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Kashiura M, Oshima A, Moriya T. Characteristic three-layered intestinal contents in a case of gasoline ingestion. Clin Toxicol (Phila) 2024:1-2. [PMID: 39078015 DOI: 10.1080/15563650.2024.2384982] [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: 05/30/2024] [Revised: 07/21/2024] [Accepted: 07/22/2024] [Indexed: 07/31/2024]
Abstract
INTRODUCTION Ingestion of gasoline can cause severe pulmonary and gastrointestinal complications. Computed tomography may reveal characteristic findings. CASE SUMMARY A 61-year-old man had gastrointestinal symptoms, and subsequently developed respiratory distress and altered mental status after ingesting approximately 150 mL of gasoline. IMAGES Abdominal computed tomography revealed a characteristic three-layered appearance of intestinal contents, likely representing intestinal fluid, ingested gasoline, and gas. Chest computed tomography showed bilateral pulmonary infiltrates consistent with pneumonitis. CONCLUSION Recognition of the characteristic three-layered appearance of the intestinal contents on abdominal computed tomography might aid in the diagnosis of gasoline ingestion.
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Affiliation(s)
- Masahiro Kashiura
- Department of Emergency and Critical Care Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Ayano Oshima
- Trauma and Emergency Center, Fukaya Red Cross Hospital, Fukaya, Japan
| | - Takashi Moriya
- Department of Emergency and Critical Care Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
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Mahjoubi M, Cherif H, Aliyu H, Chouchane H, Cappello S, Neifar M, Mapelli F, Souissi Y, Borin S, Cowan DA, Cherif A. Brucella pituitosa strain BU72, a new hydrocarbonoclastic bacterium through exopolysaccharide-based surfactant production. Int Microbiol 2024:10.1007/s10123-024-00540-8. [PMID: 38867105 DOI: 10.1007/s10123-024-00540-8] [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: 08/30/2023] [Revised: 01/22/2024] [Accepted: 05/19/2024] [Indexed: 06/14/2024]
Abstract
Hydrocarbon and heavy metal pollution are amongst the most severe and prevalent environmental problems due to their toxicity and persistence. Bioremediation using microorganisms is considered one of the most effective ways to treat polluted sites. In the present study, we unveil the bioremediation potential of Brucella pituitosa strain BU72. Besides its ability to grow on multiple hydrocarbons as the sole carbon source and highly tolerant to several heavy metals, BU72 produces different exopolysaccharide-based surfactants (EBS) when grown with glucose or with crude oil as sole carbon source. These EBS demonstrated particular and specific functional groups as determined by Fourier transform infrared (FTIR) spectral analysis that showed a strong absorption peak at 3250 cm-1 generated by the -OH group for both EBS. The FTIR spectra of the produced EBS revealed major differences in functional groups and protein content. To better understand the EBS production coupled with the degradation of hydrocarbons and heavy metal resistance, the genome of strain BU72 was sequenced. Annotation of the genome revealed multiple genes putatively involved in EBS production pathways coupled with resistance to heavy metals genes such as arsenic tolerance and cobalt-zinc-cadmium resistance. The genome sequence analysis showed the potential of BU72 to synthesise secondary metabolites and the presence of genes involved in plant growth promotion. Here, we describe the physiological, metabolic, and genomic characteristics of Brucella pituitosa strain BU72, indicating its potential as a bioremediation agent.
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Affiliation(s)
- Mouna Mahjoubi
- Univ. Manouba, ISBST, BVBGR-LR11ES31, Biotechpole Sidi Thabet, 2020, Ariana, Tunisia
| | - Hanene Cherif
- Univ. Manouba, ISBST, BVBGR-LR11ES31, Biotechpole Sidi Thabet, 2020, Ariana, Tunisia
| | - Habibu Aliyu
- Institute for Biological Interfaces (IBG-5), Karlsruhe Institute of Technology, 76344, Eggenstein-Leopoldshafen, Germany
| | - Habib Chouchane
- Univ. Manouba, ISBST, BVBGR-LR11ES31, Biotechpole Sidi Thabet, 2020, Ariana, Tunisia
| | - Simone Cappello
- Istituto per le Risorse Biologiche e le Biotecnologie Marine (IRBIM)-CNR of Messina., Sp. San Raineri, 86, 98122, Messina, Italy
| | - Mohamed Neifar
- Common Services Unit "Bioreactor Coupled With an Ultrafilter"; APVA‑LR16ES20; ENIS, University of Sfax, Sfax, Tunisia
| | | | - Yasmine Souissi
- Department of Engineering, German University of Technology in Oman, P.O. Box 1816, PC 130, Muscat, Sultanate of Oman
| | - Sara Borin
- Common Services Unit "Bioreactor Coupled With an Ultrafilter"; APVA‑LR16ES20; ENIS, University of Sfax, Sfax, Tunisia
| | - Don A Cowan
- Centre for Microbial Ecology and Genomics, University of Pretoria, Pretoria, 0002, South Africa
| | - Ameur Cherif
- Univ. Manouba, ISBST, BVBGR-LR11ES31, Biotechpole Sidi Thabet, 2020, Ariana, Tunisia.
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Salardaine Q, Desjardins C, Baille G, Roze E, Nardin C. Is ethyl chloride the new nitrous oxide? A case report. BMC Neurol 2024; 24:186. [PMID: 38834958 DOI: 10.1186/s12883-024-03689-x] [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: 12/18/2023] [Accepted: 05/23/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Over the last decade, there has been an emerging trend of recreational misuse of several drugs and inhaled solvent including ethyl chloride. This case report follows CARE guidelines and highlights, with supporting video, the neurological features of ethyl chloride intoxication. CASE PRESENTATION A 48-year-old man was seen for the sudden occurrence of an unsteady gait with dizziness. His only medical history was a chronic and treated HIV infection without any complications. Clinical examination revealed a cerebellar syndrome associated with impairment of short-term memory. Biological and radiological workups were normal. After several days, the patient recalled ethyl chloride inhalation. He fully recovered after being discharged from hospital. CONCLUSION Clinicians should recognise the clinical features and neurological manifestations of ethyl chloride intoxication due to the potential fatal cardiovascular complications of this intoxication.
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Affiliation(s)
| | | | | | - Emmanuel Roze
- Sorbonne University, APHP-Salpêtrière Hospital, CNRS, INSERM, Paris Brain Institute, Paris, France
| | - Clotilde Nardin
- Neurology Department, Saint-Denis Hospital, Saint-Denis, France
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Kontos G, Tsioptsias C, Tsivintzelis I. Cellulose Acetate-Ionic Liquid Blends as Potential Polymers for Efficient CO 2 Separation Membranes. Polymers (Basel) 2024; 16:554. [PMID: 38399932 PMCID: PMC10891773 DOI: 10.3390/polym16040554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 02/15/2024] [Accepted: 02/17/2024] [Indexed: 02/25/2024] Open
Abstract
CO2 capture, applied in CO2 separation from natural gas or in CO2/N2 separation from power plant flue gas streams, is of great importance for technical, economic, and environmental reasons. The latter seems important because CO2, as a greenhouse gas, is considered the main contributor to global warming. Using polymeric membranes for CO2 separation presents several advantages, such as low energy demand, small equipment volume, and the absence of liquid waste. In this study, two ionic liquids (ILs) were used for the preparation of cellulose acetate (CA)-IL blend membranes for potential CO2 capture applications, namely, 1-butyl-3-methylimidazolium hydrogen sulfate ([Bmim+][HSO4-]) and choline glycine ([Ch+]Gly-), as they present adequate CO2 dissolution ability. The first IL is commercially available, whereas the latter was synthesized by a novel route. Several composite membranes were prepared through the solvent casting technique and characterized by a variety of methods, including thermogravimetry, calorimetry, FTIR spectroscopy, and X-ray diffraction. The CO2 sorption in the composite membranes was experimentally measured using the mass loss analysis (MLA) technique. The results showed that the ILs strongly interacted with the C=O groups of CA, which exhibited high affinity with CO2. In the case of [Bmim+][HSO4-], a reduction in the available sites that allow strong intermolecular interactions with CO2 resulted in a decrease in CO2 sorption compared to that of pure CA. In the case of [Ch+]Gly-, the reduction was balanced out by the presence of specific groups in the IL, which presented high affinity with CO2. Thus, the CA-[Ch+]Gly- blend membranes exhibited increased CO2 sorption capability, in addition to other advantages such as non-toxicity and low cost.
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Affiliation(s)
- Giannis Kontos
- Department of Chemical Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Costas Tsioptsias
- Department of Chemical Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
- Department of Chemical Engineering, University of Western Macedonia, 50132 Kozani, Greece
| | - Ioannis Tsivintzelis
- Department of Chemical Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
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Murray BP, Kiernan EA. Physiologic Effects of Substance Use. Emerg Med Clin North Am 2024; 42:69-91. [PMID: 37977754 DOI: 10.1016/j.emc.2023.06.022] [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] [Indexed: 11/19/2023]
Abstract
Physiologic and psychological effects of substance use are common occurrences. They may be the proximate purpose of the exposure or related to an unintended complication. Acute short-term exposure effects may not be the same as long-term effects. These effects are mediated by different receptors they act on and the homeostatic changes that occur due to repeat exposure. We review in this article the physiologic and psychological effects from exposure to commonly encountered drugs, ethanol, sedative hypnotics, cocaine, amphetamines, marijuana, opioids, nicotine, hydrocarbons (halogenated and non-halogenated), and nitrous oxide.
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Affiliation(s)
- Brian Patrick Murray
- Department of Emergency Medicine, Wright State Boonshoft School of Medicine, 2555 University Boulevard, Suite 110, Dayton, OH 45324, USA.
| | - Emily Anne Kiernan
- Department of Emergency Medicine, Emory University School of Medicine, 50 Hurtz Plaza Southeast, Suite 600, Atlanta, GA, USA; Georgia Poison Center, 50 Hurtz Plaza Southeast, Suite 600, Atlanta, GA, USA
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Chen D, Werder EJ, Stewart PA, Stenzel MR, Gerr FE, Lawrence KG, Groth CP, Huynh TB, Ramachandran G, Banerjee S, Jackson Ii WB, Christenbury K, Kwok RK, Sandler DP, Engel LS. Exposure to volatile hydrocarbons and neurologic function among oil spill workers up to 6 years after the Deepwater Horizon disaster. ENVIRONMENTAL RESEARCH 2023; 231:116069. [PMID: 37149022 PMCID: PMC10330421 DOI: 10.1016/j.envres.2023.116069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND During the 2010 Deepwater Horizon (DWH) disaster, oil spill response and cleanup (OSRC) workers were exposed to toxic volatile components of crude oil. Few studies have examined exposure to individual volatile hydrocarbon chemicals below occupational exposure limits in relation to neurologic function among OSRC workers. OBJECTIVES To investigate the association of several spill-related chemicals (benzene, toluene, ethylbenzene, xylene, n-hexane, i.e., BTEX-H) and total petroleum hydrocarbons (THC) with neurologic function among DWH spill workers enrolled in the Gulf Long-term Follow-up Study. METHODS Cumulative exposure to THC and BTEX-H across the oil spill cleanup period were estimated using a job-exposure matrix that linked air measurement data to detailed self-reported DWH OSRC work histories. We ascertained quantitative neurologic function data via a comprehensive test battery at a clinical examination that occurred 4-6 years after the DWH disaster. We used multivariable linear regression and modified Poisson regression to evaluate relationships of exposures (quartiles (Q)) with 4 neurologic function measures. We examined modification of the associations by age at enrollment (<50 vs. ≥50 years). RESULTS We did not find evidence of adverse neurologic effects from crude oil exposures among the overall study population. However, among workers ≥50 years of age, several individual chemical exposures were associated with poorer vibrotactile acuity of the great toe, with statistically significant effects observed in Q3 or Q4 of exposures (range of log mean difference in Q4 across exposures: 0.13-0.26 μm). We also observed suggestive adverse associations among those ≥ age 50 years for tests of postural stability and single-leg stance, although most effect estimates did not reach thresholds of statistical significance (p < 0.05). CONCLUSIONS Higher exposures to volatile components of crude oil were associated with modest deficits in neurologic function among OSRC workers who were age 50 years or older at study enrollment.
