Poisoning by castor beans

Ricin, otrov iz biljke Ricinus communis, naročito sjemenki, vrlo je jak biljni otrov koji se po toksičnosti može mjeriti s toksičnošću difterije ili otrovom kobre. Autor opisuje 14 slučajeva otrovanja liječenih bolnički ili ambulantno. Liječeno je 7 odraslih osoba koje su jele sjemenke smatrajući da imaju laksativno djelovanje i sedmero djece primamljene njegovim okusom. Nakon nekoliko sati dolazilo bi do čestog i obilatog povraćanja s vodenim proljevima i ponekad dehidracijom. Zapaženi su nadalje pad krvnog tlaka, leukocitoza s neutrofilijom i eozinolimfopenijom, eventualno uz lakše povišenje glukoze u krvi i uz EKG promjene s devalvacijom finalnih kompleksa. U jednom slučaju te su promjene evoluirale u daljnjem toku i trajale više od mjesec dana, a u drugome 8 dana. Terapija je bila simptomatska. Otrovanja biljnim otrovima, pa tako i ricinom, kod nas su zanemareno područje. Za prevenciju je od najveće važnosti zdravstveno prosvjećivanje, što pokazuje i autorovo iskustvo.Ricin, a phytotoxin from the beans of Ricinus comrnunis, belongs to the strongest plant toxins, its toxicity being similar to the toxin of diphtheria or to the cobra venom. In this country castor-oil plant is grown as a decorative plant. Seven adults who took castor beans as laxatives and seven children attracted by their good taste were poisoned and treated in hospital or in outpatient clinic. The symptoms of poisoning appeared a few hours after ingestion as profuse vomiting and watery diarrhoea sometimes leading to de-hydration. Arterial blood pressure dropped, leucocytosis with neutrophilia and cosinolymphopenia appeared, occasionally associated with a slight increase of blood glucose and ECG changes with a lowering of final complexes. In one case the ECG changes developed further and persisted for more than one month, and in another for eight days. The medical treatment was symptomatic. So far poisonings by plant toxins including ricin have not been receiving proper attention, although they may present an important problem to public health. The most efficient means of prevention is health education, as shown by the author\u27s own experience

Human immunodeficiency virus infection and intestinal tuberculosis: a case report

Opisujemo tridesetdvogodišnjeg bolesnika zaraženog HIV-om koji se razbolio pet mjeseci prije prijema u Kliniku s progresivnim mršavljenjem, febrilitetom i dijarejom. Zadnja 4 dana prije prijama osjetio je jače bolove u trbuhu. U času prijama u bolnicu bio je afebrilan, orijentiran, usporen, blijed, afoničan, klonuo, kahektičan i nepokretan. Abdomen je bio mekan, difuzno lagano osjetljiv na palpaciju. Opće stanje je bilo teže poremećeno. Na rendgenogramu pluća bila su obostrano prisutna inhomogena zasjenjenja. Postupno se razvijao akutni abdomen te je bolesnik operiran, nađeno je više perforacija na tankom i debelom crijevu, uz sterkoralni peritonitis. Učinjena je resekcija dijela terminalnog ileuma, desna hemikolektomija, ileotransverzalna terminoterminalna anastomoza i jejunostomija. Patohistološkom pretragom nađena je granulomatozna upala s kazeoznom nekrozom u stijenci tankog i debelog crijeva. Bolesnik je imao 11 limfocita CD4+ u mikrolitru krvi, te HIV-1 viremiju određenu metodom PCR od 1 480 000 kopija u mililitru plazme. Liječen je uspješno antituberkuloticima i kombinacijom antibiotika uz antiretrovirusno liječenje i parenteralnu i enteralnu alimentaciju. Privremena jejunostoma zatvorena je 3 mjeseca po prvoj operaciji, a 8 mjeseci potom bolesnik ima uobičajenu tjelesnu težinu (ukupno je dobio 35 kg). PCR HIV1 RNK je tada bila nedektabilna, a apsolutni broj limfocita CD4+ iznosio je 163/μL plazme.We present a case of a thirty-two-year-old HIV infected patient who presented with a 5 months history of weight loss, fever and diarrhea. Four days before admission he started to experience abdominal pain. On admission to the hospital the patient had no fever was pale, cachectic and immobile. The abdomen was diffusely tender on palpation. His general condition was poor. Achest X-ray upon the admission showed bilateral inhomogenous infiltrations. The patient developed clear signs of acute abdomen. Surgery was performed and multiple perforations of the small and large intestine were found together with a stercoral peritonitis. The terminal ileum was partially removed, a right hemicolectomy with a terminoterminal ileotransversal anastomosis and a jejunostomy were performed. Patohistological examination of the intestine revealed granulomatous inflammation of the small and large intestine areas of caseous necrosis. The CD4 lymphocyte count was 11 per microliter and the plasma HIV viral load measured by PCR showed 1 480 000 copies per milliliter. The patient was successfully treated with antituberculous drugs and other antimicrobials together with antiretrovirals. Parenteral and enteral alimentation was also given. The temporary jejunostomy was closed three months after the first operation. Eight months after the operation the patients regained his normal body weight (weight gain: 35 kg). HIV1 RNA was at that time undetectable and his CD4+ lymphocyte count was 163/μL

