To see the other types of publications on this topic, follow the link: Atropinization.
Journal articles on the topic 'Atropinization'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 35 journal articles for your research on the topic 'Atropinization.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Mohamad, Abeer, Hind Mahdi, and Majid Younis. "THE COMPARISON BETWEEN THE EFFECT OF TWO HOURS ATROPINIZATION VERSUS THREE DAYS ATROPINIZATION ON THE CYCLOPLEGIC OUTCOME IN CHILDREN." Iraqi Journal of Medical Sciences 16, no. 4 (2018): 372–77. http://dx.doi.org/10.22578/ijms.16.4.3.
Full textAbstract:
Background: Cycloplegia abolishes the accommodative power by causing paralysis of ciliary muscle by anticholinergic drugs, which will inhibit stimulation of both ciliary muscle and sphincter pupillae causing cycloplegia and mydriasis. Atropine is widely used in cycloplegic refraction despite its potential toxicity. Objective:To evaluate the possible role of two hours atropinization versus three days atropinization on the cycloplegic outcome in children. Methods: This is a clinical interventional study that included fifty children aged two to seven years' old who attended Ibn Alhaitham Teaching Hospital from October 2012 to March 2013; manual refraction was done for each child after 120 minutes of two drops atropine 1% five minutes apart and refraction was repeated after three days of twice daily atropine 1% administration by the parents. T-test was used for means comparison. Results: Fifty patients (26 males, mean age 3.89 ± 1.3) were included in the study. Spherical equivalent results obtained after three days atropinization (M = 4.2, SD = 1.85) were significantly higher than those obtained after two hours atropinization (M = 3.84, SD = 1.64) (t(49) = - 6.60, p < 0.05). Conclusion: Two hour atropinization was inferior to the standard three days atropinization as it has less cycloplegic effect and so it cannot be recommended based on the current evidence. Keywords: Atropine, cycloplegia, atropinization, refraction Citation: Mohamad AA, Mahdi HA, Younis MS. The comparison between the effect of two hours atropinization versus three days atropinization on the cycloplegic outcome in children. Iraqi JMS. 2018; 16(4): 372-377. doi: 10.22578/IJMS.16.4.3
2
Auffarth, Gerd, and Wilfried Hunold. "Cycloplegic refraction in children: Single-dose-atropinization versus three-day-atropinization." Documenta Ophthalmologica 80, no. 4 (1992): 353–62. http://dx.doi.org/10.1007/bf00154384.
Full text
3
Park, Jong-uk, Young-gi Min, Sangcheon Choi, Dong-wan Ko, and Eun Jung Park. "Assessment and Methods of Nutritional Support during Atropinization in Organophosphate and Carbamate Poisoning Cases." Journal of The Korean Society of Clinical Toxicology 18, no. 2 (2020): 123–29. http://dx.doi.org/10.22537/jksct.2020.18.2.123.
Full textAbstract:
Purpose: Atropine is an antidote used to relieve muscarinic symptoms in patients with organophosphate and carbamate poisoning. Nutritional support via the enteral nutrition (EN) route might be associated with improved clinical outcomes in critically ill patients. This study examined the administration of nutritional support in patients undergoing atropinization, including methods of supply, outcomes, and complications. Methods: A retrospective observational study was conducted in a tertiary care teaching hospital from 2010 to 2018. Forty-five patients, who were administered with atropine and on mechanical ventilation (MV) due to organophosphate or carbamate poisoning, were enrolled. Results: Nutritional support was initiated on the third day of hospitalization. Thirty-three patients (73.3%) were initially supported using parenteral nutrition (PN). During atropinization, 32 patients (71.1%) received nutritional support via EN (9) or PN (23). There was no obvious reason for not starting EN during atropinization (61.1%). Pneumonia was observed in both patient groups on EN and PN (p=0.049). Patients without nutritional support had a shorter MV duration (p=0.034) than patients with nutritional support. The methods of nutritional support during atropinization did not show differences in the number of hospital days (p=0.711), MV duration (p=0.933), duration of ICU stay (p=0.850), or recovery at discharge (p=0.197). Conclusion: Most patients undergoing atropinization were administered PN without obvious reasons to preclude EN. Nutritional support was not correlated with the treatment outcomes or pneumonia. From these results, it might be possible to choose EN in patients undergoing atropinization, but further studies will be necessary.
4
Bark, Sang U., Jeong Mi Moon, and Byeng Jo Chun. "Enteral nutrition in mechanically ventilated patients after organophosphate poisoning." Journal of The Korean Society of Clinical Toxicology 22, no. 1 (2024): 1–9. http://dx.doi.org/10.22537/jksct.2024.00001.
Full textAbstract:
Purpose: Nutritional therapy is a crucial component of therapy for critically ill patients, but there is a lack of nutritional support guidelines for organophosphate (OP) poisoning, likely due to the gastrointestinal effects of atropine, the main antidote for OP. This study investigated whether enteral nutrition (EN) during atropinization is acceptable for mechanically ventilated patients after OP poisoning.Methods: This retrospective study classified 82 patients with OP poisoning according to whether they were fed during atropinization while on mechanical ventilation (MV). Data on the baseline characteristics, nutritional support, and clinical outcomes were compared. Univariate and multivariate regression models were constructed to analyze the associations between atropine administration for OP poisoning and feeding intolerance-related EN after adjustment for risk factors.Results: Eighty-two patients received EN after 72 hours on MV, and 40 of them simultaneously received 2 mg/hr atropine for the first 120 hours after EN initiation. The overall incidence of feeding intolerance was 57.3% during the first 12 days after EN initiation and did not differ according to atropine administration. Appropriate atropinization during EN in regression model 1 and the dosage of atropine administered during EN and the duration of EN during atropinization in model 2 were not associated with feeding intolerance in patients on MV after OP poisoning.Conclusion: Appropriate atropinization is not associated with feeding intolerance after EN provision in patients on MV after OP poisoning. This study will help establish nutritional guidelines for OP poisoning patients. More research on nutritional support is needed to validate our results.
