RESUMO
Objetivo: avaliar as notificações de intoxicação exógena por raticida no Brasil entre 2008 e 2022. Métodos: foi realizado um estudo ecológico, do tipo série temporal, avaliando a quantidade anual de notificações nos últimos 15 anos, considerando os casos confirmados pelo Sistema de Informação de Agravos de Notificação (SINAN). A tendência temporal e as razões de incidência antes e durante a pandemia de COVID-19 foram examinadas com nível de significância de 5%. Resultados: entre 2008 e 2022, 48.448 notificações de intoxicação exógena por raticidas foram registradas. A tendência temporal foi estabelecida como estacionária nos últimos 15 anos (p = 0,285), mas tornou-se, significativamente, crescente ao remover os anos relacionados à pandemia de COVID-19 (p = 0,001; VPA = 5,4% [IC95% = 2,1, 8,6). Além disso, ao comparar com período pré-pandemia, a incidência de notificações foi 34% menor (RI = 0,66 [IC95% = 0,59, 0,73]) no primeiro e 28% menor (RI = 0,72 [IC95% = 0,65, 0,79]) no segundo ano da pandemia de COVID-19. Por fim, observou-se que 82,2% das circunstâncias foram tentativas de suicídio, 89,4% foram exposições do tipo aguda-única e a maioria (91,1%) evoluíram para cura sem sequelas. Conclusão: foi possível concluir que as intoxicações exógenas por raticidas persistem como um problema de Saúde Pública no Brasil.
Objectives: to evaluate notifications of exogenous poisoning by rodenticides in Brazil between 2008 and 2022. Methods: an ecological time-series study was carried out, evaluating the annual number of notifications in the last 15 years, considering the cases confirmed by the Notifiable Diseases Information System (SINAN). Temporal tendency and incidence ratios before and during the COVID-19 pandemic were examined at a 5% significance level. Results: between 2008 and 2022, 48,448 notifications of exogenous poisoning by rodenticides were reported. The temporal tendency was established as stationary over the last 15 years (p = 0.285) but became significantly increasing when removing the COVID-19 pandemic years (p = 0.001; VPA = 5.4% [95%CI = 2 .1, 8.6). In addition, when compared to the pre-pandemic period, the incidence of notifications was 34% lower (IRR = 0.66 [CI95% = 0.59, 0.73]) in the first and 28% lower (IRR = 0,72 [CI95% = 0.65, 0.79]) in the second year of the COVID-19 pandemic. At last, it was observed that 82.2% of the circumstances were suicide attempts, 89.4% were acute-single exposures, and most (91.1%) evolved to cure without sequelae. Conclusion: it was possible to conclude that exogenous poisoning by rodenticides persists as a Public Health problem in Brazil.
Assuntos
Rodenticidas , Brasil , EpidemiologiaRESUMO
Os casos suspeitos de intoxicações exógenas são frequentes na clínica de cães e gatos. O presente trabalho objetivou realizar um estudo retrospectivo dos casos suspeitos de intoxicação em cães e gatos atendidos no Hospital Veterinário Universitário da UFPI, localizado em Teresina PI, durante o período de 2017 a 2021. Os casos foram classificados por agente tóxico suspeito, espécie, idade e ano de ocorrência. No total foram registrados 324 casos, sendo 58 em 2017, 88 em 2018, 94 em 2019, 50 em 2020 e 34 em 2021. A maioria dos casos ocorreu em 2019 (29,01%) tendo como causa principal a intoxicação medicamentosa (16,04%), seguida da intoxicação por agrotóxicos (10,80%). A maior prevalência foi em animais com idade inferior a cinco anos (87,03%); machos (56,79%); cães (68,20%). Foram observados: elevado número de casos sem agente tóxico identificado (28,08%) e de fichas de atendimento não preenchidas (8,33%) pelos médicos veterinários em atendimento. A prevenção, a educação continuada dos tutores e a capacitação dos médicos veterinários são destacadas como essenciais para a redução dos casos de intoxicações exógenas em cães e gatos.(AU)
Suspected cases of exogenous poisoning are frequent in the clinic of dogs and cats. The present study aimed to perform a retrospective study of suspected cases of intoxication in dogs and cats treated at the University Veterinary Hospital of UFPI, located in Teresina PI, during the period from 2017 to 2021. The cases were classified by suspected toxic agent, species, age and year of occurrence. A total of 324 cases were recorded, being 58 in 2017, 88 in 2018, 94 in 2019, 50 in 2020 and 34 in 2021. Most cases occurred in 2019 (29.01%) with drug intoxication (16.04%) as the main cause, followed by pesticide intoxication (10.80%). The highest prevalence was in animals less than five years old (87.03%); males (56.79%); dogs (68.20%). It was observed: high number of cases without identified toxic agent (28.08%) and unfilled attendance forms (8.33%) by the attending veterinarians. Prevention, continued education of guardians and training of veterinarians are highlighted as essential for the reduction of cases of exogenous poisoning in dogs and cats.(AU)
Los casos sospechosos de intoxicaciones exógenas son frecuentes en la clínica de perros y gatos. El presente estudio tuvo como objetivo realizar un estudio retrospectivo de los casos sospechosos de intoxicación en perros y gatos tratados en el Hospital Veterinario Universitario de la UFPI, ubicado en Teresina PI, durante el período de 2017 a 2021. Los casos se clasificaron por agente tóxico sospechoso, especie, edad y año de ocurrencia. Se registraron un total de 324 casos, 58 en 2017, 88 en 2018, 94 en 2019, 50 en 2020 y 34 en 2021. La mayoría de los casos se produjeron en 2019 (29,01%) siendo la intoxicación por fármacos la principal causa (16,04%), seguida de la intoxicación por plaguicidas (10,80%). La mayor prevalencia se dio en animales menores de cinco años (87,03%); machos (56,79%); perros (68,20%). Se observó un elevado número de casos sin agente tóxico identificado (28,08%) y de formularios asistenciales no cumplimentados (8,33%) por los veterinarios asistentes. Se insiste en que la prevención, la educación continuada de los propietarios de animales de compañía y la formación de los veterinarios son esenciales para reducir los casos de intoxicación exógena en perros y gatos.(AU)
