquat harm to human health in China, 24 h hotline information about paraquat intoxication consultation from January Ist, 2002 to December 31st, 2011 was collected by experienced practitioners in the Poison Control Center (National Poison Control Center, NPCC)展开更多
Cadmium (Cd), one of the most dangerous heavy metals, has a very similar ionic radius to calcium (Ca). The interference of cadmium in calcium homeostasis may play an important role in cadmium toxicity. Recent reports ...Cadmium (Cd), one of the most dangerous heavy metals, has a very similar ionic radius to calcium (Ca). The interference of cadmium in calcium homeostasis may play an important role in cadmium toxicity. Recent reports indicate that calmodulin (CaM) inhibitors such as trifluoperazine and chlorpromazine (CPZ) could protect rodents against cadmium toxicity. It was also reported that pretreatment of mice with zinc (Zn) could reduce the adverse effects induced by cadmium. The aim of this study is to determine whether Cd changes the balance of other essential metals such as Zn and copper (Cu) in rat tissues, and whether CPZ can reverse these changes which are induced by cadmium intoxication. Adult male Sprague Dawley (SD) rats were injected intraperitoneally (ip) with cadmium chloride (CdCl 2) (0.2, 0.4, 0.8 mg Cd/kg body weight) alone and 0.4mg Cd/kg in association with CPZ (5 mg/kg) daily for a week. The control animals were injected with normal saline only. The results showed that the cadmium content in the liver, kidney and testis increased significantly with a dose response relationship. Cadmium treatment markedly increased the Zn and Ca content in some of the tissues. Hepatic and renal metallothionein (MT) increased significantly after cadmium intoxication. CPZ treatment, however, reduced cadmium content in liver, but not blood and kidney. CPZ seemed to decrease the content of MT in liver and significantly increase the amounts of MT in kidney. These data suggest that the intervention of cadmium with tissue essential metals may play a role in cadmium toxicity in rats, and calmodulin inhibitors to some extent can reduce the adverse effect of cadmium by decreasing the cadmium load in tissues and reversing the unbalance of essential metals.展开更多
Antagonising effects of α-ketoglutarate (α-KG) could be attributed to complexing of the reactive nucleophile (CN-) to form cyanohydrin in cyanide intoxication. However, an enormous protection obtained could not be d...Antagonising effects of α-ketoglutarate (α-KG) could be attributed to complexing of the reactive nucleophile (CN-) to form cyanohydrin in cyanide intoxication. However, an enormous protection obtained could not be delineated on account of possible in situ binding of α-KG given intraperitoneally (i.p.) in mice to cyanide administered through the same route. The present study was designed to see the efficacy of a-KG alone or in combination with sodium nitrite (SN) and/or sodium thiosulfate (STS) in male mice exposed to cyanide administered through subcutaneous (s.c.) or inhalation route. A technique for generation of hydrogen cyanide (HCN) is also discussed. On the basis of protection index (PI), defined here as the LD50 of cyanide in protected mice/LD50 of cyanide in unprotected mice and survival time, STS + α-KG regimen was equipotent to the conventional SN + STS regimen. This is further substantiated by effect of α-KG in reducing plasma cyanide levels. The efficacy of α-KG remains undeterred irrespective of the route of cyanide intoxication, while the magnitude of protection varies.展开更多
<strong>Background: </strong>The main causes of mortality in patients with burn injury are the development of systemic inflammatory process, multiple organ failure and septic complications. <strong>T...<strong>Background: </strong>The main causes of mortality in patients with burn injury are the development of systemic inflammatory process, multiple organ failure and septic complications. <strong>The aim of the research:</strong> Improvement of diagnostic and therapeutic approaches to the detection and elimination of endogenous intoxication in patients with burn injury. <strong>Materials and methods:</strong> The main study group consisted of 19 patients and the comparison group—of 10 patients with burn injury. 92 blood serum (BS) samples of the patients of the main group were tested, using the method of fluorescence spectroscopy (MFS). The advanced therapeutic tactics were proposed for the patients of both groups. The control group consisted of 40 healthy individuals (donors). BS of these patients was also tested using MFS. <strong>Results: </strong>Patients with burn injury have endogenous intoxication in their blood. The effective concentration of albumin is reduced in patients with burn injury due to the blockage of albumin binding centers by bacterial metabolism products. Fluorescence spectra (FS) of BS in patients with burn trauma and donors were obtained and investigated. Based on MFS results, an improved treatment regimen using infusion of albumin solution was proposed. <strong>Conclusions:</strong> An improved technique for the management of patients with burn injury is based on the use of MFS for the diagnostic evaluation of endogenous intoxication in them. The idea of pathological changes in albumin molecules in patients with burn injury is pathogenetically substantiated by the successful use of infusion of albumin solution in these patients on the basis of the MFS.展开更多
In a quest for better chelating therapy drugs for the treatment of intoxication by Fe, Al, oractinides, two new series of mixed catechol-bisphosphonate through amide linkage were synthesized.Benzyl group was used as p...In a quest for better chelating therapy drugs for the treatment of intoxication by Fe, Al, oractinides, two new series of mixed catechol-bisphosphonate through amide linkage were synthesized.Benzyl group was used as protecting group to avoid the breakage of amide by acid hydrolysis orimcomplete reaction in silylation-dealkylation using bromotrimethylsilane.展开更多
Thirty-two mongrel dogs were divided into 4 groups.24 dogs of the 3 therapeutic groupswere inflicted with mild,medium,and severe hemorrhage through right femoral artery bleeding untilthe arterial systolic pressure dro...Thirty-two mongrel dogs were divided into 4 groups.24 dogs of the 3 therapeutic groupswere inflicted with mild,medium,and severe hemorrhage through right femoral artery bleeding untilthe arterial systolic pressure dropped to 9.33,6.67 and 5.33 kPa,respectively,and then intoxicatedby intravenous NaCN 2.5mg/kg 3min after intoxication,intravenous 4-dimethylaminophenol(DMAP) 2 mg/kg was given.8 dogs of the control were inflicted with mild hemorrhage and similar-ly intoxicated,but no treatment was given.The changes of hemodynamics,blood gases andmethemoglobin were observed in the dogs.It was found that all the dogs of the control died with-in 5 min after administration of NaCN.DMAP could exert an excitatory effect on hemodynamicsand rescue the animals from death.The excitatory effect of DMAP became weaker whilehemorrhage became more severe.DMAP could further disturb the oxygen-caring capacity ofhemoglobin because of the formation of large amounts of methemoglobin when it was used as an anti-dote for cyanide intoxidation accompanied with acute hemorrhage.展开更多