5
Muzaffar, Ali Shaikh Muhammad Iqbal* Mumtaz Ali Lakho Syed Jahanghir Sadia Shaikh and Hamid Nawaz Ali Memon. "CASUAL COMPARATIVE ANALYSIS OF SPEED OF INITIAL ATROPINIZATION AND RATE OF SYMPTOM RESOLUTION AMONG PATIENTS OF ACCIDENTAL ORGANOPHOSPHATE POISONING." Indo American Journal of Pharmaceutical Sciences 04, no. 10 (2017): 3445–50. https://doi.org/10.5281/zenodo.1001730.
Full textAbstract:
Objective: This study hopes to compare the rate of symptom resolution achieved with different recommended speeds of initial atropinization as part of treatment of patients presenting with accidental organophosphate insecticide poisoning. Methodology: The casual-comparative analysis was conducted at the department of medicine, Liaquat university hospital, upon a total of 117 patients from October 2016 to July 2017. Informed consent was acquired from each patient before administering each of the recommended dosage regimens. Results: The best performing regimen was administration of a beginning bolus of one to two milligrams of atropine, seconded shortly (five minutes) by a doubled dose of atropine. This practice of administering a doubled dose after 5 minutes is followed till complete atropinization is obtained. Among the many up sides of our most successful regimen, most notable were the facts that, administration of a mean dose (25 mg) required not more than twenty minutes, it worked well even for rare cases that required rather large quantities of atropine, allowing 75 mg of atropine to be administered in no more than 25–30 minutes, and finally, it even catered to the needs of patients that require small doses owing to the fact that the beginning bolus can be a mere 1 mg. Conclusion: After careful consideration and deliberation on the obtained results, the use of a dosage regimen with the high pace of initial atropinization to halt the adverse effects seems to be the best choice. It shall help to considerably decrease the mortality owing to organophosphate poisoning. It addition to that, the use of a simple and easy to follow dosage regimen is more likely to be followed correctly. Keywords: Atropinization, Organophosphate Poisoning, Accidental Poising, Symptom Resolution, Treatment Speed and Modality Speed Comparison.
6
Ninomiya, I., K. Matsukawa, T. Honda, N. Nishiura, and M. Shirai. "Cardiac sympathetic nerve activity and heart rate during coronary occlusion in awake cats." American Journal of Physiology-Heart and Circulatory Physiology 251, no. 3 (1986): H528—H537. http://dx.doi.org/10.1152/ajpheart.1986.251.3.h528.
Full textAbstract:
Responses in efferent cardiac sympathetic nerve activity (CSNA) and heart rate (HR) to a 100-s anterior descending coronary artery occlusion were measured in cats under awake, atropinized, anesthetized, or anesthetized and atropinized states. In the conscious state, at 20 and 90 s of occlusion, CSNA increased by 23% and then decreased by 7%, respectively, whereas HR decreased by 5 and 17%, respectively. With atropinization and/or anesthesia, the initial increase in CSNA was inhibited and the later decrease in CSNA was enhanced, whereas the bradycardia was diminished. HR changed in proportion to CSNA responses with high correlations, i.e., r = +0.89, +0.90, +0.96, and +0.91 for the four states, respectively. In the conscious state, the CSNA-HR relation line shifted toward bradycardia, but this shift was blocked by atropinization and anesthesia. This finding suggested that, in the conscious state, cardiac vagal nerve activity (CVNA) increased immediately and did not decrease during occlusion. At the early stage of occlusion, HR response (bradycardia or tachycardia) was determined by the relative contribution of enhanced CSNA and CVNA. At the later stage of occlusion, bradycardia was induced by a combination of decreased CSNA and enhanced CVNA. In anesthesia and/or atropinization it was induced mainly by the decreased CSNA.
7
SVENNERSTEN, K., L. NELSON, and K. JUVNÄS-MOBERG. "Atropinization decreases oxytocin secretion in dairy cows." Acta Physiologica Scandinavica 145, no. 2 (1992): 193–94. http://dx.doi.org/10.1111/j.1748-1716.1992.tb09355.x.
Full text
8
Dr., Digbijay Kumar Thakur, Rameshwar Mahaseth Dr., and SidhiDatri Jha Dr. "Predictors of Morbidities in Organophosphate Poisoning." International Journal of Innovative Science and Research Technology 7, no. 3 (2022): 878–94. https://doi.org/10.5281/zenodo.6421676.
Full textAbstract:
Organophosphate compounds are the most common pesticides with high potential for producing acute and sub-acute toxicities. As we know, debates continue over indicators of poor prognosis and mortality.we intended to observe if morbidity in terms of requirement of ventilation, complications developed, prolongation of QTc interval, derangement in liver and renal functions, hospital stay and need of ICU admission can be assessed from clinical parameters at presentation.This might enable clinicians to identify patients needing intensive monitoring and treatment. Methods: This is a cross sectional observational hospitalbasedstudy.Patients were grouped into age class intervals, severity of poisoning done on the basis of ACHE level and POP score. QTc was calculated by Bazzetˈs formula, grouped into normal and prolonged categories. Statistical analysis was done by SPSS 25. Observations and results: Altogether 66 patients were enrolled in this study. Among them, 22(33.33%) were male and 44(66.7%) were female. Patients with deranged LFT and RFT were found to have higher mean amount of organophosphate compound ingested, p < 0.05. Both deranged LFT and RFT group were having higher mean value for dose of atropine to reach atropinization, WBC count, QTc level and lower mean value for O2 saturation; p < 0.05. Those admitted in ICU and having infiltrates on chest x-ray were having higher mean amount of op compound ingested, were requiring higher atropine to reach atropinization, having higher pop score, found to have tachypnoea, higher mean QTc interval, lower mean SBP and lower mean O2 saturation; p < 0.05. Patients with long hospital stays and developing complications specially those requiring vasopressor and ventilatory support were having higher mean amount of op compound ingested, large mean dose of atropine to reach atropinization, prolonged mean QTc interval, high mean respiratory rate, higher WBC count, higher mean pop score, lower SBP and lower mean O2 saturation. Similarly, patients with lower GCS score were having higher mean value for amount of op compound ingested (p = 0.018), pop score (p = 0), RR (p = 0) and lower mean value for O2. similarly, patients with severe poisoning were requiring higher dose of atropine to reach atropinization, developing complications and needing ICU admission, requiring long hospital stays, needing vasopressor support, having prolonged QTc interval and low GCS core; p < 0.05. Conclusion: Amount of organophosphate compound ingested, higher dose of atropine to achieve atropinization, low GCS, high respiratory rate, low oxygen saturation, prolongation of QTc interval, high WBC count, low systolic BP, low serum ACHE level and high pop scores are predictors of morbidities in acute organophosphate poisoning
9
Buckley, Nicholas A., Andrew H. Dawson, and Ian M. Whyte. "Organophosphate Poisoning: Peripheral Vascular Resistance – A Measure of Adequate Atropinization." Journal of Toxicology: Clinical Toxicology 32, no. 1 (1994): 61–68. http://dx.doi.org/10.3109/15563659409000431.
