Cases Of Poisoning Research Articles

N-Ethylhexedrone: A very long and bad trip! A case series.

N-ethylhexedrone (NEH) is a new cathinone derivative with, currently, low toxicokinetic and toxicodynamic knowledge. We present three documented clinical cases of NEH intoxication with plasma and urine concentrations. A thorough search for metabolites was performed. The three patients were admitted to the emergency department, and two out of the three were hospitalized for an extended period. While recovering from the drug effects, 12-24 h after nasal intake of New Psychoactive Substance (NPS), the patients described the following disorders: anxiety, feelings of persecution, asthenia, anhedonia, abulia, psychomotor slowing and loss of consciousness. NEH was identified in all samples by liquid chromatography-high resolution mass spectrometry (LC-HRMS), and quantified by liquid chromatography coupled to tandem mass spectrometry (LC-MS-MS). Quantitative analysis showed decreasing concentrations over time: for Case 1, from 97.2 (Day 1, D1) to 0.7 (Day 7, D7) µg/L for plasma, and from 724 (D1) to 0.5 (D7) µg/L for urine. NEH concentration of 7.9 µg/L was found in the plasma collected at admission for Case 2. For Case 3, concentrations ranging from 49 (D1) to 1.8 (D7) µg/L in plasma, and from 327.3 (Day 6, D6) to 116.8 (D7) µg/L in urine were found. NEH was no longer detected in the urine sample at Day 10. Elimination half-life was estimated at 19, and 28 hours in Patients 1 and 3, respectively. Four metabolites were identified in blood and urine: reduced NEH, dealkyl-NEH, reduced dealkyl-NEH and hydroxy-NEH. The cases presented highlight the long detectable lifetime of NEH. Characterization of the metabolites will allow better identification of the consumption of this drug. Serious adverse events can be observed after NEH consumption, as two out of the three patients required intubation and ventilation. A syndrome of inappropriate antidiuretic hormone secretion (SIADH) was also diagnosed. Two out of the three cases are notable because of the number of samples collected and because NEH was the only drug of abuse detected.

#3073 Should we expand the indications for hemodialysis in lithium intoxications beyond the EXTRIP recommendations?

Abstract Background and Aims EXTRIP Workgroup (EW) recommends renal replacement therapy (RRT) in lithium poisoning when serum lithium levels >4 mmol/l in cases of impaired kidney function, decreased consciousness, seizures or dysrhythmias, and suggests RRT in cases of serum lithium >5 mmol/l or when there is confusion or the expected time to obtain lithium levels <1 mmol/l with optimal management exceeds 36 hours. The aim of this study was to assess the benefit of RRT in the conditions recommended and suggested by the EW, and evaluate the benefit from RRT in other conditions of lithium poisoning. Method We conducted a retrospective mutli-centre observational study that included patients with a diagnosis of lithium poisoning from January 2006 to December 2022. Demographic data, kidney function and comorbidities, clinical presentation including neurologic, cardiac and renal manifestations, type of intoxication, previous poisonings or concomitant intake of other toxic substances and treatments used were registered. In patients receiving RRT, the type of RRT, duration and number of sessions were registered. Lithium levels during hospitalization were recorded, and time for lithium levels <1 mmol/l was calculated. The primary outcomes were death from lithium poisoning and persistent neurologic deficits (syndrome of irreversible lithium-effectuated neurotoxicity, SILENT). Results The study included 179 cases of lithium poisoning (62.6% chronic lithium poisoning, 34.6% acute on chronic and 2.8% acute poisoning),with a mean age of 56.3 ± 15.4 years, and patients were predominantly females (57%). 130 patients (72.6%) presented neurological manifestations, out of which 33 patients (18.4%) presented a decreased conscious level or generalized convulsions, and 40 patients (22.3%) presented confusion. 98 patients (54.7%) presented acute kidney injury (AKI) and 21 patients (11.7%) presented life-threatening dysrhythmias. 68 patients (38%) were treated with RRT. 31 patients (17.3%) developed persistent neurological deficits (SILENT) and only 2 patients (1.1%) died of lithium poisoning during hospitalization. Concerning patients in whom hemodialysis was recommended according to EW guidelines, only 34 out of 53 patients (64.2%) received RRT. In this group of patients, those who received RRT developed less frequently SILENT (11.8% vs 36.8%, p = 0.031) Regarding patients in whom hemodialysis is suggested according to EW, only 34 out of 106 patients (32.1%) received RRT. Overall, combining patients in whom dialysis is recommended or suggested according to EW, SILENT developed less frequently in those who received RRT (13.2% vs 20.4%) Beyond the recommendations by the EW, we found that patients with lithium levels > 2 mEq/l with AKI and any neurological manifestations presented less frequently SILENT when receiving RRT (7% vs 26%, p = 0.033). We also observed that patients who received RRT had a shorter in-hospital stay (3.3 [IQR 2-7] days vs 9.4 [IQR 5-11] days, p = 0.01). Conclusion Patients presenting with lithium poisoning and impaired kidney function or any neurological manifestations who received RRT presented less frequently persistent neurologic deficits (SILENT) after discharge, regardless of lithium levels or type of poisoning. We suggest that EXTRIP should recommend RRT in any patient with lithium poisoning who presents with neurological symptoms or impaired kidney function, regardless of lithium levels.

