Cases Of Poisoning Research Articles

Epidemiología y calidad asistencial de las intoxicaciones agudas en el adulto mayor de 65 años en Alicante, España

IntroductionThe objective of this study was to examine the epidemiology of acute poisonings in the emergency department (ED) of a tertiary center and to analyze the compliance level with quality indicators (QIs) in patients 65 years and older compared rest of adults. Materials and methodsThis was an observational and retrospective study that included diagnosed cases of acute poisoning in patients over 14 years old treated in the ED of a tertiary hospital. Demographic variables, type of toxic substances, and cause of poisoning were collected, along with 19 QIs and patient outcomes, with the main outcome variable being the degree of compliance with the QIs. ResultsA total of 1144 cases were recorded, with 10.4% (n=119) being patients 65 years and older. Patients 65 years and older were more likely to be female (72.8% vs. 60.9%; p=0.015), experience more accidental poisonings (37.6% vs. 25.7%; p=0.006), and fewer intentional poisonings (35.0% vs. 49.6%; p=0.003). There were fewer cases of alcohol poisoning (5% vs. 17.8%; p<0.001), and no cases of illegal drug poisoning (p<0.001) in this age group. Most QIs showed a high degree of compliance (>85%) in both patients 65 years and older and rest of adults. However, there were differences in the indication of oxygen therapy in cases of carbon monoxide poisoning (64.2% vs. 40.9%; p=0.005). ConclusionsThe epidemiological profile of poisoning in patients 65 years and older differs from that of adult patients, with a similar degree of compliance with QIs. Based on the results obtained, there does not appear to be significant differences in the management of poisoned patients based on their age.

Quantitative analysis of phosphine in variety of biological samples from two cases of fatal poisoning

Quantitative analysis of phosphine in variety of biological samples from two cases of fatal poisoning

Структура острых отравлений химической этиологии в мегаполисе на фоне пандемии COVID-19 в 2020–2021 гг.

The spread of COVID-19 in Russia has led to restrictive measures. The stress associated therewith had a noticeable psychoemotional effect on the population, which could not but affect the numbers and patterns of acute chemical poisonings (ACP). This study aimed to investigate the patterns of ACP in Moscow in the context of the COVID-19 pandemic. We analyzed data describing cases admitted with ACP to N.V. Sklifosovsky Research Institute for Emergency Medicine in 2019–2021, factoring in the dynamics COVID-19 prevalence as diagnosed with RT-PCR tests. The results of the analysis were processed using nonparametric methods and GraphPad Prism 9 software. Within the considered period, 2020 was the peak year. The number of acute poisonings (AP) with ethanol and its surrogates in 2020 was 109.7% greater than in 2019 (both sexes; the figure for women alone was 286.2%). Male patients suffered AP with drugs and corrosive substances more often than female (p &lt; 0.0001). The number of drug abuse cases in 2019–2021 varied slightly, increasing by 2.4 and 6.7% annually. Synthetic narcotic substances were most common: methadone, cathinones, psychostimulants, and mixtures of substances. We discovered parallel trends in dynamics of ethanol intoxication and COVID-19 cases, and no such between drug poisonings and the said morbidity. Thus, the identified specifics of ACP patterns in the capital of Russia associated with the COVID-19 pandemic are a spike in alcohol abuse (especially among women), and lack of noticeable effect of the disease on use of drugs.

Hexahydrocannabinol Pharmacology, Toxicology, and Analysis: The First Evidence for a Recent New Psychoactive Substance.

During the last two years, hexahydrocannabinol (HHC), the hydrogenated derivative of tetrahydrocannabinol has been freely sold by internet websites as a "legal" replacement to THC and cannabis in a range of highly attractive branded and unbranded products, some of which are sold as "legal highs". Potentially, there could be a large demand for HHC products by individuals in Europe and internationally. Studies reporting HHC pharmacology, toxicology and analysis were identified from Pubmed and Scopus databases, and official international organizations' websites were considered. HHC showed the effects of the typical cannabinoid on the central nervous system, with lower potency than Δ9-THC. A few studies highlighted that 9(R)-HHC is more potent than 9(S)-HHC. This molecule showed an affinity for cannabinoid receptor CB1 both in vitro and in vivo, suggesting a possible therapeutic effect in several pathologies. However, the affinity for the CB1 receptor suggests a possible addiction potential, inducing the users to misuse it. Since actual intoxication cases have not yet been reported, the HHC harmful potential was not described, probably due to the lack of effective analytical methods to detect HHC in biological matrices. Conversely, different analytical assays were developed and validated to separate HHC epimers in natural and non-natural sources. Similarly to other NPS, the HHC represents a cheaper alternative to the controlled Δ9-THC. Its monitoring is a crucial challenge for toxicological and forensic purposes. To this concern, it is essential to further investigate HHC to support health providers in the identification of related intoxications.

