Toxic Poisoning Research Articles

Room for Change: Rural Low-Barrier Housing Policy and Program Models for People with Substance Use and Mental Health Comorbidities

Rural North American communities experience disproportionate burdens of housing instability and toxic drug poisonings. These regions face complex intersections of homelessness, substance use, and mental health issues, and innovative strategies are required to effectively address these crises. In British Columbia, Canada, new funding opportunities to address rural homelessness for complex populations have come after a lag in available resources. Complex Care Housing is a model aimed at filling gaps in the current housing and care continuum for people with mental health and substance use challenges. Due to rural-specific social characteristics, new housing models require ongoing evaluation to ensure programs meet the quality and fidelity of gold standard Housing First programs that upload the tenets of harm reduction and person-centeredness.

Dietary supplementation with glutamate enhanced antioxidant capacity, ammonia detoxification and ion regulation ability in Nile tilapia (Oreochromis niloticus) exposed to acute alkalinity stress

Saline-alkali aquaculture is an important way to improve the comprehensive utilization capacity of alkaline water and alleviate the fresh water crisis. This study investigated the effects of dietary L-glutamate (Glu) on ion regulation, ammonia detoxification and antioxidant capacity in Nile tilapia (Oreochromis niloticus) exposed to acute carbonate alkalinity stress. A total of 270 fish (6.06 ± 0.12 g) were fed three different dietary Glu supplements 0%, 1.5%, and 3.0% for 45 days. After the feeding trial, the fish were exposed to fresh water (control) or 53.57 mmol/l carbonate alkaline water for 24 h. The results showed that dietary Glu not only improved the weight gain and condition factors of tilapia but also promoted three reactions in which ammonia was converted into nontoxic substrates. After 24 h of alkalinity stress, tilapia fed a 15 g/kg Glu-supplement diet had considerably higher ion transport capacity in their gills compared to the control group (p < 0.05). Moreover, the gill structure of tilapia in the 15 g/kg Glu-supplement group was intact, while the structures in the other groups were impaired. Dietary Glu supplementation (15 g/kg) significantly increased the expression of genes related to urea and glutamine (Gln) synthesis. Additionally, the ammonia excretion capacity and antioxidant capacity were greatest in tilapia in the 15 g/kg Glu-supplement group (p < 0.05). These results indicated that in addition to promoting the growth of Nile tilapia, dietary Glu supplementation ameliorate the alkalinity tolerance of Nile tilapia and prevent oxidative damage, ionic toxicity and ammonia poisoning caused by acute carbonate alkalinity stress.

Color-tunable graphene quantum dots via one-step nitrogen-induced intramolecular charge transfer for in vivo/vitro aminotransferase fluorescence sensing

Monitoring aspartate aminotransferase (AST) has been demonstrated to be a sensitive sign of liver dysfunction and an essential method for determining the health status of the living body. The quantitative analysis of AST in vivo/vitro is still challenged by complicated processes, expensive equipment, and/or limited sensitivity. A colorimetric assay using multicolored fluorescent nanomaterials holds great promise in vivo/vitro sensing for visual and highly sensitive disease diagnosis. However, achieving a one-step synthesis of multicolored fluorescence (FL) GQDs probe presents challenges. Herein, we successfully designed novel multicolored GQDs with a high quantum yield (QY) of 60.7 % via a simple nitrogen-induced intramolecular charge transfer (ICT) approach. Leveraging the non-toxic and color-tunable properties of N-GQDs, we developed an innovative N-GQDs-based FL test paper for sensitive colorimetric on-site detection of AST, employing the FL colorimetric method based on the transamination reaction. The FL quenching intensity demonstrated an excellent linear relationship with the concentration of AST within the range of 2.0−60.0 U/L, achieving an impressively low limit of detection (LOD) as low as 0.065 U/L. Moreover, the N-GQDs were utilized for AST in vivo detection and FL imaging in living zebrafish, further showcasing their potential in various applications such as liver disease diagnosis, assessment of myocardial damage, and monitoring of drug and toxic poisonings.

Strigolactones alleviate AlCl3 stress by vacuolar compartmentalization and cell wall blocking in apple.

