Cases Of Poisoning Research Articles

Accuracy of plant identification applications to identify plants in suspected poisoning cases referred to the Queensland Poisons Information Centre

Accidental exposure to potentially poisonous plants is a common reason for contacting poisons information centres. Although most exposures are mild, early identification can be critical for severe cases. Smartphone apps that use image recognition can serve as an alternative to traditional botanist identification. This study investigates the accuracy of smartphone applications compared to botanist identification in real-life plant exposure cases referred to the Queensland Poisons Information Centre. This prospective observational study analysed data from 25 plant exposure cases between February 2022 and January 2023. In these cases, images were referred to a botanist for identification and reviewed by six researchers using six different plant identification applications (Google Lens™, PictureThis, PlantSnap, LeafSnap, Plant Identifier, and Pl@ntnet™). The researchers’ identifications were then compared to the botanist’s identification. The accuracy of the applications varied considerably, PictureThis was the best, with 74% correct identification per exposure, followed by Plant Identifier and Pl@ntnet™ (both 72%). PlantSnap had the lowest accuracy (38%). Agreement between researchers using the same application also showed variation. Current smartphone plant identification applications are not reliable enough for poison information centres to use in guiding advice for plant exposure calls. Botanist identification remains the gold standard. Clinicians should be wary of their use in real-world scenarios.

Mephedrone concentrations in clinical intoxications and fatal cases: a systematic review.

Mephedrone, a ring-substituted synthetic cathinone derivative, gained popularity as a recreational drug in the late 2000s. Reports of fatalities related to mephedrone use have emerged with varying concentrations of blood mephedrone upon forensic investigations. This study aims to evaluate the existing literature on mephedrone concentrations in instances of clinical intoxication and fatal cases. We comprehensively searched electronic databases, including Web of Science, PubMed, Embase, and the Cochrane Library, from inception to July 26, 2023. We selected case reports or case series of mephedrone intoxication presented with individual blood mephedrone concentration. Patient demographics, clinical characteristics, blood mephedrone concentrations, and outcomes were extracted for analysis. 77 cases from 14 case reports and 6 case series were identified for review. There were 34 deaths and 43 non-fatal intoxication cases. The median patient's age was 24years (IQR: 10), and 91.4% were male. Forty-five of the 63 cases (71.4%) were reported with alcohol or other illicit drugs detected. The median blood mephedrone concentration was 0.37mg/L (IQR: 1.09mg/L). Death cases were older than non-fatal cases (median = 30 vs. 22years, p = 0.029). The median blood mephedrone concentration was higher in death cases (1.30mg/L vs. 0.12mg/L, p < 0.0001). Blood mephedrone concentration in dead patients is approximately 11 times higher than in non-fatal cases. This finding could serve as a stepping stone to the diagnosis of concentrations in clinical poisoning cases and deaths, especially in the treatment of poisoning patients. In more extensive prospective studies, further research is necessary to establish a standardized, real-time available methodology and validate the predictive value of mephedrone concentrations in the prognostic value of mephedrone concentrations.

A case of intravenous injection of mercury poisoning

There are few reports of poisoning caused by high-dose intravenous injection of mercury. Its clinical manifestations are diverse and the risk of mortality is high. Currently, the pathogenesis is not clear and the treatment experience is insufficient, leading to difficulties in clinical diagnosis and treatment. In this article, the data of a case of mercury poisoning caused by intravenous self-administration was analyzed and summarized. The patient developed multiple organ dysfunction syndrome after intravenous injection of high-dose mercury. After comprehensive treatment, such as mercury removal, organ support, and infection prevention, the condition was improved. This case suggests that intravenous injection of mercury can cause damage to the functions of multiple organs, such as the heart, lungs, and kidneys. Early treatment and intervention can bring benefits.

