Severe Poisoning Research Articles

Изучение эффективности применения пептидных препаратов при острых тяжёлых отравлениях этанолом

Severe poisoning plays a significant role in ethanol poisoning and is an important cause of increased mortality in the population. Existing treatment regimens for extremely severe ethanol poisoning have shown low effectiveness, necessitating the search for drugs among pharmacological groups that have not previously been used in severe cases of ethanol poisoning. Peptides, which have demonstrated high efficacy in treating critical conditions of the body accompanied by impaired central nervous system and liver function, can be the drugs of choice. The aim of this study was to investigate the effectiveness of peptide drugs with neuroprotective and hepatoprotective activities in rats with acute severe ethanol poisoning. The studies were conducted on male albino rats, in which 40% ethanol was administered intragastrically using a probe at a dose of 1.5 LD50. The investigated pharmacological correction agents included the peptide drug Semax and a hepatoprotective agent with a peptide component, Molixan. The survival rate, average lifespan, neurological status, and vital functions (respiratory rate, heart rate, and body temperature) of the animals were evaluated. The results showed that administration of Semax and Molixan peptides increased the survival rate of rats and had a favorable effect on neurological status and vital body functions in cases of acute severe ethanol intoxication at a dose of 1.5 LD50. This study demonstrated the potential of using peptide drugs in cases of acute severe ethanol intoxication.

Favorable evolution of severe paraquat poisoning. Treatment with gastric lavage, activated charcoal, cyclophosphamide + corticoids, and conventional daily hemodialysis: case study at the Franck Joly Hospital Center in French Guiana

We report the observations of two patients, having voluntarily ingested lethal doses of paraquat with suicidal intent, with an unfavorable prognostic score. The treatment consisted of gastric lavage, administration of activated charcoal, n-acetylcysteine and cyclophosphamide + methylprednisolone + dexamethasone. The installation of acute renal failure motivated the initiation of daily conventional hemodialysis (HD) over 10 to 14 days, with a favorable evolution. The following complications were recorded: anemia, bacteremia and deep vein thrombosis. These observations raise three questions in the treatment of paraquat intoxication: the effectiveness of HD, the interest of its association with the above therapies in the prevention of pulmonary fibrosis, and the need for infectious prevention and thromboembolism. Furthermore, the absence of a paraquatemia assay cannot constitute a limitation for management, and hemoperfusion on an inaccessible charcoal column can be replaced by an HD usually available.

Demographics and Clinical Characteristics Assessment of Severe Acute Toxic Ingestions in Pediatric Patients: A Single-Center Study in Jilin Province of China.

This study aimed to describe the demographic and clinical characteristics of severe acute toxic ingestions in children in Jilin Province and provide a reference for seeking effective measures to prevent poisoning accidents. The clinical data of patients diagnosed with acute toxic ingestions and who presented with severe life-threatening symptoms or organ dysfunction at the Pediatric Intensive Care Unit of the First Hospital of Jilin University were retrospectively analyzed. Patients with incomplete clinical medical records, unclear toxic substance, and loss to follow-up within 6 months of discharge are excluded. We sorted out these children's demographic characteristics, types of poisoning, clinical manifestations, treatment process, and follow-up, etc. This study enrolled 141 cases with no significant differences in sex and region; adolescents accounted for 44.68%. The most common poisons were pesticides and insecticides for rural areas and internal medication for urban areas. With poisoning details as a grouping variable, there was no statistical difference between sex groupings (χ2 = 6.018, P = 0.198) and no difference between region groups (χ2 = 3.775, P = 0.289). However, there were statistical differences between age groups (χ2 = 28.22, P = 0.001). In this research, patients younger than 6 years are mainly unintentionally poisoned, whereas the suicide rate of the urban group (P < 0.05), adolescents (P < 0.01), and girls (P < 0.01) has increased significantly; moreover, the suicide group is more likely to take more overdose medication or pesticides and insecticides (P < 0.01). In addition, there was a statistical difference between suicide and length of intensive care unit stay (r = 0.268, P < 0.01). A total of 90.78% of the patients were successfully discharged after comprehensive treatment. Children aged younger than 12 years had good psychological and intellectual development during the follow-up period, whereas adolescents diagnosed with depression often required long-term psychological and medication intervention. This study identified poisoning details in different ages, regions, and sex of acute severe oral poisoning in children from Jilin Province. The results presentation of different prevention priorities should vary among children of different ages and emphasize adolescent suicide being a reality in Jilin Province. There is an urgent need for further culture-specific research in this area.

