Efficacy of bronchoalveolar lavage combined with prone positioning in children with Mycoplasma pneumoniae pneumonia and atelectasis: a prospective randomized controlled study / 中国当代儿科杂志

OBJECTIVES@#To study the efficacy of bronchoalveolar lavage (BAL) combined with prone positioning in children with Mycoplasma pneumoniae pneumonia (MPP) and atelectasis and its effect on pulmonary function.@*METHODS@#A prospective study was conducted on 94 children with MPP and atelectasis who were hospitalized in Ordos Central Hospital of Inner Mongolia from November 2020 to May 2023. The children were randomly divided into a treatment group and a control group, with 47 children in each group. The children in the treatment group were given conventional treatment, BAL, and prone positioning, and those in the control group were given conventional treatment and BAL. The two groups were compared in terms of fever, pulmonary signs, length of hospital stay, lung recruitment, and improvement in pulmonary function.@*RESULTS@#Compared with the control group, the treatment group had significantly shorter time to improvement in pulmonary signs and length of hospital stay and a significantly higher rate of lung recruitment on day 7 of hospitalization, on the day of discharge, and at 1 week after discharge (P<0.05). Compared with the control group, the treatment group had significantly higher levels of forced vital capacity (FVC) as a percentage of the predicted value, forced expiratory volume (FEV) in 1 second as a percentage of the predicted value, ratio of FEV in 1 second to FVC, forced expiratory flow at 50% of FVC as a percentage of the predicted value, forced expiratory flow at 75% of FVC as a percentage of the predicted value, and maximal mid-expiratory flow as a percentage of the predicted value on the day of discharge and at 1 week after discharge (P<0.05). There was no significant difference in the time for body temperature to return to normal between the two groups (P>0.05).@*CONCLUSIONS@#In the treatment of children with MPP and atelectasis, BAL combined with prone positioning can help to shorten the time to improvement in pulmonary signs and the length of hospital stay and promote lung recruitment and improvement in pulmonary function.

Mercury exposure of gold mining workers in the northwest of Iran

Mercury exposure is a health concern in the occupational settings like gold mining and chloralkali industries and blood and urine levels of mercury are used as exposure indicators. In this study, blood and urine concentrations of mercury were determined using hydride generation atomic absorption spectrophotometery [HGAAS] in sixteen gold miners with neuropsychiatric symptoms. The patients treated with two chelating agents, dimercaprol and D-penicillamine. The mean serum mercury levels before and after chelation therapy were 208.14 Micro g/L[-1] and 10.50 Micro g/L[-1], respectively. The mean urinary mercury levels before and after chelation therapy were 134.70 Micro g/L[-1] and 17.23 Micro g/L[-1], respectively. The results of this study showed that there are significant differences between concentration of blood and urine mercury before and after intervention [p<0.005]. There were no significant differences between in the biochemistry parameters of patients before and after treatment. This study indicated that the gold miners in the northwest of Iran had been exposed to high levels of mercury vapors [Hg[0]]

Doença de Wilson (degeneração hepatolenticular): revisão bibliográfica e relato de caso / Wilson’s disease (hepatolenticular degeneration): revision and case report

Este estudo faz, inicialmente, revisão dos aspectos mais atuais referentes a conceito, quadro clínico, diagnóstico e tratamento do distúrbio metabólico do cobre, definido como doença de Wilson. E relata o caso clínico de um jovem acometido de uma sequência de sintomas superpostos de origem gastrintestinal, neurológico e psiquiátrico. Pela multiplicidade e gravidade dos sintomas, teve o diagnóstico final de transtorno psicótico agudo polimórfico, com intensa inibição psicomotora. A partir de uma análise integrada dos exames já solicitados, suspeitou-se de um distúrbio metabólico de origem hereditária ou adquirida que justificasse simultaneamente os sintomas. O distúrbio da excreção do cobre, doença de Wilson, veio justificar toda a sintomatologia referida e foi confirmado a partir da dosagem sanguínea baixa de ceruloplasmina e da presença dos anéis de Kaiser-Fleischer na córnea do paciente.