LNCS

We introduce the monitoring of trace properties under assumptions. An assumption limits the space of possible traces that the monitor may encounter. An assumption may result from knowledge about the system that is being monitored, about the environment, or about another, connected monitor. We define monitorability under assumptions and study its theoretical properties. In particular, we show that for every assumption A, the boolean combinations of properties that are safe or co-safe relative to A are monitorable under A. We give several examples and constructions on how an assumption can make a non-monitorable property monitorable, and how an assumption can make a monitorable property monitorable with fewer resources, such as integer registers

Elektrokardiografske promjene nakon ujeda i uboda otrovnih životinja

Data on the effects of certain animal venoms on the ECG in in men and experimental animals are presented. The Latrodectus bites in humans caused sinus bradycardia, high P waves in II and III leads, flattened T-waves, and a prolonged QTc-interval. In guinea pigs Wenckebach\u27s phenomenon was observed. Negative T-waves including atrioventricular block I degree were also seen after envenomation of guinea pigs with the venoms of the spiders Steatoda paykulliana and Pterinochilus sp. In guinea pigs injected with the venom of the scorpion Mesobuthus gibbosus sinus bradycardia, Wenckebach\u27s phenomenon, elevated ST-intervals and atrioventricular dissociation were seen. Following stings of Hymenoptera in humans, a wandering pacemaker, negative T-waves and slow ventricular tachycardia were observed. Weeverfish and sconpionfish stings in some patients resulted in an atrioventricular block I degree. After the injuries by the sea anemone Anemonia sulcata, the jelly-fish Pelagia noctiluca, Seolopendra cingulata, Tabanids and Vipera ammodytes no significant ECG changes were registered.Prikazuje se djelovanje nekih životinjskih otrova na elektrokardiogram bolesnika i pokusnih životinja. Kod latrodektizma ljudi opažala se sinus bradikardija, visoki P valovi u II i III odvodu, niski T valovi i produženi QT interval. Kod intoksiciranih zamoraca mogao se vidjeti Wenckebachov fenomen. Negativni T-valovi, kao i atrioventrikularni blokovi I stupnja bili su nazočni kod zamoraca uslijed djelovanja otrova pauka Steatoda paykulliana, kao i Pterinochilus sp, Otrov škorpiona Mesobuthus gibbosus izazivao je u zamoraca sinus bradikardiju, atrioventrikularnu disocijaciju i Wenckebachov fenomen, te podignute ST-intervale. Nakon uboda opnokrilaca zabilježili smo u bolesnika lutanje centra vodiča, negativne T-valove i ventrikularnu tahikardiju sporog tipa (slow ventricular tachycardia). Ubodi morskog pauka i škarpine izazivali su u nekih bolesnika atrioventrikularne blokove I stupnja. Iza uboda, odnosno ujeda smeđe vlasulje, meduze Pelagia noctiluca, skolopendra, obada i poskoka nisu zapažene značajnije elektrokardiografske promjene