Heavy metal poisoning caused by Chinese folk remedies in psoriasis patients: a retrospective analysis

Psoriasis, characterized as a chronic relapsing disease with a protracted course, often drives patients to seek relief through Chinese folk remedies (CFR). Nonetheless, the complex compositions of these remedies frequently result in unintended adverse effects, notably various types of heavy metal poisoning. Our study involved an exhaustive collection and analysis of clinical data from psoriasis patients who developed heavy metal poisoning due to CFR usage, admitted to Beijing Chao-Yang Hospital from January 2011 to October 2023. Our analysis identified 44 cases of mercury poisoning, 17 of lead poisoning, 21 of arsenic poisoning, and 4 instances of mixed heavy metal poisoning. The folk remedies used ranged from fumigation and inhalation to skin application and oral administration. Distinct pathogenic characteristics were observed in each poisoning type. After treatment with metal chelating agents, all patients experienced a reduction in heavy metal levels in their bodies, accompanied by varying degrees of symptom alleviation. This study underscores the vital necessity of opting for formal, medically approved treatments for psoriasis, thereby avoiding the hazardous consequences of unregulated folk remedies that may lead to severe heavy metal poisoning.

#2507 Enhancing critical care nephrology: analyzing continuous renal replacement therapy with a citrate-based anticoagulation focus

