Oral Treatment of Organophosphate Poisoning in Mice

OBJECTIVE: Organophosphates are used as pesticides, herbicides, and chemical warfare agents. Treatment of organophosphate poisoning is with intravenous atropine and pralidoxime in addition to supportive care. This study determined the efficacy of oral agents in preventing death from organophosphate poisoning. METHODS: The organophosphate paraoxon (8 mg/kg) was used in a murine model with lethality at four and 24 hours as an end point. For oral treatment, 15 male Balbc mice were given either atropine sulfate (4 mg/kg), or a combination of atropine sulfate (4 mg/kg) with pralidoxime (100 mg/kg), by oral gavage. A control group of 22 mice received water by oral gavage. Chi-square analysis was used to compare results in the different groups. RESULTS: Of the control group, six of 22 survived to four hours after paraoxon exposure. Of the exposed animals treated with oral atropine, eight of 15 survived to four hours. Of the exposed animals treated with a combination of atropine and pralidoxime, 13 of 15 survived to four hours. All animals surviving to four hours survived to 24 hours. The increased survival of animals in the atropine group relative to the control group was not significant (p = 0.09). Survival was significant in the group treated with atropine and pralidoxime relative to atropine alone (p = 0.02) and to the control group (p = 0.0002). All treated mice surviving at four hours were alive at 24 hours. CONCLUSIONS: Both oral atropine and a combination of oral atropine and pralidoxime improved survival, and combination therapy achieved statistical significance. Generalization of this result to other organophosphate pesticides, other doses of paraoxon, and other species cannot be made without further investigations.     

有机磷农药中毒病人洗胃方法的探讨

[目的]提高有机磷农药中毒病人抢救成功率。[方法]把169例急性有机磷农药中毒病人按来诊先后随机分组,采用不同洗胃方法进行洗胃并时效果比较分析。[结果]左侧卧位插胃管洗胃、延长胃管插入长度洗胃与低压少量洗胃液洗胃在插胃管、洗胃时间、洗胃效果方面明显优于对照组,有统计学意义。[结论]采用左侧卧位插胃管、延长胃管插入长度至55cm～70cm、低压少量洗胃液反复洗胃,可提高有机磷农药中毒抢救成功率。     

新生儿科实施整体护理的对比分析

整体护理是以现代护理观为指导，以护理程序为框架，根据病人身心、社会文化需要而提供的优质护理。为适应现代护理发展需要，作为护理人员必须转变观念，将过去以“疾病为中心”的功能制护理转为以“病人为中心”的整体护理，以提高护理质量，降低护理并发症，为此，我们根据新生儿专科特     

口服有机磷农药中毒洗胃术的临床研究进展

从洗胃方法、洗胃时机、洗胃液的选择、洗胃液量和温度、胃管插入深度与洗胃时的体位、安全防护等方面阐述了有机磷农药中毒洗胃的临床研究进展。     

NEUROTOXICOLOGY

Abstract

Obidoxime is an oxime used in several countries as an antidote in organophosphate intoxication. Its pharmacokinetics were studied in a 20 year-old female with severe and complicated methamidophos intoxication. Obidoxime elimination half life was 6.9?h, volume of distribution 0.845 L/kg, total body clearance 85.4 mL/min, and renal clearance 69 mL/min (creatinine clearance 54 mL/min). Eighty percent of the dose was excreted in the urine over 5?h. Possible reasons for the different pharmacokinetic values as compared with values previously reported in healthy volunteers are discussed. Obidoxime dose should be adjusted according to renal function. More studies are needed to establish the therapeutic window of obidoxime in patients with organophosphate intoxication.     

Organophosphorus pesticide exposure and neurobehavioral performance in Latino children living in an orchard community

Children living in agricultural communities have a greater risk from pesticides due to para-occupational pathways. The goal of this study was to assess the impact of exposure to organophosphorus pesticides on the neurobehavioral performance of school-aged Latino children over time. Two exposure measures were used to estimate children’s pesticide exposure: parent's occupation (agricultural or non-agricultural) and organophosphate residues in home carpet dust samples. During 2008–2011, 206 school-aged children completed a battery of neurobehavioral tests two times, approximately one year apart. The associations between both exposure measures and neurobehavioral performance were examined. Pesticide residues were detected in dust samples from both agricultural and non-agricultural homes, however, pesticides were detected more frequently and in higher concentrations in agricultural homes compared to non-agricultural homes. Although few differences were found between agricultural and non-agricultural children at both visits, deficits in learning from the first visit to the second visit, or less improvement, was found in agricultural children relative to non-agricultural children. These differences were significant for the Divided Attention and Purdue Pegboard tests. These findings are consistent with previous research showing deficits in motor function. A summary measure of organophosphate residues was not associated with neurobehavioral performance. Results from this study indicate that children in agricultural communities are at increased risk from pesticides as a result of a parent working in agricultural. Our findings suggest that organophosphate exposure may be associated with deficits in learning on neurobehavioral performance, particularly in tests of with motor function. In spite of regulatory phasing out of organophosphates in the U.S., we still see elevated levels and higher detection rates of several organophosphates in agricultural households than non-agricultural households, albeit lower levels than prior studies.     

