Comportamiento de la intoxicación moderada y severa por Ofidiotoxicosis Bothrópica en Córdoba- Colombia / Behavior of moderate and severe poisoning by ofidiotoxicosis bothropica in Cordoba. Colombia

Objetivo. Analizar la distribución de ofidiotoxicosis por mordedura de serpientes del género Bothrops entre la población que labora en la actividad agrícola en Córdoba, Colombia. Materiales y métodos. Descriptivo, retrospectivo. La población fue la información de 272 víctimas de accidentes ofídicos entre 2013-2015. Resultados. La prevalencia de accidente ofídico en el departamento de Córdoba se estima por año entre 12 a 13 casos por/100.000h. Los principales sistemas afectados por ofidiotoxicosis fueron digestivo (68%), neuromuscular (39,5%) y hematológico (27,6%); la sintomatología de ofidiotoxicosis incluyó nefrotoxicidad secundaria (27,6%), vómito (23.1%) y falla ventilatoria (16,7%%). Conclusiones. La ofidiotoxicosis que predomina en Córdoba es Bothropica por las especies atrox y asper.

Objective. To identify the factors associated with the non-reporting of adverse events in diagnostic support services in a primary level of care, in order to make decisions aimed at providing a safe care to its users. Materials and methods. This research corresponds to a retrospective descriptive, exploratory study. Based on the analysis of the records of the management and follow-up records of adverse events not reported in the institution's patient safety program, during the period from January 1, 2010 to December 31, 2015. Results. 46.5% of adverse events in the clinical laboratory service and 45% of adverse events in the diagnostic imaging service during the study period were not reported by default; situation that affects the safety of the patient indicating a poor culture on the report of adverse events. Conclusions. The highest percentage of unreported adverse events in diagnostic support services during the study period was not carried out of fear, this situation was attributed to the staff involved fearing that punitive actions were taken as a consequence of the presentation of these events.

Vascular injury in spontaneous subacute toxicosis caused by organic arsenic in cattle / Injúria vascular na toxicose subaguda espontânea causada por arsênio orgânico em bovinos

Monosodium methanearsonate (MSMA) is an organic form of arsenic present in the formulations of some herbicides. Accidental ingestion of pasture contaminated with arsenic may lead to toxicosis in cattle. Almost 200 head of cattle maintained in an area sprayed with MSMA presented with intense diarrhea and dehydration after grazing. Subsequently, 16 of these animals died. Toxic levels of arsenic (>1.5µg/g) were detected in the kidney, liver, urine, and skeletal muscle of 6 animals. At gross inspection were observed multifocal to coalescent ulcers in the mucosa from on the forestomachs associated with hemorrhagic areas and marked wall edema. Microscopic examination mainly showed fibrinoid necrosis of vessels with multifocal thrombosis associated with ischemic infarction that were characterized by large transmural necrotic areas in the forestomachs. The clinical and pathological changes interestingly showed that this form of arsenic although considered less toxic, has caused severe vascular injury in forestomachs of cattle.(AU)

Metano-arseniato ácido monossódico (MSMA) é uma forma orgânica de arsênio, presente nas formulações de alguns herbicidas. A ingestão acidental de pasto contaminado por arsênio pode levar a toxicose em bovinos. Aproximadamente 200 bovinos que estavam em uma pastagem pulverizada com MSMA manifestaram intensa diarreia e desidratação após o pastejo. Subsequentemente, 16 animais morreram. Níveis tóxicos de arsênio (>1.5µg/g) foram detectados no rim, fígado, urina e músculo esquelético de 6 animais. A inspeção macroscópica revelou úlceras multifocais a coalescentes na mucosa de pré-estômagos, adjacentes a focos de hemorragia e intenso edema de parede. A avaliação microscópica revelou, predominantemente, necrose fibrinoide de vasos com trombose multifocal associada a infarto, caracterizado por grandes áreas de necrose transmural em pré-estômagos. As alterações clínicas e patológicas, interessantemente, demonstraram que esta forma de arsênio, apesar de ser considerada menos tóxica, causou severa injúria vascular em pré-estômagos de bovinos.(AU)

