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  1. Article ; Online: Banning toxic pesticides is effective at preventing suicides in South Asia.

    Eddleston, Michael

    BMJ (Clinical research ed.)

    2023  Volume 382, Page(s) 1838

    MeSH term(s) Humans ; Suicide ; Asia, Southern ; Suicide Prevention ; Pesticides
    Chemical Substances Pesticides
    Language English
    Publishing date 2023-08-16
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 1362901-3
    ISSN 1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    ISSN (online) 1756-1833
    ISSN 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    DOI 10.1136/bmj.p1838
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: CON: Oximes should not be used routinely in organophosphorus insecticide poisoning.

    Eddleston, Michael

    British journal of clinical pharmacology

    2022  Volume 88, Issue 12, Page(s) 5070–5073

    Abstract: Organophosphorus (OP) insecticide poisoning causes respiratory failure due to acetylcholinesterase (AChE) inhibition. The AChE reactivating antidote pralidoxime was developed in the 1950s and was soon noted to benefit patients occupationally poisoned ... ...

    Abstract Organophosphorus (OP) insecticide poisoning causes respiratory failure due to acetylcholinesterase (AChE) inhibition. The AChE reactivating antidote pralidoxime was developed in the 1950s and was soon noted to benefit patients occupationally poisoned with the highly potent OP insecticide parathion. Routine use of pralidoxime and other oximes such as obidoxime then became widely recommended. However, nearly all severe cases of OP poisoning now result from self-poisoning with large volumes of less potent (WHO hazard class Ib and II) insecticides and co-formulated solvents. Unfortunately, oxime clinical trials have never shown benefit from their use for these patients, and some have shown that pralidoxime may be associated with harm, including increased mortality. Oximes should not be used routinely for the care of OP insecticide-poisoned patients until translational and clinical studies have identified a safe and effective oxime regimen and identified the patients who benefit.
    MeSH term(s) Humans ; Insecticides/therapeutic use ; Oximes/therapeutic use ; Acetylcholinesterase/therapeutic use ; Organophosphorus Compounds/therapeutic use ; Organophosphate Poisoning/drug therapy ; Cholinesterase Inhibitors/therapeutic use ; Poisoning
    Chemical Substances pralidoxime (P7MU9UTP52) ; Insecticides ; Oximes ; Acetylcholinesterase (EC 3.1.1.7) ; Organophosphorus Compounds ; Cholinesterase Inhibitors
    Language English
    Publishing date 2022-02-07
    Publishing country England
    Document type Journal Article
    ZDB-ID 188974-6
    ISSN 1365-2125 ; 0306-5251 ; 0264-3774
    ISSN (online) 1365-2125
    ISSN 0306-5251 ; 0264-3774
    DOI 10.1111/bcp.15217
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  3. Article ; Online: Evidence for the efficacy of the emetic PP796 in paraquat SL20 formulations - a narrative review of published and unpublished evidence.

    Eddleston, Michael

    Clinical toxicology (Philadelphia, Pa.)

    2022  Volume 60, Issue 10, Page(s) 1163–1175

    Abstract: Background: The bipyridyl herbicide paraquat was first introduced into agriculture in the 1960s by Imperial Chemical Industries. Due to issues with unintentional poisoning, the centrally acting emetic PP796 was added in 1976 to the company's 20% ... ...

