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Basic & Clinical Pharmacology &... Jun 2023Cyclopeptide mushroom poisoning is responsible for 90%-95% of deaths from macrofungi ingestion. The main objectives of this study are to describe cases of cyclopeptide...
Cyclopeptide mushroom poisoning is responsible for 90%-95% of deaths from macrofungi ingestion. The main objectives of this study are to describe cases of cyclopeptide mushroom poisoning and to determine risk factors that may influence the severity/mortality of poisoned patients. We included all cases of amatoxin toxicity reported to two French Poison Centers from 2013 through 2019. We compared the severity with the Poison Severity Score (PSS) and the outcomes of patients using simple logistic regression and multinomial logistic regression. We included 204 cases of amatoxin toxicity. More than three-quarters developed an increase in AST and/or ALT (78.1%), and over half developed a decrease in prothrombin ratio (<70%: 53%) and/or Factor V (<70%: 54%). One-third developed an acute renal injury (AKI). Twelve patients (5.9%) developed post-poisoning sequelae (persistent kidney injury more than 1 month after ingestion and liver transplant). Five patients (2.5%) received a liver transplant, and nine died (4.4%). The mean time to onset of digestive disorders was shorter in PSS2 and PSS3-4 patients (10.9 ± 3.9/11.3 ± 6.3 h) than in PSS1 patients (14 ± 6.5 h; p < 0.05). Patients who died or developed post-poisoning sequelae had more frequent cardiovascular comorbidities compared with recovered patients (60.0% versus 29.5%; p < 0.01).
Topics: Humans; Mushroom Poisoning; Peptides, Cyclic; Retrospective Studies; Liver Failure, Acute; Disease Progression; Poisons
PubMed: 36908014
DOI: 10.1111/bcpt.13858 -
Emergency Medicine Clinics of North... May 2022Approximately 30% of poison exposures reported to centers each year are either referred to or initiated within a health care facility. Among these exposures,... (Review)
Review
Approximately 30% of poison exposures reported to centers each year are either referred to or initiated within a health care facility. Among these exposures, undifferentiated poisoned patients are among the most challenging cases faced in the emergency department. Airway, breathing, circulation (ABCs) is central to the management of unknown poisoned patient. After initial stabilization, taking a systematic approach presented here may be beneficial to the clinician. This includes considering key additional history, a possible toxidrome, and data in the form of vital signs, physical examination, laboratory analysis, ECG, and imaging. After which a tailored approach to supportive care, decontamination, possible antidotes, and enhanced elimination techniques will improve outcomes.
Topics: Antidotes; Emergency Service, Hospital; Humans; Physical Examination; Poisoning
PubMed: 35461619
DOI: 10.1016/j.emc.2022.01.011 -
Annals of Global Health Jul 2019The dearth of information on the economic cost of childhood poisoning in sub-Saharan Africa necessitated this study.
BACKGROUND
The dearth of information on the economic cost of childhood poisoning in sub-Saharan Africa necessitated this study.
OBJECTIVE
This study has investigated the prevalence of childhood drug and non-drug poisoning, treatment modalities and economic costs in Nigeria.
METHOD
A retrospective study of childhood drug and non-drug poisoning cases from January 2007 to June 2014 in the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria was carried out. Medical records were analysed for demographic and aetiological characteristics of poisoned children (0-14 years of age), as well as fiscal impact of poisoning cases.
FINDINGS
Of the 100 poisoned patients, 46% were male and 54% female, with female/male ratio of 1.17:1. Most of the children were under five years of age. Paracetamol, amitriptyline, chlorpromazine, ferrous sulphate, kerosene, organophosphates, carbon monoxide, snake bite, alcohol and rodenticides were involved in the poisoning. The average cost of poison management per patient was about $168, which is high given the economic status of Nigeria.
CONCLUSION
Childhood poisoning is still a significant cause of morbidity among children in Nigeria and accounts for an appreciable amount of health spending, therefore preventive strategies should be considered.
Topics: Acetaminophen; Adolescent; Age Distribution; Amitriptyline; Analgesics, Non-Narcotic; Antipsychotic Agents; Carbon Monoxide Poisoning; Child; Child, Preschool; Chlorpromazine; Ethanol; Female; Ferrous Compounds; Health Care Costs; Humans; Infant; Infant, Newborn; Kerosene; Length of Stay; Male; Nigeria; Organophosphate Poisoning; Poisoning; Prevalence; Retrospective Studies; Rodenticides; Sex Distribution; Snake Bites
PubMed: 31298824
DOI: 10.5334/aogh.2544 -
Journal of Psychiatric Research Jul 2023In the U.S., intentional self-poisonings with analgesics that are available without a prescription increased from 2000 to 2018. Given concerns regarding mental health...
