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Journal of Hypertension Aug 2024
A novel approach using a time-stratified analysis of a national cohort to uncover the need for population health and policy for lead-associated mortality in the United States.
Topics: Humans; United States; Population Health; Cohort Studies; Lead; Health Policy; Lead Poisoning
PubMed: 38934186
DOI: 10.1097/HJH.0000000000003755 -
China CDC Weekly Jun 2024() is a species of toxic mushroom known to induce symptoms of photosensitive dermatitis.
WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?
() is a species of toxic mushroom known to induce symptoms of photosensitive dermatitis.
WHAT IS ADDED BY THIS REPORT?
In the months of May and June 2023, a total of four patients in Chuxiong Yi Autonomous Prefecture, Yunnan Province, were affected by poisoning, occurring over two distinct incidents. The condition of two patients deteriorated after they were re-exposed to sunlight on the seventh day following the initial poisoning. Separately, an additional two patients reported experiencing a mild, needle-like sensation on areas of their skin exposed to the sun, recorded on the twelfth day subsequent to the poisoning.
WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?
Given that symptoms of photosensitive dermatitis, a potential severe consequence of poisoning, can manifest up to a week post-sun exposure, it is advisable to avoid sunlight for a minimum of two weeks following poisoning.
PubMed: 38934025
DOI: 10.46234/ccdcw2024.091 -
Heliyon Jun 2024The botulinum toxin is an extremely potent substance that impacts the nervous system. There has been a rise in cases of medical poisoning associated with it,...
BACKGROUND
The botulinum toxin is an extremely potent substance that impacts the nervous system. There has been a rise in cases of medical poisoning associated with it, particularly in the field of plastic and aesthetic procedures, in recent years.
CASE DESCRIPTION
A 51-year-old woman underwent a facial wrinkle reduction procedure with an unauthorized injection of 100 U of botulinum toxin at an unlicensed medical facility six days prior to hospitalization. Over time, her toxicity symptoms intensified, impacting her respiratory muscles, and she did not receive antitoxin treatment. She was concurrently diagnosed with a COVID-19 infection during this period. Nonetheless, she experienced a full recovery 86 days after the injection.
CONCLUSION
Currently, there is no effective antidote for botulism. Nevertheless, the timely administration of antitoxin can contribute to reducing the duration of the illness, alleviating symptoms, and preventing its recurrence. It is essential to recognize that individual responses may vary, and in this instance, the absence of antitoxin treatment did not significantly prolong the course of the disease. Accurate diagnosis of medical poisoning can be based on injection history and clinical symptoms. Early indications like fatigue and dry mouth warrant particular attention, emphasizing the importance of immediate medical intervention. To address emergencies, the Center for Disease Control (CDC) should maintain an accessible supply of antitoxin. Patients with severe poisoning should be hospitalized until their respiratory muscle strength is fully restored.
PubMed: 38933984
DOI: 10.1016/j.heliyon.2024.e32237 -
Frontiers in Immunology 2024Poisoning by widow-spider (genus ) bites occurs worldwide. The illness, termed latrodectism, can cause severe and persistent pain and can lead to muscle rigidity,...
Poisoning by widow-spider (genus ) bites occurs worldwide. The illness, termed latrodectism, can cause severe and persistent pain and can lead to muscle rigidity, respiratory complications, and cardiac problems. It is a global health challenge especially in developing countries. Equine serum-derived polyclonal anti-sera are commercially available as a medication for patients with latrodectism, but the use of sera imposes potential inherent risks related to its animal origin. The treatment may cause allergic reactions in humans (serum sickness), including anaphylactic shock. Furthermore, equine-derived antivenom is observed to have batch-to-batch variability and poor specificity, as it is always an undefined mix of antibodies. Because latrodectism can be extremely painful but is rarely fatal, the use of antivenom is controversial and only a small fraction of patients is treated. In this work, recombinant human antibodies were selected against alpha-latrotoxin of the European black widow () by phage display from a naïve antibody gene library. Alpha-Latrotoxin (α-LTX) binding scFv were recloned and produced as fully human IgG. A novel alamarBlue assay for venom neutralization was developed and used to select neutralizing IgGs. The human antibodies showed neutralization efficacy both as single antibodies and antibody combinations. This was also confirmed by electrophysiological measurements of neuronal activity in cell culture. The best neutralizing antibodies showed nanomolar affinities. Antibody MRU44-4-A1 showed outstanding neutralization efficacy and affinity to α-LTX. Interestingly, only two of the neutralizing antibodies showed cross-neutralization of the venom of the Southern black widow (). This was unexpected, because in the current literature the alpha-latrotoxins are described as highly conserved. The here-engineered antibodies are candidates for future development as potential therapeutics and diagnostic tools, as they for the first time would provide unlimited supply of a chemically completely defined drug of constant quality and efficacy, which is also made without the use of animals.
