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The American Journal of Gastroenterology Dec 2023Diagnosis of drug-induced liver injury (DILI) is difficult. We reviewed cases in the DILI Network prospective study that were adjudicated to have liver injury due to... (Review)
Review
INTRODUCTION
Diagnosis of drug-induced liver injury (DILI) is difficult. We reviewed cases in the DILI Network prospective study that were adjudicated to have liver injury due to other causes to discover pearls for improved diagnostic accuracy.
METHODS
Cases were adjudicated by expert opinion and scored from 1 (definite DILI) to 5 (unlikely DILI). Confirmed cases (1-3) were compared with unlikely cases (5).
RESULTS
One hundred thirty-four of the 1,916 cases (7%) were unlikely DILI. Alternative diagnoses were autoimmune hepatitis (20%), hepatitis C (20%), bile duct pathology (13%), and hepatitis E (8%).
DISCUSSION
Thorough evaluation, including follow-up, is essential to minimize incorrect diagnosis of idiosyncratic DILI.
Topics: Humans; Prospective Studies; Chemical and Drug Induced Liver Injury; Liver; Hepatitis C; Causality
PubMed: 37311048
DOI: 10.14309/ajg.0000000000002370 -
Orphanet Journal of Rare Diseases Jun 2024This study aimed to analyze and map scientific literature on Neuroleptic Malignant Syndrome (NMS) and Serotonin Syndrome (SS) from prestigious, internationally indexed... (Review)
Review
OBJECTIVE
This study aimed to analyze and map scientific literature on Neuroleptic Malignant Syndrome (NMS) and Serotonin Syndrome (SS) from prestigious, internationally indexed journals. The objective was to identify key topics, impactful articles, prominent journals, research output, growth patterns, hotspots, and leading countries in the field, providing valuable insights for scholars, medical students, and international funding agencies.
METHODS
A systematic search strategy was implemented in the PubMed MeSH database using specific keywords for NMS and SS. The search was conducted in the Scopus database, renowned for its extensive coverage of scholarly publications. Inclusion criteria comprised articles published from 1950 to December 31st, 2022, restricted to journal research and review articles written in English. Data were analyzed using Microsoft Excel for descriptive analysis, and VOSviewer was employed for bibliometric mapping.
RESULTS
The search yielded 1150 articles on NMS and 587 on SS, with the majority being case reports. Growth patterns revealed a surge in NMS research between 1981 and 1991, while SS research increased notably between 1993 and 1997. Active countries and journals differed between NMS and SS, with psychiatry journals predominating for NMS and pharmacology/toxicology journals for SS. Authorship analysis indicated higher multi-authored articles for NMS. Top impactful articles focused on review articles and pathogenic mechanisms. Research hotspots included antipsychotics and catatonia for NMS, while SS highlighted drug interactions and specific medications like linezolid and tramadol.
CONCLUSIONS
NMS and SS represent rare but life-threatening conditions, requiring detailed clinical and scientific understanding. Differential diagnosis and management necessitate caution in prescribing medications affecting central serotonin or dopamine systems, with awareness of potential drug interactions. International diagnostic tools and genetic screening tests may aid in safe diagnosis and prevention. Reporting rare cases and utilizing bibliometric analysis enhance knowledge dissemination and research exploration in the field of rare drug-induced medical conditions.
Topics: Neuroleptic Malignant Syndrome; Humans; Serotonin Syndrome; Bibliometrics
PubMed: 38825678
DOI: 10.1186/s13023-024-03227-5 -
The Science of the Total Environment Sep 2023Bald eagles often scavenge hunting remains embedded with lead bullet fragments, which debilitate and kill many eagles. Measuring blood lead concentrations (BLC) in...
Bald eagles often scavenge hunting remains embedded with lead bullet fragments, which debilitate and kill many eagles. Measuring blood lead concentrations (BLC) in free-flying bald eagles and those received by rehabilitators allows researchers to both actively and opportunistically monitor exposure. From 2012 to 2022, we captured 62 free-flying bald eagles and measured their BLC following the big-game hunting season in Montana, USA, which occurs from late October through late November. Between 2011 and 2022, we also measured the BLC of 165 bald eagles received by Montana's four raptor rehabilitation centers. Most of the free-flying bald eagles (89 %) had BLC above background (≥10 μg/dL), and BLC of juveniles tended to be lower as winter progressed (ρ = -0.482, P = 0.017). Bald eagles received by rehabilitators had an almost identical prevalence of BLC above background (90 %) over that same timeframe (n = 48). However, those eagles in rehabilitation were more likely to have BLC exceeding the clinical threshold (≥ 60 μg/dL), which we observed only from November through May. Between June and October, 45 % of bald eagles in rehabilitation had sub-clinical BLC (10-59 μg/dL), suggesting that many eagles may live with BLC chronically above background concentrations. Hunters may help lower BLC in bald eagles by switching to lead-free bullets. Those mitigation efforts could be evaluated through a continued monitoring of BLC in both free-flying bald eagles and those received by rehabilitators.
