[Ten practical issues concerning acute poisoning with carbon monoxide in pregnant women].

Background: The poisoning of carbon monoxide (CO) is the leading cause of death by poisoning in France. Its consequences are potentially serious to the fetus. Literature is ancient and little known.

Toxicological methods for tracing drug abuse: chromatographic, spectroscopic and biological characterisation of ecstasy derivatives.

Analysis often reveals variability in the composition of ecstasy pills from pure 3,4-methylenedioxymethamphetamine (MDMA) to mixtures of MDMA derivatives, amphetamine, and other unidentified substances. For a comprehensive toxicological analysis one needs to know all steps to MDMA synthesis which may originate impurities. The aim of this study was to synthesise and determine the chemical-physical and in vitro biological properties of a series of MDMA derivatives.

Determination of the acetylator phenotype in Moroccan tuberculosis patients using isoniazid as metabolic probe.

A large interindividual variability in drug acetylation is associated with genetic polymorphism of the polymorphic Type 2 N-acetyltransferase (NAT2), and an important interethnic difference has been frequently observed. However, few data on this polymorphism in the Moroccan population are available. In the present study the acetylator phenotype in 89 Moroccan patients with tuberculosis has been determined using isoniazid (INH) as metabolic probe.

Unusual neurotoxic envenomations by Vipera aspis aspis snakes in France.

Vipera aspis aspis (V.a.a.

Therapeutic isoniazid monitoring using a simple high-performance liquid chromatographic method with ultraviolet detection.

Simultaneous measurement of isoniazid and its main acetylated metabolite acetylisoniazid in human plasma is realized by high-performance liquid chromatography. The technique used is evaluated by a factorial design of validation that proved to be convenient for routine drug monitoring. Plasma samples are deproteinized by trichloroacetic acid and then the analytes are separated on a microBondapak C18 column (Waters).

[Drug-induced fever caused by hydroxyurea. Apropos of 3 new cases].

Drug-induced fever is a frequent (3-5% of all adverse effects) but under recognized adverse effect of several drugs. Hydroxyurea, an antimetabolite cytostatic agent, has rarely been involved in the occurrence of fever. We report three additional cases of hydroxyurea-induced fever including one case with pulmonary involvement (acute alveolitis).

Ochratoxin A in beverages from Morocco: a preliminary survey.

In a preliminary study, samples of Moroccan wines (n = 30), beers (n = 5) and fruit juices (n = 14) were assayed for ochratoxin A (OTA) by HPLC with fluorimetric detection, followed by confirmation by cleavage of the OTA molecule using carboxypeptidase with HPLC-fluorimetric determination of ochratoxin alpha (OT alpha). All the wine samples were contaminated, and the overall median OTA concentration was 0.65 microg/l (range 0.

[Acute poisoning with industrial products].

Poisonings with industrial products represent approximately 7% of the cases reported to the poison centres. Ingestion of petroleum distillates induces irritation of the gastrointestinal tract, central nervous system depression and aspiration pneumonitis which may be severe; treatment is mainly supportive. Ethylene and diethylene glycol poisonings produce central nervous system depression, anion gap metabolic acidosis, osmolar gap and acute tubular necrosis; in severe cases, hypocalcaemia, cerebral oedema and heart failure may be observed; treatment often associates supportive measures, haemodialysis and administration of competitive inhibitors of alcohol dehydrogenase (ethanol or 4-methylpyrazole).

Noninvasive pressure support ventilation (NIPSV) with face mask in patients with acute cardiogenic pulmonary edema (ACPE).

Objectives: To assess (1) the short-term hemodynamic, respiratory and arterial blood gas effects of NIPSV in patients with ACPE who were likely to require endotracheal intubation, (2) the initial causes of failure and (3) the side effects and the difficulties of this technique.

Design: Uncontrolled, prospective clinical study.

Setting: Teaching hospital intensive care unit.

Intermediate syndrome with delayed distal polyneuropathy from ethyl parathion poisoning.

An acute poisoning in a 44-y-old female who ingested 50 ml of ethyl parathion concentrate (25 g) is described. She was treated by gastric lavage, administration of pralidoxime and atropine, and mechanical ventilation. As signs of intoxication disappeared at day 3, treatment was discontinued.

[Snake bite by European vipers. A multicenter study of tolerance to Viperfav, a new intravenous antivenom].

Objectives: To evaluate the tolerance and the effectiveness of i.v. Viperfav, a new antivenom containing F(ab')2 fragments of equine antibodies, for the treatment of European viper envenomed patients.

[Acute renal insufficiency caused by Amanita proxima poisoning: experience of the Poison Center of Marseille].

