bluuebunny/crossref_metadata_2025 huggingface dataset:
Age and Self-Poisoning: The Epidemiology in Newcastle upon Tyne in the 1980s
Authors: Wynne H. , Bateman D.N. , Hassanyeh F. , Rawlins M.D. , Woodhouse K.W.
Published: December 2008

The epidemiology of 737 consecutive self-poisoning admissions to Freeman Hospital, Newcastle upon Tyne, has been investigated with reference to age in young (< 35), mid-aged (35-64) and elderly (≥ 65 year) patients. The most important differences were increased formal psychiatric illness in the elderly, demonstrated by increased likelihood of admission to psychiatric units; less likelihood of overdose with multiple agents in the elderly, and less use of alcohol. There were also differences in the types of drugs used. The youngest patients took more paracetamol and less psychoactive drugs and more of their drugs were prescribed for a relative than the other two groups. The elderly were much less likely to receive gastric lavage or emesis and more likely to receive supportive treatment only than younger patients. This difference may, in part, be explained by the more frequent occurrence of benzodiazepine poisoning in those over 65 years.
Cigarette and Nicotine Chewing Gum Toxicity in Children
Authors: Smolinske S.C. , Spoerke D.G. , Spiller S.K. , Wruk K.M. , Kulig K. , Rumackt B.H.
Published: December 2008

A prospective review of 51 cases of tobacco ingestion and 5 cases of nicotine resin chewing gum exposure was conducted to evaluate the incidence and degree of toxicity caused by these products in children. A dose-response relationship was observed for cigarette exposures. Nine of 10 children ingesting more than one cigarette or three cigarette butts developed signs or symptoms, while 12 of 24 ingesting lesser amounts became symptomatic (P < 0.01). Severe symptoms (e.g. limb jerking and unresponsiveness) were only seen with the larger amounts. Nicotine resin gum produced toxicity in 4 of 5 children who chewed 1/2 to 4 pieces. Agitation, lethargy, tachycardia, hypotension, abdominal pain, and vomiting were seen within 30 min of exposure to the gum.
UK Blood Lead Monitoring Programme 1984-1987: Results for 1985
Authors: Quinn M.J. , Delves H.T.
Published: December 2008

The Department of the Environment (DOE) has undertaken an extensive programme to monitor blood lead concentrations annually over the period 1984 to 1987 in the context of the reduction in the maximum permissible lead content of petrol from 0.4 to 0.15 g/l from 1 January 1986. The 2500 participants in the study include adults living in heavily trafficked urban areas and in occupational groups particularly exposed to petrol lead; children aged 6-7 years attending schools in heavily trafficked urban areas; and control groups of adults and children in rural areas. Blood samples (all venous) are being analysed for lead by atomic absorption spectrophotometry (AAS); considerable efforts are being made to ensure the validity of the analytical results during the period of the study.

Average blood lead concentrations in 1984 and 1985 in both adults and children were generally low and were in line with levels expected on the basis of earlier surveys; only a very small proportion of individuals had raised levels. Detailed statistical analyses have confirmed that blood lead concentrations are related to a range of personal, social and environmental factors including age, sex and smoking and drinking habits.

Blood lead levels in the exposed groups of adults and children were on average just under 1 μg/ 100 ml lower in 1985 than in 1984, while overall changes in the police and control groups were smaller; there was, however, considerable variability in the changes in the individual surveys, particularly those of children. Levels fell in all social classes and in both categories of age of dwelling, but changes tended to be less marked in those who were older (particularly for men), smoked more, drank more or had lived for more than 15 years at their current address.
Underestimation of Dose - Response Relationship with Particular Reference to the Relationship between the Dietary Intake of Mercury and its Concentration in Blood
Authors: Sherlock J.C. , Quinn M.J.
Published: December 2008

Wide discrepancies have been observed between controlled and uncontrolled intake studies of the relationship of blood mercury concentration to intake of mercury. The probable reason for the apparent discrepancies is that the within-subject variation of mercury intake in the uncontrolled studies was almost certainly considerably larger than the within-subject variation in blood mercury concentration; in these circumstances, the apparent slope obtained from a linear regression of blood mercury on intake will invariably be much smaller than the true slope. Studies of the exposure or intake of any substance should therefore include a consideration of the likely within-subject variation in the exposure or intake relative to that in the effect.
The Metabolism of Ceramic and Non-ceramic Forms of Uranium Dioxide after Deposition in the Rat Lung
Authors: Stradling G.N. , Stather J.W. , Gray S.A. , Moody J.C. , Hodgson A. , Sedgwick D. , Cooke N.
Published: December 2008

Ceramic and non-ceramic forms of uranium dixoide, produced industrially, were administered to rats either by inhalation or as an aqueous suspension which was injected directly into the pulmonary region of the lungs. The results showed that:

1 both materials should be assigned to inhalation class Y as defined by the International Commission on Radiological Protection;

2 whilst the translocation of uranium to the blood for the non-ceramic UO2 was about twice that obtained for the ceramic form, the two dioxides were unlikely to be differentiated on the basis of their lung retention kinetics;

3 the distribution of uranium amongst body tissues and the relationship between systemic content and cumulative urinary excretion indicated that it was transported in the hexavalent form;

4 in addition to air sampling procedures, lung radioactivity counting measurements could be used to advantage for assessing occupational exposures;

5 the exposure limits should be based on radiation dose rather than chemical toxicity.
Characterization of Lymphocyte Stimulation by Phorbol Related Compounds
Authors: Dewdney R.S. , Soper C.J. , Anderson D.
Published: December 2008

1 The stimulation of ( 3H)-thymidine incorporation by lymphocytes in response to phorbol and seven other phorbol related compounds was investigated.

