Cassava (Bitter Manioc Linamarin) kple Apricot Kernel (Amygdalin / Laetrile) ɖuɖu: Aɖi si Wotsɔna Ðea Dɔgboa me si Tsi Megbe¶

Nuɖuɖu si wotsɔ tsi si mesɔ o alo esi womeɖa nyuie o bitter cassava (Manihot esculenta, manioc/yuca), apricot-ku vevewo ɖuɖu, peach/cherry/plum do siwo wogbã, alo almond veve, alo atike bubu "Vitamin B17" mimi (amygdalin alo laetrile) kpeɖeŋutɔ nana wòdea ame ƒe agbe afɔku me dɔgbo ƒe Hydrogen Cyanide si tsi megbe (HCN) aɖi tsɔtsɔ de ame me. Ƒo ka na wò nutoa me xexlẽdzesi kpata (911 le United States kple Canada, 112 le Europa Dukɔwo ƒe Habɔbɔ bliboa me, 999 le United Kingdom) alo nàbia míaƒe... dukɔwo dome xexlẽdzesi siwo ku ɖe nudzɔdzɔ kpatawo ŋu ƒe nyatakakadzraɖoƒe enumake, eye nàgblɔ na dɔnɔdzikpɔla be dɔnɔa hiã Hydroxocobalamin ( .Cyanokit) alo Cyanide ƒe Dɔlékuiwutike (Sodium Thiosulfate / Sodium Nitrite). Esi nèle kpekpeɖeŋunalawo lalam la, na wò beléle enumake nasɔ kple mía tɔ cyanide kple dɔwɔƒewo ƒe gas gbɔgbɔ ƒe kpekpeɖeŋunanu gbãtɔ, de vovototo ʋu si le dzo dam si me cyanide ƒe aɖi le tso methemoglobinemia si ƒe amadede nye tsokolet-blɔ, eye nàdzra ɖo ɖe... status epilepticus ƒe alɔ̃madɔmadɔ ɣeyiɣi didi alo CPR ƒe dɔwɔwɔ.

To vovo na hydrogen cyanide gas si wogbɔna (si nana wògbãna le ememe 10 to 60 seconds), mimi cyanogenic glycosides, vevietɔ linamarin (le cassava veve, lima beans, kple flaxseed me) alo amygdalin / prunasin (le apricot nuku vevewo, almond vevewo, Rosaceae atikutsetse ƒe kpewo, kple bambu ƒe aŋgbawo me), ɖea ameflunu ** fiana.30-minute to 4-hour dzesi aɖeke manɔmee latency fesre**. Le ɖoɖoezizi ƒe ɣeyiɣi sia me la, numiemie kple dɔgbo ƒe beta-glucosidase kple hydroxynitrile lyase enzymewo tsɔa tsi ƒua gbe ɖe glycosides siwo womi la me vivivi le dɔgbo sue si me alkali le kple dɔgboa me, si wɔnɛ be hydrogen cyanide (HCN) yi ɖe ʋu si le agbo nu. Cyanide si woxɔ la blana kple ferric (Fe3+) gayibɔ atɔm si le mitochondrial cytochrome c oxidase ( .Complex IV), si atɔ te lãmenugbagbeviwo ƒe yagbɔgbɔ si me ya le keŋkeŋ togbɔ be ɔksidzin gakpɔtɔ yɔ dɔnɔa ƒe ʋukawo kple ʋukawo me hã (arterialization of venous blood). Ne wometsɔ oxygen kpeɖeŋutɔ 100%, dɔgbo ƒe ɖiƒoƒo ɖeɖeɖa, kple Hydroxocobalamin (5 grams IV) alo Sodium Thiosulfate ( .12.5 grams IV) + Sodium Nitrite ( .300 mg IV), amesiwo ŋu wòku ɖo la yia ŋgɔ kabakaba tso taɖuame, ʋuʋudedi, kple gbɔgbɔtsixetsixe ƒe tachypnea (Kussmaul breathing) va ɖo anion-dome si sɔ gbɔ si mexɔa dzo o lactic acidosis ( .serum lactate > 8 to 10 mmol/L), alɔ̃madɔmadɔ si bɔ, dzitodzito ƒe ʋuʋu, kple ku.

+-------------------------------------------------------------------------+
|       CYANOGENIC GLYCOSIDE DELAYED GUT CYANIDE TRIAGE TIMELINE          |
+-------------------------------------------------------------------------+
|  0 TO 60 MINUTES (THE SILENT ENZYMATIC HYDROLYSIS WINDOW):              |
|  * Victim eats bitter Apricot Kernels, Laetrile, or Bitter Cassava      |
|  * Plant beta-glucosidase (emulsin/linamarase) + Human gut microflora   |
|    cleave Amygdalin/Linamarin -> Mandelonitrile/Acetone Cyanohydrin     |
|    -> Lethal HYDROGEN CYANIDE (HCN) absorbed across intestinal wall     |
|  * Immediate Action: Call 911/112/999; give Activated Charcoal (< 1-2h) |
+-------------------------------------------------------------------------+
|  30 MINUTES TO 4 HOURS (ONSET OF CELLULAR HYPOXIA / HISTOTOXIC SHOCK):  |
|  * Early Signs: Headache, dizziness, anxiety, nausea/vomiting, cherry-  |
|    red flushed skin, tachycardia, and deep gasping hyperventilation     |
|  * Late Signs: Coma, tonic-clonic seizures, hypotension, bradycardia    |
|  * Lab Clues: Venous blood looks bright "cherry-red" (PvO2 > 50-60 mmHg)|
|    + Serum Lactate > 8 to 10 mmol/L (confirms acute cyanide poisoning)  |
+-------------------------------------------------------------------------+
|  DEFINITIVE HOSPITAL ANTIDOTAL RESCUE:                                  |
|  * Give 100% High-Flow Oxygen (ALWAYS safe & beneficial in cyanide)     |
|  * 1st Choice Antidote: IV Hydroxocobalamin (Cyanokit) 5 g (70 mg/kg)   |
|    + IV Sodium Thiosulfate 12.5 g (25% solution, 50 mL) for slow release|
|  * 2nd Choice Antidote: IV Sodium Nitrite (300 mg) + Sodium Thiosulfate |
+-------------------------------------------------------------------------+