The correlation between CT score of lung injury and oxygenation index in patients with acute hydrogen sulphide poisoning / 中华劳动卫生职业病杂志

Objective@#To explore correlation between chest CT score and oxygenation index in patients with acute hydrogen sulphide poisoning, whether CT score can be applied to assess acute lung injury after acute hydrogen sulfide poisoning and provide basis and reference.@*Methods@#The clinic and a series of CT datas of 32 acute hydrogen sulphide poisoning cases were retrospectively analysed and compared, According to GBZ31-2002 (the diagnostic standard of occupational H2S acute poisoning) , these patients were divided into 2 grouds including moderate groud and severe groud; The CT score were improved, referenceing the scoring criteria of the chest X-ray; The difference of the CT score and the oxygenation index were analyzed between moderate and severe group in the acute phase and the disperse phase; The correlation between CT score and oxygenation index were analyzed.@*Results@#The CT score in moderate poisoning group were lower than severe group (2.26±1.37 vs 10.44±2.55, 1.34±0.65 vs 4.55±2.45, all P<0.05) in the acute phase and the dissipation phase.The oxygen index of the 19 cases in the acute phase were 307.55±28.29, and the oxygen index of the 8 cases in the dissipation phase was 435.75±37.00; The oxygen index of the 9 cases in the acute phase and the dissipation phase were respectively 193.17±36.41, 347.67±44.49. The oxygen partial pressure and oxygenation index in severe group were significantly lower than those in moderate group (all P<0.01) in the acute phase and the dissipation phase. Pearman correlation analysis showed that the CT score were negatively correlated to the oxygen index in the acute phase and the dissipation phase, respectively (r=-0.97、-0.75, all P<0.01) .@*Conclusions@#The CT score of lung injury and oxygenation index is negatively correlated. The CT score can be used to evaluate the degree of lung injury, and can be used in the evaluation of acute lung injury after acute hydrogen sulfide poisoning.

Surto de intoxicação por sal em ovinos no estado do Pará / Salt poisoning outbreak in sheep in the state of Pará

O presente trabalho relata um surto de intoxicação por sal em ovinos no Brasil, em uma propriedade no estado do Pará. De um total de 545 ovinos, oito animais adoeceram (1,46%) e quatro destes morreram (50%). A avaliação das instalações e do manejo indicaram como fatores predisponentes a ingestão excessiva de mistura mineral e a restrição hídrica. Os principais sinais clínicos foram decúbito, diminuição ou ausência da sensibilidade cutânea, ausência dos reflexos de ameaça, palpebral e auricular, midríase, nistagmo, opistótono, espasticidade de membros, sonolência e estupor. Havia ainda, timpanismo, diarreia, taquipneia, taquicardia, desidratação e poliúria. A evolução do quadro clínico nos animais que morreram variou de duas horas e meia a 48 horas. As médias das concentrações séricas de sódio e de potássio de 31 ovinos do mesmo lote afetado pela intoxicação, em amostras colhidas durante o surto, revelaram hipernatremia (190mEq/l) e hipercalemia (8,2mEq/l). À necropsia, observou-se em um animal, achatamento das circunvoluções cerebrais. Microscopicamente, neste animal, evidenciou-se vacuolização moderada do neurópilo, particularmente nas lâminas intermediárias do córtex cerebral, com aumento dos espaços perineural e perivascular. Nessas áreas foram observados ainda, acentuada tumefação e edema dos astrócitos e necrose neuronal aguda. A dosagem de sódio no encéfalo de um ovino, revelou-se elevada com valor de 3.513ppm. O diagnóstico foi realizado com base na epidemiologia, nos sinais clínicos, nas lesões macro e microscópicas e nas dosagens de sódio no soro e no encéfalo dos ovinos.(AU)

