1
|
Turner BRH, Jenkinson PI, Huttman M, Mullish BH. Inflammation, oxidative stress and gut microbiome perturbation: A narrative review of mechanisms and treatment of the alcohol hangover. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024. [PMID: 38965644 DOI: 10.1111/acer.15396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/17/2024] [Accepted: 06/03/2024] [Indexed: 07/06/2024]
Abstract
Alcohol is the most widely abused substance in the world, the leading source of mortality in 15-49-year-olds, and a major risk factor for heart disease, liver disease, diabetes, and cancer. Despite this, alcohol is regularly misused in wider society. Consumers of excess alcohol often note a constellation of negative symptoms, known as the alcohol hangover. However, the alcohol hangover is not considered to have long-term clinical significance by clinicians or consumers. We undertook a critical review of the literature to demonstrate the pathophysiological mechanisms of the alcohol hangover. Hereafter, the alcohol hangover is re-defined as a manifestation of sickness behavior secondary to alcohol-induced inflammation, using the Bradford-Hill criteria to demonstrate causation above correlation. Alcohol causes inflammation through oxidative stress and endotoxemia. Alcohol metabolism is oxidative and increased intake causes relative tissue hypoxia and increased free radical generation. Tissue damage ensues through lipid peroxidation and the formation of DNA/protein adducts. Byproducts of alcohol metabolism such as acetaldehyde and congeners, sleep deprivation, and the activation of nonspecific inducible CYP2E1 in alcohol-exposed tissues exacerbate free radical generation. Tissue damage and cell death lead to inflammation, but in the intestine loss of epithelial cells leads to intestinal permeability, allowing the translocation of pathogenic bacteria to the systemic circulation (endotoxemia). This leads to a well-characterized cascade of systemic inflammation, additionally activating toll-like receptor 4 to induce sickness behavior. Considering the evidence, it is suggested that hangover frequency and severity may be predictors of the development of later alcohol-related diseases, meriting formal confirmation in prospective studies. In light of the mechanisms of alcohol-mediated inflammation, research into gut permeability and the gut microbiome may be an exciting future therapeutic avenue to prevent alcohol hangover and other alcohol-related diseases.
Collapse
Affiliation(s)
| | - Poppy I Jenkinson
- Department of Anaesthetics, Royal Surrey County Hospital, Surrey, UK
| | - Marc Huttman
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Benjamin H Mullish
- Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Department of Hepatology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| |
Collapse
|
2
|
Singh BP, Hwang SJ. Unveiling the potential of polymer cholesteric liquid crystal interpenetrating networks as a label-free alcohol biochemical sensor. Analyst 2024; 149:3456-3467. [PMID: 38738996 DOI: 10.1039/d4an00464g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
In this study, an optical sensor is developed, incorporating hydrogen-bonded photonic array dots containing poly(acrylic acid) (PAA) within a polymer cholesteric liquid crystal interpenetrating polymer network (PCLCIPN) framework, thereby effectively controlling porosity. This methodology involves the fabrication of a porous photonic film, subsequent infusion with a hydrogel (PAA), and precise UV-curing to generate patterned array dots. The sensor exhibits exceptional discriminatory capability between methanol and ethanol, accurately discerning their varying concentrations within alcohol solutions. The optical sensing performance of the film is rigorously evaluated through continuous monitoring of wavelength shifts in the transmission spectrum across various alcohol concentrations. Notably, the observed wavelength shifts demonstrate a linear correlation with the concentration of alcohol, thereby enabling precise quantitative analysis of the alcohol solutions. The sensor exhibits a sensitivity of 0.44 nm/% for ethanol concentrations ranging from 5% to 60%, increasing to 2.1 nm/% for concentrations between 60% and 80%. Similarly, for methanol, sensitivities of 0.68 nm/% (5-60%) and 2.2 nm/% (60-80%) are recorded. Remarkably, this sensitivity trend extends seamlessly to 1 : 1 ethanol/methanol ratios, with values of 0.49 nm/% (5-60%) and 2.25 nm/% (60-80%). Furthermore, these sensors demonstrate colorimetric response to different alcohols, rendering them accessible and cost-effective biosensors for visual detection, thus obviating the necessity for complex analytical instruments.
Collapse
Affiliation(s)
- Bhupendra Pratap Singh
- Department of Electro-Optical Engineering, National United University, Miao-Li 360, Taiwan.
| | - Shug-June Hwang
- Department of Electro-Optical Engineering, National United University, Miao-Li 360, Taiwan.
| |
Collapse
|
3
|
Sobhi N, Abdollahi M, Arman A, Mahmoodpoor A, Jafarizadeh A. Methanol Induced Optic Neuropathy: Molecular Mysteries, Public Health Perspective, Clinical Insights and Treatment Strategies. Semin Ophthalmol 2024:1-12. [PMID: 38804878 DOI: 10.1080/08820538.2024.2358310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 05/17/2024] [Indexed: 05/29/2024]
Abstract
Methanol-induced optic neuropathy (MION) represents a critical public health issue, particularly prevalent in lower socioeconomic populations and regions with restricted alcohol access. MION, characterized by irreversible visual impairment, arises from the toxic metabolization of methanol into formaldehyde and formic acid, leading to mitochondrial oxidative phosphorylation inhibition, oxidative stress, and subsequent neurotoxicity. The pathogenesis involves axonal and glial cell degeneration within the optic nerve and potential retinal damage. Despite advancements in therapeutic interventions, a significant proportion of affected individuals endure persistent visual sequelae. The study comprehensively investigates the pathophysiology of MION, encompassing the absorption and metabolism of methanol, subsequent systemic effects, and ocular impacts. Histopathological changes, including alterations in retinal layers and proteins, Müller cell dysfunction, and visual symptoms, are meticulously examined to provide insights into the disease mechanism. Furthermore, preventive measures and public health perspectives are discussed to highlight the importance of awareness and intervention strategies. Therapeutic approaches, such as decontamination procedures, ethanol and fomepizole administration, hemodialysis, intravenous fluids, electrolyte balance management, nutritional therapy, corticosteroid therapy, and erythropoietin (EPO) treatment, are evaluated for their efficacy in managing MION. This comprehensive review underscores the need for increased awareness, improved diagnostic strategies, and more effective treatments to mitigate the impact of MION on global health.
Collapse
Affiliation(s)
- Navid Sobhi
- Nikookari Eye Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mirsaeed Abdollahi
- Nikookari Eye Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Arman
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ata Mahmoodpoor
- Research Center for Integrative Medicine in Aging, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Anesthesiology and Intensive care, Faculty of Medicine, Tabriz University of Medical Science, Tabriz, Iran
| | - Ali Jafarizadeh
- Nikookari Eye Center, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
4
|
Shum PH, Dennany L. Towards voltammetric point of care detection of leucovorin. Analyst 2024; 149:2655-2663. [PMID: 38563222 DOI: 10.1039/d4an00227j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Current healthcare trends have seen an increased emphasis on the move towards personalised precision medicine to tailor treatments to the individual and their response to diseases and disease therapies. This highlighting a transition from traditional "one size fits all" to a more nuanced approach. Despite advancements in fundamental knowledge to facilitate personalised prevision approaches, lack of resources to implement such plans remains one of the largest hurdles to overcome. Monitoring of drug therapies is one key aspect that could aid in the evolution of precision medicine alongside the development of drugs and targeted treatment systems. This contribution illustrates the potential of square wave voltammetry (SWV) as a proof-of-concept for monitoring of circulating blood concentrations of treatment therapies within artificial urine, using leucovorin calcium (LV) as a model cancer therapy drug. A low cost, easy-to-use and portable sensor has been developed and successfully employed for the detection of LV over the linear range 0.5-30 μM which represents the therapeutically relevant concentrations for LV within artificial urine without any prior sample preparation required with a limit of detection of 2.63 μM and initial investigations into saliva and serum as biological matrices. The developed sensor describe herein exhibits a proof-of-concept for the engagement of such electrochemical sensors as point-of-care devices, where the sensors ease of use and removal of time-consuming and complex sample preparation methods will ultimately increase its usability by physicians, widening the avenues where electrochemical sensors could be employed.
Collapse
Affiliation(s)
- Pui Hang Shum
- WESTChem Department of Pure and Applied Chemistry, University of Strathclyde, Technology and Innovation Centre, 99 George Street, Glasgow, G1 1RD, UK.
| | - Lynn Dennany
- WESTChem Department of Pure and Applied Chemistry, University of Strathclyde, Technology and Innovation Centre, 99 George Street, Glasgow, G1 1RD, UK.
| |
Collapse
|
5
|
Kaimori R, Nishida H, Murata K, Tamura M, Kuroki K, Daa T, Mori S. Ultrastructural endothelial cell alterations in methanol poisoning with bilateral putaminal hemorrhages: An autopsy case report. J Neuropathol Exp Neurol 2024; 83:370-373. [PMID: 38557743 DOI: 10.1093/jnen/nlae030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Affiliation(s)
- Ryo Kaimori
- Faculty of Medicine, Department of Forensic Medicine, Oita University, Yufu, Oita, Japan
- Faculty of Medicine, Department of Diagnostic Pathology, Oita University, Yufu, Oita, Japan
| | - Haruto Nishida
- Faculty of Medicine, Department of Diagnostic Pathology, Oita University, Yufu, Oita, Japan
| | - Kumi Murata
- Faculty of Medicine, Department of Forensic Medicine, Oita University, Yufu, Oita, Japan
| | - Mari Tamura
- Faculty of Medicine, Department of Forensic Medicine, Oita University, Yufu, Oita, Japan
| | - Kohji Kuroki
- Faculty of Medicine, Department of Forensic Medicine, Oita University, Yufu, Oita, Japan
| | - Tsutomu Daa
- Faculty of Medicine, Department of Diagnostic Pathology, Oita University, Yufu, Oita, Japan
| | - Shinjiro Mori
- Faculty of Medicine, Department of Forensic Medicine, Oita University, Yufu, Oita, Japan
| |
Collapse
|
6
|
Cowen T, Grammatikos S, Cheffena M. Molecularly imprinted polymer nanoparticle-carbon nanotube composite electrochemical gas sensor for highly selective and sensitive detection of methanol vapour. Analyst 2024; 149:2428-2435. [PMID: 38488210 DOI: 10.1039/d4an00045e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
An electrochemical gas sensor has been fabricated using molecularly imprinted polymer nanoparticles (nanoMIPs) and multiwalled carbon nanotubes on screen-printed electrodes. Methanol vapour was chosen as the target due to its toxicity as its suitability as a model for more harmful pollutant gases. The sensor functions under ambient conditions and in the required concentration range, in contrast to all previous MIP-based gas sensors for methanol. The sensitivity of the sensor was greatly improved by the addition of multiwall carbon nanotubes, resulting in a limit of detection of approximately 10 ppm. The nanoMIPs provide an inherent selectivity for the target inherent in its design. Selectivity studies were performed with structurally analogous alcohols at various concentrations, demonstrating selectivity for methanol 12.1 times that for ethanol at 2 mmol dm-3 and 4.2 times that for ethanol at 1 mmol dm-3. Interactions with isopropanol and n-propanol were found to be non-specific, and the response to water was negligible. This demonstrates an improvement over previous methanol gas sensors based on molecularly imprinted polymers. No response was observed with carbon nanotubes alone, and no selectivity was observed with non-imprinted equivalents of the nanoMIP sensor. The resulting device is by far the most practical MIP-based instrument for methanol gas sensing thus far described in the literature, being the only example capable of functioning at the necessary methanol vapour concentrations and at the required temperature and humidity. With the selectivity and sensitivity described and the simple design, the developed device provides a substantial advance in the field of molecularly imprinted gas sensors.
Collapse
Affiliation(s)
- Todd Cowen
- Norwegian university of Science and Technology, Teknologivegen 22, 2815 Gjøvik, Norway.
| | - Sotirios Grammatikos
- Norwegian university of Science and Technology, Teknologivegen 22, 2815 Gjøvik, Norway.
| | - Michael Cheffena
- Norwegian university of Science and Technology, Teknologivegen 22, 2815 Gjøvik, Norway.
| |
Collapse
|
7
|
Alnefaie SA, Aldlgan AA, Albakiri KM, Kaabi MA, Alzwen GM, Al-Otaibi SS, Alasmari F. Methanol intoxication in the central region of Saudi Arabia: Five case studies. Saudi Pharm J 2024; 32:102018. [PMID: 38497087 PMCID: PMC10940806 DOI: 10.1016/j.jsps.2024.102018] [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] [Indexed: 03/19/2024] Open
Abstract
Outbreaks of methanol poisoning have been described in the medical literature worldwide. However, the few outbreaks that have occurred in Saudi Arabia remain undocumented. This is especially noteworthy in light of the fact that Saudi Arabia is among the countries that explicitly prohibit the usage of alcoholic beverages and recreational drugs. Herein, we describe five cases of methanol poisoning in Saudi Arabia. The first three comprise patients admitted to the emergency room (ER) with signs of methanol toxicity, such as heart palpitations, vomiting, and blurred vision; otherwise, those patients were considered medically free. The remaining two cases were examined postmortem. A headspace gas chromatography-flame ionization detector was used to test blood, vitreous humor, and urine samples for methanol. Specific lethal concentrations of methanol were defined based on published case studies as 23-740 mg/dL in blood and 12-396 mg/dL in vitreous humor. In postmortem cases of our present study, samples exhibited lethal concentrations: 118 and 257 mg/dL in blood, 116.3 and 283 mg/dL in vitreous humor. In ER cases, methanol concentrations in urine samples were lower, at 7.5, 9.1, and 20.9 mg/dL; however, toxic symptoms were still observed. These case studies indicate that it is necessary to raise community awareness about the risk of methanol poisoning in order to minimize future poisoning epidemics.