Topics: Humans; Animals; Black Widow Spider; Antibodies, Neutralizing; Spider Venoms; Antivenins; Single-Chain Antibodies; Spider Bites; Immunoglobulin G
PubMed: 38933276
DOI: 10.3389/fimmu.2024.1407398 -
Frontiers in Public Health 2024Proper disposal of unwanted medicines, in addition to reducing wastage, has a positive impact on the environment and public health. Improper disposal of medications...
BACKGROUND
Proper disposal of unwanted medicines, in addition to reducing wastage, has a positive impact on the environment and public health. Improper disposal of medications increases the risk of accidental poisonings, particularly among children. This study aimed to assess the level of knowledge, attitudes, and awareness regarding the proper disposal of unused medicines in Gondar city, northwest Ethiopia.
METHOD
From 30 July to 30 August 2023, a community-based cross-sectional study was conducted among the public in Gondar city. The data were gathered using the Kobo toolbox, exported into an Excel sheet, and then analyzed using SPSS version 27. Multivariate and bivariate binary logistic regressions were performed. A -value of 0.05 with a 95% confidence interval (CI) was used to determine statistical significance.
RESULT
From 786 study participants, the overall knowledge and attitude of the community toward the proper disposal of unused medicines were 42.6 and 42.9%, respectively. Factors identified in this study included ages between 19 and 25 [AOR = 6.91, 95% CI: (3.45, 13.84); education level: secondary [AOR = 11.82, 95% CI: (1.01, 3.29)] and college and above [AOR = 5.68, 95% CI: (2.25, 14.30)]; prior information [AOR = 6.41; 95% CI: (4.02, 10.22)]; and good attitudes [AOR = 2.11; 95% CI: (1.47, 3.02)]] as factors associated with good knowledge toward proper disposal of unused medicines. In addition, receiving information [AOR = 1.86 95% CI: (1.22, 2.86)], taking medication in the past 6 months [AOR = 1.61, 95% CI: (1.09, 2.38)], and being knowledgeable [AOR = 2.07 95% CI: (1.46, 2.94)] were factors contributing to positive attitudes toward the disposal of unused medicines among the general public. Furthermore, approximately 369 participants (46.9%) in our study lacked awareness about the harmful effects of disposing of unused medicine in regular waste.
CONCLUSION
A relatively low level of knowledge and attitudes about the proper disposal of unused medications is present in the community. In this regard, a well-coordinated and methodical public awareness campaign is recommended to disseminate information and promote the appropriate disposal of unused medications.
Topics: Humans; Ethiopia; Health Knowledge, Attitudes, Practice; Adult; Female; Cross-Sectional Studies; Male; Middle Aged; Young Adult; Surveys and Questionnaires; Adolescent; Refuse Disposal; Pharmaceutical Preparations; Medical Waste Disposal
PubMed: 38932773
DOI: 10.3389/fpubh.2024.1372739 -
Pharmaceutical Development and... Jun 2024Over the past decades, opium derivatives have been discovered as new anti-cancer agents. In our study, Fe3O4 superparamagnetic nanoparticles (SPIONs) decorated with...
