BACKGROUND:In clinical practice,some patients might not be able or unwilling to provide a thorough history of medication and poison exposure.The aim of this study was to use toxicological analysis to examine the clini...BACKGROUND:In clinical practice,some patients might not be able or unwilling to provide a thorough history of medication and poison exposure.The aim of this study was to use toxicological analysis to examine the clinical characteristics of patients with acute poisoning whose exposure history was uncertain from a toxicological analysis perspective.METHODS:This was a retrospective and descriptive study from an institute of poisoning.Patient registration information and test reports spanning the period from April 1,2020 to March 31,2022,were obtained.Patients with uncertain exposure histories and who underwent toxicological analysis were included.Clinical manifestations and categories of toxics were analyzed.RESULTS:Among the 195 patients with positive toxicological analysis results,the main causes of uncertain exposure history was disturbance of consciousness(62.6%),unawareness(23.6%)and unwillingness or lack of cooperation(13.8%).The predominant clinical manifestations were disturbed consciousness(62.6%),followed by vomiting and nausea(14.4%)and liver function abnormalities(8.7%).A comparison of clinical manifestations between patients with positive and negative(n=99)toxicological analyses results revealed significantly different proportions of disturbances in consciousness(63%vs.21%),dizziness(1.5%vs.5.1%),multi-organ failure(1.5%vs.7.1%),and local pain(0 vs 4%).The main categories of substances involved were psychiatric medications(23.1%),sedatives(20.5%),insecticides(13.8%),and herbicides(12.8%).CONCLUSION:The clinical manifestations of acute poisoning in patients with an uncertain exposure history are diverse and nonspecific,and toxicological analysis plays a pivotal role in the diagnosis and differential diagnosis of such patients.展开更多
Bayesian networks are a powerful class of graphical decision models used to represent causal relationships among variables.However,the reliability and integrity of learned Bayesian network models are highly dependent ...Bayesian networks are a powerful class of graphical decision models used to represent causal relationships among variables.However,the reliability and integrity of learned Bayesian network models are highly dependent on the quality of incoming data streams.One of the primary challenges with Bayesian networks is their vulnerability to adversarial data poisoning attacks,wherein malicious data is injected into the training dataset to negatively influence the Bayesian network models and impair their performance.In this research paper,we propose an efficient framework for detecting data poisoning attacks against Bayesian network structure learning algorithms.Our framework utilizes latent variables to quantify the amount of belief between every two nodes in each causal model over time.We use our innovative methodology to tackle an important issue with data poisoning assaults in the context of Bayesian networks.With regard to four different forms of data poisoning attacks,we specifically aim to strengthen the security and dependability of Bayesian network structure learning techniques,such as the PC algorithm.By doing this,we explore the complexity of this area and offer workablemethods for identifying and reducing these sneaky dangers.Additionally,our research investigates one particular use case,the“Visit to Asia Network.”The practical consequences of using uncertainty as a way to spot cases of data poisoning are explored in this inquiry,which is of utmost relevance.Our results demonstrate the promising efficacy of latent variables in detecting and mitigating the threat of data poisoning attacks.Additionally,our proposed latent-based framework proves to be sensitive in detecting malicious data poisoning attacks in the context of stream data.展开更多
BACKGROUND Most species of aconite contain highly toxic aconitines,the oral ingestion of which can be fatal,primarily because they cause ventricular arrhythmias.We describe a case of severe aconite poisoning that was ...BACKGROUND Most species of aconite contain highly toxic aconitines,the oral ingestion of which can be fatal,primarily because they cause ventricular arrhythmias.We describe a case of severe aconite poisoning that was successfully treated through venoarterial extracorporeal membrane oxygenation(VA-ECMO)and in which detailed toxicological analyses of the aconite roots and biological samples were performed using liquid chromatography-tandem mass spectrometry(LC-MS/MS).CASE SUMMARY A 23-year-old male presented to the emergency room with circulatory collapse and ventricular arrhythmia after ingesting approximately half of a root labeled,“Aconitum japonicum Thunb”.Two hours after arrival,VA-ECMO was initiated as circulatory collapse became refractory to antiarrhythmics and vasopressors.Nine hours after arrival,an electrocardiogram revealed a return to sinus rhythm.The patient was weaned off VA-ECMO and the ventilator on hospital days 3 and 5,respectively.On hospital day 15,he was transferred to a psychiatric hospital.The other half of the root and his biological samples were toxicologically analyzed using LC-MS/MS,revealing 244.3 mg/kg of aconitine and 24.7 mg/kg of mesaconitine in the root.Serum on admission contained 1.50 ng/mL of aconitine.Beyond hospital day 2,neither were detected.Urine on admission showed 149.09 ng/mL of aconitine and 3.59 ng/mL of mesaconitine,but these rapidly decreased after hospital day 3.CONCLUSION The key to saving the life of a patient with severe aconite poisoning is to introduce VA-ECMO as soon as possible.展开更多
BACKGROUND This report delves into the diagnostic and therapeutic journey undertaken by a patient with high-dose cantharidin poisoning and multiorgan dysfunction syndrome(MODS).Particular emphasis is placed on the com...BACKGROUND This report delves into the diagnostic and therapeutic journey undertaken by a patient with high-dose cantharidin poisoning and multiorgan dysfunction syndrome(MODS).Particular emphasis is placed on the comprehensive elucidation of the clinical manifestations of high-dose cantharidin poisoning,the intricate path to diagnosis,and the exploration of potential underlying mechanisms.CASE SUMMARY A patient taking 10 g of cantharidin powder orally subsequently developed MODS.The patient was treated with supportive care,fluid hydration and antibiotics,and hemoperfusion and hemofiltration therapy for 24 h and successfully recovered 8 d after hospital admission.Cantharidin poisoning can cause lifethreatening MODS and is rare clinically.This case underscores the challenge in diagnosis and highlights the need for early clinical differentiation to facilitate accurate assessment and prompt intervention.CONCLUSION This article has reported and analyzed the clinical data,diagnosis,treatment,and prognosis of a case of high-dose cantharidin poisoning resulting in MODS and reviewed the relevant literature to improve the clinical understanding of this rare condition.展开更多
Rationale:Multi-organ failure is a symptom of paraquat poisoning,resulting in high mortality and morbidity rates.Though paraquat is widely available,poisoning through inhalation is rare.Patient’s Concern:A 37-year-ol...Rationale:Multi-organ failure is a symptom of paraquat poisoning,resulting in high mortality and morbidity rates.Though paraquat is widely available,poisoning through inhalation is rare.Patient’s Concern:A 37-year-old male reported to the emergency department with complaints of vomiting after an alleged history of inhalation of paraquat while at work.Diagnosis:Paraquat poisoning.Interventions:Supportive management along with multiple sessions of hemodialysis.Outcomes:Renal complications caused by paraquat were improved after multiple sessions of hemodialysis.However,the patient developed respiratory complications and later due to persistent hypoxemia and non-responsive to supportive therapy,he succumbed to his illness.Lessons:Acute kidney injury is a complication of paraquat poisoning.However,kidney involvement with the inhalational mode is rare.It is caused by reduction and oxidation cycles,as well as the formation of reactive oxygen species,necessitating hemodialysis as the treatment.Without a clear history,a specific clinical trait,or a diagnostic test,diagnosis can be difficult.Our case thus highlights the inhaled paraquat poisoning,presenting with acute kidney injury with late respiratory impairment as a consequence.展开更多
