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Medicine Jul 2017The Acute Physiology and Chronic Health Evaluation II (APACHE II) score is used to determine disease severity and predict outcomes in critically ill patients. However,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The Acute Physiology and Chronic Health Evaluation II (APACHE II) score is used to determine disease severity and predict outcomes in critically ill patients. However, the prognostic significance of APACHE after acute paraquat (PQ) poisoning remains unclear. The meta-analysis was aimed to study the value of APACHE II in predicting mortality in PQ-exposed Chinese and Korean patients.
METHODS
Databases that included PubMed, Embase, Cochrane Library, and the Chinese National Knowledge Infrastructure were searched through August 2016. Studies using APACHE II to predict mortality in PQ-poisoned patients were selected. The odds ratio and weighted mean difference (WMD) were used to pool binary and continuous data. Additionally, we aggregated sensitivity, specificity, and other measures of accuracy. Statistical analyses were made using the Stata V.13.0 software.
RESULTS
This study included 29 studies, and 25 studies evaluated APACHE II scores on admission. Pooled data showed that survivors had significantly lower total scores than nonsurvivors (WMD = -7.29, and I = 98.2%, both P <.05). The pooled sensitivity of an APACHE II score ≥5 for predicting mortality was 75% and the pooled specificity was 86%. The positive likelihood ratio (PLR) was 5.3 and the negative likelihood ratio (NLR) was 0.29. The pooled sensitivity of an APACHE II score ≥10 for predicting mortality was 88% and the pooled specificity was 84%. The pooled PLR and NLR was 5.5 and 0.15, respectively.
CONCLUSION
This study showed PQ-poisoned nonsurvivors had significantly higher APACHE II score than did survivors. APACHE II scores satisfactorily predicted mortality.
Topics: APACHE; China; Herbicides; Humans; Mortality; Paraquat; Prognosis; Republic of Korea
PubMed: 28746171
DOI: 10.1097/MD.0000000000006838 -
Industrial Health Feb 2020This study explored the potential association between chronic exposure to pesticide mixtures including paraquat and respiratory outcomes among Colombian farmers....
This study explored the potential association between chronic exposure to pesticide mixtures including paraquat and respiratory outcomes among Colombian farmers. Sociodemographic and occupational data, respiratory symptoms and spirometric data were collected. Paraquat in spot urine samples were quantified with solid-phase extraction high-performance liquid chromatography. Multiple Poisson regressions with robust variance were used to determine factors associated with respiratory outcomes. Profiles of pesticide mixtures used were identified among 217 farmworkers, but profenofos and methamidophos-based mixtures were more frequent. Chronic paraquat exposure was slightly associated with self-reported asthma (PR: 1.06; 95% CI 1.00 to 1.13). Different pesticide mixtures were associated with flu, thoracic pain, allergic rhinitis, and obstructive pattern in spirometry. Although acute exposure to paraquat is low among Colombian farmers participating in the study, associations between respiratory outcomes and chronic pesticide mixtures exposure including profenofos, methamidophos or glyphosate require further specific studies.
Topics: Adolescent; Adult; Aged; Chest Pain; Colombia; Farmers; Female; Humans; Male; Middle Aged; Occupational Exposure; Organothiophosphates; Organothiophosphorus Compounds; Paraquat; Pesticides; Respiratory Tract Diseases; Rhinitis, Allergic; Spirometry
PubMed: 30996154
DOI: 10.2486/indhealth.2018-0111 -
The Journal of Biological Chemistry Oct 1986NADPH-cytochrome P-450 reductase-catalyzed reduction of paraquat promoted the release of iron from ferritin. Aerobically, iron release was inhibited approximately 60% by...
