Poison Control Centers Research Articles

A Guide to the Clinical Management of Vipera Snakebite in Italy.

The genus Vipera encompasses most species of medically significant venomous snakes of Europe, with Italy harbouring four of them. Envenomation by European vipers can result in severe consequences, but underreporting and the absence of standardised clinical protocols hinder effective snakebite management. This study provides an updated, detailed set of guidelines for the management and treatment of Vipera snakebite tailored for Italian clinicians. It includes taxonomic keys for snake identification, insights into viper venom composition, and recommendations for clinical management. Emphasis is placed on quick and reliable identification of medically relevant snake species, along with appropriate first aid measures. Criteria for antivenom administration are outlined, as well as indications on managing potential side effects. While the protocol is specific to Italy, its methodology can potentially be adapted for other European countries, depending on local resources. The promotion of comprehensive data collection and collaboration among Poison Control Centres is advocated to optimise envenomation management protocols and improve the reporting of epidemiological data concerning snakebite at the country level.

Effectiveness of enteral tube feeding by gravity drip soup for patients at Nghe An General Friendship Hospital

Enteral nutrition via feeding tube aims to maintain nutrition by the gastrointestinal tract, protect the physiological function of the digestive system and provide early enteral nutrition for critically ill patients. Enteral tube feeding is an efficient method recommended to start within 48 hours after admission. This study aims to evaluate the effectiveness of enteral tube feeding by gravity drip soup for patients in Nghe An General Friendship Hospital. The descriptive and prospective studies were conducted on 255 patients, from April 2022 to June 2022 at the Intensive Care, Surgical Intensive Care, Poison Control, General Infections, Gastrointestinal Surgery, Burns Departments, and Stroke Centre. The results showed that the total energy intake provided on the 1st and 7th days was 1,015.2 kcal and 1,409 kcal, respectively. The malnutrition rate assessed by the mid-upper arm circumference (MUAC) index increased from 6.7 to 8.2%; serum albumin index decreased from 78.6 to 76.2%; by the subjective global assessment (SGA) index increased from 54.9 to 77.6%; the energy supply is relatively adequate and malnutrition is improved.

Epidemiological Profile of Cases of Hair Cosmetic Poisoning and Investigation of Risk Factors in Morocco (1981-2011)

Intoxications from cosmetic products are common incidents resulting from inappropriate or excessive use, whether accidental or intentional, through ingestion, inhalation, or skin absorption of substances present in cosmetic products. The aim of this retrospective study is to establish the epidemiological profile of hair cosmetic poisoning cases reported to the Moroccan Poison Control and Pharmacovigilance Center (CAPM) between 1981 and 2011. The results indicate a predominance of females (74.12%). However, 54.11% are adults, 20% are infants + toddlers, and 24.70% are adolescent children. Furthermore, 66.67% of them suffered from hair dye and coloring intoxication. On the other hand, a majority of 41% showed a slight risk or no risk at all. Another notable observation is that 39% of the victims have shown a moderate risk. Furthermore, it is worth mentioning that the fatality rate is 1.1%. Furthermore, there is a need to raise awareness among the public and the media about the dangers of using certain cosmetic products.

EXPLORING BRAND AWARENESS AND UTILIZATION PATTERNS OF POISON CONTROL CENTER SERVICES IN THAILAND: A COMPARATIVE STUDY AMONG HEALTHCARE PROFESSIONALS AND THE GENERAL PUBLIC

Purpose – The purpose of this study is to compare the brand awareness and utilization patterns of Poison Control Center services in Thailand among healthcare professionals and the general public.Methodology – This study employs quantitative methodology to compare the brand awareness and utilization patterns of Poison Control Center services among healthcare professionals and the general public in Thailand.Results – The results of the study reveal that healthcare professionals in Thailand have significantly higher brand awareness of Poison Control Center services compared to the general public. The findings also indicate that healthcare professionals are more likely to utilize these services than the general public.Implications – Implications of this study suggest the need for targeted educational campaigns to increase brand awareness and encourage more effective utilization of Poison Control Center services among the general public in Thailand.Originality/Value – This study contributes to the existing literature by examining the brand awareness and utilization patterns of Poison Control Center services in Thailand, specifically comparing healthcare professionals and the general public. The findings highlight the need for targeted educational campaigns to increase brand awareness and promote the effective utilization of Poison Control Center services among the general public in Thailand. The findings of this study highlight the disparity in brand awareness and utilization of Poison Control Center services between healthcare professionals and the general public in Thailand.