Pattern of poisoning cases in Bir Hospital

Background: Poisoning is one of the major causes of hospitalization through emergency and is a major public health problem in the country. For starting preventive measures, information on nature and extent of poisoning is required. For some years, there has been no study on poisoning at Bir hospital. Objectives: To find out the patient profile, the common poisons and outcome of poisoning cases. Materials and Methods: A retrospective analysis of all acute poisoning cases admitted to the emergency department of Bir Hospital from January 2005 to June 2005 was done to study the pattern of acute poisoning. Data on age, sex, time elapsed after intake, circumstances of poisoning, name of the poisonous substance, actual use, chemical type, hospitalization days, severity and outcome were collected and analyzed. Results: The age of the patients varied from 16 to 65 years. The male female ratio was 1:1.3. More than three-fourth (76.8%) of the female patients were from 16 to 25 years age group. Similarly, 46.5% of the male patients were from 16 to 25 years age group. In more than 25 years of age, there was malepredominance in all the age group. The common insecticides used for poisoning were organophosphorus compounds mainly Methyl Parathion (Metacid) and Dichlorovos (Nuvan). Paracetamol alone or combination preparations with antihistamines were the most common analgesic used. Benzodiazepines were the most commonly used anxiolytics. Ninety-seven percent of caseswere intentional poisoning for suicidal attempt. Most of the cases (61.6%) had arrived hospital within 3 hours after exposure to the poison. The hospital stay of the admitted patients with poisoningranged from one to sixteen days. The mean hospital stay was 5.9 days. During the hospital stay, six (6.0%) cases were managed in Intensive Care Unit (ICU) service. In this study, only 3% cases had mortality. There were 5 cases of Aluminium Phosphide poisoning but surprisingly, none of them died from this highly toxic poison. Conclusion: Suicide among adolescents and young adults is a common public health problem. Patients with intentional poisoning must undergo psychiatric consultation during their stay in the hospital for the treatment poisoning. This will minimize the risk of next attempt of self harm. In addition, strict rules must be followed regarding sale of psychotropic medicines and pesticides. Effective clinical management of poisoning can minimize the mortality.

Acute poisoning in children in Chengdu, China: a retrospective study (2019–2022)

ObjectiveTo analyze the characteristics of children with acute poisoning admitted to emergency departments in the southwestern region of China.MethodsData were retrospectively collected from the hospital information system in Chengdu, West China Second Hospital from January 2019 to December 2022 and the frequency and substance of pediatric poisoning, clinical management and outcome were described in this study.ResultsA total of 2036 cases with acute poisoning aged from 0–14 years were included, of these, 272 were hospitalized, with 40 admitted to the pediatric intensive care unit. The incidence was slightly higher in boys than girls (51.2% vs. 48.8%). The most common route of poisoning was the digestive system (99.3%), and the majority were accidental poisonings (92.7%). Medications were the most common toxic substances (62.1%), followed by pesticides (12.4%) and household cleaners (8.8%). The proportion of toxic substances varied among different age groups, with household cleaners being the most common in infants, and pesticides in other age groups, excluding medications.ConclusionChildren in early childhood accounted for most acute poisoning cases, mostly due to unintentional ingestion of a single substance. Female adolescents were the most common patients intentionally ingested toxic substances, mainly psychotropic drugs.

Explainable artificial intelligence (XAI) for predicting the need for intubation in methanol-poisoned patients: a study comparing deep and machine learning models