Discrimination of lethal Russula subnigricans from wild edible and morphologically similar mushrooms in the genus Russula using SCAR markers

Russula is a diverse genus of mushrooms that is consumed worldwide. Russula subnigricans is a lethal species that causes myotoxicity upon ingestion. It is morphologically similar to wild foraged species, including R. nigricans and R. densifolia. Misidentification of these mushrooms can lead to severe food poisoning. Several PCR-based approaches have been used to overcome this problem. In this study, 22 samples of wild edible Russula species were collected, and five clinical samples of R. subnigricans leftovers were obtained. Based on the sequence data of the internal transcribed spacer, the phylogenetic trees revealed that these 27 samples could be classified into well-established clades of six subgenera. Fifty arbitrary primers were used in high annealing temperature rapid amplified polymorphic DNA (HAT-RAPD) technique to screen polymorphic bands among R. subnigricans, R. nigricans, R. densifolia, and other edible species. Distinctive RAPD fragments were obtained from 11 primers and used in sequence characterized amplified region (SCAR) technique. Three pairs of species-specific SCAR primers were selected to distinguish lethal R. subnigricans, R. nigricans, and R. densifolia with SCAR markers of 213, 420, and 609 bp, respectively. Ten-fold sensitivity test revealed that the SCAR marker of R. subnigricans could be detected at DNA template concentrations as low as 30 pg/μL. This marker could detect the presence of lethal R. subnigricans even at 1% in a cooked sample of mixed mushroom remnants. The developed SCAR markers ensured rapid and accurate diagnosis of suspected myotoxic mushrooms, thereby reducing the risk of severe foodborne illness and death.

Issue of alcoholism of the population in the work of a general practitioner

Alcoholism is the major medical and social problem all over the world, including in Russia. Alcohol abuse leads to severe poisoning of the human body and provokes the development of irreversible consequences in it. Alcohol negatively affects people's health, causing illness and premature mortality of working-age citizens, leading to large losses in production, as well as huge costs for medical care. According to statistics, in the Russian Federation there are more than 5 million alcohol-dependent people, which is 3.4 % of the population, while barely half are registered. In general, it is very difficult to quantify the scale of the problem of alcohol consumption, as the majority of the rural population consumes homemade products. If we also take into account the illegal alcohol trade, the actual volume of alcohol will significantly increase. When analyzing data on the amount of alcohol consumed by the population of our country, it can be concluded that in the period from 2010 to 2012, there was a slight increase in the consumption of alcoholic beverages, then from 2012 to 2018 there was a gradual decrease in the alcohol consumption, and in 2019 there was a sharp jump in the amount of alcohol consumption by the population by 46.7 %, and this indicator has maintained its value for almost all recent 4 years, i.e. from 2019 to 2022. In general, there were no significant changes in the indicators from 2010 to 2022. Analysis of the causes and clinical manifestations of alcoholism allow creating measures to prevent this disease and influence the medical and social aspects of the population’s health and quality of life. The results of the study can be used by general practitioners in their professional activities.

Causes, clinical characteristics, and outcomes of high lithium levels and intoxications: Retrospective analysis of patient records.

The mood stabilizer lithium has a narrow therapeutic index with a relevant risk of intoxication. We used real-world hospital data to identify causes, treatment courses, and outcomes of high lithium levels and intoxications. Retrospective chart review of patients with a lithium concentration of ⩾1.1 mmol/L, who were treated at Charité University Medical Center Berlin. We identified 136 patients (58% women; mean age: 54.7 years) with high lithium levels or intoxication. 66.9% were chronic (stable lithium dose but changes in other variables such as co-medication). 40.4% took at least one risk medication with a relative contraindication for concurrent lithium treatment. 11.1% of the cases with a high therapeutic level showed moderate to severe intoxications. Feverish infections were significantly associated with severe intoxications. Overall, 97.1% (132/136) of patients fully recovered, two had residual but mild symptoms and two died during hospitalization (unlikely related to the intoxication). In 37.5% of patients, no psychiatrist was involved in the management of high lithium levels or intoxication. In these patients, lithium treatment was adjusted or discontinued in 37.3% of the cases compared to 64.7% when a psychiatrist was involved (χ²(1) = 9.683, p = 0.002). Patients and medical doctors should be aware of the increased risk of lithium intoxication already within the high therapeutic range and should consider alternative medications without relative contraindications for concurrent lithium use. Involving psychiatrists during or after an intoxication event is associated with more frequent adjustment of the maintenance lithium dose and should be considered in most cases.