Assuntos
Animais , Intoxicação/veterinária , Rodenticidas/efeitos adversos , Agroquímicos/análise , Brasil , Gatos , CãesRESUMO
La intoxicación humana por rodenticidas anticoagulantes de acción prolongada, conocidos como superwarfarinas, provoca coagulopatía de prolongado manejo. Presentamos el caso de un hombre de 42 años que ingirió una dosis tóxica de rodenticida en un intento suicida, evolucionando con epistaxis, INR de 11,6 y necesidad de hospitalización. Durante 7 días se realizaron controles seriados de pruebas de coagulación, con optimización de diferentes dosis de suplementación de Vitamina K. El caso destaca la potencia y vida media prolongada (aproximadamente 6 semanas) de este tipo de anticoagulantes, hecho que requiere un control clínico regular y una adherencia al tratamiento satisfactoria.
Human intoxication by long-acting anticoagulant rodenticides, known as superwarfarins, causes coagulopathy that is difficult to manage. We present the case of a 42-year-old man who ingested a toxic dose of rodenticide in a suicide attempt, evolving with epistaxis, INR of 11.6, and needing hospitalization. For seven days, serial controls of coagulation tests were carried out, with optimization of different doses of Vitamin K supplementation. The case highlights this type of anticoagulant's potency and prolonged half-life (approximately six weeks), which requires regular clinical control and satisfactory treatment adherence.
Assuntos
Humanos , Masculino , Adulto , Rodenticidas/intoxicação , Tentativa de Suicídio , Anticoagulantes/intoxicação , Vitamina K/uso terapêutico , 4-Hidroxicumarinas/intoxicaçãoRESUMO
Human intoxication by long-acting anticoagulant rodenticides, known as superwarfarins, causes coagulopathy that is difficult to manage. We present the case of a 42-year-old man who ingested a toxic dose of rodenticide in a suicide attempt, evolving with epistaxis, INR of 11.6, and needing hospitalization. For seven days, serial controls of coagulation tests were carried out, with optimization of different doses of Vitamin K supplementation. The case highlights this type of anticoagulant's potency and prolonged half-life (approximately six weeks), which requires regular clinical control and satisfactory treatment adherence.
Assuntos
Anticoagulantes , Rodenticidas , Tentativa de Suicídio , Humanos , Masculino , Adulto , Rodenticidas/intoxicação , Anticoagulantes/intoxicação , 4-Hidroxicumarinas/intoxicação , Vitamina K/uso terapêuticoRESUMO
BACKGROUND: The presence of synanthropic rodents, such as Rattus norvegicus, in urban environments generates high costs of prophylaxis and control, in large part due to the environmental transmission of the pathogenic spirochete Leptospira interrogans, which causes leptospirosis. In Salvador, Brazil, The Center for Control of Zoonosis (CCZ) is responsible for planning and implementing Rodent Control Programs (RCP) which are based on chemical rodenticide. However, these strategies have not been standardized for use in developing countries. AIM: This study aimed to identify the effect of a chemical control campaign on the demographic variables of urban R. norvegicus, analyzing relative abundance, sex structure, body mass, and age of the population, as well as the characterization of spatial distribution among households, rodent capture campaigns and interventions. METHODS: This study was carried out during 2015 in three valleys of an urban poor community in Salvador. Individuals of R. norvegicus were systematically captured before (Pre-intervention) and three months (1st post-intervention) and six months (2nd post-intervention) after a chemical control intervention conducted by the CCZ in two valleys of the study area while the third valley was not included in the intervention campaign and was used as a non-intervention reference. We used analysis of variance to determine if intervention affected demographic variables and chi-square to compare proportions of infested households (Rodent infestation index-PII). RESULTS: During the chemical intervention, 939 households were visited. In the pre-intervention campaign, an effort of 310 trap nights resulted in 43 rodents captured, and in the 1st and 2nd, post-intervention campaigns resulted in 47 rodents captured over 312 trap nights and 36 rodents captured over 324 traps-nights, respectively. The rodent infestation index (PII) points did not show a reduction between the period before the intervention and the two periods after the chemical intervention (70%, 72%, and 65%, respectively). Regarding relative abundances, there was no difference between valleys and period before and two periods after chemical intervention (trap success valley 1: 0,18; 0,19; 0,18 / Valley 3 0,15; 0,17; 0,13/ P>0,05). Other demographic results showed that there was no difference in demographic characteristics of the rodent population before and after the intervention, as well as there being no influence of the application of rodenticide on the areas of concentration of capture of rodents between the campaigns. CONCLUSION: Our study indicates that the chemical control was not effective in controlling the population of R. norvegicus and provides evidence of the need for re-evaluation of rodent control practices in urban poor community settings.
