Salicylate toxicity from ingestion of traditional massage oil.

A 16-month-old child developed a brief generalised tonic-clonic fitting episode and vomiting at home, after accidental ingestion of traditional massage oil. As the patient presented with clinical features of salicylate toxicity, appropriate management was instituted. He was admitted to the intensive care unit for multiorgan support. The child was discharged well 1 week after the incident. Methyl-salicylate is a common component of massage oils which are used for topical treatment of joint and muscular pains. However, these massage oils may be toxic when taken orally. Early recognition of the salicylate toxicity is very important in producing a good patient outcome.

The epidemiology of childhood poisonings in Cyprus.

Information on childhood poisonings in Cyprus is limited. Our objective was to examine the epidemiology of poisonings among children in Cyprus. All children up to 15 years of age admitted for poisoning to the Archbishop Makarios Hospital in Nicosia, Cyprus between 2005 and 2008 were included in our study. All hospital poisoning records were reviewed. A total of 257 children were admitted for poisoning. The mean age of children was 3.1 years, of which 83.7% were below the age of 5 years old, while 53% were boys. The poisoning hospitalizations accounted for about 3% of all admissions to the pediatric department during the study period (4 years). The annual cumulative incidence of childhood poisoning hospitalizations was 116 per 100,000 children. Medications accounted for 46.1% of all poisonings, the most frequent cause being paracetamol (9.8%), cardiovascular medications (5.3%), antitussive medications (4.5%), and other painkillers (4.1%). Another 37.6% of hospitalizations involved household products such as household cleaning products (11.8%), petroleum products (11.0%), and rodenticides (5.7%). Among children who ingested petroleum distillates, 55.6% developed clinical symptomatology. The vast majority of cases were accidental (93.8%). Suicidal cases involved children 8-14 years old, mainly girls, and the most frequent poisoning ingested was paracetamol (46.7%). Poisoning hospitalizations represent an important cause of morbidity among children in Cyprus. Preventive strategies should include the education of caregivers on the handling of medications and household products as well as legislation requiring child-resistant packaging for all medications and household products including petroleum distillates.

ERCC2, ERCC1 polymorphisms and haplotypes, cooking oil fume and lung adenocarcinoma risk in Chinese non-smoking females.

BACKGROUND: Excision repair cross-complementing group 1 (ERCC1) and group 2 (ERCC2) proteins play important roles in the repair of DNA damage and adducts. Single nucleotide polymorphisms (SNPs) of DNA repair genes are suspected to influence the risk of lung cancer. This study aimed to investigate the association between the ERCC2 751, 312 and ERCC1 118 polymorphisms and the risk of lung adenocarcinoma in Chinese non-smoking females. METHODS: A hospital-based case-control study of 285 patients and 285 matched controls was conducted. Information concerning demographic and risk factors was obtained for each case and control by a trained interviewer. After informed consent was obtained, each person donated 10 ml blood for biomarker testing. Three polymorphisms were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. RESULTS: This study showed that the individuals with the combined ERCC2 751AC/CC genotypes were at an increased risk for lung adenocarcinoma compared with those carrying the AA genotype [adjusted odds ratios (OR) 1.64, 95% confidence interval (CI) 1.06-2.52]. The stratified analysis suggested that increased risk associated with ERCC2 751 variant genotypes (AC/CC) was more pronounced in individuals without exposure to cooking oil fume (OR 1.98, 95%CI 1.18-3.32) and those without exposure to fuel smoke (OR 2.47, 95%CI 1.46-4.18). Haplotype analysis showed that the A-G-T and C-G-C haplotypes were associated with increased risk of lung adenocarcinoma among non-smoking females (ORs were 1.43 and 2.28, 95%CIs were 1.07-1.91 and 1.34-3.89, respectively). CONCLUSION: ERCC2 751 polymorphism may be a genetic risk modifier for lung adenocarcinoma in non-smoking females in China.

Multiple organ failure following lamp oil aspiration.

