Bald Eagles and Lead Poisoning, 2011

Data sheet produced by the Iowa Department of Natural Resources is about different times of animals, insects, snakes, birds, fish, butterflies, etc. that can be found in Iowa.

Death following acute poisoning by moclobemide

A fatality due to ingestion of a reversible inhibitor of monoamine-oxidase A (MAO-A) is reported. Moclobemide is generally considered as a safe drug far less toxic than tricyclic anti-depressants. However, severe intoxications may result from interactions with other drugs and food such as selective serotonin reuptake inhibitors (SSRIs), anti-Parkinsonians of the MAOI-type (e.g. selegiline) or tyramine from ripe cheese or other sources. In the present case, high levels of moclobemide were measured in peripheral blood exceeding toxic values reported so far in the scientific literature. The body fluid concentrations of moclobemide were of 498 mg/l in peripheral whole blood, 96.3 mg/l in urine while an amount of approximately 33 g could be recovered from gastric contents. The other xenobiotics were considered of little toxicological relevance. The victim (male, 48-year-old) had a past history of depression and committed one suicide attempt 2 years before death. Autopsy revealed no evidence of significant natural disease or injury. It was concluded that the manner of death was suicide and that the unique cause of death was massive ingestion of moclobemide.

Severe hypertension following accidental clonidine overdose during the refilling of an implanted intrathecal drug delivery system.

BACKGROUND:   Complications associated with intrathecal pumps may be linked to the surgical procedure, the implanted device, or the medication itself.¦CASE REPORTS:   Three patients treated chronically with intrathecal clonidine presented with clonidine overdose due to inadvertent extravasation during the refilling procedure. All patients experienced loss of consciousness and severe systemic hypertension that required aggressive parenteral treatment.¦DISCUSSION:   Clonidine is an alpha-2 agonist with a nearly 100% bioavailability after oral or rectal administration. With high plasma concentration secondary to massive systemic overdose, the specificity for the alpha-2 receptor is lost and an alpha-1 agonist activity predominates and causes marked hypertension. Management of clonidine overdose consists of supportive therapy guided by signs and symptoms.¦CONCLUSION:   Inadvertent injection into the subcutaneous pocket rather than the reservoir is rare but very dangerous as the drug cannot be retrieved and massive doses are involved. Signs and symptoms of systemic overdose with drugs commonly used in implanted drugs delivery system should be well known to ensure early diagnosis and treatment.

Antidote treatment for cyanide poisoning with hydroxocobalamin causes bright pink discolouration and chemical-analytical interferences.

Here we report the case of a 70-year-old woman who committed suicide by cyanide poisoning. During resuscitation cares, she underwent an antidote treatment by hydroxocobalamin. Postmortem investigations showed marked bright pink discolouration of organs and fluids, and a lethal cyanide blood concentration of 43 mg/L was detected by toxicological investigation. Discolouration of hypostasis and organs has widely been studied in forensic literature. In our case, we interpreted the unusual pink coloration as the result of the presence of hydroxocobalamin. This substance is a known antidote against cyanide poisoning, indicated because of its efficiency and poor adverse effects. However, its main drawback is to interfere with measurements of many routine biochemical parameters. We have tested the potential influence of this molecule in some routine postmortem investigations. The results are discussed.

Lessons Learned: Acute Mercury Poisoning From A Residential Work/Hobby Exposure In Iowa, 2014

This document is about the different ways Mercury can poison a person and the exposure in Iowa.

Poisoning effect of s on pd surfaces

In this study we observe the poisoning effect of S to the adsorption and dissociation of 02 molecule on Pd surfaces. To perform this study we used Viennaab initio Simulation Package (VASP) and Spanish Initiative for Electronic structure with thousands of Atoms (SIESTA) ab initio softwares. To describe all Pd surfaces we selected the (100), and (211) surfaces, because we need very reactive and simple surfaces. Before studying the poison¬ing effect of S we had to study the dissociation of 02 on the surfaces. We discovered that on the (100) surface the hollow site is the most reactive site, but at room temperature the steric hinderace effect occurs very easily. If the molecule has enough vibrational energyit will dissociate. On the (211) surface the (100) micro facet's hollow site is the most reactive site and the molecule dissociates in the site without any barrier, and the molecule drifts from the terrace to this site. An S atom sticks on the Pd (100) surface in the hollow site. It affects the d-band density of states of the nearests Pd atoms; It moves the center of the d-band downin energy, when the bond between the Pd atom and the 0 atom is more antibonding. In the hollow site the S atom also blocks the dissociation site of the molecule. On the Pd(211) surface the energetically favourable site of the S atom is the(100) microfacet's hollow site. There it blocks the most reactive site, but its effect to the Pd atoms next to it is not significant.