CLINICAL CASE REPORT OF ACUTE HEART INJURY AND ACUTE RHABDOMYOLYSIS DUE TO CYANUA POISONING

Cyanide poisoning is one of the most dangerous poisonings, it can be absorbed into the body through the mouth, inhalation and through the skin. A 32-year-old female patient was admitted to our poison control center because of high fever, severe vomiting, and seizures. Physical examination found that the patient was drowsy, had a high fever of 40 degrees Celsius, pulse of 140 beats/minute, and increased tendon and bone reflexes. Exploiting the patient's information, it was discovered that the patient bought Cyanide to drink with the intention of committing suicide. The patient was quickly treated with gastric lavage and activated charcoal. Echocardiography recorded EF: 35%, reduced movement of the entire myocardium. CK blood test: 4562 U/L. The patient's condition rapidly deteriorated and the patient was made ECMO, IHD and CVVHDF. After 3 days of treatment, the patient's condition did not improve, so the family asked for the patient to go home. This article aims to describe the rapidly progressing and severe damage to the heart and muscles of patients with cyanide poisoning.

Performance of several clinical scoring systems as predictors of adverse outcomes in acute exposure to toxic alcohols.

Toxic alcohols are chemicals with common metabolic characteristics resulting in severe morbidities and mortalities. The current study aimed to assess the efficacy of six scoring systems: The Poison Severity Score (PSS), Acute Physiology and Chronic Health Evaluation (APACHE) II score, Sequential Organ Failure Assessment (SOFA) score, Rapid Acute Physiology Score (RAPS), Rapid Emergency Medicine Score (REMS), and Modified Early Warning Score (MEWS) in stratifying the patients exposed to toxic alcohol based on liability of organ failure, prolonged hospital stay, and need for an antidote. A seven-year retrospective cross-sectional study was conducted using medical records of adult patients admitted to a poison control center. About 42.6% were complicated with adverse outcomes. Methanol was the worst toxic alcohol and the only cause of blindness and death. About 27.1% of methanol-exposed patients suffered from acute kidney injury, 15.3% suffered from hemodynamic instability and neurological dysfunction, and 8.5% suffered from respiratory failure. An APACHE II score above 8 was the best predictor of unfavorable outcomes, exhibiting the highest area under the curve (0.972), followed by the SOFA score. The APACHE II score was praised for being the best discriminator of an expected prolonged hospital stay. Yet, the simple scores, including RAPS and REMS, showed good performance as unfavorable outcome predictors with no significant variations to PSS, APACHE II score, and SOFA scores. The current study concluded that though the APACHE II and SOFA scores were superior to others, the RAPS and REMS are good, simple, and effective alternatives, particularly when resources are restricted.

Mortality of acute poisoning and its predictors in Ethiopia: A systematic review and meta-analysis

