Incidence Of Poisoning Research Articles

Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry for rapid analysis of eight Gelsemium elegans Benth alkaloids in human plasma and urine

Gelsemium elegans Benth alkaloids are the main components of G. elegans and can cause acute toxicosis or even death. Although several studies have reported methods for detecting G. elegans alkaloids, a high-throughput and environmental-friendly strategy for detection of multiple G. elegans alkaloids has not been realized. In this work, a matrix-assisted laser desorption/ionization time-of-flight mass spectrometry method was developed for rapid detection of G. elegans alkaloids in human plasma and urine for diagnosis of poisoning. Multiple matrices and crystal spotting methods were evaluated to obtain stable and high peak intensities without “sweet spot”. We verified the methodology and obtained excellent results. The matrix effects with different dilutions were compared and good recoveries and a low relative standard deviation were obtained with a 40-fold dilution. This method could shorten the analysis time and greatly reduce the consumption of chemical solvents. Furthermore, it could be applied to quantitative assessment of G. elegans alkaloid poisoning incidents.

The association between glucose-dependent insulinotropic polypeptide and/or glucagon-like peptide-1 receptor agonist prescriptions and substance-related outcomes in patients with opioid and alcohol use disorders: A real-world data analysis.

This study aimed to estimate the strength of association between prescriptions of glucose-dependent insulinotropic polypeptide (GIP) and/or glucagon-like peptide-1 receptor agonists (GLP-1 RA) and the incidence of opioid overdose and alcohol intoxication in patients with opioid use disorder (OUD) and alcohol use disorder (AUD), respectively. This study also aimed to compare the strength of the GIP/GLP-1 RA and substance use-outcome association among patients with comorbid type 2 diabetes and obesity. A retrospective cohort study analyzing de-identified electronic health record data from the Oracle Cerner Real-World Data. About 136 United States of America health systems, covering over 100 million patients, spanning January 2014 to September 2022. The study included 503 747 patients with a history of OUD and 817 309 patients with a history of AUD, aged 18 years or older. The exposure indicated the presence (one or more) or absence of GIP/GLP-1 RA prescriptions. The outcomes were the incidence rates of opioid overdose in the OUD cohort and alcohol intoxication in the AUD cohort. Potential confounders included comorbidities and demographic factors. Patients with GIP/GLP-1 RA prescriptions demonstrated statistically significantly lower rates of opioid overdose [adjusted incidence rate ratio (aIRR) in OUD patients: 0.60; 95% confidence interval (CI) = 0.43-0.83] and alcohol intoxication (aIRR in AUD patients: 0.50; 95% CI = 0.40-0.63) compared to those without such prescriptions. When stratified by comorbid conditions, the rate of incident opioid overdose and alcohol intoxication remained similarly protective for those prescribed GIP/GLP-1 RA among patients with OUD and AUD. Prescriptions of glucose-dependent insulinotropic polypeptide and/or glucagon-like peptide-1 receptor agonists appear to be associated with lower rates of opioid overdose and alcohol intoxication in patients with opioid use disorder and alcohol use disorder. The protective effects are consistent across various subgroups, including patients with comorbid type 2 diabetes and obesity.

Development of a Rapid Detection Method for Ethylene Glycol and Glycolic Acid in Feline Samples: A Response to Increasing Antifreeze Poisoning Incidents in Korea

Recently, cases of antifreeze poisoning in companion animals, particularly cats, have surged in the Republic of Korea. Ethylene glycol (EG), the toxic primary component of antifreeze, is metabolized into glycolic acid (GA), leading to severe metabolic acidosis, acute kidney injury, and death. Traditional detection methods, although effective, are often time-consuming owing to complex sample preparation. This study involved a novel analytical method utilizing GC-MS for EG and LC-MS/MS for GA detection, which streamlined the detection process by eliminating the need for derivatization. The method was validated for accuracy and reliability, enabling the rapid and precise identification of EG and GA in biological samples. This study also included the successful application of this method in a case where initial exposure to antifreeze was not apparent, which highlighted the effectiveness of this method in diagnosing poisoning even in cases where clinical history is unclear. The development of this rapid diagnostic approach addresses the urgent need for the efficient detection of antifreeze poisoning, improving animal welfare and supporting forensic investigations.