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Wɔ esia fifia¶

1. Ƒo ka na dɔwɔƒe siwo kpɔa nudzɔdzɔ kpatawo gbɔ kple Aɖidzikpɔƒe enumake, ne amea gakpɔtɔ se le eɖokui me be yeƒe lãme sẽ keŋkeŋ gɔ̃ hã. Ƒo ka na 911 (U.S. kple Canada), 112 (European Union), 999 (United Kingdom), 000 (Australia), alo 111 (New Zealand). Gblɔ nusi tututu womi na ame si ɖoe ɖa (bitter apricot kernels, . laetrile / amygdalin tablets, . bitter cassava / manioc, alo bitter almonds), nuku alo gram nenie woɖu, kple ɣeyiɣi si woɖui ale be kɔdzi si xɔe nate ŋu adzra Hydroxocobalamin (Cyanokit) kple Sodium Thiosulfate le gbɔgbɔyɔyɔ ƒe teƒea hafi dɔnɔa nadze anyi.
2. Mègahe ʋuʋudedi vɛ gbeɖe o, eye mègagbɔ agbe nu me yi nu me gbeɖe mɔxenu ƒe ametakpɔnu manɔmee o. Ne dɔnɔ si mi cyanogenic glycosides alo cyanide salts ƒo ʋu la, gastric acid trɔa cyanide wòzua hydrogen cyanide si me dzoxɔxɔ le (HCN) gas ( ) .which smells weakly like bitter almonds to the 40% to 60% of people genetically able to detect the odor). Ne dɔnɔa dzudzɔ gbɔgbɔ la, zã bag-valve-mask (BVM) alo kotoku me CPR-nutsyɔnu si yia mɔ ɖeka dzi si me oxygen sina fũu le tsɔ wu be woatsɔe aƒo nu kple nu tẽ.
3. Na Oxygen 100% si sina sisi ŋutɔ ne kpekpeɖeŋunalawo va ɖo ko. Togbɔ be pulse oximetry (SpO2) axlẽ 98% to 100% elabena lãmenugbagbevi siwo me aɖi le mate ŋu aɖe ɔksidzin le ʋua me o, si naa ** .100% normobaric oxygen** dzia plasma oxygen ƒe tete ɖe edzi, eʋlia ho kple cyanide le cytochrome c oxidase ƒe kadodoƒewo, eye wòdoa sodium thiosulfate kple hydroxocobalamin ƒe dɔlékuiwutikewo ƒe dɔwɔwɔ ɖekae ɖe ŋgɔ.
4. Xɔ Vitamin C si woano nu (Ascorbic Acid) kpeɖeŋutɔ. Ne ame aɖe no apricot nukuwo alo no nu me laetrile, kpɔe ɖa be woawo hã no Vitamin C si ƒe agbɔsɔsɔme sɔ gbɔ hã. Vitamin C si wozãna le nu me ƒe agbɔsɔsɔ gã aɖe ( .> 1 to 3 grams) nana amygdalin trɔna kabakaba le dɔgboa me wòzua hydrogen cyanide eye wòɖea cysteine ​​si le lãmenugbagbeviwo me si aklãa ƒe rhodanese detoxifying enzyme hiã la dzi kpɔtɔna.
5. Dzra agbaa, nukukotokua, alo cassava ke si susɔ la ɖo. Tsɔ apricot-ku ƒe nugoe, . B17 kpeɖeŋutɔ aŋetu, alo cassava tuber ƒuƒu na dɔwɔƒe si kpɔa nudzɔdzɔ kpatawo gbɔ. Xlẽ alo bu akɔnta le nuku agbɔsɔsɔme si tututu woɖu ŋu: chewing just ** .5 to 10 bitter apricot kernels le ɖevi sue aɖe me** alo ** .20 to 60 bitter apricot kernels (0.5 to 3.5 mg/kg ƒe cyanide si sɔ kple) le ame tsitsi me** ate ŋu ahe aɖi si nye cyanide si ate ŋu ade ame ƒe agbe afɔku me alo awu ame vɛ.

--- .

Nyametsotsoti: Dɔgbo ƒe cyanogenic glycoside triage kple atikewɔmɔnu tiatia si tsi megbe¶

flowchart TD
    A["Cassava Vevie, Apricot Vevie, Atikutsetse Dowo, alo Laetrile (Amygdalin) ɖuɖu ."] --> B{"Nukae Woɖu & Aleke Woɖu?"}
    B -->|"1-3 Cherry/Plum/Peach Do Blibo Siwo Womegbã O alo Akɔɖuku ʋɛ aɖewo"| C["Afɔku sue: Nuku ƒe awu si me gblẽ o xea mɔ na Amygdalin ƒe dodo; Lé ŋku ɖe eŋu le aƒeme negbe ɖe woɖui hafi"]
    B -->|"Aprikot Vevie Si Woɖu/Glui, Almond Vevie, Laetrile Kplu, alo Cassava Vevie"| D["AFƆKU GÃ aɖe BE AGUT HCN ƑE AKƆME SI HEHE HEHE (ƔEYIƔI 30 min va ɖo gaƒoƒo 4)"]
    D --> E["Ƒo ka na 911/112/999; De Oxygen si Sina Kɔkɔ 100% de eme; Na Activated Charcoal (1 g/kg vaseɖe 50-100 g) ne < Gaƒoƒo 1-2 eye Nyɔ"]
    E --> F["Ðoɖo Stat Ʋuka me Gas (VBG), Ʋukawo me Ʋu ƒe Ya (ABG), Serum Lactate, kple Basic Metabolic Panel"]
    F --> G{"Da Dɔnɔdzikpɔƒe ƒe Sesẽme & Serum Lactate kpɔ"}
    G -->|"Dzesi aɖeke mele eŋu o & Lactate < 3.0 mmol/L"| H["Lé ŋku ɖe eŋu le ED/ICU me hena Gaƒoƒo 6 va ɖo 12 ya teti (Delayed Gut Hydrolysis); Gbugbɔ wɔ Lactate q1-2h"]
    G -->|"Susu ƒe Nɔnɔme Tɔtrɔ, Alɔ̃madɔmadɔ, Ʋusɔgbɔdɔ, Tachypnea, ALOO Lactate >= 8-10 mmol/L"| I["ATIKƆMEDZRAÐOƑE DODO KPƆKPƆ (MÈGALA cyanide ƒe agbɔsɔsɔ le dodokpɔxɔ me o) ."]
    I --> J{"Cyanide Atike Kae Li Si Woate Ŋu Akpɔ Enumake?"}
    J -->|"Hydroxocobalamin (Cyanokit) si li (Tiatia 1 lia) ."| K["Do Hydroxocobalamin 5 g IV (70 mg/kg le ɖeviwo me) ɖe lãme na ame hena miniti 15 + Tsɔ Sodium Thiosulfate 12.5 g IV de eme hena dɔgboa ƒe dodo ɖaa"]
    J -->|"Nitrite + Thiosulfate Kit koe Li"| L["Na Sodium Nitrite 300 mg IV (10 mL le 3%) me le miniti 2-4 me (Kpɔ Hemoglobin gbã) -> Tsɔ Sodium Thiosulfate 12.5 g IV kplɔe ɖo"]