Collapse
Affiliation(s)
- Sattam A. Alnefaie
- Department of Forensic Sciences, College of Criminal Justice, Naif Arab University for Security Sciences, Riyadh, Saudi Arabia
| | | | - Khalid M. Albakiri
- Riyadh Poisons Control & Medical Forensic Chemistry Center, Ministry of Health, Riyadh, Saudi Arabia
| | - Mohammed A. Kaabi
- Department of Pathology and Laboratory Medicine, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Ghada M. Alzwen
- Department of Medical Laboratory Science, College of Applied Medical Sciences, University of Hail, Hail, Saudi Arabia
| | - Sarah S. Al-Otaibi
- Drug & Poison Information Center, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Fawaz Alasmari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
8
|
Durmaz Engin C, Kucuk HC, Yaman A, Men S, Bajin MS. The Role of Optic Nerve Diffusion Restriction on Visual Prognosis in Methanol Poisoning. Neuroophthalmology 2024; 48:159-168. [PMID: 38756343 PMCID: PMC11095577 DOI: 10.1080/01658107.2023.2293865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/22/2023] [Indexed: 05/18/2024] Open
Abstract
The aim of this study was to investigate the role of optic nerve diffusion status on cranio-orbital magnetic resonance imaging (MRI) in predicting visual prognosis in cases of methanol intoxication. Diffusion-weighted imaging (DWI) from 16 eyes of eight patients who were admitted to our clinic due to methanol intoxication was analysed retrospectively. The relationship between clinical and laboratory findings, treatment regimen, visual prognosis, and imaging findings was investigated. Diffusion restriction (DR) of the optic nerve on DWI was observed in seven (43%) eyes. Regardless of the clinical and laboratory characteristics and treatment regimen, visual acuity (VA) improved in eyes in which restricted diffusion regressed over the follow-up period. DWI of the optic nerve during the acute phase of methanol poisoning may provide prognostically important data. Improvement of DR during follow-up may be an indicator of an increase in VA.
Collapse
Affiliation(s)
- Ceren Durmaz Engin
- Department of Ophthalmology, Buca Seyfi Demirsoy Education and Research Hospital, Izmir, Turkey
| | - Hasan Can Kucuk
- Department of Ophthalmology, Dokuz Eylul University, Izmir, Turkey
| | - Aylin Yaman
- Department of Ophthalmology, Dokuz Eylul University, Izmir, Turkey
| | - Suleyman Men
- Department of Radiology, Dokuz Eylul University, Izmir, Turkey
| | | |
Collapse
|
9
|
Sadeghi M, Fakhar M, Hoseininejad SM, Zakariaei Z, Sadeghi A. The clinico-epidemiological, diagnostic and therapeutic aspects of methanol poisoning: A five-year retrospective study, northern Iran. Drug Alcohol Depend 2023; 253:111024. [PMID: 38006673 DOI: 10.1016/j.drugalcdep.2023.111024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 10/23/2023] [Accepted: 11/03/2023] [Indexed: 11/27/2023]
Abstract
INTRODUCTION Methanol poisoning (MP) is a serious health issue that has become more prevalent in recent years and has resulted in numerous deaths. Early detection and timely treatment are critical for preventing fatalities and reducing the incidence of neurological complications. PATIENTS AND METHODS This study was designed as a retrospective investigation with the purpose of analyzing the clinico-epidemiological, diagnostic, and therapeutic aspects of patients who were admitted to two training hospitals in northern Iran due to MP. The selection of samples for this study was based on a pre-defined checklist. Following the completion of the treatment period in the hospital, the patients were categorized into three groups based on their clinical outcome. All relevant variables for each group were recorded and reported separately, using the SciPy library in the Python programming language. RESULTS The majority of the patients (88.12%) were male (P=0.012), the average age was 41.46, and mostly (82.18%) lived in urban regions (P=0.025). The primary clinical complaint reported was visual disorders, accounting for 75.25% of the cases, followed by nervous, gastrointestinal, respiratory, and chest pain accordingly. The average hospitalization length for the patients was 5.065 days. Out of the 101 patients, 65 (64.36%) were discharged without any complications, 17 (16.83%) were discharged with complications, and unfortunately, 19 (18.81%) were died. CONCLUSION A decreased level of consciousness and severe metabolic acidosis are commonly associated with unfavorable outcomes in MP. The use of systemic corticosteroids as a treatment method has a significant association with reducing mortality rates.
Collapse
Affiliation(s)
- Mahdieh Sadeghi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Fakhar
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Zakaria Zakariaei
- Toxicology and Forensic Medicine Division, Mazandaran Registry Center for Opioids Poisoning, Antimicrobial Resistance Research Center, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Alireza Sadeghi
- Intelligent Mobile Robot Lab (IMRL), Department of Mechatronics Engineering, Faculty of New Sciences and Technologies, University of Tehran, Tehran, Iran
| |
Collapse
|
10
|
Ranjan RS, Singh AK, Namrata, Singh SK. Toxic Leucoencephalopathy with Bilateral Optic Nerve Necrosis in Two Suspected Cases of Methanol Inhalational Poisoning. Neurol India 2023; 71:1052-1055. [PMID: 37929468 DOI: 10.4103/0028-3886.388093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Affiliation(s)
- Rahul S Ranjan
- Department of Radiodiagnosis, Rama Medical College, Kanpur, Uttar Pradesh, India
| | - Anil K Singh
- Radiodiagnosis, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Namrata
- Department of Ophthalmology, Rama Medical College, Kanpur, Uttar Pradesh, India
| | - Shailesh K Singh
- Department of Surgery, Rama Medical College, Kanpur, Uttar Pradesh, India
| |
Collapse
|
11
|
Shah N, Khayat M, Owshalimpur D, Banda M, Munoz J, White WC, Forster BM, Petteys SK, Sullivan SB, Watson M, King JD. Mass Poisoning From Ethylene Glycol at a U.S. Military Base. Mil Med 2023; 188:e3261-e3264. [PMID: 36562097 DOI: 10.1093/milmed/usac380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/29/2022] [Accepted: 11/17/2022] [Indexed: 12/24/2022] Open
Abstract
Ethylene glycol (EG) toxicity is an important cause of toxic alcohol poisoning in the USA with over 5,000 exposures reported annually. While classically characterized by solitary accidental or intentional ingestions, mass toxic alcohol poisoning outbreaks and more rarely collective consumptions (typically of methanol) have been described. We describe an ethylene glycol poisoning from collective ingestion that involved soldiers presenting at William Beaumont Army Medical Center in El Paso, Texas. Eleven soldiers presented to the emergency department over a 12-h period after ingestion of an unknown substance. The first two patients exhibited severe neurologic symptoms, while the remainder were asymptomatic. As serum EG levels were not immediately available, treatment decisions were based on surrogate laboratory values. Two patients received immediate hemodialysis, and fomepizole (FOM) because of severe acidosis with elevated anion and osmolal gaps. These patients developed acute kidney injury with renal recovery within a 3-week period. Two patients with elevated lactate received bicarbonate-based intravenous (IV) fluids and FOM. Two patients received IV fluids only and required prolonged observation for worsening acidosis and/or acute kidney injury. Five patients with normal laboratory values were treated with IV fluids and observation. All patients received cofactors including thiamine and pyridoxine. All patients survived. The outbreak occurred in the setting of limited dialysis resources, limited FOM availability, and in a resource-limited community. Additional guidelines are needed to determine allocation of limited resources, optimal dialysis and FOM treatment course, and comorbid conditions, which may prolong recovery.
Collapse
Affiliation(s)
- Nina Shah
- Department of Medicine-Nephrology, William Beaumont Army Medical Center, El Paso, TX 79918, USA
| | - Maurice Khayat
- Department of Medicine-Nephrology, Madigan Army Medical Center, Joint Base Lewis-McChord, WA 98431, USA
| | - David Owshalimpur
- Department of Medicine-Nephrology, Madigan Army Medical Center, Joint Base Lewis-McChord, WA 98431, USA
| | - Michelle Banda
- Department of Medicine-Internal Medicine, William Beaumont Army Medical Center, El Paso, TX 79918, USA
| | - Jesus Munoz
- Department of Medicine-Internal Medicine, William Beaumont Army Medical Center, El Paso, TX 79918, USA
| | - William C White
- Department of Medicine-Internal Medicine, William Beaumont Army Medical Center, El Paso, TX 79918, USA
| | - Benjamin M Forster
- Department of Medicine-Nephrology, William Beaumont Army Medical Center, El Paso, TX 79918, USA
| | - Sarah K Petteys
- Department of Medicine-Pulmonary/Critical Care Medicine, William Beaumont Army Medical Center, El Paso, TX 79918, USA
| | - Scott B Sullivan
- Department of Medicine-Critical Care/Emergency Medicine, William Beaumont Army Medical Center, El Paso, TX 79918, USA
| | - Maura Watson
- Department of Medicine-Nephrology, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
| | - Joshua D King
- Department of Toxicology-Maryland Poison Center and Department of Medicine-Nephrology, University of Maryland, Baltimore, MD 21201, USA
| |
Collapse
|
12
|
Kobylarz D, Noga M, Frydrych A, Milan J, Morawiec A, Glaca A, Kucab E, Jastrzębska J, Jabłońska K, Łuc K, Zdeb G, Pasierb J, Toporowska-Kaźmierak J, Półchłopek S, Słoma P, Adamik M, Banasik M, Bartoszek M, Adamczyk A, Rędziniak P, Frączkiewicz P, Orczyk M, Orzechowska M, Tajchman P, Dziuba K, Pelczar R, Zima S, Nyankovska Y, Sowińska M, Pempuś W, Kubacka M, Popielska J, Brzezicki P, Jurowski K. Antidotes in Clinical Toxicology-Critical Review. TOXICS 2023; 11:723. [PMID: 37755734 PMCID: PMC10534475 DOI: 10.3390/toxics11090723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/11/2023] [Accepted: 08/20/2023] [Indexed: 09/28/2023]
Abstract
Poisoning and overdose are very important aspects in medicine and toxicology. Chemical weapons pose a threat to civilians, and emergency medicine principles must be followed when dealing with patients who have been poisoned or overdosed. Antidotes have been used for centuries and modern research has led to the development of new antidotes that can accelerate the elimination of toxins from the body. Although some antidotes have become less relevant due to modern intensive care techniques, they can still save lives or reduce the severity of toxicity. The availability of antidotes is crucial, especially in developing countries where intensive care facilities may be limited. This article aims to provide information on specific antidotes, their recommended uses, and potential risks and new uses. In the case of poisoning, supportive therapies are most often used; however, in many cases, the administration of an appropriate antidote saves the patient's life. In this review, we reviewed the literature on selected antidotes used in the treatment of poisonings. We also characterised the antidotes (bio)chemically. We described the cases in which they are used together with the dosage recommendations. We also analysed the mechanisms of action. In addition, we described alternative methods of using a given substance as a drug, an example of which is N-acetylcysteine, which can be used in the treatment of COVID-19. This article was written as part of the implementation of the project of the Polish Ministry of Education and Science, "Toxicovigilance, poisoning prevention, and first aid in poisoning with xenobiotics of current clinical importance in Poland", grant number SKN/SP/570184/2023.
Collapse
Affiliation(s)
- Damian Kobylarz
- Department of Regulatory and Forensic Toxicology, Institute of Medical Expertises, Łódź, ul. Aleksandrowska 67/93, 91-205 Łódź, Poland
| | - Maciej Noga
- Department of Regulatory and Forensic Toxicology, Institute of Medical Expertises, Łódź, ul. Aleksandrowska 67/93, 91-205 Łódź, Poland
| | - Adrian Frydrych
- Laboratory of Innovative Toxicological Research and Analyzes, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland
| | - Justyna Milan
- Laboratory of Innovative Toxicological Research and Analyzes, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland
| | - Adrian Morawiec
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Agata Glaca
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Emilia Kucab
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Julia Jastrzębska
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Karolina Jabłońska
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Klaudia Łuc
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Gabriela Zdeb
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Jakub Pasierb
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Joanna Toporowska-Kaźmierak
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Szczepan Półchłopek
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Paweł Słoma
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Magdalena Adamik
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Mateusz Banasik
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Mateusz Bartoszek
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Aleksandra Adamczyk
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Patrycja Rędziniak
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Paulina Frączkiewicz
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Michał Orczyk
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Martyna Orzechowska
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Paulina Tajchman
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Klaudia Dziuba
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Rafał Pelczar
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Sabina Zima
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Yana Nyankovska
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Marta Sowińska
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Wiktoria Pempuś
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Maria Kubacka
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Julia Popielska
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Patryk Brzezicki
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland (E.K.); (G.Z.); (M.B.); (M.O.)
| | - Kamil Jurowski
- Department of Regulatory and Forensic Toxicology, Institute of Medical Expertises, Łódź, ul. Aleksandrowska 67/93, 91-205 Łódź, Poland
- Laboratory of Innovative Toxicological Research and Analyzes, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland
| |
Collapse
|
13
|
Shaher SAA, Mihailescu DF, Amuzescu B. Aspartame Safety as a Food Sweetener and Related Health Hazards. Nutrients 2023; 15:3627. [PMID: 37630817 PMCID: PMC10459792 DOI: 10.3390/nu15163627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/21/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Aspartame is the methyl-ester of the aspartate-phenylalanine dipeptide. Over time, it has become a very popular artificial sweetener. However, since its approval by the main food safety agencies, several concerns have been raised related to neuropsychiatric effects and neurotoxicity due to its ability to activate glutamate receptors, as well as carcinogenic risks due to the increased production of reactive oxygen species. Within this review, we critically evaluate reports concerning the safety of aspartame. Some studies evidenced subtle mood and behavioral changes upon daily high-dose intake below the admitted limit. Epidemiology studies also evidenced associations between daily aspartame intake and a higher predisposition for malignant diseases, like non-Hodgkin lymphomas and multiple myelomas, particularly in males, but an association by chance still could not be excluded. While the debate over the carcinogenic risk of aspartame is ongoing, it is clear that its use may pose some dangers in peculiar cases, such as patients with seizures or other neurological diseases; it should be totally forbidden for patients with phenylketonuria, and reduced doses or complete avoidance are advisable during pregnancy. It would be also highly desirable for every product containing aspartame to clearly indicate on the label the exact amount of the substance and some risk warnings.