In the U.S., intentional self-poisonings with analgesics that are available without a prescription increased from 2000 to 2018. Given concerns regarding mental health outcomes during the COVID-19 pandemic, we examined and compared trends in pediatric and adult intentional self-poisoning with acetaminophen, aspirin, ibuprofen, and naproxen from 2016 to 2021 using the National Poison Data System (NPDS) to see if these trends have continued. We extracted annual case counts of all suspected suicide attempts from intentional poisoning, and of suspected suicide attempts resulting in major effects or death, from the NPDS for non-prescription single ingredient adult formulation acetaminophen, non-prescription single ingredient adult formulation aspirin, single ingredient formulation ibuprofen, and single ingredient formulation naproxen. We enumerated the cases by year, age, and gender. Most cases of intentional self-poisoning within the review period involved acetaminophen and ibuprofen and the 13-19-year-olds constituted the highest proportion of intentional self-poisoning cases across age groups for all four analgesics. Cases involving females predominated cases involving males by 3:1 or greater. The 13-19-year-old age group also represented the largest proportion of cases that resulted in major clinical effects or deaths. An increasing trend in suicide poisoning cases with acetaminophen and ibuprofen was observed in the 6-19-years age group and this trend appeared to exacerbate from 2020 to 2021 corresponding with the start of the COVID-19 pandemic period.
Topics: Male; Adult; Female; Humans; Child; Adolescent; Young Adult; Poisons; Acetaminophen; Ibuprofen; Naproxen; Pandemics; Poison Control Centers; COVID-19; Analgesics; Aspirin
PubMed: 37270880
DOI: 10.1016/j.jpsychires.2023.05.076 -
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 -
Naunyn-Schmiedeberg's Archives of... Nov 2022Poisoning occurs frequently in TV crime series but, to the best of our knowledge, has not yet been analyzed scientifically. This study examines the plausibility of...
Poisoning occurs frequently in TV crime series but, to the best of our knowledge, has not yet been analyzed scientifically. This study examines the plausibility of poisoning cases in Germany's most popular crime series, Tatort (crime scene), from 1974 to 2022. In the TV series, the increasing rate of poisoning in Germany as well as the increasing variety of substances leading to poisoning over the years are depicted. Largely in line with reality, similar substance categories and routes of administration are presented. However, poisoning outcomes in Tatort differ from reality: over 50% of the victims die in Tatort, whereas in reality, more than 80% survive. In > 95% of the episodes, the mechanism of action of a poison is not explained, omitting an important opportunity for raising public awareness. The TV series also deviates from reality in terms of the etiology of poisonings: External poison delivery is largely overrepresented, while the high rate of accidental poisonings in real life is underrepresented. Almost no accidental poisonings occur in Tatort, although this is the most frequent type of poisoning in real life. In Tatort, men are overrepresented as offenders and victims of poisoning compared to reality. Thus, the crime series does not convey the message that anyone can be a potential victim of poisoning and that particularly vulnerable groups need proper education and the best possible protection. This paper discusses the conflict between detailed, plausible episodes with cases of poisoning and the potential for imitation that they may cause.
Topics: Crime; Germany; Humans; Male; Poisons
PubMed: 35970967
DOI: 10.1007/s00210-022-02281-9 -
The Journal of Experimental Biology Feb 2021Poison frogs sequester chemical defenses from their diet of leaf litter arthropods for defense against predation. Little is known about the physiological adaptations...
Poison frogs sequester chemical defenses from their diet of leaf litter arthropods for defense against predation. Little is known about the physiological adaptations that confer this unusual bioaccumulation ability. We conducted an alkaloid-feeding experiment with the Diablito poison frog () to determine how quickly alkaloids are accumulated and how toxins modify frog physiology using quantitative proteomics. Diablito frogs rapidly accumulated the alkaloid decahydroquinoline within 4 days, and dietary alkaloid exposure altered protein abundance in the intestines, liver and skin. Many proteins that increased in abundance with decahydroquinoline accumulation are plasma glycoproteins, including the complement system and the toxin-binding protein saxiphilin. Other protein classes that change in abundance with decahydroquinoline accumulation are membrane proteins involved in small molecule transport and metabolism. Overall, this work shows that poison frogs can rapidly accumulate alkaloids, which alter carrier protein abundance, initiate an immune response, and alter small molecule transport and metabolism dynamics across tissues.
