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Nogué S, Echarte J, Puiguriguer J, Miró Ò. Acerca de la epidemiología de las intoxicaciones. Rev Clin Esp 2009; 209:525. [DOI: 10.1016/s0014-2565(09)72645-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Mas A, Nogué S. N-acetilcisteína en el tratamiento de la intoxicación por Amanita phalloides. Med Clin (Barc) 2009; 133:486; author reply 487. [DOI: 10.1016/j.medcli.2009.01.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2008] [Accepted: 01/13/2009] [Indexed: 10/20/2022]
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Castanyer B, Barceló B, Puiguriguer J, Nogué S. Uso de paracetamol en pacientes con hepatopatía. Med Clin (Barc) 2009; 133:567. [DOI: 10.1016/j.medcli.2009.01.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2008] [Accepted: 01/13/2009] [Indexed: 10/20/2022]
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Miró Ò, Montori E, Ramos X, Galicia M, Nogué S. Trends in research activity in toxicology and by toxicologists in seven European countries. Toxicol Lett 2009; 189:1-4. [DOI: 10.1016/j.toxlet.2009.04.029] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2009] [Accepted: 04/29/2009] [Indexed: 11/25/2022]
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Miró Ò, Galicia M, Nogué S. Cocaína: una causa de patología que no cesa. Rev Clin Esp 2009; 209:104-5. [DOI: 10.1016/s0014-2565(09)70639-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Sanz P, Nogué S, Vilchez D, Salvadó E, Casal A, Logroscino G. Myoclonic encephalopathy after exposure to trichloroethylene. INDUSTRIAL HEALTH 2008; 46:635-7. [PMID: 19088417 DOI: 10.2486/indhealth.46.635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Trichloroethylene is a widely-used industrial solvent that is absorbed through the digestive or respiratory tracts or cutaneously. It has a selective tropism for the cardiovascular and central nervous systems and may cause death due to cardiac arrest or neurological sequelae. We present the case of a 25-yr-old women who was exposed to trichloroethylene in the workplace for 18 months and who developed a disabling myoclonic encephalopathy. Non-toxicological causes were excluded. Although the exposure ceased, the disease progressed with thalamic and cerebellar involvement. The patient, who had only a partial response to symptomatic treatment, suffered severe limitations in the activities of daily living and was registered as permanently disabled due to a work-related disability.
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Galicia M, Nogué S, To-Figueras J, Echarte JL, Iglesias ML, Miró O. [Poisoning by liquid ecstasy (GHB) in hospital emergency departments of Barcelona: a 2-years study]. Med Clin (Barc) 2008; 130:254-8. [PMID: 18355425 DOI: 10.1157/13116549] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND OBJECTIVE Liquid ecstasy (GHB) is a new cause of drug overdose in our country. To describe the epidemiological profile and clinical manifestations, we analyzed cases of poisoning by GHB attended by the Emergency Departments (ED) of 2 hospitals of the city of Barcelona. PATIENTS AND METHOD During two years (2003-2004) all cases of poisoning or overdose due to GHB attended in the ED of the Hospital del Mar and the Hospital Clinic of Barcelona were collected. The diagnosis was clinical and/or by means of toxicological analysis. Epidemiological, clinical, laboratory and therapeutic variables as well as the evolution were collected. RESULTS A total of 339 patients (mean age 23.5 years, 62% male) were identified. Most patients (89%) were admitted during the early morning and during weekends (89%). Symptoms began in a public place in 97%. Reduced consciousness was the most important clinical manifestation, since 72% of patients had a Glasgow Coma Score of 12 or less. Seventy per cent stated having consumed GHB with other drugs, mainly ethyl alcohol (53%) and cocaine (16%). Some form of treatment was required in 32% of cases and 20 cases were administered an antidote: naloxone (12 cases), flumazenil (8 cases) and physostigmine (6 cases). Five patients needed orotracheal intubation and ventilatory support. One patient needed advanced vital support. There were no deaths. CONCLUSIONS GHB intoxication leading to reduced consciousness is a frequent motive for admission to the ED, mostly in young people and in the early morning during the weekend. GHB intoxication should be discarded in all cases of coma of unknown origin.
