Plasma recycling of chloroorganic wastes

A high temperature of thermal plasma provides more efficient decomposition of the wastes in comparison to traditional combustion. Due to the high temperature and high density of energy in the plasma, the destruction rate is high, which determines a high efficiency waste decomposition. The main products of pyrolysis plasma chloroorganic compounds are pyrolysis gas and pyrolysis coke.

In order to reduce carbon soot, the steam supported reaction was used. Application of plasma at a temperature range from 1000 to 1750 K enabled destruction of the chloroorganic compounds with a very good yield. Several degradation products were received , which were analyzed. In the research electric arc plasma was used in the process of pyrolysis chloroorganic waste utilization. The reactor with a rotating arc was applied. Selected chloroorganic compounds were selected as the model: chloromethane (CH3Cl), carbon tetrachloride (CCl4), chlorobenzene (C6H5Cl) and dichlorobiphenyl (PCB-C12H8Cl2). Based on the amount of the individual components, chloroorganic in the exhaust gases, and the amount introduced to the plasma decomposition, percentage yield was calculated.

Research results indicated that decomposition efficiency was more than 99,8% with the exception of CCl4 pyrolysis, which in the exhaust had a content of 0.2% CCl4.

[Acute ethylene glycol poisoning among patients of Nofer Institute of Occupational Medicine in Łódź, Toxicology Unit, hospitalized in the years 2000-2009]

Acute poisonings with ethylene glycol pose real challenge in the clinical toxicology. The main objective of this study is an analysis of clinical features and identification of prognostic factors in poisoning with ethylene glycol of patients hospitalized in the Toxicology Unit in the years 2000-2009. The medical records of the patients were identified and separated. In the years 2000-2009, 102 patients were hospitalized due to ethylene glycol poisoning, what accounted for 0.38% of total admissions to the unit (26.801 hospitalized people). The mean age of patients amounted 48.05 +/- 12.55 years, the history positive for chronic alcohol abuse was present in 63 (61.76%) cases. Mean values of ethylene glycol concentration were as: in serum 173.14 mg/dl, in urine 6576.46 mg/l. Patients condition on admission varied, with 63 (61.76%) cases described as the severe state. The most frequently noted pathologies were consciousness disturbances and tachycardia. 14 patients died within the analysed group and 63 (61.76%) developed single or multiorgan complications in the course of disease. The most commonly encountered complication were: acute renal failure, anaemia, pneumonia and central nervous system damage. Such parameters as: BE and HCO3 measured on admission should be considered as the prognostic factors, determining the course of the disease and the outcomes of treatment. Poor prognosis may be associated with such clinical features on admission, as: respiratory and circulatory disturbances and cerebral sequelae. The importance of acute poisoning of ethylene glycol is determined both by high frequency of immediate life threatening conditions and by the risk of complications leading to permanent organs damage.

[Acute novel drugs poisoning among patients of Nofer Institute of Occupational Medicine in Lodz, Toxicology Unit, hospitalized in the years 2008-2012--epidemiology, clinical state]

Intoxication with novel recreational drugs poses significant challenge for medical staff due to diagnostic difficulties, complex clinical pattern, resulting from polyethiology of poisoning and potential risk of life threatening complications.

OBJECTIVES

Description of clinical pattern novel drug intoxication.

METHODS

retrospective review of medical records patients hospitalized in the Toxicology Unit (TU) with diagnosis of intoxication with novel recreational drugs.

RESULTS

During the period from 2008-2010--431 patients were admitted to TU with mentioned above diagnosis. 159 (36.9%) patients were positive for ethanol with its average concentration in blood 150 mg%. Presence of other substances like amphetamine, cannabinoids, atropine, ephedrine, carbamazepine, benzodiazepines and dextrometorphan was confirmed. The most frequent clinical symptoms observed on admission were: anxiety, agitation, complaints associated with circulatory system and vertigo Average pulse rate and both: diastolic and systolic pressure were within normal limits, however authors noted slight tendency toward tachycardia. One patients died due to multiorgan failure. Average period of hospitalization amounted 2.24 days. Co-poisoning with ethanol was associated with higher frequency of circulatory system disturbances.

