Aldicarb poisoning

Aldicarb, 2-methyl-2 (methylthio) propanal o-[(methylamino)-carbonyl] oxime is a pesticide manufactured since 1965. This carbamate ester is sold under the tradename Temik and is used as an insecticide and nematicide. The Environmental Protection Agency has classified aldicarb in the highest toxicity category and has defined a strict control for its delivery and use. In Brazil and the Caribbean island of Guadeloupe, aldicarb is illegally used as a household rodenticide with a widespread risk of poisoning. Our study presents the first review of aldicarb poisoning with clinical and analytical findings and oxime treatment is discussed. Eighteen patients with cholinergic symptoms admitted to the Emergency Unit and two with a history of aldicarb poisoning who died were included in the study. As agricultural workers, only two of them could legally use Temik. Seventy percent of the patients were managed by the Emergency Mobile Unit. Serum cholinesterase activity was always < 30 percent of the normal range and aldicarb was identified by ultraviolet spectra and retention time after liquid chromatography separation. The most common muscarinic effect was diarrhoea (98 percent), the main nicotinic sign was fasciculation (78 percent) and 44 percent of the poisoned patients had central nervous system depression (Glasgow Coma Score < 8). Four patients had serious abnormalities and two of them died. These results suggest that aldicarb intoxication is always severe. Oxime treatment did not produce side effects and should be recommended whenever the pesticide involved is unknown. Effective measures should be implemented to stamp out the illicit use of aldicarb.(Au)

Modified EMIT Dau Immunossay to allow cocaine metabolites determination in urine of crack cocaine smokers - abstract

Alkaloidal cocaine (COPC) is widely sold in the West Indies in a form suitable for smoking. These little rocks called "crack", addictive in high doses (typically 120 mg), produce a rapid, intense, high and a very compelling type of COC dependence. The bioavailability and the metabolism of the smoked form (half-life of 56 min versus 78 and 80 min, respectively, after IV and IN COC administration) conduce to low levels of metabolites in serum and in urine. Clinical and forensic toxicology laboratories are more and more solicited for testing major cocaine metabolite: benzoylecgonine (BZE). The Enzyme Multiplied Immunossay Technique (EMIT) is a fast, simple and reliable technology. However, the assay cut off concentration for BZE of the commercially available kit: (EMIT dau Cocaine Metabolite Immunoassay) is too high (300ng/ml) for serum or urine detectable levels of BZE in cocaine smokers. We proposed a modified EMIT assay to make this technique suitable for level of detection. The immunoassay was applied to ROCHE COBAS MIRA Plus analyser. The increase of the sample volume up to 25 ul and the use of calibration standards 0 to 300 ng/ml conduce to a lower detection limit of 50ng/ml. The within run precision of the assay was less than 10 percent. The results were confirmed by gas chromatography mass spectrometry. The increase of sensitivity was near 30 percent. No false positive results were observed. The presented modification demonstrates the application of currently available EMIT Immunoassay to rapid and reliable testing for BZE in cocaine smokers. (AU)