[Dementia as the first manifestation of idiopathic hypoparathyroidism].
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Biomedical subjects
Publications and source records attributed to F Laynez Bretones.
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A case of family food poisoning by the organophosphate insecticide (OPI) parathion is revised. Poisoning was involuntary, affecting four brothers in one family that ate eggplant floured with parathion, which was mistaken for flour. As a result, 2 patients died suddenly and the other two had cardiorespiratory arrest, one dying from this while hospitalized, the other discharged without further consequences. The clinical diagnosis of poisoning was confirmed by the below-normal levels of plasmatic cholinesterase. Presence of parathion was detected in the gastric juices and blood of those poisoned as well as in the sample of the fried eggplant. We emphasize the need for public information campaigns on the storage and use of OPI in order to avoid this kind of accidents.
The most severe cases of arachnidism are those due to Latrodectus tredecimguttatus spider-bite. The Mediterranean area is the habitat of the L. tredecimguttatus species. In the last few years no series of patients with latrodectism has been reported in Spain. A retrospective study of the patients admitted for L. tredecimguttatus spider bite in the Torrecárdenas Hospital in Almeria, Spain from 1984 to 1994 was performed. Twelve patients were diagnosed with latrodectism. Eleven were bitten while carrying out agricultural tasks, 8 of which were performed in greenhouses. The mean time between the bite and the appearance of the general symptoms was 40 minutes (20-120 minutes), with the most common signs and symptoms being: pain and abdominal stiffness (10 cases), erythema (10 cases) or pain (8 cases) at the site of the bite, thoracic pain, pain in extremities and contractures and psychomotor alterations (6 cases). Laboratory findings were limited to leukocytosis (4 cases), increase in creatinphosphokinase count (4 cases) and proteinuria (3 cases). All the patients received analgesics, 6 were administered myorelaxants and calcium gluconate was given in 6 cases. The evolution was good without complications in all of the patients. Latrodectism is a rare phenomenon Spain. The diagnosis is difficult when there is absence of a clear history of spider bite and due to the lack of knowledge as to its semiology. Antivenom serum is not usually required.
A total of 506 cases of acute poisoning with organophosphorus insecticides attended at Hospital Torrecárdenas, Almería, from 1981 to 1992 were prospectively studied. In all cases a predetermined clinical and therapeutical protocol was followed. Eighty per cent of poisoning events were accidental in nature, most occurred in males, greenhouse workers, and the toxic agents was most commonly absorbed through the skin and airways. All patients presented initially with overt cholinergic symptoms. The presence of bronchorrhea, tremor-fasciculations, respiratory depression and a lower level of consciousness was associated with severe poisonings. Uncommon and exceptional complications included: 5 cases with complete atrio-ventricular block, 3 cases with pancreatitis, 17 cases with endogenous re-intoxications and 3 patients with central diabetes insipidus.
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