The need for intubation in methanol-poisoned patients, if not predicted in time, can lead to irreparable complications and even death. Artificial intelligence (AI) techniques like machine learning (ML) and deep learning (DL) greatly aid in accurately predicting intubation needs for methanol-poisoned patients. So, our study aims to assess Explainable Artificial Intelligence (XAI) for predicting intubation necessity in methanol-poisoned patients, comparing deep learning and machine learning models. This study analyzed a dataset of 897 patient records from Loghman Hakim Hospital in Tehran, Iran, encompassing cases of methanol poisoning, including those requiring intubation (202 cases) and those not requiring it (695 cases). Eight established ML (SVM, XGB, DT, RF) and DL (DNN, FNN, LSTM, CNN) models were used. Techniques such as tenfold cross-validation and hyperparameter tuning were applied to prevent overfitting. The study also focused on interpretability through SHAP and LIME methods. Model performance was evaluated based on accuracy, specificity, sensitivity, F1-score, and ROC curve metrics. Among DL models, LSTM showed superior performance in accuracy (94.0%), sensitivity (99.0%), specificity (94.0%), and F1-score (97.0%). CNN led in ROC with 78.0%. For ML models, RF excelled in accuracy (97.0%) and specificity (100%), followed by XGB with sensitivity (99.37%), F1-score (98.27%), and ROC (96.08%). Overall, RF and XGB outperformed other models, with accuracy (97.0%) and specificity (100%) for RF, and sensitivity (99.37%), F1-score (98.27%), and ROC (96.08%) for XGB. ML models surpassed DL models across all metrics, with accuracies from 93.0% to 97.0% for DL and 93.0% to 99.0% for ML. Sensitivities ranged from 98.0% to 99.37% for DL and 93.0% to 99.0% for ML. DL models achieved specificities from 78.0% to 94.0%, while ML models ranged from 93.0% to 100%. F1-scores for DL were between 93.0% and 97.0%, and for ML between 96.0% and 98.27%. DL models scored ROC between 68.0% and 78.0%, while ML models ranged from 84.0% to 96.08%. Key features for predicting intubation necessity include GCS at admission, ICU admission, age, longer folic acid therapy duration, elevated BUN and AST levels, VBG_HCO3 at initial record, and hemodialysis presence. This study as the showcases XAI's effectiveness in predicting intubation necessity in methanol-poisoned patients. ML models, particularly RF and XGB, outperform DL counterparts, underscoring their potential for clinical decision-making.

Forensic analysis of hydrogen sulfide poisoning cases: Innovative LC-MS/MS methodology for accurate detection in human blood

Identification of hydrogen sulfide poisoning cases has long been a challenging issue in the field of forensic science. Due to the relatively limited histopathological features associated with hydrogen sulfide poisoning, traditional anatomy faces difficulties in accurately determining such cases. Additionally, existing detection methods have inherent limitations, including complex analytical processes and low sensitivity. This research uses the principle of the reaction between triazine and hydrogen sulfide to generate thiadiazine to measure hydrogen sulfide levels in the blood, applying this method to practical case examinations. A 0.2 mL blood sample is taken and diluted with 0.8 mL saturated borax solution. In a test tube, 1 mL acetonitrile solution containing 0.1 % formic acid is taken, followed by the sequential addition of 0.1 mL diluted solution and 0.1 mL 1 % triazine aqueous solution. After thorough mixing, the mixture is allowed to stand for 30 min, during which hydrogen sulfide undergoes a derivative reaction with triazine, producing thiazine. Subsequently, the sample undergoes centrifugation and membrane filtration, and the resulting solution is analyzed using Liquid Chromatograph Mass Spectrometer. The results reveal a strong linear relationship of hydrogen sulfide within the concentration range of 10 to 2000 ng/mL, with an R2 of 0.9989. The detection limit is 3 ng/mL, and the quantification limit is 10 ng/mL. In six cases of hydrogen sulfide poisoning, the presence of hydrogen sulfide in the blood of all deceased individuals is detected, with concentrations ranging from 0.25 to 0.79 μg/mL. For the first time, this study establishes an LC-MS/MS method for determining hydrogen sulfide in blood, meeting the detection requirements for hydrogen sulfide poisoning cases.

Paraquat Poisoning: A Growing Homicidal Threat: Insights and Strategies

Abstract Paraquat is a widely used non-selective herbicide in Indian agriculture. It has gained popularity for its misuse in suicidal poisoning, primarily because it lacks an antidote, and ingestion often leads to death. When examining the historical trends of pesticide-related suicidal poisonings in India, there is a noticeable transition from endrin, organophosphates and rodenticides to the current prevalent use of paraquat. This review delves into globally reported cases of homicidal paraquat poisonings, which are sporadically reported in India as well, although not published in mainstream academia. Clinicians must remain vigilant in homicidal paraquat poisoning situations as there is often improper history at the time of presentation. Such cases typically present with some non-specific symptoms such as oral and pharyngeal burns and appear like any other typical acute gastroenteritis or a flu-like illness which ultimately leads to death as a result of pulmonary complications. At the same time, forensic pathologists need to be well versed in the characteristic autopsy findings and analytical toxicology considerations of paraquat-induced criminal poisoning, given the occasional incidents in India. The use of paraquat as a weapon in poisoning cases is a significant public health concern that underscores the need for a ban on paraquat in India.