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Affiliation(s)
- Dazhe Chen
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Emily J Werder
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | | | - Mark R Stenzel
- Exposure Assessment Applications, LLC, Arlington, VA, USA
| | - Fredric E Gerr
- Department of Occupational and Environmental Health, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Kaitlyn G Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Caroline P Groth
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Tran B Huynh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Sudipto Banerjee
- Department of Biostatistics, Fielding School of Public Health, University of California - Los Angeles, Los Angeles, CA, USA
| | | | - Kate Christenbury
- Social & Scientific Systems, Inc, a DLH Holdings Company, Durham, NC, USA
| | - Richard K Kwok
- Population Studies and Genetics Branch, National Institute on Aging, Bethesda, MD, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
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Lv JJ, Li XY, Shen YC, You JX, Wen MZ, Wang JB, Yang XT. Assessing volatile organic compounds exposure and chronic obstructive pulmonary diseases in US adults. Front Public Health 2023; 11:1210136. [PMID: 37475768 PMCID: PMC10354632 DOI: 10.3389/fpubh.2023.1210136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 06/13/2023] [Indexed: 07/22/2023] Open
Abstract
Background Volatile organic compounds (VOCs) are a large group of chemicals widely used in People's Daily life. There is increasing evidence of the cumulative toxicity of VOCs. However, the association between VOCs and the risk of COPD has not been reported. Objective We comprehensively evaluated the association between VOCs and COPD. Methods Our study included a total of 1,477 subjects from the National Health and Nutrition Examination Survey, including VOCs, COPD, and other variables in the average US population. Multiple regression models and smooth-curve fitting (penalty splines) were constructed to examine potential associations, and stratified analyses were used to identify high-risk groups. Results We found a positive association between blood benzene and blood o-xylene concentrations and COPD risk and identified a concentration relationship between the two. That is, when the blood benzene and O-xylene concentrations reached 0.28 ng/mL and 0.08 ng/mL, respectively, the risk of COPD was the highest. In addition, we found that gender, age, and MET influence the relationship, especially in women, young people, and people with low MET. Significance This study revealed that blood benzene and blood o-xylene were independently and positively correlated with COPD risk, suggesting that long-term exposure to benzene and O-xylene may cause pulmonary diseases, and providing a new standard of related blood VOCs concentration for the prevention of COPD.
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Affiliation(s)
- Jia-jie Lv
- Department of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
- Department of Vascular Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xin-yu Li
- Department of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
- Department of Neurosurgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yu-chen Shen
- Department of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jian-xiong You
- Department of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Ming-zhe Wen
- Department of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jing-bing Wang
- Department of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xi-tao Yang
- Department of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
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Barzallo TP, Marchan CA, Salgado OJ, Espinosa HM. Spontaneous Pneumomediastinum in a 15-Year-Old Adolescent After Unintended Overexposure to Paint Diluent (Thinner) Fumes: First Reported Case. THERAPEUTIC ADVANCES IN PULMONARY AND CRITICAL CARE MEDICINE 2023; 18:11795484231201751. [PMID: 37822328 PMCID: PMC10564079 DOI: 10.1177/11795484231201751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/02/2023] [Indexed: 10/13/2023]
Abstract
Spontaneous pneumomediastinum (SPM) is the presence of air in the mediastinal interstices in the absence of any surgical or medical procedure, chest trauma, or mechanical ventilation. SPM can occur during vigorous Valsalva maneuvers, such as weight lifting, coughing fits, hyperemesis gravidarum, and so on, or during inhalation of illicit substances or toxic agents, as a result of an abrupt increase in pressure in the tracheal tree. Preexisting underlying lung disease may be a contributing factor. In the present case, we report for the first time an SPM due to accidental overexposure to paint thinner in a 15-year-old male from a low-income rural family. He was offered a job painting the inside of a house, which he accepted to earn some money for the family household. However, due to his inexperience, he overdosed on a can of paint with thinner. About 2 h after starting work, he began to feel increasingly severe chest pain and had to be rushed to the local level one basic hospital by his parents. Physical examination revealed subcutaneous emphysema over the supraclavicular area and crackles in the precordial area. Chest radiographs showed a pneumomediastinum. In retrospect, the patient denied coughing or sneezing attacks after exposure. He was transferred to a regional tertiary hospital for further diagnostic evaluation to rule out airway/esophageal perforation. Chest computed tomography confirmed underlying SPM and subcutaneous emphysema. The oesophagogram and bronchoscopy were unremarkable. SPM, possibly secondary to overexposure to thinner vapors, a hydrocarbon-based compound, was the final diagnosis. The patient was discharged asymptomatic on day 5.
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Affiliation(s)
- Tania P Barzallo
- School of Medicine, Universidad Católica de Cuenca (UCACUE), Cuenca, Ecuador
- Formerly: Department of Pediatrics, Hospital Vicente Corral Moscoso, Cuenca, Ecuador
| | - Claudia A Marchan
- School of Medicine, Universidad Católica de Cuenca (UCACUE), Cuenca, Ecuador
| | - Octavio J Salgado
- Department of Medical Research, School of Medicine, Universidad Católica de Cuenca (UCACUE), Cuenca, Ecuador
| | - Hermel M Espinosa
- Department of Medical Research, School of Medicine, Universidad Católica de Cuenca (UCACUE), Cuenca, Ecuador
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Yadav S, Tripathi S, Purchase D, Chandra R. Development of a biofilm-forming bacterial consortium and quorum sensing molecules for the degradation of lignin-containing organic pollutants. ENVIRONMENTAL RESEARCH 2023; 226:115618. [PMID: 36921788 DOI: 10.1016/j.envres.2023.115618] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 02/18/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
The presence of lignin along with other pollutants makes effluent more complex when it is discharged from Pulp and paper mills. The present study investigates the use of biofilm-forming bacteria isolated from pulp paper mill effluent contaminated sites (PPMECSs) for lignin degradation. Isolated biofilm-forming and lignin-degrading bacteria were identified as Bacillus subtilis, Enterobacter cancerogenus, and Bacillus licheniformis by 16S rRNA gene sequencing. Thin liquid chromatography (TLC) analysis showed that the consortium of bacteria produced acyl-homoserine lactone (AHL) as quorum sensing molecules and extracellular polymeric substances (EPS) that protect the bacterial consortium under unfavorable conditions. The potential consortium was able to reduce lignin (900 ppm) by 73% after 8 days of incubation in a minimal salt medium containing kraft lignin and glucose at pH 7.0 and 37 °C as compared to individual strains. The degradation by-products were identified as amides, alcohols, and acids. The major organic pollutants in the effluent were reduced after treatment of the constructed consortium, thus confirming active biotransformation and biodegradation of the lignin. Microscopic examination also indicated the presence of lignin induced biofilm formation. Hence, the constructed biofilm-forming bacterial consortia based on quorum sensing offered a sustainable and effective solution to treat lignin-containing complex pollutants.
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Affiliation(s)
- Sangeeta Yadav
- Department of Microbiology, Dr. Shakuntala Misra National Rehabilitation University, Lucknow, 226017, Uttar Pradesh, India; Department of Botany, Vaishno Devi Prashikshan Mahavidyalaya, Godahi, Kunda, Pratapgarh, Uttar Pradesh, India.
| | - Sonam Tripathi
- Department of Environmental Microbiology, School for Environmental Sciences, Babasaheb Bhimrao Ambedkar University (A Central University), Vidya Vihar, Raebareli Road, Lucknow, 226025, Uttar Pradesh, India
| | - Diane Purchase
- Department of Natural Sciences, Faculty of Science and Technology, Middlesex University, The Burroughs, Hendon, London, England, NW4 4BT, UK
| | - Ram Chandra
- Department of Environmental Microbiology, School for Environmental Sciences, Babasaheb Bhimrao Ambedkar University (A Central University), Vidya Vihar, Raebareli Road, Lucknow, 226025, Uttar Pradesh, India.
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Zwolinski NM, Patel KS, Vadivelu N, Kodumudi G, Kaye AD. ERAS Protocol Options for Perioperative Pain Management of Substance Use Disorder in the Ambulatory Surgical Setting. Curr Pain Headache Rep 2023; 27:65-79. [PMID: 37079258 PMCID: PMC10116112 DOI: 10.1007/s11916-023-01108-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 04/21/2023]
Abstract
Even prior to the COVID-19 pandemic, rates of ambulatory surgeries and ambulatory patients presenting with substance use disorder were increasing, and the end of lockdown has further catalyzed the increasing rates of ambulatory patients presenting for surgery with substance use disorder (SUD). Certain subspecialty groups of ambulatory procedures have already established protocols to optimize early recovery after surgery (ERAS), and these groups have subsequently enjoyed improved efficiency and reduced adverse outcomes as a result. In this present investigation, we review the literature as it relates to substance use disorder patients, with a particular focus on pharmacokinetic and pharmacodynamic profiles, and their resulting impact on the acute- or chronic user ambulatory patient. The systematic literature review findings are organized and summarized. We conclude by identifying areas of opportunity for further study, specifically with the aim of developing a dedicated ERAS protocol for substance use disorder patients in the ambulatory surgery setting. - Healthcare in the USA has seen an increase in rates of both substance use disorder patients and separately in ambulatory surgery cases. - Specific perioperative protocols to optimize outcomes for patients who suffer from substance use disorder have been described in recent years. - Agents of interest like opioids, cannabis, and amphetamines are the top three most abused substances in North America. - A protocol and recommend further work should be done to integrate with concrete clinical data, in which strategies should be employed to confer benefits to patient outcomes and hospital quality metrics like those enjoyed by ERAS protocol in other settings.
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Affiliation(s)
- Nicholas M Zwolinski
- Department of Anesthesiology, Yale University School of Medicine, 333, Cedar Street, New Haven, CT, 06520, USA
| | - Kaiwal S Patel
- Department of Anesthesiology, Yale University School of Medicine, 333, Cedar Street, New Haven, CT, 06520, USA
| | - Nalini Vadivelu
- Department of Anesthesiology, Yale University School of Medicine, 333, Cedar Street, New Haven, CT, 06520, USA
| | - Gopal Kodumudi
- Department of Anesthesiology, LSU School of Medicine, 1542 Tulane Avenue Room 659, New Orleans, LA, 70112, USA
| | - Alan David Kaye
- Department of Anesthesiology, LSU School of Medicine, 1542 Tulane Avenue Room 659, New Orleans, LA, 70112, USA.
- Department of Anesthesiology, Louisiana State University Health Sciences Center, 1501 Kings Hwy, Shreveport, LA, 71103, USA.
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Ichimata S, Hata Y, Zaimoku R, Nishida N. Acute benzyl alcohol intoxication: An autopsy case report. Medicine (Baltimore) 2023; 102:e33395. [PMID: 37000071 PMCID: PMC10063254 DOI: 10.1097/md.0000000000033395] [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: 02/17/2023] [Accepted: 03/09/2023] [Indexed: 04/01/2023] Open
Abstract
INTRODUCTION The main mechanism of death and the pathological appearance of cases of benzyl alcohol intoxication has not been fully investigated. Autopsy reports of cases of benzyl alcohol intoxication have not been published. CASE PRESENTATION A 24-year-old man was found in the state of cardiopulmonary arrest at a construction site. He had been performing paint stripping. He was immediately transferred to the hospital, but he did not recover. An autopsy showed focal coloring of the skin without any major caustic injury. A histopathological investigation showed vacuolar degeneration in the epidermis and dermo-epidermal junction, and severe erosion of the tracheal and bronchial mucosa. No pathological changes in the kidney were evident. A neuropathological investigation showed central chromatolysis of neuronal cells in pontine nuclei and grumose degeneration in the cerebellar dentate nucleus. The blood content of benzyl alcohol was 780.0 μg/mL. LESSONS Present case suggest that multiple pathways of exposure may be associated with more rapid progression in acute benzyl alcohol intoxication, and that early and/or severe involvement of the central nervous system rather than renal dysfunction may be associated with an early death.
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Affiliation(s)
- Shojiro Ichimata
- Department of Legal Medicine, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Yukiko Hata
- Department of Legal Medicine, Faculty of Medicine, University of Toyama, Toyama, Japan
| | | | - Naoki Nishida
- Department of Legal Medicine, Faculty of Medicine, University of Toyama, Toyama, Japan
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12
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Berling I, Chiew A, Brown J. Poisonings from hydrocarbon inhalant misuse in Australia. Addiction 2023. [PMID: 36776135 DOI: 10.1111/add.16166] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/19/2023] [Indexed: 02/14/2023]
Abstract
BACKGROUND AND AIMS Inhalational misuse of volatile substances has been a significant public health concern because of the risk of sudden death and associated chronic complications such as encephalopathy. The Australian Government released a Consensus-based clinical practice guideline in 2011 on the management of volatile substance use in Australia, which noted a lack of available data particularly on harms. This study aimed to measure (1) the number of calls received by the New South Wales Poisons Information Centre (NSWPIC) regarding inhalational hydrocarbon exposures or poisonings and (2) the number of unintentional deaths reported to the National Coronial Information System (NCIS) in Australia. DESIGN, SETTING, CASES, MEASUREMENTS We performed a retrospective review of all recreational inhalational hydrocarbon exposure calls to the NSWPIC between 1 January 2010 and 31 December 2020. A search was made of the NCIS database in all states and territories over the same period to determine the number of non-intentional inhalational hydrocarbon-related deaths in Australia. FINDINGS Between January 2010 and December 2020, there were 752 primary calls made to the NSWPIC regarding hydrocarbon use or exposure. Age or age bracket was recorded in 748 cases, with 508 (67%) calls involving children or adolescents. Over the same time, there were 58 unintentional deaths involving the recreational use of inhalational hydrocarbons. The median age at death was 23 years (interquartile range = 15-30 years), and 72% (42 cases) were male. Cause of death was predominately acute suffocation/asphyxia, encephalopathy related to chronic use, cardiac arrest likely from sudden sniffing syndrome or thermal injuries secondary to unintentional fires sparked by the volatile agents. CONCLUSION Although death and cardiac arrest are uncommon among people in Australia who misuse hydrocarbons for recreational use, the deaths and cardiac arrests tend to occur in adolescents.
