Acute necrotic hepatotoxicity caused by Lantana camara L. ingestion in dairy cattle

ABSTRACT: This study describes an outbreak of acute necrotic hepatopathy associated with spontaneous poisoning by Lantana camara L. in dairy cattle. A herd of 15 cows and heifers was introduced into a native pasture with limited food supply, and, sixteen days later, eight animals had spontaneous nasal hemorrhage, fever, lethargy, jaundice, and dry, dark stools with mucus and blood. The clinical course varied from two to five days. In the pasture where the cattle were kept, abundant adult specimens of L. camara L. with evident signs of consumption were observed. In total, seven cattle died and necropsy was performed in three of them. All animals had moderate jaundice, hemorrhage in the subcutaneous tissue and on the surface of different organs. The liver was slightly enlarged, with orange discoloration and enhanced lobular pattern. Histologically, multifocal areas of coagulative necrosis of hepatocytes in the centrilobular area, occasionally extending to the midzonal area, were observed, as well as marked hepatocellular degeneration and prominent cholestasis. The current study suggests that L. camara L. poisoning should be considered a differential diagnosis of acute and necrotic hepatotoxicity in cattle, despite the absence of photosensitization.

RESUMO: Esse estudo descreve um surto de hepatopatia necrótica aguda associada a intoxicação espontânea por Lantana camara L. em bovinos leiteiros. Um lote de 15 vacas e novilhas foram introduzidas em um piquete com campo nativo, com escassa oferta de alimento. Após dezesseis dias, oito animais manifestaram epistaxe, febre, apatia, icterícia, fezes ressecadas e escuras com muco e sangue. A evolução do quadro clínico variou de dois a cinco dias. No piquete em que os bovinos estavam alojados havia grande quantidade de L. camara L. com sinais evidentes de consumo. No total, sete bovinos morreram, e destes, o exame post mortem foi realizado em três. Os bovinos exibiam moderada icterícia, hemorragias no tecido subcutâneo e na superfície de diferentes órgãos. O fígado estava discretamente aumentado, com coloração alaranjada e padrão lobular evidente. As lesões histológicas consistiam em acentuada necrose de coagulação de hepatócitos em região centrolobular, por vezes se estendendo a região mediozonal, além de acentuada degeneração dos hepatócitos e evidente Colestase. O presente trabalho alerta para que intoxicação por L. camara L. seja levada em consideração nos diagnósticos diferenciais de hepatotoxicidade necrótica aguda em bovinos, mesmo sem indícios de fotossensibilização.

Acute necrotic hepatotoxicity caused by Lantana camara L. ingestion in dairy cattle / Hepatotoxicidade necrótica aguda por ingestão de Lantana camara L. em bovinos leiteiros

This study describes an outbreak of acute necrotic hepatopathy associated with spontaneous poisoning by Lantana camara L. in dairy cattle. A herd of 15 cows and heifers was introduced into a native pasture with limited food supply, and, sixteen days later, eight animals had spontaneous nasal hemorrhage, fever, lethargy, jaundice, and dry, dark stools with mucus and blood. The clinical course varied from two to five days. In the pasture where the cattle were kept, abundant adult specimens of L. camara L. with evident signs of consumption were observed. In total, seven cattle died and necropsy was performed in three of them. All animals had moderate jaundice, hemorrhage in the subcutaneous tissue and on the surface of different organs. The liver was slightly enlarged, with orange discoloration and enhanced lobular pattern. Histologically, multifocal areas of coagulative necrosis of hepatocytes in the centrilobular area, occasionally extending to the midzonal area, were observed, as well as marked hepatocellular degeneration and prominent cholestasis. The current study suggests that L. camara L. poisoning should be considered a differential diagnosis of acute and necrotic hepatotoxicity in cattle, despite the absence of photosensitization.(AU)

