Paracetamol poisoning

Significant Increase in Deliberate Self-Poisonings Among Adolescents During the Second Year of the COVID-19 Pandemic

PURPOSE

The COVID-19 pandemic has been associated with a decline in mental health of adolescents. The aim of this study was to analyze the rate of deliberate self-poisonings (DSPs) among adolescents reported to the Dutch Poisons Information Center before and during the COVID-19 pandemic.

METHODS

A retrospective study from 2016 until 2021 was performed to characterize DSPs among adolescents, and to analyze trends in the number of DSPs. All DSPs among adolescents with the age of 13 up to and including 17 years were included. DSP characteristics included: age, gender, bodyweight, used substance, dose, and treatment advice. Trends in the number of DSPs were analyzed using time series decomposition and Seasonal Autoregressive Integrated Moving Average models.

RESULTS

Six thousand nine hundred fifteen DSPs in adolescents were recorded from January first 2016 until December 31st 2021. Females were involved in 84% of adolescent DSPs. A strong increase in the number of DSPs was observed in 2021 (45% increase compared to 2020), which deviated from the predicted trend based on previous years. This increase was most prominent in 13-, 14-, and 15-year-old female adolescents. Commonly involved drugs were paracetamol, ibuprofen, methylphenidate, fluoxetine, and quetiapine. The contribution of paracetamol rose from 33% in 2019 to 40% in 2021.

DISCUSSION

The strong increase in the number of DSPs during the second year of the COVID-19 pandemic suggests that long-term containment measures such as quarantines, lockdowns, and school closures may enhance self-harm behavior among adolescents, especially among younger females (13-15 years of age), with a preference for paracetamol as DSP substance.

Hepatoprotective Effect of Dried Red Jujube Fruit Extract Against Acetaminophen-Induced Acute Hepatotoxicity

Background A liver injury could impair the integration of the body's organ system, which may cause complications that can lead to death. The dried red jujube fruit extract has the potential to protect the liver from toxic substances through its antioxidant properties. Aims To determine and analyze the hepatoprotective effect of dried red jujube fruit extract on aminotransferase levels against acetaminophen-induced acute hepatotoxicity. Methods Male Wistar rats were divided into five groups. The negative control group (G1) received carboxymethylcellulose sodium (CMC-Na) 1%. The positive control group (G2) received acetaminophen. The treatment group G3 received dried red jujube fruit extract 70 mg/kg BW + acetaminophen, G4 received dried red jujube fruit extract 140 mg/kg BW + acetaminophen, and G5 received dried red jujube fruit extract 280 mg/kg BW + acetaminophen. Dried red jujube fruit extract was given for 10 consecutive days. Acetaminophen (3 g/kg BW) was given on the ninth day. Blood samples were collected, and aminotransferase levels were measured on the 11th day. Results Kruskal-Wallis comparison test showed significant differences (p < 0.01) between all groups on alanine aminotransferase (ALT; p = 0.003) and aspartate aminotransferase (AST; p = 0.001) levels. Mann-Whitney post hoc test showed significant differences (p < 0.01) between G2:G3, G2:G4, and G2:G5 groups on ALT and AST levels. Pearson correlation test showed a significant negative correlation (p < 0.01; r = -1) between all given doses of dried red jujube fruit extract on ALT (p = 0.000; r = -0.778) and AST (p = 0.000; r = -0.774) levels. Conclusion The dried red jujube fruit extract has a hepatoprotective effect on aminotransferase levels against acetaminophen-induced acute hepatotoxicity at 70 mg/kg BW, 140 mg/kg BW, and 280 mg/kg BW (the most effective dose), and there was a negative correlation between all doses and the aminotransferase levels.

Precision-cut liver slices as a model for assess hepatic cellular response of chitosan-glutathione nanoparticles on cultures treated with zilpaterol and clenbuterol

Zilpaterol and clenbuterol are two β-adrenergic agonist drugs used in animal production. Both drugs have anabolic effects with advantages on carcass yield. Meanwhile, zilpaterol is approved for animal feed in authorized countries. Clenbuterol is a banned substance due to the risk of toxicity; however, it is still being used in unknown dose levels in many farm species. Therefore, the use and abuse of these substances should be closely monitored, considering the clenbuterol ability and the not proved yet of zilpaterol to produce reactive oxygen and nitrogen species. Regarding glutathione which is the main intracellular antioxidant plays detoxification functions on liver metabolism; in this work, it is our interest to know the capacity of chitosan-glutathione nanoparticles (CS/GSH-NP) as a complementary source of exogenous GSH to modify the oxide-reduction status on bovine precision-cut liver slice cultures (PCLS) exposed to clenbuterol and zilpaterol. A single drug assay was performed in first instance by adding clenbuterol, zilpaterol, chitosan nanoparticles (CS-NP), and CS/GSH-NP. Then combinate drug assay was carried out by testing clenbuterol and zilpaterol combined with CS-NP or CS/GSH-NP. The results showed that both β-adrenergic agonists modify in a dose-dependent manner in oxide-reduction response through ROS generation. The activity or content of glutathione peroxidase activity, intracellular GSH, gamma glutamyl-transpeptidase, aspartate aminotrasnferase and alanine aminotrasnferase were modified. The exogenous GSH delivered by nanoparticles could be used to modulate these markers.

Understanding the solid-liquid equilibria between paracetamol and activated carbon: Thermodynamic approach of the interactions adsorbent-adsorbate using equilibrium, kinetic and calorimetry data

In this work, we presented the paracetamol-activated carbon interactions and their effect on the adsorption capacity. We evaluated kinetic, equilibrium, and calorimetric data using different solvents (water, HCl 0.1 M, and NaCl 0.1 M) to evaluate the changes in the adsorbent-adsorbate interaction. In addition, the commercial activated carbon (AC) was modified through thermal (ACTT) and chemical (ACNA) methods to change the physicochemical properties of the adsorbents. The relative kinetic constants decrease with the content of basic groups on the activated carbon, indicating a lower influence of diffusion on the adsorption rate when the chemical interactions increase (0.1 _ACNA >0.09 _AC >0.03 _ACTT mmol g^-1). The adsorption capacity for AC at acidic pH increases slightly compared to tests carried out in the water. Under this condition, the adsorbed amount of paracetamol was 1.31 mmol g^-1. However, the maximum adsorption capacity was achieved on ACTT using water as solvent (1.57 mmol g^-1). The paracetamol adsorbed decreases in NaCl (osmotic, ionic strength) on all activated carbons by around 20%. The interaction enthalpy of the paracetamol-activated carbon interaction presents values between - 18.0 and 2.3 J per molecule adsorbed. The Gibbs energy released during the adsorption process is between - 33.1 and - 29.8 kJ mol^-1.