Methanol Poisoning Research Articles

Acute Toxic Encephalopathy in Occupational Exposure with Polyvinyl Chloride (PVC) Fumes: A Case Series.

Toxic encephalopathy is a spectrum of central nervous system disorders caused by exposure to toxins, especially from occupational workplace. Polyvinylchloride (PVC) is a synthetic chemical polymer that is used widely in daily activities of living. PVC is produced by polymerization of monomer units of vinyl chloride. Its manufacturing requires multiple procedures and additives for heat and light stabilization involving heavy metals. In this novel case series, we present the diverse clinical presentation of 10 patients, working in plastic recycling factory having inhalational exposure to PVC fumes, manifesting as acute toxic encephalopathy. All the patients were screened for the causes of acute encephalopathy including heavy metals, methanol poisoning, and organotins along with arterial blood gas analysis, brain imaging, and electroencephalogram. Memory loss, confusion, vertigo, headache, and nausea were complained in all the patients while seizure occurred in three patients. Neurocognitive status was grossly impaired in all the patients. Metabolic acidosis in presence of hyponatremia and/or hypokalemia was observed in nine cases. Five of the patients were having evidence of white matter involvement in brain imaging. The screening for heavy metal, methanol, and organotin were negative. Hemodialysis was done in six patients. Recovery was good in everyone and the average discharge was by 10.8 days (range: 2-25 days). All the patients were symptom-free at 3-months follow-up. Early suspicion and aggressive management can have favorable outcome in PVC toxic encephalopathy. Occupational hazards due to PVC toxicity are increasing in the present industrial era but it is very less identified.

The danger of the toxicity and inefficacy of alcohol-based hand rubs in Iran during COVID-19: a cross-sectional study

BackgroundThe use of disinfectants and alcohol-based hand rubs (ABHR) to prevent COVID-19 transmission increased in the first wave of the infection. To meet the increased demand, the Iranian Ministry of Health issued an emergency use authorization allowing new manufacturers to enter the market, despite the limited capacity for surveillance of these products during COVID-19. Methanol poisoning outbreaks spread rapidly, and more people died from methanol poisoning than COVID-19 in some cities. The aim of this study was to analyze some ABHRs in the Iranian market to see if (a) ABHRs are standard and suitable for hand antisepsis and (b) contained potentially dangerous toxic alcohols.MethodBetween February and March 2020, 64 brands of ABHR were conveniently collected from pharmacies, supermarkets, and shops selling hygienic products and analyzed using Gas Chromatography. World Health Organization and Food and Drug Administration guidelines were used to define minimum requirements for ABHR. For estimating the risk for acute methanol poisoning, we assumed a serum methanol concentration of 200 mg/L following ABHR ingestion was sufficient to cause intoxication. This threshold concentration would be achieved in an average 75-kg adult after consuming 8000 mg (or eight grams) methanol in 1–2 h.ResultsThe median [IQR] (range) concentration of ethanol, isopropanol, and methanol were 59% v/v [32.2, 68] (0, 99), 0 mg/L [0, 0] (0, 197,961), and 0 mg/L [0, 0] (0, 680,100), respectively. There was a strong negative correlation between methanol and ethanol contents of hand rubbers (r= -0.617, p < 0.001). Almost 47% of ABHRs complied with minimum standards. In 12.5% of ABHRs, high concentrations of methanol were observed, which have no antiseptic properties but could cause acute methanol poisoning if ingested.ConclusionCOVID-19 initiated a policy for distribution and use of ABHR with little control. As ABHR and masks are still accepted preventive measures of the disease, non-standard ABHR compositions may increase the population’s risk to both COVID-19 infection and methanol poisoning.

Time course study of optical coherence tomography angiography in patients with methanol induced optic neuropathy