Full text
10
Connors, Nicholas J., Zachary H. Harnett, and Robert S. Hoffman. "Comparison of Current Recommended Regimens of Atropinization in Organophosphate Poisoning." Journal of Medical Toxicology 10, no. 2 (2013): 143–47. http://dx.doi.org/10.1007/s13181-013-0324-9.
Full text
11
Rauhofer, E. A., D. Greenberg, and G. P. Smith. "Peripheral atropinization does not change meal size controlled by prepyloric mechanisms." Physiology & Behavior 59, no. 2 (1996): 237–40. http://dx.doi.org/10.1016/0031-9384(95)02132-9.
Full text
12
Sudhan Devkota, Sanjog Kandel, Bhawana Giri, et al. "Sigmoid Volvulus: A Rare Complication of Atropine Therapy in a Patient with Organophosphorus Poisoning: A Case Report." Journal of Universal College of Medical Sciences 12, no. 01 (2024): 65–68. http://dx.doi.org/10.3126/jucms.v12i01.65661.
Full textAbstract:
Various complications of atropine therapy in cases of organophosphorus poisoning have been reported. Among them, atropine induced paralytic ileus is a serious gastrointestinal complication with very few cases published worldwide. The tendency of over atropinization in organophosphorus poisoning despite regular monitoring is common and may develop life threatening complications as well. This necessitates knowledge, thorough examination, and an experienced approach to aid in treatment and complications management. We have discussed a case of organophosphorus poisoning, with symptoms of atropine toxicity and acute abdominal complication treated with surgical approach in our setting.
13
Singh, Supriya, Bidri RC, and Veeresh Badiger. "COMPARATIVE STUDY OF COMMONLY PRACTICED ATROPINIZATION REGIMENS IN ACUTE ORGANOPHOSPHORUS COMPOUND POISONING." International Journal of Clinical and Biomedical Research 4, no. 2 (2018): 56. http://dx.doi.org/10.5455/ijcbr.2018.42.13.
Full text
14
Sah, Arun Kumar, and Rajesh Kumar Mandal. "Prognostic Value of Serum Cholinesterase in Acute Organophosphate Poisoning." International Journal of Health Sciences and Research 12, no. 2 (2022): 125–31. http://dx.doi.org/10.52403/ijhsr.20220217.
Full textAbstract:
Background: Organophosphorus (OP) compounds are anti acetylcholinesterase, used abundantly as pesticides and often misused as poisoning agents. Irreversible inhibition of cholinesterase enzymes is attributed to the serious clinical outcomes in these patients. This study aims to identify the relationship between the serum cholinesterase (SChE) activity and outcome. Material and Methods: A descriptive cross-sectional study conducted in the Department of Internal Medicine of Bir Hospital, Kathmandu from July 2019 to December 2019. 50 patients of OP poisoning were studied. Laboratory investigations including SChE activity were performed and their management and their outcomes were recorded and analyzed by using statistical package for social sciences (SPSS) version 20. Results: Poisoning was more predominant in young adults of the age group of 15 to 35(68%) years. Most common compound used for poisoning was chlorpyriphos 50% + cypermethrin 5% followed by dichlorvos 85% and cypermethrin. Among 50 cases 48 cases were discharged after successful management while 2 cases expired. No significant relation between initial serum level of acetylcholinesterase and outcome was observed in this study with p- value >0.05. Significant relation between initial serum acetylcholinesterase level, duration of hospital stay, atropinization dose and hospital arrival time from ingestion of poison was found with p- value of <0.05. Conclusion: There was a significant correlation between SCH levels and total atropinization dose, duration of hospital stay and hospital arrival time. However no significant correlation was found for the clinical outcome and need of mechanical ventilator. Key words: organophosphorous poisoning, serum acetylcholinesterase, cholinesterase.
15
Wang, W., Q.-F. Chen, H.-L. Ruan, K. Chen, B. Chen, and J.-M. Wen. "Can anisodamine be a potential substitute for high-dose atropine in cases of organophosphate poisoning?" Human & Experimental Toxicology 33, no. 11 (2014): 1186–90. http://dx.doi.org/10.1177/0960327114532382.
Full textAbstract:
A case of organophosphate (OP) poisoning was admitted to the emergency room. The patient accepted treatment with pralidoxime (PAM), atropine, and supporting therapy. It was observed that even after 22 h after treatment, 960 mg of atropine was not enough for the patient to be atropinized. However, a 160-mg follow-up treatment of anisodamine was quite enough for atropinization after 4 h. As a case report, more studies are required before any definite conclusion can be reached regarding the use of anisodamine as a potential substitute for high-dose atropine in cases of OP poisoning.
16
Vieira De Melo Junior, E., I. Natalia Solarte Agredo, S. B. D. Oliveira, et al. "PNS9 BUDGET IMPACT OF NEW RECOMMENDATION FOR ATROPINIZATION IN BRAZILIAN GUIDELINES FOR ANTICOLINESTARASIS INTOXICATION." Value in Health Regional Issues 19 (October 2019): S64. http://dx.doi.org/10.1016/j.vhri.2019.08.357.
Full text
17
Whatham, Andrew R., Daniel Lunn, and Stuart J. Judge. "Effects of Monocular Atropinization on Refractive Error and Eye Growth in Infant New World Monkeys." Investigative Opthalmology & Visual Science 60, no. 7 (2019): 2623. http://dx.doi.org/10.1167/iovs.18-24490.
Full text
18
Garcia, S. I., S. M. Dabsys, D. Santajuliana, et al. "Interaction between thyrotrophin-releasing hormone and the muscarinic cholinergic system in rat brain." Journal of Endocrinology 134, no. 2 (1992): 215–19. http://dx.doi.org/10.1677/joe.0.1340215.
