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Cells Oct 2020Ciguatera fish poisoning (CFP), the most prevalent seafood poisoning worldwide, is caused by the consumption of tropical and subtropical fish contaminated with potent... (Review)
Review
Ciguatera fish poisoning (CFP), the most prevalent seafood poisoning worldwide, is caused by the consumption of tropical and subtropical fish contaminated with potent neurotoxins called ciguatoxins (CTXs). Ciguatera is a complex clinical syndrome in which peripheral neurological signs predominate in the acute phase of the intoxication but also persist or reoccur long afterward. Their recognition is of particular importance in establishing the diagnosis, which is clinically-based and can be a challenge for physicians unfamiliar with CFP. To date, no specific treatment exists. Physiopathologically, the primary targets of CTXs are well identified, as are the secondary events that may contribute to CFP symptomatology. This review describes the clinical features, focusing on the sensory disturbances, and then reports on the neuronal targets and effects of CTXs, as well as the neurophysiological and histological studies that have contributed to existing knowledge of CFP neuropathophysiology at the molecular, neurocellular and nerve levels.
Topics: Action Potentials; Animals; Ciguatera Poisoning; Ciguatoxins; Diagnostic Errors; Humans; Nervous System Diseases; Prevalence
PubMed: 33066435
DOI: 10.3390/cells9102291 -
Toxicology Letters Jun 2021Sulfur mustard (SM) is a chemical warfare agent that has been used throughout recent history and remains a threat today. Exposed soldiers and civilians experience a... (Review)
Review
Sulfur mustard (SM) is a chemical warfare agent that has been used throughout recent history and remains a threat today. Exposed soldiers and civilians experience a variety of symptoms primarily in the respiratory system, skin, and eyes. The ocular tissues are highly sensitive to damage by SM and undergo unique manifestations of acute, chronic, and delayed complications that can persist for months and years after exposure. The mechanisms of this unique mustard gas keratopathy are still not fully understood and animal models for the study of this disease are discussed. Recent advances in mechanisms of injury are included in this review. Ophthalmic manifestations of SM injury including persistent epithelial defects, limbal stem cell deficiency, corneal neovascularization, dry eye, and corneal opacification have been reported. A wide variety of medical and surgical therapies have been studied and are reviewed here along with potential future therapies.
Topics: Chemical Warfare Agents; Drug Administration Schedule; Eye Diseases; Humans; Mustard Gas
PubMed: 33600921
DOI: 10.1016/j.toxlet.2021.02.007 -
BMC Pharmacology & Toxicology Feb 2023Poisoning is a major health problem especially in developing countries and leads to high morbidity and mortality.
BACKGROUND
Poisoning is a major health problem especially in developing countries and leads to high morbidity and mortality.
AIM
To identify the profile of acute poisoning in the Toxicology Unit at Tanta University Hospital, Egypt (2017-2021).
METHODS
A cross-sectional study using data extracted from medical records from beginning of January 2017 to end of December 2021. Data including demographic data, Glasgow coma scale, type of poisons, manner of poisoning, time of admission and discharge and state at discharge.
RESULTS
This study included 9713 cases. Rodenticides represented the most frequent cause of poisoning among both males (30%) and females (27%). Pharmaceutical drugs, CNS abused pharmaceutical drugs, and chemicals represent the most common categories (24%, 22%, and 21%, respectively) among children (up to 12 years). Rodenticides and pharmaceutical drugs represent the highest categories among other age groups. Evening admissions represented 52% of cases. Glasgow coma scale was 15 among 86.3% of cases. Intentional poisoning was more common than accidental poisoning (58.6% and 34.7%, respectively). One half (52.2%) of the admitted cases were discharged within 24 hours of admission and 44.4% of them were discharged after 48-72 hours. Family request was the main reason of discharge of cases (70.3%), 15.7% were improved, 4% died. Mortality by rodenticide was 12.5%.