Real-time Deep Learning Based Mobile Application for Detecting Edible Fungi: Mushapp

Mushroom consumption and wild mushroom gathering are increasing in our country and in the world. Mushroom poisoning has an important place in food poisoning cases. Mushroom poisoning accounts for approximately 7% of poisoning cases in adults. Mushroom collection and consumption is common in many regions of our country. In this study, a deep learning based mobile application was developed to reduce the incidence of mushroom poisoning by taking a photo of a mushroom and determining the type and toxicity of the mushroom from the photo. This mobile application is called MushAPP. In the first phase of the study, 5150 mushroom images of 20 mushroom species were used to create the dataset. The dataset was then pre-processed and converted into a format that can be used by the deep learning algorithm. The mobile application side of the project was developed in Android Studio IDE environment. An artificial intelligence model was integrated into the designed mobile application. In the application, the type and toxicity status of the mushroom viewed from the mobile device camera are determined and presented to the user. The research findings were analyzed and it was determined that the accuracy rate of the application in detecting the mushroom species was 99.8%.

Combined effects of alcohol and lead on cerebrospinal fluid production

Currently, due to the development of industry, a high incidence of heavy metal salt poisoning is observed, especially in people with alcohol dependence. The study aims to investigate the combined effects of these pathogens on the central nervous system. The study demonstrates changes in intracranial pressure and cerebrospinal fluid production in isolated and combined poisoning of lead and ethanol based on experimental models on 10 and 40 days of exposure, 3 main groups were formed – the group of lead salts, ethanol, combined intoxication, after which the main indicators were measured. The effect of separate and combined action of alcohol and lead on cerebrospinal fluid production and haemodynamic indices in experimental animals was studied. It was found at 40-day intoxication indices remained above normal, systemic arterial pressure was 131.8 mmHg, and the rate of cerebrospinal fluid production was 0.073±0.002 ml/min. Combined 10-day combined action of alcohol and lead enhances their excitatory effect, which is characterised by an increase in systemic arterial pressure (to the level of 135.6 mmHg) and general psycho-somatic agitation, the rate of cerebrospinal fluid production was 0.077±0.008 ml/min. The 40-day co-exposure manifested mainly toxic effects of lead, as shown by a decrease in cerebrospinal fluid production of 0.049±0.001 ml/min, and a decrease in blood pressure to a level of 93.6 mmHg. The results of this study will make it possible to develop treatment protocols for patients with ethanol and heavy metal salt poisoning, especially in the field of anti-oedema therapy

Lateral flow immunoassay device to detect staphylococcal enterotoxin B (SEB) in durian candy.

Staphylococcal enterotoxin B (SEB), a potent enterotoxin produced by Staphylococcus aureus, has been implicated in incidences of Staphylococcal food poisoning in the Philippines. The use of lateral flow immunoassay devices to detect this toxin in solid food samples, like durian candy, at the point of sampling is constrained by the requirement for sample purification (e.g. centrifugation). This problem is also true with the other applications of LFIA devices on food samples. To overcome this challenge, a lateral flow immunoassay (LFIA) device capable of detecting SEB in unpurified durian candy sample was developed in this study. A modified LFIA device was assembled with three layers of glass fiber pads functioning as sample pads instead of a conventional cellulose fiber pad. Unlike with the cellulose fiber pad, the glass fiber sample pads acted as filter and allowed the flow of a 1:5 dilution of durian candy. The LFIA device applied to spiked 1:5 diluted durian candy samples achieved a visual limit of detection of 5ng/mL for SEB, which is twofold lower than reported for previous LFIA devices designed to detect SEB in food samples.