Characterization of the pyrolysis patterns of 44 synthetic cannabinoids and their application in illicit drug analysis

The toxicological research and analysis of synthetic cannabinoids (SCs) have been the focus of scientists. SCs often cause severe acute intoxication after smoking, which may be related to the pyrolysis products formed during the heating process. However, the toxicology studies in vitro and in vivo are hampered by the lack of data on pyrolysis products. Moreover, SCs are diverse and rapidly updated, and the detection of SCs is always a step behind the changes in the illegal market. Here, 44 SCs were analyzed using pyrolysis-gas chromatography/mass spectrometry at 300, 600, and 800 ℃, respectively. The pyrolysis patterns of different SCs under the oxygen-free condition were proposed, based on the pyrolysis products. The shared and characteristic pyrolysis products of 44 SCs were obtained and employed as analytical markers for SCs identification. SCs in one seized e-liquid sample were accurately identified on the basis of the shared and characteristic pyrolysis products. The pyrogram profiles obtained by pyrolyzing SC standards at 600 ℃ were characteristic and reproducible. Therefore, a pyrogram library containing 44 entries for SCs was built through Similarity Evaluation System for Chromatographic Fingerprint of Traditional Chinese Medicine. The pyrogram fingerprinting was used to identify eight unknown SC powders successfully. The results demonstrate the great potential of the pyrolysis pattern of SCs in drug analysis.

Young patient diagnosed with severe poisoning caused by yew leaves

Young patient diagnosed with severe poisoning caused by yew leaves

The effect of the combined use of the mineral feed additive "Calvolit" and the probiotic additive Biolatic G-500 on the clinical blood parameters of calves with nonspecific dyspepsia

Nonspecific dyspepsia is a common pathology of the early neonatal period, characterized by widespread and severe course, severe intoxication and dehydration. Due to diarrheal syndrome, leukocytes, immunoglobulins, water, macro- and microelements are excreted from the body of young animals. It is possible to restore the lack of inorganic substances by introducing mineral supplements into the treatment regimen, and normalize the digestive processes through the use of probiotics. Considering that the data from their combined use in the treatment of nonspecific dyspepsia of young animals are extremely scarce and sometimes contradictory, the goal was set to establish the degree of influence of the combined use of the mineral feed additive "Calvolit" and the probiotic supplement Biolatic G–500 on the main clinical blood parameters of calves in the treatment of nonspecific dyspepsia. The object of the study was 30 calves of a three-day-old black-and-white Holstein breed, selected according to the principle of pairs of analogues that had a body weight from 30.0 to 35.0 kg at birth. Three groups were formed from them. The first (control) group (n=10) included healthy animals (normotrophics) with no clinical signs of dyspepsia. The second (n=10) and third (n=10) groups were formed from animals with a characteristic clinical picture of a simple form of dyspepsia. The animals of the second group were assigned a treatment regimen used on the farm. In addition, Biolatic G-500 preparations at a dose of 5.0 g (0.5 tablespoons) and the mineral feed additive Calvolit at a dose of 30.0 g per head per day were introduced into the treatment regimen for animals of the third group. The control of the clinical condition of the animals was carried out taking into account the clinical blood test. It was found that the combined use of the probiotic drug "Biolatic" (Biolatic) G-500 and the mineral feed additive "Calvolit" as part of the treatment regimens for nonspecific dyspepsia contributes to the acceleration of normalization of clinical blood parameters and leukocyte profile of young animals.