IntroductionPoison is defined as any chemical that has the potential to affect or harm human physiology due to its chemical activity. Poisoning is becoming a major preventable public health issue in many countries, including Ethiopia. There is a variation in acute poisoning mortality among the existing evidence in Ethiopia. This study aims to determine the pooled mortality rate from acute poisoning and its predictors in Ethiopia. MethodsWe searched available evidence of acute poisoning mortality in databases such as PubMed, Hinari, Cochrane, ScienceDirect, and other search engines. Using the Microsoft Excel data extraction form, three authors independently extracted all relevant data. The Higgins I2 test statistics were used to examine heterogeneity among included studies A random-effects model was used to analyze the pooled estimates and predictors in Stata MP version 17. ResultsWe retrieved 2685 relevant records from different database sources, and after screening, 21 studies (17 published and 4 unpublished) were included. The pooled mortality rate for acute poisoning was 4.69(95 % CI: 3.69, 5.69 I2 = 94.7 %). The most common poisoning agents are organophosphate (29.9 %), household cleansing agents (17.5 %), and pharmaceuticals/medications (9.3 %). The majority of poisoning cases were intentional poisoning committed suicide. Poisoning cases in rural areas [RR: 3.98(95 % CI: 1.41, 11.25)] and delayed arrival times [RR: 2.90(95 % CI: 1.45, 5.84)] were identified predictors of mortality. ConclusionsIn this study, the pooled mortality from acute poisoning was 4.69 %. Poisoned cases from rural areas and delayed arrival times to the hospital were predictors of mortality. To prevent mortality, healthcare professionals should give special attention to rural residents and delayed arrival of poison cases. To control this avoidable death, poison control centers should be strengthened, and other preventive measures implemented at the national level.

Understanding collective suicides in Morocco: A 35-year epidemiological study

IntroductionSuicide is a major public health concern, ranking among the leading causes of death worldwide.ObjectivesThis study investigated the epidemiological features of collective suicide incidents in Morocco.MethodsWe performed a retrospective analysis of suicidal poisoning cases recorded by the Moroccan Poison Control Center (MPCC) over a 35-year period.ResultsDuring the study’s duration, the MPCC recorded 168 suicide cases. The mean age of those involved in these incidents was 23.9 years, with a female-to-male ratio of 1.57. The majority of those affected were adolescents and young adults, specifically between 15 and 34 years of age. Pesticides and drugs were the most commonly used methods of suicide and accounted for 31.1% and 20.1% of the cases, respectively. The majority of incidents occurred in the home environment and were primarily caused by oral exposure. The symptoms of poisoning varied according to the consumed substance, amount ingested, and elapsed time until medical treatment. The symptoms included disturbances in the neurological, gastrointestinal, respiratory, and cardiovascular systems. Of the 100 cases with known outcomes, one person died due to poisoning, whereas the remaining cases survived, although some enduring complications.ConclusionsSuicide accounted for 1.3% of global mortality, ranking as the 17th most common cause of death in 2019, according to data from the World Health Organization (WHO). This trend emphasizes the urgent need for continuous efforts at all levels to address and mitigate this rapidly growing issue.Disclosure of InterestNone Declared

Deliberate self-poisoning in children and adolescents

IntroductionSuicide is a significant global public health issue that has a severe impact on children and adolescents.ObjectivesThis study examined the epidemiological features of self-poisoning events among these groups in Morocco.MethodsIn this retrospective study, data on intentional poisoning cases among children under 15 years of age and adolescents aged 15-19 years were analyzed. The Moroccan Poison Control Center has reported these cases over a period of 34 years.Results During the study period, 7,111 deliberate self-poisoning cases were documented among children and adolescents, representing 30% of all reported self-poisoning cases (out of a total of 23,711 cases with known ages). The vast majority of the cases (80.8%) involved females, indicating a significant female-to-male ratio of 4.2. The patients had a mean age of 16.05 ± 2.10 years. Notably, drugs were the predominant method of self-poisoning, comprising 51.7% of the cases, followed by pesticides at 31.3%. The symptoms of poisoning manifested with significant variation, contingent on the type of toxin involved, the amount ingested, and the time passed before medical care was administered. Of the 4,711 cases with known outcomes, 144 (3.06%) were fatal. Nonetheless, the outcomes were favorable for the remaining cases, with or without lasting sequelae.ConclusionsThe ongoing prevalence of suicide and suicide attempts among children and adolescents is a prominent issue in public health. Our research emphasizes the crucial necessity to address suicide, as it remains one of the primary causes of mortality in young individuals.Disclosure of InterestNone Declared

Severely Painful and Pruritic Forearm Rash: A Case of Caterpillar Envenomation in South Florida.

