"chumbinho" Poisoning: Challenge To Clinical Diagnosis And Treatment [intoxicação Por "chumbinho": Um Desafio Para O Diagnóstico Clínico E Para O Tratamento]

"Chumbinho" is a popular name of a granular pesticide registered for agriculture use, which has been illegally commercialized as a household rodenticide in Brazil and is responsible for many poisonings cases, specially related to adults in suicide attempts. Carbamates and organophosphates, both cholinesterase inhibitor insecticides, are the main constituents of this product, specially aldicarb, carbofuran and phorate. By toxicological point of view, there are small variations in clinical presentation, but significant differences in treatment of these insecticides, that is extremely concerning, mainly in terms of incidental cases, where the differentiation of carbamate from organophosphorate poisoning is impractical. It becomes a real challenge in the case of "chumbinho" because, most of the time, the active ingredient in the formulation is not known. The purpose of this study was to realize an actual and critical approach about the clandestine use of "chumbinho", including description of epidemiological data, clinical diagnosis aspects and types of treatment considered suitable in these poisonings.1727178Alonzo, H.G.A., Corrêa, C.L., Praguicidas (2003) Fundamentos de Toxicologia, pp. 437-458. , OGA, S. São Paulo: Atheneu(2004) Aldicarb, , http://www4.anvisa.gov.br/AGROSIA/asp/frm_dados_ingrediente.asp?iVarAux= 1&CodIng=17, SIA - Sistema de Informação sobre Agrotóxicos(2002) Carbofurano, , http://www4.anvisa.gov.br/AGROSIA/asp/frm_dados_ingrediente.asp?iVarAux= 1&CodIng=75, SIA - Sistema de Informação sobre Agrotóxicos(2002) Forato, , http://www4.anvisa.gov.br/AGROSIA/asp/frm_dados_ingrediente.asp?iVarAux= 1&CodIng=316, SIA - Sistema de Informação sobre AgrotóxicosBittencourt, J.E.A., Carrazza, M.Z.N., Milano, S.O., Rebaixamento da atividade da colinesterase plasmática e presença de aldicarb no sangue de pacientes agudamente intoxicados por "chumbinho" (2003) Rev. Bras. Toxicol., 16 (1 SUPPL.), p. 166Burgess, J.L., Bernstein, J.N., Hurlbut, K., Aldicarb poisoning. A case report with prolonged cholinester inhibition and improvement after pralidoxime therapy (1994) Arch. Intern. Med., 154 (2), pp. 221-224Clark, R.F., Insecticides: Organic phosphorus compounds and carbamates (2002) Goldfrank's Toxicology Emergencies, pp. 1346-1365. , GOLDFRANK, L.R. ed. New York: McGraw-HillEcobichon, D.J., Carbamate insecticides (2001) Handbook of Pesticide Toxicology: Agents, pp. 1087-1106. , KRIEGER, R. I. ed. London: Academic PressFruchtengarten, L.V.G., Graff, S.E., Ferreira, M.G., Duarte, J.G., Fonseca, P., Alves, F.G., Avaliação clínica e epidemiológica de 561 casos de intoxicações agudas pelo raticida "chumbinho" (1999) Rev. Bras. Toxicol., 12 (2 SUPPL.), p. 79Holstege, C.P., Baer, A.B., Insecticides (2004) Curr. Treat. Options Neurol., 6 (1), pp. 17-23Itho, S.F., (2001) Intoxicações pelo "Chumbinho" (Aldicarb) no Espírito Santo - Brasil: Freqüência, Perfil Epidemiológico e Clínico e Propostas de um Protocolo Padronizado de Evolução Clínica e Tratamento Atropínico, , São Paulo. [Tese de doutorado - Faculdade de Ciências Farmacêuticas da USP]Itho, S.F., Silva, J.A., Naseri, A.P., Silva, T.M.D., Vicente, G.S., Intoxicação por chumbinho: Pode-se correlacionar a gravidade do quadro clínico e o quantitativo de atropina necessária? (2003) Rev. Bras. Toxicol., 16 (1 SUPPL.), p. 161Jeyaratnam, J., Maroni, M., Organophosphorous compounds (1994) Toxicology, 91, pp. 15-27Kurtz, P.H., Pralidoxime in the treatment of carbamate intoxication (1990) Am. J. Emerg. Med., 8 (1), pp. 68-70Leitão, R.C.N., Carvalho, T.M.J.P., Análise das intoxicações agudas por praguicidas atendidas pelo CEATOX-CE nos anos de 1997/1998 (1999) Rev. Bras. Toxicol., 16 (2 SUPPL.), p. 68Lieske, C.N., Clark, J.H., Maxwell, D.M., Zoeffel, L.D., Sultan, W.E., Studies