Elimination of persistent toxicants from the human body

Human and Experimental Toxicology

Volumn 30, Issue 1, 2011, Pages 3-18

  Genuis, Stephen J ^a  

^a UNIVERSITY OF ALBERTA   (Canada)

Author keywords

bile acid sequestrants; chelation; cholestyramine; colon cleansing; detoxification; dialysis; enterohepatic circulation; environmental medicine; fasting; massage; phlebotomy; plasmapheresis; probiotics; saponin compounds; sauna therapy; toxicology; zeolites

Indexed keywords

BILE ACID SEQUESTRANT; PREBIOTIC AGENT; PROBIOTIC AGENT; XENOBIOTIC AGENT; ZEOLITE;

ARTICLE; CHELATION; CLEANING; COLON LAVAGE; DIET RESTRICTION; DRUG DETOXIFICATION; ENTEROHEPATIC CIRCULATION; EXERCISE; HEMODIALYSIS; HERBAL MEDICINE; HUMAN; IONIC FOOT BATH; LEECHING; MASSAGE; NONHUMAN; PLASMAPHERESIS; PRIORITY JOURNAL; SAUNA; THERMAL SPRING;

ANIMALS; BIOTRANSFORMATION; BODY BURDEN; ENTEROHEPATIC CIRCULATION; ENVIRONMENTAL EXPOSURE; HUMANS; XENOBIOTICS;

EID: 78650198287     PISSN: 09603271     EISSN: 14770903     Source Type: Journal    
DOI: 10.1177/0960327110368417     Document Type: Article

References (128)