2 Lymphocytes from each of a small group of individuals were treated with the test compounds over wide concentration ranges.

3 All the tested compounds, including the most active, 12-0-tetradecanoylphorbol-13-acetate, were far less effective lymphocyte mitogens than the plant lectin phytohaemagglutinin.

4 Inter-individual differences were detected in the maximum response to the phorbols but not in their stimulating potency, as estimated by the concentration producing a half maximal response.

5 The rank order of the lymphocyte stimulating potency of the tested compounds was similar to the rank order of both tumour promoting activity and irritant potency in mouse skin.

6 Lymphocyte stimulation was paralleled equally well by these two mouse skin responses.
Haemodialysis or Haemoperfusion in Severe Salicylate Poisoning?
Authors: Jacobsen D. , Wiik-Larsen E. , Bredesen J.E.
Published: December 2008

Two cases of severe salicylate poisoning with maximal plasma levels of 6.9 and 8.9 mmol/l are described. In addition to supportive treatment and forced alkaline diuresis, one case was treated with haemoperfusion and the other with haemodialysis. The use of the same blood pump and blood flow allowed us to compare directly the effect of these methods in removing salicylate. There was a non-significant higher dialysance (mean 86 ml/min, s.d. ± 8) than haemoperfusion clearance (mean 81 ml/min s.d. ± 17) at a blood flow of 200 ml/min. As haemodialysis offers the theoretical advantage of correcting acid-base and electrolyte disturbances, does not trap platelets and has a lower heparin requirement, the present comparison indicates that haemodialysis is preferable when extracorporal elimination is indicated in salicylate poisoning.
Specific Treatment of Benzodiazepine Overdose
Authors: Lheureux P. , Askenasi R.
Published: December 2008

Intentional benzodiazepine (BZD) overdose is usually a benign condition frequently encountered in the emergency department of hospital. Twenty-one patients, who were suspected of BZD overdose, were treated with the antagonist of the central type BZD-receptors Ro 15-1788. Samples for toxicological analysis were taken before and after treatment. The patients were divided into three groups. In the first group (pure BZD overdose, n = 9), rapid and complete awakening was observed in all the patients (9/9) with 3.5 ± 1.5 mg Ro 15-1788. In the second group of patients with multiple drugs poisoning (including BZD, n = 6), CNS depression improved in all the patients despite incomplete awakening. In the last group (n = 6), where no BZD were detected in toxicological samples, none of the comatous patients improved significantly during Ro 15-1788 administration, except one patient with pure ethanol intoxication.

No undesirable effects are reported, except mild transitory withdrawal syndrome in three cases following rapid injection.

This study supports the introduction of Ro 15-1788 as a useful antidote in the diagnosis and the treatment of drug-induced coma.
A Ceramic Glazer Presenting with Extremely High Lead Levels
Authors: Ooi D.S. , Perkins S.L.
Published: December 2008

A case of lead poisoning in a ceramic glazer is reported. The patient had an extremely high level of blood lead at 29.5 μmol/l, and many of the laboratory features of lead toxicity: normocytic anaemia with marked basophilic stippling, abnormal blood and urinary porphyrins, and elevated liver enzymes. Surprisingly, the patient had no electromyographic evidence of neurologic involvement. The patient was treated with intravenous EDTA-calcium followed by oral penicillamine. Urinary porphyrin and porphyrin precursor excretion followed an interesting pattern, correlating with the chelator used. This patient illustrates that extremely high blood lead level can be achieved through the oral route in an adult.
Acute Tricresylphosphate Intoxication in Childhood
Authors: Goldstein D.A. , McGuigan M.A. , Ripley B.D.
Published: December 2008

Tricresylphosphates (TCP) have been responsible for a large number of epidemic and individual intoxications since the recognition, in 1899, that phospho-creosote was the cause of paralysis in patients being treated for tuberculosis. Although children are mentioned as being among the victims of epidemic intoxication, no well documented reports of acute tricresylphosphate ingestion in childhood are available in the literature. We report a case of severe intoxication in a 4½-year-old child following ingestion of a lubricant containing TCP. Clinical findings in this child were typical of previously reported acute ingestions in adults: acute gastro-intestinal symptoms, delayed cholinergic crisis and neurological toxicity. Previous literature is reviewed briefly and discussed.
Severe Ethylene Glycol Butyl Ether Poisoning. Kinetics and Metabolic Pattern
Authors: Rambourg-Schepens M.O. , Buffet M. , Bertault R. , Jaussaud M. , Journe B. , Fay R. , Lamiable D.
Published: December 2008

A case of severe poisoning with ethylene glycol butyl ether (EGBE) after massive ingestion is described.

Deep coma, metabolic acidosis, hypokalaemia, haemoglobinuria, oxaluria and a transitory rise in the serum creatinine level were observed.