Objective:To study the value of some biochemical indicators and Peradeniya Organophosphate Poisoning scale in prediction and prognosis of organophosphorus poisoning.Methods:This was a hospital-based prospective,observ...Objective:To study the value of some biochemical indicators and Peradeniya Organophosphate Poisoning scale in prediction and prognosis of organophosphorus poisoning.Methods:This was a hospital-based prospective,observational study.Various biochemical tests viz.complete blood count,random blood sugar,liver and renal function tests,creatine phosphokinase,and electrolytes were performed.Patients were assessed based on the Peradeniya Organophosphate Poisoning scale.All the patients were followed till the end point like recovery/death.Results:Out of the 100 patients,72%were males and 28%were females.The majority of the patients were farmers and 21 to 30 years of age.Suicidal was the most common manner(92,92%).Based on the Peradeniya Organophosphate Poisoning scale,47%were mild,34%moderate,and 19%severe.Serum creatinine,creatine phosphokinase,serum glutamic-oxaloacetic transaminase,serum glutamic pyruvic transaminase,and alkaline phosphatase levels showed a significant correlation with severity.Conclusions:Some biochemical indicators such as creatine phosphokinase,alkaline phosphatase can be used as prognostic markers of organophosphorus poisoning.The Peradeniya Organophosphate Poisoning scale can be used for assessing severity of the poisoning.展开更多
Standard management protocols are lacking and specific antidotes are unavailable for acute carbamazepine(CBZ)poisoning.The objective of this review is to provide currently available information on acute CBZ poisoning,...Standard management protocols are lacking and specific antidotes are unavailable for acute carbamazepine(CBZ)poisoning.The objective of this review is to provide currently available information on acute CBZ poisoning,including its management,by describing and summarizing various therapeutic methods for its treatment according to previously published studies.Several treatment methods for CBZ poisoning will be briefly introduced,their advantages and disadvantages will be analyzed and compared,and suggestions for the clinical treatment of CBZ poisoning will be provided.A literature search was performed in various English and Chinese databases.In addition,the reference lists of identified articles were screened for additional relevant studies,including non-indexed reports.Nonpeer-reviewed sources were also included.In the present review,154 articles met the inclusion criteria including case reports,case series,descriptive cohorts,pharmacokinetic studies,and in vitro studies.Data on 67 patients,including 4 fatalities,were reviewed.Based on the summary of cases reported in the included articles,the cure rate of CBZ poisoning after symptomatic treatment was 82%and the efficiency of hemoperfusion was 58.2%.Based on the literature review,CBZ is moderately dialyzable and the recommendation for CBZ poisoning is supportive management and gastric lavage.In severe cases,extracorporeal treatment is recommended,with hemodialysis as the first choice.展开更多
A ZrV_(2)alloy is typically susceptible to poisoning by impurity gases,which causes a considerable reduction in the hydrogen storage properties of the alloy.In this study,the adsorption characteristics of oxygen on Zr...A ZrV_(2)alloy is typically susceptible to poisoning by impurity gases,which causes a considerable reduction in the hydrogen storage properties of the alloy.In this study,the adsorption characteristics of oxygen on ZrV_(2)surfaces doped with Hf,Ti,and Pd are investigated,and the effect of oxygen on the hydrogen storage performance of the alloy was discussed.Subsequently,the adsorption energy,bond-length change,density of states,and differential charge density of the alloy before and after doping are analyzed using the first-principles method.The theoretical results show that Ti doping has a limited effect on the adsorption of oxygen atoms on the ZrV_(2)surface,whereas Hf doping decreases the adsorption energy of oxygen on the ZrV_(2)surface.Oxygen atoms are more difficult to adsorb at most adsorption sites on Pd-substituting surfaces,which indicates that Pd has the best anti-poisoning properties,followed by Hf.The analysis of the differential charge density and partial density of states show that the electron interaction between the oxygen atom and surface atom of the alloys is weakened,and the total energy is reduced after Hf and Pd doping.Based on theoretical calculations,the hydrogen absorption kinetics of ZrV_(2),Zr_(0.9)Hf_(0.1)V_(2),and Zr(V_(0.9)Pd_(0.1))_(2) alloys are studied in a hydrogen-oxygen mixture of 0.5 vol%O_(2) at 25℃.The experimental results show that the hydrogen storage capacities of ZrV_(2),Zr_(0.9)Hf_(0.1)V_(2),and Zr(V_(0.9)Pd_(0.1))_(2) decrease to 19%,69%,and 80%of their original values,respectively.The order of alloy resistance to 0.5 vol%O_(2) poisoning is Zr(V_(0.9)Pd_(0.1))_(2)>Zr_(0.9)Hf_(0.1)V_(2)>ZrV_(2).Pd retains its original hydrogen absorption performance to a greater extent than undoped surfaces,and it has the strongest resistance to poisoning,which is consistent with previous theoretical calculations.展开更多
The main toxic component of tetramine is tetramethylenedisulfotetramine(TETS).It is a sulfonamide derivative without special antidote,tasteless and tasteless,with high toxicity and high mortality.[1]It was first disco...The main toxic component of tetramine is tetramethylenedisulfotetramine(TETS).It is a sulfonamide derivative without special antidote,tasteless and tasteless,with high toxicity and high mortality.[1]It was first discovered by a German scientist Hagen in 1949.Although its use has been banned worldwide due to its high toxicity and mortality rate,it is still available in certain countries and has led to cases of intentional and unintentional poisoning.Tetramine blocksγ-neurons,leading to dizziness,fatigue,nausea,vomiting,convulsions,and other symptoms.[2-4]Due to the lack of recognized effective antidotes,many poisoned people suff ocate and die as a result of continuous spasms of the respiratory muscles.[5-7]Tetramine poisoning sometimes occurs,but it is rare for vegetables grown in tetraminecontaminated soil to cause group poisoning after being eaten.展开更多
One of the primary challenges in relation to phosphoric acid fuel cells is catalyst poisoning by phosphate anions that occurs at the interface between metal nanoparticles and the electrolyte.The strong adsorption of p...One of the primary challenges in relation to phosphoric acid fuel cells is catalyst poisoning by phosphate anions that occurs at the interface between metal nanoparticles and the electrolyte.The strong adsorption of phosphate anions on the catalyst surface limits the active sites for the oxygen reduction reaction(ORR),significantly deteriorating fuel cell performance.Here,antipoisoning catalysts consisting of Pt-based nanoparticles encapsulated in an ultrathin carbon shell that can be used as a molecular sieve layer are rationally designed.The pore structure of the carbon shells is systematically regulated at the atomic level by high-temperature gas treatment,allowing O_(2) molecules to selectively react on the active sites of the metal nanoparticles through the molecular sieves.Besides,the carbon shell,as a protective layer,effectively prevents metal dissolution from the catalyst during a long-term operation.Consequently,the defect-controlled carbon shell leads to outstanding ORR activity and durability of the hybrid catalyst even in phosphoric acid electrolytes.展开更多