The asp caterpillar (Megalopyge opercularis) is endemic to the southeastern United States, with most sightings in Florida, Texas, and Louisiana. A few hundred caterpillar envenomations are reported annually with most cases occurring in July-November. Asp caterpillars have hollow spines along their backs that contain venom. Contact with these spines is what produces the characteristic "sting" resulting in contact dermatitis and a localized hypersensitivity reaction collectively referred to as lepidopterism. Symptoms of lepidopterism may include severe burning pain, pruritis, edema, nausea, vomiting, abdominal pain, and headache. Symptoms are often self limited, and treatment should focus on expedited removal of implanted spines and aggressive symptom management. We present the case of a patient presenting to the emergency department (ED) with acute-onset severe left forearm pain with associated pruritic rash incurred while working in a retail store. Initial therapeutic management included administration of analgesics, antihistamines, and steroids. After obtaining a comprehensive history and consulting with the Poison Control Center, we suspected an asp caterpillar envenomation. Following extraction of the caterpillar spines with silk tape, the patient's symptoms improved. After a period of observation in the ED, the patient was discharged home without any known sequelae. Although asp caterpillars typically inhabit trees and foliage, human exposure to the caterpillar may occur in developed environments. Effective history-taking, prompt communication with toxicologic experts, and complete removal of intact spines are essential for early identification and effective clinical management of asp caterpillar envenomation.

Albuterol as an adjuvant in acute anticholinesterase pesticide poisoning: a randomized, placebo-controlled clinical trial.

Acute anticholinesterase pesticide poisoning is a serious clinical problem, particularly in developing countries. Atropine is the most acceptable treatment for acute anticholinesterase poisoning. However, it only stops fluid production. Albuterol is a beta-2 receptor agonist that can increase fluid removal and speed the return of effective oxygen exchange. This study aims to evaluate the safety and efficacy of nebulized albuterol as an adjuvant therapy in patients with acute anticholinesterase poisoning. This stratified block randomized, single-blinded, placebo-controlled, parallel-group clinical trial was conducted between November 2020 and October 2021. It enrolled 80 patients with acute anticholinesterase pesticide poisoning who were admitted to Tanta University Poison Control Center. Patients were allocated into two groups (40 patients each). The strata were based on the severity of poisoning (moderate and severe). Patients in group I received 10mg of nebulized albuterol. Group II received an equivalent volume of nebulized normal saline. Additionally, standard treatment was provided to both groups. Outcomes included oxygenation, mortality, need for endotracheal intubation and mechanical ventilation, hospital stay duration, time to atropinization, and total doses of atropine and oxime. We found insignificant differences in sociodemographics, exposure characteristics, clinical manifestations, or routine laboratory tests between the studied groups. The median values of oxygen saturation by pulse oximetry were 99% in the albuterol moderate toxicity group and 98% in the control moderate toxicity group. Albuterol significantly improved oxygen saturation in moderate intoxicated patients (P=0.039). Therefore, nebulized albuterol is a safe drug. Moreover, it may improve oxygenation in acute anticholinesterase pesticide poisoning.

Epidemiology and Clinical Characteristics of Acute Plant Exposure in Patients Aged between 0 and 18 Years-A Six-Year Retrospective Study.

