BackgroundTo evaluate the etiological and demographic characteristics of adult poisoning patients followed up in a toxicology unit in Konya, Turkey.MethodsPatients (≥ 15 years old) followed up with the diagnosis of poisoning in our toxicology unit in 2011 were included in this retrospective study. The patients’ medical records were investigated. Age, gender, medical history, the first medical center the patient had been admitted to, the routes and causes of poisoning, the toxins involved, the number of the pills taken, treatments, complications, the length of stay in the hospital and the outcome were recorded.ResultsA total of 623 patients were included in the study. The mean age of patients was 28.1 ± 15.1. Four hundred and forty-five (71.4%) of patients were female, 541 (86.9%) of them were poisoned via the oral route and 75 (12.0%) of them were poisoned by inhalation. The causes of poisoning were drugs in 408 (65.5%) patients, pesticides/insecticides in 58 (9.3%) patients and carbon monoxide in 49 (7.9%) patients. The commonly used drugs were as follows: analgesics (57.2%), antidepressants (25.4%) and gastrointestinal system drugs (15.8%). The poisonings were suicidal in 489 (78.5%) patients, accidental in 120 (19.3%) patients and overdose in 14 (2.2%) patients. The number of women was higher in the suicide group. At the end of the treatment, 604 (97.0%) of the patients were discharged and 3 (0.4%) of them died. The duration of follow-up was 39.2 ± 37.5 h.ConclusionThe most common causes of poisoning are drugs, pesticides/insecticides and carbon monoxide. Health and educational policies at a national level are needed in order to prevent this medicosocial problem. Furthermore, specially equipped toxicology units should be constructed for the treatment and follow-up of the poisoned patients in order to reduce the morbidity and mortality to a significant extent.

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SUMMARYThe identification of risk factors for the initiation of left ventricle hypertrophy (LVH), which is an independent risk factor for cardiovascular mortality and morbidity in hypertensive patients, is very important. The objective of the present study was to identify the relationship of aldosterone with LVH and different geometrical patterns of left ventricle that develop in patients with essential hypertension.A total of 83 patients with essential hypertension (44 females, mean age, 51 ± 8 years, 39 males, mean age, 57 ± 10 years) were included in this study. Thirty-two had LVH. When evaluated according to the geometrical patterns of LVH, 18 patients had concentric LVH, 14 had eccentric LVH, and 17 had concentric remodeling. Thirty-four patients had normal left ventricle geometry. Two weeks after the cessation of antihypertensive medications, sodium, potassium, and proteinuria in 24-hour urine samples and plasma aldosterone levels and plasma renin activity were measured. Plasma aldosterone levels of the patients with LVH were found to be significantly higher (9.92 ± 6.34 ng/dL versus 5.83 ± 3.5 ng/dL, P < 0.01). The difference between plasma renin activities was not statistically significant. Linear regression analysis revealed that plasma aldosterone level and age were independent parameters increasing left ventricle mass index. The plasma aldosterone levels of patients with concentric hypertrophy of the left ventricle were significantly higher than those of patients with normal geometry and concentric remodeling. There was no significant difference between plasma renin activities. Twenty-four hour urine protein concentrations of the patients with LVH were found to be significantly higher and sodium to be significantly lower.Plasma aldosterone levels seem to be correlated with LVH especially with concentric hypertrophy of the left ventricle in patients with essential hypertension. (Jpn Heart J 2004; 45: 807-821)

Consumption and production of bismuth compounds are increasing, however, little information on the toxic effects and effective methods in removal of bismuth compounds are available. Although bismuth intoxication is currently rare, a careful evaluation should be carried out for possible exposure. We reported a16-year-old female who developed acute kidney failure, tonsillar ulceration and posterior reversible encephalopathy syndrome after an ingestion of 19 grams of bismuth subcitrate for suicidal attempt. (Hong Kong j.emerg.med. 2015;22:121-125)