RESULTS

Clinical pattern of poisoning with novel drugs could partially correspond with mild sympathomime. tic syndrome.

[Intoxication or false-positive acetaminophen result of toxicological determinations? Two case reports]

The aim of this study was to show the diagnostic procedure used in the two cases with false-positive serum acetaminophen results in suspected acetaminophen poisoning. The determination of serum acetaminophen were carried out using a UV/VIS spectrophotometer (Specord 40 Analytik Jena), coupled with an analytic computer station WinASPECT. The employed method of determination was based on the acetaminophen reaction with sodium nitrite, which yields yellow colour of solution in the presence of sodium hydrate. The intensity of the yellow colour depends on the concentration of acetaminophen in serum. The relationship between absorbance and concentration was linear at concentrations in the range 50-600 microg/mL, with relative standard deviation of +/- 2.1% and detection limit of 30 microg/mL. To confirm or reject the doubtful results of colorimetric assays, the serums of patients were measured with high performance liquid chromatography with mass spectrometry detection and gas chromatography with mass spectrometry detection. The analysis of presented cases leads to a conclusion that acetaminophen results should be confirmed either by scanning urine for p-aminophenol presence (which is a routine procedure in our laboratory) or by using a different method of measuring acetaminophen serum levels.

[Kidney transplants from donors burdened metabolic acidosis in the course of poisoning with methanol and carbon monoxide]

The question of obtaining organs from donors who died of methanol poisoning has been discussed in the medical literature for many years. The results of such transplants published so far are very optimistic. However, the possibility of permanent and significant injury to transplanted organs caused by poisons or its metabolites raises serious concerns regarding the procedure. The long-term effects of intensive treatment of poisoning need to be considered as well. Metabolic acidosis and high blood osmolality are agents with recognized damaging potential impairing organ function at cellular level. The study traced the fate of kidney transplants from 13 donors who died of methanol poisoning and one isoned with carbon monoxide. The donors group consisted of 12 men and 2 women, of mean age 49 years (SD +/- 7.93). The kidneys were transplanted 20 men and 8 women. The mean age of recipients was 50.29 years (SD +/- 12.9). At the time of admission to the Department of Toxicology all donors presented with profound metabolic acidosis and high plasma osmolality (mean 434.71 mOsm/kg H2O (SD +/- 73.29). Metabolic acidosis was treated high doses of sodium bicarbonate (mean infusion volume of was 409 ml) before the HD procedure. Blood methanol levels were between 125 and 470 mg% (mean 317.23 SD +/- 136.83). The carboxyhaemoglobin concentration of in the donor poisoned with carbon monoxide was 47.2%. Transplantation was performed after confirmation of the brain death, the period of cold ischemia (CIT) ranged from 6 to 22 hours (mean 16.06 hours; SD +/- 3.99). Kidneys have taken function immediately after transplantation in 21 recipients. In seven cases, patients required two or three HD procedures. A total of 16 dialysis were performed post-transplants. In the group of patients, the mean glomerular filtration rate (GFR) at 3 months after transplantation was 46.71 ml/min/1.73m2 (SD +/- 10.89). During the 18 months follow-up a constant upward trend to the mean GFR 50.55 was noticed. In the group of donors, the mean blood urea concentration (BUN) 3 months after transplantation was 61.43 mg/dL, including 7 patients with BUN within the range of 80-100 mg/dL. At 18 months post transplant, the average concentration was 42.36 mg/dL, with no cases exceeding 55 mg/dL. Similarly, serum creatinine level normalized with the mean value of 3.01 mg/dL at 3 months and 1.68 mg/dL at 18 months post the procedure. There was no case exceeding 2 mg/dL. One recipient died of a heart attack after a period of more than 18 months after transplantation. However, the transplant was efficiently active at all times (GFR 56-60 ml).

