-
The New England Journal of Medicine Apr 2018
Review
Topics: Algorithms; Chemical Terrorism; Chemical Warfare; Chemical Warfare Agents; Decontamination; Diagnosis, Differential; History, 20th Century; History, Ancient; Humans; Poisoning; Triage
PubMed: 29694809
DOI: 10.1056/NEJMra1705224 -
Journal of Applied Toxicology : JAT Apr 2022The potential of acridines (amsacrine) as a topoisomerase II inhibitor or poison was first discovered in 1984, and since then, a considerable number of acridine... (Review)
Review
The potential of acridines (amsacrine) as a topoisomerase II inhibitor or poison was first discovered in 1984, and since then, a considerable number of acridine derivatives have been tested as topoisomerase inhibitors/poisons, containing different substituents on the acridine chromophore. This review will discuss a series of studies published over the course of the last decade, which have investigated various novel acridine derivatives against topoisomerase II activity.
Topics: Acridines; Amsacrine; Antineoplastic Agents; DNA Topoisomerases, Type II; Poisons
PubMed: 34514603
DOI: 10.1002/jat.4238 -
The Veterinary Clinics of North... Nov 2020Poisonous plant intoxication is one of the first considerations for various livestock diseases and unexplained animal deaths. Although toxic plants commonly poison... (Review)
Review
Poisonous plant intoxication is one of the first considerations for various livestock diseases and unexplained animal deaths. Although toxic plants commonly poison livestock, obtaining a definitive diagnosis is difficult and challenging. This article provides a framework to help livestock producers, veterinarians, and diagnosticians reach the most accurate and definitive diagnosis. For this discussion poisoning caused by plants containing dehydropyrrolizidine alkaloids is used to provide examples and suggestions for investigating and sampling. It is also used to show how to recruit expert collaborators, diagnostic resources, and information sources to amass required expertise, information, and laboratory results to produce the best diagnosis.
Topics: Animals; Livestock; North America; Plant Poisoning; Plants, Toxic
PubMed: 33032697
DOI: 10.1016/j.cvfa.2020.08.001 -
Environmental Science and Pollution... May 2021Organophosphorus compounds (OPs) are neurotoxic molecules developed as pesticides and chemical warfare nerve agents (CWNAs). Most of them are covalent inhibitors of...
Organophosphorus compounds (OPs) are neurotoxic molecules developed as pesticides and chemical warfare nerve agents (CWNAs). Most of them are covalent inhibitors of acetylcholinesterase (AChE), a key enzyme in nervous systems, and are therefore responsible for numerous poisonings around the world. Many animal models have been studied over the years in order to decipher the toxicity of OPs and to provide insights for therapeutic and decontamination purposes. Environmental impact on wild animal species has been analyzed to understand the consequences of OP uses in agriculture. In complement, various laboratory models, from invertebrates to aquatic organisms, rodents and primates, have been chosen to study chronic and acute toxicity as well as neurobehavioral impact, immune response, developmental disruption, and other pathological signs. Several decontamination approaches were developed to counteract the poisoning effects of OPs. Among these, enzyme-based strategies are particularly attractive as they allow efficient external decontamination without toxicity or environmental impact and may be of interest for treatment. Approaches using bioscavengers for prophylaxis, treatment, and external decontamination are emphasized and their potential is discussed in the light of toxicological observations from various animal models. The relevance of animal models, regarding their cholinergic system and the abundance of naturally protecting enzymes, is also discussed for better extrapolation of results to human.
Topics: Acetylcholinesterase; Animals; Antidotes; Chemical Warfare Agents; Cholinesterase Inhibitors; Organophosphate Poisoning; Organophosphorus Compounds; Pesticides; Poisoning
PubMed: 29959732
DOI: 10.1007/s11356-018-2465-5 -
Endocrine, Metabolic & Immune Disorders... 2022The first traces of man's of poison use date back to ten thousand years ago since the last period of the Paleolithic era. Man used poison for hunting and defense.... (Review)
Review
The first traces of man's of poison use date back to ten thousand years ago since the last period of the Paleolithic era. Man used poison for hunting and defense. Indeed, in the second half of the 19th century, arrows made from the bones of animals characterized by particular grooves were found in some caves. In ancient Greece, the term pharmakon (φάρμακον) had a double meaning: remedy for therapy and venom. This is the period in which humans became aware of the fact that poison cannot be defined simply as a substance capable of changing the properties of things. Poison is very frequently mentioned in the history of the Roman Empire, and its use continued through the Renaissance and even during the modern era. Poison was the protagonist in multiple political intrigues of power and is one of the most used lethal weapons over the years. Thought of as the optimal solution for a perfect murder, the poison has a long history. Its success is due to the invisible, untraceable, and often unpunished death it causes.
