Fatal Methanol Ingestion in a Child: Case Report

The records of Forensic Medicine Council of Turkey Bursa Morgue Department reveal the first case of fatal methanol ingestion in a child. Household methanol exposures are mostly due to accidental ingestion of washing fluids. A 4 year-old girl was admitted to the emergency department with her parents with gastrointestinal symptoms; nausea, vomiting and abdominal pain. Toxicological studies revealed 79 mg/dl blood level of methanol. We presented infant autopsy case of methanol toxicity and discussed the case from medicolegal aspect

Linkage of national soil quality measurements to primary care medical records in England and Wales: a new resource for investigating environmental impacts on human health

Background: Long-term, low-level exposure to toxic elements in soil may be harmful to human health but large longitudinal cohort studies with sufficient follow-up time to study these effects are cost-prohibitive and impractical. Linkage of routinely collected medical outcome data to systematic surveys of soil quality may offer a viable alternative. Methods: We used the Geochemical Baseline Survey of the Environment (G-BASE), a systematic X-ray fluorescence survey of soil inorganic chemistry throughout England and Wales to obtain estimates of the concentrations of 15 elements in the soil contained within each English and Welsh postcode area. We linked these data to the residential postcodes of individuals enrolled in The Health Improvement Network (THIN), a large database of UK primary care medical records, to provide estimates of exposure. Observed exposure levels among the THIN population were compared with expectations based on UK population estimates to assess representativeness. Results: 377 of 395 English and Welsh THIN practices agreed to participate in the linkage, providing complete residential soil metal estimates for 6,243,363 individuals (92% of all current and former patients) with a mean period of prospective computerised medical data collection (follow-up) of 6.75 years. Overall agreement between the THIN population and expectations was excellent; however, the number of participating practices in the Yorkshire & Humber strategic health authority was low, leading to restricted ranges of measurements for some elements relative to the known variations in geochemical concentrations in this area. Conclusions: The linked database provides unprecedented population size and statistical power to study the effects of elements in soil on human health. With appropriate adjustment, results should be generalizable to and representative of the wider English and Welsh population

Acid-Base Disorders in ICU Patients

Metabolic acid-base disorders are comnom clinical problems in ICU patients. Arterial blood gas analysis and anion gap (AG) are important laboratory data in approaching acid-base interpretation. When measuring the AG, several factors such as albumin have influence on unmeasured anions and unmeasured cations. If a patient has hypoalbuminemia, the AG should be adjusted according to the albumin level. High AG metabolic acidoses including lactic acidosis, ketoacidosis, and ingestion of toxic alcohols are common in ICU patients. The treatment target of lactic acidosis and ketoacidosis is not the acidosis, but the underlying condition causing acidosis. Gastric acid loss, diuretics, volume depletion, renal compensation for respiratory acidosis, hypokalemia, and mineralocorticoid excess are common causes of metaboic alkalosis. In chloride responsive metaboic alkalosis, volume and potassium repletion are mandatory

Test purchase, synthesis and characterization of 3-fluorophenmetrazine (3-FPM) and differentiation from its ortho- and para-substituted isomers.

The knowledge captured in patent and scientific research literature stimulates new ideas and fosters new drug development efforts. Manufacturers and entrepreneurs dedicated to the sale of 'research chemicals' and/or new psychoactive substances (NPS) also make use of access to information to identify, prepare, and launch a range of new substances. One of the most recent compounds to appear on the NPS market is the phenmetrazine analog 3-fluorophenmetrazine (3-FPM) which represents one of many phenylmorpholines designed to explore treatment options in areas such as obesity and drug dependence. The anorectic drug analogs phenmetrazine and phendimetrazine, used as prescription medicines before they were withdrawn, feature amphetamine-like properties associated with monoamine release. Available data on 3-FPM suggest that the effects might show mechanistic overlaps. This study describes the synthesis and extensive analytical characterization of 3-FPM and its differentiation from synthesized ortho- and para- substituted isomers, 2-FPM and 4-FPM, respectively. This study was triggered by the purchase of five powdered samples advertised as 3-FPM by five different Internet vendors based in the United Kingdom. The analytical data obtained for the vendor samples were consistent with the synthesized 3-FPM standard and differentiation between all three isomers was possible. The presence of positional isomers and the absence of suitable reference material can cause difficulties in the day-to-day operation of forensic work and given the rate at which many of the newly emerging NPS appear on the market, a comprehensive approach is needed when attempting to decipher the identity of NPS arriving onto the drug market. Copyright © 2016 John Wiley & Sons, Ltd

Insights into the different effects of food on intestinal secretion using magnetic resonance imaging

