scholarly journals Temporal trends of carbon monoxide poisoning mortality at the global, regional and national levels: a cross-sectional study from the Global Burden of Disease study, 1990 and 2017

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e053240
Author(s):  
Jianhai Long ◽  
Yawei Sun ◽  
Junxiu Zhao ◽  
Jie Liu ◽  
Xiaobo Peng
Keyword(s):  
Carbon Monoxide ◽  
Carbon Monoxide Poisoning ◽  
National Level ◽  
Temporal Trends ◽  
Global Burden ◽  
Co Poisoning ◽  
Cross Sectional Survey ◽  
Mortality Trends ◽  
Fatal Poisoning ◽  
Cross Sectional

ObjectivesCarbon monoxide (CO) poisoning is one of the most frequent causes of fatal poisoning worldwide. Few studies have explored the mortality trends of CO poisoning grouped by age and gender, at the regional, national and global levels. We therefore aimed to determine the pattern of CO poisoning mortality, as well as temporal trends at all levels.DesignA cross-sectional survey design was used in this study.SettingCO poisoning data collected from the Global Burden of Diseases (GBDs), from 1990 to 2017, was arranged by sex, age, region and country. In addition, we used human development index data at the national level from the World Bank.ParticipantsWe collected over 100 000 information on CO poisoning mortality between 1990 and 2017, derived from the GBD study in 2017.Main outcomes and measuresWe have calculated the estimated annual percentage changes in CO poisoning age-standardised mortality rate (ASR), by sex and age at different regions and countries to quantify the temporal trends in CO poisoning ASR.ResultsGlobally, death cases of CO poisoning decreased 7.2% from 38 210 in 1990 to 35 480 in 2017. The overall ASR decreased by an average of 1.83% (95% CI 2.10% to 1.56%) per year in this period. This decreasing pattern was heterogeneous across ages, regions and countries. The most pronounced decreases were generally observed in countries with a high sociodemographic index, including Estonia, South Korea and Puerto Rico.ConclusionsCurrent prevention strategies should be reoriented, and much more targeted and specific strategies should be established in some countries to forestall CO poisoning.

Epidemiological aspects and a current approach to the problem of carbon monoxide poisoning

2020 ◽  
Vol 6 (4) ◽  
pp. 4-9
Author(s):  
Sayit I. Indiaminov ◽  
Antonina A. Kim
Keyword(s):  
Carbon Monoxide ◽  
World Literature ◽  
Carbon Monoxide Poisoning ◽  
Epidemiological Data ◽  
Current Approach ◽  
Co Poisoning ◽  
Fatal Poisoning ◽  
Young Males ◽  
Causes Of Mortality ◽  
Mechanical Asphyxia

Background: Carbon monoxide (CO) poisoning is the leading cause of death from poisoning (accidental and intentional). The number of cases of CO poisoning is increasing day by day. Aims: The aim of the study was to analyze the epidemiological situation of CO poisoning and identify the urgent aspects of this problem. In the article, the author provided a retrospective analysis of 117 cases of CO poisoning, registered in a number of regional branches of the Republican Scientific and Practical Center of the Forensic Medical Examination of Uzbekistan, after he studied and analyzed the world literature on the epidemiology of CO poisoning. It has been revealed that fatal poisoning ranks third after mechanical injuries and mechanical asphyxia and constitutes 6.3% (513 cases) in the range of deaths by violence (8078 cases). Therefore, CO poisoning is considered as one of the most prevailing (51%) causes of mortality. Conclusion: This is a global problem, with young males at risk. Further studies on the current clinical and forensic aspects of CO poisoning are required, and the necessity for regular analysis of epidemiological data for taking comprehensive measures to prevent CO poisoning is emphasized.

Determination of netrin-1 levels and its relationship with neurotoxicity in carbon monoxide poisoning

2019 ◽  
Vol 38 (5) ◽  
pp. 561-566 ◽  
Author(s):  
U Gedikli ◽  
E Emektar ◽  
SK Corbacioglu ◽  
S Dagar ◽  
H Uzunosmanoglu ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Patient Group ◽  
Carbon Monoxide Poisoning ◽  
Neurological Impairment ◽  
Neurological Involvement ◽  
Control Group ◽  
Co Poisoning ◽  
Cross Sectional ◽  
Significant Difference ◽  
Neurological Effects