Topics: Animals; Greece, Ancient; Humans; Male; Poisons; Venoms
PubMed: 32885764
DOI: 10.2174/1871530320666200904105816 -
Bundesgesundheitsblatt,... Nov 2019Exotic poisonous animals such as snakes, marine animals, spiders, and scorpions are a rarity in Central Europe, but are kept as pets by some people. Poisoning caused by... (Review)
Review
Exotic poisonous animals such as snakes, marine animals, spiders, and scorpions are a rarity in Central Europe, but are kept as pets by some people. Poisoning caused by these animals is a particular challenge in medical care.Over a period of six years (2001-2006), a total of 202 cases of poisoning with exotic animals were registered and evaluated at four poison information centers in Germany and France. Of the accidents, 91% happened in the home environment; the rest in pet stores. The poisonings were caused by snakes (38%), marine animals (31%), arthropods (spiders and scorpions, 27%), and other poisonous animals (4%). Severe poisoning was involved in 8% of the cases, all caused by snake bites. The severe poisonings were in the form of coagulopathies, severe local symptoms, and a respiratory insufficiency requiring intubation. In six cases of severe poisoning, an immune serum (antivenom) was administered and in three cases a surgical procedure was needed. Deaths did not occur.After the bite of a poisonous animal, the affected limb should usually be immobilized and disinfected, but not tied, cut, or sucked. The exact biological name of the species should be identified. In addition to hospitalization, it is recommended to consult a poison information center.
Topics: Animals; Animals, Exotic; Europe; Germany; Humans; Poisoning; Scorpions; Snake Bites
PubMed: 31578622
DOI: 10.1007/s00103-019-03025-6 -
Legal Medicine (Tokyo, Japan) Feb 2023Poisons are potentially harmful substances that can cause damage to the human body. Children are a vulnerable group to poisoning. This article aims to review the deaths... (Review)
Review
Poisons are potentially harmful substances that can cause damage to the human body. Children are a vulnerable group to poisoning. This article aims to review the deaths due to poisoning among children in Saudi Arabia. A comprehensive search was conducted on 13 January 2022 using PubMed, Scopus, and Web of Science databases to identify articles that reported on pediatric poisoning deaths in Saudi Arabia. Eight articles met the inclusion criteria and were included in this systematic review. Some articles included one city, for instance, Jeddah or Riyadh, while others included different regions of the country. Children got poisoned most commonly at their homes by accidental ingestion. The common substances that caused fatality included drugs and pesticides. Low caregiver awareness and neglect were recognized as risk factors for pediatric poisoning. Further studies should be conducted to provide comprehensive details about the victims, the poisons involved, and the circumstances of pediatric poisonings in Saudi Arabia at the national and sub-national levels. Public awareness campaigns should be organized to raise community awareness about safety measures and risks of neglect to prevent pediatric poisonings.
Topics: Female; Child; Humans; Saudi Arabia; Poisons; Perinatal Death; Risk Factors; Poisoning
PubMed: 36395600
DOI: 10.1016/j.legalmed.2022.102173 -
Clinical Toxicology (Philadelphia, Pa.) Sep 2022Cyanide is a prevalent, lethal chemical. Possible sources of exposure include products of combustion, plant material, industry, chemical warfare and terrorism.
INTRODUCTION
Cyanide is a prevalent, lethal chemical. Possible sources of exposure include products of combustion, plant material, industry, chemical warfare and terrorism.
METHODS
Retrospective review of UK Poisons Information Database of telephone enquiries to the National Poisons Information Service between 1 January 2008 and 31 December 2019 where cyanide poisoning was considered a possibility. Data extracted included demographics, exposure source, clinical features, Poisoning Severity Score, lactate concentration and antidotes given.