IntroductionIn countries where alcoholic beverages are legally prohibited, methanol toxicity usually occurs due to ingesting homemade alcoholic drinks. The initial ophthalmologic symptoms of methanol toxicity typically appear 6–48 h after ingestion, and the severity of symptoms varies widely from mild and painless decreased vision to no-light perception vision.MethodsThis prospective study examines 20 patients with acute methanol poisoning within 10 days of use. Patients underwent ocular examinations, BCVA (Best Corrected Visual Acuity) recording, and OCTA (Optical Coherence Tomography Angiography) of the macula and optic disc. BCVA measurement and imaging were repeated one month and three months after intoxication.ResultsThere was a statistically significant reduction in superficial parafoveal vascular density (P-value = 0.026), inner retinal thickness (P-value = 0.022), RNFL (Retinal Nerve Fiber Layer) thickness (P-value = 0.031), and an increase in cup to disc ratio (P-value < 0.001), and central visual acuity (P-value = 0.002) in this time course. However, there was no statistically significant difference in FAZ (Foveal Avascular Zone) area (P-value = 0.309), FAZ perimeter (P-value = 0.504), FD-300 (Foveal density, vascular density within a 300 μm wide region of the FAZ) (P-value = 0.541), superficial vascular density (P-value = 0.187), deep foveal vascular density (P-value = 0.889), deep parafoveal vascular density (P-value = 0.830), choroidal flow area (P-value = 0.464), total retinal thickness (P-value = 0.597), outer retinal thickness (P-value = 0.067), optic disc whole image vascular density (P-value = 0.146), vascular density inside the disc (P-value = 0.864), or peripapillary vascular density (P-value = 0.680) at different times.ConclusionOver time, methanol poisoning can cause changes in retinal layers thickness, vasculature, and optic nerve head. The most important changes include cupping of the optic nerve head, reduction in RNFL thickness, and inner retinal thickness.

Bilateral Lateral Geniculate Body Infarction: A Systematic Review (P6-5.028)

<h3>Objective:</h3> To present a unique case of acute onset bilateral painless vision loss due to bilateral hemorrhagic infarction of the lateral geniculate bodies (LGB) and to conduct a systematic literature review to better understand the underlying pathophysiology. <h3>Background:</h3> Bilateral lateral geniculate body (LGB) infarct is an exceedingly rare cause of acute bilateral painless vision loss. A descriptive case report is presented on a 17-year old female diagnosed with acute pancreatitis who developed acute onset bilateral painless vision loss. <h3>Design/Methods:</h3> The systematic literature review was conducted on September 24th, 2022 in PubMed/PubMed Central/MEDLINE, ScienceDirect, and Scopus electronic databases. The following search string: ‘(lateral geniculate bod* OR lateral geniculate nucle*) AND (bilateral hemorrhagic infarct* OR bilateral ischemic infarct*). The review was prospectively registered on PROSPERO (Registration ID:CRD42022362491). <h3>Results:</h3> The reported 17-year old female was found to have purtscher-like retinopathy on fundoscopic evaluation as well as MRI findings consistent with bilateral hemorrhagic infarction of the LGB. A systematic literature review yielded 18 records for analysis. 15/18 (83.3%) of reported cases occurred in females. Bilateral vision loss was seen in all cases. Gastrointestinal pathology (i.e. pancreatitis, gastroenteritis, etc.) was seen in 7/18 (38.8%) of cases. Other reported causes include H1N1 influenza, extrapontine myelinolysis, preeclampsia, hysterectomy, methanol toxicity, traumatic brain injury, syphilitic arteritis, Behçet’s disease, and anaphylactic shock. All cases had MRI findings consistent with lesions to the bilateral LGB. 7/18 (38.8%) cases had neuroimaging or pathological evidence of hemorrhagic infarction of the LGB. <h3>Conclusions:</h3> Bilateral LGB infarction is a rare cause of vision loss. A systematic literature review and analysis of 18 cases revealed that it can concur due to a multitude of etiologies. It is often associated with an underlying inflammatory, coagulopathic, hypotensive, or osmotic pathology. Most reported cases are in females and occur due to a gastrointestinal etiology (i.e. acute pancreatitis, gastroenteritis, post-ERCP). <b>Disclosure:</b> Dr. Henninger has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astrocyte Pharmaceuticals, Inc.. The institution of Dr. Henninger has received research support from DoD. The institution of Dr. Henninger has received research support from NIH. Dr. Srichawla has nothing to disclose. Dr. Catton has nothing to disclose. Dr. Lichtenberg has nothing to disclose.