The elimination of the various metabolites butoxyacetic acid and oxalate was assessed in urine and a metabolic pattern for EGBE is suggested.
Is There a Central Nervous Withdrawal Syndrome Associated with Discontinuing Long-term Treatment with Propranolol?
Authors: Al-Qassab H. , Cleeves L.A. , Francis P.L. , Al-Sereiti M.R. , Findley L. , Hedges A. , Silman R. , Turner P.
Published: December 2008

Thirty healthy volunteers were treated with beta-adrenoceptor blocking doses of long-acting propranolol for at least 28 days before being randomized to continue propranolol treatment, receive identical placebo under double-blind conditions, or discontinue all treatment. No evidence of a central nervous withdrawal syndrome occurred during the next 28 days as assessed by changes in psychomotor tests, rating scales, visual analogue scales, tremor recordings and melatonin excretion. Three subjects in the placebo withdrawal group but none in the propranolol group complained of insomnia for up to 14 days of the withdrawal period.
Microbial Amino Acid Metabolites and Bladder Cancer: No Evidence of Promoting Activity in Man
Authors: Renwick A.G. , Thakrar A. , Lawrie C.A. , George C.F.
Published: December 2008

1 Indole, p-cresol and phenol are microbial amino acid metabolites which show co-carcinogenic or promoting activity in animal studies. Their involvement in the development of human bladder cancer has been determined by measuring the urinary excretion of indican (indoxyl sulphate) and conjugated phenols.

2 Thirty-two patients (22 males, 10 females) with histologically confirmed carcinoma of the urinary bladder and a similar number of age and sex matched controls took part in the study. The excretion of indican, p-cresol and phenol showed wide interindividual variability, but did not differ significantly between the two groups.

3 The findings indicate that these endogenous metabolites do not contribute significantly to the development of human bladder cancer.
Gasoline and Kerosene Components in Blood - A Forensic Analysis
Authors: Kimura K. , Nagata T. , Hara K. , Kageura M.
Published: December 2008

A reliable method to analyse small amounts of fuel components in biological materials, using two simultaneous procedures, head space and solvent extraction methods has been developed. Gas chromatography/mass spectrometry (GC/MS) was used for qualitative and quantitative determinations. The aliphatic hydrocarbons with carbon numbers of 5 to 8 and aromatics such as benzene, toluene and xylenes were detected in laboratory animals, following exposure to gasoline vapour, using the head space method. Aliphatic hydrocarbons with carbon numbers over 9 as well as the aromatics with carbon number 9 group including cumene, mesitylene, pseudocumene and 1,2,3-trimethylbenzene were determined by the solvent extraction method following exposure to kerosene vapour. The lower limits of detection were 0.01 μg and 50 pg in gasoline and kerosene components, respectively. The methods were found to be applicable in confirming the cause of human deaths.
Activated Charcoal in Tricyclic Antidepressant Poisoning
Authors: Hultén B-Å. , Adams R. , Askenasi R. , Dallos V. , Dawling S. , Heath A. , Volans G.
Published: December 2008

Tricyclic antidepressants (TCA) bind to activated charcoal both in vitro and in vivo in healthy volunteers after a therapeutic dose of TCA. These findings provide a basis for the routine use of activated charcoal in TCA poisoning. The object of this study was to examine the effect of a single dose of 20 g of activated charcoal in overdose patients. Ninety-one patients from four centres with suspected TCA overdose were entered into a randomized study. Gastric lavage was performed on all patients. Thirty-four received 20 g of activated charcoal and 43 served as controls. Fourteen patients were excluded. Plasma drug concentrations were taken on admission and at 1, 2, 4, 8 and 24 h. The incidence of toxic symptoms was registered during 24 h. There was no significant difference in the area under the plasma drug concentration versus time curve, the peak plasma concentrations or plasma half-lives between the two groups. Toxic symptoms were more frequent in the non-treated groups although this difference was not statistically significant. In patients with TCA overdose initially treated with gastric lavage, a single dose of 20 g of activated charcoal had no effect on the systemic absorption or elimination of TCA.
The Relationship between Plasma Ibuprofen Concentrations and Toxicity in Acute Ibuprofen Overdose
Authors: Jenkinson M.L. , Fitzpatrick R. , Streete P.J. , Volans G.N.
Published: December 2008

1 The information available from the literature and from a prospective survey of ibuprofen overdose being undertaken by the London centre of the National Poisons Information Service (NPIS) was examined utilizing the Generalized Linear Interactive Modelling (GLIM) statistical computing package.

2 This confirmed that timed ibuprofen plasma concentrations were related to the symptoms of tachycardia, dizziness, tinnitus, ocular symptoms and coma/stupor as well as to reversible renal impairment and plasma hepatic enzyme elevation.

3 The best model of the relationship between symptomatic toxicity and timed ibuprofen plasma concentrations, was an exponential equation in time. Because of the lack of specificity or sensitivity in this model, and absence of demonstrable clinical advantages from its application, we do not recommend its use as a guide to predict toxicity.

4 However analysis of a larger information base utilizing similar methodology could, by increasing the statistical power of the resultant model, provide a useful means of predicting ibuprofen toxicity.

5 A previously postulated relationship between post-ingestion ibuprofen plasma concentrations and toxicity was not confirmed.
Radiotherapy for the Treatment of Pulmonary Complications of Paraquat Poisoning
Authors: Talbot A.R. , Barnes M.R.
Published: December 2008

The effect of radiotherapy on the pulmonary damage caused by paraquat (24% solution of 1,1'dimethyl-4,4'-bipyridylium dichloride) was investigated in a preliminary series of nine patients. Paraquat intoxication was diagnosed by quantitative analysis of urine and plasma using colorimetry after extraction of a cation exchange column. The irradiation was given as a planned procedure from day 2 in cases 1 to 7, and after changes in chest X-ray were recognized in cases 8 and 9. A cobalt-60 unit with opposed anterior and posterior portals was used to give a total dose of 12.50 Gy (uncorrected) over 10 fractions, sparing the pericardium and mediastinum as much as possible. Each fraction consisted of 1.25 Gy (125 rad) given once a day, alternating between the left and right lungs.