[Suicidal intoxication with digoxin--still actual problem in clinical toxicology--case report]

We present case a male patient who attempted suicide by ingestion of 90 tablets of digoxin in total dose of 22.5 mg. A measured peak level of digoxin was 6,75 ng/ml. Temporary invasive cardiac pacing with single chamber ventricular pacer was performed for treatment of the life-threatening rhythm and conduction disturbances that revealed within few hours after admission. According to the authors, presented method of therapy should always be taken into consideration in case development of cardiovascular disturbances in acute poisoning with digoxin.

[Acute methanol poisoning among patients of Toxicology Unit, Nofer Institute of Occupational Medicine in Łódź, during the period 2000-2009]

The main objective of this study was an analysis of the cohort of patients hospitalized due to intoxication with this agent during the period 2000-2009 and investigate factors, which determined the course of poisoning. During the search process, 288 (1.07%) patients were identified within total number of 26801 patients hospitalized. Within analysed cohort male patients formed majority with 227 males, whereas only 61 females were found within this group. The mean methanol blood concentration was 50.09 mg/dl and ethanol - 292.90 mg/dl. Patients condition on admission varied, the most frequently noted pathologies were consciousseness disturbances and tachycardia, namely the former was recorded in 171 cases (59.4%) whereas the latter in 89 patients (30.90%). 11 patients died within the analysed group and 72 developed single or multiorgan complications in the course of poisoning. The most commonly encountered complication was pneumonia. Features of central nervous system (CNS) damage were found in 20 cases (6.94%). Average concentrations of methanol in the group of the 11 deceased patients were: 158.73 mg/ dl, 20.91 mg/dl for ethanol. The average values of arterial blood gases parameters in this group were pH= 6.98; BE=(-) 22.482; HCO3=9.67 mmol/l. Within the non survivors group such complications as CNS damage, seizures, pneumonia, liver injury and pancreatitis were noted more frequently, with statistical significance. The concentrations of methanol and ethanol in the blood on admission and such ABG parameters as pH, BE, HCO3, pCO2 i pO2 also measured on admission should be considered as the prognostic factors, determining the course of the disease and the outcomes of treatment. Poor prognosis may be associated with such clinical features on admission, as: respiratory and circulatory disturbances and cerebral sequelae.

[Acute poisonings with carbon monoxide among the patients hospitalized in the Toxicology Unit during the period of 2006-2010]

Acute poisonings with carbon monoxide pose real challenge in the clinical toxicology. Its importance is determined both by high frequency of immediate life threatening conditions and by the risk of complications leading to permanent organs damage. The main objective of this study is an identification of prognostic factors on the base of analysis the cohort of patients hospitalized due to intoxication with these agents in the Toxicology Unit during the period 2006-2010. During the search process 571 patients hospitalized due to carbon monoxide poisoning during the period 2006-2010 were identified within total number of 21 400 subjects hospitalized during studied period. Therefore intoxications with carbon monoxide accounted for 2.66% of total admissions to the unit. The main sources of exposure were faulty gas heaters. Patients condition on admission varied, with most cases described as the moderate and severe state. At the moment of admission to hospital, the most frequently noted pathologies were: vertigo, headeache and complains from the respiratory tract. The most commonly encountered complication were labyrinths' injuries, neurological abnormalities and pneumonia. Mean concentration of COHb measured on admission in this group was in the blood 21.50 +/- 10.96%. Poor prognosis may be associated with such clinical features on admission, as: respiratory and circulatory disturbances, cerebral sequelae and reported sequelae from labyrinths. Such parameters as: COHb level, lactate and troponine concentrations and BE values measured on admission should be considered as the prognostic factors, determining the course of the disease and the outcomes of treatment.

[Management of acute carbon monoxide poisoning--Polish Medical Society, Section of Clinical Toxicology position statement]

Paper presents Polish Medical Society, Section of Clinical Toxicology position statement on the prehospital and hospital management of carbon monoxide poisoning.