Epidemiological, clinical, therapeutic and toxicological profile of acute intoxications: A monocentric retrospective study

Objectives. Acute poisonings remain a significant cause of morbidity and mortality globally, posing a major public health challenge. In Algeria, data on the profile of acute poisonings are limited. The objective of this study, conducted at the University Hospital of Setif, was to provide an epidemiological, clinical, therapeutic, and toxicological overview of acute poisonings in this country. Results. This retrospective study, covering the period from the last quarter of 2016 to April 30, 2018, included 406 cases. The results showed a sex ratio of 1.41 with a female predominance. The intoxicated patients had a mean age of 24.74 years, with the most affected age group being between 19 and 29 years (28%). Poisonings were mainly accidental (57%), with 18% of cases involving intentional poisonings, more common among men. Medication poisonings were the most common (54%), followed by carbon monoxide poisonings (37%). Carbon monoxide poisonings were exclusively accidental, while medication poisonings were intentional in 27% of cases. Cosmetics, household products, and carbon monoxide were more often implicated in cases involving females. An incidence peak was observed in winter. The average time between poisoning and hospitalization was 15 hours and 24 minutes. Symptomatic treatment alone or combined with evacuation or detoxification treatment was used in 8.9%, 2%, and 0.2% of cases, respectively. About one-third of patients received specific management, with antidote administration only for carbon monoxide poisonings. Conclusion. The results underscore the importance of public awareness regarding the dangers of poisonings, reducing access to toxic products, and providing healthcare professionals with training to improve therapeutic management and reduce the incidence of acute poisonings.

An analysis of 4695 acute poisoning cases in Tianjin-Heibei from 2020-2022

Objective: To study and analyze the epidemiological regularity of acute poisoning in Tianjin-Hebei region from 2020 to 2022, and to provide reference for the treatment and prevention of related patients. Methods: In December 2023, the analysis results and clinical data of 4695 patients with drug poisoning from January 2020 to December 2022 in multiple centers of Tianjin-Hebei region were collected as research objects. Gender, age, type of drug poisoning, season and poisoning route of the research objects were analyzed, and statistical analysis was conducted as well. Results: The sex ratio of men and women was 1∶1.16 (2173/2522). The poisoning of antidepressants and benzodiazepines were the most common drug poisonings, accounting for 1550 and 1274 cases respectively (33%, 27.1%). Paraquat poisoning has decreased year by year, while the poisonings of herbicides with low toxicity such as diquat, glyphosate and cremart have increased. The number of cases reached a peak during May to August which was the poisoning season, while was relatively fewer during October to December. Conclusion: Effective intervention measures should be taken according to the age of high incidence of poisoning, different seasons and populations. Essential drug poisoning prevention measures should be established and improved. The systems of sedative drug management and use should be established, and pesticide management and storage need to be strengthened.

Agro-input dealers' perspectives on the design of a certification scheme for pesticide risk reduction.

While pesticides are essential for crop protection and food security, they pose serious risks to human health and the environment. Agro-input dealers can play an important role in mitigating pesticide risks, given that they are a major source of pesticides and plant health information for many developing-country farmers. In this article, we assess the willingness of agro-input dealers to offer integrated pest management-based advisory services and promote pesticide risk reduction through a voluntary certification scheme. Using survey data from 557 agro-input dealers in Uganda and a discrete choice experiment, we find that the proposed certification scheme is significantly valued by agro-input dealers, particularly for its potential to provide training opportunities and ensure safety to human health and the environment. Agro-input dealers have a positive attitude towards a certification scheme that restricts the sale of high-risk pesticide products, especially if it stimulates additional income-generating opportunities. Further analysis shows that preferences for voluntary certification attributes are influenced by certification experience, agro-dealership experience, business ownership status and incidence of acute pesticide poisoning. The study findings demonstrate that agro-input dealers are conscious of pesticide risks to human and environmental health and are keen to participate in a certification scheme promoting safer plant protection products. © 2024 The Author(s). Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