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Lluís M, Nogué S, Miró O. Severe acute poisoning due to a glufosinate containing preparation without mitochondrial involvement. Hum Exp Toxicol 2008; 27:519-24. [DOI: 10.1177/0960327108092291] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Glufosinate is a non-selective herbicide widely used in domestic gardens and agriculture. Few cases of glufosinate poisoning have been reported although there has been an increase in recent years, particularly in Japan. Glufosinate toxicity is related to its capacity to inhibit glutamine synthetase and glutamate decarboxylase, which may lead to a potentially fatal multiorgan failure. We report the case of a 41-year-old woman who ingested between 30 and 50 mL of a herbicide (Finale®) containing glufosinate (14%) in a suicide attempt. One hour after ingestion, the patient attended the Emergency Department of her own volition. Her overall status was good, and the physical examination was unremarkable. Gastric lavage was carried out, 25 g of activated charcoal was administered, and the patient was admitted for observation. Seventeen hours later, the patient presented drowsiness and a sinus bradycardia of 40 bpm. Thirty-two hours after ingestion, the Glasgow Coma Score was 8, and orotracheal intubation and mechanical ventilation were begun. At 3 days, the patient presented a self-limiting episode of ventricular tachycardia. She recovered consciousness progressively and was extubated without complications. The evolution was favorable, but the sinus bradycardia persisted up to 8 days after the ingestion. A study of lymphocyte mitochondrial function showed no alteration in mitochondrial oxidative capacity or the enzymatic activity of the complexes of the electron transport chain. A small ingestion of glufosinate can cause severe poisoning, whose manifestations predominantly involve the central nervous system and heart rhythm. Signs and symptoms may not appear for several hours and may persist for several days. In spite of these multi-organ manifestations, no alteration in lymphocyte mitochondrial function has been reported.
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Nogué S, Fernández-Solá J, Rovira E, Montori E, Fernández-Huerta JM, Munné P. Sensibilidad química múltiple: análisis de 52 casos. Med Clin (Barc) 2007; 129:96-8; quiz 99. [PMID: 17594860 DOI: 10.1157/13107370] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND OBJECTIVE Multiple chemical sensitivity (MCS) is characterized by a loss of tolerance to various environmental chemicals. The objective of this study was to describe patients with MCS seen in our hospital. PATIENTS AND METHOD Patients consecutively seen by the Toxicology and Chronic Fatigue Units who presented symptoms of MCS were included. The diagnosis was clinical. All patients completed the Quick Environmental Exposure and Sensitivity Inventory (QEESI) questionnaire. RESULTS Fifty-two patients were included. The average age (standard deviation) was 47.2 (7.6) years, and 46 (88%) were females. The origin of the syndrome was related to occupational exposure to various chemical agents in 31 cases (59.6%), including occupational accidents in 14 patients (fumigation of the workplace with insecticides). In 20 patients (38.5%), the syndrome could not be associated with any toxic exposure and was considered a manifestation of chronic fatigue syndrome. The QEESI showed mean scores of 72.9 (18.6) on the chemical inhalant intolerance scale, 45.5 (20.6) on the other intolerances scale, 69.8 (20.6) on the symptom severity scale, 4.4 (1.8) on the masking index and 66.6 (21.7) on the life impact scale. All patients were followed up for a minimum of 12 months, and during this period they remained stable with no deaths. CONCLUSIONS MCS normally affects middle-aged women. It is frequently triggered by exposure to chemical agents, especially insecticides. An association with chronic fatigue syndrome is common. The prognosis is good but the patients' quality of life is seriously affected.
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Sanz P, Nogué S, Vilchez D, Vilchez J, Casal A, Logroscino G. Progressive supranuclear palsy-like parkinsonism resulting from occupational exposure to lead sulphate batteries. J Int Med Res 2007; 35:159-63. [PMID: 17408069 DOI: 10.1177/147323000703500119] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A 53-year-old man who had worked for 17 years manufacturing car batteries, with overt exposure to lead, developed a clinical picture initially characterized by signs of parkinsonism, followed by atypical signs such as loss of memory, reduction of eye movement, dysarthria, chorea-like dyskinesia and sexual impotence. The diagnosis of atypical parkinsonism was eventually changed to progressive supranuclear palsy-like parkinsonism. The patient was treated with various anti-Parkinson's disease drugs, including levodopa, with modest improvement. The symptoms deteriorated progressively, leading to permanent occupational disability with noticeable limitation of daily activities. Toxicological studies revealed abnormally high blood levels of lead. Discontinuation of lead exposure was followed first by clinical stabilization and then steady improvement. This case confirms recent reports that link exposure to lead and its compounds with degenerative diseases of the central nervous system, such as Parkinson's disease.