The efficacy of α mercapto β (2_furyl) acrylic acid (MFA), α mercapto β (5_sodiumsulfonate, 2_furyl) acrylic acid (MSFA) and α mercapto β (5_acetoxymethyl, 2_furyl) acrylic acid (MAFA) to mobilize intra...The efficacy of α mercapto β (2_furyl) acrylic acid (MFA), α mercapto β (5_sodiumsulfonate, 2_furyl) acrylic acid (MSFA) and α mercapto β (5_acetoxymethyl, 2_furyl) acrylic acid (MAFA) to mobilize intracellularly bound cadmium in liver and kidney was investigated in rats pre_exposed to cadmium. MFA was effective in reducing cadmium levels of hepatic and renal supernatant cytosolic fraction (SCF) while MSFA and MAFA were effective in lowering cadmium levels of renal SCF and hepatic SCF respectively. All the chelating agents also enhanced the excretion of cadmium more in feces than in urine. However, substitution on the furan ring lowered cadmium mobilizing efficacy of the parent compound, MFA. The treatment with MFA did not affect the status of endogenous zinc and copper while the treatment with MSFA and MAFA enhanced their excretion. MSFA increased hepatic and renal zinc and renal copper while MAFA increased their copper levels.展开更多
Levothyroxine intoxication is a rare clinical entity which is usually asymptomatic. However, severe symptoms such as respiratory failure, malignant hyperthermia, seizures, arrhythmia, and coma have been reported. In t...Levothyroxine intoxication is a rare clinical entity which is usually asymptomatic. However, severe symptoms such as respiratory failure, malignant hyperthermia, seizures, arrhythmia, and coma have been reported. In this case report, a patient who ingested high dose (15 mg) levothyroxine for suicide and admitted to intensive care unit was presented. There was a decrease in Glasgow coma score in the follow-up. The patient was intubated due to acute respiratory failure. Gastric lavage, activated charcoal, methylprednisolone, cholestyramine and therapeuthic plasma exchange were administered. Despite ingestion of high dose of levothyroxine, thyrotoxicosis symptoms resolved with appropriate treatment and the patient was discharged from the intensive care unit.展开更多
Objective: The objective of this study was to analyse the reversibility of the anticoagulant effect of warfarin by comparing prothrombin complex concentrate (PCC) versus frozen fresh plasma (FFP) in cardiology patient...Objective: The objective of this study was to analyse the reversibility of the anticoagulant effect of warfarin by comparing prothrombin complex concentrate (PCC) versus frozen fresh plasma (FFP) in cardiology patients with serious warfarin intoxication. Methods: This was an observational and retrospective study comprising 67 patients (18 in group I [PCC] and 49 in group II [FFP]). The primary endpoint was the reversal of anticoagulant effect of warfarin after 2 and 24 hours of PCC or FFP administration. Comparisons between the groups were made using T-test and Q-square. Multivariate analyses were conducted using logistic regression, and the results were considered significant when p Results: The medium dose used was 27.6 UI/kg of PCC and 14.5 ml/kg of FFP. Significant differences were observed between groups I and II in the INR reversibility measurements after 2 hours (33.3% vs. 6.1%, p = 0.001) and 24 hours (38.9% vs. 12.2%, p = 0.009) as well as in the occurrence of pulmonary edema (5.6% vs. 42.9%, OR = 11.10, p = 0.04). The AUC for PCC was 0.891 (CI 95% [0.72 - 1.0]), and for FFP, it was 0.291 (CI 95% [0.09 - 0.49]). Conclusions: PCC is better than FFP treatment in reversing the warfarin intoxication after 2 and 24 hours of administration. Furthermore, PCC showed lower pulmonary edema in cardiology patients.展开更多
Renal damage secondary to paracetamol intoxication is rare, estimated between 1% and 2% of intoxication cases. Its pathophysiology is still debated, the clinical involvement consisting in an acute tubular necrosis wit...Renal damage secondary to paracetamol intoxication is rare, estimated between 1% and 2% of intoxication cases. Its pathophysiology is still debated, the clinical involvement consisting in an acute tubular necrosis with a good prognosis if it is rapidly treated. Renal damage can sometimes occur without prior hepatic damage, and the onset of renal manifestations is generally between the 2nd and 7th day after taking paracetamol. If its management remains exclusively symptomatic, its late onset can sometimes lead to serious metabolic complications. It is therefore important to systematically monitor renal function following paracetamol drug intoxication. We report the case of a 60-year-old male subject hospitalized for the management of voluntary drug intoxication (VDI) with paracetamol complicated by acute hepatocellular failure and acute renal failure. His management required extrarenal purification (hemodialysis) and the evolution was favorable with recovery ad integrumof renal function. Conclusion: Although less known and of unelucidated physiopathology, nephrotoxicity secondary to voluntary drug intoxication with paracetamol is a reality and can lead in extreme cases to the use of extrarenal purification technique (hemodialysis).展开更多
The use of bioactive compounds as alternative medicine in the treatment of some intoxication cases is growing in the last years.Flavonoids are one of these bioactive compounds that are plant-based dietary nutrients.Na...The use of bioactive compounds as alternative medicine in the treatment of some intoxication cases is growing in the last years.Flavonoids are one of these bioactive compounds that are plant-based dietary nutrients.Naringenin is the most influential flavonoid wherein it is found in citrus fruits such as orange,grapefruit,and mandarin.A lot of studies showed the ability of naringenin to scavenge free radicals in different body tissues preventing oxidative stress toxicity and lipid peroxidation.Therefore,naringenin can protect many body organs and systems against toxic manifestations of many drugs and toxic agents.So,it prevents the liver,kidney,heart,testes,and neurological system from toxic effects of a wide range of toxicants.Moreover,it can also ameliorate manifestations of cytotoxicity and developmental toxicity based on its efficacy as an antioxidant.展开更多
