Accuracy of detection of carboxyhemoglobin and methemoglobin in human and bovine blood with an inexpensive, pocket-size infrared scanner

De Novo Construction of Fluorophores via CO Insertion-Initiated Lactamization: A Chemical Strategy toward Highly Sensitive and Highly Selective Turn-On Fluorescent Probes for Carbon Monoxide

Extensive studies in the last few decades have led to the establishment of CO as an endogenous signaling molecule and subsequently to the exploration of CO's therapeutic roles. In the current state, there is a critical conundrum in CO-related research: the extensive knowledge of CO's biological effects and yet an insufficient understanding of the quantitative correlations between the CO concentration and biological responses of various natures. This conundrum is partially due to the difficulty in examining precise concentration-response relationships of a gaseous molecule. Another reason is the need for appropriate tools for the sensitive detection and concentration determination of CO in the biological system. We herein report a new chemical approach to the design of fluorescent CO probes through de novo construction of fluorophores by a CO insertion-initiated lactamization reaction, which allows for ultra-low background and exclusivity in CO detection. Two series of CO detection probes have been designed and synthesized using this strategy. Using these probes, we have extensively demonstrated their utility in quantifying CO in blood, tissue, and cell culture and in cellular imaging of CO from exogenous and endogenous sources. The probes described will enable many biology and chemistry labs to study CO's functions in a concentration-dependent fashion with very high sensitivity and selectivity. The chemical and design principles described will also be applicable in designing fluorescent probes for other small molecules.

[Carbon monoxide intoxication-New aspects and current guideline-based recommendations]

Carbon monoxide poisoning is a common and potentially life-threatening intoxication, showing an interindividual variety of unspecific symptoms as well as late neurological and other sequelae. Two new German guidelines (S2k guidelines diagnosis and treatment of carbon monoxide poisoning as well as S3 guidelines oxygen therapy in the acute care of adult patients) focus on current evidence-based information on diagnostics as well as therapeutic options with considerable uncertainty remaining. This review summarizes current information and presents a flow scheme for daily practical use.

Bluetooth-Connected Pocket Spectrometer and Chemometrics for Olive Oil Applications

Unsaturated fatty acids are renowned for their beneficial effects on the cardiovascular system. The high content of unsaturated fatty acids is a benefit of vegetable fats and an important nutraceutical indicator. The ability to quickly check fat composition of an edible oil could be advantageous for both consumers and retailers. A Bluetooth-connected pocket spectrometer operating in NIR band was used for analyzing olive oils of different qualities. Reference data for fatty acid composition were obtained from a certified analytical laboratory. Chemometrics was used for processing data, and predictive models were created for determining saturated and unsaturated fatty acid content. The NIR spectrum also demonstrated good capability in classifying extra virgin and non-extra virgin olive oils. The pocket spectrometer used in this study has a relatively low cost, which makes it affordable for a wide class of users. Therefore, it may open the opportunity for quick and non-destructive testing of edible oil, which can be of interest for consumer, retailers, and for small/medium-size producers, which lack easy access to conventional analytics.

Tips for avoiding common mistakes in out-of-hospital diagnosis of carbon monoxide poisoning

Acute carbon monoxide poisoning is the leading cause of intoxication from exogenous substances in the world. It is also a major cause of morbidity and mortality due to poisoning in the USA. In the USA, it determines to 50,000 visits per year in emergency departments with a mortality ranging from 1 to 3%. Although prevalence and incidence data reveal the large impact of carbon monoxide poisoning on public health, some studies have shown that errors in its diagnosis have a high incidence (30%) and that awareness campaigns have allowed the reduction of the same to 5%. In addition, many diagnostic and/or therapeutic errors were found both in small first aid situations and in the context of rescue units belonging to prestigious hospitals. To formulate a diagnosis, the collection of clues from the environment in which the patient is found is essential. Especially when the routine use of environmental gas detectors or handheld CO-oximeters is not possible, the emergency doctor, in addition to concentrating on the clinical presentation of the case, will have to give a quick overview of the patient and his environment. In addition to age, sex, and already known comorbidities, it is not irrelevant to evaluate socio-economic and cultural characteristics, hygiene conditions, habits, etc.The purpose of this study is to provide useful information to the doctor who comes first to the site of intoxication to reduce diagnostic and therapeutic errors in the pre- and intra-hospital phase as much as possible.

Portable Near-Infrared Spectroscopy as a Screening Test of Corrosive Solutions Concealed in Plastic Containers

The use of corrosive substances for criminal intent has recently increased in many countries, with 619 violent assaults recorded from 2019 to 2020 only in the UK. Criminals often conceal corrosive solutions, such as common household cleaners, in inconspicuous plastic bottles and splashing the content in order to incapacitate a victim while committing a robbery or to cause physical harm. There is currently no method available to law enforcement for the safe identification of these corrosive substances without being exposed to them. In this work, the feasibility of a near infrared (NIR) handheld spectrometer for the screening of corrosive inorganic solutions through plastic bottles is investigated. First, a training set comprising samples of five different corrosives was used to build a spectral library for data analysis and chemometric model design. Four models were then tested on three hundred samples of corrosive substances, as well as harmless substances such as water and soft drinks, to evaluate their performance. The models designed identified the corrosive substances in scenarios of concentrated solutions, showcasing the potential capability of this technique for the pre-screening of corrosive substances.