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Affiliation(s)
- Ingrid Berling
- School of Medicine and Public Health, University of Newcastle, University Dr, Callaghan, Newcastle, New South Wales, 2308, Australia.,Department of Emergency Medicine, Calvary Mater Newcastle, Edith St, Waratah, New South Wales, 2298, Australia.,Department of Clinical Toxicology, Prince of Wales Hospital, Randwick, New South Wales, 2031, Australia.,New South Wales Poisons Information Centre, Sydney Children's Hospital, Sydney, New South Wales, 2298, Australia
| | - Angela Chiew
- Department of Clinical Toxicology, Prince of Wales Hospital, Randwick, New South Wales, 2031, Australia.,New South Wales Poisons Information Centre, Sydney Children's Hospital, Sydney, New South Wales, 2298, Australia.,Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, 2052, Australia
| | - Jared Brown
- New South Wales Poisons Information Centre, Sydney Children's Hospital, Sydney, New South Wales, 2298, Australia
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Shayuti MSM, Zainal S, Ya TMYST, Abdullah MZ, Shahruddin MZ, Othman NH, Alias NH, Mohd TAT, Sharudin RW. Assessment of contaminants in sand production from petroleum wells offshore Sabah. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:17122-17128. [PMID: 35469382 DOI: 10.1007/s11356-022-20389-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 04/18/2022] [Indexed: 06/14/2023]
Abstract
Sand production remains a huge obstacle in many oil and gas fields around the world, but the hazards of contaminants riding on the produced sand are often not emphasised. Improper disposal of the sand could see the toxic leaching into the environment including the food chain, endangering all living organisms. The impending sand production from an oilfield offshore Sabah also suffers from the lack of hazards identification; hence, this study was conducted to assess the contaminant on the produced sand. Sand samples were collected from multiple wells in the area, with the contaminants extracted using n-hexane and subjected to chemical and thermal analyses. FTIR and GC-MS detected traces of harmful pollutants like naphthalene, amine substances, cyclohexanol, and short-chain alkanes. It was discovered that the volatile fraction of the contaminants was able to evaporate at 33 °C, while high energy was needed to remove 100% of the contaminants from the sand. Overall, the produced sand from the oilfield was unsafe and required treatment before it could be dumped or used.
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Affiliation(s)
- Muhammad Shafiq Mat Shayuti
- Mechanical Engineering Department, Universiti Teknologi PETRONAS, 32610, Seri Iskandar, Perak, Malaysia.
- College of Engineering, School of Chemical Engineering, Universiti Teknologi MARA, 40450, Shah Alam, Selangor, Malaysia.
| | - Suzalina Zainal
- Group Research & Technology, PETRONAS, 43000, Bandar Baru Bangi, Selangor, Malaysia
| | - Tuan Mohammad Yusoff Shah Tuan Ya
- Mechanical Engineering Department, Universiti Teknologi PETRONAS, 32610, Seri Iskandar, Perak, Malaysia
- High Performance Computing Centre, Universiti Teknologi PETRONAS, 32610, Seri Iskandar, Perak, Malaysia
| | - Mohamad Zaki Abdullah
- Mechanical Engineering Department, Universiti Teknologi PETRONAS, 32610, Seri Iskandar, Perak, Malaysia
| | - Munawar Zaman Shahruddin
- College of Engineering, School of Chemical Engineering, Universiti Teknologi MARA, 40450, Shah Alam, Selangor, Malaysia
| | - Nur Hidayati Othman
- College of Engineering, School of Chemical Engineering, Universiti Teknologi MARA, 40450, Shah Alam, Selangor, Malaysia
| | - Nur Hashimah Alias
- College of Engineering, School of Chemical Engineering, Universiti Teknologi MARA, 40450, Shah Alam, Selangor, Malaysia
| | - Tengku Amran Tengku Mohd
- College of Engineering, School of Chemical Engineering, Universiti Teknologi MARA, 40450, Shah Alam, Selangor, Malaysia
| | - Rahida Wati Sharudin
- College of Engineering, School of Chemical Engineering, Universiti Teknologi MARA, 40450, Shah Alam, Selangor, Malaysia
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14
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Wang H, Lu S, Li H, Wang Y. Mycobacterium infection secondary to exogenous lipoid pneumonia caused by nasal drops: a case report and literature review. BMC Pulm Med 2023; 23:47. [PMID: 36721116 PMCID: PMC9887914 DOI: 10.1186/s12890-022-02265-8] [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: 04/14/2022] [Accepted: 11/24/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Exogenous lipoid pneumonia (ELP) is a rare disease and its diagnosis is often mistaken or delayed. Secondary infection with rapidly growing non-tuberculous mycobacteria is a rare complication of lipoid pneumonia. CASE PRESENTATION A 38-year-old man presented with fever, cough, sputum, chest tightness, and shortness of breath. He had a 2-year history of allergic rhinitis and used liquid paraffin-containing menthol nasal drops daily. A chest CT scan showed multiple patchy ground glass opacities with blurred borders in both lungs, which were located in the inner pulmonary field and distributed along the bronchi. His ambient air PO2 was 63 mmHg. The patient was diagnosed with ELP by CT-guided lung biopsy. The nasal drops were discontinued, and systemic glucocorticoids were administered. During treatment, the pulmonary lesions deteriorated, and bronchoalveolar lavage was performed during bronchoscopy. Additionally, Mycobacterium abscessus was detected in the lavage fluid. Upon detection of a secondary M. abscessus infection, glucocorticoids were gradually discontinued, and anti-M. abscessus treatment was implemented. The patient's symptoms rapidly ameliorated. After 11 months of anti-M. abscessus treatment, a repeat CT scan showed clear regression of the lung lesions. CONCLUSION Routine microbiological examination of samples, including sputum or alveolar lavage fluid, is necessary for patients with diagnosed or suspected ELP.
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Affiliation(s)
- Huihong Wang
- grid.13402.340000 0004 1759 700XDepartment of Respiratory Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003 China ,grid.469636.8Department of Respiratory Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, 317000 Zhejiang Province China
| | - Shan Lu
- grid.13402.340000 0004 1759 700XDepartment of Respiratory Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003 China
| | - Hequan Li
- grid.13402.340000 0004 1759 700XDepartment of Respiratory Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003 China
| | - Yuehong Wang
- grid.13402.340000 0004 1759 700XDepartment of Respiratory Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003 China
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15
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牛飼 純, 桑波田 聡, 窪田 唯, 佐田 千, 手塚 綾, 岩谷 徳, 竹中 俊, 大石 充. [An elderly male patient with dementia who showed repeated episodes of pneumonia due to chronic oral intake of kerosene]. Nihon Ronen Igakkai Zasshi 2023; 60:448-450. [PMID: 38171763 DOI: 10.3143/geriatrics.60.448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Affiliation(s)
| | | | | | | | | | | | | | - 充 大石
- 鹿児島大学大学院医歯学総合研究科心臓血管・高血圧内科学
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16
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1,1-Difluoroethane Hydrocarbon Cardiomyopathy. JACC Case Rep 2022; 7:101716. [PMID: 36776796 PMCID: PMC9911916 DOI: 10.1016/j.jaccas.2022.101716] [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: 07/11/2022] [Revised: 10/26/2022] [Accepted: 11/23/2022] [Indexed: 12/24/2022]
Abstract
1,1-Difluoroethane (DFE) cardiomyopathy results from the direct inhalation of toxic halogenated hydrocarbons. We present a case series of acute DFE cardiomyopathy illustrating the typical presentation of severe DFE cardiomyopathy along with a detailed description of its mechanism of injury. (Level of Difficulty: Advanced.).
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17
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Crawford KA, Doherty BT, Gilbert-Diamond D, Romano ME, Claus Henn B. Waxing activity as a potential source of exposure to per- and polyfluoroalkyl substances (PFAS) and other environmental contaminants among the US ski and snowboard community. ENVIRONMENTAL RESEARCH 2022; 215:114335. [PMID: 36150439 DOI: 10.1016/j.envres.2022.114335] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/31/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Skiers and snowboarders apply waxes and solvents to their equipment to enhance glide across the snow. Waxing results in exposures to per- and polyfluoroalkyl substances (PFAS) and particulate matter, which have been associated with adverse health effects among professional wax technicians in Scandinavia. However, little is known about exposure among people who participate at other levels of sport, including recreationally, in other regions. OBJECTIVE We sought to characterize wax-related exposures among US skiers and snowboarders who participate across numerous levels of sport to expand scientific understanding of environmental health risks among this population. METHODS We used an anonymous electronic survey to evaluate wax-related exposures among US cross-country and downhill skiers and snowboarders. Specifically, we assessed (Fang et al., 2020): duration of time involved with each sport in any role (Freberg et al., 2013), intensity of wax-related exposures based on time spent in waxing areas, wax use, and wax type (Rogowski et al., 2007), frequency of fluorinated wax application, and (Freberg et al., 2010) use of exposure interventions. RESULTS Participants tended to be long-term winter sports enthusiasts (e.g., median downhill skiing duration: 31 years). Nearly all (92%) participants personally applied some wax to their skis/snowboards and most applied waxes containing PFAS (67%) and solvents (62%). Ski professionals waxed the most pairs of skis with fluorinated waxes annually (median (IQR): 20 (1, 100)), though individuals participating recreationally also applied fluorinated waxes regularly. Exposure interventions were not widely used. SIGNIFICANCE Waxing activities may pose significant risk of exposure to PFAS and other environmental contaminants among the US ski and snowboard community. Efforts are needed to reduce these exposures through changes to wax use patterns and broader adoption of exposure reduction strategies.
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Affiliation(s)
| | | | - Diane Gilbert-Diamond
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Megan E Romano
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Birgit Claus Henn
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
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18
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Chao CCJ, Ronco J. A case report of recreational use of inhaled Freon leading to acute hypoxemic respiratory failure salvaged by veno-venous extracorporeal membrane oxygenation. Can J Anaesth 2022; 69:1300-1304. [PMID: 35882725 PMCID: PMC9323881 DOI: 10.1007/s12630-022-02296-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] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/16/2022] [Accepted: 04/13/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Freon™ is a halogenated hydrocarbon often used as a refrigerant. When inhaled recreationally, it has the desired effects of euphoria and intoxication. Toxic effects include cardiovascular and neurologic insults such as arrhythmias and seizures, and less well-described toxicities include airway and lung injury. The treatment in general is primarily supportive. CLINICAL FEATURES We present the case of a 42-yr-old previously healthy male who developed acute bronchiolitis and pneumonitis following inhalation of Freon leading to severe respiratory failure. He was supported by veno-venous extracorporeal membrane oxygenation and managed with high-dose corticosteroids. CONCLUSION To our knowledge, this is the first case report of an inhaled Freon exposure resulting in acute lung injury refractory to conventional therapy that was salvaged by vv-ECMO as a bridge towards a full recovery.
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Affiliation(s)
- Chung-Chi Jennifer Chao
- Division of Critical Care, Department of Medicine, The University of British Columbia, 855 West 12th Ave, Vancouver, BC, V5Z 1M9, Canada.
| | - Juan Ronco
- Division of Critical Care, Department of Medicine, The University of British Columbia, 855 West 12th Ave, Vancouver, BC, V5Z 1M9, Canada
- Intensive Care Unit, Vancouver General Hospital, Vancouver, BC, Canada
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19
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Wei C, Chen Y, Yang Y, Ni D, Huang Y, Wang M, Yang X, Chen Z. Assessing volatile organic compounds exposure and prostate-specific antigen: National Health and Nutrition Examination Survey, 2001–2010. Front Public Health 2022; 10:957069. [PMID: 35968491 PMCID: PMC9372286 DOI: 10.3389/fpubh.2022.957069] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/14/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundVolatile organic compounds (VOCs) are a large group of chemicals widely used in people's daily routines. Increasing evidence revealed the VOCs' accumulating toxicity. However, the VOCs toxicity in male prostate has not been reported previously. Thus, we comprehensively evaluated the association between VOCs and prostate-specific antigen (PSA).MethodsA total of 2016 subjects were included in our study from the National Health and Nutrition Examination Survey with VOCs, PSA, and other variables among U.S. average population. We constructed XGBoost Algorithm Model, Regression Model, and Generalized linear Model (GAM) to analyze the potential association. Stratified analysis was used to identify high-risk populations.ResultsXGBoost Algorithm model identified blood chloroform as the most critical variable in the PSA concentration. Regression analysis suggested that blood chloroform was a positive association with PSA, which showed that environmental chloroform exposure is an independent risk factor that may cause prostate gland changes [β, (95% CI), P = 0.007, (0.003, 0.011), 0.00019]. GAM observed the linear relationship between blood chloroform and PSA concentration. Meanwhile, blood chloroform linear correlated with water chloroform in the lower dose range, indicating that the absorption of water may be the primary origin of chloroform. Stratified associations analysis identified the high-risk group on the chloroform exposures.ConclusionThis study revealed that blood chloroform was positively and independently associated with total PSA level, suggesting that long-term environmental chloroform exposure may cause changes in the prostate gland.