Assuntos
Leptospira interrogans , Leptospirose , Doenças dos Roedores , Rodenticidas , Animais , Brasil/epidemiologia , Leptospirose/epidemiologia , Ratos , Doenças dos Roedores/epidemiologia , RoedoresRESUMO
Esta pesquisa buscou analisar os casos de intoxicações por organofosforados e carbamatos, presentes em agrotóxicos e pesticidas, registrados na base de dados do Centro de Informação e Assistência Toxicológica do Paraná (CIATox/PR). Trata-se de estudo retrospectivo em que foram avaliadas variáveis sociodemográficas e clínicas relacionadas à intoxicação, à forma de exposição, à causa e ao desfecho. Para a análise estatística foram utilizados testes de Kolmogorov-Smirnov, Shapiro-Wilk, Qui-Quadrado e Teste Exato de Fisher, considerando p<0,05. A amostra foi composta por 426 casos, sendo 218 (51,2%) mulheres. O principal agente foi raticida clandestino em 278 (65,2%) pacientes. A principal circunstância das intoxicações foi tentativa de suicídio com 293 (68,8%) casos. Houve predominância de exposição via oral (89,9%) e zona urbana em 349 (81,9%) casos, a maioria considerados leves (52,6%) e assistidos em serviços médicos (66,4%). Cerca de 327 (76,8%) indivíduos apresentavam manifestações clínicas. O tempo decorrido entre a exposição e o contato com o CIATox/PR foi maior nos casos considerados graves (p= 0,041). A atropina foi utilizada em 94 (49%) pacientes intoxicados por carbamatos, em 31 (33,3%) por organofosforados e em 84 (59,6%) por outros inibidores da colinesterase não especificados. Duas mulheres e um adolescente apresentaram desfecho fatal, tendo em comum a ingesta intencional de "chumbinho". A casuística predominante nesta série histórica foi paciente do sexo feminino, faixa etária adulta, residente na região metropolitana, exposta a agrotóxico por via oral, sintomática, classificada como gravidade leve, sem necessidade de atropina, contudo ocorreram três casos com desfecho para o óbito.
This research aimed to analyze the cases of poisoning by organophosphates and carbamates, present in agrochemicals and pesticides, registered in the database of the Information and Toxicological Assistance Center of Paraná (CIATox/PR). This is a retrospective study in which sociodemographic and clinical variables related to intoxication, form of exposure, cause and outcome were evaluated. For the statistical analysis, the Kolmogorov-Smirnov, Shapiro-Wilk, Chi-Square and Fisher's Exact Test were used, considering p<0.05. The sample consisted of 426 cases, 218 (51.2%) of which were women. The main agent was clandestine rodenticide in 278 (65.2%) patients. The main circumstance of intoxication was a suicide attempt with 293 (68.8%) cases. There was a predominance of oral exposure (89.9%) and urban areas in 349 (81.9%) cases, most considered mild (52.6%) and assisted in medical services (66.4%). About 327 (76.8%) individuals had clinical manifestations. The time elapsed between exposure and contact with CIATox/PR was longer in cases considered severe (p=0.041). Atropine was used in 94 (49%) patients intoxicated by carbamates, in 31 (33.3%) by organophosphates and in 84 (59.6%) by other unspecified cholinesterase inhibitors. Two women and one teenager had a fatal outcome, having in common the intentional ingestion of "chumbinho". The predominant casuistry in this historical series was a female patient, adult age, living in the metropolitan region, exposed to pesticides orally, symptomatic, classified as mild severity, without the need for atropine, however, there were three cases with an outcome of death.
Assuntos
Humanos , Masculino , Feminino , Organofosfatos , Intoxicação , Carbamatos , Inibidores da Colinesterase , Colinesterases , Agroquímicos , Casuísmo , RodenticidasRESUMO
Resumen En la industria agrícola se ha implementado el uso de plaguicidas lo que ha aumentado la cantidad y calidad de los productos agrícolas en varios países en desarrollo, su objetivo es mejorar la calidad de vida y sustento de los consumidores, sin embargo, el uso inadecuado puede causar graves intoxicaciones tanto por ingestión accidental, ocupacional o ingestión con fines suicidas u homicidas, lo cual los hace un tema de relevancia médico legal. El fosfuro de aluminio es un rodenticida, insecticida y fumigante sólido usado como una sustancia ideal para la conservación de los granos, ya que es altamente tóxico contra los insectos que invaden los granos en todos sus estadios sin afectar como tal las semillas y su germinación, es un compuesto accesible y económico lo que hace que su uso con fines suicidas y homicidas sea elevado, ante la intoxicación con fosfuro de aluminio se han descritos síntomas bastante inespecíficos como lo son dolor en el epigastrio, vómitos, diarrea, mareos, disnea y en algunos casos acompañado de un olor a ajo que es característico de ésta intoxicación lo que aumenta la sospecha clínica. Se realizó una revisión bibliográfica en diferentes bases de datos, de los artículos publicados referentes al tema de los últimos doce años, con el objetivo de profundizar en las características del fosfuro de aluminio, su mecanismo de acción y toxicidad. Se concluye que es fundamental conocer los diferentes plaguicidas y sus efectos en la salud, principalmente de aquellos con una alta letalidad, que se podrían estar utilizando clandestinamente y que al ser sumamente económicos son de fácil acceso para emplearse con fines delictivos.