Information-Centric Networking(ICN)is considered a viable strategy for regulating Internet consumption using the Internet’s underlying architecture.Although Named Data Networking(NDN)and its reference-based implement...Information-Centric Networking(ICN)is considered a viable strategy for regulating Internet consumption using the Internet’s underlying architecture.Although Named Data Networking(NDN)and its reference-based implementa-tion,the NDN Forwarding Daemon(NFD),are the most established ICN solu-tions,their vulnerability to the Content Poisoning Attack(CPA)is regarded as a severe threat that might dramatically impact this architecture.Content Poisoning can significantly minimize the impact of NDN’s universal data caching.Using verification signatures to protect against content poisoning attacks may be imprac-tical due to the associated costs and the volume of messages sent across the net-work,resulting in high computational costs.Therefore,in this research,we designed a method in NDN called Bird Swarm Optimization Algorithm-Based Content Poisoning Mitigation(BSO-Content Poisoning Mitigation Scheme).By aggregating the security information of entire routers along the full path,this sys-tem introduces the BSO to explore the secure transmission path and alter the con-tent retrieval procedure.Meanwhile,based on the determined trustworthy value of each node,the BSO-Content Poisoning Mitigation Scheme can bypass malicious routers,preventing them from disseminating illicit content in the future.Addition-ally,the suggested technique can minimize content poisoning utilizing removing erroneous Data packets from the cache-store during the pathfinding process.The proposed method has been subjected to extensive analysis compared with the ROM scheme and improved performance justified in several metrics.BSO-Con-tent Poisoning Mitigation Scheme is more efficient and faster than the ROM tech-nique in obtaining valid Data packets and resulting in a higher good cache hit ratio in a comparatively less amount of time.展开更多
BACKGROUND Cochineal red is an organic compound widely used in food,cosmetics,pharmaceuticals,textiles,and other fields due to its excellent safety profile.Poisoning caused by eating foods containing cochineal red is ...BACKGROUND Cochineal red is an organic compound widely used in food,cosmetics,pharmaceuticals,textiles,and other fields due to its excellent safety profile.Poisoning caused by eating foods containing cochineal red is rare,and repeated atrial arrhythmia due to cochineal red poisoning is even rarer.CASE SUMMARY An 88-year-old Asian female patient was admitted to hospital due to a disturbance of consciousness.Twelve hours prior to presentation,the patient consumed 12 eggs containing cochineal red over a period of 2 h.At presentation,the patient was in a coma and had a score of 6 on the Glasgow Coma Scale(E2+VT+M4).The patient’s skin and mucous membranes were pink.Electrocardiography(ECG)revealed rapid atrial fibrillation without any signs of ischemia.We prescribed cedilan and fluid replacement for arrhythmia correction.Shortly after admission,the atrial fibrillation corrected to a normal sinus rhythm.On the day 2 of admission,the patient had a sudden atrial flutter accompanied by hemodynamic instability and rapidly declining arterial oxygen saturation between 85%and 90%.The sinus rhythm returned to normal after two electrical cardioversions.Six days after admission,the skin color of the patient returned to normal,and the ECG results were normal.The patient was transferred out of the intensive care unit and eventually discharged after 12 d in hospital.At the 2-mo follow-up visit,the patient was in good health with no recurrence of arrhythmia.CONCLUSION Although cochineal red is a safe,natural food additive,excessive consumption or occupational exposure can induce cardiac arrhythmias.展开更多
BACKGROUND With the withdrawal of paraquat from the market,diquat is widely used,so the treatment of diquat poisoning has become one of the focuses of emergency poisoning diagnosis and treatment.CASE SUMMARY We studie...BACKGROUND With the withdrawal of paraquat from the market,diquat is widely used,so the treatment of diquat poisoning has become one of the focuses of emergency poisoning diagnosis and treatment.CASE SUMMARY We studied the case of a 17-year-old male patient who drank 200 mL(20 g/100 mL)of diquat solution two hours before arriving at the hospital.Despite the use of treatments such as gastric lavage,hemoperfusion,continuous hemodialysis,glucocorticoids,and organ support,the patient’s condition rapidly progressed to multiorgan failure,and he died 23.5 h after admission.CONCLUSION We summarized the clinical characteristics and treatment strategies of diquat poisoning through this case and performed a literature review to provide a basis and direction for clinical treatment.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19),which recently spread throughout the entire world,is still a significant health issue.Additionally,the most common cause of risky poisoning in emergency services is carbon...BACKGROUND Coronavirus disease 2019(COVID-19),which recently spread throughout the entire world,is still a significant health issue.Additionally,the most common cause of risky poisoning in emergency services is carbon monoxide(CO)poisoning.Both disorders seem to merit more research as they have an impact on all bodily systems via the lungs.AIM To determine how arterial blood gas and carboxyhemoglobin(COHb)levels affect the clinical and prognostic results of individuals requiring emergency treatment who have both COVID-19 and CO poisoning.METHODS Between January 2018 and December 2021,479 CO-poisoning patients participated in this single-center,retrospective study.Patients were primarily divided into two groups for analysis:Pre-pandemic and pandemic periods.Additionally,the pandemic era was divided into categories based on the presence of COVID-19 and,if present,the clinical severity of the infection.The hospital information system was used to extract patient demographic,clinical,arterial blood gas,COVID-19 polymerase chain reaction,and other laboratory data.RESULTS The mean age of the 479 patients was 54.93±11.51 years,and 187(39%)were female.226(47%)patients were in the pandemic group and 143(30%)of them had a history of COVID-19.While the mean potential of hydrogen(pH)in arterial blood gas of all patients was 7.28±0.15,it was 7.35±0.10 in the pre-pandemic group and 7.05±0.16 in the severe group during the pandemic period(P<0.001).COHb was 23.98±4.19%in the outpatients and 45.26%±3.19%in the mortality group(P<0.001).Partial arterial oxygen pressure(PaO2)was 89.63±7.62 mmHg in the pre-pandemic group,and 79.50±7.18 mmHg in the severe group during the pandemic period(P<0.001).Despite the fact that mortality occurred in 35(7%)of all cases,pandemic cases accounted for 30 of these deaths(85.7%)(P<0.001).The association between COHb,troponin,lactate,partial arterial pressure of carbon dioxide,HCO3,calcium,glucose,age,pH,PaO2,potassium,sodium,and base excess levels in the pre-pandemic and pandemic groups was statistically significant in univariate linear analysis.CONCLUSION Air exchange barrier disruption caused by COVID-19 may have pulmonary consequences.In patients with a history of pandemic COVID-19,clinical results and survival are considerably unfavorable in cases of CO poisoning.展开更多
