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Langston J, Stump S, Filigenzi M, Tkachenko A, Guag J, Poppenga R, Rumbeiha WK. Extensive evaluation of a new LC-MS-MS method to quantify monofluoroacetate toxin in the kidney. J Anal Toxicol 2024; 48:210-216. [PMID: 38581653 DOI: 10.1093/jat/bkae032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/21/2024] [Accepted: 04/02/2024] [Indexed: 04/08/2024] Open
Abstract
Monofluoroacetate is a highly lethal toxin that causes death by inhibiting cellular adenosine triphosphate (ATP) production. The heart and brain are the primary target organs. Acute death is attributed to cardiac fibrillation and/or convulsions. Although it occurs naturally in some plants, a major source of animal intoxication is access to sodium monofluoroacetate (NaMFA) pesticide, which continues to be a concern in the USA and around the world despite restricted use in some countries including the USA. There are also concerns about misuse of this pesticide for malicious poisoning. Currently, a tissue-based diagnostic method for NaMFA intoxication in animals is lacking. There is a critical need by the veterinary diagnostic community for a simple, sensitive and reliable tissue-based diagnostic test to confirm NaMFA poisoning in animals. We have developed and extensively evaluated a sensitive novel liquid chromatography combined with tandem mass spectrometry method suitable for this purpose. The limits of detection and limits of quantitation are 1.7 and 5.0 ng/g, respectively. The accuracy and precision met or exceeded expectations. The method performance was verified using the incurred kidney obtained from animal diagnostic cases. This novel kidney-based method is now available for clinical use and can help with diagnostic purposes, including detecting potential issues related to animal foods.
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Affiliation(s)
- James Langston
- California Animal Health and Food Safety Laboratory, University of California Davis, Davis, CA, United States
- Department of Molecular Biosciences, University of California Davis, 1089 Veterinary Medicine Dr., 1210 VM3B, Davis, CA, United States
| | - Samuel Stump
- California Animal Health and Food Safety Laboratory, University of California Davis, Davis, CA, United States
| | - Michael Filigenzi
- California Animal Health and Food Safety Laboratory, University of California Davis, Davis, CA, United States
| | - Andriy Tkachenko
- Center for Veterinary Medicine, US Food and Drug Administration, 8401 Muirkirk Rd, Laurel MD 20708 Laurel, MD, United States
| | - Jake Guag
- Center for Veterinary Medicine, US Food and Drug Administration, 8401 Muirkirk Rd, Laurel MD 20708 Laurel, MD, United States
| | - Robert Poppenga
- California Animal Health and Food Safety Laboratory, University of California Davis, Davis, CA, United States
| | - Wilson K Rumbeiha
- Department of Molecular Biosciences, University of California Davis, 1089 Veterinary Medicine Dr., 1210 VM3B, Davis, CA, United States
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Prihed H, Shifrovitch A, Shamai Yamin T, Madmon M, Belay C, Blanca M, Weissberg A. Rapid and simple identification of trace amounts of sodium azide in beverages and bodily fluids followed by derivatization and liquid chromatography-electrospray ionization tandem mass spectrometry. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2023; 37:e9624. [PMID: 37799031 DOI: 10.1002/rcm.9624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 10/07/2023]
Abstract
RATIONALE Sodium azide (NaN3 ) is a toxic chemical agent to humans by ingestion and inhalation with a growing number of intentional exposures and accidental cases over the last few decades. Due to its low molecular weight and lack of any chromophore, its retention and detection by reverse-phase liquid chromatography-ultraviolet-mass spectrometry methods are a challenging task. METHODS To be able to confirm azide exposure, we have developed a method to identify azide in both beverages and bodily fluids. The identification of azide (N3 - ) is based on derivatization with N-(2-(bromomethyl)benzyl)-N,N-diethylethanaminium bromide (CAX-B) at 25°C for 15 min followed by LC/ESI-MS/MS analysis, with no other sample preparation. RESULTS The azide after derivatization (CAX-N3 ) was stable, retainable by LC and sensitively detected by selected reaction monitoring. The ESI-MS/MS fragmentation of the M+ precursor ion produced characteristic product ions at m/z 118, 100, 91 and 86. The calibration curves for CAX-N3 showed linearity over two orders of magnitude with R2 value of 0.99. Low limits of identification of 0.1-0.5 ng/mL were obtained in all investigated matrices (drinking water, tea, orange juice, plasma and urine). CONCLUSIONS Compared with previously reported chromatography-based methods, this method that was based on derivatization and LC/ESI-MS/MS analysis was substantially more sensitive, simpler and faster. The method can be used for forensic investigation to confirm azide exposure from fatal use to much smaller intoxication dose.