Abstract The agricultural industry has implemented the use of pesticides, which has increased the quantity and quality of agricultural products in several developing countries, its objective is to improve the quality of life and livelihood of consumers, however, improper use can cause serious intoxications both by accidental ingestion, occupational or ingestion for suicidal or homicidal purposes, which makes them an issue of medico-legal relevance. Aluminum phosphide is a rodenticide, insecticide and solid fumigant used as an ideal substance for the preservation of grains, since it is highly toxic against insects that invade the grains in all their stages without affecting the seeds and their germination, it is an accessible and economic compound which makes its use for suicidal and homicidal purposes high, In the face of aluminum phosphide poisoning, quite unspecific symptoms have been described, such as pain in the epigastrium, vomiting, diarrhea, dizziness, dyspnea and in some cases accompanied by a garlic odor which is characteristic of this poisoning, which increases clinical suspicion. A bibliographic review was conducted in different databases, of the articles published on the subject in the last twelve years, with the aim of deepening in the characteristics of aluminum phosphide, its mechanism of action and toxicity. It is concluded that it is essential to know the different pesticides and their effects on health, those with a high lethality, which could be used clandestinely and which, being extremely cheap, are easily accessible to be used for criminal purposes
Assuntos
Rodenticidas/toxicidade , Compostos de Alumínio/toxicidadeRESUMO
Rodenticides are pesticides used worldwide, with little information available regarding health consequences in wildlife and humans. The aim of the present study was to use virtual screening to identify potential targets for flocoumafen, a superwarfarin rodenticide. Blind docking of more than 841 human proteins was carried out employing AutoDock Vina. The strength of the ligand interaction with the proteins was quantified based on the binding affinity score (kcal/mol). Results indicate that flocoumafen could be a promiscuous ligand for diversity of cellular protein targets. The best complexes were obtained for prostaglandin F synthase (-14.2 kcal/mol) and serum albumin (-14.0 kcal/mol) followed by glucocorticoid receptor 2, matrix metalloproteinase-9, nuclear receptor ROR-alpha, and activin receptor type-1, all with values equal or better than -13.5 kcal/mol. Docking method validation based on the root-mean-square deviation showed that flocoumafen had good capability to predict corresponding co-crystallized poses; and molecular dynamics simulations suggested the complex with greater binding affinity was thermodynamically stable. Protein-protein interaction networks built with main protein targets revealed that protein kinase B (AKT1), ribosomal protein S6 kinase B1 (RPS6KB1), phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA), retinoid X receptor alpha (RXRA), and protein phosphatase 2 catalytic subunit alpha (PPP2CA) were major hub proteins, whereas the gene ontology analysis reported that cellular response to endogenous stimulus, protein binding, and the TOR complex were the biological processes, molecular function, and cell component enrichments, respectively. These results should motivate more ecotoxicity testing for flocoumafen and other superwarfarins, as well as precautionary legislation to minimize exposure to these highly toxic chemicals. Environ Toxicol Chem 2021;40:2034-2043. © 2021 SETAC.
Assuntos
Praguicidas , Rodenticidas , 4-Hidroxicumarinas , Anticoagulantes , Humanos , Ligantes , Simulação de Acoplamento Molecular , Simulação de Dinâmica MolecularRESUMO
Abstract Introduction: Sodium fluoroacetate, known as compound 1080, was discovered in Germany during the Second World War. It is usually used as a rodenticide, it is an odorless and tasteless substance, with a lethal dose in humans of 2 mg / kg that is why it was withdrawn from the market in some countries, including Colombia; however, it is obtained illegally. This substance has biochemical and physiological effects at the cellular level that alter the transport of citrate at the mitochondrial level, generating accumulation of lactic acid and alteration of the glucose use. The clinical manifestations are nonspecific since there is no any cardinal symptom. Therefore, its diagnosis is made due to high clinical suspicion associated with establishment of exposure to the compound in view of the difficulty to obtain paraclinical confirmation in a timely manner. Methods: We present a case report of intentional ingestion of sodium fluoroacetate in an adolescent that is associated with an infection added to the bloodstream by methicillin- sensitive Staphylococcus aureus (MSSA). The patient developed multiple complications that lead to support in the Intensive Care Unit (ICU) with a satisfactory outcome. In view of the lack of a specific antidote, she was treated with ethanol in order to increase the level of acetate; thus, offering an alternative substrate to the Krebs cycle. It is suggested that the ethanol offers benefits in the acute treatment of these patients. Results: The patient with sodium fluoroacetate poisoning and kidney failure received renal replacement therapy with a favorable evolution and survival at discharge from the intensive care unit of a third-level hospital in the city of Pereira, Risaralda, Colombia. Conclusions: Sodium fluoroacetate poisoning is relatively rare and can cause acute kidney injury and multi-organ failure with a high rate of complications and death. A case of self-inflicted poisoning that received a timely manner continuous renal replacement therapy with a favorable outcome in terms of ICU survival was presented.