Collapse
Affiliation(s)
- Shurooq Asaad Abdulameer Shaher
- Department of Biophysics and Physiology, Faculty of Biology, University of Bucharest, 005095 Bucharest, Romania; (S.A.A.S.); (D.F.M.)
- Department of Medical Laboratories, Babylon Technical Institute, Al-Furat Al-Awsat Technical University, Najaf 54001, Iraq
| | - Dan Florin Mihailescu
- Department of Biophysics and Physiology, Faculty of Biology, University of Bucharest, 005095 Bucharest, Romania; (S.A.A.S.); (D.F.M.)
| | - Bogdan Amuzescu
- Department of Biophysics and Physiology, Faculty of Biology, University of Bucharest, 005095 Bucharest, Romania; (S.A.A.S.); (D.F.M.)
| |
Collapse
|
14
|
Ma HZ, Luo C, Zhao JN, Shao Y, Zhang YH, Liu X, Li S, Yin B, Zhang K, Ke K, Zhou L, Yang MB. Metal-Organic Framework Based Triboelectric Nanogenerator for a Self-Powered Methanol Sensor with High Sensitivity and Selectivity. ACS APPLIED MATERIALS & INTERFACES 2023; 15:37563-37570. [PMID: 37498012 DOI: 10.1021/acsami.3c07966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Triboelectric nanogenerators have shown great potential in the area of self-powered gas sensors in the past decade. In this paper, we developed a triboelectric nanogenerator (TENG) based on spiky structured ZIF-8@ZnO, which can harvest energy with high efficiency and act as a self-powered methanol sensor. The open-circuit voltage and short-circuit current generated by a ZIF-8@ZnO-based TENG is 58 V and 10 μA, achieving 2.4 times and 3.3 times enhancement compared to ZnO-based TENGs. The TENG can charge capacitors fast and light up at least 40 LEDs. ZIF-8@ZnO-based TENGs show good sensitivity and selectivity to methanol gas at room temperature due to the porous structure provided by ZIF-8 and the heterostructure of ZIF-8@ZnO. The response of ZIF-8@ZnO-based TENG to methanol reaches 30.35% at 100 ppm with excellent response (∼5.9 s) and recovery time (∼2.2 s). This work demonstrates the application of MOF-modified metal oxide semiconductors based on a self-powered gas sensor and proposes a promising solution to enhance the output performance and sensing properties of TENGs based on metal oxide semiconductors.
Collapse
Affiliation(s)
- Hong-Zhi Ma
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, 610065 Sichuan, China
| | - Chen Luo
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, 610065 Sichuan, China
| | - Jiang-Nan Zhao
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, 610065 Sichuan, China
| | - Yan Shao
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, 610065 Sichuan, China
| | - Yu-Hao Zhang
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, 610065 Sichuan, China
| | - Xu Liu
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, 610065 Sichuan, China
| | - Shuang Li
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, 610065 Sichuan, China
| | - Bo Yin
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, 610065 Sichuan, China
| | - Kai Zhang
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, 610065 Sichuan, China
| | - Kai Ke
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, 610065 Sichuan, China
| | - Ling Zhou
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, 610065 Sichuan, China
| | - Ming-Bo Yang
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, 610065 Sichuan, China
| |
Collapse
|
15
|
Jangjou A, Moqadas M, Mohsenian L, Kamyab H, Chelliapan S, Alshehery S, Ali MA, Dehbozorgi F, Yadav KK, Khorami M, Zarei Jelyani N. Awareness raising and dealing with methanol poisoning based on effective strategies. ENVIRONMENTAL RESEARCH 2023; 228:115886. [PMID: 37072082 DOI: 10.1016/j.envres.2023.115886] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 04/04/2023] [Accepted: 04/10/2023] [Indexed: 05/16/2023]
Abstract
Intoxication with methanol most commonly occurs as a consequence of ingesting, inhaling, or coming into contact with formulations that include methanol as a base. Clinical manifestations of methanol poisoning include suppression of the central nervous system, gastrointestinal symptoms, and decompensated metabolic acidosis, which is associated with impaired vision and either early or late blindness within 0.5-4 h after ingestion. After ingestion, methanol concentrations in the blood that are greater than 50 mg/dl should raise some concern. Ingested methanol is typically digested by alcohol dehydrogenase (ADH), and it is subsequently redistributed to the body's water to attain a volume distribution that is about equivalent to 0.77 L/kg. Moreover, it is removed from the body as its natural, unchanged parent molecules. Due to the fact that methanol poisoning is relatively uncommon but frequently involves a large number of victims at the same time, this type of incident occupies a special position in the field of clinical toxicology. The beginning of the COVID-19 pandemic has resulted in an increase in erroneous assumptions regarding the preventative capability of methanol in comparison to viral infection. More than 1000 Iranians fell ill, and more than 300 of them passed away in March of this year after they consumed methanol in the expectation that it would protect them from a new coronavirus. The Atlanta epidemic, which involved 323 individuals and resulted in the deaths of 41, is one example of mass poisoning. Another example is the Kristiansand outbreak, which involved 70 people and resulted in the deaths of three. In 2003, the AAPCC received reports of more than one thousand pediatric exposures. Since methanol poisoning is associated with high mortality rates, it is vital that the condition be addressed seriously and managed as quickly as feasible. The objective of this review was to raise awareness about the mechanism and metabolism of methanol toxicity, the introduction of therapeutic interventions such as gastrointestinal decontamination and methanol metabolism inhibition, the correction of metabolic disturbances, and the establishment of novel diagnostic/screening nanoparticle-based strategies for methanol poisoning such as the discovery of ADH inhibitors as well as the detection of the adulteration of alcoholic drinks by nanoparticles in order to prevent methanol poisoning. In conclusion, increasing warnings and knowledge about clinical manifestations, medical interventions, and novel strategies for methanol poisoning probably results in a decrease in the death load.
Collapse
Affiliation(s)
- Ali Jangjou
- Department of Emergency Medicine, School of Medicine, Namazi Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran; Emergency Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mostafa Moqadas
- Department of Emergency Medicine, School of Medicine, Namazi Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran; Emergency Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Mohsenian
- Department of Emergency Medicine, School of Medicine, Namazi Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran; Emergency Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hesam Kamyab
- Faculty of Architecture and Urbanism, UTE University, Calle Rumipamba S/N and Bourgeois, Quito, Ecuador; Department of Biomaterials, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, 600 077, India; Process Systems Engineering Centre (PROSPECT), Faculty of Chemical and Energy Engineering, Faculty of Engineering, Universiti Teknologi Malaysia, Skudai, Johor, Malaysia.
| | - Shreeshivadasan Chelliapan
- Engineering Department, Razak Faculty of Technology and Informatics, Universiti Teknologi Malaysia, Jln Sultan Yahya Petra, 54100, Kuala Lumpur, Malaysia.
| | - Sultan Alshehery
- Department of Mechanical Engineering King Khalid University, zip code - 62217, Saudi Arabia
| | - Mohammed Azam Ali
- Department of Mechanical Engineering King Khalid University, zip code - 62217, Saudi Arabia
| | - Farbod Dehbozorgi
- Department of Emergency Medicine, School of Medicine, Namazi Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran; Emergency Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Medical Nanotechnology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Krishna Kumar Yadav
- Faculty of Science and Technology, Madhyanchal Professional University, Ratibad, Bhopal, 462044, India; Environmental and Atmospheric Sciences Research Group, Scientific Research Center, Al-Ayen University, Thi-Qar, Nasiriyah, 64001, Iraq
| | - Masoud Khorami
- Department of Civil Engineering, Islamic Azad University, Central Tehran Branch, Tehran, Iran
| | - Najmeh Zarei Jelyani
- Department of Emergency Medicine, School of Medicine, Namazi Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran; Emergency Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
16
|
Alqurashi GI, Alqurashi FS, Alhusayni KM, Falemban AH, Alhindi YZ, Alsanosi SM, Alzahrani AR, Al-Ghamdi SS, Ayoub N. Case Reports Study on Methanol Poisoning in King Abdul Aziz Specialist Hospital, Taif, Saudi Arabia. J Clin Med 2023; 12:4282. [PMID: 37445316 DOI: 10.3390/jcm12134282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 05/28/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
Methanol poisoning is a challenging issue due to its inducing acute multiple organ failures, and especially due to a lack of preparedness, available antidotes, and management protocols. The current study presents six cases of methanol poisoning that attended the emergency department of King Abdul Aziz Specialist Hospital, Taif, Saudi Arabia, between March and November 2022. All of the patients suffered from severe metabolic acidosis and visual impairment following the ingestion of homemade alcoholic beverages and colonia. Three patients were comatose, suffered from post-cardiac pulmonary arrest, and, finally, died, while the other three were non-comatose and discharged from the ICU after improvement. Management was based on clinical symptoms and other laboratory findings due to a shortage of methanol level measurement resources. The antidote, fomepizole, was not given to all of the cases due to its deficiency, and ethanol was given only to one patient due to difficulties in administering it without monitoring its concentration. Methanol poisoning and its outbreak provide insights into the dangers of hazardous homemade alcohol and other pharmaceutical preparations that might be adulterated with methanol, particularly to the shortage of suitable diagnostic testing and antidotes in addition to poor resources for management of intoxicated patients in some regions of Saudi Arabia.
Collapse
Affiliation(s)
- Ghadi I Alqurashi
- Pharmacy Department, King Abdulaziz Hospital, Taif 26521, Saudi Arabia
- Saudi Toxicology Society, Umm Al-Qura University (UQU), Makkah 21955, Saudi Arabia
| | - Fahad S Alqurashi
- Pharmacy Department, King Abdulaziz Hospital, Taif 26521, Saudi Arabia
| | | | - Alaa H Falemban
- Saudi Toxicology Society, Umm Al-Qura University (UQU), Makkah 21955, Saudi Arabia
- Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University (UQU), Makkah 21955, Saudi Arabia
| | - Yosra Z Alhindi
- Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University (UQU), Makkah 21955, Saudi Arabia
| | - Safaa M Alsanosi
- Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University (UQU), Makkah 21955, Saudi Arabia
| | - Abdullah R Alzahrani
- Saudi Toxicology Society, Umm Al-Qura University (UQU), Makkah 21955, Saudi Arabia
- Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University (UQU), Makkah 21955, Saudi Arabia
| | - Saeed S Al-Ghamdi
- Saudi Toxicology Society, Umm Al-Qura University (UQU), Makkah 21955, Saudi Arabia
- Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University (UQU), Makkah 21955, Saudi Arabia
| | - Nahla Ayoub
- Saudi Toxicology Society, Umm Al-Qura University (UQU), Makkah 21955, Saudi Arabia
- Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University (UQU), Makkah 21955, Saudi Arabia
| |
Collapse
|
17
|
Tabatabaei SA, Amini M, Haydar AA, Soleimani M, Cheraqpour K, Shahriari M, Hassanian-Moghaddam H, Zamani N, Akbari MR. Outbreak of methanol-induced optic neuropathy in early COVID-19 era; effectiveness of erythropoietin and methylprednisolone therapy. World J Clin Cases 2023; 11:3502-3510. [PMID: 37383889 PMCID: PMC10294205 DOI: 10.12998/wjcc.v11.i15.3502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 02/01/2023] [Accepted: 04/14/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Methanol is a highly toxic, non-potable alcohol. Outbreaks of methanol toxicity occur due to its fraudulent addition to alcoholic beverages as a cheaper substitute for ethanol. Recently, alongside the coronavirus disease 2019 (COVID-19) pandemic, rumors circulated on social media that consuming alcohol can prevent or cure the virus, leading to a COVID-19 and methanol-induced optic neuropathy (MON) syndemic.
AIM To investigate the impact of erythropoietin (EPO) on the outcomes of patients diagnosed with MON.
METHODS In this prospective study, 105 patients presenting with acute bilateral visual loss secondary to methanol intoxication were enrolled from March to May 2020 at Farabi Eye Hospital. A comprehensive ocular examination was conducted for all participants. Recombinant human EPO and methylprednisolone were administered intravenously to all patients for three consecutive days.
RESULTS The mean age of the participants was 39.9 years (± 12.6). Ninety-four patients were male and eleven were female. The mean pre-treatment best corrected visual acuity (BCVA) improved from 2.0 ± 0.86 to 1.39 ± 0.69 logarithm of the minimum angle of resolution post-treatment (P < 0.001), with significant improvement observed in all age categories and genders (P < 0.001). Visual acuity improvement was also significant regardless of whether the patient presented before or after 72 h (P < 0.001), and the post-treatment BCVA remained significant at all monthly follow-up visits (P < 0.001).
CONCLUSION EPO and methylprednisolone therapy have been shown to be effective in improving visual outcomes in patients with MON when administrated within the first month of exposure. Public awareness efforts are necessary to prevent further outbreaks of methanol toxicity in the current COVID-19 era.