Radiological diagnosis consisted of clear chest X-rays (cases 2 to 4), pulmonary oedema (cases 7 and 9) and interstitial infiltrates (cases 1, 5, 6 and 8). Cases 1, 5, and 8 survived. Case 8 had residual interstitial infiltrates three months after ingestion but these had cleared one month later, suggesting that the diagnosis of irreversible fibrosis should only be made after a follow-up period of at least one year. The results have failed to show a definite benefit, but do support the fact that radiotherapy should be assessed carefully in a randomized trial which is now in progress.
Screening of Chromosomal Aberrations and Sister Chromatid Exchanges in Peripheral Lymphocytes of Vegetable Garden Workers
Authors: Rupa D.S. , Rita P. , Reddy P.P. , Reddi O.S.
Published: December 2008

1 Twenty-five male workers occupationally exposed to DDT, BHC malathion, parathion, dimethoate, fenitrothion, urea and gromor were selected as subjects for the analysis of chromosomal aberrations and sister chromatid exchanges (SCE) in peripheral lymphocytes.

2 Blood samples were collected from 30 normal healthy males from the same age group and socioeconomic class for the control.

3 The frequency of chromosomal aberrations and SCEs increased significantly irrespective of the duration of exposure to pesticides, when compared to controls.
The Effects of Ingestion of 60 mg Pyridostigmine Bromide on Contrast Sensitivity in Man
Authors: Kay C.D. , Morrison J.D.
Published: December 2008

The effects on vision of ingestion of the anticholinesterase pyridostigmine bromide (60 mg), assessed from pharmacokinetic data to provide at least 20% inhibition of blood cholinesterase over the 1½-4½ h experimental period, was compared with 60 mg lactose in a double-blind crossover protocol. Contrast sensitivity to stationary oscilloscope-generated gratings of 3-40 c/deg showed a small but significant increase of 7% which was consistent with a small reduction in pupil diameter, surmised to cause a small improvement in optical quality. This reduction in pupil diameter was, however, overshadowed by a larger though still non-significant reduction on the second visit to the laboratory compared with the first. Contrast sensitivities to laser interference fringes observed in the Maxwellian view, by which the effects of the optical media are essentially bypassed, thus providing an entirely neural assessment, were unchanged after pyridostigmine. It is concluded that pyridostigmine may be given as a prophylactic in anticipation of exposure to an organophosphorus anticholinesterase without a deleterious effect on stationary visual function.
What is Toxicology?
Authors: Connors T.A.
Published: December 2008

1 The ultimate objective of toxicology is the reduction of morbidity and mortality that occurs in man as a result of exposure to toxic substances.

2 The present emphasis on 'strategic' research could divert funding to answer specific but largely irrelevant questions to the detriment of 'basic' research.

3 True advances can only be made if 'basic' research is supported to the same extent as 'strategic' research and if the regulation of environmental chemicals is based on good evidence from clinicians,epidemiologists and scientists.
The Safety-in-use of Cosmetics and Toiletries
Authors: Ness L.
Published: December 2008

Manufacturers of cosmetics and toiletries have a clear responsibility under Article 2 of the EEC Cosmetics Directive to ensure that their products are safe for use.

They have shown that they are able to discharge this responsibility, as illustrated by the type of safety assessment programme described in this paper and by market-place experience.

Considerable resources are invested by industry in safety assurance. As might be expected, this is particularly true of larger companies which have been responsible for many recent technological advances.

Industry will continue to regard the safety of its products as paramount, and contends that existing legislation is more than adequate to ensure continued safety-in-use.
Analytical Toxicology
Authors: Flanagan R.J. , Widdop B. , Ramsey J.D. , Loveland M.
Published: December 2008

Major advances in analytical toxicology followed the introduction of spectroscopic and chromatographic techniques in the 1940s and early 1950s and thin layer chromatography remains important together with some spectrophotometric and other tests. However, gas- and high performance-liquid chromatography together with a variety of immunoassay techniques are now videly used.

The scope and complexity of forensic and clinical toxicology continues to increase, although the compounds for which emergency analyses are needed to guide therapy are few. Exclusion of the presence of hypnotic drugs can be important in suspected 'brain death' cases.

Screening for drugs of abuse has assumed greater importance not only for the management of the habituated patient, but also in 'pre-employment' and 'employment' screening. The detection of licit drug administration in sport is also an area of increasing importance.

In industrial toxicology, the range of compounds for which blood or urine measurements (so called 'biological monitoring') can indicate the degree of exposure is increasing. The monitoring of environmental contaminants (lead, chlorinated pesticides) in biological samples has also proved aluable.

In the near future a consensus as to the units of measurement to be used is urgently required and more emphasis will be placed on interpretation, especially as regards possible behavioural effects of drugs or other poisons. Despite many advances in analytical techniques there remains a need for reliable, simple tests to detect poisons for use in smaller hospital and other laboratories.
Serum Concentrations and Accumulation of Silver in Skin During Three Months Treatment with an Anti-smoking Chewing Gum containing Silver Acetate
Authors: Jensen E.J. , Rungby J. , Hansen J.C. , Schmidt E. , Pedersen B. , Dahl R.
Published: December 2008

