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Biomedical subjects

M L Efthymiou

Publications and source records attributed to M L Efthymiou.

At least 37 records · Page 2Linked to original sources

Poisoning with Veratrum-containing sneezing powders.

1 Nine cases of accidental poisoning of children with sneezing powder are reported. Symptoms, besides sneezing, included gastrointestinal disturbances and syncope, whilst examination demonstrated bradycardia and hypotension. 2 The powder, as supplied, carried no information on its constituents but Veratrum alkaloids were identified on analysis. The signs and symptoms observed were compatible with poisoning from these compounds. 3 As a result of these observations, it was possible to trace the manufacturers and a change was made to a safer formulation. This example emphasises the value of toxic vigilance by Poison Control Centres.

Adolescent↗

[Lung injury after use of respiratory revival materials sterilized with ethylene oxide].

One of the most used method of medical appliances sterilization uses ethylene oxide. At high concentration, this very reactive product, causes caustic burns of skin and mucous membranes. In one case of acute pulmonary oedema, levels of ethylene oxide in the endotracheal catheter were discovered. This led us to review the toxicological data on this substance. It should be emphasized that the sterilization and the desorption according to simple and precise rules should prevent such acute accidents.

Adult↗

[Acute poisoning by viloxazine chlorhydrate taken by itself].

One of the missions of the Poison Control Centres is to collect an important number of cases concerning a substance in order to determine its toxicological pattern for man. Such data were collected for Viloxazine chlorhydrate, an antidepressant belonging to a new chemical, ingested without association with other drugs, at doses varying from 100 mg to 4 g. The toxicological action of this drug was moderate, as no death occurred in the cases under study. The depression of the central nervous system was characterised only by a transitory loss of consciousness with recovery within a few hours. Two cases of convulsive seizure and one of extrapyramidal syndrome were the only complications in these intoxications. This confirms the difference between viloxazine and other antidepressants (tricyclics or IMAO inhibitors) whose toxic action on C.N.S. is more pronounced and sometimes complicated by cardiovascular disorders.

Adolescent↗

[Prognostic factors in acute paraquat poisoning. A retrospective study of cases registered by the Poison Control Center of Paris in 1981].

Twenty years after the publication of the first cases, the intoxication with the herbicide Paraquat still has a low prognosis because of no efficient treatment. But many studies have allowed the definition of prognostic factors. Nearly, BISMUTH and als(2) demonstrated that the following criteria are significant: the oral route, the gastric lesions, the organic renal failure, the plasma-Paraquat concentration. Through a series of cases collected in 1981 at the Poison Control Center of Paris, the following prognostic factors have been studied: route of administration, sex of patient, circumstances of the poisoning, ingested volume, concentration of the solution, existence of an emetic in the commercial solution, gastric content, lesions of the upper digestive tract (mouth, oesophagus, stomach), renal impairment, hepatic failure, blood gasometry, lung function tests, plasma and urine paraquat concentrations. Forty-one cases were collected during this period, with thirty-four concerning acute Paraquat poisonings in humans. We studied twenty-seven of them caused by acute oral poisoning, with accidental circumstances in nine cases (two died) and intentional circumstances in eighteen cases (all died) (other cases concerned two ocular projections, four inhalations and one skin projection). The interest of this new investigation is the particularity of our series. Because of our recruitment (larger geographic distribution of patients, larger diversity of circumstances, of routes of administration, of ingested quantities, of treatments...). This series of cases is quite different from others previously published. This study confirms the validity of prognostic factors defined by BISMUTH and als(2). The factors, which look significant, strictly depend on the ingested quantity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Acute paracetamol poisoning. A retrospective study of data from the Paris Antipoison Center. 1974-1981 (author's transl)].

Seventy-five cases of acute poisoning with effervescent tablets of paracetamol have been recorded. No patients developed hepatitis. Ingested doses were low, and resulted only in minor manifestations. As each package contains only 6.6 g of paracetamol and effervescent tablets cannot be ingested in large quantities, the risk of serious overdosage is low.

Acetaminophen↗

[Thiazolidine carboxylic acid toxicity. A review of 78 cases (author's transl)].

Among the calls for information recently received by the French Poison Control Centers, 78 concerned a liver protecting agent, thiazolidine carboxylic acid. In almost every case, doses well above the therapeutic range have provided a status epilepticus. Thus confirming the neurotoxicity of the drug which had been known to the Poison control Centers for the past 10 years. Several patients had also metabolic acidosis, severe hypoglycaemia, or, more scarcely, hyperglycaemia. Seizures convulsions occurred specially in young children whose immature blood-brain barrier allowed penetration into the CSF of thiazolidine carboxylic acid, later metabolized locally into the strongly irritant compound formaldehyde. In view of its toxicity, the drug should never be administered to young children. The usual measures to prevent intoxication should be applied and in case of overdosage the patients should be admitted to hospital for observation. Long-lasting anti-epileptic treatments should be avoided.

Adolescent↗

Acute thioproline poisoning.

Thiazolidine-4-carboxylic acid (A.T.C.) has been marketed in France since 1964 for the treatment of hepatic and biliary disorders. [Hepalidine (Riker Lab.): Packs of 20 tablets, each containing 100 mg. Thiobiline (Riker Lab.): Packs of 20 vials, each containing 100 mg.] As early as 1970, both the Paris and Marseilles Poison Control Centres had emphasized the toxicity of this drug which induces convulsions in children subject of overdosage [1]. Brugarolas and Gosalvez have recently suggested the use of A.T.C. in the treatment of epidermoid carcinoma. They believe that the drug causes reverse transformation of tumor cells to normal ones [2]. If its efficiency is confirmed, A.T.C. should soon be very widely used and therefore its therapeutic risk needs to be clarified.

Adolescent↗

Spanish adulterated oil matter. An important discovery by Spanish toxicologists: the toxicity of anilides of unsaturated fatty acids.

Collective intoxication resulting from the addition of aniline in adulterated vegetal oils which were re-treated in order to make them available for consumption, was clinically characterized by polyneuritis, atypical pneumonia, symptoms of vascularity. After studying the infection and allergic syndrome, the toxicological approach presented a set of experimental clinical arguments in favor of a specific toxicity of anilides of unsaturated fatty acids. The toxicokinetics of oleylaniline shows a half life of several weeks, which explains its evolution. Its mode of action involves peroxide formation, membrane toxic and attractive substances of immunocompetent cells. Peroxide formation could result from an excess of superoxide ions, an inhibition of superoxide-dismutases, an excessive consumption of NADPH or more often of any facilitation of lipid peroxidation by a biologically active peroxidized intermediate.

Anilides↗

[Subcutaneous injection of metallic mercury. Report of 4 cases].

4 cases of subcutaneous injection of metallic mercury are reported and compared with those recorded by others. Subcutaneous injection always causes local inflammatory reaction and granuloma formation. Systematic mercury absorption is the rule as it is proved by high mercury levels in blood and urine. Nevertheless this absorption is usually too small to be responsible for toxic manifestations. Surgical excision of all accessible contaminated subcutaneous areas should be performed. When residual mercury is roentgenographically detectable regular monitoring of CNS, renal function and urinary and/or blood mercury levels are necessary.

Accidents↗

Thioproline.

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Adult↗