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Critical Reviews in Toxicology Oct 2020Organophosphorus agents (OP) are widely used as pesticides due to their cost effectiveness, yet they present a significant public health risk owing to their high... (Review)
Review
Organophosphorus agents (OP) are widely used as pesticides due to their cost effectiveness, yet they present a significant public health risk owing to their high toxicity, especially in cases of occupational exposure in agriculture, during suicide attempts using pesticides, and as nerve agents in warfare. Their vigorous permeability through inhalation, ingestion, and dermal exposure results in a high number of reported OP poisoning cases and alarming mortality rates. Initial first-aid management involves decontamination, ventilation, and hemodialysis. Additionally, current treatment guidelines recommend prompt administration of atropine as a first-line antidote, oximes as a follow-up, benzodiazepines for seizure control, and pyridostigmine for prophylaxis. Nevertheless, current treatment options are associated with several challenges. Thus, recent research has focused on investigating novel approaches for their potential in improving current management strategies. This article intends to review recent advances in OP poisoning treatment, including agents investigated for their use as an alternative or adjunctive therapy, novel formulations such as nasal drops or sublingual tablets for emergency administration of atropine, as well as innovative strategies for enhanced oximes delivery and overall efficacy. However, two major barriers may limit these innovations, ethical issues associated with their clinical assessment in emergencies, and limited profitability in countries where most cases occur.
Topics: Animals; Antidotes; Atropine; Chemical Warfare Agents; Cholinesterase Inhibitors; Humans; Organophosphate Poisoning; Organophosphates; Organophosphorus Compounds; Oximes; Pesticides; Seizures
PubMed: 33185501
DOI: 10.1080/10408444.2020.1837069 -
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 -
Toxins May 2022Tetrodotoxin is one of the most potent neurotoxins in the aquatic world. This review of published and unpublished reports aims to describe the poisoning cases that have... (Review)
Review
Tetrodotoxin is one of the most potent neurotoxins in the aquatic world. This review of published and unpublished reports aims to describe the poisoning cases that have occurred in mainland France and overseas territories. Six articles were included, with 13 poisoning events, individuals or collective (number () = 53 patients). Moreover, 13 unpublished poisoning events from toxicovigilance networks were found ( = 17). All cases happened in overseas territories: French Guyana ( = 7), New Caledonia ( = 11), Reunion ( = 35) and French Polynesia ( = 17). The median age was 36 years. The most frequent signs were neurological (81.8%), digestive (54.5%) and general (52.3%). Three cases of dysgueusia and nine cases of urogenital discomfort were observed in French Polynesia. Twelve severe cases were reported, including seven deaths. Only three events (11.5%) were documented by a tetrodotoxin assay. Two families of fish accounted for 91.6% of the poisonings: 33.3% due to the Diodontidae family and 58.3% to the Tetraodontidae family. Although rare, information and collection campaigns on tetrodotoxin poisoning are, therefore, essential.
Topics: Animals; Ciguatera Poisoning; France; Humans; Neurotoxicity Syndromes; Tetraodontiformes; Tetrodotoxin
PubMed: 35622597
DOI: 10.3390/toxins14050351 -
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 -
Clinical Toxicology (Philadelphia, Pa.) Mar 2022The objectives of this study were to describe poisonings occurring in older or disabled patients residing in structured living facilities, identify risk factors, and... (Observational Study)
Observational Study
OBJECTIVE
The objectives of this study were to describe poisonings occurring in older or disabled patients residing in structured living facilities, identify risk factors, and propose preventive measures.
METHOD
This was a prospective and observational study, covering all cases of poisoning occurring in structured living facilities in the Brittany region of France. All calls were received at the Grand Ouest Poison Control Centre (PCC) of Angers and were recorded from 1 February 2019 to 31 January 2020. The clinical severity of the poisonings was assessed using the Poisoning Severity Score (PSS). Clinical severity was compared by univariate and multivariate analyses using the following dependent variables: PSS score < 2 and PSS ≥ 2.
RESULTS
This study included 158 residents with a median age of 83 years (5-116 years old). The average number of residents supervised by a member of the supervisory staff was 11 (+/-10.7). The substance ingested was a personal hygiene product or a cleaning product in 48% and 25% of cases, respectively. The most frequently ingested product was a bar of soap ( = 20). All moderate to severe cases (4.6%, = 8 including one death) occurred in residents with dementia living in nursing homes for elderly patients, and 9% of residents required hospital treatment. In more than 50% of cases ( = 83), the product was provided by the facility and in 23% ( = 40), it was brought in by the family. Ingestion of a bar of soap or a product brought in by the family was significantly associated with higher poisoning severity (PSS ≥ 2). After adjustment for age, sex and the number of residents per supervisor, the severity of poisoning was significantly greater after ingestion of a bar of soap (OR = 12.33, CI95 [2.12, 71.63], = 0.005).
CONCLUSION
Older adults residing in medical facilities who have a history of dementia and/or cognitive impairment are more at risk of non-medicinal product poisoning. Clinical severity and the hospitalisation rate were greater when bar soap was ingested.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; France; Humans; Middle Aged; Nursing Homes; Poison Control Centers; Poisoning; Prospective Studies; Risk Factors; Young Adult
PubMed: 34409905
DOI: 10.1080/15563650.2021.1965158 -
Toxicon : Official Journal of the... Jan 2024In France, mushroom picking is part of the culture. The practice is not without risk, as around 1300 people are poisoned each year by eating wild mushrooms on the French...
In France, mushroom picking is part of the culture. The practice is not without risk, as around 1300 people are poisoned each year by eating wild mushrooms on the French mainland. However, this practice is not part of local culture on Reunion Island, a French territory located in the Indian Ocean. Indeed, there are practically no reports of mushroom poisoning on Reunion Island. Here we describe, through a retrospective study, cases of mushroom poisoning recorded in the Indian Ocean toxicosurveillance system database from 2020 to 2021. Overall, 19 people were poisoned following wild mushroom ingestion on Reunion Island: 15 in 2020 and 4 in 2021. Six events were recorded: the majority of poisonings involved clusters (n = 5) during a shared meal (pan-fried), only one case was single mushroom poisoning by ingesting a raw mushroom. Of all patients, 15 cases presented a gastrointestinal irritant syndrome (latency between 30 min and 3 h). Chlorophyllum molybdites was positively identified by mycologists in 4 cases, suspected by emergency doctor in 1 case and in one self-declared case, Volvariella volvacea was consumed. Poisoning following ingestion of wild mushrooms does occur on Reunion Island, and Chlorophyllum molybdites is the main culprit.
Topics: Humans; Mushroom Poisoning; Reunion; Retrospective Studies; Agaricales
PubMed: 38072316
DOI: 10.1016/j.toxicon.2023.107554 -
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 -
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