Time trend of pesticide poisoning in Jiaxing from 2008 to 2020 / 环境与职业医学

Background Pesticide poisoning is not only a common acute poisoning, but also an indispensable public health problem. It is important to describe and analyze the epidemic characteristics and trends of pesticide poisoning for its prevention and control. Objective To understand the epidemiological characteristics and trends of pesticide poisoning in Jiaxing from 2008 to 2020, and provide a basis for making effective intervention measures. Methods The relevant information of pesticide poisoning cases in Jiaxing from 2008 to 2020 was collected through the Occupational Disease and Occupational Health Information Monitoring System of the China Disease Prevention and Control Information System, and the demographic information was obtained from the statistical yearbook of Jiaxing. Joinpoint regression models were used to analyze trends in overall, gender, age, season, type of poisoning, and type of pesticide among poisoned individuals. Results A total of 3109 cases of pesticide poisoning were reported in Jiaxing City from 2008 to 2020. The overall pesticide poisoning incidence trended downward from 2008 to 2014, with an annual percent change (APC) of −9.0% (95%CI: −16.6%-−0.7%). The female pesticide poisoning incidence trended downward from 2008 to 2015, with an APC of −8.6% (95%CI: −13.9%-−2.9%). The 18-34 age group showed a decreasing trend of pesticide poisoning incidence from 2008 to 2015, with an APC of −11.0% (95%Cl: −17.4%-4.3%), and an increasing trend from 2015 to 2020, with an APC of 18.5% (95%Cl: 4.7%-34.0%). The >60 age group showed a decreasing trend of pesticide poisoning incidence from 2008 to 2014, with an APC of -12.9% (95%Cl: −20.4%-−4.7%). The second quarter showed an increasing trend of pesticide poisoning incidence from 2010 to 2020, with an APC of 4.4% (95%CI: 0.3%-8.5%); the third quarter showed a decreasing trend, with an APC of −4.9% (95%CI: −8.6%-−1.1%); the fourth quarter showed an increasing trend from 2015 to 2020, with an APC of 17.8% (95%CI: 4.4%-33.0%). Productive poisoning showed a decreasing trend, with an APC of −11.1% (95%CI: −16.2%-−5.7%); self-poisoning showed a decreasing trend from 2008 to 2014, with an APC of -9.5% (95%CI: −17.4%-−0.7%), and an increasing trend from 2014 to 2020, with an APC of 10.2% (95%CI: 0.5%-20.8%). The incidences of poisoning by herbicides, fungicides, and mixed formulations all showed an increasing trend from 2008 through 2020, with an APC of 8.6% (95%CI: 5.8%-11.5%), 9.1% (95%CI: 0.3%-18.7%), and 193.3% (95%CI: 11.6%-671.0%), respectively; the incidence of poisoning by other types of pesticides showed a decreasing trend from 2008 to 2020, with an APC of −14.1% (95%CI: −23.7%-−3.2%). Conclusion The overall reported pesticide poisoning incidents in Jiaxing City present a decline then a rise in 2008 to 2020. Relevant departments should take timely measures to prevent and reduce the occurrence of pesticide poisoning according to the changing characteristics and occurrence trends of local pesticide poisonings.

Analysis of clinical characteristics of 294 acute poisoning patients with gastric lavage / 中华急诊医学杂志

Objective:To describe the current situation of gastric lavage operation and put forward measures for improvement by analyzing the clinical characteristics of 294 patients with gastric lavage in Poisoning Treatment Center of The First Affiliated Hospital of Nanjing Medical University.Methods:The clinical data of 294 patients with acute poisoning and gastric lavage from 2019 to 2021 were collected and analyzed retrospectively, and the related parameters (poison type, gastric lavage volume, poisoning to gastric lavage time, etc.) of each year were compared.Results:A total of 653 poisoning patients underwent gastric lavage from 2019 to 2021, with an average age of (44.2 ±20.1) years, and 134 (45.6%) were male. The main causes of gastric lavage were pesticide poisoning (52.72%) and drug poisoning (42.86%). The volume of gastric lavage was less than 10 L for 43.8% of patients and 10-20 L for 32.7% of patients. Patients with gastric lavage within 60 min after ingestion of poison accounted for 45.3%, followed by 25.8% within 61-120 min. The in-hospital mortality rate was 17.7%. The common complications of gastric lavage were: the incidence of gastrointestinal bleeding (55/121, 45.5%), the incidence of aspiration pneumonia (54/140, 38.6%), and the incidences of electrolyte disorder (21% of low potassium, 29% low calcium, and 10.0% low sodium). Compared with the groups in different years, the proportion of gastric lavage in poisoning was 58.85% vs. 46.60% vs. 32.41%, which decreased year by year, with statistical difference ( P <0.05). And there was no difference in the period from ingestion to gastric lavage and gastric lavage fluid volume. There was an increasing trend in poison types between diquat and other insecticides, but there was no statistical difference. Conclusions:From 2019 to 2021, the most common causes of acute gastric lavage were pesticide poisoning and drug poisoning, and the proportion of diquat and other pesticides showed an overall upward trend. A majority of the patients (71.1%) had gastric lavage within 2 h, and 76.5% of the patients had less than 20 L gastric lavage fluid. In the future, we will further control the amount of gastric lavage fluid and pay attention to the gastric lavage operation of new insecticide poisoning.