Analysis of The Use Of Canva Learning Media in The Food and Beverage Sanitation Course in The Public Health Study Program, Prima Nusantara University Bukittinggi

Based on data from the Ministry of Health, there were 4,792 cases of food poisoning in October 2023. The biggest source of mass poisoning was home cooking which accounted for 53% of cases. Household cooking is the cause of poisoning due to lack of attention to hygiene and sanitation when cooking. Therefore, it is very urgent to carry out the process of providing knowledge to students regarding food hygiene and sanitation by utilizing innovative learning media, with the hope of achieving the 3rd SDGs, namely increasing the level of health and welfare of the community. The aim of the research is to obtain information regarding the effectiveness of using Canva media in food and beverage sanitation lectures. This research was carried out at Prima Nusantara University Bukittinggi in September 2023 - November 2023. This research method was a quantitative method with a descriptive approach, involving 45 public health students, specializing in environmental health who were selected through purposive sampling. The research results show that the use of the Canva application in food and beverage sanitation lectures brings many benefits to students, not only the skills needed in the 21st century, but also creativity and imagination. Of course, in its use it requires assistance from lecturers or experts in the field. The conclusion obtained is that the Canva learning media is effective for use in food and beverage sanitation courses. Therefore, it is hoped that all lecturers and students at universities can take advantage of innovative learning media based on technology and artificial intelligence used in lectures so that they feel interesting and not monotonous.

1338. Changes in Volume and Diagnoses in a Pediatric Emergency Department during the COVID-19 Pandemic in Northeast Mexico

Abstract Background During the first months of the COVID-19 pandemic, a reduction in the volume of patients who sought care in pediatric emergency departments (ED) was observed. An apparent change in discharge diagnoses was also witnessed. There is scarce evidence about the impact of the pandemic on pediatric emergency departments in Mexico and Latin America. Methods We conducted a retrospective observational study at a tertiary care hospital in Mexico. We compared the volume and discharge diagnoses of patients aged 0-16 years admitted to the ED during the COVID-19 pandemic from Dec 2020 to Feb 2021 and during the same 3 months in the previous year (Dec 2019 to Feb 2020). As a secondary objective, we compared the subjects’ demographic characteristics and comorbidities. Chi-square test was performed to compare proportions and Student’s t test to compare the median age of patients between the two periods. Results In the pre-pandemic period (Dec 2019 to Feb 2020) there were 1,686 admissions to the ED, compared to 941 during the pandemic period (Dec 2020 to Feb 2021). This represented a 44.1% decrease in pediatric admissions to the ED. Median age in months was higher during the pandemic period (50.8) compared to the previous year (69.8) (Table 1). There was a significant increase in the percentage of patients who had a positive history of comorbidities. The percentage of infectious and respiratory diseases significantly declined during the pandemic period, particularly pneumonia (13.1% vs. 1.9%), bronchiolitis (10.7% vs. 1.3%), and rhinopharyngitis (4.1% vs. 1.3%) (Table 2). There was also an increase in intoxication cases (1.7% vs. 3.4%) and accidents (6.6% vs. 14.7%). The percentage of neonatal, surgical, neurological, rheumatological, and gastrointestinal diseases also increased during the pandemic period. Conclusion There was a substantial decrease in the total volume of patients as well as a significant change in discharge diagnoses between the pre-pandemic and pandemic studied periods. This study adds to the scarcity of literature available about the impact of COVID-19 on pediatric EDs in Mexico and Latin America. Further studies regarding medical attention-seeking behavior during the pandemic are crucial to planning for the allocation of health resources in case of future health emergencies. Disclosures All Authors: No reported disclosures