Full textAbstract:
ABSTRACT TRH increases the pressor response to acetylcholine through an increment in muscarinic receptors. As chronic atropinization produces a similar effect, we hypothesized that both phenomena may be related. The effect of chronic atropine treatment on the TRH content of several brain areas in Wistar rats was studied. Atropine produced significant increases in TRH content in the preoptic and septal areas, while decreases were observed in the hypothalamus and hypophysis. The concentration of TRH in cerebrospinal fluid rose significantly in atropine-treated rats compared with controls. A similar effect was observed with eserine, an acetylcholinesterase inhibitor. Finally, perfusion of brain preoptic area slices from normal rats with Krebs–Ringer solution in the presence of pilocarpine increased basal TRH release significantly and this effect was blocked by atropine. These results are compatible with a muscarinic control on the activity of the central TRH system. Journal of Endocrinology (1992) 134, 215–219
19
Wang, Wei, Quan-Fang Chen, Qi-Bin Li, et al. "Efficiency of anisodamine for organophosphorus-poisoned patients when atropinization cannot be achieved with high doses of atropine." Environmental Toxicology and Pharmacology 37, no. 2 (2014): 477–81. http://dx.doi.org/10.1016/j.etap.2013.12.016.
Full text
20
Pierzynowski, S. G., R. Zabielski, P. Podgurniak, et al. "Effects of reversible cold vagal blockade and atropinization on exocrine pancreatic function during liquid food consumption in calves." Journal of Animal Physiology and Animal Nutrition 67, no. 1-5 (1992): 268–73. http://dx.doi.org/10.1111/j.1439-0396.1992.tb00609.x.
Full text
21
Zabielski, R., S. Kato, SG Pierzynowski, H. Mineo, P. Podgurniak, and W. Barej. "Effect of intraduodenal HCl and soybean extract on pancreatic juice secretion during atropinization and cold vagal blockade in calves." Experimental Physiology 77, no. 6 (1992): 807–17. http://dx.doi.org/10.1113/expphysiol.1992.sp003647.
Full text
22
Allen, D. A., E. R. Schertel, S. E. Weisbrode, and P. D. Myerowitz. "Acute lung injury isolated to an in situ lung preparation causes sustained reflex cardiovascular depression in dogs." Journal of Applied Physiology 77, no. 4 (1994): 1850–57. http://dx.doi.org/10.1152/jappl.1994.77.4.1850.
Full textAbstract:
We tested the hypothesis that acute lung injury (ALI) isolated to a perfused in situ left lung preparation results in sustained reflex cardiovascular depression. Phorbol myristate acetate (PMA), an agent that activates neutrophils, administered into the isolated lung preparation of chloralose-anesthetized dogs resulted in ALI, as assessed by wet-to-dry weight ratios and histopathology, and significant decreases in heart rate (43%), mean arterial pressure (27%), aortic blood flow (29%) and maximum rate of change in left ventricular pressure (30%). Significant reflex effects occurred by 20 min after PMA administration and were sustained for 40 min (n = 7). Hemodynamic variables recovered when the left lung was denervated 60 min after PMA administration. Indomethacin administered into the isolated circulation before PMA (n = 5) did not significantly influence the ALI or reflex effects. Systemic atropinization (n = 6) prevented only the bradycardia. Left lung denervation before ALI (n = 3) prevented all reflex effects. We conclude that PMA administration into an isolated in situ lung preparation results in ALI and sustained reflex cardiovascular depression that is most likely elicited by pulmonary C-fiber stimulation and mediated by withdrawal of sympathetic efferent nerve activity.
23
NINOMIYA, Ishio, Kanji MATSUKAWA, Toshihiro HONDA, Naoki NISHIURA, and Akihiro NABUCHI. "Effects of baroceptor reflex on cardiac and renal sympathetic nerve activity before and after atropinization in awake cats at rest." Japanese Journal of Physiology 38, no. 4 (1988): 491–506. http://dx.doi.org/10.2170/jjphysiol.38.491.
Full text
24
Ackermann, Uwe, Julie Khanna, and Terumi G. Irizawa. "Atrial natriuretic factor alters autonomic interactions in the control of heart rate in conscious rats." Canadian Journal of Physiology and Pharmacology 66, no. 7 (1988): 930–36. http://dx.doi.org/10.1139/y88-151.
Full textAbstract:
Regulation of heart rate was studied in rats receiving either i. v. saline at 64 μL/min or synthetic 28-residue rat atrial natriuretic peptide (ANF) at a dose sufficient to decrease mean arterial blood pressure by 10%. Autonomic influences were deduced from steady-state heart rate responses of each group to propranolol, atropine, or propranolol and atropine combined. A multiplicative model of heart rate control was used to derive quantitatively from the data the modulation of intrinsic heart rate by sympathetic and parasympathetic mechanisms. Animals receiving ANF showed a lower heart rate than control animals. This relative bradycardia was abolished by atropine. Blocking of sympathetic effects with propranolol had no effect on basal heart rate in either group, and atropinization led to significant increases in heart rate in both groups of rats. Mathematical analysis of the results showed that the bradycardia produced by ANF was due predominantly to a reduced intrinsic heart rate and to enhanced vagal inhibition of postganglionic sympathetic activity. Parasympathetic contribution to heart rate in the absence of sympathetic activity was negligible in control rats and small during ANF. We conclude that the major influences of ANF on heart rate control are a decrease of intrinsic heart rate and enhanced parasympathetic inhibition of postganglionic presynaptic sympathetic activity.
25
Perera, PMS, S. Shahmy, I. Gawarammana, and AH Dawson. "Comparison of two commonly practiced atropinization regimens in acute organophosphorus and carbamate poisoning, doubling doses vs. ad hoc: a prospective observational study." Human & Experimental Toxicology 27, no. 6 (2008): 513–18. http://dx.doi.org/10.1177/0960327108091861.