Silver acetate chewing gum was used for 12 weeks as a smoking deterrent in 21 adults. The effect of silver on serum concentrations, its accumulation in the skin and the risk of developing clinically evident argyria were investigated. Serum concentrations of silver clearly rose after chewing gum use had started, and concentrations quickly returned to normal after use had ceased. In most cases the number of silver granules in skin biopsies, observed by autometallography, increased after the gum had been used for 12 weeks. No one developed clinical signs of argyria. Silver acetate containing remedies can be used as an aid to stop smoking, but the consumption must be monitored to avoid accumulation of larger amounts of silver in the body.
Fatal Chloroquine Self-poisoning
Authors: Kintz P. , Ritter-Lohner S. , Lamant J.M. , Tracqui A. , Mangin P. , Lugnier A.A.J. , Chaumont A.J.
Published: December 2008

High performance liquid chromatography was employed to quantify chloroquine in biological fluids and tissues in a death attributed to chloroquine overdose. The blood concentration of chloroquine was 16.71 mg/l. Results are discussed in the light of the existing literature.
Severity Grading in Self-poisoning
Authors: Starmark J.E. , Heath A.
Published: December 2008

1 The reliability and validity of three different coma scales was studied in 26 patients with acute drug overdose.

2 A comparison of six painful stimulation techniques showed that sternal rubbing and retromandibular pressure were most effective.

3 The improper use of stimulation techniques may underestimate level of responsiveness in 4-19% of cases.

4 The Reaction Level Scale (RLS) was the most reliable scale.

5 Both the RLS and the Glasgow Coma Scale may be unnecessarily complicated for the evaluation of the drug overdose patient, but should be chosen if concomitant brain injury is suspected.

6 This study confirms the basic concepts and shows the reliability of the Matthew-Lawson scale for use in the poisoned patient.
Scalp Hair as an Indicator of Aluminium Exposure: Comparison to Bone and Plasma
Authors: Wilhelm M. , Passlick J. , Busch T. , Szydlik M. , Ohnesorge F.K.
Published: December 2008

1 Aluminium concentrations were measured in hair, plasma and bone samples from different groups of chronic renal insufficient patients and from a control group (75 healthy volunteers plus 21 deceased subjects). A cross-sectional study with 40 haemodialysis patients and two longitudinal studies were undertaken, the first comprising of 12 home haemodialysis patients and the second 16 patients undergoing continuous ambulatory peritoneal dialysis (CAPD).

2 Before introduction of water treatment by reverse osmosis, the hair aluminium levels of home haemodialysis patients were elevated compared to controls. Aluminium in the hair of all other groups were within the normal range. Hair aluminium levels were not related to the daily aluminium intake, nor to the cumulative aluminium intake, nor to bone and plasma aluminium concentrations.

3 Plasma aluminium concentrations in all patients were higher than in the controls. Dialysis without reverse osmosis water treatment increased aluminium plasma levels. After installation of reverse osmosis units there was a decrease in the aluminium concentrations in plasma. In CAPD patients insignificant increases in the aluminium levels in plasma were observed. When low contaminated dialysis fluid was available the plasma aluminium concentrations returned to the initial level.

4 Aluminium concentrations in bone were increased in renal insufficient patients compared with controls. Aluminium bone content increased with increasing cumulative aluminium intake by phosphate binding therapy.

5 Hair analysis is of very limited value for the diagnosis of aluminium exposure. Bone analysis is suitable for the assessment of the individual body burden.
Effects of Calcium Entry Blockers on Human Platelet Metabolism Measured by Microcalorimetry
Authors: Edvinsson L. , Ikomi-Kumm J. , Monti M.
Published: December 2008

1 The direct overall metabolic effects of calcium entry blockers on human platelets were evaluated using a sensitive microcalorimetric method.

2 The effect on platelet metabolism of four calcium entry blockers with different profiles of action was examined and compared with the relaxant response on human cerebral vessels in vitro.

3 Diltiazem (10 -8, 10-4 M) and nifedipine (10-10, 10-6M) were without effect on overall platelet metabolism. On the other hand flunarizine (10-4M) and verapamil (10-4M) significantly reduced metabolism, while lower concentrations of these agents did not change heat production.

4 The thermogenic response occurred at concentrations of the calcium entry blockers that were much higher than those observed during therapy and the concentrations which relax human cerebral arteries in vitro.
Acute Vapour Inhalation Toxicity of Acrolein and its Influence as a Trace Contaminant in 2-Methoxy-3,4-dihydro-2H-pyran
Authors: Ballantyne B. , Dodd D.E. , Pritts I.M. , Nachreiner D.J. , Fowler E.H.
Published: December 2008

1 The LC50 values for acrolein (AC) vapour to Sprague-Dawley rats (combined sexes) were determined to be 26 ppm (1 h) and 8.3 ppm (4 h). Signs of severe irritancy were present, and death was due to lung injury.

2 Exposure of rats to a 2-methoxy-3,4-dihydro-2H-pyran (MDP) saturated vapour atmosphere statically generated from liquid MDP containing 0.037% AC, caused severe irritancy and death from accumulation of AC vapour. Sparging the impure material with nitrogen gas before atmosphere generation significantly reduced or abolished lethal toxicity.

3 Dynamically generated MDP vapour atmosphere produced transient respiratory and occular irritancy, but no mortalities. The intrinsic acute vapour inhalation toxicity of MDP is low.

4 The presence of highly volatile toxic impurities in a material may confer a significant acute inhalation toxicity and hazard under conditions of low air movement. Assessment of potential inhalation hazards from liquid mixtures may require investigation by static and dynamic methods for vapour generation.
An Introduction to the Practice, Prevalence and Chemical Toxicology of Volatile Substance Abuse
Authors: Ramsey J. , Anderson H.R. , Bloor K. , Flanagan R.J.
Published: December 2008

1 Volatile substance abuse is largely a teenage practice; it is estimated that in the UK 3.5-10% of young people have at least experimented and that 0.5-1% are current users.