S2k guideline diagnosis and treatment of carbon monoxide poisoning

Carbon monoxide (CO) can occur in numerous situations and ambient conditions, such as fire smoke, indoor fireplaces, silos containing large quantities of wood pellets, engine exhaust fumes, and when using hookahs. Symptoms of CO poisoning are nonspecific and can range from dizziness, headache, and angina pectoris to unconsciousness and death. This guideline presents the current state of knowledge and national recommendations on the diagnosis and treatment of patients with CO poisoning. The diagnosis of CO poisoning is based on clinical symptoms and proven or probable exposure to CO. Negative carboxyhemoglobin (COHb) levels should not rule out CO poisoning if the history and symptoms are consistent with this phenomenon. Reduced oxygen-carrying capacity, impairment of the cellular respiratory chain, and immunomodulatory processes may result in myocardial and central nervous tissue damage even after a reduction in COHb. If CO poisoning is suspected, 100% oxygen breathing should be immediately initiated in the prehospital setting. Clinical symptoms do not correlate with COHb elimination from the blood; therefore, COHb monitoring alone is unsuitable for treatment management. Especially in the absence of improvement despite treatment, a reevaluation for other possible differential diagnoses ought to be performed. Evidence regarding the benefit of hyperbaric oxygen therapy (HBOT) is scant and the subject of controversy due to the heterogeneity of studies. If required, HBOT should be initiated within 6 h. All patients with CO poisoning should be informed about the risk of delayed neurological sequelae (DNS).

A Rare Case of Fatal Self-Poisoning With Sodium Nitrite: Autopsy and Toxicological Findings

ABSTRACT

Fatal sodium nitrite poisonings are unusual in the forensic setting. Suicide by poisoning includes drug overdose, the inhalation of toxic gasses, and poisoning from pesticides and chemical substances. Sodium nitrite is an inorganic compound usually seen as a crystalline powder that is very water soluble. Sodium nitrite is used mostly in the food industry (as a preservative) and in medical field (as an antidote to cyanide poisoning), and if ingested in large enough amounts, it can be fatal.The ingestion of sodium nitrite can cause severe methemoglobinemia, which is a metabolic disorder characterized by an inability of hemoglobin (which gets oxidized into methemoglobin) to bind (and therefore carry) oxygen. Severe cases of this condition, if not treated, can be fatal.We describe a case of fatal self-poisoning with sodium nitrite; in particular, the article focuses on the autoptic and toxicological investigations that enabled the correct diagnosis to be established.

Assessment of carboxyhemoglobin content in the blood with high accuracy: wavelength range optimization for nonlinear curve fitting of optical spectra

The impact of carbon monoxide (CO) gas on the human organism is very dangerous. The affinity of CO to hemoglobin is considerably higher than that of oxygen. Thus, the interaction of CO with the blood results in a higher content of carboxyhemoglobin (HbCO) in red blood cells (RBCs) and correspondingly in tissue hypoxia. The disruption in the organism depends on the HbCO content in the blood. To assess any complications in the body at a given moment due to CO exposure and predict future consequences, it is necessary to measure the dynamics of hemoglobin derivative concentrations simultaneously. However, measuring HbCO and other derivatives in RBCs without hemolysis accurately is complicated due to the strong intercollinearity between the molar absorptivities of hemoglobin derivatives and superposition of absorption and scattering spectra. In the present study, to quantitatively assess the contents of the hemoglobin derivatives in the blood after exposure to CO, improved accuracy is achieved by optimizing the wavelength range used for the nonlinear curve fitting of optical spectra. Experimental spectra were measured in the wavelength range Δλ=500−700nm. For each experimental curve, it was established the value of optimal interval Δλopt for which the correlation coefficient between experimental data and corresponding points of the theoretical fitting curve was the maximum in the wavelength range Δλtyp=535−580nm, which contains the typical absorption peaks for HbO2, Hb, and HbCO. The concentrations obtained based on such fitting curves were considered to be highly accurate. The quantitative assessment enabled the determination of theHbCO nonlinear increase with the time of CO exposure in the in vitro experiment and the study of the dynamics of hemoglobin derivative transformations during blood incubation.

The Diagnosis and Treatment of Carbon Monoxide Poisoning

BACKGROUND

The symptoms of carbon monoxide (CO) poisoning are nonspecific, ranging from dizziness and headache to unconsciousness and death. A German national guideline on the diagnosis and treatment of this condition is lacking at present.

METHODS

This review is based on a selective literature search in the PubMed and Cochrane databases, as well as on existing guidelines from abroad and expert recommendations on diagnosis and treatment.

RESULTS

The initiation of 100% oxygen breathing as early as possible is the most important treatment for carbon monoxide poisoning. In case of CO poisoning, the reduced oxygen-carrying capacity of the blood, impairment of the cellular respiratory chain, and immune-modulating processes can lead to tissue injury in the myocardium and brain even after lowering of the carboxyhemoglobin (COHb) concentration. In patients with severe carbon monoxide poisoning, an ECG should be obtained and biomarkers for cardiac ischemia should be measured. Hyperbaric oxygen therapy (HBOT) should be critically considered and initiated within six hours in patients with neurologic deficits, unconsciousness, cardiac ischemia, pregnancy, and/or a very high COHb concentration. At present, there is no general recommendation for HBOT, in view of the heterogeneous state of the evidence from multiple trials. Therapeutic decision-making is directed toward the avoidance of sequelae such as cognitive dysfunction and cardiac complications, and the reduction of mortality. Smoke intoxication must be considered in the differential diagnosis. The state of the evidence on the diagnosis and treatment of this condition is not entirely clear. Alternative or supplementary pharmacological treatments now exist only on an experimental basis.

CONCLUSION

High-quality, prospective, randomized trials that would enable a definitive judgment of the efficacy of HBOT are currently lacking.