Esse estudo descreve um surto de hepatopatia necrótica aguda associada a intoxicação espontânea por Lantana camara L. em bovinos leiteiros. Um lote de 15 vacas e novilhas foram introduzidas em um piquete com campo nativo, com escassa oferta de alimento. Após dezesseis dias, oito animais manifestaram epistaxe, febre, apatia, icterícia, fezes ressecadas e escuras com muco e sangue. A evolução do quadro clínico variou de dois a cinco dias. No piquete em que os bovinos estavam alojados havia grande quantidade de L. camara L. com sinais evidentes de consumo. No total, sete bovinos morreram, e destes, o exame post mortem foi realizado em três. Os bovinos exibiam moderada icterícia, hemorragias no tecido subcutâneo e na superfície de diferentes órgãos. O fígado estava discretamente aumentado, com coloração alaranjada e padrão lobular evidente. As lesões histológicas consistiam em acentuada necrose de coagulação de hepatócitos em região centrolobular, por vezes se estendendo a região mediozonal, além de acentuada degeneração dos hepatócitos e evidente Colestase. O presente trabalho alerta para que intoxicação por L. camara L. seja levada em consideração nos diagnósticos diferenciais de hepatotoxicidade necrótica aguda em bovinos, mesmo sem indícios de fotossensibilização.(AU)

Determination of arsenic species compound in blood by high performance liquid chromatographyatomic fluorescence spectrometry / 中华劳动卫生职业病杂志

Objective@#To establish a method for determination of arsenic species in blood with high performance liquid chromatography-atomic fluorescence spectrometry (HPLC-AFS) .@*Methods@#The effect of mobile phase about chromatography separation and sample pretreatment conditions and atomic fluorescence spectrometry detection parameters has been optimized to reliably measure the following four kinds of species arsenic compound including arsenic[As (III) ]、dimethylarsinic acid (DMA) 、monomethylarsonic acid (MMA) and arsenate[As (V) ] in acute intoxication human blood. The method of technical standard about within-run, between-run and recoveries of standard were optimized.@*Results@#The method showed As (III) linear relationship was 2.63-100.00 μg/L, The detection limit was 2.63 μg/L. The relative coefficient (r) was 0.9999; DMA linear relationship was 3.21-100.00 μg/L, The detection limit was 3.21 μg/L. The r was 0.9992; MMA linear relationship was 3.41-100.00 μg/L, The detection limit was 3.41 μg/L. The r was 0.9998; As (V) linear relationship was 3.90-100.00 μg/L, The detection limit was 3.90 μg/L. The r was 0.9996. The average recovery of four species arsenic in tested samples ranged from 91.3%-99.8% with the relative standard deviation (RSD) from 2.39% to 4.05%. The within-run and between-run relative standard deviations (RSD) of repetitive measurement at 10.00, 40.00, 80.00 μg/L concentration levels were 1.99%-4.59% and 2.72%-4.53%.@*Conclusion@#This method is low detection limit, good accurate and high sensitivity, proposed method had been applied to the analysis of arsenic species in blood samples those who acute intoxication or poisoning diagnosis.

Antioxidant and hepatoprotective effects of ethanolic and ethyl acetate stem bark extracts of Copaifera multijuga (Fabaceae) in mice / Efeitos antioxidante e hepatoprotetor dos extratos brutos etanólico e acetato de etila da casca do caule da Copaifera multijuga(Fabaceae) em camundongos

The properties of oil-resin of copaiba, Copaifera multijuga are commonly mentioned in the literature, but there are few studies on extracts from its stem bark. We evaluated the antioxidant effects of ethanolic (EE) and ethyl acetate (EA) crude stem bark extracts from copaiba and compared them to rutin in a paracetamol (PCM)-induced oxidative stress model in mice. All test comparisons differed significantly. Hepatic catalase (CAT) and glutathione-S-transferase (GST) activity decreased in the PCM group, and there was an increase of protein carbonyls in the liver, kidney and brain. However, the protein carbonyls decreased in the liver for the PCM + EE group, in the kidneys for the PCM + EA and PCM + Rutin groups, and in the brain for all treatments. Hepatic GSH decreased in the PCM group and increased in the PCM + EE group. The extracts showed a positive effect on ascorbic acid (ASA), since they were able to restore the levels of parameters that had been changed by PCM. There was an increase of ALT and AST activity in the plasma within the PCM group. Even though ALT decreased in the PCM + Rutin, PCM + EE and PCM + EA groups, EE and EA did not have an effect on AST. The strongest antioxidant effect was observed for EE, due to the presence of the phenolic compounds epicatechin and epiafzelechin, as well as the highest concentration of total phenols and an excellent antioxidant potential observed in the DPPH· test.