Expositionen mit Fruchtpflanzen in Deutschland im Zeitraum 2010–2019

ZusammenfassungHintergrundAnfragen zu Fruchtpflanzen sind ein häufiger Konsultationsgrund von Giftinformationszentren, wobei hervorzuheben ist, dass es keine großen systematischen Studien zur Giftigkeit auf Grundlage von Expositionsdaten gibt. Ziel der Arbeit ist die Bestimmung des Vergiftungsrisikos durch Fruchtpflanzen in Deutschland.MethodenRetrospektive Untersuchung der Daten des Gemeinsamen Giftinformationszentrums Erfurt zu Vergiftungsanfragen bzgl. Fruchtpflanzen (2010–2019) mit ausführlicher Darstellung vorab publizierter Zwischenergebnisse, tabellarischer Handreichung und Pflanzenfotografien als Identifizierungshilfe sowie Trendanalysen.ErgebnisseAus 16.088 Pflanzenexpositionen mit 16.700 Pflanzen wurden 214 verschiedene Fruchtpflanzenarten identifiziert. 45 Fruchtpflanzenarten (21 %) stellten sich als relevant (≥ 30 Anfragen) heraus, davon 6 (2,8 %) als hochrelevant (≥ 300 Anfragen). Allen relevanten Pflanzen wurde eine definierte Risikokategorie (RK) zugeordnet: RK 0 (2; 4,4 %), RK 1 (26; 57,8 %), RK 2 (12; 26,7 %) und RK 3 (5; 11,1 %). Von den Anfragen bezogen sich 6 % (459/7607) auf RK 0, 47,9 % (3645/7607) auf RK 1, 39,3 % auf RK 2 (2986/7607) und 6,8 % (517/7607) auf RK 3. 69,5 % (5284/7607) der Anfragen betrafen Kleinkinder (1 bis < 6 Jahre). Die Expositionsfolgen waren für alle Altersklassen zu 82 % symptomlos, 14,7 % leichtgradig, 3 % mittelschwer und 0,3 % schwer, wobei schwere Vergiftungen durch 7 Pflanzenarten verursacht wurden. Eine Intervention wurde in 66,8 % (5079) der Anfragen eingeleitet. Anfragen betrafen am häufigsten: Taxus baccata, Ligustrum vulgare, Physalis alkekengi, Prunus laurocerasus, Convallaria majalis, Mahonia spec., Sambucus spec., Lonicera spec., Sorbus aucuparia, Thuja spec., Hedera helix und Cotoneaster spec.DiskussionVergiftungen durch Fruchtpflanzen in Deutschland sind selten. Es besteht allerdings ein hoher Informations- und Aufklärungsbedarf.

A case of West Nile fever in the Kursk region of Russia

Aim: to analyze the features of the clinical course of a case of West Nile fever (WNF) first detected in the Kursk region. Materials and methods. The article presents the first case of WNF detected in the Kursk region, confirmed by detection of pathogen RNA in the PCR test. Results. Patient Ch., 68 years old, was hospitalized to the intensive care unit of the Regional Clinical Infectious Diseases Hospital with severe intoxication, fever up to 39°C, positive meningeal symptoms of Kernig, Brudzinsky, severe neck stiffness. Upon admission, the analysis of peripheral blood showed leukocytosis up to 13.6×109, lymphopenia up to 5%, ESR acceleration up to 20 mm/h. Biochemical analysis revealed a significant increase in CRP, an increase in transaminase activity. In the cerebrospinal fluid, cytosis was noted up to 71 cells per mm3, an increase in protein up to 872 mg/l, the number of neutrophils up to 60%, lymphocytes - up to 40%, and the loss of a delicate plaque. The results of the study revealed high titers of Ig M and Ig G to the antigens of the virus, as well as the detection of WNF virus RNA in the blood and cerebrospinal fluid by PCR. Taking into account the data of the epidemiological anamnesis, clinical symptoms, positive results of ELISA and PCR of blood and cerebrospinal fluid for the causative agent of WNF, the diagnosis was made: West Nile fever with CNS damage, meningeal form (serous meningitis), severe course. Dyscirculatory encephalopathy of complex (dyscirculatory, dysmetabolic) genesis with scattered microsymptomatics. Conclusion. The described clinical case indicates that the WNF causative agent circulates in the Kursk region, which justifies the need for blood and cerebrospinal fluid testing in all patients with hyperthermia of unknown origin, combined with neurological symptoms for the WNF virus.