Poor management and excess fertilization of apple (Malus domestica Borkh.) orchards are causing increasingly serious soil acidification, resulting in Al toxicity and direct poisoning of roots. Strigolactones (SLs) are reported to be involved in plant responses to abiotic stress, but their role and mechanism under AlCl3 stress remain unknown. Here, we found that applying 1 μm GR24 (an SL analoge) significantly alleviated AlCl3 stress of M26 apple rootstock, mainly by blocking the movement of Al through cell wall and by vacuolar compartmentalization of Al. RNA-seq analysis identified the core transcription factor gene MdWRKY53, and overexpressing MdWRKY53 enhanced AlCl3 tolerance in transgenic apple plants through the same mechanism as GR24. Subsequently, we identified MdPMEI45 (encoding pectin methylesterase inhibitor) and MdALS3 (encoding an Al transporter) as downstream target genes of MdWRKY53 using chromatin immunoprecipitation followed by sequencing (ChIP-seq). GR24 enhanced the interaction between MdWRKY53 and the transcription factor MdTCP15, further increasing the binding of MdWRKY53 to the MdPMEI45 promoter and inducing MdPMEI45 expression to prevent Al from crossing cell wall. MdWRKY53 also bound to the promoter of MdALS3 and enhanced its transcription to compartmentalize Al in vacuoles under AlCl3 stress. We therefore identified two modules involved in alleviating AlCl3 stress in woody plant apple: the SL-WRKY+TCP-PMEI module required for excluding external Al by blocking the entry of Al3+ into cells and the SL-WRKY-ALS module allowing internal detoxification of Al through vacuolar compartmentalization. These findings lay a foundation for the practical application of SLs in agriculture.

IDENTIFICATION OF K3 HAZARD RISK IN FIREFIGHTERS AT MEDAN CITY FIRE AND RESCUE SERVICE

Firefighters are particularly vulnerable to several work-related illnesses and injuries, including toxic gas poisoning, burns, respiratory distress, and bodily injury. Therefore, an important first step in implementing successful prevention tactics is to identify possible K3 hazards precisely and accurately. To prevent industrial accidents that endanger workers due to hazards arising in the Medan City Fire and Rescue Department, the purpose of this study is to identify hazards and evaluate risks using the HIRA method analysis. The research was conducted using qualitative methodology. Three data collection methods were used: documentation, in-depth interviews, and observation. The informants in this study amounted to 4 people consisting of 2 key informants and 2 main informants. Based on the results of hazard identification and risk assessment, there are 19 accident risks spread across 5 activities in the Medan City Fire and Rescue Service. Based on the results of the study, it was concluded that 10 potential hazards fall into the meaningful category, 4 potential hazards fall into the medium-risk category, 4 potential hazards fall into the low-risk category, and high-risk categories as many as 1 potential hazard. Based on these conclusions, suggestions were submitted to the Medan City Fire and Rescue Service to increase the provision of personal protective equipment (PPE) such as gloves, helmets, heat-resistant shirts, and pants, and SCBA was an anticipation of the proposal submitted to the Medan City Fire and Rescue Service. Medan City Fire and Rescue Officers are also required to always comply with established work rules to reduce risks and avoid work accidents.

Concentration of metals and metalloids in livers of birds of various foraging guilds collected during the autumn migration period in Poland.

During migration, birds explore various habitats at stopover sites that differ in food resources and contamination levels. In this study, hepatic concentrations of 21 elements (metals and metalloids) in 11 species of birds, representing various foraging habitats (such as aquatic, aquatic/terrestrial, and terrestrial) and migration modes (migratory and sedentary) representing various foraging guilds (omnivores, piscivores, and molluscivores), were analyzed. The samples (N = 84) were collected during the autumn migration period in Poland. The concentrations of elements determined in this study exhibited high inter-species variability, reflecting the diversity in contamination levels depending on food resources used by specific bird groups. Many of the investigated individuals from different species showed exceeded levels of subclinical toxicity and moderate clinical poisoning due to Cd and Hg. Higher concentrations of As, Hg, and Ba and lower V concentrations were found in migratory birds as compared to sedentary birds. Species foraging in terrestrial habitat had different concentrations of some elements compared to aquatic and aquatic/terrestrial species. Some specific inter-species differences in hepatic elemental concentrations were found. Differences in elemental concentrations among various groups can primarily be attributed to their foraging guilds, with certain elements, particularly As, V, and Hg, playing a significant role in the dissimilarity of elemental concentrations between foraging habitat groups and migratory mode groups. The data collected confirmed the limited ability of As to enter ecosystem pathways. The results of this study contribute to understanding the year-round exposure of migratory birds to environmental contamination, which can have carry-over effects on their performance in wintering and breeding grounds.