CASE REPORT: A 26-month-old previously healthy boy of 15 kg was admitted to our hospital due to cyanosis following the aspiration of lamp oil. Aspiration resulted from the patient's father inducing emesis by digital stimulation of the boy's throat after the patient had ingested an unknown amount of lamp oil. Endotracheal intubation was done on the second hospital day in the Pediatric Intensive Care Unit (PICU) due to respiratory failure manifested by hypercapnia and hypoxemia. Mechanical ventilation, including high frequency oscillatory ventilation (HFOV) with iNO at 20 ppm, was started. However, he developed a spiked fever and developed an acute respiratory distress syndrome, a pneumothorax, and diffuse subcutaneous emphysema. His course was further complicated by anuric renal failure, rhabdomyolysis, severe hepatitis, pancytopenia, elevation of cardiac enzymes, and disseminated intravascular coagulation over the following days. He died on the ninth day of hospitalization because of multiorgan failure.

Bioavailability of polycyclic aromatic hydrocarbons from buried shoreline oil residues thirteen years after the Exxon Valdez oil spill: a multispecies assessment.

Seven taxa of intertidal plants and animals were sampled at 17 shoreline sites in Prince William Sound ([PWS]; AK, USA), that were heavily oiled in 1989 by the Exxon Valdez oil spill (EVOS) to determine if polycyclic aromatic hydrocarbons (PAH) from buried oil in intertidal sediments are sufficiently bioavailable to intertidal prey organisms that they might pose a health risk to populations of birds and wildlife that forage on the shore. Buried residues of EVOS oil are present in upper and middle intertidal sediments at 16 sites. Lower intertidal (0 m) sediments contain little oil. Much of the PAH in lower intertidal sediments are from combustion sources. Mean tissue total PAH (TPAH) concentrations in intertidal clams, mussels, and worms from oiled sites range from 24 to 36 ng/g (parts per billion) dry weight; sea lettuce, whelks, hermit crabs, and intertidal fish contain lower concentrations. Concentrations of TPAH are similar or slightly lower in biota from unoiled reference sites. The low EVOS PAH concentrations detected in intertidal biota at oiled shoreline sites indicate that the PAH from EVOS oil buried in intertidal sediments at these sites have a low bioavailability to intertidal plants and animals. Individual sea otters or shorebirds that consumed a diet of intertidal clams and mussels exclusively from the 17 oiled shores in 2002 were at low risk of significant health problems. The low concentrations of EVOS PAH found in some intertidal organisms at some oiled shoreline sites in PWS do not represent a health risk to populations of marine birds and mammals that forage in the intertidal zone.

Análisis de los pacientes geriátricos afectados por el síndrome del aceite tóxico ingresados en el Hospital Río Carrión durante el trienio 1998-2000 / Analysis of toxic oil syndrome geriatric patients admitted at Río Carrión Hospital in the 1998-2000 triennium

Introducción: nuestro objetivo es examinar la evolución clínica de pacientes geriátricos con síndrome del Aceite Tóxico (SAT) en la provincia de Palencia. Material y métodos: análisis retrospectivo delos pacientes afectos de SAT mayores de 65años ingresados en el Hospital Río Carrión de Palencia en el trienio 1998-2000.Resultados: en el trienio estudiado, ingresaron en nuestro centro 24 pacientes mayores de65 años con SAT, en un total de 40 episodios, principalmente en los Servicios de Cardiología, Medicina Interna, Urología, Neumología y Cirugía. Los motivos de ingreso más frecuentes fueron: cirugía programada, infecciones respiratorias, complicaciones de neoplasias y síndromes coronarios. Habían mejorado ostensiblemente o normalizado su clínica neuromuscular el 94,4%,el 88,2% la respiratoria, el 100% sus síntomas constitucionales y el 92,3% los cutáneos. Conclusiones: en nuestro estudio no hemos objetivado que el SAT motivara un incremento significativo en los ingresos hospitalarios en eltrienio 1998-2000 en la provincia de Palencia. Destaca asimismo una evolución mayoritariamente favorable en todos los síntomas causados por el SAT desde 1981 hasta la actualidad