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Dɔlélenutsiŋutete: Alesi numiemiewo ƒe glycosides trɔna zua Hydrogen Cyanide (HCN) le amegbetɔ ƒe dɔgbo me¶

To eta 2,500 numiemie ƒomeviwo wɔa cyanogenic glycosides abe dzɔdzɔmeŋusẽ ƒe ametakpɔnu tso gbeɖuɖɔ ɖulawo ŋu ene. Le numiemie ƒe aŋgba, ke, alo nuku si me gblẽ o me la, wodzraa cyanogenic glycoside la ɖo dedie ɖe lãmenugbagbeviwo ƒe vacuoles me, eye woɖea wo ɖa ŋutɔŋutɔ tso eƒe hydrolytic enzymes siwo wɔa dɔ gbɔ (beta-glucosidase kple hydroxynitrile lyase), siwo nɔa numiemie ƒe lãmenugbagbeviwo ƒe gli alo cytoplasm me.

1. Amygdalin kple Linamarin ƒe enzyme ƒe afɔɖeɖe eve ƒe mama¶

+-------------------------------------------------------------------------+
|       BIOCHEMICAL CONVERSION OF AMYGDALIN & LINAMARIN TO CYANIDE        |
+-------------------------------------------------------------------------+
|                                                                         |
|  PATHWAY 1: APRICOT KERNELS, BITTER ALMONDS, PEACH/CHERRY PITS, LAETRILE|
|  Amygdalin (D-mandelonitrile-beta-D-gentiobioside)                      |
|      |                                                                  |
|      |  Step 1: Beta-Glucosidase (Plant 'Emulsin' when chewed OR        |
|      |          Human intestinal microflora beta-glucosidase in gut)    |
|      v                                                                  |
|  Prunasin + Glucose  --->  Mandelonitrile + Glucose                     |
|                                  |                                      |
|                                  |  Step 2: Hydroxynitrile Lyase OR     |
|                                  |  Spontaneous dissociation in         |
|                                  |  alkaline duodenum (pH > 6.5)        |
|                                  v                                      |
|              Benzaldehyde  +  HYDROGEN CYANIDE (HCN)                    |
|              (Almond odor)    (Lethal Complex IV inhibitor)             |
|                                                                         |
+-------------------------------------------------------------------------+
|  PATHWAY 2: BITTER CASSAVA (MANIOC / YUCA), LIMA BEANS, BAMBOO SHOOTS   |
|  Linamarin (alpha-hydroxyisobutyronitrile-beta-D-glucopyranoside)       |
|      |                                                                  |
|      |  Step 1: Linamarase (plant beta-glucosidase) OR Gut bacteria     |
|      v                                                                  |
|  Acetone Cyanohydrin + Glucose                                          |
|      |                                                                  |
|      |  Step 2: Hydroxynitrile Lyase OR Spontaneous breakdown at pH > 5 |
|      v                                                                  |
|  Acetone  +  HYDROGEN CYANIDE (HCN)                                     |
+-------------------------------------------------------------------------+

• Nukatae wogblɔe kple nu Laetrile / . Amygdalin nye aɖi wu esi wodona ɖe ʋuka me zi gbɔ zi 40 Laetrile: "Vitamin B17" dodo ɖe ŋgɔ alakpatɔ gblɔ le ŋutinya me be laetrile mele dedie o elabena atike si wodona ɖe ʋuka me na lãwo mehea aɖi sue aɖe vɛ enumake o. Ne wodoe to ʋuka me la, amygdalin si me dɔlékui mele o toa nuɖuɖumeŋusẽ ŋu eye wòdoa goe > 90% metrɔna le aɖuɖɔ me o elabena beta-glucosidase enzymes mele amegbetɔ ƒe ʋu kple lãkusiwo me o. Gake ne wonoe to nu me la, amegbetɔ ƒe dɔgbo kple dɔgbo sue me dɔlékuiwo ƒe beta-glucosidase ƒe dɔwɔwɔ sɔ gbɔ ŋutɔ. Ne ame aɖe ɖa apricot-kuwo be woatsɔ atrɔ asi le numiemiea ŋutɔ tɔ ŋu gɔ̃ hã emulsin enzyme, alo mimi atike siwo ŋu wokɔ laetrile tablets, woawo ŋutɔ ƒe dɔgbo me dɔlékuiwo ma glycoside la me 1 to 4 hours emegbe le ƒunukpeƒetetedɔ kple dɔgbo ƒe akpa si le ete, eye wòtsɔa hydrogen cyanide si wua ame (HCN).
• Nusitae Bitter Cassava dea aɖi ƒomewo me le kuɖiɖi kple nuɖuɖu ƒe veve me: Woda cassava ƒomeviwo ɖe hatsotsowo me ɖe "vivi" cassava (< 50 milligrams ƒe HCN si sɔ kple ke yeye kilogram ɖeka, si ƒe akpa gãtɔ le gotagome aŋgba me) kple "veve" cassava (100 to > 500 milligrams ƒe HCN le kilogram ɖeka me si woma ɖe lã bliboa si me starch le me). Le kuɖiɖi sesẽwo me la, cassava numiemiewo dzia woƒe linamarin ƒe agbɔsɔsɔ ɖe edzi zi gbɔ zi etɔ̃ va ɖo atɔ̃. Dekɔnu dzadzraɖo dedie le cassava veve bia be woaɖee, atsɔe aƒoe/agbãe, etsɔe de tsi me/aƒoe ɖe tsi me ŋkeke 3 va ɖo 5 (si ɖea mɔ ɖe endogenous ŋu linamarase be woatrɔ linamarin wòazu acetone cyanohydrin), eye emegbe etsɔe ƒu gbe alo atɔ dzoe le dzoxɔxɔ gã me be wòana acetone cyanohydrin la nazu dzo eye HCN gas. Ne ƒome aɖe si dɔ le wuwum ɖa cassava ke veve siwo wometsɔ tsi o la ɖe ko 20 minutes, alo ɖua cassava si wotsɔ afã ƒo ɖe eme 24 hours, dzoxɔxɔa trɔa asi le eŋu linamarase enzyme hafi linamarin la nagbã, si gblẽa linamarin kple acetone cyanohydrin ɖe nuɖuɖua me. Ne wonya mi acetone cyanohydrin ko la, egblẽna le eɖokui si zua nusi wua ame HCN le alkaline duodenum me, esime dɔgboa me dɔlékuiwo tsɔa tsi ƒua linamarin susɔea le esi kplɔe ɖo me 2 to 6 hours.