Manufacture and Combustion Characteristics of Cellulose Flame-Retardant Plate through the Hot-Press Method.

This study focuses on the increased risk of high heat release and asphyxiation (toxic gas poisoning) in the event of a fire involving polyurethane (PU)- and MDF-based building materials, which are commonly used in buildings. Among them, polyurethane (PU) building materials are very commonly used in buildings, except in Europe and some other countries, due to their excellent thermal insulation performance. Still, problems of short-term heat release and the spread of toxic gases in the event of a fire continue to occur. To overcome these problems, researchers are actively working on introducing various flame retardants into building materials. Therefore, in this study, we produced a laboratory-sized (500 mm × 500 mm) plate-like flame-retardant board that can be utilized as a building material with a lower heat release rate and a lower toxicity index. The material was made by mixing expanded graphite and ceramic binder as flame retardants in a material that is formulated based on the cellulose of waste paper, replacing the existing building materials with a hot-press method. According to the ISO-5660-1 test on the heat release rate of the plate-like flame-retardant board, the Total Heat Release (THR) value was 2.9 (MJ/m2) for 10 min, showing an effect of reducing the THR value by 36.3 (MJ/m2) compared to the THR value of 39.2 (MJ/m2) of the specimen made using only paper. In addition, the toxicity index of the flame-retardant board was checked through the NES (Naval Engineering Standards)-713 test. As a result, the test specimen showed a toxicity index of 0.7, which is 2.4 lower than the toxicity index of 3.1 of MDF, which is utilized as a conventional building material. Based on the results of this study, the cellulose fire-retardant board showed the effect of reducing the heat release rate and toxicity index of building materials in a building fire, which reduces the risk of rapid heat spread and smoke toxicity. This has the potential to improve the evacuation time (A-SET) of evacuees in fires. It is also important to show that recycling waste paper and utilizing it as the main material for building materials can be an alternative in terms of sustainable development.

Masson pine pollen aqueous extract ameliorates cadmium-induced kidney damage in rats.

Introduction: Cadmium (Cd) is a hazardous environmental pollutant present in soil, water, and food. Accumulation of Cd in organisms can cause systematic injury and damage to the kidney. The Masson pine pollen aqueous extract (MPPAE) has attracted increasing attention due to its antioxidant activity and ability to enhance immunity. Methods: In this study, we investigated the potential of MPPAE to protect against Cd-induced kidney damage in rats and the underlying mechanism. The transcriptome and metabolome of rats with Cd-induced kidney damage, following treatment with MPPAE, were explored. Results: The concentrations of superoxide dismutase (SOD) and malondialdehyde (MDA) were both significantly altered after treatment with MPPAE. Furthermore, sequencing and analysis of the transcriptome and metabolome of rats with Cd-induced kidney damage, following treatment with MPPAE, revealed differential expression of numerous genes and metabolites compared with the untreated control rats. These differentially expressed genes (DEGs) included detoxification-related genes such as cytochrome P450 and the transporter. The differentially expressed metabolites (DEMs) included 4-hydroxybenzoic acid, L-ascorbate, and ciliatine. Conjoint transcriptome and metabolome analysis showed that several DEGs were correlated with DEMs. Conclusion: These preliminary findings indicate the potential of MPPAE for the treatment of toxic metal poisoning.

Strategies for enhanced bioavailability of oxime reactivators in the central nervous system.