L'hémodiayse intermittente, irremplaçable dans certains cas d'intoxications sévères [Intermittent hemodialysis, irreplaceable in specific cases of severe poisoning].

Le médecin praticien est souvent bien sensibilisé aux indications à l'hémodialyse au cours de l'insuffisance rénale sévère, que celle-ci soit aiguë ou chronique. En dehors des indications traditionnelles à une épuration extrarénale, il existe certaines situations comme des intoxications (metformine, éthylène glycol ou lithium) et d'autres conditions (hypercalcémie, lyse tumorale), dans lesquelles l'hémodialyse intermittente représente le traitement le plus efficace, voire le seul. Bien que ces situations demeurent peu fréquentes, il est décisif de les reconnaître rapidement The medical practitioner is in general well aware of the indications for hemodialysis in severe, acute or chronic renal insufficiency. Apart from the traditional indications for renal replacement therapy, there are some cases such as metfomin and ethylene glycol poisoning, lithium intoxication severe hypercalcemia and tumor lysis syndrome, in which intermittent hemodialysis is the most effective treatment, or sometimes the only effective one. Although these situations remain infrequent, it is crucial to recognize them as quickly as possible.

Suicide par sulfure d'hydrogène et délai post mortem long : à propos d'un cas. [Suicide by hydrogen sulfide inhalation and significant post mortem delay: A case report].

L'hydrogène sulfuré (H2S) est un gaz toxique retrouvé à l'état naturel et dans certains milieux industriels, à l'origine d'intoxication accidentelle, mais pouvant être également et facilement synthétisé de manière domestique. Des cas de suicide par hydrogène sulfuré ont ainsi été décrits à partir de produits ménagers dans la littérature depuis 2009, aux États-Unis et au Japon. La plupart présentait des délais post mortem (DPM) courts (moins de 72 heures). En France, les intoxications aiguës à l'H2S demeurent rares et sont le plus souvent liées à des accidents du travail. Nous rapportons ici le cas d'un homme âgé de 37 ans découvert à son domicile, en état de décomposition avancée avec un DPM de deux mois. Compte tenu de la présence d'une importante signalétique avisant du danger potentiel d'exposition à l'H2S, des mesures de précaution ont été mises en oeuvre dès la découverte du corps et poursuivies jusqu'aux opérations d'autopsie. Les analyses toxicologiques ont confirmé la présence d'H2S au niveau des prélèvements de cerveau et de muscle. Le cas présenté constitue le premier cas de suicide avec un délai post mortem long à l'H2S rapporté en France. Dans la littérature, les constatations macroscopiques à l'autopsie ne sont pas spécifiques tandis que les analyses toxicologiques reposent essentiellement sur la recherche et la quantification d'H2S. En raison de leur redistribution post mortem, les résultats de ces analyses doivent être interprétés avec prudence, et encore plus en cas de délai post mortem long et de phénomènes de putréfaction qui peuvent également être une source de génération d'H2S post mortem. Hydrogen sulfide (H2S) which is a poisonous gas found either in the natural state or in industrial environments and potentially linked with accidental intoxication, can also be easily handmade. Several cases of suicide by inhaling H2S produced by mixing household products have been reported in the literature since 2009 in USA and Japan. Most of them involved short post mortem delays up to 72 hours. In France, acute H2S poisoning remains rare and mostly accidental. We report the case of a 37-year-old man found at home, in an advanced stage of decomposition with a 2-month post mortem delay. As numerous warning signs about a high risk of H2S exposure were present, some precautionary measures were taken from the discovery of the cadaver to the autopsy. Toxicological analyses confirmed the presence of H2S in brain and muscle samples. This observation is the first French case with a long post mortem delay. As macroscopic findings in such cases are described to be unspecific in literature, toxicological analysis must focus on the detection and the quantification of H2S. However, due to the phenomena of post mortem drug redistribution and neo-formation, their results should be interpreted with much more caution when the post mortem delay is long. The potential increase in such voluntary-intoxication-related-deaths in France, similar to the recent Japanese and American waves of suicides, requires for forensic scientists, a good knowledge of both thanatological and toxicological pictures, and precautionary measures to adopt in such situations.