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Affiliation(s)
- Hagit Prihed
- Department of Analytical Chemistry, Israel Institute for Biological Research (IIBR), Ness Ziona, Israel
| | - Avital Shifrovitch
- Department of Analytical Chemistry, Israel Institute for Biological Research (IIBR), Ness Ziona, Israel
| | - Tamar Shamai Yamin
- Department of Analytical Chemistry, Israel Institute for Biological Research (IIBR), Ness Ziona, Israel
| | - Moran Madmon
- Department of Analytical Chemistry, Israel Institute for Biological Research (IIBR), Ness Ziona, Israel
| | - Chen Belay
- Department of Analytical Chemistry, Israel Institute for Biological Research (IIBR), Ness Ziona, Israel
| | - Merav Blanca
- Department of Analytical Chemistry, Israel Institute for Biological Research (IIBR), Ness Ziona, Israel
| | - Avi Weissberg
- Department of Analytical Chemistry, Israel Institute for Biological Research (IIBR), Ness Ziona, Israel
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van der Heijden LT, van den Hondel KE, Olyslager EJH, de Jong LAA, Reijnders UJL, Franssen EJF. Internet-Purchased Sodium Azide Used in a Fatal Suicide Attempt: A Case Report and Review of the Literature. TOXICS 2023; 11:608. [PMID: 37505573 PMCID: PMC10385699 DOI: 10.3390/toxics11070608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 07/29/2023]
Abstract
There has been a significant increase in sodium azide intoxications since the 1980s. Intoxications caused by sodium azide are becoming increasingly prevalent in the Netherlands as a result of its promotion for the purpose of self-euthanasia. The mechanism of toxicity is not completely understood but is dose-dependent. The presented case describes a suicide by sodium azide of a young woman (26 years old) with a history of depression and suicide attempts. The decedent was found in the presence of prescription medicine, including temazepam, domperidone in combination with omeprazole, and the chemical preservative sodium azide. Quantitative toxicology screening of whole blood revealed the presence of 70 µg/L temazepam (toxic range > 1000 µg/L) and 28 mg/L sodium azide (fatal range: 2.6-262 mg/L). Whole blood qualitative analysis revealed the presence of temazepam, temazepam-glucuronide, olanzapine, n-desmethylolanzapine, and acetaminophen. In circles promoting sodium azide, it is recommended to use sodium azide in combination with medications targeting sodium azide's negative effects, such as analgesics, antiemetics, and anti-anxiety drugs. The medicines recovered at the body's location, as well as the results of the toxicology screens, were consistent with the recommendations of self-euthanasia using sodium azide.
