We finished the year with a lots of visitors, more than  75,000 in November,  and some surprises, as this month USA is the third country, after Argentina and Mexico, from where came the visits. Moved well to the classics third: Spain.We recommended in this number: Vistonuridine in 5-fluorouracil overdose; A pathway by which arsenic may be contaminating the drinking water in Bangladesh; An article about association between cannabis use and adverse outcomes; Memory problems with ketamine; Alcohol plus caffeine equals a serious health threat; A weight loss supplement found to contain undeclared drug ingredients; Original detector molecule for cyanide; Another spot for phthalates...; Antimony Toxicity in Firefighters; British anti-toxin against ricin poisoning; Brazilian mint tea as painkiller and the most read article; Recent titles & abstracts about Herbs & Dietary Supplements from AACT. You can read and answer many toxicological trivias. The logo of this issue is our gift with best wishes for a happy and peaceful holiday. Until next year (and the next issue). JCP

Vistonuridine: An orally administered, life-saving antidote for 5-fluorouracil (5FU) overdose. R. von Borstel, J. O'Neil, M. Bamat; Wellstat Therapeutics Corporation, Gaithersburg, MD. J Clin Oncol 27:15s, 2009 (suppl; abstr 9616) Abstract:Background: 5FU is widely used to treat solid tumors and is often administered via infusion pump at or near its maximum tolerated dose (MTD). Toxicities and even death can occur in patients over-exposed to 5FU. Uridine is a direct biochemical antagonist of 5FU toxicity; uridine nucleotides dilute intracellular fluorouridine nucleotides derived from 5FU, reducing their lethal incorporation into RNA. However, uridine is poorly bioavailable (7%) and is therefore not a clinically viable antidote. Vistonuridine is an orally administered prodrug of uridine that delivers approximately 8-fold more uridine than administration of uridine itself. Methods: 17 patients overdosed with 5FU have been treated with vistonuridine as an antidote. Patients received vistonuridine (10g q6h for 20 doses) beginning 8 to 96 hours after overdose. Data from 13 patients with similar 5FU overdoses provide the time course and outcomes for patients receiving available supportive care without vistonuridine. A severity score, integrating dose and infusion rate, was calculated for all the patients, and this tool could be used by healthcare workers to determine the expected severity and outcome of a 5FU overdose. Results: All 17 overdose patients treated with vistonuridine recovered fully. Most, especially those for whom vistonuridine treatment was initiated sooner, had relatively modest toxicity. In marked contrast, all 11 of the literature-reported cases of 5FU overdose for which an outcome of death would have been predicted died from the overdose despite receiving available supportive care. Conclusions: These clinical data illustrate the serious, debilitating and life threatening nature of 5FU overdose and the current lack of effective treatments. Vistonuridine appears to be a safe and effective, life-saving antidote to 5FU overdose.
Vistouridine is available in USA under emergency-use IND provisions from Wellsata Therapeutics (443)831-5626

MIT scientists pinpoint origin of dissolved arsenic in Bangladesh drinking water.brightsurf.November 16, 2009. Researchers in MIT's Department of Civil and Environmental Engineering believe they have pinpointed a pathway by which arsenic may be contaminating the drinking water in Bangladesh, a phenomenon that has puzzled scientists, world health agencies and the Bangladeshi government for nearly 30 years. The research suggests that human alteration to the landscape, the construction of villages with ponds, and the adoption of irrigated agriculture are responsible for the current pattern of arsenic concentration underground. The pervasive incidence of arsenic poisoning in Bangladesh and its link to drinking water were first identified in the scientific literature in the early 1980s, not long after the population began switching from surface water sources like rivers and ponds to groundwater from newly installed tube wells. That national effort to decrease the incidence of bacterial illnesses caused by contaminated drinking water led almost immediately to severe and widespread arsenic poisoning, which manifests as sores on the skin and often leads to cancers of the skin, lung, liver, bladder and pancreas. [ See ]

Adverse health effects of non-medical cannabis use, Wayne Hall, Louisa Degenhardt. The Lancet,  Volume 374, Issue 9698, Pages 1383 - 1391, 17 October 2009.  Abstract; For over two decades, cannabis, commonly known as marijuana, has been the most widely used illicit drug by young people in high-income countries, and has recently become popular on a global scale. Epidemiological research during the past 10 years suggests that regular use of cannabis during adolescence and into adulthood can have adverse effects. Epidemiological, clinical, and laboratory studies have established an association between cannabis use and adverse outcomes. We focus on adverse health effects of greatest potential public health interest—that is, those that are most likely to occur and to affect a large number of cannabis users. The most probable adverse effects include a dependence syndrome, increased risk of motor vehicle crashes, impaired respiratory function, cardiovascular disease, and adverse effects of regular use on adolescent psychosocial development and mental health.

