Niveles de colinesterasa sérica en agricultores de San Pablo de Borbur, Boyacá, expuestos a organofosforados

Introducción: Las colinesterasas son enzimas que se encargan de hidrolizar la acetilcolina en ácido acético y colina, poniéndole fin a la transmisión nerviosa a lo largo de la sinapsis de las uniones neuromusculares. La medición de la actividad de la colinesterasa sérica constituye un indicador del efecto causado por la exposición prolongada a los organofosforados. Objetivo: Determinar los niveles de colinesterasa sérica y factores relacionados con la exposición a organofosforados en agricultores de la vereda de Páramo Lagunas de San Pablo de Borbur, Boyacá, Colombia. Metodología: Estudio prospectivo, de corte transversal, con una muestra de 57 trabajadores. A cada individuo se le aplicó una encuesta de datos sociodemográficos y factores laborales, posteriormente se les tomó una muestra de sangre venosa en ayuno de 8-12 horas; con el fin de determinar las concentraciones de colinesterasa sérica (kit Colinesterasa Butiriltiocolina Biosystems®) con el equipo automatizado de química clínica A-15 de Biosystems®. Resultados: El rango de edad de los participantes estuvo entre los 22 y 64 aflos, el 72 % de los individuos pertenecía al sexo masculino. El 3,5 % (2 varones) presentó valores inferiores al intervalo biológico de referencia (IBR), el 88 % de las personas afirmó realizar tareas con plaguicidas y el 54 % afirmó no utilizar los elementos de protección personal (EPP) al trabajar con estas sustancias. Conclusiones: Se evidenció la falta de escolaridad y la ausencia del acompaflamiento técnico en esta zona, lo que induce a que estos agricultores realicen procesos agrícolas relacionados con la aplicación de plaguicidas sin el adecuado conocimiento y sin la utilización adecuada de EPP.

Introduction: Cholinesterases are enzymes responsible for hydrolyzing acetylcholine in acetic acid and choline, which ends nerve transmission along the synapse of neuromuscular junctions. Measurement of serum cholinesterase activity acts as an indicator of the effect caused by prolonged exposure to organophosphates and carbamates Objective: To determine serum cholinesterase levels and factors related to exposure to organophosphates in farmers from the county of Páramo Lagunas in San Pablo de Borbur, Boyacá, Colombia. Methodology: Prospective, cross-sectional study, with a sample of 57 agricultural workers, a survey of sociodemographic data and labor factors was applied to each individual and a venous blood sample was taken in an 8-12 hour fasting, Serum cholinesterase concentrations were determined (Biosystems® Butyrylthiocholine Cholinesterase kit), by means of the Biosystems® A-15 automated clinical chemistry kit. Results: The age range of the participants was between 22 and 64 years old, 72% of the individuals belonged to the male sex. 3.5% (2 male individuals) presented values lower than the biological reference interval (BRI); 88% of the people affirmed to carry out tasks with pesticides and 54% of them affirmed not to use personal protective equipment (PPE) when working with these substances. Conclusions: The lack of schooling was evidenced in most of the farmers, as well as the absence of technical support to this area, which induces these farmers to carry out agricultural processes such as pesticide application, without adequate knowledge and without the proper use of PPE.

Effects of nimodipine on cognitive function in patients with Alzheimer's disease / 中国基层医药

Objective:To investigate the effects of nimodipine on cognitive function in patients with Alzheimer's disease.Methods:A total of 200 patients with Alzheimer's disease who received treatment in Shuangqiao Hospital from January 2019 to January 2022 were included in this study. They were randomly divided into a control group and an observation group ( n = 100/group). The control group was treated with Donepezil. The observation group was treated with nimodipine and Donepezil. Before and 2 months after treatment, mental status and cognitive function were evaluated in each group. Results:After treatment, total response rate in the observation group was significantly higher than that in the control group [95% (95/100) vs. 81% (81/100), χ2 = 9.58, P < 0.05]. Alzheimer's disease assessment scale cognitive subscale score was significantly lower after treatment compared with before treatment in each group ( P < 0.05). Mini-mental State Examination score was significantly higher after treatment compared with before treatment in each group ( P < 0.05). Alzheimer's disease assessment scale cognitive subscale score in the observation group was significantly lower than that in the control group [(17.38 ± 1.95) points vs. (29.63 ± 3.39) points, t = -3.26, P < 0.05]. Mini-mental State Examination score in the observation group was significantly higher than that in the control group [(23.47 ± 4.59) points vs. (18.68 ± 3.91) points, t = 2.14, P < 0.05]. Conclusion:Nimodipine can improve cognitive function in patients with Alzheimer's disease.

