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Introduction Diethylene glycol (DEG) is a colourless and odourless liquid and a human toxicant. It is commonly used in industry and can be found in commercial products such as resins, [...], Objective In September 2006, a Panamanian physician reported an unusual number of patients with unexplained acute renal failure frequently accompanied by severe neurological dysfunction. Twelve (57%) of 21 patients had died of the illness. This paper describes the investigation into the cause of the illness and the source of the outbreak. Methods Case-control and laboratory investigations were implemented. Case patients (with acute renal failure of unknown etiology and serum creatinine ≥ 2 mg/dl) were individually matched to hospitalized controls for age (+ or -] 5 years), sex and admission date (≤ 2 days before the case patient). Questionnaire and biological data were collected. The main outcome measure was the odds of ingesting prescription cough syrup in cases and controls. Findings Forty-two case patients and 140 control patients participated. The median age of cases was 68 years (range: 25-91 years); 64% were male. After controlling for pre-existing hypertension and renal disease and the use of angiotensin-converting enzyme inhibitors, a significant association was found between ingestion of prescription cough syrup and illness onset (adjusted odds ratio: 31.0, 95% confidence interval: 6.93-138). Laboratory analyses confirmed the presence of diethylene glycol (DEG) in biological samples from case patients, 8% DEG contamination in cough syrup samples and 22% contamination in the glycerin used to prepare the cough syrup. Conclusion The source of the outbreak was DEG-contaminated cough syrup. This investigation led to the recall of approximately 60 000 bottles of contaminated cough syrup, widespread screening of potentially exposed consumers and treatment of over 100 affected patients. Objectif En septembre 2006, un medecin panameen a signale un nombre inhabituel d'insuffisances renales aigues inexpliquees, s'accompagnant frequemment d'un dysfonctionnement neurologique severe, Douze (57 %) des 21 malades sont morts de cette insuffisance. Le present article decrit l'enquete reatisee sur les causes de la maladie et l'origine de la flambee epidemique. Methodes Une etude cas-temoin et des investigations en laboratoire ont ete menees. Les cas (personnes presentant une insuffisance renale aigue d'etiologie inconnue et un taux de creatinine serique [superieur ou egal a] 2 mg/dl) ont ete apparies individuellement a des temoins hospitalises en fonction de l'age ([+ o-] 5 ans), du sexe et de la date d'admission (2 jours au plus avant la declaration du cas ou plus tard). Un questionnaire et des donnees biologiques ont ete recueillis. La principale mesure de resultat etait l'odds ratio de la prise de sirop antitussif sur prescription par les cas et les temoins. Resultats Quarante-deux cas et 140 temoins ont ete inclus dans l'etude. L'age median des cas etait de 68 ans (plage de variation : 25-91 ans) et 64% d'entre eux etaient des hommes. Apres ajustement pour une hypertension ou une pathologie renale preexistante et pour l'utilisation d'inhibiteurs de l'enzyme de conversion de l'angiotensine, une association importante a ete relevee entre la prise de sirop antitussif soumis a prescription et l'apparition de la maladie (odds ratio ajuste : 31,0, intervalle de confiance a 95% : 6,93-138). Les analyses de laboratoire ont confirme la presence de diethylene glycol (DEG) dans les echantillons biologiques provenant des cas, un taux de contamination par le DEG de 8 % des echantillons de sirop pour la toux et un taux de contamination de 22 % de la glycerine ayant servi a preparer ce sirop. Conclusion L'origine de la flambee etait un sirop antitussif contamine par du DEG. Les investigations ont conduit au rappel d'environ 60 000 flacons de sirop contamine, a un depistage a grande echelle des consommateurs potentiellement exposes et au traitement de plus de 100 patients touches. Objetivo En septiembre de 2006, un medico panameno notifico un numero inhabitual de pacientes aquejados de insuficiencia renal aguda idiopatica, asociada con frecuencia a disfuncion neurologica grave. Doce (57%) de 21 pacientes habian muerto a causa de la enfermedad. Se describe aqui la investigacion realizada para determinar la causa de la enfermedad y la fuente dei brote. Metodos Se Ilevaron a cabo estudios de casos y controles e investigaciones de laboratorio. Los pacientes objeto de estudio (con insuficiencia renal aguda de origen desconocido y creatinina serica [mayor que o iqual a] 2 mg/dl) fueron apareados individualmente con pacientes control hospitalizados considerando la edad ([+ 0-] 5 anos), el sexo y la fecha de ingreso ([menor que o igual a] 2 dias antes o despues del ingreso del paciente estudiado). Se recopilaron dates de cuestionarios y dates biologicos. El criterio principal de valoracion fueron las posibilidades de cases y controles de haber tornado jarabe contra la tos de venta con receta. Resultados Participaron en el estudio 42 cases y 140 controles. La mediana de la edad de los cases fue de 68 anos (intervalo: 25-91 anos); el 64% eran varones. Tras determinar si los pacientes presentaban una historia previa de hipertension y nefropatia y de use de inhibidores de la enzima conversora de la angiotensina, se detecto una relaci6n significativa entre la ingestion de jarabe antitusigeno y la aparicion de la enfermedad (razon de posibilidades (OR) ajustada: 31,0, intervalo de confianza del 95%: 6,93-138). Los analisis de laboratorio confirmaron la presencia de dietilenglicol (DEG) en las muestras biologicas de los pacientes estudiados, con una contaminacion per DEG del 8% en las muestras de jarabe y del 22% en la glicerina utilizada para preparar dicho jarabe. Conclusion La fuente del brote fue el jarabe antitusigeno contaminado per DEG. Esta investigacion Ilevo a retirar aproximadamente 60 000 frascos del jarabe contaminado, realizar un amplio cribado de los consumidores potencialmente expuestos, y tratar a mas de cien pacientes afectados.