It will be initially revised by the authors the most actual aspects of the concept, clinical situation, diagnosis and treatment concerning to a metabolic disturbance of the copper, Wilson?s disease. Afterwards it will be described the clinical case of a young man attacked of a sequence of superposed symptoms of gastrintestinal, neurological and psychiatric origin. For the multiplicity and gravity of the symptoms acute polimórfico with intense psicomotora inhibition had the final diagnosis of "psychotic Upheaval". Starting from an integrated analysis of the exams, it was suspected about a metabolic disturbance of hereditary or acquired origin that justify all the symptoms simultaneously. The disturbance of the excretion of copper, Wilson's disease, came to justify all the referred symptomatology and it was confirmed by the decrease sanguine dosage of ceruloplasmin, the presence of rings of Kayser-Fleischer in the córnea of the patient and of neurological lesion at the magnetic nuclear ressonance. The diagnosis of Wilson's disease in patients with simultaneous digestive (hepática cirrhosis), neurological and inexplicable psychiatric disturbances will always have to be faneed because the precocious treatment will mainly prevent serious and permanent organic damages for the liver and brain. The specific treatment was initiated and the maintenance of exactly has provoked significant improvements and a gradual new outbreak of the symptoms reintegrating the patient the family and the society.

Copper sulphate toxicity in a young male complicated by methemoglobinemia, rhabdomyolysis and renal failure

Copper sulphate is a compound prepared by the action of sulphuric acid on copper II. Copper sulphate is widely used as fungicide, herbicide and for photography. In a human being, it can lead to anemia. Medical literature is lacking regarding accidental or suicidal poisoning cases of copper sulphate in Pakistan. We present a case of accidental ingestion of copper sulphate resulting in severe acute toxicity, which was successfully managed by intensive supportive measures and Dimercaprol [BAL]

The Effect of Vitamin C for Mercury Excretion by Hair Mercury Analysis / 가정의학회지

BACKGROUND: Humans are exposed to mercury via many different routes and in different forms. Studies concerned with the exposure in the general population were done many times in the past. But, the treatment of mercury exposure and mercury intoxication is limited. Therefore, chelators such as birth anti lewistite, 2,3-dimercaptopropanol (BAL), dimercaptopropane-1-sulphonate (DMPS), and dimercaptosuccinic acid (DMSA) were given to patients with acute symptoms resulting from the central nervous system due to confirmed mercury poisoning. In this paper, we reported the effects of oral Vitamin C on mercury excretion. METHODS: This study has been reviewed in the clinical findings of 213 patients aged 30-80 who visited Kosin University Gospel Hospital during 3 months from March to September 2007. We measured hair mercury levels at the initial visit and at 3-4 months after the oral vitamin C (4 g/day) treatment. RESULTS: The number of patients who had initial hair mercury level over 1.5 ppm were 57 patients among 213 patients, and 41 patients rechecked the hair mercury level. Twenty patients who had hair mercury level over 1.5 ppm were treated with oral vitamin C for 3 months and rechecked the hair mercury level and 21 patients without vitamin C treatment. The vitamin treatment group had a hair mercury level that was three times lower than the non-treated group. CONCLUSION: The vitamin C oral treatment significantly decreased the level of hair mercury.

Acute renal failure due to copper sulfate poisoning; a case report

Copper sulfate is a blue and odorless salt with various industrial, chemical, agricultural and medicinal applications. Copper sulfate poisoning is rare in children. A 23-month old boy accidentally ingested a solution of copper sulfate, used as a disinfectant agent in animal husbandry. He was referred to Children's Hospital of Tabriz because of frequent vomiting and lethargy. The major systemic complications were intravascular hemolysis, anemia and acute renal failure. The patient was successfully treated with multiple packed cell transfusions, dimercaprol, penicillamine and peritoneal dialysis. Plasma copper level 15 days after ingestion was 216 micro g/dl. Copper sulfate is a highly toxic agent that, when ingested, can cause local and systemic damage including coma, shock, severe intravascular hemolysis, hepatotoxicity and acute renal failure with high mortality

Quadriplegia due to lead-contaminated opium - case report

Utilization of lead-contaminated opium may lead to severe motor neuron impairment and quadriplegia. Forty years oriented old male, opium addict, was admitted to the ICU, with headache, nausea and abdominal pain, and weakness in his lower and upper extremities without definitive diagnosis. The past medical and occupational history was negative. Laboratory investigation showed: anemia [Hb 7.7 g/dl]. slightly elevated liver function tests, elevated total bilirubin, and ESR. Abdominal sonography and brain CT scan were normal. FMG and NCV results and neurologic examination were suggestive for Guillain-Barre. He underwent five sessions of plasmapheresis. Blood lead level was > 200 micro g/dl. He received dimercaprol [BAL] and calcium disodium edetate [CaEDTA] for two five days session. Upon discharge from ICU all laboratory tests were normal and blood lead level was reduced, but he was quadriplegic. The delayed treatment of lead poisoning may lead to irreversible motor neuron defect

Arsenic induced oxidative stress and the role of antioxidant supplementation during chelation: a review.

