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Abstracts / Toxicology Letters 180S (2008) S32–S246 mental mercury deposits and chelation therapy. The impact of In cases of lower level poisonings, basic supportive treatment is chelation on long-term outcome of parenteral mercury exposure required while for heavy poisoning, specific antidote therapy using flumazenil based procedure is recommended.
Mining corrosive poisoned patients data to develop triage
Investigation the changes of alpha-1-antitrypsin on chronic pul-
monary disease due to sulfur mustard
Gennadiy Prostakishin ∗, Salavat Sarmanaev, Nadeshda Ilina Majid Shohrati ∗, Mostafa Ghanei, Khoshbaten Ali, ShamspourNavab All-Russian Centre of Disasters Medicine “Protection”, Moscow, Baqiyatallah, Medical Sciences University, Tehran, Islamic Republic of Background: Diagnostic process—classification of patient statusaccording to clinical–laboratory results of investigation. For simpli- There are a lot of chemical veterans who are suffering from chronic fication, diagnostic of disease may use data mining, that searching lung complication due to sulfur mustard. Bronchiolar abnormal- useful information in data base for decision making.
ities play an important role in the pathogenesis of chronic lung Objective: Incidence of acute corrosive poisonings is represent- complications in patients exposed to mustard gas. One of the ing to date the third cause of toxic death in the Russia. Our objective most important factor in pulmonary defense system is alpha-1- was to identify of searing liquids (SL) type with support. Data min- antitrypsin, and there are a lot of researches about the role of ing of clinical–laboratory signs of corrosive poisoned patients (CPP).
alpha-1-antitrypsin in ordinary patients. Current study was per- Methods: CPP were divided on four groups by different SL types: formed to evaluate the role of alpha-1 antitrypsin and its correlation type “I”, 185 cards; type “II’, 178 cards; type “III’, 220 cards; type “IV”, with lung function in patients exposed to sulfur mustard (SM).
84 cards. The electronic medical record data base of CPP (n = 667) Our study was a historical cohort. One hundred chemical was comparison analyzed on 77 clinical–laboratory signs. We made patients who were exposed to sulfur mustard in Iraq–Iran war tree of decision using SPSS Clementine 11.1 supplement for identi- with determined pulmonary lesions were selected from Sardasht population and enrolled to the study. Fifty persons in the control Results: There was creating of classification rules structure “IF- group in the same area from non-exposed civilians were enrolled to THEN” that has tree appearance. Testing of rules was carrying out the study. Phonotype of alpha-1 antitrypsin and trypsin inhibitory in the control group with mistake of the decision tree less 15%.
capacity (TIC) were measured.Phonotype of alpha-1 antitrypsin in Conclusions: (1) We demonstrated data mining for create triage patients and control group were normal (MM). The mean of TIC in rules with diagnostic ability by classify different types of SL. (2) patients group was 3.4 ± 0.3 ␮mol/min/ml which was lower than The decision tree can be use for support of decision making of CPP control group 4.2 ± 0.1 ␮mol/min/ml (p = 0.001). Also there was sig- nificant correlation between severity of lung lesions and mean ofTIC in patients group (p = 0.001).This study shows that there is cor- relation between the reduction of activity of alpha-1 antitrypsinand lung function in patient with chronic lung injuries due to sulfur Benzodiazepen poisoning in Nis
Simonida Seskar Stojancov ∗, Slobodanka Milicevic Misic Clinical Centre of Nis, Department of Toxicoligy, Nis, Serbia C48
Use of fumigants in sea containers can lead to serious human

During 2006, 103 patients in Nis suffered from acute poisoning poisonings
exclusively with medicines belonging to the benzodiazepam groupof medications. Patients that suffered from combined poisoning Henneke Spijkerboer ∗, Irma de Vries, Jan Meulenbelt with medicines belonging to benzodiazepams and other groups National Poisons Information Centre, National Institute for Public of medications were not taken into account during the analy- Health and the Environment, Bilthoven, Netherlands sis presented in this paper. Purpose of this paper is to establishclinical manifestation of poisonings with various groups of benzo- Background: Before long-term transport, many sea containers are diazepins and with various concentrations as well as the level of fumigated with, e.g. methyl bromide or phosphine to prevent poisoning and the outcome recorded for treated patients. Results damage to the cargo by vermin. These volatile substances can obtained from clinical manifestations of acute poisonings using cause serious intoxications when inhaled in high concentrations.
