B ackground: the ingestion of chemical agents, of caustic nature, represents a serious problem for clinical toxicology. If the ingestion doesn't cause death during the acute period, it will most often cause severe side effects in the upper gastrointestinal tract during the chronic phase. Aims: The purpose of this study is to show the clinical, epidemiological and socio-economical characteristics seen in acute corrosive poisonings such as ingested caustic agents, causes for abuse and most consequential complications. Material and methods: a ten year medical data was constructed and collected (2000-2009) from patients with acute corrosive poisonings who were hospitalized and treated in the University Clinic of toxicology and urgent internal medicine in Skopje, Republic of Macedonia. The variables included were: age, sex, type of poisonings and percentage of late post-corrosive complications. Results: In the study, 735 patients files were analyzed, collected in a period of ten years. The mean age of patients is 32.9±15.6 years. Majority of patients ingested hydrochloric acid (HCl; n=354; 48,16%). Conclusion: Demographic, diagnostic and therapeutic findings in acute corrosive poisonings are found to be similar to the findings observed in the referenced literature. Conclusively, women between 14 and 30 years old represent a high risk group; hydrochloric acid is the most often abused agent; and high percentage of post-corrosive complications are observed.

Introduction:Acute corrosive poisonings are caused by ingestion of corrosive chemicals which are most commonly used as household agents. Intoxications with these kind of agents produce numerous and severe post-corrosive complications of the upper gastrointestinal tract. On the other hand, our experience showed that corrosive agents may also cause injuries of the respiratory system, which makes the treatment very hard and additionally complicates the severe clinical condition of the patient.Objective:The aim of the study is to show the incidence of respiratory complications in acute corrosive poisonings, the need of various clinical investigations and also the treatment and final outcome of these kind of poisoning. Methods: We retrospectively analyzed clinical records of 415 patients hospitalized and treated at the University clinic for toxicology and urgent internal medicine, in Skopje, Republic of Macedonia, in the period between 2007 and 2011. The protocol consisted of methods for analyzing the systemic complications, with an accent on the post-corrosive respiratory complications.Results:From the total number of patients even 98 (23.61%) exhibited systemic complications, from which 51 (52.04%) are respiratory complications. The majority of patients are female (n=40, 78.43%) and the most common complication is pneumonia (n=47). The youngest patient in this study was 14 and the oldest was 87 years old.Conclusion:Besides the gastrointestinal complications in the acute corrosive poisonings respiratory complications are also very often. They complicate the clinical state of patient and very often lead to fatal endings.

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i ntroduction. Earlier studies have reported that heroin might cause the structural and antigen changes on numerous tissues, organs and subsequent development of autoimmune reactions (production of antibodies and creation of immune complexes) as a result the immunotoxic effect of heroin. The aims of our study were to: a) Evaluate CIC and antiβ2GP1 in heroin addicts; b) Correlate between the values of the obtained CIC and antiβ2GP1 (stratified by the duration and route of heroin application); c) Compare the CIC and antiβ2GP1 in heroin addicts and the control group and d) Assess the clinical importance of CIC and antiβ2GP1 in heroin addicts. Patients and methods. This was a cross-sectional study performed at the University Clinic of Toxicology and the Institute of Transfusiology, Skopje, Republic of Macedonia. Patients referred to the Clinic for clinical examinations who met the inclusion criteria were analyzed. Protocol for work was the following: 1.) detailed anamnestic data, 2.) a whole set of laboratory biochemical blood and urine analyses, 3.) examination with the Schiller's twelve-channel ECG; 4.) toxicological analyses for opioids in a urine sample; circulating immune complexes and 5.) antiphospholipid antibodies (antiβ2GP1, fractions: IgA, IgG, IgM). The obtained results were statistically analyzed. Results. We included 37 heroin addicts and a control group of 27 healthy subjects. Male abusers predominated over female in-28 (76%) subjects; mean age being 26 ±5.06. The results which refer to the increased values of circulating immune complexes have shown a high statistically significant dominance of heroin addicts, in comparison with the control group (p<0.01) and increased values above the reference ones of IgG antiβ2GP1, alone in the group of intravenous heroin abusers (p<0.025). The mean duration of the heroin use in intravenous abusers was 6.21± 3.25 years, whereas in those snorting heroin was 5.15 ±2.26 years. Duration of heroin application was in a positive correlation with IgG antiβ2GP1 (p=0.35). Conclusions. Our data showed that heroin-dependent patients in our study had increased values of circulating immune complexes and changes in IgG and IgM antiβ2GP1 with significantly increased values of IgG antiβ2GP1 in the intravenous heroin abusers. The duration of heroin application is in direct proportional relationship with IgG antiβ2GP1. Heroin addicts had significantly higher values of circulating immune complexes and statistically significant difference in IgG antiβ2GP1, in comparison with the control group. Changes in the fractions of antiβ2GP1 and CIC suggest a possible relation with the somatic changes found in heroin addicts (i.e. thrombocytopenia, reduced renal clearance, etc).

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In the 2020 annual report of the American Association of Poison Control Centers, 2562 toxic exposures to carbamazepine have been reported, 908 resulted in hospitalization, and among these about 5-6% were life-threatening or resulted in significant disability. A 15-year-old female patient was brought under suspicion of alcohol poisoning. The result of alcoholemia was 11.0mg/dL and the toxicological screening for THC, opiates, methadone, tramadol, amphetamine, MDMA, cocaine, benzodiazepines, buprenorphine was negative. At admission she was comatose (GCS=6), with metabolic acidosis, hypotension, rare short-term partial seizures, isochoric and later dilated pupils, body temperature was 36.4°C, with oxygen saturation from 89 up to 93%. Toxicological analysis were immediately extended. After three hours of admission, a result was obtained where the plasma concentration for carbamazepine was 167mmol/L. The patient was quickly prepared for hemodialysis which was performed for four hours. After 8 hours of admission the patient woke up with stable vital parameters.

Introduction: Acute corrosive poisonings are caused by ingestion of corrosive chemicals which are most commonly used as household agents. Intoxications with these kind of agents produce numerous and severe post-corrosive complications of the upper gastrointestinal tract. On the other hand, our experience showed that corrosive agents may also cause injuries of the respiratory system, which makes the treatment very hard and additionally complicates the severe clinical condition of the patient. Objective: The aim of the study is to show the incidence of respiratory complications in acute corrosive poisonings, the need of various clinical investigations and also the treatment and final outcome of these kind of poisoning. Methods: We retrospectively analyzed clinical records of 415 patients hospitalized and treated at the University clinic for toxicology and urgent internal medicine, in Skopje, Republic of Macedonia, in the period between 2007 and 2011. The protocol consisted of methods for analyzing the systemic complications, with an accent on the post-corrosive respiratory complications. Results: From the total number of patients even 98 (23.61%) exhibited systemic complications, from which 51 (52.04%) are respiratory complications. The majority of patients are female (n=40, 78.43%) and the most common complication is pneumonia (n=47). The youngest patient in this study was 14 and the oldest was 87 years old. Conclusion: Besides the gastrointestinal complications in the acute corrosive poisonings respiratory complications are also very often. They complicate the clinical state of patient and very often lead to fatal endings.