Abstract Background and Aims Continuous renal replacement therapy (CRRT) is pivotal for managing acute kidney injury (AKI) unstable patients. However, questions persist regarding prescription and the role of anticoagulation. This study aims to examine CRRT practices, focus on citrate-based anticoagulation and clarify contraindications. Method This study comprises a retrospective analysis of a patient cohort requiring CRRT and admitted to the Postoperative Intensive Care Unit and Burn Unit. Inclusion criteria involved the need for CRRT and adult age, with exclusion criteria based on treatment duration (<48 hours), reducing the initial cohort from 256 to 176 patients. Clinical variables, including gender, age, underlying pathology, CRRT modality, and anticoagulation type, were characterized. Subsequently, the association between anticoagulation type and clot formation within 48 hours and in-hospital mortality was investigated. Furthermore, an analysis of citrate-based CRRT was conducted, evaluating laboratory values (Table 1) at the beginning and 48 hours using the Wilcoxon test, and their correlation with clot development and mortality. Additionally, we used a logistic regression model to explore the relationship between AST, ALT, and lactate values with citrate accumulation. Finally, a survival analysis was conducted. Results The sample consisted of 66.5% males and 33.5% females, with an average age of 59.48 years. Reasons for admission are depicted in Fig. 1. CRRT modalities were 20.5% HDVVC, 76.1% HDFVVC, and 3.4% HFVVC. Anticoagulation included 35.2% none, 28.4% heparin, 33.5% citrate, and 2.8% alprostadil. Filter clotting occurred in 29.1% withing 48 hours. Heparin was associated with a 5.4-fold increased risk of clotting compared to citrate. Mortality was 63.3%, with no anticoagulation type showing a significant association. Parameters at CRRT initiation and 48 hours for citrate-based CRRT patients and Wilcoxon test results are presented in Table 1. Only 5.1% had filter clotting <48 hours, and no baseline parameters were significantly associated with an increased clotting risk. There was one case of citrate intoxication due to a programming error, which was not included. 76.81% had CaT/CaI <2.1, and 7.25% had CaT/CaI >2.1, requiring technique adjustments. Aminotransferases and lactate values, often considered as contraindications for citrate, were analyzed: The average AST and ALT values were 188.53 IU/l and 108.08 IU/l, respectively. When AST levels exceeded 5 times the normal range and ALT levels exceeded 3 times the normal range, a statistically significant association with CaT/CaI >2.1 at the 48-hour mark of CRRT utilization was observed (p < 0.001 for both).The average lactic acid value was 1.74 mg/dl. Having a lactic acid level >4 was associated (p < 0.05) with a higher risk of developing CaT/CaI >2.1. 54.2% of the sample died. No baseline parameters were significantly associated with it. At 48 hours, higher bicarbonate levels and metabolic alkalosis were associated with increased mortality (p < 0.05). The median survival time was 11 days (±4.38). Conclusion This study supports the use of citrate-based anticoagulation in CRRT, as no cases of citrate intoxication (CaT/CaI >2.5) were found. Nonetheless, a significantly elevated AST (>5 times normal), ALT (>3 times normal), and lactate (>4 mg/dl), were associated with a higher risk of citrate accumulation (CaT/CaI >2.1). Customized approaches and preventive measures to mitigate the development of metabolic alkalosis are essential for optimizing patient outcomes.

Patterns of acute chemical poisoning cases registered with the Spanish Toxicovigilance System between 2015 and 2019

Patterns of acute chemical poisoning cases registered with the Spanish Toxicovigilance System between 2015 and 2019

Two cases of pyridaben poisoning were successfully treated by blood purification

Pyridaben is a broad-spectrum acaricide widely used in agriculture, accidental or self-administration of large doses of pyridaben can cause multiple organ failure in patients. Due to its damage to multiple organs and no specific antidote, the mortality rate is high. This paper reports two patients who took a large amount of pyridaben, developed severe metabolic acidosis, hyperlactatemia, toxic encephalopathy, and liver, kidney, heart and digestive tract damage. After timely gastric lavage, catharsis, organ support andblood purification treatment, the condition improved and discharged. It is expected to provide clinical ideas for the treatment of pyridaben poisoning.

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.

Revolutionising pesticide detection: a high-sensitivity electrochemical sensor with CdS/g-C3N4/MWCNTs for paraquat monitoring