A retrospective study of 29 fatal cases of insulin overdose

PurposeTo summarize recent cases of fatal insulin poisoning both domestically and internationally, thereby offering valuable insights for the forensic identification of insulin overdose cases. MethodsLiterature published since 2000 on fatal insulin overdose were systematically searched and screened. Data encompassing variables such as year, age, sex, cause of death, scene conditions, occupations, medical histories of victims and perpetrators, autopsy timing, dosage and administration methods, forensic pathology, and toxicological analysis, were compiled for rigorous statistical analysis. ResultsAmong the 29 fatal cases of insulin poisoning, suicides and homicides accounted for 55.2 % and 41.4 %, respectively. Precisely 34.5 % of victims or perpetrators were associated with the medical industry, 27.6 % had diabetes, and 24.1 % had mental illnesses such as depression. Intravenous injection resulted in quicker death than did subcutaneous injection. In some cases, immunohistochemical staining of insulin and protamine at injection sites yielded positive results. The average molar ratio of insulin to C-peptide in post-mortem blood was 13.76 ± 5.167, indicating a significant diagnostic value for insulin poisoning. ConclusionAssessment of cases of fatal insulin overdose should be thorough, incorporating case investigation, scene examination, medical records review, autopsy findings, pathological examinations, and laboratory tests, alongside considering the condition of the body and timing of death autopsy. Using mass spectrometry to detect insulin proves valuable, particularly in cases of poor body preservation.

A QSAR-based application for the prediction of lethal blood concentration of new psychoactive substances

The rapid development and introduction of new psychoactive substances (NPS) into illegal markets present an enormous challenge for forensic toxicologists, as there is limited knowledge about their toxicity in humans. To strengthen forensic interpretation of NPS intoxication cases, we have developed a predictive model for estimating human lethal blood concentrations (LBC) of various NPS. This quantitative structure-activity relationship (QSAR) model focuses on opioids, designer benzodiazepines, synthetic cathinones, synthetic cannabinoids, and phenethylamines. Utilising linear regression and multilayer perceptron algorithms, the models was trained using data from the existing literature. A toxicological significance-based approach have been applied to refine the selection of training data. The model demonstrated satisfactory performance metrics through cross-validation (R ≈ 0.8, MAE ≈ 0.6) and comparison with experimental data (R ≈ 0.9). A Python-based web application have been developed to facilite the use of the created model in predicting LBC of NPS. Despite the model's reliability, limitations due to data availability, quality and the complexities of post-mortem toxicology mean that its predictions should be interpreted with caution.

A Case of Fatal Poisoning: Use of 2-4 Dinitrophenol for Weight Loss

Aim: 2,4-dinitrophenol (DNP®) causes rapid weight loss. Therefore, this drug is used for weight loss, is mostly sold on internet sites, and is banned for sale owing to its deadly side effects. In this case report, we aimed to report a patient who was admitted to our hospital with DNP poisoning. Case: In the present study, we present a 29-year-old patient who took 200-mg DNP® once a day for 5 days and who applied to our emergency department approximately 6 hours after taking two tablets on the last day. He developed cardiopulmonary arrest 8 hours after admission despite all supportive treatments and died despite effective and adequate cardiopulmonary resuscitation. Conclusion: DNP poisoning can be fatal even in small doses. It is difficult to control because the drug is freely available on the internet, and urgent diagnosis and treatment is critical. In recent times, where sedentary life and obesity are on the rise, people should be better informed about healthy living and the risks associated with weight loss drugs that can be obtained illegally. Preventing the unauthorized sale of these products, which have a limited response to treatment and a high mortality rate, over the internet and early recognition of poisoning by emergency room physicians is the most important preventive measure in DNP poisonings and the most important step in treatment.

