Bromadiolone, commonly known as super warfarin, is a long-acting coumarin dicoumarin rodenticide. The mechanism of bromadiolone is mainly to inhibit vitamin K1 epoxide reductase and affect the synthesis of coagulation factors Ⅱ, Ⅶ, Ⅸ and Ⅹ, which causes blood coagulation dysfunction and systemic multiple organ hemorrhage. Here, we report of a case of bromadiolone poisoning patient who had digestive tract, abdominal hemorrhage, as well as secondary paralytic ileus. After blood product transfusion and vitamin K1 supplementation, the patient was discharged after the physical condition was improved. It's suggestied that clinicians should pay attention to rare complications to prevent missed diagnosis when treating other bromadiolone poisoning.
4-Hydroxycoumarins ; Blood Coagulation Factors ; Dicumarol ; Hemorrhage ; Humans ; Intestinal Pseudo-Obstruction/chemically induced* ; Oxidoreductases ; Rodenticides ; Vitamin K 1 ; Warfarin

Superwarfarin intoxications that induce profound and prolonged coagulopathy are being increasingly reported, to such an extent that it is becoming a comparatively common intoxication. However, there have been few reported cases of superwarfarin intoxication with an inadvertent cause or an unknown origin. A 58-year-old man with recurrent painless hematuria was found to have an acquired deficiency of vitamin K dependent clotting factors, and a large amount of vitamin K was required to correct the coagulopathy. He had no history of warfarin use or any exposure to rodenticides, but brodifacoum was detected in his serum. It is important for physicians to be aware that significant coagulopathy can occur secondary to superwarfarin intoxication, without any known exposure to substances that might induce this.
4-Hydroxycoumarins ; Hematuria ; Humans ; Middle Aged ; Rodenticides ; Vitamin K ; Warfarin

4-Hydroxycoumarins ; blood ; Animals ; Chromatography, High Pressure Liquid ; methods

OBJECTIVETo establish a method for determining brodifacoum in workplace air by high-performance liquid chromatography (HPLC).

METHODSBrodifacoum in workplace air was collected with a polytetrafluoroethylene filter and desorbed by mixed solution of methanol and dichloromethane (20:80, V:V), and was then separated using an ODS column and determined by an ultraviolet detector; retention time was used for identification, and peak area was used for quantification.

RESULTSThe concentration of brodifacoum showed a linear relationship with peak area within 0.2∼10.0 µg/ml; the elution efficiency was 91.6%∼95.1%; the detection limit was 0.08 µg/ml (injection volume: 20 µl eluate); the minimum detectable concentration was 0.000 67 mg/m(3) (calculated by 240 L air sample).

CONCLUSIONThis HPLC method is convenient and simple for air collection and sample preparation and meets the methodological requirements. Therefore, this method can be used for the determination of brodifacoum in workplace air.

It has been a challenge to establish the accurate diagnosis of developmental tooth anomalies based on periapical radiographs. Recently, three-dimensional imaging by cone beam computed tomography has provided useful information to investigate the complex anatomy of and establish the proper management for tooth anomalies. The most severe variant of dens invaginatus, known as dilated odontome, is a rare occurrence, and the cone beam computed tomographic findings of this anomaly have never been reported for an erupted permanent maxillary central incisor. The occurrence of talon cusp occurring along with dens invaginatus is also unusual. The aim of this report was to show the importance of cone beam computed tomography in contributing to the accurate diagnosis and evaluation of the complex anatomy of this rare anomaly.
4-Hydroxycoumarins ; Cone-Beam Computed Tomography ; Dental Pulp ; Endodontics ; Imaging, Three-Dimensional ; Incisor ; Tooth ; Tooth Abnormalities

Superwarfarin, such as brodifacoum, is a highly lethal vitamin K antagonist used as a rodenticide. Brodifacoum has a particularly long half-life in the body, which ranges to several months, and therefore requires prolonged treatment with antidotal vitamin K. We experienced a case whereby an 18-year-old male was presented to the hospital with a severe bleeding disorder. It was discovered that he had ingested brodifacoum rodenticide with intent to commit suicide. Despite continual treatment with vitamin K, the bleeding disorder persisted for several months before he recovered. We report this case with literature review.
4-Hydroxycoumarins ; Adolescent ; Half-Life ; Hemorrhage ; Humans ; Male ; Suicide ; Vitamin K ; Vitamins

OBJECTIVEA determination method of brodifacoum in rat plasma with bromadiolone as an internal standard was developed.

METHODSA volume of 10 microl internal standard (bromadiolone) was added into rat plasma, and then extracted by 0.5 ml of acetonitrile by shaking for 2 min. The residue was dissolved with 200 microl of mobile phase after centrifugation for 10 min, and evaporation to dryness by Nitrogen blowing. A C18 column and PDA detector were used for separating and detecting. The wavelength was 254 nm, the flow rate was 1.0 ml/min, and the injection volume was 20 microl.

RESULTSThe liner range was 1.0-20 microg/ml, and the correlation coefficient was 0.9992. The detection limit was 0.3 microg/ml in plasma (S/N=3). The intra-assay and inter-assay coefficients of variation were 1.89%-2.45% and 2.51%-3.61% respectively. The recoveries in plasma at levels of low, middle and high concentrations were (80.8 +/- 3.1)%, (81.8 +/- 2.7)% and (87.9 +/- 3.6)% (n=6), respectively. The accuracies were 84.1%-91.5% and 86.7%-93.2%, respectively.

CONCLUSIONThis method is simple, fast and accurate for the determination of brodifacoum in rat plasma.

4-Hydroxycoumarins ; poisoning ; Child ; Female ; Humans ; Lower Extremity ; blood supply ; Thrombosis ; etiology

4-Hydroxycoumarins ; poisoning ; Adolescent ; Adult ; Female ; Humans ; Male ; Rodenticides ; poisoning ; Young Adult

4-Hydroxycoumarins ; poisoning ; Acute Disease ; Adult ; Humans ; Male ; Poisoning ; diagnosis ; Prothrombin Time