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Affiliation(s)
- Lisa T van der Heijden
- Department of Pharmacy & Pharmacology, Antoni van Leeuwenhoek/The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
- Division of Pharmacology, Antoni van Leeuwenhoek/The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
| | | | - Erik J H Olyslager
- Department of Clinical Pharmacy, Expert Center Gelre-iLab, Gelre Hospitals, 1066 CX Apeldoorn/Zutphen, The Netherlands
| | - Lutea A A de Jong
- Department of Clinical Pharmacy, Expert Center Gelre-iLab, Gelre Hospitals, 1066 CX Apeldoorn/Zutphen, The Netherlands
| | - Udo J L Reijnders
- Department of Forensic Medicine, GGD Amsterdam, 1066 CX Amsterdam, The Netherlands
| | - Eric J F Franssen
- Department of Clinical Pharmacy, OLVG Hospital, 1066 CX Amsterdam, The Netherlands
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Tat J, Chang SC, Link CD, Razo-Lopez S, Ingerto MJ, Katebian B, Chan A, Kalyanaraman H, Pilz RB, Boss GR. The vitamin B 12 analog cobinamide ameliorates azide toxicity in cells, Drosophila melanogaster, and mice. Clin Toxicol (Phila) 2023; 61:212-222. [PMID: 37010385 PMCID: PMC10348668 DOI: 10.1080/15563650.2023.2185125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 04/04/2023]
Abstract
CONTEXT The azide anion (N3-) is highly toxic. It exists most commonly as sodium azide, which is used widely and is readily available, raising the potential for occupational incidents and use as a weapon of mass destruction. Azide-poisoned patients present with vomiting, seizures, hypotension, metabolic acidosis, and coma; death can occur. No specific azide antidote exists, with treatment being solely supportive. Azide inhibits mitochondrial cytochrome c oxidase and is likely oxidized to nitric oxide in vivo. Cytochrome c oxidase inhibition depletes intracellular adenosine triphosphate and increases oxidative stress, while increased nitric oxide causes hypotension and exacerbates oxidative damage. Here, we tested whether the cobalamin (vitamin B12) analog cobinamide, a strong and versatile antioxidant that also neutralizes nitric oxide, can reverse azide toxicity in mammalian cells, Drosophila melanogaster, and mice. RESULTS We found cobinamide bound azide with a moderate affinity (Ka 2.87 × 105 M-1). Yet, cobinamide improved growth, increased intracellular adenosine triphosphate, and reduced apoptosis and malondialdehyde, a marker of oxidative stress, in azide-exposed cells. Cobinamide rescued Drosophila melanogaster and mice from lethal exposure to azide and was more effective than hydroxocobalamin. Azide likely generated nitric oxide in the mice, as evidenced by increased serum nitrite and nitrate, and reduced blood pressure and peripheral body temperature in the animals; the reduced temperature was likely due to reflex vasoconstriction in response to the hypotension. Cobinamide improved recovery of both blood pressure and body temperature. CONCLUSION We conclude cobinamide likely acted by neutralizing both oxidative stress and nitric oxide, and that it should be given further consideration as an azide antidote.
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Affiliation(s)
- John Tat
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
| | - Stephen C. Chang
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
| | - Cole D. Link
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
| | - Suelen Razo-Lopez
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
| | - Michael J. Ingerto
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
| | - Behdod Katebian
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
| | - Adriano Chan
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
| | - Hema Kalyanaraman
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
| | - Renate B. Pilz
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
| | - Gerry R. Boss
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
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Methods in food defence: a simple and robust screening for 16 rodenticides by LC-DAD/FLD following QuEChERS-based extraction. Anal Bioanal Chem 2022; 414:5829-5836. [PMID: 35715587 PMCID: PMC9293804 DOI: 10.1007/s00216-022-04145-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/29/2022] [Accepted: 05/19/2022] [Indexed: 11/01/2022]
Abstract
Fortunately, the intentional contamination of food or water supplies out of criminal or terroristic motivation is a rather rare event. However, in the face of asymmetric warfare and as the consequences of such an event would be severe, food defence as a necessary supplement to food safety is gaining increased attention. While some progress has been made in developing non-target detection devices, the contamination of food or water supplies using readily available rodenticides may still be revealed only by complex analytical techniques. The presented study therefore aimed to develop a quick and easy screening method for the detection of sixteen globally common rodenticides in foodstuffs. Robust operation with limited personnel and analytical resources were one benchmark to be met by the method, which uses a slightly modified QuEChERS (quick, easy, cheap, effective, rugged, safe) protocol for dispersive solid-phase extraction and subsequent ion-pair chromatography with diode-array and fluorescence detection. Quantification limits were as low as 5 µg/kg with satisfying bias (recovery) and repeatability rates of 77 to 117% and 1.8 to 17.1%, respectively. The developed method provides reliable and robust detection of these deadly poisons at toxic concentrations, which was demonstrated impressively in an improvised assault scenario.