Over the past decades, opium derivatives have been discovered as new anti-cancer agents. In our study, Fe3O4 superparamagnetic nanoparticles (SPIONs) decorated with chitosan were loaded with papaverine or noscapine to surmount dug delivery-related obstacles. Modifying the magnetic nanoparticles (MNP) surface with polymeric materials such as chitosan prevents oxidation and provides a site for drug linkage, which renders them a great drug carrier. The obtained systems were characterized by DLS (20- 40 nm were achieved for MNPs and medicine loaded MNPs),TEM (spherical with average size of 11-20 nm)FTIR, XRD, and VSM (71.3 - 42.8 emu/g). Contrary to noscapine, papaverine-magnetic nanoparticles (MNPs) attenuated 4T1 murine breast cancer cell proliferation (11.50 ± 1.74 µg/ml) effectively compared to the free drug (62.35 ± 2.88 µg/ml) while sparing L-929 fibroblast cells (138.14 ± 4.38 µg/ml). Furthermore, SPION and SPION-chitosan displayed no cytotoxic activity. Colony-formation assay confirmed the long-term cytotoxicity of nanostructures. Both developed formulations promoted ROS production accompanied by late apoptotic cell death. The biocompatible nanoparticle exerted an augmenting effect to deliver papaverine to metastatic breast cancer cells.
PubMed: 38932720
DOI: 10.1080/10837450.2024.2372568 -
Expert Opinion on Drug Safety Jun 2024Fomepizole is a competitive alcohol dehydrogenase inhibitor used for the treatment of ethylene glycol and methanol poisoning. We evaluated the safety and effectiveness...
Real-world safety and effectiveness of intravenous fomepizole in patients with ethylene glycol and methanol poisoning in Japan: results of a 7-year post-marketing surveillance study.
BACKGROUND
Fomepizole is a competitive alcohol dehydrogenase inhibitor used for the treatment of ethylene glycol and methanol poisoning. We evaluated the safety and effectiveness of fomepizole in patients with ethylene glycol or methanol poisoning in Japan.
RESEARCH DESIGN AND METHODS
This retrospective post-marketing surveillance study conducted in Japan registered patients who received fomepizole intravenous infusion per the package insert (January 2015-June 2022). Endpoints included adverse drug reactions/infections (ADRs), arterial blood pH, and treatment outcomes.
RESULTS
Of 147 patients registered (91 institutions), 131 and 126 were included in the safety and effectiveness analysis set, respectively. Mean age was 43.6 years, and 66.4% were male. Mean time from poison ingestion to treatment was 15.1 hours; 66.4% received concomitant hemodialysis. No serious ADRs were reported. ADRs were reported in seven patients; the most-reported ADR was vomiting (2.3%). Seven patients died, 105 survived without sequelae, and 19 survived with sequelae. Most common sequelae were renal failure or renal dysfunction. Mean arterial blood pH increased to 7.4 by 4 hours of treatment, remaining stable for 24 hours post-treatment.
CONCLUSIONS
Fomepizole is well tolerated and helps improve clinical outcomes in patients with ethylene glycol or methanol poisoning in Japan.
TRIAL REGISTRATION
Japanese Pharmaceutical Information Center (JapicCTI-152817).
PubMed: 38932699
DOI: 10.1080/14740338.2024.2372410 -
Viruses May 2024Seroprevalence of lyssaviruses in certain bat species has been proven in the Republic of Croatia, but there have been no confirmed positive bat brain isolates or human...