Clinical study on revised penehyclidine hydrochloride treatment program for acute severe organophosphorus pesticide poisoning / 环境与职业医学

Background The current treatment program with penehyclidine hydrochloride (PHC) for acute severe organophosphorus pesticide poisoning (ASOPP) patients exerts a positive effect but with concerned adverse reactions. Objective To evaluate the treatment effect of a revised ASOPP treatment program with PHC. Methods A prospective single-blind randomized controlled trial was conducted. A total of 157 patients with ASOPP were divided into a revised treatment group (82 cases) and a conventional treatment group (75 cases) by random number table. The two groups received the same basic treatment measures including active life support, routine gastric lavage, catharsis, and pralidoxime treatment. The revised treatment group followed a revised PHC treatment protocol initiated by first a small dose of PHC and followed by small doses of PHC administration/discontinuation through frequent observations at different time points. The conventional treatment group received the conventional program. Treatment effects and incidence rates of possible adverse reactions were compared between the two groups. Results Compared with the conventional treatment group, the revised treatment group obtained delay in penetrogenation time point, higher success rate in catharsis, earlier cholinesterase-turning time, and shorter hospitalization period with statistical significance (all Ps＜0.05). No differences were found in terms of time for symptoms of poisoning to disappear, incidence rates of intermediate myasthenic syndrome and delayed polyneuropathy, mechanical ventilation time, and cure rate (all Ps＞0.05). Less adverse reactions occurred in the revised treatment group including tachycardia and delirium than in the conventional treatment control group (all Ps＜0.05). Conclusion The revised ASOPP treatment program with PHC is similar to the current recommended treatment program in treatment effects, but with less adverse reactions.

Estruturação das informações sobre intoxicações agudas por agrotóxicos no estado da Bahia, utilizando o Caderno de Monitoramento e Avaliação da Atenção Básica ­ CAMAB / Structuring information on acute poisoning by pesticides in the state of Bahia using the primary care monitoring and evaluation booklet / Estructuración de información sobre intoxicaciones agudas por plaguicidas en el estado de bahía (brasil) utilizando el Cuaderno de Evaluación y Seguimiento de Atención Primaria ­ CAMAB

A partir de 2008, o Brasil tornou-se o maior consumidor de agrotóxicos do mundo, mantendo-se nessa posição desde essa época. A Bahia, por sua vez, situou-se, em 2014, como o oitavo estado brasileiro de maior comercialização de agrotóxicos e o primeiro da região Nordeste. Nesse contexto, não surpreende que o agrotóxico seja a terceira maior causa de intoxicação no país e no estado. Apesar da gravidade da situação, a Bahia tem poucas informações sistematizadas sobre agrotóxicos. Os conhecimentos existentes encontram-se dispersos em diversas áreas do setor da saúde e em outros setores. Nesse sentido, este trabalho tem como objetivo apresentar uma ferramenta que disponibiliza informações estruturadas e de fácil acesso aos profissionais de saúde, gestores e comunidade, possibilitando a eles o conhecimento sobre a distribuição dos casos de intoxicação aguda por agrotóxico por macrorregiões, regiões de saúde e municípios. Trata-se do Caderno de Avaliação e Monitoramento da Atenção Básica (Camab), elaborado pela Coordenação de Avaliação e Monitoramento (Coam) da Diretoria de Atenção Básica (DAB) e divulgado no site da Secretaria de Saúde do Estado da Bahia. A elaboração do Camab foi uma estratégia importante para dar maior visibilidade às questões relacionadas aos agrotóxicos no âmbito da DAB e, consequentemente, nos municípios por ela apoiados. Por fim, acredita-se que o acesso a informações em tempo hábil contribui para o fortalecimento da vigilância e o desenvolvimento das ações de promoção da saúde e prevenção de agravos junto às populações expostas ao potencial risco de intoxicação por agrotóxicos.

From 2008 onwards, Brazil became the world's largest consumer of pesticides. Moreover, Bahia was ranked the eighth Brazilian state with the largest pesticide commercialization in 2014 and the first in the Northeast Region ­ so that, not surprisingly, pesticides are the third leading cause of poisoning in the country and state. Despite the severity of the situation, information on pesticides are little systematized in Bahia, and the available information is dispersed across different health sectors as well as in other fields. This study aims to present a tool that provides structured and easily accessible information on cases of acute pesticide poisoning by macro-regions, health regions, and municipalities to health professionals, managers, and the overall community: the Primary Care Monitoring and Evaluation Booklet (CAMAB). Prepared by the Monitoring and Evaluation Coordination (COAM) of the Primary Care Board (DAB) and published on the website of the Health Department of the State of Bahia, the CAMAB was an important strategy to give greater visibility to pesticide-related issues within the scope of DAB and municipalities supported by it. Timely access to information contributes to the strengthening of surveillance and the development of actions aimed at promoting health and preventing diseases together with populations exposed to the potential risk of poisoning by pesticides.

