RESUMO
We present the case of a 24-year-old-female patient, who made an attempt to autolysis with valproic acid, benzodiazepines and neuroleptic. The valproic acid plasma level was very high (1437 µg/mL), confirming it was a severe intoxication. She presents an acute encephalopathy with prolonged status epilepticus, a lactic metabolic acidosis and hematologic disorders such as bicytopenia. Treatment including L-carnintine and continuous veno-venous haemodialysis (CVVHD) was rapidly introduced to prevent the occurrence of cerebral oedema. The evolution was favourable despite the occurrence of a nosocomial ventilation acute lung injury. The patient had motor sequelae of cranial nerves following status epilepticus extended, which disappeared spontaneously after several days.
Assuntos
Anticonvulsivantes/intoxicação , Carnitina/uso terapêutico , Hemofiltração/métodos , Ácido Valproico/intoxicação , Acidose Láctica/induzido quimicamente , Acidose Láctica/terapia , Lesão Pulmonar Aguda/etiologia , Anticonvulsivantes/sangue , Doenças dos Nervos Cranianos/induzido quimicamente , Eletroencefalografia , Feminino , Humanos , Respiração Artificial/efeitos adversos , Estado Epiléptico/induzido quimicamente , Estado Epiléptico/terapia , Tentativa de Suicídio , Trombocitopenia/etiologia , Trombocitopenia/terapia , Ácido Valproico/sangue , Adulto JovemAssuntos
Agricultura , Animais Domésticos , Abastecimento de Alimentos , População Rural , Mudança Social , Agricultura/economia , Agricultura/educação , Agricultura/história , Animais , Redes Comunitárias/economia , Redes Comunitárias/história , Abastecimento de Alimentos/economia , Abastecimento de Alimentos/história , Tecnologia de Alimentos/economia , Tecnologia de Alimentos/educação , Tecnologia de Alimentos/história , França/etnologia , História do Século XX , Saúde da População Rural/história , População Rural/história , Mudança Social/história , Classe Social/históriaRESUMO
To evaluate the potential risk of pulmonary damage due to aerial spraying of the insecticide fenitrothion, rat lungs were examined under light and electron microscopy at 3, 7, 21, and 60 days after exposure. Rats were exposed by a "nose-only" apparatus for 1 hr to 2 or 500 mg/m3 of aerosolized fenitrothion (15%) mixed with solvent Cyclosol 63 (35%) and diluent oil 585 (50%). Aerosol size particles were monitored by a light scattering apparatus. Only minor modifications of lung alveolar tissues were observed after exposure to the high concentration. At 3 days, discrete foci of mild inflammation were detected, including interstitial edema, cellular infiltration, and increased number of alveolar macrophages. At 7 days, signs of irritation were diminished while at 21 and 60 days alveolar tissues were essentially normal. Exposure to lower concentration induced more limited changes at 3 days; no modifications were seen at later periods. It is concluded that a single exposure to this fenitrothion mixture at 500 mg/m3 presents no serious hazard of pulmonary toxicity.