La desaparición del luchecillo (egeria densa) del santuario del río Cruces (Valdivia, Chile): una hipótesis plausible / Decay of egeria densa (luchecillo) on the natur sanctuary of the Cruces river

El Santuario de la Naturaleza “Carlos Anwandter” (Valdivia, Chile) incluye el cauce del río Cruces, varios tributarios de él y zonas aledañas de inundación permanente (bañados). En dicho humedal existía una rica flora acuática y palustre, que albergaba una variada fauna, especialmente aves. En octubre de 2004 se denunció la muerte de algunos Cisnes de cuello negro y la migración de la mayoría de ellos, por escasez de alimento, constituido principalmente por el macrófito sumergido y arraigado al sustrato, Egeria densa, que había desaparecido de los bañados, pero se conservaba sumergido en los cauces. Los Cisnes de cuello negro sumergían cuerpo y cabeza tironeando las plantas, arrancándolas y ayudando así a su desaparición. La causa de la muerte en los bañados y profundización de Egeria densa en los cauces, es aún una incógnita, aunque se ha señalado como culpable a una industria de celulosa ubicada a orillas del río Cruces unos 30 km aguas arriba del humedal, que empezó sus actividades productivas en febrero de 2004. Se supone una contaminación con hierro, presente en los sedimentos y liberados por los riles de la industria. Las características de la posible contaminación del humedal no son típicas de una actividad industrial, que tampoco podría haberse presentado en tan corto plazo. La presencia de los mismos síndromes observados en el Santuario del río Cruces, en las lagunas (Grande y Chica) de San Pedro de la Paz en Concepción, 400 km más al Norte, indican una causa más generalizada. La sobrevivencia de plantas sumergidas, indican un factor atmosférico que se atenúa en profundidad. Ante estas y otras evidencias se hipotetiza que la causa de la muerte de Egeria densa sería la alta radiación UV-B en la región, aumentada por el paulatino adelgazamiento de la capa de ozono. Esta hipótesis deberá ser comprobada en la próxima primavera, época en que aumenta la radiación.

Acute iron poisoning: clinical picture, intensive care needs and outcome.

In this retrospective study, we examined the prevalence of acute iron poisoning among children attending Pediatric Emergency service of a teaching hospital, and studied their clinical profile, treatment and outcome to define intensive care needs. During the 5 years' study period of 27125 patient visits to Pediatric Emergency, 337 (1.2%) were for accidental poisoning. Of these 21(7%) patients had iron poisoning; 18 were transferred to PICU. Three patients were asymptomatic, others had vomiting (n =15, 83%), diarrhoea (n =13, 72%), malena (n = 8, 44%), and hemetemesis (n=6, 33%) generally within 6 hours of ingestion. Nine progressed to shock and/or impaired consciousness; two had acute liver failure. Dose of ingested iron and clinical signs were most useful guide to iron toxicity and management decisions; serum iron did not help. Gastric lavage yielded fragments of iron tablets in 10 patients. On desferrioxamine infusion Vin-rose colour urine was not seen in 31% even in presence of high serum iron. Shock responded to normal saline (33 +/- 15 mL/kg) and dopamine (10 +/- 4 microg/kg/min) within 4-24 hours in 7 of 9 patients. Presence of shock or acute liver failure with coagulopathy and/or severe acidosis predicted all the four deaths. Desferrioxamine infusion and supportive care of shock was the mainstay.

Acute iron poisoning: management guidelines.

Serum iron level may not be available and fully reliable in management decision and prognostication in our setting. An estimated ingestion of >60 mg/kg elemental iron, onset of symptoms, blood sugar >150 mg/dL, total leukocyte count >15,000 cumm and presence of iron tablets on abdominal radiograph indicates severe toxicity and need for chelation therapy. Appearance of "vin-rose" color urine following a dose of desferrioxamine may be helpful, but is not seen consistently after chelation therapy. Early decontamination of gut (gastric lavage/whole gut irrigation), desferrioxamine infusion (15 mg/kg/hour in saline), and aggressive management of shock, and organ failure preferably in a PICU are mainstay of management, and has improved the outcome. Shock, coagulopathy (prothrombin index <50%), severe acidosis and acute liver failure are poor prognostic indicators. Guardians should be counseled about safe storage of iron tablets made for adults, and general poisoning prevention measures.

Acute iron ingestion.

OBJECTIVE: Intoxication is one of the most common causes of admissions to emergency department in pediatric age group. Incidence of iron poisoning gradually increased because of wide spread use of iron containing drugs. METHOD: In this report, we present five cases of iron ingestion who were admitted to our emergency department within a year. RESULT: Whole bowel irrigation in addition to gastric lavage with an iron dose of over 50 mg/kg as well as deferoxamine treatment for patients in whom clinical and laboratory indications are present. CONCLUSION: The prompt recognition and treatment of children with acute iron poisoning is the single and the most critical point for decreasing the morbidity and mortality associated with iron containing products.

Intoxicación aguda por hierro en un caso / Acute iron poisoning: report of case

The ingestion of iron-containing products is a potential toxicological emergency. It is a leading cause of pediatric unintentional ingestion fatalities because some iron-containing compounds are readily available (vitamin mixtures, iron pills). Among adults, it has been described as accidental overdoses (mainly in pregnancy) and as suicidal attempts. We report a 42 years old woman, admitted due to the intentional ingestion of iron pills with suicidal purposes. A plain abdominal X ray showed at least 20 pills in the gastric fundus and antrum. She was successfully treated with intravenous desferroxamine chelation. Plain abdominal X ray examination can be very useful in the diagnosis of acute iron poisoning

infant with irritability and red urine

An infant with irritability and red urine following accidental ingestion of iron tablets is being discussed. Accidental ingestion of iron is one of the common causes of accidental poisoning in toddlers leading to high mortality and morbidity. The free availability of iron tablets to antenatal women and the attractive size and color of these tablets may be the reason. Strategies in the management and prevention of iron poisoning are being discussed

Acute iron poisoning.

Accidental iron ingestion is not uncommon in children and has become a leading cause of unintentional pharmaceutical ingestion fatality. Difficulty in obtaining urgent serum iron levels in majority of hospitals in India, lack of objective indices for starting and stopping the chelation therapy and the cost of chelation therapy, all pose a significant challenge for a clinician in managing an acutely intoxicated patient. This review emphasizes the need for early recognition and correct intervention of a child with acute iron overdose to avoid undue morbidity and mortality.

Skeletal manifestations in beta-thalassaemia intermedia.

Thalassaemia intermedia with distressing complications is reported from India. An 11 year old boy presented with recurrent fractures since 6 years of age. Investigations revealed that he had multiple healed fractures of long bones, hypersplenism, iron overload and a red blood cell half life (t1/2) of 17 1/2 days. Splenectomy was planned.