The article presents a research on a rapid, cost-effective method for analyzing organophosphorus pesticide metabolites in human urine for counter-terrorism response. It also evaluates several analytical methods to determine the most reliable and cost-effective methods for incident response. It notes that the study includes different internal standards, different isolation techniques, and different analysis platforms. The researchers found that isotopically labeled standards were a necessity to provide accurate quantification, the chemically similar surrogate was not suitable as an internal standard. It suggests that the most sensitive and precise method uses isotopically labeled standards with gas chromatography-tandem mass spectrometry analysis.

The article provides a historical background regarding the identification and quantification of diethylene glycol (DEG) in pharmaceutical products that caused mass poisoning in Nigeria, Haiti, and Panama. It mentions that a timely public health response was put in place by the Centers for Disease Control and Prevention in Atlanta, Georgia because they were able to identify DEG contamination within 24 hours of the incident. Moreover, they accomplished the identification of a biochemical marker that can differentiate between those who ingested DEG and those who did not. The article concludes that a faster analytical tool and a standardized methodology are needed to respond to future epidemics.

Determines the dynamics of formation of polyalkylsiloxane from monolayers at air/water interface. Description of the resultant molecular ordering; Non-occurrence of substrate-induced in-plane positional ordering; Dependence of the positional order on the intrinsic molecular packing.

Dialkylphosphates (DAPs) are urinary metabolites and breakdown products of organophosphorous (OP) pesticides. Urinary DAPs are widely used to assess exposure to OP pesticides in epidemiologic studies. Recent evidence suggests that preformed DAPs are present in food and that they may also be present in other parts of the environment. Thus, DAP concentrations observed in urine may reflect a person's exposure to both parent OP pesticides and preformed DAPs in food and other environmental media. The presence of preformed DAPs in multiple media may indicate that previous studies have overestimated exposure to OP pesticides and that the use of urinary DAPs as biomarkers of exposure for OP pesticides may not accurately characterize exposure in non-acute settings. To establish the presence of DAPs in environmental and food media, we developed analytical methods to measure six DAPs in dust and orange juice. The limits of detection (LOD) for the dimethyl phosphates (dimethylphosphate (DMP), dimethylthiophosphate, and dimethyldithiophosphate) ranged from 2.8-9.9 ng g(-1) and 0.2-0.4 ng mL(-1) in dust and juice, respectively. The LODs for the diethyl phosphates (diethylphosphate (DEP), diethylthiophosphate, diethyldithiophosphate) ranged from 5.2-10.4 ng g(-1) and 0.5-3.0 ng mL(-1) in dust and juice, respectively. The extraction efficiencies for the analytes ranged from 23% to 91% and from 41% to 85% in dust and orange juice, respectively. DMP was detected in about half of the dust samples whereas DEP was detected in 80% of the dust samples tested. Other DAPs were less frequently detected in dust. Less than 3% of intact pesticide present in the matrices was converted to their respective DAPs during the pre-analytic and analytic process. Evaluation of the conversion of intact pesticides in the samples to DAPs will help us to better understand the contribution of preformed DAPs to urinary DAP concentrations.