Association between serum cholinesterase and insulin resistance in patients with type 2 diabetes mellitus / 中华内分泌代谢杂志

Objective:To investigate the association of serum cholinesterase(ChE) with insulin resistance(IR) in patients with type 2 diabetes mellitus(T2DM).Methods:General information and laboratory results of 376 hospitalized patients with type 2 diabetes were collected from the Endocrinology Department of Xuzhou Medical University Affiliated Hospital from June 2020 to November 2022. Based on quartile levels of serum cholinesterase(ChE), the patients were divided into four groups: Q1 group(≤7 912 IU/L), Q2 group(7 913-9 083 IU/L), Q3 group(9 084-10 304 IU/L), and Q4 group(≥10 305 IU/L). The Homeostasis model was used to evaluate insulin resistance(HOMA-IR) for each group, and the correlation between ChE and HOMA-IR was analyzed. Results:As ChE levels increased, HOMA-IR levels significantly increased( P<0.05). Spearman correlation analysis showed that ChE was positively correlated with body mass index, diastolic blood pressure, high-sensitivity C-reactive protein, HbA 1C, total cholesterol, triglycerides, low density lipoprotein-cholesterol(LDL-C), aspartate aminotransferase, alanine aminotransferase(ALT), glutamyl transpeptidase, prealbumin, albumin, uric acid, and HOMA-IR( P<0.05). ChE was negatively correlated with age, duration of diabetes, and blood urea nitrogen( P<0.05). Multivariat stepwise linear regression analysis showed that disease duration, body mass index, HbA 1C, ALT, and ChE were independent influencing factors of HOMA-IR( P<0.01). Logistic regression analysis showed that compared to the Q1 group, the risks of developing IR in the Q4, Q3, and Q2 groups were 3.969(1.791-8.797), 2.100(1.059-4.164), and 2.026(1.071-3.833), respectively. Conclusion:Serum ChE is closely associated with IR in patients with T2DM.

Investigation on health status of workers exposed to glyphosate / 中华劳动卫生职业病杂志

Objective: To analyze the concentrations of glyphosate and its metabolites in occupational exposed workers and their possible effects on human health, so as to provide a reference for improving the safe use of glyphosate and toxicity research. Methods: From April to December 2020, 247 workers directly exposed to glyphosate in 5 enterprises were selected as the contact group, and 237 workers who were not exposed to glyphosate and other pesticides in the same enterprise were selected as the control group. Questionnaire survey and occupational health examination were conducted on objects, and the concentrations of glyphosate and its metabolites in the air of workplaces and biological samples were detected. The correlation between the concentrations and the difference of health examination between the two groups were analyzed. Results: The urine glyphosate concentration (0.022-47.668 mg/L), the rate of exceeding the standard (60.32%, 149/247) and the urine aminomethyl phosphonic acid concentration (<0.010-1.624 mg/L) in the contact group were higher than those in the control group [urine glyphosate concentration (<0.020-4.482 mg/L), the rate of exceeding the standard (2.53%, 6/237) and the urine aminomethyl phosphonic acid concentration (<0.010-0.524 mg/L) ], respectively (P<0.001). The exceeding standard rate of glyphosate concentration in the workplace was 33.67% (33/98). The concentration of glyphosate in the workplace was positively correlated with the concentrations of glyphosate and aminomethylphosphonic acid in urine (r(s)=0.804, 0.238, P<0.001), and the concentration of glyphosate in urine was positively correlated with the concentration of aminomethylphosphonic acid in urine (r(s)=0.549, P<0.001). The alanine aminotransferase (ALT), white cell ratio, creatinine, uric acid, the abnormal rates of ALT and total protein (TP) in the contact group were higher than those in the control group, and TP was lower than that in the control group, the differences were statistically different (P<0.05). The abnormal rates of overall liver function, overall renal function, blood routine test, urine routine test, electrocardiogram, liver B ultrasound and blood lipid in the contact group were significantly higher than those in the control group (P<0.05) . Conclusion: The concentration of glyphosate in the workplace is related to the concentrations of glyphosate and aminomethyl phosphonic acid in the urine of workers, and exposure to glyphosate may have some harmful effects on human health.

