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Article ; Online: Reversible leukoencephalopathy associated with organotin poisoning.

Dang, Tinh Quang / Doan, Uyen Vy / Nguyen, Tri Dung / Nguyen, Thanh Vinh / Nguyen, Thang Ba

2023 Volume 61, Issue 6, Page(s) 476–478

Abstract: Introduction: Organotin compounds are widely used in the plastic industry. We demonstrate the role of brain magnetic resonance imaging in a patient with leukoencephalopathy.: Clinical course: A 38-year-old man who worked with trimethyltin and ... ...

Abstract	Introduction: Organotin compounds are widely used in the plastic industry. We demonstrate the role of brain magnetic resonance imaging in a patient with leukoencephalopathy. Clinical course: A 38-year-old man who worked with trimethyltin and dimethyltin in a polyvinyl chloride factory reported a two-week progression of impaired memory, loss of balance, apathy, tinnitus, scaly darkened skin, and psychomotor slowing that rendered him unable to continue his daily activities. Magnetic resonance imaging revealed diffuse bilateral white matter lesions. Tin concentrations in both blood (344 μ/L) and urine (3,050 μg/L) were elevated. Removal from exposure and treatment with succimer were associated with clinical, laboratory, and imaging improvements. Discussion: The high lipid content of myelin is a likely target for lipid-soluble alkyl tin compounds. Conclusions: This patient demonstrates the clinical and magnetic resonance imaging findings of organotin toxicity. The contribution of chelation to the patient's recovery is uncertain and warrants further study.
MeSH term(s)	Humans ; Male ; Adult ; Organotin Compounds/toxicity ; Leukoencephalopathies/chemically induced ; Leukoencephalopathies/diagnostic imaging ; Brain/diagnostic imaging ; Magnetic Resonance Imaging ; Lipids
Chemical Substances	Organotin Compounds ; Lipids
Language	English
Publishing date	2023-06-26
Publishing country	England
Document type	Case Reports ; 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	10.1080/15563650.2023.2218026
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Article ; Online: Unintentional ingestion of Cordyceps fungus-infected cicada nymphs causing ibotenic acid poisoning in Southern Vietnam.

Doan, Uyen Vy / Mendez Rojas, Bomar / Kirby, Ralph

Clinical toxicology (Philadelphia, Pa.)

2017 Volume 55, Issue 8, Page(s) 893–896

Abstract: Background: Cordyceps fungus found in infected cicada nymphs ("cicada flowers") is utilized in traditional Chinese medicine. Cordyceps fungus toxicity in humans has not been previously reported. We report 60 cases of apparent Cordyceps poisoning in ... ...

Abstract	Background: Cordyceps fungus found in infected cicada nymphs ("cicada flowers") is utilized in traditional Chinese medicine. Cordyceps fungus toxicity in humans has not been previously reported. We report 60 cases of apparent Cordyceps poisoning in Southern Vietnam. Methods: We retrospectively collected demographic and clinical data from the medical records (21 cases) and by telephone interview (39 cases) of patients admitted to seven hospitals in Southern Vietnam following ingestion of cicada flowers between 2008 and 2015. We also determined the species of Cordyceps present in the cicada flowers and performed a partial chemical analysis of the fungus. Results: Sixty cases of toxic effects following ingestion of cicada flowers were documented. Symptom onset occurred within 60 minutes following ingestion. Symptoms included dizziness, vomiting, salivation, mydriasis, jaw stiffness, urinary retention, seizures, agitated delirium, hallucinations, somnolence and coma. None of the patients suffered liver or kidney injury. There was one fatality. The Cordyceps fungus involved in these poisoning was identified as Ophiocordyceps heteropoda. The presence of ibotenic acid was confirmed, but musimol and muscarine were absent. Conclusions: Cicada infected with Ophiocordyceps heteropoda in Vietnam contain ibotenic acid and are associated with a clinical syndrome consistent with its effects.
MeSH term(s)	Accidents ; Adolescent ; Adult ; Animals ; Child ; Cordyceps/classification ; Cordyceps/isolation & purification ; Cordyceps/metabolism ; Female ; Food Microbiology ; Foodborne Diseases/diagnosis ; Foodborne Diseases/etiology ; Foodborne Diseases/microbiology ; Foodborne Diseases/mortality ; Fruiting Bodies, Fungal/classification ; Fruiting Bodies, Fungal/isolation & purification ; Fruiting Bodies, Fungal/metabolism ; Hemiptera/embryology ; Hemiptera/microbiology ; Humans ; Ibotenic Acid/metabolism ; Ibotenic Acid/poisoning ; Male ; Middle Aged ; Nymph ; Retrospective Studies ; Soil Microbiology ; Vietnam ; Young Adult
Chemical Substances	Ibotenic Acid (2552-55-8)
Language	English
Publishing date	2017-09
Publishing country	England
Document type	Journal Article ; Observational Study
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	10.1080/15563650.2017.1319066
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Article ; Online: Estimating economic and disease burden of snakebite in ASEAN countries using a decision analytic model.

