Poison Control Centers Research Articles

Severe childhood poisoning caused by Ferraga practices. Data from the Moroccan Poison Control and Pharmacovigilance Centre.

To highlight the complications associated with the products and practice of healers "Ferraga" who treat young children using traditional Moroccan pharmacopoeia. This is a retrospective analysis of cases of products and practice of "Ferraga" intoxication in young children reported to the Moroccan Poison Control and Pharmacovigilance Center (MPCPC), Rabat, Morocco, from 2010-2020. During the study period, 24 cases of products and practice of "Ferraga" poisoning were reported to MPCPC, Rabat, Morocco. The average age of the patients was 2.48 years. The oral route was noted in 21 cases. The vast majority of patients (23 cases) exhibited symptoms upon admission, predominantly of digestive (16 cases), respiratory (3 cases), and neurological (4 cases). However, 29.16% of patients presented with both digestive and respiratory symptoms, 20.83% had digestive and neurological symptoms, and 4 cases manifested all 3 types of symptoms. The outcome was positive in 18 patients and fatal in 2 infants. Products and practice of "Ferraga" poisoning in children remains a major health problem. It is crucial to implement a strategy to combat this type of practice in order to reduce the prevalence of such poisoning.

A Survey of Melatonin in Dietary Supplement Products Sold in the United States.

In the United States, melatonin products are widely available as dietary supplements. During the past few decades, melatonin products have gained popularity primarily as a sleep aid, with a variety of product forms available for different age groups of consumers. Recent reports have highlighted a rise in melatonin ingestion among children reported to poison control centers. The increased use of melatonin-containing products, the diversity in product forms, and reported label discrepancies has emphasized the need for additional research to better understand the marketplace. This work aims to measure melatonin content in products sold as dietary supplements and marketed for children, evaluate method performance across different product categories, and determine if product form has an impact on melatonin stability. One hundred ten (110) dietary supplement products labeled to contain melatonin and marketed towards children were purchased and analyzed using a targeted LC-MS/MS method validated for the qualitative determination of serotonin and quantification of melatonin, N1-acetyl-N2-formyl-5-methoxykynuramine (AFMK), and N1-acetyl-5-methoxykynuramine (AMK). Melatonin was identified in 108 of 110 products (98%) with a median concentration of 1.2 mg/g (range: 0.017-130 mg/g) or 1.7 mg/serving (range: 0.042-50 mg/serving). Further, in the tested products, melatonin content ranged from 0% to 667% of the label declaration. This study provides evidence to inform safety assessments and investigate potential factors that may influence reported concentrations, such as product stability and matrix influences.

The trajectory of serum salicylate concentrations after ingestion of medicinal oil containing methyl salicylate

Introduction The toxicokinetics of methyl salicylate after unintentional or intentional ingestion of medicinal oil containing methyl salicylate has not been well studied. We aimed to characterize the trajectory of serum salicylate concentrations and to evaluate factors associated with the peak serum salicylate concentration and the time from ingestion to peak concentration. Methods This was a retrospective cohort study of consecutive patients reported to the Hong Kong Poison Control Centre for laboratory-confirmed methyl salicylate poisoning by all local public emergency departments between 1 July 2008 and 30 June 2023. We analyzed cases with at least three serum salicylate concentrations. Multivariable generalized linear regression was used to identify factors significantly associated with the peak serum concentration and the time from ingestion to peak concentration. Results We included 41 patients (median age 81.0 years; 32 women and nine men). The median time from ingestion to the first peak serum salicylate concentration was 5.6 h (IQR: 3.2–10.8 h). Multiple regression showed that gastric aspiration (adjusted regression coefficient [β] − 2.50; 95% CI: −3.93 to −1.08; P = 0.001) and single-dose activated charcoal (adjusted β − 1.22; 95% CI: −2.02 to −0.42; P = 0.003) were significantly associated with a lower peak concentration, after adjusting for patient age, sex, exposure due to intentional self-harm, reported ingested dose, time from ingestion to emergency department presentation, vomiting, concurrent use of aspirin (acetylsalicylic acid) and other medications that affect gastric emptying or gastric acid secretion, blood pH, serum albumin concentration, and creatinine clearance. Discussion The serum salicylate concentration did not peak as quickly as generally believed, highlighting the importance of continued monitoring. Gastric aspiration and single-dose activated charcoal may help reduce gastrointestinal absorption, but their impact on clinical outcomes remains unclear. Conclusions Given the median time of 5.6 h (IQR: 3.2–10.8 h) from ingestion to the peak salicylate concentration, gastric aspiration and single-dose activated charcoal can be considered in patients up to a few hours after medicinal oil ingestion when the airway is protected.

