PubMed Health⌕ Search

Biomedical subjects

M Mathieu-Nolf

Publications and source records attributed to M Mathieu-Nolf.

At least 19 recordsLinked to original sources
PubMed2006

[Accidental ingestion of methadone and buprenorphine by children. A case review of the Lille Poison Centre between 1995 and 2005].

We have performed a retrospective study (1995-2005) on 218 accidental intoxications in children less than 15 years old, linked to drugs used in the management of opiate withdrawal (cases registered at the Lille poison centre) This study shows a peak of frequency in children less than 3 years old, with a predominance of boys. Poisonings with buprenorphine are more frequent but ingestions of methadone are often more severe (p = 0.004).

Adolescent↗
PubMed2006

[Fatal poisoning caused by the ingestion of a concentrated solution of 2,4-D and MCPP].

We report a clinical case of lethal ingestion of an herbicide containing 100 g/L of 2,4-D and 400 g/L de MCPP. The patient shows quickly disturbances of consciousness and cardiac arythmy, a severe metabolic acidosis and an hyperkalemia. The digestive endoscopy at day 4 after ingestion shows an haemorrhagic mucous membrane at oesophagus and stomach level with numerous aulcerations. The bronchial endoscopy shows an inflammatory mucous membrane covered with haemorrhagic liquid. At day 6, appearance of a toxic medullar aplasia. The patient dies at day 7. the autopsy shows haemorrhagic digestive lesions, a bilateral pneumopathy, lungs oedema, an ascite but no cerebral oedema.

2,4-Dichlorophenoxyacetic Acid↗
PubMed2005

[What public health measures could reduce antenatal exposure to tobacco and improve the quality of perinatal care: the gynecologist-obstetrician's point of view].

The progression of addiction to smoking among young women is particularly alarming. The fatal effects of the nicotine-poisoning on the pregnancy and on the child constitute a serious public health issue. For young women, the period of maternity plays an essential educational role. Contact with medical care during pregnancy offers a special opportunity to establish a sound basis for health. Clinicians must strive to help women become fully aware of the fatal effects of smoking, providing methods and support for abstinence through a global, structured strategy of health care. The "Maternity without tobacco" network was developed to achieve these objectives. Expired CO analysis can be an interesting tool to search for active or passive addiction to smoking, and more generally carbon monoxide poisoning.

Female↗
PubMed2002

[Aldicarb poisoning: review of cases in the North of France between 1998 and 2001].

Among the 2,726 cases of human pesticide poisoning collected at the Poison Centre of Lille from January 1998 to May 2001, 39 cases were related to the ingestion of aldicarb. Analysis of the circumstances found a suicide attempts in 33 cases and an accidental ingestion in 6 cases. The sex-ratio was 31 men for 8 women, mean age was of 36.6 years (15 months--77 years). Thirty one poisoning were symptomatic with muscarinic signs (20 cases), digestive (15 cases), neurological (8 cases), nicotinic signs (6 cases). Treatment was based on digestive evacuation (14 cases), administration of activated charcoal (14 cases), atropine (7 cases), pralidoxime (1 case), preservative vital functions by intubation and ventilation (7 cases). Sedation was necessary in 4 cases. Hospitalization was necessary in 34 cases. The Poison Severity Score was estimated at 0 (any gravity) in 5 cases, 1 (weak) in 12 cases, 2 (moderate) in 7 cases, 3 (severe) in 8 cases and 4 (lethal) in 2 cases. In one of deaths, aldicarb was determined by HPLC-DAD in blood (6.04 micrograms/ml), urines (1.88 micrograms/ml) and gastric contents (3.98 micrograms/ml). These concentrations are the most important ever described in the literature. Aldicarb is the most toxic carbamate insecticide for human.

Administration, Oral↗
PubMed2002

[Fatal intoxication after accidental ingestion of viscous 2% lidocaine in a young child].

