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Introduction: The aim was to assess the impact of the COVID-19 pandemic on French Poison Control Centre (PCC) call characteristics., Methods: Reported cases of xenobiotic exposures from 1 March to 30 April in 2018, 2019, and 2020 were extracted from the French National Database of Poisonings. The collected data included call, patient, and exposure characteristics for both general calls and for calls involving sentinel xenobiotic categories related to the COVID-19 pandemic. The 2020 exposures were compared to 2018-2019 exposures by using simple logistic models in order to provide effect size with odds ratios., Results: From March to April 2020, 32,182 exposures were reported to French PCCs with an overall increase of 5.6% compared to exposures in the same time frame in 2018-2019. A similar increase in calls was observed in non-epidemic and epidemic COVID-19 areas with an increase in calls from the public (+13.6%) while calls from health-professionals decreased (-7.5%). Despite the increase in exposures, the incidence of symptomatic exposures remained stable (-0.4%) with a decrease in severity (moderate/severe -17.2%). A significant increase in exposures to home cleaning products containing biocides, essential oils, and alcohol-based hand sanitizers (odds ratio >1.3, p  < .0001) was observed., Discussion and Conclusion: The COVID-19 pandemic altered calls to French PCCs with a small increase in calls during the study period and changes in the pattern of exposure. These changes possibly reflected the indirect consequences of the COVID-19 pandemic i.e., limited access to primary care, fear of contracting COVID-19 and anxiety related to home isolation.

Introduction: Most household and body soaps have an alkaline pH (9-12). In addition to their foaming effect, they irritate the skin. This study aims to review soap exposure reported to the Angers Poison Control Centre., Method: A retrospective study of accidental or deliberate oral exposure to solid soaps reported to the Angers Poison Control Centre between 1 January 2000 and 1 April 2015. Poisoning severity was reassessed for each case according to the Poisoning Severity Score (PSS)., Results: 553 cases of exposure were recorded. In more than 40% of cases (n = 226), exposure occurred in community settings (retirement homes, nursing homes). Patients had a history of dementia in 220 cases (40%). The most common symptoms were labial oedema (28%, n = 153), oropharyngeal irritation (10%, n = 56), salivation (10%, n = 53), vomiting (9%, n = 48) and cough (8%, n = 45). Among symptomatic patients (n = 276), one patient died from aspiration pneumonia and one patient died from a cardiogenic shock following oropharyngeal oedema, vomiting, cough and bronchial obstruction. Patients with dementia were more often symptomatic (75% vs 34%, p < .001) and more frequently hospitalised (22% vs 0.8%, p < .001). They experienced more moderate to severe symptoms (8% vs 0%, p < .001). Mildly severe (PSS2, n = 14), highly severe (PSS3, n = 1) and fatal (PSS4, n = 2) poisoning were observed only in patients with dementia., Conclusion: Ingestion of soap bars is potentially serious, especially in patients with dementia. This type of soap should not be available to them in community settings and close monitoring should be considered in the event of oral exposure.

Context: Among the numerous varieties of squash that exist, some are edible while other bitter-tasting ones are not fit for human consumption. Cases of confusion seem to be multiplying and are characterized by digestive problems (diarrhea, vomiting, and abdominal pain)., Methods: This is a descriptive retrospective study of cases of exposure reported to French Poison Control Centers between 1 January 2012 and 12 December 2016., Results: 353 patients were included, with 71.7% belonging to collective cases of poisoning. The male to female sex ratio was 0.75 for an average age of 38.2 ± 23.6 years. The circumstances of exposure were dietary for 337 patients (95.5%). The majority of the squash consumed was purchased at a store (55.8%) but some also came from the garden (25.5%). 204 patients (57.8%) mostly presented with diarrhea, vomiting, abdominal pain, sometimes with the consequent dehydration, hypotension, tachycardia, headaches, or vertigo. There were no deaths or severe (Poisoning Severity Score (PSS) 3) cases, but there were 14 patients (4.0%) of moderate severity, 190 patients (53.8%) of minor severity (PSS 1), and 149 patients (42.2%) without severity (PSS 0) but among which we include the bitter taste of the squash. The average age of PSS 2 patients was significantly (p = .003) older than that of the PSS <2 patients., Conclusion: As the first consequential series in Europe, our study shows that exposure to non-edible squash is frequent. Usually benign, poisoning could be the consequence of the irritating effect of certain cucurbits, the molecules responsible for the taste and toxicity of the fruits. In terms of prevention therefore, we recommend disposing of any squash with a bitter taste.

