Emamectin Poisoning in Thailand: Clinical Characteristics and Outcomes.

IF 3.9 3区 环境科学与生态学 Q2 ENVIRONMENTAL SCIENCES Toxics Pub Date : 2024-09-13 DOI:10.3390/toxics12090668
Satariya Trakulsrichai, Perapatn Sittiyuno, Phantakan Tansuwannarat, Achara Tongpoo
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Abstract

Emamectin benzoate (Emamectin) is a broad-spectrum insecticide. Current data regarding emamectin poisoning in humans are very limited. We performed a 10-year retrospective cross-sectional study (2011-2020) using data from the Ramathibodi Poison Center database to examine the clinical characteristics and outcomes in patients exposed to emamectin. Eighty-eight patients were included. Most of the patients were male (72.7%) and exposure was frequently oral (86.4%) and intentional (67.0%).Their mean age was 42.8 years. The clinical presentations included gastrointestinal tract symptoms (62.5%), neurological symptoms (27.3%) including seizures, respiratory symptoms (6.8%), and local effects (12.5%). At presentation, the majority of patients exhibited normal consciousness and vital signs. Eleven patients showed no obvious clinical effects. Initially, 15 patients had metabolic acidosis and 11 had hypokalemia. Overall, 46 and 52 patients were administered gastric lavage and activated charcoal, respectively. Most patients (78.4%) were hospitalized, with a median hospital stay of 40 h, and generally received supportive treatment. Eight patients were intubated for ventilator support and one received inotropic drugs. Most patients (90.9%) showed no or minor outcomes; however, two patients died. The presence of Glasgow Coma Scale (GCS) <15 differed significantly (p < 0.001) between patients with no or minor outcomes (n = 80) and those with moderate or fatal outcomes (n = 8). In conclusion, emamectin poisoning mainly caused no or minor clinical effects. A low GCS at presentation was associated with worse outcomes. Therefore, patients who present with low GCS should be closely observed, monitored, and properly managed during hospitalization.

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泰国的埃玛菌素中毒事件:临床特征和结果。
苯甲酸阿维菌素(埃玛菌素)是一种广谱杀虫剂。目前有关人类埃玛菌素中毒的数据非常有限。我们利用拉马提博迪毒物中心数据库的数据进行了一项为期 10 年(2011-2020 年)的回顾性横断面研究,以考察接触埃马菌素的患者的临床特征和结果。研究共纳入了 88 名患者。他们的平均年龄为 42.8 岁。临床表现包括胃肠道症状(62.5%)、神经系统症状(27.3%)(包括癫痫发作)、呼吸系统症状(6.8%)和局部影响(12.5%)。大多数患者发病时意识和生命体征正常。11 名患者无明显临床症状。最初,15 名患者出现代谢性酸中毒,11 名患者出现低钾血症。总共有 46 和 52 名患者分别接受了洗胃和活性炭治疗。大多数患者(78.4%)住院治疗,中位住院时间为 40 小时,一般都接受了支持性治疗。八名患者插管接受呼吸机支持治疗,一名患者接受了肌力药物治疗。大多数患者(90.9%)未出现任何后果或后果较轻;但有两名患者死亡。无结果或轻微结果的患者(80 人)与中度或致命结果的患者(8 人)之间的格拉斯哥昏迷量表(GCS)P < 0.001。)总之,埃马菌素中毒主要导致无临床症状或轻微临床症状。发病时 GCS 低与较差的预后有关。因此,住院期间应密切观察、监测并妥善处理 GCS 偏低的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Toxics
Toxics Chemical Engineering-Chemical Health and Safety
CiteScore
4.50
自引率
10.90%
发文量
681
审稿时长
6 weeks
期刊介绍: The Journal accepts papers describing work that furthers our understanding of the exposure, effects, and risks of chemicals and materials in humans and the natural environment as well as approaches to assess and/or manage the toxicological and ecotoxicological risks of chemicals and materials. The journal covers a wide range of toxic substances, including metals, pesticides, pharmaceuticals, biocides, nanomaterials, and polymers such as micro- and mesoplastics. Toxics accepts papers covering: The occurrence, transport, and fate of chemicals and materials in different systems (e.g., food, air, water, soil); Exposure of humans and the environment to toxic chemicals and materials as well as modelling and experimental approaches for characterizing the exposure in, e.g., water, air, soil, food, and consumer products; Uptake, metabolism, and effects of chemicals and materials in a wide range of systems including in-vitro toxicological assays, aquatic and terrestrial organisms and ecosystems, model mammalian systems, and humans; Approaches to assess the risks of chemicals and materials to humans and the environment; Methodologies to eliminate or reduce the exposure of humans and the environment to toxic chemicals and materials.
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