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Much caution does no harm! Organophosphate poisoning often causes pancreatitis

Overview of attention for article published in Journal of Intensive Care, April 2015
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Title
Much caution does no harm! Organophosphate poisoning often causes pancreatitis
Published in
Journal of Intensive Care, April 2015
DOI 10.1186/s40560-015-0088-1
Pubmed ID
Authors

Shozo Yoshida, Hideshi Okada, Shiho Nakano, Kunihiro Shirai, Toshiyuki Yuhara, Hiromasa Kojima, Tomoaki Doi, Hisaaki Kato, Kodai Suzuki, Kentaro Morishita, Eiji Murakami, Hiroaki Ushikoshi, Izumi Toyoda, Shinji Ogura

Abstract

Organophosphate poisoning (OP) results in various poisoning symptoms due to its strong inhibitory effect on cholinesterase. One of the occasional complications of OP is pancreatitis. A 62-year-old woman drank alcohol and went home at midnight. After she quarreled with her husband and drank 100 ml of malathion, a parasympathomimetic organophosphate that binds irreversibly to cholinesterase, she was transported to our hospital in an ambulance. On admission, activated charcoal, magnesium citrate, and pralidoxime methiodide (PAM) were used for decontamination after gastric lavage. Abdominal computed tomography detected edema of the small intestine and colon with doubtful bowel ischemia, and acute pancreatitis was suspected. Arterial blood gas analysis revealed severe lactic acidosis. The Ranson score was 6 and the APACHE II (Acute Physiology and Chronic Health Evaluation) score was 14. Based on these findings, severe acute pancreatitis was diagnosed. One day after admission, hemodiafiltration (HDF) was started for the treatment of acute pancreatitis. On the third hospital day, OP symptoms were exacerbated, with muscarinic manifestations including bradycardia and hypersalivation and decreased plasma cholinesterase activity. Atropine was given and the symptoms improved. The patient's general condition including hemodynamic status improved. Pancreatitis was attenuated by 5 days of HDF. Ultimately, it took 14 days for acute pancreatitis to improve, and the patient discharged on hospital day 32. Generally, acute pancreatitis associated with OP is mild. In fact, one previous report showed that the influence of organophosphates on the pancreas disappears in approximately 72 hours, and complicated acute pancreatitis often improves in 4-5 days. However, it was necessary to treat pancreatitis for more than 2 weeks in this case. Therefore, organophosphate-associated pancreatitis due to malathion is more severe. Although OP sometime causes severe necrotic pancreatitis or pancreatic pseudocysts, it was thought that the present patient had a good clinical course without these complications due to the appropriate intensive care including nafamostat, antibiotics, fluid resuscitation, and HDF. In conclusion, OP-associated pancreatitis requires careful assessment because it may be aggravated, as in this case.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 37 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Colombia 1 3%
Unknown 36 97%

Demographic breakdown

Readers by professional status Count As %
Other 10 27%
Researcher 4 11%
Student > Ph. D. Student 3 8%
Professor 2 5%
Lecturer 2 5%
Other 8 22%
Unknown 8 22%
Readers by discipline Count As %
Medicine and Dentistry 21 57%
Engineering 2 5%
Pharmacology, Toxicology and Pharmaceutical Science 2 5%
Arts and Humanities 1 3%
Nursing and Health Professions 1 3%
Other 1 3%
Unknown 9 24%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 21 October 2020.
All research outputs
#15,369,917
of 19,188,609 outputs
Outputs from Journal of Intensive Care
#369
of 445 outputs
Outputs of similar age
#169,860
of 241,897 outputs
Outputs of similar age from Journal of Intensive Care
#1
of 1 outputs
Altmetric has tracked 19,188,609 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
So far Altmetric has tracked 445 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 10.4. This one is in the 9th percentile – i.e., 9% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 241,897 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 17th percentile – i.e., 17% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them