Organophosphorus poisoning: study of evaluation of clinically relevant indicators

Background:POP scale andserum cholinesterase estimation are purported to be meaningful indicators for mortality prediction in the cases of organophosphorus poisoning. The present study was undertaken to substantiate the correlation ofPOP scale score and serum cholinesterase levels in acute OP poisoning with mechanical ventilation requirement and mortality in our setting. Methods:Data of 150 eligible participants was collected, with POP scale andserum cholinesterase levels being assessed during initial presentation in each of them. Clinical course of the cases was monitored anddocumented. Results:The observed case fatality rate was 32.7%. POP scale scoring revealed 30out of 75 patients to be from moderate group and 19 out of 22 patients to be from severe group. Forty nine outof 75 in moderate group & all patients in severe group required ventilator support. With respect to Serum Cholinesterase level; 20 out of 23 and 29 out of 77 patients died in the severe & moderate poisoning categories respectively. Forty eight out of 77 in moderate poisoning andall patients in severe poisoning required ventilator support. Conclusions: POP scale scoring and serum Cholinesterase level assessments are clinically relevant indicators in acute OP poisoning cases and are of great utility towards assessment ofmechanical ventilation requirement and mortality prediction.

Identification of potential AChE inhibitors through combined machine-learning and structure-based design approaches-Supplementary data

Alzheimer’s disease (AD) is an irreversible, progressive neurodegenerative disease characterised by dementia.The depletion of acetylcholine (ACh) is involved the synaptic cleft is responsible for dementia due to neuronal loss. The acetylcholinesterase (AChE) enzyme isinvolved in the hydrolytic degradation of ACh and its inhibition is therapeutically beneficial for the treatment in memory loss.The use of machine learning (ML) for the identification of enzyme inhibitors has recently become popular. It identifies important patterns in the reported inhibitors to predict the new molecules. Hence, in this study, a set of support vector classifier-based ML models were developed,validated and employed to predict AChE inhibitors. Further, 247 predicted compounds obtained through PAINS and molecular property filters were docked on the AChE enzyme. The docking study identified compounds AAM132011183, ART21232619 and LMG16204648 as AChE inhibitors with suitable ADME properties. The selected compounds produced stable interactions with enzymes in molecular dynamics studies. The novel inhibitors obtained from the study may be proposed as active leads for AChE inhibition.

Identification of potential AChE inhibitors through combined machine-learning and structure-based design approaches-Supplementary data

Alzheimer’s disease (AD) is an irreversible, progressive neurodegenerative disease characterised by dementia.The depletion of acetylcholine (ACh) is involved the synaptic cleft is responsible for dementia due to neuronal loss. The acetylcholinesterase (AChE) enzyme isinvolved in the hydrolytic degradation of ACh and its inhibition is therapeutically beneficial for the treatment in memory loss.The use of machine learning (ML) for the identification of enzyme inhibitors has recently become popular. It identifies important patterns in the reported inhibitors to predict the new molecules. Hence, in this study, a set of support vector classifier-based ML models were developed,validated and employed to predict AChE inhibitors. Further, 247 predicted compounds obtained through PAINS and molecular property filters were docked on the AChE enzyme. The docking study identified compounds AAM132011183, ART21232619 and LMG16204648 as AChE inhibitors with suitable ADME properties. The selected compounds produced stable interactions with enzymes in molecular dynamics studies. The novel inhibitors obtained from the study may be proposed as active leads for AChE inhibition.

Identification of potential AChE inhibitors through combined machine-learning and structure-based design approaches

Alzheimer’s disease (AD) is an irreversible, progressive neurodegenerative disease characterised by dementia.The depletion of acetylcholine (ACh) is involved the synaptic cleft is responsible for dementia due to neuronal loss. The acetylcholinesterase (AChE) enzyme isinvolved in the hydrolytic degradation of ACh and its inhibition is therapeutically beneficial for the treatment in memory loss.The use of machine learning (ML) for the identification of enzyme inhibitors has recently become popular. It identifies important patterns in the reported inhibitors to predict the new molecules. Hence, in this study, a set of support vector classifier-based ML models were developed,validated and employed to predict AChE inhibitors. Further, 247 predicted compounds obtained through PAINS and molecular property filters were docked on the AChE enzyme. The docking study identified compounds AAM132011183, ART21232619 and LMG16204648 as AChE inhibitors with suitable ADME properties. The selected compounds produced stable interactions with enzymes in molecular dynamics studies. The novel inhibitors obtained from the study may be proposed as active leads for AChE inhibition.