Carbon monoxide poisoning (COP) from 2 to 9 October 2019 was a major public health concern in Ulaanbaatar, Mongolia, after a transition from consumption of raw coal to upgraded briquette fuel. During the period, a tot...Carbon monoxide poisoning (COP) from 2 to 9 October 2019 was a major public health concern in Ulaanbaatar, Mongolia, after a transition from consumption of raw coal to upgraded briquette fuel. During the period, a total of 186 residents, which is 16 times more than the previous years, were exposed to COP and 6 persons died at home. We conduct a cross-sectional study by using registration data and medical history of all hospitalized patients with a diagnosis of COP from 2 to 9 October 2019 and had an in-depth interview. 144 (77.4%) people from 85 households registered as potential cases and 124 (86.1%) people were diagnosed with COP. All households used upgraded briquettes, and 41 households (48.2%) used them for the first time. In 50% of cases, the stove was broken, the chimney was short, not heated, and the clay joint connecting the wall stove was broken. The majority of interviewees were unaware of COP and improperly used briquettes, and the safety of chimneys and stoves was insufficient which caused unintentional COP. It is necessary to provide information to the local population about the potential risks of COP, install CO alarms in households, and educate the population. In further, a well-established poisoning surveillance system is an important aspect of public health emergency preparedness in Mongolia.展开更多
Carbon monoxide (CO) poisoning is a frequent cause of emergency room admissions, especially during winter days, the symptoms are varied ranging from a simple headache to a serious cardiac and neurological impairment t...Carbon monoxide (CO) poisoning is a frequent cause of emergency room admissions, especially during winter days, the symptoms are varied ranging from a simple headache to a serious cardiac and neurological impairment that can be deadly. Diagnosis is based on the circumstances of occurrence as well as the dosage of carboxyhemoglobin in the blood. Exposure to CO has serious consequences, neurological and cardiac manifestations are not negligible and vary from repolarization disorders to heart attack. Treatment is urgent with normobaric or hyperbaric oxygen therapy. We report a case of a 2-year male child admitted to the emergency room for CO intoxication with an intracardiac thrombus subsequently complicated by an ischemic stroke with a fatal outcome in order to highlight this complication rarely described in literature.展开更多
Objectives and Study: Cade oil is aromatic oil obtained from the branches and wood of Juniperus oxycedrus, common in the Mediterranean region and widely used in traditional medicine. This oil contains many chemical co...Objectives and Study: Cade oil is aromatic oil obtained from the branches and wood of Juniperus oxycedrus, common in the Mediterranean region and widely used in traditional medicine. This oil contains many chemical compounds with neurological, cardiac, renal, respiratory, hepatic, and gastrointestinal toxicity. Cade oil poisoning often requires intensive care admission due to the severity of the clinical picture. The objective of this study is to highlight the multiple manifestations found in the pediatric population due to cade oil exposure objectifying its significant toxicity. Methods: The authors report during this article a series of five cases of cade oil poisoning on pediatric patients hospitalized in the pediatric intensive care unit of El HARROUCHI hospital at the CHU Ibn Rochd in Casablanca during the period from 11/01/2022 to 12/07/2022. The patients have been exposed, a few hours before their admission, to an external cade oil application used by parents for therapeutic purposes. Main Findings: Our patients were aged from 1 month to 4 years, the average age was 1.5 years with a female predominance and a sex ratio of 1.5:1. The patients had no prior medical history, and the cade oil application was spontaneously declared by the parents of only 2 patients, 3 of them reported the use of it after the detection of the substance by the clinician. For all the cases, cade oil was applied to treat fever. All five (5) patients presented initial neurological signs. 3 of them were admitted to an acute consciousness disorder and the 2 other patients presented respectively a convulsive status epilepticus and generalized-onset seizure. We report respiratory symptoms in 4 cases ranging from a simple caught, rhinorrhea to severe respiratory distress. Three patients presented acute liver failure with very high transaminase levels associated with acute kidney failure. Two of them presented digestive symptoms such as abundant hematemesis, vomiting, and watery diarrhea. All patients received high doses of N acetylcysteine in their initial treatments. The evolution was unfavorable for 4 patients who developed a multiorgan failure, 3 of them died, with a good clinical improvement in the fifth patient after supportive and symptomatic treatment. Conclusion: Cade oil poisoning remains a very frequent situation in our context. Its toxicity is widely described in the literature. The increasing number of cases admitted, and the seriousness of the clinical picture require mass awareness among the population and the scientific community toward the use of medicinal plants.展开更多
BACKGROUND:Penehyclidine is a newly developed anticholinergic agent.We aimed to investigate the role of penehyclidine in acute organophosphorus pesticide poisoning(OP)patients.METHODS:We searched the Pubmed,Cochrane l...BACKGROUND:Penehyclidine is a newly developed anticholinergic agent.We aimed to investigate the role of penehyclidine in acute organophosphorus pesticide poisoning(OP)patients.METHODS:We searched the Pubmed,Cochrane library,EMBASE,Chinese National Knowledge Infrastructure(CNKI),Chinese Biomedical literature(CBM)and Wanfang databases.Randomized controlled trials(RCTs)recruiting acute OP patients were identifi ed for meta-analysis.Main outcomes included cure rate,mortality rate,time to atropinization,time to 60%normal acetylcholinesterase(AchE)level,rate of intermediate syndrome(IMS)and rate of adverse drug reactions(ADR).RESULTS:Sixteen RCTs involving 1,334 patients were identifi ed.Compared with the atropineor penehyclidine-alone groups,atropine combined with penehyclidine significantly increased the cure rate(penehyclidine+atropine vs.atropine,0.97 vs.0.86,RR 1.13,95%CI[1.07–1.19];penehyclidine+atropine vs.penehyclidine,0.93 vs.0.80,RR 1.08,95%CI[1.01–1.15])and reduced the mortality rate(penehyclidine+atropine vs.atropine,0.015 vs.0.11,RR 0.17,95%CI[0.06–0.49];penehyclidine+atropine vs.penehyclidine,0.13 vs.0.08,RR 0.23,95%CI[0.04–1.28]).Atropine combined with penehyclidine in OP patients also helped reduce the time to atropinization and AchE recovery,the rate of IMS and the rate of ADR.Compared with a single dose of atropine,a single dose of penehyclidine also signifi cantly elevated the cure rate,reduced times to atropinization,AchE recovery,and rate of IMS.CONCLUSION:Atropine combined with penehyclidine benefi ts OP patients by enhancing the cure rate,mortality rate,time to atropinization,AchE recovery,IMS rate,total ADR and duration of hospitalization.Penehyclidine combined with atropine is likely a better initial therapy for OP patients than atropine alone.展开更多
