1/23. A case of transient diabetes insipidus associated with poisoning by a herbicide containing glufosinate.BACKGROUND: The herbicide BASTA (AgrEvo, germany), containing glufosinate ammonium (20%) and an anionic surfactant, polyoxyethylene alkylether sulfate (33%), is widely used. In acute oral BASTA poisoning, patients develop a variety of clinical signs, including disturbed consciousness, convulsions, and apnea. These effects are suspected to be due to the effects of glufosinate on the central nervous system. CASE REPORT: A 60-year-old man ingested 500 mL of BASTA herbicide in a suicide attempt. He developed not only unconsciousness, respiratory distress, and convulsions but also an increase in urine output (7885 mL/d), elevated serum sodium (167 mEq/L), elevated plasma osmolality (332 mOsm/kg), and a decrease in both urine osmolality (200 mOsm/kg) and urine specific gravity (1.003), which suggested the development of diabetes insipidus. The plasma level of antidiuretic hormone remained within the normal range (1.3 pg/mL), despite high plasma osmolality. The administration of desmopressin was successful in normalizing urine volume, specific gravity, and osmolality. serum sodium corrected gradually within 48 hours. The possible mechanisms causing the diabetes insipidus are discussed.- - - - - - - - - - ranking = 1keywords = nervous system (Clic here for more details about this article) |
2/23. Heavy metal poisoning in glass worker characterised by severe.The paper presents the clinical description of the masticatory organ and biochemical assessment of dental tissue in a patient employed in a glassworks for 20 years. During 12 years the patient has suffered baldness ("alopecia areata") and atypical extensive and non-healing cutaneous lesions. Dental examination revealed changes typical of chronic poisoning by cadmium and bismuth compounds.- - - - - - - - - - ranking = 16.232079196731keywords = metal (Clic here for more details about this article) |
3/23. Changes in concentrations of type IV collagen and tissue inhibitor of metalloproteinase-1 in patients with paraquat poisoning.Respiratory failure is one of the major causes of death in patients with paraquat poisoning. In paraquat-poisoned lungs, abnormal extracellular matrix regulation occurs. The aim of the present study is to determine whether serum concentrations of type IV collagen and tissue inhibitor of metalloproteinase-1 (TIMP-1) are altered during the course of paraquat poisoning and whether haemoperfusion therapy affects these concentrations. Twenty-one patients were admitted within 3 h after ingestion of paraquat and all patients received direct haemoperfusion therapy. Five out of 21 patients survived and 16 patients died within 28 days. plasma paraquat concentrations in non-survivors (5740 /- 380 microg l(-1)) were not significantly different from those in survivors ( 5920 /- 280 microg l(-1)) before treatment. Haemoperfusion reduced these concentrations in both non-survivors (120 /- 7 microg l(-1)) as well as survivors (136 /- 9 microg l(-1)) on day 5. serum concentrations of type IV collagen and TIMP-1 in survivors showed little change between day 1 (type IV collagen, 90.4 /- 3.6 ng ml(-1); TIMP-1, 172.2 /- 7.0 ng ml(-1)) and day 5 (type IV collagen, 92.6 /- 4.2 ng ml(-1); TIMP-1, 174.2 /- 7.2 ng ml(-1)). In contrast, these concentrations in non-survivors on day 5 (type IV collagen, 143.6 /- 7.8 mg ml(-1); TIMP-1, 246.8 /- 13.6 ng ml(-1)) were significantly higher than those on day 1 (type IV collagen, 88.4 /- 4.2 ng ml(-1), P < 0.01; TIMP-1, 170.6 /- 9.2 ng ml(-1), P < 0.05). These data suggest that serum concentrations of type IV collagen and TIMP-1 may be useful indicators for the development of respiratory failure in patients with paraquat poisoning.- - - - - - - - - - ranking = 20.290098995914keywords = metal (Clic here for more details about this article) |
4/23. The nail and hair in forensic science.Drugs, chemicals, and biological substances accumulate and are stored in hair and nails where they can be detected and measured. Advantages of analyzing hair and nail samples also include their easy and non-invasive collection, the small sample size required for analysis, and their easy storage at room temperature. We report 3 examples of heavy metal poisoning diagnosed because of the hair or nail symptoms. Drugs and toxins that can be detected in hair and nails are reviewed and the application of hair/nail analysis in general and in forensic medicine is discussed.- - - - - - - - - - ranking = 1677.7966159063keywords = heavy metal, metal (Clic here for more details about this article) |
5/23. ethylene glycol toxicity associated with ischemia, perforation, and colonic oxalate crystal deposition.Severe ethylene glycol toxicity can cause profound morbidity and is almost universally fatal if untreated. central nervous system depression with intoxication, pulmonary edema, and acute oliguric renal failure with crystalluria are among the most commonly encountered complications of ingestion. The previously reported gastrointestinal side effects of ethylene glycol toxicity are mostly nonspecific, including nausea, abdominal pain, and cramping. In addition, hepatic damage due to calcium oxalate deposition has been reported. We describe a patient who developed acute colonic ischemia following ethylene glycol intoxication. Three months after the ingestion, the patient presented with severe abdominal pain secondary to a colonic stricture and perforation, necessitating emergent colectomy. histology of the resected colon revealed polarizable polyhedral crystals suggestive of oxalate deposition. The pathophysiology underlying ethylene glycol intoxication, treatment strategies, and gastrointestinal toxicity are discussed.- - - - - - - - - - ranking = 1keywords = nervous system (Clic here for more details about this article) |