Oxime reactivators of acetylcholinesterase are commonly used to treat highly toxic organophosphate poisoning. They are effective nucleophiles that can restore the catalytic activity of acetylcholinesterase; however, their main limitation is the difficulty in crossing the blood-brain barrier (BBB) because of their strongly hydrophilic nature. Various approaches to overcome this limitation and enhance the bioavailability of oxime reactivators in the CNS have been evaluated; these include structural modifications, conjugation with molecules that have transporters in the BBB, bypassing the BBB through intranasal delivery, and inhibition of BBB efflux transporters. A promising approach is the use of nanoparticles (NPs) as the delivery systems. Studies using mesoporous silica nanomaterials, poly (L-lysine)-graft-poly(ethylene oxide) NPs, metallic organic frameworks, poly(lactic-co-glycolic acid) NPs, human serum albumin NPs, liposomes, solid lipid NPs, and cucurbiturils, have shown promising results. Some NPs are considered as nanoreactors for organophosphate detoxification; these combine bioscavengers with encapsulated oximes. This study provides an overview and critical discussion of the strategies used to enhance the bioavailability of oxime reactivators in the central nervous system.

Multiplex TaqMan real-time PCR assay for high-throughput identification of highly toxic mushroom species-induced foodborne poisoning

The highly toxic Amanita species, Russula subnigricans, and Lepiota brunneoincarnata are the major mushroom types causing mushroom poisoning fatalities worldwide, which seriously endanger human life and health. However, the detection method for the simultaneous identification of these highly toxic mushroom types is scarce. In this study, a one-tube multiplex TaqMan real-time PCR assay was established for simultaneous detection of the highly toxic mushroom species from three genera. The developed assay could simultaneously detect at least 6 highly toxic Amanita species and specially identify R. subnigricans and L. brunneoincarnata without the cross-reaction in 37 mushroom species. The method detection limits were 0.1 pg/μL, 1 pg/μL, and 0.1 pg/μL DNA for highly toxic Amanita species, R. subnigricans, and L. brunneoincarnata with high amplification efficiency. Moreover, the multiplex real-time PCR assay was successfully applied to the cooked mushroom. The developed method is expected to become an effective tool for high-throughput identification of foodborne poisoning associated with these highly toxic mushroom species.

An evaluation of the Compassion, Inclusion, and Engagement initiative: learning from PWLE and communities across British Columbia

BackgroundThe Compassion, Inclusion and Engagement initiative (CIE) was a social contact intervention that operated in British Columbia between 2015 and 2021. The primary objective of CIE was to increase the participation of people with lived experience of substance use (PWLE) in the planning, design, implementation, and evaluation of harm reduction supports and services.Case presentationCIE used the developmental evaluation methodology outcome mapping to define and measure progress towards its goals. Developmental evaluation emphasizes learning in contrast to other forms of evaluation which are often more focused on determining the value or success of a project or programme based on predetermined criteria. Outcome mapping is a relational practice which acknowledges that change is achieved by an initiative’s partners and the role of the initiative is to provide access to resources, ideas and opportunities that can facilitate and support change.ConclusionsThrough the implementation and evaluation of CIE, it became clear that directly supporting PWLE facilitated more meaningful and lasting change than solely working to improve the health and social services that supported them. The impacts of the CIE initiative extend far beyond the outcomes of any of the dialogues it facilitated and are largely the result of an increase in social capital. CIE engagements created the opportunity for change by inviting people most affected by the toxic drug supply together with those committed to supporting them, but their ability to bring about systemic change was limited. Both PWLE and service providers noted the lack of support to attend CIE engagements, lack of support for actions that came from those engagements, and lack of PWLE inclusion in decision-making by health authorities as limiting factors for systemic change. The lack of response at a systemic level often resulted in PWLE carrying the burden of responding to toxic drug poisonings, often without resources, support, or compensation.

Gut microbiome helps honeybee (Apis mellifera) resist the stress of toxic nectar plant (Bidens pilosa) exposure: Evidence for survival and immunity.

Honeybee (Apis mellifera) ingestion of toxic nectar plants can threaten their health and survival. However, little is known about how to help honeybees mitigate the effects of toxic nectar plant poisoning. We exposed honeybees to different concentrations of Bidens pilosa flower extracts and found that B. pilosa exposure significantly reduced honeybee survival in a dose-dependent manner. By measuring changes in detoxification and antioxidant enzymes and the gut microbiome, we found that superoxide dismutase, glutathione-S-transferase and carboxylesterase activities were significantly activated with increasing concentrations of B. pilosa and that different concentrations of B. pilosa exposure changed the structure of the honeybee gut microbiome, causing a significant reduction in the abundance of Bartonella (p < 0.001) and an increase in Lactobacillus. Importantly, by using Germ-Free bees, we found that colonization by the gut microbes Bartonella apis and Apilactobacillus kunkeei (original classification as Lactobacillus kunkeei) significantly increased the resistance of honeybees to B. pilosa and significantly upregulated bee-associated immune genes. These results suggest that honeybee detoxification systems possess a level of resistance to the toxic nectar plant B. pilosa and that the gut microbes B. apis and A. kunkeei may augment resistance to B. pilosa stress by improving host immunity.

