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Chronic Poisoning

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medical...
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UFMG

About the document

Raphael N.
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documents in English
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  1. Definition
  2. Etiology
  3. Lead
    1. Etiology
    2. Clinical Manifestations
    3. Diagnosis
    4. Treatment
  4. Mercury
    1. Etiology
    2. Clinical Manifestations and Treatment
  5. Arsenic
    1. Etiology
    2. Clinical Manifestations
    3. Arsenic ingestion
    4. Diagnosis
    5. Treatment
  6. Conclusions
  7. Bibliography

The chemical environment was recognized as a threat to health early in history. Well-documented outbreaks of occupational mercury and lead "poisonings" had been recorded and preventive measures implemented by 200 BC. In the Middle Ages, arsenic poisoning was used as a political weapon. In more recent times, industrial toxins, "accidental poisoning" in childhood, purposeful overdoses in adults, adverse reactions to drugs, medication mix-ups in hospitals, and environmental hazards increasingly have been recognized. The patient's metabolic and genetic variability determine the impact of a given molecule in hereditary disorders such as phenylketonuria, glucose-6-phosphate dehydrogenase deficiency, and others.

[...] Arsenic poisoning also has resulted from using certain herbal preparations, from ingesting illegal (moonshine) whiskey, from burning arsenate-treated wood, and from administering arsenic-containing folk and prescription medicines. In contrast to mercury, organic arsenic is far less toxic to humans than the inorganic form. Etiology For coastal inhabitants who consume large amounts of shellfish (e.g., clams, oysters, mussels), urinary excretion of arsenic may be elevated to three to four times normal values, but the arsenic is typically organic and not an important risk. [...]


[...] In the Middle Ages, arsenic poisoning was used as a political weapon. Definition In more recent times, industrial toxins, "accidental poisoning" in childhood, purposeful overdoses in adults, adverse reactions to drugs, medication mix-ups in hospitals, and environmental hazards increasingly have been recognized. The patient's metabolic and genetic variability determine the impact of a given molecule in hereditary disorders such as phenylketonuria, glucose-6-phosphate dehydrogenase deficiency, and others. Etiology New analytical techniques can identify poisonings promptly and completely and have uncovered the causes of diverse entities such as Minamata disease (teratogenesis consequent to methyl mercury), an outbreak of ascending paralysis affecting more than 4000 with more than 400 deaths in Iraq (also caused by methyl mercury), the "gray syndrome" in premature infants (caused by chloramphenicol), mesotheliomas induced by asbestos, and an epidemic of angiosarcoma of the liver among industrial workers (caused by vinyl chloride). [...]


[...] Treatment Chelation should be undertaken only after careful consideration for patients with milder evidence of poisoning because each of the agents may be associated with significant adverse effects. Because most of the body lead is stored in the bones, clinical improvement and reduction in blood lead levels (or reduction in erythrocyte protoporphyrin or zinc protoporphyrin) may be temporary, to be followed by increases in blood lead concentrations and clinical evidence of repoisoning owing to mobilization of lead from bone. Treatment In these cases, chelating agents may need to be readministered. [...]

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