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Affiliation(s)
- Chengcheng Wei
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yumao Chen
- Department of Urology, Ezhou Central Hospital, Ezhou, China
| | - Yu Yang
- Department of Pathologist and Laboratory Medicine, Staff Pathologist, Deaconess Hospital, Evansville, IN, United States
| | - Dong Ni
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Huang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Miao Wang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiong Yang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Xiong Yang
| | - Zhaohui Chen
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Zhaohui Chen
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20
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López-Landavery EA, Amador-Cano G, Tripp-Valdez MA, Ramírez-Álvarez N, Cicala F, Gómez-Reyes RJE, Díaz F, Re-Araujo AD, Galindo-Sánchez CE. Hydrocarbon exposure effect on energetic metabolism and immune response in Crassostrea virginica. MARINE POLLUTION BULLETIN 2022; 180:113738. [PMID: 35635877 DOI: 10.1016/j.marpolbul.2022.113738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 05/03/2022] [Accepted: 05/06/2022] [Indexed: 06/15/2023]
Abstract
Crassostrea virginica was exposed to different light crude oil levels to assess the effect on transcriptomic response and metabolic rate. The exposure time was 21 days, and levels of 100 and 200 μg/L were used, including a control. The most significant difference among treatments was the overexpression of several genes associated with energy production, reactive oxygen species (ROS) regulation, immune system response, and inflammatory response. Also, a hydrocarbon concentration-related pattern was identified in ROS regulation, with a gene expression ratio near 1.8:1 between 200 and 100 μg/L treatments. Statistical analysis showed no interaction effect for metabolic rate; however, significant differences were found for oil concentration and time factors, with a higher oxygen consumption at 200 μg/L. Our findings provide novel information about the metabolic response of C. virginica during hydrocarbons exposure. In addition, our results point out which biological processes should be investigated as targets for searching bioindicators.
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Affiliation(s)
- E A López-Landavery
- Laboratorio de Genómica Funcional, Departamento de Biotecnología Marina, Centro de Investigación Científica y Educación Superior de Ensenada (CICESE), Ensenada, BC, Mexico; Laboratorio de Genética, Fisiología y Reproducción, Facultad de Ciencias, Universidad Nacional del Santa, Nuevo Chimbote, Ancash, Peru
| | - G Amador-Cano
- Universidad Tecnológica del Mar de Tamaulipas Bicentenario, La Pesca, Soto La Marina, Tamaulipas, Mexico
| | - M A Tripp-Valdez
- Departamento de Acuicultura, Centro de Investigación Científica y Educación Superior de Ensenada (CICESE), Ensenada, BC, Mexico
| | - N Ramírez-Álvarez
- Instituto de Investigaciones Oceanológicas (IIO), Universidad Autónoma de Baja California (UABC), Carretera Tijuana-Ensenada No. 3917, Ensenada, BC, Mexico
| | - F Cicala
- Laboratorio de Genómica Funcional, Departamento de Biotecnología Marina, Centro de Investigación Científica y Educación Superior de Ensenada (CICESE), Ensenada, BC, Mexico
| | - R J E Gómez-Reyes
- Laboratorio de Genómica Funcional, Departamento de Biotecnología Marina, Centro de Investigación Científica y Educación Superior de Ensenada (CICESE), Ensenada, BC, Mexico; Facultad de Ciencias Marinas, Universidad Autónoma de Baja California (UABC), Carretera Tijuana-Ensenada No. 3917, Ensenada, BC, Mexico
| | - F Díaz
- Laboratorio de Genómica Funcional, Departamento de Biotecnología Marina, Centro de Investigación Científica y Educación Superior de Ensenada (CICESE), Ensenada, BC, Mexico
| | - A D Re-Araujo
- Laboratorio de Genómica Funcional, Departamento de Biotecnología Marina, Centro de Investigación Científica y Educación Superior de Ensenada (CICESE), Ensenada, BC, Mexico
| | - C E Galindo-Sánchez
- Laboratorio de Genómica Funcional, Departamento de Biotecnología Marina, Centro de Investigación Científica y Educación Superior de Ensenada (CICESE), Ensenada, BC, Mexico.
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21
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Salles Rosa Neto N, Englert D, McAlister WH, Mumm S, Mills D, Veis DJ, Burshell A, Boyde A, Whyte MP. Periarticular calcifications containing giant pseudo-crystals of francolite in skeletal fluorosis from 1,1-difluoroethane "huffing". Bone 2022; 160:116421. [PMID: 35429657 DOI: 10.1016/j.bone.2022.116421] [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: 02/21/2022] [Revised: 04/03/2022] [Accepted: 04/08/2022] [Indexed: 01/28/2023]
Abstract
Inhalant use disorder is a psychiatric condition characterized by repeated deliberate inhalation from among a broad range of household and industrial chemical products with the intention of producing psychoactive effects. In addition to acute intoxication, prolonged inhalation of fluorinated compounds can cause skeletal fluorosis (SF). We report a young woman referred for hypophosphatasemia and carrying a heterozygous ALPL gene variant (c.457T>C, p.Trp153Arg) associated with hypophosphatasia, the heritable metabolic bone disease featuring impaired skeletal mineralization, who instead suffered from SF. Manifestations of her SF included recurrent articular pain, axial osteosclerosis, elevated bone mineral density, maxillary exostoses, and multifocal periarticular calcifications. SF was suspected when a long history was discovered of 'huffing' a computer cleaner containing 1,1-difluoroethane. Investigation revealed markedly elevated serum and urine levels of F-. Histopathology and imaging techniques including backscattered electron mode scanning electron microscopy, X-ray microtomography, energy dispersive and wavelength dispersive X-ray emission microanalysis, and polarized light microscopy revealed that her periarticular calcifications were dystrophic deposition of giant pseudo-crystals of francolite, a carbonate-rich fluorapatite. Identifying unusual circumstances of F- exposure is key for diagnosing non-endemic SF. Increased awareness of the disorder can be lifesaving.
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Affiliation(s)
- Nilton Salles Rosa Neto
- Division of Bone and Mineral Diseases, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA; Center for Metabolic Bone Disease and Molecular Research, Shriners Hospitals for Children - St. Louis, St. Louis, MO 63110, USA.
| | - Daniel Englert
- Endocrinology Department, Ochsner Medical Center, New Orleans, LA 70121, USA.
| | - William H McAlister
- Pediatric Radiology Section, Mallinckrodt Institute of Radiology at St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, MO 63110, USA.
| | - Steven Mumm
- Division of Bone and Mineral Diseases, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA; Center for Metabolic Bone Disease and Molecular Research, Shriners Hospitals for Children - St. Louis, St. Louis, MO 63110, USA.
| | - David Mills
- Dental Physical Sciences, Dental Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, E1 4NS, UK.
| | - Deborah J Veis
- Division of Bone and Mineral Diseases, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA; Center for Metabolic Bone Disease and Molecular Research, Shriners Hospitals for Children - St. Louis, St. Louis, MO 63110, USA.
| | - Alan Burshell
- Endocrinology Department, Ochsner Medical Center, New Orleans, LA 70121, USA.
| | - Alan Boyde
- Dental Physical Sciences, Dental Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, E1 4NS, UK.
| | - Michael P Whyte
- Division of Bone and Mineral Diseases, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA; Center for Metabolic Bone Disease and Molecular Research, Shriners Hospitals for Children - St. Louis, St. Louis, MO 63110, USA.
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22
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Abdul Malik AA, Ng BH, Nik Abeed NN, Abdul Hamid MF, Ban AY. Hydrofluorocarbons pneumonitis as a complication of inhalation injury following air‐conditioning repairs. Respirol Case Rep 2022; 10:e0983. [PMID: 35685849 PMCID: PMC9171686 DOI: 10.1002/rcr2.983] [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: 03/05/2022] [Accepted: 05/17/2022] [Indexed: 11/12/2022] Open
Abstract
Hydrofluorocarbon (HFC) pneumonitis is an uncommon cause of inhalation injury. HFCs are a group of chemicals predominantly used for refrigeration and cooling. A 19‐year‐old air‐conditioning technician developed acute onset of dyspnoea and chest tightness while servicing an air conditioner in a confined space. We diagnosed him with HFC pneumonitis based on the history of exposure and the high‐resolution computed tomography (HRCT) thorax findings. He was treated with steroids and supportive oxygen therapy. He recovered fully after 5 days of hospitalization and was discharged. Review at 2 weeks in the outpatient setting showed significant radiological improvement on HRCT thorax.
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Affiliation(s)
- Afifah Aqilah Abdul Malik
- Pulmonology Unit, Department of Internal Medicine, Faculty of Medicine Universiti Kebangsaan Malaysia Medical Centre Kuala Lumpur Malaysia
| | - Boon Hau Ng
- Pulmonology Unit, Department of Internal Medicine, Faculty of Medicine Universiti Kebangsaan Malaysia Medical Centre Kuala Lumpur Malaysia
| | - Nik Nuratiqah Nik Abeed
- Pulmonology Unit, Department of Internal Medicine, Faculty of Medicine Universiti Kebangsaan Malaysia Medical Centre Kuala Lumpur Malaysia
| | - Mohamed Faisal Abdul Hamid
- Pulmonology Unit, Department of Internal Medicine, Faculty of Medicine Universiti Kebangsaan Malaysia Medical Centre Kuala Lumpur Malaysia
| | - Andrea Yu‐Lin Ban
- Pulmonology Unit, Department of Internal Medicine, Faculty of Medicine Universiti Kebangsaan Malaysia Medical Centre Kuala Lumpur Malaysia
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23
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Toxic benzyl alcohol inhalation: Altered mental status with metabolic acidosis and hyperammonemia. Am J Emerg Med 2022; 57:234.e3-234.e5. [PMID: 35466010 DOI: 10.1016/j.ajem.2022.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/28/2022] [Accepted: 04/07/2022] [Indexed: 11/20/2022] Open
Abstract
This report presents the case of a patient whose inhalation exposure to benzyl alcohol led to clinical manifestations similar to toluene intoxication, including sudden altered mental status, metabolic acidosis, hypokalemia, hypophosphatemia, and hyperammonemia. Toxicity from benzyl alcohol inhalation is quite rare, and hyperammonemia associated with renal tubular dysfunction in poisoning cases has not been reported in the past.
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Qiu H, Chuang KJ, Fan YC, Chang TP, Bai CH, Ho KF. Acute effects of ambient non-methane hydrocarbons on cardiorespiratory hospitalizations: A multicity time-series study in Taiwan. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 234:113370. [PMID: 35255250 DOI: 10.1016/j.ecoenv.2022.113370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/26/2022] [Accepted: 03/01/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Few environmental epidemiological studies and no large multicity studies have evaluated the acute short-term health effects of ambient non-methane hydrocarbons (NMHC), the essential precursors of ground-level ozone and secondary organic aerosol formation. OBJECTIVE We conducted this multicity time-series study in Taiwan to evaluate the association between airborne NMHC exposure and cardiorespiratory hospital admissions. METHODS We collected the daily mean concentrations of NMHC, fine particulate matter (PM2.5), ozone (O3), weather conditions, and daily hospital admission count for cardiorespiratory diseases between 2014 and 2017 from eight major cities of Taiwan. We applied an over-dispersed generalized additive Poisson model (GAM) with adjustment for temporal trends, seasonal variations, weather conditions, and calendar effects to compute the effect estimate for each city. Then we conducted a random-effects meta-analysis to pool the eight city-specific effect estimates to obtain the overall associations of NMHC exposure on lag0 day with hospital admissions for respiratory and circulatory diseases, respectively. RESULTS On average, a 0.1-ppm increase of lag0 NMHC demonstrated an overall 0.9% (95% CI: 0.4-1.3%) and 0.8% (95% CI: 0.4-1.2%) increment of hospital admissions for respiratory and circulatory diseases, respectively. Further analyses with adjustment for PM2.5 and O3 in the multi-pollutant model or sensitivity analyses with restricting the NMHC monitoring from the general stations only confirmed the robustness of the association between ambient NMHC exposure and cardiorespiratory hospitalizations. CONCLUSION Our findings provide robust evidence of higher cardiorespiratory hospitalizations in association with acute exposure to ambient NMHC in eight major cities of Taiwan.
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Affiliation(s)
- Hong Qiu
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, Hong Kong, China
| | - Kai-Jen Chuang
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yen-Chun Fan
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Ta-Pang Chang
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Chyi-Huey Bai
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.
| | - Kin-Fai Ho
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, Hong Kong, China.