In southern France, some Amanita species are usually eaten like Amanita ovoidea (Quélet, 1872) which is a common white mushroom. In same areas, a similar and less common fungus can be encountered: Amanita proxima (Dumee, 1916). The first published cases of Amanita proxima poisonings with acute renal failure have been reported in 1994 by a medical team from Montpellier.

[Lead impregnation in inhabitants of the Rabat region (Morocco)].

Objectives: No current data is available on plumbism in Morocco. We conducted this work to evaluate blood lead levels in inhabitants of the Rabat region.

Patients And Methods: The study included 385 subjects, 300 men and 85 women, age range 18-55 years, who were volunteer blood donors at the Rabat blood bank.

Acute selenium poisoning.

Reports of acute human selenium toxicity are rare. We report 2 new cases. One patient ingested a mouthful of selenic acid (30 g/L); he only suffered mild gastrointestinal disturbances.

Gamma butyrolactone poisoning and its similarities to gamma hydroxybutyric acid: two case reports.

Clinical experience with toxicity induced by products containing gamma butyrolactone is limited. We report here 2 cases of gamma butyrolactone poisoning with a nail polish remover labelled "acetone-free". Rapid onset of coma, respiratory depression and bradycardia occurred in both patients.

Drug-induced autoimmunity: experience of the French pharmacovigilance system.

Spontaneous reporting of suspected adverse drug reactions to a pharmacovigilance structure is a reasonable tool to detect new associations between drugs and a given toxic effect. An analysis of the French national database of pharmacovigilance was undertaken to evaluate how such a system is relevant to survey and/or detect drug-associated autoimmune disorders. Only 0.

[Acute paracetamol and aspirin poisoning].

Liver injury is the main feature of paracetamol poisoning. Early administration of N-acetylcysteine is an effective antidotal treatment. There are also effective treatments for salicylate poisoning and severe cases are always due to delayed diagnosis.

Antibiotic-associated hepatitis: update from 1990.

Objective: To review the literature on the recent available evidence of antibiotic-associated acute liver injury.

Data Sources: All published articles from January 1990 to July 1995 were extracted from the monthly updated HEPATOX database. Additional articles were found using MEDLINE, EMBASE, and PASCAL searches.

[Mass ciguatera poisoning after eating barracuda in Mexico: prognostic and therapeutic implications].

Thirty patients were admitted to the Anti-Poison Center of Marseille, France, on the fifth day of ciguatera fish poisoning due to ingestion of the same barracuda in Mexico. The purpose of this prospective study conducted during management of this group was to identify prognostic factors and evaluate the efficacy of treatment using mannitol. Upon admission severity was individually scored based on clinical findings.

Central and peripheral neurotoxic effects of chronic methyl bromide intoxication.

Objective: To examine all methyl bromide poisonings reported to the Marseille Poison Centre and to describe more precisely the infrequent cases of chronic, nonacute exposure.

Design: Retrospective observational cohort.

Method: Data retrieval from the French Poison Centres National Data Bank (ARIT) which contains all the cases of poisonings collected by the Marseille Poison Centre (Hot Line observations, Toxicovigilance, Toxicological intensive care unit).

Research into individual predisposition to develop acute rhabdomyolysis attributed to fenoverine.

A xenobiotic, well tolerated by the majority of treated patients, can cause serious complications in patients with individual susceptibility. Based on the hypothesis that such a phenomenon may occur in rare cases of rhabdomyolysis attributed to fenoverine (DCI), we designed a protocol to look for a genetic predisposition. Six patients were included who had previously had an episode of rhabdomyolysis after taking fenoverine.

[Acute methotrexate poisoning: apropos of 16 cases reported to the Paris Poison Control Center and review of the literature].

16 cases of acute methotrexate (MTX) poisoning were reported to the Paris Poison Control Centre and 62 others were published between 1974 and 1995. Until 1992, MTX was mainly prescribed for neoplastic diseases. Clinical features involve acute renal failure, pancytopenia, and cutaneous or mucous injury.

[Carbon monoxide poisoning: current aspects].

Carbon monoxide (CO) poisoning still represents a frequent and severe casualty in France. Aside the well-known effect of CO on hemoglobin, the role of CO binding to other hemoproteins like myoglobin and cytochrome a3 have been more recently recognized. Moreover, in addition to these hypoxic injuries, the reoxygenation phase may itself induce toxic effects by a mechanism close to the ischemia-reperfusion phenomenon.

Glutathione transferase activity and formation of macromolecular adducts in two cases of acute methyl bromide poisoning.

Objectives: To determine the activity of glutathione transferase and to measure the S-methylcysteine adducts in blood proteins, after acute inhalation exposure to methyl bromide. To examine the influence of the polymorphism of glutathione-S-transferase theta (GSTT1) on the neurotoxicity of methyl bromide.

Methods: Two workers acutely exposed to methyl bromide with inadequate respiratory protective devices were poisoned.