Impact of the COVID-19 Pandemic on Childhood Lead Testing and Blood Lead Levels

ObjectiveTo evaluate the effect of the COVID-19 pandemic on childhood lead testing and blood lead levels. MethodsA retrospective analysis of lead tests and results was performed across 3 urban medical centers during the pre-COVID-19 (March 10, 2019–March 9, 2020) and COVID-19 (March 10, 2020–March 10, 2022) periods. Interrupted time series analysis with quasi-Poisson regression was used to evaluate changes in lead testing between study periods. The relationship between sociodemographic features with detectable (≧2 µg/dL) and elevated (≧3.5 µg/dL) blood lead levels (BLLs) was assessed with multivariable logistic regression. ResultsAmong a total of 16,364 lead tests across 10,362 patients, weekly testing rates significantly decreased during COVID-19 (relative risk (RR) 0.64, 95% (confidence interval) CI 0.53–0.78). Census tracts with the greatest proportion of pre-1950s housing had a stronger association with detectable BLLs during the COVID-19 period (pre-COVID-19 adjusted odds ratio (aOR) 1.73, 95% CI 1.35–2.20; aOR 2.58, 95% CI 2.13–3.12; interaction P value .014). When limited to 1 year following COVID-19 (March 10, 2020–March 10, 2021), the association between both elevated BLLs (pre-COVID-19: aOR 1.49, 95% CI 0.87–2.53; COVID-19: aOR 3.51, 95% CI 1.98–6.25; interaction P value .032) and detectable BLLs with pre-1950s housing were greater during the COVID-19 period (pre-COVID-19: aOR 1.73, 95% CI 1.35–2.20; COVID-19: aOR 2.56, 95% CI 1.95–3.34; interaction P value .034). ConclusionsThe COVID-19 pandemic led to a significant reduction in lead surveillance and magnified the effect of known risk factors for lead exposure. Concerted clinical, public health, and community advocacy are needed to address care gaps and excess cases of lead poisoning.

Central Extracorporeal Membrane Oxygenation Support Following Calcium Channel Blocker Overdose in Children.

Refractory vasodilatory shock (RVS) following massive calcium channel blocker (CCB) overdose remains a challenging clinical entity. Peripheral venoarterial extracorporeal membrane oxygenation (ECMO) has proven useful in several cases of CCB intoxication, however, its use in the pediatric population poses unique challenges given the generally small size of pediatric peripheral vasculature in comparison to the high flow rates necessary for adequate mechanical circulatory support. As a result of these challenges, our group has adopted a "primary" central ECMO cannulation approach to the treatment of children and adolescents admitted to our center with profound RVS after CCB ingestion. We present four cases within the last year using this approach. All patients were successfully discharged from the hospital with no late morbidity at most recent follow-up. Central ECMO support in cases of massive vasodilatory shock following CCB overdose is safe and effective and should be considered early in the clinical course of these critically ill patients.

Test of Escherichia Coli and Total Microbes on Burger Meat Sold in Kedinding and Pogot Villages, Surabaya, East Java

A burger is a type of fast food that consists of a bun in the middle that contains a patty (ground beef), vegetables, and some sauce. There are several parameters in determining food quality and safety, one of which is analyzing the content of microbiology such as bacteria, viruses, and protozoa in food. Biological hazards, especially in food, need special attention because they are often the causative agents of food poisoning cases. This study aims to determine Eschericia coli contamination and Total Plate Number (TPC) in burger meat samples sold in Kedinding and Pogot villages, Surabaya, East Java. This research is observational with a cross sectional approach. The inspection method used to determine Escherichia coli contamination and the Total Plate Count (TPC) is the Most Likely Number method to determine E. coli and the Total Plate Count (TPC). The results of this study showed that there was no E. coli in all burger meat samples and there were 6 burger meat samples contaminated with bacteria, namely in Samples A, B, C, G, H and I, which exceeded the contamination limit according to to SNI 8503 (2018).

Is Lead Exposure Still The Best Explanation For Beethoven’s Deafness?