Patikorn, Chanthawat / Blessmann, Jörg / Nwe, Myat Thet / Tiglao, Patrick Joseph G / Vasaruchapong, Taksa / Maharani, Tri / Doan, Uyen Vy / Zainal Abidin, Syafiq Asnawi / Ismail, Ahmad Khaldun / Othman, Iekhsan / Taychakhoonavudh, Suthira / Chaiyakunapruk, Nathorn

PLoS neglected tropical diseases

2022 Volume 16, Issue 9, Page(s) e0010775

Abstract: Background: Understanding the burden of snakebite is crucial for developing evidence-informed strategies to pursue the goal set by the World Health Organization to halve morbidity and mortality of snakebite by 2030. However, there was no such ... ...

Abstract	Background: Understanding the burden of snakebite is crucial for developing evidence-informed strategies to pursue the goal set by the World Health Organization to halve morbidity and mortality of snakebite by 2030. However, there was no such information in the Association of Southeast Asian Nations (ASEAN) countries. Methodology: A decision analytic model was developed to estimate annual burden of snakebite in seven countries, including Malaysia, Thailand, Indonesia, Philippines, Vietnam, Lao PDR, and Myanmar. Country-specific input parameters were sought from published literature, country's Ministry of Health, local data, and expert opinion. Economic burden was estimated from the societal perspective. Costs were expressed in 2019 US Dollars (USD). Disease burden was estimated as disability-adjusted life years (DALYs). Probabilistic sensitivity analysis was performed to estimate a 95% credible interval (CrI). Principal findings: We estimated that annually there were 242,648 snakebite victims (95%CrI 209,810-291,023) of which 15,909 (95%CrI 7,592-33,949) were dead and 954 (95%CrI 383-1,797) were amputated. We estimated that 161,835 snakebite victims (69% of victims who were indicated for antivenom treatment) were not treated with antivenom. Annual disease burden of snakebite was estimated at 391,979 DALYs (95%CrI 187,261-836,559 DALYs) with total costs of 2.5 billion USD (95%CrI 1.2-5.4 billion USD) that were equivalent to 0.09% (95%CrI 0.04-0.20%) of the region's gross domestic product. >95% of the estimated burdens were attributed to premature deaths. Conclusion/significance: The estimated high burden of snakebite in ASEAN was demonstrated despite the availability of domestically produced antivenoms. Most burdens were attributed to premature deaths from snakebite envenoming which suggested that the remarkably high burden of snakebite could be averted. We emphasized the importance of funding research to perform a comprehensive data collection on epidemiological and economic burden of snakebite to eventually reveal the true burden of snakebite in ASEAN and inform development of strategies to tackle the problem of snakebite.
MeSH term(s)	Antivenins/therapeutic use ; Asia, Southeastern/epidemiology ; Cost of Illness ; Humans ; Snake Bites/epidemiology ; Snake Bites/therapy ; Thailand
Chemical Substances	Antivenins
Language	English
Publishing date	2022-09-28
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2429704-5
ISSN	1935-2735 ; 1935-2735
ISSN (online)	1935-2735
ISSN	1935-2735
DOI	10.1371/journal.pntd.0010775
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Article ; Online: Datura and Brugmansia plants related antimuscarinic toxicity: an analysis of poisoning cases reported to the Taiwan poison control center.