6/23. Aconite: a lethal Chinese herb.physicians and the public often assume that herbal preparations are harmless. Aconite is a Chinese herb used as an analgesic by homeopaths; its chief effects are on the cardiovascular and central nervous systems. The first two reported cases of aconite poisoning in australia are described.- - - - - - - - - - ranking = 1keywords = nervous system (Clic here for more details about this article) |
7/23. An unusual presentation from xylazine-ketamine.Veterinary anesthestics have gained popularity as drugs of abuse. A case of multiple drug abuse by a 36-y-old veterinarian involved the injection of xylazine-ketamine, resulting in gastrointestinal, cardiovascular and central nervous system effects, and unexpected hypertension, tachycardia and electrocardiogram changes.- - - - - - - - - - ranking = 1keywords = nervous system (Clic here for more details about this article) |
8/23. Atypical reactions associated with heroin use--five states, January-April 2005.heroin use typically produces a well-recognized syndrome of euphoria, miosis, and respiratory and central nervous system depression; cardiovascular effects are not a common finding. In January 2005, a man aged 21 years in new jersey was hospitalized with an atypical reaction (e.g., tachycardia and palpitations) after reported heroin use. During the next 3 months, 25 additional persons in five states were reported to poison control centers (PCCs) and local public health agencies with a similar reaction after reported heroin use; in all, 24 of 26 patients were hospitalized. Analysis of drug specimens or testing of urine was performed in certain cases; in eight patients, the veterinary pharmaceutical clenbuterol was detected. This report describes four representative cases and summarizes the investigation by state and local health and law enforcement authorities and CDC into the 26 cases of atypical reactions after heroin use reported in five states (connecticut, new jersey, new york, north carolina, and south carolina) during January 28-April 17, 2005. Unintentional or intentional adulteration of illicit drugs such as cocaine or heroin is an additional potential hazard associated with their use.- - - - - - - - - - ranking = 1keywords = nervous system (Clic here for more details about this article) |
9/23. Common poisons in singapore--past and present.A study on past toxicological activities in singapore enabled us to capture the trends of poisons abused in this country over the last 108 years. Until the early sixties, corrosive alkali and acids, alcohol (poisoning cases), inorganic chemicals, heavy metals and plant alkaloids were the mainstay of poisons principally used. The seventies and eighties saw a swing towards pharmaceuticals. The 1988-89 data gave alcohol (poisoning cases), pharmaceuticals, household items such as detergents, hypochlorite and antiseptic, carbon monoxide, paraquat, malathion, organic solvents (toluene and xylenes) and narcotics as the mainstay of poisons encountered. The last two classes of poisons reflect the continuing problems of glue sniffing and narcotics abuse facing singapore.- - - - - - - - - - ranking = 1677.7966159063keywords = heavy metal, metal (Clic here for more details about this article) |
10/23. poisoning or primary nervous system disease?--difficulties of the differential diagnosis exemplified by four different clinical cases.Acute or chronic injury of the nervous system caused by xenobiotics can resemble primary disorders of the nervous system. In this study, four different cases that are characterized by unclear clinical presentation have been discussed; they required a detailed differential diagnostics using modern radiologic and electrophysiologic studies. Case 1. A young alcohol abuser was referred to the Acute Poisonings Unit at Wroclaw with a presumptive diagnosis of methanol poisoning. Neither methanol nor ethylene glycol were detected in patient's serum and urine. During hospitalization in our ward he lost vision completely, and neurologic examination was consistent with a transverse spinal cord injury. Traumatic spinal cord injury coexisting with methanol poisoning, or even Devic's syndrome were considered in differential diagnosis. The MRI did not reveal a spinal cord injury, and the EMG showed severe demyelinating-axonal polyneuropathy. Finally the patient was diagnosed with methanol poisoning complicated by both loss of vision and severe alcoholic polyneuropathy. Case 2. A 27-year-old man was found unconscious in a street. A head CT revealed numerous small intracerebral hemorrhages, and patient's urine contained high concentration of amphetamine. A presumptive diagnosis of amphetamine poisoning complicated by intracranial hemorrhage was proposed. The repeat head CT revealed traumatic injury of the skull in a form of depression. Based on this result, the patient was diagnosed with a posttraumatic intracranial hemorrhage. Case 3. A young man with history of schizophrenia was transferred to our ward from a psychiatric hospital with a presumptive diagnosis of neuroleptic malignant syndrome complicated by rhabdomyolysis. infection of the nervous system and focal lesions in the brain were ruled out with help of lumbar puncture and a brain MRI. After having obtained additional details of patient's history, it appeared that the patient had not been taking neuroleptics, and therefore it was assumed that patient's condition be connected with a catatonic type of schizophrenia exacerbation. Case 4. A 17-year-old woman, who returned from a disco club, presented with a bizarre behavior, she spoke incoherently, and she saw everything in bright and intense colors. Then she experienced a severe seizure attack with loss of consciousness and apnea. Toxicologic tests were negative. The patient was referred to neurology where she was finally diagnosed with epilepsy, and the attack was induced by strobe lights in a disco club.- - - - - - - - - - ranking = 7keywords = nervous system (Clic here for more details about this article) |
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