[Management of acute cyanide poisoning--Polish Medical Society, Section of Clinical Toxicology position statement]

Paper presents Polish Medical Society, Section of Clinical Toxicology position statement on the prehospital and hospital management of cyanide poisoning.

[The application of 4-aminopyridine in calcium channel inhibitors acute poisoning]

Calcium channel inhibitors have been extensively used to treat arterial hypertension, ischaemic heart disease and supraventricular rhythm irregularities. The poisonings by that category of drugs are extremely dangerous, particularly when accompanied by intoxication with other drugs affecting the circulatory function. This paper reports 3 cases of poisonings with calcium channel inhibitors (verapamil and diltiazem) in combination with angiotensin convertase inhibitors and nonselective beta-adrenolytics. Circulatory insufficiency and cardiac rhythm abnormalities were noted in all reported cases, in one in the form of ventricular bigeminy and two episodes of ventricular fibrillation, while in the two other cases in the form of 1 degree atrioventricular block. The persisting hypotonia combined with heart rhythm disturbances could not be prevented by the typical conservative treatment involving intravenous administration of infusion fluids, calcium formulations, catecholamines and atropin. The application of 4-amino-pyridine (Pymadin) caused that arterial tension and heart rate were higher, and the heart rhythm disturbances disappeared. The reported cases suggest a beneficial effect of 4-aminopyridine used to treat cases of poisonings by calcium channel inhibitors; however, up to the present time, no detailed procedures have been determined for 4-aminopyridine administration in cases like those reported above. 4-aminopyridine has not been included in the list of the antidotes approved by the WHO and, therefore, broader tests and more clinical observations are required to confirm its therapeutic value.

[Clinical presentation of ST-elevation acute coronary syndrome in the course of intoxication with megadose of rifampicin. A case report]

We present a case of 29-year-old male, with coronary artery disease in mother's history, after suicidal poisoning with 30 g of rifampicin, who presented severe chest pain, ST elevations in ECG, low values of blood pressure and elevated troponin I. Echocardiography revealed generalised hypokinesia, and depressed contractility--left ventricle ejection fraction was 7%. Urgent coronary angiography has shown normal epicardial arteries with slow contrast inflow. The toxic properties of rifampicin as well as hypotension due to dehydration are considered reasons of symptoms in the presented case.

[MMPI- and BDI-scale-based self-assessment of the psychic condition of patients after a suicidal attempt]

Parasuicide (suicidal attempt) is an intentional, self-aggressive behaviour intended to damage the body rather than cause death. About 75% of suicidal attempts are those committed for the first time. The majority of suicidal attempts are impulsive. About 66% of the parasuicide patients said that they had thought about the act for less than an hour beforehand. Only 30% of the patients had been psychiatrically diagnosed before they were admitted to the hospital. After prompt re-diagnosing, the percentage was considerably lower. The aim of the work is to analyse, using Minnesota Multiphasic Personality Inventory (MMPI-DMS subscale) and Beck Depression Inventory (BDI), the self-assessment of the psychical condition of patients hospitalised at the Acute Poisonings Clinic, Nofer Institute of Occupational Medicine, Lodz, Poland, for attempted suicide. The study subjects included 222 patients (148 women and 74 men) treated in 2003. The control comprised 137 volunteers random-selected from among patients visiting Institute's Outpatient Clinic of Occupational Diseases. The psychiatric testing revealed mood and personality disorders, and acute stress disorders. Depression or other psychotic reactions were not diagnosed in any of the cases. Mean MMPI subscale scoring for the women was 10.7 (subjects) and 3.5 (control). The MMPI rating after 6 months since the attempted suicide was 6.03, i.e. by 4.3 scores lower. The corresponding values for the men were 10.1 (subjects) and 3.06 (control), and after 6 months the value was 4.64, by 5.46 scores lower. Mean BDI scale scoring for the women was 10.56 (subjects) and 7.9 (control). The BDI score after 6 months since the poisoning was 7.74, i.e. by 2.83 scores lower. The corresponding values for the men were 10.77 (subjects) and 5.27 (control), and after 6 months the value was by 2.86 scores lower. The results are statistically significant (p<0.001).