Epidemiologic and clinical features of cyanobacteria harmful algal bloom exposures reported to the National Poison Data System, United States, 2010–2022: a descriptive analysis

BackgroundHarmful algal bloom occurrences have been increasingly reported globally and over time. Exposure to the variety of toxins and co-contaminants that may be present in harmful algal blooms can cause illness and even death. Poison control data is a valuable public health information source that has been used to characterize many types of toxin exposures, including harmful algal blooms. Prior studies have been limited by location and time, and knowledge gaps remain regarding cyanobacteria harmful algal bloom (cyanoHAB) exposure circumstances, and the breadth and severity of associated clinical effect.MethodsThe objective of this study was to characterize epidemiologic and clinical features of cyanoHAB exposure cases reported to 55 US poison control centers and available in the National Poison Data System (NPDS). We identified 4260 NPDS cyanoHAB exposure cases reported from 2010 to 2022, including symptomatic exposure cases with and without clinical effects related to the exposure and asymptomatic exposure cases. We assessed demographics; exposure routes, locations, chronicity; clinical effects; and medical outcomes. We calculated case rates annually and 13-year case rates by US geographic division.ResultsOver half of cyanoHAB exposure cases were children < 20 years old (n = 2175). Most cyanoHABs exposures occurred in a “public area” (n = 2902, 68.1%); most were acute (≤ 8 h) (n = 3824, 89.8%). Dermal and ingestion routes and gastrointestinal effects predominated. 2% (n = 102) of cases experienced a moderate or major medical outcome; no deaths were reported. National rates increased from 0.4 cases/1 million (1 M) person-years in 2010 to 1.4 cases/1 M person-years in 2022. The Mountain division had the highest 13-year rate (7.8 cases/1 M person-years).ConclusionsCyanoHAB exposure case rates increased 2010–2022, despite a decrease in all-cause exposure cases during the same period. NPDS data provide valuable public health information for characterization of cyanoHAB exposures, an emerging public health challenge.

Treatment response and clinical features of snakebite envenomation in Alborz province, Iran: A cross-sectional study.

Snakebite envenomation is a significant yet neglected public health burden. Our aim was to investigate the clinical and demographic factors of snakebite envenomation, as well as the factors associated with its severity and response to treatment, in Alborz province, northern Iran. In this cross-sectional study, we included 50 patients diagnosed with snakebite envenomation, referring to the Poison Control Centre of Alborz University of Medical Sciences. The presenting signs and symptoms, demographic data, treatment dose, response to treatment, complications, laboratory findings, and snakebite severity scale (SSS) were collected. Forty-six patients (92%) were men, the total mean age was 31.7 ± 12.06 years, and mean SSS was 6.54 ± 3.39. The patients were admitted for a median of 2 days, and 11 patients needed ICU admissions. The majority of snakebites were in upper extremities (60%) and they mainly occurred in summer (56%). SSS was significantly associated with response to treatment, ICU admission, gastrointestinal adverse events, thrombocytopenia, and length of stay. Similarly, response to treatment was significantly related to the history of snakebite, ICU admission, gastrointestinal adverse events, thrombocytopenia, length of stay, and SSS. Gastrointestinal symptoms, higher severity scores, and longer hospital stays were associated with poor treatment response. Importantly, no mortality was observed in this cohort. Further research is needed to confirm these findings and optimize treatment strategies for snakebite management.