ABSTRACT Over a decade, the Malaysia National Poison Centre found that 40% of pesticide poisoning cases may be linked to excessive paraquat (PQ) in water, soil, or food, underscoring the widespread impact on public health and emphasising the importance of detecting even trace amounts of PQ residues in the environment. Thus, this study presents a novel electrochemical sensor based on multiwalled carbon nanotubes (MWCNTs) reinforced cadmium sulphide co-anchoring on graphitic carbon nitride (CdS/g-C3N4) nanocomposites for PQ detection. The CdS/g-C3N4 nanocomposite was successfully synthesised and characterised through FTIR, XRD, EDX, FESEM and TEM analysis. The modified electrode (CdS/g-C3N4/MWCNTs PE) exhibited improved electrocatalytic activity, as demonstrated by cyclic voltammetry (CV) and impedance spectroscopy. The CdS/g-C3N4/MWCNTs PE displayed a high CV peak and low Rct value which corresponded to a higher electron transfer rate, reduced charge transfer resistance and enhanced mass transport properties. The electrochemical sensor’s performance was evaluated for the detection of PQ, and it demonstrated a linear response in a range of 1.0 µM to 0.1 mM with a limit of detection of 0.14 μM. Furthermore, the sensor exhibited selectivity with a less than 16% potential interference from various organic chemicals and inorganic ions. The sensor’s applicability was tested by quantifying PQ in real water samples, showing excellent recovery percentages ranging from 98.9% to 102.0%. The developed electrochemical sensor provides a practical solution for the rapid and accurate monitoring of PQ levels in the environment. This work establishes the foundation for the development of a selective electrochemical sensor for pesticide analysis, addressing both public health and environmental concerns.

Genomic perspectives on foodborne illness.

Whole-genome sequencing of bacterial pathogens is used by public health agencies to link cases of food poisoning caused by the same source of contamination. The vast majority of these appear to be sporadic cases associated with small contamination episodes and do not trigger investigations. We analyzed clusters of sequenced clinical isolates of Salmonella, Escherichia coli, Campylobacter, and Listeria that differ by only a small number of mutations to provide a new understanding of the underlying contamination episodes. These analyses provide new evidence that the youngest age groups have greater susceptibility to infection from Salmonella, Escherichia coli, and Campylobacter than older age groups. This age bias is weaker for the common Salmonella serovar Enteritidis than Salmonella in general. Analysis of these clusters reveals significant regional variations in relative frequencies of Salmonella serovars across the United States. A large fraction of the contamination episodes causing sickness appear to have long duration. For example, 50% of the Salmonella cases are in clusters that persist for almost three years. For all four pathogen species, the majority of the cases were part of genetic clusters with illnesses in multiple states and likely to be caused by contaminated commercially distributed foods. The vast majority of Salmonella cases among infants < 6 months of age appear to be caused by cross-contamination from foods consumed by older age groups or by environmental bacteria rather than infant formula contaminated at production sites.

EFFECTS OF DEFICIENT DIETARY INFORMATION, WITH A FOCUS ON THE WORKING CLASS OF INDIA

Maintaining dietary equilibrium is essential for the well-being of individuals and future generations. However, a significant portion of the Indian population, specifically the working class, lack access to adequate dietary information and resources. This impedes their ability to maintain a balanced diet. This paper explores the importance of adequate nutrition, the dire ramifications of its absence, and possible solutions to this deficiency in nutrition. Using research techniques such as case studies and government data analysis, the paper investigates the current state of nutrition in India, particularly among the working class. It identifies cases of inadequate nutrition and food poisoning and their causes. The findings reveal that many Indians do not meet their daily nutritional requirements, with common deficiencies in vitamins B12 and D3, zinc, iron, calcium, folic acid, and Vitamin C. This inadequacy’s root causes are traditional dietary practices, vegetarianism, and, most importantly, the lack of dietary education and information among the working class of India. These nutritional deficits contribute to health issues such as obesity, heart disease, strokes, type 2 diabetes, and various cancers. Furthermore, food poisoning poses a significant threat to one's health, causing numerous deaths annually. Several methods of improvement for this bleak situation were deduced, such as awareness campaigns, collaborations between healthcare practitioners and schools or community centers, and the distribution of educational pamphlets in local languages, making dietary information easily accessible to the masses.

Sigmoid Volvulus: A Rare Complication of Atropine Therapy in a Patient with Organophosphorus Poisoning: A Case Report

Various complications of atropine therapy in cases of organophosphorus poisoning have been reported. Among them, atropine induced paralytic ileus is a serious gastrointestinal complication with very few cases published worldwide. The tendency of over atropinization in organophosphorus poisoning despite regular monitoring is common and may develop life threatening complications as well. This necessitates knowledge, thorough examination, and an experienced approach to aid in treatment and complications management. We have discussed a case of organophosphorus poisoning, with symptoms of atropine toxicity and acute abdominal complication treated with surgical approach in our setting.