2 The products abused are many and varied but only about 20 chemical compounds, notably toluene, chlorinated solvents such as 1,1,1-trichloroethane, fuel gases such as butane and aerosol propellants, are commonly encountered.

3 The acute hazard varies with the compound, product and mode of abuse. Mortality in the UK is now about 100 per year, from all social classes, 90% of whom are male.

4 Chronic toxicity is difficult to assess, partly because of the diversity of products abused. However it is clear that some long-term abusers suffer permanent damage to the central nervous system, heart, liver and kidney.

5 Toxicological analysis may be relied upon for confirmation of diagnosis, providing attention is paid to the kinetics of excretion and stability in the sample.

6 Responses include codes of practice for the sale of products and educational strategies; legislation has also been enacted. There is little evidence that any of these measures have made a significant impact on the problem.
Mechanism of Sudden Death Associated with Volatile Substance Abuse
Authors: Shepherd R.T.
Published: December 2008

1 Sudden death is a recognized hazard of volatile substance abuse and may occur during exposure or in the subsequent hours. Intoxication may also lead to indirect deaths due to trauma.

2 Specific post-mortem features have not as yet been identified either macroscopically or microscopically in VSA-related deaths. Toxicological examination for volatile substances of all unnatural teenage deaths is strongly recommended.

3 Four mechanisms for acute, direct VSA-related deaths are discussed, viz anoxia, vagal inhibition, respiratory depression and cardiac arrhythmia. Of these, cardiac arrhythmia due to 'sensitization' of the heart to adrenaline is probably the most common and is well documented in experimental conditions.

4 Deaths from cardiac arrhythmia during or soon after VSA are unpredictable, unpreventable and resuscitation is rarely successful. Previous uneventful sessions of abuse provide no protection from this mode of death.
Volatile Substance Abuse in Relation to Alcohol and Illicit Drugs: Psychosocial Perspectives
Authors: Edeh J.
Published: December 2008

1 Volatile substance abusers are a heterogeneous population despite some demographic and social characteristics which appear similar.

2 Though predominantly an adolescent group activity, adult cases have been reported. Family disruption, alcohol misuse and antisocial behaviour feature prominently.

3 Evidence currently available suggests that only a minority of cases progress to illicit drug use; however a review of literature reveals serious discrepancies.

4 Further research of a longitudinal nature using standardized criteria of psychiatric morbidity and social adjustment and long-term follow-up is indicated to examine the extent of progression to heavy alcohol or illicit drug use.
Volatile Substance Abuse: The Role of Agencies in the Community In Prevention and Counselling
Authors: Billington A.C.
Published: December 2008

1 Voluntary agencies fulfill a need by providing information on volatile substance abuse to schools, the parents/guardians of abusers and, last but by no means least, the abusers themselves.

2 Consideration of case file data from the period 1982-1987 shows that the average age of clients has dropped from 15.9 years (n=70 ) to 13.3 years ( n=312) while the male:female ratio has dropped from 8:1 to 3:1.

3 In 1982, 80% of clients 'sniffed' glue but by 1987, 42% of new clients claimed to abuse butane and 23% aerosols. Of the 945 clients counselled, 41 have since suffered 'sudden sniffing death'.

4 Voluntary agencies can offer intensive, confidential counselling of abusers in an informed setting. It is hoped to extend the services provided outside the Greater London area and to provide residential care for those in need.
Weather Influence on the Prevalence of Carbon Monoxide Intoxications
Authors: Gijsenbergh F.P. , Vispoel M. , Poppel H. , Delooz H.
Published: December 2008

In a retrospective study over 7 years, data from patients admitted to the Emergency Department with CO intoxication, together with meteorological data were analysed.

A statistically significant difference in weather conditions was noticed between CO-intoxication days and reference days.

Different weather conditions were found to be present, according to the source of CO, i.e. gas boiler or coal stove.

If these data are confirmed, a major role in the prevention of CO intoxication or its sequellae can be played by the media through weather broadcasting. Warning can raise the index of suspicion of physicians and warn the population for vague, collectively appearing sensations of ill feeling.
Chloroquine Phosphate Induced Haematemesis
Authors: Bhasin D.K. , Chhina R.S.
Published: December 2008

Two cases who developed haematemesis, 30 and 36 hours after ingestion of 4 tablets (600 mg base) of chloroquine phosphate are described. Upper gastrointestinal endoscopy revealed erosions in the stomach and duodenum.
Fatal Lignocaine Poisoning: Report of Two Cases and Review of the Literature
Authors: Dawling S. , Flanagan R.J. , Widdop B.
Published: December 2008

1 Two fatal cases of deliberate self-poisoning with lignocaine are reported, one by oral ingestion and one by intravenous injection. Post-mortem blood lignocaine concentrations were 40 and 53 mg/l, respectively.

2 Lignocaine self-poisoning is rare since no formulations for oral use other than gels are available. However, serious toxicity can follow the oral application or ingestion of such gels, especially in children and in the elderly. Fatalities due to accidental oral overdosage with 10-25 g of lignocaine in adults have also been reported.

3 The frequent incidental occurrence of lignocaine in specimens submitted for toxicological analysis should not exclude the possibility of poisoning with this compound.
Effect of Nicotine and Cotinine on the Production of Oxygen Free Radicals by Neutrophils in Smokers and Non-smokers
Authors: Srivastava E.D. , Hallett M.B. , Rhodes J.
Published: December 2008

1 Neutrophils play a role in the pathogenesis of ulcerative colitis. Most of the patients with ulcerative colitis are non-smokers.

