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For: Liu HF, Ku CH, Chang SS, Chang CM, Wang IK, Yang HY, Weng CH, Huang WH, Hsu CW, Yen TH. Outcome of patients with chlorpyrifos intoxication. Hum Exp Toxicol 2020;39:1291-1300. [PMID: 32336155 DOI: 10.1177/0960327120920911] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]

For:	Liu HF, Ku CH, Chang SS, Chang CM, Wang IK, Yang HY, Weng CH, Huang WH, Hsu CW, Yen TH. Outcome of patients with chlorpyrifos intoxication. Hum Exp Toxicol 2020;39:1291-1300. [PMID: 32336155 DOI: 10.1177/0960327120920911] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]

Number

Cited by Other Article(s)

Guerrero Ramírez JR, Ibarra Muñoz LA, Balagurusamy N, Frías Ramírez JE, Alfaro Hernández L, Carrillo Campos J. Microbiology and Biochemistry of Pesticides Biodegradation. Int J Mol Sci 2023;24:15969. [PMID: 37958952 PMCID: PMC10649977 DOI: 10.3390/ijms242115969] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/17/2023] [Accepted: 10/20/2023] [Indexed: 11/15/2023] Open

Abstract

Pesticides are chemicals used in agriculture, forestry, and, to some extent, public health. As effective as they can be, due to the limited biodegradability and toxicity of some of them, they can also have negative environmental and health impacts. Pesticide biodegradation is important because it can help mitigate the negative effects of pesticides. Many types of microorganisms, including bacteria, fungi, and algae, can degrade pesticides; microorganisms are able to bioremediate pesticides using diverse metabolic pathways where enzymatic degradation plays a crucial role in achieving chemical transformation of the pesticides. The growing concern about the environmental and health impacts of pesticides is pushing the industry of these products to develop more sustainable alternatives, such as high biodegradable chemicals. The degradative properties of microorganisms could be fully exploited using the advances in genetic engineering and biotechnology, paving the way for more effective bioremediation strategies, new technologies, and novel applications. The purpose of the current review is to discuss the microorganisms that have demonstrated their capacity to degrade pesticides and those categorized by the World Health Organization as important for the impact they may have on human health. A comprehensive list of microorganisms is presented, and some metabolic pathways and enzymes for pesticide degradation and the genetics behind this process are discussed. Due to the high number of microorganisms known to be capable of degrading pesticides and the low number of metabolic pathways that are fully described for this purpose, more research must be conducted in this field, and more enzymes and genes are yet to be discovered with the possibility of finding more efficient metabolic pathways for pesticide biodegradation.

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Wu YJ, Chang SS, Chen HY, Tsai KF, Lee WC, Wang IK, Lee CH, Chen CY, Liu SH, Weng CH, Huang WH, Hsu CW, Yen TH. Human Poisoning with Chlorpyrifos and Cypermethrin Pesticide Mixture: Assessment of Clinical Outcome of Cases Admitted in a Tertiary Care Hospital in Taiwan. Int J Gen Med 2023;16:4795-4804. [PMID: 37908758 PMCID: PMC10614644 DOI: 10.2147/ijgm.s432861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 10/12/2023] [Indexed: 11/02/2023] Open

Abstract

Background and Purpose

There is an overall paucity of data regarding the human toxicity of chlorpyrifos and cypermethrin pesticide mixture. Both organophosphate and pyrethroid insecticides are metabolized by carboxylesterases. Thus, its pesticide combination, organophosphates may boost the toxicity of pyrethroids via inhibited its detoxification by carboxylesterases. This study examined the clinical course, laboratory tests, and outcomes of patients with chlorpyrifos, cypermethrin or their pesticide mixture poisoning, and to determine what association, if any, might exist between these findings.

Patients and Methods

Between 2000 and 2021, 121 patients poisoned with chlorpyrifos, cypermethrin, or their pesticide mixture were treated at Chang Gung Memorial Hospital. Patients were categorized as chlorpyrifos (n=82), cypermethrin (n=27) or chlorpyrifos and cypermethrin (n=12) groups. Demographic, clinical, laboratory and mortality data were collected for analysis.