Patterns and clinical outcomes of childhood poisoning presenting to a children’s emergency department in Yenagoa, Nigeria: a 10-year retrospective study

IntroductionBackground: Childhood poisoning, characterised by exposure to toxic substances, poses a global health concern with variations across regions. Despite the importance of having current information about childhood acute poisoning in...

Analyzing DNA barcoding and identifying toxins caused by neurotoxic mushroom poisoning using liquid chromatography tandem mass spectrometry

Background: Neurotoxic mushroom poisoning often exhibits rapid symptom onset, typically attributed to compounds such as Ibotenic acid, which affect the central nervous system. This study addresses a new case of mushroom-related food poisoning in southern Thailand. Objective: The objectives are to determine the presence of ibotenic acid in cases of mushroom-related food poisoning utilizing liquid chromatography-tandem mass spectrometry (LC-MS/MS) and to identify toxic Amanita species implicated in these cases. Materials and methods: Remnant mushroom samples obtained from three clinically reported cases were used. Nucleotide similarity was compared against the rRNA/ ITS databases using NCBI BLAST search. Phylogenetic analyses were conducted using maximum likelihood (ML) and FastTree approaches. LC-MS/MS was employed to separate of Ibotenic acid, determine its molecular weight and perform precursor ion fragmentation. Results: Analysis of the rRNA/ITS databases revealed a high nucleotide similarity between suspected mushroom samples and Amanita digitosa. Detailed phylogenetic analysis confirmed that mushroom samples from the three poisoning cases clustered with A. digitosa. LC-MS/MS analysis showed the presence of ibotenic acid, with precursor ion (m/z 159) and product ion (m/z 113.1) as the major toxic substances. Clinically, patients poisoned by ibotenic acid-containing mushrooms exhibited a short latent period with symptoms of nausea, vomiting, vertigo, delirium, confusion, and fatigue. Conclusion: The genus Amanita comprises both edible and inedible species that produce several lethal toxins. The report of ibotenic acid in A. digitosa is a novel finding, valuable for food safety monitoring and healthcare decision-maker. This is especially notable due to the accuracy and rapidity of the analytical process.

Clinico-demographic characteristic and outcome of adult acute organophosphorus (OP) poisoning in Teaching Hospital of Madhesh Province, Nepal

Background &amp; Objectives: Organophosphorus (OP) poisoning is a major health problem worldwide, especially in developing countries. This study aimed to find out the demographic, clinical presentation and outcome of OP poisoning patients. Materials and Methods: A cross-sectional study of two years duration was conducted on patients presenting to Emergency Department (ER) with clinical features of OP poisoning at Janaki Medical College Teaching Hospital (JMCTH), a tertiary care hospital. Results: A total of 84 cases of acute poisoning were reported in ER-JMCTH. Patient ages ranged from 15 to 60 years. The highest number of poisoning cases was observed in the 15-25 years age group (44 cases 52.4%) male = 33 (39.3%) and female = 51(60.7%), ratio M: F = (1:1.5). Most cases of poisoning were due to suicidal intention (n = 63, 75%), most common toxic substances used for suicidal purposes of OP were chlorpyriphos (n = 56, 66.7%) and dichlorvos (n = 17, 20.2%). Most of the cases belonged to illiterate (n = 26, 31%) and primary education (n=19, 22.6%). About 79.8% of the patient’s symptoms were cholinergic effect (muscarinic), 9.5% nicotinic and 10.7% central nervous system (CNS) effect. Nearly 93% (n = 78) patients survived and 7% resulted in death. Conclusion: The majority of OP poisoning patients were of young age and OP poisoning was more common in women compared to men. Suicidal poisonings were more frequent than accidental ones. The research team's a treating physicians noted miosis as the most common symptom, whereas patients most frequently complained of nausea and vomiting.

