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Visual evoked potentials in patients after methanol poisoning

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Urban P., Zakharov S., Diblík P., Pelclová D., Ridzoň P.

International Journal of Occupational Medicine and Environmental Health

2015

vol. 29

issue 3

471-478

Objectives We report the results of the visual evoked potentials (VEP) examination in patients after severe poisoning by methanol. Material and Methods The group of 47 patients (38 males and 9 females) was assembled out of persons who survived an outbreak of poisoning by the methanol adulterated alcohol beverages, which happened in the Czech Republic in 2012–2013. The visual evoked potentials examination was performed using monocular checkerboard pattern-reversal stimulation. Two criteria of abnormality were chosen: missing evoked response, and wave P1 latency > 117 ms. Non-parametric statistical methods (median, range, and the median test) were used to analyze factors influencing the VEP abnormality. Results The visual evoked potential was abnormal in 20 patients (43%), 5 of them had normal visual acuity on the Snellen chart. The VEP abnormality did not correlate significantly with initial serum concentrations of methanol, formic acid or lactate; however, it showed statistically significant inverse relation to the initial serum pH: the subgroup with the abnormal VEP had significantly lower median pH in comparison with the subgroup with the normal VEP (7.16 vs. 7.34, p = 0.04). The abnormality was not related to chronic alcohol abuse. Conclusions The visual evoked potentials examination appeared sensitive enough to detected even subclinical impairment of the optic system. Metabolic acidosis is likely to be the key factor related to the development of visual damage induced by methanol. The examination performed with a delay of 1–9 months after the poisoning documented the situation relatively early after the event. It is considered as a baseline for the planned long-term follow-up of the patients, which will make it possible to assess the dynamics of the observed changes, their reversibility, and the occurrence of potential late sequelae.

Occupational asthma follow-up - Which markers are elevated in exhaled breath condensate and plasma?

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Pelclová D., Fenclová Z., Vlčková Š., Klusáčková P., Lebedová J., Syslová K., Běláček J., Kuzma M., Navrátil T., Zakharov S., Kačer P.

International Journal of Occupational Medicine and Environmental Health

2014

vol. 27

issue 2

206-215

Objectives: To search for optimal markers in the exhaled breath condensate (EBC), plasma and urine that would reflect the activity/ severity of occupational asthma (OA) after the withdrawal from the exposure to the allergen. Material and Methods: Markers of oxidative stress: 8-iso-prostaglandin $ \text{F}_\text{2α}$ (8-isoprostane, 8-ISO), malondialdehyde (MDA), 4-hydroxy-trans-2-nonenale (HNE), cysteinyl leukotrienes (LT) and LTB₄ were determined using liquid chromatography and mass spectrometry in 43 subjects with immunological OA (49.3±11.8 years), removed from the exposure to the sensitizing agent 10.5±6.5 years ago; and in 20 healthy subjects (49.0±14.9 years). EBC was harvested both before and after the methacholine challenge test. In parallel, identical markers were collected in plasma and urine. The results were analyzed together with forced expiratory volume in one second (FEV1), blood eosinophils, immunoglobulin E (IgE) and eosinophilic cationic protein (ECP) and statistically evaluated (Spearman rank correlation $r_S$, two- or one-sample t tests and alternatively Kruskal Wallis or pair Wilcoxon tests). Results: Several parameters of lung functions were lower in the patients (FEV₁% predicted, MEF25% and MEF50%, Rtot%, p < 0.001). Shorter time interval since the removal from the allergen exposure correlated with higher ECP ($r_S$ = 0.375) and lower FEV1%, MEF25% and MEF50% after methacholine challenge ($r_S$ = -0.404, -0.425 and -0.532, respectively). In the patients, IgE (p < 0.001) and ECP (p = 0.009) was increased compared to controls. In EBC, 8-ISO and cysteinyl LTs were elevated in the asthmatics initially and after the challenge. Initial 8-ISO in plasma correlated negatively with FEV₁ ($r_S$ = -0.409) and with methacholine PD₂₀ ($r_S$ = -0.474). 8-ISO in plasma after the challenge correlated with IgE ($r_S$ = 0.396). Conclusions: The improvement in OA is very slow and objective impairments persist years after removal from the exposure. Cysteinyl LTs and 8-ISO in EBC and 8-ISO in plasma might enrich the spectrum of useful objective tests for the follow-up of OA.

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2 International Journal of Occupational Medicine and Environmental Health

2 Pelclová D.

2 Zakharov S.

1 Běláček J.

1 Diblík P.

1 Fenclová Z.

1 Kačer P.

1 Klusáčková P.

1 Kuzma M.

1 Lebedová J.

1 Navrátil T.

1 Ridzoň P.

1 Syslová K.

1 Urban P.

1 Vlčková Š.

1 2015

1 2014

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Visual evoked potentials in patients after methanol poisoning

Occupational asthma follow-up - Which markers are elevated in exhaled breath condensate and plasma?