Exposure to plants accounts for approximately 5% of human poisoning cases reported by poison control centers in North America and Europe. The aim of this study was to investigate acute plant poisoning in patients aged 0-18 years admitted to a Romanian pediatric poison center, focusing on epidemiological and clinical aspects. A retrospective observational study was conducted between 2017 and 2022, analyzing medical records for demographic information, clinical features, biological findings, and outcomes. Statistical analysis was performed using Microsoft Excel. 71 patients (aged 7 months to 16 years) presented with acute plant poisoning. Most cases were unintentional (92.9%), peaking during the autumn season. Colocasia (18.3%), Dieffenbachia (9.8%), and Ricinus (5%) were the most frequently involved plants. Gastrointestinal symptoms, especially vomiting, predominated. The Poisoning Severity Score classified most cases as mild (52.1%), with no severe or fatal cases. The mean length of hospitalization was 1.8 days. Unintentional plant exposure, mainly in children under 5 years of age, accounted for more than 90% of cases. Gastrointestinal exposure and symptoms were prevalent, and treatment consisted mainly of symptomatic and supportive measures. Severe and fatal cases were rare, highlighting the generally favorable outcome and low incidence of severe poisoning in the pediatric population.

Evaluation of Global Dystonia Rating Scale as a predictor of unfavorable outcomes among acute antipsychotics poisoned patients

Worldwide, acute antipsychotic poisoning results in high morbidities and mortalities. Though extrapyramidal syndromes are commonly associated, the extent of extrapyramidal syndromes in relation to the severity of antipsychotic poisoning has not been addressed yet. Thus, this study aimed to assess the Global Dystonia Rating Scale (GDRS) as an unfavorable outcomes predictive tool in acute antipsychotic poisoning. A cross-sectional study included 506 antipsychotic-poisoned patients admitted to Tanta University Poison Control Center, Egypt, over three years was conducted. The mean GDRS was 9.1 ± 16.7 in typical antipsychotic poisoning, which was significantly higher than that of atypical antipsychotics (4.2 ± 11.5) (p = 0.003). Patients with GDRS> 20 showed significantly higher liability for all adverse outcomes (p < 0.05). However, poisoning with typical antipsychotics was associated with significantly more cardiotoxicity (p = 0.042), particularly prolonged QRS (p = 0.005), and intensive care unit (ICU) admission (p = 0.000). In contrary to the PSS, which failed to predict the studied adverse outcomes, GDRS significantly predicted all adverse outcomes (p < 0.000) for all antipsychotic generations. In atypical antipsychotics, GDRS above three accurately predicted cardiotoxicities, prolonged QTc interval, and respiratory failure with Area under curves (AUC) of 0.937, 0.963, and 0.941, respectively. In typical antipsychotic poisoning, at higher cutoffs (7.5, 27.5, 18, and 7.5), cardiotoxicities, prolonged QTc interval, and respiratory failure were accurately predicted (AUC were 0.974, 0.961, and 0.960, respectively). GDRS is an objective, substantially useful tool that quantifies dystonia and can be used as an early reliable predictor of potential toxicity in acute antipsychotic poisoning.

Actes auto-agressifs avec substance chez les moins de 18 ans : étude prospective des cas régulés par le centre antipoison et de toxicovigilance de Marseille

ObjectivesTo describe poison exposures in case of self-poisoning subjects younger than 18 years old reported to the Marseille Poison Control Center. Patients and methodThis is a descriptive, monocentric and prospective review of self-poisoning patients aged<18years who reported to the Marseille Poison Control Center from 1st October 2021 to 31st January 2022. ResultsThe 308 subjects included were aged 11 to 17years with an average age of 14.9years (±1.5) for girls and 14.6 (±1.7) for boys (P=0.234). The sex ratio was 0.14. Two hundred and forty patients (77.9%) already had prior psychological or psychiatric follow-up. It was a recurrence of suicide attempts in 43.8% of cases (n=135). The use of an emergency department was almost systematic (n=277, 89.9%). Most of these were mono-intoxications (n=193, 62.7%). The poisonings were in most cases drug-induced (n=281, 91.2%). Analgesics-antipyretics were the most used drug class (n=147 patients, 47.7%), followed by anxiolytics (n=62, 20.1%). Paracetamol proved to be the most ingested substance (n=108, 35.1%). One hundred and six patients remained asymptomatic (34.4%). Of the 308 cases included, 78.6% were hospitalized for an average of four days. Two hundred forty-nine cases (80.8%) had one psychiatric evaluation in an emergency department and 200 (64.9%) will have an appointment for a psychiatric consultation on discharge. DiscussionThe demographic characteristics of young suicides and those of intoxication were globally like those found in the literature although our recurrence rate was higher than those in the literature. More than two years after the start of the SARS-CoV-2 pandemic, the malaise of young people remains while the care offer is already saturated. To reverse the trend by 2027 the French Ministry of Health and Prevention has updated its national prevention strategy by various means. A subsequent study could be interesting to see the impact of these measures. ConclusionThis study is limited but seems to complement some indicators, which shows that the pediatric mental health crisis is worsening, especially among the youngest adolescents who have an increased recurrence rate. We must remain vigilant and continue to implement screening actions and means of prevention, particularly of recurrences.

