Autonomic Function following Acute Organophosphorus Poisoning A Cohort Study 英文参考文献.docVIP

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Autonomic Function following Acute Organophosphorus Poisoning A Cohort Study 英文参考文献.doc

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Autonomic Function following Acute Organophosphorus Poisoning A Cohort Study 英文参考文献

AutonomicFunctionfollowingAcuteOrganophosphorus Poisoning:ACohortStudy SudheeraS.Jayasinghe1,2,3*,KithsiriD.Pathirana3 1Department of Pharmacology, Faculty of Medicine, University of Ruhuna, Karapitiya, Galle, Sri Lanka, 2South Asian Clinical Toxicology Research Collaboration, Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka, 3Clinical Neuroscience Center, Department of Medicine, Faculty of Medicine,UniversityofRuhuna,Karapitiya,Galle,SriLanka Abstract Autonomic dysfunction after chronic low level exposure to organophosphorus (OP) pesticides has been consistently reportedintheliterature,butnotfollowingasingleacuteoverdose.InordertostudyautonomicfunctionafteranacuteOP overdose,sixty-sixoverdosepatientswerecomparedto70matchedcontrols.Assessmentofautonomicfunctionwasdone by heart rate response to standing, deep breathing (HR-DB) and Valsalva manoeuvre; blood pressure (BP) response to standingandsustainedhandgrip;amplitudeandlatencyofsympatheticskinresponse(SSR);pupilsizeandpost-voidurine volume.Thepatientswereassessedoneandsixweeksaftertheexposure.Thenumberofpatientswhoshowedabnormal autonomic function compared to standard cut-off values did not show statistically significantly difference from that of controlsbyChi-Squaretest.Whencomparedtothecontrolsatoneweektheonlysignificantdifferencesconsistentwith autonomic dysfunction were change of diastolic BP 3min after standing, HR-DB, SSR-Amplitude, SSR-Latency, post-void urinevolumeandsizeofthepupil.At6weekssignificantrecoveryofautonomicfunctionwasobservedandonlyHR-DBwas decreased to a minor degree, 25 beats/min [95%CI 2–8]. This study provides good evidence for the lack of long term autonomicdysfunctionfollowingacuteexposuretoOPpesticides. Citation: Jayasinghe SS, Pathirana KD (2012) Autonomic Function following Acute Organophosphorus Poisoning: A Cohort Study. PLoS ONE 7(5): e37987. doi:10.1371/journal.pone.0037987 Editor:JamesM.Wright,UniversityofBritishColumbia,Canada Receiv