Delayed reversal of methanol-induced blindness in an adult by a combination of erythropoietin and a high dose of methylprednisolone: a case report

BackgroundThe clinical manifestation following methanol toxicity accounts for a life-threatening problem that contributes to metabolic disorders, neurological complications, blindness, and even death. There is no completely effective treatment to retain the patient’s vision. Herein, we apply a new therapeutic strategy for the recovery of bilateral blindness in a patient who had ingested methanol.Case presentationA 27-year-old Iranian man with complete bilateral blindness was referred 3 days after accidental ingestion of methanol to the poisoning center at Jalil Hospital, Yasuj, Iran, in 2022. After taking his medical history, performing neurologic and ophthalmologic examinations, and routine laboratory tests, ordinary management was undertaken and counterpoisons were given for 4–5 days; however, the blindness did not reverse. Following the 4–5 days of unsuccessful standard management, he was given ten doses of subcutaneous erythropoietin 10,000 IU/12 hours twice daily, folinic acid 50 mg/12 hours, and methylprednisolone 250 mg/6 hours for 5 days. After five days, vision of both eyes recovered, reaching 1/10 in the left and 7/10 in the right eye. He remained under daily supervision until his release from the hospital, and he was discharged from the hospital 15 days post admission. In outpatient follow-up, his visual acuity was improved without having any side effects at 2 weeks after discharge.ConclusionA combination of erythropoietin and a high dose of methylprednisolone were useful for relieving the critical optic neuropathy and improved the optical neurological disorder following methanol toxicity.

Awareness raising and dealing with methanol poisoning based on effective strategies

Intoxication with methanol most commonly occurs as a consequence of ingesting, inhaling, or coming into contact with formulations that include methanol as a base. Clinical manifestations of methanol poisoning include suppression of the central nervous system, gastrointestinal symptoms, and decompensated metabolic acidosis, which is associated with impaired vision and either early or late blindness within 0.5–4 h after ingestion. After ingestion, methanol concentrations in the blood that are greater than 50 mg/dl should raise some concern. Ingested methanol is typically digested by alcohol dehydrogenase (ADH), and it is subsequently redistributed to the body's water to attain a volume distribution that is about equivalent to 0.77 L/kg. Moreover, it is removed from the body as its natural, unchanged parent molecules. Due to the fact that methanol poisoning is relatively uncommon but frequently involves a large number of victims at the same time, this type of incident occupies a special position in the field of clinical toxicology. The beginning of the COVID-19 pandemic has resulted in an increase in erroneous assumptions regarding the preventative capability of methanol in comparison to viral infection. More than 1000 Iranians fell ill, and more than 300 of them passed away in March of this year after they consumed methanol in the expectation that it would protect them from a new coronavirus. The Atlanta epidemic, which involved 323 individuals and resulted in the deaths of 41, is one example of mass poisoning. Another example is the Kristiansand outbreak, which involved 70 people and resulted in the deaths of three. In 2003, the AAPCC received reports of more than one thousand pediatric exposures. Since methanol poisoning is associated with high mortality rates, it is vital that the condition be addressed seriously and managed as quickly as feasible. The objective of this review was to raise awareness about the mechanism and metabolism of methanol toxicity, the introduction of therapeutic interventions such as gastrointestinal decontamination and methanol metabolism inhibition, the correction of metabolic disturbances, and the establishment of novel diagnostic/screening nanoparticle-based strategies for methanol poisoning such as the discovery of ADH inhibitors as well as the detection of the adulteration of alcoholic drinks by nanoparticles in order to prevent methanol poisoning. In conclusion, increasing warnings and knowledge about clinical manifestations, medical interventions, and novel strategies for methanol poisoning probably results in a decrease in the death load.

Identifying the cause of intoxication case without a clear history using flowcharts

Background: Suspicion of intoxication and its causative agents are required in the clinical practice of intensive care units. Patients with loss of consciousness and no history of leading causation present obstacles in emergency room management. An understanding of toxidromes and epidemiological evidence can help clinicians. However, classic toxidromes are not always presented. Objectives: This case was presented to determine the flow of approaches to identify the cause of intoxication and to design early strategies for supportive care in intoxication case management. Case: A woman with loss of consciousness accompanied by seizures, deep and rapid breathing, and hypotension. Since the search for collateral information did not produce any meaningful findings, the toxin diagnosis was given based on vital signs, pupil size, and mental status. Methanol intoxication was suspected based on hypothermia, decreased consciousness, normal pupil size, and Kussmaul breathing. Forensic analysis showed her serum was positive for ethanol and methanol. Conclusion: When facing a case without the classic presentation of the toxidrome, the toxin diagnosis can be directed based on vital signs, pupil size, mental status, and muscle tone. Introduction to epidemiology is also important in tracking intoxication causation

Male- and female-specific microRNA expression patterns in a mouse model of methanol poisoning.