Background Ileostomy output determines need for parenteral fluid support. Plant foods may contain chemicals that stimulate intestinal secretion eg. lactucins in lettuce and rhein in rhubarb. These may account for increases in ileostomy output but experimental demonstration of this is burdensome for patients. Objective Determine the effect of different foods on intestinal water content in healthy volunteers using Magnetic Resonance Imaging (MRI). Design Crossover trial of three isocaloric meals in healthy adults. Subjects underwent MRI scans fasting and hourly to 180min postprandial. Meals: 2 slices white bread with 10g butter; 300g rhubarb with 60mL lactose-free cream; 300g lettuce with 30mL mayonnaise. Visits one week apart. Primary outcome: small bowel water content (SBWC) using MRI. Secondary outcomes: ascending colon water content; T1 relaxation time of ascending colon (T1AC); gastric volume; visual analogue scales of bloating and satiety (0-100) scored half-hourly. Results 15 subjects completed the study. 9 female, 6 male, median age 21(IQR 20, 22). Bread induced a fall in SBWC compared to a rise after lettuce and greater rise after rhubarb, with significant differences in the area under the curve (0- 3 hours) of the change from baseline (Prhubarb >bread. Conclusion Lettuce and rhubarb meals increased intestinal water content, demonstrating how different foods can alter small bowel secretion. MRI can be used to evaluate the effects of diet, enteral feed and pharmaceuticals on intestinal content and function

Isolation and identification of cobalt- and caesium-resistant bacteria from a nuclear fuel storage pond

One of the issues facing the nuclear power industry is how to store spent nuclear fuel which is contaminated with radionuclides produced during nuclear fission, including caesium ((134)Cs(+), (135)Cs(+) and (137)Cs(+)) and cobalt ((60)Co(2+)). In this study, we have isolated Co(2+)- and Cs(+)-resistant bacteria from water collected from a nuclear fuel storage pond. The most resistant Cs(+) and Co(2+) isolates grew in the presence of 500 mM CsCl and 3 mM CoCl2. Strain Cs67-2 is resistant to fourfold more Cs(+) than Cupriavidus metallidurans str. CH34 making it the most Cs(+)-resistant strain identified to date. The Cs(+)-resistant isolates were closely related to bacteria in the Serratia and Yersinia genera, while the Co(2+)-resistant isolates were closely related to the Curvibacter and Tardiphaga genera. These new isolates could be used for bioremediation

Severe and protracted cholestasis in 44 young men taking bodybuilding supplements: assessment of genetic, clinical and chemical risk factors

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149370/1/apt15211_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149370/2/apt15211.pd

Uncoventional Views on Certain Aspects of Toxin-Induced Metabolic Acidosis

This discussion will highlight the following 9 specific points that related to metabolic acidosis caused by various toxins. The current recommendation suggests that alcohol dehydrogenase inhibitor fomepizole is preferred to ethanol in treatment of methanol and ethylene glycol poisoning, but analysis of the enzyme kinetics indicates that ethanol is a better alternative. In the presence of a modest increase in serum osmolal gap (<30 mOsm/L), the starting dose of ethanol should be far less than the usual recommended dose. One can take advantage of the high vapor pressure of methanol in the treatment of methanol poisoning when hemodialysis is not readily available. Profuse sweating with increased water ingestion can be highly effective in reducing methanol levels. Impaired production of ammonia by the proximal tubule of the kidney plays a major role in the development of metabolic acidosis in pyroglutamic acidosis. Glycine, not oxalate, is the main final end product of ethylene glycol metabolism. Metabolism of ethylene glycol to oxalate, albeit important clinically, represents less than 1% of ethylene glycol disposal. Urine osmolal gap would be useful in the diagnosis of ethylene glycol poisoning, but not in methanol poisoning. Hemodialysis is important in the treatment of methanol poisoning and ethylene glycol poisoning with renal impairment, with or without fomepizole or ethanol treatment. Severe leucocytosis is a highly sensitive indicator of ethylene glycol poisoning. Uncoupling of oxidative phosphorylation by salicylate can explain most of the manifestations of salicylate poisoning

O fra Bernardinu Splićaninu, priređivaču prvog izdanja hrvatskog lekcionara, ponovo!

The use of miniaturised isotachophoresis to allow the simultaneous determination of two inorganic selenium species has been investigated using a poly(methyl methacrylate) chip with a 44-mm-long, 200-μm-wide, 300-μm-deep separation channel. The miniaturised device included an integrated on-column, dual-electrode conductivity detector and was used in conjunction with a hydrodynamic fluid transport system. A simple electrolyte system has been developed which allowed the separation of selenium(IV) and selenium(VI) species to be made in under 210 s. The limits of detection were calculated to be 0.52 mg L−1 for selenium(IV) and 0.65 mg L−1 for selenium(VI). The method allowed the separation of the selenium species from a range of common anions including fluoride, nitrate, nitrite, phosphate, sulfate and sulfite