This paper reports an outbreak of salt poisoning in sheep on a farm in the state of Pará, northern Brazil. Eight (1.46%) animals were affected from a total of 545 sheep and four (50%) of them died. The evaluation of the facilities and the handling indicated as predisposing factors excessive intake of the mineral supplement and water restriction. The main clinical signs were recumbency, decrease or absence of cutaneous sensibility, absence of auricular, palpebral and menace reflex, mydriasis, nystagmus, opisthotonus, spasticity of limbs, somnolence and stupor. Beside these signs bloat, diarrhea, tachypnea, tachycardia, dehydration and polyuria were observed. The course of the disease in animals that died ranged from two hours and a half to 48 hours. The medium of serum concentration of sodium and potassium of 31 sheep from the same group affected on samples collected during the outbreak revealed hypernatremia (190mEq/l) and hyperkalemia (8.2mEq/l). At necropsy, there was flattening of the cerebral gyri in one sheep; in this animal was found vacuolization of the neuropil in the cerebral cortex with moderate intensity in the intermediary and mild on the superficial layers, with increased perineural and perivascular spaces. In these areas there were markedly swollen nucleus of astrocytes with acute neuronal necrosis. The dosage of sodium in the brain of a sheep revealed a high value of 3.513ppm. The diagnosis was made based on the epidemiology, clinical signs, macro and microscopic lesions and in the dosages of sodium in serum and brain.(AU)

Aspectos epidemiológicos, clínicos e anatomopatológicos da intoxicação por aceturato de diminazeno em cães / Epidemiological, clinical, and pathological aspects of diminazene aceturate toxicosis in dogs

Os aspectos epidemiológicos, clínicos e anatomopatológicos da intoxicação espontânea por aceturato de diminazeno foram estudados em 10 cães. Em todos os casos, os cães afetados demonstraram sinais de síndrome tálamo-cortical, principalmente alteração do nível de consciência, tetraparesia, rigidez extensora e crise convulsiva. Em alguns casos, os cães acometidos apresentaram sinais de síndrome cerebelar, como tremores musculares generalizados de alta frequência e baixa amplitude, e/ou de síndrome vestibular, como ataxia, inclinação de cabeça e quedas. Esses sinais ocorreram entre 24 e 48 horas após o uso do fármaco injetável por via intramuscular e se mantiveram até a morte ou eutanásia dos cães (entre 1 e 7 dias). Tais sinais clínicos refletiam encefalomalacia hemorrágica focal simétrica, que afetava a medula oblonga, a ponte, a medular do cerebelo, o tálamo, o mesencéfalo, os pedúnculos cerebelares e os núcleos da base. Esse artigo: 1) descreve e discute essa forma de intoxicação medicamentosa tão pouco citada na literatura internacional e desconhecida da maior parte dos clínicos e patologistas veterinários brasileiros, 2) estabelece critérios clínicos e anatomopatológicos para o seu diagnóstico e, principalmente, 3) atenta para os riscos da utilização desse princípio ativo na terapêutica canina.

The epidemiological, clinical, and pathological aspects of diminazene aceturate (DA) spontaneous toxicosis were evaluated in 10 dogs. All affected dogs developed signs of thalamic-cortical syndrome, characterized mainly by neurological changes in the conscience levels, tetraparesis, extensor stiffness, and seizures. In some cases there was also evidence of cerebellar syndrome, characterized by generalized muscle tremors (high-frequency and low-amplitude) and/or vestibular syndrome, characterized by or ataxia, head tilt, and falling. These clinical signs occurred between 24 and 48 hours following intramuscular administration of DA and persisted until spontaneous death or euthanasia occurred between 1 and 7 days after the onset of clinical signs. The mentioned clinical signs reflected lesions that consisted of focal symmetrical hemorrhagic encephalomalacia affecting medulla oblongata, pons, cerebellar medulla, thalamus, midbrain, cerebellar peduncles, and basal nuclei. This article (1) describes and discusses DA toxicosis in dogs, a poorly-described clinical entity that is unknown by most clinicians and pathologists in Brazil; (2) establishes the clinical and pathological criteria for the diagnosis of DA toxicosis in dogs; and (3) calls up the attention for the risks of using DA in dogs in clinical settings.