The aims of this study were to determine the miRNAs involved in the methanol poisoning, and identify the male- and female-specific miRNA expression patterns in mice. Methanol was applied orally at the doses of 4g/kg and 8g/kg to induce mild and severe methanol poisoning in Balb/c mice. miRNA expression levels were detected at 3 different time periods (30, 60, and 180min) following methanol exposure. miRNA expression profiles were determined using the high-throughput Fluidigm BioMark real-time PCR. We observed that serum miR-206 expression in male mice and miR-6357 expression in female mice could be an indicator of methanol poisoning. miR-9-3p downregulation and miR-1187 upregulation could be important for liver tissue. miR-3106-5p and miR-133a-5p upregulations and miR-122-3p downregulation could be poison biomarkers for ocular tissue in male mice. However, miR-194-5p downregulation could be a biomarker for ocular tissue in female mice. miR-122-5p and miR-124-3p downregulations and miR-499a-5p upregulation appeared to be important for kidney tissue in male mice. miR-543 and miR-6342 upregulations could be potential candidate biomarkers for kidney tissue in female mice. Our study is the first to report that differential miRNA expressions are involved in blood and tissues in male and female mice after methanol treatment.

English

It has been established that peroxidation, inflammatory processes, and organ damage are involved in the pathogenesis of methanol intoxication. Research has shown that using hyperbaric oxygen reduces oxidative stress, inflammation, and tissue damage. In this research, it was investigated how hyperbaric oxygen therapy affected methanol-induced peroxidation and retinal damage in rats. The animals were classified into six categories (n = 8): control group (C), nitrous oxide (N2O) treated group, hyperbaric oxygen (HBO) treated group, methanol (MeOH) treated group, N2O+methanol treated group (N2O+MeOH) and N2O+methanol+hyperbaric oxygen (N2O+MeOH+HBO) treated group. Folate deficiency was started with N2O, four hours before the starting dose (4g/kg) of methanol. The rats were given a methanol maintenance dose (2g/kg, i.p) 24h and 48h after the starting dose. After each methanol administration, rats were given HBO (2 ATA) for 1 hour. Methanol intoxication decreased plasma folic acid levels while increasing formate levels and oxidative stress index and it caused a decrease in the amount of the retinal ganglion cells and thinned the total retinal thickness in folate-deficient mice. HBO treatment reduced the oxidative stress index but did not adequately improve retinal healing. Our findings indicate that the HBO treatment used to treat retinal damage in methanol poisoning was ineffective. However, increasing the duration of HBO therapy may be effective in preventing methanol-induced retinal damage

Delta values as a prognostic marker in methanol poisoning: a retrospective cohort study

Purpose: The aim of the study was to evaluate the mortality prediction performances of delta bicarbonate, delta anion gap, and delta ratio in methanol poisoning (MP) cases.&#x0D; Materials and Methods: This clinical study, which followed a cross-sectional study design, involved patients with MP who were still alive when they initially arrived at the emergency department of a tertiary care hospital. Patients were divided into two groups mortality and non-mortality. Patients who died during treatment and follow-up were assigned to the mortality group, while others were assigned to the non-mortality group. Receiver Operating Characteristic (ROC) analysis was used to determine the cut-off in the diagnostic value measurements of biomarkers predicting mortality. &#x0D; Results: Nine (20%) of the 45 patients in the study died during their follow-up. The two groups showed a significant difference in the averages of pH, bicarbonate (HCO3-), lactate, anion gap, delta anion gap, delta HCO3-, and delta ratio, but not in the averages of partial carbon dioxide pressure (pCO2). In predicting mortality, pH, anion gap, and delta anion gap were found to have outstanding diagnostic power (AUC&gt;0.9), while HCO3-, delta HCO3-, delta ratio were found to have acceptable diagnostic power (AUC: 0.7-0.8). &#x0D; Conclusion: Delta anion gap, delta bicarbonate, and delta ratio can be used as prognostic factors in predicting mortality in MP cases.

Factors affecting the severity and prognosis of visual damage in inhalational methanol poisoning.

