Neurological sequelae including gait impairment were reported in survivors after methanol intoxication; however, no systematic study has been published so far. We aimed to analyse gait and balance impairment in a group of Czech methanol poisoning survivors. We examined 43 patients (age 46 ± 13 years) 2-8 months after methanol poisoning and 43 healthy controls. Investigations contained a shortened version of Falls Efficacy Scale (FES), clinical tests of gait and balance including Timed Up and Go test (TUG) and gait analysis using GaitRite® system, neurological and neuropsychological examination, brain imaging, EMG and tests of alcohol consumption. Nineteen patients admitted balance and gait impairment according to FES. Mild to moderate parkinsonian signs showed seven patients. Patients were slower (8.8 versus 5.7 s, p < 0.001) and performed more steps (11.1 versus 7.9, p < 0.001) in TUG compared with the controls. Gait analysis revealed shorter step length (76.5 versus 88.7 cm, p < 0.001), increased double support phase (18.8 versus 15.5%, p < 0.001) and wider base of support (11.3 versus 9.6 cm, p = 0.006) in patients. Eleven patients had deficit of executive function and performed higher cadence compared to the patients with normal execution (122.7 versus 115.0 step/min., p = 0.025). Lower limb polyneuropathy was verified in nine patients, without relation with gait or balance parameters. Neuroimaging revealed lesions mainly in the basal ganglia. Methanol poisoning survivors presented slower wide-based gait with shortened steps corresponding with frontal gait disorder. Higher stepping cadence associated with executive deficit supported the evidence of frontal lobe dysfunction related to impairment of basal ganglia and connections in frontal cortico-basal ganglia loops.
- MeSH
- Gait drug effects MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Methanol poisoning MeSH
- Brain diagnostic imaging drug effects MeSH
- Nervous System Diseases chemically induced diagnosis epidemiology MeSH
- Neuroimaging methods MeSH
- Postural Balance drug effects MeSH
- Survivors statistics & numerical data MeSH
- Solvents poisoning MeSH
- Aged MeSH
- Walk Test MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic epidemiology MeSH
BACKGROUND: Alcohol variants such as ethanol and methanol are simple organic compounds widely used in foods, pharmaceuticals, chemical synthesis, etc. Both are becoming an emerging health problem; abuse of ethanol containing beverages can lead to disparate health problems and methanol is highly toxic and unfit for consumption. METHODS AND RESULTS: This review summarizes the basic knowledge about ethanol and methanol toxicity, the effect mechanism on the body, the current care of poisoned individuals and the implication of alcohols in the development of diseases. Alcohol related dementia, stroke, metabolic syndrome and hepatitis are discussed as well. Besides ethanol, methanol toxicity and its biodegradation pathways are addressed. CONCLUSIONS: The impact of ethanol and methanol on the body is shown as case reports, along with a discussion on the possible implication of alcohol in Alzheimer's disease and antidotal therapy for methanol poisoning. The role of ethanol in cancer and degenerative disorders seems to be underestimated given the current knowledge. Treatment in case of poisoning is another issue that remains unresolved even though effective protocols and drugs exist.
- MeSH
- Aldehyde Dehydrogenase drug effects metabolism MeSH
- Alcohol Dehydrogenase drug effects metabolism MeSH
- Alcoholic Beverages adverse effects analysis MeSH
- Alcoholism etiology metabolism MeSH
- Antidotes therapeutic use MeSH
- Ethanol adverse effects metabolism poisoning MeSH
- Humans MeSH
- Methanol adverse effects metabolism poisoning MeSH
- Receptors, Cell Surface drug effects MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
Intoxikace metanolem může způsobit diagnostické potíže, pokud neexistuje údaj o požití závadné látky. V úvodu epidemie metanolových otrav v ČR v roce 2012 jsme se s negativní anamnézou konzumace alkoholu potýkali hned několikrát. Hladiny metanolu byly u těchto několika pacientů stopové, někdy dokonce nulové. Pacienti trpěli četnými přidruženými nemocemi, někteří z nich museli být během přijetí resuscitováni. Jednoduchá metoda stanovení hladiny kyseliny mravenčí nebyla v prvních dnech vlny otrav běžně dostupná. Intoxikace metanolem byla definitivně potvrzena v těchto případech až dodatečným vyšetřením kyseliny mravenčí v séru ve specializované laboratoři s odstupem několika dalších dnů. Tyto skutečnosti nás vedly k ověření možnosti detekce nadlimitní koncentrace formiátu v séru rychlým screeningovým vyšetřením. Analýza vzorků krevního séra, odebraných během léčby intoxikace metanolem, kapilární elektroforézou ukázala, že lze dobře monitorovat hladinu formiátu v séru jak před zahájením terapie, tak během ní. Klíčová slova: metanol – kyselina mravenčí – acidóza – kapilární elektroforéza – hemodialýza