A cross-sectional study examining the pattern of acute poisoning among patients admitted to a governmental hospitals in Sana'a City, Yemen

IntroductionAs in other countries, acute poisoning cases in Yemen are a public health problem that causes a high level of morbidity and mortality. Understanding the general aspects of this issue helps in reducing its severity. ObjectivesThe general goals of this study are to identify patterns of acute poisoning in Yemen, with a focus on poison type and sociodemographic variables. MethodsThis is a cross-sectional study conducted on 177 cases of acute poisoning in the emergency units of three government hospitals in Sana'a, Yemen. Information was collected using a questionnaire that included all sociodemographic and medical data related to each case. ResultsCases of acute poisoning were more common in males (56.5 %) than females(43.5 %), and concentrated in the age group of 21–30 years. Approximately 66,1 % of cases occurred in individuals residing in rural areas. The percentage of non-educated individuals (53.7 %) was higher than educated ones(46.3 %). The study indicated that poisoning incidents were either intentional or non-intentional. Regarding intentional poisoning, it was categorized into homicidal or suicidal acts. The most common toxic substances involved were pesticides(30.5 %), followed by household poisoning (22.0 %), food poisoning(20.9 %), and medications(16.9 %). The most prevalent symptoms accompanying poisoning were nausea and vomiting. With regard to loss of consciousness, the percentage of those who lost consciousness was (28.8 %), and most of the cases were those who were exposed to medicines. ConclusionsCases of acute poisoning are mostly caused by exposure to pesticides, followed by household poisoning incidents and food poisoning. Awareness about the risks of pesticides and how to handle them is crucial, especially since most poisoning cases occur in rural areas among non-educated individuals.

RNA-Seq analysis of the fruiting bodies and mycelia of angel-wing mushroom Pleurocybella porrigens that cause acute encephalopathy

ObjectiveIn 2004, after consuming angel-wing mushrooms, Pleurocybella porrigens, 59 incidents of food poisoning were reported in Japan. Consequently, 17 individuals died of acute encephalopathy. In 2023, we proved that a lectin, pleurocybelline, and pleurocybellaziridine from this mushroom caused damage to the brains of mice. Although we reported genomic and transcriptomic data of P. porrigens in 2013, the assembly quality of the transcriptomic data was inadequate for accurate functional annotation. Thus, we obtained detailed transcriptomic data on the fruiting bodies and mycelia of this mushroom using Illumina NovaSeq 6000.ResultsDe novo assembly data indicated that the N50 lengths for the fruiting bodies and mycelia were improved compared with those previously reported. The differential expression analysis between the fruiting bodies and the mycelia revealed that 1,937 and 1,555 genes were significantly up-regulated in the fruiting bodies and the mycelia, respectively. The biological functions of P. porrigens transcripts, including PA biosynthetic pathways, were investigated using BLAST search, Gene Ontology, and Kyoto Encyclopedia of Genes and Genomes pathway analysis. The obtained results revealed L-valine, a predicted precursor of PA, is biosynthesized in the fruiting bodies and mycelia. Furthermore, real-time RT-PCR was performed to evaluate the accuracy of the results of differential expression analysis.

Current status and progress of detection methods for common clinical toxicants

With the progress of science and technology and the development of society, more and more chemical substances have been discovered and countless chemicals have been artificially synthesized, and the risk of exposure to some toxic chemicals by human beings has been greatly increased, resulting in the increasing incidence of acute poisoning, which has seriously endangered the public's physical health and life safety. As the poisoned patients are unconscious or refuse treatment when they are admitted to the hospital, it is difficult to understand the drug exposure history by asking the medical history, so the toxicity detection has become the key to the clinical diagnosis and treatment, and this paper briefly introduces some common toxicity detection methods in the clinic in the hope that it will bring help to the clinical doctors.

Incidence of alcoholic intoxication in injured patients who assisted to the Emergency Room Service at the ilitary Central Hospital in 1999..