Life-Saving Resin: Hemoperfusion's Role in Overcoming Acute Organophosphate and Carbamate Poisoning

Background: Acute poisoning from organophosphates and carbamates is a major public health concern. These poisons inhibit acetylcholinesterase, leading to severe clinical manifestations. Traditional treatments, such as atropine and oximes, often fall short in severe cases, necessitating alternative therapeutic approaches. Hemoperfusion, an extracorporeal blood purification technique, has shown promise in improving outcomes for poisoning cases. This study aimed to estimate the clinical outcomes of resin-based HOD in individuals with acute organophosphate and carbamate poisoning admitted to a South Asian tertiary care hospital. Methods: A prospective observational study was carried out involving 50 patients diagnosed with acute organophosphate (n=30) or carbamate (n=20) poisoning. Patients underwent standard treatment protocols, and eligible individuals received resin-based hemoperfusion. Data on demographic details, clinical outcomes, complications, and biochemical parameters were collected and analysed using SPSS version 25.0. Results: The study found an overall recovery rate of 84%, with 80% recovery in the organophosphate group and 90% in the carbamate group. The complication rate was 12%, and the mortality rate was 4%. Cholinesterase levels significantly increased post-hemoperfusion, with a mean rise of 600 U/L. Time to treatment was a significant predictor of positive outcomes (p=0.011). Conclusion: Resin-based hemoperfusion is effective in treating acute organophosphate and carbamate poisoning, significantly improving recovery rates and reducing mortality. Early intervention is crucial for optimal outcomes. This treatment modality should be considered a valuable component of poisoning management protocols, especially in resource-limited settings. Recommendations: Further research with larger sample sizes and randomized controlled trials is recommended to confirm these findings and explore additional factors influencing treatment outcomes. Implementation of resin-based hemoperfusion in standard treatment protocols for severe poisoning cases is advised to enhance patient care and survival rates. Keywords: Organophosphate poisoning, Carbamate poisoning, Hemoperfusion, Clinical outcomes

Acute atrazine intoxication in heifers: Case report and toxicological studies

AbstractAtrazine is a triazine organochloride herbicide, frequently used in different agricultural activities. Rare acute intoxication with atrazine is reported in production animals, and its metabolism in mammals is unknown. We report a spontaneous case of atrazine acute intoxication in 16.1% animals of a 168‐beef heifer herd exposed to the herbicide at a farm located in Buenos Aires province, Argentina. Affected heifers showed different neurological signs and died suddenly, similar to the previous natural atrazine intoxication report. During autopsy, no gross lesions were observed. Different body fluids and tissues samples were collected during postmortem examination. No relevant histopathological findings were observed. High levels of atrazine and its metabolites were detected in different fluids and tissues by ultra‐liquid chromatography high performance coupled to triple quadrupole mass spectrometry. These findings suggest ruminal or hepatic metabolization of atrazine in the exposed cattle. This is the first report of quantification and distribution of atrazine and its metabolites in intoxicated mammals providing relevant information for diagnostic purposes.

Intoxication cases in the Emergency Department at a Norwegian University Hospital 2019-20.

Acute intoxication is a common chief complaint in emergency medicine, but there is a lack of up-to-date studies from the emergency departments in Norway on the incidence and prevalence of various toxic substances. The aim of this study was to survey acute intoxications at the emergency department of St Olav's Hospital, Trondheim. In this review of patient records, we used data from the emergency department at St Olav's Hospital in Trondheim in the period 1 January 2019-31 December 2020. All cases with 'acute intoxication' as the reason for the emergency department visit were included. In a patient population of 836 unique patients, there were a total of 1423 intoxications, of which 168/836 patients (20.0%) had more than one intoxication episode in the period. The median age was 31 years (interquartile range 22-47), and 395/836 (47.2%) of the patients were women. Combined drug intoxication constituted 666/1423 (46.8%) of the cases, and the most frequent intoxications were from ethanol: 802/1423 (56.4%); benzodiazepines 314/1423 (24.0%); and opioids 243/1423 (17.1%). Altogether, 1146/1423 (80.5%) incidents resulted in hospital admission. There were no deaths during their hospital stay. Emergency departments must be prepared to manage patients who have taken various poisoning agents. The antidotes must be available, and it must be possible to perform interventions.