We report a case of fatal intoxication with 2% viscous lidocaine. A 18 month old infant was admitted after malaise and cardiorespiratory arrest at home. He was resuscitated, then seizures appeared before arrival at the hospital. Treatment was symptomatic, including cardiorespiratory resuscitation and administration of anticonvulsants. Identification of lidocaine and its metabolite monoethylglycinexylidide (MEGX) MEGX was performed after organic extraction by High Performance Liquid Chromatography (HPLC) with Diode Array Detection (DAD); the serum concentrations, determined by Fluorescence Polarisation Immuno Assay (FPIA), were: 1.1 micrograms/ml for lidocaine and 0.94 microgram/ml for MEGX (H + 7) and 0.30 microgram/ml for the lidocaine (Day + 1). Neurotoxic manifestations appear at lower concentrations than cardiotoxic symptoms which are correlated with plasma levels of lidocaine. The toxic symptoms begin with headache, hallucinations, seizure, coma, respiratory arrest and circulatory collapse. The toxic symptoms can persist even after the decrease of lidocaine concentration under therapeutic levels. There is no antidote and acute lidocaine toxicity is managed with supportive therapy (diazepam for seizures, intubation, chronotropic agents). Considering the gravity of these poisonings which remain rare, the 2% viscous lidocaine prescription is forbidden for children under 6 years old.

Administration, Oral↗
PubMed2001

Flumazenil use in an emergency department: a survey.

OBJECTIVE: To evaluate the efficacy of flumazenil use by a one-year survey of practice in tan emergency department. DESIGN: During a one-year period, an observational prospective study in the emergency department of an urban community hospital enrolled every patient admitted with a history of pure or mixed benzodiazepine acute poisoning. Case records were secondarily reviewed by an expert group. Actual flumazenil use during hospitalization was compared to currently recommended indications. In order to evaluate the efficacy of flumazenil use, patients who received flumazenil were matched with those who did not and effects on mortality, morbidity, number of costly procedures (CT scan, diagnostic toxicology, etc.) and duration of hospital stay were determined. RESULTS: Of the 1529 patients admitted in 1 year for acute poisoning, 478 reportedly ingested at least one benzodiazepine. Twenty-nine patients (6%) received flumazenil in the emergency department whereas the expert reviewers recommended flumazenil use in only 18 (3.7%). In 11/29 (38%) cases, the use of fumazenil was considered inappropriate. The expert group considered flumazenil to be contraindicated in 93 of 478 patients. Nonetheless, flumazenil was used in 11 patients (rate of potentially harmful flumazenil use: 11/93; 12%), and a severe complication occurred in one of these patients after flumazenil. No significant difference could be shown in outcome, complication rate, number of complex procedures or duration of hospital stay between patients who received flumazenil and matched patients who did not. CONCLUSION: The use of flumazenil in the clinical practice of an emergency department fails to show any beneficial effect in adult patients. Moreover, contraindications are frequently overlooked and this may expose patients to substantial risk of complications.

Adolescent↗
PubMed2000

Carbon monoxide poisoning--a public health perspective.

Carbon monoxide (CO) may be the cause of more than one-half of the fatal poisonings reported in many countries; fatal cases also are grossly under-reported or misdiagnosed by medical professionals. Therefore, the precise number of individuals who have suffered from CO intoxication is not known. The health effects associated with exposure to CO range from the more subtle cardiovascular and neurobehavioral effects at low concentrations to unconsciousness and death after acute or chronic exposure to higher concentrations of CO. The morbidity and mortality resulting from the latter exposures are described briefly to complete the picture of CO exposure in present-day society. The symptoms, signs, and prognosis of acute CO poisoning correlate poorly with the level of carboxyhemoglobin (COHb) measured at the time of hospital admission; however, because CO poisoning is a diagnosis frequently overlooked, the importance of measuring COHb in suspicious settings cannot be overstated. The early symptoms (headache, dizziness, weakness, nausea, confusion, disorientation, and visual disturbances) also have to be emphasized, especially if they recur with a regular periodicity or in the same environment. Complications occur frequently in CO poisoning. Immediate death is most likely cardiac in origin because myocardial tissues are most sensitive to the hypoxic effects of CO. Severe poisoning results in marked hypotension, lethal arrhythmias, and electrocardiographic changes. Pulmonary edema may occur. Neurological manifestation of acute CO poisoning includes disorientation, confusion, and coma. Perhaps the most insidious effect of CO poisoning is the development of delayed neuropsychiatric impairment within 2-28 days after poisoning and the slow resolution of neurobehavioral consequences. Carbon monoxide poisoning during pregnancy results in high risk for the mother by increasing the short-term complication rate and for the fetus by causing fetal death, developmental disorders, and chronic cerebral lesions. In conclusion, CO poisoning occurs frequently; has severe consequences, including immediate death; involves complications and late sequelae; and often is overlooked. Efforts in prevention and in public and medical education should be encouraged.