As propriedades do óleo-resina da copaíba, Copaifera multijuga são comumente citadas na literatura, mas há poucos estudos sobre extratos da casca do caule. Avaliamos os efeitos antioxidantes de extratos brutos etanólico (EE) e acetato de etila (EA) da casca do caule da copaíba e os comparamos à rutina no modelo de estresse oxidativo induzido por paracetamol (PCM) em camundongos. Todas as comparações de teste diferiram significativamente. A atividade da catalase hepática (CAT) e da glutationa-S-transferase (GST) diminuiu no grupo PCM, e houve um aumento de proteínas carboniladas no fígado, rim e cérebro. No entanto, as proteínas carboniladas diminuíram no fígado para o grupo PCM + EE, nos rins para os grupos PCM + EA e PCM + rutina, e no cérebro para todos os tratamentos. A GSH hepática diminuiu no grupo PCM e aumentou no grupo PCM + EE. Os extratos mostraram um efeito positivo sobre o ácido ascórbico (ASA), uma vez que foram capazes de restaurar os níveis dos parâmetros que foram alterados pelo PCM. Houve um aumento da atividade de ALT e AST no plasma dentro do grupo PCM. Embora a ALT tenha diminuído nos grupos PCM + rutina, PCM + EE e PCM + EA, EE e EA não afetaram a AST. O efeito antioxidante mais forte foi observado para o EE, provavelmente devido à presença dos compostos fenólicos epicatequina e epiafzelequina, assim como à maior concentração de fenóis totais e um excelente potencial antioxidante observado no teste DPPH·

Intoxicacion por monoxido de carbono / Carbon monoxide poisoning

Resumen:La intoxicación por monóxido de carbono o "asesino silente" es la intoxicación mortal más común, encontrándose en fuentes de exposición muy comunes como automóviles, tabaquismo y combustión de gases o combustibles.La principal característica nociva aguda del gas se basa en su alta afinidad por la hemoglobina, mientras que los efectos crónicos se basan en su interacción con otras proteínas. Ante la clínica inespecífica del cuadro, se debe tener un alto grado de sospecha diagnóstica, para iniciar el tratamiento adecuado o oxigenoterapia normobárica o hiperbárica según corresponda.

Abstract:Carbon monoxide poisoning or "silent killer" is the most common fatal poisoning, found in very common sources of exposure such as cars, smoking and gas or fuel combustion. The main acute harmful characteristic of gas is based on its high affinity for hemoglobin, while the chronic effects are based on its interaction with other proteins.Before the nonspecific clinic of the table, must have a high degree of diagnostic suspicion, to start the appropriate treatment or normobaric or hyperbaric oxygen therapy as appropriate.

Infrared image monitoring of local anesthetic poisoning in rats / Monitorização por imagem infravermelha da intoxicação por anestésico local em ratos

Abstract Background and objectives: To evaluate the thermographic predictive value of local anesthetic poisoning in rats that indicates the early recognition of thermal signs of intoxication and enable the immediate start of advanced life support. Methods: Wistar rats underwent intraperitoneal injection of saline and ropivacaine; they were allocated into pairs, and experiments performed at baseline and experimental times. For thermography, central and peripheral compartment were analyzed, checking the maximum and average differences of temperatures between groups. Thermographic and clinical observations were performed for each experiment, and the times in which the signs of intoxication occurred were recorded. In the thermal analysis, the thermograms corresponding to the times of interest were sought and relevant data sheets extracted for statistical analysis. Results: Basal and experimental: the display of the thermal images at times was possible. It was possible to calculate the heat transfer rate in all cases. At baseline it was possible to see the physiology of microcirculation, characterized by thermal distribution in the craniocaudal direction. It was possible to visualize the pathophysiological changes or thermal dysautonomias caused by intoxication before clinical signs occur, characterized by areas of hyper-radiation, translating autonomic nervous system pathophysiological disorders. In animals poisoned by ropivacaine, there was no statistically significant difference in heat transfer rate at the experimental time. Conclusions: The maximum temperature, medium temperature, and heat transfer rate were different from the statistical point of view between groups at the experimental time, thus confirming the systemic thermographic predictive value.