A study of white blood cell counts as a prognostic marker among patients sustaining organophosphate poisoning presenting to the Emergency Department of a Tertiary Care Hospital

Abstract Background: Organophosphate (OP) pesticide poisoning is a primary concern in rural regions of developing nations, posing a significant clinical challenge. The mortality rate from acute OP compound poisoning surpasses any other harmful substance. In the case of stressful events like injuries and poisoning, the observed leucocytosis and neutrophilia can be attributed to neutrophil margination rather than an increase in bone marrow production. Materials and Methods: Between June 2020 and September 2021, a prospective observational study was conducted at a tertiary care institute in Tamil Nadu. The study included 50 patients admitted to the Institute’s Medical Emergency Ward with suspected Organophosphorus poisoning. These patients were categorized into three grades, mild, moderate, and severe, using Dresbach’s classification based on the severity of their manifestations. Results: Among the 50 cases studied, 29 were females, and 21 were males. The predominant agent is responsible for organophosphate (OP) poisoning was chlorpyrifos, affecting 37 patients. Most cases (78%) presented with mild manifestations, 12% presented with moderate presentations, and 10% had severe manifestations. Most (72%) of patients sought medical attention within 4 h of consumption (n = 36). Conclusion: While insufficient to confirm or rule out severe poisoning, leukocyte counts hold some moderate capacity to differentiate between patients with and without significant poisoning. As a result, these counts could have a meaningful impact on decisions regarding patient disposition.

Diagnosis and correction of immunological reactivity disorders in tuberculosis and toxocariasis infection

The article is a systematic review of the literature on toxocariasis and tuberculosis. Human toxocariasis is a neglected tropical disease that has a global distribution and a significant impact on global public health. The infection can lead to a number of serious conditions in humans, including in cases associated with other infections. Invasion with Toxocara canis represents a strong endogenous factor in the formation of the regulatory imbalance of the immune system, which is manifested by the decrease in phagocytosis indices, the increase in the content of circulating immune complexes, and total IgE. The integral evaluation of these indices serves as an important criterion in the diagnosis of toxocariasis and the effectiveness of the applied therapy. Immunosuppression caused by parasites inhibits metabolic processes in the human body, and enzyme activity, making it difficult to absorb antiparasitic, antibacterial, and other chemotherapeutic drugs. Therefore, the treatment of tissue helminthiasis is difficult, because the larvae are in the tissues, while antiparasitic drugs do not have a high absorption capacity. Decreased eosinophils and IL-10 indicate that asymptomatic helminth infection significantly suppresses immunity in tuberculosis patients. The association of pulmonary tuberculosis wit toxocariasis is a combination of two diseases with severe endogenous intoxication, which is insufficiently elucidated.

Lithium-induced subacute diencephalic angio endotheliopathy.

A 65-years-old woman with bipolar affective disorder presented to our ED with a severe lithium intoxication and the recent onset of confusion, clumsiness, and tremors. Symptoms worsened to stupor and anarthria immediately after hospital admission. Gadolinium-enhanced brain Magnetic Resonance Imaging (MRI) showed signal hyperintensity involving both thalami in T2weighted (T2w)/Fluid Attenuated Inversion Recovery sequences (right > left), restricted areas of proton diffusivity at the level of both occipital lobes and a sharp contrast enhancement of thalami, rhombencephalon, and of leptomeninges from either the temporal, parietal, occipital lobes as well as from the cerebellar folia (right > left). These findings were consistent with a severe form of Posterior Encephalopathy known as Subacute Diencephalic Angio Endotheliopahty (SDAE). In addition, Magnetic Resonance Angiography revealed thrombosis of the right transverse and sigmoidal sinuses up to confluence with the jugular vein. The MRI picture resolved one month later after a course of high dosage dexamethasone. The patient deceased one month after discharge, mainly due to Diabetes Insipidusassociated hypernatremia. Dissecting the "Pandora's box" represented by complex MRI findings (SDAE and sinus thrombosis) in lithium-induced neurotoxicity is fundamental in timely recognizing this threating but potentially reversible clinical picture.

Blood-Derived Exosomes With Anti-Inflammatory Properties As A New Minimally Invasive Intratesticular Therapy For Aflatoxin B1-Associated Chronic Testopathy