Topics: Animals; Humans; Lead; Eagles; Seasons; Lead Poisoning; Montana
PubMed: 37209742
DOI: 10.1016/j.scitotenv.2023.164256 -
Revista Paulista de Pediatria : Orgao... 2023To describe the profile of children assisted in the Emergency Room of a Children reference Hospital in the South of Brazil, victims of acute poisoning between 2016 and... (Observational Study)
Observational Study
OBJECTIVE
To describe the profile of children assisted in the Emergency Room of a Children reference Hospital in the South of Brazil, victims of acute poisoning between 2016 and 2021, to characterize the toxic agents and to present the factors related to hospitalization.
METHODS
Retrospective, descriptive and observational study with data collection from medical records at a children's hospital from July 2016 to June 2021 based on the compulsory notification forms. The characteristics of victims, of the incident, the type and class of the substance involved, the procedures demanded and the need for the Intensive Care Unit were evaluated. The outcome considered was hospitalization. Absolute and relative frequencies were calculated for the categorical variables and measures of central tendency and dispersion for the numerical ones. Binary logistic regression was performed to identify variables related to hospitalization.
RESULTS
There were 411 consultations, with the mean age of 7.2±5.5 years, and predominance of females (59.9%). Most of the poisoning occurred at home (82.1%) and orally (93.7%). Chemicals or cleaning products were the main agents in children up to 1 year of age, whereas in the other age groups accidents occurred most frequently with medicines. Hospital admission occurred in 38.7% of the cases, with related variables being: number of agents, type of substance involved, medication that acts on the Central Nervous System, recurrence, motivation (accidental/intentional), and performance of simple exams.
CONCLUSIONS
More preventive actions are needed, such as legislation, as well as greater guidance to parents on how to store products in the domestic environment, in order to reduce the number of exogenous intoxications in the pediatric population.
Topics: Female; Child; Humans; Infant; Child, Preschool; Male; Retrospective Studies; Hospitalization; Emergency Service, Hospital; Hospitals; Acute Disease; Poisoning
PubMed: 38088677
DOI: 10.1590/1984-0462/2024/42/2023028 -
Medicine Dec 2023Currently, drug-induced liver injury (DILI) has become one of those public issues in society, which has added a huge burden to both the individuals and the society. In... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Currently, drug-induced liver injury (DILI) has become one of those public issues in society, which has added a huge burden to both the individuals and the society. In the current clinical stage, there are numerous drugs developed to treat this disease, and different drug treatment measures have been proven to achieve certain clinical efficacy in the corresponding randomized controlled trials. However, there are still many therapeutic drugs that have not been directly compared and studied. Therefore, it is difficult to directly compare the effectiveness and safety of various strategies for the treatment of DILI. In this regard, the present study collected the therapeutic efficacy of diverse treatments in DILI in recent years through network meta-analysis, evaluated and screened the existing optimal clinical therapeutic plan, and helped physicians formulate clinical therapeutic plans.
METHODS
Databases, including the Chinese Journal Full-text Database, Wanfang Data Journal Paper Resources (Wangfang), VIP Chinese Science and Technology Journal Full-text Database, The Cochrane Library, PubMed, and EMBASE, were searched using keywords from inception to January 2023. Eligible randomized controlled trials were selected in line with eligibility criteria, and mesh meta-analysis of binary variables was carried out using Stata 16 software.
CONCLUSION
In combination with alanine aminotransferase, aspartate aminotransferase, and total bilirubin, MI may be the intervention measure for minimizing alanine aminotransferase levels in patients after treatment. Besides, compound glycyrrhizin may be the intervention for minimizing aspartate aminotransferase levels in patients after treatment, and polyene phosphatidylcholine may be the intervention for minimizing total bilirubin levels in patients after treatment. Placebo is the potential intervention that has the least adverse reactions post-treatment, and RT has the second least adverse reactions. Moreover, hepatocyte growth-promoting factors may be the most effective intervention after treatment.