Background: The aim of this study was to evaluate the clinical and epidemiological characteristics of patients with acute intoxication admitted to the Intensive Care Unit (ICU). Material and Methods: An observational ...Background: The aim of this study was to evaluate the clinical and epidemiological characteristics of patients with acute intoxication admitted to the Intensive Care Unit (ICU). Material and Methods: An observational retrospective study was conducted on intoxicated patients who admitted to ICU between January 2022 and January 2024. Data were collected from the patients medical records. The demographic characteristics, causes of intoxications, clinical parameters, the mean stay in the ICU, treatment modalities and prognosis were recorded. Results: A total of 2875 critically ill patients were admitted during the study period, and 109 (3.79%) of them were acute intoxications. Their mean of ages was 38.09 ± 12.29. The female-to-male ratio was 1.37/1. Drugs were found to be the primary cause (62.39%) of intoxications, and analgesics, antidepressants, and antibiotics were the most frequent agents. Suicidal attempts were present in 66 patients, most of them were female (62.13%) and between 17 - 24 years (40.91%). The other common causes of intoxications were carbon monoxide (CO) (22.02%), methyl/ethyl alcohol (8.26%) and mushroom (5.50%). The mean stay in the ICU was 2.69 ± 0.89 days. Mechanical ventilation was applied to 10 of our patients. Renal replacement therapy was required in 6 patients. Despite all treatments, 6 of our patients died, and we found the mortality rate to be 5.50%. Conclusion: Intoxications were more frequent in young female patients and drugs were the most common cause with suicidal intent. Unfortunately, CO poisoning continues to be a very important problem in our city. These findings provided significant information about the characteristics of intoxications in Karabuk.展开更多
Chinese medicine (CM) has been widely used in Hong Kong for centuries. In fact, CM practitioners currently provide over 20% of the medical consultations in Hong Kong and about 60% of the population has previously used...Chinese medicine (CM) has been widely used in Hong Kong for centuries. In fact, CM practitioners currently provide over 20% of the medical consultations in Hong Kong and about 60% of the population has previously used CM. In 1999, the Legislative Council passed the Chinese Medicine Ordinance with aims to govern practice, use, trading, and manufacturing of CM in Hong Kong. While it is usually safe to use CM under proper application and guidance, there have been frequent reports on intoxication and fatalities. The misuse of potent/toxic CM, because of misidentification or overdose, can cause severe aconite, aristolochic acid, anticholinergic, podophyllin, grayanotoxin, pyrrolizidine alkaloids, matrine, gelsemine, teucvin, and strychnine poisoning. In this review, we summarized CM intoxication cases in Hong Kong, concentrating on the discussion of toxic and adverse effects as well as the quality control of CM. By increasing the awareness of CM toxicity, we hope to enhance the regulatory process and stimulate further research on their toxic dose, toxic ingredients, intoxication mechanisms, and quality control.展开更多
Objectives:To investigate the effectiveness and safety of Xingnaojing Injection(XNJ,醒脑静注射液)compared with naloxone for the treatment of acute alcohol intoxication(AAI),and provide the latest evidence through evid...Objectives:To investigate the effectiveness and safety of Xingnaojing Injection(XNJ,醒脑静注射液)compared with naloxone for the treatment of acute alcohol intoxication(AAI),and provide the latest evidence through evidence-based approach.Methods:Seven electro-databases including Pub Med,EMBASE,Cochrane Central Register of Controlled Trials,Chinese National Knowledge Infrastructure Databases,Chinese Biomedical Literature Database,Chinese Science and Technology Periodical Database(VIP)and Wanfang Database were searched from the inception to January 2018.Randomized controlled trials(RCTs)comparing XNJ with naloxone for patients with AAI and reporting at least one of the below outcomes were included:patients’conscious recovery time,stay length in emergency department,disappearance time of the ataxia symptom,the severity of the symptoms,the blood alcohol content as wel as the adverse events.Methodological quality of included trials was assessed using the risk of bias tool which recommended by the Cochrane Col aboration.Meta-analysis was conducted by Review Manager 5.3 software.Results:Total y 141 trials with 13,901 patients were included in this review,al of them were assessed as unclear or high risk of bias.Results showed that on the basis of routine therapy,standard dose XNJ(10–20 m L)may have similar results with naloxone on the recovery time of consciousness(MD 12 min,95%CI 7.2–17.4 min)and disappearance time of symptoms(MD 6 min,95%CI–13.8–25.8 min)for patients with AAI.Larger dose of XNJ Injection(21–40 m L)may speed up the time(almost 1 h earlier).Combination of XNJ and naloxone seemed superior to the naloxone alone for al the relevant outcomes.The average difference of time in consciousness recovery was 2 h and the number of AAI patients whose consciousness recovery within 1 h was above 50%the combination group than in the control group(RR 1.42,95%CI 1.29 to 1.56).No severe adverse events or adverse reactions of XNJ were reported in the included trials.Conclusions:Low quality of evidence showed XNJ may have equal effect as naloxone and may achieve better effect as add-on intervention with naloxone for patients with AAI.We failed to evaluate the safety of XNJ Injection due to the insufficient evidence in this review.展开更多
Cases of acute pancreatitis induced by organophosphate intoxication are encountered occasionally in clinics, but very few of them develop into severe pancreas necrosis and irreversible pancreatic function impairment. ...Cases of acute pancreatitis induced by organophosphate intoxication are encountered occasionally in clinics, but very few of them develop into severe pancreas necrosis and irreversible pancreatic function impairment. Here, we report a 47-year-old female organophosphate poisoning case after ingestion of massive insecticides;she was considered to have total necrosis and function failure of the pancreas via serum amylase test, glucose level test, and CT imaging. The patient exhibited no relief under the regular medicine treatment, which included sandostatin, antibiotics, intravenous atropine, and pralidoxime methiodide. She received percutaneous catheterization and drainage of pancreatic zone to expel hazardous necrotic waste, also by which the pathogenic evidence was obtained and the antibiotics were adjusted subsequently. The patient recovered gradually, was discharged after 2 weeks, and was prescribed with oral pancreatin capsules before meals and hypodermic insulin at meals and bedtime to compensate the impaired pancreatic function.展开更多
3-Methoxyphencyclidine(3-MeO-PCP)is a new psychoactive substance that belongs to the phencyclidines family,first identified in Europe in 2012.This drug presents a stronger binding to N-methyl-D-aspartate(NMDA)receptor...3-Methoxyphencyclidine(3-MeO-PCP)is a new psychoactive substance that belongs to the phencyclidines family,first identified in Europe in 2012.This drug presents a stronger binding to N-methyl-D-aspartate(NMDA)receptors when compared to phencyclidine,which results in more potent effects,even at low concentrations.Very few articles have been published regarding 3-MeO-PCP in forensic toxicology.In this paper,the authors present a fatal 3-MeO-PCP intoxication case.In addition to the detection of the parent drug,metabolites were investigated in urine and,for the first time in the scientific literature,in blood.3-MeO-PCP and its metabolites were quantitated by liquid chromatography-tandem mass spectrometry system(LC-MS/MS).Identification was confirmed by liquid chromatography-high resolution mass spectrometry(LC-HRMS).3-MeO-PCP tested positive in femoral blood(3525 ng/mL)and urine(7384 ng/mL).The femoral blood concentration was higher than the fatal concentrations range already reported in the literature(from 50 to 3200 ng/mL).3-MeO-PCP metabolites,including O-demethyl-3-MeO-PCP,piperidine-OH-3-MeO-PCP,O-demethyl-piperidine-di-OH-3-MeO-PCP and piperidine-di-OH-3-MeO-PCP,were detected in blood.In addition,two new metabolites,O-demethyl-piperidine-OH-3-MeO-PCP and O-demethyl-cyclohexyl-OH,were identified in both blood and urine.Unfortunately,due to the lack of reference material on the market,it was not possible to measure the concentration of these metabolites.However,the ratios between the metabolites and the parent drug were useful to estimate their analytical response and prevalence.At this time,considering the low ratios(<1)between metabolites and parent drug,metabolites testing does not seem useful to increase the detection window of the drug.展开更多