RESULTS
A total of 1,252 cases of suspected cyanide poisoning were identified, 239 (19%) involved children under 10 years. The commonest sources of exposure were ingestion of plant material (437 cases; 35%) and smoke inhalation (399; 32%). Smoke inhalation caused the majority of severe and fatal cases (139; 71%). Clinical features associated with fatal outcomes were cardiac arrest (OR 36.4; 95% CI 14.4-92.2), hypotension (15.8; 7.0-35.9), coma (10.8; 5.6-21.0) and lactic acidosis (7.8; 4.1-14.8). 110 patients (9%) were given an antidote and 40 patients (3%) died.Lactate concentrations correlate with Poisoning Severity Score category ( = 0.6, < 0.0001). Serum lactate <2.0 mmol/L was associated with Poisoning Severity Score None or Minor (sensitivity 76%; specificity 86%) and >11.0 mmol/L was associated with fatal outcome (sensitivity 74%; specificity 80%). 61 cases (5%) had severe carboxyhaemoglobin toxicity (COHb >30%). This was associated with a fatal outcome (OR 7.0; 95% CI 1.5-33.7) and there was positive correlation between carboxyhaemoglobin and Poisoning Severity Score, = 0.57, < 0.0001.
CONCLUSIONS
Most cases of ingestion of plant material involved children under five years and resulted in no or mild symptoms. In adults smoke inhalation was associated with the most severe poisoning. The lactate cut-off values associated with each severity score calculated in this study are lower than the values used by NPIS on TOXBASE. Analytical conformation of cyanide exposure was unavailable in the majority of case, limiting the strength of these conclusions.
Topics: Adult; Antidotes; Carboxyhemoglobin; Child; Child, Preschool; Cyanides; Humans; Information Services; Lactic Acid; Poisoning; Poisons; Smoke; Smoke Inhalation Injury; United Kingdom
PubMed: 35635241
DOI: 10.1080/15563650.2022.2080074 -
Hepatology (Baltimore, Md.) Jul 2019
Topics: Alleles; Biomarkers; Chemical and Drug Induced Liver Injury, Chronic; Fallopia multiflora; HLA-B Antigens; Humans; Poisons; Polygonum
PubMed: 31155733
DOI: 10.1002/hep.30798 -
Clinical Toxicology (Philadelphia, Pa.) Mar 2023Although poisonings due to a toxic substance being decanted into a secondary container are often reported to poison centers, we were unable to locate prior European data...
BACKGROUND
Although poisonings due to a toxic substance being decanted into a secondary container are often reported to poison centers, we were unable to locate prior European data about their circumstances, incidence and consequences. We sought to describe the circumstances and outcomes of this behavior.
MATERIALS AND METHOD
We conducted a prospective study of all poison exposures involving transfer to a secondary container reported to our poison center during a six month interval (January 1, 2021 through June 30, 2021). We called patients and clinicians for follow up the next day. We used a prepared questionnaire and added the responses to the national database for French poison centers.
RESULTS
We identified and included 238 patients (104 male, 134 female) with a median age of 39 years [range 0-94 y]. Exposure was mainly oral ( = 221), the secondary container was mainly a water bottle ( = 173), toxic substances were essentially cleaning products ( = 63) or bleach ( = 48). Symptoms were gastrointestinal (vomiting, diarrhea, abdominal pain) ( = 143) or respiratory (cough, dyspnea, aspiration pneumonia) ( = 15). The World Health Organisation/International Programme on Chemical Safety/European Commission/European Association of Poison Centres and Clinical Toxicologists Poisoning Severity Score was none in 76 cases (31.9%), minor in 147 (61.8%), moderate in 12 (5%), and severe in three cases (1.3%). Products that led to severe poisoning contained either ammonium hydroxide or sodium hydroxide. Two of the patients required intensive care treatment. At the end of the follow-up, 235 patients fully recovered, and three patients had sequelae.
CONCLUSIONS
The study illustrates the risk of toxic substance transfer. Water bottles were the secondary containers in most exposures to decanted substances. Most had minor or no effects, but nearly one-quarter were admitted to the hospital. The few severe exposures involved either ammonium hydroxide or sodium hydroxide.
Topics: Humans; Male; Female; Infant, Newborn; Infant; Child, Preschool; Child; Adolescent; Young Adult; Adult; Middle Aged; Aged; Aged, 80 and over; Sodium Hydroxide; Ammonium Hydroxide; Prospective Studies; Poison Control Centers; Poisons; Poisoning
PubMed: 36892538
DOI: 10.1080/15563650.2022.2163658