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首页> 外文期刊>Journal of toxicology-Clinical toxicology >Aldicarb poisoning by an illicit rodenticide imported into the United States: Tres Pasitos.
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Aldicarb poisoning by an illicit rodenticide imported into the United States: Tres Pasitos.

机译：进口到美国的非法杀鼠剂造成的涕灭威中毒：Tres Pasitos。

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OBJECTIVE: Although intentional and unintentional rodenticide poisoning is common, most readily available agents are of relatively low acute toxicity. A four-year long epidemic of severe toxicity from rodenticide exposure continues among patients predominantly of Dominican descent living in New York City. This study characterizes the ongoing epidemic of acute cholinesterase inhibitor poisoning due to an illicit rodenticide and identifies its etiology. METHODS: A prospectively collected case series of poisoned patients referred to the New York City Poison Control Center. The main outcome measures include the clinical characteristics upon presentation, antidotal and other therapeutic requirements, and patient outcome. Product analysis was performed with paper chromatography, gas chromatography/mass spectrometry, and high-performance liquid chromatography. A murine model assessing both clinical effect and cholinesterase activity was also performed. RESULTS: Thirty-five patients were referred following exposure to Tres Pasitos. Patients developed signs of cholinergic hyperactivity and many required high doses of atropine (>10 mg) to control these symptoms. The source was identified as a rodenticidal compound sold illicitly in local groceries primarily within the Dominican community. Murine cholinesterase activity fell significantly following exposure to the rodenticide. High-performance liquid chromatography identified aldicarb, an extremely potent carbamate-type cholinesterase inhibitor, not licensed for rodenticidal use in this country. CONCLUSION: Illicit sale of undocumented compounds poses a substantial public health threat. Despite several public health interventions, the epidemic continues.
机译：目的：尽管有意和无意灭鼠剂中毒很普遍，但大多数现成的药物急性毒性较低。在居住于纽约市的多米尼加血统的患者中，持续四年的灭鼠剂暴露导致严重毒性流行。这项研究的特点是由于非法杀鼠剂导致的急性胆碱酯酶抑制剂中毒的持续流行，并确定了其病因。方法：前瞻性收集的一系列中毒患者病例转至纽约市毒物控制中心。主要结局指标包括就诊时的临床特征，解毒和其他治疗要求以及患者结局。用纸色谱，气相色谱/质谱和高效液相色谱进行产物分析。还进行了评估临床效果和胆碱酯酶活性的鼠模型。结果：35名患者在接触Tres Pasitos后被转诊。患者出现胆碱能亢进的体征，许多人需要使用大剂量的阿托品（> 10 mg）来控制这些症状。来源被确认为主要在多米尼加社区内以当地杂货非法出售的杀鼠剂。暴露于灭鼠剂后，鼠胆碱酯酶活性显着下降。高效液相色谱法鉴定了涕灭威，一种极为有效的氨基甲酸酯型胆碱酯酶抑制剂，在该国未获许可用于灭鼠。结论：非法销售无证化合物构成了重大的公共卫生威胁。尽管采取了几种公共卫生干预措施，但该流行病仍在继续。

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