- CODEN : IAJPBB
- issn 2349-7750
TITLE:
ARTIFICIAL NEURAL NETWORK MODELING OF SEVERITY OF POISONING AND MORTALITY PROGNOSIS FOR ALPHA-AMANITIN POISONING
AUTHORS:
Alekseev Nikolay Yuryevich, Sviridova Tatyana Nikolaevna, Kuzmenko Nadezhda Yuryevna, Sudakov Oleg Valerievich, Gladskih Natalya Alexandrovna
ABSTRACT:
In Russia, from year to year, a large number of poisonings with conditionally edible and poisonous mushrooms are recorded. A significant part of this statistics falls on the Voronezh region, for example, in 2000, 240 people were hospitalized with mushroom poisoning, among them 58 children, 44 patients died, and in 2001 322 people were poisoned, and 41 died. Mortality in case of mushroom poisoning was 13-18%. The main share in the structure of mushroom poisoning in the forest-steppe belt of Russia is poisonous poisoning (Amanita phalloides) - up to 80%. Toxins of the pale toadstool have mainly hepatotoxic and nephrotoxic and enterotoxic effects, cause damage to membrane structures, inhibit oxidative phosphorylation, inhibit the formation of RNA, DNA, damage the cytoskeleton. Pale toadstool contains two groups of toxins: phallotoxins (the main representative is phalloidin) and amatoxins (mainly amanitin). -amanitin contained in the mushrooms of the genus Amanita is a highly toxic compound, the lethal dose for humans is 5–8 mg (orally), toxic when inhaled, inhaled. The main cause of death in amatoxin poisoning is acute hepatic failure, less often acute hepatorenal failure. The prognosis for recovery of injuries depends on the severity of the poisoning. Poisonings are divided into lungs - with moderate gastroenteritis and mild hepatopathy; moderate severity - accompanied by severe gastroenteritis, hepatopathy and nephropathy; and severe - pronounced gastroenteritis, severe hepato-and nephropathy. The degree of toxic hepatopathy is determined on the basis of clinical and laboratory data. Mild hepatopathy is detected only by laboratory and instrumental studies. In case of moderate hepatopathy, clinical signs of liver damage are noted (an increase and tenderness during palpation, jaundice, hemorrhagic diathesis phenomena) in combination with more intensive changes in laboratory and instrumental data. Severe hepatopathy along with more pronounced changes characteristic of moderately severe hepatopathy are characterized by mental disorders with the development of hepatic encephalopathy. At present, the concept of the predominant hepato-nephrotoxicity of the toadstool fungi dominates. In accordance with this, the clinic conducts dynamic monitoring of the indicators of cytolytic, cholestatic and hepatopathy syndromes, as well as signs of renal failure and coagulopathy in victims. These indicators are contained in archival materials on the basis of which the neural network model of mushroom poisoning developed by us was built. Clustering was performed using a Kohonen self-organizing matrix of 3 by 3 dimensions. The resulting 9 clusters were combined into three “superclusters,” which increased the stability of the cluster structure. The resulting clusters are characterized by a low risk of death (5%), medium risk (20%) and high risk (70%) of death. Keywords: acute liver failure, mushroom poisoning, amanita phalloides, hepatopathy forecast, Kohonen matrix clustering,
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NLM ID:101711216 [Serial]
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ICV 2015 - 61.16
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cosmos Impact Factor:4.153
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