Latest Articles and News - Jul 7, 2025
post on 07 Jul 2025
Latest Articles and News - Jul 7, 2025
Occult organophosphate poisoning mimicking acute coronary syndrome.
Organophosphate (OP) poisoning is a frequent toxicological emergency worldwide, particularly in low- and middle-income countries. Because the characteristic cholinergic toxidrome involves multiple systems, the absence of a clear history of exposure and clinical suspicion may lead to a disastrous misdiagnosis. We report a previously healthy male who presented with acute dyspnoea, chest pain, and diaphoresis, whose signs were suggestive of non-ST elevation acute coronary syndrome and pneumonia. Despite standard treatment, he deteriorated, necessitating intubation. However, the characteristic odour of OP prompted atropine treatment, leading to significant clinical improvement. Serum acetylcholinesterase activity was markedly reduced, confirming OP poisoning as the underlying cause.
https://pubmed.ncbi.nlm.nih.gov/40620201/Accidental dexmedetomidine overdose in preterm newborns: a report of 3 cases.
Dexmedetomidine use in neonatal units is increasing. Data on its safety are still limited. There are no previous reports of clinical presentation of dexmedetomidine overdose in newborns. Three babies simultaneously developed a similar clinical picture of recurrent apneas, a typical "gasping" breathing pattern, irritability followed by hypotonia and hyporeactivity, hyperglycaemia, hypocapnia, increase in lactates and a suppression-burst pattern on CFM/EEG. Babies required intubation and mechanical ventilation due to poor respiratory effort. Symptoms resolved completely in a few hours. Dexmedetomidine was administered enterally by a nasogastric tube in place of caffeine due to "look alike" medication error. Dexmedetomidine was retrieved in biological samples. Babies were developing regularly at post-discharge follow up visits. Dexmedetomidine overdose due to medication error is possible in newborns and should be suspected in case of clinical presentations similar to the one we reported. Measures should be implemented in neonatal units for a safe use of dexmedetomidine.
https://pubmed.ncbi.nlm.nih.gov/40619398/Analysis on forensic pathology of water intoxication: A review.
Post-mortem diagnosis of water intoxication should be confirmed through analysis during an autopsy. Demonstrating typical tissue changes in accordance with the clinical history is useful for assessing the reliability of a hyperhydrated state. A review of current literature on autopsy cases involving excessive liquid intake was conducted, and a definition of pathological death due to water intoxication is proposed. Analyzed cases revealed general cerebral and lung abnormalities along with significant right ventricular heart dilation. Histological findings included neuronal degeneration characterized by lax core chromatin, enlarged nerve cells, and perivascular spaces, often associated with neuronal necrosis. Cardiac findings included the absence of cardiomyocyte striations and vacuolation of cardiomyocytes. Post-mortem blood examination (n = 5) showed a mean ± SD serum sodium concentration of 90.4 ± 12.8 mmol/L (Median = 85, IQR = 20.5; IQ1-3 = 81.5-102). Post-mortem blood sodium level appears to be a specific marker of recent excessive liquid intake. Post-mortem examination is necessary to evaluate the effects of electrolyte imbalance in cases of an anarcatic state.
https://pubmed.ncbi.nlm.nih.gov/40618460/
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