Severe fenthion intoxications due to ingestion and inhalation with survival outcome

Two cases of severe fenthion intoxication are presented. The first is a case of a psychiatric patient who attempted suicide with ingestion of the compound, and the second case was of a child exposed to the chemical agent by air spraying. Both patients were treated in the intensive care unit with atropine and pralidoxime and finally survived. Fenthion blood levels on admission were 2.7 and 0.95 microg/mL, respectively. Different concentrations of pralidoxime were added to the first patient's poisoned serum in order to assess in vitro the effect of pralidoxime on cholinesterase reactivation. The clinical and toxicological data of the poisonings are discussed, as well as the potential therapeutic use of pralidoxime in organophosphate intoxication.     

Factors predicting adverse short-term outcomes in patients with acute cholangitis undergoing ERCP: A single center experience

AIM: To identify potential factors that can predict adverse short-term outcomes in patients with acute cholangitis undergoing endoscopic retrograde cholangiopancreatography(ERCP). METHODS: Retrospective analysis of consecutive patients admitted to our center for acute cholangitis and underwent ERCP from 2001 to 2012. Involvement of two or more organ systems was termed as organ failure(OF). Cardiovascular failure was defined based on a systolic blood pressure of 90 mmHg despite fluid replacement and/or requiring vasopressor treatment; respiratory failure if the Pa02 /Fi02 ratio was 300 mmHg and/or required mechanical ventilation; coagulopathy if the platelet count was 80; and renal insufficiency if serum creatinine was 1.9 mg/dL. Variables associated with short term adverse clinical outcomes defined as persistent OF and/or 30-d mortality was determined. RESULTS: A total of 172 patients(median age 62 years, 56.4% female) were included. The median door to ERCP time was 17 h. Bile duct stones were the most common etiology(n = 67, 39.2%). In multivariate analysis, factors that were independently associated with persistent OF and/or 30-d mortality included American Society of Anesthesiology(ASA) physical classification score 3(OR = 7.70; 95%CI: 2.73-24.40), presence of systemic inflammatory response syndrome(OR = 3.67; 95%CI: 1.34-10.3) and door to ERCP time greater than 72 h(OR = 3.36; 95%CI: 1.12-10.20). Door to ERCP time greater than 72 h was also associated with 70% increase in the mean length of stay(P 0.001). Every one point increase in the ASA physical classification and every 1 mg/dL increase in the preERCP bilirubin level was associated with a 34% and 2% increase in the mean length of hospital stay, respectively. Transfer status did not impact clinical outcomes. CONCLUSION: Higher ASA physical classification and delays in ERCP are associated with adverse clinical outcomes and prolonged length of hospital stay in patients with acute cholangitis undergoing ERCP.     

Nutrient intake and food consumption among medical students in Greece assessed during a Clinical Nutrition course

The objective of this study was to determine nutrient intake and food consumption patterns among medical students at the University of Crete, Greece. As part of the Clinical Nutrition course from 1989 to 2001, a total of 951 third-year medical students (500 male, 451 female) aged 22+/-2 years underwent dietary interview, during which individual 24-h dietary recalls were taken. The students also completed a questionnaire on smoking habits, and anthropometric measurements were performed. The Mann-Whitney test was applied to assess differences in nutrient and food group intake between lower and higher fat eaters. Analysis of covariance was used to study relationships between nutrient intakes and tobacco use, adjusting for gender, age, and body mass index. The mean daily energy intake was 2493 kcal (10437 kJ) for males and 1675 kcal (7012 kJ) for females. The contribution of total fat to energy intake was 40% in each gender. Lower fat eaters (/=46.0% of total energy). Smokers had higher intakes of energy (P<0.05) and saturated fatty acids (P<0.01), and lower intakes of fiber (P<0.001), folate (P<0.05) and vitamin C (P<0.001) than non-smokers/ex-smokers. Our results indicate a need for Greek medical students to improve their dietary and health habits. Dietary assessment could be used to enhance nutrition education in medical schools.     

Combined use of Amplified Fragment Length Polymorphism and IS<Emphasis Type="Italic">6110</Emphasis> -RFLP in fingerprinting clinical isolates of <Emphasis Type="Italic">Mycobacterium tuberculosis</Emphasis> from Kerala,South India

Background  

DNA fingerprinting by IS6110-RFLP has shown a high incidence of Mycobacterium tuberculosis isolates having no and low copies of the insertion sequence in Kerala, South India. Amplified Fragment Length Polymorphism (AFLP) would scan the entire genome rather than a few repetitive elements, we thought that this technique would help us in differentiating the large reservoir of isolates from an endemic region. Here we evaluate the ability of Amplified Fragment Length Polymorphism (AFLP) to type clinical isolates.     

药物稳定性自由变温加速试验及其计算方法研究

介绍了一种以袖珍电子计算机为核心,用于药物稳定性自由变温加速试验的测温记录装置;介绍了一种用优选法和辛普森数值积分法处理自由变温加速试验数据的新算法。在这一新算法中,未作任何近似处理,也不需用多项式(或任何其它函数式)拟合温度—时间曲线,计算简明而结果准确,用袖珍电子计算机即可完成全部温度测量、记录和数据处理工作。