Seven- and thirty-day mortality in digoxin poisoning: Results from the DIGITOX study

BackgroundDigoxin poisonings are relatively common and potentially fatal, requiring immediate therapeutic intervention, with special attention to the patient's hemodynamic status and the presence of electrocardiographic and electrolytic disturbances. ObjectiveTo identify factors associated with seven-day and thirty-day mortality in digoxin poisoning. Design, settings and participantsA retrospective, observational, multicenter study was conducted across 15 Hospital Emergency Departments (HED) in Spain. All patients over 18 years of age who presented to participating HEDs from 2015 to 2021 were included. The inclusion criteria encompassed individuals meeting the criteria for digoxin poisoning, whether acute or chronic. Outcomes measure and analysisTo identify independent factors associated with 7-day and 30-day mortality, a multivariate analysis was conducted. This analysis included variables of clinical significance, as well as those exhibiting a trend (p < 0.1) or significance in the bivariate analysis. Main findingsA total of 658 cases of digoxin poisoning were identified. Mortality rates were 4.5% (30 patients) at seven days and 11.1% (73 patients) at thirty days. Regarding 7-day mortality, the mean age of deceased patients was comparable to survivors (84.7 (8.9) vs 83.9 (7.9) years; p = ns). The multivariate analysis revealed that factors independently associated with 7-day mortality encompassed the extent of dependence assessed by the Barthel Index (BI 60–89 OR 0.28; 95% CI 0.10–0.77; p = 0.014 and BI>90 OR 0.22; 95% CI 0.08–0.63; p = 0.005), the identification of ventricular arrhythmias (OR 1.34; 95% CI 1.34–25.21; p = 0.019), and the presence of circulatory (OR 2.84; 95% CI 1.19–6.27; p = 0.019) and neurological manifestations (OR 2.67; 95% CI 1.13–6.27; p = 0.025). Factors independently associated with 30-day mortality encompassed extent of dependence (BI 60–89 OR 0.37; 95% CI 0.20–0.71; p = 0.003 and BI>90 OR 0.18; 95% CI 0.09–0.39; p < 0.001) and the identification of circulatory (OR 2.13; 95% CI 1.10–4.15; p = 0.025) and neurological manifestations (OR 2.39; 95% CI 1.25–3.89; p = 0.006). ConclusionsThe study identifies the degree of dependency assessed by the Barthel Index and the presence of cardiovascular and neurological symptoms as independent predictors of both 7-day and 30-day mortality. Additionally, the detection of ventricular arrhythmia is also an independent factor for 7-day mortality.

The Role of Enzymatic Molecular Autopsy for Law Enforcement in Cyanide Poisoning Cases in Rabat, Morocco

Introduction: Cyanide poisoning is a serious public health problem throughout the world, including in Morocco. Enzymatic molecular autopsy offers a powerful method for detecting and quantifying cyanide levels in body tissue, which can assist law enforcement in poisoning cases. Methods: This observational study was conducted on 112 research subjects who died from cyanide poisoning in Rabat, Morocco. An enzymatic molecular autopsy was performed to measure cyanide levels in the blood, liver, and brain. Data were analyzed to determine the relationship between cyanide levels and demographic, clinical, and toxicological factors. Results: The highest levels of cyanide are found in the blood, followed by the liver and brain. There is a significant relationship between cyanide levels and causes of death, with cyanide levels highest in suicides and homicides. Conclusion: Enzymatic molecular autopsy should be considered as a routine method in the investigation of cyanide poisoning cases. This can help law enforcement to achieve justice for victims and their families.

A case of fatal poisoning caused by etomidate: evidence from pathological and toxicological analyses.

