Severe dyspnea and uncontrolled seizures following meperfluthrin poisoning: a case report.

BACKGROUND: Meperfluthrin is a novel sanitary cyhalothrin insecticide invented in China and has increasingly been used to produce liquid mosquito repellents. Oral meperfluthrin poisoning in human has rarely been reported. Here, we reported a case of meperfluthrin poisoning by ingestion of a meperfluthrin-based liquid mosquito repellent in a 16-month-old infant. CASE PRESENTATION: A 16-month-old boy with a history of accident ingestion of meperfluthrin was admitted to our hospital's emergency department. He exhibited severe dyspnea, and lung radiograph showed multiple patchy and cord-like high-density shadows bilaterally in a short time. He also suffered 35 min of seizures which were finally controlled by the intravenous infusion of propofol. He was diagnosed with meperfluthrin poisoning, status epilepticus and severe pneumonia. After treated with methylprednisolone, aerosolized beclomethasone dipropionate, anti-infection, and some critical supportive therapy, the patient was in good health and showed no symptoms during 12 months of follow-up. CONCLUSIONS: Meperfluthrin poisoning is rare. Oral meperfluthrin poisoning shows neurotoxic effects and pulmonary toxicity. Controlling seizures rapidly and ensuring an adequate oxygen supply are critical to the successful treatment.

The influence of inhaled corticosteroid discontinuation in children with well-controlled asthma.

Asthma is a chronic inflammatory disease that requires adherence to both preventative and therapeutic interventions in disease management. Children with asthma are likely to discontinue inhaled corticosteroids (ICS), especially when symptoms are under control. We aimed to investigate the impact of ICS adherence in children whose symptoms were under control.The study is cohort study; 35 children with controlled asthma that had undergone 3 years of follow-up were included. Serum eosinophil count, serum total IgE (tIgE), and lung function (FEV1, FEV1/FVC, PEF, FEF20-75%, and PC20) were evaluated at the beginning and end of the follow-up.At baseline, patients in both the adherent and nonadherent groups were similar. After 3 years, the nonadherent group who had discontinued ICS had a decrease in FEV1 (P < .05), FEV1/FVC (P < .05), PEF (P < .05), and FEF20-75% (P < .05). The nonadherent group had no significant improvement in PC20 compared with their values at the beginning of the follow-up, whereas the adherent group had improvement in PC20. Furthermore, there was an increase in serum eosinophil (P < .001) and tIgE (P < .05) in the nonadherent compared with the adherent group.Despite good asthma control, airway hyperresponsiveness (AHR) was detected in a large proportion of children with asthma. ICS discontinuation affected lung function, serum eosinophil count, tIgE, and AHR. Adequate adherence is important in asthma management. The benefits of ICS and the influence of drug discontinuation despite good asthma control may encourage better adherence from patients.

A new method for noninvasive venous blood oxygen detection.

BACKGROUND: Blood oxygen saturation of vein (SvO2) is an important clinical parameter for patient monitoring. However, the existing clinical methods are invasive, expensive, which are also painful for patients. METHODS: Based on light-absorption, this study describes a new noninvasive SvO2 measurement method by using external stimulation signal to generate cyclical fluctuation signal in the vein, which overcomes the low signal-to-noise ratio problem in the measurement process. In this way, the value of SvO2 can be obtained continuously in real time. RESULTS: The experimental results demonstrate that the method can successfully measure venous oxygen saturation by artificial addition of stimulation. Under hypoxic conditions, the system can reflect the overall decline of venous oxygen saturation better. When the results measured by the new method are compared with those measured by the invasive method, the root mean square error of the difference is 5.31 and the correlation coefficient of the difference is 0.72. The new method can be used to measure SvO2 and evaluate body oxygen consumption, and its accuracy needs improvement. CONCLUSIONS: Real-time and continuous monitoring can be achieved by replacing invasive method with noninvasive method, which provides more comprehensive clinical information in a timely manner and better meet the needs of clinical treatment. However, the accuracy of the new noninvasive SvO2 measurement based on light-absorption has to be further improved.