Results

The patients experienced a broad range of clinical symptoms, including aspiration pneumonia (44.6%), salivation (42.5%), acute respiratory failure (41.3%), acute kidney injury (13.9%), seizures (7.5%), hypotension (2.6%), etc. Leukocytosis (12,700±6600 /uL) and elevated serum C-reactive protein level (36.8±50.4 mg/L) were common. The acute respiratory failure rate was 41.3%, comprising 48.8% in chlorpyrifos, 11.1% in cypermethrin as well as 58.3% in chlorpyrifos and cypermethrin poisoning. Patients with chlorpyrifos and cypermethrin pesticide mixture poisoning suffered higher rates of acute respiratory failure (P=0.001) and salivation (P=0.001), but lower Glasgow Coma Scale score (P=0.011) and serum cholinesterase level (P<0.001) than other groups. A total of 17 (14.0%) patients expired. The mortality rate was 14.0%, including 17.1% in chlorpyrifos, 3.7% in cypermethrin as well as 16.7% in chlorpyrifos and cypermethrin poisoning. No significant differences in mortality rate were noted (P=0.214).

Conclusion

Chlorpyrifos pesticide accounted for the major toxicity of the pesticide mixture. While the data show a higher rate of respiratory failure in the chlorpyrifos and cypermethrin pesticide mixture group than others, other measures of toxicity such as mortality and length of stay were not increased.

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Affiliation(s)

Yi-Jan Wu Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City, Taiwan College of Medicine, Chang Gung University, Taoyuan City, Taiwan
Shu-Sen Chang Institute of Health Behaviors and Community Sciences, Department of Public Health, College of Public Health, National Taiwan University, Taipei City, Taiwan
Hsien-Yi Chen Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City, Taiwan
Kai-Fan Tsai College of Medicine, Chang Gung University, Taoyuan City, Taiwan Division of Nephrology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Branch, Kaohsiung City, Taiwan
Wen-Chin Lee College of Medicine, Chang Gung University, Taoyuan City, Taiwan Division of Nephrology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Branch, Kaohsiung City, Taiwan
I-Kuan Wang Department of Nephrology, China Medical University Hospital, Taichung City, Taiwan College of Medicine, China Medical University, Taichung City, Taiwan
Chern-Horng Lee Division of General Internal Medicine and Geriatrics, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City, Taiwan
Chao-Yu Chen Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City, Taiwan College of Medicine, Chang Gung University, Taoyuan City, Taiwan
Shou-Hsuan Liu Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City, Taiwan College of Medicine, Chang Gung University, Taoyuan City, Taiwan
Cheng-Hao Weng Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City, Taiwan College of Medicine, Chang Gung University, Taoyuan City, Taiwan
Wen-Hung Huang Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City, Taiwan College of Medicine, Chang Gung University, Taoyuan City, Taiwan
Ching-Wei Hsu Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City, Taiwan College of Medicine, Chang Gung University, Taoyuan City, Taiwan
Tzung-Hai Yen Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City, Taiwan College of Medicine, Chang Gung University, Taoyuan City, Taiwan

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Joshi V, Jindal MK, Sar SK. Approaching a discussion on the detachment of chlorpyrifos in contaminated water using different leaves and peels as bio adsorbents. Sci Rep 2023;13:11186. [PMID: 37433845 DOI: 10.1038/s41598-023-38471-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/08/2023] [Indexed: 07/13/2023] Open

Liang CA, Chang SS, Chen HY, Tsai KF, Lee WC, Wang IK, Chen CY, Liu SH, Weng CH, Huang WH, Hsu CW, Yen TH. Human Poisoning with Methomyl and Cypermethrin Pesticide Mixture. TOXICS 2023;11:372. [PMID: 37112599 PMCID: PMC10143879 DOI: 10.3390/toxics11040372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/27/2023] [Accepted: 04/11/2023] [Indexed: 06/19/2023]