    Abstract Background: The bipyridyl herbicide paraquat was first introduced into agriculture in the 1960s by Imperial Chemical Industries. Due to issues with unintentional poisoning, the centrally acting emetic PP796 was added in 1976 to the company's 20% paraquat ion soluble liquid (SL20) formulations (Gramoxone
    Methods: PubMed and Google were searched for published studies on the emetic using the search terms "paraquat" and ["emetic" or "PP796"]. Company documents reporting pre-clinical and clinical studies were accessed at the website of
    Results: Pre-clinical dog and monkey studies indicated that the PP796 EC50 dose for vomiting was around 0.5-2 mg/kg. Further increasing the PP796 concentration speeded up the time to first vomit and reduced the amount of paraquat absorbed (as assessed by the 0-24 h plasma area-under-the-curve) 100-fold compared to a control group receiving no PP796. However, the dose selected for paraquat SL20 formulations by the company (0.5 g/L or 0.05%) was based exclusively on a phase II study in the early 1970s involving five volunteers receiving 3 different doses, with only two individuals actually vomiting, supplemented by data from 37 patients taking 2 mg in clinical trials. A UK-mandated toxicovigilance study in the 1980s identified only 21 patients ingesting paraquat SL20 with PP796 for whom data on time to vomit was available; of these patients, 11 vomited within 30 min (52.4%, 95%CI 31-73.7%). No effect on mortality could be identified from any study of paraquat SL containing 0.05% PP796. A clinical study in Sri Lanka 30 years after the emetic was first introduced, of a revised formulation (Gramoxone
    Conclusion: Pre-clinical studies showed a clear dose response for PP796 to cause early vomiting, with effective doses in the 0.5-20 mg/kg range. A too low concentration of PP796 was selected for paraquat formulations based on an inadequate phase II study. Currently, evidence that PP796 at 0.05% in paraquat SL20 causes more rapid vomiting after ingestion is weak or unpublished; no evidence of clinical benefit or fewer deaths has been identified. There is no evidence to support the FAO/WHO Joint Meeting on Pesticide Specifications mandate to include PP796 or any other emetic in paraquat products. Products with higher emetic concentrations have been developed but are not widely used; it is possible they may prevent deaths.
    MeSH term(s) Dogs ; Animals ; Paraquat/toxicity ; Emetics/therapeutic use ; 2,2'-Dipyridyl ; Herbicides/toxicity ; Vomiting/chemically induced ; Pesticides ; Alginates ; Clinical Trials, Phase II as Topic
    Chemical Substances Paraquat (PLG39H7695) ; Emetics ; 2,2'-Dipyridyl (551W113ZEP) ; Herbicides ; Pesticides ; Alginates
    Language English
    Publishing date 2022-08-11
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 204476-6
    ISSN 1556-9519 ; 0009-9309 ; 0731-3810 ; 1556-3650
    ISSN (online) 1556-9519
    ISSN 0009-9309 ; 0731-3810 ; 1556-3650
    DOI 10.1080/15563650.2022.2105709
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Book: Oxford handbook of tropical medicine

    Eddleston, Michael

    2008  

    Title variant Handbook of tropical medicine ; Tropical medicine
    Author's details Michael Eddleston
    Keywords Tropical Medicine ; Tropenmedizin
    Language English
    Size XXVII, 843 S. : Ill., graph. Darst., Kt.
    Edition 3. ed.
    Publisher Oxford Univ. Press
    Publishing place Oxford u.a.
    Publishing country Great Britain
    Document type Book
    HBZ-ID HT015320240
    ISBN 978-0-19-920409-0 ; 0-19-920409-8
    Database Catalogue ZB MED Medicine, Health

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    Shelf markLoan statusLocation
    2008 A 2215 order for loan Magazin

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  5. Book: Oxford handbook of tropical medicine

    Eddleston, Michael

    [practical advice for clinicians in the tropics. Includes WHO guidelines, revised and updated text, new colour plate section]

    (Oxford medical publications)

    2005  

    Title variant Tropical medicine
    Author's details Michael Eddleston
    Series title Oxford medical publications
    Keywords Tropical Medicine ; Tropenmedizin
    Language English
    Size XXVI, 686 S. : Ill., graph. Darst., Kt.
    Edition 2. ed.
    Publisher Oxford Univ. Press
    Publishing place Oxford u.a.
    Publishing country Great Britain
    Document type Book
    HBZ-ID HT014070688
    ISBN 0-19-852509-5 ; 978-0-19-852509-7
    Database Catalogue ZB MED Medicine, Health

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  6. Article: Response to Jors et al,

    Eddleston, Michael

    Environmental health insights

    2018  Volume 12, Page(s) 1178630218788554

    Language English
    Publishing date 2018-07-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2452946-1
    ISSN 1178-6302
    ISSN 1178-6302
    DOI 10.1177/1178630218788554
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  7. Article ; Online: Are Oximes Still Indicated for Acute Organophosphorus Insecticide Self-Poisoning?

    Eddleston, Michael

    Journal of medical toxicology : official journal of the American College of Medical Toxicology

    2018  Volume 14, Issue 1, Page(s) 1–2

    MeSH term(s) Antidotes/therapeutic use ; Cholinesterase Reactivators/therapeutic use ; Humans ; Insecticides/poisoning ; Organophosphate Poisoning/drug therapy ; Oximes/therapeutic use ; Pralidoxime Compounds/therapeutic use ; Suicide, Attempted
    Chemical Substances Antidotes ; Cholinesterase Reactivators ; Insecticides ; Oximes ; Pralidoxime Compounds ; pralidoxime (P7MU9UTP52)
    Language English
    Publishing date 2018-01-31
    Publishing country United States
    Document type Editorial
    ZDB-ID 2435016-3
    ISSN 1937-6995 ; 1556-9039
    ISSN (online) 1937-6995
    ISSN 1556-9039
    DOI 10.1007/s13181-018-0651-y
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  8. Article ; Online: Novel Clinical Toxicology and Pharmacology of Organophosphorus Insecticide Self-Poisoning.

    Eddleston, Michael

    Annual review of pharmacology and toxicology

    2018  Volume 59, Page(s) 341–360

    Abstract: Organophosphorus insecticide self-poisoning is a major global health problem, killing over 100,000 people annually. It is a complex multi-organ condition, involving the inhibition of cholinesterases, and perhaps other enzymes, and the effects of large ... ...