Serum glucose/potassium ratio as an indicator of early and delayed outcomes of acute carbon monoxide poisoning.

Carbon monoxide (CO) poisoning is a major health problem associated with a high rate of severe morbidity and mortality. This study aimed to evaluate the validity of the serum glucose/potassium (Glu/K) ratio as a quick predictor of both early and delayed unfavorable outcomes following acute CO poisoning. This prospective cohort study included 136 patients with acute CO poisoning admitted at Tanta Poison Control Center, Egypt, between January 2023 and June 2024. The serum Glu/K ratio was calculated for all patients. The primary outcome was a prediction of mortality. Secondary outcomes were the prediction of delayed neurological sequelae (DNS) within six months after CO exposure, the need for mechanical ventilation, and the need for hyperbaric oxygen. A receiver operating curve analysis was applied to test the performance of the Glu/K ratio in predicting acute CO poisoning outcomes. The mortality rate was 12.5% of patients with acute CO poisoning. Meanwhile, 14.7% of patients developed DNS. Furthermore, mechanical ventilation was required in 16.9% of patients. An elevated Glu/K ratio was significantly associated with the severity of acute CO poisoning. At a cut-off value of >31.62, the Glu/K ratio demonstrated an AUC of 0.649 for predicting mortality. The Glu/K ratio was employed to predict DNS at a cut-off value of 33.10, with a sensitivity of 60.0%, a specificity of 82.76%, and an AUC of 0.692. Early Glu/K ratio may be an effective, reliable, and convenient laboratory predictor of mortality, DNS, and the need for mechanical ventilation in patients with acute CO poisoning.

Preventing Pediatric Opioid Poisoning: Unusual Sources and Scenarios

This retrospective study analyzed 230 pediatric opioid exposures from a statewide poison control center over a 5-year period. Most exposures involved pharmaceutical opioids and children under two-years-old. Narrative details were reviewed to identify uncommon sources of opioids involved in poisoning and highlight the need for tailored prevention strategies and guidance.

Assessment of co-ingestion effects on poisoning patterns, drug-drug interactions, and adverse outcomes in acute toxic exposure

Multiple toxic exposures are increasing nowadays. In cases of acute poisoning involving multiple agents, there is a potential for additional toxicity that goes beyond the effects and toxicity of each drug. Very scarce studies have investigated the problem of multiple toxic exposures where the information on drug-drug interactions (DDIs) originates from clinical experience, which is inconclusive and cannot be generalized to patients. Therefore, the current study aimed to explore the influence of co-ingestion on the clinical presentation of exposed patients and to identify the common associated DDIs and their effect on poisoning outcomes, including the need for mechanical ventilation (MV), intensive care unit (ICU) utilization, and prolonged hospital stay. The current study is a retrospective cross-sectional study that was conducted using medical records of 169 adult patients admitted to a poison control center and diagnosed with acute drug poisoning. Of them, 40.8 % were exposed to multiple drugs. The total number of drugs reported in the current study was 320 preparations, with an average of 1.9 drugs per patient. There were about 726 potential DDIs; more than half of these interactions were significant (n = 486). Antidepressants and psychotropics showed the highest total number of DDIs. Patients with multiple ingestion were significantly older and this pattern of exposure was more frequent among suicidal attempters, substance abusers, cardiac patients, and patients diagnosed with neurological and psychological problems. Moreover, patients with multiple ingestions showed severe presentations indicated by higher grades of Poison Severity Score and lower Glasgow Coma Scale. Multiple ingestion was associated with higher liability for MV, ICU admission, and prolonged length of hospital stay (p < 0.001). There was a significant moderate direct correlation between the number of drugs consumed and the number of resulting DDIs (r = 0.542, p < 0.001). There was a significant direct correlation between the occurrence of significant chronic/chronic drug interactions from one side and the history of substance abuse (r = 0.596, p = 0.041) and psychological illness (r = 0.662, p = 0.019) from the other side. Moreover, significant acute/acute drug interactions were correlated with being male (r = 0.969, p < 0.001) of older age (r = 0.672, p = 0.024). Similarly, significant acute/chronic drug interactions were moderately correlated with being a male (r = 0.692, p = 0.013). The presence of epilepsy and psychological problems were the main significant predictors of multiple acute toxic exposures. Among the patients exposed acutely to more than one agent who were on long-term treatment, exposure to three drugs or more could significantly predict the need for MV with excellent area under the curve (AUC) of 0.896 and 77.0 % accuracy. Moreover, and it was a fair predictor of ICU admission (AUC = 0.625), with an 88.9 % ability to exclude patients unlikely to need ICU admission. Particular attention should be paid to the patients at risk of potential DDIs. When prescribing drugs, the minimum number of drugs with the lowest effective doses, and minimal potential DDIs should be prioritized.