Doan, Uyen Vy / Wu, Ming-Ling / Phua, Dong-Haur / Mendez Rojas, Bomar / Yang, Chen-Chang

Clinical toxicology (Philadelphia, Pa.)

2018 Volume 57, Issue 4, Page(s) 246–253

Abstract: Introduction: Datura and Brugmansia plants, especially Datura species, have been used for their hallucinogenic effects in the United States and Europe; whereas Datura plants have been used as a traditional medicine in many Asian countries. This study ... ...

Abstract	Introduction: Datura and Brugmansia plants, especially Datura species, have been used for their hallucinogenic effects in the United States and Europe; whereas Datura plants have been used as a traditional medicine in many Asian countries. This study was conducted to better understand the pattern and outcome of Datura/Brugmansia plant related poisoning in Taiwan. Methods: This is a retrospective case series study of all cases with Datura/Brugmansia exposure reported to the Taiwan Poison Control Center between 1986 and 2015. Data for patients with relevant poisoning were reviewed and abstracted. Logistic regression analysis was used to identify potential predictors of the severity of poisoning; bivariate analysis was employed to assess the effectiveness of physostigmine in the treatment of Datura/Brugmansia poisoning. Results: A total of 203 cases involving 114 Datura exposures and 89 Brugmansia suaveolens exposures were eligible for analysis. Using Datura/Brugmansia for a medicinal purpose by the patients without consulting Chinese medicine practitioners was the most common reason of poisoning (81.2%); whereas only 2% of the patients were poisoned after medicinal use associated with the prescription from Chinese medicine practitioners. None of the 203 patients had used Datura/Brugmansia plant for recreational purpose. Most frequently observed clinical effect was mydriasis (53.2%), followed by confusion (40%), tachycardia (35.5%), dry mouth (35.5%), dizziness (34%), dry skin (32.5%), and delirium (31%). Seventy-three cases (36%) had severe effects; none of them died. Misidentification of the plants and ingestion of plant parts other than flowers were positively associated with the severity of poisoning. Forty patients (19.7%) received physostigmine therapy and patients receiving physostigmine had an earlier resolution of central nervous system toxicity than those who did not. Conclusions: Medicinal use without consulting Chinese medicine practitioners is the main reason for Datura/Brugmansia poisoning in Taiwan. Consumption of parts other than flowers and misidentification of the plants predicted the severity of poisoning in this study. Patients who received physostigmine appear to have earlier improvement in the central nervous system effects. No adverse events were reported from physostigmine administration.
MeSH term(s)	Adult ; Brugmansia/poisoning ; Cholinesterase Inhibitors/therapeutic use ; Datura/poisoning ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Muscarinic Antagonists/toxicity ; Physostigmine/therapeutic use ; Plant Poisoning/drug therapy ; Plant Poisoning/epidemiology ; Plant Poisoning/etiology ; Plants, Medicinal/adverse effects ; Plants, Medicinal/poisoning ; Poison Control Centers/statistics & numerical data ; Retrospective Studies ; Taiwan/epidemiology
Chemical Substances	Cholinesterase Inhibitors ; Muscarinic Antagonists ; Physostigmine (9U1VM840SP)
Language	English
Publishing date	2018-12-06
Publishing country	England
Document type	Journal Article ; Video-Audio Media
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	10.1080/15563650.2018.1513527
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Article: Envenomation by

Chiang, Liao-Chun / Tsai, Wei-Jen / Liu, Po-Yu / Ho, Cheng-Hsuan / Su, Hung-Yuan / Lai, Chih-Sheng / Lai, Kuo-Lung / Lin, Wen-Loung / Lee, Chi-Hsin / Yang, Yi-Yuan / Doan, Uyen Vy / Maharani, Tri / Mao, Yan-Chiao

The journal of venomous animals and toxins including tropical diseases

2020 Volume 26, Page(s) e20200043

Abstract: Background: Trimeresurus stejnegeri stejnegeri: Materials: This study included patients bitten by : Results: A total of 185 patients were evaluated: three patients (1.6%) were asymptomatic; whereas tissue swelling and pain, local ecchymosis, wound ...