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25
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Han Z, Tian H, Pang X, Song G, Sun D. Ethylene dimethacrylate used as an NH 3 adsorbent with high adsorption capacity and selectivity. CHEMOSPHERE 2022; 293:133539. [PMID: 34998851 DOI: 10.1016/j.chemosphere.2022.133539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/23/2021] [Accepted: 01/03/2022] [Indexed: 06/14/2023]
Abstract
NH3 molecularly imprinted polymers (NH3-MIPs) were synthesized that could successfully separate and recover NH3 during sludge aerobic composting; however, increased toluene usage during the adsorbent preparation incurred a high cost and severe environmental risks. The purpose of this study was to reduce toluene usage by optimizing the reagent composition of NH3-MIPs, based on maintaining a high NH3 adsorption capacity and selectivity. Five adsorbent groups, including NH3-MIPs, and NH3-Ethylene dimethacrylate adsorbents (NH3-EGDMA) with 0%, 75%, 90%, and 100% toluene reduction efficiencies, were prepared and tested for their adsorption performance. The results showed that NH3-EGDMA with 75% toluene reduction not only had a high NH3 adsorption capacity (104.42 mg g-1) but also had a high separation factor for NH3/methyl sulfide (3121) and NH3/dimethyl disulfide (4597). The adsorption mechanism was identified as a chemical force between NH3 and NH3-EGDMA with a 75% toluene reduction using the analysis of the kinetic model. This study significantly reduces NH3 adsorbent cost as well as harm to the environment during the adsorbent preparation, which was beneficial to the popularization and application of this NH3 adsorbent.
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Affiliation(s)
- Zhangliang Han
- Beijing Key Lab for Source Control Technology of Water Pollution, Engineering Research Center for Water Pollution Source Control & Eco-remediation, College of Environmental Science & Engineering, Beijing Forestry University, Beijing, 100083, China; College of Environment, Zhejiang University of Technology, Hangzhou, 310014, China
| | - Haozhong Tian
- Beijing Key Lab for Source Control Technology of Water Pollution, Engineering Research Center for Water Pollution Source Control & Eco-remediation, College of Environmental Science & Engineering, Beijing Forestry University, Beijing, 100083, China
| | - Xiaobing Pang
- College of Environment, Zhejiang University of Technology, Hangzhou, 310014, China; Shaoxing Research Institute, Zhejing University of Technology, Shaoxing, 312000, China
| | - Guoyong Song
- Beijing Key Lab for Source Control Technology of Water Pollution, Engineering Research Center for Water Pollution Source Control & Eco-remediation, College of Environmental Science & Engineering, Beijing Forestry University, Beijing, 100083, China
| | - Dezhi Sun
- Beijing Key Lab for Source Control Technology of Water Pollution, Engineering Research Center for Water Pollution Source Control & Eco-remediation, College of Environmental Science & Engineering, Beijing Forestry University, Beijing, 100083, China.
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26
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Derkits DR, Meggs WJ, Parker Cote JL. Trending of a falsely elevated serum creatinine after a pediatric nitromethane ingestion: A case report. J Am Coll Emerg Physicians Open 2022; 3:e12689. [PMID: 35310404 PMCID: PMC8913454 DOI: 10.1002/emp2.12689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 01/26/2022] [Accepted: 02/08/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- David R. Derkits
- Department of Emergency Medicine Brody School of Medicine at East Carolina University Greenville North Carolina USA
| | - William J. Meggs
- Department of Emergency Medicine Brody School of Medicine at East Carolina University Greenville North Carolina USA
| | - Jennifer L. Parker Cote
- Department of Emergency Medicine Brody School of Medicine at East Carolina University Greenville North Carolina USA
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27
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Rudduck EL, Concannon E, Coghlan P, Govindan T, Kurmis R, Solanki N. Management of hydrocarbon burns: Considering mental health and biochemical abnormalities. J Burn Care Res 2022; 43:552-566. [PMID: 35041736 DOI: 10.1093/jbcr/irac007] [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: 11/13/2022]
Abstract
Volatile substance misuse, particularly the inhalation of hydrocarbons, is a growing issue globally. Consequences of VSM, both acute or chronic, causes cardiovascular, respiratory, renal, metabolic and central nervous system damage. Whilst the effects of hydrocarbon abuse have been reported, the combination of intoxication with hydrocarbon and burns sustained has not yet been presented. A retrospective case series of patients who presented in the last 5 years to the Royal Adelaide Hospital with hydrocarbon-related burns in the context of illicit use was undertaken. Our aims are to present to the wider scientific community the high morbidity and mortality of hydrocarbon burn injuries and why this tertiary Burns Unit feel it most appropriate to medically stabilise these patients prior to definitive surgery for their burn. All patients that presented with acute hydrocarbon intoxication and sustained concomitant burns had significant psychiatric disorder and substance abuse history and three of five had either not eaten in several days resulting in acute malnourishment, refeeding syndrome or had evidence of chronic malnourishment with deranged electrolytes and hypoalbuminaemia. Their definitive burns surgery was delayed where appropriate in order to facilitate medical stabilisation as they were too high risk of cardiac membrane instability, electrolyte derangement and/or respiratory compromise to undergo safe general anaesthetic and burns debridement. We propose a multidisciplinary team approach, utilising not only our Burns Unit care model of physiotherapists, psychologists, social work and burns trained nurses and surgeons but also Intensive Care, Toxicology, Addiction medicine and General Medical physicians in the management of these patients.
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Affiliation(s)
- Emma-Leigh Rudduck
- Burns Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | | | - Patrick Coghlan
- Burns Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Thiru Govindan
- Department of Emergency Medicine, Royal Adelaide Hospital, South Australia, Australia.,Clinical Toxicology Service, Royal Adelaide Hospital, South Australia, Australia
| | - Rochelle Kurmis
- Burns Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Nicholas Solanki
- Burns Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
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28
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Goenka U, Jajodia S, Jash D, Ghosh S, Bandyopadhyay S. Acute exogenous lipoid pneumonia: Unusual presentation as cavitating lung disease with pneumothorax. Respir Med Case Rep 2022; 36:101593. [PMID: 35145844 PMCID: PMC8818583 DOI: 10.1016/j.rmcr.2022.101593] [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: 09/16/2021] [Revised: 12/14/2021] [Accepted: 01/24/2022] [Indexed: 11/30/2022] Open
Abstract
Acute lipoid pneumonia is quite uncommon and is associated with oily or lipid contents within the alveoli. Exogenous lipoid pneumonia due to kerosene poisoning, manifests with a wide clinical spectrum ranging from subtle chemical pneumonitis to marked severe pulmonary and systemic inflammation. We present an interesting case of an adult male with kerosene poisoning. He manifested with severe cavitating lung disease. In addition, he developed spontaneous pneumothorax. Both cavitating lung disease and pneumothorax are unusual manifestations of acute exogenous lipoid pneumonia and perhaps follow severe lung injury following high volume kerosene exposure.
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George N, Chin B, Neeki AS, Dong F, Neeki MM. Acute Inhalant-Induced Atrial Fibrillation With Severe Hypocalcemia: A Case Report and Review of the Pathophysiology. Cureus 2021; 13:e19897. [PMID: 34966608 PMCID: PMC8710132 DOI: 10.7759/cureus.19897] [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] [Accepted: 11/25/2021] [Indexed: 11/29/2022] Open
Abstract
The recreational use of inhalants is associated with various detrimental health effects ranging from inebriation to cardiac arrest. It also presents a challenging clinical problem as the diagnosis is made by the presentation and patient’s history, which is often difficult to obtain in an intoxicated or obtunded individual. The incidence of inhalant use is relatively high. National surveys have reported that nearly 21.7 million Americans aged 12 and older have used inhaled substances at least once in their lives. There is no reversal agent or antidote for inhalants and supportive care is generally recommended. We present a case of a young patient presenting with acute inhalant toxicity accompanied by atrial fibrillation with a rapid ventricular response and severe hypocalcemia.
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Affiliation(s)
- Nicholas George
- Department of Emergency Medicine, Arrowhead Regional Medical Center, Colton, USA
| | - Brian Chin
- Department of Emergency Medicine, Arrowhead Regional Medical Center, Colton, USA
| | - Arianna S Neeki
- Department of Emergency Medicine, Arrowhead Regional Medical Center, Colton, USA
| | - Fanglong Dong
- Department of Emergency Medicine, Arrowhead Regional Medical Center, Colton, USA
| | - Michael M Neeki
- Department of Emergency Medicine, Arrowhead Regional Medical Center, Colton, USA.,Department of Emergency Medicine, California University of Science and Medicine, Colton, USA
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30
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Schwartz C, Tooley L, Knight R, Steinberg M. Queering poppers literature: A critical interpretive synthesis of health sciences research on alkyl nitrite use and Canadian policy. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 101:103546. [PMID: 34920219 DOI: 10.1016/j.drugpo.2021.103546] [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: 07/23/2021] [Revised: 11/15/2021] [Accepted: 11/18/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Poppers (alkyl nitrites) are vasodilators used by many gay, bisexual, and other men who have sex with men (GBMSM) to relieve pain, enhance pleasure, and facilitate penetration during sex. In 2013, the Canadian government cracked down on the sale of poppers products, however prevalence of poppers use among GBMSM in Canada remains high. Poppers have been studied by medical researchers since the 1980s, yet qualitative and community-based research to inform federal policy, remains somewhat less common. METHODS We conducted a critical interpretive synthesis (CIS) to better understand poppers health literature using the medical model of health as a point of reference. Analysis was performed using inductive and deductive methods including reflexive note-taking, mind-mapping, and close coding. 153 publications were identified to inform this review of which 5 were chosen for coding based on a purposive sampling framework. RESULTS Our findings are unified within a theoretical construct we term responsibility. Responsibility is a construct we use to describe the bias we identified in health sciences literature regarding poppers use that tends to exaggerate the necessity for poppers cessation, and devalue both the benefits of poppers use and the perspectives and experiences of people who use poppers. The emphasis on individual behavior change within the literature appears to be motivated less by objective measures or assessments of health risks and outcomes, and more by harmful stereotypes that position gay men and people who use drugs as inherently irresponsible. CONCLUSION We conclude by discussing how these findings have important implications for the review of current policy on poppers sales in Canada which remains influenced by a literature base prejudiced by factors such as homophobia, heteronormativity, and drug stigma, and recommend areas for future work.
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Affiliation(s)
- Cameron Schwartz
- Faculty of Health Sciences, Simon Fraser University, 8888 University Dr, Burnaby, BC V5A 1S6, Canada; Community-Based Research Centre, 1007-808 Nelson St, Vancouver, BC V6Z 2H2, Canada.
| | - Len Tooley
- Community-Based Research Centre, 1007-808 Nelson St, Vancouver, BC V6Z 2H2, Canada
| | - Rod Knight
- British Columbia Centre on Substance Use, 400-1045 Howe St, Vancouver, BC V6Z 2A9, Canada; Department of Medicine, University of British Columbia, 2775 Laurel Street, 10th Floor, Vancouver, BC V5Z 1M9, Canada
| | - Malcolm Steinberg
- Faculty of Health Sciences, Simon Fraser University, 8888 University Dr, Burnaby, BC V5A 1S6, Canada
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31
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van der Voet M, Teunis M, Louter-van de Haar J, Stigter N, Bhalla D, Rooseboom M, Wever KE, Krul C, Pieters R, Wildwater M, van Noort V. Towards a reporting guideline for developmental and reproductive toxicology testing in C. elegans and other nematodes. Toxicol Res (Camb) 2021; 10:1202-1210. [PMID: 34950447 PMCID: PMC8692742 DOI: 10.1093/toxres/tfab109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 10/07/2021] [Accepted: 10/27/2021] [Indexed: 11/13/2022] Open
Abstract
Implementation of reliable methodologies allowing Reduction, Refinement, and Replacement (3Rs) of animal testing is a process that takes several decades and is still not complete. Reliable methods are essential for regulatory hazard assessment of chemicals where differences in test protocol can influence the test outcomes and thus affect the confidence in the predictive value of the organisms used as an alternative for mammals. Although test guidelines are common for mammalian studies, they are scarce for non-vertebrate organisms that would allow for the 3Rs of animal testing. Here, we present a set of 30 reporting criteria as the basis for such a guideline for Developmental and Reproductive Toxicology (DART) testing in the nematode Caenorhabditis elegans. Small organisms like C. elegans are upcoming in new approach methodologies for hazard assessment; thus, reliable and robust test protocols are urgently needed. A literature assessment of the fulfilment of the reporting criteria demonstrates that although studies describe methodological details, essential information such as compound purity and lot/batch number or type of container is often not reported. The formulated set of reporting criteria for C. elegans testing can be used by (i) researchers to describe essential experimental details (ii) data scientists that aggregate information to assess data quality and include data in aggregated databases (iii) regulators to assess study data for inclusion in regulatory hazard assessment of chemicals.
