Species identification of poisonous medicinal plant using DNA barcoding.

The aim is to select a universal DNA barcode for identifying all poisonous medicinal plants in Chinese pharmacopoeia and their poisonous related species or adulterants. We chose 4 commonly used regions as candidate DNA barcodes (ITS2, psbA-trnH, matK and rbcL) and compared their identification efficiency in 106 species from 27 families and 65 genera totally. Data analysis was performed including the information of sequence alignment, inter/intra-specific genetic distance and data distribution, identification efficiency and the situation of Neighbor-Joining (NJ) phylogenetic trees. We found ITS2 sequence region had high variation, stable genetic distance and identification efficiency relatively. The topological structure of NJ phylogenetic tree showed monophyletic. Our findings show that ITS2 can be applied as a universal barcode for identifying poisonous medicinal plants in Chinese pharmacopoeia and their poisonous related species or adulterants.

Evaluation of types of poisoning exposure calls managed by the Malaysia National Poison Centre (2006-2015): A retrospective review.

OBJECTIVE: Accidental or intentional poisoning is a public health concern requiring intervention. The current study designs to evaluate the types of poisoning exposure calls received by the Malaysia National Poison Centre (NPC) over a 10-year period. SETTINGS AND DATA SOURCES: The poisoning enquiries database (2006-2015) from the Malaysia NPC was used for the analysis. PARTICIPANTS: The NPC records all telephone calls that it manages using a validated and standardised form. Demographics and types of the poisoning exposure calls were extracted and descriptive analysis was applied. PRIMARY AND SECONDARY OUTCOMES: The primary outcome of this study is to evaluate NPC data for trends in the poisoning exposure calls based on the types and modes of poisoning over a 10-year period. The secondary outcome is to evaluate the characteristics of human exposure cases based on the calls received by the NPC. RESULTS: There was a notable increase in the number of poisoning exposure calls noticed during the 10-year period but dropped significantly in 2012. The highest number of poisoning exposure calls came from Selangor (21.0%), Perak (18.0%) and Negeri Sembilan (9.8%). More than half of the exposure was intentional (53.8%) involving more women (50.3%) as compared with men (41.9%), and in the 20-29 years age group category (33.5%). Exposure mostly occurred at home (96%) through the ingestion route (94.1%). Pharmaceutical products (40.5%), pesticides (31.7%) and household products (20.1%) were the common agents implicated for intentional exposure. CONCLUSIONS: There is an increasing trend in enquiries on poisoning exposure calls made to the NPC. Most of the intentional poisoning exposures occurred among younger women and involved pharmaceuticals, pesticides or household products. Poisoning safety education and other interventions are needed to curb poisoning incidents.

Vulture mortality resulting from illegal poisoning in the southern Balkan Peninsula.

A study was carried out to determine the incidents of illegal poisoning of griffon vulture (Gyps fulvus), Egyptian vulture (Neophron percnopterus), black vulture (Aegypius monachus), and bearded vulture (Gypaetus barbatus) in the southern Balkan Peninsula between 1982 and 2017. A total of 38 poisoning cases affecting 224 vultures were analyzed to identify their causes and the primary target species for poisoning. Nine different compounds were used in these incidents and the most frequently applied were strychnine, carbamate, and organophosphoros compounds. The poison used to kill gray wolf had the most significant collateral damage to the vulture populations in comparison to the other investigated reasons. It was the primary cause of 60% of all registered vulture poisoning events in the southern Balkan Peninsula during the last 36 years. Establishing permanent feeding sites for vultures in areas with wolves appears to be an effective way to minimize the risk of poisoning. There is a pressing need for the development of an appropriate conservation practice taking into consideration relationships among the main and casual target species for poisoning as an essential element in conjunction with the human activities.

Prospects of poisoning - a multi facet study.

Aim of the study is to find out demographic profile, clinical characteristics and analysis of poison in clinical set up. The study carried out in Sri Aurobindo Medical College and PG Institute Indore, Madhya Pradesh. Total 75 cases of poisoning were studied for demographic profile, vitals (BP, pulse, heart rate, pupils, etc.), clinical features (such as vomiting, salivation, consciousness, etc.), type of poison and its analysis. Results: Poisoning was more common in cases between 15 and 25 years of age, in males than in females and in Hindu religion. Poisoning cases were predominantly from rural areas and in married people. Majority of cases were discharged after proper treatment and counseling. Altered vitals and clinical features were found in most of the cases. Organophosphate and aluminum phosphide compound were evaluated in most of the cases. Conclusions: Preventive measures should be applied through educating people, proper counseling, promoting poison information centers, and introducing separate toxicological units in hospitals.