various groups of benzodiazepins have been analyzed. Poisonings Therefore, fumigated containers must carry a warning sign and be have been diagnosed based on anamnestic and/or heteroanamnes- ventilated before dock workers can enter them without wearing tic data on poisoning, clinical manifestations, physical examination protection. Serious incidents can occur when these precautionary and results obtained through various tests including toxicological analysis. Based on tests and research performed in the field of acute Case report: Two men were exposed to methyl bromide after poisonings using benzodiazepins, the following can be concluded: opening and entering a sea container. They did not wear any (1) Benzodiazepins cause mainly lower level poisonings in almost protection, because no warning sign was present on the con- 60% of cases and dominant poisoning manifestations come from tainer. Initially, they had no complaints but shortly thereafter, CNS and cardiovascular system. (2) Serum concentrations of ben- they suffered from acute neurological symptoms with headache zodiazepins do not fully correlate to the level of poisoning and are and vertigo. They developed severe seizures and coma, requiring not dominant neither in therapeutic nor in diagnostic sense. (3) mechanical ventilation and treatment with anticonvulsant medica- Abstracts / Toxicology Letters 180S (2008) S32–S246 tion. Both men survived the intoxication but suffer from prolonged neurological symptoms as concentration disturbances, intention A case of toxic epidermal necrolysis (TEN) induced by nons-
tremor, ataxia, and convulsions, despite treatment with anticon- teroidal anti-inflammatory drug (NSAID) in Emergency Medical
vulsants. According to the waybill, the container was fumigated with 64 g/m3 methyl bromide approximately 1 month before the Kim Sun Pyo ∗, Yoon Dae Heung, Kim Seong Jung, Cho Soo Hyeong, Discussion: The toxic mechanism of methyl bromide is not completely understood, but may involve formation of neurotoxic Chosun university hospital, Gwang-ju, Republic of Korea intermediates like methanethiol and formaldehyde. Furthermore,methyl bromide may react with sulfhydryl groups. This mechanism Purpose: We presented one patient with TEN with 40% skin slough can cause irreversible inhibition of numerous enzymes involved in who was transferred to our Emergency Medical Center from local clinic with impression of unknown origin dermatologic disorder.
It is important that dock workers are informed about the pos- Case: A 53-year-old women bring her with complaints of erythe- sible presence of fumigants in containers to prevent other serious matous rash and blister on her trunk and both proximal extremity.
incidents. Furthermore, dock workers need to be trained on how to She took NSAIDS 1300 mg per oral every 8 h for 5 days which is composition of acetaminophen that she had. Five days later, admin-istration of NSAIDS, they recognized that the rash with blister begin on her back and progress to extremity. After 4 days progression shecame to use. On physical examination, she had asymptomatic mul- tiple clear filled bullae and erosion with brown to black colored Carbon monoxide-related deaths in Greece
hyperpigmentation on trunk and proximal extremity involving A retrospective study, 1987–2007
40% of body surface. Her vital signs were, BP: 110/70 mmHg, PR95 min−1, RR 14 min−1, temperature 39 ◦C (102 F) and WBC count Maria Stefanidou ∗, Constantinos Maravelias, Sotiris Athanaselis, were 16,680/with 78.2% of neutrophil and other laboratory finding Artemisia Dona, Chara Spiliopoulou, Antonis Koutselinis was non-specific. She was admitted in solitary room for preven-tion of secondary infection and received management including Department of Forensic Medicine and Toxicology, Medical School, fluid replacement, third generation cephalosporin and corticos- University of Athens, Athens, Greece teroid administration and intensive wound care. Till three hospital Carbon monoxide (CO) is the cause of more than one-half of the days, she had 50% superficial skin loss and persistent fever, but 4 fatal poisonings throughout the world. The aim of this study was days later the majority of wounds healed rapidly. At 15th admitted to assess the characteristics of non-fire carbon monoxide-related days, no further treatment was required. There was just a little scar deaths in Greece. Toxicological reports of cases of decedents due and mild dispigmentation lesion was found.
to CO, received by the Department of Forensic Medicine and Toxi- Conclusion: Emergency physician should think about TEN if the cology, during the period 1987–2007, were reviewed and compiled patient have extensive exfolating skin lesion and patients with sus- according to the official coroner’s verdict as to the manner of poi- pected TEN must be directed at minimizing fluid and electrolyte soning (accident or suicide), as well as according to the gender and loss and preventing secondary infection.
the nationality of the victims. The registered victims were 153 (119 males, 34 females). A percentage of 97% of CO deaths were acci-dental and 3% were suicides, through automobile exhaust. Amongthe decedents, 30 victims were immigrants (28 males, 2 females).
The average annual death rate for males was nearly three and a Study of morphometrical and histomorphometrical changes of
half times higher than females. An increase of 55% in the number kidney after using phenol in mice
of accidental deaths from CO in Greece during the second decade Zahra Tootian ∗, Simin Fazelipour, Ali Looei Monfared was observed. This increase suggests a need for preventive strate-gies targeting not only high-risk population, such as homeless or Faculty of Veterinary Sciences, Tehran, Central, Islamic Republic of immigrants, but general population. Preventive strategies include: (1) frequent inspection and routine maintenance of vented com-bustion appliances and fireplaces; (2) not allowing automobiles to Keywords: Phenol; Kidney; Morphometric; Histomophometric; idle in closed or open garages; (3) not using unvented combustion sources nor a generator indoors; (4) not heating a house with agas oven and (5) installation of CO alarms. Preventive messages in Exposure to phenol in working environments or when consuming many languages through the media about potential sources of CO contaminated food or drinking water may be occurred. In taking phoned immediately would be metabolized in liver and exertedin urine via the kidneys. So, one of the most important organs exposed to it, is the kidney. Therefore evaluation of morphometri-cal and histomorphometrical changes of kidneys following phenoladministration is necessary.
For this experimental study, a total number of 60 allot female Balb/c mice were selected and after weighting were divided intoone control and three experimental groups of 15 individuals. Thecontrol group, consisted of the mice received only distilled waterwithout any additive materials by gastric tube as gavages metedfor 10 days, the three experimental groups received some dosesof 80, 180 and 320 mg/kg phenol for the same time and method,respectively. After 10 days, the mice were weighted again and


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