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Affiliation(s)
| | - Marc Teunis
- Utrecht University of Applied Sciences, Innovative testing in Life Sciences & Chemistry, 3584 CH, Utrecht, the Netherlands
| | - Johanna Louter-van de Haar
- Utrecht University of Applied Sciences, Innovative testing in Life Sciences & Chemistry, 3584 CH, Utrecht, the Netherlands
| | - Nienke Stigter
- Utrecht University of Applied Sciences, Innovative testing in Life Sciences & Chemistry, 3584 CH, Utrecht, the Netherlands
| | - Diksha Bhalla
- KU Leuven, Centre of Microbial and Plant Genetics, Faculty of Bioscience Engineering, 3001, Leuven, Belgium
| | - Martijn Rooseboom
- Toxicology group Shell International B.V., 2596 HR, The Hague, the Netherlands
| | - Kimberley E Wever
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department for Health Evidence, 6525 GA, Nijmegen, the Netherlands
| | - Cyrille Krul
- Utrecht University of Applied Sciences, Innovative testing in Life Sciences & Chemistry, 3584 CH, Utrecht, the Netherlands
| | - Raymond Pieters
- Utrecht University of Applied Sciences, Innovative testing in Life Sciences & Chemistry, 3584 CH, Utrecht, the Netherlands
- Utrecht University, Institute for Risk Assessment Sciences, 3584 CM, Utrecht, the Netherlands
| | | | - Vera van Noort
- KU Leuven, Centre of Microbial and Plant Genetics, Faculty of Bioscience Engineering, 3001, Leuven, Belgium
- Leiden University, Institute of Biology Leiden, 2333 BE, Leiden, the Netherlands
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32
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Campos-Ordoñez T, Alcalá E, Ibarra-Castañeda N, Buriticá J, González-Pérez Ó. Chronic exposure to cyclohexane induces stereotypic circling, hyperlocomotion, and anxiety-like behavior associated with atypical c-Fos expression in motor- and anxiety-related brain regions. Behav Brain Res 2021; 418:113664. [PMID: 34780858 DOI: 10.1016/j.bbr.2021.113664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 10/29/2021] [Accepted: 11/07/2021] [Indexed: 12/27/2022]
Abstract
Recreational abuse of solvents continues, despite cyclohexane (CHX) is used as a safe replacement in gasoline or adhesive formulations. Increasing evidence indicates that CHX inhalation affects brain functioning; however, scanty information is available about its effects on behavior and brain activity upon drug removal. In this study, we used CD1 adult mice to mimic an intoxication period of recreational drugs for 30 days. During the CHX exposure (~30,000 ppm), we analyzed exploratory and biphasic behaviors, stereotypic circling, and locomotion. After CHX removal (24 h or a month later), we assessed anxiety-like behaviors and quantified c-Fos cells in motor- and anxiety-related brain regions. Our findings indicate that the repeated inhalation of CHX produced steady hyperactivity and reduced ataxia, sedation, and seizures as the exposure to CHX progressed. Also, CHX decreased grooming and rearing behaviors. In the first week of CHX inhalation, a stereotypic circling behavior emerged, and locomotion increased gradually. One month after CHX withdrawal, mice showed low activity in the center zone of the open field and more buried marbles. Twenty-four hours after CHX removal, c-Fos expression was low in the dorsal striatum, ventral striatum, motor cortex, dorsomedial prefrontal cortex, basolateral amygdala, lateral hypothalamus, and ventral hippocampus. One month later, c-Fos expression remained low in the ventral striatum and lateral hypothalamus but increased in the dorsomedial prefrontal cortex and primary motor cortex. This study provides a comprehensive behavioral characterization and novel histological evidence of the CHX effects on the brain when is administered in a recreational-like mode.
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Affiliation(s)
- Tania Campos-Ordoñez
- Laboratory of Neuroscience, School of Psychology, University of Colima, Colima, Mexico; Centro de Estudios e Investigaciones en Comportamiento, University of Guadalajara, Jalisco, Mexico.
| | - Emmanuel Alcalá
- Centro de Estudios e Investigaciones en Comportamiento, University of Guadalajara, Jalisco, Mexico; Research Laboratory on Optimal Design, Devices and Advanced Materials, Department of Mathematics and Physics, ITESO, Jalisco, Mexico
| | - Nereida Ibarra-Castañeda
- Laboratory of Neuroscience, School of Psychology, University of Colima, Colima, Mexico; Medical Science PhD Program, School of Medicine, University of Colima, Colima, Mexico
| | - Jonathan Buriticá
- Centro de Estudios e Investigaciones en Comportamiento, University of Guadalajara, Jalisco, Mexico
| | - Óscar González-Pérez
- Laboratory of Neuroscience, School of Psychology, University of Colima, Colima, Mexico.
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Abstract
Toxic inhalants include various xenobiotics. Irritants cause upper and lower respiratory tract injuries. Highly water-soluble agents injure the upper respiratory tract, while low water-soluble inhalants injure the lower track. Asphyxiants are divided into simple asphyxiants and chemical asphyxiants. Simple asphyxiants displace oxygen, causing hypoxia, while chemical asphyxiants also impair the body's ability to use oxygen. Cyanide is a classic chemical asphyxiant. Treatment includes hydroxocobalamin. Electronic cigarette or vaping use-associated lung injury (EVALI) is a relatively new illness. Patients present with respiratory symptoms and gastrointestinal distress. EVALI appears to be associated with vaping cannabinoids. Treatment is supportive and may include steroids.
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Affiliation(s)
- Evan S Schwarz
- Washington University School of Medicine, 660 South Euclid, Campus Box 8072, St Louis, MO 63110, USA.
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34
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Burke J, Haigney MCP, Farasat M, Mehler PS, Krantz MJ. Huffing and twist: Fatal Torsade de pointes associated with Tetrafluoroethane Inhalation and amphetamine use. Clin Case Rep 2021; 9:CCR33838. [PMID: 34466229 PMCID: PMC8385681 DOI: 10.1002/ccr3.3838] [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: 09/22/2020] [Revised: 11/25/2020] [Accepted: 12/24/2020] [Indexed: 11/12/2022] Open
Abstract
Many volatile chemicals inhaled for a recreational high have a chemical structure similar to chloroform and may lead to Ikr blockade and subsequent torsades de pointes. This is one potential mechanism of action for huffing-associated sudden death.
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Affiliation(s)
- Joseph Burke
- Department of MedicineDivision of CardiologyDenver Health and Hospital AuthorityDenverCOUSA
- Department of MedicineUniversity of Colorado School of MedicineAuroraCOUSA
| | | | - Morteza Farasat
- Department of MedicineDivision of CardiologyDenver Health and Hospital AuthorityDenverCOUSA
- Department of MedicineUniversity of Colorado School of MedicineAuroraCOUSA
| | - Philip S. Mehler
- Department of MedicineUniversity of Colorado School of MedicineAuroraCOUSA
| | - Mori J. Krantz
- Department of MedicineDivision of CardiologyDenver Health and Hospital AuthorityDenverCOUSA
- Department of MedicineUniversity of Colorado School of MedicineAuroraCOUSA
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35
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Kosnik MB, Enroth S, Karlsson O. Distinct genetic regions are associated with differential population susceptibility to chemical exposures. ENVIRONMENT INTERNATIONAL 2021; 152:106488. [PMID: 33714141 DOI: 10.1016/j.envint.2021.106488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 06/12/2023]
Abstract
Interactions between environmental factors and genetics underlie the majority of chronic human diseases. Chemical exposures are likely an underestimated contributor, yet gene-environment (GxE) interaction studies rarely assess their modifying effects. Here, we describe a novel method to profile the human genome and identify regions associated with differential population susceptibility to chemical exposures. Single nucleotide polymorphisms (SNPs) implicated in enriched chemical-disease intersections were identified and validated for three chemical classes with expected GxE interaction potential (neuroactive, hepatoactive, and cardioactive compounds). The same approach was then used to characterize consumer product classes with unknown risk for GxE interactions (washing products, cosmetics, and adhesives). Additionally, high-risk variant sets that may confer differential population susceptibility were identified for these consumer product groups through frequent itemset mining and pathway analysis. A dataset of 2454 consumer product chemical-disease linkages, with risk values, SNPs, and pathways for each association was developed, describing the interplay between environmental factors and genetics in human disease progression. We found that genetic hotspots implicated in GxE interactions differ across chemical classes (e.g., washing products had high-risk SNPs implicated in nervous system disease) and illustrate how this approach can discover new associations (e.g., washing product n-butoxyethanol implicated SNPs in the PI3K-Akt signaling pathway for Alzheimer's disease). Hence, our approach can predict high-risk genetic regions for differential population susceptibility to chemical exposures and characterize chemical modifying factors in specific diseases. These methods show promise for describing how chemical exposures can lead to varied health outcomes in a population and for incorporating inter-individual variability into chemical risk assessment.
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Affiliation(s)
- Marissa B Kosnik
- Science for Life Laboratory, Department of Environmental Science, Stockholm University, 114 18 Stockholm, Sweden.
| | - Stefan Enroth
- Department of Immunology, Genetics, and Pathology, Biomedical Center, Science for Life Laboratory Uppsala, Uppsala University, 751 85 Uppsala, Sweden.
| | - Oskar Karlsson
- Science for Life Laboratory, Department of Environmental Science, Stockholm University, 114 18 Stockholm, Sweden.
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36
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Lott C, Truhlář A, Alfonzo A, Barelli A, González-Salvado V, Hinkelbein J, Nolan JP, Paal P, Perkins GD, Thies KC, Yeung J, Zideman DA, Soar J. [Cardiac arrest under special circumstances]. Notf Rett Med 2021; 24:447-523. [PMID: 34127910 PMCID: PMC8190767 DOI: 10.1007/s10049-021-00891-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 01/10/2023]
Abstract
These guidelines of the European Resuscitation Council (ERC) Cardiac Arrest under Special Circumstances are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. This section provides guidelines on the modifications required for basic and advanced life support for the prevention and treatment of cardiac arrest under special circumstances; in particular, specific causes (hypoxia, trauma, anaphylaxis, sepsis, hypo-/hyperkalaemia and other electrolyte disorders, hypothermia, avalanche, hyperthermia and malignant hyperthermia, pulmonary embolism, coronary thrombosis, cardiac tamponade, tension pneumothorax, toxic agents), specific settings (operating room, cardiac surgery, cardiac catheterization laboratory, dialysis unit, dental clinics, transportation [in-flight, cruise ships], sport, drowning, mass casualty incidents), and specific patient groups (asthma and chronic obstructive pulmonary disease, neurological disease, morbid obesity, pregnancy).
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Affiliation(s)
- Carsten Lott
- Department of Anesthesiology, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Deutschland
| | - Anatolij Truhlář
- Emergency Medical Services of the Hradec Králové Region, Hradec Králové, Tschechien
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Hradec Králové, Charles University in Prague, Hradec Králové, Tschechien
| | - Anette Alfonzo
- Departments of Renal and Internal Medicine, Victoria Hospital, Kirkcaldy, Fife Großbritannien
| | - Alessandro Barelli
- Anaesthesiology and Intensive Care, Teaching and research Unit, Emergency Territorial Agency ARES 118, Catholic University School of Medicine, Rom, Italien
| | - Violeta González-Salvado
- Cardiology Department, University Clinical Hospital of Santiago de Compostela, Institute of Health Research of Santiago de Compostela (IDIS), Biomedical Research Networking Centres on Cardiovascular Disease (CIBER-CV), A Coruña, Spanien
| | - Jochen Hinkelbein
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Köln, Deutschland
| | - Jerry P. Nolan
- Resuscitation Medicine, Warwick Medical School, University of Warwick, CV4 7AL Coventry, Großbritannien
- Anaesthesia and Intensive Care Medicine, Royal United Hospital, BA1 3NG Bath, Großbritannien
| | - Peter Paal
- Department of Anaesthesiology and Intensive Care Medicine, Hospitallers Brothers Hospital, Paracelsus Medical University, Salzburg, Österreich
| | - Gavin D. Perkins
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, Großbritannien
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, Großbritannien
| | - Karl-Christian Thies
- Dep. of Anesthesiology and Critical Care, Bethel Evangelical Hospital, University Medical Center OLW, Bielefeld University, Bielefeld, Deutschland
| | - Joyce Yeung
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, Großbritannien
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, Großbritannien
| | | | - Jasmeet Soar
- Southmead Hospital, North Bristol NHS Trust, Bristol, Großbritannien
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37
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Cruz SL, Bowen SE. The last two decades on preclinical and clinical research on inhalant effects. Neurotoxicol Teratol 2021; 87:106999. [PMID: 34087382 DOI: 10.1016/j.ntt.2021.106999] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/24/2021] [Accepted: 05/18/2021] [Indexed: 12/21/2022]
Abstract
This paper reviews the scientific evidence generated in the last two decades on the effects and mechanisms of action of most commonly misused inhalants. In the first section, we define what inhalants are, how they are used, and their prevalence worldwide. The second section presents specific characteristics that define the main groups of inhalants: (a) organic solvents; (b) aerosols, gases, and volatile anesthetics; and (c) alkyl nitrites. We include a table with the molecular formula, structure, synonyms, uses, physicochemical properties and exposure limits of representative compounds within each group. The third and fourth sections review the direct acute and chronic effects of common inhalants on health and behavior with a summary of mechanisms of action, respectively. In the fifth section, we address inhalant intoxication signs and available treatment. The sixth section examines the health effects, intoxication, and treatment of nitrites. The seventh section reviews current intervention strategies. Finally, we propose a research agenda to promote the study of (a) solvents other than toluene; (b) inhalant mixtures; (c) effects in combination with other drugs of abuse; (d) age and (e) sex differences in inhalant effects; (f) the long-lasting behavioral effects of animals exposed in utero to inhalants; (g) abstinence signs and neurochemical changes after interrupting inhalant exposure; (h) brain networks involved in inhalant effects; and finally (i) strategies to promote recovery of inhalant users.