Resumo Justificativa e objetivos: Estudar o valor preditivo termográfico na intoxicação por anestésico local em ratos que efetue o reconhecimento precoce dos sinais térmicos de intoxicação e possibilite o início imediato do suporte avançado de vida. Método: Ratos Wistar foram submetidos à injeção intraperitoneal de soro fisiológico e ropivacaína, alocados aos pares, e foram feitos experimentos em tempos basal e experimental. Para o estudo termodinâmico foram analisados o compartimento central e o periférico, verificaram-se as diferenças das temperaturas máximas e médias entre os grupos. Foram feitas observações clínicas e termográficas para cada experimento e anotados os tempos em que os sinais de intoxicação ocorriam. Foram buscados na análise termográfica os termogramas correspondentes aos tempos de interesse e extraídas as planilhas de dados correspondentes, para análise estatística. Resultados: Foi possível a visibilização das imagens térmicas nos momentos basal e experimental. Foi possível calcular a taxa de transferência de calor em todos os casos. No momento basal foi possível observar a fisiologia da microcirculação, caracterizada por distribuição térmica no sentido craniocaudal. Foi possível visibilizar as alterações fisiopatológicas ou disautonomias térmicas causadas pela intoxicação antes que os sinais clínicos ocorressem, caracterizadas por áreas de hiperradiação e traduziram perturbações fisiopatológicas do Sistema Nervoso Autônomo. Nos animais intoxicados por ropivacaína houve diferença estatisticamente significativa na taxa de transferência de calor no momento experimental. Conclusões: Constatou-se que a temperatura máxima, a temperatura média e a taxa de transferência de calor foram diferentes do ponto de vista estatístico entre os grupos no momento experimental, o que corrobora o valor preditivo termográfico sistêmico.

Intoxicación letal con aldicarb: análisis de sangre post mortem mediante LC-ESI-MS/MS / Fatal intoxication with aldicarb: Analysis in post mortem blood by LC-ESI-MS/MS

Antecedentes. El aldicarb es un plaguicida carbamato de alta toxicidad asociado a intoxicaciones agudas fatales en el ser humano. Su mecanismo de acción consiste en la inhibición de la enzima acetilcolinesterasa (AChE) que ocasiona la acumulación del neurotransmisor acetilcolina en la hendidura sináptica. Esta acumulación provoca síntomas colinérgicos y, dependiendo de la dosis de exposición, puede paralizar los sistemas respiratorio y nervioso hasta llegar a la muerte. Objetivo. Determinar el nivel de aldicarb en sangre post mortem en casos de intoxicación aguda. Materiales y métodos. Investigación de tipo experimental empleando un cromatógrafo líquido con espectrometría de masas, con ionización electrospray y análisis en modo tándem (LC-ESI-MS/MS). Los estándares de aldicarb y el aldicarb-d3 fueron comprados de Dr. Ehrenstorfer GmbH. El método consiste en una precipitación de proteínas de la sangre y su posterior análisis por LC-ESI-MS/MS, utilizando el aldicarb-d3 como estándar interno. El método fue aplicado a siete casos de intoxicación letal por presunta acción del aldicarb. Resultados. El aldicarb se encontró en la sangre de seis de los casos estudiados, en niveles desde 0.12 a 1.90 µg/mL. Solo en uno de los casos no se detectó aldicarb. En cuanto la presunta manera de muerte, en seis de los casos analizados fue el suicidio y en un caso se clasificó como muerte en estudio. Conclusiones. Los resultados obtenidos con la metodología analítica y la técnica LC-ESI-MS/MS son satisfactorios en términos de la determinación cuantitativa de aldicarb en sangre total post mortem. La aplicación de la metodología descrita en toxicología forense evidencia el empleo de este plaguicida en actos suicidas.

