Poisoning by non-edible squash: retrospective series of 353 patients from French Poison Control Centers

CONTEXT: Among the numerous varieties of squash that exist, some are edible while other bitter-tasting ones are not fit for human consumption. Cases of confusion seem to be multiplying and are characterized by digestive problems (diarrhea, vomiting, and abdominal pain). METHODS: This is a descriptive retrospective study of cases of exposure reported to French Poison Control Centers between 1 January 2012 and 12 December 2016. RESULTS: 353 patients were included, with 71.7% belonging to collective cases of poisoning. The male to female sex ratio was 0.75 for an average age of 38.2 ± 23.6 years. The circumstances of exposure were dietary for 337 patients (95.5%). The majority of the squash consumed was purchased at a store (55.8%) but some also came from the garden (25.5%). 204 patients (57.8%) mostly presented with diarrhea, vomiting, abdominal pain, sometimes with the consequent dehydration, hypotension, tachycardia, headaches, or vertigo. There were no deaths or severe (Poisoning Severity Score (PSS) 3) cases, but there were 14 patients (4.0%) of moderate severity, 190 patients (53.8%) of minor severity (PSS 1), and 149 patients (42.2%) without severity (PSS 0) but among which we include the bitter taste of the squash. The average age of PSS 2 patients was significantly (p = .003) older than that of the PSS <2 patients. CONCLUSION: As the first consequential series in Europe, our study shows that exposure to non-edible squash is frequent. Usually benign, poisoning could be the consequence of the irritating effect of certain cucurbits, the molecules responsible for the taste and toxicity of the fruits. In terms of prevention therefore, we recommend disposing of any squash with a bitter taste

Male gonadal dose of ionizing radiation delivered during X-ray examinations and monthly probability of pregnancy: a population-based retrospective study

BACKGROUND: Male gonadal exposure to ionizing radiation may disrupt spermatogenesis, but its influence on the fecundity of couples has been rarely studied. We aimed to characterize the influence of male gonadal dose of ionizing radiation delivered during radiodiagnostic on the monthly probability of pregnancy. METHODS: We recruited a random sample of women who retrospectively described 1110 periods of unprotected intercourse beginning between 1985 and 1999 and leading either to a live birth or to no pregnancy; their duration was censored after 13 months. The male partner answered a telephone questionnaire on radiodiagnostic examinations. We assigned a mean gonadal dose to each type of radiodiagnostic examination. We defined male dose for each period of unprotected intercourse as the sum of the gonadal doses of the X-ray examinations experienced between 18 years of age and the date of discontinuation of contraception. Time to pregnancy was analysed using a discrete Cox model with random effect allowing to estimate hazard ratios of pregnancy. RESULTS: After adjustment for female factors likely to influence fecundity, there was no evidence of an association between male dose and the probability of pregnancy (test of homogeneity, p = 0.55). When compared to couples with a male gonadal dose between 0.01 and 0.20 milligrays (n = 321 periods of unprotected intercourse), couples with a gonadal dose above 10 milligrays had a hazard ratio of pregnancy of 1.44 (95% confidence interval, 0.73–2.86, n = 31). CONCLUSION: Our study provides no evidence of a long-term detrimental effect of male gonadal dose of ionizing radiation delivered during radiodiagnostic on the monthly probability of pregnancy during the year following discontinuation of contraceptive use. Classification errors due to the retrospective assessment of male gonadal exposure may have limited the statistical power of our study

French population exposure to ionizing radiation from diagnostic medical procedures in 2007

International audienceThe objective of this study was to update the 2002 data on medical exposure of the French population to ionizing radiation. It is based on 2007 data and only includes exposures from diagnostic procedures conventional radiology, computed tomography, nuclear medicine, and diagnostic interventional radiology. Relevant data concerning the nature and frequencies of the examinations were obtained from two main sources the national health insurance data for private practice and representative surveys in public hospitals for public practice. An "average" effective dose was assessed for each type of examination using principally dosimetric data collected to update the French diagnostic reference levels and professional guidance. The results showed that 74.6 million examinations were performed in 2007, leading to an average effective dose per inhabitant equal to 1.3 mSv per year. Conventional radiology and CT represented 63% and 10.1% of the examinations and 26.1% and 58.0% of the effective dose, respectively. The annual number of examinations per inhabitant was constant between 2002 and 2007 (about 1.2 examinations). However, the corresponding average effective dose per inhabitant increased by 57%, from 0.83 to 1.3 mSv per year. This increased dose was due mostly to a growing number of CT and nuclear medicine examinations. As recommended by the European Commission, studies should be conducted every 5 y to survey the evolution of medical exposure of the French population. Furthermore, specific studies should be conducted to evaluate whether this estimated increase in dose delivered for diagnostics is related to an increase in the medical benefit. Copyright © 2012 Health Physics Society

Pinnatoxines : Évaluation des risques et toxicovigilance

International audienc

Retrospective poisons centres-based study on adverse effects due to plant food supplements

Objective: Plant Food Supplements (PFS) are products of increasing popularity and widespread distribution. Nevertheless, information about their risks and bene ts is limited. To fill this gap, the PlantLIBRA project - a part of the EU\u2019s Seventh-Framework- Programme - was started. Within this project, a poisons centre- based study on the risks of PFS was performed. Methods: Through a systematic multicenter retrospective review of data from selected European and brazilian poisons centres (PCs), documented human cases of adverse effects or poisoning due to plants consumed as food or ingredients of food supplements or due to misidenti ed poisonous plants consumed as food were collected for the period 2006\u20132010. Results: From the 66 contacted PCs, 11 were able to provide a total of 153 cases: 76 cases of adverse effects after intentional ingestion, 76 cases of poisoning due to misidenti cation, and one case of interaction between a PFS and a pharmaceutical. A total of 249 plants and plant-related substances (e.g. caffeine, naringin, olive oil) were involved. The 10 most frequently reported plants were Mandragora offcinarum, Valeriana offcinalis, Aesculus hippocastanum, Colchicum autumnale, Camellia sinensis, Melissa offcinalis, Passifora incarnata, Paullinia cupana, and Mentha piperita. Most cases occurred in adults (91%). The plants most frequently involved in the 76 cases of adverse effects due to intentional ingestion were Valeriana offcinalis and Camellia sinensis. Irritation of skin or mucosa, gastro-intestinal symptoms, signs of neurotoxicity (e.g. dizziness, somnolence, restlessness), and hepatotoxicity were the most frequently observed clinical events. Most cases showed a benign clinical course, however, a severe outcome was recorded in 5 cases. In the 76 cases of misidentifcation only 6 different identi ed plants were recorded: Mandragora offcinarum, Aesculus hippocastanum, Colchicum autumnale, Digitalis sp./D. purpurea, Allium ursinum, Datura stramonium. Severe symptoms were only observed with Colchicum autumnale (multi-organ failure) and Mandragora of cinarum (anticholinergic syndrome). In the remaining cases, mostly mild gastro-intestinal symptoms were recorded. Conclusion: PFS-related adverse effects seem to be relatively infrequent issues for PCs. Most cases showed mild symptoms and a benign clinical course. Nevertheless, the occurrence of some severe adverse effects and the increasing popularity of PFS require continuous active surveillance, and further research is warranted