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Tat J, Heskett K, Satomi S, Pilz RB, Golomb BA, Boss GR. Sodium azide poisoning: a narrative review. Clin Toxicol (Phila) 2021; 59:683-697. [PMID: 34128439 PMCID: PMC8349855 DOI: 10.1080/15563650.2021.1906888] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/15/2021] [Accepted: 03/17/2021] [Indexed: 12/30/2022]
Abstract
CONTEXT Sodium azide is a highly toxic chemical. Its production has increased dramatically over the last 30 years due to its widespread use in vehicular airbags, and it is available for purchase online. Thus, accidental exposure to azide or use as a homicidal or suicidal agent could be on the rise, and secondary exposure to medical personnel can occur. No antidote exists for azide poisoning. We conducted a systematic review of azide poisoning to assess recent poisoning reports, exposure scenarios, clinical presentations, and treatment strategies. METHODS We searched both medical and newspaper databases to review the literature between 01/01/2000 and 12/31/2020, pairing the controlled vocabulary and keyword terms "sodium azide" or "hydrazoic acid" with terms relating to exposures and outcomes, such as "ingestion," "inhalation," "exposure," "poisoning," and "death." We included all peer-reviewed papers and news articles describing human azide poisoning cases from English and non-English publications that could be identified using English keywords. Data abstracted included the number, age, and gender of cases, mode of exposure, exposure setting, azide dose and route of exposure, symptoms, outcome, and treatment modalities. RESULTS We identified 663 peer-reviewed papers and 303 newspaper articles. After removing duplicated and non-qualifying sources, 54 publications were reviewed describing 156 cases, yielding an average of 7.8 reported azide poisoning cases per year. This rate is three times higher than in a previous review covering the period of 1927 to 1999. Poisoning occurred most commonly in laboratory workers, during secondary exposure of medical personnel, or from a ripped airbag. Hypotension occurred commonly, in some cases requiring vasopressors and one patient received an intra-aortic ballon pump. Gastric lavage and/or activated charcoal were used for oral azide ingestion, and sodium nitrite, sodium thiosulfate, and/or hydroxocobalamin were used in severely poisoned patients. CONCLUSIONS Recent increases in azide poisoning reports may stem from greater commercial use and availability. Treatment of systemic poisoning may require aggressive hemodynamic support due to profound hypotension. Based on mechanistic considerations, hydroxocobalamin is a rational choice for treating azide poisoning.