Abstract

There is limited literature analyzing the outcome of human poisoning with methomyl and cypermethrin pesticide mixture. Between 2002 and 2018, a total of 63 patients intoxicated with methomyl, cypermethrin, or their pesticide mixture were treated at Chang Gung Memorial Hospital. The patients were categorized into three groups based on the type of pesticide, as methomyl (n = 10), cypermethrin (n = 31), or methomyl and cypermethrin (n = 22). Demographic, clinical, laboratory, and mortality data were obtained for analysis. The patients were aged 54.9 ± 18.9 years. Following ingestion, the patients experienced a wide range of clinical symptoms, including aspiration pneumonia (50.8%), acute respiratory failure (41.3%), acute kidney injury (33.3%), multiple organ failure (19.0%), emesis (19.0%), acute hepatitis (12.7%), diarrhea (7.9%), seizures (4.8%), lacrimation (4.8%), etc. After analysis, it was found that patients with methomyl and cypermethrin poisoning suffered higher incidences of acute respiratory failure (p < 0.001), aspiration pneumonia (p = 0.004), acute kidney injury (p = 0.011), and multiple organ failure (p < 0.001) than the other groups. Laboratory analyses revealed that patients with methomyl and cypermethrin poisoning had a higher creatinine level (p = 0.011), white blood cell count (p < 0.001), and neutrophil count (p = 0.019) than the other groups. A total of seven (11.1%) patients died. The average duration of hospitalization was 9.8 ± 10.0 days. In a multivariate logistic regression model, it was revealed that methomyl pesticide (p = 0.045) or methomyl and cypermethrin pesticide mixture (p = 0.013) were significant risk factors for acute respiratory failure. Nevertheless, no mortality risk factor could be identified. Therefore, the analytical results suggest that methomyl pesticide is the major contributor to the toxicity of methomyl and cypermethrin pesticide mixture poisoning. More research is needed.

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Affiliation(s)

Chi-Ang Liang Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Branch and College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
Shu-Sen Chang Institute of Health Behaviors and Community Sciences, Department of Public Health, College of Public Health, National Taiwan University, Taipei 100, Taiwan
Hsien-Yi Chen Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou Branch and College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
Kai-Fan Tsai Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
Wen-Chin Lee Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
I-Kuan Wang Department of Nephrology, China Medical University Hospital and College of Medicine, China Medical University, Taichung 406, Taiwan
Chao-Yu Chen Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Branch and College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
Shou-Hsuan Liu Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Branch and College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
Cheng-Hao Weng Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Branch and College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
Wen-Hung Huang Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Branch and College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
Ching-Wei Hsu Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Branch and College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
Tzung-Hai Yen Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Branch and College of Medicine, Chang Gung University, Taoyuan 333, Taiwan

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Ramadori GP. Organophosphorus Poisoning: Acute Respiratory Distress Syndrome (ARDS) and Cardiac Failure as Cause of Death in Hospitalized Patients. Int J Mol Sci 2023;24:6658. [PMID: 37047631 PMCID: PMC10094912 DOI: 10.3390/ijms24076658] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/22/2023] [Accepted: 03/31/2023] [Indexed: 04/05/2023] Open

Abstract

Industrial production of food for animals and humans needs increasing amounts of pesticides, especially of organophosphates, which are now easily available worldwide. More than 3 million cases of acute severe poisoning are estimated to occur worldwide every year, and even more cases remain unreported, while 200,000-350,000 incidentally or intentionally poisoned people die every year. Diagnostic and therapeutic procedures in organophosphate poisoning have, however, remained unchanged. In addition to several neurologic symptoms (miosis, fasciculations), hypersecretion of salivary, bronchial, and sweat glands, vomiting, diarrhea, and loss of urine rapidly induce dehydration, hypovolemia, loss of conscience and respiratory distress. Within hours, signs of acidosis due to systemic hypoxia can be observed at first laboratory investigation after hospitalization. While determination of serum-cholinesterase does not have any diagnostic value, it has been established that hypoalbuminemia alone or accompanied by an increase in creatinine, lactate, or C-reactive protein serum levels has negative prognostic value. Increased serum levels of C-reactive protein are a sign of systemic ischemia. Protective mechanical ventilation should be avoided, if possible. In fact, acute respiratory distress syndrome characterized by congestion and increased weight of the lung, accompanied by heart failure, may become the cause of death. As the excess of acetylcholine at the neuronal level can persist for weeks until enough newly, locally synthesized acetylcholinesterase becomes available (the value of oximes in reducing this time is still under debate), after atropine administration, intravenous albumin and fluid infusion should be the first therapeutic interventions to reestablish normal blood volume and normal tissue oxygenation, avoiding death by cardiac arrest.

