title: Organophosphate poisoning due to a wheat bagel.
abstract: OBJECTIVE
  Organophosphate compounds are possibly the most widely-used insecticides worldwide. Organophosphate compounds cause poisoning, inhibiting acetylcholinesterase at the cholinergic synapses. Civilian casualties resulted from a terrorist attack with sarin in a Tokyo subway. Recent terrorist activities have also raised concerns that organophosphate or nerve agents may be used as a weapon of terror or mass destruction.
  
  
  METHODS
  In this study, an extraordinary type of mass poisoning was evaluated. Especially by focusing on the way of poisoning, the demographic features and clinical findings of patients were analyzed.
  
  
  RESULTS
  After eating a wheat bagel, 13 patients with organophosphate poisoning were admitted to our emergency department. Seven were males and 6 were females. The mean age of the patients was 26 +/- 13.9. The mean serum acetylcholinesterase level was 2945.1+/-2648.9 U/L. Nine patients who had supportive treatment and who were given atropine and pralidoxime were hospitalized approximately 6.8+/-6.5 days. All of the patients recovered after the treatment and no deaths occurred.
  
  
  CONCLUSIONS
  If organophosphate poisoning is not diagnosed and treated in time, it may be fatal. When cases of food poisoning are admitted to the hospital, attention must be taken especially if it is a mass poisoning.
authors.affiliation: Atatürk Training and Research Hospital Emergency Department, Ankara, Turkey. cemkavalci@yahoo.com
authors.forename: Cemil
authors.initials: C
authors.lastname: Kavalci
authors.forename: Polat
authors.initials: P
authors.lastname: Durukan
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ozer
authors.forename: Yunsur
authors.initials: Y
authors.lastname: Cevik
authors.forename: Gülsüm
authors.initials: G
authors.lastname: Kavalci
mesh_terms: D000110:Acetylcholinesterase / Q000097:blood; D000293:Adolescent; D000328:Adult; D000931:Antidotes / Q000627:therapeutic use; D001285:Atropine / Q000627:therapeutic use; D002800:Cholinesterase Inhibitors / Q000506:poisoning; D002801:Cholinesterase Reactivators / Q000627:therapeutic use; D004006:Dichlorvos / Q000506:poisoning; D005260:Female; D005506:Food Contamination / Q000032:analysis; D005517:Foodborne Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007306:Insecticides / Q000506:poisoning*; D008297:Male; D062025:Organophosphate Poisoning; D011220:Pralidoxime Compounds / Q000627:therapeutic use; D012189:Retrospective Studies; D014908:Triticum / Q000506:poisoning*; D014421:Turkey; D055815:Young Adult
chemical_list: D000931:Antidotes; D002800:Cholinesterase Inhibitors; D002801:Cholinesterase Reactivators; D007306:Insecticides; D011220:Pralidoxime Compounds; D001285:Atropine; D004006:Dichlorvos; D000110:Acetylcholinesterase; C028797:pralidoxime