Collapse
Affiliation(s)
- Seyed Ali Tabatabaei
- Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
| | - Mohammad Amini
- Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
| | - Ali A Haydar
- Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
| | - Mohammad Soleimani
- Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
| | - Kasra Cheraqpour
- Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
| | - Mansoor Shahriari
- Department of Ophthalmology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran 1617763141, Iran
| | - Hossein Hassanian-Moghaddam
- Department of Clinical Toxicology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran 1964512642, Iran
| | - Nasim Zamani
- Department of Internal Medicine, Street, Agnes Medical Center, Fresno, CA 93720, United States
| | - Mohammad Reza Akbari
- Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
| |
Collapse
|
18
|
Wang C, Hiremath S, Sikora L, Kanji S, Bugeja A, Samaha D, Sood MM, Kong JWY, Clark EG. Kidney outcomes after methanol and ethylene glycol poisoning: a systematic review and meta-analysis. Clin Toxicol (Phila) 2023; 61:326-335. [PMID: 37293897 DOI: 10.1080/15563650.2023.2200547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 03/28/2023] [Accepted: 04/03/2023] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Ingestions with methanol, ethylene glycol, diethylene glycol, propylene glycol, and isopropanol are rare yet exceedingly dangerous conditions that may require emergent management with kidney replacement therapy. Little is known regarding short- and long-term kidney outcomes post-ingestion. OBJECTIVES To comprehensively synthesize existing evidence regarding short- and long-term kidney and other outcomes of adult patients following these poisonings. METHODS We developed a search strategy in MEDLINE via OVID and then translated it into other databases including EMBASE (via OVID), PubMed, CENTRAL (via OVID). The databases were searched from their dates of inception to 29 July 2021. A grey literature search was conducted in the International Traditional Medicine Clinical Trial Registry and ClinicalTrials.gov. All interventional and observational studies and case series with ≥ five participants that reported on the outcomes of toxic alcohol (methanol, ethylene glycol, diethylene glycol, propylene glycol and isopropanol) poisonings in adult patients ≥18 years old were included. Studies that reported mortality, kidney outcomes and/or complications attributed to toxic alcohol poisoning were eligible. RESULTS The search strategy identified 1,221 citations. Sixty-seven studies (13 retrospective observational studies, one prospective observational study, 53 case series) met inclusion criteria (total N = 2,327 participants). No randomized controlled trials were identified per our prespecified criteria. Generally, included studies had small sample sizes (median of 27 participants) and were of low quality. Methanol and/or ethylene glycol poisoning made up 94.1% of included studies, whereas one study reported on isopropanol and none reported on propylene glycol. Results of the 13 observational studies of methanol and/or ethylene glycol poisoning were pooled for meta-analyses. The pooled in-hospital mortality estimates amongst patients with methanol and ethylene glycol poisoning were 24 and 11%, respectively. A more recent year of publication, female sex and mean age were associated with lower in-hospital mortality amongst individuals with ethylene glycol poisoning. Although hemodialysis was the most frequently employed kidney replacement therapy, the indications for initiation of this therapy were not reported in the majority of studies. At hospital discharge, kidney recovery occurred in 64.7-96.3% of patients with ethylene glycol poisoning. In studies of methanol and/or ethylene glycol poisoning, 2-3.7% of individuals required ongoing dialysis. Only one study reported post-discharge mortality. Furthermore, long-term toxic alcohol-mediated sequelae, such as visual and neurologic outcomes, were scarcely reported. DISCUSSION Ingestions of methanol and ethylene glycol were associated with a significant short-term risk of mortality. Although a wealth of literature in the form of case reports and case series exists, high-quality evidence regarding kidney outcomes after these poisonings is lacking. We identified a paucity of standardized reporting in clinical presentations, therapeutics and outcomes amongst adults with toxic alcohol poisoning. Amongst the included studies, there was substantial heterogeneity encompassing study type, outcomes, duration of follow-up and treatment modalities. These sources of heterogeneity restricted our ability to perform comprehensive meta-analyses of all outcomes of interest. An additional limitation is the lack of studies pertaining to propylene glycol and the paucity of data on isopropanol. CONCLUSIONS The indications for hemodialysis, long-term kidney recovery and long-term mortality risk vary widely in these poisonings and are inconsistently reported in the literature. This highlights the need for further research with standardized reporting of baseline kidney function, indications for initiation of kidney replacement therapy and short-term and long-term kidney outcomes. REGISTRATION This systematic review protocol is registered at PROSPERO, CRD42018101955.
Collapse
Affiliation(s)
- Carol Wang
- Division of Nephrology, Department of Medicine, Western University, London, ON, Canada
| | - Swapnil Hiremath
- Division of Nephrology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Lindsey Sikora
- Health Sciences Library, University of Ottawa Library, University of Ottawa, Ottawa, ON, Canada
| | - Salmaan Kanji
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Ann Bugeja
- Division of Nephrology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Daniel Samaha
- Division of Nephrology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Manish M Sood
- Division of Nephrology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Jennifer W Y Kong
- Division of Nephrology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Edward G Clark
- Division of Nephrology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| |
Collapse
|
19
|
Rafizadeh A, Kolahi AA, Shariati S, Zamani N, Roberts DM, Hassanian-Moghaddam H. The danger of the toxicity and inefficacy of alcohol-based hand rubs in Iran during COVID-19: a cross-sectional study. Antimicrob Resist Infect Control 2023; 12:42. [PMID: 37098641 PMCID: PMC10127170 DOI: 10.1186/s13756-023-01244-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 04/15/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND The use of disinfectants and alcohol-based hand rubs (ABHR) to prevent COVID-19 transmission increased in the first wave of the infection. To meet the increased demand, the Iranian Ministry of Health issued an emergency use authorization allowing new manufacturers to enter the market, despite the limited capacity for surveillance of these products during COVID-19. Methanol poisoning outbreaks spread rapidly, and more people died from methanol poisoning than COVID-19 in some cities. The aim of this study was to analyze some ABHRs in the Iranian market to see if (a) ABHRs are standard and suitable for hand antisepsis and (b) contained potentially dangerous toxic alcohols. METHOD Between February and March 2020, 64 brands of ABHR were conveniently collected from pharmacies, supermarkets, and shops selling hygienic products and analyzed using Gas Chromatography. World Health Organization and Food and Drug Administration guidelines were used to define minimum requirements for ABHR. For estimating the risk for acute methanol poisoning, we assumed a serum methanol concentration of 200 mg/L following ABHR ingestion was sufficient to cause intoxication. This threshold concentration would be achieved in an average 75-kg adult after consuming 8000 mg (or eight grams) methanol in 1-2 h. RESULTS The median [IQR] (range) concentration of ethanol, isopropanol, and methanol were 59% v/v [32.2, 68] (0, 99), 0 mg/L [0, 0] (0, 197,961), and 0 mg/L [0, 0] (0, 680,100), respectively. There was a strong negative correlation between methanol and ethanol contents of hand rubbers (r= -0.617, p < 0.001). Almost 47% of ABHRs complied with minimum standards. In 12.5% of ABHRs, high concentrations of methanol were observed, which have no antiseptic properties but could cause acute methanol poisoning if ingested. CONCLUSION COVID-19 initiated a policy for distribution and use of ABHR with little control. As ABHR and masks are still accepted preventive measures of the disease, non-standard ABHR compositions may increase the population's risk to both COVID-19 infection and methanol poisoning.
Collapse
Affiliation(s)
- Ali Rafizadeh
- Faculty of Nursing & Midwifery, Rasht Branch, Islamic Azad University, Rasht, Iran
| | - Ali-Asghar Kolahi
- Social Determinant of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahab Shariati
- Department of Chemistry, Rasht Branch, Islamic Azad University, Rasht, Iran
| | - Nasim Zamani
- Department of Internal Medicine, St. Agnes Medical Center, Fresno, CA, USA
| | - Darren M Roberts
- Edith Collins Centre, Drug Health Services, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Hossein Hassanian-Moghaddam
- Social Determinant of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Department of Clinical Toxicology, School of Medicine, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
20
|
Günay N, Taheri S, Memiş M, Yilmaz Şükranli Z, Şahin T, Demiryürek Ş, Ekici Günay N, Aslan YE, Demiryürek AT. Male- and female-specific microRNA expression patterns in a mouse model of methanol poisoning. Food Chem Toxicol 2023; 174:113666. [PMID: 36780935 DOI: 10.1016/j.fct.2023.113666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/29/2023] [Accepted: 02/09/2023] [Indexed: 02/13/2023]
Abstract
The aims of this study were to determine the miRNAs involved in the methanol poisoning, and identify the male- and female-specific miRNA expression patterns in mice. Methanol was applied orally at the doses of 4 g/kg and 8 g/kg to induce mild and severe methanol poisoning in Balb/c mice. miRNA expression levels were detected at 3 different time periods (30, 60, and 180 min) following methanol exposure. miRNA expression profiles were determined using the high-throughput Fluidigm BioMark real-time PCR. We observed that serum miR-206 expression in male mice and miR-6357 expression in female mice could be an indicator of methanol poisoning. miR-9-3p downregulation and miR-1187 upregulation could be important for liver tissue. miR-3106-5p and miR-133a-5p upregulations and miR-122-3p downregulation could be poison biomarkers for ocular tissue in male mice. However, miR-194-5p downregulation could be a biomarker for ocular tissue in female mice. miR-122-5p and miR-124-3p downregulations and miR-499a-5p upregulation appeared to be important for kidney tissue in male mice. miR-543 and miR-6342 upregulations could be potential candidate biomarkers for kidney tissue in female mice. Our study is the first to report that differential miRNA expressions are involved in blood and tissues in male and female mice after methanol treatment.
Collapse
Affiliation(s)
- Nurullah Günay
- Department of Emergency Medicine, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey.
| | - Serpil Taheri
- Department of Medical Biology, Faculty of Medicine, Erciyes University, Kayseri, 38280, Turkey; Erciyes University, Betül-Ziya Eren Genome and Stem Cell Center (GENKOK), Kayseri, 38280, Turkey
| | - Mehmet Memiş
- Erciyes University, Betül-Ziya Eren Genome and Stem Cell Center (GENKOK), Kayseri, 38280, Turkey; Erciyes University, Gevher Nesibe Genome and Stem Cell Institute, Department of Medical Biology and Genetics, Kayseri, 38280, Turkey
| | - Zeynep Yilmaz Şükranli
- Erciyes University, Betül-Ziya Eren Genome and Stem Cell Center (GENKOK), Kayseri, 38280, Turkey
| | - Taner Şahin
- Kayseri City Hospital, Clinics of Emergency Medicine, Kayseri, 38080, Turkey
| | - Şeniz Demiryürek
- Department of Physiology, Faculty of Medicine, Gaziantep University, Gaziantep, 27310, Turkey
| | - Nahide Ekici Günay
- Kayseri City Hospital, Clinics of Medical Biochemistry, Kayseri, 38080, Turkey
| | - Yusuf Ertugrul Aslan
- Department of Emergency Medicine, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey
| | | |
Collapse
|
21
|
Allata Y, Chouhani BA, El Bardai G, Kabbali N, Sqalli Houssaini T. The Role of Nephrologists in the Management of Methanol Poisoning. Cureus 2023; 15:e37471. [PMID: 37187623 PMCID: PMC10176525 DOI: 10.7759/cureus.37471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 05/17/2023] Open
Abstract
Acute methanol poisoning is a rare but serious condition that can lead to significant morbidity and mortality. Toxic metabolites produced by methanol, primarily formaldehyde, can cause high anion gap metabolic acidosis, with the severity of clinical presentation ranging from mild symptoms to multi-organ failure. Nine people died and four patients needed treatment at our university hospital following a collective intoxication caused by the consumption of homemade alcoholic beverages in the central region of Morocco. The four patients presented to the emergency department with varying clinical symptoms, such as decreased visual acuity, severe agitation, and dyspnea. The laboratory tests confirmed high anion gap metabolic acidosis and a subsequent toxicology screen revealed that they had consumed methanol-tainted alcohol. The treatment regimen involved inhibiting the formation of toxic metabolites using an antidote (ethanol or fomepizole), correcting metabolic acidosis, enhancing the elimination of toxic metabolites through prolonged hemodialysis, and administering adjunctive therapies. While two patients had favorable outcomes, the other two died from multi-organ failure. These findings highlight the importance of prompt diagnosis and treatment in cases of methanol poisoning.
Collapse
Affiliation(s)
- Yassine Allata
- Nephrology, Hemodialysis and Transplantation, Hassan II University Hospital, Fez, MAR
| | - Basmat Amal Chouhani
- Nephrology, Hemodialysis and Transplantation, Hassan II University Hospital, Fez, MAR
- Epidemiology and Health Sciences Research Laboratory, Faculty of Medicine, Pharmacy and Dentistry, Sidi Mohamed Ben Abdellah University, Fez, MAR
| | - Ghita El Bardai
- Nephrology, Hemodialysis and Transplantation, Hassan II University Hospital, Fez, MAR
- Epidemiology and Health Sciences Research Laboratory, Faculty of Medicine, Pharmacy and Dentistry, Sidi Mohamed Ben Abdellah University, Fez, MAR
| | - Nadia Kabbali
- Nephrology, Hemodialysis and Transplantation, Hassan II University Hospital, Fez, MAR
- Epidemiology and Health Sciences Research Laboratory, Faculty of Medicine, Pharmacy and Dentistry, Sidi Mohamed Ben Abdellah University, Fez, MAR
| | - Tarik Sqalli Houssaini
- Nephrology, Hemodialysis and Transplantation, Hassan II University Hospital, Fez, MAR
- Epidemiology and Health Sciences Research Laboratory, Faculty of Medicine, Pharmacy and Dentistry, Sidi Mohamed Ben Abdellah University, Fez, MAR
| |
Collapse
|
22
|
Jose KP, Ravi S, Sivadas DK, Anthony SP, Madhu V. Fluorometric Detection of Methanol by Using Triphenylamine Fluorophore Tethered Terpyridine Probe. ChemistrySelect 2023. [DOI: 10.1002/slct.202204978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Affiliation(s)
- Karolin P. Jose
- Department of Applied Chemistry Karunya Institute of Technology and Sciences Coimbatore 641 114 Tamil Nadu India
| | - Sasikala Ravi
- School of Chemical & Biotechnology SASTRA Deemed University Thanjavur 613401 Tamil Nadu India
| | - Deepanjaly K. Sivadas
- Department of Applied Chemistry Karunya Institute of Technology and Sciences Coimbatore 641 114 Tamil Nadu India
| | | | - Vedichi Madhu
- Department of Applied Chemistry Karunya Institute of Technology and Sciences Coimbatore 641 114 Tamil Nadu India
| |
Collapse
|
23
|
Somisetty S, Santina A, Sarraf D, Mieler WF. The Impact of Systemic Medications on Retinal Function. Asia Pac J Ophthalmol (Phila) 2023; 12:115-157. [PMID: 36971705 DOI: 10.1097/apo.0000000000000605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/02/2023] [Indexed: 03/29/2023] Open
Abstract
This study will provide a thorough review of systemic (and select intravitreal) medications, along with illicit drugs that are capable of causing various patterns of retinal toxicity. The diagnosis is established by taking a thorough medication and drug history, and then by pattern recognition of the clinical retinal changes and multimodal imaging features. Examples of all of these types of toxicity will be thoroughly reviewed, including agents that cause retinal pigment epithelial disruption (hydroxychloroquine, thioridazine, pentosan polysulfate sodium, dideoxyinosine), retinal vascular occlusion (quinine, oral contraceptives), cystoid macular edema/retinal edema (nicotinic acid, sulfa-containing medications, taxels, glitazones), crystalline deposition (tamoxifen, canthaxanthin, methoxyflurane), uveitis, miscellaneous, and subjective visual symptoms (digoxin, sildenafil). The impact of newer chemotherapeutics and immunotherapeutics (tyrosine kinase inhibitor, mitogen-activated protein kinase kinase, checkpoint, anaplastic lymphoma kinase, extracellular signal-regulated kinase inhibitors, and others), will also be thoroughly reviewed. The mechanism of action will be explored in detail when known. When applicable, preventive measures will be discussed, and treatment will be reviewed. Illicit drugs (cannabinoids, cocaine, heroin, methamphetamine, alkyl nitrite), will also be reviewed in terms of the potential impact on retinal function.