Predictors of Serotonin Syndrome in Acute Poisoning with 5-Hydroxytryptamine Modulators.

5-Hydroxytryptamine (5-HT) modulators are commonly prescribed medications with potentially life-threatening outcomes, particularly serotonin syndrome (SS). Early prediction of SS is critical not only to avoid lethal drug combinations but also to initiate appropriate treatment. The present work aimed to recognize the significant predictors of SS through a retrospective cross-sectional study that was conducted among patients exposed to an overdose of 5-HT modulators and admitted to a poison control center where 112 patients were enrolled. Of them, 21 patients were diagnosed with SS, and 66.7% of patients with SS were exposed to long-term co-ingestion. There was a noticeable surge in SS between April and May, and 52.4% of patients who suffered from SS were admitted after suicidal exposure (p < 0.05). Patients with SS showed severe presentation indicated by high-grade poison severity scores (PSS) and low Glasgow coma scales (GCS). PSS was a significant predictor of SS with an area under the curve of 0.879. PCO2, pulse, GCS, HCO3, and erythrocytic count were other significant predictors of SS. Combinations of serotonergic agents increase the likelihood of developing SS. Clinicians should be vigilant when prescribing a combination of serotonergic therapy, particularly for patients on illicit sympathomimetic and over-the-counter medications like dextromethorphan.

Trends in poisoning associated with the use of insecticides for bed bug infestations: a 20-year retrospective study in France

Bed bugs are pervasive global pests that have reemerged in the last 20 years as a significant public health concern, especially in densely populated urban areas. Beyond financial losses, expenses, inconvenience, and psychological distress, bed bug infestations often necessitate chemical management, posing poisoning risks to those with an infestation. The French Poison Control Centers recorded 1056 cases of exposure to bed bug insecticide products between 1999 and 2021. This study followed cases over 2007–2021, with a notable surge in reports of adverse reactions from 2016 onwards. Data revealed an increased recurrent misuse of insecticides, including substances banned or not approved for this use. Our findings underscore the growing public reliance on chemical insecticides for home bed bug management. With this is the concern of increased poisoning risks, and potential long-term health consequences from non-professional efforts by the public to manage bed bugs in their homes. This escalating trend emphasizes the need for safer and more sustainable pest management strategies in urban environments.

Evaluation of the Role of Neutrophil to Lymphocyte Ratio, Platelet to Lymphocyte Ratio and Mean Platelet Volume as Predictors of the Outcome in Patients with Hemotoxic Snake Bite: A Prospective Study on Patients in Poison Control Centers Ain Shams University Hospitals and Assiut University Hospitals

