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[The clinical efficacy of hemoperfusion in treatment of drug poisoning].

OBJECTIVE: To investigate the ability of hemoperfusion to remove some drugs or toxin from the body and its clinical efficacy. METHODS: Sixty-nine cases of poisoning due to tetramine or other drugs poisoning in our hospital between July 1990 and December 2003 were studied. Thirty-four patients among them received conventional treatment (including early gastric lavage, hepatoprotection, diuresis or respiratory support), and the remaining were given conventional treatment and hemoperfusion. Toxin concentration changes in blood before and after hemoperfusion, survival rate, time from come onset to regaining consciousness and convulsion termination and duration of clinical course were compared. RESULTS: In the hemoperfusion group, three patients died, the survival rate was 91.4%, whereas in the non-hemoperfusion group, the survival rate was 85.3% (P > 0.05). Meanwhile the clinical course was markedly shortened in the hemoperfusion group (P < 0.05). The time from coma onset to regaining consciousness and convulsion termination in the hemoperfusion group was significantly shorter than that in the non-hemoperfusion group. The clearance rate was different for different poisons, among them the benzodiazepines had an excellent clearance. CONCLUSIONS: Hemoperfusion could adsorb from blood a different amount of poisons. There is obvious efficacy in shortening clinical course and reducing complications. It could possibly raise survival rate in serious poisoning.

Adolescent↗

Effects of an extract of Gingko biloba on bromethalin-induced cerebral lipid peroxidation and edema in rats.

The effects of administration of a commercially available extract of Gingko biloba (EGB) on bromethalin-induced brain lipid peroxidation and cerebral edema in adult male Sprague-Dawley rats was determined. Gingko biloba extract was given (100 mg/kg) by gavage immediately after bromethalin (1.0 mg/kg) administration. Rats were euthanatized at 24 hours after dosing. Brain lipid peroxidation was determined by measurement of brain malonaldehyde-thiobarbituric acid chromophore (MDA-TBA) concentration, brain sodium concentration, and brain water content. Treatment of bromethalin-dosed rats (10/group) with EGB was associated with a statistically significant (P less than 0.05) decrease in clinical sign severity, compared with bromethalin-dosed saline solution-treated rats. All rats given bromethalin and saline solution developed clinical signs of toxicosis including CNS depression, hind limb weakness, ataxia, paralysis, and coma. Some rats given bromethalin and EGB developed clinical signs, however, none developed hind limb paralysis. The brain MDA-TBA concentration (2.4 +/- 0.5 delta MDA-TBA concentration/mg of protein), percentage of water in brain tissue (80.3 +/- 0.30%), and brain sodium concentration (6.68 +/- 0.21 mg/g of dry weight) were significantly increased in rats given bromethalin and saline solution, compared with control rats given saline solution (1.0 +/- 0.1 delta MDA-TBA concentration/mg of protein; 78.1 +/- 0.33% water in brain tissue; 4.83 +/- 0.30 mg of brain Na+/g of dry weight) and rats given bromethalin and EGB (1.6 +/- 0.2 delta MDA-TBA concentration/mg of protein; 79.3 +/- 0.31% water in brain tissue; 5.37 +/- 0.34 mg of brain Na+/g of dry weight).(ABSTRACT TRUNCATED AT 250 WORDS)

Aniline Compounds↗

[Determination of sodium monofluoroacetate in human blood and food samples by ion chromatography].

A method was developed for the determination of sodium monofluoroacetate in human blood by ion chromatography. The analysis was performed on a Dionex Ion Pac AS11 column (250 mm x 4 mm i.d.) with an AG11 guard column (50 mm x 4 mm i.d.). A conductivity detector, an SRS suppressor and a 25 microL sample loop were used. The eluent was 2.0 mmol/L Na2B4O7 with a flow rate of 1.0 mL/min. A blood sample of 0.2 mL was pipetted into a test tube followed by adding 1.0 mL of pure water. And then acetonitrile was used to dilute it to 3.0 mL. After the protein was settled down from the blood sample, the supernatant layer was filtered through a 0.45 microm filter before injected into the ion chromatographic system. Good linear relationship between the peak area and the concentration of sodium monofluoroacetate was found with correlation coefficient (r2) of 0.9978 within the range from 0.10 to 10.0 mg/L. The detection limit for blood was 2.5 mg/L. This method also can be used for the determination of sodium monofluoroacetate in food samples.

Animals↗

[Guidelines for the organization and management of disinfection and disinfestation from rodents and mosquitoes].

Two recent legislative acts (D.P.C.M. 29.11.2001 and D.G.R. Veneto n. 2093, issued 02.08.2002) give to Local Health Authorities responsibility over surveillance of disinfestations activities. Authority over the implementation of these actions remains with the municipalities. Another legislative act (D.G.R. Veneto 3015) established the creation of a task force in order to define guidelines regarding new managerial methods toward disinfections, disinfestations and rodent control for public administration. The "Guidelines for the organization and management of disinfection and of rodent and mosquito control" redefine the roles for the public administration units involved, propose a new organizational model and an innovative managerial approach to activities, provides technical recommendations for the preparation of specific contracts and for the implementation of disinfestation actions. Finally, the guidelines include a proposal for the development of regulations supporting the technical propositions.

Animals↗

Tetramine poisoning.

We report on two patients who presented with status epilepticus due to ingestion of rat poison containing tetramine. Both had eaten the same meal, subsequently presumed to be the source of the poison. Physical examination and investigation were unremarkable and diagnosis was based on patient history. Seizures were ultimately controlled with ketamine, after unsuccessful attempt of benzodiazepine and sodium thiopentone. One week after poisoning, both patients underwent one session of high-volume haemofiltration followed by charcoal haemoperfusion to eliminate the toxin from the body. Plasma tetramine levels then decreased from 0.95 microgram/mL to 0.35 microgram/mL and from 0.53 microgram/mL to 0.40 microgram/mL, respectively.

Adult↗

Accidental ingestion of a cholecalciferol-containing rodent bait in a dog.

A diagnosis of cholecalciferol toxicity in a young dog was made on the basis of adequate history and the finding of extremely elevated serum calcium levels. The traditional treatment of fluid therapy, diuresis and corticosteroids resulted in lowering the serum calcium levels over a 5-d period. The dog displayed clinical signs of severe depression, anorexia and intermittent vomiting during this time interval. Serum calcium levels rose on day 6 and remained elevated up until the dog was euthanized on day 9. Gross and histopathological examinations revealed diffuse metastatic mineralization throughout the body, particularly involving the lung, kidney, atria and stomach. The amount of cholecalciferol ingested was determined well below the lethal dose reported in dogs. This report indicates that young dogs may be much more susceptible to the lethal effects of this compound than initially believed.

Animals↗