Full textAbstract:
There is a wide variation and lack of evidence in current recommendations for atropine dosing schedules leading to subsequent variation in clinical practice. Therefore, we sought to examine the safety and effectiveness of a titrated vs. ad hoc atropine treatment regimen in a cohort of patients with acute cholinesterase inhibitor pesticide poisoning. A prospective cohort study was conducted in three district secondary referral hospitals in Sri Lanka using a structured data collection form that collected details of clinical symptoms and outcomes of cholinesterase inhibitor pesticide poisoning, atropine doses, and signs of atropinization. We compared two hospitals that used a titrated dosing protocol based on a structured monitoring sheet for atropine infusion with another hospital using an ad hoc regime. During the study, 272 symptomatic patients with anticholinesterase poisoning requiring atropine were admitted to the three hospitals. Outcomes of death and ventilation were analyzed for all patients, 226 patients were prospectively assessed for atropine toxicity. At baseline, patients in the titrated dose cohort had clinical signs consistent with greater toxicity. This in part may be due to ingestion of more toxic organophosphates. They received less pralidoxime and atropine, and were less likely to develop features of atropine toxicity, such as delirium (1% vs. 17%), hallucinations (1% vs. 35%), or either (1% vs. 35%) and need for patient restraint (3% vs. 48%) compared with the ad hoc dose regime. After adjusting for the pesticides ingested, there was no difference in mortality and ventilatory rates between protocols. Ad hoc high dose atropine regimens are associated with more frequent atropine toxicity without any obvious improvement in patient outcome compared with doses titrated to clinical effect. Atropine doses should be titrated against response and toxicity. Further education and the use of a structured monitoring sheet may assist in more appropriate atropine use in anticholinesterase pesticide poisoning.
26
Proskurina, O. V. "STATIC STREAK SKIASCOPY (RETINOSCOPY) UNDER NATURAL CONDITIONS AND IN CYCLOPLEGIA." Russian Pediatric Ophthalmology 9, no. 1 (2014): 33–36. https://doi.org/10.17816/rpoj37567.
Full textAbstract:
This study was designed to estimate the accuracy of results obtained by static streak skiascopy. It included 58 children at the age from 5 to 18 years with refraction studied under natural conditions and 79 children at the age varying from 1 to 18 years with refraction evaluated within 3 days after atropinization. The results of static streak skiascopy were compared with the data obtained by skiascopy performed using a plane mirror or by a subjective study and autorefractometry. It was shown that the results of the measurement of sphere equivalent refraction under natural conditions and by static streak skiascopy were comparable with those obtained by other methods. Static streak skiascopy under natural conditions was shown to overestimate the degree of astigmatism by 0.55±0.6 dptr compared with subjective correction, the difference along the axis amounted to 3.23±0.59°. Static streak skiascopy under natural conditions and autorefractometry yielded comparable results. In the patients with cycloplegia static streak skiascopy revealed a 0.41±0.5 dptr higher degree of astigmatism than skiascopy with a plane mirror, the difference along the axis was 10-35°. This data was comparable with the results of subjective correction and autorefractometry. It is concluded that static streak skiascopy should be used either instead of skiascopy with a plane mirror or in the cases when autorefractometry is impracticable.
27
Koirala, Deepak Prasad, Kalipatnam Seshagiri Rao, Kalpana K. Malla, and Tejesh Malla. "A Study of Clinical Features, Management and Outcome of Organophosphate and Carbamate Poisoning in Children." Journal of Nepal Paediatric Society 33, no. 2 (2013): 85–90. http://dx.doi.org/10.3126/jnps.v33i2.7799.
Full textAbstract:
Introduction: Organophosphates (OP) are commonly used pesticides in rural agricultural regions of Nepal and carbamates are popular household insecticides. Because of poor legislation these poisons are easily accessible and are the most popular suicidal poisons. Materials and Methods: This was a retrospective study done in poisoning cases admitted in PICU of Manipal Teaching Hospital (MTH) over a seven year period. Results: Out of 187 cases of poisoning, 30 (16.04%) were OPs and 4 (2.13%) were Carbamates. The male to female ratio was 56:44 and these poisonings were more common in rural areas (56%). Accidental poisoning (82.4%) was more common but suicidal attempts (17.6%) were also observed. Atropine and pralidoxime were used in 82.4% of the cases. The total atropinizing dose was 0.77±0.6 mg/kg and patients required 56.6±23.7 hours of atropinization. In our study 94.1% of the patients survived and none of them developed any sequel. Children developed muscarinic, nicotinic and CNS symptoms similar to adults. Complications were seen in 41.1% of the children and most common being seizure (85.7%). The most common OP observed in childhood poisoning was Metacid (methyl parathion) seen in 26.4% of the cases. Conclusion: OP and Carbamate poisonings are common in children. Possibility of self-harm poisoning in adolescent females cannot be ignored. Atropine is the mainstay of therapy after initial resuscitation and complications are common in children. With prompt treatment the outcome is good even with complications. The case fatality rate is much less as compared to adults.DOI: http://dx.doi.org/10.3126/jnps.v33i2.7799 J Nepal Paediatr Soc. 2013; 33(2):85-90
28
Junapati, I. Kadek Ludi, and Fabianus Anugrah Pratama. "Effectiveness of Atropine Sulfate and Diazepam in Organophosphate Poisoning in Remote Area: A Case Report." Solo Journal of Anesthesi, Pain and Critical Care (SOJA) 4, no. 2 (2024): 139. http://dx.doi.org/10.20961/soja.v4i2.77914.
Full textAbstract:
<strong>Background</strong>: Organophosphate poisoning is a significant public health concern in developing countries, including Indonesia, largely due to the widespread use of pesticides and insecticides. These chemicals, while effective for agricultural purposes, have been linked to severe health issues, including acute poisoning. One of the major health risks associated with organophosphate exposure is its potential link to suicide attempts. The toxic effects of organophosphates primarily stem from their inhibition of acetylcholinesterase, an enzyme crucial for the proper functioning of the nervous system. This inhibition leads to the accumulation of acetylcholine, resulting in overstimulation of the nervous system. Managing organophosphate poisoning poses a considerable challenge, particularly in remote areas where access to specific antidotes is limited.<br /> <strong>Case Illustration</strong>: A 17-year-old female high school student presented to the emergency room of the Boawae Primary Health Care Center with a major complaint of decreased consciousness, as evidenced by a Glasgow Coma Scale (GCS) score of 9/15. The patient had no prior history of neurological or psychiatric disorders. It was suspected that the patient had attempted suicide by ingesting pesticides approximately 60 minutes prior to admission. At the time of admission, she exhibited symptoms including nausea and vomiting, which had progressively worsened. Upon examination in the emergency room, the patient displayed increased saliva production and pinpoint pupils. In response to these symptoms, the medical team administered intravenous Diazepam and Atropine Sulfate, continuing treatment until atropinization was achieved.<br /> <strong>Conclusion</strong>:<strong> </strong>In managing organophosphate poisoning, particularly in remote regions with limited access to specific antidotes, Atropine Sulfate and Diazepam represent viable alternative treatment modalities. These treatments can effectively counteract the toxic effects of organophosphates and achieve necessary atropinized conditions to stabilize the patient’s condition.
