Journal of toxicology. Clinical toxicology最新文献

A newborn of a SSRI-treated mother presented with lethargy, no crying, and no response to tactile stimulation. EEG findings were abnormal. Laboratory and clinical evaluations were normal. He recovered at the age of two weeks. Serotonin is a neurotransmitter that has an important roll in pain modulation during fetal neurodevelopment. We suspect these symptoms are attributed to the intrauterine exposure to paroxetine, through modulation of pain signals.

Acute exposure of schoolchildren to elemental mercury continues to produce public health crises that drain available health and environmental resources. In this retrospective study, we report three incidents of limited exposure to elemental mercury in Arizona schoolchildren. Health workers screened 347 students, family, and staff by history and physical exam for exposure level and symptomatology. Urine and blood mercury testing further evaluated at-risk individuals. Environmental contamination was also assessed. Despite up to 28% of patients reporting symptoms, no individual was found to have elevated serum or urinary mercury levels requiring treatment. Elevated airborne mercury levels were demonstrated in the classrooms, dormitories, buses, and student homes and appropriate clean-up measures were instituted. Previous studies of multiple exposures to elemental mercury either focus on significant patient morbidity or lack biological data. In contrast, this study reports biological and environmental data demonstrating no clinical toxicity following acute exposure in a large sample. Confirmatory studies are necessary to develop cost-effective guidelines for the appropriate management of these public health crises.

Diseases caused by fungi are spread by direct implantation or inhalation of spores. Fungi can cause adverse human health effects to many organ systems. In addition to infection and allergy, fungi can produce mycotoxins and organic chemicals that are responsible for various toxicologic effects. We reviewed the published literature on important mycotoxins and systemic effects of mycotoxins. Scientific literature revealed a linkage between ingesting mycotoxin contaminated food and illness, especially hepatic, gastrointestinal, and carcinogenic diseases. Issues related to mycotoxin exposure, specific diseases, and management are discussed. Although there is agreement that diet is the main source of mycotoxin exposure, specific health effects and risk assessment from indoor nonagricultural exposure are limited by the paucity of scientific evidence currently available. Further research on the health effects of inhaling mycotoxins in indoor settings is needed.

The annual sale of x-ray contrast media (CM) now represents 60 million doses, and contrast nephropathy (CN) has been the third-leading cause of hospital-acquired acute renal failure. In this review article, physicochemical, pharmacokinetic, and pharmacodynamic properties of CM are surveyed. The definition of CN is presented, as well as the mechanisms involved in the pathogenesis. Low osmolar monomeric CM (LOCM) are less nephrotoxic than the older ionic high osmolar CM (HOCM), but in risk patients the incidence of CN is still high after intravascular administration of LOCM. Non-ionic dimeric CM are iso-osmolar to plasma (IOCM), and they have reduced the nephrotoxicity even more than LOCM. The most important risk factors for CN are diabetes mellitus and impaired renal function. Selection of patients, hydration, and type of CM are essential for prevention and prophylaxis of CN. We do not recommend routine prophylaxis with N-acetylcysteine (NAC) during CM investigations, but its use in high-risk patients should be considered.

Volatile alkyl nitrites have been used during the past decades for "recreational purposes," and for intensifying sexual experience. Their use has been associated with methemoglobinemia and hemolysis. We report three patients who presented over the past year with acute hemolysis after inhalation of butyl nitrite, two of them had glucose-6-phosphate dehydrogenase (G6PD) deficiency.

Background: Fipronil which has initiated the new generation of insecticides and possesses greater affinity at GABA receptors in insects than humans is supposed to be safer than the old generation of insecticides. Dermal and inhalation exposure to fipronil has not been reported in the literature.

Case report: A 50-year-old male was admitted to the Clinic after 5h of spraying his field with the solution of fipronil. The patient was fully conscious with the BP and HR within normal range. There were no seizures, other neurological deficits, signs of conjunctivitis or skin irritation. Physical examinations and biochemical results were normal. The patient complained of a headache, nausea, vertigo and weakness. All symptoms resolved spontaneously after about 5h. During hospitalization and the follow up after three weeks he was asymptomatic.

Conclusions: Further investigations should be carried on to evaluate the risk of fipronil in humans. The benzodiazepines are drugs of choice during seizures, B1 agonists and steroids may be useful during severe inhalation exposure.

Ricin is one of the most potent plant toxins known, and the castor plant from which it is derived, Ricinus communis, is ubiquitous. The harvesting of castor beans exceeds one million tons annually, and ricin is easier to produce than either anthrax or botulinum. As a result, ricin is a convenient, potent, and available toxin for terrorist acts. This paper will review the mechanism of toxicity, major clinical manifestations, treatment, current methods of detection, and vaccine development.