CRP COMPARISON WITH RDW AS A PROGNOSTIC MARKER FOR OUTCOME OF OP POISONING

Background: Organophosphate (OP) compounds are frequently used as pesticides in countries. This ease of availability of the OP compounds has resulted in a gradual increase in unintentional and 1 suicidal poisoning, mainly in developing countries . Elevated RDW is associated with systemic in?ammation and oxidative stress More severe poisoning means more production of free radicals and more oxidative stress. In AOPP, toxins may cause 2,5 lesions in tissues and organs in the body, leading to increased plasma CRP levels . Aim: 1-To measure CRP, serum acetylcholinesterase, red cell distribution width, in acute organophosphorus poisoning.2- To analyze the correlation between these biochemical parameters and serum acetylcholinesterase levels. 3-To analyze the validity of these biochemical parameters in prediction of severity and prognosis in op poisoning. Hospital based Methods: prospective study was conducted from OP compound consumption patients attending casualty and admitted patients in S. Nijalingappa Medical College Hospital and Research center, BAGALKOT. Patients less than 18 years, Co-ingestion of organophosphorus with other agents, Pre hospital cardiac arrest, Prior history of Iron de?ciency anemia, Vitamin B12 de?ciency and folate de?ciency anemia, Recent hemorrhage, Chronic liver disease, Prior chemotherapy, Patient on oral contraceptive pills, Patient on estrogen therapy is excluded. Results: a total of 60 patients who diagnosed with history of poisoning were involved in the study among them 29 (48.3%) were male and 31 (51.7%) were female. 75% of study population has attempted suicide by taking the poisoning and 10% of study population had accidental consumption of poisoning, and 5% of study population had occupational exposure. There is negative correlation between the cholinesterase, RDW and CRP as cholinesterase in Conclusion: creases RDW and CRP decreases and severity of poisoning decreases and as cholinesterase decreases RDW and CRP increases and severity of op poisoning increases and morbidity and mortality increases.

Synthesis, cholinesterase inhibition and hepatotoxicity of tacrine-phenol-bifendate hybrids / 药学学报

A series of tacrine-phenol-bifendate hybrids (7a-7e, 8a-8e) were designed, synthesized and evaluated as inhibitors of cholinesterases (ChEs) with low hepatotoxicity. All the compounds had potent ChEs inhibitory activity with half-inhibitory concentration (IC50) values at the nanomolar range. Compound 8d exhibited the strongest inhibition to acetylcholinesterase (AChE) with an IC50 value of 156.39 nmol·L-1 and compound 7b showed the most potent inhibition for butyrylcholinesterase with IC50 value of 16.33 nmol·L-1. Kinetic and molecular modeling studies showed that 8d targeted both the catalytic active site and the peripheral anionic site of AChE. In addition, these compounds showed low toxicity to hepatocytes, and compound 8d did not increase the level of reactive oxygen species in HepG2 cells.

Efficacy of Xiaoshuan Changrong Capsules combined with donepezil hydrochloride in the treatment of patients with vascular dementia and their effects on serum cytokines and oxidative stress / 中国基层医药