CONCLUSION
Rodenticides, pharmaceutical and CNS abused pharmaceutical drugs were the most common categories of poisoning. Intentional poisoning was more common than accidental poisoning. Rodenticides were responsible for most deaths.
Topics: Child; Female; Humans; Male; Cross-Sectional Studies; Egypt; Hospitals; Pharmaceutical Preparations; Poisoning; Rodenticides
PubMed: 36737823
DOI: 10.1186/s40360-023-00650-5 -
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 -
BMC Pediatrics Mar 2024The clinical characteristics of hospitalized children with acute poisoning were analyzed to provide a reference for preventing poisoning and seeking effective prevention...
OBJECTIVE
The clinical characteristics of hospitalized children with acute poisoning were analyzed to provide a reference for preventing poisoning and seeking effective prevention and treatment.
METHODS
The clinical data of 112 children with acute poisoning admitted to Qilu Hospital of Shandong University from January 1, 2018, to December 31, 2021, were collected and analyzed from different perspectives.
RESULTS
The majority of acute poisoning cases that occurred in children were in early childhood and preschool age (89 cases, accounting for 79.4%). The most common types of poisoning were pesticide poisoning and drug poisoning, and the main ways of poisoning were accidental administration via the digestive tract and accidental ingestion. Poisoning occurred slightly more in spring and summer all year round, and most children had a good prognosis after timely treatment.
CONCLUSION
Acute poisoning often occurs in children. Parental education and intensified child supervision are needed to prevent the incidence of unintentional poisoning.
Topics: Child; Child, Preschool; Humans; Infant; Retrospective Studies; Drug-Related Side Effects and Adverse Reactions; Hospitalization; Child, Hospitalized; Universities; Poisoning
PubMed: 38528509
DOI: 10.1186/s12887-024-04697-z -
BMJ Case Reports Apr 2021Scombroid fish poisoning (SFP), the most common fish-related illness worldwide, is a histamine response caused by the heat stable toxin histamine. A healthy 48-year-old...
Scombroid fish poisoning (SFP), the most common fish-related illness worldwide, is a histamine response caused by the heat stable toxin histamine. A healthy 48-year-old woman and co-author of this paper developed palpitations, tachycardia and hypotension 10 min after a tuna steak dinner. She subsequently developed numbness of her face, flushing, conjunctival erythema, abdominal pain, nausea, vomiting, diarrhoea, headache and chest pain. Her ECG revealed tachycardia with ST depression. Her hypotension did not respond to fluid resuscitation, and she required phenylephrine. Based on exposure history, clinical syndrome, exclusion of other diseases and consultation with poison control, a diagnosis of scombroid poisoning was established. The state health department was notified. The patient was weaned off vasopressors, dosed famotidine and discharged 43 hours after fish ingestion with no symptoms and normal ECG. SFP is an often misdiagnosed and underreported illness with the potential to cause life-threatening hypotension.
Topics: Animals; Female; Foodborne Diseases; Histamine; Humans; Hypotension; Marine Toxins; Middle Aged; Tuna
PubMed: 33906888
DOI: 10.1136/bcr-2020-241507 -
Toxicon : Official Journal of the... Nov 2022The paper presents results of AI diagnostics and treatment across the period of 2004-2020 pointing to the efficacy of two particular protocols.
UNLABELLED
The paper presents results of AI diagnostics and treatment across the period of 2004-2020 pointing to the efficacy of two particular protocols.
METHOD
Quantitative determination of amanitins in blood (ATOs) and urine (ATOu) performed by the original ELISA kit, indicated upon mycological history and clinical symptoms of poisoning. ATOu positive cases were recommended our protocol; ATOu negative results excluded amanitin poisoning.