Collapse
Affiliation(s)
- Swathi Somisetty
- Jules Stein Eye Institute, University of California, Los Angeles, CA
| | - Ahmad Santina
- Jules Stein Eye Institute, University of California, Los Angeles, CA
| | - David Sarraf
- Jules Stein Eye Institute, University of California, Los Angeles, CA
| | | |
Collapse
|
24
|
Subedi N, Pandey DP, Wagle A, Bhandari S, Paudel S, Karn M. Fatal toxicity due to locally produced unlabeled alcohol consumption: An illustrative case series from Nepal. SAGE Open Med Case Rep 2023; 11:2050313X231157985. [PMID: 36860306 PMCID: PMC9969422 DOI: 10.1177/2050313x231157985] [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: 09/29/2022] [Accepted: 01/31/2023] [Indexed: 02/26/2023] Open
Abstract
Locally prepared liquor, which is not standardized or regulated, though cheap can contain various toxic ingredients and even may be fatal. We report a case series of four adult males who died within 18.5 h due to the effect of local liquor consumption in a hilly district of Gandaki Province of Nepal. Methanol toxicity due to illicitly produced alcohol consumption should be managed with adequate supportive care and administration of specific antidotes such as ethanol or fomepizole. Liquor production should be standardized, and quality checks should be done before the sale for consumption.
Collapse
Affiliation(s)
- Nuwadatta Subedi
- Gandaki Medical College Teaching
Hospital and Research Center, Pokhara, Gandaki Province, Nepal,Nuwadatta Subedi, Gandaki Medical College
Teaching Hospital and Research Center, Pokhara, Gandaki Province, Nepal.
| | - Deb P. Pandey
- Research Center, Invention and
Innovation Center (RC-II), Pokhara, Gandaki University, Gandaki Province,
Nepal
| | - Abhishesh Wagle
- Gandaki Medical College Teaching
Hospital and Research Center, Pokhara, Gandaki Province, Nepal
| | - Shankar Bhandari
- Gandaki Medical College Teaching
Hospital and Research Center, Pokhara, Gandaki Province, Nepal
| | - Sabita Paudel
- Gandaki Medical College Teaching
Hospital and Research Center, Pokhara, Gandaki Province, Nepal
| | - Mitesh Karn
- Gandaki Medical College Teaching
Hospital and Research Center, Pokhara, Gandaki Province, Nepal
| |
Collapse
|
25
|
Shen H, Zhong LX, Fu Y, Shao W, Yang Y, Wang Z, Yang H. Factors affecting the severity and prognosis of visual damage in inhalational methanol poisoning. Front Med (Lausanne) 2023; 10:1098138. [PMID: 37035312 PMCID: PMC10080716 DOI: 10.3389/fmed.2023.1098138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/06/2023] [Indexed: 04/11/2023] Open
Abstract
Background/Aim Inhalational methanol poisoning could cause severe damage to visual function. This study analyzed the prognosis of the correlation between the visual function and the relevant risk factors. Methods In this retrospective study, 14 patients had confirmed inhalational methanol poisoning, resulting in visual impairment in both eyes. The following tests were performed: laboratory tests, best corrected visual acuity (BCVA), intraocular pressure, slit lamp, fundus photography, visual field (VF), pattern visual evoked potential (P-VEP), flash electroretinogram (F-ERG), optical coherence tomography (OCT), and orbital or cranial magnetic resonance imaging (MRI). Results With active treatment, visual function improved to varying degrees in all 14 cases (28 eyes) in this study. The BCVA of 21 eyes declined to no light perception at the onset; 16 eyes showed different degrees of improvement after treatment, with the final BCVA (LogMar) mainly ranging from 2 to 3, and vision acuity stabilized after the 5th month. The VF pattern in the acute phase was mostly blind. Other VF patterns included the central visual island, large paracentral scotomas, hemipleural VF defects, and the temporal visual island. Retinal nerve fiber layer (RNFL) thickening was observed commonly in the acute phase (146.8 ± 33.2 μm), which subsided in the 1st month, showed dramatic thinning at the 3rd month, and then stabilized in the 5th month after onset. MRI showed that the main sites involved were optic nerve impairment, the optic disk, and retrobulbar segments. The basal ganglia region was the site most involved in the central nervous system (CNS). Conclusion Inhalational methanol poisoning could lead to severe impairment of visual function, and the prognosis of visual acuity (VA) was highly relevant to the risk factors of duration of toxic exposure, delayed admission, and degree of acidosis.
Collapse
Affiliation(s)
- Hongyi Shen
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- Department of Ophthalmology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Liu Xueying Zhong
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yue Fu
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Wanwen Shao
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yan Yang
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zhenyu Wang
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Hui Yang
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Hui Yang,
| |
Collapse
|
26
|
Tomsia M, Głaz M, Nowicka J, Cieśla J, Sosnowski M, Chełmecka E. Fatal Methanol Poisoning Caused by Drinking Industrial Alcohol: Silesia Region, Poland, April-June 2022. TOXICS 2022; 10:800. [PMID: 36548633 PMCID: PMC9788088 DOI: 10.3390/toxics10120800] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/13/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
Methanol poisonings caused by drinking industrial alcohol remain a severe problem worldwide. Education on types of alcohol and their harmfulness and legal regulations limiting the industrial alcohol trade seem to be the keys to reducing the number of poisonings. Methanol distribution in different tissues after absorption is not well understood. This research aimed to quantify the methanol and formic acid distribution in body fluids and tissue material in post-mortem samples collected from 19 fatal victims of massive intoxication with industrial alcohol in the Silesia Region (Poland) who died between April and June 2022. The samples were analyzed using a gas chromatography-flame ionization detector (GC-FID), and correlation coefficients for methanol and formic acid were determined. The results show a wide distribution of methanol and formic acid in human post-mortem biological fluids (blood, urine, vitreous humor, bile, and cerebrospinal fluid) and tissues (muscle, kidney, liver, spleen, lung, and brain). The strongest correlation for methanol concentration in blood and body fluids/tissues was obtained in the cerebrospinal fluid (r = 0.997) and for formic acid in muscle tissue (r = 0.931). The obtained results may be a valuable tool in toxicological analysis and improve medical standards of early diagnosis and targeted treatment.
Collapse
Affiliation(s)
- Marcin Tomsia
- Department of Forensic Medicine and Forensic Toxicology, Medical University of Silesia, 18 Medyków Street, 40-752 Katowice, Poland
| | - Małgorzata Głaz
- Department of Forensic Medicine and Forensic Toxicology, Medical University of Silesia, 18 Medyków Street, 40-752 Katowice, Poland
| | - Joanna Nowicka
- Department of Forensic Medicine and Forensic Toxicology, Medical University of Silesia, 18 Medyków Street, 40-752 Katowice, Poland
| | - Julia Cieśla
- Students Scientific Society, Medical University of Silesia, 18 Medyków Street, 40-752 Katowice, Poland
| | - Maciej Sosnowski
- Students Scientific Society, Medical University of Silesia, 18 Medyków Street, 40-752 Katowice, Poland
| | - Elżbieta Chełmecka
- Department of Statistics, Department of Instrumental Analysis, Faculty of Pharmaceutical Sciences, Medical University of Silesia, Ostrogórska 30, 41-200 Sosnowiec, Poland
| |
Collapse
|
27
|
Stanton MT. Part
II
: Interactive case: Toxicology and poison control. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2022. [DOI: 10.1002/jac5.1725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
28
|
Lao YE, Heyerdahl F, Jacobsen D, Hovda KE. An enzymatic assay with formate oxidase for point-of-care diagnosis of methanol poisoning. Basic Clin Pharmacol Toxicol 2022; 131:547-554. [PMID: 36083569 PMCID: PMC9825986 DOI: 10.1111/bcpt.13789] [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: 06/22/2022] [Revised: 08/20/2022] [Accepted: 09/06/2022] [Indexed: 01/11/2023]
Abstract
Gas chromatographic analysis for quantification of plasma methanol requires laboratory equipment and personnel, and it is typically unavailable in short time notice, especially in low- and middle-income countries. Detection of formate with the enzyme formate oxidase (FOX) is a promising method that can make the diagnosis of methanol poisoning simple and fast. The aims of this study were to test the sensitivity and specificity of a modified FOX-enzyme and to test the specificity of a point-of-care (POC)-model containing FOX-enzyme with samples from patients with metabolic acidosis. The sensitivity and specificity of FOX-enzyme in aqueous solution were evaluated with a spectrometer and by visual detection for colour change. Formate concentrations between 1 and 20 mmol/L were used to test sensitivity, and 18 potentially interfering substances were tested for specificity. The sensitivity of the FOX-enzyme was 100% and the specificity 97%. When specificity of the POC-model was tested, no false positives were detected. As such, the sensitivity and specificity of this modified FOX-enzyme for detection of formate were high. The results with this enzyme confirm the potential for its use in formate analysis as a fast diagnosis of methanol poisoning.
Collapse
Affiliation(s)
- Yvonne Elisabeth Lao
- Norwegian National Unit for CBRNE Medicine, Department of Acute MedicineOslo University HospitalOsloNorway
| | - Fridtjof Heyerdahl
- Air Ambulance DepartmentOslo University HospitalOsloNorway,Institute of Clinical MedicineUniversity of OsloOsloNorway
| | - Dag Jacobsen
- Institute of Clinical MedicineUniversity of OsloOsloNorway,Department of Acute MedicineOslo University HospitalOsloNorway
| | - Knut Erik Hovda
- Norwegian National Unit for CBRNE Medicine, Department of Acute MedicineOslo University HospitalOsloNorway
| |
Collapse
|
29
|
Eom JS, Park DS, Lee SJ, Gu BH, Lee SJ, Lee SS, Kim SH, Kim BW, Lee SS, Kim M. Metabolomic and transcriptomic study to understand changes in metabolic and immune responses in steers under heat stress. ANIMAL NUTRITION 2022; 11:87-101. [PMID: 36189376 PMCID: PMC9483736 DOI: 10.1016/j.aninu.2022.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 05/22/2022] [Accepted: 06/23/2022] [Indexed: 11/27/2022]
Abstract
Heat stress (HS) damages livestock by adversely affecting physiological and immunological functions. However, fundamental understanding of the metabolic and immunological mechanisms in animals under HS remains elusive, particularly in steers. To understand the changes on metabolic and immune responses in steers under HS condition, we performed RNA-sequencing and proton nuclear magnetic resonance spectroscopy-based metabolomics on HS-free (THI value: 64.92 ± 0.56) and HS-exposed (THI value: 79.13 ± 0.56) Jersey steer (n = 8, body weight: 559.67 ± 32.72 kg). This study clarifies the metabolic changes in 3 biofluids (rumen fluid, serum, and urine) and the immune responses observed in the peripheral blood mononuclear cells of HS-exposed steers. This integrated approach allowed the discovery of HS-sensitive metabolic and immunological pathways. The metabolomic analysis indicated that HS-exposed steers showed potential HS biomarkers such as isocitrate, formate, creatine, and riboflavin (P < 0.05). Among them, there were several integrative metabolic pathways between rumen fluid and serum. Furthermore, HS altered mRNA expression and immune-related signaling pathways. A meta-analysis revealed that HS decreased riboflavin metabolism and the expression of glyoxylate and dicarboxylate metabolism-related genes. Moreover, metabolic pathways, such as the hypoxia-inducible factor-1 signaling pathway, were downregulated in immune cells by HS (P < 0.05). These findings, along with the datasets of pathways and phenotypic differences as potential biomarkers in steers, can support more in-depth research to elucidate the inter-related metabolic and immunological pathways. This would help suggest new strategies to ameliorate the effects of HS, including disease susceptibility and metabolic disorders, in Jersey steers.
