Predicting acute complicated glyphosate intoxication in the emergency department

Moon, Jeong Mi; Chun, Byeong Jo

doi:10.3109/15563650.2010.488640

Cited by 44 publications

(39 citation statements)

References 27 publications

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“…(15) When healthy American adults were tested using a chemical container with a 1.5-cm diameter, the mean maximum sip volumes were 14.9 mL for men and 14.3 mL for women, which were smaller than the volumes measured when using a cup. (14) In contrast, although containers with a 2.6-cm internal diameter were used in the present study, the poisoning agent sip amounts were 30.00 ± 15.28 mL for health care providers and 26.46 ± 12.76 mL for non-practitioners, which were higher than the results of the previous study (table 2). The poisoning agent mouthful amounts were 60.09 ± 17.28 mL for health care providers and 59.63 ± 20.17 mL for non-practitioners.…”

Section: Liquid Medicinecontrasting

confidence: 56%

“…(12) At present, the poisoning amounts in a Korean study of agricultural chemical intoxication were calculated by multiplying the patient-reported number of swallows by the estimated sip amount (20-30 mL). (13,14) To create a situation similar to actual agricultural chemical poisoning, a medicine bottle with a 2.6-cm internal diameter, which is similar to the sizes of agricultural chemical bottle openings, was used in the present study. Previous studies were performed using liquids contained in cups; however, agricultural chemicals and other industrial liquids are contained in special containers with internal diameters smaller than that of a cup, and toxicologically, the tastes of these chemicals differed from that of water.…”

Section: Liquid Medicinementioning

confidence: 99%

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Estimating poisoning substance amounts: Comparative study of the accuracy of health care professionals and non-practitioners

2017

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Objective. Intentional or unintentional substance intoxications are common in patients presenting to the Emergency Department (ED). When we treat intoxicated patients, it is important to know the amount of drug ingestion. We invested the actual amount of semi-quantitative term expressed by patients, and investigated the accuracy of amount estimates by the public and healthcare professionals. Participants and interventions. 200 volunteers (86 health care providers and 114 non-practitioners) participated. Participants grabbed the 3 types of tablets (5mm, 10mm, and 15mm) in handfuls and fistfuls and estimated the tablet amounts. Actual amounts were measured. 100 volunteers (58 health care providers and 41 non-practitioners) participated in the investigation of accuracy of liquid amount estimation. Participant ingested water in 2.6 cm diameter bottle in response to request to take 1 sip, 1 mouthful, and 3 sips. Results. The estimated tablet counts became more accurate in terms of both fistfuls and handfuls as the size increased within the same shape classification. Participants tended to underestimate the counts of oval-shaped tablets to a greater extent than round tablets of the same size. The estimated liquids both groups of participants tended to underestimate the amounts but both groups overestimated the volumes when drinking 3 continuous sips. In tablets and liquids, there were no statistically significant differences in accuracy between the groups. Conclusions. When approaching intoxicated patients who have visited emergency department (ED), treatment should be implemented based on the assumption that the actual ingested amounts are higher than the amounts estimated by patients.

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Section: Liquid Medicinecontrasting

confidence: 56%

Section: Liquid Medicinementioning

confidence: 99%

Estimating poisoning substance amounts: Comparative study of the accuracy of health care professionals and non-practitioners

2017

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“…The kidney may also be an organ for excretion of GPSH components (Moon and Chun, 2010;Roberts et al, 2010;Sribanditmongkol et al, 2012). Thus, early evidence of kidney injury could be used to predict the risk of a fatal outcome in GPSH toxicity.…”

Section: Introductionmentioning

confidence: 99%

“…Thus, early evidence of kidney injury could be used to predict the risk of a fatal outcome in GPSH toxicity. Plasma (pCr) or serum creatinine (sCr) and blood urea nitrogen (BUN) have usually been used as indicators, or biomarkers, for kidney injury in human GPSH intoxication (El-Shenawy, 2009;Lee et al, 2008;Moon and Chun, 2010;Talbot et al, 1991;Tominack et al, 1991). Recently, several studies have suggested that pCr is not sensitive enough to detect early kidney injury or predict subsequent functional change (Sherwin et al, 2012;Toto, 1995;Vaidya et al, 2008b;Woitas et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