Objective: The aim of the study was to assess netrin-1 levels in carbon monoxide (CO) poisoning to determine its relationship with poisoning severity and neurotoxicity. Methods: This is a cross-sectional prospective study. The patients older than 18 years with CO poisoning were included. The patients were categorized into two groups on the basis of neurological involvement. Both the patient and the control groups were sampled for netrin-1 at 0th hour, and the patient group only was sampled for netrin-1 at 4th hour. Results: A total of 84 patients and 50 healthy controls were enrolled. The median 0th hour netrin-1 level of the patient group (765.1 pg/mL (619.8-983.1) was significantly higher than the control group (484 pg/mL (376-1031.6)) ( p < 0.001). There was also a significant difference between the 0th hour and 4th hour netrin-1 (888.9 pg/mL (700.3–1175.5)) levels in the patient group ( p < 0.001).There was no significant statistical difference between patients with and without neurological involvement ( p = 0.62) and between those who underwent hyperbaric oxygen therapy (HBOT) and those who did not ( p = 0.76) with respect to 4th hour netrin-1 levels. Conclusion: The significantly higher netrin-1 levels in patients with CO poisoning, suggests that netrin-1 is elevated as a stress marker. Although there is no significant difference in netrin-1 levels in patients with neurological impairment in CO poisonings, netrin-1 may show subclinically neurological effects. Hence, we believe that netrin-1 cannot be used as a marker of poisoning severity.

Carbon monoxide poisoning cases presenting with non-specific symptoms

2016 ◽  
Vol 33 (1) ◽  
pp. 53-60 ◽  
Author(s):  
Turgut Deniz ◽  
Hayati Kandis ◽  
Oguz Eroglu ◽  
Harun Gunes ◽  
Meral Saygun ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Carbon Monoxide Poisoning ◽  
Cross Sectional Study ◽  
Motor Vehicles ◽  
Co Poisoning ◽  
Cross Sectional ◽  
Heating Systems ◽  
Presenting Symptoms ◽  
Non Invasive ◽  
Specific Symptoms

Carbon monoxide (CO) is a colourless and odourless gas appearing as a result of incomplete combustion of carbon-containing fuels. Many domestic or occupational poisonings are caused by CO exposure. Malfunctioning heating systems, improperly ventilated motor vehicles, generators, grills, stoves and residential fires may be listed in the common sources of CO exposure. The aim of this study was to emphasize the significance of early diagnosis of CO poisoning with non-invasive measurement of CO levels of the patients with non-specific symptoms using a pulse oximeter device in the triage. Our study was a cross-sectional study. Patients who presented to the emergency department (ED) due to non-specific symptoms and had a Canadian Triage and Acuity scale level of 4 or 5 were included in the study; 106 (5.9%) of 1788 patients admitted during the study period were diagnosed with CO poisoning. Patients with CO poisoning and the other patients had statistically significant differences in terms of presenting symptoms, namely, headache, dizziness, nausea, and vomiting. More CO poisoning cases were admitted in the fall and winter compared to the spring and summer. The number of CO poisoning victims can be decreased if preventive measures like CO monitoring systems and well-designed ventilation systems are generalized at homes and workplaces. Measurement of carboxyhaemoglobin levels of patients presenting to ED due to non-specific symptoms like headache and dizziness during cold seasons and winter months using a pulse CO-oximeter should be a part of the routine of emergency medicine triage.

Can initial lactate levels predict the severity of unintentional carbon monoxide poisoning?

2014 ◽  
Vol 34 (3) ◽  
pp. 324-329 ◽  
Author(s):  
NÖ Doğan ◽  
A Savrun ◽  
S Levent ◽  
GP Günaydın ◽  
GK Çelik ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Lactate Level ◽  
Carbon Monoxide Poisoning ◽  
Co Poisoning ◽  
Cross Sectional ◽  
Normobaric Oxygen ◽  
Clinical Criteria ◽  
Oxygen Treatment ◽  
Co Intoxication ◽  
Lactate Levels

Introduction: Accidental carbon monoxide (CO) intoxication is a major cause of unintentional poisoning. This study aimed to determine the value of initial lactate levels in patients with CO poisoning and to evaluate its utilization in the emergency department (ED). Methods: A retrospective cross-sectional study was carried out among patients with CO intoxication, who were admitted to the ED between April 1, 2011 and April 1, 2012. The study data were extracted from a hospital database system using International Classification of Diseases-10 diagnosis codes. The patients were analyzed according to lactate levels, carboxyhemoglobin (COHb) levels, electrocardiographic manifestations, and clinical features at admission to the ED. Results: A total of 74 patients with CO poisoning were enrolled in this study. The average COHb value of the patients was 21.5 ± 13.9%. A total of 50 patients (67.6%) received normobaric oxygen treatment and 24 patients (32.4%) received hyperbaric oxygen (HBO) treatment. The patients who received HBO treatment had increased lactate levels compared with patients receiving normobaric oxygen treatment (2.3 mmol/L vs. 1.0 mmol/L, p < 0.001). The lactate levels were positively correlated with COHb values ( r = 0.738, p < 0.001). We determined that a lactate level of 1.85 mmol/L has a sensitivity of 70.8% and a specificity of 78.0% to predict the HBO treatment needed in CO poisoning. Conclusion: In evaluating patients with CO poisoning, an initial lactate level could be taken into consideration as an adjunctive parameter of severity, together with the clinical criteria and levels of COHb.