Antecedentes. La intoxicación alcohólica tiene una gran frecuencia como causa de atención en los servicios de urgencias en pacientes lesionados, los cuales se constituyen como casos médico-legales y requieren la determinación de la severidad de la intoxicación a través de métodos clínicos o bioquímicos. Objetivo. Determinar la incidencia de intoxicación alcohólica en pacientes lesionados que acuden al Servicio de Urgencias del Hospital Central Militar. Método. Se realizó un estudio retrospectivo, observacional y descriptivo. Cada paciente atendido en el Servicio de Urgencias en 1999 fue estudiado revisando su expediente en los archivos del Departamento de Medicina Legal. El análisis estadístico incluyó determinación de valores porcentuales, así como correlación entre el resto de las variables. Resultado. De un total de 36,056 pacientes, 2,261 tuvieron al menos un tipo de lesión (6.3%), 114 pacientes (5.04%) tuvieron intoxicación alcohólica. La edad promedio fue de 26 años y se observó mayor frecuencia en hombres (97%). Conclusiones. La prevalencia de intoxicación alcohólica en pacientes lesionados atendidos en el Servicio de Urgencias (HCM) fue de 5.04%. La multiplicidad y severidad de las lesiones observadas indican la necesidad de mejorar los programas de prevención, así como la detección y el manejo oportuno en esta población.

Acute Poisoning Among Children Admitted to Alexandria Poison Center, Egypt: Patterns and Predisposing Factors.

Acute poisoning in children is a major public health problem worldwide. Children poisoning ranksamong the top unintentional injuries in children aged less than four years. This paper aimed to describe the pattern and characteristics of acute poisoning incidents, estimate the percentage of medication poisoning among those children and highlight the possible risk factors. All children aged below 10 years admitted to Alexandria Poison Centre (APC) with acute poisoning from the July1, 2022, to December 31, 2022, were included in the study. A pre-designed structured interviewing questionnaire was used to collect data: socio-demographic data of the poisoned child and his/her caregiver, medical history of the poisoned child and family members, history of previous poisoning incidents in the family, details of the poisoning incident including causative agent, route of poisoning, scene of poisoning, time interval to reach APC and the first aid done. 350 children admitted to APC were included in our study, of which 59% (n=208) of poisoned children were males with mean age 3.14 ± 2.28years. The types of poisoning found were 46.6% chemical compounds, 31.4% medication, 18% household and 4% food poisoning. Most of the children were poisoned orally. High education of caregiver, urban residence and the presence of chronic disease within a family member were significantly associated with medication poisoning while low education of caregiver, drug addiction, having chronic disease among a family member and the presence of previous poisoning accident in the family were significantly associated with poisoning with chemical compounds. The study found that acute poisoning is more common among young male children in Alexandria; the chemical compounds came first as the main source of poisoning followed by the medication poisoning.

Novaluron and indoxacarb induced methemoglobinemia – unveiling a rare poisoning

Introduction and aim. In India, the utilization of agricultural pesticides for intentional self-poisoning is a prevalent method, and it is associated with substantially higher fatality rates compared to other self-poisoning approaches. Plethora, an agricultural insecticide containing novaluron (5.25%) and indoxacarb (4.5%), has recently been introduced and widely used in India and various other regions for its broad-spectrum lepidopteran control. While there have been documented cases of isolated self-poisoning involving indoxacarb, there is currently no literature reporting incidents of human poisoning specifically related to novaluron. Description of the case. An 83-Year-old male was presented to the emergency department (ED) with a history of consumption of 50 mL of an insecticide suspension concentrate called ‘PLETHORA’ to commit suicide. He had one episode of vomiting and dizziness after the ingestion. There was associated cyanosis, and the patient was put on high-flow oxygen at 10 L/min through a face mask. The patient was diagnosed to have methemoglobinemia and was successfully treated with methylene blue and ascorbic acid. One hour post methylene blue injection showed a methemoglobin level of 1%, and the patient gradually improved. Patients presenting with novaluron and indoxacarb poisoning require supportive treatment as there is no specific antidote. There should be a high index of suspicion for methemoglobinemia in such patients, and timely management is necessary to prevent further complications. The patient was successfully managed and discharged after the 3rd day of admission. Conclusion. The management of patients with novaluron and indoxacarb poisoning primarily involves supportive care, as there is currently no specific antidote available for these substances. Maintaining a high suspicion index for the development of methemoglobinemia and timely management of other complications is crucial for the best possible patient outcomes.