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Affiliation(s)
- John Tat
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Karen Heskett
- The Library, University of California, San Diego, La Jolla, CA, USA
| | - Shiho Satomi
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Renate B. Pilz
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Beatrice A. Golomb
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Gerry R. Boss
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
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7
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DeLey Cox VE, Hartog MA, Pueblo E, Racine M, Jennings L, Tressler J, Tuet WY, Stone S, Pierce SA, Thompson L, Dukes A, Hoard-Fruchey H, Wong B, McCranor BJ. Methylene blue and monosodium glutamate improve neurologic signs after fluoroacetate poisoning. Ann N Y Acad Sci 2020; 1479:196-209. [PMID: 32285953 DOI: 10.1111/nyas.14347] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/13/2020] [Accepted: 03/17/2020] [Indexed: 12/17/2022]
Abstract
Fluoroacetate (FA) is a tasteless, odorless, water-soluble metabolic poison with severe toxicological effects. Characterized in the mid-1900s, it has been used as a rodenticide but is comparably lethal to all mammals. Many countries have restricted its use, and modern-day accidental human exposures are rare, but recently, concerns have been raised about its application as a chemical weapon with no known antidote. A combined treatment of methylene blue (MB), an antioxidant, and monosodium glutamate (MSG), a precursor of the citric acid cycle substrate alpha-ketoglutarate, has been recommended as an effective countermeasure; however, no peer-reviewed articles documenting the efficacy of this therapy have been published. Using a rodent model, we assessed the effects of MB and MSG on the neurologic, cardiac, and pulmonary systems. Transcriptomic analysis was used to elucidate inflammatory pathway activation and guide bioassays, which revealed the advantages and disadvantages of these candidate countermeasures. Results show that MB and MSG can reduce neurologic signs observed in rats exposed to sodium FA and improve some effects of intoxication. However, while this strategy resolved some signs of intoxication, ultimately it was unable to significantly reduce lethality.
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Affiliation(s)
- Vanessa E DeLey Cox
- Pharmaceutical Sciences Department, U.S. Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland
| | - Matthew A Hartog
- Pharmaceutical Sciences Department, U.S. Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland
| | - Erin Pueblo
- Pharmaceutical Sciences Department, U.S. Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland
| | - Michelle Racine
- Pharmaceutical Sciences Department, U.S. Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland
| | - Laura Jennings
- Pharmaceutical Sciences Department, U.S. Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland
| | - Justin Tressler
- Pharmaceutical Sciences Department, U.S. Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland
| | - Wing Y Tuet
- Pharmaceutical Sciences Department, U.S. Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland
| | - Samuel Stone
- Pharmaceutical Sciences Department, U.S. Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland
| | - Samuel A Pierce
- Pharmaceutical Sciences Department, U.S. Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland
| | - Lily Thompson
- Pharmaceutical Sciences Department, U.S. Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland
| | - Aliyah Dukes
- Pharmaceutical Sciences Department, U.S. Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland
| | - Heidi Hoard-Fruchey
- Pharmaceutical Sciences Department, U.S. Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland
| | - Benjamin Wong
- Pharmaceutical Sciences Department, U.S. Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland
| | - Bryan J McCranor
- Pharmaceutical Sciences Department, U.S. Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland
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8
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Isolation of the anionic toxin monofluoroacetate from a decontamination foam matrix. Microchem J 2018. [DOI: 10.1016/j.microc.2018.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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9
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Biological toxins of potential bioterrorism risk: Current status of detection and identification technology. Trends Analyt Chem 2016. [DOI: 10.1016/j.trac.2016.05.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Herrmann A, Rosén J, Jansson D, Hellenäs KE. Evaluation of a generic multi-analyte method for detection of >100 representative compounds correlated to emergency events in 19 food types by ultrahigh-pressure liquid chromatography–tandem mass spectrometry. J Chromatogr A 2012; 1235:115-24. [DOI: 10.1016/j.chroma.2012.02.061] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Revised: 02/21/2012] [Accepted: 02/27/2012] [Indexed: 10/28/2022]
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12
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Schaper A, Desel H, Wyke S, Orford R, Griffiths MR, Edwards N, Kupferschmidt H, Mathieu M, Pelclova D, Duarte-Davidson R. Countering health threats by chemicals with a potential terrorist background--creating a rapid alert system for Europe. Eur J Intern Med 2012; 23:e63-6. [PMID: 22284259 DOI: 10.1016/j.ejim.2011.09.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Revised: 09/09/2011] [Accepted: 09/26/2011] [Indexed: 10/15/2022]
Abstract
BACKGROUND The acronym "ASHT" stands for "Alerting System and Development of a Health Surveillance System for the Deliberate Release of Chemicals by Terrorists". Imagine this scenario: 15 patients with respiratory symptoms following a concert in Rome and 12 patients coughing after lunch in a cafeteria in the Czech Republic; are these events related? Today these events would never be connected as there is no mechanism to allow EU Member States to share this type of information effectively. The main objective of the ASHT project was to improve data sharing between EU Member States. In part, this was achieved by an internet accessible EU-wide alerting system with the aim to detect the deliberate (i.e. criminal or terrorist) or accidental release of chemicals. Nevertheless more information from police, fire brigades and health professionals is needed. METHODS Description of the design, development, functionality and testing of the relational database system called "RAS-CHEM" (Rapid Alert System for Chemicals). RESULTS A database structure appropriate for the description of "events" with sophisticated retrieval functions was developed. For evaluation purposes 37 events were entered into the database including 29 scenarios and 8 historical mass intoxications. The alert level was "background information" for 21 events, "suspected mass intoxication" for 6 cases and "confirmed mass intoxication" for 10 events. CONCLUSION The RAS-CHEM database works and will be integrated into the Health Emergency Operations Facility (HEOF) with other European Rapid Alert Systems. Poisons centres receive a large number of enquiries and could be important sentinels in this field of toxicovigilance.