BACKGROUND:Gastric lavage(GL)is one of the most critical early therapies for acute paraquat(PQ)poisoning;however,details of the treatment protocol remain to be established.METHODS:A rapid quantitative method involving...BACKGROUND:Gastric lavage(GL)is one of the most critical early therapies for acute paraquat(PQ)poisoning;however,details of the treatment protocol remain to be established.METHODS:A rapid quantitative method involving sodium dithionite testing was developed.It was validated for the determination of the PQ concentrations in gastric juice and eluate samples from a swine acute PQ poisoning model with early or delay GL,or without.The vital signs,laboratory testing,and PQ plasma concentrations were collected for therapeutic effect evaluation.RESULTS:The reaction conditions of the test were optimized for two types of samples.Early GL at one hour(H1)could improve the signs and symptoms after acute PQ poisoning at 24 hours(H24).In contrast,GL at 6 hours(H6)could only partially relieve the vital signs.The H1 GL group effectively reduced the peak of the plasma PQ concentration.In addition,the PQ concentrations in the plasma and the gastric juice were significantly decreased in both the GL groups as compared to the untreated group at H24.Moreover,there was no significant difference in the washing efficiencies calculated from the total eluates between the two GL groups.However,the washing efficiency of the first 10 L eluate is superior to that of the additional 10 L eluate.CONCLUSION:GL only at early stage may it benefit PQ poisoning in an animal model.The currently used 20 L GL volume may need to be reduced in view of the low washing efficiency in the later 10 L eluate.The rapid quantitative method can be used for gastric juice sample and has a certain value for clinical GL practices.展开更多
基金supported by National Natural Science Foundation of China(82172184)。
文摘BACKGROUND:In clinical practice,some patients might not be able or unwilling to provide a thorough history of medication and poison exposure.The aim of this study was to use toxicological analysis to examine the clinical characteristics of patients with acute poisoning whose exposure history was uncertain from a toxicological analysis perspective.METHODS:This was a retrospective and descriptive study from an institute of poisoning.Patient registration information and test reports spanning the period from April 1,2020 to March 31,2022,were obtained.Patients with uncertain exposure histories and who underwent toxicological analysis were included.Clinical manifestations and categories of toxics were analyzed.RESULTS:Among the 195 patients with positive toxicological analysis results,the main causes of uncertain exposure history was disturbance of consciousness(62.6%),unawareness(23.6%)and unwillingness or lack of cooperation(13.8%).The predominant clinical manifestations were disturbed consciousness(62.6%),followed by vomiting and nausea(14.4%)and liver function abnormalities(8.7%).A comparison of clinical manifestations between patients with positive and negative(n=99)toxicological analyses results revealed significantly different proportions of disturbances in consciousness(63%vs.21%),dizziness(1.5%vs.5.1%),multi-organ failure(1.5%vs.7.1%),and local pain(0 vs 4%).The main categories of substances involved were psychiatric medications(23.1%),sedatives(20.5%),insecticides(13.8%),and herbicides(12.8%).CONCLUSION:The clinical manifestations of acute poisoning in patients with an uncertain exposure history are diverse and nonspecific,and toxicological analysis plays a pivotal role in the diagnosis and differential diagnosis of such patients.
文摘Bayesian networks are a powerful class of graphical decision models used to represent causal relationships among variables.However,the reliability and integrity of learned Bayesian network models are highly dependent on the quality of incoming data streams.One of the primary challenges with Bayesian networks is their vulnerability to adversarial data poisoning attacks,wherein malicious data is injected into the training dataset to negatively influence the Bayesian network models and impair their performance.In this research paper,we propose an efficient framework for detecting data poisoning attacks against Bayesian network structure learning algorithms.Our framework utilizes latent variables to quantify the amount of belief between every two nodes in each causal model over time.We use our innovative methodology to tackle an important issue with data poisoning assaults in the context of Bayesian networks.With regard to four different forms of data poisoning attacks,we specifically aim to strengthen the security and dependability of Bayesian network structure learning techniques,such as the PC algorithm.By doing this,we explore the complexity of this area and offer workablemethods for identifying and reducing these sneaky dangers.Additionally,our research investigates one particular use case,the“Visit to Asia Network.”The practical consequences of using uncertainty as a way to spot cases of data poisoning are explored in this inquiry,which is of utmost relevance.Our results demonstrate the promising efficacy of latent variables in detecting and mitigating the threat of data poisoning attacks.Additionally,our proposed latent-based framework proves to be sensitive in detecting malicious data poisoning attacks in the context of stream data.
文摘BACKGROUND Most species of aconite contain highly toxic aconitines,the oral ingestion of which can be fatal,primarily because they cause ventricular arrhythmias.We describe a case of severe aconite poisoning that was successfully treated through venoarterial extracorporeal membrane oxygenation(VA-ECMO)and in which detailed toxicological analyses of the aconite roots and biological samples were performed using liquid chromatography-tandem mass spectrometry(LC-MS/MS).CASE SUMMARY A 23-year-old male presented to the emergency room with circulatory collapse and ventricular arrhythmia after ingesting approximately half of a root labeled,“Aconitum japonicum Thunb”.Two hours after arrival,VA-ECMO was initiated as circulatory collapse became refractory to antiarrhythmics and vasopressors.Nine hours after arrival,an electrocardiogram revealed a return to sinus rhythm.The patient was weaned off VA-ECMO and the ventilator on hospital days 3 and 5,respectively.On hospital day 15,he was transferred to a psychiatric hospital.The other half of the root and his biological samples were toxicologically analyzed using LC-MS/MS,revealing 244.3 mg/kg of aconitine and 24.7 mg/kg of mesaconitine in the root.Serum on admission contained 1.50 ng/mL of aconitine.Beyond hospital day 2,neither were detected.Urine on admission showed 149.09 ng/mL of aconitine and 3.59 ng/mL of mesaconitine,but these rapidly decreased after hospital day 3.CONCLUSION The key to saving the life of a patient with severe aconite poisoning is to introduce VA-ECMO as soon as possible.
基金Supported by Jilin Province Science and Technology Agency Project,No.20210101350JCProject of Jilin Provincial Finance Department,No.JLSWSRCZX2023-60Beijing iGandan Foundation Fund for Artificial Liver,No.iGandanF-1082023-RGG025.
文摘BACKGROUND This report delves into the diagnostic and therapeutic journey undertaken by a patient with high-dose cantharidin poisoning and multiorgan dysfunction syndrome(MODS).Particular emphasis is placed on the comprehensive elucidation of the clinical manifestations of high-dose cantharidin poisoning,the intricate path to diagnosis,and the exploration of potential underlying mechanisms.CASE SUMMARY A patient taking 10 g of cantharidin powder orally subsequently developed MODS.The patient was treated with supportive care,fluid hydration and antibiotics,and hemoperfusion and hemofiltration therapy for 24 h and successfully recovered 8 d after hospital admission.Cantharidin poisoning can cause lifethreatening MODS and is rare clinically.This case underscores the challenge in diagnosis and highlights the need for early clinical differentiation to facilitate accurate assessment and prompt intervention.CONCLUSION This article has reported and analyzed the clinical data,diagnosis,treatment,and prognosis of a case of high-dose cantharidin poisoning resulting in MODS and reviewed the relevant literature to improve the clinical understanding of this rare condition.