Carbon Monoxide Poisoning↗
PubMed2000

Accidental subcutaneous injection of elemental mercury. A case report.

Subcutaneous injection of elemental mercury is a very rare situation. The authors report the case of a 31-year-old man who accidentally injected an unknown quantity of metallic mercury into his left forearm. Several surgical procedures were required to reduce the blood and urinary levels of mercury. However, the patient never developed clinical signs of chronic poisoning. This observation confirms the lower risk of acute or chronic poisoning in subcutaneous injection of mercury and the need for early excision of contaminated tissue.

Accidents, Occupational↗
PubMed1998

Intermediate syndrome with delayed distal polyneuropathy from ethyl parathion poisoning.

An acute poisoning in a 44-y-old female who ingested 50 ml of ethyl parathion concentrate (25 g) is described. She was treated by gastric lavage, administration of pralidoxime and atropine, and mechanical ventilation. As signs of intoxication disappeared at day 3, treatment was discontinued. The patient had a relapse of acute cholinergic crisis at day 4, and the same treatment was applied again. The acute poisoning phase was followed by an intermediate syndrome and delayed distal polyneuropathy. The clinical course of this severe ethyl parathion poisoning was favorable after 40 d.

Acute Disease↗
PubMed1996

[Carbon monoxide poisoning].

Carbon monoxide (CO) poisoning still represents a frequent and severe casualty in France. Aside from the well-known effect of CO on hemoglobin, the role of CO binding to other hemoproteins like myoglobin and cytochrome a3 has been more recently recognized. Moreover, in addition to these hypoxic injuries, the reoxygenation phase may itself induce toxic effects by a mechanism close to the ischemia-reperfusion phenomenon. Clinical manifestations include neurologic disturbances, cardiac arrhythmia, respiratory and circulatory failures which usually disappear with removal from toxic atmosphere and administration of oxygen. However, long term neurologic manifestations may occur and lead to important functional impairment and disability. Hyperbaric oxygen is actually the treatment of choice to avoid the occurrence of delayed sequelae. HBO is advocated in every patient who remains comatose on hospital admission, who has lost consciousness during toxic exposure or with persisting neurologic abnormalities. CO poisoned pregnant women should also undergo HBO.

Carbon Monoxide Poisoning↗
PubMed1996

[Carbon monoxide poisoning: current aspects].

Carbon monoxide (CO) poisoning still represents a frequent and severe casualty in France. Aside the well-known effect of CO on hemoglobin, the role of CO binding to other hemoproteins like myoglobin and cytochrome a3 have been more recently recognized. Moreover, in addition to these hypoxic injuries, the reoxygenation phase may itself induce toxic effects by a mechanism close to the ischemia-reperfusion phenomenon. Clinical manifestations include neurologic disturbances, cardiac arrythmia, respiratory and circulatory failures which usually disappear with removal from toxic atmosphere and administration of oxygen. However, long term neurologic manifestations may occur and lead to important functional impairment and disability. Hyperbaric oxygen in actually the treatment of choice to avoid the occurrence of delayed sequelae. HBO is advocated in every patient who remains comatose on hospital admission, who had lost consciousness during toxic exposure or with persisting neurologic abnormalities. CO poisoned pregnant women should also undergo HBO. Well designed prevention programs are urgently needed in our country to decrease the incidence and the consequences of CO poisoning.

