1/51. Four deaths due to carbon monoxide poisoning in car washes.In a period of 13 months, three separate incidents of lethal carbon monoxide (CO) poisoning in closed car wash bays resulted in the deaths of 4 white men aged 20 to 36 years. Each man appears to have been intoxicated with mind-altering substances, which may impair judgment, perception of outside conditions, and self-awareness. All four died in winter months. For three men, the deaths were ruled accidental, and for the remaining man, the previous deaths appear to have provided a model for suicide. Warning signs may not be effective to prevent future CO deaths in car washes because of the possible role of intoxication. Mechanical or electronic methods to prevent a bay door from closing completely may be preferable.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
2/51. Delayed transient loss of consciousness in acute carbon monoxide intoxication.In acute carbon monoxide intoxication the presence of altered consciousness, ranging from transient loss of consciousness to coma, represents a poor prognostic factor and modifies the approach to therapy. Transient loss of consciousness is, as a rule, contemporaneous to the exposure, generally occurring at the scene of the intoxication. We report an unusual case of delayed transient loss of consciousness, occurring in the absence of any other evident aetiology, in one member of an orchestra composed of 110 members after a mass carbon monoxide poisoning.- - - - - - - - - - ranking = 6keywords = intoxication (Clic here for more details about this article) |
3/51. Occupational intoxication with carbon monoxide.The most important safety measure for prevention of CO poisoning is the installation of automatic systems that signal high CO concentrations in the work environment. public health measures that include stringent pollution control, introduction of low-cost CO monitors, and public education aimed at the high-risk population (e.g., new workers, drivers) should decrease the number of deaths from CO poisoning and should save productive years of life. Toxicity of CO is a consequence of tissue hypoxia created by the displacement of oxygen from hemoglobin and the subsequent impairment of oxygen release to the tissues. Early symptoms of CO intoxication are insidious and can resemble other diseases; physical examination may be unremarkable. For these reasons, many cases of CO poisoning are not readily recognized.- - - - - - - - - - ranking = 5keywords = intoxication (Clic here for more details about this article) |
4/51. Apoptotic and necrotic brain lesions in a fatal case of carbon monoxide poisoning.A 41-year-old man was accidentally exposed to carbon monoxide (CO) gas and found in a state of cardiopulmonary arrest while he took bath. After admission, he was resuscitated and underwent artificial ventilation in a comatose state and died about 19h later. Computed tomography (CT) examination disclosed bilateral low density area in the basal ganglia and the thalamus, a well-known finding in the CO intoxication. Necropsy, histological examination, dna ladder assay gave the first line of evidence for the presence of apoptosis as well as necrosis in the human case of CO intoxication. TdT-mediated dUTP-biotin nick-end labeling (TUNEL) positive apoptotic cells were more predominant in the CA2 area than in CA1 area. There is general co-relation between the ratio of TUNEL-positive cells and the dna laddering on the agarose gel. basal ganglia and thalamus, which showed bilateral low density area in CT, were revealed to be severe edema. The two types of cell death occurred in the cortex, basal ganglia, hippocampus, thalamus, and cerebellum. Hypoxia caused by CO-hemoglobin formation alone cannot explain the phenomena.- - - - - - - - - - ranking = 2keywords = intoxication (Clic here for more details about this article) |
5/51. Successful cardiac transplantation with methanol or carbon monoxide-poisoned donors.BACKGROUND: patients succumbing to methanol or carbon monoxide poisoning are usually rejected for heart donation. Increasing demand for donors has lead to the expansion of acceptance criteria and increased use of the marginal donor. methods: We transplanted hearts from donors who had had methanol intoxication in three cases and carbon monoxide exposure in two cases. Standard donor evaluation criteria and transplantation techniques were used. RESULTS: All of the transplants were successful. Three of the recipients required significant inotropic support for a few days postoperatively; however, all of the hearts functioned well over the intermediate and long term. Two recipients (1 from each group) died of complications other than heart failure (1.5 and 2 years postoperatively). CONCLUSIONS: Successful heart transplantation can be achieved using the hearts from patients succumbing to methanol or carbon monoxide poisoning. Routine evaluation of cardiac function and myocardial damage is adequate for screening these donors. Hearts from methanol-poisoning victims may require longer inotropic support postoperatively before complete recovery, but can provide excellent long-term function and results.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
