No abstract

Ethylenebisdithiocarbamates (EBDCs) are metabolized into ethylenethiourea (ETU), a possible human carcinogen and an antithyroid compound. In this study our goal was to correlate ETU levels with the incidence of thyroid gland disorders among banana plantation workers exposed to EBDC. We randomly selected 57 directly exposed workers and 31 indirectly exposed workers from four banana plantations and 43 workers from an organic farm; all subjects underwent complete medical examinations and laboratory tests. Results showed a higher mean thyroid-stimulating hormone measurement among exposed workers compared with the control group, although the levels were well within normal range. Nine of the exposed farmers had abnormal thyroid ultrasound findings, consisting mostly of solitary nodules, compared with three among the control group. Analysis of variance showed significantly different blood ETU levels among the directly exposed, indirectly exposed, and control groups (p < 0.001), but ETU levels in urine were not significantly different (p = 0.10). Environmental ETU levels were below the U.S. Environmental Protection Agency remediation levels. Among farmers with solitary thyroid nodules, we found a very good direct correlation between the size of the nodule and blood ETU level. In this study we showed that blood ETU is a more reliable biomarker for EBDC exposure than urinary ETU; therefore, the determination of blood ETU should be part of medical surveillance efforts among workers exposed to EBDC to detect occurrences of thyroid gland disorders.

No abstract

The incidence of rhabdomyolysis in isoniazid poisoning was 3/100 cases a year. The findings suggesting its direct toxic effect on the muscles may not be clinically relevant.

We describe a clinical decision support system (CDSS) designed to provide timely information germane to poisoning. The CDSS aids medical decision making through recommendations to clinicians for immediate evaluation. The system is implemented as a rule-based expert system with two major components: the knowledge base and the inference engine. The knowledge base serves as the database which contains relevant poisoning information and rules that are used by the inference engine in making decisions. This expert system accepts signs and symptoms observed from a patient as input and presents a list of possible poisoning types with the corresponding management procedures which may be considered in making the final diagnosis. A knowledge acquisition tool (KAT) that allows toxicological experts to update the knowledge base was also developed. This article describes the architecture of the fully featured system, the design of the CDSS and the KAT as web applications, the utilisation of the inferencing mechanism of C Language Integrated Production System (CLIPS), which is an expert system shell that helps the system in decision-making tasks, the methods used as well as problems encountered. We also present the results obtained after testing the system and propose some recommendations for future work.