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Lari S, Yamagani P, Pandiyan A, Vanka J, Naidu M, Senthil Kumar B, Jee B, Jonnalagadda PR. The impact of the use of personal-protective-equipment on the minimization of effects of exposure to pesticides among farm-workers in India. Front Public Health 2023;11:1075448. [PMID: 37026139 PMCID: PMC10072124 DOI: 10.3389/fpubh.2023.1075448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/20/2023] [Indexed: 04/08/2023] Open

Abstract

Introduction

Although excessive use of pesticides and unsafe agricultural practices may contribute to numerous intoxications, the role of PPE (personal-protective-equipment) in the minimization of toxicological effects due to pesticide exposure has not been addressed so far. The present study aimed to assess the impact of the use of PPE on the minimization of effects of exposure to pesticides among farm-workers.

Methods

A community-based follow-up study with questionnaire-based survey and field observations was undertaken among farm-workers (n = 180) of Rangareddy district, Telangana, India. Biomarkers of exposure such as cholinesterase activity, inflammatory markers (TNF-α, IL-1β, IL-6, cortisol, and hs-C reactive protein), nutrients (vitamins A, E), liver function (total protein and A/G ratio, AST and ALT levels) were investigated in the laboratory by following the standard protocols.

Results

Farm-workers who had a mean farming exposure of 18 years of and who neither followed safe pesticide handling practices nor used PPE and also showed reluctance to obey good agricultural practices (GAPs). Inhibition of AChE (acetylcholine esterase) with increased inflammation was found among farm-workers as compared to their respective normal values when they have not used PPE. Linear regression statistical analysis revealed a profound effect on inhibition in the AChE activity and various inflammatory markers with the increase in the duration of pesticide exposure. Further, there was no effect of the duration of pesticide exposure on the levels of vitamins A, E, ALT, AST, total protein, and A/G ratio. Further, intervention studies carried out on the use of PPE provided (commercially available and cost-effective) for 90 days showed a significant reduction in the biomarker levels (p < 0.01).

Conclusion

This study demonstrated the importance of the use of PPE during pesticide applications and other agricultural tasks to minimize pesticide-associated adverse health effects.

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Maksimović ŽM, Jović-Stošić J, Vučinić S, Perković-Vukčević N, Vuković-Ercegović G, Škrbić R, Stojiljković MP. Acute organophosphate and carbamate pesticide poisonings - a five-year survey from the National Poison Control Center Of Serbia. Drug Chem Toxicol 2023;46:113-121. [PMID: 34875948 DOI: 10.1080/01480545.2021.2012481] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]

Abstract

Pesticide poisonings, intentional as well as accidental, are common, especially in undeveloped and developing countries. The goal of this study was to analyze the clinical presentation of patients hospitalized due to acute organophosphate (OPP) or carbamate pesticide (CP) poisoning as well as to analyze the factors that potentially influenced the severity and outcome of the poisonings. A retrospective cross-sectional study was performed. The age and gender of each patient were recorded, the type of ingested pesticide, whether the poisoning was intentional or accidental, number of days of hospitalization, the severity of the poisoning, and the outcome of the treatment (i.e., whether the patient survived or not). Clinical aspects of poisonings were analyzed, as well as the therapeutic measures performed. 60 patients were hospitalized due to acute OPP or CP poisoning, out of 51 (85.00%) were cases of intentional self-poisoning. The majority of patients were poisoned by OPPs (76.67%), in one-third the causative agent was malathion, followed in frequency by chlorpyrifos and diazinon. Dimethoate poisonings were manifested with the most severe clinical picture. A 70% or lower activity of reference values of acetylcholinesterase and butyrylcholinesterase was found in 50% and 58% of patients, respectively. The most common symptom was miosis (58.33%), followed by nausea and vomiting. Pralidoxime reactivated acetylcholinesterase inhibited by chlorpyrifos or diazinon, but not with malathion or dimethoate. Impairment of consciousness and respiratory failure, as well as the degree of acetylcholinesterase and butyrylcholinesterase inhibition, were prognostic signs of the severity of poisoning. The lethal outcome was more often found in older patients (t = 2.41, p = 0.019). The type of ingested pesticide significantly affects the severity and outcome of poisoning as well as the effectiveness of antidotes.