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Affiliation(s)
- A Schaper
- GIZ-Nord Poisons Centre, University Medical Centre, Robert Koch Strasse 40, D-37099, Göttingen, Germany.
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Hamelin EI, Mawhinney DB, Parry R, Kobelski RJ. Quantification of monofluoroacetate and monochloroacetate in human urine by isotope dilution liquid chromatography tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2010; 878:1045-50. [DOI: 10.1016/j.jchromb.2010.03.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2009] [Revised: 02/25/2010] [Accepted: 03/08/2010] [Indexed: 10/19/2022]
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Abstract
Molds are ubiquitous throughout the biosphere of planet earth and cause infectious, allergic, and toxic diseases. Toxic diseases arise from exposure to mycotoxins produced by molds. Throughout history, there have been a number of toxic epidemics associated with exposure to mycotoxins. Acute epidemics of ergotism are caused by consumption of grain infested by fungi of the genus Claviceps, which produce the bioactive amine ergotamine that mimics the neurotransmitters norepinephrine, serotonin, and dopamine. Acute aflatoxin outbreaks have occurred from ingestion of corn stored in damp conditions that potentiate growth of the molds of the species Aspergillus. Contemporary construction methods that use cellulose substrates such as fiber board and indoor moisture have caused an outbreak of contaminated buildings with Stachybotrys chartarum, with the extent of health effects still a subject of debate and ongoing research. This article reviews several of the more prominent epidemics and discusses the nature of the toxins. Two diseases that were leading causes of childhood mortality in England in the 1970s and vanished with changing dietary habits, putrid malignant fever, and slow nervous fever were most likely toxic mold epidemics.
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Affiliation(s)
- William J Meggs
- Division of Toxicology, Department of Emergency Medicine, Brody School of Medicine, East Carolina University, USA,
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Tsuji H, Shimizu H, Dote T, Usuda K, Imanishi M, Tanida E, Fujimoto K, Furuya E, Kono K. Effects of sodium monofluoroacetate on glucose, amino-acid, and fatty-acid metabolism and risk assessment of glucose supplementation. Drug Chem Toxicol 2009; 32:353-61. [DOI: 10.1080/01480540903170720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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16
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Sterling J. Recent Publications on Medications and Pharmacy. Hosp Pharm 2007. [DOI: 10.1310/hpj4210-964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Hospital Pharmacy presents this feature to keep pharmacists abreast of new publications in the medical/pharmacy literature. Articles of interest will be abstracted monthly regarding a broad scope of topics. Suggestions or comments may be addressed to: Jacyntha Sterling, Drug Information Specialist at Saint Francis Hospital, 6161 S Yale Ave., Tulsa, OK 74136 or e-mail: jasterling@saintfrancis.com .
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