2 Neutrophil function was examined in healthy males, five smokers and five non-smokers, measuring production of oxygen free radicals by chemiluminescence.

3 The chemiluminescence was examined in the presence of nicotine and its main metabolite cotinine in various concentrations.

4 10 mM nicotine inhibited production of oxygen free radicals (90.2% ± 11.6) compared with controls (P < 0.001), as did the same concentration of cotinine (58.9% ± 34.2), (P < 0.05).

5 1 mM solutions had no effect and 3 mM nicotine was required to achieve 50% inhibition.

6 Smokers and non-smokers did not differ.

7 Since plasma concentrations of nicotine after a cigarette are only between 5 and 15 mM, the observed effects of nicotine and cotinine in much higher pharmacological concentrations in this system are unlikely to be of clinical relevance in ulcerative colitis
Acute Renal Failure Following Accidental Cutaneous Absorption of Phenol: Application of NMR Urinalysis to Monitor the Disease Process
Authors: Foxall P. J. D , Bending M.R. , Gartland K.P.R. , Nicholson J.K.
Published: December 2008

An unusual case of acute renal failure is reported following accidental cutaneous absorption of phenol and exposure to dichloromethane. Renal function during the onset of the nephrotoxic episode and the subsequent recovery period was monitored using a combination of standard clinical biochemical techniques and high resolution1H-NMR urinalysis. The initial urine biochemical patterns (up to 2 weeks following exposure) showed amino aciduria, glycosuria and lactic aciduria consistent with renal cortical necrosis. There followed a period of polyuria revealing a biochemical pattern (succinic aciduria,dimethylaminuria and N,N-dimethylglycinuria) consistent with renal papillary damage. Haemodialysis was required for a period of 3 weeks and the patient was discharged 42 days after admission to hospital when renal function was normal by standard clinical chemistry criteria (urea, potassium, sodium, creatinine, calcium, phosphate, urine glucose and protein).1H-NMR spectroscopic urinalysis revealed residual renal biochemical abnormalities consistent with renal papillary damage that were not detected by conventional analytical techniques. One year after the incident the patient is still polyuric, passing up to 3 1 of urine a day.
Pharmacokinetics and Toxic Effects of Diltiazem in Massive Overdose
Authors: Ferner R.E. , Odemuyiwa O. , Field A.B. , Walker S. , Volans G.N. , Bateman D.N.
Published: December 2008

A 50-year-old man with ischaemic heart disease took 98 tablets of diltiazem 60 mg with alcohol. He developed a junctional bradycardia, hypotension and reduced cardiac function refractory to intravenous calcium gluconate. He survived with temporary cardiac pacing and infusion of dopamine. As much as half the dose was vomited back, but nonetheless the plasma diltiazem concentration reached 6090 μg/l before falling mono-exponentially with a half-life of 8.6 h. Sinus rhythm returned when the plasma concentration of diltiazem was around 750 μg/l. Standard resuscitative procedures sufficed to treat massive diltiazem overdosage.
A Cluster of Central Nervous System Defects in Jamaica
Authors: Golding J. , Foster-Williams K. , Coard K. , Ashley D.
Published: December 2008

1 Information was collected on all stillbirths and neonatal deaths on the island of Jamaica during the 12-month period between September 1986 and August 1987.

2 There were 33 such deaths with anencephaly, spina bifida and hydrocephalus out of an estimated 54 400 total births.

3 There was a statistically significant cluster in respect to time of conception in one small rural area of the island.

4 There were no obvious differences between parents involved in the cluster and the rest of the population, but particular Jamaican fruit and vegetables have been shown to be teratogenic in animals. It is postulated that the cluster may have been associated with an unripe crop.
Safety of Late Acetylcysteine Treatment in Paracetamol Poisoning
Authors: Parker D. , White J.P. , Paton D. , Routledge P.A.
Published: December 2008

Twenty patients who had taken overdoses of paracetamol were treated with acetylcysteine between 12 and 24 hours after the incident. Although 19 patients had plasma paracetamol concentrations greater than those associated with a 90% risk of moderate to severe liver damage, this complication occurred in only seven (35%) individuals. No patient developed hepatic encephalopathy or acute renal failure and all recovered without sequelae. We conclude that acetylcysteine administration up to 24 hours following paracetamol overdose is not dangerous and may prevent further liver damage.
Human Metabolism of Arsenobetaine Ingested with Fish
Authors: Brown R.M. , Newton D. , Pickford C.J. , Sherlock J.C.
Published: December 2008

1 Six volunteers ingested 74As-labelled arsenobetaine with a fish meal. The retention and distribution of the tracer were studied by body radioactivity measurements.