Структура и динамика острых отравлений в г. Рязани в 2016–2021 гг.

Summary. Investigation purposes – to analyze a structure of acute poisonings in the city of Ryazan in 2016-2021; to identify a summary dynamic of poisonings and poisonings classified according to separated toxicants, as well as sex characteristics. Materials and methods of the investigation. Investigation materials – maps of ambulance crew calls in the city of Ryazan in 2016-2021. Investigation results and their analysis. An analysis of statistic data collected in 2016-2021 showed a derision of ambulance calls for victims with acute poisonings. In Ryazan, as well as in Russia at all, alcohol poisonings and toxic spirits poisonings prevailed. On the second position there were medicines poisonings, on the third there were different fumes, chlorine vapors, carbon dioxide methane and others vapors. Among medicines poisonings a psychotropic, anticonvulsant, sedative and hypnotic medicines poisonings prevailed. Among the patients males prevailed primary because of alcohol and toxic spirts poisonings as well as drugs and psychodysleptics poisonings. In 2016-2021 proportion of lethal outcomes caused by acute poisonings was 0,1% in pre-hospital period and didn’t have tendency to increase. Patients were hospitalized to medical treatment organizations in 57,5% of cases. Data on the spread and dynamic of acute poisonings allow to determine linkers for organization measures in a context of urgent medical treatment provision in pre-hospital period.

Raoultella ornithinolytica as a Potential Candidate for Bioremediation of Heavy Metal from Contaminated Environments.

Disposal of waste containing heavy metals into the environment is a major threat to human health and can result in toxic or chronic poisoning in aquatic life. In the current study, metal-resistant Raoultella ornithinolytica was isolated from metal-contaminated samples collected from the Tanjaro River, located southwest of Sulaymaniyah, Iraq. R. ornithinolytica was identified by partial amplification of 16S rRNA. The uptake potency of heavy metals was assessed using inductively coupled plasma-optical emission spectroscopy (ICP-OES) and indicated that R. ornithinolytica removed 67, 89, 63.4, 55.6, 56.5, 65, and 61.9% of Cd, Pb, Cr, Ni, Zn, Co, and Fe, respectively. These removal rates were influenced by temperature, pH, and contact time; at 35°C and pH 5 with a change in the incubation time, the reduction rate improved from 89 to 95% for Pb, from 36.4 to 45% for Cu, and from 55.6 to 64% for Ni. Gene analysis indicated that R. ornithinolytica contained pbrT, chrB, nccA, iroN, and czcA genes, but the pcoD gene was absent. Energy-dispersive X-ray spectroscopy (EDS) images showed evidence of metal ion binding on the cell wall surface with different rates of binding. Transmission electron microscopy (TEM) detected different mechanisms for metal particle localization; cell surface adsorption was the main mechanism for Pb, Zn, and Co uptake, while Cd, Ni, and Fe were accumulated inside the cell. The current study describes, for the first time, the isolation of R. ornithinolytica from metal-contaminated water, which can be used as an eco-friendly biological expedient for the remediation and detoxification of metals from contaminated environments.