Background. Aldicarb is a high toxicity carbamate pesticide associated to human fatal acute intoxications. Its mechanism of action consists of the inhibition of the acetylcholinesterase enzyme (AChE), which induces the accumulation of the neurotransmitter acetylcholine in the synaptic cleft. This accumulation induces cholinergic symptoms and, depending on the exposition dose, it can paralyze the respiratory and nervous systems, leading to death. Objective. To determine aldicarb levels in post mortem blood in cases of acute intoxication. Materials and methods. An experimental research was conducted using liquid chromatography tandem-mass spectrometry (LC-ESI-MS/MS) with electrospray ionization. The aldicarb and aldicarb-d3 standards were purchased from Dr. Ehrenstorfer GmbH corporation. This method carries out a protein precipitation of blood and its analysis using LC-ESI-MS/MS, using aldicarb-d3 as internal standard. This method was applied to seven cases of fatal intoxication by presumable action of aldicarb. Results. Aldicarb was found in six of the studied cases on levels between 0.12 and 1.90 µg/mL. Aldicarb was not detected in blood only in one case. Six of the cases were associated to suicide as a manner of death and in one of them it remained under study. Conclusions. The results obtained with the analytical methodology and the use of the LC-ESI-MS/MS technique are satisfactory in terms of the quantitative determination of aldicarb in post mortem total blood. The application of the described methodology in forensic toxicology evidences the use of this pesticide in suicidal practices.

Proyecto: Creación de una Unidad de Desintoxicación / Project: Creation of a Detoxification Unit

Las adicciones constituyen un problema de salud en el mundo actual. El aumento del consumo de alcohol y el abuso de drogas registrados en los últimos años, incrementaron las consultas en los Servicios de Emergencias de los Hospitales Públicos, tanto por cuadros agudos, intoxicación o abstinencia, como por efectos secundarios de las sustancias. Confluyen en su génesis factores psicológicos, culturales y sanitarios. La situación constituye un problema sanitario de alto costo personal, social y económico. La complejidad del problema, su desconocimiento, las valoraciones peyorativas, los prejuicios y las estigmatizaciones de los aspectos relacionados con el consumo exigen una mirada multidisciplinaria e intersectorial que permita comprender la difícil realidad y proponer el adecuado manejo de técnicas y metodologías, elementos esenciales para lograr intervenciones superadoras de la cuestión

Addictions are a problem in the actual world. The rise in drugs and alcohol abuse in later years have increased consultations in emergency services for intoxications or abstinence as well as for secondary effects to substances abuse. In their genesis coincide psichological, sanitary and cultural factors. This situation constitutes a sanitary problem of high personal social and echonomic level. The complexity of the problem, its lack of knowledge, prjeudices and stigmatizations of many aspects relationed to drug consume demand a multidisciplinary look that allows to undertsand the difficult reality and to propose adequate handling of techniques and methodology which are essential to achieve adequate interventions

As adicções são um problema de saúde no mundo de hoje. O aumento do consumo de álcool e o abuso de drogas registrados nos últimos anos, acrescentaram as consultas nos Serviços de Pronto Socorro dos Hospitais Públicos, tanto por casos agudos, intoxicação ou abstinência, quanto por efeitos colaterais das substâncias. Convergem para gerá-los fatores psicológicos, culturais e de saúde. A situação constitui um problema de saúde pública de grande custo pessoal, social e econômico. A complexidade, o desconhecimento, as qualificações pejorativas, os preconceitos e as estigmatizações dos aspectos relacionados com o consumo exigem um olhar multidisciplinar e intersectorial para a compreensão da difícil realidade e para propor técnicas e metodologias adequadas, que são essenciais para alcançar intervenções superadoras da questão

Rabdomiolisis secundaria a intoxicación etílica: caso clínico / Rhabdomyolysis following alcohol intoxication: a case report