2 The tracer became rapidly dispersed in soft tissues, with no major concentration in any localized organ or region.

3 In all subjects < 1% of the ingested activity remained in the body after 24 days.

4 Any losses from the skin were minor in relation to those by other routes of excretion.
Strength of Meaning—Strong Words and a Certain Message?
Authors: Woodward K.N. , Dayan A.D.
Published: December 2008

The ability to convey specific meanings is important to scientists in their writing. However, difficulties arise when the ideas to be portrayed are judgemental. While extreme terms expressing strength of meaning are readily understood, more subtle ones appear not to be.
Human Brain Sulphotransferase and Glucuronyltransferase
Authors: Viani A. , Temellini A. , Tusini G. , Pacifici G.M.
Published: December 2008

The activities of cytosolic sulphotransferase (ST) and microsomal glucuronyltransferase (GT) were measured with 1-naphthol as the substrate in three frontal cortex, three temporal cortex, one parietal cortex, one occipital cortex and two cerebellar cortex specimens from human brain. The average activity was 11.7 ± 4.2 pmol/min/mg protein/(ST) and 26.8 ± 13.6 pmol/min/mg protein (GT). The kinetics of ST were studied varying the concentration of 1-naphthol in five brain specimens (temporal cortex, temporal subcortex, occipital cortex, cerebellum cortex and frontal cortex) whereas those of GT were studied in a sample obtained by pooling the microsomal fractions from the following eight brain tissues: one frontal cortex, four temporal cortex, one parietal cortex and two cerebellar cortex specimens. The Km of the first and second enzyme was 1.55 ± 0.47 μM (mean ± s.d.) and 121 μM, respectively. The Vmax values were 13.70 ± 8.16 (mean ± s.d.) pmol/min/mg protein (ST) and 103 pmol/min/mg protein (GT). Vmax/ Km was ten times higher for ST than GT. These data suggest that ST is the predominant pathway at low concentrations of 1-naphthol whereas at higher concentrations, GT becomes the predominant pathway.
The Effect of Storage upon Cyanide in Blood Samples
Authors: Bright J.E. , Inns R.H. , Tuckwell N.J. , Marrs T.C.
Published: December 2008

CDPA blood of human origin was 'spiked' with a solution of potassium cyanide at four different concentrations. When such blood was left in contact with the atmosphere for up to 10 min an appreciable amount of the cyanide was lost. Stoppered tubes containing the 'spiked' blood were stored at -20°C and 4°C for up to 6 months. Most samples, especially those 'spiked' at the highest concentrations, showed a loss of cyanide.
Toxicological Implications of Enzymatic Control of Reactive Metabolites
Authors: Oesch F. , Doehmer J. , Friedberg T. , Glatt H.R. , Oesch-Bartlomowicz B. , Platt K.L. , Steinberg P. , Utesch D. , Thomas H.
Published: December 2008

Many foreign compounds are transformed into reactive metabolites, which may produce genotoxic effects by chemically altering critical biomolecules. Reactive metabolites are under the control of activating, inactivating and precursor sequestering enzymes. Such enzymes are under the long-term control of induction and repression, as well as the short-term control of post-translational modification and low molecular weight activators or inhibitors. In addition, the efficiency of these enzyme systems in preventing reactive metabolite-mediated toxicity is directed by their subcellular compartmentalization and isoenzymic multiplicity. Extrapolation from toxicological test systems to the human requires information of these variables in the system in question and in man. Differences in susceptibility to toxic challenges between species and individuals are often causally linked to differences in these control factors.
Intravenous N-Acetylcysteine, Hepatotoxicity and Plasma Glutathione S-Transferase in Patients with Paracetamol Overdosage
Authors: Beckett G.J. , Donovan J.W. , Hussey A.J. , Proudfoot A.T. , Prescott L.F.
Published: December 2008

The concentration of glutatione S-transferase B1(GST B1) subunits was measured in sequential plasma samples taken at frequent intervals for 48 h from ten patients with severe paracetamol poisoning who were treated with intravenous N-acetylcysteine. No significant increase in plasma GST B1concentration was observed over the study period and within 4 h of starting treatment with N-acetylcysteine there were significant decreases in plasma GST B1concentrations. None of the patients subsequently developed significant liver damage. At the dose used for the treatment of paracetamol poisoning, N-acetylcysteine has no hepatotoxic effects.
Herbal Medicine as a Cause of Combined Lead and Arsenic Poisoning
Authors: Mitchell-Heggs C.A.W. , Conway M. , Cassar J.
Published: December 2008

1 Combined chronic lead and arsenic poisoning was diagnosed in a 33-year-old Korean woman following consumption of a Korean herbal medicine prescribed for haemorrhoids.

2 The patient had malaise, severe difficulty walking, arthralgia, oedema and abdominal pain with diarrhoea.

3 Investigation showed anaemia with basophilic stippling, fragmentation and a raised reticulocyte count.

4 Raised blood and urine lead levels and urine arsenic levels were found.

5 Analysis of the herbal medicine revealed a high lead and arsenic content.

6 Treatment with the newer chelating agent 2,3-dimercaptosuccinic acid was successful, with no detectable side-effects.
The Clinical Value of Drug Analyses in Deliberate Self-Poisoning
Authors: Rygnestad Tarjei , Aarstad Kjell , Gustafsson Kari , Jenssen Unni
Published: December 2008

1. In a prospective, unselective study of self-poisoned patients in 1978 and 1987 blood samples for drug analyses were drawn on admission in 265 and 400 cases, respectively.

2. The results from the drug analyses were compared with the clinical information obtained on admission. The main drug taken was identified on admission in 228 (86%) in 1978 and in 383 cases (96%) in 1987 (P < 0.001).

3. The clinical impression was completely in accordance with the results from the drug analyses in 192 cases (72%) in 1978 and 232 cases (58%) cases in 1987 (P < 0.001). The discrepancies mainly involved secondary drugs.

4. There was no significant difference in the clinical course of the poisonings in situations where the correct main drug was identified on admission and where the wrong main drug was suspected.

5. Knowledge of the correct drugs used when admitted would not have prevented complications or deaths.

6. We conclude that extensive pharmacological drug analyses play a limited role in the routine management of patients admitted for deliberate self-poisoning.