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The scale of drinking and driving
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Abstracts / Toxicology Letters 258S (2016) S62–S324
of mechanical ventilation. Mechanical ventilation and supportive therapy were continuing with other two patients. http://dx.doi.org/10.1016/j.toxlet.2016.06.1449 P04-025 The scale of drinking and driving A.G. Fatma Forensic Unit, University Hospital, Annaba, Algeria Introduction: The traffic accidents are a major public health problem. An estimated 1.2 million people are killed and not less than 50 million injured every year worldwide in traffic accidents. According to projections, these figures will increase by about 65% over the next 20 years. Material and method: We performed a retrospective study of 5725 cases by the requisitions ordered by various judicial police. This study concerns a 10 year period from 2000 to 2009. Results: The number of alcohol dosage demand is increasing. We found a male predominance. Over 50% of drivers have their blood alcohol level above the legal dose There is a rise in the number of driving offenses with suspicion driving while intoxicated during the summer season. We observed a decrease in blood alcohol content since the application of a new law that sets the lower legal threshold to 0.2 g/l. Discussion: Algerian law on road safety has known the reforms regarding the legal alcohol limit during driving, In 1987 the statutory rate was less than 0.8 g/l. The law of 2001 reduces the level which becomes less than 0.1 g/l. The 2009 law, imposed a rate less than 0.2 g/l currently used. Conclusion: Despite religious and social taboos, the associated alcohol consumption or not to psychoactive substances is common, with a male predominance and during the summer seasons. http://dx.doi.org/10.1016/j.toxlet.2016.06.1450 P04-026 Acute hepatitis due to prolonged use of slimming pills – Case report R.C. Tincu 1,∗ , C. Cobilinschi 2 , D. Tomescu 3 , Z. Ghiorghiu 1 , R.A. Macovei 1 1 Critical Care Toxicology Unit, Clinical Emergency Hospital Bucharest, Romania 2 Anesthesiology and Critical Care Unit, Clinical Emergency Hospital Bucharest, Romania 3 Anesthesiology and Critical Care Unit, “Fundeni” Clinical Institute, Romania
Introduction: Unwisely slimming pills marketing has spread very rapidly in the last decade in our country. They are easily sold online and are widely used for their supposed benefits in population of all ages. Methods: We report the case of a 41-years-old female patient who presented to our Critical Care Toxicology Unit for persistent jaundice, after she was investigated in the past six week in Gastroenterology and Infectious Disease Departments. Results: After extended laboratory investigations, our colleagues excluded viral and parasitic infectious hepatitis, as well as autoimmune and genetic causes of chronic liver disease. She was performed liver biopsy, due to unknown etiology of chronic cytolysis process and jaundice persistence that revealed pericentral moderate cholestasis suggesting toxic etiology. We were
able to obtain detailed information about any toxic ingestion: she was taking slimming pills starting 2 months ago while she progressively developed fatigability, anorexia and jaundice. Laboratory findings revealed hypokalemia, due to persistent diarrhea. After anti-oxidant and liver detoxifying therapy, her evolution was constantly improving, with decreasing values of bilirubin and transaminase and the patient was discharged home within a week. Follow-up procedure revealed normal liver function during both 1 and 3 months evaluations. Conclusions: Slimming pills are not considered as medicine, so the law itself permits to have unknown ingredients and their marketing approval can easily skip scientific authorization leading to serious adverse effects. http://dx.doi.org/10.1016/j.toxlet.2016.06.1451 P04-027 Unusual chronic arsenic poisoning R. Tincu 1,∗ , C. Cobilinschi 2 , D. Tomescu 3 , Z. Ghiorghiu 1 , R.A. Macovei 1 1 Critical Care Toxicology Unit, Clinical Emergency Hospital Bucharest, Romania 2 Anesthesiology and Critical Care Unit, Clinical Emergency Hospital Bucharest, Romania 3 Anesthesiology and Critical Care Unit, “Fundeni” Clinical Institute, Romania
Introduction: Arsenic was used during times as a pesticide, chemotherapeutic drug, but this toxic had a long history as a homicidal poison. Chronic exposure is insidious, involving multiple hospital admissions. Arsenic is a special toxic named metalloid, which has metal and nonmetal properties and it is called “the king of the poisons” due to its potency. Methods: We present the case of a 40-years-old female, without any medical events or history of toxic exposure, who develop sensorimotor polyneuropathy and myopathy, headache, insomnia, weakness. After multiple hospital admissions, there was no conclusion regarding the etiology of the neurological disorders. Results: Evaluation in our toxicology department showed: moderate skin pigmentation preponderantly to the distal extremities and diffuse desquamation of the palms. She describe multiple episodes of conjunctiva congestion. Laboratory investigations revealed normochromic and normocytic anemia, leucopenia with mild thrombocytopenia. Electromyography showed a decrease in nerve condition amplitude with modest change in nerve velocity. Arsenic level in urine was 415 g/L and blood level was 1.6 g/L. Personal data showed numerous conflicts in job relationships and she was very worried about her mouth water being contaminated. Analyze of the product showed a high proportion of arsenic. The chelator treatment and antioxidant therapy were initiated immediately. We expect the second evaluation of the patient. Conclusions: Although arsenic poisoning is rare in Romania in present times, it should be tested in patients with unexplained neurological and hematologic abnormalities. http://dx.doi.org/10.1016/j.toxlet.2016.06.1452