Thermal transport of radially magnetized peristalsis of non-Newtonian nanofluid through an asymmetric curved channel

Present examination explores the heat and mass transfer phenomena for magnetohydrodynamics (MHD) peristaltic transport of diethylene glycol (DEG)-based Cross nanofluid through an asymmetric curved channel. The mass and thermal characteristics of nanofluid are established through the assessment of Buongiorno nano-liquid model, which allows to identify intriguing features of thermophoretic and Brownian diffusion coefficients. Further, velocity slip conditions are enforced on the peristaltic walls. The influences of thermal radiation, radius-dependent magnetic field and viscous dissipation are also taken into consideration. The governing equations are simplified by employing lubrication theory (“biological estimate of the creeping transportation phenomenon”), and resulting system is tackled numerically. Impacts of different flow parameters on the nanofluid’s velocity, nanomaterials concentration profile, heat and mass transfer, streamlines, temperature of nanofluid, and stresses at the wall are analyzed via graphs and tables. The findings of this investigation report that nanofluid’s temperature enhances against Hartmann and Brinkman numbers, whereas it declines for the thermal radiation parameter. The distribution of the concentration profile decreases for Brownian motion while it increases for the thermophoresis parameter. Further, a development in the stresses, thermal and mass transfer rates at the boundary is seen for better values of the Hartmann number. Additionally, higher values of the velocity slip parameter show increasing behavior for the velocity of nanofluid near the walls of the channel. The effects of MHD with magnesium aluminate nanoparticles suspended in DEG base fluid-based nanofluid through an asymmetric curved conduit have many uses in industry, organic compounds, biomedical engineering, and commercial productions, such as brake fluid, tobacco, polyester resins, certain dyes, printing ink, polyurethanes, glue, resins, antifreeze, nitrocellulose, oils, cigarettes, plasticizers, and so forth. DEG-based nanofluids are also used in human medications, including acetaminophen and sulfanilamide, which can result in incidents of human poisoning, some of which have been fatal, either intentionally or unintentionally.

The occurrence of unusually cold weather could contribute to the incidence of carbon monoxide poisoning.

The occurrence of unusually cold weather could contribute to the incidence of carbon monoxide poisoning.

Regulatory role of oxidative stress in retrorsine – Induced apoptosis and autophagy in primary rat hepatocytes

Pyrrolizidine alkaloids (PAs) are a group of naturally occurring alkaloids widely present in plants. PAs are highly hepatotoxic and have been documented to cause many incidents of human and animal poisoning. Retrorsine (RTS) is a pyrrolizidine alkaloid (PA) derived from the Compositae Senecio, which has been shown to cause hepatotoxicity. Human liver poisoning occurs through the consumption of RTS-contaminated food, and animals can also be poisoned by ingesting RTS-containing toxic plants. The mechanism of RTS-induced liver toxicity is not fully understood. In this study, we demonstrated that RTS-induced oxidative stress plays a pivotal role in RTS-induced liver toxicity involving apoptosis and autophagy. The results showed that RTS treatment in the cultured Primary rat hepatocytes caused cytotoxicity and release of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in a time- and dose-dependent manner. Our study showed that treatment of RTS induced ROS and MDA (malondialdehyde, a lipid peroxidation marker) in the hepatocytes, and reduced antioxidant capacity (GSH content, SOD activity), suggesting RTS treatment caused oxidative stress response in the hepatocytes. Furthermore, we found that RTS induced apoptosis and autophagy in the hepatocytes, and RTS-induced apoptosis and autophagy could be alleviated by ROS scavenger N-acetylcysteine (NAC) and the MAPK pathway inhibitors suggesting ROS/MAPK signaling pathway plays a role in RTS induced apoptosis and autophagy. Collectively, this study reveals the regulatory mechanism of oxidative stress in RTS-induced apoptosis and autophagy in the hepatocytes, providing important insights of molecular mechanisms of hepatotoxicity induced by RTS and related pyrrolizidine alkaloids in liver. This mechanism provides a basis for the prevention and treatment of PA poisoning in humans and animals.