一起有机磷农药污染餐具所致食物中毒调查分析

目的探讨一起有机磷农药中毒发生原因,防止类似事件发生。方法对中毒人群进行流行病学调查,实验室检验。结果 3例病人均曾用一个曾盛过有机磷农药敌敌畏的碗,误盛红烧肉饮食史,3例病人临床检验乙酰胆碱酯酶活性分别为对照组的70%、60%、45%。结论综合流行病学调查、临床检验、临床症状及治疗情况,证实为一起误服有机磷农药敌敌畏所致食物中毒事件。     

军队有害生物监控与发展概况

对军队有害生物的概念、种类和军队有害生物监控专业的特色进行了概述,并总结分析了军队有害生物防治面临的形势和今后专业发展方向。     

探讨CRRT联合长托宁对急性有机磷农药中毒患者的抢救效果

目的探讨连续性肾脏替代治疗(CRRT)联合长托宁对急性有机磷农药中毒患者的抢救效果。方法以黔西南布依族苗族自治州人民医院收治的60例急性有机磷农药中毒患者为研究对象,选取的时间范围为2017年1月-2018年8月,分为对照组和联合组,每组30例患者。对照组患者进行长托宁治疗,联合组患者进行CRRT联合长托宁治疗。观察两组患者治疗后的治疗效果、临床指标、治疗前后的血清炎性反应指标水平以及不良反应发生率。结果研究结果显示,联合组患者的治疗效果(90.00%)明显好于对照组(63.33%);联合组患者的苏醒时间、呼吸肌麻痹恢复时间和住院时间分别为(11.33±2.13)h、(3.01±1.11)d、(7.12±2.23)d,均短于对照组的(15.42±4.79)h、(6.51±3.76)d、(12.47±3.64)d;治疗后,两组患者的炎性因子C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和白介素-8(IL-8)的含量都有所下降,但是联合组的CRP(52.21±13.24)mg/L、IL-6(73.32±17.11)ng/L、TNF-α(67.85±12.52)ng/L、IL-8(46.28±17.47)ng/L含量明显低于对照组的(76.47±17.68)mg/L、(99.40±17.45)ng/L、(84.67±13.12)ng/L、(68.52±17.49)ng/L;联合组患者的不良反应发生率(16.67%)明显低于对照组(40.00%),差异均具有统计学意义(P<0.05)。结论CRRT联合长托宁可以提高对急性有机磷农药中毒患者的治疗效果,帮助缩短苏醒时间、呼吸肌麻痹恢复时间、胆碱酯酶恢复时间和住院时间,降低炎性因子CRP、IL-6、TNF-α、IL-8的含量,减少炎症反应,降低患者的不良反应发生率。     

Clinical presentation and laboratory findings of organic phosphorus poisoning

This study was conducted to evaluate the demographic, causative, and biologic characteristics of patients with organophosphate (OP) poisoning who were admitted to tertiary teaching and research hospitals at 2 different universities. All patients admitted to the emergency departments of Cukurova University Hospital in Adana, Turkey, between 2001 and 2003 and the Hospital of Mustafa Kemal University in Hatay, Turkey, between 2004 and 2006 were included. The study group consisted of subjects with a mean age of 28.5±14.1 y (range, 14–80 y), and the maximum number of cases in the second decade of life; the female-to-male ratio was 2.2:1. In all, 27 of 43 females and 16 of 20 males were married. Most subjects (n=55) had graduated from primary school; 3 were illiterate and 5 were highly educated. A total of 36 (57.1%) subjects belonged to lower socioeconomic groups. Fifty-three patients intended to commit suicide, and 10 cases were accidental. Mean arrival time of subjects to the hospital after poisoning was 9.9±16.1 h (range, 1–96 h); mean Glasgow Coma Scale score was 10.2±2.9 (range, 3–15). A total of 19 subjects were intubated, and 4 died. A total of 59 patients recovered completely. The mortality rate (6.3%) depended on various factors such as OP compound consumed, amount ingested, time interval before hospitalization, and patients’ general health. Chances for recovery were greater when the patient was hospitalized at the earliest indication. In conclusion, OPs especially affected young single females, and most cases were due to attempted suicide. Because OP poisoning is an important cause of morbidity and mortality, therapy should be started immediately to avoid undesirable consequences.