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Affiliation(s)
- Silvia L Cruz
- Department of Pharmacobiology, Center of Research and Advanced Studies (Cinvestav), Calzada de los Tenorios No. 235, Col. Granjas Coapa, México City 14330, México.
| | - Scott E Bowen
- Department of Psychology, Wayne State University, 5057 Woodward Ave., Suite 7906.1, Detroit, MI 48202, USA.
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Affiliation(s)
- David C Sheridan
- Department of Emergency Medicine, Oregon Health & Science University, Portland, OR
| | - Adrienne Hughes
- Department of Emergency Medicine, Oregon Health & Science University, Portland, OR.,Oregon Poison Center, Portland, OR
| | - B Zane Horowitz
- Department of Emergency Medicine, Oregon Health & Science University, Portland, OR.,Oregon Poison Center, Portland, OR
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39
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Zhang R, Yao Y, Tu L, Luan T, Chen B. Non-targeted metabolomics of multiple human cells revealing differential toxic effects of perfluorooctanoic acid. JOURNAL OF HAZARDOUS MATERIALS 2021; 409:125017. [PMID: 33421881 DOI: 10.1016/j.jhazmat.2020.125017] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/26/2020] [Accepted: 12/29/2020] [Indexed: 06/12/2023]
Abstract
Differences in toxic effects of contaminants among human cells are essential for evaluating their health risks to humans. In this study, non-targeted metabolomics of multiple human cell lines (A549 (lung), DLD-1 (intestine) and L-02 (liver) cells) was used to address the differential toxicity of perfluorooctanoic acid (PFOA). The number of differential metabolites (DMs) identified in the PFOA-treated A549 cells (67) was highest, followed by DLD-1 (12) and L-02 cells (10). The categorization of DMs was almost uniquely specific to each of cell lines. PFOA significantly promoted linoleic acid metabolism in L-02 cells whereas this metabolism was inhibited in the PFOA-treated A549 cells. The levels of interleukin (IL)-1β, IL-6, IL-8 and IL-13 were about 1.5 times higher in the PFOA-treated A549 and L-02 cells than in the controls. PFOA stimulated the biosynthesis of arginine and the metabolism of vitamin B6 in A549 cells. Arginine and vitamin B6 supplemented into cell culture effectively decreased the levels of IL-6 and IL-8. The inhibition of purine metabolism by PFOA resulted in the arrestation of DLD-1 cells at the G0/G1-phase. Our results suggest that the differential toxicity of PFOA related to exposure pathways could be elucidated by metabolic profiles specific to various human cells.
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Affiliation(s)
- Ruijia Zhang
- Sate Key Laboratory of Biocontrol, School of Life Sciences, Sun Yat-Sen University, Guangzhou 510275, China
| | - Yao Yao
- Sate Key Laboratory of Biocontrol, School of Life Sciences, Sun Yat-Sen University, Guangzhou 510275, China
| | - Lanyin Tu
- Sate Key Laboratory of Biocontrol, School of Life Sciences, Sun Yat-Sen University, Guangzhou 510275, China
| | - Tiangang Luan
- Sate Key Laboratory of Biocontrol, School of Life Sciences, Sun Yat-Sen University, Guangzhou 510275, China; Institute of Environmental and Ecological Engineering, Guangdong University of Technology, Guangzhou 510006, China.
| | - Baowei Chen
- Southern Marine Science and Engineering Guangdong Laboratory, School of Marine Sciences, Sun Yat-Sen University, Zhuhai 519082, China.
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40
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Martínez-Sánchez L, López-Ávila J, Barasoain-Millán A, Angelats-Romero CM, Azkunaga-Santibañez B, Molina-Cabañero JC, Alday A, Andrés A, Angelats C, Aquino E, Astete J, Baena I, Barasoain A, Bello P, Benito C, Benito H, Botifoll E, Burguera B, Campos C, Canduela V, Clerigué N, Comalrena C, Del Campo T, De Miguel B, Fernández R, Fernández B, García E, García M, García M, García M, García-Vao C, Herrero L, Huerta P, Humayor J, Hurtado P, Iturralde I, Jordá A, Khodayar P, Lalinde M, Lobato Z, López J, López V, Luaces C, Mangione L, Martín L, Martínez S. L, Martínez L, Martorell J, May M, Melguizo M, Mesa S, Molina J, Muñiz M, Muñoz J, Muñoz N, Oliva S, Palacios M, Pérez A, Pérez C, Pinyot M, Peñalba A, Pociello N, Rodríguez A, Rodríguez M, Señer R, Serrano I, Vázquez P, Vidal C. Actions that should not be taken with a paediatric patient who has been exposed to a potentially toxic substance. An Pediatr (Barc) 2021. [DOI: 10.1016/j.anpede.2020.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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41
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Polidoro B, Matson CW, Ottinger MA, Renegar DA, Romero IC, Schlenk D, Wise JP, Beltrán González J, Bruns P, Carpenter K, Cobián Rojas D, Collier TK, Duda TF, González-Díaz P, Di Giulio R, Grubbs RD, Haney JC, Incardona JP, Horta-Puga G, Linardich C, Moore JA, Pech D, Perera Valderrama S, Ralph GM, Strongin K, Ringwood AH, Würsig B. A multi-taxonomic framework for assessing relative petrochemical vulnerability of marine biodiversity in the Gulf of Mexico. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 763:142986. [PMID: 33168243 DOI: 10.1016/j.scitotenv.2020.142986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/04/2020] [Accepted: 10/08/2020] [Indexed: 06/11/2023]
Abstract
A fundamental understanding of the impact of petrochemicals and other stressors on marine biodiversity is critical for effective management, restoration, recovery, and mitigation initiatives. As species-specific information on levels of petrochemical exposure and toxicological response are lacking for the majority of marine species, a trait-based assessment to rank species vulnerabilities to petrochemical activities in the Gulf of Mexico can provide a more comprehensive and effective means to prioritize species, habitats, and ecosystems for improved management, restoration and recovery. To initiate and standardize this process, we developed a trait-based framework, applicable to a wide range of vertebrate and invertebrate species, that can be used to rank relative population vulnerabilities of species to petrochemical activities in the Gulf of Mexico. Through expert consultation, 18 traits related to likelihood of exposure, individual sensitivity, and population resilience were identified and defined. The resulting multi-taxonomic petrochemical vulnerability framework can be adapted and applied to a wide variety of species groups and geographic regions. Additional recommendations and guidance on the application of the framework to rank species vulnerabilities under specific petrochemical exposure scenarios, management needs or data limitations are also discussed.
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Affiliation(s)
- Beth Polidoro
- School of Mathematics and Natural Sciences, Arizona State University, 4701 W. Thunderbird Rd, Glendale, AZ 85306, USA.
| | - Cole W Matson
- Department of Environmental Science, Baylor University, One Bear Place #97266, Waco, TX 76798, USA
| | - Mary Ann Ottinger
- Department of Biology and Biochemistry, 3455 Cullen Boulevard, #221E, University of Houston, Houston, TX 77204-5001, USA
| | - D Abigail Renegar
- Halmos College of Arts and Sciences, Nova Southeastern University, 8000 North Ocean Drive, Dania, FL 33004, USA
| | - Isabel C Romero
- University of South Florida, College of Marine Science, 140 7th Ave S, St Petersburg, FL 33701, USA
| | - Daniel Schlenk
- Department of Environmental Sciences, University of California Riverside, 900 University Blvd., Riverside, CA 92054, USA
| | - John Pierce Wise
- Wise Laboratory of Environmental and Genetic Toxicology, 500 S. Preston St., 55A Department of Pharmacology and Toxicology, University of Louisville, Louisville, KY 40292, USA
| | - Jesús Beltrán González
- Centro de Investigación y Manejo Ambiental del Transporte (Cimab), Ctra. del Cristo esq. Tiscornia, Casablanca, Habana, Cuba
| | - Peter Bruns
- Department of Environmental Science, Baylor University, One Bear Place #97266, Waco, TX 76798, USA
| | - Kent Carpenter
- International Union for Conservation of Nature Marine Biodiversity Unit, Department of Biological Sciences, Old Dominion University, 5115 Hampton Blvd., Norfolk, VA 23529, USA
| | - Dorka Cobián Rojas
- Parque Nacional Guanahacabibes, Centro de Investigaciones y Servicios Ambientales (ECOVIDA), Ministerio de Ciencia, Tecnología y Medio Ambiente (CITMA), La Bajada, 22100 Sandino, Pinar Del Río, Cuba
| | - Tracy K Collier
- Huxley College of the Environment, Western Washington University, 516 High Street, Bellingham, WA 98225-9079, USA
| | - Thomas F Duda
- Museum of Zoology & Department of Ecology of Evolutionary Biology, University of Michigan, 1105 N. University, Ann Arbor, MI 48109-1085, USA
| | - Patricia González-Díaz
- Centro de Investigaciones Marinas, Universidad de La Habana, Calle 16, No. 114 entre 1ra y 3ra, Municipio Playa, La Habana CP: 11300, Cuba
| | - Richard Di Giulio
- Nicholas School of the Environment, Duke University, Research Drive, Durham, NC 27708, USA
| | - R Dean Grubbs
- Florida State University Coastal and Marine Laboratory, 3618 Highway 98, St. Teresa, FL 32358, USA
| | - J Christopher Haney
- Terra Mar Applied Sciences, 1370 Tewkesbury Place NW, Washington, DC 20012, USA
| | - John P Incardona
- Ecotoxicology Program, Environmental Conservation Division, Northwest Fisheries Science Center, National Oceanic and Atmospheric Administration, Seattle, WA 98112, USA
| | - Guillermo Horta-Puga
- Lab. Biogeoquímica, UBIPRO, FES Iztacala, Universidad Nacional Autónoma de México, Av. de los Barrios 1, Los Reyes Iztacala, Tlalnepantla, México 54090, Mexico
| | - Christi Linardich
- International Union for Conservation of Nature Marine Biodiversity Unit, Department of Biological Sciences, Old Dominion University, 5115 Hampton Blvd., Norfolk, VA 23529, USA
| | - Jon A Moore
- Wilkes Honors College, Florida Atlantic University, 5353 Parkside Dr., Jupiter, FL 33458, USA; Harbor Branch Oceanographic Institute, 5600 US 1, Ft. Pierce, FL 34964, USA
| | - Daniel Pech
- Laboratorio de Biodiversidad Marina y Cambio Climático (BIOMARCCA), El Colegio de la Frontera Sur, Lerma, 24500 Campeche, Mexico
| | - Susana Perera Valderrama
- National Commission for the Knowledge and Use of Biodiversity (CONABIO), Liga Periférico - Insurgentes Sur 4903, Parques del Pedregal, Tlalpan, 14010 Mexico City, Mexico
| | - Gina M Ralph
- International Union for Conservation of Nature Marine Biodiversity Unit, Department of Biological Sciences, Old Dominion University, 5115 Hampton Blvd., Norfolk, VA 23529, USA
| | - Kyle Strongin
- School of Mathematics and Natural Sciences, Arizona State University, 4701 W. Thunderbird Rd, Glendale, AZ 85306, USA
| | - Amy H Ringwood
- Dept of Biology, 9201 University City Blvd, University of North Carolina Charlotte, Charlotte, NC 28223, USA
| | - Bernd Würsig
- Department of Marine Biology, Texas A&M University at Galveston, 200 Seawolf Pkwy, Galveston, TX 77553, USA
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Lott C, Truhlář A, Alfonzo A, Barelli A, González-Salvado V, Hinkelbein J, Nolan JP, Paal P, Perkins GD, Thies KC, Yeung J, Zideman DA, Soar J. European Resuscitation Council Guidelines 2021: Cardiac arrest in special circumstances. Resuscitation 2021; 161:152-219. [PMID: 33773826 DOI: 10.1016/j.resuscitation.2021.02.011] [Citation(s) in RCA: 302] [Impact Index Per Article: 100.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
These European Resuscitation Council (ERC) Cardiac Arrest in Special Circumstances guidelines are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. This section provides guidelines on the modifications required to basic and advanced life support for the prevention and treatment of cardiac arrest in special circumstances; specifically special causes (hypoxia, trauma, anaphylaxis, sepsis, hypo/hyperkalaemia and other electrolyte disorders, hypothermia, avalanche, hyperthermia and malignant hyperthermia, pulmonary embolism, coronary thrombosis, cardiac tamponade, tension pneumothorax, toxic agents), special settings (operating room, cardiac surgery, catheter laboratory, dialysis unit, dental clinics, transportation (in-flight, cruise ships), sport, drowning, mass casualty incidents), and special patient groups (asthma and COPD, neurological disease, obesity, pregnancy).