6/51. High-resolution magnetic resonance imaging reveals symmetric bitemporal cortical necrosis after carbon monoxide intoxication.High-resolution magnetic resonance images obtained in a patient several months after carbon monoxide (CO) intoxication revealed nearly symmetric regional atrophy of both lateral temporal lobes. This pattern of cortical lesions after CO exposure has not been reported before. The patient suffered from severe cognitive deficits including a transient Kluver-Bucy-like behavior. This report underlines the value of high-resolution magnetic resonance imaging in chronic stages of CO intoxication in the attempt to understand the neuroanatomical bases of the observed behavior.- - - - - - - - - - ranking = 6keywords = intoxication (Clic here for more details about this article) |
7/51. Hyperbaric oxygen for carbon monoxide poisoning-induced delayed neuropsychiatric sequelae.The clinical manifestations of delayed neuropsychiatric sequelae after carbon monoxide (CO) intoxication are variable. In addition, there is no specific therapy for these complications. Fortunately, these complications have occurred less frequently in recent years, probably due to the usage of hyperbaric oxygen (HBO) therapy. We report an 8-year-old boy who developed late psychiatric disturbances 2 days after full recovery of consciousness from initial CO intoxication. His neuropsychiatric symptoms included consciousness disturbance, motor dysfunction, chorea, aphasia and agnosias. He received HBO therapy at 2.0 barr for 60 minutes once a day for 7 consecutive days. Three weeks later, he was functioning normally with no neuropsychiatric symptoms. A literature review concluded that HBO may be effective in treating neuropsychiatric sequelae. Moreover, immediate administration of HBO during acute CO intoxication may prevent these complications.- - - - - - - - - - ranking = 3keywords = intoxication (Clic here for more details about this article) |
8/51. Twenty-nine years after carbon monoxide intoxication.Carbon monoxide (CO) is a worldwide environmental toxin and a leading cause of deliberate or accidental poisoning. There is an extensive literature devoted to the clinical features and treatment of those victims who have survived acute CO poisoning for a short length of time. The long-term sequelae of non-fatal poisoning have received scanty references, and the prospects for the long-lasting survivors of acute CO intoxication are less clear. literature review uncovered reports of only three patients who were followed for a considerable period of time. We present a case of CO poisoning with progressive neurological and psychological deterioration that began 17 years after recovery from a severe, accidental CO asphyxia. The patient was examined in the neurology out patient clinic 29 years after the initial CO intoxication. We believe the unique status of this patient, her similarity to one other case in the literature and the circumstances allowing correlation of the clinical picture to the CO poisoning warrants emphasis.- - - - - - - - - - ranking = 6keywords = intoxication (Clic here for more details about this article) |
9/51. Asphyxial deaths caused by automobile exhaust inhalation not attributable to carbon monoxide toxicity: study of 2 cases.The authors report two suicides that resulted from the intentional inhalation of automobile exhaust gases in which death occurred without the formation of physiologically significant amounts of carboxyhemoglobin. These circumstances are correlated with measurements of the involved vehicles' exhaust gases, which showed reduced concentrations of carbon monoxide present, reflecting improvements in automobile engine technology. In the absence of carbon monoxide toxicity, the authors attribute death in these cases to asphyxia caused by carbon dioxide intoxication and diminished atmospheric oxygen concentrations.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
10/51. Cardiogenic shock complicating acute carbon monoxide poisoning despite neurologic and metabolic recovery.We report the cases of 2 previously healthy young patients with acute carbon monoxide intoxication who deteriorated to cardiogenic shock in the face of apparent metabolic and neurologic recovery. Prolonged exposure to sublethal levels of carbon monoxide (>24 hours, carboxyhemoglobin level of 20.4% and 22.6%) and massive binding of the toxin to myocardial myoglobin and mitochondrial cytochrome chain enzymes might explain their protracted cardiac failure. The good response to inotropic agents and the findings of repeated echocardiographic studies support the probable diagnosis of myocardial stunning. Complete cardiac recovery was observed in both patients.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
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