Introduction: Our goal is to search the clinical evolution of Toxic Oil Syndrome (TOS) geriatric patients at Palencia country. Material and methods: Retrospective analysisof the TOS patients with more of 65 years oldadmitted at Palencia Río Carrión Hospital in the1998-2000 triennium. Results: In the affected triennium, 24 TOS patients with more of 65 years old were admitted atour Centre, in a total of 40 episodes, mainly at Cardiology, Internal Medicine, Urology, Pneumologyand Surgery Services. The more importantad mission motives were: programmed operation, respiratory infection, complications of neoplasmand coronary syndrome. Ninety four per cent of patients had improved manifestly or normalized their neuromuscular clinic; 88.2% their respiratory clinic, 100% their constitutional symptomsand 92.3% their cutaneous ones. Conclusions: In our study we haven’t objectijy that TOS causes a significative increase of the hospitalizations in the 1998-2000 triennium at Palencia country. It also stands out a chiefly favourable development of all the symptoms caused by TOS from 1981 to present day

Extremely elevated relative risk of paraffin lamp oil exposures in Orthodox Jewish children.

BACKGROUND: In observance of the Sabbath and other religious holidays, many Orthodox Jews maintain a burning lamp that uses paraffin lamp oil as fuel. Unintentional pediatric exposure to paraffin lamp oil, a hydrocarbon, is typically by ingestion and carries a risk of aspiration with subsequent pneumonitis. This investigation was prompted by an apparent increase in paraffin lamp oil exposures during the Jewish Sabbath, from sunset Friday until sunset Saturday, noted by the staff of our regional poison control center. OBJECTIVE: In this investigation, we retrospectively reviewed all exposures to paraffin lamp oil occurring in our large city in children <18 years old reported to our regional poison control center between January 1, 2000, and February 1, 2003. Reports were investigated to ascertain the frequency of occurrence of paraffin lamp oil exposures on the Jewish Sabbath and Jewish religious holidays. Caregivers of involved children were surveyed by telephone to determine the exposed child's religion and circumstances of exposure. RESULTS: During these 25 months, 45 cases met inclusion criteria, and all were ingestions. Orthodox Jews accounted for 32 cases (71%), 4 cases (9%) occurred in children who were not Orthodox Jews, and demographic data were unavailable in 9 cases (20%). Twenty-four cases (53%) occurred within 10 hours before or during the Jewish Sabbath or Jewish religious holidays. The relative risk of Orthodox Jewish children to ingest paraffin lamp oil, calculated by using census data, is 374 times that of other children. CONCLUSIONS: Public health authorities and caregivers of Orthodox Jewish children should be cognizant of this phenomenon. Educational efforts directed toward both Orthodox Jews and the general public aimed at preventing paraffin lamp oil exposures are warranted.

[Oil spill identification by near-infrared spectroscopy].

Petroleum oil spill happens occasionally at sea. It's important to differentiate the exact products in order to carry out following actions to decrease harmfulness. In the present study, a rapid oil spill identification method by near infrared spectroscopy coupled with pattern recognition techniques is proposed. 56 simulated spilled oils of gasoline, diesel fuel and lubricating oil in marine were chosen to develop the method. Organic reagent of CCl4 was used to extract the oil. Pattern recognition techniques were established by principal component analysis (PCA) coupled with Mahalanobis' distance with the multiplicative signal correction (MSC) and Norris first derivative pretreatment. The study shows that PCA technique is a useful method to extract the main characteristics, and Mahalanobis' distance is an ellipsoidal boundary that circumscribes a data cluster. And oil spill samples with concentration above 0.4 microL x mL(-1) can be successfully identified by the method. The developed technique could be further applied to the identification of spilled oil in marine.

[Cannabis poisoning after eating salad]. / Cannabis-Intoxikation nach Salatgenuss.

