Eventos toxicológicos em idosos atendidos por centro de informação e assistência toxicológica: análise de tendência / Toxicological events in older adults attended by toxicological information center: a trend analysis / Eventos toxicológicos en ancianos atendidos por centro de información y asistencia toxicológica: análisis de tendencia

Por produzir elevado impacto socioeconômico, promovendo custos e danos evitáveis, além de ter efeitos nocivos ao organismo humano, a intoxicação humana é considerada um problema importante em saúde pública. Com o envelhecimento, os indivíduos ficam suscetíveis a diversas doenças e agravos em saúde, e dentre eles, é importante notar-se os eventos toxicológicos ocorridos por várias circunstâncias, como o uso de polifarmácia, tentativa de suicídio, erro de prescrição médica, erro na administração do medicamento, entre outros, causas cada vez mais presente nessa população. Dessa forma, este artigo tem o objetivo de determinar o perfil e a tendência dos eventos toxicológicos ocorridos em idosos. Trata-se de estudo de tendência, realizado com indivíduos com 60 anos ou mais, notificados por um Centro de Informação e Assistência Toxicológica de Londrina (CIATox-Londrina), de 1985 a 2014. As variáveis foram coletadas através do banco de dados do CIATox-Londrina, e a análise de tendência realizada por meio de modelos de regressão linear simples. Identificou-se 2.042 casos de eventos toxicológicos em idosos, predominando a faixa etária de 60 a 69 anos (61,9%). A maioria (69,1%) foram casos de evento acidental, de forma aguda (98,2%), envolvendo animais (64,6%), pesticidas (16,5%) e medicamentos (10,8%) como principais agentes. Casos com animais apresentaram tendências de aumento significativas (R2 = 0,682; p = 0,03; ß1 = 1,542). Tal tendência também foi observada no sexo masculino (R2 = 0,766; p = 0,001; ß1 = 1,855). Observou-se predominância de eventos envolvendo animais, pesticidas e medicamentos, com tendência de aumento significativo em casos com animais, tanto em toda população avaliada como no sexo masculino.

Human intoxication is considered an important public health problem because it produces a high socioeconomic impact, promoting avoidable costs and damages, in addition to having harmful effects on the human body. With aging, individuals are susceptible to various diseases and health problems. Among several health problems, it is important to note the toxicological events that occurred due to various circumstances, such as polypharmacy, suicide attempt, wrong medical prescription, wrong medication administration, among others, causes increasingly present in this population. This study aims at determining the profile and trend of toxicological events among older adults. A trend study was conducted with individuals aged 60 years or older that were notified by a Center for Information and Toxicological Assistance of Londrina CIATox, from 1985 to 2014. Variables were obtained from the CIATox database. Trend analysis performed using simple linear regression models. In total, 2042 cases of toxicological events were identified, predominating from 60 to 69 years (61.9%). The events were mostly accidental (69.1%) and acute (98.2%), involving animals (64.6%), pesticides (16.5%) and drugs (10.8%) as main agents. Cases with animals showed significant increase tendencies (R2 = 0.682, p = 0.03, ß1 = 1.542). This trend was also observed in males (R2 = 0.766, p = 0.001, ß1 = 1.855). There was predominance of events involving animals, pesticides and drugs, with tendency to increase in cases with animals, both among the total population and among males.

Dado que la intoxicación humana produce un alto impacto socioeconómico, con costos y daños evitables, además de tener efectos nocivos sobre el cuerpo humano, se considera este trastorno un importante problema de salud pública. Con el envejecimiento, las personas son susceptibles a diversas enfermedades y problemas de salud; entre los cuales es importante tener en cuenta los eventos toxicológicos que ocurrieron debido a diversas circunstancias, como el uso de polifarmacia, intento de suicidio, error de prescripción médica, error en la administración de medicamentos, entre otros, causas cada vez más presentes en esta población. Este estudio tuvo como objetivo determinar el perfil y la tendencia de eventos toxicológicos que ocurrieron con los ancianos. Este es un estudio de tendencias, realizado con individuos de 60 años o más, notificados por un Centro de Información y Asistencia Toxicológica (CIATox) en Londrina, de 1985 a 2014. Las variables fueron recopiladas por la base de datos CIATox; y el análisis de tendencias se realizó con el uso de modelos de regresión lineal simple. Se identificaron 2.042 casos de eventos toxicológicos en ancianos, con una predominancia de edad de 60 a 69 años (61,9%). La mayoría (69,1%) fueron casos accidentales, agudos (98,2%), involucrando animales (64,6%), pesticidas (16,5%) y medicamentos (10,8%) como principales agentes. Los eventos con animales mostraron tendencias significativas al alza (R2 = 0,682; p = 0,03; ß1 = 1,542). Esta tendencia también se observó en varones (R2 = 0,766; p = 0,001; ß1 = 1,855). Hubo un predominio de eventos que involucraron animales, pesticidas y medicamentos, con una tendencia a un aumento significativo en los casos con animales, tanto en toda la población evaluada como en el sexo masculino.