Collapse
Affiliation(s)
- Jun Sik Eom
- Institute of Agriculture and Life Science, Gyeongsang National University, Jinju, 52828, Republic of Korea
| | - Da Som Park
- Department of Animal Science, College of Natural Resources & Life Science, Pusan National University, Miryang, 50463, Republic of Korea
| | - Sang Jin Lee
- Department of Animal Science, College of Natural Resources & Life Science, Pusan National University, Miryang, 50463, Republic of Korea
| | - Bon-Hee Gu
- Life and Industry Convergence Research Institute, Pusan National University, Miryang, 50463, Republic of Korea
| | - Shin Ja Lee
- Institute of Agriculture and Life Science, Gyeongsang National University, Jinju, 52828, Republic of Korea
- University-Centered Labs, Gyeongsang National University, Jinju, 52828, Republic of Korea
| | - Sang-Suk Lee
- Ruminant Nutrition and Anaerobe Laboratory, Department of Animal Science and Technology, Sunchon National University, Suncheon, 57922, Republic of Korea
| | - Seon-Ho Kim
- Ruminant Nutrition and Anaerobe Laboratory, Department of Animal Science and Technology, Sunchon National University, Suncheon, 57922, Republic of Korea
| | - Byeong-Woo Kim
- Department of Animal Science, College of Natural Resources & Life Science, Pusan National University, Miryang, 50463, Republic of Korea
| | - Sung Sill Lee
- Institute of Agriculture and Life Science, Gyeongsang National University, Jinju, 52828, Republic of Korea
- University-Centered Labs, Gyeongsang National University, Jinju, 52828, Republic of Korea
- Division of Applied Life Science (BK21), Gyeongsang National University, Jinju, 52828, Republic of Korea
- Corresponding authors.
| | - Myunghoo Kim
- Department of Animal Science, College of Natural Resources & Life Science, Pusan National University, Miryang, 50463, Republic of Korea
- Life and Industry Convergence Research Institute, Pusan National University, Miryang, 50463, Republic of Korea
- Corresponding authors.
| |
Collapse
|
30
|
AYDIN H, DOĞANAY F, ERDOĞAN M, DOĞAN H, BEŞTEMİR A, TUNCAR A. Risk factors associated with mortality in patients with methanol poisoning: a retrospective study. ACTA MEDICA ALANYA 2022. [DOI: 10.30565/medalanya.1184894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Aim: Methanol poisoning (MP) is an essential medical problem worldwide, and despite advances in diagnosis and treatment, the mortality rate in these cases is high. This study aimed to evaluate the clinical and laboratory factors to determine in-hospital mortality in patients with MP.
Methods: This single-center, retrospective, observational study was conducted with adult 65 MP cases visiting the emergency department (ED) of a tertiary training and research hospital between January 01, 2017, and February 01, 2022. Data were statistically compared between survivors and non-survivors.
Results: The in-hospital mortality rate was 41.5%. The rate of cases with respiratory distress, low Glasgow coma scale (GCS) (≤8), and delayed arrival to the hospital (>24 hours) was higher in the group of non-survivors compared to the group of survivors. Non-survivors had a higher anion gap (30.5 mEq/L vs. 25.5mEq/L), base excess (-25.0 mmol/L vs. -18.6 mmol/L), lactate (10.2 mmol/L vs. 2.2 mmol/L) levels, and lower pH (6.76 vs. 7.14) and bicarbonate (6.3 mmol/L vs. 10.3 mmol/L) levels than survivors (p
Collapse
Affiliation(s)
- Hakan AYDIN
- University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Emergency Medicine
| | - Fatih DOĞANAY
- University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Emergency Medicine
| | - Mehmet ERDOĞAN
- University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Emergency Medicine
| | - Halil DOĞAN
- University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Emergency Medicine
| | | | - Alpay TUNCAR
- The Minister of Health, Department of Medical Specialty Board
| |
Collapse
|
31
|
Zarei M, Sheikhghomi S, Aghsaei Fard M. Hemi-central retinal artery occlusion following methanol toxicity. GMS OPHTHALMOLOGY CASES 2022; 12:Doc20. [PMID: 36569357 PMCID: PMC9762174 DOI: 10.3205/oc000207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective To describe a patient with hemi-retinal artery occlusion following methanol toxicity. Methods Observational case report. Results We report a case presented with an acute altitudinal visual field loss in the right eye following consumption of illicit alcoholic drink. In fundus photography, a well demarcated superior hemi-retinal whitening with foveal sparing was noted. Careful inspection of the optic nerve head in the right eye revealed that there was no main trunk of the central retinal artery anterior to the lamina cribrosa. Two separately emerging superior and inferior arterial trunks were noted. In fundus fluorescein angiography, earlier dye filling in the territory of the superior arterial trunk compared to the inferior arterial trunk was evident. Conclusion Hemi-central retinal occlusion may happen as an ocular consequence of methanol toxicity in patients with a proximal bifurcation of the central retinal artery.
Collapse
Affiliation(s)
- Mohammad Zarei
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sima Sheikhghomi
- Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj, Iran,*To whom correspondence should be addressed: Sima Sheikhghomi, Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj, Iran, E-mail:
| | | |
Collapse
|
32
|
PÉREZ-BELTRÁN CH, PÉREZ–CABALLERO G, ANDRADE JM, CUADROS-RODRÍGUEZ L, JIMÉNEZ-CARVELO AM. Non-targeted Spatially Offset Raman Spectroscopy-based vanguard analytical method to authenticate spirits: White Tequilas as a case study. Microchem J 2022. [DOI: 10.1016/j.microc.2022.108126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
33
|
Ma H, Cheng P, Chen C, Geng X, Yang K, Lv F, Ma J, Jiang Y, Liu Q, Su Y, Li J, Zhu N. Highly Selective Wearable Alcohol Homologue Sensors Derived from Pt-Coated Truncated Octahedron Au. ACS Sens 2022; 7:3067-3076. [PMID: 36173279 DOI: 10.1021/acssensors.2c01392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Unhealthy alcohol inhalation is among the top 10 causes of preventable death. However, the present alcohol sensors show poor selectivity among alcohol homologues. Herein, Pt-coated truncated octahedron Au (Ptm@Auto) as the electrocatalyst for a highly selective electrochemical sensor toward alcohol homologues has been designed. The alcohol sensor is realized by distinguishing the electro-oxidation behavior of methanol (MeOH), ethanol (EtOH), or isopropanol (2-propanol). Intermediates from alcohols are further oxidized to CO2 by Ptm@Auto, resulting in different oxidation peaks in cyclic voltammograms and successful distinction of alcohols. Ptm@Auto is then modified on wearable glove-based sensors for monitoring actual alcohol samples (MeOH fuel, vodka, and 2-propanol hand sanitizer), with good mechanical performance and repeatability. The exploration of the Ptm@Auto-based wearable alcohol sensor is expected to be suitable for environmental measurement with high selectivity for alcohol homologues or volatile organic compounds.
Collapse
Affiliation(s)
- Hongting Ma
- Zhang Dayu School of Chemistry, Dalian University of Technology, Dalian, Liaoning 116024, China
| | - Peihao Cheng
- Zhang Dayu School of Chemistry, Dalian University of Technology, Dalian, Liaoning 116024, China
| | - Chuanrui Chen
- Zhang Dayu School of Chemistry, Dalian University of Technology, Dalian, Liaoning 116024, China
| | - Xiaodong Geng
- Zhang Dayu School of Chemistry, Dalian University of Technology, Dalian, Liaoning 116024, China
| | - Kaizhou Yang
- Zhang Dayu School of Chemistry, Dalian University of Technology, Dalian, Liaoning 116024, China
| | - Fengjuan Lv
- Zhang Dayu School of Chemistry, Dalian University of Technology, Dalian, Liaoning 116024, China
| | - Junlin Ma
- Zhang Dayu School of Chemistry, Dalian University of Technology, Dalian, Liaoning 116024, China
| | - Yue Jiang
- Zhang Dayu School of Chemistry, Dalian University of Technology, Dalian, Liaoning 116024, China
| | - Quanli Liu
- Zhang Dayu School of Chemistry, Dalian University of Technology, Dalian, Liaoning 116024, China
| | - Yan Su
- School of Chemical Engineering, Dalian University of Technology, Dalian, Liaoning 116024, China
| | - Jian Li
- Center for Reproductive Medicine, Dalian Women and Children's Medical Center (Group), Dalian 116037, China
| | - Nan Zhu
- Zhang Dayu School of Chemistry, Dalian University of Technology, Dalian, Liaoning 116024, China
| |
Collapse
|
34
|
Eskandrani R, Almulhim K, Altamimi A, Alhaj A, Alnasser S, Alawi L, Aldweikh E, Alaufi K, Mzahim B. Methanol poisoning outbreak in Saudi Arabia: a case series. J Med Case Rep 2022; 16:357. [PMID: 36199119 PMCID: PMC9535885 DOI: 10.1186/s13256-022-03600-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 09/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background Outbreaks of methanol poisoning have been described in the medical literature in different regions around the world. Even though in Saudi Arabia a few outbreaks of methanol poisoning have occurred, they remain undocumented. Herein, we describe several cases of methanol poisoning in Saudi Arabia with the goal of increasing awareness about the dangers of methanol poisoning among healthcare staff. Case presentation Nine middle-aged Saudi patients (five men aged 24, 26, 27, 36, and 49 years and four females aged 19, 20, 24, and 25 years) were admitted to our emergency department after alcohol consumption. All patients presented with severe metabolic acidosis and some visual impairment. Treatment was initiated based on the clinical suspicion of methanol intoxication because of laboratory test limitations and time constraints. Patients showed improvement and favorable hospital outcomes after aggressive empirical treatment. Conclusions Many social and cultural factors influence the lack of reporting of methanol poisoning cases in Saudi Arabia. We believe it is important to document these outbreaks to increase the knowledge among healthcare providers and promote public health awareness. A high index of suspicion and the development of local public health networks to monitor, survey, follow-up, and facilitate data exchange can help healthcare providers recognize and aggressively treat affected individuals. Early empiric and aggressive management can greatly decrease morbidity and mortality despite challenges and limited resources.
Collapse
Affiliation(s)
- Rawan Eskandrani
- Poison Control Center, Emergency Medicine Administration, King Fahad Medical City, Prince Abdulaziz Ibn Jalwi St, As Sulimaniyah, Riyadh, 12231, Saudi Arabia.
| | - Khalid Almulhim
- Poison Control Center, Emergency Medicine Administration, King Fahad Medical City, Prince Abdulaziz Ibn Jalwi St, As Sulimaniyah, Riyadh, 12231, Saudi Arabia
| | - Abdulla Altamimi
- Poison Control Center, Emergency Medicine Administration, King Fahad Medical City, Prince Abdulaziz Ibn Jalwi St, As Sulimaniyah, Riyadh, 12231, Saudi Arabia
| | - Abeer Alhaj
- Poison Control Center, Emergency Medicine Administration, King Fahad Medical City, Prince Abdulaziz Ibn Jalwi St, As Sulimaniyah, Riyadh, 12231, Saudi Arabia
| | - Shahd Alnasser
- Poison Control Center, Emergency Medicine Administration, King Fahad Medical City, Prince Abdulaziz Ibn Jalwi St, As Sulimaniyah, Riyadh, 12231, Saudi Arabia
| | - Laale Alawi
- Poison Control Center, Emergency Medicine Administration, King Fahad Medical City, Prince Abdulaziz Ibn Jalwi St, As Sulimaniyah, Riyadh, 12231, Saudi Arabia
| | - Eman Aldweikh
- Poison Control Center, Emergency Medicine Administration, King Fahad Medical City, Prince Abdulaziz Ibn Jalwi St, As Sulimaniyah, Riyadh, 12231, Saudi Arabia
| | - Khalid Alaufi
- Poison Control Center, Emergency Medicine Administration, King Fahad Medical City, Prince Abdulaziz Ibn Jalwi St, As Sulimaniyah, Riyadh, 12231, Saudi Arabia.,Emergency Medicine Department, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia
| | - Bandr Mzahim
- Poison Control Center, Emergency Medicine Administration, King Fahad Medical City, Prince Abdulaziz Ibn Jalwi St, As Sulimaniyah, Riyadh, 12231, Saudi Arabia.,Emergency Medicine Administration, King Fahad Medical City, Riyadh, Saudi Arabia
| |
Collapse
|
35
|
ŞAHİN T, BOL O, ALTUNTAŞ M. Acil Servise Başvuran Metil Alkol Zehirlenmelerinin Geriye Dönük Analizi. KONURALP TIP DERGISI 2022. [DOI: 10.18521/ktd.1147742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objective: Methyl alcohol poisoning remains a significant cause of mortality and morbidity. This poisoning is still one of the important reasons for admission to emergency services. We aimed to examine the admission complaints, laboratory findings, treatment methods, clinical outcomes and examine the factors affecting the mortality of patients diagnosed with methyl alcohol poisoning in the emergency department.
Methods: In this retrospective descriptive study, we analysed the patients who were considered to be diagnosed with methyl alcohol intoxication among those who came to our emergency department due to alcohol intoxication from June 1, 2018 to June 1, 2020.
Results: The study included 20 (4.86%) individuals with methyl alcohol poisoning among 411 people who presented to the emergency department due to ethyl and methyl alcohol intake and resulting effects.The mean age of the patients was 47.35±14.2 years and 85% (n=17/20) were male. Upon reviewing the patients' admission symptoms, 70% were observed to have visual problems, 60% complaints of vomiting, 45% shortness of breath, and 40% changes in consciousness. In the study, it was revealed that 18.2%(n=2/11) females and 81.8%(n=9/11) males died, and the mortality rate was calculated as 55%(n=11/20).
Conclusions: The presence of visual problems, hypotension, and coma in clinical findings, high anion gap metabolic acidosis, marked osmolar gap, an increase in lactate level, and hyperglycemia in laboratory findings may be the early signs of mortality in patients with methyl alcohol poisoning. Therefore, patients with these signs should be followed up more closely and treated.