Desde 2008, Brasil se convirtió en el mayor consumidor de plaguicidas del mundo y ha mantenido esta posición. El estado brasileño de Bahía, en 2014, se ubicó en el octavo puesto con mayor comercialización de plaguicidas y en el primer de la región Nordeste. En este contexto, no es de extrañar que los plaguicidas sean la tercera causa principal de intoxicación en el país y el estado. A pesar de la gravedad de la situación, existe poca información sistematizada sobre plaguicidas en Bahía. Los datos existentes están dispersos en varias áreas del sector salud y en otros sectores. En este sentido, el presente trabajo tiene como objetivo presentar una herramienta que brinde información estructurada y de fácil acceso a los profesionales de la salud, los gestores y la comunidad, que les permita conocer la distribución de los casos de intoxicación aguda por plaguicidas por macrorregiones, regiones sanitarias y municipios. Se trata del Cuaderno de Evaluación y Seguimiento de Atención Primaria (Camab), elaborado por la Coordinación de Evaluación y Seguimiento (Coam) de la Junta de Atención Primaria (DAB) y publicado en la página web de la Secretaría de Salud del Estado de Bahía. La elaboración del Camab fue una estrategia importante para dar mayor visibilidad a los temas relacionados con plaguicidas en el ámbito de la DAB y, en consecuencia, en los municipios apoyados por la misma. Finalmente, el acceso oportuno a la información debe de contribuir al fortalecimiento de la vigilancia y al desarrollo de acciones de promoción de la salud y prevención de enfermedades junto con las poblaciones expuestas al riesgo potencial de intoxicación por plaguicidas.

Research progress of pesticide poisoning detection technology / 公共卫生与预防医学

In order to meet the needs of detection of poisoning-inducing pesticides occurring in poisoning emergency events, this article introduces and discusses the characteristics, scope of application, and advantages and disadvantages of two types of detection technologies: laboratory detection and on-site rapid detection. The sample pre-processing technology suitable for on-site detection is also elaborated.

Role of penehyclidine in acute organophosphorus pesticide poisoning / 世界急诊医学杂志（英文）

BACKGROUND@#Penehyclidine is a newly developed anticholinergic agent. We aimed to investigate the role of penehyclidine in acute organophosphorus pesticide poisoning (OP) patients.@*METHODS@#We searched the Pubmed, Cochrane library, EMBASE, Chinese National Knowledge Infrastructure (CNKI), Chinese Biomedical literature (CBM) and Wanfang databases. Randomized controlled trials (RCTs) recruiting acute OP patients were identified for meta-analysis. Main outcomesincluded cure rate, mortality rate, time to atropinization, time to 60% normal acetylcholinesterase (AchE) level, rate of intermediate syndrome (IMS) and rate of adverse drug reactions (ADR).@*RESULTS@#Sixteen RCTs involving 1,334 patients were identified. Compared with the atropine-or penehyclidine-alone groups, atropine combined with penehyclidine significantly increased the cure rate (penehyclidine+atropine vs. atropine, 0.97 vs. 0.86, RR 1.13, 95% CI [1.07–1.19]; penehyclidine+atropine vs. penehyclidine, 0.93 vs. 0.80, RR 1.08, 95% CI [1.01–1.15]) and reduced the mortality rate (penehyclidine+atropine vs. atropine, 0.015 vs. 0.11, RR 0.17, 95% CI [0.06–0.49]; penehyclidine+atropine vs. penehyclidine, 0.13 vs. 0.08, RR 0.23, 95% CI [0.04–1.28]). Atropine combined with penehyclidine in OP patients also helped reduce the time to atropinization and AchE recovery, the rate of IMS and the rate of ADR. Compared with a single dose of atropine, a single dose of penehyclidine also significantly elevated the cure rate, reduced times to atropinization, AchE recovery, and rate of IMS.@*CONCLUSION@#Atropine combined with penehyclidine benefits OP patients by enhancing the cure rate, mortality rate, time to atropinization, AchE recovery, IMS rate, total ADR and duration of hospitalization. Penehyclidine combined with atropine is likely a better initial therapy for OP patients than atropine alone.