RESULTS
To sum up, the present work compared the clinical effects of 13 liver protective drugs through meta-analysis and provided a systematic understanding of commonly used drugs for the treatment of DILI in clinical practice.
Topics: Humans; Network Meta-Analysis; Drugs, Chinese Herbal; Bilirubin; Protective Agents; Chemical and Drug Induced Liver Injury
PubMed: 38115246
DOI: 10.1097/MD.0000000000036538 -
BMJ Open Jul 2023Charcoal production and utilisation are linked to various health issues and occupational hazards. However, to our knowledge, no systematic review has primarily focused...
UNLABELLED
Charcoal production and utilisation are linked to various health issues and occupational hazards. However, to our knowledge, no systematic review has primarily focused on the health implications of charcoal production and its use while distinguishing charcoal from other solid fuels such as wood and coal.
OBJECTIVES
This systematic review presents a synthesis of the evidence on the health risks associated with producing and using charcoal across the world.
DESIGN
Systematic review using a systematic narrative synthesis approach.
DATA SOURCES
MEDLINE (through Ovid interface), CINAHL, Embase, Web of Science, PsycINFO, Cochrane Library and SCOPUS, from inception to 26 February 2021.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
Peer-reviewed journal articles reporting empirical findings on the associations between charcoal usage/production and health parameters.
DATA EXTRACTION AND SYNTHESIS
Two independent reviewers extracted data and assessed the quality of primary studies.
RESULTS
Our findings showed that charcoal production and usage are linked with specific adverse health outcomes, including respiratory diseases (n=21), cardiorespiratory and neurological diseases (n=1), cancer (n=3), DNA damage (n=3), carbon monoxide (CO) poisoning (n=2), physical injury (n=2), sick house syndrome (n=1), unintentional weight loss and body mass index (BMI) reduction (n=2), increase in blood pressure (n=1) and CO death (n=1). Among the included articles that reported respiratory diseases (n=21), there was one case of asthma and tuberculosis and two cases of chronic obstructive pulmonary disease.
CONCLUSIONS
This review links charcoal production/usage and some associated human health risks. These include respiratory diseases and other non-respiratory illnesses such as sick-building syndrome, cardiovascular diseases, DNA damage, CO poisoning and death, unintentional weight loss and BMI reduction, and physical injuries.
Topics: Humans; Charcoal; Asthma; Blood Pressure; Carbon Monoxide; Carbon Monoxide Poisoning
PubMed: 37487686
DOI: 10.1136/bmjopen-2022-065914 -
Toxicology Mar 2024Lead (Pb) is a hazardous heavy metal that is pervasive in the human environment as a result of anthropogenic activity, and poses serious health risks, particularly in... (Review)
Review
Lead (Pb) is a hazardous heavy metal that is pervasive in the human environment as a result of anthropogenic activity, and poses serious health risks, particularly in children. Due to its innumerable unique physical and chemical properties, it has various applications; therefore, it has become a common environmental pollutant. Lead may cause oxidative stress, and accumulating evidence indicates that oxidative stress influences the pathophysiology of lead poisoning, also called plumbism. The immune system is continually exposed to various environmental pathogens and xenobiotics, including heavy metals such as lead, and appears to be one of the most vulnerable targets. After being exposed to lead, cells are subjected to oxidative stress as a result of reactive oxygen species (ROS) production. When the generation and consumption of ROS are out of equilibrium, various cell structures, particularly phospholipids are disrupted leading to lipid peroxidation. Various inflammatory signalling pathways are activated as a consequence, along with reduced disease resistance, inflammation, autoimmunity, sensitization and disruption of the cell-mediated and humoral immune systems. Lead negatively affects the metabolism of cytokines, including the interleukins IL-2, IL-1b, IL-6, IL-4, IL-8, tumor necrosis factor-alpha (TNF-α), and interferon-gamma (IFN), as well as the expression and functioning of inflammatory enzymes such as cyclooxygenases. However, the cause of toxicity depends on the kind of lead, dosage, route of entry, exposure period, age, host and genetic predisposition.