Ketamine drug use 'harms memory'. bbcnews. November 17, 2009. Frequent use of ketamine - a drug popular with clubbers - is being linked with memory problems, researchers say. The University College London team carried out a range of memory and psychological tests on 120 people. They found frequent users performed poorly on skills such as recalling names, conversations and patterns. Previous studies said the drug might cause kidney and bladder damage. The London team and charity Drugscope said users should be aware of the risks. [ See ]

Caffeine plus alcohol equals a dangerous mix. theolympian.November 24, 2009.Under pressure from state attorneys general, the federal Food and Drug Administration has announced plans to crack down on 30 manufacturers of caffeinated alcoholic beverages.Dr. Joshua Sharfstein, principal deputy commissioner of food and drugs, said it’s time for the FDA to look into the safety and legality of the products and pull them from the marketplace if they don’t meet federal standard. [ See ] See also in examiner: Caffeinated alcohol companies fire back at the FDA

GMP Herbal Products, Inc. Issues a Voluntary Nationwide Recall of a Weight Loss Supplement Found to Contain Undeclared Drug Ingredients. November 12, 2009 – Westminster, CA – GMP Herbal Products, Inc. has been informed by the Food and Drug Administration (FDA) that Pai You Guo, a weight loss dietary supplement, sold and marketed by the firm contains undeclared drug ingredients.  FDA lab analyses of dietary supplements distributed by the company were found to contain undeclared sibutramine, an FDA-approved drug used as an appetite suppressant for weight loss; and phenolphthalein, a solution used in chemical experiments and a suspected cancer-causing agent that is not approved for marketing in the United States. Read more in  MedWatch website at wwww.fda.gov/Safety/MedWatch/default.htm

Designer molecule detects tiny amounts of cyanide, then glows. chemie.de.Oct 26,  2009.  A small molecule designed to detect cyanide in water samples works quickly, is easy to use, and glows under ultraviolet or "black" light. Although the fluorescent molecule is not yet ready for market, its Indiana University Bloomington creators report in the Journal of the American Chemical Society (now online) that the tool is already able to sense cyanide below the toxicity threshold established by the World Health Organization."This is the first system that works in water at normal pH levels and can be modified at will to enhance its reactivity," said IU Bloomington chemist Dongwhan Lee, who led the research. "We are now looking at how to make the detector more sensitive." [ See ]

Plastic chemicals 'feminise boys'. BBCnews. November 16, 2009. Chemicals in plastics alter the brains of baby boys, making them "more feminine", say US researchers.Males exposed to high doses in the womb went on to be less likely to play with boys' toys like cars or to join in rough and tumble games, they found.The University of Rochester team's latest work adds to concerns about the safety of phthalates, found in vinyl flooring and PVC shower curtains.The findings are reported in the International Journal of Andrology.[ See ]

Pseudo-Outbreak of Antimony Toxicity in Firefighters --- Florida, 2009. November 27, 2009 / 58(46);1300-1302. Antimony oxides, in combination with halogens, have been used as flame retardants in textiles since the 1960s. Uniforms made from fabric containing antimony are common among the estimated 1.1 million firefighters in the United States. In October 2008, CDC received a report from the fire chief of a fire department in Florida (fire department A) regarding an outbreak of antimony toxicity among 30 firefighters who had elevated antimony levels detected in hair samples. This report summarizes the ensuing health hazard evaluation conducted by CDC to determine the source of antimony exposure. In February 2009, CDC administered questionnaires to and collected urine samples from two groups of firefighters: 20 firefighters from fire department A who did not wear pants made from antimony-containing fabric, and 42 firefighters from fire department B (also located in Florida) who did. All 20 firefighters from fire department A and 41 (98%) from fire department B had urine antimony concentrations below or within the laboratory reference range (1). CDC concluded that wearing pants made from antimony-containing fabric was not associated with elevated levels of urinary antimony. Only validated methods (e.g., urine testing) should be used for the determination of antimony toxicity. Accurate and timely risk communication during suspected workplace exposures should underscore the importance of using validated tests, thereby refuting an unproven hypothesis, allaying unsubstantiated concerns, and enhancing public trust.

Ricin 'antidote' to be produced. BBC News, November 11, 2009. An anti-toxin that protects against ricin poisoning is to move into production for the first time.It is the result of eight years of work by researchers at the Defence Science and Technology Laboratory based at Porton Down in Wiltshire.The antidote can protect against death up to 24 hours after exposure, according to Dr Jane Holley from DSTL.Security experts say ricin - roughly 1,000 times more toxic than cyanide - could be used in a bio-terror attack. [ See ]

Cup of mint tea is an effective painkiller. bbcnewa, November 25, 2009. A cup of Brazilian mint tea has pain relieving qualities to match those of commercially available analgesics, a study suggests.Hyptis crenata has been prescribed by Brazilian healers for millennia to treat ailments from headaches and stomach pain to fever and flu. Working on mice, a Newcastle University team has proved scientifically that the ancient medicine men were right.The study is published in the journal Acta Horticulturae. [ See ]

Ver Imagen Current awareness of Clinical Toxicology, has been published monthly since 1997 and gives a selected list of references relevant to clinical toxicology.  It is edited by Sarah Cage and Allister Vale and is produced by the National Poisons Information Service (Birmingham Unit). See October 2009 PDF.

American Academy of Clinical Toxicology: Herbs & Dietary Supplements Special Interest Group (September 29, 2009.). 23 abstracts send by Javier Waksman.

Struggle in Brazil against attempts coming from the asbestos industry to withdraw the law that banned asbestos in the State of São Paulo.

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