Prospective study of spectrum, clinico-epidemiology, profile complication and outcome of pesticide poisoning in children

Background: Konaseema region of Andhra Pradesh is a rural area having well irrigated lands and rice fields. Agriculture is the major some of income, and pesticide use is high.' As per one report of deccan chronicle (a daily newspaper) Andhra Pradesh and Telangana accounts for 24% share of pesticide consumption in the country. Pediatric pesticide poisoning is under reported in India as well. In this background resent study has been designed to study clinic-epidemiology, profile, complication and treatment outcome of pesticide poisoning in Konaseema region of Andhra Pradesh.Methods: In present study clinico-epidemiology, clinical profile, complication and outcome of the patient admitted in the Department of Emergency medicine and Paediatric were evaluated over a period of 12years.Results: Most of the children were above 5years of age that is 74.0% (n=40), rest were below 5years of age. Male children out numbered female children and accounted for 77.78% (n=42). Accidental poisoning was more than suicidal poisoning that is 94.59% of the patients. 9.35% patient (n=5) developed respiratory failure and required ventilator support. Non-carcinogenic pulmonary edema was present in 8 (14.81%) patients. Four patients have atropine toxicity, electrolyte in balance was found in 7.4% (n=4) patients. Acute kidney injury was present in two patients, 5.5% (n=3) patients developed cardiac arrhythmia.Conclusions: Chlorpyrifos was common agent which is responsible for poisoning most common complication in our patients were respiratory complications which required ventilatory support. Lack of information, improper disposal of container, non-existence of training and regulation is supported to the cause of accidental exposure of pesticide to paediatric patients.

Analysis of structural equation modeling on influencing factors for patients with deliberated acute pesticide poisoning / 中华疾病控制杂志

Objective To explore the influencing factors of deliberated acute pesticide poisoning (APP), so as to provide prevention and health promotion for the disease. Methods The deliberated APP patients related factors questionnaire was used to investigate deliberated APP and non-deliberated APP patients. The data was analyzed with Structural Equation Modeling. Results APP was directly affected by cognitive factors, psychological factors and social environment factors. Their standardized regression coefficients were -0.831, -0.752 and -0.469 respectively. Cognitive factors had a direct effect on psychological factors and social environment factors. APP was affected indirectly by cognitive deviation, absolutization, copying manner, social support, pesticide management and negative life events. Their standardized regression coefficients were 0.757, 0.541, 0.773, 0.576, 0.824 and 0.782, respectively. Conclusions Paying attention to the influencing factors for deliberated APP patients, improving sociological influencing factors, improving coping style and provide social support and strengthen pesticide management is benefided to reduce the incidence of APP.

Analysis of spatial-temporal distribution of pesticide poisoning in Quzhou, 2013-2017 / 中华劳动卫生职业病杂志

Objective@#To analysis the epidemic and spatial characteristics of pesticide poisoning in Quzhou during 2013-2017, and to provide scientific basis for the prevention and control of influenza in Quzhou in the future.@*Methods@#The incidence data of pesticide poisoning from January 1, 2013 to December 31, 2017 in Quzhou collected from China Information System For Disease Control And Prevention. The descriptive analysis conducted by using SPSS18.0 software, and the Sa T Scan 9.2 software was used to complete space-time scan. Finally, ArcMap10.2 software was used to visualize the results.@*Results@#There were 1819 cases of pesticide poisoning in Quzhou from 2007 to 2016, among which 298 cases were reported for productive poisoning, the incidence peak was from August to September, the highest number of patients in productive poisoning was in the age group of 46-60 years old and over 61 years old, with 109 patients in each group, and the number of male patients was significantly higher than that of female (χ2=63.857, P<0.01) . 1521 cases of non-productive pesticide poisoning were reported, among which the proportion of suicide poisoning (57.65%) was far higher than that of accidental poisoning (28.97%) , the number of female suicide poisoning was higher than that of male (χ2=5.510, P=0.019) , the proportion of accidental poisoning was the highest in the ≤15 years age group (89.00%, 89/100) , furthermore the number of suicide poisoning was the highest in the ≥61 years age group (314) . The incidence of pesticide poisoning could be detected by temporal-spatial scanning statistics, the time clustering is from August to September, the spatial clustering is in Jiangshan city, there are consistent with the descriptive of pesticide poisoning.@*Conclusion@#The pesticide poisoning in Quzhou is mainly caused by non-productive suicide poisoning, and the spatial clustering is in Jiangshan city. Relevant departments should carry out targeted prevention and control measures according to the different characteristics of pesticide poisoning in clustered and non-clustered areas.