29
Kumar Thakur, Dr Digbijay, Dr Sidhi Datri Jha, Dr Rameshwar Mahaseth, and Dr Manish Pande. "Clinical consequences of Hypotension in patient with organophosphate poisoning." International Journal of Medical Science and Clinical Invention 8, no. 12 (2021): 5858–64. http://dx.doi.org/10.18535/ijmsci/v8i12.04.
Full textAbstract:
Objective: Aim of study is to describe the clinical consequences of hypotension in patient with organophosphate poisoning. Method: In the retrospective cohort study, we analyzed data of 66 patients with organophosphate poisoning who were treated at Bir Hospital, Nams Kathmandu. Data from those with hypotension and normal blood pressure were compared to identify significant clinical consequences. Results: All together 66 patients were enrolled in this study out of which 44(66.7%) were female and 22(33.3%) were male. After analyzing data, we found 18.2% of case with severe poisoning (ACHE < 700 U/L). Among all, 41(62%) were found to have normal blood pressure and 25(37.9%) were found to have low blood pressure. Among those with hypotension, around 56% were found to have prolonged QTc interval, p < 0.003 and there was statistically significant association between QTc prolongation and vasopressor requirement, X2(1) = 22.98, P < 0.001. Patients requiring higher dose to reach atropinization had statistically significant hypotension, P < 0.001. Those with low blood pressure were found to require more days of hospital admission, P < 0.001. Patients with hypotension were found to have severe poisoning both on the basis of POP Score severity grading, 16(64%) P <0.002 and ACHE Severity scale, 7(28%) P < 0.05. In comparison with normal blood pressure group, low blood pressure group had significantly more chance of developing complications like septic shock (2), aspiration pneumonia (5), ARDS (1) and bed sore, P = 0.002. Vasopressor requirement was significantly more among those with low blood pressure, P < 0.001. Most of hypotensive patients were needing ICU care, found to have higher WBC count P = 0.002 and lower GCS Score at admission P < 0.001. There was positive correlation between hypotension and POP Score at admission P < 0.001. Conclusion: Hypotension is a common complication in patient with organophosphate poisoning and is associated with higher POP Score, lower ACHE level, lower GCS Score, increased vasopressor requirement, more hospital stays, increasing ICU admission, more chance of developing septic shock and aspiration pneumonia.
30
Khanum, Easnem, Md Ashraful Islam, Mohammad Salim, SM Rafiqul Islam, and Md Rezaul Haque PK. "Management of OPC and Carbamate Poisoning in Intensive Care Unit of Enam Medical College & Hospital, Savar, Dhaka." Journal of Enam Medical College 8, no. 3 (2018): 144–52. http://dx.doi.org/10.3329/jemc.v8i3.38364.
Full textAbstract:
Background: Bangladesh is an agriculture-dependent country. Organophosphorus insecticides are widely used for the better outcome of cultivation. It is used for suicidal purpose due to its easy availability all over the country. Worldwide, acute pesticide poisoning is causing major health problems with high mortality in developing countries.Objective: The objective of our study was to establish that early management of acute poisoning with organophosphorus and carbamate in ICU along with ventilatory support in severe respiratory distress reduces the mortality rate.Materials and Methods: This study was conducted in the Department of Anesthesiology & ICU in Enam Medical College & Hospital, Savar, Dhaka from January 2013 to December 2015. Total 84 patients with acute poisoning cases were selected. The diagnosis was confirmed by the history of ingestion of insecticides, observing clinical signs and symptoms and presence of foul smelling of poisonous agent. Management included supportive care, intubation, artificial ventilation in selective cases, administration of antidotes as loading and maintenance dose for atropinization with atropine and pralidoxime, antibiotics, anti-ulcerant, anticonvulsant, inotropic support (in severe hypotension) along with other symptomatic treatment. After stabilization, decontamination was started with removal of contaminated clothes, thorough wash with soap and water, irrigation of eyes with water and normal saline. Gastric lavage was given within 2 to 3 hours of ingestion of poison.Results: Acute poisoning was observed more in male (60.71%) than in female (39.29%) and in age group of 21–40 years (60.71%). Suicidal attempt was present in 97.61% cases and causes of suicidal poisoning were familial disharmony (76.19%), financial loss (14.28%) and failure in examination (9.52%). Organophosphate group poison ingestion was in 77.38% cases and carbamate group poison in 21.43% and both agents in 1.19% cases. Ventilatory support was given in 48.80% cases and 78.05% patients were successfully extubated from mechanical ventilator. Mean duration of ventilatory support was 2–14 days. Out of 84 patients, 75 (89.28%) survived and 9 (10.72%) patients expired. Fifty two (61.91%) patients were discharged within 4–6 days, 16 (19.04%) within 2–3 days, and 7 (8.33%) patients were discharged within 7–14 days.Conclusion: Early ICU admission and appropriate management of patients after ingestion of poisonous agent results in reduced morbidity and mortality.J Enam Med Col 2018; 8(3): 144-152
31
М.Р., Мадиева, Тусупжанова А.К. та Жаркимбаева А.Д. "КЛИНИЧЕСКИЙ СЛУЧАЙ: ВОЗМОЖНОСТИ РЕНТГЕНОЛОГИЧЕСКОГО МЕТОДА В ДИАГНОСТИКЕ ВРОЖДЕННОГО ГИПЕРТРОФИЧЕСКОГО ПИЛОРОСТЕНОЗА". Наука и здравоохранение, № 2(23) (30 квітня 2021): 170–75. http://dx.doi.org/10.34689/sh.2020.22.6.019.