Intoxicação por organofosforados em búfalos (Bubalus bubalis) no Rio Grande do Sul / Organophosphate poisoning in buffaloes (Bubalus bubalis) in southern Brazil

Descreve-se um surto de intoxicação por organofosforados (ORFs) em búfalos (Bubalus bubalis) na região sul do Rio Grande do Sul. Os animais foram submetidos à aplicação de Expertan® pour-on (clorpirifós) na dose de 12mg/kg de peso animal para controle de infestação por piolhos e desenvolveram sinais clínicos de intoxicação em um período variável entre 7-45 dias após a exposição ao produto. Os sinais clínicos caracterizaram-se por anorexia, diarréia, salivação intensa, incoordenação motora, tremores musculares, paresia e paralisia flácida, decúbito lateral e morte. Em conseqüência da intoxicação morreram 61 búfalos de um total de 267 animais sob risco. Foram realizadas três necropsias de búfalos que morreram 24-72 horas após o início dos sinais clínicos. As lesões macroscópicas caracterizaram-se por congestão e hemorragias intestinais, enfisema e edema pulmonares. Não foram observadas alterações microscópicas significativas em nenhum dos animais. Apesar da ausência de alterações histológicas no sistema nervoso central e periférico, os achados epidemiológicos, clínicos, macroscópicos e toxicológicos sugerem o diagnóstico de neurotoxicidade tardia induzida por ORFs.

This paper describes organophosphate (ORF) poisoning in a herd of water buffaloes (Bubalus bubalis) in southern Brazil, which were treated with a single dose of 12mg/kg body weight of Expertan® pour-on (chlorpyriphos) to control ectoparasites. Clinical signs, observed 7-45 days after exposure, were diarrhea, hypersalivation, ataxia, muscular tremors, weakness of pelvic limbs, paresis and flaccid paralysis and lateral recumbence. Out of 267 buffaloes 61 died. Necropsy of three animals that died 24-72 hours after onset of clinical signs, revealed congestion and serosal hemorrhages scattered along the bowel, emphysema and edema of the lungs. No significant histopathological changes were found. Residues of chlorpyriphos were detected in liver, kidneys and nervous system of the one necropsied buffalo. Despite the absence of histological lesions in the central and peripheral nervous system, the epidemiological, clinical, gross and toxicological findings suggest delayed neurotoxicity induced by organophosphates.

Young ovine death during hyperimmunization: crotalic envenomation or copper toxicosis?

The unfavorable evolution of a young ovine during hyperimmunization process with Crotalus durissus terrificus venom was investigated in order to differentiate its origin between ophidic envenomation and copper toxicosis. Clinical, laboratory, necroscopic and histological exams as well as evaluation and measurement of heavy metals (copper) in the kidneys and in the liver were carried out. Blood counts revealed anemia and serological tests showed high levels of blood urea nitrogen, creatinine, aspartate aminotransferase, creatine phosphokinase, total bilirubin and indirect bilirubin; which indicates liver, kidney and skeletal muscle damages. At necropsy, the animal presented hepatopathy and nephropathy. Histological examination revealed renal and hepatic features that may imply copper intoxication. Copper levels were 237.8 µg/g in the liver and 51.2 µg/g in the kidneys. Although the amount of metal found in both organs was below the level that can cause death, according to the literature, anatomopathological signs were suggestive of copper intoxication. Therefore, the hypothesis of metal toxicosis during the hyperimmunization process became more consistent than the crotalic envenomation one.(AU)

Effectiveness of naloxone treatment for 262 cases of acute alcohol toxicosis / 中国基层医药

Objective To observe the effectiveness of naloxone treatment for acute alcohol toxicosis.Methods The effectiveness of naloxone treatment for 262 cases of acute alcohol toxicosis were compared with the effectiveness of routine treatment for 184 cases of the same toxicosis.Results The mean syptom subsidence time of medium degree toxicosis cases and the mean consciousness regaining time of serious degree toxicosis cases of naloxone treatment group were separately (05?02) hours and (98?21) hours(P