文摘Rationale:Multi-organ failure is a symptom of paraquat poisoning,resulting in high mortality and morbidity rates.Though paraquat is widely available,poisoning through inhalation is rare.Patient’s Concern:A 37-year-old male reported to the emergency department with complaints of vomiting after an alleged history of inhalation of paraquat while at work.Diagnosis:Paraquat poisoning.Interventions:Supportive management along with multiple sessions of hemodialysis.Outcomes:Renal complications caused by paraquat were improved after multiple sessions of hemodialysis.However,the patient developed respiratory complications and later due to persistent hypoxemia and non-responsive to supportive therapy,he succumbed to his illness.Lessons:Acute kidney injury is a complication of paraquat poisoning.However,kidney involvement with the inhalational mode is rare.It is caused by reduction and oxidation cycles,as well as the formation of reactive oxygen species,necessitating hemodialysis as the treatment.Without a clear history,a specific clinical trait,or a diagnostic test,diagnosis can be difficult.Our case thus highlights the inhaled paraquat poisoning,presenting with acute kidney injury with late respiratory impairment as a consequence.
文摘Objective:To study the value of some biochemical indicators and Peradeniya Organophosphate Poisoning scale in prediction and prognosis of organophosphorus poisoning.Methods:This was a hospital-based prospective,observational study.Various biochemical tests viz.complete blood count,random blood sugar,liver and renal function tests,creatine phosphokinase,and electrolytes were performed.Patients were assessed based on the Peradeniya Organophosphate Poisoning scale.All the patients were followed till the end point like recovery/death.Results:Out of the 100 patients,72%were males and 28%were females.The majority of the patients were farmers and 21 to 30 years of age.Suicidal was the most common manner(92,92%).Based on the Peradeniya Organophosphate Poisoning scale,47%were mild,34%moderate,and 19%severe.Serum creatinine,creatine phosphokinase,serum glutamic-oxaloacetic transaminase,serum glutamic pyruvic transaminase,and alkaline phosphatase levels showed a significant correlation with severity.Conclusions:Some biochemical indicators such as creatine phosphokinase,alkaline phosphatase can be used as prognostic markers of organophosphorus poisoning.The Peradeniya Organophosphate Poisoning scale can be used for assessing severity of the poisoning.
基金Science and Public Welfare Research Fund of Liaoning Province,No.2022JH4/10100075and National Nature Science Foundation of China,No.81772056.
文摘Standard management protocols are lacking and specific antidotes are unavailable for acute carbamazepine(CBZ)poisoning.The objective of this review is to provide currently available information on acute CBZ poisoning,including its management,by describing and summarizing various therapeutic methods for its treatment according to previously published studies.Several treatment methods for CBZ poisoning will be briefly introduced,their advantages and disadvantages will be analyzed and compared,and suggestions for the clinical treatment of CBZ poisoning will be provided.A literature search was performed in various English and Chinese databases.In addition,the reference lists of identified articles were screened for additional relevant studies,including non-indexed reports.Nonpeer-reviewed sources were also included.In the present review,154 articles met the inclusion criteria including case reports,case series,descriptive cohorts,pharmacokinetic studies,and in vitro studies.Data on 67 patients,including 4 fatalities,were reviewed.Based on the summary of cases reported in the included articles,the cure rate of CBZ poisoning after symptomatic treatment was 82%and the efficiency of hemoperfusion was 58.2%.Based on the literature review,CBZ is moderately dialyzable and the recommendation for CBZ poisoning is supportive management and gastric lavage.In severe cases,extracorporeal treatment is recommended,with hemodialysis as the first choice.
基金the Youth Innovation Promotion Association,Chinese Academy of Science(No.2019263)the National Natural Science Foundation of China(No.12105355).
文摘A ZrV_(2)alloy is typically susceptible to poisoning by impurity gases,which causes a considerable reduction in the hydrogen storage properties of the alloy.In this study,the adsorption characteristics of oxygen on ZrV_(2)surfaces doped with Hf,Ti,and Pd are investigated,and the effect of oxygen on the hydrogen storage performance of the alloy was discussed.Subsequently,the adsorption energy,bond-length change,density of states,and differential charge density of the alloy before and after doping are analyzed using the first-principles method.The theoretical results show that Ti doping has a limited effect on the adsorption of oxygen atoms on the ZrV_(2)surface,whereas Hf doping decreases the adsorption energy of oxygen on the ZrV_(2)surface.Oxygen atoms are more difficult to adsorb at most adsorption sites on Pd-substituting surfaces,which indicates that Pd has the best anti-poisoning properties,followed by Hf.The analysis of the differential charge density and partial density of states show that the electron interaction between the oxygen atom and surface atom of the alloys is weakened,and the total energy is reduced after Hf and Pd doping.Based on theoretical calculations,the hydrogen absorption kinetics of ZrV_(2),Zr_(0.9)Hf_(0.1)V_(2),and Zr(V_(0.9)Pd_(0.1))_(2) alloys are studied in a hydrogen-oxygen mixture of 0.5 vol%O_(2) at 25℃.The experimental results show that the hydrogen storage capacities of ZrV_(2),Zr_(0.9)Hf_(0.1)V_(2),and Zr(V_(0.9)Pd_(0.1))_(2) decrease to 19%,69%,and 80%of their original values,respectively.The order of alloy resistance to 0.5 vol%O_(2) poisoning is Zr(V_(0.9)Pd_(0.1))_(2)>Zr_(0.9)Hf_(0.1)V_(2)>ZrV_(2).Pd retains its original hydrogen absorption performance to a greater extent than undoped surfaces,and it has the strongest resistance to poisoning,which is consistent with previous theoretical calculations.
基金supported by a grant from the National Key R&D Program of China(2019YFC16063000).
文摘The main toxic component of tetramine is tetramethylenedisulfotetramine(TETS).It is a sulfonamide derivative without special antidote,tasteless and tasteless,with high toxicity and high mortality.[1]It was first discovered by a German scientist Hagen in 1949.Although its use has been banned worldwide due to its high toxicity and mortality rate,it is still available in certain countries and has led to cases of intentional and unintentional poisoning.Tetramine blocksγ-neurons,leading to dizziness,fatigue,nausea,vomiting,convulsions,and other symptoms.[2-4]Due to the lack of recognized effective antidotes,many poisoned people suff ocate and die as a result of continuous spasms of the respiratory muscles.[5-7]Tetramine poisoning sometimes occurs,but it is rare for vegetables grown in tetraminecontaminated soil to cause group poisoning after being eaten.
基金National Research Foundation of Korea(NRF),Grant/Award Number:2021R1A2C2012685Korea Institute of Energy Technology Evaluation and Planning(KETEP),Grant/Award Number:20203020030010Ministry of Trade,Industry&Energy(MOTIE,Korea),Grant/Award Number:20020400。
文摘One of the primary challenges in relation to phosphoric acid fuel cells is catalyst poisoning by phosphate anions that occurs at the interface between metal nanoparticles and the electrolyte.The strong adsorption of phosphate anions on the catalyst surface limits the active sites for the oxygen reduction reaction(ORR),significantly deteriorating fuel cell performance.Here,antipoisoning catalysts consisting of Pt-based nanoparticles encapsulated in an ultrathin carbon shell that can be used as a molecular sieve layer are rationally designed.The pore structure of the carbon shells is systematically regulated at the atomic level by high-temperature gas treatment,allowing O_(2) molecules to selectively react on the active sites of the metal nanoparticles through the molecular sieves.Besides,the carbon shell,as a protective layer,effectively prevents metal dissolution from the catalyst during a long-term operation.Consequently,the defect-controlled carbon shell leads to outstanding ORR activity and durability of the hybrid catalyst even in phosphoric acid electrolytes.