Objective:To investigate the efficacy of Xiaoshuan Changrong Capsules combined with donepezil hydrochloride in the treatment of patients with vascular dementia and their effects on serum cytokines and oxidative stress. Methods:A total of 102 patients with vascular dementia who received treatment in Hangzhou Seventh People's Hospital, China between January 2019 and January 2021 were included in this study. They were randomly divided into control and observation groups, with 51 patients per group. The control group was treated by oral donepezil hydrochloride. The observation group was given oral Xiaoshuan Changrong Capsules combined with oral donepezil hydrochloride. All patients were treated for 12 weeks. Efficacy was compared between the two groups. The Clinical Dementia Rating score, the Mini-Mental State Examination score, and serum levels of interleukin 6, insulin-like growth factor-1, tumor necrosis factor-α, superoxide dismutase and malondialdehyde were compared between before and after treatment. Results:Total response rate in the observation group was significantly higher than that in the control group [90.20% (46/51) vs. 70.59% (36/51), χ 2 = 6.22, P < 0.05]. At 12 weeks after treatment, the Clinical Dementia Rating score in the observation group was significantly lower than that in the control group [(1.34 ± 0.27) points vs. (1.89 ± 0.31) points, t = 9.55, P < 0.05]. At 12 weeks after treatment, the Mini-Mental State Examination score in the observation group was significantly higher than that in the control group [(25.45 ± 1.98) points vs. (22.32 ± 2.10) points, t = 7.74, P < 0.05]. At 12 weeks after treatment, interleukin-6, insulin-like growth factor-1, and tumor necrosis factor-α levels in the observation group were (31.28 ± 7.35) ng/L, (0.34 ± 0.08) ng/L and (9.46 ± 2.27) ng/L, respectively, which were significantly lower than those in the control group [(46.43 ± 6.28) ng/L, (0.48 ± 0.07) ng/L, (20.98 ± 3.56) ng/L, t = 11.19, 9.40, 19.48, all P < 0.05]. At 12 weeks after treatment, superoxide dismutase in the observation group was significantly higher than that in the control group [(98.91 ± 7.25) U/L vs. (86.59 ± 5.63) U/L, t = 9.58, P < 0.05] . At 12 weeks after treatment, malondialdehyde in the observation group was significantly lower than that in the control group [(3.25 ± 0.50) mmol/L vs. (4.81 ± 0.35) mmol/L, t = 18.25, P < 0.05]. Conclusion:Xiaoshuan Changrong Capsules combined with donepezil hydrochloride is highly effective on vascular dementia. It can reduce cellular inflammatory response and improve oxidative stress response. This study is of great innovation and science.

Synthesis of ferulic acid derivatives and their inhibition of cholinesterase inhibitory activity / 中国药科大学学报

@#Ferulic acid (FA), a natural product of phenylpropanoids containing phenolic hydroxyl groups, has a wide range of pharmacological activities and some therapeutic effect on Alzheimer's disease (AD).Using FA as the raw material, the ferulic acid carbamate aniline derivatives were first synthesized by 4-step esterification reaction, splicing carbamate active functional groups, hydrolysis reaction and amide condensation.These FA derivatives were evaluated for in vitro cholinesterase inhibition activity by the Ellman method.A total of 15 novel FA derivatives were designed and synthesized, and their structures were confirmed by 1H NMR, 13C NMR and ESI-MS.Cholinesterase activity tests showed that compounds 5c, 5f, 5j, 5g, 5m possessed good acetylcholinesterase inhibition activity.Except for 5l, 5m, almost all compounds have inhibition activity on butyrylcholinesterase, which is much higher than that on acetylcholinesterase.In conclusion, compounds 5c, 5f, 5j and 5g can be used as potential anti-AD inhibitors targeting cholinesterase..

Association of plasma cholinesterase and triglyceride level in patients with newly diagnosed type 2 diabetes / 中华内分泌代谢杂志

Objective:To investigate the relationship of plasma cholinesterase (ChE) with triglyceride (TG) levels in newly diagnosed patients with type 2 diabetes (T2DM).Methods:Clinical data and biochemical parameters of 321 patients with newly diagnosed T2DM admitted to the Department of Endocrinology of People′s Hospital of Shanghai Putuo from January 2018 to June 2020 were retrospectively collected. The patients were classified into four groups based on the plasma ChE level: Q1group ( n=81, <6 915 U/L), Q2 group ( n=80, 6 916-8 268 U/L), Q3 group ( n=80, 8 269-9 578 U/L), and Q4 group ( n=80, ≥9 579 U/L). The correlation of plasma ChE with TG level was analyzed. Results:With the increased ChE level, TG level significantly increased ( P<0.001). Correlation analysis showed that ChE was positively correlated with body weight, body mass index (BMI), TG, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), uric acid (UA), alanine aminotransferase (ALT), aspartate aminotransferase (AST)( r=0.35, 0.39, 0.35, 0.31, 0.27, 0.24, 0.25, 0.11, P<0.05, P<0.01 or P<0.001)while negatively correlated with age, systolic blood pressure, blood urea nitrogen (BUN), creatinine, and glycated albumin (GA)( r=-0.46、-0.14、-0.20、-0.14、-0.21, P<0.05 or P<0.001). Multivariate stepwise regression analysis showed that ChE was an independent risk factor for TG ( β=0.270, P<0.001). Logistic Multivariate regression analysis showed that after adjustment for sex, age, body weight, hemoglobin, leukocytes, total protein, albumin, globulin, ALT, BUN, creatinine, uric acid, smoking history, drinking history, HbA 1C, GA, TC, and LDL-C, the risk of hypertriglyceridemia in Q4 was 6.024 folds higher than Q1 group ( P=0.011). With the TG (1.70 mmol/L) as cut-off value, the optimal cut-off point of the ChE was 7 801 U/L, as calculated by receiver operating characteristic(ROC) curve analysis of ChE and hypertriglyceridemia. Conclusions:ChE level is positively correlated with TG in newly diagnosed patients with T2DM.