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Affiliation(s)
- Carsten Lott
- Department of Anesthesiology, University Medical Center, Johannes Gutenberg-University Mainz, Germany.
| | - Anatolij Truhlář
- Emergency Medical Services of the Hradec Králové Region, Hradec Králové, Czech Republic; Department of Anaesthesiology and Intensive Care Medicine, Charles University in Prague, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Annette Alfonzo
- Departments of Renal and Internal Medicine, Victoria Hospital, Kirkcaldy, Fife, UK
| | - Alessandro Barelli
- Anaesthesiology and Intensive Care, Catholic University School of Medicine, Teaching and Research Unit, Emergency Territorial Agency ARES 118, Rome, Italy
| | - Violeta González-Salvado
- Cardiology Department, University Clinical Hospital of Santiago de Compostela, Institute of Health Research of Santiago de Compostela (IDIS), Biomedical Research Networking Centres on Cardiovascular Disease (CIBER-CV), A Coruña, Spain
| | - Jochen Hinkelbein
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Jerry P Nolan
- Resuscitation Medicine, University of Warwick, Warwick Medical School, Coventry, CV4 7AL, UK; Anaesthesia and Intensive Care Medicine, Royal United Hospital, Bath, BA1 3NG, UK
| | - Peter Paal
- Department of Anaesthesiology and Intensive Care Medicine, Hospitallers Brothers Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Gavin D Perkins
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK; University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Karl-Christian Thies
- Department of Anesthesiology, Critical Care and Emergency Medicine, Bethel Medical Centre, OWL University Hospitals, Bielefeld University, Germany
| | - Joyce Yeung
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK; University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Jasmeet Soar
- Southmead Hospital, North Bristol NHS Trust, Bristol, UK
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Esashi R, Fujikawa H, Kataoka Y, Saito M. Double gastric fluid level and aspiration pneumonitis in kerosene poisoning. BMJ Case Rep 2021; 14:e241560. [PMID: 33622759 PMCID: PMC7903119 DOI: 10.1136/bcr-2021-241560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Ryuki Esashi
- Department of Internal Medicine, Suwa Central Hospital, Chino, Nagano, Japan
| | - Hirohisa Fujikawa
- Department of Internal Medicine, Suwa Central Hospital, Chino, Nagano, Japan
- Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yu Kataoka
- Department of Internal Medicine, Suwa Central Hospital, Chino, Nagano, Japan
| | - Minoru Saito
- Department of Internal Medicine, Suwa Central Hospital, Chino, Nagano, Japan
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44
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Sirayder U, Inal-Ince D, Acik C, Soyuer F. Impaired exercise capacity in electrostatic polyester powder paint workers. Inhal Toxicol 2021; 33:55-65. [PMID: 33622153 DOI: 10.1080/08958378.2021.1876189] [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: 10/22/2022]
Abstract
PURPOSE Limited number of studies investigated the effects of Electrostatic powder paints (EPP) on human health. We investigated the effects of EPP exposure on lung function, exercise capacity, and quality of life, and the factors determining exercise capacity in EPP workers. METHODS Fifty-four male EPP workers and 54 age-matched healthy male individuals (control group) were included. Lung function and respiratory muscle strength were measured. The lower limit of normal (LLN) cut-points for FEV1 and FEV1/FVC were calculated. An EPT was used to evaluate bronchial hyperactivity. The handgrip and quadriceps muscle strength were evaluated using a hand-held dynamometer. An ISWT was used to determine exercise capacity. The physical activity level was questioned using the IPAQ. The SGRQ and NHP were used to assessing respiratory specific and general quality of life, respectively. RESULTS Duration of work, FEV1, MIP, handgrip strength, and ISWT distance were significantly lower, and the change in FEV1 after EPT and %HRmax were significantly higher in the EPP group compared to the control group (p < 0.05). There were no subjects with a < LLN for FEV1 and FEV1/FVC in both groups. In the EPP group, ISWT distance was significantly related to age, height, duration of work, FEV1, change in FEV1 after EPT, MIP, MEP, handgrip strength, IPAQ, SGRQ, and NHP total scores (p < 0.05). The change in FEV1 after EPT, MIP, and duration of work explained % 62 of the variance in the ISWT distance (p < 0.001). CONCLUSIONS Changes in lung function based on LLN for the FEV1 and FEV1/FVC were not clinically relevant in EPP workers. Exercise capacity is impaired in EPP workers. Degree of exercise-induced bronchospasm, inspiratory muscle strength, and duration of work are the determinants of exercise capacity in EPP workers.
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Affiliation(s)
- Ukbe Sirayder
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Nuh Naci Yazgan University, Kayseri, Turkey
| | - Deniz Inal-Ince
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Cihangir Acik
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Nuh Naci Yazgan University, Kayseri, Turkey
| | - Ferhan Soyuer
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Antalya Bilim University, Antalya, Turkey
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45
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Koenig ZA, Robertson GA, Koenig NI, Durkin PR, McCarthy R. Massive Gasoline Ingestion in a 64-Year-Old Female: An Explosive Situation. Cureus 2021; 13:e13466. [PMID: 33777555 PMCID: PMC7987296 DOI: 10.7759/cureus.13466] [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: 12/04/2022] Open
Abstract
Hydrocarbons from gasoline are toxins that can affect a multitude of organ systems based on the route of chemical intoxication exposure, with a majority involving oral ingestion or inhalation. Data is still incomplete concerning the systemic complications of gasoline ingestion due in part to variability in the chemical composition of various gasoline products. A 64-year-old female presented to her local emergency department following the ingestion of gasoline in a suicide attempt with altered mental status, hypotension, shortness of breath, tachypnea, sinus tachycardia, coarse rhonchi bilaterally, and hyperactive bowel sounds. Treatment upon admission included intravenous ampicillin/sulbactam, intubation, an intravenous fluid bolus, and ketamine to address the developing hypotension. The patient developed multiorgan failure and acute toxic encephalopathy despite medical interventions and hemodialysis. After four days, comfort care measures were initiated, and the patient passed away. Gasoline toxicity can have a profound effect on multiple organs based on the chemical properties and the route of exposure. These sequelae can be monitored through patient symptoms as well as radiologic imaging. Early supportive therapy and decontamination are vital in decreasing the morbidity and mortality associated with gasoline ingestion.
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Affiliation(s)
| | | | | | - Paige R Durkin
- School of Dentistry, West Virginia University, Morgantown, USA
| | - Ryan McCarthy
- Internal Medicine, West Virginia University, Martinsburg, USA
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46
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Rague J, Grush J, Buchanan J. A Case Series of Chemical Dermal Injury Requiring Operative Intervention after Prolonged Dermal Methylene Chloride Exposure. J Med Toxicol 2021; 17:222-226. [PMID: 33403570 DOI: 10.1007/s13181-020-00818-z] [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: 07/30/2020] [Revised: 10/29/2020] [Accepted: 10/30/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Methylene chloride, also known as dichloromethane, is a volatile hydrocarbon used in paint strippers and removers. Toxicity from methylene chloride may include narcosis and elevated carbon monoxide (CO) levels. Significant injury to the skin can occur after prolonged exposure to methylene chloride and other hydrocarbon-based solvents causing a chemical dermal injury. CASE REPORT This case series describes three male patients with prolonged exposure to a methylene chloride-containing paint remover to the bilateral hands with two of the three patients requiring transfer to a tertiary burn center and operative intervention. The clinical significance and impressive resolution of dermal injury from prolonged methylene chloride exposure are highlighted with detailed images and a literature review. DISCUSSION Chemical dermal injury secondary to methylene chloride exposure likely results from destruction of lipids within the epidermis and dermis and direct chemical injury. Prolonged exposure to skin can result in clinically important injury that requires management by a burn specialist and may necessitate operative intervention. The severity of the dermal injury can range from severe to mild and should be considered by a clinician after skin exposure to hydrocarbons.
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Affiliation(s)
- John Rague
- Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, 777 Bannock Street, Denver, CO, 80204, USA. .,Department of Emergency Medicine, Denver Health and Hospital Authority, 777 Bannock Street, Denver, CO, 80204, USA.
| | - Jordan Grush
- University of Nevada, Las Vegas, Emergency Medicine Residency, 901 Rancho Lane, Suite 135, Las Vegas, NV, 89106, USA
| | - Jennie Buchanan
- Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, 777 Bannock Street, Denver, CO, 80204, USA.,Department of Emergency Medicine, Denver Health and Hospital Authority, 777 Bannock Street, Denver, CO, 80204, USA
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47
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Affiliation(s)
- David C Sheridan
- Department of Emergency Medicine, Oregon Health & Science University, Portland, OR
| | - Adrienne Hughes
- Department of Emergency Medicine, Oregon Health & Science University, Portland, OR.,Oregon Poison Center, Portland, OR
| | - B Zane Horowitz
- Department of Emergency Medicine, Oregon Health & Science University, Portland, OR.,Oregon Poison Center, Portland, OR
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48
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Shrestha TM, Bhatta S, Balayar R, Pokhrel S, Pant P, Nepal G. Diesel siphoner's lung: An unusual cause of hydrocarbon pneumonitis. Clin Case Rep 2021; 9:416-419. [PMID: 33505692 PMCID: PMC7813127 DOI: 10.1002/ccr3.3545] [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: 08/18/2020] [Revised: 10/23/2020] [Accepted: 10/25/2020] [Indexed: 11/09/2022] Open
Abstract
The practice of manual siphoning of diesel from fuel tanks is common among automobile mechanics in Nepal. When an automobile mechanic with a history of diesel siphonage presents with respiratory symptoms, the diesel siphoner's lung diagnosis should be considered. Clinical suspicion confirmed by radiological findings can help in early management and prevention of permanent damage.
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Affiliation(s)
- Tirtha Man Shrestha
- Department of General Practice and Emergency MedicineTribhuvan University Teaching HospitalMaharajgunjNepal
| | - Suraj Bhatta
- Maharajgunj Medical CampusTribhuvan University Institute of MedicineMaharajgunjNepal
| | - Ramesh Balayar
- Maharajgunj Medical CampusTribhuvan University Institute of MedicineMaharajgunjNepal
| | - Sagar Pokhrel
- Maharajgunj Medical CampusTribhuvan University Institute of MedicineMaharajgunjNepal
| | - Pankaj Pant
- Department of Pulmonology and Critical careTribhuvan University Teaching HospitalMaharajgunjNepal
| | - Gaurav Nepal
- Maharajgunj Medical CampusTribhuvan University Institute of MedicineMaharajgunjNepal
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49
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Martínez-Sánchez L, López-Ávila J, Barasoain-Millán A, Angelats-Romero CM, Azkunaga-Santibañez B, Molina-Cabañero JC. [Actions that should not be taken with a paediatric patient who has been exposed to a potentially toxic substance]. An Pediatr (Barc) 2020; 94:285-292. [PMID: 33131718 DOI: 10.1016/j.anpedi.2020.07.002] [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: 05/23/2020] [Revised: 07/02/2020] [Accepted: 07/14/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To show the preparation process by the Poisoning Working Group of the Spanish Society of Paediatric Emergencies (GTI-SEUP), of the list of things «not to do» for a paediatric patient who has been exposed to a potentially toxic substance. METHOD The preparation process of the list was carried out in three phases. First: «Brainstorming» that was open to all members of the GTI-SEUP. Second: Recommendations were selected by following modified-Delphi methodology. All participants were asked to rate the proposals (from 1 = strongly disagree to 9 = strongly agree). Those with an average score greater than 8 were accepted (provided that at least two-thirds of the participants had given them a score ≥ 7), and a second consultation was made for the recommendations with an average score between 6 and 8. Third: Writing and creating a consensus of the final document was done. RESULT A total of 11 proposals were initially obtained. Thirty-two of the 57 GTI-SEUP participants completed the scoring questionnaire. In the first consultation, seven «not to do» recommendations were accepted, and four obtained a doubtful average score (between 6 and 8). After the second consultation, the list was made up of eight recommendations. Two refer to general management, four to gastrointestinal decontamination techniques, and two to the administration of antidotes. CONCLUSION The list of actions that should not be taken with a child that has been exposed to a possible poison is a consensus tool, within the GTI-SEUP, to promote improvement in the quality of care offered to these patients. This improvement is based on avoiding unnecessary measures, which can sometimes be harmful to the child.
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Affiliation(s)
| | - Javier López-Ávila
- Servicio de Urgencias de Pediatría. Hospital Universitario de Salamanca, Salamanca, España
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Reversible Nephropathy Associated with Jet Fuel Exposure. Case Rep Nephrol 2020; 2020:2932415. [PMID: 32802530 PMCID: PMC7415096 DOI: 10.1155/2020/2932415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/12/2020] [Accepted: 07/17/2020] [Indexed: 11/17/2022] Open
Abstract
Acute kidney injury (AKI) with progression to oliguric or anuric acute renal failure (ARF) is often related to use of well-known nephrotoxic agents including medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), angiotensin-converting enzyme inhibitors (ACEis)/angiotensin II receptor blockers (ARBs), and certain classes of antibiotics. Hyperosmolar IV contrast is also a well-known nephrotoxic agent. Severe sepsis with subsequent hypotension, marked hyperglycemia, and those with difficulty accessing water or with poor oral intake can also present with acute kidney injury related to kidney hypoperfusion, dehydration, and volume depletion. In this case report, we discover and discuss the possible effects of regular and daily occupational exposure of jet fuel (a mixture of hydrocarbons) on renal function. Jet fuel is an underdescribed and not well-known nephrotoxic agent; however, its direct toxicity on kidney function appears to be reversible with removal of exposure and aggressive fluid hydration.
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