Retrospective analysis on pesticide poisoning cases in Zhejiang Province / 预防医学

Objective To explore the regularity and characteristics of pesticide poisoning in Zhejiang Province and to provide scientific basis for pesticide poisoning prevention. Methods The cases of pesticide poisoning in Zhejiang Province from 2007 to 2016 were collected through the occupational diseases and occupational health information monitoring system. The district, types of pesticides, time, gender and age of poisoning were analyzed. Results There were 46 671 cases of pesticide poisoning in Zhejiang Province from 2007 to 2016, 14.91% of which were productive exposure poisoning, while 85.09% were non-productive exposure poisoning. There were 2 735 death cases, so the fatality rate was 5.86%. There was no obvious change trend in the mortality rate of productive poisoning(P>0.05), which was 0.88%. The mortality rate of non-productive poisoning was much higher, which was 6.73%(P<0.05), with a decreasing trend in this decade(P<0.05). The pesticide poisoning occurred more from July to September than other months, with a total number of 16 806 cases, which was 36.01% of the 46 671 cases. Hangzhou, Taizhou and Huzhou reported the largest number of cases. The number of organophosphorus pesticide poisoning cases was the highest, accounting for 56.89% of the total poisoning cases. The highest incidence of poisoning was among 35-64 years old ones 51.44% of the cases). The number of death cases in groups older than 75 years was the largest, accounting for 11.44% of the total number of deaths. The cases of suicide poisoning accounted for 77.07% of non-productive pesticides poisoning, and the fatality rate was 8.11%. The mortality rate increased with age(P<0.05). The mortality rate of suicide poisoning in male patients was 9.82%, which was higher than that of female(6.59%)(P<0.05). Conclusion The pesticide poisoning in Zhejiang Province is mainly caused by non-productive self-service poisoning. The mortality rate of pesticide poisoning in the elderly population is high.

Capability and spatial accessibility of the emergency service at township hospitals in Fushun county,Sichuan / 中国卫生政策研究

Objective:To understand the capability of the emergency service at township hospitals in Fushun county and take emergency treatment of pesticide poisoning in Fushun as an example to measure the spatial accessibil-ity of the emergency service center. Methods:Gathered the heads of 26 township hospitals,using self compiled ques-tionnaire to collect emergency services data;basic data including administrative districts,hydrographic net,road net-work, population distribution and the position of the first aid post were collected, Travel cost method was used to quantitatively measure the emergency service spatial accessibility based on GIS platform. Results: The proportion of hospitals that are able to carry out rescue projects is low;it takes 13.57minutes on average from a residential area to a first aid post of pesticide poisoning in Fushun. The regions with poor accessibility of the first aid post are mainly distributed in the southwest boundary. Conclusion:The hardware and software level of emergency resources of town-ship hospitals in Fushun were lower;Township emergency network need to be improved;That using GIS to assess the accessibility of the first aid post is intuitive and easy to operate.

A Study of Emergency Measures and Curative Effect of Respiratory Failure Caused by Organophosphorus Pesticide Poisoning / 昆明医科大学学报

Objective To improve the prognosis among patients with respiratory failure poisoned by organophosphorus pesticide though analyzing and discussing the emergency measures and treatment effects. Methods From January 2014 to December 2016, 86 patients with respiratory failure caused by severe organophosphorus pesticide poisoning were received in the Emergency Department in Nanchong Central Hospital.The patients were numbered according to the order of the treatment and randomly divided into control group and observation group with 43 cases in each group.All patients were treated with routine emergency measures (gastric lavage and endotracheal intubation, rehydration, and symptomatic treatment).The control group was treated with pralidoxime chloride injection and injection of atropine detoxification while the observation group was given pralidoxime chloride combined with Penehyclidine Hydrochloride Injection detoxification.We compared the alleviation of clinical symptoms and the changes of cholinesterase (CHE) and respiratory function (respiratory frequency, Pa02, Pa02/Fi02) between the two groups of patients 10 min and 30 min after administration. The statistics of atropinization time, blood purification treatment rate, tracheotomy rate, hospital mortality,complications and treatment time were recorded. Results No statistic significance was observed among the two groups of patients in gender,age, weight,body mass index (BMI),the severity of poisoning,types of organophosphorus drugs and blood cholinesterase (CHE) at the first visit (P＞0.05).Blood CHE was effectively improved among the two groups 10 min and 30 min after the treatment and significantly higher CHE was seen in the observation group compared to the control group (P＜0.05) . The overall clinical symptom rate was lower 10min and 30min after the treatment (P＜ 0.05), and the clinical symptom rate of the observation group was lower than that of the control group (P＜0.05) . The respiratory function indexes (respiratory rate, Pa02, Pa02/Fi02) were significantly improved 10 min and 30 min after the treatment in both groups compared with those before the treatment (P＜ 0.05) .The blood purification treatment rate, tracheotomy rate, complication rate, hospitalization time and atropine time of the observation group were significantly lower than those of the control group (P＜ 0.05) . No significant difference was found in mortality rate between the two groups (P＞0.05).Conclusion After giving effective respiration and circulation support, administration of penehyclidine hydrochloride combined with pralidoxime chloride detoxification can effectively restore the cholinesterase activity among patients with organophosphorus pesticide poisoning and improve respiratory function and prognosis, whichshows a high clinical value.