Etomidate is a nonbarbiturate sedative derived from imidazole. Prolonged and excessive use of etomidate can lead to the suppression of adrenocortical function, myoclonus, and even death. This report describes a rare case of a 47-year-old man who died from acute intoxication after oral ingestion of liquid containing etomidate. The cause of death was conclusively attributed to etomidate based on a comprehensive investigation, including autopsy, histopathological examination, toxicological analysis, and biochemical analysis. This is the first reported case of a fatality solely resulting from the oral ingestion of etomidate, which can provide valuable insights for future forensic investigations involving etomidate poisoning. Therefore, it is imperative to share this case with the scientific community.

Development and validation of a multi-substance method for routine analysis of pesticides in post-mortem samples by Ultra-High Performance Liquid Chromatography-Tandem Mass Spectrometry

Pesticides play an important role in forensic toxicology and are usually classified as a single class of chemicals. Despite their commonly perceived unity, pesticides encompass a spectrum of compounds, including organophosphates, carbamates, pyrethroids or organochlorines, among others, each with varying degrees of toxicity. Pesticide analysis in post-mortem samples can be difficult due to the complexity of the samples and to the high toxicity of these compounds. The aim of this study was to develop and validate an easy to use, sensitive, and robust method, using ultra-performance liquid chromatography-tandem mass spectrometry to be incorporated in the routine flow for pesticide analysis in post-mortem blood samples. Described herein is a streamlined, expeditious, yet highly efficient method facilitating the screening, qualitative assessment, and quantitative confirmation of 15 pesticides, including acetamiprid, azinphos-ethyl, bendiocarb, carbofuran, chlorfenvinphos, dimethoate, imidaclopride, malathion, methiocarb, methomyl, parathion, pirimicarb, strychnine, tetrachlorvinphos, and thiacloprid in post-mortem blood, recognizing the pivotal role blood plays in forensic investigations. The developed method was linear from 10 to 200 ng/mL; limits of detection were between 1 and 10 ng/mL, depending on the compound; it was successfully evaluated a dilution ratio of 1–2, 5 and 10; and 8 substances showed maximum stability for the time interval studied. This UHPLC-MS/MS method is useful and a powerful tool in a toxicology lab because it is fast, simple, effective, and trustworthy. The results of this validation highlight the robustness of the analytical method, providing a valuable tool for the accurate and sensitive detection of pesticides in post-mortem blood. Poised for routine implementation, this method has already found success in suspected intoxication cases, promising to elevate the standards of forensic pesticide analysis.

Two cases of diquat poisoning in adolescent children

Diquat (DQ) is among the most widely used herbicides, and its intake can cause severe systemic toxicity that manifests rapidly. The resultant symptoms can cause the dysfunction of a range of tissues and organs,. As there is no specific antidote for diquat poisoning and the efficacy of extant treatments is suboptimal, physicians must acquire a more comprehensive understanding of the most effective approaches to managing affected patients. Relative few studies have been published to date focused on diquat poisoning in pediatric patients. In this report, we compare two similar cases of juvenile diquat poisoning with dynamic changes in clinical manifestations, laboratory values, and imaging results. For the first time, the difference in whether to perform blood flow perfusion and the time difference of initiation of hemoperfusion had a clear clinical difference in the subsequent effects of diquat poisoning in children with diquat poisoning. Limited evidence is available regarding the efficacy of early hemoperfusion for diquat poisoning; however, the differences in clinical outcomes articulated here highlight the benefits of early and timely hemoperfusion therapy in the treatment of DQ toxicity in children, in conjunction with primary supportive care in the management of DQ poisoning in children.

Diquat poisoning leads to ARDS: report of two cases

Diquat (DQ) is a non-selective, foliage-applied herbicide that is known to cause liver and kidney damage, while the impact on the lungs is relatively mild. Current domestic and international reports on diquat poisoning primarily focus on liver and kidney injuries, with limited documentation of cases leading to acute respiratory distress syndrome (ARDS) and lung damage. This paper presents a retrospective analysis of two documented cases of diquat poisoning, both exhibiting ARDS. In both cases, the condition rapidly progressed upon the onset of ARDS despite aggressive treatment, ultimately resulting in the death of the patients.