Introduction: rhabdomyolysis is a potentially lethal syndrome characterized by disintegration of striated muscle fibers. In children Rhabdomyolysis is caused mostly by trauma, nonketotic hyperosmolar coma, viral myositis, dystonia and malignant hyperthermia. Case report: a 14 year old male was brought into the emergency room because of a decreased level of consciousness following alcohol and cannabis. An initial assessment indicated the presence of hypothermia and a Glasgow Coma Scale of 9. A blood biochemical analysis showed a mixed acidosis and CPK levels of 12260 U/L (CK-MB 132 U/L). After diagnosing alcohol induced coma and rhabdomyolysis, intravenous fluids and urinary alkalinization are administered. The patient presented a rapid neurological improvement reaching normal within 12 hours. He remained normotensive, adequate diuresis, negative balances, normal blood gas values and urine test strips presented no pathological changes. A maximum level of serum CPK was observed 24 hours after ingestion (20820 U/L), with subsequent decline to 6261 U/L at day 5, once he was discharged. Discussion: alcohol poisoning is a rare cause of rhabdomyolysis in pediatrics. The main therapeutic goal is to prevent acute renal failure, aggressive fluid therapy and urine alkalinization then must be administered, monitoring possible electrolyte abnormalities and the presence of myoglobinuria. In conclusion, rhabdomyolysis is one of the possible complications after alcohol poisoning. Given its potential morbidity, it should always be considered.

Introducción: la rabdomiolisis es un síndrome potencialmente letal caracterizado por la destrucción de fibras musculares estríadas. En niños es producido fundamentalmente por traumatismos, coma hiperosmolar no cetósico, miositis vírica, distonía o hipertermia maligna. Caso clínico: varón de 14 años que es traído al servicio de Urgencias por disminución del nivel de conciencia secundaria a consumo de alcohol y cannabis. En la valoración inicial en nuestro centro se constatan hipotermia y una puntuación según la escala de Glasgow de 9. En el análisis bioquímico sanguíneo destacan una acidosis mixta y niveles de CPK de 12.260 U/L (CK-MB 132 U/L). Con los diagnósticos de coma etílico y rabdomiolisis se inicia administración de fluidoterapia intravenosa y alcalinización urinaria. Presentó una rápida mejoría neurológica con normalización en las primeras 12 h. Se mantuvo normotenso, con adecuada diuresis, balances negativos, normalización de los valores gasométricos y tiras reactivas de orina seriadas sin hallazgos patológicos. Se objetivó un nivel máximo de CPK sérica 24 h tras la ingesta (20.820 U/L), con descenso posterior hasta 6.261U/L a los 5 días, cuando se dio de alta. Discusión: la intoxicación etílica constituye una causa infrecuente de rabdomiolisis en pediatría. El principal objetivo terapéutico es evitar el fracaso renal agudo, por lo que se deben iniciar fluidoterapia agresiva y eventual alcalinización de la orina, manteniendo monitorizados las posibles alteraciones electrolíticas así como la presencia de mioglobinuria. En conclusión, la rabdomiolisis es una de las posibles complicaciones de la intoxicación etílica. Dada su potencial morbimortalidad, siempre debe ser tenida en cuenta.

Muertes por intoxicación accidental aguda por alcohol y drogas de abuso en Costa Rica entre 2006 y 2010 / Accidental poisoning deaths acute alcohol and drug abuse in Costa Rica between 2006 and 2010

En este artículo se presenta el análisis de 15642 autopsias realizadas en el Departamento de Medicina Legal de Costa Rica entre los años 2006 a 2010, de las cuales se extrajeron aquellas cuyas causa de muerte fue una intoxicación accidental (sobredosis) por alcohol o drogas de abuso. Se encontraron 210 casos que arrojaron el siguiente perfil de las víctimas: sexo masculino, edad entre 30 y 59 años, habitantes de Guanacaste o San José, que fallece los fines de semana o a fin y principio de año, de una intoxicación aguda por alcohol si es costarricense o nicaragüense o de una intoxicación por cocaína o heroína si se trata de un norteamericano o europeo. Asimismo se demostró que en el período en estudio ha habido un aumento significativo de la tasa de mortalidad por esta causa...