Cypermethrin-induced Repeated-dose Immuno-toxicity in Oryctolagus Cuniculus: An Investigation into Pathology of Spleen and Blood

Background: Cypermethrin is a pyrethroid insecticide widely used in agriculture and medicines. Its toxicity effects on spleen and blood in male and female rabbits is studied in this research. Methods: Age- and weight-matched does/females (n=24) and bucks/males (n=24) of Japanese White rabbits were subjected to intraperitoneal cypermethrin administration @50, 100 and 150 mg.kg-1 b.wt. in groups B, C and D, respectively.  The experimental rabbit does and bucks were tested for hematology alterations after each of 5 CY-treatments, at days 1, 8, 15, 22 and 29.  One rabbit doe and one rabbit buck were sacrificed fortnightly (days 15, 29, 43, 57 and 71) to obtain spleen for histological studies. Results: CY-treated rabbit bucks developed anemia, leukopenia, neutropenia, monocytosis, eosinophilia and basocytopenia mostly in dose and time dependent manner.  In contrast, rabbit does show transient but significant leukocytosis, neutropenia, lymphopenia, monocytosis, eosinophilia and basophilia only in high dose group.  Moreover, spleen histology revealed congestion, depletion of white pulp with increased red pulp and hemosiderin deposition in CY treated rabbit bucks, but not rabbit does. Conclusions: This study concludes that immuno-toxicity by cypermethrin insecticide is not similar in male and female subjects.

Valores de colinesterasa plasmática y eritrocitaria con ácido 6-6'-ditiodinicotínico (DTNA) como indicador / Plasma and eritrocitary cholinesterase values with 6-6'-dithiodinicotinic acid (DTNA) as indicator / Valores da colinesterase plasmática e eritrocitária utilizando o ácido 6-6-ditiodinicotínico (DTNA) como indicador

Resumen Se realizó un estudio descriptivo transversal empleando ácido 6-6'-ditiodinicotinico (DTNA) como indicador para calcular los valores de la actividad de colinesterasa plasmática (AchP) y eritrocitaria (AchE) humana y estandarizarlos para ser utilizados como indicadores de riesgo laboral por exposición a organofosforados y carbamates en la población de la zona cafetera de Colombia. Se eligió esta técnica pues es una alternativa precisa, sencilla y económica: con pocos interferentes permite analizar AchP y AchE, no se tiene que corregir con hemoglobina; el DTNA es estable congelado o refrigerado y permite analizar muchas muestras en poco tiempo. Se evaluaron 819 muestras de agricultores. La AchE fue significativamente mayor en las personas menores de 45 años y en personas no fumigadoras, la AchP fue mayor en los fumigadores; esto es un indicador de que la población fumigadora se encuentra expuesta a organofosforados y carbamatos de forma prolongada. Se sugiere utilizar como valores máximos de referencia de la AchE y AchP 11378 U/L y 10354 U/L, respectivamente como indicadores de intervención ocupacional.

Abstract A cross-sectional descriptive study using 6-6'-dithiodinicotinic acid (DTNA) as an indicator was performed to calculate the values of plasma cholinesterase (AchP) and erythrocyte (AchE) activity and to standardize them to be used as indicators of occupational risk by exposure to organophosphates and carbamates in the population of the Colombian Coffee Growing Area. This method was chosen because it is an accurate, simple, and nonexpensive alternative: with few interferents it allows measuring both AchP and AchE, it does not have to be corrected with hemoglobin; The DTNA is stable frozen or refrigerated and allows to analyze many samples in a short time. A number of 819 samples from farmers were evaluated. While AchE was significantly higher in people under 45 years and in non-fumigating people, AchP was higher in fumigators; this result is an indicator that the fumigant population is exposed to organophosphates and carbamates on a long-term basis. It is suggested to use as maximum reference values of AchE and AchP 11378 U / L and 10354 U / L, respectively as indicators of occupational intervention.

Resumo Foi realizado um estudo descritivo transversal usando ácido 6-6'-ditiodinicotinico (DTNA) como indicador a fim de calcular os valores de atividade da colinesterase plasmática (AchP) e eritrocitária (AchE) humana e padronizar estes valores para ser utilizados na região cafeteira da Colômbia. Esta técnica foi elegida porque e uma alternativa precisa, simples e econômica: tem poucos interferentes e permite analisar AchP e AchE, não deve corrigir-se com hemoglobina; o DNTA e estável congelado ou refrigerado e permite analisar muitas amostras em pouco tempo. Foram avaliadas 819 amostras de agricultores. A AchE foi significativamente maior nas pessoas com menos de 45 anos e em pessoas não pulverizadoras, a AchP foi maior nas pessoas pulverizadoras; isso e um indicador de que a população pulverizadora encontra-se exposta a organofosforados e carbamatos de maneira prolongada. Sugere-se utilizar como valores máximos de referência da AchE e AchP 11378 U/L y 10354 U/L, respectivamente como indicadores de intervenção ocupacional.

