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Absence of re-epithelialization in a fatal case of toxic epidermal necrolysis: is hyperbilirubinemia a culprit?
Kamada N, Utani A, Yoneyama K, Kobayashi T, Momota Y, Matsumoto F, Nakada T, Hirasawa H, Shinkai H.
Publication Types:
PMID: 15655162 [PubMed - indexed for MEDLINE]
Superwarfarin poisoning.
Pavlu J, Harrington DJ, Voong K, Savidge GF, Jan-Mohamed R, Kaczmarski R.
Department of Haematology, Hillingdon Hospital, Uxbridge, UB8 3NN, UK. pavluj@yahoo.com
PMID: 15708110 [PubMed - in process]
Measuring exposure to an elemental mercury spill--Dakota County, Minnesota, 2004.
Centers for Disease Control and Prevention (CDC).
Elemental mercury spills can cause contamination of neighborhoods and homes and result in neurologic and kidney disorders in exposed persons who inhale mercury vapors. Often, however, difficulties exist in determining the magnitude of exposure and effectiveness of decontamination or in recognizing that reexposure has occurred. This report summarizes the response to an elemental mercury exposure that resulted in the decontamination of 48 persons and the subsequent analysis of blood and urine samples from 14 exposed youths aged 6-16 years. Data from these analyses suggest that 1) blood samples are more sufficiently acquired and can be used to evaluate recent acute exposure and 2) use of a real-time mercury vapor analyzer can help public health officials determine the magnitude of exposures and help prevent reexposures. In addition, demolition and waste-disposal firms and government agencies must take actions to ensure that elemental mercury is adequately secured before disposal.
Publication Types:
PMID: 15716806 [PubMed - indexed for MEDLINE]
Activated charcoal administration in a pediatric emergency department.
Osterhoudt KC, Alpern ER, Durbin D, Nadel F, Henretig FM.
Section of Medical Toxicology, Division of Emergency Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. Osterhoudtk@email.chop.edu
OBJECTIVES: Activated charcoal is the commonest form of gastrointestinal decontamination offered to potentially poisoned children within United States emergency departments. Our aim was to describe this practice with regard to timing, route of administration, use of flavoring agents, and occurrence of adverse events other than vomiting. METHODS: Descriptive data were prospectively collected from consecutive administrations of single-dose activated charcoal, within an urban, academic pediatric emergency department, over a period of 2.5 years. RESULTS: Two hundred seventy-five subjects were enrolled. The median time elapsed between ingestion and emergency department arrival was 1.2 hours. Although 55% of children were administered charcoal within 1 hour of emergency department presentation, only 7.8% received charcoal within 1 hour of poisoning exposure. Forty-four percent of children younger than 6 years, 50% of 6-year to 12-year olds, and 89% of 12-year to 18-year olds drank the charcoal voluntarily (P < 0.01). Medical staff chose not to offer charcoal orally to 42 asymptomatic children among the 176 subjects under the age of 6 years. Of the 114 young children offered oral charcoal, 36 (32%) refused or were intolerant. Nurses added flavoring agents to the charcoal in 59% of oral administrations, but this act did not enhance observed palatability. Among children younger than 6 years, the median time from first sip to complete ingestion of charcoal slurry was 15 minutes. One pulmonary aspiration event and a case of constipation were noted. CONCLUSIONS: Despite published guidelines, children treated in an emergency department rarely received charcoal within 1 hour of ingestion. Gastric tube administration of charcoal varies by age and is partly subjective in its application. We found no evidence that excipient flavoring of charcoal improved success of administration. Pulmonary aspiration of charcoal, although uncommon, should be considered when assessing the risk of therapy. We offer a report of symptomatic constipation from single-dose charcoal.
PMID: 15295243 [PubMed - indexed for MEDLINE]
Maternal milk as methylmercury source for suckling mice: neurotoxic effects involved with the cerebellar glutamatergic system.
Manfroi CB, Schwalm FD, Cereser V, Abreu F, Oliveira A, Bizarro L, Rocha JB, Frizzo ME, Souza DO, Farina M.
Departamento de Bioquimica, Instituto de Ciencias Basicas da Saude, Universidade Federal do Rio Grande do Sul, 90035-003, Porto Alegre, RS, Brazil.
Methylmercury (MeHg) is a highly neurotoxic compound and several studies have reported intoxication signs in children whose mothers were exposed to this environmental toxicant. Although it is well established that the in utero exposure to MeHg causes neurological deficits in animals and humans, there is no evidence of the exclusive contribution of lactational exposure to MeHg as a possible cause of neurotoxicity in the offspring. In this study, we investigated the exclusive contribution of MeHg exposure through maternal milk on biochemical parameters related to the glutamatergic homeostasis (glutamate uptake by slices) and to the oxidative stress (total and nonprotein sulfhydryl groups, nonprotein hydroperoxides, glutathione peroxidase and catalase activities) in the cerebellum of suckling mice (Swiss albino). The same parameters were also evaluated in the cerebellum of mothers. Our results showed, for the first time, that lactational exposure to MeHg caused a high percent of inhibition (50%) on glutamate uptake by cerebellar slices in pups. Contrarily, this effect was not observed in mothers, which were submitted to a direct oral exposure to MeHg (15 mg/l in drinking water). In addition, behavioral/functional changes were observed in the weaning mice exposed to MeHg. It was observed an increase in the levels of nonprotein hydroperoxides in cerebellum, and this increase was negatively correlated to the glutamate uptake by cerebellar slices. This study indicates that (1) the exposure of lactating mice to MeHg causes inhibition of the glutamate uptake by cerebellar slices in the offspring; (2) this inhibitory effect seems to be related to increased levels of hydroperoxide.
PMID: 15201443 [PubMed - indexed for MEDLINE]
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