Inhalational methanol poisoning could cause severe damage to visual function. This study analyzed the prognosis of the correlation between the visual function and the relevant risk factors. In this retrospective study, 14 patients had confirmed inhalational methanol poisoning, resulting in visual impairment in both eyes. The following tests were performed: laboratory tests, best corrected visual acuity (BCVA), intraocular pressure, slit lamp, fundus photography, visual field (VF), pattern visual evoked potential (P-VEP), flash electroretinogram (F-ERG), optical coherence tomography (OCT), and orbital or cranial magnetic resonance imaging (MRI). With active treatment, visual function improved to varying degrees in all 14 cases (28 eyes) in this study. The BCVA of 21 eyes declined to no light perception at the onset; 16 eyes showed different degrees of improvement after treatment, with the final BCVA (LogMar) mainly ranging from 2 to 3, and vision acuity stabilized after the 5th month. The VF pattern in the acute phase was mostly blind. Other VF patterns included the central visual island, large paracentral scotomas, hemipleural VF defects, and the temporal visual island. Retinal nerve fiber layer (RNFL) thickening was observed commonly in the acute phase (146.8 ± 33.2 μm), which subsided in the 1st month, showed dramatic thinning at the 3rd month, and then stabilized in the 5th month after onset. MRI showed that the main sites involved were optic nerve impairment, the optic disk, and retrobulbar segments. The basal ganglia region was the site most involved in the central nervous system (CNS). Inhalational methanol poisoning could lead to severe impairment of visual function, and the prognosis of visual acuity (VA) was highly relevant to the risk factors of duration of toxic exposure, delayed admission, and degree of acidosis.

Brain imaging findings of methanol poisoning and detection of chronic stage nervous system damage: A case report

In this article, we presented the chronic neurological findings of an acute case of methanol intoxication due to the use of homemade alcohol. In the neurological examination performed 6 months after intoxication, bilateral vision loss, tremor, dysarthria, dysphagia, loss of taste sensation, and decrease in the Cognitive State Test score were detected. Peripheral polyneuropathy consistent with axonopathy was detected in the peripheral nerve conduction study, and optical neuropathy was detected in the examination of the pattern visual evoked potential. Brain magnetic resonance imaging revealed findings compatible with bilateral putaminal necrosis.

Epiglottis Cartilage, Costal Cartilage, and Intervertebral Disc Cartilage as Alternative Materials in the Postmortem Diagnosis of Methanol Poisoning.

Alternative materials for postmortem diagnosis in the case of fatal poisonings are much needed when standard materials, such as blood and urine, are unavailable. The study presents a case of fatal mass methanol intoxication resulting from industrial alcohol consumption. The study aimed to determine methanol and formic acid concentrations in epiglottis cartilage, costal cartilage, and intervertebral disc cartilage and to analyze the correlation between their concentrations in cartilage tissues and the femoral blood. Methanol and formic acid concentrations in samples collected from 17 individuals (n = 17) were estimated using gas chromatography with flame ionization detection (GC-FID). Methanol concentration in the costal cartilage correlated with its concentration in the femoral blood (r = 0.871). Similar correlations were found for epiglottis cartilage (r = 0.822) and intervertebral disc cartilage (r = 0.892). Formic acid concentration in the blood correlated only with its concentration in urine (r = 0.784) and the epiglottis (r = 0.538). Cartilage tissue could serve as an alternative material for methanol analyses in postmortem studies. Formic acid, a methanol metabolite, does not meet the requirements for its presence determination in cartilage tissues.

Intoxicación por metanol

Methanol poisoning can occur unnoticed, by the ingestion of adulterated alcoholic beverages. In general, it is a rare entity, however, an increase in incidence has been reported during the SARS-CoV-2 pandemic. Methanol poisoning represents a medical emergency as it can cause severe damage to the central and peripheral nervous systems, as well as metabolic acidosis, acute kidney injury, and even death. This article presents the case of a patient who inadvertently developed methanol intoxication after consuming presumably adulterated alcoholic beverages. In the brain, hemorrhagic necrosis of both putamen nuclei was demonstrated, in addition to presenting with bilateral optic neuritis and peripheral polyneuropathy. He was managed with intravenous steroid pulses, which significantly improved his visual, sensory, and motor function. In the present case there were no fatal complications and presented a good response to treatment, however, the case highlights the need for better regulation in the production and marketing of alcoholic beverages in our country, and on the other hand, to invite consumers to take more precautions in the consumption of alcoholic beverages of dubious quality or origin. Keywords: Poisoning; methanol; nervous system; optic neuritis; polyneuropathy.

