ABSTRACT
Troponin is a specific cardiac infarction isoform (TnIc, TnTc) and its determination is used for the diagnosis of myocardial infarction even with normal Electrocardiography. The increase of cardiac troponins occurs in a variety of clinical situations without an acute coronary syndrome (ACS), cardiologists and emergency physicians are often confronted with positive troponins that are difficult to interpret. Few data exist about the occurrence, the clinical characteristics and the predictive value in case of absence of ACS. The objective of this study is to present the main extracardiac causes responsible of the increase of TnIc. We present some clinical cases that illustrate this diagnostic problem. A troponin elevation is observed in myopericarditis, renal failure, heart failure, pulmonary embolism, septic shock, rhabdomyolysis, stroke and others where there is a myocardial damage unrelated to coronary occlusion. Many cases of false positives, which raise the possibility of analytical interferences, must be identified.
Subject(s)
Acute Coronary Syndrome/blood , Biomarkers/blood , Hypertension/diagnosis , Stroke/diagnosis , Troponin/blood , Adult , Diagnosis, Differential , Humans , Hypertension/blood , Hypertension/complications , Male , Stroke/blood , Stroke/complications , Up-RegulationABSTRACT
The methomyl is increasingly involved in suicidal and autolytic attempts. Intoxication with carbamate (CM) compounds is still a frequent cause for admission in the Emergency department of the medical assistance center (MAC) in Tunis, Tunisia. The aim of this study was to describe the demographics, clinical features and hospital course of patients presenting with CM intoxication to the ED of MAC in Tunis, Tunisia. This was a retrospective study about 52 cases of acute poisoning by methomyl, compiled in the MAC from 1st January, 2009 to December 31, 2012. Intoxications were all oral, mostly intentional (33 cases: 65%) and in young patients (29 years old). Females outnumbered males by almost 2:1. The most frequent symptom was hypotension (41 cases: 80%), followed by miosis (39 cases: 75%), rhabdomyolysis (29 cases: 55%), vomiting (18 cases: 43%), bronchorrhea (14 cases: 27%), diarrhea (11 cases: 21%) and fasciculations (8 cases: 17%). Treatments included gastric lavage in 16 patients (32%), assisted ventilation in 8 cases (17%) and atropine in 44 patients (85%). Seven patients died during hospitalization. Pesticide poisoning is a significant public health problem and some preventive measures must be strictly enforced to limit this kind of intoxication.
Subject(s)
Cholinesterase Inhibitors/poisoning , Methomyl/poisoning , Pesticides/poisoning , Acute Disease , Adult , Carbamates/poisoning , Female , Humans , Male , Respiration, Artificial/statistics & numerical data , Respiratory Distress Syndrome/chemically induced , Respiratory Distress Syndrome/mortality , Respiratory Distress Syndrome/therapy , Retrospective Studies , Tunisia/epidemiology , Young AdultABSTRACT
Under normal environmental conditions, many plants synthesize cyanogenic glycosides, which are able to release hydrogen cyanide upon hydrolysis. Each year, there are frequent livestock and occasional human victims of cyanogenic plants consumption. The present work aims to determine the hydrocyanic acid content in different samples of cyanogenic plants, selected from the Tunisian flora, and in the almond syrup. In order to evaluate their toxicity and their impact on the consumer health in the short term as well as in the long term, using the ISO 2164-1975 NT standard, relating to the determination of cyanogenic heterosides in leguminous plants.