The study was designed to analyze the incidence and pattern of anticoagulant rodenticide intoxication in east China and to discuss strategies of diagnosis based on laboratory analysis experience.A total of 117 patient...The study was designed to analyze the incidence and pattern of anticoagulant rodenticide intoxication in east China and to discuss strategies of diagnosis based on laboratory analysis experience.A total of 117 patients with anticoagulant rodenticide poisoning confirmed by toxicological analysis in east China were included in this study from 2011 to 2013.The mean concentration of anticoagulant rodenticide,age,and gender of these patients,as well as the mode and type of poisoning,were discussed.The age ranged from less than 1 to 80 years with the feeble preponderance of males(M D 53.0%,F D 47.0%).The 0–9 age group covered the largest ratio of these anticoagulant rodenticide poisoning patients.Accidental or voluntary ingestion seems to be the most common cause of intoxication,with still the poisoning cause being unknown for a large number of positive analyses.Bromadiolone was the most commonly observed anticoagulant rodenticide found in the biological samples,followed by brodifacoum.The concentrations of bromadiolone and brodifacoum that were detected in the first collected whole blood from each patient ranged from 1 to 878 ng/mL(mean 97.9 ng/mL)and from 0.5 to 1566 ng/mL(mean 225.1 ng/mL),respectively.The data analysis shows a high incidence of anticoagulant rodenticide poisoning without awareness of the poisoned subjects,clearly emphasizing the need for toxicological analysis in patients with vitamin K-dependent coagulation disorder and restriction on availability of anticoagulant rodenticide.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19),which recently spread throughout the entire world,is still a significant health issue.Additionally,the most common cause of risky poisoning in emergency services is carbon...BACKGROUND Coronavirus disease 2019(COVID-19),which recently spread throughout the entire world,is still a significant health issue.Additionally,the most common cause of risky poisoning in emergency services is carbon monoxide(CO)poisoning.Both disorders seem to merit more research as they have an impact on all bodily systems via the lungs.AIM To determine how arterial blood gas and carboxyhemoglobin(COHb)levels affect the clinical and prognostic results of individuals requiring emergency treatment who have both COVID-19 and CO poisoning.METHODS Between January 2018 and December 2021,479 CO-poisoning patients participated in this single-center,retrospective study.Patients were primarily divided into two groups for analysis:Pre-pandemic and pandemic periods.Additionally,the pandemic era was divided into categories based on the presence of COVID-19 and,if present,the clinical severity of the infection.The hospital information system was used to extract patient demographic,clinical,arterial blood gas,COVID-19 polymerase chain reaction,and other laboratory data.RESULTS The mean age of the 479 patients was 54.93±11.51 years,and 187(39%)were female.226(47%)patients were in the pandemic group and 143(30%)of them had a history of COVID-19.While the mean potential of hydrogen(pH)in arterial blood gas of all patients was 7.28±0.15,it was 7.35±0.10 in the pre-pandemic group and 7.05±0.16 in the severe group during the pandemic period(P<0.001).COHb was 23.98±4.19%in the outpatients and 45.26%±3.19%in the mortality group(P<0.001).Partial arterial oxygen pressure(PaO2)was 89.63±7.62 mmHg in the pre-pandemic group,and 79.50±7.18 mmHg in the severe group during the pandemic period(P<0.001).Despite the fact that mortality occurred in 35(7%)of all cases,pandemic cases accounted for 30 of these deaths(85.7%)(P<0.001).The association between COHb,troponin,lactate,partial arterial pressure of carbon dioxide,HCO3,calcium,glucose,age,pH,PaO2,potassium,sodium,and base excess levels in the pre-pandemic and pandemic groups was statistically significant in univariate linear analysis.CONCLUSION Air exchange barrier disruption caused by COVID-19 may have pulmonary consequences.In patients with a history of pandemic COVID-19,clinical results and survival are considerably unfavorable in cases of CO poisoning.展开更多
Background: Acute intoxications result from intentionally or accidentally taking a relatively significant amount of a chemical substance which triggers disturbances in the level of psychophysiological functions, the c...Background: Acute intoxications result from intentionally or accidentally taking a relatively significant amount of a chemical substance which triggers disturbances in the level of psychophysiological functions, the complications of which may lead to mental disorders, physical causalities, and death. Any acute intoxication mostly requires emergency care. Objective: To highlight the prevalence, history, clinical features, emergency treatment, and prediction of acute intoxication cases referred to the emergency services at the Provincial General Reference Hospital in Bukavu, DR-Congo. Methods: A retrospective cross-sectional study was conducted from January 2021 to October 2022 based on an analysis of patients’ medical files. Triage was performed among all-type of patient files recorded in the computerized hospital database Ebale-Sante to sort cases of intoxication. Results: During the observational period, 3966 emergency admissions were counted, of which 321 (8.09%) patients were identified as having acute intoxication. Among these, 100 files that containing sufficient information fit the quality criteria for this study’s analysis. The victims were infants, adolescents and adults aged 1 - 45 years, and 52% were female and 48% were male. Most cases were accidental and, occurred at home, and the victims were driven to the hospital within 2 - 24 hours. The substances consumed included household products, drugs, and herbs. Resuscitation care, antidotes and supportive symptomatic medications ensured that 85% were healed and 10% experienced sequelae;however, 5% died. Conclusion: Acute intoxication occurs in infants mostly accidentally though the ingestion of household products and medicines. Furthermore, suicide cases may occur in traumatized adolescents and discordant couples. People should be informed about how to store hazardous products (e.g.: drugs, household products and pesticides), which should not be available to children, to avoid unintentional poisoning. Special training in clinical toxicology is required to reduce treatment failure.展开更多