Poisons, toxungens, and venoms: redefining and classifying toxic biological secretions and the organisms that employ them.

Despite extensive study of poisonous and venomous organisms and the toxins they produce, a review of the literature reveals inconsistency and ambiguity in the definitions of 'poison' and 'venom'. These two terms are frequently conflated with one another, and with the more general term, 'toxin.' We therefore clarify distinctions among three major classes of toxins (biological, environmental, and anthropogenic or man-made), evaluate prior definitions of venom which differentiate it from poison, and propose more rigorous definitions for poison and venom based on differences in mechanism of delivery. We also introduce a new term, 'toxungen', thereby partitioning toxic biological secretions into three categories: poisons lacking a delivery mechanism, i.e. ingested, inhaled, or absorbed across the body surface; toxungens delivered to the body surface without an accompanying wound; and venoms, delivered to internal tissues via creation of a wound. We further propose a system to classify toxic organisms with respect to delivery mechanism (absent versus present), source (autogenous versus heterogenous), and storage of toxins (aglandular versus glandular). As examples, a frog that acquires toxins from its diet, stores the secretion within cutaneous glands, and transfers the secretion upon contact or ingestion would be heteroglandular-poisonous; an ant that produces its own toxins, stores the secretion in a gland, and sprays it for defence would be autoglandular-toxungenous; and an anemone that produces its own toxins within specialized cells that deliver the secretion via a penetrating wound would be autoaglandular-venomous. Adoption of our scheme should benefit our understanding of both proximate and ultimate causes in the evolution of these toxins.

Poisoning in Israel: annual report of the Israel Poison Information Center, 2012.

BACKGROUND: The Israel National Poison Information Center (IPIC), Rambam Health Care Campus, provides 24 hour telephone consultations in clinical toxicology as well as drug and teratogen information. It participates in research, teaching and regulatory activities, and also provides laboratory services. OBJECTIVES: To report data on the epidemiology of poisonings and poison exposures in Israel. METHODS: We made computerized queries and descriptive analyses of the medical records database of the IPIC during 2012. RESULTS: A total of 31,519 poison exposure cases were recorded, a 157.6% increase compared with 1995. Children < 6 years of age were involved in 43.1% of cases; 74.0% of calls were made by the public and 23.7% by physicians; 74.8% of exposures were unintentional and 9.1% intentional. Chemicals were involved in 35.8% of all cases (single and multiple substances), pharmaceuticals in 48.8%, bites and stings in 3.8%, and plants and mushrooms in 1.6%. Substances most frequently involved were analgesics, cleaning products and antimicrobials. Clinical severity was moderate/major in 3.4%. Substances most frequently involved in moderate/major exposures were corrosives, insecticides and snake venom. Four fatalities were recorded; all were intentional exposures in adults (corrosive, medications, energy drink). CONCLUSIONS: Poison exposures and poisonings have increased significantly and have contributed substantially to morbidity and mortality in Israel. The IPIC database is a valuable national resource for the collection and monitoring of poisoning exposure cases. It can be used as a real-time surveillance system for the benefit of public health. It is recommended that reporting to the IPIC become mandatory and its activities be adequately supported by national resources.

[Analysis of the characteristics of toxins in 6005 cases of acute poisoning in Guangxi].

OBJECTIVE: To investigate the toxin characteristics of toxins in patients of acute poisoning in the Guangxi area. METHODS: A retrospective study was conducted. The data of acute poisoning cases and the causative toxins collected from 63 hospitals of Guangxi, including 36 city hospitals, 12 county hospitals, and 15 township health centers from January 2005 to December 2009 were collected. The data were descriptively analyzed and classified by year. RESULTS: A total of 6005 cases with acute poisoning induced by 532 kinds of poisons were enrolled. The 532 kinds of toxin were classified by high-occurrence (producing poisoning for 5 continuous years), low-occurrence (leading to poisoning for 2-4 continuous years) and newly occurred categories (leading to poisoning only in 1 year). The numbers of poisons of these 3 categories accounted for 10.15% (54 kinds), 29.70% (158 kinds), 60.15% (320 kinds) of total number of poisons, respectively. There were 4688 (78.07%), 780 (12.99%), and 537 (8.94%) cases for each category respectively. And the poisoning cases of each toxin involved from 8 to 837, 2 to 25, and 1 to 69 cases respectively. 77.78% (42/54) of high-occurrence poisons affect more than 20 cases, and 89.87% (142/158), 98.75% (316/320) of low-occurrence and new-occurrence poisons involved less than 10 cases. In the dynamic analyses for 5 years, frequency of toxin caused by high-occurrence, low-occurrence and newly occurred poisons in 5 years were 5 times, 2.6 times, and 1 time, respectively. The number of poisons caused by the high-occurrence toxin each year were same, but the average-annual growth rates of poison numbers caused by the low-occurrence and new-occurrence poisons each year were 17.61% and 20.10%. The average-annual growth rates of poisoning cases caused by the 3 categories of poisons were 14.08%, 16.53%, 31.96%, and the average-annual growth rates of poisoning cases caused by each categories were 10.28%, 1.13%, 11.45%, respectively. CONCLUSIONS: In the high-occurrence category, the poison species was least, the poisoning cases were most, the variety of the affected cases by each poison was largest, and the case involved by each toxin was increased by year. But in the newly occurred category, the poison constituent ratio was largest, but the poisoning population was the least, the disparity of each poison was least, and the toxin increased and the population affected each year were elevated. The characteristics of low-occurrence poison were between high-occurrence poison and newly occurred poison.