Abstract Background Snakebite envenomation is considered a major health problem especially in developing centuries. Snakebite envenomation cause major morbidities, disabilities and mortalities. Novel biomarkers as; neutrophils to lymphocytes Ratio (NLR) and plateletto lymphocytes Ratio (PLR)are hematological inflammatory indices that can be a guide for diagnosis, prognosis of the snakebite envenomation. Methodology This was a prospective case control study, which was carried out on 60 hemotoxic snake bite envenomed patients that admitted at Poisoning Control Center AinShams University Hospitals (PCCAUH) and Assiut University Hospitals (AUH) in the period from 1st of July 2019 to 31st of October 2021. In addition, 60 healthy volunteers were used as control subjects. The study aimed to evaluate the role of NLR, PLR and Mean Platelet Volume (MPV) at admission as predictors of the outcome in patients with hemotoxic snakebite envenomation. The patients were divided into mild, moderate and severe groups according to severity of snake envenomation. Result Sixty hemotoxic snake bite envenomed patients (28 patients admitted at PCC-ASUH and 32 admitted at AUH), were divided into (38.4%) mild, (31.6%) moderate and (30%) severe groups according to the severity of snake envenomation. Maximum incidence was found in male (95%) from rural areas (80%) and were farmers (43.3%) from total cases. It was observed that bite was more frequent at lower limbs (70%), outdoors (81.6%), at night (51%) and during autumn season (43.3%). It was found that there was significant positive correlation between NLR at admission and duration of hospitalization, PLR, creatine phosphokinase (CPK) level and whitebloodcells (WBCs) count. While, significant negative correlation was found between NLR and prothrombin concentration (PC), red blood cells(RBCs) and plateletcounts. Also, significant positive correlation was found between PLR at admission and duration of hospitalization, NLR, CPK level and platelets count. Inaddition, significant positive correlation was found between MPV and PT. About 47 (78.33%) patients had complete recovery and about 13 (21.67%) patients recovered with complications including; local complications in (21.67%), systemic complications in (13.33%) and chronic complications In (5%). There were no recorded deaths in the study. It was found that hemotoxic snake bit eenvenomed patients Admitted at PCC-ASUH were significantly more severe,required more antivenom vials and more intensive care unit(ICU) admission than those admitted at AUH. Conclusion NLR and PLR values at admission were significantly high in hemotoxic snake bite envenomed patients and can be used as predictors for diagnosis and prognosis of hemotoxic snake envenomation.In addition, NLR and PLR had significant association with severity of envenomation, duration of hospitalization.

Assessment of the Role of Keratin 18 and High Mobility Group Box 1 Biomarkers for Early Prediction of Drugs and Chemicals Induced Hepatotoxicity A Prospective Study in the Poison Control Center of Ain Shams University Hospitals (PCC-ASUH)

Abstract Background Drug-induced hepatotoxicity represents a major clinical problem worldwide. Hepatotoxicity may be caused by drugs, chemicals used in laboratories and industries or natural products and rodenticides such as metal phosphides. Early identification of hepatotoxicity would facilitate patient- individualized treatment strategies. New biomarkers (HMGB1and K18) used to identify subsequent acute liver injury (ALI) in patients on admission to the hospital. Objectives This study aims to assess the role of keratin 18 and high mobility group box 1 biomarkers in early prediction of drugs and chemicals induced hepatotoxicity for better outcome and to compare these new liver biomarkers with the currently used parameters (ALT &amp; AST) in the early prediction of drugs and chemicals induced hepatotoxicity. Methods This prospective study was conducted on 50 adult patients of both sex presented to the PCC- ASUH with acute intoxication of hepatotoxic drugs or chemicals. For all patients, we measured high mobility group box-1 (HMGB1), keratin-18 (K18), AST and ALT on admission then patients were followed- up for development of liver injury . Subjects were classified into group I (control group), group II (no liver affection) and group III (with liver affection). Receiver operator characteristic (ROC) curve was used to compare sensitivity and specificity to report liver injury versus alanine transaminase (ALT) and aspartate transaminase (AST). Results This study showed that HMGB1 and K18 were much more elevated in patients who developed liver injury in the first hospital presentation when ALT and AST were within normal ranges with a highly significant difference between the hepatotoxic and non-hepatotoxic group. ROC analysis showed that HMGB1 and K18 were more sensitive than ALT and AST and more specific than AST in predicting ALI. Conclusion Elevations in plasma HMGB1, and K18 identified subsequent ALI development in patients on admission to the hospital, soon after drug and chemical overdose, and in patients with ALT and AST in the normal range.