Using a DNA mini-barcode within the ITS region to identify toxic Amanita in mushroom poisoning cases

Mushroom poisoning contributes significantly to global foodborne diseases and related fatalities. Amanita mushrooms frequently cause such poisonings; however, identifying these toxic species is challenging due to the unavailability of fresh and intact samples. It is often necessary to analyze residues, vomitus, or stomach extracts to obtain DNA sequences for the identification of species responsible for causing food poisoning. This usually proves challenging to obtain usable DNA sequences that can be analyzed using conventional molecular biology techniques. Therefore, this study aimed to develop a DNA mini-barcoding method for the identification of Amanita species. Following the evaluation and optimization of universal primers for DNA mini-barcoding in Amanita mushrooms, we found that the internal transcribed spacer (ITS) gene sequence primer ITS-a was the most suitable DNA barcode primer for identifying Amanita species. Forty-three Amanita samples were subsequently amplified and sequenced. The sequences obtained were analyzed for intra- and inter-species genetic distances, and a phylogenetic tree was constructed. The findings indicated that the designed primers had strong universality among the Amanita samples and could accurately identify the target gene fragment with a length of 290 bp. Notably, the DNA mini-barcode accurately identified the 43 Amanita samples, demonstrating high consistency with the conventional DNA barcode. Furthermore, it effectively identified DNA from digested samples. In summary, this DNA mini-barcode is a promising tool for detecting accidental ingestion of toxic Amanita mushrooms. It may be used as an optimal barcode for species identification and traceability in events of Amanita-induced mushroom poisoning.Key points• Development of a DNA mini-barcoding method for Amanita species identification without fresh samples.• The ITS-a primer set was optimized for robust universality in Amanita samples.• The mini-barcode is suitable for screening toxic mushroom species in mushroom poisoning cases.Graphical

Severe morel mushroom poisonings in France – a nationwide French poison centres study 2010–2020

Introduction In 2023, two fatalities attributed to the ingestion of uncooked morels (Morchella spp.) were reported in the United States; both patients developed severe gastrointestinal symptoms. Morel-induced gastrointestinal toxicity is well recognized, but no deaths had been reported until 2023, suggesting a potential shift in the severity of morel poisoning. Methods Using the Poisoning Severity Score, we analyzed the severity of symptomatic cases of morel ingestion recorded in the French National Database of Poisonings from 2010 to 2020. Results We found 446 cases of exposure in which morels were the sole mushroom species involved. Of these, 83.6 per cent and 53.3 per cent developed gastrointestinal and neurological symptoms, respectively. Eight patients developed shock attributed to severe gastrointestinal symptoms, resulting in two deaths. Discussion Morel ingestion can lead to severe complications. As in the United States, the deaths reported in this study were attributed to imported cultivated morels. The shift, since 2006, towards a predominance of cultivated over wild morel sales may have played a role in the reporting of severe cases of morel poisoning. Conclusions Reports of severe morel poisoning highlight the need for cautious consumption, particularly of raw or undercooked preparations. Emerging complications signal potential changes in toxicity. Surveillance and awareness are key to reducing the risks of consuming morels.

Identification of Organic Solvents in Agrochemicals Intoxication Cases

In South Korea, deaths caused by poisoning are mostly suicides due to drug overdoses, or agrochemical poisonings. Even though the latter is becoming less frequent, they are still occurring in large numbers across the country. In some cases, deaths result from toxicity of organic solvents contained in the agrochemical products. In this study, we identified organic solvents in post-mortem blood of acute agrochemical poisoning cases using solid phase microextraction-gas chromatography/mass spectrometry with black fiber. Out of 42 cases, organic solvents were detected in 29, with toluene and butanol detected simultaneously in 13 cases. In these 13 cases, the original pesticides were of various types, including organophosphorus compounds, carbamate, nicotine, and oxadiazine. Xylene and ethyl benzene were simultaneously detected six times. In these six cases, the original pesticides were mainly pyrethroid-based pesticides, such as cypermethrin and deltamethrin. Methoxypropanol was detected in five cases in which the water-soluble pesticide glufosinate was detected. These organic solvents may cause acute poisoning and even death in some agrochemical poisoning cases.

Covalent Binding of Reactive Anhydride of Cantharidin to Biological Amines.