[The most popular poisons from Graeco-Roman world]. / Najbardziej popularne trucizny swiata grecko-rzymskiego.

Article presents the most popular antique poisons. Information from encyclopaedic literature and literary texts of the Roman Empire period has been compared with the etymology of the names of some poisons of plant and animal origin.

Changing trends and predictors of outcome in patients with acute poisoning admitted to the intensive care.

BACKGROUND: Acute poisoning in children is a medical emergency and preventable cause of morbidity and mortality. Knowledge about the nature, magnitude, outcome and predictors of outcome is necessary for management and allocation of scant resources. METHODS: This is a retrospective study conducted in the Pediatric Intensive Care Unit (PICU) of an urban multi speciality teaching and referral hospital in North India from January 1993 to June 2008 to determine the epidemiology, clinical profile, outcome and predictors of outcome in children with acute poisoning. Data of 225 children with acute poisoning was retrieved from case records with respect to demographic profile, time to presentation, PRISM score, clinical features, investigations, therapeutic measures, complications and outcome in terms of survival or death. Survivors and non-survivors were compared to determine the predictors of mortality. RESULTS: Acute poisoning constituted 3.9% of total PICU admissions; almost all (96.9%) were accidental. The mean age of study patient's was 3.3 ± 3.1 (range 0.10-12) years with majority (61.3%) being toddlers (1-3 years). In the overall cohort, kerosene (27.1%) and prescription drugs (26.7%) were the most common causative agents followed by organophosphates (16.0%), corrosives (7.6%), carbamates (4.9%) and aluminum phosphide (4.9%). However the trends of the three 5-year interval (1993 till the end of 1997, 1998 till the end of 2002 and 2003 till the end of June 2008) revealed a significant decrease in kerosene, aluminum phosphide and iron with increase in organophosphate compound poisoning. Ninety nine (44%) patients required supplemental oxygen, of which nearly half (n = 42; 42.4%) needed mechanical ventilation. Twenty (8.9%) died; cause of death being iron poisoning in five; aluminum phosphide in four; organophosphates in three and one each because of kerosene, diesel, carbamate, corrosive, sewing machine lubricant, isoniazid, salicylate and maduramycin poisoning. There has been a significant decrease in the mortality over the years. The non-survivors were older, had a higher PRISM score and hypotension at admission and higher need for oxygen and ventilation. On multiple logistic regression analysis hypotension at admission was the most significant predictor of death (adjusted odds ratio: 5.59; 95% confidence interval: 1.38-22.63; p = 0.016). CONCLUSION: Acute poisoning in children over the past 15 years has shown a changing trend with significant decrease in kerosene, iron and aluminum phosphide and an increase in organophosphate and prescription drugs. The overall mortality has decreased significantly. Hypotension at admission was the most significant predictor of death.

Evaluation of completeness of selected poison control center data fields.

Poison control center data are used in research and surveillance. Due to the large volume of information, these efforts are dependent on data being recorded in machine readable format. However, poison center records include non-machine readable text fields and machine readable coded fields, some of which are duplicative. Duplicating this data increases the chance of inaccurate/incomplete coding. For surveillance efforts to be effective, coding should be complete and accurate. Investigators identified a convenience sample of 964 records and reviewed the substance code determining if it matched its text field. They also reviewed the coded clinical effects and treatments determining if they matched the notes text field. The substance code matched its text field for 91.4% of the substances. The clinical effects and treatments codes matched their text field for 72.6% and 82.4% of occurrences respectively. This under-reporting of clinical effects and treatments has surveillance and public health implications.