Topics: Child; Humans; Cytokines; Reactive Oxygen Species; Lead; Metals, Heavy; Environmental Pollutants; Oxidative Stress; Lead Poisoning
PubMed: 38452865
DOI: 10.1016/j.tox.2024.153771 -
Molecules (Basel, Switzerland) Sep 2023Ochratoxin A (OTA) is considered as the most toxic of the other ochratoxins synthesized by various fungal species belonging to the and families. OTA commonly... (Review)
Review
Ochratoxin A (OTA) is considered as the most toxic of the other ochratoxins synthesized by various fungal species belonging to the and families. OTA commonly contaminates food and beverages, resulting in animal and human health issues. The toxicity of OTA is known to cause liver damage and is still being researched. However, current findings do not provide clear insights into the toxin mechanism of action. The current studies focusing on the use of potentially protective compounds against the effects of the toxin are insufficient as they are mainly conducted on animals. Further research is required to fill the existing gaps in both fields (namely the exact OTA molecular mechanism and the prevention of its toxicity in the human liver). This review article is a summary of the so far obtained results of studies focusing on the OTA hepatotoxicity, its mode of action, and the known approaches of liver cells protection, which may be the base for expanding other research in near future.
Topics: Animals; Humans; Ochratoxins; Beverages; Food; Chemical and Drug Induced Liver Injury
PubMed: 37764392
DOI: 10.3390/molecules28186617 -
Applied and Environmental Microbiology Dec 2023causes gas gangrene and food poisoning in humans, and monitoring this bacterium is important for public health. Although whole-genome sequencing is useful to...
causes gas gangrene and food poisoning in humans, and monitoring this bacterium is important for public health. Although whole-genome sequencing is useful to comprehensively understand the virulence, resistome, and global genetic relatedness of bacteria, limited genomic data from environmental sources and developing countries hamper our understanding of the richness of the intrinsic genomic diversity of this pathogen. Here, we successfully accumulated the genetic data on strains isolated from hospital effluent and provided the first evidence that predicted pathogenic may be disseminated in the clinical environment in Ghana. Our findings suggest the importance of risk assessment in the environment as well as the clinical setting to mitigate the potential outbreak of food poisoning in Ghana.
Topics: Humans; Clostridium perfringens; Wastewater; Ghana; Foodborne Diseases; Clostridium Infections
PubMed: 38051072
DOI: 10.1128/aem.01619-23 -
PloS One 2023Researchers have begun studying the impact of human opioid and cannabinoid use on dog populations. These studies have used data from an animal poison control center...
Comparing the diagnostic performance of ordinary, mixed, and lasso logistic regression models at identifying opioid and cannabinoid poisoning in U.S. dogs using pet demographic and clinical data reported to an animal poison control center (2005-2014).
Researchers have begun studying the impact of human opioid and cannabinoid use on dog populations. These studies have used data from an animal poison control center (APCC) and there are concerns that due to the illicit nature and social stigma concerning the use of these drugs, owners may not always be forthcoming with veterinarians or APCC staff regarding pet exposures to these toxicants. As a result, models derived from APCC data that examine the predictability of opioid and cannabinoid dog poisonings using pet demographic and health disorder information may help veterinarians or APCC staff more reliably identify these toxicants when examining or responding to a call concerning a dog poisoned by an unknown toxicant. The fitting of epidemiologically informed statistical models has been useful for identifying factors associated with various health conditions and as predictive tools. However, machine learning, including lasso regression, has many useful features as predictive tools, including the ability to incorporate large numbers of independent variables. Consequently, the objectives of our study were: 1) identify pet demographic and health disorders associated with opioid and cannabinoid dog poisonings using ordinary and mixed logistic regression models; and 2) compare the predictive performance of these models to analogous lasso logistic regression models. Data were obtained from reports of dog poisoning events collected by the American Society for the Prevention of Cruelty to Animals' (ASPCA) Animal Poisoning Control Center, from 2005-2014. We used ordinary and mixed logistic regression models as well as lasso logistic regression models with and without controlling for autocorrelation at the state level to train our models on half the dataset and test their predictive performance on the remainder. Although epidemiologically informed logistic regression models may require substantial knowledge of the disease systems being investigated, they had the same predictive abilities as lasso logistic regression models. All models had relatively high predictive parameters except for positive predictive values, due to the rare nature of calls concerning opioid and cannabinoid poisonings. Ordinary and mixed logistic regression models were also substantially more parsimonious than their lasso equivalents while still allowing for the epidemiological interpretation of model coefficients. Controlling for autocorrelation had little effect on the predictive performance of all models, but it did reduce the number of variables included in lasso models. Several disorder variables were associated with opioid and cannabinoid calls that were consistent with the acute effects of these toxicants. These models may help build diagnostic evidence concerning dog exposure to opioids and cannabinoids, saving time and resources when investigating these cases.
Topics: Animals; Dogs; Humans; United States; Analgesics, Opioid; Logistic Models; Poison Control Centers; Hazardous Substances; Demography; Poisoning
PubMed: 37428780
DOI: 10.1371/journal.pone.0288339