Seroprevalence of lyssaviruses in certain bat species has been proven in the Republic of Croatia, but there have been no confirmed positive bat brain isolates or human fatalities associated with bat injuries/bites. The study included a retrospective analysis of bat injuries/bites, post-exposure prophylaxis (PEP) and geographic distribution of bat injuries in persons examined at the Zagreb Antirabies Clinic, the Croatian Reference Centre for Rabies. In the period 1995-2020, we examined a total of 21,910 patients due to animal injuries, of which 71 cases were bat-related (0.32%). Of the above number of patients, 4574 received rabies PEP (20.87%). However, for bat injuries, the proportion of patients receiving PEP was significantly higher: 66 out of 71 patients (92.95%). Of these, 33 received only the rabies vaccine, while the other 33 patients received the vaccine with human rabies immunoglobulin (HRIG). In five cases, PEP was not administered, as there was no indication for treatment. Thirty-five of the injured patients were biologists or biology students (49.29%). The bat species was confirmed in only one of the exposure cases. This was a serotine bat (Eptesicus serotinus), a known carrier of . The results showed that the bat bites were rather sporadic compared to other human injuries caused by animal bites. All bat injuries should be treated as if they were caused by a rabid animal, and according to WHO recommendations. People who come into contact with bats should be strongly advised to be vaccinated against rabies. Entering bat habitats should be done with caution and in accordance with current recommendations, and nationwide surveillance should be carried out by competent institutions and in close collaboration between bat experts, epidemiologists and rabies experts.
Topics: Rabies; Chiroptera; Humans; Animals; Post-Exposure Prophylaxis; Croatia; Female; Bites and Stings; Adult; Male; Retrospective Studies; Middle Aged; Young Adult; Rabies Vaccines; Adolescent; Child; Rabies virus; Aged; Child, Preschool; Seroepidemiologic Studies; Lyssavirus
PubMed: 38932168
DOI: 10.3390/v16060876 -
Pharmaceuticals (Basel, Switzerland) Jun 2024The extensive use of rodenticides poses a severe threat to non-target species, particularly birds of prey and scavengers. In this study, a GC-MS/MS-based method was used...
The extensive use of rodenticides poses a severe threat to non-target species, particularly birds of prey and scavengers. In this study, a GC-MS/MS-based method was used to unlock the cause of bird deaths in Poland. Organs (liver, heart, kidney, and lungs) collected during autopsies of two rooks () and one carrion crow (), as well as fecal samples, were analyzed for the presence of anticoagulant coumarin derivatives, i.e., warfarin and bromadiolone. As for warfarin, the highest concentration was found in crow samples overall, with concentrations in the feces and lungs at 5.812 ± 0.368 µg/g and 4.840 ± 0.256 µg/g, respectively. The heart showed the lowest concentration of this compound (0.128 ± 0.01 µg/g). In the case of bromadiolone, the highest concentration was recorded in the liver of a rook (16.659 ± 1.499 µg/g) and this concentration significantly exceeded the levels in the other samples. By revealing the reality of the threat, these discoveries emphasize the need to regulate and monitor the trade in rodenticides.
PubMed: 38931431
DOI: 10.3390/ph17060764 -
Pharmaceuticals (Basel, Switzerland) Jun 2024Accidental poisonings by ingesting conjunctival fluid mixed with eye drops commonly involve alpha-2 adrenergic receptor agonists and tetrahydrozoline. These substances... (Review)
Review
Accidental poisonings by ingesting conjunctival fluid mixed with eye drops commonly involve alpha-2 adrenergic receptor agonists and tetrahydrozoline. These substances are recognized in commonly reported ingestions. Victims of all ages, otherwise in good health, often present as pale and lethargic to the emergency department (ED) after unintentionally ingesting topical eye medication. While eye drop poisoning cases in childhood include accidents during the play and poisonings in adults mean either suicide attempts or side effects caused by the systemic absorption of the substance, fluid of the ocular surface is a risk to all age groups. With this in mind, this study aimed to summarize data in the literature on tetrahydrozoline and alpha-2 adrenergic receptor agonists as dangerous medications, even when administered in low-bioavailability forms, such as eye drops. With this aim, a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-compliant systematic review of relevant studies was conducted. A search of PubMed, Scopus, Web of Science, and EBSCOhost yielded nine studies that met the rigorous inclusion criteria. The primary studies were subject to a meta-analysis once a quality appraisal of the studies and a narrative synthesis of the extracted data had been conducted. The author hopes that this information will provide observations that will lead to better designs for over-the-counter eye drops, off-label drug usage policies, and parental attention.
PubMed: 38931425
DOI: 10.3390/ph17060758