A case of chemical eye injuries and aspiration pneumonia caused by occupational acute chemical poisoning

Dear editor,According to the China’s National Standard Diagnostic Criteria of Occupational Diseases,occupational acute chemical poisoning refers to the short-term exposure of workers to several chemicals during production,resulting in corresponding organ damage.Herein,we report a case of chemical eye injuries and aspiration pneumonia caused by acute chemical poisoning in the chemical industry.

Beware of the serious harm of veterinary drug poisoning:a case report

Veterinary drugs are substances(including pharmaceutical feed additives)used to prevent,treat,and diagnose diseases or regulate the physiological functions of animals.Veterinary drug poisoning in humans is relatively rare both in China and the rest of the world.Here,we report a case of death from veterinary drug poisoning from avermectin-closantel.Avermectin-closantel is a broad-spectrum antiparasitic drug,which has high efficacy against a variety of trematodes and nematodes.

Early diagnosis, treatment, and outcomes of five patients with acute thallium poisoning

BACKGROUND Thallium poisoning is rare and difficult to recognize.Early diagnosis and treatment of thallium-poisoned patients are essential to prevent morbidity and mortality.AIM To evaluate the efficacy of treatments and outcomes of five patients with early diagnosis of acute thallium poisoning.METHODS Five patients who consumed a thallium-contaminated meal were hospitalized in succession,and underwent clinical examinations such as blood tests and electromyography tests.Urine and blood tests confirmed the diagnosis of thallotoxicosis,revealing the occurrence of food poisoning.All patients underwent detoxification treatment,including hemoperfusion(HP)and treatment with Prussian blue(PB).A 24-mo follow-up was performed to evaluate the long-term outcomes on the patients after discharge.RESULTS Initially,the patients presented with symptoms of acute thallium poisoning including hyperalgesia of the limbs and abdominalgia,which may differ from common peripheral neuropathy.Accompanying symptoms such as hepatic damage and alopecia were observed in all the patients,which further confirmed the diagnosis of poisoning.Treatment with chelating agents was ineffective,while HP and treatment with PB drastically decreased the thallium concentration in the urine and blood.With early diagnosis and intervention,four patients had a good prognosis and no permanent sequelae.One patient developed blindness and disability during the 24-mo follow-up period.CONCLUSION Identification of incident cluster and characteristic symptoms is extremely important for early diagnosis of acute thallium poisoning.HP plus PB is essential to improve the prognosis of thallium-poisoned patients.

Clinical analysis of pipeline dredging agent poisoning:A case report

BACKGROUND Pipeline dredging agents are new household deep cleaning products used to dredge blockages in kitchen and bathroom pipeline caused by grease,hair,vegetable residue,paper cotton fibre,and other organic substances.Pipeline dredging agents are corrosive chemicals that can cause poisoning through corrosive damage to the digestive tract;however,this has not been reported clinically.Therefore,this report emphasises that oral pipeline dredging agent poisoning can cause corrosive damage to the digestive tract and may have serious health consequences.CASE SUMMARY A 68-year-old man consumed liquor(200 m L) at approximately 13:00 on April 22,2021.At approximately 16:00,his family found him unresponsive with blackened lips,blood spots in the corners of the mouth,and blood stains on the ground,as well as an empty bottle of a pipeline dredging agent.One hour later,he was admitted to the emergency department of a local hospital.Considering the empty bottle,he was suspected to have sustained severe corrosive damage to the digestive tract and was transferred to our department at 23:15 on April 22,2021.He developed dysphagia and intermittent fever and experienced difficulty in opening his mouth throughout his hospital stay.The patient’s condition gradually stabilised.However,he suddenly developed respiratory failure on day 12,and endotracheal intubation and ventilator-assisted ventilation were performed.However,the patient died after 1.5 h despite emergency rescue efforts.CONCLUSION Pipeline dredging agents are highly corrosive and may cause corrosive damage to the digestive tract and asphyxia upon consumption.

An incident of chloroform poisoning on a university campus

Dear editor,University laboratory-related events include fire,explosion,chemical gas leakage,poisoning related to the loss of toxic reagents,specific pathogen infection,leakage of radioactive material,etc.[1]Chloroform is an important material used frequently in the laboratory,for organic synthesis or used as an organic glass binder and organic matter extractor.[2]As a widely used anesthetic in clinics in the 1950s and the 1960s,[3]chloroform was abandoned because of hepatorenal toxicity.We report a case of a 24-year-old suicidal female student with chloroform poisoning.

Neurotoxicity due to dimethylamine borane poisoning via skin absorption:a case report

Dear editor,Dimethylamine borane(DMAB,CAS no.74-94-2),also called boron-dimethylamine complex,is a white crystalline solid.It has an amine odour under mild conditions.[1]As an excellent reducing agent,DMAB is widely used in the semiconductor industry,pharmaceutical manufacturing,[2]oligomer and polymer production,and hydrogen storage.[3]Acute DMAB exposure may cause eye or respiratory irritation,throat discomfort,vomiting,diarrhoea,and pulmonary oedema.[1,4]Isolated reports indicated that DMAB exposure causes acute cerebellar oedema and peripheral neuropathy.[1,5,6]Herein,we report a case of DMAB poisoning via dermal absorption in which the central and peripheral nervous systems were the primary sites of toxic injury.We highlight the use of brain magnetic resonance imaging(MRI)and electromyography(EMG)for evaluation after exposure.

Expert consensus on prevention and cardiopulmonary resuscitation for cardiac arrest in COVID-19

Background:Cardiopulmonary resuscitation(CPR)strategies in COVID-19 patients differ from those in patients suffering from cardiogenic cardiac arrest.During CPR,both healthcare and non-healthcare workers who provide resuscitation are at risk of infection.The Working Group for Expert Consensus on Prevention and Cardiopulmonary Resuscitation for Cardiac Arrest in COVID-19 has developed this Chinese Expert Consensus to guide clinical practice of CPR in COVID-19 patients.Main recommendations:1)A medical team should be assigned to evaluate severe and critical COVID-19 for early monitoring of cardiac-arrest warning signs.2)Psychological counseling and treatment are highly recommended,since sympathetic and vagal abnormalities induced by psychological stress from the COVID-19 pandemic can induce cardiac arrest.3)Healthcare workers should wear personal protective equipment(PPE).4)Mouth-to-mouth ventilation should be avoided on patients suspected of having or diagnosed with COVID-19.5)Hands-only chest compression and mechanical chest compression are recommended.6)Tracheal-intubation procedures should be optimized and tracheal-intubation strategies should be implemented early.7)CPR should be provided for 20-30 min.8)Various factors should be taken into consideration such as the interests of patients and family members,ethics,transmission risks,and laws and regulations governing infectious disease control.Changes in management:The following changes or modifications to CPR strategy in COVID-19 patients are proposed:1)Healthcare workers should wear PPE.2)Hands-only chest compression and mechanical chest compression can be implemented to reduce or avoid the spread of viruses by aerosols.3)Both the benefits to patients and the risk of infection should be considered.4)Hhealthcare workers should be fully aware of and trained in CPR strategies and procedures specifically for patients with COVID-19.