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Paris F, Sanz-Gallén P, Nogué S, Melloni P. Imagen de la semana. Med Clin (Barc) 2007; 128:280. [PMID: 17335749 DOI: 10.1016/s0025-7753(07)72565-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Miró O, Nogué S. Acerca del cálculo de los riesgos del tabaquismo pasivo. Med Clin (Barc) 2006; 127:76; author reply 76. [PMID: 16801008 DOI: 10.1157/13089998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Sanjurjo E, Montori E, Nogué S, Sánchez M, Munné P. Urgencias por cocaína: un problema emergente. Med Clin (Barc) 2006; 126:616-9. [PMID: 16826639 DOI: 10.1157/13087719] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND OBJECTIVE The consumption of cocaine has increased in Spain in recent years, leading to a probable increase in overdoses. The associated use of other drugs of abuse may be increasing the toxicity of cocaine, and therefore, increasing consultations to the emergency department (ED). PATIENTS AND METHOD We collected patients seen by the ED of our hospital who reported cocaine consumption in the previous hours. The relationship between cocaine consumption and the reason for attending the ED was analysed. We reviewed the medical records of a sample of overdoses to determine the clinical profile. RESULTS During the period 2002-2004, 745 patients were detected (average age 31 years, 68% males). The annual distribution was 223 cases in 2002, 232 in 2003, and 290 in 2004. Fifty-three percent of patients attended the ED at the weekend and 53% from 0:00 to 12:00 h. The main drugs associated with cocaine consumption were ethyl alcohol (38%), opiates (14%), cannabis (13%) and amphetamine derivatives (9%). Cocaine was the substance causing clinical symptoms in 70% of cases. The main reasons for attending the ED were anxiety or agitation (48%) and thoracic pain or palpitations (25%). Eleven percent of cases required hospital admission (19 intensive care unit) and 3 patients died. CONCLUSIONS The consumption of cocaine, almost always associated with other drugs of abuse, has generated an increase in patients attending the ED. Although mortality is low, cocaine consumption generates substantial morbidity and frequent hospital admissions.
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Sarmiento J, García-Díez AI, Nogué S. Mujer de 67 años con dolor, parestesias y debilidad progresiva en las extremidades. Med Clin (Barc) 2005; 125:346-52. [PMID: 16185636 DOI: 10.1157/13078795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Gratacós L, Soy D, Lluís M, López B, Nicolás JM, Codina C, Nogué S, Ribas J. Apparent anaphylaxis associated with pantoprazole. Am J Health Syst Pharm 2005; 62:1388-9. [PMID: 15972383 DOI: 10.2146/ajhp040375] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Mondón S, Navarro V, Trullás JC, Nogué S. Inhalación de laca para el pelo: ¿una adicción peligrosa? Med Clin (Barc) 2005; 124:637. [PMID: 15871787 DOI: 10.1157/13074399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Nogué S, Monsalve C. [Designer drugs and anesthesia]. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2005; 52:191-2. [PMID: 15901023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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Abstract
The use of gamma hydroxybutyrate (GHB) as a recreational drug has quickly spread among European young people during the past decade. Although it has been claimed that GHB can be potentially used to facilitate sexual assault, no case reports have been previously described. A case is described in which GHB was used with that criminal purpose and a review of previous literature is undertaken.
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Nogué S, Sanjurjo E, Espigol G, Miró O. [Club drugs: new challenges for the emergency departments]. Med Clin (Barc) 2005; 124:239; author reply 239. [PMID: 15737313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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Nogué S, Sanjurjo E, Espigol G, Miró O. Club drugs: nuevos retos para los que trabajan en urgencias. Med Clin (Barc) 2005. [DOI: 10.1157/13071772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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74
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Nogué S, Sanz-Gallén P, María Gili J, Pagés F. Cartas al editor. Med Clin (Barc) 2005. [DOI: 10.1157/13071770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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75
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Nogué S, Sanz-Gallén P, María Gili J, Pagés F. Picadura por coral de fuego: un riesgo asociado al turismo en aguas tropicales. Med Clin (Barc) 2004. [DOI: 10.1157/13065209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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