Methanol intoxication can be difficult to diagnose, especially if there is no supporting evidence of ingestion of the toxic compound. At the begining of the methanol intoxication epidemic in the Czech Republic (2012) we faced a negative anamnesis of alcohol consumption several times. The measured levels of methanol in these patients were very low, sometimes methanol was even not detected. The patients were suffering from concomitant illnesses and some of them had to be resuscitated during admission. Simple screening methods able to detect formic acid were not available at the beginning of the epidemic. Eventually, methanol intoxication was confirmed a few days later in a specialized toxicological laboratory. Therefore, we tested a novel capillary electrophoretic method for the rapid screening of concentration of formic acid in the serum above its normal physiological range. Analysis of the serum of the patients intoxicated with methanol proved that monitoring of formate concentration in the serum with the newly developed method before and during the medical management is possible. Keywords: methanol – formic acid – acidosis – capillary electrophoresis – haemodialysis
- Keywords
- kyselina mravenčí,
- MeSH
- Acidosis etiology physiopathology therapy MeSH
- Antidotes therapeutic use MeSH
- Early Diagnosis MeSH
- Time Factors MeSH
- Renal Dialysis MeSH
- Electrophoresis, Capillary * methods statistics & numerical data utilization MeSH
- Ethanol administration & dosage therapeutic use MeSH
- Fomepizole MeSH
- Formates * blood metabolism MeSH
- Middle Aged MeSH
- Humans MeSH
- Methanol * blood metabolism poisoning MeSH
- Poisoning diagnosis physiopathology therapy MeSH
- Critical Care MeSH
- Pyrazoles therapeutic use MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- Research Support, Non-U.S. Gov't MeSH
BACKGROUND: Methanol is a widely used industrial short-chain aliphatic alcohol with known neurotoxic properties. Mass poisoning outbreaks due to the consumption of methanol-adulterated alcoholic drinks present a challenge to healthcare providers due to the high mortality and serious central nervous system (CNS) damage in survivors. However, the impact of methanol exposure on the peripheral nervous system is unknown. OBJECTIVES: To investigate the role of acute methanol exposure in the development of peripheral polyneuropathy (PNP) during the years following discharge from the hospital. METHODS: A total of 55 patients with confirmed methanol poisoning (mean age of 47.9 ± 3.6 years; 9 females) were examined 4 times within a 6-year prospective longitudinal cohort study. The program included neurological and electromyographic examinations, visual evoked potentials, ocular examinations with retinal nerve fibre layer thickness measurements, brain magnetic resonance imaging, and a series of biochemical and toxicological tests. RESULTS: PNP was observed in 20/55 (36 %) patients, which, in most of the cases, was mild axonal sensorimotor neuropathy. In 8/55 (15 %) patients, worsening of electromyographic findings was registered during the follow-up period, including 5 cases with newly diagnosed PNP and 3 cases of PNP progression. In one subject, complete reversal of PNP was registered after cessation of alcohol intake. The patients with PNP were significantly older (57.3 ± 5.3 versus 42.5 ± 3.9 years; p < 0.001), with higher blood glucose (5.93 ± 0.97 versus 4.81 ± 0.32 mmol/L; p = 0.035) and lower vitamin B1 (45.5 ± 7.4 versus 57.5 ± 5.2 ug/L; p = 0.015) concentrations. The number of chronic alcohol abusers was significantly higher in the PNP group (17/20 versus 20/35; p = 0.034). No associations between PNP prevalence/ dynamics and acute parameters of poisoning severity, arterial blood pH (7.26 ± 0.07 with PNP versus 7.18 ± 0.09 without PNP; p = 0.150), or serum methanol (1320.0 ± 700.0 with PNP versus 1430.0 ± 510.0 mg/L without PNP; p = 0.813) and ethanol (460.0 ± 560.0 with PNP versus 340.0 ± 230.0 mg/L without PNP; p = 0.675) concentrations at admission were found. No difference in the number of patients with visual (9/20 with PNP versus 12/35 patients without PNP; p = 0.431) and CNS sequelae (9/20 with PNP versus 15/35 patients without PNP; p = 0.877) of poisoning was present. DISCUSSION: Despite the relatively high number of PNP cases, no association was found between the severity of acute methanol poisoning and the prevalence of PNP and its dynamics during six years of observation. We did not find an association between methanol-induced visual/ brain damage and the prevalence of PNP in survivors of poisoning. A high prevalence of PNP and its progression might be attributed to other causes, mainly a history of chronic alcohol abuse and insufficiently treated diabetes mellitus. Our results highlight the importance of complete cessation of alcohol consumption and better control of glycaemia in diabetic patients in the prevention and treatment of peripheral PNP.