Cantharidin is a terpenoid from coleoptera beetles. Cantharidin has been used to treat molluscum contagiosum and some types of tumors. Cantharidin is highly toxic, and cantharidin poisoning and fatal cases have been reported worldwide. The mechanisms underlying cantharidin-induced toxicity remain unclear. Cantharidin contains anhydride, which may react with biologic amines. This study aimed to examine the chemical reactivity of cantharidin toward nucleophiles and characterize adducts of cantharidin with biologic amines in vitro and in mice. Here two types of conjugates were formed in the incubation of cantharidin under physiologic conditions with free amino acids, a mimic peptide, or amine-containing compounds, respectively. Amide-type conjugates were produced by the binding of cantharidin anhydride with the primary amino group of biologic amines. Imide-type conjugates were generated from the dehydration and cyclization of amide-type conjugates. The structure of the conjugates was characterized by using high-resolution mass spectrometry. We introduced the 14N/15N and 79Br/81Br isotope signatures to confirm the formation of conjugates using L-(ε)15N-lysine, L-lysine-15N2, and bromine-tagged hydrazine, respectively. The structure of imide conjugate was also confirmed by nuclear magnetic resonance experiments. Furthermore, the amide and imide conjugates of cantharidin with amino acids or N-acetyl-lysine were detected in mouse liver and urine. Cantharidin was found to modify lysine residue proteins in mouse liver. Pan-cytochrome P450 inhibitor 1-aminobenzotriazole significantly increased the urine cantharidin-N-acetyl-lysine conjugates, whereas it decreased cantharidin metabolites. In summary, cantharidin anhydride can covalently bind to biologic amines nonenzymatically, which facilitates a better understanding of the role of nonenzymatic reactivity in cantharidin poisoning. SIGNIFICANCE STATEMENT: Anhydride moiety of cantharidin can covalently bind to the primary amino group of biological amines nonenzymatically. Amide and imide conjugates were generated after the covalent binding of cantharidin anhydride with the primary amino groups of amino acids, a mimic peptide, and protein lysine residues. The structure of conjugates was confirmed by 14N/15N and 79Br/81Br isotope signatures using isotope-tagged reagents and nuclear magnetic resonance experiments. This study will facilitate the understanding of the role of nonenzymatic reactivity in cantharidin poisoning.

Japanese Yew (Taxus) poisoning of wild ungulates in Utah during the winter of 2022–2023

Taxus is a genus of coniferous shrubs and trees, commonly known as the yews, in the family Taxaceae. All species of yew contain taxine alkaloids, which are ascribed as the toxic principles. Anecdotally, free ranging ruminants such as antelope, deer, elk, and moose have been regarded as tolerant to yew. Herein several cases of intoxication of deer, elk, and moose by yew from the state of Utah in the winter of 2022–2023 are documented. Ingestion of yew was documented by three means among the poisoned cervids; plant fragments consistent with yew were visually observed in the rumen contents, chemical analysis, and subsequent detection of the taxines from rumen and liver contents, and identification of exact sequence variants identified as Taxus species from DNA metabarcoding. Undoubtedly, the record snowfall in Utah during the winter of 2022–2023 contributed to these poisonings.

The negative effects of lead paint on different physiological systems

Lead (Pb) in paints is a serious public health hazard that has piqued the international community’s interest. Lead concentrations in lead-based paints have been assessed in several research conducted across the world. As a result, the goal of this article was to describe the findings of these research, give some knowledge of their human health consequences for law enforcement, and promote public awareness. The most notable gaps found have been highlighted in order to open the door for additional research efforts aimed at producing thorough data on this subject. Some of the evaluated studies found considerable amounts of lead in paints that were considerably over the allowable limits, despite the many regulatory controls on lead content in paints that exist worldwide. There have been reports of children cases of lead poisoning in a number of nations, including South Africa, France, Morocco, and the US. Lead levels in South Africa (145,000 ppm), China (860,000 ppm), and the US (22,550 ppm) have all been found to be high. 4,485.11 ppm in Thailand. India (104 ppm) and Palestine (6036 ppm). As a result, tight law enforcement measures pertaining to the progressive removal of paints containing lead and the management of lead content are required throughout the globe.