Topics: Animals; Anura; Arthropods; Poisons; Predatory Behavior; Toxins, Biological
PubMed: 33408255
DOI: 10.1242/jeb.230342 -
Emergency Medicine Clinics of North... May 2022When evaluating a potentially poisoned patient, there is no substitute for a thorough history and physical examination. Clues from the examination are generally more... (Review)
Review
When evaluating a potentially poisoned patient, there is no substitute for a thorough history and physical examination. Clues from the examination are generally more likely to be helpful than a "shotgun" laboratory approach that involves indiscriminate testing of blood or urine for multiple agents. When used appropriately, diagnostic tests may be of help in the management of the intoxicated patient. When a specific toxin or even class of toxins is suspected, requesting qualitative or quantitative levels may be appropriate. The purpose of this review is to examine the role of common diagnostic tests in the evaluation of the poisoned patient.
Topics: Humans; Poisoning; Poisons; Toxicology
PubMed: 35461632
DOI: 10.1016/j.emc.2022.01.003 -
American Journal of Therapeutics Aug 2021This study aims to compare the poisoned patients who could not be administered activated charcoal because of its unavailability with the poisoned patients who were...
BACKGROUND
This study aims to compare the poisoned patients who could not be administered activated charcoal because of its unavailability with the poisoned patients who were administered charcoal in the later period and to reveal the results about its effectiveness.
STUDY QUESTION
Is the use of activated charcoal effective against poisoning caused by oral medication?
STUDY DESIGN
This retrospective cohort study with historical control was planned at a tertiary hospital. Patients older than 18 years were admitted to the emergency department because of oral drug poisoning during the study periods. A total of 1159 patients who were not given activated charcoal and 877 patients who were given activated charcoal were included in this study.
MEASURES AND OUTCOMES
The frequency of clinical findings secondary to the drug taken, the frequency of antidote use, the frequency of intubation, and the hospitalization length were determined as clinical outcome parameters.
RESULTS
There was no statistically significant difference in the development of central nervous system findings, cardiovascular system findings, frequency of intubation, and blood gas disorders, as well as the length of hospitalization periods according to the activated charcoal application. Hepatobiliary system findings and electrolyte disturbances were found to be less common in patients given activated charcoal. The frequency of tachycardia, speech impairment, coma, and respiratory acidosis was found to be statistically higher in patients who were administered activated charcoal. The hospitalization period of the patients who were given activated charcoal was longer in patients with drug findings; however, there was no difference in the hospitalization periods of the patients who were given an antidote.
CONCLUSIONS
The use of activated charcoal in poisoned patients may not provide sufficient clinical benefits. However, clinical studies with strong evidence levels are needed to determine activated charcoal's clinical efficacy, which is still used as a universal antidote.
Topics: Antidotes; Charcoal; Humans; Poisoning; Poisons; Retrospective Studies
PubMed: 34469920
DOI: 10.1097/MJT.0000000000001422 -
PloS One 2022Poisoning commonly occurs among children due to their curiosity, where they tend to explore and investigate their surroundings. They frequently put what they find into...
BACKGROUND
Poisoning commonly occurs among children due to their curiosity, where they tend to explore and investigate their surroundings. They frequently put what they find into their mouths as they do not understand the danger and probably cannot read the warning label. As this issue has not been extensively studied in Malaysia; hence, a retrospective analysis of records was carried out to determine the profile of phone call enquiries regarding poisoning among children at the National Poison Centre (NPC).
METHODOLOGY
The records of all cases of poisoning among children below the age of 18 years were retrospectively reviewed over a period of 10 years from 2006 to 2015. The data on the cases were analysed according to age group and gender, the circumstances and the toxic agent implicated in the poisoning.
RESULTS
During the 10-year study period, 13,583 calls that met the criteria for this study were referred to the NPC. Of these calls, 62.2% involved children between the age of 0 to 5 years, 9% were children aged between 6 to 12 years, and 28.8% were children between 13 to 18 years. Unintentional poisoning accounted for 96.7% of the incidents involving children between the age of 0 to 5 years, although among the children who were between the age of 13 to 18 years, 76% of the cases were intentional. In all the cases involving children, pharmaceutical agents were the most frequent source of the poisoning. More than 95% of the cases were exposed to poisoning through the oral route.
CONCLUSION
Poisoning in children between the age of 0 to 5 years was mainly unintentional, while poisoning in children between the age of 13 to 18 years was mainly intentional, where pharmaceutical and household agents were responsible for more than two-thirds of the poisoning cases. Most of these incidents could have been prevented if protective measures, such as child-resistant enclosures, had been implemented and if the parents and guardians had been educated about preventive measures, such as keeping poisoning agents out of the reach of children.
Topics: Child, Preschool; Humans; Infant; Infant, Newborn; Malaysia; Pharmaceutical Preparations; Poisons; Retrospective Studies
PubMed: 35482773
DOI: 10.1371/journal.pone.0266767