文摘Urea as a source of cheap non-protein nitrogen is used to adulterate fish and meat meals which are basic components of broiler diets. The present study was carried out to elucidate the effects of urea on weight gain, and hematological and biochemical profiles. A total of 48 broiler chicks were randomly allotted into 4 groups, designated Groups 1, 2, 3 and 4 of 12 birds each. Birds in Groups 2, 3 and 4 were fed on diets containing urea at the levels of 1%, 2.5% and 4%, respectively. Birds in Group 1 served as control and were not exposed to urea. Experimentation period was for 3 weeks and experiment was terminated when birds were 42 days of age. Body weight of all intoxicated birds at the various intervals was significantly decreased in comparison with that of the untreated control. Compared with control, all intoxicated broilers manifested significant (P ≤ 0.05) decrease in all hematological parameters involving erythrocytic and total leucocytic counts, Hemoglobin (Hb) and Packed Cell Volume (PCV) on a dose- and time-pattern. In comparison with the control levels, biochemical profile of the intoxicated birds disclosed significant decrease in blood glucose level and significant increase in serum uric acid, urea, Alkaline Phosphatase (ALP) and Lactate Dehydrogenase (LDH) levels. Based upon the present data, it was concluded that the addition of urea to broiler diets bears serious sequences concerning the general health condition, performance, weight gain, and hematological and biochemical profiles.
基金supported by Key Program of Scientific Research of Public Welfare Project from the Ministry of Health of the People's Republic of China (No 201202006-02)
文摘Paraquat, is a Bipy herbicide have been widely used in last decade in China. Because of its high human toxicity and mortality characteristics, paraquat has been gained considerable attention in recent years. In order to evaluate the epidemic status of paraquat harm to human health in China, 24 h hotline information about paraquat intoxication consultation from January Ist, 2002 to December 31st, 2011 was collected by experienced practitioners in the Poison Control Center (National Poison Control Center, NPCC)
基金ThisprojectwasgrantedbyNationalNaturalScienceFoundationofChina (No :396 4 0 0 0 6 )
文摘Cadmium (Cd), one of the most dangerous heavy metals, has a very similar ionic radius to calcium (Ca). The interference of cadmium in calcium homeostasis may play an important role in cadmium toxicity. Recent reports indicate that calmodulin (CaM) inhibitors such as trifluoperazine and chlorpromazine (CPZ) could protect rodents against cadmium toxicity. It was also reported that pretreatment of mice with zinc (Zn) could reduce the adverse effects induced by cadmium. The aim of this study is to determine whether Cd changes the balance of other essential metals such as Zn and copper (Cu) in rat tissues, and whether CPZ can reverse these changes which are induced by cadmium intoxication. Adult male Sprague Dawley (SD) rats were injected intraperitoneally (ip) with cadmium chloride (CdCl 2) (0.2, 0.4, 0.8 mg Cd/kg body weight) alone and 0.4mg Cd/kg in association with CPZ (5 mg/kg) daily for a week. The control animals were injected with normal saline only. The results showed that the cadmium content in the liver, kidney and testis increased significantly with a dose response relationship. Cadmium treatment markedly increased the Zn and Ca content in some of the tissues. Hepatic and renal metallothionein (MT) increased significantly after cadmium intoxication. CPZ treatment, however, reduced cadmium content in liver, but not blood and kidney. CPZ seemed to decrease the content of MT in liver and significantly increase the amounts of MT in kidney. These data suggest that the intervention of cadmium with tissue essential metals may play a role in cadmium toxicity in rats, and calmodulin inhibitors to some extent can reduce the adverse effect of cadmium by decreasing the cadmium load in tissues and reversing the unbalance of essential metals.
文摘Antagonising effects of α-ketoglutarate (α-KG) could be attributed to complexing of the reactive nucleophile (CN-) to form cyanohydrin in cyanide intoxication. However, an enormous protection obtained could not be delineated on account of possible in situ binding of α-KG given intraperitoneally (i.p.) in mice to cyanide administered through the same route. The present study was designed to see the efficacy of a-KG alone or in combination with sodium nitrite (SN) and/or sodium thiosulfate (STS) in male mice exposed to cyanide administered through subcutaneous (s.c.) or inhalation route. A technique for generation of hydrogen cyanide (HCN) is also discussed. On the basis of protection index (PI), defined here as the LD50 of cyanide in protected mice/LD50 of cyanide in unprotected mice and survival time, STS + α-KG regimen was equipotent to the conventional SN + STS regimen. This is further substantiated by effect of α-KG in reducing plasma cyanide levels. The efficacy of α-KG remains undeterred irrespective of the route of cyanide intoxication, while the magnitude of protection varies.
文摘<strong>Background: </strong>The main causes of mortality in patients with burn injury are the development of systemic inflammatory process, multiple organ failure and septic complications. <strong>The aim of the research:</strong> Improvement of diagnostic and therapeutic approaches to the detection and elimination of endogenous intoxication in patients with burn injury. <strong>Materials and methods:</strong> The main study group consisted of 19 patients and the comparison group—of 10 patients with burn injury. 92 blood serum (BS) samples of the patients of the main group were tested, using the method of fluorescence spectroscopy (MFS). The advanced therapeutic tactics were proposed for the patients of both groups. The control group consisted of 40 healthy individuals (donors). BS of these patients was also tested using MFS. <strong>Results: </strong>Patients with burn injury have endogenous intoxication in their blood. The effective concentration of albumin is reduced in patients with burn injury due to the blockage of albumin binding centers by bacterial metabolism products. Fluorescence spectra (FS) of BS in patients with burn trauma and donors were obtained and investigated. Based on MFS results, an improved treatment regimen using infusion of albumin solution was proposed. <strong>Conclusions:</strong> An improved technique for the management of patients with burn injury is based on the use of MFS for the diagnostic evaluation of endogenous intoxication in them. The idea of pathological changes in albumin molecules in patients with burn injury is pathogenetically substantiated by the successful use of infusion of albumin solution in these patients on the basis of the MFS.