Lipid Emulsion Treatment for Drug Toxicity in Pediatric Patients

Medication mistakes continue to be one of the most serious issues in hospitals. Such mistakes can occur during the prescription, distribution, or administration of medications. Lipid emulsions are commonly utilized in whole or partial parenteral feeding initially, Following convincing results from animal models and effective case reports in humans, the use of intravenous lipid emulsions (ILEs) as an antidote in local anesthetic systemic toxicity has acquired considerable acceptance. Although intravenous lipid emulsion (ILE) was initially employed to treat life-threatening local anesthetic (LA) toxicity, its application has broadened to cover non-LA poisoning and less severe symptoms of toxicity. However, in recent years, the function of lipid emulsions in the treatment of lipophilic chemical toxicity and overdose has been established. In addition to typical poisoning treatment, lipid emulsion therapy was employed. The observed sequence of events provides substantial support for the importance of ILE treatment in the effective management of both instances. However, further study is needed in this area to provide definite guidelines for the use of intravenous lipid emulsions in pediatric lipophilic agent poisoning. The body of data supporting the use of ILEs in acute drug intoxication is growing. The current data supports the use of ILEs only when there is an imminent threat to life from local anesthetic systemic toxicity or lipophilic cardio-toxin poisoning. Lipid emulsion therapy is a potential and less expensive alternative in cases of acute lipophilic poisoning where a specific antidote is unavailable.

Construction of perovskite structured ZnSnO3 embedded graphene oxide nanosheets for in-situ electrochemical quantification of organoarsenic roxarsone

4-hydroxy-3-nitrophenylarsonic acid (HNPA) is an organoarsenic drug commonly known as roxarsone, which has been intensively used as a feed additive in poultry industries. However, the HNPA can easily degrade into highly toxic inorganic arsenic poisoning in biotic and abiotic nature, which threatens human health and the environment. Along with various conventional techniques, the electrochemical sensor based on nanomaterials has emerged as a potential tool for analyzing organoarsenic chemicals, owing to its ease of operation and accuracy. Herein, for the first time, we report the efficient and tremendously sensitive perovskite-structured ZnSnO3@GO nanocomposites for the electrochemical analysis of HNPA. The as-prepared ZnSnO3@GO nanocomposites with good chemical stability, excellent electron mobility, and larger specific area are beneficial to the HNPA reduction. In addition, the analytical performance of the developed sensor shows the minimized reduction potential of (−0.63 V vs Ag/AgCl) with an admirable linear range of 0.01–453.4 µM and a lower detection limit of 0.0043 µM toward HNPA detection. Finally, the real sample analysis of the developed sensor was quantified in the chicken and soil samples, which exhibits appreciable accuracy. The developed ZnSnO3@GO/GCE provides a powerful tool for the rapid and sensitive detection of HNPA in actual samples.

The geography of overdose in British Columbia.

Illicit drug toxicity poisoning (overdose) continues to be a public health emergency in British Columbia (BC) with record high rates of illicit drug toxicity during the COVID-19 pandemic. In 2021, 2224 people died of overdose in BC with some of the highest rates recorded in rural and remote regions. Understanding the geographic variations in overdose mortality risk is necessary to avoid disproportionate risk resulting from service access inequity. Using novel linked administrative health data from the BC Provincial Overdose Cohort we estimated the odds of fatal overdose per event (2015 - 2018) using both conventional logistic regression and Generalized Additive Models (GAM). The results of GAM were mapped to identify spatial-temporal trends in the risk of fatal overdose. We found that the likelihood of fatal overdose was about 20% higher in rural areas than in large urban centers, with some regions reporting odds 50% higher than others. Temporal variations in fatal risk exhibit an increasing trend over the entire province. However, risks in the Interior and Northern BC increased earlier and faster. The results of this study demonstrate the importance of geography to health outcomes and suggest that rural and remote regions may lack harm reduction services to counteract the province-wide increase in illicit drug toxicity death.

ADVERSE EFFECTS OF NASAL DECONGESTANTS (REVIEW OF LITERATURE)