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Chung YL, Hou YC, Wang IK, Lu KC, Yen TH. Organophosphate pesticides and new-onset diabetes mellitus: From molecular mechanisms to a possible therapeutic perspective. World J Diabetes 2021;12:1818-1831. [PMID: 34888010 PMCID: PMC8613664 DOI: 10.4239/wjd.v12.i11.1818] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/27/2021] [Accepted: 09/22/2021] [Indexed: 02/06/2023] Open

Wang X, Hou JW, Liu WR, Bao J. Plant-microbial remediation of chlorpyrifos contaminated soil. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART. B, PESTICIDES, FOOD CONTAMINANTS, AND AGRICULTURAL WASTES 2021;56:925-931. [PMID: 34558375 DOI: 10.1080/03601234.2021.1977570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]

Yu JR, Hou YC, Fu JF, Wang IK, Chan MJ, Chen CY, Weng CH, Huang WH, Yang HY, Hsu CW, Yen TH. Outcomes of elderly patients with organophosphate intoxication. Sci Rep 2021;11:11615. [PMID: 34079035 PMCID: PMC8172550 DOI: 10.1038/s41598-021-91230-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 05/24/2021] [Indexed: 11/08/2022] Open

Affiliation(s)

Jia-Ruei Yu Department of Nephrology, Clinical Poison Center, Kidney Research Center, Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, 199 Tung Hwa North Road, Taipei, Taoyuan, 105, Taiwan
Yi-Chou Hou Division of Nephrology, Department of Internal Medicine, Cardinal Tien Hospital, and School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
Jen-Fen Fu Department of Medical Research, Chang Gung Memorial Hospital, Linkou, and Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
I-Kuan Wang Department of Nephrology, China Medical University Hospital, China Medical University, Taichung, Taiwan
Ming-Jen Chan Department of Nephrology, Clinical Poison Center, Kidney Research Center, Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, 199 Tung Hwa North Road, Taipei, Taoyuan, 105, Taiwan
Chao-Yu Chen Department of Nephrology, Clinical Poison Center, Kidney Research Center, Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, 199 Tung Hwa North Road, Taipei, Taoyuan, 105, Taiwan
Cheng-Hao Weng Department of Nephrology, Clinical Poison Center, Kidney Research Center, Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, 199 Tung Hwa North Road, Taipei, Taoyuan, 105, Taiwan
Wen-Hung Huang Department of Nephrology, Clinical Poison Center, Kidney Research Center, Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, 199 Tung Hwa North Road, Taipei, Taoyuan, 105, Taiwan
Huang-Yu Yang Department of Nephrology, Clinical Poison Center, Kidney Research Center, Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, 199 Tung Hwa North Road, Taipei, Taoyuan, 105, Taiwan
Ching-Wei Hsu Department of Nephrology, Clinical Poison Center, Kidney Research Center, Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, 199 Tung Hwa North Road, Taipei, Taoyuan, 105, Taiwan
Tzung-Hai Yen Department of Nephrology, Clinical Poison Center, Kidney Research Center, Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, 199 Tung Hwa North Road, Taipei, Taoyuan, 105, Taiwan.

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Clinical profile and outcome of acute organophosphate poisoning in children of Upper Egypt: a cross-sectional study. BMC Pediatr 2021;21:98. [PMID: 33637060 PMCID: PMC7908781 DOI: 10.1186/s12887-021-02563-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 02/19/2021] [Indexed: 12/03/2022] Open

Abstract

Background

Organophosphates are one of the most common agents of poisoning in developing countries including Egypt. Due to lack of data about characteristics of organophosphates poisoning in our localities, we aimed to evaluate its clinical pattern and factors affecting outcome.