Effect of immediate abundant sucraffate suspension perfusion to prevent upper gastrointestinal hemorrhage after washing stomach / 中华急诊医学杂志

Objective To study effect of immediate abundant sucralfate suspension perfusion to prevent upper gastrointestinal hemorrhage on the organophosphorous insecticides toxicosis suffer after washing stomach.Methods Total 83 patients suffering organophosphorous insecticides toxicosis were divided randomly into 2 groups randomly.In the control group,40 samples were given cimetidine 0.4 g by vein injection after stomach washing completely twice one day. Meanwhile,they were taken sucralfate 1.0 g/(4 times day) orally or by nastal feeding,continuing 5 days.In the treatment group,the samples were perfused sucralfate suspension 3.0 g (grind to powder,mixed with warm water 80 ml) by stomach tube after each stomach washing,and given routine treatment to assist (method as the control group).Results In the aspects of recessive hemorrhage,conspicuous hemorrhage and hospitalizing period the treatment group was significant decreased compared with the control group (P＜0.05).However,Analysis of the results showed no significant difference in death rate (P＞0.05).Conclusion Immediate abundant sucralfate suspension perfusion after washing stomach has significant curative effect on preventing upper gastrointestinal hemorrhage and decreasing hospitalizing period.

Inherited canine copper toxicosis in Australian Bedlington Terriers

Inherited copper toxicosis in Bedlington Terriers (CTBT) is a copper associated hepatopathy caused by an autosomal recessive genetic defect of gene involving copper metabolism. To compare clinical and histopathological findings with previous reports and to expand our knowledge for future genetic studies, 18 terriers were clinically and histopathologically examined in this study. Pedigree information and dietary history were obtained from the owners before a thorough clinical examination was undertaken. Following the examination, a blood sample was collected for haematology, biochemistry and genetic analysis and a urine sample for urinalysis. Seven dogs were also liver biopsied for histopathology, histochemistry and electron microscopy. In this study, plasma alanine transaminase (ALT) activity was highly concordant with DNA marker test results and was the most reliable and sensitive biochemical test measured. Also clinical and biochemical copper toxicosisaffected states were noticed in a genotyped carrier dog. Histopathological and electron microscopy findings showed that the severity of the lesion was more closely correlated to the presence of clinical signs than to hepatic copper concentration. In addition, the involvement of apoptosis and p53 gene was observed in electron microscopy. The general findings related to CT-BT in this study was similar to those previously reported except few differences in histopathology and electron microscopy.

Some biochemical changes in pregnant toxicosis

104 pregnant women were divided into 2 groups (group 1: 52 of healthy pregnant women, group 2: 52 of women with pregnant toxicosis) were tested for some biochemical indicators. The results have shown that the blood total proteins in pregnant women of group 2 were reduced significantly when compared with this in group 1. The serum uric acid in group 2 was highly increased although there was no clinical manifestation of nephritis. There were no differences of uremia, creatinemia, SGPT between pregnant women in group 1 and pregnant toxicosis women in the mild and mordirate grade. These biochemical indicators helped both for diagnosis and prognosis.

Intoxicação experimental por narasina em ovinos

Experimental poisoning by narasin was induced in 13 sheep through oral administration of the drug. Six sheep died, three were killed in extremis and four recovered. The onset of clinical signs was 2 hours to 7 days after the administration of the drug, and the clinical course lasted from 7 hours to 14 days. Initially there were laborious breathing, tachypnea, fever and ruminal atony. These signs were followed by incoordinated gait, stiffness, reluctance to move and changes in frequency and intensity of cardiac sounds. Grunting, grinding of teeth, myoglobinuria, and sternal and lateral recumbency were also observed. One sheep had sudden death. Necropsy findings were observed in seven of the sheep that died and consisted of pale areas in the skeletal muscles and myocardium. More frequently affected muscles were masseter, semitendinosus, sternocephalicus, brachiocephalicus, extrinsec muscles of the tongue, pectoral, supraspinatus and teres major. Hydropericardium, edema of the lungs and the wall of the gall bladder were also observed. Ocasionally the cut surface of the lymph nodes was reddened and moist. In one sheep there was edema surrounding the esophagus and within the cervical muscles; in another one there was a bolus of partially chewed food in the oral cavity. Histologically, the pale areas in the skeletal muscles and myocardium corresponded to multifocal or focal extensive degeneration and necrosis of myofibers; these lesions were sometimes associated with processes of regeneration in skeletal muscles and reparation in the myocardium. The histological muscle lesions were more pronounced in the tongue and muscles of the limbs.

