Pulmonary involvement from animal toxins: the cellular mechanisms

Abstract Venomous animals and their venom have always been of human interest because, despite species differences, coevolution has made them capable of targeting key physiological components of our bodies. Respiratory failure from lung injury is one of the serious consequences of envenomation, and the underlying mechanisms are rarely discussed. This review aims to demonstrate how toxins affect the pulmonary system through various biological pathways. Herein, we propose the common underlying cellular mechanisms of toxin-induced lung injury: interference with normal cell function and integrity, disruption of normal vascular function, and provocation of excessive inflammation. Viperid snakebites are the leading cause of envenomation-induced lung injury, followed by other terrestrial venomous animals such as scorpions, spiders, and centipedes. Marine species, particularly jellyfish, can also inflict such injury. Common pulmonary manifestations include pulmonary edema, pulmonary hemorrhage, and exudative infiltration. Severe envenomation can result in acute respiratory distress syndrome. Pulmonary involvement suggests severe envenomation, thus recognizing these mechanisms and manifestations can aid physicians in providing appropriate treatment

Suicidal attempts and self‐poisoning: 1‐year retrospective cohort study from the quaternary hospital in Thai metropolitan area

Abstract Background and Aims In Thailand, suicide is the leading cause of death among middle‐aged adults. We believe suicide characteristics depend on different cultural/socioeconomic status. This study aimed to describe the characteristics and associated factors of suicidal attempts by self‐poisoning in Bangkok, the metropolitan city of Thailand. Methods Records of all patients visiting the emergency department of King Chulalongkorn Memorial Hospital, Bangkok, Thailand, with self‐poisoning suicidal attempts throughout 2021 were collected and analyzed. Results Self‐poisoning accounted for 110 attempts (by 74 patients). Females aged 11–30 were the most prevalent group. Pharmaceutical agents were commonly used. Most patients (86.4%) had underlying psychiatric illness(es), mostly major depressive disorder. Female, history of psychiatric illness and follow‐ups, personality comorbid, and previous attempts reached statistical significance by univariate regression for factors associated with reattempting suicide, but only personality comorbid was significant from multivariable study (p = 0.02). Reattempting mostly recurred within 8 days after the prior attempt. Conclusion Majority of self‐poisoned patients in Bangkok were young adults taking medications, which differs from the overall Thai population where most instances involve patients of older patients (30–50 years) and ingestion of agricultural substances. Appropriate strategies are needed for specific psychosocial/socioeconomic contexts and within the critical period after previous nonfatal attempts

Cannabis and adverse cardiovascular events: A systematic review and meta-analysis of observational studies

Background: Cannabis is the most used illicit drug in the world. Global trends of decriminalization and legalization of cannabis lead to various forms of cannabis use and bring great concerns over adverse events, particularly in the cardiovascular (CV) system. To date, the association between cannabis and adverse CV events is still controversial. Purpose: We aim to conduct a systematic review and meta-analysis to assess the adverse CV events from cannabis use. Patients and methods: A systematic search for publications describing the adverse CV events of cannabis use, including acute myocardial infarction (MI) and stroke, was performed via PubMed, Scopus, and Cochrane Library databases. Data on effect estimates in individual studies were extracted and combined via random-effects meta-analysis using the DerSimonian and Laird method, a generic inverse-variance strategy. Results: Twenty studies with a total of 183,410,651 patients were included. The proportion of males was 23.7%. The median age and follow-up time were 42.4 years old (IQR: 37.4, 50.0) and 6.2 years (IQR: 1.7, 27.7), respectively. The prevalence of cannabis use was 1.9%. Cannabis use was not significantly associated with acute MI (pooled odds ratio (OR): 1.29; 95%CI: 0.80, 2.08), stroke (pooled OR 1.35; 95%CI: 0.74, 2.47), and adverse CV events (pooled OR: 1.47; 95%CI: 0.98, 2.20). Conclusion: The risk of adverse CV events including acute MI and stroke does not exhibit a significant increase with cannabis exposure. However, caution should be exercised when interpreting the findings due to the heterogeneity of the studies