Resumen Introducción: El fluoroacetato de sodio ⎯conocido como compuesto 1080⎯, fue descubierto en Alemania durante la segunda guerra mundial, suele ser utilizado como raticida y se caracteriza por ser una sustancia inodora e insabora. En humanos, una dosis de 2 a mg/kg es letal; debido a su toxicidad fue retirado del mercado en algunos países, incluyendo Colombia, no obstante, se consigue de forma ilegal. Esta sustancia tiene efectos bioquímicos y fisiológicos a nivel celular que altera el transporte del citrato a nivel mitocondrial, generando acumulación de ácido láctico y alteración en la utilización de la glucosa. Las manifestaciones clínicas son inespecíficas y no existe un síntoma cardinal. Por ende, su diagnóstico se realiza por alta sospecha clínica, asociado al establecimiento de la exposición al compuesto, ya que la confirmación paraclínica es difícil de realizar oportunamente. Métodos: Se presenta un reporte de caso de ingestión intencional en un adolescente, asociado con infección agregada al torrente sanguíneo por Estafilococos Aureos Meticilino Sensible (EAMS). El paciente desarrolló múltiples complicaciones y requirió asistencia en Unidad de Cuidados Intensivos (UCI) con desenlace satisfactorio. Ya que no se cuenta con antídoto específico , se le dio tratamiento con etanol para aumentar el nivel de acetato, ofreciendo así un sustrato alterno al ciclo de Krebm. Se estima que el etanol puede ofrecer beneficios en el tratamiento agudo de estos pacientes. Resultados: Paciente con intoxicación por fluoroacetato de sodio e insuficiencia renal, recibe terapia de reemplazo renal con un evolución favorable y supervivencia al alta de la Unidad de Cuidados Intensivos de un hospital de tercer nivel en la ciudad de Pereira, Risaralda, Colombia. Conclusiones: La intoxicación por fluoroacetato de sodio es relativamente poco frecuente y puede causar injuria renal aguda y falla multiorgánica con alta tasa de complicaciones y muerte. Se presentó un caso de intoxicación autoinfligida que recibió terapia de reemplazo renal continua temprana con un desenlace favorable en términos de supervivencia en la UCI.
Assuntos
Humanos , Masculino , Adolescente , Staphylococcus aureus , Toxicidade , Fluoracetatos , Meticilina , Acetatos , Rodenticidas , Ciclo do Ácido Cítrico , Ácido Cítrico , Ácido Láctico , Diagnóstico , Etanol , Ingestão de Alimentos , Injúria Renal Aguda , Colecionismo , Sobrevivência , Terapia de Substituição Renal Contínua , Glucose , Hospitais , Unidades de Terapia Intensiva , ChumboRESUMO
Objetivo: Avaliar a indicação da lavagem gástrica no tratamento de intoxicações causadas por ingestão. Métodos: Todos os casos de intoxicação causada por ingestão que foram atendidos em dois hospitais do interior de São Paulo e submetidos à lavagem gástrica no período de 1° de janeiro de 2011 a 31 de dezembro de 2015 foram avaliados retrospectivamente quanto à indicação do procedimento, considerando o tempo entre ingestão e atendimento, a toxicidade da substância e as contraindicações para o procedimento. Resultados: Dos 587 casos atendidos, 338 (57,6%) foram submetidos à lavagem gástrica. Dentre esses casos, constatou-se a realização equivocada do procedimento em 95,8% casos. Conclusão: O número de pacientes submetidos à lavagem gástrica neste trabalho foi considerado elevado, mesmo quando orientado pelo centro de atendimento. Apesar da falta de evidências de que a lavagem gástrica traga benefícios nos casos de intoxicação, ela é largamente utilizada em virtude do desconhecimento das indicações e contraindicações desse procedimento por parte dos profissionais de saúde
Objective: To evaluate the indication of gastric lavage in the treatment of poisoning caused by ingestion. Methods: All cases of poisoning caused by ingestion that were treated in two hospitals in inland cities of São Paulo and subjected to gastric lavage from January 1, 2011 to December 31, 2015 were retrospectively assessed as for the indication of the procedure, considering the time between ingestion and care, substance toxicity, and procedure contraindications. Results: Of the 587 cases treated, 338 (57.6%) underwent gastric lavage. The procedure was considered incorrect in 95.8% of cases. Conclusion: The number of patients undergoing gastric lavage in this study was considered high, even when instructed by the center of attendance. Despite the lack of evidence that gastric lavage brings benefits in cases of poisoning, it is widely used due to the lack of knowledge by health professionals of the indications and contraindications of this procedure.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Intoxicação/terapia , Lavagem Gástrica/normas , Hospitais Universitários , Rodenticidas/intoxicação , Tentativa de Suicídio , Epidemiologia Descritiva , Estudos Transversais , Estudos Retrospectivos , Agroquímicos/intoxicação , Exposição a Produtos Químicos , Transtornos Relacionados ao Uso de Substâncias/terapia , Distribuição por Idade e Sexo , Registros Eletrônicos de Saúde , Overdose de Drogas/terapia , Contraindicações de Procedimentos , Lavagem Gástrica/efeitos adversos , HospitalizaçãoRESUMO
Introduction: Rice-field rats are one of the most important pests because it can give large losses in all planting seasons including the storehouse. Synthetic rodenticide is the most commonly used of chemical technique for controlling rice-field rats. The application of these materials indirectly causes negative impacts; one of them is for the environment. As an alternative for controlling rice-field rats, natural materials can be used as a repellent. Objective: To examine the effects of methanol extract of Plumeriarubra leaves on metabolism, daily activity patterns, and its potency as a repellent of the rice-field rat. Methods: The experiments were conducted at the Laboratory of Pests, UniversitasPadjadjaran involves choice test (T-maze arena), and the Laboratory of Rats, Indonesian Center for Rice Research involves no-choice test (metabolic cage) from February until May 2019. The observations including food (g), water consumption (ml), feces production (g), urine production (ml), body weight (g), and its changes (%), also the daily activities (time spent for locomotion, foraging, and resting).The treatment was done with three replications for twelve mature male and twelve mature non-pregnant females. Data experiments analysis followed by a T-test. Results: Rice-field rats on the T-Maze arena avoided consuming food and beverage that close to methanol extract of Plumeriarubra leaves treatment. The treatment of methanol extract of Plumeria leaves in metabolic cage caused metabolic disorder of rice-field rat, which was significantly indicated by the decrease of the average consumption of food by 2.28 g and excretion of feces by 0.34 g, and also the increase of average consumption of beverage by 3.89 ml, excretion of urine by 3.15 ml, and body weight by 6.67 g. The treatment also caused daily activity patterns disorder of rice-field rats, which was significantly indicated by the increase of the average percentage of time for movement activities (locomotion) by 7.64 % and the decrease of time for eating and drinking activities (foraging) by 16.46 %. Conclusion: Methanol extract of Plumeria leaves affects a repellent for the rice-field rat.