文摘Information-Centric Networking(ICN)is considered a viable strategy for regulating Internet consumption using the Internet’s underlying architecture.Although Named Data Networking(NDN)and its reference-based implementa-tion,the NDN Forwarding Daemon(NFD),are the most established ICN solu-tions,their vulnerability to the Content Poisoning Attack(CPA)is regarded as a severe threat that might dramatically impact this architecture.Content Poisoning can significantly minimize the impact of NDN’s universal data caching.Using verification signatures to protect against content poisoning attacks may be imprac-tical due to the associated costs and the volume of messages sent across the net-work,resulting in high computational costs.Therefore,in this research,we designed a method in NDN called Bird Swarm Optimization Algorithm-Based Content Poisoning Mitigation(BSO-Content Poisoning Mitigation Scheme).By aggregating the security information of entire routers along the full path,this sys-tem introduces the BSO to explore the secure transmission path and alter the con-tent retrieval procedure.Meanwhile,based on the determined trustworthy value of each node,the BSO-Content Poisoning Mitigation Scheme can bypass malicious routers,preventing them from disseminating illicit content in the future.Addition-ally,the suggested technique can minimize content poisoning utilizing removing erroneous Data packets from the cache-store during the pathfinding process.The proposed method has been subjected to extensive analysis compared with the ROM scheme and improved performance justified in several metrics.BSO-Con-tent Poisoning Mitigation Scheme is more efficient and faster than the ROM tech-nique in obtaining valid Data packets and resulting in a higher good cache hit ratio in a comparatively less amount of time.
基金Anhui University of Chinese Medicine,No.2022LAY012.
文摘BACKGROUND Cochineal red is an organic compound widely used in food,cosmetics,pharmaceuticals,textiles,and other fields due to its excellent safety profile.Poisoning caused by eating foods containing cochineal red is rare,and repeated atrial arrhythmia due to cochineal red poisoning is even rarer.CASE SUMMARY An 88-year-old Asian female patient was admitted to hospital due to a disturbance of consciousness.Twelve hours prior to presentation,the patient consumed 12 eggs containing cochineal red over a period of 2 h.At presentation,the patient was in a coma and had a score of 6 on the Glasgow Coma Scale(E2+VT+M4).The patient’s skin and mucous membranes were pink.Electrocardiography(ECG)revealed rapid atrial fibrillation without any signs of ischemia.We prescribed cedilan and fluid replacement for arrhythmia correction.Shortly after admission,the atrial fibrillation corrected to a normal sinus rhythm.On the day 2 of admission,the patient had a sudden atrial flutter accompanied by hemodynamic instability and rapidly declining arterial oxygen saturation between 85%and 90%.The sinus rhythm returned to normal after two electrical cardioversions.Six days after admission,the skin color of the patient returned to normal,and the ECG results were normal.The patient was transferred out of the intensive care unit and eventually discharged after 12 d in hospital.At the 2-mo follow-up visit,the patient was in good health with no recurrence of arrhythmia.CONCLUSION Although cochineal red is a safe,natural food additive,excessive consumption or occupational exposure can induce cardiac arrhythmias.
文摘BACKGROUND With the withdrawal of paraquat from the market,diquat is widely used,so the treatment of diquat poisoning has become one of the focuses of emergency poisoning diagnosis and treatment.CASE SUMMARY We studied the case of a 17-year-old male patient who drank 200 mL(20 g/100 mL)of diquat solution two hours before arriving at the hospital.Despite the use of treatments such as gastric lavage,hemoperfusion,continuous hemodialysis,glucocorticoids,and organ support,the patient’s condition rapidly progressed to multiorgan failure,and he died 23.5 h after admission.CONCLUSION We summarized the clinical characteristics and treatment strategies of diquat poisoning through this case and performed a literature review to provide a basis and direction for clinical treatment.
文摘BACKGROUND Coronavirus disease 2019(COVID-19),which recently spread throughout the entire world,is still a significant health issue.Additionally,the most common cause of risky poisoning in emergency services is carbon monoxide(CO)poisoning.Both disorders seem to merit more research as they have an impact on all bodily systems via the lungs.AIM To determine how arterial blood gas and carboxyhemoglobin(COHb)levels affect the clinical and prognostic results of individuals requiring emergency treatment who have both COVID-19 and CO poisoning.METHODS Between January 2018 and December 2021,479 CO-poisoning patients participated in this single-center,retrospective study.Patients were primarily divided into two groups for analysis:Pre-pandemic and pandemic periods.Additionally,the pandemic era was divided into categories based on the presence of COVID-19 and,if present,the clinical severity of the infection.The hospital information system was used to extract patient demographic,clinical,arterial blood gas,COVID-19 polymerase chain reaction,and other laboratory data.RESULTS The mean age of the 479 patients was 54.93±11.51 years,and 187(39%)were female.226(47%)patients were in the pandemic group and 143(30%)of them had a history of COVID-19.While the mean potential of hydrogen(pH)in arterial blood gas of all patients was 7.28±0.15,it was 7.35±0.10 in the pre-pandemic group and 7.05±0.16 in the severe group during the pandemic period(P<0.001).COHb was 23.98±4.19%in the outpatients and 45.26%±3.19%in the mortality group(P<0.001).Partial arterial oxygen pressure(PaO2)was 89.63±7.62 mmHg in the pre-pandemic group,and 79.50±7.18 mmHg in the severe group during the pandemic period(P<0.001).Despite the fact that mortality occurred in 35(7%)of all cases,pandemic cases accounted for 30 of these deaths(85.7%)(P<0.001).The association between COHb,troponin,lactate,partial arterial pressure of carbon dioxide,HCO3,calcium,glucose,age,pH,PaO2,potassium,sodium,and base excess levels in the pre-pandemic and pandemic groups was statistically significant in univariate linear analysis.CONCLUSION Air exchange barrier disruption caused by COVID-19 may have pulmonary consequences.In patients with a history of pandemic COVID-19,clinical results and survival are considerably unfavorable in cases of CO poisoning.