Brain CT-Scan Features in Methanol Toxicity and Their Association with Clinical Manifestations and Outcome; a Cross-Sectional Study

Purpose: Early month of the COVID-19 pandemic. The belief of alcoholic beverages as a protective factor against the virus was got viral. We experienced a methanol toxicity outbreak by illegally produced beverages. We had insufficient data about Imaging and clinical finding in Methanol poisoning. We aimed to determine the frequency and importance of each brain finding its clinical manifestation with the prognosis of patients. Methods: in this cross-sectional study, we retrospectively assessed methanol toxicity patients in March and April 2020 at Shiraz Teaching Hospitals. We recorded demographic data, clinical manifestations, vital signs, duration, Lab data, and outcomes. Brain CT scan was reviewed by three clinical radiologists, independently. Brain CT scan results, including hemorrhage, hypodensity, and location of findings, had collected. All data analyzed by chi2 , T-test, and Pearson test was used for assessing correlation. Results: 306 patients had entered. There were 268 (88.88%) male patients. The total mean age of 32.10±9.9 years. 65 (21.8 %) with GCS< 8 were hospitalized mean duration of 2.72±2.46 days. 60(19.9%) patients passed away. about 75.9% (223) blindness, 128 (49.2%) Chronic alcohol users 46(15%) cases with abnormal findings. 30(50%) dead persons had normal imaging. There were 5(1.6 %) ICH Hypo Putamen 34 (11.11%) and diffused cerebral edema 23(7.5%), cerebellum nucleus hypoattenuation, and hemorrhage were the poorest prognosis findings in the CT scan. Conclusion: about 15% of patients had abnormal CT scans, Putamen hypodensity, Cerebellum nucleus hypodensity, and diffused cerebral edema were the most finding. Cerebellum nucleus hypodensity, diffused cerebral edema and ICH are the most faithful brain findings. Blindness, Renal failure, GCS<8, and pH<7.2 were the most faithful findings in the final prognosis.

Investigation of deaths related to methyl alcohol intoxication in Izmir: A 5-year retrospective study

Methyl alcohol consumption results in serious poisoning symptoms and even causes death, so it is not used in legal alcoholic beverages. We aimed to examine deaths due to methyl alcohol intoxication in our region through forensic autopsies performed in Izmir-Turkey to compare these data with international studies. A total of 13,701 autopsies performed between 2016-2021 were scanned retrospectively. 214 cases in which the exact cause of death was methanol intoxication were included in the study. All the cases were analyzed in terms of age, gender, date of death, place of death, length of hospitalization, methanol levels detected in blood and the vitreous humor, ethanol presence in blood, and pathological findings. The ratio of autopsies of the exact cause of death of methanol poisoning to total autopsies is 1.56%. Of these cases, 94.9% were male and 5.1% were female. The age range was 25–80 years, with a mean age of 53.4. According to the age distributions, the highest rate was 39.3% in the sixth decade. The highest number of cases was 129 (60.3%) in 2020. In the analysis of blood methanol levels, the concentration was found to be in the range of 0-642 mg/dl and the mean was 178 mg/dl. During the COVID-19 pandemic, there has been a significant increase in methanol poisoning cases associated with the economic and social problems experienced in Turkey. Our study showed that methanol poisoning deaths are especially common in men aged 50-60 years so this group is at higher risk of methanol poisoning.

Antioxidant Activity of Usnic Acid Compound from Methanol Extract of Lichen Usnea sp.

Lichen Usnea sp. is one of the sources of natural bioactive compounds which are currently being developed as medicinal ingredients. The purpose of this study was the isolation and identification of secondary metabolites from methanol extract, toxicity test and antioxidant activity of Usnea sp. Lichen was isolated by maceration using methanol solvent, then separated by liquid-liquid partition and separation using vacuum chromatography. Based on the results of the study, NMR-1D spectral data and FTIR spectrum is the presence of functional groups showed the presence of F15 compound is usnic acid consisting of 18 carbons with 3 carbons from the C=O carbonyl group. The results of the toxicity test showed that all of them were active against Artemia salina L. shrimp larvae with LC50 values of 0.820 µg/mL (Usnea sp.), 1.030 µg/mL (n-hexane), 1.056 µg/mL (ethyl acetate), and 1.236 µg/mL (methanol extract). The results of the antioxidant activity test showed that the inhibitory activity of usnic acid isolate was very active with an IC50 value of 11.696 µg/mL. Meanwhile, methanol extracts and ethyl acetate showed antioxidant activity with IC50 values of 18.098 and 26.917 µg/mL, respectively.