Objectives: An article in Current Biology in March 2023 suggested that lead poisoning does not apply to Beethoven because the Hiller lock was found to be inauthentic. In addition, bone samples that contained high levels of lead have also been discovered to be inauthentic. This communication is a response to this as well as other challenges to the article in The Laryngoscope in 2013 about lead and the hearing loss of Ludwig van Beethoven. Methods: An in-depth review of these articles was accomplished to assess whether lead poisoning is still a viable theory for Beethoven’s hearing loss. Results: A substantial review of over 2000 cases in 2016 showed uniformly abnormal auditory brainstem responses with chronic lead poisoning that correlate well with the shrunken cochlear nerves found at Beethoven’s autopsy. An article published in 2017 postulated a new reason for Paget’s Disease, but has serious deficiencies. The current case of lead poisoning in The Laryngoscope in 2020 supports lead as a cause significant hearing loss. In 2022 a suggestion of congenital syphilis was found to lack substantial evidence. Although the article in Current Biology in March 2023 suggested that lead poisoning does not apply to Beethoven because the Hiller lock was found to be inauthentic, no authentic samples have ever been tested for lead. Therefore, this is a premature opinion. Conclusion: Future directions listed in the Current Biology article include testing for exposure to environmental causes of disease. We will therefore wait with great anticipation to the analyses of authentic hair samples. It may not be surprising that these will also show high levels of lead. If they do not, all of the suggested reasons for Beethoven’s hearing loss will have major problems, and we may never fulfill his wish to discover the etiology of his loss.

DETECTION AND PATHOGENICITY LEVEL SCREENING OF HEMOLYTIC BACTERIA ISOLATED FROM UNPACKED CHICKEN NUGGET

Food poisoning is a severe threat that can lead to death. According to the WHO, cases of food poisoning have been on the rise in recent years. Pathogenic bacteria are responsible for food poisoning, often originating from contaminated food. Chicken nuggets, a popular ready-to-eat food, are susceptible to bacterial growth due to the risk of microbial contamination during storage. This study aims to assess the pathogenicity levels of bacteria in chicken nuggets when stored at room temperature for seven days. Samples from chicken nuggets left at room temperature were diluted and cultured on Nutrient Agar (NA) media. Subsequently, bacterial pathogenicity screening was conducted using MacConkey Agar (MC), Blood Agar Plate (BAP), and Chocolate Agar Plate (CAP). The results revealed six bacterial isolates labeled FMCN-1 to FMCN-6 (FMCN denoting Fatmawati Market chicken nugget). Most isolates exhibited a moderate level of pathogenicity (FMCN-2, FMCN-3, FMCN-4, FMCN-5, and FMCN-6), with only one isolate demonstrating low pathogenicity (FMCN-1). In conclusion, storing chicken nuggets at room temperature for seven days can lead to bacterial contamination with mostly moderate pathogenicity. Further molecular analysis is required to identify the potentially harmful bacteria.

DETECTION AND PATHOGENICITY LEVEL SCREENING OF HEMOLYTIC BACTERIA ISOLATED FROM UNPACKED CHICKEN NUGGET

Food poisoning is a severe threat that can lead to death. According to the WHO, cases of food poisoning have been on the rise in recent years. Pathogenic bacteria are responsible for food poisoning, often originating from contaminated food. Chicken nuggets, a popular ready-to-eat food, are susceptible to bacterial growth due to the risk of microbial contamination during storage. This study aims to assess the pathogenicity levels of bacteria in chicken nuggets when stored at room temperature for seven days. Samples from chicken nuggets left at room temperature were diluted and cultured on Nutrient Agar (NA) media. Subsequently, bacterial pathogenicity screening was conducted using MacConkey Agar (MC), Blood Agar Plate (BAP), and Chocolate Agar Plate (CAP). The results revealed six bacterial isolates labeled FMCN-1 to FMCN-6 (FMCN denoting Fatmawati Market chicken nugget). Most isolates exhibited a moderate level of pathogenicity (FMCN-2, FMCN-3, FMCN-4, FMCN-5, and FMCN-6), with only one isolate demonstrating low pathogenicity (FMCN-1). In conclusion, storing chicken nuggets at room temperature for seven days can lead to bacterial contamination with mostly moderate pathogenicity. Further molecular analysis is required to identify the potentially harmful bacteria.