Intoxicação por agrotóxicos no Distrito Federal, Brasil, de 2004 a 2007 - análise da notificação ao Centro de Informação e Assistência Toxicológica / Intoxication due to pesticides in the Federal District of Brazil between 2004 and 2007 -analysis of notification to the Toxicological Information and Assistance Center

Exposure to toxic substances, including pesticides, can cause irreversible damage to humans, including death, and is therefore considered a serious public health problem worldwide. This is a retrospective study using data gathered by the Toxicological Information and Assistance Center of Brazil's Federal District (Ciat-DF) between 2004 and 2007. During this period, 709 intoxications with pesticide occurred in the DF and were analyzed in this study. Fifty-one percent of the intoxicated individuals were men; the events occurred mostly in the home (91 percent), in the urban area (86.3 percent) and by ingestion (84 percent). Children from 1 to 4 years of age and adults from 20 to 39 years were involved in 30 percent and 36 percent of the cases, respectively. Accidental intoxication corresponded to 47.1 percent of the cases, followed by attempted suicide (44.2 percent). The illegal rodenticide known as "chumbinho", the main ingredient of which is carbamate insecticide aldicarb, was involved in 35.1 percent of the cases, mostly in suicide attempts. In eighteen cases, the intoxicated individuals died after exposure to the pesticides, namely 15 suicides and 3 accidental poisonings. When compared with other data sources, this study identified a high level of underreporting to the Ciat-DF of intoxication by pesticide during the period under study.

A exposição humana a substâncias tóxicas, incluindo agrotóxicos, pode levar a danos irreversíveis no organismo e até ao óbito, sendo considera um grave problema de saúde pública. Este é um estudo retrospectivo, que utilizou dados reportados ao Centro de Informação e Assistência Toxicológica do Distrito Federal, Brasil (Ciat-DF) referentes a intoxicações por agrotóxicos ocorridas no DF de 2004 a 2007. Nesse período, 709 intoxicações foram notificadas e avaliadas neste estudo. A maioria dos indivíduos envolvidos nas intoxicações foi do sexo masculino (51,2 por cento), intoxicados no domicílio (91 por cento), em área urbana (86,3 por cento) e por via oral (84 por cento). Crianças de 1 a 4 anos e adultos de 20 a 39 anos estiveram envolvidos em 30 e 36 por cento das intoxicações, respectivamente. As intoxicações acidentais corresponderam a 47,1 por cento dos casos, seguidas pelas tentativas de suicídio (44,2 por cento). O raticida ilegal chumbinho, conhecido por conter, principalmente, o inseticida carbamato aldicarbe, esteve envolvido em 35,1 por cento dos casos, principalmente em tentativas de suicídio. Dezoito das intoxicações registradas evoluíram a óbito, 15 por suicídio e 3 por acidente individual. Quando comparado com outras fontes de dados, este estudo detectou uma alta taxa de subnotificação das intoxicações por agrotóxicos reportadas ao Ciat-DF no período do estudo.

Two Cases of Methyl Bromide Intoxication Mimicking Bickerstaff's Brainstem Encephalitis

BACKGROUND: Methyl bromide is toxic to the central and peripheral nervous systems. Two patients with occupational exposure to this agent are described. CASE: Two cases of previously healthy young men were involved. They had worked in a fumigating plant spraying fruits using methyl bromide for several months before admission. They showed general weakness, severe ataxia, bilateral dysmetria and bilateral lateral gaze limitation. And gaze-evoked nystagmus was observed in one of them. Brain MRI showed symmetrically increased signal intensity lesions including the brainstem, cerebellum and splenium of corpus callosum. After conservative treatment, they gradually improved over the next few weeks. CONCLUSIONS: Symmetry and topography of our patients??clinical and radiographic abnormalities support the proposal that methyl bromide exposure can produce symptoms similar to Bickerstaff's brainstem encephalitis.