Abstract	Background: Trimeresurus stejnegeri stejnegeri Materials: This study included patients bitten by Results: A total of 185 patients were evaluated: three patients (1.6%) were asymptomatic; whereas tissue swelling and pain, local ecchymosis, wound necrosis, coagulopathy, thrombocytopenia, rhabdomyolysis, and renal impairment were present in 182, 53, 13, 15, 10, 1, and 3 patients, respectively. One patient died from coagulopathy and hemorrhagic shock. Antivenom was administered to all envenomed patients at a median time of 1.8 h after the bite. The median total dose of antivenom was five vials. Chi-square analysis showed that bitten fingers, using cold packs during first aid, presence of bullae or blisters, lymphangitis or lymphadenitis, local numbness and suspected infection to be significantly associated with wound necrosis. After adjustment using a multivariate logistic regression model, only cold packs as first aid, bulla or blister formation, and wound infection remained significant. Conclusions: The main effects of
Language	English
Publishing date	2020-09-18
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2031021-3
ISSN	1678-9199
ISSN	1678-9199
DOI	10.1590/1678-9199-JVATITD-2020-0043
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Article ; Online: Clinical manifestations and treatments of

Mao, Yan-Chiao / Liu, Po-Yu / Chiang, Liao-Chun / Lee, Chi-Hsin / Lai, Chih-Sheng / Lai, Kuo-Lung / Lin, Wen-Loung / Su, Hung-Yuan / Ho, Cheng-Hsuan / Doan, Uyen Vy / Maharani, Tri / Yang, Yi-Yuan / Yang, Chen-Chang

Clinical toxicology (Philadelphia, Pa.)

2020 Volume 59, Issue 1, Page(s) 28–37

Abstract: Introduction: Protobothrops mucrosquamatus: Materials and methods: A total of 186 patients with : Results: No differences were observed between definite and suspected cases in terms of symptomatology and management. Of the 186 patients, 7 (3.8%) ... ...

Abstract	Introduction: Protobothrops mucrosquamatus Materials and methods: A total of 186 patients with Results: No differences were observed between definite and suspected cases in terms of symptomatology and management. Of the 186 patients, 7 (3.8%) were asymptomatic, 179 (96.2%) experienced tissue swelling and pain, and 107 (57.5%) had local ecchymosis. Coagulopathy, thrombocytopenia, and renal impairment were found in 13 (7%), 19 (10.2%), and 7 (3.8%) patients, respectively. None of the patients required transfusion therapy or hemodialysis. Furthermore, no systemic bleeding or death occurred. Antivenom was administered to all 179 envenomed patients at a median of 1.5 h post-bite. The median total dose of the specific antivenom was 5.5 vials. In multivariate logistic regression analysis, finger as the bite site, bullae and blister formation, and wound infection were significantly associated with wound necrosis; whereas finger as the bite site and bullae and blister formation were related to debridement or finger/toe amputation. Discussion and conclusions: Protobothrops mucrosquamatus
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Amputation ; Animals ; Anti-Bacterial Agents/therapeutic use ; Antivenins/adverse effects ; Antivenins/therapeutic use ; Child ; Child, Preschool ; Clinical Protocols ; Crotalid Venoms/antagonists & inhibitors ; Crotalid Venoms/metabolism ; Debridement ; Female ; Fingers/pathology ; Fingers/surgery ; Humans ; Male ; Middle Aged ; Necrosis ; Renal Dialysis ; Renal Insufficiency/etiology ; Renal Insufficiency/therapy ; Retrospective Studies ; Snake Bites/blood ; Snake Bites/complications ; Snake Bites/pathology ; Snake Bites/therapy ; Taiwan ; Toes/pathology ; Toes/surgery ; Trimeresurus/metabolism ; Wound Infection/microbiology ; Wound Infection/therapy ; Young Adult
Chemical Substances	Anti-Bacterial Agents ; Antivenins ; Crotalid Venoms
Language	English
Publishing date	2020-05-13
Publishing country	England
Document type	Comparative Study ; Journal Article ; Multicenter Study ; Observational Study
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	10.1080/15563650.2020.1762892
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Article: Situation of snakebite, antivenom market and access to antivenoms in ASEAN countries.

