Introduction. Today, the spread of the Sosnovsky hogweed plant has acquired an unprecedented scale, which is accompanied by an annual increase in the number of victims due to the occurrence of photochemical dermatitis (PD).Aim of study. To study the clinical picture of PD arising in patients as a result of contact with Sosnovsky hogweed juice, to develop measures for their prevention and treatment.Material and methods. The study involved 139 patients with a diagnosis of photochemical dermatitis who were treated in the department of acute poisoning and somatopsychiatric disorders of the N.V. Sklifosovsky Research Institute for Emergency Medicine.Results. All patients had skin lesions of varying prevalence, more often the upper and lower extremities, similar in depth to superficial thermal burns of I, II, IIIA degrees.Conclusions. The complex of treatment for patients should include detoxification, antihistamine, analgesic, hormonal, antibacterial therapy, as well as local treatment carried out by combustiologists.

Jervine, protoveratrine A (proA), and protoveratrine B (proB) are Veratrum alkaloids that are presented in some remedies obtained from Veratrum lobelianum, such as Veratrum aqua. This paper reports on a single-center pilot cardiotoxic mechanism study of jervine, proA, and proB in case series. The molecular aspects were studied via molecular dynamic simulation, molecular docking with cardiac sodium channel Na_V1.5, and machine learning-based structure–activity relationship modeling. HPLC-MS/MS method in combination with clinical events were used to analyze Veratrum alkaloid cardiotoxicity in patients. Jervine demonstrates the highest docking score (−10.8 kcal/mol), logP value (4.188), and pK_a value (9.64) compared with proA and proB. Also, this compound is characterized by the lowest calculated IC₅₀. In general, all three analyzed alkaloids show the affinity to Na_V1.5 that highly likely results in cardiotoxic action. The clinical data of seven cases of intoxication by Veratrum aqua confirms the results of molecular modeling. Patients exhibited nausea, muscle weakness, bradycardia, and arterial hypotension. The association between alkaloid concentrations in blood and urine and severity of patient condition is described. These experiments, while primary, confirmed that jervine, proA, and proB contribute to cardiotoxicity by Na_V1.5 inhibition.

Background.In acute poisoning, accompanied by a violation of the parameters of homeostasis, the problem of its management by the enteral route has been insufficiently studied.Purpose of the study.To assess the possibility of correcting electrolyte and volemic disorders of the body using an enteral solution (ER) in case of poisoning with psychopharmacological drugs.Material and methods.The study involved 120 patients who underwent intestinal lavage (IL) with ER on the 1st day in complex therapy. In the following days, 40 of them received infusion therapy, and 80 — drank glucose enteral solution (GES), 3–4 liters per day.Results.IL had a corrective effect on the electrolyte composition of the blood, volemic and hemorheological parameters, as well as on central and peripheral hemodynamics. The subsequent administration of GER had a stabilizing effect on these indicators, comparable to that of infusion therapy.Conclusion.In case of poisoning with psychopharmacological drugs, the use of saline enteral solution in the form of intestinal lavage and subsequent oral administration of the same solution in a daily volume of 3–4 liters, but with the addition of glucose, provides correction of impaired homeostasis indicators and may be an alternative to infusion therapy.

A method is developed for the detection of some antihypertensive drugs, atenolol, bisoprolol, enalapril, metoprolol, nifedipine and propranolol by gas chromatography coupled with mass spectrometry. It is also applicable to screening in clinical toxicology and the identification of both intact APDs and their metabolites. The chances that propranolol, bisoprolol, atenolol, enalapril, and nifedipine form some artifacts in the analysis are assessed. The structures of these compounds are elucidated and a mechanism of their formation in the chromatograph injector is proposed.

Структура острых экзотоксикозов в первые три месяца пандемии COVID-19 (по данным отделения острых отравлений ГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского ДЗМ»)

Background. The relative availability of Phenazepam makes it a frequent cause of overdose, suicide and non-medical use. At the same time, it remains insufficiently studied in chemical and toxicological terms.The aim of study. to create an accessible, rapid method for detecting Phenazepam in biological matrices of patients with acute poisoning.Materials and methods. We used thin-layer chromatography (TLC), gas chromatography with a mass selective detector (GC-MS), high performance liquid chromatography with a tandem mass-selective detector (LC-MS/MS) and immunochromatographic analysis (ICA). The preparation of samples of intact urine with the addition of standard solutions of Phenazepam and real urine samples of patients with acute poisoning with Phenazepam was carried out using liquid-liquid extraction or precipitation of related components of the sample with acetonitrile. Hydrolysis and derivatization were also added in GC-MS analysis.Results. The analysis of statistics of the Department of Acute Poisonings of the N.V. Sklifosovsky Research Institute for Emergency Medicine in 2014-2016 showed that Phenazepam poisonings averaged 9.2% of the total number of admissions and mainly occurred as suicidal attempts. A technique has been developed for the detection of Phenazepam by TLC, which gives more objective results than ICA. For confirmatory analysis, it is advisable to use LC-MS/MS method for the native substance and GC-MS for the products of hydrolysis after derivatization. Compared to confirmatory methods, the developed TLC-screening technique is expressive, does not require the use of expensive high-tech equipment, difficult sample preparation, and makes it possible to reliably detect toxic and lethal concentrations of Phenazepam.