Introducción: Las ratas arroceras son una de las plagas más importantes porque pueden producir grandes pérdidas en todas las temporadas de siembra, incluso en el almacenaje. La técnica química más utilizada para controlar las ratas de los arrozales es el raticida sintético. Sin embargo, la aplicación de estos químicos provoca indirectamente impactos negativos, por ejemplo, en el ambiente. Una alternativa para controlar la rata arrocera es la utilización de compuestos naturales como repelentes. Objetivo: Examinar los efectos del extracto metanólico de hojas de Plumeria rubra sobre el metabolismo, los patrones de actividad diaria en las ratas arroceras y su potencial como repelente. Métodos: Los experimentos se llevaron a cabo en Laboratory of Pests, UniversitasPadjadjaran usando la prueba T-maze arena, y en Laboratory of Rats, Indonesian Center for Rice Research usando la prueba metaboliccage, desde febrero hasta mayo 2019. Las observaciones incluyeron consumo de alimentos (g), consumo de agua (ml), producción de heces (g), producción de orina (ml), peso corporal (g) y cambios (%), además actividades diarias (tiempo dedicado a la locomoción, búsqueda de alimento, y reposo). El tratamiento se realizó con tres repeticiones para 12 machos maduros y 12 hembras maduras no gestantes. Los análisis de experimentos de datos se realizaron con la prueba T. Resultados: Las ratas arroceras en la T-maze arena evitaron consumir alimentos y bebidas cercanos al extracto de metanol de hojas de Plumeria rubra. El tratamiento del extracto metanólico de hojas de Plumeria rubra en la prueba metaboliccage provocó un trastorno metabólico en estas ratas, lo cual se demostró significativamente en la disminución del consumo promedio de alimento en 2.28 g y la excreción de heces en 0.34 g, además en el aumento del consumo promedio de bebida en 3.89 ml, excreción de orina en 3.15 ml y peso corporal en 6.67 g. El tratamiento también provocó un trastorno en los patrones de actividad diaria de las ratas, lo cual fue demostrado por el aumento significativo en el porcentaje promedio de tiempo para actividades de movimiento (locomoción) en un 7.64 % y la disminución del tiempo para comer y beber (búsqueda de alimento) en un 16.46 %. Conclusión: El extracto metanólico de hojas de Plumeria rubra tiene un efecto repelente en las ratas arroceras.
Assuntos
Animais , Rodenticidas/administração & dosagem , Sigmodontinae , Extratos Vegetais/análise , Controle de Roedores/métodosRESUMO
Resumen Los rodenticidas son sustancias de venta libre ampliamente utilizadas a nivel agrícola y a nivel doméstico para el control de roedores. Los rodenticidas anticoagulantes de larga duración tienen un mecanismo de acción similar al de la warfarina, pero con mayor potencia de acción. El espectro de manifestaciones clínicas de la intoxicación por rodenticidas anticoagulantes es muy amplio, que se puede presentar de manera asintomática hasta con sangrados que comprometan la vida del paciente. El tratamiento se basa en el control del sangrado y la reposición con su antídoto lógico que corresponde a la vitamina K para restablecer la hemostasis.
Abstract Rodenticides are agriculturally and domestically used substances used for the control of rats and other rodents, easily available on the market. Anticoagulant rodenticides have a similar mechanism of action than that of warfarin, but their potency is bigger. The spectrum of clinical manifestations of rodenticide intoxications is broad; and it varies from asymptomatic cases to hemorrhages that compromise the patient's life. Treatment is based on active bleeding control and reposition of its logical antidote Vitamin K in order to restore hemostasis.
Assuntos
Humanos , Intoxicação , Rodenticidas , AnticoagulantesRESUMO
Rodents infest urban environments, causing damage and acting as vectors for disease transmission. Currently, anticoagulants are the most widely used chemical rodenticides, and their extensive and widespread use can contaminate the environment. To ensure effectiveness and avoid accumulation of rodent baits in the environment, it is important to evaluate how long rodent baits maintain their palatability and efficacy. In rodent control programs, rodent baits are placed in locations such as sewers, but after a few days, baits appear altered, causing doubts about the control efficacy. For this reason, baits are replaced periodically, which increases costs and generation of chemical waste. The objective of this study was to evaluate the palatability and efficacy of commercial paraffin-type rodent bait blocks placed in sewers in São Paulo City over a period of 90 days. Bait blocks were placed in sewers and collected after 30, 60, and 90 days. Additionally, in a laboratory two-choice test, wild-caught urban Norway rats were offered 40-60 g of bait and an equal volume of standard rat pellets. The amount of bait and rat pellet consumed was registered, the palatability was calculated, and the efficacy was measured as the percentage mortality over 14 days. The results showed that, even when they had an altered appearance, bait blocks remained palatable to the rats and were effective after at least 90 days. Leaving bait blocks for longer periods could be an effective strategy for reducing costs and could help to ensure the control of urban rodents in an environmentally sustainable way.