CONCLUSION

The results show that 6 months after the suicidal attempt, the self-assessment of patients' psychical condition improves, the mood normalises. The suicidal attempt is often an impulsive act intended to relieve the rapidly growing stress.

[Paracetamol: therapeutic action, pathogenesis and treatment of acute poisonings complicated by severe liver damage]

The biosynthesis of prostaglandins proceeds in the presence of fatty acid cycloxygenases (COX-1, COX-2). COX-1 is responsible for the synthesis of prostaglandins indispensable for normal homeostasis, while COX-2 regulates local expression of pro-inflammatory prostaglandins. Paracetamol is a selective inhibitor of COX-2 thus having an analgesic and antipyretic potential. The drug is metabolised primarily in the liver. About 5% of the dose transforms into N-acetylo-p-benzoquinoneimine (NAPQI), a highly active compound. Ingestion of a single paracetamol dose higher than 8 g leads to a depletion of hepatic glutathione reserves and a loss of the detoxifying property of the liver. As a result, hepatic necrosis develops. The specific antidote is N-acetylcysteine (NAC). If applied within 10-15 h since the poisoning it enables complete survival. The efficacy of specific treatment decreases after 24 h but blood paracetamol is an indication for NAC therapy. The surviving patients with advanced paracetamol poisoning require long-lasting conservative treatment with ornithine and phospholipids as well as a light diet.

[Acute poisoning with selected hepatotoxic agents: biochemistry of toxic effect, clinical symptoms and treatment]

The paper discusses etiopathogenesis, clinical symptoms and treatment in acute poisoning with hepatotoxic agents. The liver is a critical organ in acute poisoning with Amanita phalloides, carbon tetrachloride, iron compounds and isonicotinic acid hydrazide. Based on literature reports and own experience the authors present the current outlook on the specific treatment of acute poisoning with these xenobiotics. Special consideration was given to biochemical etiopathogenesis of hepatoxicity: oxidative stress, lipid peroxidation and impaired homeostasis of calcium ions and glutathione. Basic principles were also discussed of conservative treatment in hepatic encephalopathy due to toxic liver necrosis.

[Biological and toxic effects of ethanol: diagnostics and treatment of acute poisonings]

Ethyl alcohol (ethanol) is readily absorbed from all parts of the gastrointestinal tract due to its hydrophilic potential. The biological effects in humans refer to practically every organ and system. The basic enzyme involved in its oxidation is alcohol dehydrogenase. Another important metabolic pathway is the Microsomal Ethanol-Oxidizing System (MEOS). Toxic effect on basic cell functions is produced both by ethanol and acetic aldehyde, its oxidation product which accounts for most of the acute and delayed effects of ethanol toxicity. In acute ethanol intoxication's the CNS symptoms are the first to manifest. Ethanol affects the CNS functions mainly through stimulating opiate and benzodiazepine receptors and a number of neurotransmitters. However, the attempts to diminish the toxic effects of ethanol on CNS by blocking the affected receptors have proved to be ineffective. In acute poisoning a basic essential is to sustain vital functions by following the principles of intensive care. Each case of acute ethanol intoxication must be subject to neurological examination for possible cerebro-cranial traumas. The diagnostics and treatment procedures should take account of the possible symptoms: convulsions, respiratory and cardiac failure, hypoglycemia, hypothermia, and severe gastric dysfunction. Vital signs monitoring and control of acid-base and water-electrolyte balance are a must. The toxic properties of ethanol metabolites can be particularly hazardous to patients treated with disulfiram. The patients who develop "antabuse response" should be given immediately iron and vitamin C intravenously.