Nasal decongestants are ones of the most popular and widespread medicines due to high frequency of respiratoryinfections. But on the other hand they are characterized by significant abuse potential for users seeking such effectsas euphoria, psychostimulation, less of appetite and lose the weight.The affections of the cardio-circulation and nervous systems are the most frequent complications after overdosing ofthe nasal decongestants. The development of the strikes in the young age was associated with the nasal decongestantsabuse in every tenth patient.The cases of the malignant arterial hypertension, cerebral hemorrhages, ischemic strokes, heart decompensationafter the nasal decongestants abuse is known as nasal decongestants poisoning. And although the side effects moreoften develop when nasal decongestants are used orally, intranasal way could not be considered as absolutely safe,especially in cases of overdosing.The development of the psychotic disorders is one of the most frequent nasal decongestants adverse effects. Theelderly people with organic brain damage, drug addiction, mental illness are in the risk group for the developmentof psychotic complications.Misuse of the nasal decongestants in children is especially dangerous because of the high risk of the developmentof the life-threatening toxic poisoning. Fatal cases of poisoning were associated with small age of a child, usingseveral medicines with the same ingredient, using decongestants in a daycare setting, mistakes in measuring andidentification the medicine, the absence of the doctor’s prescription, use of the product for adult age.Using nasal decongestants in supine position of the patient may lead to the significantly dose increase inside thenasal cavity and may cause toxic poisoning.Adolescents are quite sensitive to the development of nasal decongestants side effects with such risk factors asage, gender, family income, physical and mental health, use of other medicines and alcohol.The special type of the adverse effects of the long-term using of the nasal decongestants is the rhinitismedicamentosa taking place in adult persons with predisposition to the nasal hyperreactivity. The diagnosis ofthe rhinitis medicamentosa is based on the nasal hyperactivity and swelling of the nasal mucous membrane incombination with poor response on treatment caused or exaggerated by long-term use of topical nasal decongestants.The development of the rhinitis medicamentosa depends on a number of factors such as the type of nasaldecongestants, the type of preservative, the presence of risk factors that determine the patient's predisposition to thedevelopment of nasal hyperreactivity.Here we review the existing literature concerning the adverse effects of the nasal decongestants including thedevelopment of the rhinitis medicamentosa.

Effect of plasma carboxyhemoglobin level on gonadal hormone levels.

In emergency departments, carbon monoxide (CO) is a common cause of toxic poisoning. We aimed to determine the relationship between plasma carboxyhemoglobin (COHb) levels and late post-treatment gonadal hormone changes in CO poisoning. The study included 237 patients older than 18 who presented to the Emergency Department due to CO intoxication between January 2008 and December 2016. Patients with a COHb level of less than 30% were classified as having mild-to-moderate disease, while those with a COHb level of more than 30% were classified as having severe disease. Of 41 (17%) patients with gonadal hormone change (GHC), 19 (46.3%) were females. In cases with GHC, the exposure time was 5.76±1.64 hours (P=0.001). COHb level was 50.46±4.43% in the severe group (P=0.001), while hormone levels were normal in women and men before CO poisoning. GHC within one month and two years after poisoning was significantly higher (P=0.001). There were 138 (58.2%) patients in the mild-to-moderate group, and 99 (41.8%) patients in the severe group. Of the gonadal hormones, LH2 (luteinizing hormone) was 13.54±3.40 mIU/mL, FSH2 (follicle-stimulating hormone) 16.69±4.35 mIU/mL, PRL2 (prolactin) 16.23±4.73 ng/mL, and TTN2 (testosterone) 644.06±120.40 (P=0.001). In addition, COHb was found to be 42.68±8.42% (P=0.001). In univariate and multivariate Cox regression analysis, gender, LH1, LH2, PRL2, TTN2 and COHb values were found to be prognostic signs in terms of endocrine gonadal hormone change (P<0.05). In the correlation of COHb level with GHC, positive moderate-strong correlation was found between LH2, FSH2, PRL2, TTN2 (P=0.001). In patients admitted to the emergency services due to CO poisoning, elevated COHb may help predict the risk for late gonadal hormone levels.

Viscoelastic and Viscoplastic Glucose Theory (VGT #22): Applying the Concepts of Viscoelasticity, Viscoplasticity and Perturbation Theories to Predict Cancer Risk Percentages using the overall Lifestyle Scores and Calculated Cancer Risk Change Rates with Corresponding Lifestyle Scores as the Respective Viscosity Factors along with Studying the Relationship between Cancer Risks and Diabetic Glucoses Based on the GH-Method: Math-Physical Medicine (No. 601)

Viscoelastic and Viscoplastic Glucose Theory (VGT #22): Applying the Concepts of Viscoelasticity, Viscoplasticity and Perturbation Theories to Predict Cancer Risk Percentages using the overall Lifestyle Scores and Calculated Cancer Risk Change Rates with Corresponding Lifestyle Scores as the Respective Viscosity Factors along with Studying the Relationship between Cancer Risks and Diabetic Glucoses Based on the GH-Method: Math-Physical Medicine (No. 601)