We describe 4 patients who suffered gastrointestinal disorders and psychological effects after eating salad prepared with hemp seed oil. The concentration of tetrahydrocannabinol (THC) in this oil far exceeded the recommended tolerance dose. Our observations prompted the Swiss Federal Office of Public Health to publish warnings in the press concerning consumption of this oil. We describe the symptoms of orally ingested THC and point out unresolved problems connected with food containing hemp.

Medicated oils and severe salicylate poisoning: quantifying the risk based on methyl salicylate content and bottle size.

In Hong Kong, medicated oils containing methyl salicylate account for 48% of acute salicylate poisoning cases treated in the general medical ward of the Prince of Wales Hospital. To quantify better the risk to average persons who have intentionally ingested these medicated oils, the methyl salicylate content and bottle size of 7 commonly available formulations were examined. Koong Yick Hung Far Oil had the highest methyl salicylate content (67%) and was available only in 60-ml bottles. If the entire bottle of this product were ingested, the equivalent of 184 adult 300-mg aspirin tablets would have been swallowed. Accidental ingestions of as little as 6 ml of Koong Yick Hung Far Oil by a child can be fatal. Six other products contained 15-40% methyl salicylate and their biggest bottle sizes range from 28-57 ml. Among medicated oils commonly found in Hong Kong, Koong Yick Hung Far Oil poses the greatest threat for severe salicylate poisoning if swallowed because of its high salicylate content and its availability in 60-ml bottles. The threat from medicated oils can probably be reduced by restricting their bottle size and methyl salicylate concentration. Physicians and clinical toxicologists should appreciate the toxic potential of these products.

Treatment of hydrocarbon pneumonitis. High frequency jet ventilation as an alternative to extracorporeal membrane oxygenation.

A child presented with hydrocarbon ingestion leading to pneumonitis and adult respiratory distress syndrome (ARDS). Treatment with conventional ventilation in this child led to very high pressures and pulmonary air leaks. Treatment with high frequency jet ventilation (HFJV) resulted in less barotrauma, resolution of air leak, and clinical improvement. Thus, HFJV is an acceptable alternative to both conventional ventilation and extracorporeal membrane oxygenation in the treatment of hydrocarbon pneumonitis leading to ARDS.

[Correlation between development indices and later intelligence quotients--the follow-up study of chlorinated biphenyls affected children].

All intelligence tests are for children old than two and a half years; we still do not have an intelligence assessment tool for children younger than this age. If we knew the relationship between the intelligence quotient and developmental indices as measured by the Bayley Scale of Infant Development (BSID), it would allow us to assess the mental development of young children earlier and to start adequate management sooner. The present study was designed to meet this need. We collected our data from a six-year follow-up study of Yu-Cheng (oil disease) children born to mothers who had a history of ingesting rice cooking oil contaminated with polychlorinated biphenyls (PCBs) in 1978-1979 and their matched controls. We analyzed the correlations between the developmental indices of the BSID assessed on 44 pairs of Yu-Cheng children and their controls in 1985 and the Stanford-Binet Intelligence Quotients (S-B IQ) assessed on the same group of children in 1987 and 1988. For the matched controls, we found practically no significant correlation between the BSID developmental indices and the S-B IQ (r = .04-.20, p = .23-.82). In the Yu-Cheng children, that is at-risk group, there was a significant correlation between the Mental Developmental Index (MDI) of BSID and the S-B IQ (r = .33-.43, p = .01-.05) and between the Psychomotor Developmental Index (PDI) of BSID and the S-B IQ (r = .31-.47, p = .00-.07). We conclude that the development indices of BSID has a better predictive power on the intelligence among the at-risk group such as Yu-Cheng children.

[Alveolar paraffinosis. (Apropos of an inhalation pneumopathy resistant to antibiotics in an aged woman)]. / Paraffinose Alvéolaire. (A propos d'une pneumopathie d'inhalation résistante aux antibiotiques chez une femme âgée).

Case report of an exogenous lipoid pneumonitis fortuitously discovered during acute barbituric intoxication. Discussion about pathogenicity of paraffin oil.