[Poisonings by selected drugs: analysis of 1995-1999 data files of the Clinic of Acute Poisonings Institute of Occupational Medicine in Łódź]

Over the period of 1995-1999 a total number of 439 cases were admitted to the Clinic of Acute Poisonings, Łódź, Poland, due to poisoning with opiates, opioids, amphetamine, cannabis products, LSD and cocaine. Most of the patients were males, the male to female ratio was 1:1.5 (266 to 173). The distribution by age indicated the persons aged 21-30 yr as the highest risk group, then those aged 14-21 yr. Over the period under study the structure of poisonings changed significantly. Since 1997 the number of poisonings with amphetamine and cannabis products increased dramatically, while that of opiate poisonings declined. Approximately 84% of cases were found to be addicted to a combination of drugs and psychotropic agents, mostly benzodiazepine and ethyl alcohol. Drug addiction was reported by over 80% patients with opiate poisoning, 44.8% with tetrahydrocannabinole poisoning and only 9.5% with amphetamine poisoning. The efficacy of treatment in cases of drug addiction is very low. Repeated treatment was reported by almost 100% of patients who had attempted to quit drug abuse. Among opiate poisoning cases, only 8 out of 45 patients did not question the effectiveness of the withdrawal treatment.

Acute potassium dichromate poisoning: a toxicokinetic case study

CASE REPORT

A 48-year-old man drank 150 mL of an aqueous solution containing potassium dichromate 22.5 g in a suicidal attempt and was admitted 7 hours after the ingestion. Hemodialysis was promptly undertaken and chromium concentrations in serum, erythrocytes, and dialysate were determined during the treatment. Chromium elimination in urine was monitored during hemodialysis and the subsequent 400 hours. The total chromium eliminated via hemodialysis and urine was calculated as 36.7 mg or 0.16% of the ingested dose. Spontaneous urinary elimination proceeded according to an open one-compartment model. The elimination half-life was 71.37 hours +/- 17.13 hours (95% CI). Chromium elimination from serum followed an open two-compartment model, with the half-lives of 3.16 hours +/- 2.63 hours for phase 1 and 50 hours +/- 27 hours (95% CI) for phase 2. Calcium-EDTA therapy had no influence on erythrocyte, serum, or urine chromium level. It contributed, however, to a significant increase in chromium elimination rate in the dialysate. Serum zinc was very low at admission and serum zinc, copper, and magnesium were controlled during the initial 30 hours.

Telephone toxicological information service on pesticide poisonings

The problem of pesticide poisonings has been discussed with reference to the records of the toxicological information provided in 1993-1995 by the staff of the National Poison Information Centre and the physicians of the Clinic of Acute Poisonings in Lódź. Based on those data, pesticide poisonings occupy second place among the categories of chemical most frequently responsible for acute poisonings, while the first place is occupied by drugs. In the pesticide category, most of the information related to poisonings with pyrethroids, followed by organophosphorous compounds, coumarine derivatives, carbamates. Pesticide poisonings in children continue to be a serious problem. Coumarine derivatives and zinc phosphide found in rodenticides constitute the most frequent source of pesticide poisoning among children. Considering the circumstances of pesticide poisoning, accidental poisonings are the most frequent. The high incidence of pesticide poisoning shows that it is a serious problem and the steps should be taken to prevent poisonings with pesticides.

[Alcohol and suicide attempts]

A large number of patients (30%) admitted to the Clinic of Acute Poisonings, Lódź, Poland, with suicidal drug poisoning have been found to act under the influence of alcohol. Sociological interview revealed that 6% of them were alcoholics and 3.8% reported to have repeated the suicidal attempt because of alcohol addiction. From the sociological point of view the female and adolescent (15-18 years old) family members are most vulnerable as they are frequently exposed to highly stressful conditions which may eventually result in their becoming addicted to alcohol as well.