Assuntos
Drenagem Sanitária , Controle de Roedores/métodos , Animais , Anticoagulantes , Brasil , Meio Ambiente , Masculino , Ratos , Rodenticidas/análiseRESUMO
Leptospirosis is a re-emergent worldwide zoonosis. It is endemic in Martinique where transmission conditions are favourable. Humans are usually infected through contact with water contaminated with urine of rodents. Recent human leptospirosis outbreaks in Martinique require today effective rodent management to prevent leptospirosis transmission. Nowadays, use of anticoagulant rodenticides (AR) is the main method implemented to control rodent populations. Nevertheless, intensive use of these AR has selected worldwide many VKORC1-based resistant rodent strains to AR. Our aim was to characterize the sensitivity of Martinique commensal rodents to AR to better prevent leptospirosis transmission. Resistance of house mice to first-generation and in rare cases even to second-generation ARs were clearly demonstrated in Martinique with the detection of the Y139C mutation with a very high allelic frequency of 40% and the A26T/Y139C double-mutation with an allelic frequency of 0.9%. In black rat, the most prevalent rodent in Martinique, 3 new Vkorc1 coding mutations were detected, the H68N, A115T and S149N mutations associated with moderate resistance to first generation AR. Therefore, rodent management in Martinique must be carried carefully to avoid resistance diffusion and maintain long-term effective rodent management, to be able to efficiently prevent leptospirosis transmission.
Assuntos
Anticoagulantes/farmacologia , Resistência a Medicamentos , Leptospirose/epidemiologia , Leptospirose/microbiologia , Controle de Roedores , Rodenticidas/farmacologia , Alelos , Animais , Resistência a Medicamentos/genética , Frequência do Gene , Genótipo , Geografia , Humanos , Leptospirose/transmissão , Fígado/efeitos dos fármacos , Martinica/epidemiologia , Mutação , Vigilância em Saúde Pública , Controle de Roedores/métodos , Roedores , Vitamina K Epóxido Redutases/genéticaRESUMO
Introducción. Los superwarfarinicos (SWF) son una de las herramientas utilizadas por el ser humano para el control de roedores y a la vez son tóxicos para el hombre y pueden conducir a la muerte sin los debidos cuidados en su uso.Casos clinicos. Tres pacientes masculinos, que consultaron por sangrados (gingivorragia, epistaxis, hematuria, hemartrosis y hematomas cutaneos) asociados a alteraciones del coagulograma (Tiempo de protrombina (TP) y tiempo de tromboplastina parcial (KPTT) prolongados). Todos tuvieron exposición a superwarfarinicos. Nuestro servicio no dispone del análisis de SWF en suero. Se administró vitamina K1 en los tres pacientes y plasma fresco congelado (PFC) en uno solo (sangrado mayor: hematuria). El seguimiento se realizó mediante controles seriados de coagulograma y su evolución fue favorable. Discusión. En todos los casos, el diagnóstico de intoxicación por SWF fue clínico, basado en caracteristicas clínicas de pacientes y alteraciones en sus parámetros de coagulación, y debido a imposibilidad de derivación de análisis a otro laboratorio. Se realizo tratamiento especifico (vitamina K1 y PFC) segun recomendación de expertos, ya que no hay hasta la fecha, estudios clinicos que evaluen las diferentes opciones terapéuticas. Conclusión. La intoxicación por SWF aunque no es frecuente, debe sospecharse en casos de paciente con coagulopatia sin otras causas que puedan justificarlo. El manejo del cuadro tóxico es la reposición de vitamina k y de plasma fresco congelado, en casos donde se necesite una rápida corrección de la alteración hemostática, como los sangrados mayores. Es imprescindible la oportuna consulta con médicos hematólogos y/o la consulta con un centro regional de control de intoxicaciones para todas las exposiciones sospechosas por SWF.
Introduction. Superwarfarinics (SWF) are one of the tools used by humans for rodent control. They are toxic to humans and can lead to death without due care in its use. Clinical cases. Three male patients, who consulted due to bleeding (gingivorragia, epistaxis, hematuria, hamartrosis and skin hematomas) associated with coagulogram alterations (prolonged protombine time (PT) and partial thromboplastin time (KPTT)). All them exposure to superwarfarinics. SWF serum analysis was not available in our hospital. Vitamin K1 was administered in all three patients and fresh frozen plasma (PFC) in only one (major bleeding: hematuria). The followup was performed by serial coagulogram controls and the evolution was. Discussion. In all cases, the diagnosis of SWF intoxication was clinical, based on clinical characteristics of patients and alterations in their coagulation parameters, due to the impossibility of deriving the analysis of SWF in serum to another laboratory. Specific treatment was carried out (vitamin k and PFC) according to experts' recommendation, since there are no clinical studies to evaluate the different therapeutic options to date. Conclusion. SWF poisoning, although not frequent, should be suspected in patients with coagulopathy without other causes that may justify it. The management of toxic symptoms is the administration of vitamin K1 and fresh frozen plasma, in cases where a rapid correction of the haemostatic alteration is required, such as major bleedings. It is essential to consult with hematologists and / or consult a regional poison control center for all suspicious exposures by superwarfarins.