Collapse
Affiliation(s)
- Taner ŞAHİN
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, KAYSERİ SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ
| | - Oğuzhan BOL
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, KAYSERİ ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ
| | - Mükerrem ALTUNTAŞ
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, KAYSERİ SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ
| |
Collapse
|
36
|
Tonezzer M, Bazzanella N, Gasperi F, Biasioli F. Nanosensor Based on Thermal Gradient and Machine Learning for the Detection of Methanol Adulteration in Alcoholic Beverages and Methanol Poisoning. SENSORS 2022; 22:s22155554. [PMID: 35898057 PMCID: PMC9329758 DOI: 10.3390/s22155554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 01/01/2023]
Abstract
Methanol, naturally present in small quantities in the distillation of alcoholic beverages, can lead to serious health problems. When it exceeds a certain concentration, it causes blindness, organ failure, and even death if not recognized in time. Analytical techniques such as chromatography are used to detect dangerous concentrations of methanol, which are very accurate but also expensive, cumbersome, and time-consuming. Therefore, a gas sensor that is inexpensive and portable and capable of distinguishing methanol from ethanol would be very useful. Here, we present a resistive gas sensor, based on tin oxide nanowires, that works in a thermal gradient. By combining responses at various temperatures and using machine learning algorithms (PCA, SVM, LDA), the device can distinguish methanol from ethanol in a wide range of concentrations (1–100 ppm) in both dry air and under different humidity conditions (25–75% RH). The proposed sensor, which is small and inexpensive, demonstrates the ability to distinguish methanol from ethanol at different concentrations and could be developed both to detect the adulteration of alcoholic beverages and to quickly recognize methanol poisoning.
Collapse
Affiliation(s)
- Matteo Tonezzer
- Research and Innovation Centre, Fondazione Edmund Mach, via E. Mach 1, 38010 San Michele all’Adige, Italy; (F.G.); (F.B.)
- Center Agriculture Food Environment, University of Trento/Fondazione Edmund Mach, via E. Mach 1, 38010 San Michele all’Adige, Italy
- IMEM-CNR, Sede di Trent o-FBK, Via alla Cascata 56/C, Povo, 38123 Trento, Italy
- Correspondence: ; Tel.: +39-0461-314-828
| | - Nicola Bazzanella
- Department of Physics, Università degli Studi di Trento, Povo, 38123 Trento, Italy;
| | - Flavia Gasperi
- Research and Innovation Centre, Fondazione Edmund Mach, via E. Mach 1, 38010 San Michele all’Adige, Italy; (F.G.); (F.B.)
- Center Agriculture Food Environment, University of Trento/Fondazione Edmund Mach, via E. Mach 1, 38010 San Michele all’Adige, Italy
| | - Franco Biasioli
- Research and Innovation Centre, Fondazione Edmund Mach, via E. Mach 1, 38010 San Michele all’Adige, Italy; (F.G.); (F.B.)
| |
Collapse
|
37
|
YURTSEVER G, ARIKAN C, ACAR H, SORGUN O, BORA ES. Methanol poisoning in the emergency department: a retrospective study. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1095045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: Massive methanol poisonings have occurred in the past decades, resulting in a large number of deaths. In this study, our aim is to retrospectively analyze methanol poisoning cases admitted to the emergency department between 2019-2021, to evaluate their demographic characteristics, causes of poisoning, clinical and laboratory findings, treatments applied and mortality, and to contribute to the poisoning data of our country.
Material and Method: The cases of methanol poisoning who applied to the emergency department in a 3-year period were analyzed retrospectively. Medical files of patients aged 18 years and older were reviewed. Patients diagnosed with 'methanol poisoning' as a result of the examination were included in the study.
Results: A total of 59 patients were included in the study. 88% (n=52) of the patients with a mean age of 53±10 were male. The presence of neurological symptoms and GCS were associated with mortality among the symptoms of patients presenting to the emergency department (p=0.017, p
Collapse
|
38
|
KARAER BÜBERCİ R, KARAHİSAR ŞİRALİ S, DURANAY M. The predictors of mortality in patients with methyl alcohol intoxication. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1102111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: Methanol intoxication is a worldwide public health problem. Mortality rates are quite high unless there is early intervention and diagnosis. The aim of this study was to investigate the predictors of mortality in patients with methyl alcohol intoxication.
Material and Method: The study included 18 patients admitted to emergency department of our hospital in 2019-2020, who were diagnosed with methanol intoxication. Laboratory parameters and basic features of the patients were recorded. According to the criteria of 2012 Clinical Practice Guideline for Acute Kidney Injury (AKI), patients were diagnosed with AKI.
Results: The mean age of the patients was 45.7±15.21 years and 72.2% of those were male. The mortality and AKI rate were 38.9% and 44.4%, respectively. In regression analyses, delay in admission to hospital, low Glasgow coma scale score, AKI development and high lactate level were independent predictors of mortality. According to ROC analyses when lactate level was more than 5.75 mmol/L, mortality rate increased more rapidly.
Conclusion: Mortality rate is very high in methanol intoxication. Patients with AKI and high lactate levels should be intervened faster.
Collapse
Affiliation(s)
- Refika KARAER BÜBERCİ
- Sağlık Bilimleri Üniversitesi, Ankara Eğitim ve Araştırma Hastanesi, Nefroloji Kliniği
| | | | - Murat DURANAY
- Sağlık Bilimleri Üniversitesi, Ankara Eğitim ve Araştırma Hastanesi, Nefroloji Kliniği
| |
Collapse
|
39
|
CT and MR Imaging Findings in Methanol Intoxication Manifesting with BI Lateral Severe Basal Ganglia and Cerebral Involvement. J Belg Soc Radiol 2022; 106:66. [PMID: 35859917 PMCID: PMC9267022 DOI: 10.5334/jbsr.2836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/21/2022] [Indexed: 11/28/2022] Open
Abstract
Our case report describes a 54-year-old man who was admitted to our hospital complaining of visual impairment with gastrointestinal and neurological symptoms. Initial computed tomography examination showed bilateral symmetric putaminal and cerebral white matter hypodensities. Evaluation of the following magnetic resonance imaging, restricted diffusion in these corresponding areas were found to be compatible with cytotoxic edema. Teaching Point: Diffusion-weighted imaging (DWI) plays a crucial role in the diagnosis of acute methanol intoxication.
Collapse
|
40
|
Li J, Feng ZJ, Liu L, Ma YJ. Acute methanol poisoning with bilateral diffuse cerebral hemorrhage: A case report. World J Clin Cases 2022; 10:6571-6579. [PMID: 35979299 PMCID: PMC9294890 DOI: 10.12998/wjcc.v10.i19.6571] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 04/04/2022] [Accepted: 05/07/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Acute methanol poisoning (AMP) is a systemic disease that mainly affects the central nervous system and is characterized by ocular damage and metabolic acidosis. If appropriate treatments are inadequate or delayed, the mortality can exceed 40%. As the most serious complication, cerebral hemorrhage is rare with reported prevalence of 7%-19%.
CASE SUMMARY A 62-year-old man drank liquor mixed with 45% methanol and 35% alcohol. His vision blurred 10 h later and he fell into coma in another 9 h. Serum toxicological tests were performed immediately, and continuous renal replacement therapy (CRRT) was carried out as the lactic acid exceeded 15 mmol/L and blood pH was 6.78. In addition, the toxicological report revealed 1300.5 μg/mL of methanol in serum and 1500.2 μg/mL in urine. After 59 h of CRRT, the methanol level decreased to 126.0 μg/mL in serum and 151.0 μg/mL in urine. However, the patient was still unconscious and his pupillary light reflex was slow. Computed tomography showed hemorrhage in the left putamen. After 16 d of life support treatment, putamen hemorrhage developed into diffuse symmetric intracerebral hemorrhage. In the end, his family gave up and the patient was discharged, and died in a local hospital.
CONCLUSION Cerebral hemorrhage requires constant vigilance during the full course of treatment for severe cases of AMP.
Collapse
Affiliation(s)
- Jin Li
- Department of Critical Care Medicine, Air Force Medical Center, PLA, Beijing 100142, China
| | - Zhi-Juan Feng
- Department of Critical Care Medicine, Air Force Medical Center, PLA, Beijing 100142, China
| | - Lei Liu
- Department of Critical Care Medicine, Air Force Medical Center, PLA, Beijing 100142, China
| | - Yu-Jie Ma
- Department of Critical Care Medicine, Air Force Medical Center, PLA, Beijing 100142, China
| |
Collapse
|
41
|
Almeida Franzoi AE, Colaço CF, Borges de Macedo Zubko LE, Nascimento de Souza MF, Kruger RS. Bilateral and Symmetrical Lesions in the Basal Ganglia Associated With Metabolic Acidosis in a Patient With a History of Alcohol Addiction: A Case Report. Cureus 2022; 14:e26307. [PMID: 35911282 PMCID: PMC9314236 DOI: 10.7759/cureus.26307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 11/05/2022] Open
Abstract
Metabolic acidosis is defined as a pathologic process that, when unopposed, increases the concentration of hydrogen ions in the body and reduces the concentration of HCO3. Methanol poisoning is an important cause of metabolic acidosis. Methanol and ethylene glycol poisonings cause scores of fatal intoxications annually, and even relatively small ingestions of these alcohols can produce significant toxicity. Neuroimaging findings are very suggestive and help in the diagnosis even before the measurement of serum methanol (when available at the health service). Rapid recognition and early treatment, including alcohol dehydrogenase inhibition, are crucial. In this sense, some studies question that many intoxications by different chemical agents (in addition to methanol and ethylene glycol) generate a conglomeration of neuroimaging findings that summarily reflect the presence of metabolic acidosis. Therefore, in this article, we discuss the imaging findings of metabolic acidosis, methanol poisoning, and their main differential diagnoses in neuroimaging, directing earlier diagnostic reasoning in order to initiate the most appropriate treatment promptly.
Collapse
|
42
|
Wu X, Gu M, Wang W, Zhang H, Tang Z. Case Report: Early Recognition, Treatment, and Occupational Safety Protection are Crucial for Methanol Toxicity. Front Med (Lausanne) 2022; 9:918812. [PMID: 35774994 PMCID: PMC9237385 DOI: 10.3389/fmed.2022.918812] [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: 04/12/2022] [Accepted: 05/24/2022] [Indexed: 11/16/2022] Open
Abstract
Background Despite significant progress in treating methanol poisoning, the lack of training, hazard communication, and occupational safety protection education contributes to the risk of occupational exposure and methanol toxicity. In addition, early diagnosis and timely medical care are essential to reduce the risk of morbidity and mortality, yet it remains a challenging procedure. Case Report A 35-year-old man working in a fireworks factory came to our emergency department with acute mental change and progressive disturbance of consciousness. The patient's vital signs were stable, and he presented with enlargement of both pupils with a weak reaction to light. Head computed tomography showed low signal intensities in the bilateral basal ganglia. He was admitted to the neurologic intensive care unit, where additional laboratory workup showed high anion-gap metabolic acidosis. Methanol poisoning was thus considered. Before being treated with sodium bicarbonate infusion, hemodialysis, folate, and high-dose vitamin B, the blood and urine samples were collected for toxicity tests, which turned out to be methanol poisoning. After 8 hours of hemodialysis, the patient's consciousness recovered, but he complained of a complete loss of vision in both eyes. Brain and optic nerve magnetic resonance images showed bilateral symmetric putamen lesions and optic neuropathy. Ophthalmic tests indicated visual pathway impairment and optic disc swelling but no fluorescein leakage. The right eye's vision was partially restored on the third day, but he could only count fingers at 20 cm. Unfortunately, his eyesight ceased to improve during the 6 months of follow-up. Conclusions Early diagnosis and prompt treatment will improve the prognosis of methanol poisoning in terms of vision and patient survival. Awareness and supervision of commercial alcohol use are indispensable for similar industrial processes.
Collapse
Affiliation(s)
- Xiaomei Wu
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Meifeng Gu
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Wei Wang
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Hainan Zhang
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhenchu Tang
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Tumor Models and Individualized Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
43
|
Erfanifar A, Mahjani M, Salimpour S, Zamani N, Hassanian-Moghaddam H. Diabetic ketoacidosis as a complication of methanol poisoning; a case report. BMC Endocr Disord 2022; 22:148. [PMID: 35655196 PMCID: PMC9164356 DOI: 10.1186/s12902-022-01037-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/02/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Diabetic ketoacidosis (DKA) is a complication of diabetes presenting with high anion gap metabolic acidosis. Methanol poisoning, on the other hand, is a toxicology emergency which presents with the same feature. We present a case of methanol poisoning who presented with DKA. CASE PRESENTATION A 28-year-old male was referred to us with blurred vision and loss of consciousness three days after ingestion of 1.5 L of an unknown mixture of bootleg alcoholic beverage. He had history of insulin-dependent diabetes and had neglected his insulin shots on the day prior to hospital admission due to progressive loss of consciousness. Vital signs were normal and venous blood gas analysis showed severe metabolic acidosis and a methanol level of 10.2 mg/dL. After eight hours of hemodialysis, he remained unresponsive. Diabetic ketoacidosis was suspected due to positive urine ketone and blood sugar of 411 mg/dL. Insulin infusion was initiated which was followed by full awakening and extubation. He was discharged completely symptom-free after 4 weeks. CONCLUSIONS Diabetic ketoacidosis and methanol poisoning can happen simultaneously in a diabetic patient. Given the analogous high anion gap metabolic acidosis, physicians should pay particular attention to examination of the diabetic patients. Meticulous evaluation for both conditions is highly recommended.