Development of a risk prediction nomogram for delayed neuropsychiatric sequelae in patients with acute carbon monoxide poisoning

Objectives Delayed neuropsychiatric sequelae (DNS) are critical complications following acute carbon monoxide (CO) poisoning that can substantially affect the patient’s life. Identifying high-risk patients for developing DNS may improve the quality of follow-up care. To date, the predictive DNS determinants are still controversial. Consequently, this study aimed to construct a practical nomogram for predicting DNS in acute CO-poisoned patients. Methods This retrospective study was conducted on patients with acute CO poisoning admitted to the Tanta University Poison Control Center (TUPCC) from December 2018 to December 2022. Demographic, toxicological, and initial clinical characteristics data, as well as laboratory investigation results, were recorded for the included patients. After acute recovery, patients were followed up for six months and categorized into patients with and without DNS. Results Out of 174 enrolled patients, 38 (21.8%) developed DNS. The initial Glasgow Coma Scale (GCS), carboxyhemoglobin (COHb) level, CO exposure duration, oxygen saturation, PaCO2, and pulse rate were significantly associated with DNS development by univariate analysis. However, the constructed nomogram based on the multivariable regression analysis included three parameters: duration of CO exposure, COHb level, and GCS with adjusted odd ratios of 1.453 (95% CI: 1.116–1.892), 1.262 (95% CI: 1.126–1.415), and 0.619 (95% CI: 0.486–0.787), respectively. The internal validation of the nomogram exhibited excellent discrimination (area under the curve [AUC] = 0.962), good calibration, and satisfactory decision curve analysis for predicting the DNS probability. Conclusions The proposed nomogram could be considered a simple, precise, and applicable tool to predict DNS development in acute CO-poisoned patients.

Construction of a Crucial Score to predict the Outcome of Patients with Aluminum Phosphide Poisoning at the Poison Control Center - Ain Shams University Hospitals

Construction of a Crucial Score to predict the Outcome of Patients with Aluminum Phosphide Poisoning at the Poison Control Center - Ain Shams University Hospitals

Evaluation of The risk Factors Influencing The prognosis of Elderly Patients with Acute Poisoning Admitted to Poison Control Center, Ain Shams University Hospitals during 2022

Evaluation of The risk Factors Influencing The prognosis of Elderly Patients with Acute Poisoning Admitted to Poison Control Center, Ain Shams University Hospitals during 2022

“Assessment of Medical Documentation Process in Poison Control Center Ain Shams University’’

“Assessment of Medical Documentation Process in Poison Control Center Ain Shams University’’

Assessment of B-type natriuretic peptide as an early predictor of mortality in acutely poisoned patients with cardiotoxicities.

Cardiotoxicity is a major toxic effect induced by several types of drugs. An electrocardiogram is done routinely in cardiovascular drug exposures. Cardiac troponin I (cTnI) is the usual biomarker for diagnosing myocardial injury. B-type natriuretic peptide (BNP) is a well-established predictor of disease state in suspected heart failure. The study aimed to assess BNP's role as an early predictor of mortality compared with cTnI and ECG changes in acutely poisoned patients with cardiotoxicities. This study enrolled 70 patients with acute cardiotoxicity by drugs and toxins known to cause cardiac injury admitted to Tanta University Poison Control Center (TUPCC). Collected data included socio-demographic data, toxicological history, vital signs, ECG changes, Poison Severity Score (PSS), BNP, and cTnI serum levels. Patients were classified as survivors and non-survivors. Significantly more delay time was recorded in non-survivors. Moreover, vital signs were significantly abnormal in non-survivors. There was no statistical significance regarding the initial ECG abnormalities between survivors and non-survivors. BNP and cTnI levels were significantly higher among non-survivors. For mortality prediction, BNP had good predictive power (AUC=0.841) with 100% sensitivity and 79.7% specificity while cTnI had an acceptable predictive power (AUC=0.786), with 83.3% sensitivity and 78.1% specificity with insignificant difference between both biomarkers. BNP and cTnI levels can predict mortality in acute cardiotoxicity compared to ECG which has no statistically significant prediction. BNP has a higher discriminatory power than cTnI for the prediction of mortality.