Elektrokardiografske promjene nakon ujeda i uboda otrovnih životinja

Data on the effects of certain animal venoms on the ECG in in men and experimental animals are presented. The Latrodectus bites in humans caused sinus bradycardia, high P waves in II and III leads, flattened T-waves, and a prolonged QTc-interval. In guinea pigs Wenckebach\u27s phenomenon was observed. Negative T-waves including atrioventricular block I degree were also seen after envenomation of guinea pigs with the venoms of the spiders Steatoda paykulliana and Pterinochilus sp. In guinea pigs injected with the venom of the scorpion Mesobuthus gibbosus sinus bradycardia, Wenckebach\u27s phenomenon, elevated ST-intervals and atrioventricular dissociation were seen. Following stings of Hymenoptera in humans, a wandering pacemaker, negative T-waves and slow ventricular tachycardia were observed. Weeverfish and sconpionfish stings in some patients resulted in an atrioventricular block I degree. After the injuries by the sea anemone Anemonia sulcata, the jelly-fish Pelagia noctiluca, Seolopendra cingulata, Tabanids and Vipera ammodytes no significant ECG changes were registered.Prikazuje se djelovanje nekih životinjskih otrova na elektrokardiogram bolesnika i pokusnih životinja. Kod latrodektizma ljudi opažala se sinus bradikardija, visoki P valovi u II i III odvodu, niski T valovi i produženi QT interval. Kod intoksiciranih zamoraca mogao se vidjeti Wenckebachov fenomen. Negativni T-valovi, kao i atrioventrikularni blokovi I stupnja bili su nazočni kod zamoraca uslijed djelovanja otrova pauka Steatoda paykulliana, kao i Pterinochilus sp, Otrov škorpiona Mesobuthus gibbosus izazivao je u zamoraca sinus bradikardiju, atrioventrikularnu disocijaciju i Wenckebachov fenomen, te podignute ST-intervale. Nakon uboda opnokrilaca zabilježili smo u bolesnika lutanje centra vodiča, negativne T-valove i ventrikularnu tahikardiju sporog tipa (slow ventricular tachycardia). Ubodi morskog pauka i škarpine izazivali su u nekih bolesnika atrioventrikularne blokove I stupnja. Iza uboda, odnosno ujeda smeđe vlasulje, meduze Pelagia noctiluca, skolopendra, obada i poskoka nisu zapažene značajnije elektrokardiografske promjene

Medical importance of araneism in Yugoslavia a case of the bite of »non-venomous« spider Aranea sexpunctata L.

Otrovanje ujedom pauka naziva se araneizam (od lat. aranea = pauk). Taj je termin bolji od izraza »arahnidizam«, jer ovaj može značiti i otrovanje izazvano arahnidima općenito. U našoj zemlji u pojedinim krajevima i pojedinih sezona ujedi paukova, osobito latrodektusa, mogu poprimiti epidemijski karakter i postati značajan medicinski problem. Osim pauka Latrodectus tredecimguttatus u nas žive i drugi, iako manje toksični pauci, kao Chiracanthium punctorium, Lycosa tarantula i Steatoda paykulliana. U posljednje vrijeme opisivani su i slučajevi gdje su otrovni paukovi iz drugih zemalja tovarima razne robe bili nenamjerno uneseni u zemlje gdje obično ne žive. Međutim postoji mogućnost da se pod određenim okolnostima i drugi pauci koji obitavaju na našem području pokažu kao otrovni, kako je to bio slučaj i s paukom Aranea sexpunctata, koji je ujeo radnicu u Tvornici olovaka u Zagrebu. Naši liječnici nisu dovoljno upoznati s araneizmom, pa nas taj slučaj opominje da bi bilo korisno bolje se upoznati s tom problematikom.The intoxication due to the spider bite is called araneism (from the Latin term »aranea« which means spider). This term is more adequate than »arachinidism«, which can also refer to envenomation induced by Arachinida in general. In certain areas of Yugoslavia during some seasons spider bites, particularly those of Latrodectus tredecimguttatus, can assume an epidemic character and become an important medical problem. Besides Latrodectus there are also other less toxic spiders in Yugoslavia, such as Chiracanthium punctorium, Lycosa tarantula and Steatoda paykulliana. It has been also reported that venomous spiders from other countries were unintentionally imported with loads of various goods into countries in which they normally do not live. It is also possible that some other spiders which are living here under certain conditions demonstrate their toxicity, as it was in the case of Aranea sexpunctata bite which occurred in the Pencil Factory in Zagreb. As physicians in Yugoslavia may not be sufficiently acquainted with araneism, this is an example that it would be useful to pay more attention to the problem