文摘In a quest for better chelating therapy drugs for the treatment of intoxication by Fe, Al, oractinides, two new series of mixed catechol-bisphosphonate through amide linkage were synthesized.Benzyl group was used as protecting group to avoid the breakage of amide by acid hydrolysis orimcomplete reaction in silylation-dealkylation using bromotrimethylsilane.
文摘Thirty-two mongrel dogs were divided into 4 groups.24 dogs of the 3 therapeutic groupswere inflicted with mild,medium,and severe hemorrhage through right femoral artery bleeding untilthe arterial systolic pressure dropped to 9.33,6.67 and 5.33 kPa,respectively,and then intoxicatedby intravenous NaCN 2.5mg/kg 3min after intoxication,intravenous 4-dimethylaminophenol(DMAP) 2 mg/kg was given.8 dogs of the control were inflicted with mild hemorrhage and similar-ly intoxicated,but no treatment was given.The changes of hemodynamics,blood gases andmethemoglobin were observed in the dogs.It was found that all the dogs of the control died with-in 5 min after administration of NaCN.DMAP could exert an excitatory effect on hemodynamicsand rescue the animals from death.The excitatory effect of DMAP became weaker whilehemorrhage became more severe.DMAP could further disturb the oxygen-caring capacity ofhemoglobin because of the formation of large amounts of methemoglobin when it was used as an anti-dote for cyanide intoxidation accompanied with acute hemorrhage.
文摘The efficacy of α mercapto β (2_furyl) acrylic acid (MFA), α mercapto β (5_sodiumsulfonate, 2_furyl) acrylic acid (MSFA) and α mercapto β (5_acetoxymethyl, 2_furyl) acrylic acid (MAFA) to mobilize intracellularly bound cadmium in liver and kidney was investigated in rats pre_exposed to cadmium. MFA was effective in reducing cadmium levels of hepatic and renal supernatant cytosolic fraction (SCF) while MSFA and MAFA were effective in lowering cadmium levels of renal SCF and hepatic SCF respectively. All the chelating agents also enhanced the excretion of cadmium more in feces than in urine. However, substitution on the furan ring lowered cadmium mobilizing efficacy of the parent compound, MFA. The treatment with MFA did not affect the status of endogenous zinc and copper while the treatment with MSFA and MAFA enhanced their excretion. MSFA increased hepatic and renal zinc and renal copper while MAFA increased their copper levels.
文摘Levothyroxine intoxication is a rare clinical entity which is usually asymptomatic. However, severe symptoms such as respiratory failure, malignant hyperthermia, seizures, arrhythmia, and coma have been reported. In this case report, a patient who ingested high dose (15 mg) levothyroxine for suicide and admitted to intensive care unit was presented. There was a decrease in Glasgow coma score in the follow-up. The patient was intubated due to acute respiratory failure. Gastric lavage, activated charcoal, methylprednisolone, cholestyramine and therapeuthic plasma exchange were administered. Despite ingestion of high dose of levothyroxine, thyrotoxicosis symptoms resolved with appropriate treatment and the patient was discharged from the intensive care unit.
文摘Objective: The objective of this study was to analyse the reversibility of the anticoagulant effect of warfarin by comparing prothrombin complex concentrate (PCC) versus frozen fresh plasma (FFP) in cardiology patients with serious warfarin intoxication. Methods: This was an observational and retrospective study comprising 67 patients (18 in group I [PCC] and 49 in group II [FFP]). The primary endpoint was the reversal of anticoagulant effect of warfarin after 2 and 24 hours of PCC or FFP administration. Comparisons between the groups were made using T-test and Q-square. Multivariate analyses were conducted using logistic regression, and the results were considered significant when p Results: The medium dose used was 27.6 UI/kg of PCC and 14.5 ml/kg of FFP. Significant differences were observed between groups I and II in the INR reversibility measurements after 2 hours (33.3% vs. 6.1%, p = 0.001) and 24 hours (38.9% vs. 12.2%, p = 0.009) as well as in the occurrence of pulmonary edema (5.6% vs. 42.9%, OR = 11.10, p = 0.04). The AUC for PCC was 0.891 (CI 95% [0.72 - 1.0]), and for FFP, it was 0.291 (CI 95% [0.09 - 0.49]). Conclusions: PCC is better than FFP treatment in reversing the warfarin intoxication after 2 and 24 hours of administration. Furthermore, PCC showed lower pulmonary edema in cardiology patients.
文摘Renal damage secondary to paracetamol intoxication is rare, estimated between 1% and 2% of intoxication cases. Its pathophysiology is still debated, the clinical involvement consisting in an acute tubular necrosis with a good prognosis if it is rapidly treated. Renal damage can sometimes occur without prior hepatic damage, and the onset of renal manifestations is generally between the 2nd and 7th day after taking paracetamol. If its management remains exclusively symptomatic, its late onset can sometimes lead to serious metabolic complications. It is therefore important to systematically monitor renal function following paracetamol drug intoxication. We report the case of a 60-year-old male subject hospitalized for the management of voluntary drug intoxication (VDI) with paracetamol complicated by acute hepatocellular failure and acute renal failure. His management required extrarenal purification (hemodialysis) and the evolution was favorable with recovery ad integrumof renal function. Conclusion: Although less known and of unelucidated physiopathology, nephrotoxicity secondary to voluntary drug intoxication with paracetamol is a reality and can lead in extreme cases to the use of extrarenal purification technique (hemodialysis).
文摘The use of bioactive compounds as alternative medicine in the treatment of some intoxication cases is growing in the last years.Flavonoids are one of these bioactive compounds that are plant-based dietary nutrients.Naringenin is the most influential flavonoid wherein it is found in citrus fruits such as orange,grapefruit,and mandarin.A lot of studies showed the ability of naringenin to scavenge free radicals in different body tissues preventing oxidative stress toxicity and lipid peroxidation.Therefore,naringenin can protect many body organs and systems against toxic manifestations of many drugs and toxic agents.So,it prevents the liver,kidney,heart,testes,and neurological system from toxic effects of a wide range of toxicants.Moreover,it can also ameliorate manifestations of cytotoxicity and developmental toxicity based on its efficacy as an antioxidant.