of the amplification of carbaryl toxicity by various oximes (1992) Toxicol. Lett., 62 (2-3), pp. 127-137Lifshitz, M., Rotenberg, M., Sofer, S., Tamiri, T., Shahak, E., Almong, S., Carbamate poisoning and oxime treatment in children: A clinical and laboratory study (1994) Pediatrics, 93 (4), pp. 652-655Lefshitz, M., Shahak, E., Bolotin, A., Sofer, S., Carbamate and organophosphate poisoning in young childen (1999) Pediatr. Emerg. Care, 12 (2), pp. 102-103Lifshitz, M., Shahak, E., Bolotin, A., Sofer, S., Carbamate poisoning in early chilhood and in adults (1997) J. Toxicol. Clin. Toxicol., 35 (1), pp. 25-27Lima, J.S., Reis, C.A.G., Poisoning Due to Ilegal Use of Carbamates as a Rodenticide in Rio de Janeiro (1995) Clin. Toxicol., 33 (6), pp. 687-690Lotti, M., Clinical toxicology of anticholinesterase agents in humans (2001) Handbook of Pesticide Toxicology: Agents, pp. 1043-1086. , KRIEGER, R. I. ed. London: Academic PressMachemer, L.H., Pickel, M., Carbamate insecticides (1994) Toxicology, 91, pp. 29-36Magalhães, A.F.A., Pardal, P.P.O., Vieira, J.L., Ribeiro, M.B., Yamano, E.Y.S., Miranda, A.S.P., Uso carbamato "chumbinho" por via vaginal na tentativa de abortamento: Relato de um caso clínico (2000) Rev. Para. Med., 14 (1), pp. 77-79Martins, I.O., (2001) Intoxicação Aguda por Chumbinho no Rio de Janeiro: Achados Epidemiológicos, Clínicos e Análise Química, , Rio de Janeiro. [Tese de doutorado - Departamento de Farmacologia Básica e Clínica da UFRJ]Martins, I.O., Caldas, L.Q.A., Riqueta, D.S., Intoxicações por chumbinho: Epidemiologia e aspectos clínicos (2000) Rev. Bras. Toxicol., 13 (1 SUPPL.), p. 122Martins, I.O., Caldas, L.Q.A., Santos, P.S., Baptista, R.S., Garcia, H., Repercussões clínicas das intoxicações exógenas por chumbinho (1999) Rev. Bras. Toxicol., 12 (2 SUPPL.), p. 62Moraes, A.C.L., (1999) Contribuição para o Estudo das Intoxicações por Carbamato: O Caso do Chumbinho no Rio de Janeiro, , Rio de Janeiro. [Dissertação de mestrado - Fundação Oswaldo Crus, Escola Nacional de Saúde Pública]Nelson, L.S., Perrone, J., Deroos, F., Stork, C., Hoffman, R.S., Aldicarb poisoning by an illicit rodenticide imported into the United States: Tres pasitos (2001) Clin. Toxicol., 39 (5), pp. 447-452Ragoucy-Sengler, C., Tracqui, A., Chavonnet, A., Daijardin, J.B., Simonetti, M., Kintz, P., Pileire, B., Aldicarb poisoning (2000) Hum. Exp. Toxicol., 19 (12), pp. 657-662Rodrigues, D.S., Rebouças, D.S., Barbosa, M.G.R., Santos, S.H.J., Jesus, E.C.G., Chumbinho - Intoxicações por raticida na Bahia no período 2000-2002 (2003) Rev. Bras. Toxicol., 16 (1 SUPPL.), p. 150Sakamoto, K.S., Sato, K.M., Kuntz, J., Eyng, C., Grando, M., Zannin, M., Intoxicações provocadas pelo "CHUMBINHO" utilizado como raticida: Registro de 18 anos no CIT/SC (2003) Rev. Bras. Toxicol., 16 (1 SUPPL.), p. 149Silva, A.C.B., Guerra, L.R., Konitz, W., Santos, R.E., Caldas, L.Q.A., Análise da qualidade do atendimento das intoxicações por "chumbinho" notificadas ao centro de controle de intoxicações da Universidade Federal Fluminense (2003) Rev. Bras. Toxicol., 16 (1 SUPPL.), p. 147Sofer, S., Tal, A., Shahak, E., Carbamate and organophosphate poisoning in early childhood (1989) Pediatr. Emerg. Care, 5 (4), pp. 222-225Stuetzer, G., Corrêa, E.A., O uso de raticidas ilegais (2003) Rev. Bras. Toxicol., 16 (1 SUPPL.), p. 260Trevisan, L.R.P., Baptista, G.C., (2004) Caracterização Positiva/Negativa de Aldicarb em Amostra de Raticida, , Piracicaba: ESALQ/USP. InéditoWagner, S.L., Diagnosis and treatment of organophosphate and carbamate intoxication (1997) Occup. Med., 12 (2), pp. 239-249Zwiener, R.J., Ginsburg, C.M., Organophosphate and carbamate poisoning in infants and children (1988) Pediatrics, 81 (1), pp. 121-12

Reduction, Refinement And Replacement Of Animal Use In Toxicity Testing: An Overview [redução, Refinamento E Substituição Do Uso De Animais Em Estudos Toxicológicos: Uma Abordagem Atual]