Arsenic is a naturally occurring metalloid, ubiquitously present in the environment in both organic and inorganic forms. Arsenic contamination of groundwater in the West Bengal basin in India is unfolding as one of the worst natural geoenvironmental disaster to date. Chronic exposure of humans to high concentration of arsenic in drinking water is associated with skin lesions, peripheral vascular disease, hypertension, Blackfoot disease and high risk of cancer The underlying mechanism of toxicity includes the interaction with the sulphydryl groups and the generation of reactive oxygen species leading to oxidative stress. Chelation therapy with chelating agents like British Anti Lewisite (BAL), sodium 2,3-dimercaptopropane 1-sulfonate (DMPS), meso 2,3 dimercaptosuccinic acid (DMSA) etc., is considered to be the best known treatment against arsenic poisoning. The treatment with these chelating agents however is compromised with certain serious drawbacks/side effects. The studies show that supplementation of antioxidants along with a chelating agent prove to be a better treatment regimen. This review attempts to provide the readers with a comprehensive account of recent developments in the research on arsenic poisoning particularly the role of oxidative stress/free radicals in the toxic manifestation, an update about the recent strategies for the treatment with chelating agents and a possible beneficial role of antioxidants supplementation to achieve the optimum effects.

Intoxicaçäo crônica por chumbo / Chronic lead poisoning

Os autores relatam o caso de paciente de 30 anos, do sexo masculino, proveniente de Apucarana-PR, que desenvolveu alteraçöes gastrintestinais neurológicas graves devido à exposiçäo ao chumbo durante 10 anos. Trabalhava em fábrica de baterias automotivas, mantendo durante este período contato cutâneo e inalatório com o produto.

Arsenic: the forgotten poison?

Chronic arsenic poisoning is an uncommon cause of peripheral neuropathy in Jamaica. A patient with this disorder is described. The insidious nature of chronic arsenic poisoning, with its disabling complications, is emphasised.

Central hyperthermic effect of arsenic in rabbits.

Hyperthermic effect of arsenic was investigated in rabbits. Injections of arsenic trioxide (0.0001 to 0.1 micrograms) into a lateral cerebral ventricle of the rabbit evoked a dose-dependent hyperthermia, respiratory stimulation and peripheral vasodilatation. Heat loss through respiratory stimulation and peripheral vasodilatation appeared responsible for the long latent period and the slight hypothermia sometimes obtained during this period as these effects followed the same time course. These effects were centrally mediated as demonstrated by the lack of efficacy of the same doses by the intravenous route. The hyperthermic effect of arsenic was antagonized by the sulphydryl donator, dimercaprol, the a-adrenoceptor blocking agent-phenoxybenzamine and the PG-synthesis inhibitor-aspirin. Multiple sites, for antagonistic effects of these substances can be explained by the action of arsenic in inactivating sulphydryl containing enzymes which are many and catalyze diverse biochemical reactions.

Atypical Wilson disease--a case report with CT scan.

A case of atypical Wilson disease is being reported. Possible mechanism of the process, diagnostic features and CT appearance of brain is described. Early detection and therapy with copper chelating agents result in neurologic and performance improvement of patients.

Recomendaciones en el manejo de intoxicación por plomo / Recommendations in the management of lead poisoning

Se presentan las recomendaciones en el manejo del niño intoxicado por plomo, que se utilizan en los grandes centros de concentración de intoxicaciones. Se habla de la prueba provocadora que se emplea para conocer la cantidad de plomo que puede ser removido y el tratamiento que se deben utilizar con las diferentes concentraciones de plomo en sangre, así como las recomendaciones en el uso de agentes quelantes

Growth of Mycobacterium leprae in a redox system: II. Further improvements in the system and growth efficiency.

Improvement of the Redox System for growth of M. leprae as brought about by modification in the concentration and mode of preparation of individual media constituents, and by addition of newer substances, is being reported. A structural modification in the construction of the Thunberg's tubes and flasks that are used as culture vessels, has been introduced for ease of handling. Vitamin E (alpha-tocopherol) has been found to be useful. Concentrations of Liposomes and Gelatin in the medium could be reduced by at least five folds, considerably easing thereby smearing and harvesting of cultures. Dimercaptopropanol British Anti-lewisite or BAL) has been used, but its usefulness or otherwise is yet to be determined conclusively. The basis of intracellular parasitism of M. leprae has been discussed.