Outcome prediction of methadone poisoning in the United States: implications of machine learning in the National Poison Data System (NPDS)

Methadone is an opioid receptor agonist with a high potential for abuse. The current study aimed to compare different machine learning models to predict the outcomes following methadone poisoning. This six-year retrospective longitudinal study utilizes National Poison Data System (NPDS) data. The severity of outcomes was derived from the NPDS Coding Manual. Our database was divided into training (70%) and test (30%) sets. We used a light gradient boosting machine (LGBM), extreme gradient boosting (XGBoost), random forest (RF), and logistic regression (LR) to predict the outcomes of methadone poisoning. A total of 3847 patients with methadone exposures were included. Our results demonstrated that machine learning models conferred high accuracy and reliability in determining the outcomes of methadone poisoning cases. The performance evaluation showed all models had high accuracy, precision, specificity, recall, and F1-score values. All models could reach high specificity (more than 96%) and high precision (80% or more) for predicting major outcomes. The models could also achieve a high sensitivity to predict minor outcomes. Finally, the accuracy of all models was about 75%. However, XGBoost and LGBM models achieved the best performance among all models. This study showcased the accuracy and reliability of machine learning models in the outcome prediction of methadone poisoning.

Highlight the Diseases Generated by Food Pathogens: A Review

Foods are exposing to infection with different types of pathogenic bacteria and fungi, and the emergence of many epidemics and cases of food poisoning in various regions of the world, particularly in developing countries. The article includes, causes of food disease, which is happening as a result of eating toxic substances with food that may be of microbial origin (bacteria, fungi, parasites, viruses), animal, plant or chemical origin, which generates food poisoning. Microbial poisoning may result either from ingestion of microorganism toxins like Staphylococcus aureus or as a result of infection like Campylobacter jejuni also, some cases of food poisoning with some types of bacteria may recover without the need for medical intervention like S. aureus, and others may be fatal even in low concentrations with a high mortality rate, such as Cl.botulinum. The article also, reviewed the dangers of mycotoxins as a global concern and more dangerous than bacterial toxins, as they have a cumulative toxic effect that does not appear until years later, and responsible for many different cancers. It is also impossible to avoid food contamination with mycotoxins even with the use of high technologies in food processing, and the best solution lies in preventing the growth of toxic molds that secrete these toxins on food, by using Good Agricultural Practices (GAP) and Good Manufacturing Practices (GMP).

Occupational Carbon Monoxide Poisoning in Wisconsin: Results From a Statewide Electronic Disease Surveillance System and From the Wisconsin Poison Center, 2018-2021.

Prevention methods for carbon monoxide (CO) poisoning in Wisconsin address occupational and nonoccupational exposures together, but differences between the settings could inform new approaches to preventing occupational CO poisonings. We described occupational CO poisonings in Wisconsin from July 1, 2018, through July 1, 2021, using surveillance data from the Wisconsin Electronic Disease Surveillance System and Wisconsin Poison Center. We identified cases of CO poisoning from the Wisconsin Electronic Disease Surveillance System and Wisconsin Poison Center. Occupational CO poisonings were records where "workplace" was recorded as the location of exposure. We excluded records classified as suspect/not a case, those missing laboratory results or information on exposure source/location, and intentional poisonings. We compared characteristics between occupational and nonoccupational settings using odds ratios (ORs), and we estimated crude incidence rates of occupational exposures by occupation. We identified 614 cases of CO poisoning, of which 168 (27.4%) were occupational exposures. When compared with patients with nonoccupational exposures, patients with occupational exposures were more likely to be male (OR = 3.8; 95% CI, 2.4-6.1), Hispanic (OR = 2.4; 95% CI, 1.4-4.2), and younger (mean difference [SD] = 6.6 [20.9]). Several CO sources were significantly associated with occupational poisonings: forklifts (OR = 58.4; 95% CI, 13.9-246.1; P < .001), pressure sprayers (OR = 2.4; 95% CI, 1.3-4.4; P = .003), and other gasoline-powered tools (OR = 3.8; 95% CI, 2.3-6.3; P < .001). The natural resources, construction, and maintenance occupation group had the highest crude incidence rate-45.0 poisonings per 100 000 full-time equivalent employees. Incorporating data from the Wisconsin Poison Center improved data quality, but surveillance is limited by underreporting. Creating strategies to increase reporting would allow for a more comprehensive understanding of occupational CO poisoning.