Rationale — Aflatoxin B1 (AB1) is a dangerous toxin causing severe poisoning and even death in human. Testopathy or even infertility is one of the adverse effects of AB1. Exosomes (Ex) with anti-inflammatory action are known as biological substances derived from body fluids. This experimental study aimed to investigate the possible therapeutic effects of blood-derived Ex on orchitis caused by chronic exposure to AB1. Methods — Male rats (n=18) were distributed among three groups: control, AB1 and AB1+Ex. Orchitis was induced with AB1 (45 μL/kg of rat weight) for 40 days (3 times a week). A day later, 10 IU Ex were injected intratesticularly. A week later, testicular tissue and blood serum were sampled. To confirm the therapeutic effects of Ex, inflammatory genes (TNF-α, IL-6 and IL-10), nitric oxide (NO), malondialdehyde (MDA), testosterone (Tes) and sperm quality were fully evaluated. In addition, H&amp;E staining was used to investigate tissue changes, and immunohistochemical (IHC) assessment was employed to detect the inflammatory protein, galectin-3. The results were analyzed using SPSS (v.19). Results and Discussion — Our results confirmed that Ex therapy can significantly (p&lt;0.05) increase normal morphology (25.01±2.23 in the AB1+Ex group vs. 10.1±0.9 in the AB1 group), number (76.12±6.7 in the AB1+Ex group vs. 27.8±3.2 in AB1 group), and vitality (53.4±6.12 in AB1+Ex vs. 41.9±4.6 in AB1) of sperm cells. Blood-derived Ex significantly (p&lt;0.05) reduced the expression of inflammatory genes (6-fold change was observed in AB1+Ex vs. 17-fold in AB1 for TNF-α, 3-fold change was detected in AB1+Ex vs. 6-fold in AB1 for IL-6, and 2-fold change took place in AB1+Ex vs. 6-fold in AB1 for IL-10), NO (23.1±2.6 in AB1+Ex vs. 62.8±8 0.1 in AB1) and MDA (33.2±4.9 in AB1+Ex vs. 68.9±5.46 in AB1), and increased Tes level (7.1±0.5 in AB1+Ex vs. 1.14±0.3 in AB1) in AB1-affected rats. Histopathological evaluations revealed tissue regeneration after Ex injection. Also, the produced sperm cells were of high quality. Conclusion — Intratesticular injection of Ex from the blood can be considered as a novel anti-inflammatory therapy after AB1-induced orchitis.

Application of extracorporeal membrane oxygenation technique in patients with refractory shock caused by dichlorvos poisoning

Dichlorvos poisoning can cause muscarinic (M) -like symptoms, nicotinoid (N) -like symptoms and central nervous system manifestations. When severe poisoning is combined with refractory shock, the mortality rate exceeds 60%. At present, there are more and more studies on ECMO for poisoning, but there is no report on ECMO for treating refractory hypotension caused by dichlorvos poisoning. We analyzed 3 successful cases of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in the treatment of refractory shock caused by acute severe dichlorvos poisoning to explore the effectiveness of VA-ECMO in patients with severe poisoning.

S-layer is a key element in metabolic response and entry into the stationary phase in Bacillus cereus AH187

Bacillus cereus is a food-borne Gram-positive pathogen. The emetic reference strain B. cereus AH187 is surrounded by a proteinaceous surface layer (S-layer) that contributes to its physico-chemical surface properties, and promotes its adhesion in response to starvation conditions. The S-layer produced by B. cereus AH187 is composed of two proteins, SL2 and EA1, which are incorporated at different growth stages. Here, we showed that deletion of the genes encoding SL2 and EA1 produced viable cells, but decreased the glucose uptake rate at the start of growth, and induced extensive reorganization of the cellular and exoproteomes upon entry into the stationary phase. As a consequence, stationary cells were less resistant to abiotic stress. Taken together, our data indicate that the S-layer is crucial but comes at a metabolic cost that modulates the stationary phase response. SignificanceThe emetic strains of Bacillus cereus are known to cause severe food poisoning, making it crucial to understand the factors contributing to their selective enrichment in foods. Most emetic strains are surrounded by a crystalline S-layer, which is a costly protein structure to produce. In this study, we used high-throughput proteomics to investigate how S-layer synthesis affects the allocation of cellular resources in the emetic B. cereus strain AH187. Our results demonstrate that the synthesis of the S-layer plays a crucial role in the pathogen's ability to thrive under stationary growth phase conditions by modulating the stress response, thereby promoting its lifestyle as an emetic pathogen. We conclude that the synthesis of the S-layer is a critical adaptation for emetic B. cereus to successfully colonize specific niches.