    Abstract Organophosphorus insecticide self-poisoning is a major global health problem, killing over 100,000 people annually. It is a complex multi-organ condition, involving the inhibition of cholinesterases, and perhaps other enzymes, and the effects of large doses of ingested solvents. Variability between organophosphorus insecticides-in lipophilicity, speed of activation, speed and potency of acetylcholinesterase inhibition, and in the chemical groups attached to the phosphorus-results in variable speed of poisoning onset, severity, clinical toxidrome, and case fatality. Current treatment is modestly effective, aiming only to reactivate acetylcholinesterase and counter the effects of excess acetylcholine at muscarinic receptors. Rapid titration of atropine during resuscitation is lifesaving and can be performed in the absence of oxygen. The role of oximes in therapy remains unclear. Novel antidotes have been tested in small trials, but the great variability in poisoning makes interpretation of such trials difficult. More effort is required to test treatments in adequately powered studies.
    MeSH term(s) Animals ; Antidotes/pharmacology ; Antidotes/therapeutic use ; Humans ; Insecticides/toxicity ; Organophosphate Poisoning/drug therapy ; Organophosphorus Compounds/toxicity
    Chemical Substances Antidotes ; Insecticides ; Organophosphorus Compounds
    Language English
    Publishing date 2018-09-19
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 196587-6
    ISSN 1545-4304 ; 0362-1642
    ISSN (online) 1545-4304
    ISSN 0362-1642
    DOI 10.1146/annurev-pharmtox-010818-021842
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  9. Article ; Online: A lethal cocktail - shining a light on the relationship between alcohol use and pesticide self-poisoning.

    Schölin, Lisa / Sørensen, Jane Brandt / Eddleston, Michael

    Clinical toxicology (Philadelphia, Pa.)

    2023  Volume 61, Issue 8, Page(s) 581–583

    Abstract: Introduction: Alcohol and pesticides are toxic substances that each cause acute and chronic harm to humans. Alcohol plays an important and complex role in pesticide self-poisoning, involving toxicological, public health, and social aspects important for ...

    Abstract Introduction: Alcohol and pesticides are toxic substances that each cause acute and chronic harm to humans. Alcohol plays an important and complex role in pesticide self-poisoning, involving toxicological, public health, and social aspects important for research, prevention, and interventions.
    Alcohol use disorder and social harms: While the evidence on alcohol co-ingestion in the context of pesticide self-poisoning is limited, it appears that alcohol use increases complications. Even fewer studies address alcohol use disorder and dependence among pesticide self-poisoning patients. The harmful use of alcohol also impacts social life, families, and communities in several ways, including pesticide self-poisoning among individuals around the alcohol user. This, however, is vastly understudied.
    Outside influences: Agrochemicals and alcohol are produced by industries with financial interests, and the outcome of individual acts of pesticide self-poisoning depends on the lethality of the pesticide purchased and ingested. The promotion of acutely toxic pesticides by companies must be acknowledged within this issue.
    Conclusion: The relationship between alcohol and pesticide self-poisoning is increasingly clear, but more studies are needed to guide management. We cannot ignore that pesticide self-poisoning and harmful use of alcohol occur within the context of wider, often structural, stressors and are influenced by commercial entities.
    MeSH term(s) Humans ; Alcoholism ; Pesticides ; Alcoholic Beverages ; Ethanol ; Rural Population ; Poisoning/epidemiology ; Poisoning/etiology ; Poisoning/prevention & control
    Chemical Substances Pesticides ; Ethanol (3K9958V90M)
    Language English
    Publishing date 2023-10-10
    Publishing country England
    Document type Journal Article
    ZDB-ID 204476-6
    ISSN 1556-9519 ; 0009-9309 ; 0731-3810 ; 1556-3650
    ISSN (online) 1556-9519
    ISSN 0009-9309 ; 0731-3810 ; 1556-3650
    DOI 10.1080/15563650.2023.2259599
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  10. Article ; Online: Comment on Glatstein's case series of

    Lamb, Thomas / Eddleston, Michael

    Clinical toxicology (Philadelphia, Pa.)

    2021  Volume 60, Issue 5, Page(s) 661–662

    MeSH term(s) Animals ; Child ; Humans ; Viper Venoms ; Viperidae
    Chemical Substances Viper Venoms
    Language English
    Publishing date 2021-11-15
    Publishing country England
    Document type Letter ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 204476-6
    ISSN 1556-9519 ; 0009-9309 ; 0731-3810 ; 1556-3650
    ISSN (online) 1556-9519
    ISSN 0009-9309 ; 0731-3810 ; 1556-3650
    DOI 10.1080/15563650.2021.2001482
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