NADPH-cytochrome P-450 reductase-catalyzed reduction of paraquat promoted the release of iron from ferritin. Aerobically, iron release was inhibited approximately 60% by superoxide dismutase, whereas xanthine oxidase-dependent iron release was inhibited nearly 100%. This suggests that both superoxide and the paraquat cation radical can catalyze the release of iron from ferritin. Accordingly, under anaerobic conditions, the paraquat radical mediated a very rapid, complete release of iron from ferritin. Similarly, the cation free radicals of the closely related chemicals, diquat and benzyl viologen, also promoted iron release. ESR studies demonstrated that electron transfer from the paraquat cation radical to ferritin accounts for the reductive release of iron. The ferritin structure was not altered by exposure to the paraquat radical and also retained its ability to re-incorporate iron. These studies indicate that release of iron from ferritin may be a common feature contributing to free radical-mediated toxicities.
Topics: Animals; Electron Spin Resonance Spectroscopy; Ferritins; Free Radicals; Iron; NADPH-Ferrihemoprotein Reductase; Oxygen; Paraquat; Rats; Superoxide Dismutase; Time Factors
PubMed: 3020022
DOI: No ID Found -
Respiratory Care Mar 2005
Topics: Adult; Fatal Outcome; Female; Herbicides; Humans; Lung Diseases; Mediastinal Emphysema; Multiple Organ Failure; Paraquat; Pneumopericardium; Poisoning; Radiography; Suicide
PubMed: 15779152
DOI: No ID Found -
QJM : Monthly Journal of the... Nov 2003Acute paraquat self-poisoning is a significant problem in parts of Asia, the Pacific and the Caribbean. Ingestion of large amounts of paraquat results in rapid death,... (Review)
Review
BACKGROUND
Acute paraquat self-poisoning is a significant problem in parts of Asia, the Pacific and the Caribbean. Ingestion of large amounts of paraquat results in rapid death, but smaller doses often cause a delayed lung fibrosis that is usually fatal. Anti-neutrophil ('immunosuppressive') treatment has been recommended to prevent lung fibrosis, but there is no consensus on efficacy.
AIM
To review the evidence for the use of immunosuppression in paraquat poisoning, and to identify validated prognostic systems that would allow the use of data from historical control studies and the future identification of patients who might benefit from immunosuppression.
DESIGN
Systematic review.
METHODS
We searched PubMed, Embase and Cochrane databases for 'paraquat' together with 'poisoning' or 'overdose'. We cross-checked references and contacted experts, and searched on [www.google.com] and [www.yahoo.com] using 'paraquat', 'cyclophosphamide', 'methylprednisolone' and 'prognosis'.
RESULTS
We found ten clinical studies of immunosuppression in paraquat poisoning. One was a randomized controlled trial (RCT). Seven used historical controls only; the other two were small (n = 1 and n = 4). Mortality in controls and patients varied markedly between studies. Three of the seven non-RCT controlled studies measured plasma paraquat; analysis using Proudfoot's or Hart's nomograms did not suggest that immunosuppression increased survival in these studies. Of 16 prognostic systems for paraquat poisoning, none has been independently validated in a large cohort.
DISCUSSION
The authors of the RCT have performed valuable and difficult research, but their results are hypothesis-forming rather than conclusive; elsewhere, the use of historical controls is problematic. In the absence of a validated prognostic marker, a large RCT of immunosuppression using death as the primary outcome is required. This RCT should also prospectively test and validate the available prognostic methods, so that future patients can be selected for this and other therapies on admission.
Topics: Acute Disease; Anti-Inflammatory Agents; Cyclophosphamide; Herbicides; Humans; Immunosuppressive Agents; Methylprednisolone; Paraquat; Pulmonary Fibrosis; Treatment Outcome
PubMed: 14566036
DOI: 10.1093/qjmed/hcg137 -
Mediators of Inflammation 2021The effects of () and pioglitazone (a PPAR- agonist) alone and in combination, on systemic inflammation and oxidative stress induced by inhaled paraquat (PQ) as a...