Full textAbstract:
В данной статье представлен клинический случай врожденного гипертрофического пилоростеноза (ВГП), диагностика которого основывается на рентгенологическом методе, до сих пор являющимся «золотым стандартом» для данной патологии у детей. Этиология до сих пор до конца не изучена. По-видимому, существуют генетические, семейные и экологические факторы предрасположенности, необходимые для развития ВГП [7]. Проведенный анализ демонстрируемой истории болезни показывает тактику ведения пациентов с врожденным пилоростенозом, основанный на клинико-диагностическом наблюдении, и свидетельствует о роли рентгенодиагностики в постановке диагноза. Несмотря на известную клиническую картину, имелись сложности в дифференциальной диагностике пилороспазма с субкомпенсированным пилоростенозом вследствие отклонения от классического течения заболевания и наличия сопутствующей патологии. С антиспастической целью проводилась терапия с антихолинэргическим препаратом (атропин) и динамическое рентгенологическое исследование. Из-за отсутствия динамики в клинике (повторяющаяся рвота, потеря массы тела) на фоне комплексного лечения было проведено оперативное вмешательство: пилоромиотомия по Фреде-Раштдету на 14 сутки от начала заболевания. Послеоперационный период протекал без осложнений. Ребенок выписан с выздоровлением и направлен на диспансерное наблюдение. Таким образом, диагностика ВГП на современном этапе продолжает основываться на клинико-анамнестических данных и рентгенологическом исследовании, что позволяет прогнозировать последующее восстановление таких детей. This article presents a clinical case of congenital hypertrophic pylorostenosis (HPS), the diagnosis of which is based on the X-ray method, which is still the "gold standard" in the diagnosis of this pathology in children. The etiology is still not fully understood. Apparently, there are genetic, family, and environmental predisposition factors necessary for the development of HPS [7]. The analysis of the demonstrated medical history shows the management tactics of patients with congenital pylorostenosis, based on clinical and diagnostic observation, and indicates the role of X-ray diagnostics in the diagnosis. Despite the well-known clinical picture, there were difficulties in the differential diagnosis of pylorospasm with subcompensatedpylorostenosis due to deviations from the classical course of the disease. Atropinization and X-ray examination were performed for anti-spastic purposes. Lack of dynamics against the background of complex treatment (repeated vomiting, weight loss), surgical intervention was performed: pylorotomy according to Fred-Rashtdet on the 7th day from the onset of the disease. The child was discharged with recovery and sent for medical observation. Thus, the diagnosis of HPS at the present stage continues to be based on clinical and anamnestic data and X-ray examination, which makes it possible to predict the subsequent recovery of such children. Бұл мақалада туа біткен гипертрофиялық пилориялықстеноздың (ТГП) клиникалық жағдайы келтірілген, оның диагностикасы рентген әдісіне негізделген, бұл балалардағы осы патологияны анықтауда«алтынстандарт» болып табылады. Этиология әлі толық зерттелмеген. Шамасы, ТГП дамуына қажетті генетикалық, отбасылық және экологиялық бейімділік факторлары бар [7]. Көрсетілген ауру тарихын талдау клиникалық-диагностикалық бақылауға негізделген туа біткен пилориялық стенозы бар науқастарды басқару тактикасын көрсетеді және диагностикадағы рентгендік диагностиканың рөлін көрсетеді. Белгілі клиникалық көрініске қарамастан, аурудың классикалық ағымынана уытқуына байланысты субкомпенсацияланған пилориялық стенозбен пилорлықспазмты дифференциалды диагностикалау да қиындықтар болды. Атропинизация және динамикалық рентгенологиялық зерттеу спастикаға қарсы мақсатта жүргізілді. Кешенді емдеу фонында динамиканың болмауы (қайталама құсу, дене салмағының төмендеуі) хирургиялық араласу арқылы жүргізілді: аурудың басталуынан бастап 7-ші күні Фреде-Раштдеттің айтуынша пилоротомия. Операциядан кейінгі кезең қиындықсыз өтті. Бала сауығыпкетіп, диспансерлік бақылауға жіберілді. Осылайша, қазіргі кезеңдегі ТГП диагнозы клиникалық және анамнестикалық мәліметтермен рентгенологиялық зерттеулерге негізделген, бұл осындай балалардың кейінгі қалпына келуін болжауға мүмкіндік береді
32
Yuksel Elgin, Cansu, Ahmet Fırat Atseven, Ofeliya Mammadzada, and Özcan Ocakoğlu. "Daratumumab-induced acute angle closure glaucoma: bone marrow transplantation as a possible risk factor and atropinization as a potential solution." BMC Ophthalmology 25, no. 1 (2025). https://doi.org/10.1186/s12886-025-04214-5.
Full textAbstract:
Abstract This case report describes a 29-year-old female with recurrent T-cell Acute Lymphoblastic Leukemia who developed acute angle closure glaucoma (AACG) following daratumumab infusion. The patient, with a history of bone marrow transplantation and head-neck radiotherapy, experienced sudden eye pain and blurred vision minutes after treatment initiation. Ophthalmological examination revealed bilateral closed angles and elevated intraocular pressure. Ultrasound biomicroscopy showed ciliary malrotation and effusion, suggesting choroidal effusion secondary to daratumumab. The condition was successfully managed with topical medications and subsequent infusions were administered with atropine premedication, preventing recurrence. This case highlights bone marrow transplantation as a potential risk factor for daratumumab-induced AACG and demonstrates the effectiveness of atropinization in managing this complication.
33
Ye, Changqing, Qiang Zhang, Yongsheng Chao, and Chun Yin. "Case Report: Effective Treatment for Acute Chlorpyrifos Poisoning Complicated by a Non-ST-Segment Elevation Myocardial Infarction." Frontiers in Cardiovascular Medicine 8 (April 30, 2021). http://dx.doi.org/10.3389/fcvm.2021.623708.
