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dc.contributor.authorAzevedo, M.en_US
dc.contributor.authorCarmichael, W.en_US
dc.contributor.authorJochimsen, M.en_US
dc.contributor.authorRinehart, L.en_US
dc.contributor.authorLau, Sharonen_US
dc.contributor.authorShaw, Glen Ren_US
dc.contributor.authorEaglesham, K.en_US
dc.date.accessioned2017-04-24T08:02:04Z
dc.date.available2017-04-24T08:02:04Z
dc.date.issued2002en_US
dc.date.modified2009-02-27T06:44:35Z
dc.identifier.issn0300-483Xen_US
dc.identifier.doi10.1016/S0300-483X(02)00491-2en_AU
dc.identifier.urihttp://hdl.handle.net/10072/21490
dc.description.abstractIn February 1996, an outbreak of illness occurred at a hemodialysis clinic in Caruaru, Pernambuco State-Brazil. At this clinic 116 (89%) of 131 patients experienced visual disturbances, nausea, vomiting, and muscle weakness, following routine haemodialysis treatment. Subsequently, 100 patients developed acute liver failure. As of December 1996, 52 of the deaths could be attributed to a common syndrome now called 'Caruaru Syndrome'. Examination of previous years' phytoplankton counts showed that cyanobacteria were dominant in the water supply reservoir since 1990. Analyses of carbon and other resins from the clinic's water treatment system plus serum and liver tissue of patients led to the identification of two groups of hepatotoxic cyanotoxins: microcystins (cyclic heptapeptides) in all of these samples and cylindrospermopsin (alkaloid hepatotoxic) in the carbon and resins. Comparison of victims symptoms and pathology with animal studies on these two cyanotoxins, leads us to conclude that the major contributing factor to death of the dialysis patients was intravenous exposure to microcystins, specifically microcystin-YR, -LR and -AR. In 2000, a review of the Brazilian regulation for drinking water quality, promoted by Brazilian Health Ministry with collaboration of PAHO, incorporated cyanobacteria and cyanotoxins into this new regulation as parameters that must to be monitored for water quality control.en_US
dc.description.peerreviewedYesen_US
dc.description.publicationstatusYesen_AU
dc.languageEnglishen_US
dc.language.isoen_AU
dc.publisherElsevieren_US
dc.publisher.placeAmsterdamen_US
dc.relation.ispartofpagefrom441en_US
dc.relation.ispartofpageto446en_US
dc.relation.ispartofjournalToxicologyen_US
dc.relation.ispartofvolume181-182en_US
dc.subject.fieldofresearchcode321201en_US
dc.titleHuman intoxication by microcystins during renal dialysis treatment in Caruaru-Brazilen_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Peer Reviewed (HERDC)en_US
dc.type.codeC - Journal Articlesen_US
gro.date.issued2002
gro.hasfulltextNo Full Text


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