Toxicity assessment is the process of predicting the adverse effects that may be caused to an organism by exposuring it to a given chemical and, for regulation purposes, the most used model in toxicity testing is the animal. However, in today's society the use of animals has become a subject of much public health due to the large number of animals used as well as the pain and distress caused, mainly related to acute toxicity testing. The concept of the "Three Rs" - reduction, refinement, and replacement of animal use - emerged as a mean of removing inhumanity from animal experimentation and aiming to lower the number of animals used, in order to decrease the incidence or severity of inhumane procedures and to find alternative procedures to replace in vivo testing. Many alternative toxicological tests have already been implemented, even knowing that this process is very complex and need to be extensively validated and accepted by regulatory bodies. This paper presents an overview on several aspects of the "Three Rs", including historical evolution and implementation and validation of alternative methods, emphasizing its application on toxicity testing and in global harmonization.403289299Chronology (1997) Overview of the Issues, , http://www.hsus.org/ace/12443, [S.Is.n.], [entre]Balls, M., Replacement of animal procedures: Alternatives in research, education and testing (1994) Lab. Animals, 28, pp. 193-211Balls, M., Van Zeller, A.-M., Halder, M., (2000) Progress in the Reduction, Refinement and Replacement of Animal Experimentation, , Amsterdam: Elsevier. 1795 pBarros, S.B.M., Davino, S.C., Avaliação da toxicidade (2003) Fundamentos de Toxicologia. 2.Ed., 5, pp. 57-68. , Oga, S. São Paulo: Atheneu. cap. 1Botham, C., Holmes, P., Levy, L.S., Harrison, P.T.C., (2001) Prospects for the Use of Alternative Test Methods, , http://www.le.ac.uk/ieh/pdf/HoLfmal.pdf, Leicester: MRC Institute for Environment and HealthBotham, P.A., Acute systemic toxicity (2002) ILAR J., 43 (SUPPL.), pp. S27-S30Corrêa, C.L., Alonzo, H.G.A., Trevisan, R.M.S., Avaliação do risco (2003) Fundamentos de Toxicologia. 2. Ed., pp. 69-76. , Oga, S. São Paulo: Atheneu. cap. 1.6Dipasquale, L.C., Hayes, A.W., Acute toxicity and eye irritancy (2001) Principles and Methods of Toxicology. 4.Ed., pp. 853-916. , Hayes, A. W. London: Taylor & Francis. cap. 18Ecobichon, D.J., (1997) The Basis of Toxicity Testing. 2. Ed., , Boca Raton: CRC Press. 220 pThe SIS Databases Provide Factual Information on Alternative Methods to Animal Experiments at Any Stage of Development and Validation, , http://ecvam.jrc.cec.eu.int/index.htm, [S.1: s. n.], [200-?]Background to the three Rs declaration of Bologna, as adopted by the 3 rd World Congress on Alternatives and Animal Use in the Life Sciences, Bologna, Italy, on 31 August 1999 (2000) Progress in the Reduction, Refinement and Replacement of Animal Experimentation, pp. 17-22. , Balls, M.Van Zeller, A.-MHalder, M., eda. Amsterdam: ElsevierFesting, M.F.W., Reduction of animal use: Experimental design and quality of experiments (1994) Lab. Animals, 28, pp. 212-221Flecknell, P.A., Refinement of animal use - Assessment and alleviation of pain and distress (1994) Lab. Animals, 28, pp. 222-231(2003), http://www.hsus.org/ace/352, Washington: [s.n.](2001) Annual Progress Report, , http.//iccvam.niehs.nih.gov/about/annrpt/annrpt01.pdf, [S.1.]: National Institute of Health(1999) Evaluation of the Validation Status of Toxicological Methods: General Guidelines for Submissions to ICCVAM, , http://iccvam.niehs.nih.gov/docs/guidelines/subguide.htm, [S.1.]: National Institute of Health, rev. out. NIH Publication No. 99-4496(2003) The National Toxicology Program Interagency Center for the Evaluation of Alternative Toxicological Methods (NICEATM), , http://iccvam.niehs.nih.gov, S.1.: s.n(1997) Validation and Regulatory Acceptance of Toxicological Test Methods: A Report of the Ad Hoc Interagency Coordinating Committee on the Validation of Alternative Methods, , http://iccvam.niehs.nih.gov/docs/guidelines/validate.pdf, [S.1.]: National Institute of Health. Publication NIH No: 97-3981Koeter, H.B.W.M., (2003) Development, Implementation and Use of Alternative Test Methods in Regulatory Hazard Assessment in OECD Member Countries, , http.