文摘Carbon monoxide poisoning (COP) from 2 to 9 October 2019 was a major public health concern in Ulaanbaatar, Mongolia, after a transition from consumption of raw coal to upgraded briquette fuel. During the period, a total of 186 residents, which is 16 times more than the previous years, were exposed to COP and 6 persons died at home. We conduct a cross-sectional study by using registration data and medical history of all hospitalized patients with a diagnosis of COP from 2 to 9 October 2019 and had an in-depth interview. 144 (77.4%) people from 85 households registered as potential cases and 124 (86.1%) people were diagnosed with COP. All households used upgraded briquettes, and 41 households (48.2%) used them for the first time. In 50% of cases, the stove was broken, the chimney was short, not heated, and the clay joint connecting the wall stove was broken. The majority of interviewees were unaware of COP and improperly used briquettes, and the safety of chimneys and stoves was insufficient which caused unintentional COP. It is necessary to provide information to the local population about the potential risks of COP, install CO alarms in households, and educate the population. In further, a well-established poisoning surveillance system is an important aspect of public health emergency preparedness in Mongolia.
文摘Carbon monoxide (CO) poisoning is a frequent cause of emergency room admissions, especially during winter days, the symptoms are varied ranging from a simple headache to a serious cardiac and neurological impairment that can be deadly. Diagnosis is based on the circumstances of occurrence as well as the dosage of carboxyhemoglobin in the blood. Exposure to CO has serious consequences, neurological and cardiac manifestations are not negligible and vary from repolarization disorders to heart attack. Treatment is urgent with normobaric or hyperbaric oxygen therapy. We report a case of a 2-year male child admitted to the emergency room for CO intoxication with an intracardiac thrombus subsequently complicated by an ischemic stroke with a fatal outcome in order to highlight this complication rarely described in literature.
文摘Objectives and Study: Cade oil is aromatic oil obtained from the branches and wood of Juniperus oxycedrus, common in the Mediterranean region and widely used in traditional medicine. This oil contains many chemical compounds with neurological, cardiac, renal, respiratory, hepatic, and gastrointestinal toxicity. Cade oil poisoning often requires intensive care admission due to the severity of the clinical picture. The objective of this study is to highlight the multiple manifestations found in the pediatric population due to cade oil exposure objectifying its significant toxicity. Methods: The authors report during this article a series of five cases of cade oil poisoning on pediatric patients hospitalized in the pediatric intensive care unit of El HARROUCHI hospital at the CHU Ibn Rochd in Casablanca during the period from 11/01/2022 to 12/07/2022. The patients have been exposed, a few hours before their admission, to an external cade oil application used by parents for therapeutic purposes. Main Findings: Our patients were aged from 1 month to 4 years, the average age was 1.5 years with a female predominance and a sex ratio of 1.5:1. The patients had no prior medical history, and the cade oil application was spontaneously declared by the parents of only 2 patients, 3 of them reported the use of it after the detection of the substance by the clinician. For all the cases, cade oil was applied to treat fever. All five (5) patients presented initial neurological signs. 3 of them were admitted to an acute consciousness disorder and the 2 other patients presented respectively a convulsive status epilepticus and generalized-onset seizure. We report respiratory symptoms in 4 cases ranging from a simple caught, rhinorrhea to severe respiratory distress. Three patients presented acute liver failure with very high transaminase levels associated with acute kidney failure. Two of them presented digestive symptoms such as abundant hematemesis, vomiting, and watery diarrhea. All patients received high doses of N acetylcysteine in their initial treatments. The evolution was unfavorable for 4 patients who developed a multiorgan failure, 3 of them died, with a good clinical improvement in the fifth patient after supportive and symptomatic treatment. Conclusion: Cade oil poisoning remains a very frequent situation in our context. Its toxicity is widely described in the literature. The increasing number of cases admitted, and the seriousness of the clinical picture require mass awareness among the population and the scientific community toward the use of medicinal plants.
文摘BACKGROUND:Penehyclidine is a newly developed anticholinergic agent.We aimed to investigate the role of penehyclidine in acute organophosphorus pesticide poisoning(OP)patients.METHODS:We searched the Pubmed,Cochrane library,EMBASE,Chinese National Knowledge Infrastructure(CNKI),Chinese Biomedical literature(CBM)and Wanfang databases.Randomized controlled trials(RCTs)recruiting acute OP patients were identifi ed for meta-analysis.Main outcomes included cure rate,mortality rate,time to atropinization,time to 60%normal acetylcholinesterase(AchE)level,rate of intermediate syndrome(IMS)and rate of adverse drug reactions(ADR).RESULTS:Sixteen RCTs involving 1,334 patients were identifi ed.Compared with the atropineor penehyclidine-alone groups,atropine combined with penehyclidine significantly increased the cure rate(penehyclidine+atropine vs.atropine,0.97 vs.0.86,RR 1.13,95%CI[1.07–1.19];penehyclidine+atropine vs.penehyclidine,0.93 vs.0.80,RR 1.08,95%CI[1.01–1.15])and reduced the mortality rate(penehyclidine+atropine vs.atropine,0.015 vs.0.11,RR 0.17,95%CI[0.06–0.49];penehyclidine+atropine vs.penehyclidine,0.13 vs.0.08,RR 0.23,95%CI[0.04–1.28]).Atropine combined with penehyclidine in OP patients also helped reduce the time to atropinization and AchE recovery,the rate of IMS and the rate of ADR.Compared with a single dose of atropine,a single dose of penehyclidine also signifi cantly elevated the cure rate,reduced times to atropinization,AchE recovery,and rate of IMS.CONCLUSION:Atropine combined with penehyclidine benefi ts OP patients by enhancing the cure rate,mortality rate,time to atropinization,AchE recovery,IMS rate,total ADR and duration of hospitalization.Penehyclidine combined with atropine is likely a better initial therapy for OP patients than atropine alone.
基金Natural Science Found of Jiangsu Province(BK20171500,16KJB320003)Program for Key disease of Jiangsu Province Science and Technology Department(BL2014088)+1 种基金Program for Innovative Medical Research Team of Jiangsu Province(CXTDA2017007)Jiangsu Province’s key provincial talents program(QNRC2016597).
文摘BACKGROUND:Gastric lavage(GL)is one of the most critical early therapies for acute paraquat(PQ)poisoning;however,details of the treatment protocol remain to be established.METHODS:A rapid quantitative method involving sodium dithionite testing was developed.It was validated for the determination of the PQ concentrations in gastric juice and eluate samples from a swine acute PQ poisoning model with early or delay GL,or without.The vital signs,laboratory testing,and PQ plasma concentrations were collected for therapeutic effect evaluation.RESULTS:The reaction conditions of the test were optimized for two types of samples.Early GL at one hour(H1)could improve the signs and symptoms after acute PQ poisoning at 24 hours(H24).In contrast,GL at 6 hours(H6)could only partially relieve the vital signs.The H1 GL group effectively reduced the peak of the plasma PQ concentration.In addition,the PQ concentrations in the plasma and the gastric juice were significantly decreased in both the GL groups as compared to the untreated group at H24.Moreover,there was no significant difference in the washing efficiencies calculated from the total eluates between the two GL groups.However,the washing efficiency of the first 10 L eluate is superior to that of the additional 10 L eluate.CONCLUSION:GL only at early stage may it benefit PQ poisoning in an animal model.The currently used 20 L GL volume may need to be reduced in view of the low washing efficiency in the later 10 L eluate.The rapid quantitative method can be used for gastric juice sample and has a certain value for clinical GL practices.