[Poisoning with narcotics and hallucinogens in material from the Clinic of Acute Poisoning in Lodz (1993-1996)]

Our material consists of the patients treated for poisonings with street-drugs in Clinic of Acute Poisonings, Lódź, Poland during the period 1993-1996. During the time of 4 years, the number of hospitalised patients have grown up 4.5 times. The structure of used drugs has also changed. Up to 1993 the most popular were opiates derivatives and narcotic analgetics-morphine derivatives. In 1996 almost all narcotics are common, opiates (both natural and synthetic), cocaine, LSD, amphetamine and commonly used (by youngsters especially) Cannabis sativa (marihuana etc). The most common sources of poisoning in our material were opiates and amphetamine, followed by tetrahydrocannabinol derivatives-marijuana.

[Clinical course and treatment of acute poisoning caused by some mushrooms]

Mushroom poisonings are discussed in the paper. Clinical picture and applied treatment are presented with characterisation of the most toxically species for human being.

[An attempt to use simplified mathematical analysis for evaluation of elimination of cyclobarbital from blood of acutely poisoned patients]

Two different mathematical methods were used to calculate the rate of poison elimination in 52 unconscious patients due to barbiturate poisoning. The process of poison elimination is reflected by an exponential curve. Its rate can be determined with the use of a logarithmic function formula. In the study, an attempt was made to find out whether a linear function formula could also be applied to calculate this parameter. The hypothesis was based on the observation that, when considered for short periods of time parts on an elimination curve resemble straight line. The barbiturate elimination was checked every four hours to ensure that the exponential curve be as close as possible to a straight line. Then, correlations between the rate of poison elimination calculated from both formulas and seven biochemical and clinical parameters of forced diuresis were examined. The findings revealed qualitative concordance of the results, i.e. correlations were found for the same parameters when the elimination rate was calculated either from the logarithmic or linear formula. For further verification of the hypothesis apart from a simple correlation analysis a normalized standard error (NSE) method was used to investigate these correlations. Also in this analysis a similar concordance of results was obtained: when there was a correlation between the elimination rate as a logarithmic function and particular parameter of forced diuresis, it was also found the same for the rate calculated from the linear function formula. Conversely the absence of correlation in the former case corresponded to similar absence in the latter.(ABSTRACT TRUNCATED AT 250 WORDS)

Kinetics of trichloroethylene elimination from venous blood after acute inhalation poisoning

The kinetics of trichloroethylene were examined in three men, 28-36 years old, hospitalized after an acute occupational exposure. The trichloroethylene concentration of venous blood was determined by gas chromatography with headspace analysis; urinary trichloroacetic acid was assayed by the colorimetric method of Fujiwara. The kinetics of blood trichlorethylene (t1/2 21.7 h) and the urinary elimination of trichloracetic acid over six days were used to calculate the total inhalation exposures. Blood trichlorethylene was diagnostically more relevant than urinary trichloracetic acid.

[Acute suicidal poisoning with lithium carbonate]

A case of the acute poisoning with lithium carbonate is presented. Single hemodialysis did not decrease lithium blood levels significantly. Lithium blood concentration has been slowly decreasing with persisting severe neurological symptoms. Hemodialysis should be repeated until lithium has been released from various tissue compartments.

[Evaluation of the usefulness of forced diuresis in patients with calcium cyclobarbital or reladorm poisoning]

An attempt was made at evaluating the usefulness of forced diuresis for the treatment of Phanodorm poisoning. Fifty two patients were examined, 40 of them with Reladorm (Polish trade name. Reladorm contains 100 mg of cyclobarbital and 10 mg of diazepam) poisoning and 12 with Cyclobarbitalum Calcium (Phanodorm) poisoning. The test group was selected out of those poisoned with barbiturates so that a homogeneous toxic agent would be involved and the impact that other toxins may have on the rate of metabolism and excretion eliminated. The elimination of drug from blood was compared with the elements determining ED intensity, such as i.v. fluid administration, primary infiltrate (clearance of endogenous creatinine), reabsorption in renal tubules and diuresis rate. No correlation was found which is an evidence that ED proves to be useless in the treatment of Phanodorm poisoning. The author suggests that in this type of poisoning supportive treatment should be undertaken according to daily fluid demand in relation to such factors as sex, age, body temperature, health conditions and contraindications due to the patient's general condition.