In silico design of novel proton-pump inhibitors with reduced adverse effects / 医学前沿

The development of new proton-pump inhibitors (PPIs) with less adverse effects by lowering the pKa values of nitrogen atoms in pyrimidine rings has been previously suggested by our group. In this work, we proposed that new PPIs should have the following features: (1) number of ring II = number of ring I + 1; (2) preferably five, six, or seven-membered heteroatomic ring for stability; and (3) 1 < pKa1 < 4. Six molecular scaffolds based on the aforementioned criteria were constructed, and R groups were extracted from compounds in extensive data sources. A virtual molecule dataset was established, and the pKa values of specific atoms on the molecules in the dataset were calculated to select the molecules with required pKa values. Drug-likeness screening was further conducted to obtain the candidates that significantly reduced the adverse effects of long-term PPI use. This study provided insights and tools for designing targeted molecules in silico that are suitable for practical applications.

Application of the Threshold of Toxicological Concern (TTC) to Biological Evaluation of Medical Devices / 中国医疗器械杂志

The threshold of toxicological concern (TTC), a risk estimation method based on compound structurally-related toxicity data, has been widely used by many countries and regions for the safety risk assessment of food packaging materials and additives etc. Toxicological risk estimation is of importance in the biological evaluation of medical devices. Application of the TTC approach to leachable from medical devices may reduce or replace some unnecessary biocompatibility tests, but consideration should be taken for contact duration and route differences, which could affect the applicability of TTC. We herein focused on analyzing the eligibility of TTC for its further application in biological evaluation of medical devices.

The burden of intentional self-poisoning on a district-level public Hospital in Cape Town, South Africa

Introduction :Intentional self-poisoning is a significant part of the toxicological burden experienced by emergency centres. The aim of this study was to describe all adults presenting with intentional self-poisoning over a six-month period to the resuscitation unit of Khayelitsha Hospital, Cape Town.Methods:Adult patients with a diagnosis of intentional self-poisoning between 1 November 2014 and 30 April 2015 were retrospectively analysed after eligible patients were obtained from the Khayelitsha Hospital Emergency Centre database. Missing data and variables not initially captured in the database were retrospectively collected by means of a chart review. Summary statistics were used to describe all variables.Results:A total of 192 patients were included in the analysis. The mean age was 27.3 years with the majority being female (n = 132, 68.8%). HIV-infection was a comorbidity in 39 (20.3%) patients, while 13 (6.8%) previously attempted suicide. Presentations per day of the week were almost equally distributed while most patients presented after conventional office hours (n = 152, 79.2%), were transported from home (n = 124, 64.6%) and arrived by ambulance (n = 126, 65.6%). Patients spend a median time of 3h37m in the resuscitation unit (interquartile range 1 h 45 m­7 h 00 m; maximum 65 h 49 m). Patient acuity on admission was mostly low according to both the Triage Early Warning Score (non-urgent n = 100, 52.1%) and the Poison Severity Score (minor severity n = 107, 55.7%). Pharmaceuticals were the most common type of toxin ingested (261/343, 76.1%), with paracetamol the most frequently ingested toxin (n = 48, 25.0%). Eleven patients (5.7%) were intubated, 27 (14.1%) received N-acetylcysteine, and 18 (9.4%) received benzodiazepines. Fourteen (7.3%) patients were transferred to a higher level of care and four deaths (2%) were reported. Discussion:Intentional self-poisoning patients place a significant burden on emergency centres. The high percentage of low-grade acuity patients managed in a high-acuity area is of concern and should be investigated further

Epidemiologia social aplicada às intoxicações humanas / Social epidemiology applied to human intoxications / Epidemiología social aplicada a las intoxicaciones humanas