Kidney biomarkers in MCPA-induced acute kidney injury in rats: Reduced clearance enhances early biomarker performance

Wunnapuk¹,

Liu²,

Gobé³

et al. 2014

Toxicology Letters

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Accidental or intentional ingestion of glyphosate surfactant-based herbicides, like Roundup, leads to nephrotoxicity as well as death. In this study, a panel of kidney injury biomarkers was evaluated in terms of suitability to detect acute kidney injury and dysfunction. The Roundup intoxication model involved oral administration of glyphosate to rats at dose levels of 250, 500, 1200 and 2500 mg/kg. Urinary and plasma biomarker patterns were investigated at 8, 24 and 48 hours after dosing.Biomarkers were quantified by absolute concentration; by normalising to urine creatinine; and by calculating the excretion rate. The diagnostic performances of each method in predicting of acute kidney injury were compared. By Receiver Operating Characteristic (ROC) analysis of the selected biomarkers, only urinary kidney injury molecule-1 (KIM-1) best predicted histological changes at 8 h (best cut-off point > 0.00029 µg/ml). Plasma creatinine performed better than other biomarkers at 24 h (best cut-off point > 0.21 mg/dl). Urinary KIM-1 was the best early biomarker of kidney injury in this glyphosate-induced nephrotoxicity model.

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“…A study in Korea from 2010 involving 76 patients who ingested glyphosate formulations revealed respiratory failure, hypotension, acute pancreatitis, acute kidney injury, hyperkalemia and seizures as common symptoms [60]. A study involving over 600 patients with acute poisoning from glyphosate-containing herbicides in two hospitals in Sri Lanka between 2002 and 2007 found a 3.2% fatality rate, with a median time to death of 20 hours [61].…”

Section: Discussionmentioning

confidence: 99%

Death as a Drug Side Effect in FAERS: Is Glyphosate Contamination a Factor?

Seneff¹,

Swanson²,

Li³

et al. 2015

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An analysis of selected datasets from the FDA's drug Adverse Event Reporting System (FAERS) leads us to hypothesize that glyphosate contamination in both food and drugs is a major contributor to chronic and acute kidney failure respectively. In chronic kidney failure, glyphosate-induced pancreatitis results in the release of trypsin, causing a leaky vasculature. The albumin-bound glyphosate escapes into the tissues, protecting the circulatory system and kidneys but resulting in multiple symptoms related to skin, gut, brain, bones, lungs, etc. The rare and poorly understood acute kidney failure response reported for protamine sulfate and Trasylol ® is strikingly similar to that associated with glyphosate poisoning. Both drugs are derived from biological tissues that are plausibly contaminated with glyphosate. These drugs protect from haemorrhage, which leads to retention of glyphosate in the vasculature, are followed by circulatory collapse and a high likelihood of death as an outcome. We support our argument by comparing symptom profiles of selected subsets of FAERS with those related to glyphosate poisoning, anomalous reactions to protamine sulfate, and conditions showing strong statistical time-trend correlations with glyphosate.

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Predicting acute complicated glyphosate intoxication in the emergency department

Abstract: The results of this study showed that age > 50 years, X-ray abnormalities, and ALT > 40 U/L were significant predictive factors for complications in patients with glyphosate surfactant herbicide poisoning; patients with these findings might require admission to the intensive care unit.

Cited by 44 publications

References 27 publications

Estimating poisoning substance amounts: Comparative study of the accuracy of health care professionals and non-practitioners

Estimating poisoning substance amounts: Comparative study of the accuracy of health care professionals and non-practitioners

Kidney biomarkers in MCPA-induced acute kidney injury in rats: Reduced clearance enhances early biomarker performance

Death as a Drug Side Effect in FAERS: Is Glyphosate Contamination a Factor?

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