Saeidi Sara, Dadpour Bita, Jarahi Lida, Ghamsari Anahita A, Nooghabi Mahdi J
Medical Toxicology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Indian J Crit Care Med. 2021 Apr;25(4):411-415. doi: 10.5005/jp-journals-10071-23777.
Botulism occurs periodically or in outbreaks in Iran. Botulism is lethal and accordingly a considerable issue in environmental health, although it is uncommon. This study was performed to evaluate the potential predictive factors in foodborne botulism in a 10-year span.
All medical records from patients with foodborne botulism admitted to Imam Reza Hospital in 10 years (2005-2015) were analyzed retrospectively.
61 cases were included (38 men, mean age ± SD 28.93 ± 19.14 years). All cases were treated with antitoxin. 6.6% of cases died. Canned beans were correlated with the admission to intensive care unit (ICU), and also, it increased the length of ICU stay significantly ( = 0.007 and 0.023, respectively). The incidence of dizziness and diplopia significantly induced excess demands for higher doses of antitoxin ( = 0.038 and 0.023, respectively). Risk of dysphagia was remarkably higher in cases with ptosis ( = 0.039, odds ratio: 3). While in this study, time elapsed between the onset of clinical manifestations and antitoxin administration was correlated with the occurrence of dysphagia, constipation, and blurred vision, and early treatment did not improve the outcomes. Multiple analysis of potential variables by a logistic regression model disclosed that the independent significant factors affecting mortality were the need for mechanical ventilation ( = 0.000), dyspnea ( = 0.044), general weakness ( = 0.044), and lack of consciousness ( = 0.008) at the time of admission.
Taking clinical signs and symptoms into account upon patient arrival is important and, of course, is a key to further management in the emergency setting.
Saeidi S, Dadpour B, Jarahi L, Ghamsari AA, Nooghabi MN. Clinical Predictive Values in Botulism: A 10-year Survey. Indian J Crit Care Med 2021;25(4):411-415.
肉毒中毒在伊朗呈周期性发生或暴发。肉毒中毒具有致命性,因此尽管并不常见,但仍是环境卫生领域的一个重大问题。本研究旨在评估10年间食源性肉毒中毒的潜在预测因素。
回顾性分析了10年(2005 - 2015年)间入住伊玛目礼萨医院的食源性肉毒中毒患者的所有病历。
纳入61例患者(38名男性,平均年龄±标准差28.93±19.14岁)。所有病例均接受抗毒素治疗。6.6%的病例死亡。罐装豆类与入住重症监护病房(ICU)相关,并且显著增加了在ICU的住院时间(分别为P = 0.007和0.023)。头晕和复视的发生率显著导致对抗毒素更高剂量的需求增加(分别为P = 0.038和0.023)。上睑下垂患者吞咽困难的风险显著更高(P = 0.039,比值比:3)。虽然在本研究中,临床表现出现至抗毒素给药之间的时间与吞咽困难、便秘和视力模糊的发生相关,但早期治疗并未改善预后。通过逻辑回归模型对潜在变量进行多因素分析显示,影响死亡率的独立显著因素是入院时需要机械通气(P = 0.000)、呼吸困难(P = 0.044)、全身虚弱(P = 0.044)和意识不清(P = 0.008)。
患者入院时考虑临床症状和体征很重要,当然,这也是急诊情况下进一步管理的关键。
Saeidi S, Dadpour B, Jarahi L, Ghamsari AA, Nooghabi MN. 肉毒中毒的临床预测价值:一项10年的调查。《印度危重症医学杂志》2021;25(4):411 - 415。