The effects of () and pioglitazone (a PPAR- agonist) alone and in combination, on systemic inflammation and oxidative stress induced by inhaled paraquat (PQ) as a herbicide, which induced inflammation in rats, were examined. Rats were exposed to (1) saline (control) and (2) 54 mg/m PQ aerosols (8 times, every other day, each time for 30 min) without treatment or treated with (3 and 4) two doses of (200 and 800 mg/kg/day), (5 and 6) two doses of pioglitazone (5 and 10 mg/kg/day), (7) low doses of . + pioglitazone, (Pio-5+Z-200 mg/kg/day) or (8) dexamethasone (0.03 mg/kg/day) for 16 days, after the last PQ exposure. Different variables were measured at the end of the treatment period. Exposure to PQ significantly increased total and differential white blood cells (WBC) counts, serum levels of nitrite (NO), malondialdehyde (MDA), interleukin- (IL) 17, and tumor necrosis factor alpha (TNF-), but reduced thiol, superoxide dismutase (SOD), catalase (CAT), IL-10, and interferon-gamma (INF-) ( < 0.05 to < 0.001). Most measured parameters were significantly improved in groups treated with either doses of the extract, pioglitazone, Pio-5+Z-200 mg/kg/day, or dexamethasone compared to the PQ group ( < 0.05 to < 0.001). The combination of low doses of Pio-5+Z-200 mg/kg/day showed significantly higher effects compared to each one alone ( < 0.05 to < 0.001). Systemic oxidative stress and inflammation due to inhaled PQ were improved by and pioglitazone. Higher effects of Pio-5+Z-200 mg/kg/day compared to each one alone suggest modulation of PPAR- receptors by the plant extract, but further studies using PPAR- antagonists need to be done in this regard.
Topics: Animals; Inflammation; Lamiaceae; Oxidative Stress; Paraquat; Pioglitazone; Rats
PubMed: 34054344
DOI: 10.1155/2021/5575059 -
PloS One 2023The effect of paraquat, oxadiazon and oxyfluorfen herbicides was tested on two populations of hairy fleabane (Erigeron bonariensis L.), collected from a date palm...
The effect of paraquat, oxadiazon and oxyfluorfen herbicides was tested on two populations of hairy fleabane (Erigeron bonariensis L.), collected from a date palm orchard at Tal al-Ramil (Central Jordan Valley) and al-Twal (Northern Jordan Valley) sites using the recommended rates (0.5, 1.25 and 0.792kg a.i ha-1 for each herbicide, respectively) and 10-fold (5, 12.50 and 7.92 kg a.i. ha-1, respectively) under glasshouse conditions. Results showed that the date palm weed population was resistant to the three herbicides at both application rates and al-Twal site population was highly susceptible. Two field experiments were conducted to evaluate the effectiveness of 12 herbicides in controlling the weed in the date palm orchard during the spring of 2017, revealed that E. bonariensis resists paraquat (0.5, 1.0 and 1.5 kg a.i. ha-1), oxadiazon (1.25 kg a.i. ha-1) and oxyfluorfen (0.792 kg a.i. ha-1) herbicides. None of the three herbicides was effective against the weed and treated plants continued to grow normally similar to those of untreated control. Ten-fold higher rates of these herbicides failed to control the weed. The effect of other tested herbicides was variable with bromoxynil plus MCPA (buctril®M), 2,4-D- iso-octyl ester, glyphosate, glyphosate trimesium and triclopyr being the most effective and completely controlling the weed at recommended rates of application. It is concluded that the tested populations of E. bonariensis developed resistance to paraquat, oxadiazon and oxyfluorfen but control of the weed was possible using other herbicides with different mechanisms of action. Herbicide rotation or other nonchemical weed control methods have been suggested to prevent or reduce the buildup and spread of resistant populations of this weed. These results represent the first report of herbicide resistance of E. bonariensis in Jordan.