- MeSH
- Time Factors MeSH
- Adult MeSH
- Risk Assessment MeSH
- Middle Aged MeSH
- Humans MeSH
- Longitudinal Studies MeSH
- Methanol poisoning MeSH
- Peripheral Nervous System Diseases chemically induced diagnosis epidemiology MeSH
- Poisoning diagnosis epidemiology MeSH
- Prevalence MeSH
- Prognosis MeSH
- Prospective Studies MeSH
- Risk Factors MeSH
- Severity of Illness Index MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Účel štúdie: Cieľom bolo stanoviť trendy v spotrebe silných a slabých opioidných analgetík v priebehu prvej dekády 21.storočia. Metódy: Údaje sme získali z databázy Štátneho ústavu pre kontrolu liečiv SR. Hodnotenie spotreby sme realizovali pomocou kritéria denných definovaných dávok na tisíc obyvateľov a jeden deň. Získané výsledky sme porovnali s údajmi z českého Státního ústavu na kontrolu léčiv a na porovnanie so zahraničím sme použili údaje z nórskych štatistík. Výsledky: Slovensko má násobne vyššiu spotrebu silných opioidov v porovnaní s Českou republikou. Pri hodnotení spotreby najmä silných opioidných analgetík je vidno výraznú dominanciu Nórska. Spotreba pri všetkých sledovaných liečivách má stúpajúcu tendenciu a jedinou výnimkou je relatívne ustálená spotreba buprenorfínu na Slovensku a pokles spotreby morfínu vo všetkých sledovaných krajinách. Závery: Ostáva nám len vyjadriť nádej pokračovania nastúpených trendov rastu spotreby opioidných analgetík. Lebo nemôžme tvrdiť, že by u nás bolo menej bolesti.
Objective: To assess trends in consumption of strong and weak opioid analgesics during the first decade of the 21st century. Methods: Data were collected from the State Institute for Drug Control in Slovakia. Evaluation was done using the methodology of defined daily doses per 1000 inhabitants per day. The data obtained were compared with those from the Czech State Institute for Drug Control and also comparison with statistics from Norway was done. Resuts: Slovakia has several times higher consumption of strong opioids when compared with the Czech Republic. When evaluating the consumption of strong opioids in particular, Norway is clearly dominant. Consumption of all the opioids observed is increasing except a relatively stable consumption of buprenorphine in Slovakia and a decrease in morphine consumption in all the countries. Conclusions: We hope that these increasing trends will continue. Because we cannot say that there is less pain.
- MeSH
- Buprenorphine therapeutic use MeSH
- Time Factors MeSH
- Fentanyl therapeutic use MeSH
- Codeine analogs & derivatives therapeutic use MeSH
- Humans MeSH
- Morphine therapeutic use MeSH
- Analgesics, Opioid therapeutic use MeSH
- Oxycodone therapeutic use MeSH
- Drug Utilization statistics & numerical data trends MeSH
- Tramadol therapeutic use MeSH
- Check Tag
- Humans MeSH
- Publication type
- Comparative Study MeSH
- Geographicals
- Czech Republic MeSH
- Norway MeSH
- Slovakia MeSH
Pichia pastoris, a methylotrophic yeast, is known to be an efficient host for heterologous proteins production. In this study, a recombinant P. pastoris Y11430 was found better for β-glucosidase activity in comparison with a wild type P. pastoris Y11430 strain, and thereby, subjected to methanol intermittent feed profiling for β-glucosidase production. The results showed that at 72 h of cultivation time, the cultures with 16.67% and 33.33% methanol feeding with constant rate could produce the total dry cell weight of 52.23 and 118.55 g/L, respectively, while the total mutant β-glucosidase activities were 1001.59 and 3259.82 units, respectively. The methanol feeding profile was kept at 33% with three methanol feeding strategies such as constant feed rate, linear feed rate, and exponential feed rate which were used in fed-batch fermentation. At 60 h of cultivation, the highest total mutant β-glucosidase activity was 2971.85 units for exponential feed rate culture. On the other hand, total mutant β-glucosidase activity of the constant feed rate culture and linear feed rate culture were 1682.25 and 1975.43 units, respectively. The kinetic parameters of exponential feed rate culture were specific growth rate on glycerol 0.228/h, specific growth of methanol 0.061/h, maximum total dry cell weight 196.73 g, yield coefficient biomass per methanol ([Formula: see text]) 0.57 gcell/gMeOH, methanol consumption rate ([Formula: see text]) 5.76 gMeOH/h, and enzyme productivity ([Formula: see text]) 75.96 units/h. In conclusion, higher cell mass and β- glucosidase activity were produced under exponential feed rate than constant and linear feed rates.
- MeSH
- Ethylene Glycol * adverse effects toxicity MeSH
- Methanol * adverse effects toxicity MeSH
- Alcoholic Intoxication * drug therapy complications metabolism therapy MeSH
- Alcohol Drinking drug therapy adverse effects MeSH
- Pyrazoles * administration & dosage pharmacology therapeutic use MeSH
- Publication type
- Interview MeSH
- Keywords
- dlouhodobé následky,
- MeSH
- Acute Disease MeSH
- Mass Casualty Incidents MeSH
- Humans MeSH
- Methanol * poisoning adverse effects MeSH
- Poisoning * diagnosis etiology mortality pathology MeSH
- Alcohol Drinking adverse effects MeSH
- Vision Disorders chemically induced MeSH
- Animals MeSH
- Check Tag
- Humans MeSH
- Animals MeSH