Prolonged Apnoea after Suxamethonium, Diagnosis & Treatment: A Case Report

Plasma Cholinesterase Deficiency is an autosomal recessive inherited blood plasma enzyme abnormality in which the Body's production of butyrylcholinesterase is impaired resulting in prolonged apnoea following depolarising muscle relaxants like Succinyl Choline (Suxamethonium) or Mivacurium. This is associated with paralysis & little or no neurological response. Individuals with plasma cholinesterase (Pseudocholinesterase) deficiency are often diagnosed only after experiencing prolonged apnoea after standard intubating dose of Succinyl Choline. Plasma Cholinesterase is not produced artificially & can be supplied through Blood & fresh frozen plasma. Hence treatment includes mechanical ventilation & supplementation of either whole blood or fresh frozen plasma

The acetylcholinesterase as indicative of intoxication for pesticide in farmers of conventional and organic cultivation / A acetilcolinesterase como indicativo de intoxicação por pesticidas em agricultores de cultivo convencional e orgânico

Abstract In this sense the objective of assessing the levels of pesticide poisoning in rural farmers of San Sebastian and take AL, using acetylcholinesterase enzymes Erythrocyte and plasma as biological indicator of intoxication. This is a prospective, transversal and descriptive variables analyzed were: year whose, sex, age group, education, location, condition, route of exposure. The data were acquired by collecting blood samples and socio demographic information of farmers. Was put as the determining factor the type of conventional and organic farming, and periods of drought and rainy. 56 volunteers were analyzed. The analyses were performed in the automatic biochemical Analyzer Cobas Integra 400 plus®. According to the results of the analyses, it was the largest number of individuals with reduced values of cholinesterase, specifically the Group of conventional farming, the period of greatest change index was in the rainy season, where the activity of AChE, expressive values presented in the city of São Sebastião, with 80% result of intoxicated, in the city of the foot - take, 21.73% over the same period. On analysis of the AChP, São Sebastião has obtained the highest number of contaminated with 18.75% and 30% respectively, in the District Take Foot stood between 10 and 21.73% of reduced levels of cholinesterase. This sets the organic system of cultivation, as the best alternative for prevention of future diseases, in addition to bringing quality of life for rural workers, as well as for consumers.

Resumo Nesse sentido objetivou-se avaliar os níveis de intoxicação por agrotóxicos em agricultores rurais de São Sebastião e Pé Leve - AL, utilizando as enzimas acetilcolinesterase Eritrocitária e Plasmática, como indicador biológico de intoxicação. Trata - se de um estudo prospectivo, transversal e descritivo cujas variáveis analisadas foram: ano, sexo, faixa etária, escolaridade, local, circunstância, via de exposição. Os dados foram adquiridos através da coleta das amostras de sangue e das informações sócio demográficas dos agricultores. Foi posto como fator determinante o tipo de cultivo convencional e orgânico, e os períodos de estiagem e chuvoso. Foram analisados 56 voluntários. As análises foram realizadas no analisador automático de bioquímica Cobas Integra® 400 plus. De acordo com os resultados das análises, percebeu-se maior número de indivíduos com valores diminuídos da colinesterase, especificamente no grupo de cultivo convencional, o período de maior índice de alteração foi na época chuvosa, onde a atividade da AChE, apresentou valores expressivos na cidade de São Sebastião, com resultado de 80% de intoxicados, na cidade do Pé - Leve, obteve-se 21,73% no mesmo período. Na análise da AChP, São Sebastião obteve maior número de contaminados com 18,75% e 30% respectivamente, já no Distrito Pé Leve ficou entre 10 e 21,73% de níveis diminuídos da colinesterase. Isso define o sistema orgânico de cultivo, como a melhor alternativa para prevenção de futuras patologias, além de trazer qualidade de vida para os trabalhadores rurais, como também para os consumidores.