文摘Background: The aim of this study was to evaluate the clinical and epidemiological characteristics of patients with acute intoxication admitted to the Intensive Care Unit (ICU). Material and Methods: An observational retrospective study was conducted on intoxicated patients who admitted to ICU between January 2022 and January 2024. Data were collected from the patients medical records. The demographic characteristics, causes of intoxications, clinical parameters, the mean stay in the ICU, treatment modalities and prognosis were recorded. Results: A total of 2875 critically ill patients were admitted during the study period, and 109 (3.79%) of them were acute intoxications. Their mean of ages was 38.09 ± 12.29. The female-to-male ratio was 1.37/1. Drugs were found to be the primary cause (62.39%) of intoxications, and analgesics, antidepressants, and antibiotics were the most frequent agents. Suicidal attempts were present in 66 patients, most of them were female (62.13%) and between 17 - 24 years (40.91%). The other common causes of intoxications were carbon monoxide (CO) (22.02%), methyl/ethyl alcohol (8.26%) and mushroom (5.50%). The mean stay in the ICU was 2.69 ± 0.89 days. Mechanical ventilation was applied to 10 of our patients. Renal replacement therapy was required in 6 patients. Despite all treatments, 6 of our patients died, and we found the mortality rate to be 5.50%. Conclusion: Intoxications were more frequent in young female patients and drugs were the most common cause with suicidal intent. Unfortunately, CO poisoning continues to be a very important problem in our city. These findings provided significant information about the characteristics of intoxications in Karabuk.
文摘Chinese medicine (CM) has been widely used in Hong Kong for centuries. In fact, CM practitioners currently provide over 20% of the medical consultations in Hong Kong and about 60% of the population has previously used CM. In 1999, the Legislative Council passed the Chinese Medicine Ordinance with aims to govern practice, use, trading, and manufacturing of CM in Hong Kong. While it is usually safe to use CM under proper application and guidance, there have been frequent reports on intoxication and fatalities. The misuse of potent/toxic CM, because of misidentification or overdose, can cause severe aconite, aristolochic acid, anticholinergic, podophyllin, grayanotoxin, pyrrolizidine alkaloids, matrine, gelsemine, teucvin, and strychnine poisoning. In this review, we summarized CM intoxication cases in Hong Kong, concentrating on the discussion of toxic and adverse effects as well as the quality control of CM. By increasing the awareness of CM toxicity, we hope to enhance the regulatory process and stimulate further research on their toxic dose, toxic ingredients, intoxication mechanisms, and quality control.
基金Supported by the National Natural Science Foundation of China(No.81473547,81673829)the Beijing Municipal Organization Department Talents Project(No.2017000020124G292)
文摘Objectives:To investigate the effectiveness and safety of Xingnaojing Injection(XNJ,醒脑静注射液)compared with naloxone for the treatment of acute alcohol intoxication(AAI),and provide the latest evidence through evidence-based approach.Methods:Seven electro-databases including Pub Med,EMBASE,Cochrane Central Register of Controlled Trials,Chinese National Knowledge Infrastructure Databases,Chinese Biomedical Literature Database,Chinese Science and Technology Periodical Database(VIP)and Wanfang Database were searched from the inception to January 2018.Randomized controlled trials(RCTs)comparing XNJ with naloxone for patients with AAI and reporting at least one of the below outcomes were included:patients’conscious recovery time,stay length in emergency department,disappearance time of the ataxia symptom,the severity of the symptoms,the blood alcohol content as wel as the adverse events.Methodological quality of included trials was assessed using the risk of bias tool which recommended by the Cochrane Col aboration.Meta-analysis was conducted by Review Manager 5.3 software.Results:Total y 141 trials with 13,901 patients were included in this review,al of them were assessed as unclear or high risk of bias.Results showed that on the basis of routine therapy,standard dose XNJ(10–20 m L)may have similar results with naloxone on the recovery time of consciousness(MD 12 min,95%CI 7.2–17.4 min)and disappearance time of symptoms(MD 6 min,95%CI–13.8–25.8 min)for patients with AAI.Larger dose of XNJ Injection(21–40 m L)may speed up the time(almost 1 h earlier).Combination of XNJ and naloxone seemed superior to the naloxone alone for al the relevant outcomes.The average difference of time in consciousness recovery was 2 h and the number of AAI patients whose consciousness recovery within 1 h was above 50%the combination group than in the control group(RR 1.42,95%CI 1.29 to 1.56).No severe adverse events or adverse reactions of XNJ were reported in the included trials.Conclusions:Low quality of evidence showed XNJ may have equal effect as naloxone and may achieve better effect as add-on intervention with naloxone for patients with AAI.We failed to evaluate the safety of XNJ Injection due to the insufficient evidence in this review.
文摘Cases of acute pancreatitis induced by organophosphate intoxication are encountered occasionally in clinics, but very few of them develop into severe pancreas necrosis and irreversible pancreatic function impairment. Here, we report a 47-year-old female organophosphate poisoning case after ingestion of massive insecticides;she was considered to have total necrosis and function failure of the pancreas via serum amylase test, glucose level test, and CT imaging. The patient exhibited no relief under the regular medicine treatment, which included sandostatin, antibiotics, intravenous atropine, and pralidoxime methiodide. She received percutaneous catheterization and drainage of pancreatic zone to expel hazardous necrotic waste, also by which the pathogenic evidence was obtained and the antibiotics were adjusted subsequently. The patient recovered gradually, was discharged after 2 weeks, and was prescribed with oral pancreatin capsules before meals and hypodermic insulin at meals and bedtime to compensate the impaired pancreatic function.