Topics: Paraquat; Erigeron; Herbicide Resistance; Jordan; Herbicides; Weed Control; Conyza
PubMed: 37824594
DOI: 10.1371/journal.pone.0263154 -
Ecotoxicology and Environmental Safety Jun 2023Neurogenesis is a fundamental process in the development and plasticity of the nervous system, and its regulation is tightly linked to mitochondrial dynamics. Imbalanced...
Neurogenesis is a fundamental process in the development and plasticity of the nervous system, and its regulation is tightly linked to mitochondrial dynamics. Imbalanced mitochondrial dynamics can result in oxidative stress, which has been implicated in various neurological disorders. Paraquat (PQ), a commonly used agricultural chemical known to be neurotoxic, induces oxidative stress that can lead to mitochondrial fragmentation. In this study, we investigated the effects of PQ on neurogenesis in primary murine neural progenitor cells (mNPCs) isolated from neonatal C57BL/6 mice. We treated the mNPCs with 0-40 μM PQ for 24 h and observed that PQ inhibited their proliferation, migration, and differentiation into neurons in a concentration-dependent manner. Moreover, PQ induced excessive mitochondrial fragmentation and upregulated the expression of Drp-1, p-Drp1, and Fis-1, while downregulating the expression of Mfn2 and Opa1. To confirm our findings, we used Mdivi-1, an inhibitor of mitochondrial fission, which reversed the adverse effects of PQ on neurogenesis, particularly differentiation into neurons and migration of mNPCs. Additionally, we found that Mito-TEMPO, a mitochondria-targeted antioxidant, ameliorated excessive mitochondrial fragmentation caused by PQ. Our study suggests that PQ exposure impairs neurogenesis by inducing excessive mitochondrial fission and abnormal mitochondrial fragmentation via oxidative stress. These findings identify mitochondrial fission as a potential therapeutic target for PQ-induced neurotoxicity. Further research is needed to elucidate the underlying mechanisms of mitochondrial dynamics and neurogenesis in the context of oxidative stress-induced neurological disorders.
Topics: Mice; Animals; Paraquat; Mitochondrial Dynamics; Mice, Inbred C57BL; Oxidative Stress; Neurogenesis
PubMed: 37087969
DOI: 10.1016/j.ecoenv.2023.114939 -
BMC Public Health Mar 2020Paraquat self-poisonings constitute a significant contributor to the global burden of suicide. Our aim was to evaluate the relationship between social and economic...
BACKGROUND
Paraquat self-poisonings constitute a significant contributor to the global burden of suicide. Our aim was to evaluate the relationship between social and economic variables with the incidence of self-poisoning with Paraquat in the northeast of Colombia.
METHODS
Records of 154 cases of self-poisoning with Paraquat and several socio-economic variables of six regions of northeast of Colombia were analyzed.
RESULTS
Most of the cases were mestizos, farmworkers, between 20 and 29 years, with intentional exposure using the oral route. Multivariate analyses revealed significant associations among the incidence of self-poisoning with PQ with the ecological factors such as poverty greater than 30% (IRR 15.9 IC95% 5.56-44.72), land Gini index < 0.7 (IRR 7.11 IC95% 3.58-14.12), private health insurance < 40% (IRR 3.39 IC95% 1.30-8.82) and planted area > 10% (IRR 2.47 IC95% 1.60-3.80).
CONCLUSION
There is a relationship between ecological factors and, as such, this study opens the way to further developments in the field.
Topics: Adult; Colombia; Female; Humans; Incidence; Male; Paraquat; Poisoning; Socioeconomic Factors; Suicide; Young Adult
PubMed: 32220225
DOI: 10.1186/s12889-020-08510-1 -
Laboratory Investigation; a Journal of... Sep 2016
Topics: Herbicides; Humans; Neurotoxicity Syndromes; Paraquat; Parkinson Disease
PubMed: 27562309
DOI: 10.1038/labinvest.2016.83