(210)Po poisoning as possible cause of death: forensic investigations and toxicological analysis of the remains of Yasser Arafat.

The late president of the Palestinian Authority, Yasser Arafat, died in November 2004 in Percy Hospital, one month after having experienced a sudden onset of symptoms that included severe nausea, vomiting, diarrhoea and abdominal pain and which were followed by multiple organ failure. In spite of numerous investigations performed in France, the pathophysiological mechanisms at the origin of the symptoms could not be identified. In 2011, we found abnormal levels of polonium-210 ((210)Po) in some of Arafat's belongings that were worn during his final hospital stay and which were stained with biological fluids. This finding led to the exhumation of Arafat's remains in 2012. Significantly higher (up to 20 times) activities of (210)Po and lead-210 ((210)Pb) were found in the ribs, iliac crest and sternum specimens compared to reference samples from the literature (p-value <1%). In all specimens from the tomb, (210)Po activity was supported by a similar activity of (210)Pb. Biokinetic calculations demonstrated that a (210)Pb impurity, as identified in a commercial source of 3MBq of (210)Po, may be responsible for the activities measured in Arafat's belongings and remains 8 years after his death. The absence of myelosuppression and hair loss in Mr Arafat's case compared to Mr Litvinenko's, the only known case of malicious poisoning with (210)Po, could be explained by differences in the time delivery-scheme of intake. In conclusion, statistical Bayesian analysis combining all the evidence gathered in our forensic expert report moderately supports the proposition that Mr Arafat was poisoned by (210)Po.

Intoxication aiguë au baclofène. Particularités et principes thérapeutiques

En raison de sa prescription croissante pour des indications d'aide à la réduction des consommations ou au maintien de l'abstinence à l'alcool, le risque d'intoxication volontaire ou accidentelle au baclofène s'accroît et favorise l'admission aux urgences ou en réanimation de comas profonds. La difficulté diagnostique repose sur une relative méconnaissance de cette substance et sur le fait que le baclofène ne fait pas partie des substances mises en évidence par les examens toxicologiques de dépistage habituels. La modification de la pharmaco- cinétique du baclofène en cas de surdosage expose le patient à un coma prolongé, nécessitant dès lors un soutien ventilatoire de longue durée. De manière paradoxale, le baclofène expose également à un risque potentiel de convulsions. En cas de prise en charge adéquate, le pronostic est excellent dans la majorité des cas. En partant d'un cas clinique illustratif et d'une revue de littérature, nous proposons une synthèse des principes de prise en charge d'une intoxication aiguë au baclofène. Baclofen is widely used for the treatment of neurological spastic syndromes and has been recently proposed for the treatment of alcohol dependence. The risk of accidental or self- intoxication with baclofen may therefore increase in the future. Baclofen overdose affects the autonomic nervous system and produces an inhibitory effect on the central nervous system. The classic clinical presentation involves prolonged impaired consciousness or coma and neurovegetative symptoms. Paradoxically, baclofen overdose may also promote the occurrence of seizures. The emergency management is mainly supportive and, in the majority of cases, the prognosis appears excellent. Herein we report a case of baclofen self-intoxication and review the literature regarding the toxicity of baclofen, the clinical presentation of an acute baclofen poisoning and the related principles of management.