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Nuɖuɖu me cyanogenic glycoside dzɔtsoƒewo kple aɖi si le dɔdaƒe ƒe tsɔtsɔ sɔ kple wo nɔewo¶

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Mlɔƒe ƒe dɔlélewo didi: Alesi woaɖo kpe Cyanide ƒe aɖi sesẽ dzi hafi numekukuwɔƒewo natrɔ ava¶

Ʋu bliboa ƒe cyanide dodokpɔ xɔa gaƒoƒo alo ŋkeke geɖe le nudokpɔƒewo eye menɔa anyi gbeɖe o le ɣeyiɣi nyuitɔ dzi be wòafia mɔ amewo gbugbɔgadzɔ kpata o. Atikewɔlawo ɖo kpe aɖi si woyɔna be acute gut cyanide dzi le abatia to le... 5 minutes asibidɛ etɔ̃ siwo wozãna tsɔ dia dɔlélewo enumake zazã:

1. "Arterialization" ƒe Ʋuka me Ʋu (Cherry-Red Ʋuka me Ʋu kple Narrow A-V O2 Memama)¶

• Mɔnu si wozãna: Elabena cyanide xea mɔ na mitochondrial cytochrome c oxidase (Complex IV) le eƒe oxidized ( .Fe3+) gblɔ be lãmenugbagbevi siwo le gota mate ŋu aɖe ɔksidzin tso oxyhemoglobin si toa eme me o.
• Dzesi si le aba dzi: Ne dɔnɔdzikpɔla alo ʋukaŋutinunyala ɖe ʋu si le gota ʋuka me ʋu ƒe kpɔɖeŋu la, ʋuka me ʋua dzena "cherry-red" si klẽna (womate ŋu ade vovototoe tso ʋuka me ʋu dome o) tsɔ wu be wòanye aŋutiɖiɖi-dzẽ viviti.
• Ʋu me gas ƒe kpeɖodzi: Tsɔ Arterial Blood Gas (ABG) kple titina/gota gome Venous Blood Gas (VBG):
• Togbɔ be ʋukawo me PaO2 kple ʋu ƒe sisi ƒe oximetry (SpO2) gakpɔtɔ le nɔnɔme si sɔ me (97% to 100%) le gɔmedzedzea me la, ʋuka me oxygen ƒe agbɔsɔsɔ ( .ScvO2 alo SvO2) wu 85% to 90% kple venous PvO2 wu nenema 50 to 60 mmHg.
• Oxygen ƒe vovototo si le ʋukawo me ( .A-V O2 gradient) dzi ɖena kpɔtɔna va ɖoa esi mede nenema o 1 to 2 vol%, si ɖo kpe histotoxic cellular hypoxia dzi (shared only by cyanide, hydrogen sulfide, sodium azide, and high-oxygen resuscitation).
• Fundoscopic confirmation: Direct ophthalmoscopy of the retina ɖea retinal veins siwo ƒe amadede dzĩ si klẽna pɛpɛpɛ abe ŋku ƒe ʋukawo ene fiana.

2. Lactate si le ʋumenugbagbevi dzĩ me >= 8 to 10 mmol/L (Sika-Dzidzenu si Wotsɔ Dea Eteƒe)¶

• Elabena aerobic ƒe dɔwɔwɔ ATP wotu nuƒoƒoƒu (producing only 2 ATP molecules per glucose via anaerobic glycolysis instead of 36 ATP), lãmenugbagbeviwo trɔa pyruvate kabakaba wòzua lactic acid.
• Aɖiŋutinunya ŋuti numekuku siwo wowɔ le atikewɔƒewo (Baud et al., New England Journal of Medicine) ɖo kpe edzi be le dɔnɔ si me aɖi si me dzudzɔ mele o gome la, plasma lactate ƒe agbɔsɔsɔ si nye... >= 8 mmol/L (72 mg/dL) (alo >= 10 mmol/L le dzudzɔ gbɔgbɔ me) si ** .> 90% seselelãme kple eƒe tẽnyenye na aɖi sesẽ si nu sẽ si woyɔna be cyanide** (blood cyanide > 40 micromoles/L alo > 1.0 mg/L) eye wòdo ƒome kple lãmenugbagbeviwo me cyanide ƒe agba le fli me.

3. Ʋumenugbagbeviɣi kple Yagbɔgbɔ ƒe Ʋuʋu si le Biphasic¶

• Akpa 1 (Chemoreceptor ƒe Ʋuʋudedi Gbãtɔ, 30 to 90 minutes): Cyanide doa ŋusẽ carotid ŋutilã ƒe chemoreceptors tẽ, si wɔnɛ be "cyanide gasp" kpata si wotsɔ dzesi hyperventilation / tachypnea ( ) kplɔe ɖo.Kussmaul breathing), sinus tachycardia, ʋusɔgbɔdɔ, taɖuame, taɖuame, tɔtɔ, kple ʋu ƒe sisi.
• Akpa 2 (Akpa 2 (Late Hypoxic Decompensation, 1 to 4 hours): Abe lãmenugbagbeviwo me tɔ ene ATP ne edze anyi le ahɔhɔ̃mekawo kple dzitodzito me la, dɔnɔa trɔna zi ɖeka yia yagbɔgbɔgbɔ / yagbɔgbɔ ƒe ʋuʋu, profound sinus bradycardia alo AV block, ʋukawo me ʋusɔgbɔdɔ sesẽ, generalized tonic-clonic seizures, decerebrate posturing, kple pulseless electrical activity (PEA) alo asystole ƒe dɔléle.

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Afɔɖeɖe ɖesiaɖe Kɔdzi ƒe Dɔlékuiwutike Kple Ðiƒoƒo Ŋuti Ðoɖowɔɖi¶

Elabena amygdalin kple linamarin ƒe dɔgbo me tsi ƒe ʋuʋu yia edzi hena gaƒoƒo le dɔgbo ƒe ʋuka me (to vovo na ya si wogbɔ zi ɖeka ƒe... HCN gas), numiemie cyanogenic glycoside aɖi dada bia dɔlékuiwutikewo xɔname enumake to ʋuka me KPLEE dɔgbo ƒe ɖiƒoƒo ɖa si yi edzi + sulfur-donor infusion ɣeyiɣi didi siaa.