Reportes al Centro Nacional de Toxicología de mujeres en edad fértil expuestas a plaguicidas / Reports to the National Center for Toxicology of women of childbearing age exposed to pesticides

Introducción: el amplio uso de los plaguicidas químicos en la agricultura propicia la exposición semejante de mujeres y hombres a estos productos. Los riesgos por exposición a plaguicidas, tales como los de toxicidad aguda y crónica, efectos inmunológicos, hormonales, endocrinos y sobre la reproducción, no han recibido atención suficiente a nivel mundial. Objetivo: caracterizar los reportes al Centro Nacional de Toxicología de mujeres en edad fértil expuestas a plaguicidas entre 2009 y 2013. Métodos: se realizó un estudio observacional en una serie de 402 mujeres, se analizaron las variables edad, circunstancia, gravedad de la intoxicación y tipo de pesticida. Resultados: las mujeres en edad fértil atendidas representaron la mitad del total de expuestas, con edad promedio de 30,3 años, la mayor incidencia fue de los eventos leves con fines suicidas. Los plaguicidas más involucrados pertenecen al grupo otros/varios. Conclusiones: las mujeres más afectadas fueron las del grupo 12 a 24 años de edad, con intoxicaciones intencionales suicidas de leve intensidad, ocasionadas por plaguicidas del grupo otros/varios(AU)

Introduction: The widespread use of chemical pesticides in agriculture lead to similar exposure of women and men to these products. Risks from exposure to pesticides, such as acute and chronic toxicity, immunological, hormonal, endocrine and reproductive effects, have not received sufficient global attention. Objective: Characterize the reports to the National Center for Toxicology of women of childbearing age exposed to pesticides between years 2009 and 2013. Methods: An observational study was conducted in a sample of 402 women, in which the following variables were studied; age, circumstance, severity of intoxication and type of pesticide. Results: Women of childbearing age accounted for half of the total number of patients exposed, with a mean age of 30,3 years, with milder events being suicidal. The pesticides most involved belong to the group others/various. Conclusions: The most affected women were those in the 12 to 24 years of age, with intentional poisonings of mild intensity caused by pesticides of the group others/various(AU)

Effects of Xuebijing Injection on serum CRP, TNF-α and IL-6 levels in patients with severe acute organophosphorus pesticide poisoning / 中成药

AIM To explore the effects of Xuebijing Injection (Carthami Flos,Salviae miltiorrhizae Radix et Rhizoma,Paeoniae Radix Rubra,etc.) on serum CRP,TNF-α and IL-6 levels in patients with severe acute organophosphorus pesticide poisoning (AOPP).METHODS Seventy-two cases of patients with AOPP treated from Jan 2014 to Mar 2016 in the emergency department of our hospital were randomly divided into two groups,the control group treated with atropine,pralidoxime chloride and conventional treatment,and the observation group combined with Xuebijing Injection.The dynamic changes of serum CRP,TNF-α and IL-6 levels,and clinical curative effects were compared between the two groups.RESULTS The serum CRP,TNF-α and IL-6 levels in the two groups were decreased in turn before the treatment,at the 3rd,7th days after the treatment,and the serum CRP,TNF-α and IL-6 levels in the observation group were significantly lower than those in the control group;the dosage of atropine,time of cholinesterase activity recovered 60％ and hospital stay in the observation group were significantly less than those in the control group;the rebound rate of the observation group was lower than that of the control group.The acute respiratory distress syndrome (ARDS) rate in the observation group was significantly lower than that in the control group.All the differences had statistical significances (P ＜ 0.05).CONCLUSION Xuebijing Injection can effectively inhibit the inflammatory response,reduce the incidence of complications,shorten the course,and improve the clinical efficacy in the treatment of patients with AOPP.

Comparison of cardiac muscle status in patients with severe acute organophosphorus pesticide poisoning under different blood purification schemes / 中国生化药物杂志

Objective To explore the effect of single blood perfusion combined with blood perfusion combined with continuous venous venous blood filtration (sequential blood purification) on myocardial injury in patients with severe acute organophosphorus pesticide poisoning.MethodsRetrospectively analyzed in July 2013 to July 2015 treated in our hospital see a doctor and a total of 94 patients with severe acute organophosphorus pesticide poisoning, depending on the patient's blood purification scheme, divided the patients into blood perfusion group (n=48) and sequential blood purification group (n=46), contrast after treatment on two groups of clinical curative effect, the condition of myocardial spectrum index and its complications.ResultsAfter treatment, blood perfusion group of left ventricular ejection fraction was (53.8±5.8)%, sequential left ventricular ejection fraction after blood purification treatment group was (58.1±3.4)%, both have obvious difference, has statistics meaning (P<0.05).In terms of myocardial enzyme spectrum index, and sequential blood purification group is obviously better than the index of myocardial enzymes in patients with blood perfusion group (P<0.05).The incidence of complications in patients with sequential blood purification group were lower than the blood perfusion group (P<0.05).ConclusionThe joint continuity venous blood perfusion-blood purification scheme of vein hemofiltration treatment of patients with severe acute organophosphorus pesticide poisoning can significantly improve treatment effect.