Estudi sobre l'eficàcia dels mètodes de reescalfament in situ en el tractament de la hipotèrmia accidental en muntanya

En la última dècada, els esports de muntanya, en qualsevol de les seves modalitats, s’han vist incrementats en nombre de practicants. Aquest fet ha comportat un important augment d’incidència de la hipotèrmia accidental. La hipotèrmia accidental és defineix com un estat patològic caracteritzat per la disminució de la temperatura corporal central per sota dels 35ºC, com a resultat de la incapacitat de l’organisme per generar el calor necessari per garantir el manteniment de les funcions fisiològiques. A través d’aquest estudi es vol demostrar que l’actuació in situ, a través de certes mesures de reescalfament, de la víctima que pateix hipotèrmia, milloren la supervivència i les complicacions secundàries d’aquesta patologia, a més a més d’avaluar l’eficàcia d’aquestes tècniques. És a dir, volem demostrar l’efectivitat de l’aplicació terapèutica extrahospitalaria de les tècniques de reescalfament. Realitzarem un estudi quantitatiu observacional analític de caràcter prospectiu a la zona dels Alps francesos d’una mostra de 237 casos d’hipotèrmia en persones practicants d’esports de muntanya que reuneixin uns criteris d’inclusió i exclusió. Els professionals de rescat aplicaran les mesures de reescalfament prèviament pautades, per les quals hauran estat formats, i enregistraran en el full de recollida de dades tota la informació sobre les variables d’estudi. És un estudi on la intervenció principal es porta a terma al medi natural i que per tant les condicions climatològiques i medioambientals poden actuar com a gran limitador de l’estudi, cal afegir també com a limitació el fet que el participant no vulgui formar part de l’estudi o que el professional de rescat que ha de portar a terme el pla terapèutic no ho faci adequadament.

Auto Poisoning of the Respiratory Chain by a Quorum-Sensing-Regulated Molecule Favors Biofilm Formation and Antibiotic Tolerance.

Bacterial programmed cell death and quorum sensing are direct examples of prokaryote group behaviors, wherein cells coordinate their actions to function cooperatively like one organism for the benefit of the whole culture. We demonstrate here that 2-n-heptyl-4-hydroxyquinoline-N-oxide (HQNO), a Pseudomonas aeruginosa quorum-sensing-regulated low-molecular-weight excreted molecule, triggers autolysis by self-perturbing the electron transfer reactions of the cytochrome bc1 complex. HQNO induces specific self-poisoning by disrupting the flow of electrons through the respiratory chain at the cytochrome bc1 complex, causing a leak of reducing equivalents to O2 whereby electrons that would normally be passed to cytochrome c are donated directly to O2. The subsequent mass production of reactive oxygen species (ROS) reduces membrane potential and disrupts membrane integrity, causing bacterial cell autolysis and DNA release. DNA subsequently promotes biofilm formation and increases antibiotic tolerance to beta-lactams, suggesting that HQNO-dependent cell autolysis is advantageous to the bacterial populations. These data identify both a new programmed cell death system and a novel role for HQNO as a critical inducer of biofilm formation and antibiotic tolerance. This newly identified pathway suggests intriguing mechanistic similarities with the initial mitochondrial-mediated steps of eukaryotic apoptosis.

Complications following an accidental sodium hypochlorite extrusion: A report of two cases

Sodium hypochlorite (NaOCl) is the most commonly used solution in root canal treatments, as it is a low-cost method that displays a very effective antimicrobial activity against microbiota of infected root canals. However, this solution can cause complications especially due to its cytotoxic features. When this solution is injected into the adjacent tissues, the patient usually experiences intense pain, and an urgent treatment should be implemented in order to prevent a long-term sequelae. This paper describes the clinical features of two patients that experienced an accidental extrusion of NaOCl after endodontic treatment of varying severity and with different treatments. Furthermore, it shows the long-term neurologic injuries that this type of accidents may cause and a treatment protocol for these situations will be suggested.

Poisoning and regeneration of Pt-Pd/WO3-ZrO2 short paraffin isomerization catalysts

WO3-ZrO2 catalysts promoted with Pt and Pd were tested as paraffin isomerization catalysts using n-hexane as model compound. Sulfur and amine poisoning and regeneration tests were used to assess the impact of the addition of Pt and Pd on the deactivation resistance and regenerability. Pt and PtPd catalysts were the most active for n-hexane isomerization. The low activity of the Pd catalyst was attributed to poor Pd metal properties when supported over WO3-ZrO2 and to a decrease of the number of BrQnsted acid sites. PtPd was the only catalyst capable of full regeneration after S poisoning. Amine poisoning completely supressed the isomerization activity and the original activity could only be restored by calcination and reduction.