Carbon Monoxide Poisoning↗
PubMed1992

Massive arsenic poisoning--effect of hemodialysis and dimercaprol on arsenic kinetics.

In massive arsenic poisoning, the use of hemodialysis and dimercaprol (BAL) therapy is still controversial. Hemodialysis is thought of value only for supportive care. BAL therapy has been criticized because of its delayed action, its own toxicity and its possible influence on arsenic clearance during hemodialysis. We studied arsenic kinetics during an acute suicidal intoxication (10 g of sodium arsenate). Treatment included gastric lavage, oral charcoal and supportive measures. Hemodialysis was performed immediately and repeated the next day. BAL therapy was prescribed only on the second day. Cardiovascular collapse, anuria and hepatic disturbance recovered in a few days and the patient could be discharged on the 15th day. Instantaneous serum arsenic hemodialysis clearance was 85 +/- 75 ml/min without previous BAL injection and 87.5 +/- 75 ml/min with a previous 250 mg BAL injection (difference not significant) indicating that BAL did not impede arsenic dialysis. The calculated total hemodialysis clearance of arsenic was higher than mean serum hemodialysis clearance indicating that erythrocyte bound arsenic is also eliminated during dialysis. We propose to consider early hemodialysis as an elimination measure in massive arsenic poisoning and to choose BAL as a chelator when dialysis is required.

Adult↗
PubMed1992

Evaluation of a computerized program (ARSENIC) as an aid for telephone consultations in a poison center.

ARSENIC is a computerized system providing assistance for telephone consultation in poison centers. Its main characteristic is to blend the document consultation process with the case-recording procedure. It has been used in the daily routine of our poison center since 1987. To evaluate this system, 2 weeks were randomly chosen. During one, ARSENIC was used by the telephone responders; during the other week, traditional paper documents and files were used. Document search times, coding times and quality of responders were recorded by a blinded observer and analysed in total and on the basis of the training of the telephone officer (medical student, resident or toxicologist). ARSENIC decreased the document search times (3.1 +/- 2.7 min vs 3.8 +/- 2.9 min; p less than 0.05) and did not increase coding time (2.1 +/- 1.2 min vs 2.2 +/- 1.4 min; NS). For each group of telephone responders, answer quality increased with ARSENIC. More important, the answer quality of less-trained officers using ARSENIC was similar to that of trained toxicologists without ARSENIC. The quality assurance given by ARSENIC was, for us, the most important argument for computer use at telephone desks.

Hotlines↗
PubMed1990

Answering calls from the general public: a necessity for poison centers?

There is great diversity among Poison Centers (PC) concerning the origin of their calls. If some PC answer only calls from hospitals or general practitioners, other like the Lille PC also answer calls from the public. To evaluate the value of this for the general public, we reviewed all the cases of poisoned children hospitalized at the Lille University Hospital during a 3-month period. All had not previously called the PC for advice. In the 80 relevant cases, the advice of the PC physicians would have been no treatment in 20 cases (25%), a call to a general practitioner in 13 cases (16%), and hospitalization in 47 cases (59%). A great homogeneity existed among the PC physicians' answers, with only 2 discrepancies in the no-hospitalization group. Analysis of data showed that there were significantly more symptomatic intoxications in the hospitalization group than in the no-hospitalization group. No patient who would have been advised not to be hospitalized presented any life threatening or severe symptoms during their hospital stay. We conclude that answering the calls from the general public is feasible and that the advice of a trained PC physician is practical and appropriate. We calculate that in answering calls from the general public the Lille PC saved 4,760,295 FF (US $761,650) in 1987.

Humans↗