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Biomedical subjects

R Garnier

Publications and source records attributed to R Garnier.

At least 19 recordsLinked to original sources

[Acute accidental poisoning with hospital disinfectant. 45 cases of which 13 with fatal outcome].

Airsane HP 800 is a disinfectant widely used in hospitals as a powder to be diluted in water. It mainly contains a mixture of quaternary ammonium compounds. Forty five cases of acute accidental poisoning with this product have been reported to the Paris Poison Centre. All the victims were mentally disturbed patients: 2 were young adults hospitalized in psychiatric units and the other 43 were old people hospitalized for senile dementia. All ingested the solid preparation which was left in their room by hospital workers who did not know it was dangerous. Corrosive burns of the mouth, pharynx, oesophagus and sometimes of the respiratory tract were produced in most patients. Thirteen of them died. All were old persons. Ten had inhalation pneumonitis and died of acute respiratory distress one hour to twelve days after taking the powder. Progressive deterioration was responsible for the death of the other three between the 19th and 40th days. These severe accidental poisonings could easily be prevented by a better information of hospital workers, and by storing the disinfectant and preparing the solution beyond the reach of patients.

Adolescent

[Lead poisoning in children. Apropos of 129 cases].

One hundred and twenty nine children with chronic lead poisoning were followed from August 1985 to July 1989. Old lead paint was recognized as the contaminant source at home. Pica of paint flakes was the main mode of intoxication. Children were classified according to the Center for Disease Control 1985 as follows: class IV (39 cases), class III (45 cases), class II (30 cases), class I (15 cases). Nineteen of those in class IV had blood lead levels above 700 micrograms/l and received BAL + EDTA followed by EDTA alone for a mean of 4.6 +/- 3.5 courses. With this treatment, blood lead level decreases were 50 +/- 17%. Nine of these class IV children had an evaluation at last 3 months after the last chelation course: 5 became class I or II, and 2 class III with a negative provocative test. The remaining 20 children in class IV were given a mean of 2.7 +/- 1.4 courses of EDTA. Blood lead levels decreased by 52 +/- 15%; 11 children were evaluable at least 3 months after the last chelation course: 4 became class I, and 7 class II. Thus overall 80% of class IV moved under treatment to class I or II. Among those 45 children in class II, 30 underwent a provocative test and 24 one to three courses of EDTA: 8 were further studied: 3 became class I and 5 class II. Combination of screening, medical treatment and sociocultural approach led to avoid acute effects of severe chronic childhood lead poisoning. The efficacy of such an approach in preventing chronic effects has still to be evaluated.

Chelating Agents

Specific anti-digoxin Fab fragments: an available antidote for proscillaridin and scilliroside poisoning?

The purpose of this study was to evaluate the capacity of specific anti-digoxin Fab fragments to bind to and neutralize scilliroside and proscillaridin in acute poisoning. Apparent affinity constants were determined with values of 2.6 10(8)M-1 for scilliroside and 3.8 10(7)M-1 for proscillaridin. These results are in accordance with a possible in-vivo neutralization of these toxins.

Antibody Affinity

Sensory and cognitive event related potentials in workers chronically exposed to solvents.

To obtain objective measures of possible impairment due to organic solvents, auditory, visual and somatosensory evoked potentials and cognitive event related potentials were recorded in a group of 13 workers occupationally exposed to a mixture of various solvents. The patients were compared to healthy subjects and to chronic alcoholics seen during post-alcohol withdrawal. Auditory and visual evoked potentials were almost normal but somatosensory evoked potentials showed a slight decrease of peripheral conduction velocities and an increase of central conduction times more marked in the solvent exposed workers who were also alcoholics. The late "cognitive" components reflecting attention processes (N2 and P3) were normal. Solvent-exposed workers and alcoholics were both characterized by some difficulty in modulating their attentional resources according to task demands, as reflected by a tendency to responses (N1, N2 and P3) of similar amplitudes whether the stimulus was or was not the target. These findings support the presence, in solvent exposed workers, of minor dysfunction of the nervous system at both peripheral and cortical levels potentiated by alcohol as well as of mild cognitive impairments concerning attention processes.

Adult

[Acute poisoning by Gyromitra esculenta (author's transl)].

This kind of poisoning is scarce in France, on the contrary it is most frequent in Eastern Europe. Clinical picture associating cytolytic hepatitis, seizures, and hemolysis reminds us intoxication by hydrazine. In fact there is some evidence that the toxin of this mushroom--called gyromitrin--is transformed in the stomach in methylhydrazine. The mechanism of hepatotoxicity of the later can be compared with that of the metabolites of isoniazid.

Chemical Phenomena

Paraquat poisoning. An overview of the current status.

Paraquat is a bipyridyl compound with no known chronic toxicity or teratogenicity. It is poorly absorbed when inhaled, but causes severe illness when ingested orally, death usually occurring within 2 days of ingestion of 50 mg/kg. At lower doses death may be delayed for several weeks. The toxic compound accumulates in lung tissue where free radicals are formed, lipid peroxidation is induced and nicotinamide adenine dinucleotide phosphate (NADPH) is depleted. This produces diffuse alveolitis followed by extensive pulmonary fibrosis. The most important prognostic indicator is the quantity of paraquat absorbed, as shown by the plasma paraquat concentration. While renal failure will develop in the majority of those patients who eventually die, it may not, if present alone, indicate a fatal outcome. The absence of caustic burns in the upper digestive tract indicates a good prognosis. Treatment of paraquat poisoning remains ineffective, but Fuller's earth, activated charcoal and resins may prevent some absorption of the toxin. When tubular necrosis occurs, renal excretion of the compound decreases rapidly. A 3-compartment pharmacokinetic model has been described following ingestion of tracer doses including a 'deep' compartment for active pulmonary accumulation. Haemodialysis, haemoperfusion and forced dialysis have been attempted, with no clear improvement in survival rates. Superoxide dismutase, glutathione peroxidase, N-acetylcysteine and other 'free radical scavengers' have failed to alter the outcome in poisoned patients. Other theoretical treatments, such as deferoxamine, immunotherapy, NADPH repletion and lung transplantation still require clinical validation.

Charcoal