+-------------------------------------------------------------------------+
|       TWO COMPLEMENTARY ANTIDOTAL MECHANISMS FOR GUT CYANIDE            |
+-------------------------------------------------------------------------+
|  1. HYDROXOCOBALAMIN (CYANOKIT - VITAMIN B12a PRECURSOR):               |
|     Hydroxocobalamin (Co3+ - OH)  +  Cyanide (CN-)                      |
|                     |                                                   |
|                     v  (Direct equimolar chelation in blood & cells)    |
|     Cyanocobalamin (Vitamin B12 - Non-toxic, excreted in crimson urine) |
|     * Pros: Instant onset, does NOT lower blood pressure, does NOT form |
|       methemoglobin (safe in children, pregnancy, and anemia)           |
+-------------------------------------------------------------------------+
|  2. SODIUM THIOSULFATE (SULFUR DONOR FOR HEPATIC RHODANESE):            |
|     Thiosulfate (S2O3 2-) + Cyanide (CN-) ---[Rhodanese]---> Thiocyanate|
|     * Pros: Provides continuous sulfur substrate to detoxify ongoing    |
|       slow release of HCN from apricot kernels or cassava in the gut    |
|     * CRITICAL RULE: Infuse Hydroxocobalamin and Sodium Thiosulfate     |
|       through SEPARATE IV lines (or flush thoroughly between them)      |
+-------------------------------------------------------------------------+

Afɔɖeɖe 1: Dɔgbo kple dɔgbo ƒe ɖiƒoƒo (Activated Charcoal kple Gastric Lavage) .¶

• Togbɔ be aŋɔ si wotsɔ wɔa dɔe ƒe ŋutete le gram ɖeka ɖe gram ɖeka me na potassium cyanide dzadzɛ si me agbe mele o hã (1 gram of charcoal adsorbs -35 mg of KCN), ame tsitsiwo ƒe agbɔsɔsɔme si wozãna ɖaa (50 to 100 grams of activated charcoal) xɔa amygdalin, linamarin, kple liberated si me tsi mele o ƒe miligram agbɔsɔsɔme si wua ame bɔbɔe HCN le dɔgboa me eye wòana agbetsitsi nanyo ɖe edzi ŋutɔ le aɖi siwo wodo kpɔ kple esiwo wozãna le atikewɔƒewo me.
• Ne dɔnɔa ɖe eɖokui fia le ** .1 to 2 hours** le apricot-ku veve siwo wogbã, laetrile-tikekui, alo cassava veve ɖuɖu me la, de yaƒoƒomɔ̃a me nyuie (de yaƒoƒomɔ̃a me ne woxee) eye nàwɔ gastric aspiration/lavage be nàɖe nuku kakɛ siwo susɔ la ɖa ŋutɔŋutɔ, eye nàtsɔ Activated Charcoal (1 gram/kg, vaseɖe 50 to 100 grams).

Afɔɖeɖe 2: Atike Gbãtɔ Si Wodona To Ʋuka Me: Hydroxocobalamin (Cyanokit) .¶

Hydroxocobalamin ( .Cyanokit) nye atike gbãtɔ si amewo lɔ̃na wu le xexeame katã ɖe aɖi si nye cyanide si nu sẽ ŋu le Dziehe Amerika, Europa, Eŋlisiawo, kple Australia katã elabena eblaa cyanide si le lãmenugbagbeviwo me kple esi le ʋukawo me tẽ tsɔ wɔa cyanocobalamin si megblẽa nu le ame ŋu o (Vitamin B12) evɔ magblẽ hemoglobin si tsɔa oxygen me alo ahe ʋukawo ƒe ʋuʋu si nitrites hena vɛ vɛ o.

• Ame tsitsiwo ƒe agbɔsɔsɔme: Gbugbɔ 5 gram (one 5 g vial alo two 2.5 g vials) ƒe Hydroxocobalamin le 200 milliliters ƒe 0.9% sodium chloride eye nàdoe ɖe ʋuka me le ** .15 minutes (-15 mL/minute)**.
• Ðeviwo ƒe Agbɔsɔsɔme: Infuse 70 milligrams per kilogram (70 mg/kg, vaseɖe agbɔsɔsɔ si sɔ gbɔ wu le gɔmedzedzea me si nye 5 grams) wodoa ʋuka me ɖe ** dzi.15 minutes**.
• Sedziwɔwɔ Gbugbɔ Dodo na Dɔgbo ƒe Tsi ƒe Tsitsi: Le apricot nuku, laetrile, alo cassava veve ƒe aɖi me la, dɔnɔwo kpɔa cyanide ƒe dzidziɖedzi si gbugbɔna dzɔna enuenu 2 to 6 hours le gbãtɔa megbe 5 g Hydroxocobalamin ƒe agbɔsɔsɔme esime dɔgbo me dɔlékuiwo yi edzi le glycosides siwo womexɔ o la mam le dɔgboa me. Ne lactic acidosis ( .> 4 mmol/L), ʋusɔgbɔdɔ, alo alɔ̃madɔmadɔ gagbugbɔna alo nɔa anyi, do sɛkɛnd ɖeka 5 gram (70 mg/kg ɖeviwo) ƒe agbɔsɔsɔme si nye Hydroxocobalamin wu 15 minutes to 2 hours.
• Nu Siwo Wokpɔ Mɔ Na (Harmless Chromaturia & Lab Interference): Hydroxocobalamin nye amadede si nye burgundy-red si nu sẽ ŋutɔ. Enumake etrɔa dɔnɔa ƒe ŋutigbalẽ, aɖatsi, fifia, ʋumenugbagbeviɣi, kple aɖuɖɔ wòzua dzĩ-dzẽ deto (chromaturia) na 2 to 7 days (eye vaseɖe 28 days le aɖuɖɔ me). Xlɔ̃ nu nudokpɔƒea be hydroxocobalamin spectrophotometrically doa kplamatse colorimetric dodokpɔwo hena creatinine, bilirubin, transaminases, magnesium, kple carboxyhemoglobin/methemoglobin co-oximetry, ta ʋuka siwo le gɔmedzedzea me enumake hafi nàdze ʋu dzĩ dodo gɔme.

Afɔɖeɖe 3: Sodium Thiosulfate ( .12.5 Grams) .¶

Elabena ŋutilãa ƒe dzɔdzɔmenu si ɖea aɖi ɖa le cyanide ŋu, si nye mitochondrial rhodanese (thiosulfate sulfurtransferase) le aklã kple ƒunukpeƒeŋusẽ me la, sulfur dona siwo le lãmenugbagbeviwo me vɔna kabakaba le dɔgboa me glycoside xɔxlɔ̃ ɣeyiɣi didi me, Sodium Thiosulfate dodo ɖe ʋuka me naa sulfane sulphur si nu metsina o be wòatrɔ cyanide wòazu thiocyanate si megblẽa nu le ame ŋu o (SCN-), si ayikuwo ɖena doa goe: * Ame tsitsiwo ƒe agbɔsɔsɔme: 12.5 grams (50 milliliters ƒe a 25% Sodium Thiosulfate solution) si wodo ɖe ʋuka me ɖe ** dzi.10 to 30 minutes**. * Ðeviwo ƒe Agbɔsɔsɔme: 250 milligrams per kilogram (1.0 mL/kg ƒe 25% egbɔkpɔnu, alo 412.5 mg/kg [1.65 mL/kg] le tsi si le atike si wowɔ me nu, va ɖo 12.5 grams) si wodona ɖe ʋuka me dzi 10 to 30 minutes.