Clinical correlates of hypotension in patients with acute organophosphorus poisoning / 世界急诊医学杂志（英文）

@#BACKGROUND: The aim of the present study is to describe the clinical correlates of hypotension and its associated outcomes in patients with acute organophosphorus poisoning (AOPP). METHODS: In this retrospective cohort study, we analyzed data pertaining to 871 patients with AOPP who were treated at two hospitals. Data from hypotensive and non-hypotensive patients were compared to identify clinical correlates of hypotension. We also evaluated the association between clinical parameters (including hypotension) and in-hospital mortality. RESULTS: The incidence of hypotension in AOPP patients was 16.4%. Hypotensive patients showed significantly higher in-hospital mortality (1.1% vs. 39.9%, P<0.001). Advanced age (odds ratio [OR] 1.25, 95% confidence interval [CI] 1.08-1.44), history of diabetes (OR 2.65, 95% CI 1.14-5.96), and increased white blood cell count (OR 1.06, 95% CI 1.03-1.09), plasma cholinesterase (OR 0.91, 95% CI 0.84-0.94), plasma albumin (OR 0.88, 95% CI 0.85-0.92), serum amylase (OR 1.01, 95% CI 1.01-1.02), and blood pH (OR 0.64, 95% CI 0.54-0.75) were significantly associated with hypotension. After adjusting for potential confounders, hypotension was associated with increased in-hospital mortality (hazard ratio 8.77-37.06, depending on the controlled variables). CONCLUSIONS: Hypotension is a common complication of AOPP and is associated with increased in-hospital mortality. Advanced age, history of diabetes, and changes in laboratory parameters were associated with hypotension in AOPP patients.

Relación de intencionalidad en pacientes con intoxicaciones agudas por plaguicidas en un hospital de Ibagué-Colombia / Acute pesticide poisoning and its relationship with intentionality in patients from a hospital in Ibague-Colombia

Resumen Introducción: La intoxicación aguda por plaguicidas, asociada al suicidio, es un problema de salud pública cuyo estudio es primordial por los organismos estatales. Objetivo: Establecer la relación de intencionalidad en pacientes con intoxicación aguda por plaguicidas, junto a la descripción de algunas características sociodemográficas y de exposición registrados en un hospital de Ibagué desde 2013 a 2016. Materiales y métodos: Se realizó un estudio observacional descriptivo de corte transversal retrospectivo en 137 registros notificados con intoxicación aguda por plaguicida según los códigos del CIE 10. Desarrollo de análisis estadístico descriptivo y estratificado para encontrar la asociación de características con la intencionalidad de la intoxicación. Resultados: El 50% de los casos correspondían a personas menores de 20 años; el 79,6% de las intoxicaciones tenían fines suicidas y se observó que el 45% realizaron un intento de suicidio previo; un nivel educativo alto correspondió a un bajo riesgo de envenenamiento intencional [OR=0,05; IC95% (0,01-0,56); p=0,01]. Conclusiones: Es necesaria la cooperación entre las autoridades en salud e instituciones públicas para implementar medidas de control y demás estrategias que prevengan las intoxicaciones con plaguicidas, particularmente la exposición voluntaria asociada al suicidio, fenómeno creciente en esta ciudad.

Abstract Introduction: Acute pesticide poisoning associated with suicide is a public health problem that requires special attention by state agencies. Objective: To establish the relationship of patient's intent with acute pesticide poisoning and describe some sociodemographic and exposure characteristics registered by a hospital in Ibagué (Colombia), from 2013 to 2016. Materials and methods: A retrospective, cross-sectional, descriptive, observational study was conducted on 137 reports of acute pesticide poisoning that were registered according to ICD 10 codes. A descriptive and stratified statistical analysis was applied to establish the association between characteristics of poisoning intentionality. Results: 50% of the cases corresponded to people who were under 20 years of age. 79.6% of the poisonings were due to suicide attempt and 45% had had a previous attempt. A high educational level corresponded to a lower risk of intentional poisoning [OR=0.05; IC95% (0.01-0.56); p=0.01]. Conclusions: Cooperation between health care authorities and public institutions is necessary to implement measures and strategies in order to prevent acute pesticide poisoning events, especially those associated with suicide attempts, the frequency of which is growing in this city.