RESULTS
out of 2876 fungal poisonings registered in Slovakia during the subjected period, were 698 AI suspected cases. In 557 of them, was AI reliably excluded, in 141 confirmed. Urinary ATOu correlated with the severity of poisoning in the range of 6-47 h after mushroom ingestion, without false negativity. Serum ATOs had no diagnostic value. 129 patients with confirmed AI received full treatment protocol with antidotes of penicillin plus silibinin. In this group died two patients of acute kidney injury in the early stages of poisoning and 127 patients were recovered. Silibinin without penicillin was used in 12 patients. One of them undergone liver transplantation and four patients died of fulminant liver failure, respectively intracranial hemorrhage. Treatment failure in the PNC + silibinin protocol was 1.5 % (2 of 127 patients), silibinin alone being 41.7 % (5 of 12 patients, p = 0.00058).
CONCLUSION
Early diagnostics of amanitin intoxication based on mycological and clinical history and subsequent determination of urinary amanitin levels (ATOu) allows early initiation of treatment. The use of treatment protocol with antidotes of PNC and silibinin is of high therapeutic efficacy. The omission of PNC from the treatment protocol significantly worsens patients' prognosis.
Topics: Humans; Antidotes; Silybin; Slovakia; Mushroom Poisoning; Amanita; Amanitins; Penicillins
PubMed: 36150415
DOI: 10.1016/j.toxicon.2022.09.013 -
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 -
Annals of the New York Academy of... Nov 2020Exposure to vesicants, including sulfur mustard and nitrogen mustard, causes damage to the epithelia of the respiratory tract and the lung. With time, this progresses to... (Review)
Review
Exposure to vesicants, including sulfur mustard and nitrogen mustard, causes damage to the epithelia of the respiratory tract and the lung. With time, this progresses to chronic disease, most notably, pulmonary fibrosis. The pathogenic process involves persistent inflammation and the release of cytotoxic oxidants, cytokines, chemokines, and profibrotic growth factors, which leads to the collapse of lung architecture, with fibrotic involution of the lung parenchyma. At present, there are no effective treatments available to combat this pathological process. Recently, much interest has focused on nutraceuticals, substances derived from plants, herbs, and fruits, that exert pleiotropic effects on inflammatory cells and parenchymal cells that may be useful in reducing fibrogenesis. Some promising results have been obtained with nutraceuticals in experimental animal models of inflammation-driven fibrosis. This review summarizes the current knowledge on the putative preventive/therapeutic efficacy of nutraceuticals in progressive pulmonary fibrosis, with a focus on their activity against inflammatory reactions and profibrotic cell differentiation.
Topics: Animals; Chemical Warfare Agents; Dietary Supplements; Disease Models, Animal; Humans; Irritants; Mechlorethamine; Mustard Gas; Pulmonary Fibrosis
PubMed: 32725637
DOI: 10.1111/nyas.14442 -
International Journal of Environmental... Apr 2022Among marine biotoxins, palytoxins (PlTXs) and cyclic imines (CIs), including spirolides, pinnatoxins, pteriatoxins, and gymnodimines, are not managed in many countries,... (Review)
Review
Among marine biotoxins, palytoxins (PlTXs) and cyclic imines (CIs), including spirolides, pinnatoxins, pteriatoxins, and gymnodimines, are not managed in many countries, such as the USA, European nations, and South Korea, because there are not enough poisoning cases or data for the limits on these biotoxins. In this article, we review unregulated marine biotoxins (e.g., PlTXs and CIs), their toxicity, causative phytoplankton species, and toxin extraction and detection protocols. Due to global warming, the habitat of the causative phytoplankton has expanded to the Asia-Pacific region. When ingested by humans, shellfish that accumulated toxins can cause various symptoms (muscle pain or diarrhea) and even death. There are no systematic reports on the occurrence of these toxins; however, it is important to continuously monitor causative phytoplankton and poisoning of accumulating shellfish by PlTXs and CI toxins because of the high risk of toxicity in human consumers.
Topics: Foodborne Diseases; Humans; Imines; Marine Toxins; Phytoplankton; Seafood; Shellfish; Shellfish Poisoning
PubMed: 35457784
DOI: 10.3390/ijerph19084921