Hong Kong Poison Information Centre: Annual report 2017

Lau, Kai Kee; Chow, Tin Yat Anthony; Chan, Chung-hong; Chan, Yuk Wah; Ng, Chun Ho Vember; Ng, Sze Hong; Tse, ML

doi:10.1177/1024907918798997

Cited by 10 publications

(10 citation statements)

References 13 publications

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“…A local review from the Hospital Authority of Hong Kong on 52 cases of Aconitum poisoning from 2004 to 2009 suggested that overdosing is the major underlying cause of poisoning [ 114 ]. There were five recent cases of aconite poisoning from 2016 to 2017, that the patients received medication from the Chinese Medicine Centre of Hospital Authority [ 115 ]. They were dispensed with normal doses of processed Fuzi but appeared to have symptoms from mild numbness to hypotension.…”

Section: Discussionmentioning

confidence: 99%

The toxicology and detoxification of Aconitum: traditional and modern views

2021

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Aconitum carmichaeli Debx.-derived herbal medicine has been used for anti-inflammation and anti-arrhythmia purpose for more than two thousand years. It is processed into Chuanwu (Radix Aconiti praeparata) and Fuzi (Radix Aconiti lateralis praeparata) in Traditional Chinese Medicine, which are two useful drugs but with toxic properties. There have been patients poisoned by accidental ingestion of Aconitum plants or misuse of the herbal drug, and this is of great concern to study in-depth. In this review, we provided the traditional and contemporary practice of using Aconitum herbs as medicine, from functions, processing methods to toxicity in ethnomedicine aspects to discuss the underlying connections of traditional and modern understanding on the toxicity of Aconitum plants. We summarized the functions and toxicology of the herbal drugs are analyzed from chemical and clinical aspects, with the help of traditional and modern knowledge of medicine. The medicinal doses and lethal doses determined by researches are summarized, and the usage and processing methods are updated and reviewed in the modern view. In addition, clinical management of poisoned cases using western medicine is discussed. This review provides insights and awareness of safety when using Aconitum-derived herbal medicine, and the application of modern scientific knowledge to optimize the detoxification processes. We suggest the possibility to renew the current standard processing method from the official Pharmacopoeia all over the world.

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Section: Discussionmentioning

confidence: 99%

The toxicology and detoxification of Aconitum: traditional and modern views

2021

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“…This suggests that the risk of poisoning is likely to be higher in girls. According to the public data, the reported incidence of poisoning (all causes) in females aged between 5 and 18 years is higher than for males in that age group (0.07% vs 0.04%) [ 37 , 38 ]. Additionally, sex differences in ADHD symptom severity may differ.…”

Section: Discussionmentioning

confidence: 99%

Treatment with Methylphenidate for Attention Deficit Hyperactivity Disorder (ADHD) and the Risk of All-Cause Poisoning in Children and Adolescents: A Self-Controlled Case Series Study

et al. 2021

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Background Children and adolescents with attention deficit hyperactivity disorder (ADHD) are at higher risk of all-cause poisoning by drugs and chemicals (intentional or accidental). Currently, there is limited data on whether medication treatment for ADHD can reduce the risk of all-cause poisoning. Methods Patients aged 5-18 years with a methylphenidate (MPH) prescription and an incident poisoning diagnosis between January 2001 and June 2020 were identified from the Hong Kong Clinical Data Analysis and Reporting System. A selfcontrolled case series study design was used to compare the incidence rate ratios (IRRs) of all-cause poisoning during different risk windows (30 days before the first MPH prescription, exposure periods within 30 days of the first prescription, and periods of subsequent exposure) compared with the reference window (other non-exposure periods). Results 42,203 patients were prescribed ADHD medication in Hong Kong during the study period. Of these, 417 patients who had both an MPH prescription and poisoning incident recorded were included in the main analysis. Compared with other non-exposed periods, a higher risk of poisoning was found in the 30 days before the first prescription (IRR 2.64, 95% confidence interval [CI] 1.33-5.22) and exposure periods within 30 days of the first prescription (IRR 2.18, 95% CI 1.06-4.48), but not during prolonged exposure. However, compared with 30 days before the first prescription as well as exposure periods within 30 days of the first prescription, there was a lower risk during the subsequent exposure (IRRs 0.49 and 0.60, respectively). Similar results to the main analysis were also found in the subgroup analysis of intentional poisoning and females, but not in that of accidental poisoning and males. Conclusions The risk of all-cause poisoning was higher shortly before and after the first MPH prescription and became lower during the subsequent prescription period. Our results do not support an association between the use of MPH and an increased risk of all-cause poisoning in children and adolescents and, in fact, suggest that longer-term use of MPH may be associated with a lower risk of all-cause poisoning, although this latter finding requires further study.

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“…X-ray with arrows showing “lead lines” ( C ). Reprinted from ( A )—[ 94 ], ( B )—[ 95 ], ( C )—[ 96 ].…”

Section: Leadmentioning

confidence: 99%

Clinical and Forensic Signs Resulting from Exposure to Heavy Metals and Other Chemical Elements of the Periodic Table

Machado

Dinis-Oliveira

2023

JCM

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Several heavy metals and other chemical elements are natural components of the Earth’s crust and their properties and toxicity have been recognized for thousands of years. Moreover, their use in industries presents a major source of environmental and occupational pollution. Therefore, this ubiquity in daily life may result in several potential exposures coming from natural sources (e.g., through food and water contamination), industrial processes, and commercial products, among others. The toxicity of most chemical elements of the periodic table accrues from their highly reactive nature, resulting in the formation of complexes with intracellular compounds that impair cellular pathways, leading to dysfunction, necrosis, and apoptosis. Nervous, gastrointestinal, hematopoietic, renal, and dermatological systems are the main targets. This manuscript aims to collect the clinical and forensic signs related to poisoning from heavy metals, such as thallium, lead, copper, mercury, iron, cadmium, and bismuth, as well as other chemical elements such as arsenic, selenium, and fluorine. Furthermore, their main sources of occupational and environmental exposure are highlighted in this review. The importance of rapid recognition is related to the fact that, through a high degree of suspicion, the clinician could rapidly initiate treatment even before the toxicological results are available, which can make a huge difference in these patients’ outcomes.

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Hong Kong Poison Information Centre: Annual report 2017

Cited by 10 publications

References 13 publications

The toxicology and detoxification of Aconitum: traditional and modern views

The toxicology and detoxification of Aconitum: traditional and modern views

Treatment with Methylphenidate for Attention Deficit Hyperactivity Disorder (ADHD) and the Risk of All-Cause Poisoning in Children and Adolescents: A Self-Controlled Case Series Study

Clinical and Forensic Signs Resulting from Exposure to Heavy Metals and Other Chemical Elements of the Periodic Table

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