Self-harm by single- and multi-agent medication poisoning in a retrospective analysis of a Poison Control Center database from January 2018 to December 2022.

Medication poisoning is the most common method of self-harm. Longitudinal studies incorporating pre- and post-COVID-19 pandemic data are required to describe the phenomenon and to evaluate the long-term impact on mental health. Calls to the Poison Control Center of Policlinico Umberto I Hospital - Sapienza University of Rome, Italy, were analyzed retrospectively for characteristics and clinical presentation of cases of interest from January 2018 to December 2022. A total of 756 cases of self-harm by medication poisonings were recorded in the study period. A reduction in rate of cases in 2020 was followed by a return to pre-pandemic levels by 2021. When separately analyzing single- and multi-agent cases, occurrence of cases involving just one medication increased since early 2021, with a peak in 2022 (7.8% of total calls, 95% CI 6.2-9.5, from 4.9%, 95% CI 4.1-5.8 in 2018). This increase in the rate of cases, mostly of none or mild severity, was driven by youth aged 12-21, in which the relative proportion of single- versus multi-agent cases showed an increasing trend since 2020 (from 42.6% in 2018 to 78.6% in 2022). Acetaminophen was the medication most frequently involved and benzodiazepines the largest class. A psychiatric background was increasingly seen in 2022, especially in age group 12-21. Single-agent medication self-harm may be an increasingly prevailing phenomenon. Young adolescents with a psychiatric background might be most vulnerable to this behavior in the COVID-19 pandemic aftermath. Healthcare professionals should expect favorable clinical outcome and improve both counseling and psychotherapy supervision in individuals at risk.

Development and validation of a nomogram for predicting mechanical ventilation need among acutely intoxicated patients with impaired consciousness.

A considerable portion of acutely intoxicated patients is presented with impaired consciousness. Early identification of those patients who require advanced medical care, such as mechanical ventilation (MV), can improve their prognosis. This study included 330 acutely intoxicated patients who were presented with impaired consciousness and admitted to Tanta University Poison Control Center, Egypt, in the period from January 2021 to December 2023. Patients were enrolled in derivation (257 patients) and validation (73 patients) cohorts. Patients' data were analyzed to develop and validate a predictive nomogram to determine the probability of MV need in acutely intoxicated patients. Significant predictors for MV need were mean arterial blood pressure (OR = 0.96, p = .014), PaO2 (OR = 0.96, p = .001), pH (OR = 0.00, p < . 001), and glucose/potassium ratio (OR = 1.59, p = .030). These four parameters were used to formulate a bedside nomogram. Receiver-operating characteristic (ROC) analysis for the proposed nomogram shows that area under the curve (AUC) = 95.7%, accuracy = 93.4%, sensitivity = 88.9%, and specificity = 95.1%. The internal validation for the developed nomogram was assessed using a bootstrapping method and calibration curve. Regarding external validation, AUCs for the developed nomogram probability was 96.5%, and for predicted probability using the developed nomogram was 97.8%. The current study provides a validated nomogram that could be used as a reliable tool for the accurate prediction of MV need among acutely intoxicated patients with impaired consciousness. It could assist in the early identification of patients who will require MV, especially in low-income countries with limited resources.