A study of acute kidney injury in different poisoning cases in Bundelkhand region

Background: In Bundelkhand region, 15–18% of patients who are attended in the emergency setting comprises poisoning, 60–70% of which are agriculture-based poisons due to its easy accessibility. The chief complication of poisoning is acute kidney injury (AKI). Aims and Objectives: The aim of the study was to find out the proportion of AKI in acute poisoning, the spectrum of clinical features and their complications and outcome. Materials and Methods: The cross-sectional study was performed in patients admitted in Departments of Medicine, MLB Medical College and Hospital, Jhansi over a period of 25 months (December 2020–October 2022). Results: In our study, there were 100 patients, 83% developed pre-renal AKI and 17% landed up into acute tubular necrosis. Maximum patients recovered, but 13 patients deteriorated, in which most presented after a lag time of 12 h of poison exposure, during the course of management, 5 patients required dialysis (3 peritoneal/2 hemodialysis). Out of 13 Patients, 11 expired and 2 improved, most of them consume celphos and insecticide. Conclusion: Our study shows that agriculture-based chemicals are easily available and accessible for poisoning. The time lag in proper treatment and detoxification leads to various complications; an early intervention and appropriate antidote easily reverses complications and end-organ damage, whereas some cases require dialysis or ventilator support. Middle-aged male, low socioeconomic economic groups, and psychiatric issues lay as background for most poisoning cases, where financial deprivement, lack of knowledge, and awareness have major issues.

Study on occurrence of agrochemical poisoning in Bovines at veterinary clinics of Udgir

In view of unavailability of data on agrochemical poisoning in livestock animals in India, the present work was conducted with objective to study the epidemiological aspects of agrochemical poisoning in bovines over a period of five years. A total of 98 cases of pesticide poisoning in bovines have been reported during 2016-2020 at Veterinary Clinical Complex, College of Veterinary and Animal Sciences, Udgir with hospital prevalence of 0.39%. Among various agrochemicals, insecticide poisoning was responsible for 45.91% cases, fungicide for 17.34%, herbicides for 16.32%, unknown pesticides for 10.20%, fertilizers for 7.14% and rodenticides for 3.06% cases of poisoning in bovines. Year-wise higher number of cases were reported during 2016 (30.61%) followed by 2017, 2019 (19.38% each) and 2018 (18.36%) while, month- wise highest number of poisoning cases were reported in months of November (14.28%), December (13.26%), July and September, October (11.22% each). Season-wise highest occurrence of poisoning was observed during monsoon and post-monsoon seasons while least occurrence was observed during summer season. Age-wise highest occurrence of agrochemical poisoning was reported in 4-6 year and 0-2 year age-group animals. Species-wise occurrence of poisoning revealed highest occurrence in cattle (65.31%) than buffaloes (34.69%). Among cattle 67.18% male animals while 32.82% female animals were affected. All buffaloes confirmed for poisoning were female. The findings of the present study will be helpful for formulating strategies to reduce exposure of livestock animals to agrochemicals.

Epidemiology and quality of care of acute intoxication in people over 65 years of age in Alicante, Spain

IntroductionThe objective of this study was to examine the epidemiology of acute poisonings in the emergency department (ED) of a tertiary center and to analyze the compliance level with quality indicators (QIs) in patients 65 years and older compared rest of adults. Materials and methodsThis was an observational and retrospective study that included diagnosed cases of acute poisoning in patients over 14 years old treated in the ED of a tertiary hospital. Demographic variables, type of toxic substances, and cause of poisoning were collected, along with 19 QIs and patient outcomes, with the main outcome variable being the degree of compliance with the QIs. ResultsA total of 1144 cases were recorded, with 10.4% (n = 119) being patients 65 years and older. Patients 65 years and older were more likely to be female (72.8% vs. 60.9%; p = 0.015), experience more accidental poisonings (37.6% vs. 25.7%; p = 0.006), and fewer intentional poisonings (35.0% vs. 49.6%; p = 0.003). There were fewer cases of alcohol poisoning (5% vs. 17.8%; <0.001), and no cases of illegal drug poisoning (p < 0.001) in this age group. Most QIs showed a high degree of compliance (>85%) in both patients 65 years and older and rest of adults. However, there were differences in the indication of oxygen therapy in cases of carbon monoxide poisoning (64.2% vs. 40.9%; p = 0.005). ConclusionsThe epidemiological profile of poisoning in patients 65 years and older differs from that of adult patients, with a similar degree of compliance with QIs. Based on the results obtained, there does not appear to be significant differences in the management of poisoned patients based on their age.