scholarly journals Training interns in nutrition and dietetics: a cross-sectional study of the barriers and motivators to being a Registered Dietitian Nutritionist preceptor

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Andrea M. Hutchins ◽  
Donna M. Winham ◽  
Jinette P. Fellows ◽  
Michelle M. Heer
Keyword(s):  
Experiential Learning ◽  
Professional Training ◽  
Online Survey ◽  
Selection Process ◽  
National Level ◽  
Cross Sectional Study ◽  
Registered Dietitian ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Entry Level

Abstract Background As is common across the health professions, training of Registered Dietitian Nutritionists (RDNs) requires experiential learning for interns/students to gain skills and demonstrate entry-level competency. Preceptors are essential to the experiential learning component of health care professional training, providing supervision and mentoring as students and interns gain the skills required for entry-level practice competency. Over the past 27 years, 47–73% of applicants to dietetic internships have received a placement. Practitioners willing to volunteer as preceptors are needed to generate more internship or experiential learning opportunities for the profession to continue to meet workforce demands. Methods The objective of this national-level online cross-sectional survey was to identify perceptions and attitudes associated with the preceptor role and incentives that might encourage precepting by current RDNs. A random sample of RDN and Nutrition and Dietetic Technicians, Registered (NDTR) professionals from the Commission on Dietetic Registration credentialed practitioner database were eligible to participate in the online survey. The main outcome measures included perceptions, attitudes, and preferred incentives to precept compared by preceptor experience categories (current, former, never precepted). Comparisons of perceptions, attitudes, and preferred incentives were made between preceptor experience categories using Chi-square and ANOVA. Results Of 2464 invitations, 308 participants had complete variables for analysis. Top incentives were the opportunity to earn continuing education units (65.9%) and having expenses paid to attend a national conference (49.5%). Significantly more (P < 0.001) “former” and “never” preceptors reported the ability to choose when to take an intern, training on how to teach and communicate with interns, and access to an “on-call” specialist as incentives compared to “current” preceptors. Significantly more (P < 0.01) “never” preceptors reported training on internship expectations and the ability to provide input on intern selection process as incentives compared to “current” or “former” preceptors. Conclusions Incentives to serve as a preceptor differ based on “current”, “former”, or “never” precepted status. Promoting and strategizing solutions to the current imbalance between the greater number of dietetic internship applicants compared to preceptors should be targeted based on preceptor status to retain current preceptors, encourage former preceptors to return and recruit professionals who have never served.

Verbal memory deficits associated with fornix atrophy in carbon monoxide poisoning

2001 ◽  
Vol 7 (5) ◽  
pp. 640-646 ◽  
Author(s):  
SHELLI R. KESLER ◽  
RAMONA O. HOPKINS ◽  
LINDELL K. WEAVER ◽  
DUANE D. BLATTER ◽  
HOLLY EDGE-BOOTH ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Verbal Memory ◽  
Visual Memory ◽  
Carbon Monoxide Poisoning ◽  
Neuropsychological Testing ◽  
Mr Images ◽  
Cross Sectional ◽  
Memory Processing ◽  
Within Subjects ◽  
And Gender

Magnetic resonance (MR) images and neuropsychological testing data of 69 carbon monoxide (CO) poisoned patients were prospectively obtained within 1 day of CO poisoning, two weeks and six months. CO patients' Day 1 cross-sectional fornix surface area measurements, corrected for head size by using a fornix-to-brain ratio (FBR), were compared to normal age and gender-matched controls. Additionally, a within-subjects analysis was performed comparing the mean areas between CO patients' Day 1, 2 weeks and 6-month FBR. The FBR was correlated with patients' neuropsychological data. There were no significant differences between CO patients' Day 1 fornix measurements compared to normal control subjects. However, significant atrophic changes in the fornix of CO poisoned patients occurred at two weeks with no progressive atrophy at 6 months. By 6 months, CO patients showed significant decline on tests of verbal memory (when practice effects were taken into account), whereas visual memory, processing speed and attention/concentration did not decline. This study indicates that CO results in brain damage and cognitive impairments in the absence of lesions and other neuroanatomic markers. (JINS, 2001, 7, 640–646.)

scholarly journals Obesity in Saudi Arabia in 2020: Prevalence, Distribution, and Its Current Association with Various Health Conditions

Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 311
Author(s):  
Nora A. Althumiri ◽  
Mada H. Basyouni ◽  
Norah AlMousa ◽  
Mohammed F. AlJuwaysim ◽  
Rasha A. Almubark ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
National Level ◽  
Sampling Technique ◽  
Health Conditions ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Age And Gender ◽  
Prevalence Of Obesity ◽  
And Gender ◽  
Colon Diseases

The global prevalence of obesity is increasing. Obesity is associated with many chronic diseases and health conditions. This study aims to estimate the current prevalence of obesity in Saudi Arabia and described the current national-level status of the association between obesity and various health conditions. This study is a nationwide cross-sectional survey conducted over phone-interviews in June 2020. In this study, a proportional quota-sampling technique was used to obtain equal distributions of participants, stratified by age and gender, across the 13 regions of Saudi Arabia. Weight and height were self-reported, and the obesity was determined as BMI ≥ 30. Logistic regression adjusted for age and gender was used for exploring current associations between obesity and health conditions. Of the 6239 participants contacted, 4709 participants responded and completed the interview with a response rate of 75.48%. Of them, 50.1% were female, the mean age was 36.4 ± 13.5 (Range: 18–90), and the median age was 36. The national weighted prevalence of obesity (BMI ≥ 30) was 24.7%, and the prevalence in the sample (unweighted) was 21.7%. Obesity was significantly associated with type 2 diabetes [Odd ratio, (OR) = 1.52], hypercholesterolemia (OR = 1.69), hypertension (OR = 1.61), lung diseases (OR = 1.69), rheumatoid arthritis (OR = 1.57), sleep apnea (OR = 1.82), colon diseases (OR = 1.31), and thyroid disorders (OR = 1.8). This study provides an update on the recent prevalence of obesity in Saudi Arabia. It also shows the variation in prevalence rates between different regions, which might be explored further. Although obesity shows a decreasing trend, almost one-quarter of this study sample were obese. Obesity is currently associated with many health conditions that can affect the individuals’ quality of life, impose stress on the healthcare system and impose an economic burden on the country. This evidence highlights the need for action to focus more on obesity in Saudi Arabia.

scholarly journals Predictive Role of QTc Prolongation in Carbon Monoxide Poisoning-Related Delayed Neuropsychiatric Sequelae

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Shu-Chen Liao ◽  
Yan-Chiao Mao ◽  
Yao-Min Hung ◽  
Ching-Hsing Lee ◽  
Chen-Chang Yang
Keyword(s):  
Carbon Monoxide ◽  
Roc Curve ◽  
Carbon Monoxide Poisoning ◽  
Chang Gung Memorial Hospital ◽  
Qtc Interval ◽  
Continuous Variables ◽  
Co Poisoning ◽  
Qtc Prolongation ◽  
Roc Curve Analysis ◽  
Delayed Neuropsychiatric Sequelae

Objective. Delayed neuropsychiatric sequelae (DNS) are serious complications of carbon monoxide (CO) poisoning that adversely affect poisoned patients’ quality of life as well as socioeconomic status. This study aimed to determine clinical predictors of DNS in patients with CO poisoning. Methods. This retrospective study included all CO-poisoned patients admitted to the emergency department (ED) of Linkou Chang Gung Memorial Hospital in Taiwan from 1 January 2009 to 31 December 2015. The medical records of all patients with CO poisoning were carefully reviewed, and relevant data were abstracted into a standardised form. Univariate and multivariate logistic regression models were used to identify predictors of DNS after CO poisoning. Receiver operating characteristic (ROC) curve analysis was used to determine the ideal cut-off value for continuous variables that predict the development of DNS. Results. A total of 760 patients with CO poisoning were identified during the study period. Among them, 466 were eligible for the analysis of predictors of DNS. In multivariate analysis, Glasgow Coma Scale <9 (odds ratio [OR], 2.74; 95% confidence interval [CI], 1.21–6.21), transient loss of consciousness (OR, 3.59; 95% CI, 1.31–9.79), longer duration from CO exposure to ED presentation (OR, 1.05; 95% CI, 1.03–1.08), and corrected QT (QTc) prolongation (OR, 2.61; 95% CI, 1.21–5.61) were found to be associated with a higher risk of DNS. The area under the ROC curve (AUC) for QTc interval measured within 6 h after exposure best predicted the development of DNS, with a result of 0.729 (95% CI 0.660–0.791). Moreover, the best cut-off value of the QTc interval was 471 ms, with a sensitivity of 53.3% and a specificity of 85.1%. Conclusions. We identified several potential predictors of DNS following CO poisoning. Among them, QTc prolongation found within 6 h after exposure is a novel predictor of DNS, which may be helpful in the future care of patients with CO poisoning.

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