Assuntos
Humanos , Masculino , Adulto , Rodenticidas/intoxicação , Rodenticidas/toxicidade , Vitamina K/uso terapêutico , Argentina , Sangramento por Deficiência de Vitamina KRESUMO
'Fake weed' containing rat poison raises alarm.
Assuntos
Canabinoides/efeitos adversos , Canabinoides/síntese química , Hemorragia/induzido quimicamente , Hemorragia/mortalidade , Drogas Ilícitas/efeitos adversos , Rodenticidas/efeitos adversos , Medicamentos Sintéticos/efeitos adversos , HumanosRESUMO
Background: Aluminum and zinc phosphides are solid fumigants for pest control. Metal phosphide poisoning (PP) is common in suicide and suicide attempts. In Mexico, zinc phosphide is easily available, and is a common agent in poisonings. Objective: To identify mortality in PP, and associated factors in a poison control center. Material and methods: Prospective cohort study. The starting point was the exposure (PP) and it was made a follow-up on the outcome (mortality and non-mortality). Main factors associated to PP outcome were assessed (e.g.: personal and clinical factors, duration of poisoning, detoxification, and radiographic evidence of poisoning). It was used relative risk (RR) as a risk estimator with 95% CI, as well as chi-squared with Fisher's exact test, Kaplan-Meier survival curves, and Log- Rank test as a comparative mean. Results: 44 exposed patients, and 88 non-exposed were followed up. Mortality rate in PP was of 16% in acute phase patients; there were no deaths in either subacute or chronic phases. Mortality risk was 14 (95% CI, 2 110). Main factors associated with increased mortality were: time of first medical assistance > 6 hours, RR = 15 (95% CI, 1.7-128); dose of poison ≥ 1 bottle or 1 tablet, RR = 14 (95% CI, 1.8-108); radiographic evidence of poisoning, RR = 10 (95% CI, 1.3 77). Conclusion: Metal PP has a high mortality rate and is associated to long periods of exposure to the toxic chemical due to ineffective detoxification.
Introducción: los fosfuros de aluminio y zinc son fumigantes sólidos para controlar plagas. La intoxicación por fosfuros (IpF) es un método común en suicidios o intentos de suicidio. En México los fosfuros son de fácil distribución y son un agente común en las intoxicaciones. Objetivo: identificar la mortalidad en la IpF y los factores asociados en un centro de toxicología. Material y métodos: estudio de cohorte prospectiva. Se partió de la exposición (IpF) y se siguió el desenlace (mortalidad y no mortalidad). Se evaluaron los principales factores asociados al desenlace de IpF (por ejemplo: clínicos, personales, tiempo de la intoxicación, descontaminación y evidencia radiográfica). Para estimar el riesgo se empleó el riesgo relativo (RR), con IC al 95%, chi cuadrada con prueba exacta de Fisher, curvas de supervivencia de Kaplan-Meier y su comparación por medio de Log-Rank. Resultados: se siguieron 44 pacientes expuestos y 88 no expuestos. La mortalidad por fosfuros fue del 16% de los pacientes intoxicados en la fase aguda; no hubo mortalidad en la fase subaguda y crónica. El riesgo de mortalidad fue de 14 (IC 95%: 2-110). Los factores de mayor magnitud asociados a la mortalidad en la IpF fueron: tiempo de primera atención > 6 horas, RR = 15 (IC 95% 1.7 128); dosis del tóxico ≥ 1 frasco o 1 pastilla, RR = 14 (IC 95%: 1.8 108); evidencia radiográfica del tóxico RR = 10, (IC 95%: 1.3 77). Conclusiones: la intoxicación por fosfuros metálicos tiene alta mortalidad y está asociada a estados prolongados de exposición al tóxico por descontaminación inadecuada.
Assuntos
Compostos de Alumínio/intoxicação , Praguicidas/intoxicação , Fosfinas/intoxicação , Rodenticidas/intoxicação , Compostos de Zinco/intoxicação , Doença Aguda , Adolescente , Adulto , Idoso , Criança , Doença Crônica , Intervalos de Confiança , Exposição Ambiental/efeitos adversos , Feminino , Humanos , Estimativa de Kaplan-Meier , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Intoxicação/diagnóstico por imagem , Intoxicação/mortalidade , Estudos Prospectivos , Risco , Fatores de Tempo , Adulto JovemRESUMO
A vigilância de pessoas expostas a riscos ambientais integra as ações de Vigilância em Saúde, e são coordenadas com as demais ações e serviços desenvolvidos e ofertados no Sistema Único de Saúde (SUS), para garantir a integralidade da atenção à saúde da população. Devido a especificidades próprias e para maior efetividade de ações relacionadas, foi normatizado em 2005 o Subsistema Nacional de Vigilância em Saúde Ambiental. Posteriormente, foi desenvolvido o programa de Vigilância em Saúde de Populações Expostas a Agrotóxicos (VSPEA), responsável pela execução de ações de saúde integradas, compreendendo promoção à saúde, vigilância, prevenção e controle de agravos e doenças decorrentes da intoxicação exógena por agrotóxicos...(AU)