Search Our Scientific Publications & Authors

Publications
find publications by category +
Translate page:

Osmolal and anion gaps after acute self-poisoning with agricultural formulations of the organophosphorus insecticides profenofos and diazinon: A pilot study.

Authors:
Jeevan Dhanarisi Tanita Maria Tzotzolaki Ana-Mariya D Vasileva Matti A Kjellberg Hanna Hakulinen Paula Vanninen Indika Gawarammana Fahim Mohamed Knut Erik Hovda Michael Eddleston

Basic Clin Pharmacol Toxicol 2022 Feb 3;130(2):320-327. Epub 2021 Dec 3.

South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.

Self-poisoning with organophosphorus (OP) insecticides is an important means of global self-harm. The insecticides are formulated with solvents that may also contribute to toxicity. We set up a study to detect changes in osmolal and anion gaps following ingestion of OP insecticides. We recruited consecutive patients admitted to a Teaching Hospital, Sri Lanka, with a history of OP self-poisoning. The osmolal and anion gaps were calculated on admission and at 4, 24 and 72 h post-ingestion together with ethanol concentration. Forty-nine patients were recruited (28 profenofos, 10 diazinon, one coumaphos, one chlorpyrifos, one phenthoate and eight unknown OP). Only modest increases in osmolal and anion gaps were noted. Small rises in osmolal gap above the upper limit of normal were noted in 16/49 (32.7%) of all cases, 9/28 (32.1%) profenofos cases and 4/10 (40.0%) diazinon cases. The anion gap was raised in 24/49 (49.0%) of all cases, 15/28 (53.6%) profenofos cases and 5/10 (50.0%) diazinon cases. We observed a trend for a fall in osmolal gap during the first 24 h, followed by an increase up to 72 h. There was no correlation between the anion gap and serum lactate concentration, indicating that a lactic acidosis was not responsible for the anion gap. Formate, which could have explained the increased gap, was not detected in any of the samples; ketoacids (beta-hydroxybutyrate and acetoacetate) were not measured. This pilot study found that profenofos and diazinon poisoning caused only modest increases in the osmolal and anion gaps in a minority of cases.

Download full-text PDF

 Source
http://dx.doi.org/10.1111/bcpt.13686DOI Listing
February 2022

Publication Analysis

Top Keywords

osmolal anion
20
anion gaps
20
anion gap
12
profenofos diazinon
12
diazinon cases
8
profenofos cases
8
pilot study
8
osmolal gap
8
modest increases
8
increases osmolal
8
organophosphorus insecticides
8
osmolal
7
cases
7
anion
7
gap
6
profenofos
5
diazinon
5
gaps
5
rises osmolal
4
diazinon coumaphos
4

Keyword Occurance

Similar Publications

Osmolal and anion gaps after acute self-poisoning with agricultural formulations of the organophosphorus insecticides profenofos and diazinon: A pilot study.

Authors:
Jeevan Dhanarisi Tanita Maria Tzotzolaki Ana-Mariya D Vasileva Matti A Kjellberg Hanna Hakulinen Paula Vanninen Indika Gawarammana Fahim Mohamed Knut Erik Hovda Michael Eddleston

Basic Clin Pharmacol Toxicol 2022 Feb 3;130(2):320-327. Epub 2021 Dec 3.

South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.

Self-poisoning with organophosphorus (OP) insecticides is an important means of global self-harm. The insecticides are formulated with solvents that may also contribute to toxicity. We set up a study to detect changes in osmolal and anion gaps following ingestion of OP insecticides. Read More

View Article and Full-Text PDF
February 2022
Similar Publications

Intoxication by Hand-Sanitizers and other Toxic Alcohols in a Low-Resource Setting: Two Case Reports.

Authors:
Micah LA Heldeweg Louisa G Kluijver Kenrick Berend

Eur J Case Rep Intern Med 2021 3;8(8):002751. Epub 2021 Aug 3.

Department of Internal Medicine, Curaçao Medical Center, Curaçao.

Toxic alcohol poisoning can be lethal if not identified early and treated appropriately. Toxic alcohol assays are often unavailable in low-resource setting, so clinicians have to infer a diagnosis based on suspicion, repeated evaluation and biochemical course. We report a case of toxic alcohol poisoning concealed by auto-intoxication with in-hospital hand sanitizer. Read More

View Article and Full-Text PDF
August 2021
Similar Publications

Comparative Impact of Isolated Ultrafiltration and Hemodialysis on Fluid Distribution: A Bioimpedance Study.

Authors:
Yuki Akiyama Ryo Matsuoka Takahiro Masuda Sumiya Iwamoto Shun Sugie Takafumi Muto Yuka Miyamoto Takayuki Ohdate Saki Nakagawa Mari Okada Toshimi Imai Takanori Komada Michiko Suzuki Akito Maeshima Tetsu Akimoto Osamu Saito Daisuke Nagata

Blood Purif 2022 31;51(6):492-502. Epub 2021 Aug 31.

Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.

Introduction: Isolated ultrafiltration (IUF) is an alternative treatment for diuretic-resistant patients with fluid retention. Although hemodialysis (HD) predominantly decreases extracellular water (ECW), the impact of IUF on fluid distribution compared with HD remains unclear.

Methods: We compared the effect of HD (n = 22) and IUF (n = 10) sessions on the body fluid status using a bioimpedance analysis device (InBody S10). Read More

View Article and Full-Text PDF
June 2022
Similar Publications

Approach to Patients With High Anion Gap Metabolic Acidosis: Core Curriculum 2021.

Authors:
Andrew Z Fenves Michael Emmett

Am J Kidney Dis 2021 10 13;78(4):590-600. Epub 2021 Aug 13.

Internal Medicine, Baylor University Medical Center, Dallas, Texas. Electronic address:

The anion gap (AG) is a mathematical construct that compares the blood sodium concentration with the sum of the chloride and bicarbonate concentrations. It is a helpful calculation that divides the metabolic acidoses into 2 categories: high AG metabolic acidosis (HAGMA) and hyperchloremic metabolic acidosis-and thereby delimits the potential etiologies of the disorder. When the [AG] is compared with changes in the bicarbonate concentration, other occult acid-base disorders can be identified. Read More

View Article and Full-Text PDF
October 2021
Similar Publications

Assessing urine ammonium concentration by urine osmolal gap in chronic kidney disease.

Authors:
Takuya Fujimaru Takuya Shuo Masahiko Nagahama Fumika Taki Masaaki Nakayama Yasuhiro Komatsu

Nephrology (Carlton) 2021 Oct 20;26(10):809-813. Epub 2021 Jul 20.

Department of Nephrology, St. Luke's International Hospital, Tokyo, Japan.

Acidemia is one of the risk factors for end-stage kidney disease and increases the mortality rate of patients with chronic kidney disease (CKD). Although urinary ammonium (U-NH ) is the crucial component of renal acid excretion, U-NH concentration is not routinely measured. To estimate U-NH , urine osmolal gap (UOG = urine osmolality - [2(Na + K ) + urea + glucose]) is calculated and the formula (U-NH  = UOG/2) has traditionally been used. Read More

View Article and Full-Text PDF
October 2021
Similar Publications
}