Methods

It was a cross-sectional study conducted in South valley University hospital between January 2019 and December 2019. It included all children ≤16 years of age presented with organophosphates poisoning. Diagnosis was performed from the history taken from the patient’s relatives and presenting symptoms. Demographic data, mode and route of poisoning, time from exposure to presentation, clinical symptomatology, grading and routine investigations were evaluated in addition to treatment taken and outcome.

Results

During the study period, 108 children; mean age was 7.95 ± 4.11 years (range 1. 5-16 years) presented with organophosphorous poisoning. Sixty five (60%) cases were females and 43 (40%) were males. Unintentional acts (87%) were detected more than suicidal (13%) and inhalation route (63.8%) more than ingestion (36. 2%). Miosis was the most frequent clinical sign (100%) followed by respiratory distress (77.7%). Regarding time of presentation to emergency department, 43 (40%) cases were presented within 6 h while others presented more than 6 h post-exposure. Mechanical ventilation (MV) was needed for 14 (13%) cases and 6 (5.5%) cases died due to respiratory failure. Duration of hospital stay, mean time interval from toxic exposure to hospital presentation, leucocytosis, need for MV and cumulative dose of pralidoxime were significantly higher in non survivors than survivors while Pao2 (partial arterial oxygen) and GCS (Glasgow coma scale) were significantly lower.

Conclusion

This study concluded that time consumed till presentation to hospital, low GCS, need for MV, leucocytosis, decreased PaO2 and increased cumulative dose of pralidoxime were independent risk factors of mortality.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12887-021-02563-w.

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Tsagkaris A, Migliorelli D, Uttl L, Filippini D, Pulkrabova J, Hajslova J. A microfluidic paper-based analytical device (μPAD) with smartphone readout for chlorpyrifos-oxon screening in human serum. Talanta 2021;222:121535. [DOI: 10.1016/j.talanta.2020.121535] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/05/2020] [Accepted: 08/08/2020] [Indexed: 02/06/2023]

Huang WC, Yen TH, Lin L, Lin C, Juang YY, Wang BH, Lee SH. Clinical Characteristics of Pesticide Self-Harm as Associated with Suicide Attempt Repetition Status. Neuropsychiatr Dis Treat 2020;16:1717-1726. [PMID: 32764947 PMCID: PMC7371433 DOI: 10.2147/ndt.s258475] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/28/2020] [Indexed: 11/23/2022] Open

Abstract

PURPOSE

Previous suicide behavior predicts future suicide risk. Studies of suicide repetition are important for suicide prevention. This study examined the clinical characteristics and psychiatric comorbidities of pesticide self-harm as associated with suicide attempt repetition status.

PATIENTS AND METHODS

This retrospective, observational study included patients admitted to a medical center in northern Taiwan between 2000 and 2015 following suicide attempts by pesticide. Diagnoses were made by a consultation-liaison psychiatry team based on the DSM IV-TR criteria. Independent samples t-test was used to analyze the quantitative variables and Pearson's Chi-squared test with a Bonferroni adjustment for categorical variables. Univariate binary logistic regression analysis was conducted to determine the predictors for repeated suicide attempt and multivariate binary logistic regression analysis to identify significant associated factors.

RESULTS

Among 151 patients, organophosphate pesticides were the most used (80.8%). The average age was 52.9±17.2 years. Most patients were married males from rural areas, with depressive disorder most often diagnosed (40.4%). Nearly one-third of them were suicide repeaters (n=43, 28.5%); these patients were less likely to be married (53.5%, p=0.001), had previously used psychiatric services (72.1%, p<0.001) and chose complex suicide (46.5%, p=0.014) more often compared to nonrepeaters. No significant differences were found between repeaters and nonrepeaters regarding psychiatric comorbidities. Multivariate logistic regression analysis revealed that marital status (odds ratio: 2.916, 95% confidence interval: 1.234-6.891, p=0.015) and previous psychiatric services usage (odds ratio: 6.897, 95% confidence interval: 3.012-15.625, p<0.001) were significant risk factors associated with suicide repetition.

CONCLUSION

Pesticide suicide repeaters were characterized by less likely to be married and more likely to use psychiatric services before suicide attempts. These features help ensuring that the needs of people who have made a suicide attempt are addressed, and it reduces the likelihood of repetition.

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