Full textAbstract:
Background: Acute myocardial infarction (AMI) is a rare complication of acute organophosphorus pesticide poisoning. Although chlorpyrifos has been widely used as an organophosphate insecticide, a few cases of AMI complicated by chlorpyrifos poisoning have been reported thus far. Hence, a suitable treatment strategy remains to be explored.Case Presentation: Based on the clinical manifestations, medical history, results of an auxiliary examination, and serum biomarkers, a 65-year-old male farmer with complaints of nausea, vomiting, chest tightness, and pain was clearly diagnosed as having a severe chlorpyrifos self-poisoning with acute non-ST-segment elevation MI. Because the patient and his family confirmedly refused a coronary intervention, conservative treatment was used instead. It should be noted that there were some conflicts of the management for chlorpyrifos poisoning and AMI. Although rapid atropinization would contribute to the relief of muscarinic symptoms, it would also lead to an increased heart rate and myocardial oxygen consumption in AMI. Furthermore, the reduction of platelet aggregation, which is necessary for coronary recanalization of an AMI patient, is known to aggravate the gastrointestinal injury caused by poisoning. In this case, these conflicts were properly addressed, which led to an excellent effect and prognosis of the patient.Conclusions: To our knowledge, this is the first case report of acute chlorpyrifos poisoning with AMI. It is emphasized that patients with chest pain or coronary heart disease should be treated with atropine more cautiously because of the possible AMI. Moreover, proper resolution of conflicts in the management for chlorpyrifos poisoning and AMI played contributing roles in patient improvement.
34
Kunlun, Wang, Yuan Jun, Xu Shiming, et al. "Case report: Treatment of severe phorate poisoning." Frontiers in Toxicology 7 (May 9, 2025). https://doi.org/10.3389/ftox.2025.1581362.
Full textAbstract:
BackgroundPhorate is a highly toxic organophosphorus pesticide. Owing to its low cost and insecticidal potency, it is still widely used in parts of China, resulting in cases of occupational and life poisoning. This article presents the treatment process for phorate poisoning and monitoring the toxic metabolites terminology in the body.Case reportA 23-year-old male patient ingested about 300 mL (180 g) of 60% phorate emulsion 4 h before admission at our hospital. The patient had ingested over 300 times the lethal dose. During hospitalization, the patient’s levels of cholinesterase, phorate and its metabolites, atropine and pralidoxime chloride (PAM), were monitored. Phorate was quickly absorbed into the blood, producing five metabolites. Before hemoperfusion (HP), the concentration of phorate in the blood could not be detected. After the first HP we found five metabolites of phorate in the blood (phoratoxon sulfoxide,phoratoxon sulfone, phorate sulfone, phorate sulfoxide, and phoratoxon). In the follow-up treatment, the concentration of five metabolites gradually decreased. The concentration of the phorate sulfoxide and phorate sulfone rebounded with the suspension of HP, but that of the other metabolites did not rebound. It took 20 days for cholinesterase to recover. Treatment included multiple rounds of HP, atropinization, and reactivator of cholinesterase by PAM. The patient recovered after 34 days and was discharged from hospital.ConclusionPhorate is oxidized and catalyzed into five metabolites, which cause the toxic effects. Phoratoxon sulfoxide has the highest concentration of these metabolites, followed by phoratoxon sulfone, phorate sulfone, phorate sulfoxide, and phoratoxon, respectively. HP treatment significantly lowered the serum levels of the toxic metabolites terminology. If HP treatment is interrupted, the serum levels of phorate sulfoxide and phorate sulfone tend to rise again. It takes a long time for cholinesterase to recover from severe phorate poisoning.
35
Kaymak, Hakan, Ann-Isabel Mattern, Birte Graff, et al. "Sicherheit von Brillengläsern mit DIMS-Technologie und Atropin in der Kombinationstherapie der Myopieprogresssion." Klinische Monatsblätter für Augenheilkunde, August 25, 2022. http://dx.doi.org/10.1055/a-1930-7116.
Full textAbstract:
Hintergrund: Es soll die Sicherheit im Straßenverkehr beim Tragen von Brillengläsern mit Defocus Incorporated Multiple Segments (DIMS) Technologie in der Kombination mit Atropin evaluiert werden. Patienten und Methoden: An 12 jungen Erwachsenen (Alter: 24 bis 45; 30,1 ± 5,7 Jahre) wurde der Fernvisus und die Kontrastempfindlichkeit (KE), sowie Blendempfindlichkeit bei Versorgung mit DIMS-Brillengläsern allein und in der Kombination mit 0,01% Atropin untersucht. Ergebnisse: Durch Atropineinwirkung vermindert sich der Fernvisus beim Blick durch den zentralen Bereich des DIMS-Brillenglases nicht; bei Blendung und unter Atropin kommt es zu einem Visusabfall um 0,10 LogMAR. Beim erzwungenen Blick durch den DIMS-Bereich vermindert sich der Fernvisus durch Atropineinwirkung ohne Blendung um 0,09 LogMAR; bei Blendung ist durch Atropin kein weiterer Visusabfall zu beobachten. Die Kontrastempfindlichkeit mit DIMS-Gläsern wird durch Atropineinwirkung nicht relevant verändert. Hinsichtlich der Blendempfindlichkeit findet sich bei DIMS-Gläsern keine für das Sehen und die Sicherheit im Straßenverkehr relevante Sehbeeinträchtigung. Zusätzliche Atropinisierung hat keinen Einfluss auf die Blendempfindlichkeit. Schlussfolgerung: DIMS-Brillengläser sind sicher im Straßenverkehr und verursachen keine relevante Beeinträchtigung des Sehens, auch nicht unter Einfluss von 0,01 % Atropin. DIMS Brillengläser sind daher auch bei der Behandlung von progressiven Myopien in der Kombinationstherapie mit Atropin sicher. Background: The aim of this study was to evaluate traffic safety of Defocus Incorporated Multiple Segments (DIMS) spectacle lenses in combination therapy with atropine. Patients and Methods: 12 young adults (age: 24 -45; 30,1 ± 5,7 years) were recruited to evaluate corrected distance visual acuity (CDVA), contrast sensitivity (CS) (FrACT), glare sensitivity (Mesotest) under the influence of DIMS-spectacle correction alone and combination therapy with 0,01% atropine. Results: When looking through the central area of the DIMS lens, far vision does not decrease due to the influence of atropine; influence of glare and atropine leads to a reduction of CDVA by 0.10 LogMAR. When forced to look through the DIMS area, far vision is reduced by 0.09 LogMAR due to the influence of atropine in the absence of glare; in the presence of glare, no further loss of visual acuity can be observed under the influence of atropine. Contrast vision with DIMS glasses is not altered by the effects of atropine. Concerning glare sensitivity, DIMS lenses did not show any visual impairment that would be relevant to vision and road safety. Additional atropinization does not affect glare sensitivity. Conclusion: DIMS spectacle lenses are safe for participation in road traffic and do not relevantly impair traffic safety, neither alone nor under the acute influence of 0,01 % atropine.