Comparison of clinical efficacy of penehyclidine hydrochloride and atropine in the treatment of acute organophosphorus pesticide poisoning / 中国基层医药

Objective To compare the clinical effect of penehyclidine hydrochloride and atropine in the treatment of acute organophosphorus pesticide poisoning.Methods 86 patients with organophosphorus pesticide poisoning were selected and randomly assigned to the observation group and the control group according to the digital table,43 cases in each group.The two groups were given conventional treatment,while the control group was treated with atropine,the observation group was given penehyclidine hydrochloride.The disappearance time of main symptoms, rescue success rate and adverse reactions of the two groups were observed.Results After salvage treatment, the rescue success rate of the observation group was 97.8%,which of the control group was 88.4%,the difference was statistically significant (x2=1.433,P<0.05).The disappear time of M like symptoms,N like symptoms and central nervous system symptoms in the observation group was significantly shorter compared with the control group (all P<0.05).The number of drugs,dosage,cholinesterase recovery time and hospitalization time between the two groups had statistically significant differences (P<0.05).The incidence rates of blurred vision,restlessness,heart rate and urinary retention in the control group were significantly higher than those in the observation group (all P<0.05).Conclusion Penehyclidine hydrochloride for acute organophosphorus pesticide poisoning can significantly reduce the incidence of symptoms,shorten the disappearance time of symptoms,reduce hospitalization time,improve the efficacy of rescue,reduce the incidence of adverse reactions, it is safe,effective and has great clinical significance.

Effects of penehyclidine hydrochloride injection combined with safflower injection on TLRs / NF-κB signaling pathway and T cell subsets in mononuclear cells of patients with organophosphorus pesticide poisoning / 中国生化药物杂志

Objective To investigate the effects of penehyclidine hydrochloride injection combined with safflower injection on TLRs/NF-κB signaling pathway and T cell subsets in mononuclear cells of patients with organophosphorus pesticide poisoning. Methods 80 cases of organophosphate poisoning patients from June 2014 to June 2016 in onglu first people's hospital were selected,randomly divided into control group and observation group, the control group was treated with penehyclidine hydrochloride,observation group were treated with Honghua injection based on the treatment of control group. The effects were compared between two groups of TLRs/NF-κB in peripheral blood mononuclear cells pathway and T cell subsets in peripheral blood, and compared two groups of patients with cholinesterase activity. Results On the third,fifth and 7th day of treatment,cholinesterase activity in both groups was higher than that before treatment,the activity of cholinesterase in the observation group was significantly higher than that in the control group (P<0.05).After treatment,compared with before treatment,the levels of TLR2,TLR4 and NF-κB in the two groups were significantly decreased,and TLR2,TLR4,NF-κB levels in the observation group were lower than those in the control group, the difference was statistically significant (P<0.05),Th17,Th17/Treg levels in the observation group were significantly lower,and lower than the control group,Treg content was significantly higher,and higher than the control group,the difference was statistically significant (P<0.05). Conclusion Penehyclidine hydrochloride injection combined with safflower injection can help to reduce Th17,Th17/Treg levels,increased Treg cell content,regulate the inflammatory response, and promote recovery of cholinesterase activity.

Clinical study of the therapeutic efficacy from different dosages of pralidoxime chloride used in patients with acute organophosphorus pesticide poisoning / 中华急诊医学杂志

Objective To investigate the effect of different doses of pralidoxime chloride on clinical outcome including recovery rate and mortality in patients with acute organophosphorus pesticide poisoning.Methods According to the total amount of pralidoxime chloride administered over the first 24 hours or entire duration of hospitalization,a cohort of 163 organophosphorus pesticide poisoning patients,admitted from February 2004 to December 2014 were assigned to different groups followed by a retrospective analysis.Comparisons of recovery rate,mortality rate,mean length of hospital stay,and duration of mechanical ventilation were made among groups.SPSS 18.0 was used to analyze categorical variables between the data of groups with x2 test/Fisher exact probability method and numerical variables with t test or One-way ANOVA,and statistical significance was set as P ＜ 0.05.Results According to the amount of pralidoxime chloride given over the first 24 hours,the recovery rate and the mortality rate were significantly improved in the experimental group (pralidoxime chloride ＞ 2 g) than in the control group (pralidoxime chloride ＜ 2 g) (P =0.04).There was no significant difference in mean length of hospital stay between the experimental group and the control group (P =0.171),and there were statistically significant differences in recovery rate and mortality rate among the four dose-response subgroups (total dosage administered in 24 hours in group A ＜ 1 g,in group B ＜2 g,in group C ＜4 g and in group D ＞4 g) (P =0.034).Based on the total amount of pralidoxime chloride prescribed in the entire duration of hospital stay,the recovery rate and mortality rate were significantly better in the experimental group than those in control group (P =0.002),and among the three dose-response subgroups,the significant difference in recovery rate and mortality rate were also observed (P =0.006).Conclusions Increased amounts of pralidoxime chloride prescribed in the first 24 hours and in the whole hospitalized period can improve the recovery rate and reduce the mortality rate in organophosphorus pesticide poisoning patients.