Afɔɖeɖe 4: Dɔlékuiwutike Bubuwo ƒe Ðoɖowɔɖi (Ne Hydroxocobalamin Meli O): Sodium Nitrite + Sodium Thiosulfate (Nithiodote) alo Dicobalt Edetate ( .Kelocyanor) .¶

Le nuto madeŋgɔ geɖe siwo me cassava vevewo ƒe dɔvɔ̃wo dzɔna le, alo le kɔƒenutowo me atikewɔƒe sue siwo me womewɔa dɔ le o me Cyanokit, atikewɔlawo zãa afɔɖeɖe eve ƒe ɖoɖo si wonya nyuie si nye Nitrite + Thiosulfate: 1. Amyl Nitrite (Tɔdzisasrã si wogbɔna hafi gena ɖe IV me): Migbã amyl nitrite (0.3 mL) le gauze me eye nàlée ɖe dɔnɔa ƒe ŋɔti te (alo ɖe bag-valve-mask intake dzi) hena 15 to 30 seconds ƒe aɖabaƒoƒo ɖesiaɖe esime wole IV-mɔ̃ ƒe mɔnu ɖom anyi. 2. Sodium Nitrite si wodona ɖe ʋuka me (3% ŋuɖoɖo): * Mɔnu: Ewɔa oxidizes 10% to 20% ƒe ʋumenugbagbevi dzĩ si le tsatsam ( .Fe2+) va zu ferric methemoglobin ( .Fe3+). Elabena cyanide ƒe lɔlɔ̃nu le vevie na Fe3+, methemoglobin hea cyanide tso mitochondrial cytochrome c oxidase me tsɔ wɔa cyanmethemoglobin. * Ame tsitsiwo ƒe agbɔsɔsɔme: 300 milligrams (10 milliliters ƒe 3% Sodium Nitrite) si wodo ɖe ʋuka me le ** .2 to 4 minutes** (lé ŋku ɖe ʋu ƒe sisi ŋu nyuie, elabena nitrites nana ʋukawo kekena sesĩe eye ʋusɔgbɔdɔ dzi ɖena kpɔtɔna). * Ðeviwo ƒe Agbɔsɔsɔme (Must Adjust for Hemoglobin to Prevent Fatal Methemoglobinemia): ** .6 to 10 mg/kg (0.2 to 0.33 mL/kg ƒe 3% solution, nusi sɔ gbɔ wu 300 mg)**, si dzi woɖena kpɔtɔna vevie ne ʋusɔgbɔdɔ le ɖevia ŋu (hemoglobin < 10 g/dL). Kpɔ methemoglobin ƒe agbɔsɔsɔ ɖa le 30 minutes eye nàna methemoglobin bliboa nanɔ anyi le ete 20% to 30%. 3. Sodium Thiosulfate si wodona ɖe ʋuka me (25% egbɔkpɔnu): Dze eyome enumake (after flushing the line) kple 12.5 grams (50 mL ƒe 25% ŋuɖoɖo; ɖeviwo ƒe dɔlélewo gbɔ kpɔkpɔ 1.0 to 1.65 mL/kg) be woatrɔ cyanmethemoglobin tegbee wòazu thiocyanate si le tsinyegoe me. 4. Dicobalt Edetate (Kelocyanor - UK/Commonwealth Domenyinu ƒe Nudzraɖoƒe): Wokpɔa edzi abe 300 mg (20 mL) IV wu enu 1 minute kplɔe ɖo enumake 50 mL ƒe 50% Dextrose ƒe atike. Esi wònye be cobalt femaxee hea dzi ƒe ʋuʋu sesẽ vɛ, mo/aɖuɖɔtoe me ʋuʋu, kple ʋusɔgbɔdɔ ne cyanide aɖeke mele ʋua me o ta la, ELE be woana Dicobalt Edetate na dɔnɔ siwo ŋu aɖi si ŋu ɖikeke mele o, si nu sẽ le atikewɔƒe (coma, apnea, alo shock), le mɔxexeɖedɔléle nu gbeɖe na dɔnɔ siwo ŋu dzesi aɖeke mele o.

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Cassava dzadzraɖo dedie kple seɖoƒe siwo woɖo ɖe Apricot Kernels ŋu¶

• Alesi woaɖe aɖi ɖa le Cassava Vevie me le aƒeme (The WHO / FAO "Wetting Method"):
• Grate alo pound cassava ke si woɖe ɖa la wòzu mash alo wɔ nyui aɖe (gbã lãmenugbagbeviwo ƒe gliwo ale linamarase ame siwo woate ŋu aƒo ka na linamarin).
• De tsi / ƒo mash la le tsi me na 3 to 5 days (alo ne èle cassava-wɔ si woƒu xoxo si gakpɔtɔ vivina zãm la, tsɔ wɔa tsaka kple tsi wòazu aŋe tsɛ aɖe si me tsi le eye nàkakae ɖe akpa sue aɖe me le vɔvɔli me hena 5 hours le 30 degrees Celsius ale gbegbe be enye nusi susɔ linamarase tsi linamarin la me wòzua acetone cyanohydrin si me dzoxɔxɔ le).
• Ƒoe alo ɖae nyuie le ze si le ʋuʋu ɖi me ale be acetone cyanohydrin kple... HCN gas la ƒuna yia yame, eye tsɔa tsi si le ƒoƒom/si le ƒoƒom la ƒua gbe.
• Nuxlɔ̃ame siwo ku ɖe Sededewo ŋu le Bitter Apricot Kernels ŋu:
• Europa Nuɖuɖu ƒe Dedienɔnɔ Dɔwɔƒe (EFSA) kple Eŋlisiawo ƒe Nuɖuɖu Dzidzenuwo Dɔwɔƒe (FSA) ɖo Acute Reference Dose (ARfD) ƒe 20 micrograms/kg ƒe cyanide, ƒo nya ta be ne woɖu apricot-ku sue veve siwo wu 1 va ɖo 3 le ame tsitsiwo me (alo ku sue ɖeka ƒe afã le ɖevi siwo le zɔzɔm le zɔzɔm me) wu dzidzenu si le dedie. EU (Regulation 2017/1237) kple Eŋlisiawo xe mɔ ɖe apricot-ku veve ƒuƒu siwo womeɖa o dzadzra na nuƒlela siwo wu 20 mg/kg ƒe hydrocyanic acid, kple Australia/New Zealand xe mɔ ɖe apricot-ku ƒuƒu siwo womeɖa o dzadzra le asitsaƒewo abe nuɖuɖu ene nu keŋkeŋ.
• Le United States kple Canada la, US FDA xe mɔ ɖe laetrile (amygdalin) abe nusi dzi womeda asi ɖo o, si nye ameflunu, eye aɖi le eme ŋutɔ ene, eye Health Canada ɖo seɖoƒe na cyanide si woate ŋu aɖe le apricot-ku siwo wodzra me la katã be wòaɖo 20 ppm esime wòle nu xlɔ̃m ame tsitsiwo be woagaɖu nuku vevewo gbeɖe o.

