H nuclear magnetic resonance spectroscopic investigation of urine for diagnostic and clinical assessment of methanol intoxication.

Occasional or suicidal methanol intoxications are a permanent problem for most Poisoning Centers around the World. Therefore it is important to look for new diagnostic and clinical prognostic methods. In the present paper 5 cases of methanol intoxication were analyzed. At first the methanol concentrations in blood and urine were estimated with headspace gas chromatography technique. Next the urine samples were examined with 1H NMR spectroscopy, then the levels of ethanol, methanol and its metabolite, formate, lactate and trimethylamine-N-oxide with dimethylamine were evaluated. The concentrations of the above compounds were correlated with the patient's clinical status, the level of ethanol and methanol and biochemical parameters. The results indicate the correlation between clinical course of intoxication, prognostication and lactate level. There were no significant parallels for formate level as acidosis causing metabolite and initial methanol levels. In the urine samples of intoxicated patients the increased trimethyl-N-oxide and dimethylamine levels were observed, which may indicate renal cortex damage. Contrary to the opinion of some clinicians, methanol intoxication may be connected with renal functional disturbances. 1H NMR examination of urine appears to be an excellent tool to evaluate the clinical course of methanol intoxication.

[The group intoxication by tear-gas]. / Zbiorowe zatrucie gazem drainiaco-lzawiacym.

The case of group intoxication of 52 pupils by tear CS gas (2-chlorobenzelidenemaloninitrile) at school is presented. The most often clinical signs observed at hospital admitted children, at 13-16 year old were detail described. The special attend was given for 4 cases, heavy clinical intoxication observed for young girls. The clinical symptoms, action of xenobiotics and clinical treatment compare with literature data, were discussed.

[Thioridazine intoxication of therapeutic error as the cause of death of a three-year girl]. / Zatrucie tioridazyna czy skutek bledów terapeutycznych przyczyna zgonu trzyletniej dziewczynki?

Intoxication with drugs and xenobiotics in children, particularly under the age of 7 years, represents a serious diagnostic and therapeutic challenge considering the relatively immature enzymatic detoxication systems, greater susceptibility to organ lesions, easily destabilized homeostasis (including water-electrolyte balance) and limited compensatory mechanisms in acidosis or alkalosis. We present the case of a 3-year-old girl, who died 30 hours after admission to hospital, with suspicion of ingestion of two or three 100-mg tablets of thioridazine. The medical documentation and results of autopsy are in favor of acute cardiopulmonary failure caused by extensive cerebral and pulmonary edema as a complication of "water poisoning" i.e. acute hypotonic overhydration of the child.