Intoxicação pelo antibiótico ionóforo narasina foi induzida experimentalmente em 13 ovinos; desses, seis morreram espontaneamente, três foram sacrificados in extremis e quatro se recuperaram. O início dos sinais clínicos ocorria entre 2 horas e 7 dias após a administração da droga e persistiam por 7 horas a 14 dias. Inicialmente havia respiração ofegante e entrecortada, taquipnéia, febre, redução temporária do apetite ou anorexia e atonia ruminal seguidos de alterações no andar, como arrastar das pinças, apoio sobre os boletos dos membros posteriores, incoordenação, rigidez, relutância em movimentar-se e alteração na frequência e intensidade dos sons cardíacos. Ocorriam também gemidos, ranger de dentes, urina acastanhada e decúbito esternal ou lateral. Um animal apresentou morte súbita. Alterações macroscópicas foram observadas em sete dos ovinos necropsiados e consistiam de áreas pálidas nos músculos esqueléticos e no miocárdio. Os músculos mais frequentemente atingidos foram masseter, semitendíneo, esterno-cefálico, braquicefálico, extrínsecos da língua, peitoral, supra-espinhal e redondo maior. Havia hidropericárdio, edema e congestão pulmonares, fígado pálido, edema da parede da vesícula biliar, linfonodos ocasionalmente avermelhados e suculentos ao corte, edema periesofágico e entre os feixes musculares da região cervical e acúmulo de alimento semi-mastigado acumulado na cavidade oral. Histologicamente as áreas pálidas dos músculos esqueléticos e do miocárdio correspondiam a lesões degenerativo-necróticas multifocais a focalmente extensas associadas ou não a processos regenerativos, nos músculos esqueléticos, e reparativos, no miocárdio. As lesões histológicas foram mais acentuadas nos músculos da língua e dos membros.

Intoxicação por salinomicina em bovinos

An outbreak of salinomycin toxicosis is reported. Out of a lot of 46 Simmental heifers 13 died after presenting incoordination, stiff gait, diarrhea, weight loss, muscle tremors, reduced tolerance to exercise, dyspnea and, occasionally, dark urine. Some animals were found dead or died when forced to move. Gross lesions consisted basically of pale areas in the myocardium, subepicardial hemorrhages, hydropericardium, hydrothorax, pulmonary congestion and edema, and, in some cases, pendent subcutaneous edema and nutmeg liver. Main histopathological changes consisted of necrosis and loss of myocardial fibers which were replaced by fibrous connective tissue. Approximately 9 days before the first deaths the heifers had been treated for eimeriosis with a premix containing 6% of salinomycin.

Descreve-se um surto de intoxicação por salinomicina em bovinos. De um grupo de 46 novilhas Simmental, 13 morreram após manifestação de incoorde-nação, andar rígido, diarréia, emagrecimento, tremores musculares, cansaço após pequenos movimentos, dispnéia e, ocasionalmente, urina escura. Os animais eram encontrados mortos ou morriam subitamente quando movimentados. As lesões macroscópicas consistiam basicamente de áreas pálidas no miocárdio, hemorragias subepicárdicas, hidropericárdio, hidrotórax, congestão e edema pulmonar e, em alguns casos, edema de declive e fígado de noz-moscada. Os principais achados microscópicos foram lesões multifocais de necrose e perda de fibras miocárdicas, que eram substituídas por tecido conjuntivo fibroso. Cerca de 9 dias antes do início da mortandade, as novilhas tinham sido medicadas para eimeriose, com um premix contendo 6% de salinomicina.