191. Exploring the Prevalence of Sexual Risk Behaviors in Hospitalized Adolescents Consulted From Siriraj Poison Control Center

191. Exploring the Prevalence of Sexual Risk Behaviors in Hospitalized Adolescents Consulted From Siriraj Poison Control Center

Nationwide Aquatic Envenomations Reported to US Poison Control Centers from 2011 to 2020.

Aquatic envenomations are common injuries along the coastal United States that pose a public health risk and can cause significant morbidity. We examined aquatic envenomation exposures that were called in to poison control centers (PCC) in the United States from 2011 to 2020. The Association of Poison Control Center's (AAPCC) National Poison Data System was queried for all aquatic envenomations reported during the 10 y period from January 1, 2011, to December 31, 2020. Data collected included date, exposure and geographic location, patient age and sex, signs and symptoms, management setting, treatments, and clinical outcome. Duplicated records, confirmed nonexposure, and reports not originating within the United States were excluded. There were 8517 human aquatic envenomations reported during the study period, 62% (5243) of whom were male; 56% (4264) of patients were 30 y or younger. There were an average of 852 calls per year, with 46% of calls occurring during June to August. California, Texas, and Florida had the highest number of envenomations during the study period. Fish (61%; 5159) and Cnidaria (30%; 2519) envenomations were the most common exposures. Overall, 37% (3151) of exposures were treated in healthcare facilities, with no deaths reported. The highest proportion of aquatic envenomations occurred among younger males (≤30 y) during the summer months. While rarely leading to major adverse events, aquatic envenomations were commonly reported injuries to PCC and occurred in all 50 states. Poison control centers continue to be real-time sources of information and data regarding aquatic envenomation trends.

&lt;i&gt;Loxosceles rufescens&lt;/i&gt;: single-institutional epidemiology, diagnosis and treatment

Loxosceles rufescens, also known as “violin spider” due to its characteristic appearance, is a medium-sized spider species that can potentially pose a threat to humans. For this study, patients who presented to our hospital’s Poison Control Center between January 1, 2022, and December 31, 2022, and met the following inclusion criteria were included: Suspicion of a violin spider bite, as evaluated by our center. Our protocol involves an initial local treatment, which includes local washing with copious water and disinfection, along with the application of chlorotetracycline hydrochloride. Systemic therapy utilizes Amoxicillin and Clavulanic Acid as the first-line medication. The primary endpoints of this study are the timing and effectiveness of the treatment for cutaneous lesions. Demographic and anamnestic information regarding age, gender, and timelines was summarized using descriptive methods. Our study’s results indicate that erythema and pain are the most frequent symptoms. Loxoscelism is highly concentrated in the Western hemisphere and is considered the only proven arachnological cause of dermo-necrosis. In recent years, there has been an increase in diagnoses.

Consuming unregulated “diet weed”: The social context of motivations and risk among users of Delta‐8 THC

AbstractA relatively novel, laboratory‐produced, hemp‐derived psychoactive cannabinoid called “Delta‐8 THC” has become widely available to consumers since 2020. Lack of federal oversight and a loose patchwork of regulations by states have resulted in numerous “adverse events” reported by poison control centers and the CDC, and even warnings from the industry itself. Yet consumer demand for cannabinoids like Delta‐8 THC has risen sharply. Published social science studies of Delta‐8 THC use are in their infancy and have yet to document the social context of use, consumer preferences and motivations, behaviors, embodied experiences, perceptions of risk, and risk mitigation. We conducted 25 in‐depth, qualitative interviews with consumers of Delta‐8 THC to give insight into consumer practices and preferences. Data show that consumers of Delta‐8 are aware of supply chain vulnerabilities but deploy personal calculations of risk‐benefit and personal strategies of risk mitigation to reduce perceived threats.