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Nutome ƒe nudzɔdzɔ kpatawo kple atike siwo woatsɔ axe mɔ ɖe dɔlékuiwutikewo zazã ƒe ɖoɖowo¶

• United States kple Canada: Ƒo ka na 911 enumake eye nàƒo ka na 1-800-222-1222 (US Aɖi Kpekpeɖeŋunana) alo 1-844-POISON-X (1-844-764-7669 le Canada). Agbetsitsi ƒe kpekpeɖeŋu deŋgɔ (ALS) dɔnɔdzikpɔʋuwo kple kɔdzi ƒe dɔwɔƒe siwo kpɔa nudzɔdzɔ kpatawo gbɔ le Dziehe Amerika katã dzraa Hydroxocobalamin (Cyanokit, . 5 g nugoewo) kple Nithiodote ( .Sodium Nitrite + Sodium Thiosulfate).
• United Kingdom kple Europa Dukɔwo ƒe Habɔbɔ: Ƒo ka na 999 (UK) alo 112 (EU). Atikewɔlawo yia NPIS / TOXBASE (UK) alo dukɔa ƒe EU ƒe aɖidɔwɔƒewo (CAPTV, . Giftnotruf). Le UK kple EU la, dɔwɔƒe siwo kpɔa nudzɔdzɔ kpatawo gbɔ dzraa Hydroxocobalamin (Cyanokit) kple Sodium Thiosulfate le atike si wotsɔna tsia agbe enumake ƒe nudzraɖoƒe (Category A Antidotes required immediately at every acute hospital).
• Australia kple New Zealand: Ƒo ka na 000 (Australia) alo 111 (New Zealand), eye nàkpɔ Aɖiwo Ŋuti Nyatakaka Dɔwɔƒe (13 11 26 le Australia; 0800 764 766 le New Zealand) na enumake Cyanokit kple Sodium Thiosulfate mɔfiame.
• Afrika si le Sahara ƒe anyiehe, Anyiehe Amerika, kple Anyieheɣedzeƒe Asia: Le nuto siwo me woɖua cassava le (Democratic Republic of the Congo, Mozambique, Tanzania, Nigeria, Brazil, Indonesia, Philippines), afisi Cyanokit ɖewohĩ womadzra wo ɖo ɖe kɔƒenutowo me atikewɔƒewo o, woado 100% Oxygen + Activated Charcoal + Intravenous Sodium Thiosulfate (25%, . 50 mL IV) + Sodium Bicarbonate si wodona ɖe ʋuka me (be woatsɔ aɖɔ lactic acidosis sesẽ ɖo) xɔa ame ɖe agbe eye wodzraae ɖo le teƒe geɖe.

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Nya siwo wobiaa amewo enuenu¶

Nukatae aɖi si nye cyanide si tso apricot-ku alo cassava veve me xɔa gaƒoƒo 1 va ɖo 4 hafi dzea egɔme?¶

To vovo na hydrogen cyanide gas si wogbɔna (si gena ɖe lãkusi kple ʋukawo me le sɛkɛnd ʋɛ aɖewo ko me) la, numiemiewo ƒe sukli si wobla si woyɔna be cyanogenic glycosides (amygdalin kple linamarin) le apricot ƒe nukuwo kple cassava vevewo me. Nu siawo megblẽa nu le ame ŋu o vaseɖe esime numiemiewo ƒe enzymewo (siwo wɔa dɔ to nuɖuɖu ɖuɖu me) kple amegbetɔ ƒe dɔgbo me dɔlékuiwo ɖea sukli ƒe molecule siwo le dɔgbo sue si me alkali le kple dɔgbo me la ɖa vivivi, eye woɖea hydrogen cyanide gas si woɖena faa la dona ɖe ʋua me le aɖabaƒoƒo 30 va ɖo gaƒoƒo 4 le nuɖuɖua megbe.

Nukatae "Vitamin B17" (Laetrile) nono to nu me wua ame wu atike si wodona ɖe ʋuka me?¶

Beta-glucosidase enzyme si hiã be woatsɔ agbã amygdalin wòazu cyanide mele amegbetɔ ƒe ʋu kple ŋutinuwo si o, eyata ne wodo laetrile ɖe ʋuka me la, eƒe 90% kple edzivɔ dona le aɖuɖɔ me matrɔmatrɔe. Gake ne womie to nu me la, dzɔdzɔmedɔlékui triliɔn geɖe siwo le amegbetɔ ƒe dɔgbo sue kple dɔgbo me la wɔa beta-glucosidase enzyme gbogbo aɖewo siwo mãa laetrile si woano me tẽ wòzua hydrogen cyanide si wua ame, si wɔnɛ be aɖi le atikekui siwo woano me wu esiwo wodona ɖe ʋuka me la ƒe teƒe 40 lɔƒo.

Nukae dzɔna ne ɖevi aɖe mi cherry-do alo peach-kpe blibo aɖe le vo me evɔ meɖui o?¶

Ne womi cherry-do, plum-do, peach-kpe, alo akɔɖuku bliboe keŋkeŋ eye eƒe gotagome go sesẽ si le abe ati ene la megbã o la, amygdalin la nɔa nukua ƒe awudziwui me dedie eye doa toa aɖuɖɔa me afɔku aɖeke manɔmee le ŋkeke 1 va ɖo 3 me. Ne woɖu nukuawo alo doawo, wogbã wo, ƒo wo, wotsaka wo, alo wogbã wo hafi mie ko hafi aɖi si nye cyanide dzɔna.