Epidemiology, clinical characteristics, and associated cost of acute poisoning: a retrospective study.

Poisoning is a major public health issue and a leading cause of admission to the emergency department (ED). There is a paucity of data describing the epidemiology and cost of acute poisoning. Therefore, this study investigated the epidemiology, patterns, and associated costs of acute poisoning in emergency department of the largest tertiary care healthcare centre in Qatar. This study was a retrospective review of the health records of patients admitted to the ED due to poisoning between January 2015 and December 2019. Incidence, clinical characteristics, and costs associated with acute poisoning were assessed. Frequency and percentages were calculated for categorical variables and mean and SD for continuous variables. The relationship between sociodemographic characteristics and poisoning profile was assessed using the chi-square test. A micro-costing approach using the cost of each resource was applied for cost calculations. The incidence of acute poisoning was 178 cases per 100,000 patients. Females (56%) and children below 14 years (44.3%) accounted for the largest proportion. Most of the exposures were accidental involving therapeutic agents (64.2%). The mean length of hospital stay was found to be 1.84 ± 0.81 days, and most patients (76.6%) were discharged within the first 8 h. A statistically significant difference was found between age groups and type of toxin (χ2 = 23.3, p < 0.001), cause and route of exposure (χ2 = 42.2, p < 0.001), and length of hospital stay (χ2 = 113.16, p < 0.001). Admission to intensive care units had the highest cost expenditure (USD 326,008), while general wards accounted for the least (USD 57,709). Unintentional poisoning by pharmacological agents is common in infants and children. This study will assist in the development of educational and preventive programmes to minimise exposure to toxic agents. Further studies are required to explore the impact of medical toxicology services, and post discharge monitoring of poisoning.

Comparative medical importance of spider bites in Spain over 1997-2020: a retrospective study based on hospital cases coded using ICD.

Envenomation by terrestrial toxic animals is considered a serious risk to human health worldwide. Snakes, hymenopterans, spiders, and scorpions have mainly attracted the attention of medical literature. However, the relative importance of spiders has been studied only in a few countries. Here, we present the first retrospective study on the incidence of spider bites requiring hospital care in Spain, compared to bites or stings from snakes, hymenopterans, and scorpions. Using ICD9MC and ICD10 databases from the World Health Organization's International Classification of Diseases for the period 1997-2020, we quantified the cases of envenomation by spiders, compared to those by other terrestrial toxic animals, the demographic data of envenomation cases, the relative severity of spider bites, and the geographic distribution of envenomation cases. Overall, the incidence of acute intoxication by terrestrial toxic animals in Spain was ca. 1.23 cases per million inhabitants. In decreasing order of importance, cases were due to snakes, hymenopterans, spiders, scorpions, and myriapods. Fatal cases were extremely rare, caused mainly by hymenopterans. No fatalities were caused by spiders, scorpions, and myriapods. A greater incidence of snake bites occurred in northern Spain, but no geographical trends were found for spider bites or scorpion stings. Severe poisoning or life-threatening cases due to bites or stings from toxic terrestrial animals in Spain seems to be very low, especially for spiders, compared to other countries in the world. In general, spiders do not present a risk to human health and should not be considered a major driver of morbidity.