//europa.eu.int/comm/research/info/conferences/rrr/ppt/koeter.pdf, Environment, health and safety division, OECD. Formato PDF. 1 apresentação, Power PointKoeter, H.B., Test guideline development and animal welfare: Regulatory acceptance of in vitro studies (1993) Reprod. Toxicol., 7 (SUPPL. 1), pp. 117-123Matfield, M., (2003) Research Defence Society (RDS): Understanding Animal Research in Medicine, , http://www.rds-online.org.uk, London: [s.n.]Meyer, O., Testing and assessment strategies, including alternative and new approaches (2003) Toxicol. Letters, 140-141, pp. 21-30Olden, K., (2004), http://ntp-server.niehs.nih.gov/, S.1: s.n(2000) OECD Guideline for the Testing of Chemicals: Acute Oral Toxicity - Up-and-down Procedure, , http://www.oecd.org/home/, Paris: OECD. 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Washington: Humane Society Press. chapter 8Stitzel, K.A., Tiered testing strategies - Acute local toxicity (2001) ILAR J., 43 (SUPPL.), pp. S21-S26Stokes, W.S., Humane endpoint for laboratory animals used in regulatory testing (2002) ILAR J., 43 (SUPPL.), pp. S31-S38Three Rs declaration of Bologna (2000) Progress in the Reduction, Refinement and Replacement of Animal Expérimentation, p. 15. , Balls, M.Van Zeller, A.-MHalder, M., eds. Amsterdam: ElsevierWhite, W.J., The use of laboratory animals in toxicologic research (2001) Principles and Methods of Toxicology. 4.Ed., pp. 773-818. , Hayes, A. W. London: Taylor & Francis. cap. 16Worth, A.P., Balls, M., The principles of validation and the ECVAM validation process (2002) Altern. Lab. Anim., 2 (SUPPL.), pp. 15-21Zurlo, J., Rudacille, D., Goldberg, A.M., (2002) Animal and Alternatives in Testing: History, Science, and Ethics, , http://caat.jhsph.edu/pubs/animal_alts/animal_alts.htm, Larchmont: The Johns Hopkins Universit

Animal experimentation and scientific knowledge: a thought style?

Animal experimentation, besides a research method extensively applied in the production of scientific knowledge, is also considered essential to science and with undeniable historical relevance in advances in human health. In this survey, a questionnaire was applied to a group of researchers involved with research based on non-animal models (n =18), and to another group involved with research based on animal models (n =18). The data analysis was grounded in Ludwik Fleck (1896 -1961) epistemological assumptions. The results suggested that there are at least two thought styles operating in consonance on the same research problem (advances in human health conditions) with significantly different conceptions not only concerning the research practices involved, but also the historical conceptions related to the role of animal experimentation.<br>A experimentação animal, além de método amplamente aplicado na produção do conhecimento científico, é considerada como essencial à ciência e com valor histórico inegável no progresso das condições de saúde humana. Neste levantamento, um questionário foi aplicado a um grupo de pesquisadores com trabalhos baseados em modelos não-animais (n =18) e a outro grupo com trabalhos baseados em modelos animais (n =18). A análise de dados se baseou nos pressupostos epitemológicos de Ludwik Fleck (1896-1961). Os dados sugerem que existem pelo menos dois estilos de pensamento operando em consonância sobre o mesmo problema de pesquisa (avanços nas condições de saúde humana), com concepções significativamente diferentes sobre as práticas de pesquisa envolvidas, assim como as concepções históricas relacionadas ao papel da experimentação animal