As intoxicações constituem um grave problema de saúde pública, seja pelo largo impacto na saúde individual e coletiva, seja pelo importante custo econômico e social, ou pelos riscos que oferece ao meio ambiente. Este estudo tem por objetivo analisar textos publicados em periódicos científicos acerca das intoxicações humanas, a fim de esclarecer o processo de adoecimento e a adequada tomada de decisão à luz dos pressupostos das teorias de Epidemiologia Social e da Teoria da História Natural da Doença. Trata-se de estudo com abordagem qualitativa que adota o método de revisão integrativa. Os estudos selecionados tratam de categorias de substâncias tóxicas e circunstâncias de envenenamento variadas. São esclarecidos aspectos referentes ao agente, ao ambiente e ao hospedeiro (tríade ecológica) envolvidos em eventos tóxicos. As prevenções primária, secundária e terciária das intoxicações humanas são elaboradas de acordo com características dos períodos pré-patológico e patológico. Concluiu-se que estudos com delineamento capaz de definir padrão, temporalidade e espacialização de agravos são indispensáveis e necessários para a formulação e implantação de políticas e programas preventivos de uso racional de substâncias químicas, orientando as ações em toxicovigilância.

Intoxication is a serious public health problem, due to the large impact on individual and collective health or to the significant economic and social cost, or risks to the environment. This study aims to analyze texts published in scientific journals about human intoxications, in order to clarify the process of illness and proper decision making in light of the assumptions of theories of Social Epidemiology and Theory of Natural History of Disease. It is a study with a qualitative approach that adopts the integrative review method. Selected studies address categories of toxic substances and varied poisoning circumstances. The aspects related to the agent, the environment and the host (ecological triad) involved in toxic events are clarified. The primary, secondary and tertiary preventions of human intoxications are elaborated according to characteristics of the pre-pathological and pathological periods. In conclusion, studies with a design capable of defining pattern, temporality and spatialization of diseases are indispensable and necessary for the formulation and implementation of policies and preventive programs for the rational use of chemical substances, guiding toxicovigilance actions.

Las intoxicaciones constituyen un grave problema de salud pública, sea por el amplio impacto en la salud individual y colectiva, sea por el importante costo económico y social, o riesgos que ofrece al medio ambiente. Este estudio tiene por objetivo analizar textos publicados en periódicos científicos acerca de las intoxicaciones humanas, a fin de esclarecer el proceso de enfermedad y la adecuada toma de decisión a la luz de los presupuestos de las teorías de Epidemiología Social y Teoría de la Historia Natural de la Enfermedad. Tratase de un estudio con enfoque cualitativo que adopta el método de revisión integrativa. Los estudios seleccionados tratan de categorías de sustancias tóxicas y circunstancias de envenenamiento variadas. Son aclarados aspectos referentes al agente, al ambiente y al hospedador (tríada ecológica) involucrados en eventos tóxicos. Las prevenciones primarias, secundarias y terciarias de las intoxicaciones humanas son elaboradas de acuerdo con características de los períodos pre-patológico y patológico. Concluyóse que estudios con delineamiento capaz de definir padrón, temporalidad y espacialización de agravios son indispensables y necesarios para la formulación e implantación de políticas y programas preventivos de uso racional de sustancias químicas, orientando las acciones en toxicovigilancia.

Properties of realgar bioleaching using an extremely acidophilic bacterium and its antitumor mechanism as an anticancer agent

Realgar is a naturally occurring arsenic sulfide (or Xionghuang, in Chinese). It contains over 90% tetra-arsenic tetrasulfide (As4S4). Currently, realgar has been confirmed the antitumor activities, both in vitro and in vivo, of realgar extracted using Acidithiobacillus ferrooxidans (A. ferrooxidans). Bioleaching, a new technology to greatly improve the use rate of arsenic extraction from realgar using bacteria, is a novel methodology that addressed a limitation of the traditional method for realgar preparation. The present systematic review reports on the research progress in realgar bioleaching and its antitumor mechanism as an anticancer agent. A total of 93 research articles that report on the biological activity of extracts from realgar using bacteria and its preparation were presented in this review. The realgar bioleaching solution (RBS) works by inducing apoptosis when it is used to treat tumor cells in vitro and in vivo. When it is used to treat animal model organisms in vivo, such as mice and Caenorhabditis elegans, tumor tissues grew more slowly, with mass necrosis. Meanwhile, the agent also showed obvious inhibition of tumor cell growth. Bioleaching technology greatly improves the utilization of realgar and is a novel methodology to improve the traditional method.