Collapse
Affiliation(s)
- Azam Erfanifar
- Department of Internal Medicine, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa Mahjani
- Department of Internal Medicine, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Salimpour
- Department of Internal Medicine, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasim Zamani
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Clinical Toxicology, School of Medicine, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Hassanian-Moghaddam
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Department of Clinical Toxicology, School of Medicine, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
44
|
Gursul C, Ozcicek A, Ozkaraca M, Mendil AS, Coban TA, Arslan A, Ozcicek F, Suleyman H. Amelioration of oxidative damage parameters by carvacrol on methanol-induced liver injury in rats. Exp Anim 2022; 71:224-230. [PMID: 34911876 PMCID: PMC9130043 DOI: 10.1538/expanim.21-0143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 11/08/2021] [Indexed: 11/17/2022] Open
Abstract
The methanol metabolite that causes hepatotoxicity is formic acid, generating reactive oxygen radical formation and cell damage. Carvacrol is an antioxidant monoterpenic phenol produced from Thymus vulgaris. This study aimed to investigate the effects of carvacrol on methanol-induced oxidative liver damage in rats. Eighteen rats were divided into three groups. Methotrexate was administered orally for 7 days to methotrexate+methanol (MTM) and methotrexate+methanol+carvacrol (MMC) groups. Methotrexate was given before methanol to cause methanol poisoning. Distilled water was given to the healthy group (HG) as a solvent. At the end of the 7th day, 20% methanol was administered orally at a dose of 3 g/kg to the MTM and MMC groups. Four hours after methanol administration, 50 mg/kg carvacrol was injected intraperitoneally into the MMC group. Animals were sacrificed 8 h after carvacrol injection. Biochemical markers were studied in the excised liver tissue and blood serum samples, and histopathological evaluations were made. Severe hemorrhage, hydropic degeneration, pycnosis, and mononuclear cell infiltration were observed in the liver of the MTM group. Additionally, the levels of malondialdehyde (MDA), total oxidant status (TOS), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were significantly higher, and total glutathione (tGSH) and total antioxidant status (TAS) were significantly lower in the MTM group compared to HG (P<0.001). Carvacrol prevented the increase in MDA, TOS, ALT and AST levels with methanol and the decrease in tGSH and TAS levels (P<0.001), and alleviated the histopathological damage. Carvacrol may be useful in the treatment of methanol-induced liver damage.
Collapse
Affiliation(s)
- Cebrail Gursul
- Department of Physiology, Faculty of Medicine, Erzincan Binali Yildirim University, Basbaglar Street, 24030, Erzincan, Turkey
| | - Adalet Ozcicek
- Department of Internal Medicine, Faculty of Medicine, Erzincan Binali Yildirim University, Basbaglar Street, 24030, Erzincan, Turkey
| | - Mustafa Ozkaraca
- Department of Pathology, Faculty of Veterinary Medicine, Sivas Cumhuriyet University, 69 Kayseri Street, 58140, Sivas, Turkey
| | - Ali Sefa Mendil
- Department of Pathology, Faculty of Veterinary Medicine, Erciyes University, 55 Hulusi Behcet Street, 38280, Kayseri, Turkey
| | - Taha Abdulkadir Coban
- Department of Clinical Biochemistry, Faculty of Medicine, Erzincan Binali Yildirim University, Basbaglar Street, 24030, Erzincan, Turkey
| | - Aynur Arslan
- Department of Internal Medicine, Faculty of Medicine, Halic University, 15 Temmuz Sehitler Street, Eyup, 34060, Istanbul, Turkey
| | - Fatih Ozcicek
- Department of Internal Medicine, Faculty of Medicine, Erzincan Binali Yildirim University, Basbaglar Street, 24030, Erzincan, Turkey
| | - Halis Suleyman
- Department of Pharmacology, Faculty of Medicine, Erzincan Binali Yildirim University, Basbaglar Street, 24030, Erzincan, Turkey
| |
Collapse
|
45
|
Biochemical mechanism underlying the pathogenesis of diabetic retinopathy and other diabetic complications in humans: the methanol-formaldehyde-formic acid hypothesis. Acta Biochim Biophys Sin (Shanghai) 2022; 54:415-451. [PMID: 35607958 PMCID: PMC9828688 DOI: 10.3724/abbs.2022012] [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] [Indexed: 11/25/2022] Open
Abstract
Hyperglycemia in diabetic patients is associated with abnormally-elevated cellular glucose levels. It is hypothesized that increased cellular glucose will lead to increased formation of endogenous methanol and/or formaldehyde, both of which are then metabolically converted to formic acid. These one-carbon metabolites are known to be present naturally in humans, and their levels are increased under diabetic conditions. Mechanistically, while formaldehyde is a cross-linking agent capable of causing extensive cytotoxicity, formic acid is an inhibitor of mitochondrial cytochrome oxidase, capable of inducing histotoxic hypoxia, ATP deficiency and cytotoxicity. Chronic increase in the production and accumulation of these toxic one-carbon metabolites in diabetic patients can drive the pathogenesis of ocular as well as other diabetic complications. This hypothesis is supported by a large body of experimental and clinical observations scattered in the literature. For instance, methanol is known to have organ- and species-selective toxicities, including the characteristic ocular lesions commonly seen in humans and non-human primates, but not in rodents. Similarly, some of the diabetic complications (such as ocular lesions) also have a characteristic species-selective pattern, closely resembling methanol intoxication. Moreover, while alcohol consumption or combined use of folic acid plus vitamin B is beneficial for mitigating acute methanol toxicity in humans, their use also improves the outcomes of diabetic complications. In addition, there is also a large body of evidence from biochemical and cellular studies. Together, there is considerable experimental support for the proposed hypothesis that increased metabolic formation of toxic one-carbon metabolites in diabetic patients contributes importantly to the development of various clinical complications.
Collapse
|
46
|
Hashemi SA, Bahrani S, Mousavi SM, Omidifar N, Arjmand M, Lankarani KB, Shokripour M, Ramakrishna S. Differentiable detection of ethanol/methanol in biological fluids using prompt graphene-based electrochemical nanosensor coupled with catalytic complex of nickel oxide/8-hydroxyquinoline. Anal Chim Acta 2022; 1194:339407. [PMID: 35063153 DOI: 10.1016/j.aca.2021.339407] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 12/23/2021] [Accepted: 12/27/2021] [Indexed: 02/05/2023]
Affiliation(s)
- Seyyed Alireza Hashemi
- Nanomaterials and Polymer Nanocomposites Laboratory, School of Engineering, University of British Columbia, Kelowna, BC, V1V 1V7, Canada
| | - Sonia Bahrani
- Health Policy Research Center, Health Institute, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyyed Mojtaba Mousavi
- Department of Chemical Engineering, National Taiwan University of Science and Technology, Taiwan
| | - Navid Omidifar
- Department of Pathology, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran; Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mohammad Arjmand
- Nanomaterials and Polymer Nanocomposites Laboratory, School of Engineering, University of British Columbia, Kelowna, BC, V1V 1V7, Canada.
| | - Kamran Bagheri Lankarani
- Health Policy Research Center, Health Institute, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mansoureh Shokripour
- Department of Pathology, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seeram Ramakrishna
- Department of Mechanical Engineering, Center for Nanofibers and Nanotechnology, National University of Singapore, Singapore.
| |
Collapse
|
47
|
Liberski S, Kaluzny BJ, Kocięcki J. Methanol-induced optic neuropathy: a still-present problem. Arch Toxicol 2022; 96:431-451. [PMID: 34988610 PMCID: PMC8731680 DOI: 10.1007/s00204-021-03202-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 12/09/2021] [Indexed: 11/28/2022]
Abstract
Methanol-induced optic neuropathy (Me-ION) is a serious condition that may result in long-term or irreversible visual impairment or even blindness secondary to damage and loss of function of the optic nerve and retina. Me-ION shows a tendency to occur as mass poisonings around the world with a clear predilection for poor societies in developing countries. The main mechanism underlying the molecular basis of Me-ION is the inhibition of the mitochondrial oxidative phosphorylation process through the binding of the toxic metabolite of methanol—formic acid—with the key enzyme of this process—cytochrome c oxidase. However, other mechanisms, including damage to the eye tissues by oxidative stress causing the intensification of the oxidative peroxidation process with the formation of cytotoxic compounds, as well as an increase in the synthesis of pro-inflammatory cytokines and influence on the expression of key proteins responsible for maintaining cell homeostasis, also play an important role in the pathogenesis of Me-ION. Histopathological changes in the eye tissues are mainly manifested as the degeneration of axons and glial cells of the optic nerve, often with accompanying damage of the retina that may involve all its layers. Despite the development of therapeutic approaches, persistent visual sequelae are seen in 30–40% of survivors. Thus, Me-ION continues to be an important problem for healthcare systems worldwide.
Collapse
Affiliation(s)
- Sławomir Liberski
- Department of Ophthalmology, Poznan University of Medical Sciences, ul. Augustyna Szamarzewskiego 84, 61-848, Poznań, Poland.
| | - Bartlomiej J Kaluzny
- Division of Ophthalmology and Optometry, Department of Ophthalmology, Collegium Medicum, Nicolaus Copernicus University, ul. Kornela Ujejskiego 75, 85-168, Bydgoszcz, Poland
| | - Jarosław Kocięcki
- Department of Ophthalmology, Poznan University of Medical Sciences, ul. Augustyna Szamarzewskiego 84, 61-848, Poznań, Poland
| |
Collapse
|
48
|
Zamani N, Gheshlaghi F, Haghighi-Morad M, Bahrami-Motlagh H, Alavi Darazam I, Hadeiy SK, McDonald R, Hassanian-Moghaddam H. Prevalence of clinical and radiologic features in methanol-poisoned patients with and without COVID-19 infection. Acute Med Surg 2021; 8:e715. [PMID: 34925862 PMCID: PMC8647202 DOI: 10.1002/ams2.715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/05/2021] [Accepted: 11/16/2021] [Indexed: 02/05/2023] Open
Abstract
Aim The aim of the current study was to evaluate the prevalence of coronavirus disease (COVID‐19) in methanol‐poisoned patients admitted to two toxicology academic centers during the COVID‐19 outbreak and determine their clinical features and chest/brain computed tomography (CT) findings. Methods Methanol‐poisoned patients who had been referred during the COVID‐19 pandemic were evaluated for signs and symptoms of COVID‐19 by chest CT scans and/or polymerase chain reaction test. Results A total of 62 patients with confirmed methanol poisoning were enrolled in the study, with a median (interquartile range) age of 35 (28–44) years. Thirty‐nine (62.9%) survived. Nine (14.5%) were diagnosed to have COVID‐19, of whom four survived. There was a significant correlation between COVID‐19 disease and a history of alcohol consumption (p = 0.036; odds ratio 1.7; 95% confidence interval, 1.3–2.2). Univariate analysis showed significant differences between infected and noninfected patients regarding their urea and time for first and second hemodialysis sessions, as well as the duration of ethanol administration. Conclusions In conclusion, during the pandemic, specific attention should be paid to patients with a history of alcohol ingestion and elevated creatinine, loss of consciousness, and severe acidosis as these signs/symptoms could be present in both COVID‐19 and methanol poisoning, making differentiation between the two challenging.
Collapse
Affiliation(s)
- Nasim Zamani
- Social Determinants of Health Research Center Shahid Beheshti University of Medical Sciences Tehran Iran.,Department of Clinical Toxicology Loghman-Hakim Hospital School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Farzad Gheshlaghi
- Department of Clinical Toxicology Isfahan Clinical Toxicology Research Center School of Medicine Isfahan University of Medical Sciences Isfahan Iran
| | - Maryam Haghighi-Morad
- Department of Radiology Loghman-Hakim Hospital School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Hooman Bahrami-Motlagh
- Department of Radiology Loghman-Hakim Hospital School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Ilad Alavi Darazam
- Department of Infectious Diseases Loghman-Hakim Hospital School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Seyed Kaveh Hadeiy
- Social Determinants of Health Research Center Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Rebecca McDonald
- Institute of Psychiatry, Psychology and Neuroscience National Addiction Centre King's College London London UK
| | - Hossein Hassanian-Moghaddam
- Social Determinants of Health Research Center Shahid Beheshti University of Medical Sciences Tehran Iran.,Department of Clinical Toxicology Loghman-Hakim Hospital School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran
| |
Collapse
|
49
|
Methanol poisoning during COVID-19 pandemic; A systematic scoping review. Am J Emerg Med 2021; 52:69-84. [PMID: 34883289 PMCID: PMC8611855 DOI: 10.1016/j.ajem.2021.11.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 01/01/2023] Open
Abstract
Objective In this systematic scoping review, it was aimed to assess the epidemiology of methanol poisoning, clinical findings and patients' management, causes, and recommendations regarding prevention or reduction of methanol poisoning during COVID-19 pandemic. Methods Three Electronic databases [Medline (accessed from PubMed), Scopus, and Science Direct] were searched systematically from December 01, 2019 to September 10, 2020, using MESH terms and the related keywords in English language. Considering the titles and abstracts, unrelated studies were excluded. The full texts of the remained studies were evaluated by authors, independently. Then, the studies' findings were assessed and reported. Results Total of 86 articles were obtained within the first step of searching, and 64 ones remained after removing the duplications. Through the title and abstract screening, 35 were removed. Finally, after reading the full text of the remained articles, 15 ones included in data extraction. Most of the previous reported evidence (13/15) were letter to editor, commentary and short reports. None of them were interventional, and none of them followed the patients. Findings were summarized in four categories: 1) epidemiology; 2) clinical findings and patients' management; 3) causes; and 4) recommendation regarding prevention or reduction of methanol poisoning during COVID-19 pandemic. Conclusion The recent outbreak is the largest methanol mass poisoning outbreak throughout Iran and the world in recent decades. The causes of methanol poisoning during the COVID-19 pandemic are intertwined, and most of them are modifiable by health policy makers. Building trust, educating and warning, as well as controlling and monitoring are three main recommendation for prevention or reduction of methanol poisoning.
Collapse
|
50
|
Scanlon M, Marino R, Sidlak A. Folic acid in methanol toxicity: a retrospective cohort study. TOXICOLOGY COMMUNICATIONS 2021. [DOI: 10.1080/24734306.2021.1997013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Matthew Scanlon
- Division of Medical Toxicology, Department of Emergency Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Ryan Marino
- Division of Toxicology, Department of Emergency Medicine, University Hospital, Cleveland, OH, USA
| | - Alexander Sidlak
- Department of Emergency Medicine, Inova Fairfax Medical Center, Great Falls, VA, USA
| |
Collapse
|