Toluene toxicity presenting with hypokalemia, profound weakness and U waves in the electrocardiogram

Carrizales-Sepúlveda, Edgar Francisco; Vera-Pineda, Raymundo; Jiménez-Castillo, Raúl Alberto; Treviño-García, Karla Belén; Ordáz-Farías, Alejandro

doi:10.1016/j.ajem.2019.158417

Cited by 6 publications

(1 citation statement)

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“…The most common ECG changes induced by hypokalemia include ST-segment depression, decreased T wave amplitude, and increased U wave amplitude. 3,4 Hypokalemia is also known to expose or accentuate the Brugada ECG pattern, possibly by enhancing the transient outward current with an increasing transmural or epicardial dispersion of repolarization in the right ventricle. 5,6 Notably, hyperkalemia can also cause BrP, which is more common than hypokalemia-induced BrP.…”

Section: Discussionmentioning

confidence: 99%

ST-Segment Elevation in a Man Receiving Peritoneal Dialysis

Cao

Liu

2021

JAMA Intern Med

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A man in his 60s with a history of chronic kidney disease and longterm peritoneal dialysis presented to the emergency department with heart palpitations and severe weakness of the upper and lower limbs. The patient's medical history also included an inferior wall myocardial infarction in 2011, but unexplained syncope was denied, and he reported no family history of sudden cardiac death. On admission, the patient's blood pressure was 160/80 mm Hg; heart rate, 102 beats per minute; and respiratory rate, of 20 breaths per minute. Examination of the limbs showed symmetrical weakness in the extremities. Cardiopulmonary examination showed no notable findings. The result of high-sensitivity cardiac troponin level testing was 0.03 ng/mL (reference, <0.02 ng/mL; to convert to μg/L, multiply

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Section: Discussionmentioning

confidence: 99%

ST-Segment Elevation in a Man Receiving Peritoneal Dialysis

Cao

Liu

2021

JAMA Intern Med

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Identifying and Prioritizing Hazardous Chemicals in Construction Metal Structure Coating Systems: A Roadmap for Data‐Driven Disease Prevention

Patel,

Bello,

Bello

2024

American J Industrial Med

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IntroductionOccupational exposure as a painter was classified by the International Agency for Research on Cancer (IARC) as a Group 1 carcinogen (carcinogenic to humans) in 1989. Chemical agents responsible for cancers and other illnesses among industrial painters are not well‐documented. The goal of this systematic review and synthesis was to document the chemistries of metal structure coating systems, summarize data gaps on occupational exposures and health effects among painters, and identify and prioritize hazardous chemicals to guide future exposure and occupational health studies, and ultimately disease prevention efforts.MethodsWe reviewed coating products approved by the Northeast Protective Coating Committee (NEPCOAT) for use in steel bridges in New England, with a special focus on Part B of these reactive chemical systems, and related literature on exposures and health effects.ResultsFrom the review of safety datasheets (SDS), we identified 61 unique CAS numbers belonging to different Part B chemical groups of isocyanate‐ and epoxy‐based formulations, including amine hardeners, solvents, nanomaterials, and other additives. The list of identified ingredients contained 14 potent sensitizers, two IARC Group 1 known carcinogens, and 7 IARC Group 2B possible carcinogens. Cancers of the lungs, urinary bladder, liver, kidneys, and gastrointestinal system, allergic contact dermatitis, lung fibrosis, and asthma were some possible disease endpoints. Existing occupational exposure studies focused on solvent exposures, while exposure and biomonitoring studies of amine hardeners and other ingredients of concern in these formulations are lacking.ConclusionsThe list of chemicals of concern identified here, including sensitizers and carcinogens, can serve as a basis for analytical method development and field exposure assessment studies. A national multi‐pronged strategy to reduce chemical exposures and health risks among construction painters is warranted, including research on exposure monitoring and reduction efforts, longitudinal epidemiological studies, and product reformulation.

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