Detection the severity of organophosphate intoxication using sensitive serum biomarkers S100B and amyloid β (Aβ) in Egyptian subjects

Organophosphate (OP) is a compound considered the main leading cause of morbidity and mortality from poisoning worldwide. Serum pseudocholinesterase was evaluated as a diagnostic indicator; it cannot be used to monitor therapy or severity of the intoxication. The rationale of the current study was to evaluate sensitivity, specificity, and cut-off values of serum S100B and amyloid β for neurological affection severity. This study was carried out on sixty OP-impaired patients; in addition, 20 normal controls were included. Serum liver and kidney function tests, malondialdehyde, pseudocholinesterase, and the levels of S100B and amyloid β (Aβ) were determined. Data showed that Pearson’s analysis indicated that the serum level of S100B was positively correlated with Aβ. On the contrary, the activity of pseudocholinesterase was negatively correlated with both of S100B and Aβ. Serum ALT, AST, creatinine, urea, acetylcholine, and MDA levels were elevated while pseudocholinesterase activity was reduced in moderate and severe OP intoxication versus control. A drastic elevation (p<0.001) in the levels of S100B and Aβ was performed in the patient group suffering from OP intoxication versus the normal group. The diagnostic statistical validation of targeted parameters in distinguishing between moderate OP intoxication and control clarifies that S100B displayed the best AUC (0.997) followed by Aβ (AUC=0.992), while the diagnostic veracity of S100B and Aβ in setting apart severe OP-intoxicated and normal subjects stated the symmetric efficacy of potential markers. It was concluded that the significant changes in the levels of S100B and Aβ were directly proportional to the degree of severity of OP intoxication.

Evaluation of Lac and NGAL on the Condition and Prognosis of Patients with Diquat Poisoning.

This study aims to explore the evaluation of lactic acid (Lac) and neutrophil gelatinase-associated lipocalin (NGAL) on the condition and prognosis of patients with diquat (DQ) poisoning. A total of 79 cases of DQ poisoning treated in one hospital from January 2019 through February 2023 were included: 10 cases of mild poisoning, 49 cases of moderate to severe poisoning, and 20 cases of fulminant poisoning. According to the Kidney Disease: Improving Global Outcomes-acute kidney injury (KDIGO-AKI) criteria, the patients were divided into 60 cases in the AKI group and 19 cases in the non-acute kidney injury (NAKI) group. According to the AKI diagnostic indicators, AKI patients were divided into Grade I, Grade II, and Grade III. According to prognosis, the patients were divided into survivor group and non-survivor group. During the same period, 30 healthy subjects were selected as the healthy group. The changes of blood Lac, NGAL, cystatin C (CysC), and serum creatinine (Scr) levels of patients were detected, the 28-day survival of patients was recorded, and the correlation between blood Lac, NGAL levels, and renal injury grade in patients with AKI caused by DQ poisoning was analyzed. The receiver operator characteristic (ROC) curve was used to evaluate the predictive value and prognostic value of Lac, NGAL, and their combination in patients with AKI caused by DQ poisoning. There were significant differences in AKI grade, Lac, NGAL, CysC, and Scr levels among different degrees of poisoning groups (P < .05). There were significant differences in the levels of Lac, NGAL, CysC, and Scr among patients with different AKI grades (P < .05). The levels of Lac, NGAL, CysC, and Scr in the survivor group were significantly lower than those in the non-survivor group (P < .05). The blood Lac and NGAL levels were positively correlated with AKI grades in patients with DQ poisoning (r = 0.752, 0.836; P = .000, .000). The combined detection of blood Lac and NGAL had higher predictive value for AKI and assessed value for death in DQ poisoning than either of them alone. The combined detection of Lac and NGAL have a certain clinical value in AKI grading and evaluating AKI prognosis caused by DQ poisoning.

Cannabis and Other Substance Misuse: Implications and Regulations.

Abusing controlled substances, including cannabis and various drugs, can result in severe intoxication and even death. Therefore, a comprehensive postmortem analysis is crucial for understanding the underlying causes of such fatalities. This narrative review discusses the characteristics of commonly abused controlled substances, the methodologies employed in postmortem analysis, lethal dosage levels, mechanisms of toxicity, side effects, and existing regulations. The focus centers on seven prevalent groups of controlled substances, namely cannabis, opioids, amphetamine-type stimulants, cocaine, new psychoactive substances, and hallucinogens. These groups have been linked to an increased risk of fatal overdose. Most substances in these groups exert neurotoxic effects by targeting the central nervous system (CNS). Consequently, strict regulation is essential to mitigate the potential harm posed by these substances. To combat abuse, prescribers must adhere to guidelines to ensure their prescribed medications comply with the outlined regulations. Through an enhanced understanding of controlled substance abuse and its consequences, more effective strategies can be developed to reduce its prevalence and associated mortality.