Association of CYP2D6 (G1934A) gene and hematological disturbances in chronic pesticide exposures

Cytochrome P450 family genes (CYPs) have common polymorphisms, which are evaluated for pesticide-inducedoxidative stress susceptibility. Variant alleles in CYP enzymes may uncover susceptibility biomarkers of environmentaltoxicity. This study aims to investigate the relationship between CYP2D6 (G1934A) gene polymorphisms and chronicpesticide exposures, and to evaluate the association between CYP2D6 (G1934A) gene polymorphism on biochemicaland hematological parameters. A cross-sectional study was carried out at a health promoting hospital, Suphan Buri,Thailand. Rice farmers and a control group (n = 50 for each) were recruited and their personal data were collected. Theirblood samples were obtained by venepuncture and drawn into plain and Ethylenediaminetetraacetic acid (EDTA) tubes.Serum cholinesterase (SChE), liver function test, kidney function test, and complete blood count were assessed usingautomatic analyzers; and CYP2D6 (G1934A) genotyping was carried out by polymerase chain reaction-restrictionfragment length polymorphism (PCR-RFLP). SChE in rice farmers was significantly lower (p = 0.033), which maybe related to the use of chlorpyrifos. The genotypes were significantly different between rice farmers and the controlgroup (p = 0.0001), and the GA variant in rice farmers was more frequent. The CYP2D6 (G1934A) (rs 3892097))gene and SChE level were negatively correlated (r = −0.258, p = 0.009). However, other biochemical parameters werenot different. Blood indices, including mean corpuscular hemoglobin (MCH), mean corpuscular volume (MCV), andmean corpuscular hemoglobin concentration (MCHC), values of rice farmers were significantly lower than the controlgroup; and MCH, MCV, and MCHC values of the GA variant were also significantly lower than the wild type. The GAgenotype was associated with hematological toxicity of organophosphate metabolite in chronic exposures.

Evaluation of serum paraoxonase, 1 and its association with serum cholinesterase as a cause of congenital anomalies

Background: Birth defects are conditions of prenatal origin that are present at birth, potentially impacting an infant's health, development, and/or survival. Several environmental toxins affect the growth of the fetus during the intrauterine period by affecting various cellular components. Pesticides and industrial chemicals are known toxins that can hinder the developmental process. In this study, authors are evaluating the relation of cholinesterase and paraoxonase-1 with visible congenital anomalies.Methods: Sixty babies delivered in the labor room were selected for the study. They were divided into two groups. Thirty newborns with visible congenital anomalies were included in Group I. Only babies with visible congenital anomalies were taken as inclusion criteria for this group. This group was compared with Group II, which were taken as controls and consisted of 30 healthy newborns without any congenital anomalies. Serum cholinesterase and serum paraoxonase-1 were estimated and statistical tests were applied.Results: Serum cholinesterase and serum paraoxonase-1 were significantly low in the babies with visible congenital anomalies. Serum cholinesterase levels showed a statistically significant positive correlation with serum paraoxonase 1 level in both the groups.Conclusions: Decrease in acetylcholinesterase by various environmental toxins and the associated decrease in serum paraoxonase level imposes significant oxidant stress and the resultant risk of developing congenital anomalies.

A prospective evaluation of correlation between cholinesterase level and severity of organophosphorus poisoning

Background: Organophosphorus compounds are anticholinesterases by inhibiting cholinesterase it protects acetyl chorine from hydrolysis. So, acetylcholine accumulates at the synapses, and all the clinical manifestation are due to that. So, this study has been designed to establish the reactive between level of serum and prognosis of op poisoning patients.Methods: Patient with history of organophosphorus poisoning admitted into the emergency department with following exclusion and inclusion criteria were included in this study. All patients were managed as per standard treatment protocol of op poisoning. Various parameters like demography of the patients, sign and symptoms, severity of intoxication, clinical and lab parameter manoring, Serum cholinesterase was measured every alternate day.Results: 22(47.84%) patients have mild symptom out of that 20 patient抯 serum cholinesterase was more than 2000 IU/L, and 2(4.3%) patients serum cholinesterase was between 1000-2000 IU/L. In eighteen patient抯 severity as per POP scale was moderate, out of that 2(4.3%) patients have serum cholinesterase was below 1000 IU/L, 8 having serum cholinesterase between 1000 to 2000 IU/L, and remaining eight having serum cholinesterase above 2000 IU/L.Conclusions: Serum cholinesterase was less in patient with high severity score or low serum concentration of cholinesterase was associated with high severity score. Serum cholinesterase was improved as days passes.