Metanol zehirlenmesi olan hastalarda mortalite ile ilişkili risk faktörleri: retrospektif bir çalışma

Aim: Methanol poisoning (MP) is an significant medical problem worldwide, and despite advances in diagnosis and treatment, the mortality rate in these cases remains high. This study aimed to evaluate the clinical and laboratory factors to determine in-hospital mortality in patients with MP.Methods: This single-center, retrospective, observational study was conducted with 65 adult MP cases visiting the emergency department (ED) of a tertiary training and research hospital, between January 01, 2017 and February 01, 2022. Data was statistically compared between survivors and non-survivors.Results: The in-hospital mortality rate was 41.5%. The rate of cases with respiratory distress, low Glasgow coma scale (GCS) (≤8), and delayed arrival to the hospital (&amp;gt;24 hours) was higher in the group of non-survivors compared to the group of survivors. Non-survivors had a higher anion gap (30.5 mEq/L vs. 25.5mEq/L), base excess (-25.0 mmol/L vs. -18.6 mmol/L), lactate (10.2 mmol/L vs. 2.2 mmol/L) levels, and lower pH (6.76 vs. 7.14) and bicarbonate (6.3 mmol/L vs. 10.3 mmol/L) levels than survivors (p&amp;lt;0.001). In ROC analysis, pH (AUC= 0.916) and base excess (AUC=0.915) were blood gas parameters with the highest AUC values in predicting mortality in MP cases. Folate use in the treatment had a statistically significant effect on mortality (P=0.015).Conclusion: In MP cases, delay in a hospital visit, severe metabolic acidosis, high lactate levels, low GCS on arrival to the ED and no folate therapy, were associated with increased in-hospital mortality rates. Our data will contribute to the clinical management of MP patients and the development of treatment protocols.

Comparison of Quantitative Values of Headspace Gas Chromatography--Mass Spectrometry and a Formate Quantification Kit in Blood Formate Quantification.

Methanol poisoning is caused by the toxicity of formate, a by-product of methanol metabolism. Measurement of blood formate concentrations is required for emergency treatment and investigation of the cause of death. In this study, we measured concentrations of formate in the plasma of a patient with methanol poisoning using headspace gas chromatography--mass spectrometry (HS-GC--MS) and a formate assay kit. Results showed a discrepancy as the quantitative values of the kit were higher than those of HS-GC--MS. Metabolic profiling of low-molecular-weight organic compounds in patient plasma samples showed that the concentrations of lactate were correlated with the values obtained using the kit. We observed a progression when lactate and lactate dehydrogenase were added to the kit reaction simultaneously, even in the absence of formate. Moreover, disulfiram, an aldehyde dehydrogenase inhibitor, suppressed the values of patient plasma samples in the formate assay kit, implying that formate production from remaining methanol in patient plasma samples via formaldehyde occurred during the kit reaction. The reactions of the kit with lactate and methanol were undesirable for accurate measurement of formate concentration in the sample. However, considering that elevated concentrations of lactate and remaining methanol both cause acidosis and are dangerous to the body, cross-reactions with lactate and methanol in the formate assay kit may be acceptable for rapid diagnosis in facilities where HS-GC--MS and other physical and chemical equipment are unavailable.

Fatal Methanol Poisoning Caused by Drinking Industrial Alcohol: Silesia Region, Poland, April-June 2022.

Methanol poisonings caused by drinking industrial alcohol remain a severe problem worldwide. Education on types of alcohol and their harmfulness and legal regulations limiting the industrial alcohol trade seem to be the keys to reducing the number of poisonings. Methanol distribution in different tissues after absorption is not well understood. This research aimed to quantify the methanol and formic acid distribution in body fluids and tissue material in post-mortem samples collected from 19 fatal victims of massive intoxication with industrial alcohol in the Silesia Region (Poland) who died between April and June 2022. The samples were analyzed using a gas chromatography-flame ionization detector (GC-FID), and correlation coefficients for methanol and formic acid were determined. The results show a wide distribution of methanol and formic acid in human post-mortem biological fluids (blood, urine, vitreous humor, bile, and cerebrospinal fluid) and tissues (muscle, kidney, liver, spleen, lung, and brain). The strongest correlation for methanol concentration in blood and body fluids/tissues was obtained in the cerebrospinal fluid (r = 0.997) and for formic acid in muscle tissue (r = 0.931). The obtained results may be a valuable tool in toxicological analysis and improve medical standards of early diagnosis and targeted treatment.