Aleke ɖɔkta siwo kpɔa nudzɔdzɔ kpatawo gbɔ wɔa anya aɖi si le cyanide me le miniti 5 me ne ʋu me cyanide dodokpɔ xɔ ŋkeke geɖe?¶

Ðɔktawo dia abadzivɔ ƒe dzesi eve siwo ŋu ɖikeke mele o siwo fia be lãmenugbagbeviwo ƒe oxygen zazã xe mɔ: gbãtɔ, ʋuka si le gota si woɖe tso alɔnu la dzena "cherry-red" (abe ʋukawo me ʋu ene) si klẽna eye ʋuka me oxygen ƒe agbɔsɔsɔ si wu 85% va ɖo 90% elabena mitochondria siwo me aɖi le mate ŋu aɖe oxygen tso ʋua me o; eye evelia, ʋu me lactate ƒe agbɔsɔsɔ dzina ɖe edzi wu 8 va ɖo 10 mmol/L le anaerobic metabolism kpata ta.

Nukatae ɖɔktawo naa Hydroxocobalamin (Cyanokit) kple Sodium Thiosulfate AME EVIE hena aɖi si le apricot-ku me?¶

Hydroxocobalamin (Cyanokit) ƒe agbɔsɔsɔ ɖeka si nye gram 5 naa cyanide si le tsatsam le ʋu kple ŋutinuwo me fifia la wɔa chelate enumake wòzua Vitamin B12 si megblẽa nu le ame ŋu o, si ɖea dzi kple ahɔhɔ̃ le aɖabaƒoƒo ʋɛ aɖewo ko me. Gake esi wònye be apricot-ku siwo wogbã alo cassava veve yia edzi nɔa dɔgboa me heɖea cyanide yeye ɖe go gaƒoƒo 4 va ɖo 12 bubu ta la, Sodium Thiosulfate si wodona ɖe ʋuka me (to IV-ka si woɖe ɖe vovo alo esi woɖe ɖa me) dede eme naa aklãa ƒe rhodanese enzyme la kpɔa sulfur ɖaa be wòaɖe dɔgboa me cyanide ƒe xɔxlɔ̃ si yi edzi la ɖa.

Nukae nye "Konzo" eye aleke wòdo ƒome kple cassava veve?¶

Konzo nye afɔ eveawo ƒe lãmeka siwo le etame ƒe lãmetutudɔ si gblẽa nu ŋutɔ, si womate ŋu atrɔ o (spastic paraparesis) si dzea ɖeviwo kple nyɔnu siwo xɔ ƒe si woate ŋu adzi vi dzi le kɔƒenutowo me le Afrika ƒe anyiehe Sahara le kuɖiɖi kple dɔwuameɣiwo. Edzɔna ne wozi ƒomewo dzi be woaɖu cassava veve si womede tsii nyuie o kwasiɖa sia kwasiɖa esime wole nuɖuɖu me protein ƒe veve vevie (amino acid siwo me sulfur le siwo nye methionine kple cysteine ​​si aklãa hiã be wòaɖe aɖi ɖa le cyanide me wòazu thiocyanate mele wo si o) le fu ɖem na wo.

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Be nàkpɔ aɖi, yaƒoƒo, kple dzitodzito ƒe nɔnɔme kpatawo gbɔ nyuie la, bu kpekpeɖeŋunana gbãtɔ kple CPR ƒe nusɔsrɔ̃ si wowɔna le asi me si tso Atitsoga Dzĩ Habɔbɔ, St John Ambulance, alo hehenanahabɔbɔ si ŋu woɖo kpee le nutoa me gbɔ la wuwu ŋu.

Mɔfiame siwo do ƒome kplii¶

• Cyanide, Hydrogen Sulfide, Kple Dɔwɔƒewo ƒe Gas Gbɔgbɔ ƒe Kpekpeɖeŋu Gbãtɔ
• Methemoglobinemia (Ʋu si me Tsokolet-Brown), Benzocaine-tike, kple Nitrate ƒe Aɖi
• Gbemelãwo Didi (Amatoxin) Kple Numiemie Siwo Me Aɖi Le ɖuɖu
• Status Epilepticus, Alɔ̃madɔmadɔ Ɣeyiɣi Didi, Kple Xɔnametikewo
• Aɖi Siwo Wozãna le Amewo Dome Kpekpeɖeŋu Gbãtɔ Kple Ðiƒoƒo Ŋu

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Dzɔtsoƒewo kple dziɖuɖumegãwo ƒe mɔfiame¶

• Xexeame ƒe Lãmesẽ Habɔbɔ (WHO) & Nuɖuɖu kple Agbledede Habɔbɔ (FAO): Dukɔwo Dome Atikewo Ŋuti Numekuku ƒe Agbalẽ Kpuie 61: Hydrogen Cyanide kple Cyanides: Amegbetɔ ƒe Lãmesẽ ƒe Akpawo; Cyanogenic Glycosides le Cassava kple Bambu ƒe Aŋgbawo Me (Geneva).
• Europa Nuɖuɖu ƒe Dedienɔnɔ Dɔwɔƒe (EFSA) ƒe Dɔwɔha si Kpɔa Ðiƒoƒo siwo le Nuɖuɖu ƒe Kɔsɔkɔsɔ me: Lãmesẽkuxi sesẽ siwo ku ɖe cyanogenic glycosides ƒe anyinɔnɔ le apricot nuku ƒuƒuwo kple nusiwo woɖe tso apricot nuku ƒuƒu me (EFSA Journal).
• MÍ. Dɔlélenutsitsi Kple Mɔxexe Ðe Enu Dɔwɔƒe (CDC) / ATSDR: Atikewɔwɔ Ŋuti Mɔfiamewo na Hydrogen Cyanide, Sodium Cyanide, kple Cyanogenic Compounds (United States).
• UK Dukɔa ƒe Aɖiwo Ŋuti Nyatakaka Dɔwɔƒe (NPIS) / TOXBASE & Royal College of Emergency Medicine: Atikewo ƒe Mɔfiamewo: Hydroxocobalamin (Cyanokit), Sodium Thiosulfate, kple Sodium Nitrite le Acute Cyanide kple Cyanogenic Glycoside Aɖi me (United Kingdom).
• Baud F. J., Barriot P., Toffis V., kple ame bubuwo. / Hall AH, Rumack BH: Cyanide ƒe agbɔsɔsɔ si dzi ɖe edzi le ʋu me kple plasma lactate le cyanide ƒe aɖi sesẽ me; Laetrile (Amygdalin) kple Aɖi si le Apricot Kernel me (New England Journal of Medicine / Atikewɔwɔ Kpata ƒe Ŋutinyagbalẽwo).