文摘3-Methoxyphencyclidine(3-MeO-PCP)is a new psychoactive substance that belongs to the phencyclidines family,first identified in Europe in 2012.This drug presents a stronger binding to N-methyl-D-aspartate(NMDA)receptors when compared to phencyclidine,which results in more potent effects,even at low concentrations.Very few articles have been published regarding 3-MeO-PCP in forensic toxicology.In this paper,the authors present a fatal 3-MeO-PCP intoxication case.In addition to the detection of the parent drug,metabolites were investigated in urine and,for the first time in the scientific literature,in blood.3-MeO-PCP and its metabolites were quantitated by liquid chromatography-tandem mass spectrometry system(LC-MS/MS).Identification was confirmed by liquid chromatography-high resolution mass spectrometry(LC-HRMS).3-MeO-PCP tested positive in femoral blood(3525 ng/mL)and urine(7384 ng/mL).The femoral blood concentration was higher than the fatal concentrations range already reported in the literature(from 50 to 3200 ng/mL).3-MeO-PCP metabolites,including O-demethyl-3-MeO-PCP,piperidine-OH-3-MeO-PCP,O-demethyl-piperidine-di-OH-3-MeO-PCP and piperidine-di-OH-3-MeO-PCP,were detected in blood.In addition,two new metabolites,O-demethyl-piperidine-OH-3-MeO-PCP and O-demethyl-cyclohexyl-OH,were identified in both blood and urine.Unfortunately,due to the lack of reference material on the market,it was not possible to measure the concentration of these metabolites.However,the ratios between the metabolites and the parent drug were useful to estimate their analytical response and prevalence.At this time,considering the low ratios(<1)between metabolites and parent drug,metabolites testing does not seem useful to increase the detection window of the drug.
基金supported by the National Natural Science Foundation of China[81273340],[81302614]the National Institute Scientific Program[GY2013G-7],[GY2013G-9]the Science and Technology Commission of Shanghai Municipality[13ZR1443000],[KW-201556005],[14DZ2270800/16DZ2290900].
文摘The study was designed to analyze the incidence and pattern of anticoagulant rodenticide intoxication in east China and to discuss strategies of diagnosis based on laboratory analysis experience.A total of 117 patients with anticoagulant rodenticide poisoning confirmed by toxicological analysis in east China were included in this study from 2011 to 2013.The mean concentration of anticoagulant rodenticide,age,and gender of these patients,as well as the mode and type of poisoning,were discussed.The age ranged from less than 1 to 80 years with the feeble preponderance of males(M D 53.0%,F D 47.0%).The 0–9 age group covered the largest ratio of these anticoagulant rodenticide poisoning patients.Accidental or voluntary ingestion seems to be the most common cause of intoxication,with still the poisoning cause being unknown for a large number of positive analyses.Bromadiolone was the most commonly observed anticoagulant rodenticide found in the biological samples,followed by brodifacoum.The concentrations of bromadiolone and brodifacoum that were detected in the first collected whole blood from each patient ranged from 1 to 878 ng/mL(mean 97.9 ng/mL)and from 0.5 to 1566 ng/mL(mean 225.1 ng/mL),respectively.The data analysis shows a high incidence of anticoagulant rodenticide poisoning without awareness of the poisoned subjects,clearly emphasizing the need for toxicological analysis in patients with vitamin K-dependent coagulation disorder and restriction on availability of anticoagulant rodenticide.
文摘BACKGROUND Coronavirus disease 2019(COVID-19),which recently spread throughout the entire world,is still a significant health issue.Additionally,the most common cause of risky poisoning in emergency services is carbon monoxide(CO)poisoning.Both disorders seem to merit more research as they have an impact on all bodily systems via the lungs.AIM To determine how arterial blood gas and carboxyhemoglobin(COHb)levels affect the clinical and prognostic results of individuals requiring emergency treatment who have both COVID-19 and CO poisoning.METHODS Between January 2018 and December 2021,479 CO-poisoning patients participated in this single-center,retrospective study.Patients were primarily divided into two groups for analysis:Pre-pandemic and pandemic periods.Additionally,the pandemic era was divided into categories based on the presence of COVID-19 and,if present,the clinical severity of the infection.The hospital information system was used to extract patient demographic,clinical,arterial blood gas,COVID-19 polymerase chain reaction,and other laboratory data.RESULTS The mean age of the 479 patients was 54.93±11.51 years,and 187(39%)were female.226(47%)patients were in the pandemic group and 143(30%)of them had a history of COVID-19.While the mean potential of hydrogen(pH)in arterial blood gas of all patients was 7.28±0.15,it was 7.35±0.10 in the pre-pandemic group and 7.05±0.16 in the severe group during the pandemic period(P<0.001).COHb was 23.98±4.19%in the outpatients and 45.26%±3.19%in the mortality group(P<0.001).Partial arterial oxygen pressure(PaO2)was 89.63±7.62 mmHg in the pre-pandemic group,and 79.50±7.18 mmHg in the severe group during the pandemic period(P<0.001).Despite the fact that mortality occurred in 35(7%)of all cases,pandemic cases accounted for 30 of these deaths(85.7%)(P<0.001).The association between COHb,troponin,lactate,partial arterial pressure of carbon dioxide,HCO3,calcium,glucose,age,pH,PaO2,potassium,sodium,and base excess levels in the pre-pandemic and pandemic groups was statistically significant in univariate linear analysis.CONCLUSION Air exchange barrier disruption caused by COVID-19 may have pulmonary consequences.In patients with a history of pandemic COVID-19,clinical results and survival are considerably unfavorable in cases of CO poisoning.
文摘Background: Acute intoxications result from intentionally or accidentally taking a relatively significant amount of a chemical substance which triggers disturbances in the level of psychophysiological functions, the complications of which may lead to mental disorders, physical causalities, and death. Any acute intoxication mostly requires emergency care. Objective: To highlight the prevalence, history, clinical features, emergency treatment, and prediction of acute intoxication cases referred to the emergency services at the Provincial General Reference Hospital in Bukavu, DR-Congo. Methods: A retrospective cross-sectional study was conducted from January 2021 to October 2022 based on an analysis of patients’ medical files. Triage was performed among all-type of patient files recorded in the computerized hospital database Ebale-Sante to sort cases of intoxication. Results: During the observational period, 3966 emergency admissions were counted, of which 321 (8.09%) patients were identified as having acute intoxication. Among these, 100 files that containing sufficient information fit the quality criteria for this study’s analysis. The victims were infants, adolescents and adults aged 1 - 45 years, and 52% were female and 48% were male. Most cases were accidental and, occurred at home, and the victims were driven to the hospital within 2 - 24 hours. The substances consumed included household products, drugs, and herbs. Resuscitation care, antidotes and supportive symptomatic medications ensured that 85% were healed and 10% experienced sequelae;however, 5% died. Conclusion: Acute intoxication occurs in infants mostly accidentally though the ingestion of household products and medicines. Furthermore, suicide cases may occur in traumatized adolescents and discordant couples. People should be informed about how to store hazardous products (e.g.: drugs, household products and pesticides), which should not be available to children, to avoid unintentional poisoning. Special training in clinical toxicology is required to reduce treatment failure.