Patikorn, Chanthawat / Ismail, Ahmad Khaldun / Abidin, Syafiq Asnawi Zainal / Blanco, Francis Bonn / Blessmann, Jörg / Choumlivong, Khamla / Comandante, John David / Doan, Uyen Vy / Mohamed Ismail, Zainalabidin / Khine, Yi Yi / Maharani, Tri / Nwe, Myat Thet / Qamruddin, Reza Murad / Safferi, Ruth Sabrina / Santamaria, Emelia / Tiglao, Patrick Joseph G / Trakulsrichai, Satariya / Vasaruchapong, Taksa / Chaiyakunapruk, Nathorn /

Taychakhoonavudh, Suthira / Othman, Iekhsan

BMJ global health

2022 Volume 7, Issue 3

Abstract: Introduction: Snakebite envenoming is a neglected tropical disease posing public health challenges globally. The Association of Southeast Asian Nations (ASEAN) countries are among the tropical regions with disproportionately high incidence of snakebite. ...

Abstract	Introduction: Snakebite envenoming is a neglected tropical disease posing public health challenges globally. The Association of Southeast Asian Nations (ASEAN) countries are among the tropical regions with disproportionately high incidence of snakebite. Hence, this study aimed to review the situation of snakebite, antivenom market and access to antivenoms in ASEAN. Methods: This mixed-methods study included comprehensive literature review and in-depth interviews with key informants to assess the situation of management system of snakebite, antivenom market and access to antivenoms in seven ASEAN countries, including Malaysia, Thailand, Indonesia, Philippines, Vietnam, Lao PDR and Myanmar. Data were analysed by a framework method. Results: ASEAN have developed various strategies to improve outcomes of snakebite victims. Five domestic antivenom manufacturers in the region produce up to 288 375 vials of antivenoms annually with the value of US$13 058 053 million which could treat 42 213 snakebite victims. However, there remain challenges to be addressed especially the lack of snakebite-related informatics system, inadequate antivenoms at the healthcare facilities and when the majority of snakebite victims seek traditional healers instead of conventional treatment. Conclusion: Improving the situation of snakebite and antivenom is not only about the availability of antivenom, but the whole landscape of surrounding management and supporting system. The assessment of the situation of snakebite and antivenom is crucial for countries or regions where snakebites are prevalent to recognise their current standpoint to inform the development of strategies to achieve the goal set by the WHO of halving the global burden of snakebite by 2030.
MeSH term(s)	Antivenins/therapeutic use ; Humans ; Neglected Diseases/epidemiology ; Philippines ; Public Health ; Snake Bites/drug therapy ; Snake Bites/epidemiology
Chemical Substances	Antivenins
Language	English
Publishing date	2022-03-14
Publishing country	England
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ISSN	2059-7908
ISSN	2059-7908
DOI	10.1136/bmjgh-2021-007639
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Article ; Online: Reversible leukoencephalopathy associated with organotin poisoning.

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Article ; Online: Unintentional ingestion of Cordyceps fungus-infected cicada nymphs causing ibotenic acid poisoning in Southern Vietnam.

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Article ; Online: Estimating economic and disease burden of snakebite in ASEAN countries using a decision analytic model.

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Article ; Online: Datura and Brugmansia plants related antimuscarinic toxicity: an analysis of poisoning cases reported to the Taiwan poison control center.

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Article: Envenomation by

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Article ; Online: Clinical manifestations and treatments of

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Article: Situation of snakebite, antivenom market and access to antivenoms in ASEAN countries.

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