Context: Routine biological tests are frequently ordered in self-poisoning patients, but their clinical relevance is poorly studied., Materials and Methods: This is a prospective multicentric observational study conducted in the emergency departments and intensive care units of 5 university and nonuniversity French hospitals. Adult self-poisoning patients without severely altered vital status on admission were prospectively included., Results: Routine biological test (serum electrolytes and creatinine, liver enzymes, bilirubin, blood cell count, prothrombin time) ordering and results were analyzed. A total of 1027 patients were enrolled (age, 40.2 ± 14 years; women, 61.5%); no patient died during the hospital stay. Benzodiazepine was suspected in more than 70% of cases; 65% (range, 48%-80%) of patients had at least 1 routine biological test performed. At least 1 abnormal test was registered in 23% of these patients. Three factors were associated with abnormal test results: age older than 40 years, male sex, and poisoning with a drug known to alter routine tests (ie, acetaminophen, NSAIDs, metformine, lithium). Depending on these factors, abnormal results ranged from 14% to 48%. Unexpected severe life-threatening conditions were recorded in 6 patients. Only 3 patients were referred to the intensive care unit solely because of abnormal test results., Conclusion: Routine biological tests are commonly prescribed in nonsevere self-poisoning patients. Abnormal results are frequent but their relevance at bedside remains limited., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Le mot « réglisse » désigne la plante, sa racine et son extrait aromatique. D'un point de vue commercial, Glycyrrhiza glabra est l'espèce la plus importante avec un large éventail d'utilisations (phytothérapie, industrie du tabac, cosmétique, alimentaire et pharmaceutique). La glycyrrhizine, de structure hétérosidique triterpènique, est l'un des principaux constituants de la réglisse. Elle est hydrolysée dans la lumière intestinale par des β-glucuronidases du microbiote en acide 3β-monoglucuronyl-18β-glycyrrhétinique (A3MG) et en acide 18β-glycyrrhétinique (AG), qui sont métabolisés dans le foie. La clairance plasmatique est lente en raison d'un cycle entéro-hépatique. L'A3MG et l'AG sont capables de se lier aux récepteurs des minéralocorticoïdes avec une affinité très faible, et l'A3MG induit un pseudo-hyperaldostéronisme par inhibition dose-dépendante de la 11β-hydroxystéroïde déshydrogénase de type 2 dans le tissu rénal. Les cas rapportés dans la littérature de pseudo-hyperaldostéronisme sont nombreux et parfois graves, voire mortels, le plus souvent en contexte de consommation chronique et à doses importantes. Les intoxications à la glycyrrhizine sont caractérisées par une hypertension artérielle, une rétention hydrosodée, et une hypokaliémie avec alcalose métabolique et kaliurèse augmentée. La toxicité est fonction de la dose, du type de produit consommé, du mode de consommation (aiguë ou chronique) et d'une très grande variabilité interindividuelle. Le diagnostic de pseudo-hyperaldostéronisme par intoxication à la glycyrrhizine repose sur les données de l'anamnèse, de l'examen clinique et d'analyses biochimiques. La prise en charge repose avant tout sur celles des symptômes et l'arrêt de consommation de réglisse. The word "licorice" refers to the plant, its root, and its aromatic extract. From a commercial point of view, Glycyrrhiza glabra is the most important species with a wide range of uses (herbal medicine, tobacco industry, cosmetics, food and pharmaceutical). Glycyrrhizin is one of the main constituents of licorice. Glycyrrhizin is hydrolyzed in the intestinal lumen by bacterial β-glucuronidases to 3β-monoglucuronyl-18β-glycyrrhetinic acid (3MGA) and 18β-glycyrrhetinic acid (GA), which are metabolized in the liver. Plasma clearance is slow due to enterohepatic cycling. 3MGA and GA can bind to mineralocorticoid receptors with very low affinity, and 3MGA induces apparent mineralocorticoid excess syndrome through dose-dependent inhibition of 11β-hydroxysteroid dehydrogenase type 2 in renal tissue. The cases of apparent mineralocorticoid excess syndrome reported in the literature are numerous and sometimes severe, even fatal, most often in cases of chronic high dose consumption. Glycyrrhizin poisonings are characterized by hypertension, fluid retention, and hypokalemia with metabolic alkalosis and increased kaliuresis. Toxicity depends on the dose, the type of product consumed, the mode of consumption (acute or chronic) and a very large inter-individual variability. The diagnosis of glycyrrhizin-induced apparent mineralocorticoid excess syndrome is based on the history, clinical examination, and biochemical analysis. Management is primarily based on symptomatic care and stopping licorice consumption. [ABSTRACT FROM AUTHOR]