Abstracts / Toxicology Letters 258S (2016) S62–S324
of mechanical ventilation. Mechanical ventilation and supportive therapy were continuing with other two patients. http://dx.doi.org/10.1016/j.toxlet.2016.06.1449 P04-025 The scale of drinking and driving A.G. Fatma Forensic Unit, University Hospital, Annaba, Algeria Introduction: The traffic accidents are a major public health problem. An estimated 1.2 million people are killed and not less than 50 million injured every year worldwide in traffic accidents. According to projections, these figures will increase by about 65% over the next 20 years. Material and method: We performed a retrospective study of 5725 cases by the requisitions ordered by various judicial police. This study concerns a 10 year period from 2000 to 2009. Results: The number of alcohol dosage demand is increasing. We found a male predominance. Over 50% of drivers have their blood alcohol level above the legal dose There is a rise in the number of driving offenses with suspicion driving while intoxicated during the summer season. We observed a decrease in blood alcohol content since the application of a new law that sets the lower legal threshold to 0.2 g/l. Discussion: Algerian law on road safety has known the reforms regarding the legal alcohol limit during driving, In 1987 the statutory rate was less than 0.8 g/l. The law of 2001 reduces the level which becomes less than 0.1 g/l. The 2009 law, imposed a rate less than 0.2 g/l currently used. Conclusion: Despite religious and social taboos, the associated alcohol consumption or not to psychoactive substances is common, with a male predominance and during the summer seasons. http://dx.doi.org/10.1016/j.toxlet.2016.06.1450 P04-026 Acute hepatitis due to prolonged use of slimming pills – Case report R.C. Tincu 1,∗ , C. Cobilinschi 2 , D. Tomescu 3 , Z. Ghiorghiu 1 , R.A. Macovei 1 1 Critical Care Toxicology Unit, Clinical Emergency Hospital Bucharest, Romania 2 Anesthesiology and Critical Care Unit, Clinical Emergency Hospital Bucharest, Romania 3 Anesthesiology and Critical Care Unit, “Fundeni” Clinical Institute, Romania
Introduction: Unwisely slimming pills marketing has spread very rapidly in the last decade in our country. They are easily sold online and are widely used for their supposed benefits in population of all ages. Methods: We report the case of a 41-years-old female patient who presented to our Critical Care Toxicology Unit for persistent jaundice, after she was investigated in the past six week in Gastroenterology and Infectious Disease Departments. Results: After extended laboratory investigations, our colleagues excluded viral and parasitic infectious hepatitis, as well as autoimmune and genetic causes of chronic liver disease. She was performed liver biopsy, due to unknown etiology of chronic cytolysis process and jaundice persistence that revealed pericentral moderate cholestasis suggesting toxic etiology. We were
able to obtain detailed information about any toxic ingestion: she was taking slimming pills starting 2 months ago while she progressively developed fatigability, anorexia and jaundice. Laboratory findings revealed hypokalemia, due to persistent diarrhea. After anti-oxidant and liver detoxifying therapy, her evolution was constantly improving, with decreasing values of bilirubin and transaminase and the patient was discharged home within a week. Follow-up procedure revealed normal liver function during both 1 and 3 months evaluations. Conclusions: Slimming pills are not considered as medicine, so the law itself permits to have unknown ingredients and their marketing approval can easily skip scientific authorization leading to serious adverse effects. http://dx.doi.org/10.1016/j.toxlet.2016.06.1451 P04-027 Unusual chronic arsenic poisoning R. Tincu 1,∗ , C. Cobilinschi 2 , D. Tomescu 3 , Z. Ghiorghiu 1 , R.A. Macovei 1 1 Critical Care Toxicology Unit, Clinical Emergency Hospital Bucharest, Romania 2 Anesthesiology and Critical Care Unit, Clinical Emergency Hospital Bucharest, Romania 3 Anesthesiology and Critical Care Unit, “Fundeni” Clinical Institute, Romania
Introduction: Arsenic was used during times as a pesticide, chemotherapeutic drug, but this toxic had a long history as a homicidal poison. Chronic exposure is insidious, involving multiple hospital admissions. Arsenic is a special toxic named metalloid, which has metal and nonmetal properties and it is called “the king of the poisons” due to its potency. Methods: We present the case of a 40-years-old female, without any medical events or history of toxic exposure, who develop sensorimotor polyneuropathy and myopathy, headache, insomnia, weakness. After multiple hospital admissions, there was no conclusion regarding the etiology of the neurological disorders. Results: Evaluation in our toxicology department showed: moderate skin pigmentation preponderantly to the distal extremities and diffuse desquamation of the palms. She describe multiple episodes of conjunctiva congestion. Laboratory investigations revealed normochromic and normocytic anemia, leucopenia with mild thrombocytopenia. Electromyography showed a decrease in nerve condition amplitude with modest change in nerve velocity. Arsenic level in urine was 415 g/L and blood level was 1.6 g/L. Personal data showed numerous conflicts in job relationships and she was very worried about her mouth water being contaminated. Analyze of the product showed a high proportion of arsenic. The chelator treatment and antioxidant therapy were initiated immediately. We expect the second evaluation of the patient. Conclusions: Although arsenic poisoning is rare in Romania in present times, it should be tested in patients with unexplained neurological and hematologic abnormalities. http://dx.doi.org/10.1016/j.toxlet.2016.06.1452