Epidemiology and clinical aspect of mushroom poisonings in South Sardinia: A 10-year retrospective analysis (2011-2021).

Mushroom poisoning is a severe problem of public health, however, information about its epidemiology and management is still limited. This is the first study focused on Sardinia that investigates data about mushroom poisoning describing epidemiology, clinical presentation, seasonality, and the most common involved species. In this retrospective study, we analyzed data recovered from the database of Mycological Inspectorates during a 10-year period (2011-2021). Overall, 164 cases of mushroom poisoning have been identified, with significant peaks in autumn. The highest number of episodes of intoxication were recorded in Cagliari (64), followed by Carbonia (55) and Sanluri (45), although the annual distribution of cases among the provinces varied considerably in the study period. Thanks to the expertise of the Mycological Inspectorate service, the implicated species have been identified in 162 cases (98.78%); 81 cases were caused by toxic species, 60 by edible, and 45 by not edible species. Omphalotus olearius and Agaricus xanthodermus were the most represented toxic species (22% and 18%, respectively); Boletus aereus (18%) was the most frequent edible species, while Boletaceae were the prevalent not edible mushrooms. The data collected in South Sardinia over a period of 10-years demonstrate how a correct and rapid recognition of mushroom poisoning is important to improve the prognosis of patients, however, there are still problems of lack of knowledge, on the part of the population, on the existence of the consultancy services. Because most illnesses from poisonous mushroom ingestion are preventable, increased public awareness about the potential dangers of mushroom poisoning is mandatory.

Differences in the characteristics of people who purchase pesticides from shops for self-harm versus those who use pesticides available in the domestic environment in Sri Lanka.

Data from South Asia indicate that for 15%-20% of suicide attempts, pesticides are purchased from shops; otherwise, pesticides are obtained from an individual's house or nearby environment. We aimed to investigate the difference between individuals who directly purchase pesticides from shops for suicide attempts and suicide deaths versus those related to accessing the pesticides from an individual's house or nearby environment. We conducted two comparative studies in rural Sri Lanka: (1) non-fatal shop cases (n = 50) were survivors of self-poisoning with pesticides who ingested the pesticides after purchasing them from a shop; non-fatal domestic cases (n = 192) were survivors who accessed pesticides from their house or nearby environment. (2) fatal shop cases (n = 50) were individuals who died after ingesting pesticides they purchased for the act; fatal domestic cases (n = 102) were patients who died after ingesting pesticides they accessed at house or nearby environment. Logistic regression analysis was used to assess the characteristics which distinguished between the shop and domestic cases. Data indicate that 20.7% and 32.9% of individuals who used pesticides for suicide attempts and suicide deaths had purchased them from shops, respectively. Being a non-farmer was the main distinguishing characteristic of shop cases: adjusted odds ratios (AOR) 8.9, 95% confidence intervals (CI) 3.2-24.4 for non-fatal shop cases, and AOR 4.0, 95% CI 1.5-10.6 for fatal shop cases. Non-fatal shop cases also had higher suicide intent (AOR 3.0, CI 1.0-8.9), and ingesting an insecticide (AOR 4.8, CI 1.8-1.0-8.9) than non-fatal domestic cases. A high suicide intent of individuals who purchase pesticides for the event explains the high proportion of such fatal cases. Such high suicide intent makes the prevention implications difficult to spell out for those individuals who purchase pesticides for self-poisoning. However, our findings are valuable for clinicians to assess pesticide poisoning cases in hospitals.