Validity of different scoring systems in prediction of intensive care unit admission and mortality in acute organophosphate poisoning.

Organophosphate compounds (OPCs) pose significant health risks, especially in developing countries with limited resources. Predicting outcomes in OPCs poisoning is crucial for guiding clinical management and reducing mortality rates. The aim of this study to evaluate the validity of different scoring systems Rapid Emergency Medicine Score, Multiple Organ Dysfunction Score, Acute Physiology and Chronic Health Evaluation Score, and Poison Severity Score in prediction of intensive care unit (ICU) admission and mortality of acute OPCs poisoning patients. A cross-sectional study was conducted on 103 patients admitted to Xx Poison Control Center between May 2022 and June 2023. Scoring systems were applied at admission, and their performance in predicting the need for ICU admission and mortality was evaluated using receiver operating characteristic (ROC) curve analysis. Most patients survived (92.2%). Only 13.6% of the patients required ICU admission. Significant differences in median scores were observed between survivors and non-survivors and between patients requiring ICU admission and those who did not. Multiple Organ Dysfunction Score exhibited the highest discriminatory power for predicting both ICU admission (AUC=0.983) and mortality (AUC=0.999). The findings highlight the importance of utilizing scoring systems, particularly Multiple organ dysfunction score, for prediction of poor outcomes of acute OPCs poisoning.

The synthetic cathinones MDPHP and MDPV: Comparison of the acute effects in mice, in silico ADMET profiles and clinical reports

The 3,4-methylenedioxy-alpha-pyrrolidinohexanophenone (MDPHP) is a synthetic cathinone closely related to 3,4-methylenedioxypyrovalerone (MDPV), one of the most common synthetic cathinones present in the “bath salts”. MDPHP has recently gained attention due to increasing seizures and involvement in human intoxications which occurred in Europe and Italy in the last years, but currently there is a lack of information about its pharmaco-toxicological effects. With the aim at filling this gap, the present study is endeavoured to (i) evaluate the effects of acute administration of MDPHP (0.01–20 mg/kg; i.p.) on behaviour, cardiorespiratory and cardiovascular parameters in CD-1 male mice, comparing them to those observed after administration of MDPV; (ii) predict the ADMET profile of the two analogues using the Plus ADMET Predictor®; (iii) present clinical data related to MDPHP and MDPV-induced intoxications recorded between 2011 and 2023 by the Pavia Poison Control Centre (PCC) − National Toxicology Information Centre (Istituti Clinici Scientifici Maugeri, IRCCS Pavia, Italy). Our results substantiated that MDPHP and MDPV similarly affect sensorimotor and behavioural responses in mice, importantly increased locomotion and induced aggressive behaviour, and, at higher dosage, increased heart rate and blood pressure. These findings are in line with those observed in humans, revealing severe toxidromes typically characterized by Central Nervous System (CNS) alterations (behavioural/neuropsychiatric symptoms), including psychomotor agitation and aggressiveness, cardiovascular and respiratory disorders (e.g. tachycardia, hypertension, dyspnoea), and other peripheral symptoms (e.g. hyperthermia, acidosis, rhabdomyolysis).

Un caso di botulismo infantile

A 6-month-old infant had been presenting with weak sucking and reduced spontaneous limb movements for a week. He had constipation problems for 4 days followed by hard stool. Upon admission, blood tests including metabolic screening and instrumental investigations were performed. Upon further inquiry into the family history, it was discovered that the father works as a mason. Due to suspicion of infant botulism, the Poison Control Center Unit of Pavia was contacted, and a faecal sample was sent to the Brescia Zooprophylactic Institute, which tested positive for Clostridium bacteria that produce botulinum toxin subtype B. The infant did not require respiratory or nutritional support. Antitoxin therapy was not initiated, and the infant was discharged upon negative test results. Botulism is a neuroparalytic disease characterized by acute symmetric descending flaccid paralysis caused by neurotoxin. The pathogenetic mechanism involves the botulinum toxin inhibiting the formation of the SNARE complex, crucial for the release of neurotransmitters at the neuromuscular junction.