1. Dijkers MP The value of traditional reviews in the era of systematic reviewing. Am J Phys Med Rehabil 2009 ; 88: 423-430.
2. Centers for Disease Control, Department of Health and Human Services. Fourth National Report on Human Exposure to Environmental Chemicals Atlanta: Georgia. pp. 1-529, http://www.cdc.gov/exposurereport/pdf/FourthReport.pdf ( 2009, accessed 18 January 2009 ).
3. Genuis SJ Nowhere to hide: chemical toxicants and the unborn child. Reprod Toxicol 2009 ; 28: 115-116.
4. Environmental Working Group. Body burden - the pollution in newborns: a benchmark investigation of industrial chemicals, pollutants and pesticides in umbilical cord blood. (Executive Summary) July 14, 2005, http://ewg.org/reports/ bodyburden2/execsumm.php ( 2005, accessed 16 September 2005 ).
5. Samanta G., Das D., Mandal BK, et al. Arsenic in the breast milk of lactating women in arsenic-affected areas of West Bengal, India and its effect on infants. J Environ Sci Health A Tox Hazard Subst Environ Eng 2007 ; 42: 1815-1825.
6. Chen Y., Parvez F., Gamble M., et al. Arsenic exposure at low-to-moderate levels and skin lesions, arsenic metabolism, neurological functions, and biomarkers for respiratory and cardiovascular diseases: review of recent findings from the Health Effects of Arsenic Longitudinal Study (HEALS) in Bangladesh. Toxicol Appl Pharmacol 2009 ; 239: 184-192.
7. Chakraborti D., Ghorai SK, Das B., Pal A., Nayak B., Shah BA Arsenic exposure through groundwater to the rural and urban population in the Allahabad-Kanpur track in the upper Ganga plain. J Environ Monit 2009 ; 11: 1455-1459.
8. Clark CS, Rampal KG, Thuppil V., et al. Lead levels in new enamel household paints from Asia, Africa and South America. Environ Res 2009 ; 109: 930-936.
9. Uemura H., Arisawa K., Hiyoshi M., et al. Prevalence of metabolic syndrome associated with body burden levels of dioxin and related compounds among Japan's general population. Environ Health Perspect 2009 ; 117: 568-573.
10. Neumann J., Winterton S., Lu J., Roja DEB. Polluted children, toxic nation: a report on pollution in Canadian families, http://www. environmentaldefence.ca/reports/toxicnationFamily.htm ( 2006, accessed 8 October 2006 ).
11. Knox EG Childhood cancers and atmospheric carcinogens. J Epidemiol Community Health 2005 ; 59: 101-105.
12. Genuis SJ The chemical erosion of human health: adverse environmental exposure and in-utero pollution - determinants of congenital disorders and chronic disease. J Perinat Med 2006 ; 34: 185-195.
13. Canfield RL, Henderson CR Jr, Cory-Slechta DA, Cox C., Jusko TA, Lanphear BP Intellectual impairment in children with blood lead concentrations below 10 microg per deciliter. N Engl J Med 2003 ; 348: 1517-1526.
14. Nevin R. Understanding international crime trends: the legacy of preschool lead exposure. Environ Res 2007 ; 104: 315-336.
15. Frisbee SJ The C8 health project: how a class action lawsuit can interact with public health - history of events, http://www.hsc.wvu.edu/som/cmed/c8/ index.asp ( 2008, accessed 14 February 2009 ).
16. Golomb BA Acetylcholinesterase inhibitors and Gulf War illnesses. Proc Natl Acad Sci U S A 2008 ; 105: 4295-4300.
17. World Health O. Children's Health and the Environment. WHO Training Package for the Health Sector World Health Organization, www.who.int/ceh (accessed 8 July 2009 ).
18. Campbell AW, Thrasher JD, Gray MR, Vojdani A. Mold and mycotoxins: effects on the neurological and immune systems in humans. Adv Appl Microbiol 2004 ; 55: 375-406.
19. Office of Genomics and Disease Prevention: Centers for Disease Control and Prevention. Department of Health and Human S. Gene-Environment Interaction Fact Sheet. 2000.
20. Rat Genome Sequencing Project C. Genome sequence of the Brown Norway rat yields insights into mammalian evolution. Nature. 2004 ; 428: 493-521.
21. Jandacek RJ, Anderson N., Liu M., Zheng S., Yang Q., Tso P. Effects of yo-yo diet, caloric restriction, and olestra on tissue distribution of hexachlorobenzene. Am J Physiol Gastrointest Liver Physiol 2005 ; 288: G292 - G299.
22. Michaels D. Doubt is their product: how industry's assault on science threatens your health. New York: Oxford University Press, 2008.
23. Guzelian P. Evidence-based individual toxicological analysis. Hum Exp Toxicol 2009 ; 28: 136-138.
24. Hartung T. Fundamentals of an evidence-based toxicology: 1.1 opening statement. Hum Exp Toxicol 2009 ; 28: 93-94.
25. Hauser R., Williams P., Altshul L., Calafat AM Evidence of interaction between polychlorinated biphenyls and phthalates in relation to human sperm motility. Environ Health Perspect 2005 ; 113: 425-430.
26. Ashby J., Houthoff E., Kennedy SJ, et al. The challenge posed by endocrine-disrupting chemicals. Environ Health Perspect 1997 ; 105: 164-169.
27. Anyanwu EC, Campbell AW, Vojdani A. Neurophysiological effects of chronic indoor environmental toxic mold exposure on children. Scientific World J. 2003 ; 3: 281-290.
28. Khattak S., Moghtader GK, McMartin K., Barrera M., Kennedy D., Koren G. Pregnancy outcome following gestational exposure to organic solvents: a prospective controlled study. JAMA 1999 ; 281: 1106-1109. (Pubitemid 29155887)
29. Genuis SJ Toxic causes of mental illness are overlooked. Neurotoxicology 2008 ; 29: 1147-1149.
30. Rozman K. Intestinal excretion of toxic substances. Arch Toxicol Suppl 1985 ; 8: 87-93.
31. Jandacek RJ, Tso P. Enterohepatic circulation of organochlorine compounds: a site for nutritional intervention. J Nutr Biochem 2007 ; 18: 163-167.
32. Andersen ME, Butenhoff JL, Chang SC, et al. Perfluoroalkyl acids and related chemistries-toxicokinetics and modes of action. Toxicol Sci 2008 ; 102: 3-14.
33. Katakura M., Kudo N., Tsuda T., Hibino Y., Mitsumoto A., Kawashima Y. Rat organic anion transporter 3 and organic anion transporting polypeptide 1 mediate perfluorooctanoic acid transport. J Health Sci 2007 ; 53: 77-83.
34. Fei C., McLaughlin JK, Lipworth L., Olsen J. Maternal levels of perfluorinated chemicals and subfecundity. Hum Reprod 2009 ; 24: 1200-1205.
35. Tilton SC, Orner GA, Benninghoff AD, et al. Genomic profiling reveals an alternate mechanism for hepatic tumor promotion by perfluorooctanoic acid in rainbow trout. Environ Health Perspect 2008 ; 116: 1047-1055.
36. Nakayama S., Harada K., Inoue K., et al. Distributions of perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) in Japan and their toxicities. Environ Sci 2005 ; 12: 293-313.
37. Yao X., Zhong L. Genotoxic risk and oxidative DNA damage in HepG2 cells exposed to perfluorooctanoic acid. Mutat Res 2005 ; 587: 38-44.
38. Renner R. Scientists hail PFOA reduction plan. Environ Sci Technol 2006 ; 40: 2083.
39. Imamura M., Tung TC A trial of fasting cure for PCBpoisoned patients in Taiwan. Am J Ind Med 1984 ; 5: 147-153.
40. Blanusa M., Varnai VM, Piasek M., Kostial K. Chela-tors as antidotes of metal toxicity: therapeutic and experimental aspects. Curr Med Chem 2005 ; 12: 2771-2794.
41. Aposhian HV, Maiorino RM, Gonzalez-Ramirez D., et al. Mobilization of heavy metals by newer, therapeutically useful chelating agents. Toxicology 1995 ; 97: 23-38.
42. Emet M., Aslan S., Cakir ZG, et al. Plasmapheresis is useful in phenprobamate overdose. Am J Emerg Med 2009 ; 27 (5). 626.e621 - e622.
43. Hastings D., Patel B., Torloni AS, et al. Plasmapheresis therapy for rare but potentially fatal reaction to rituximab. J Clin Apher 2009 ; 24: 28-31.
44. Horne S. Colon cleansing: a popular, but misunderstood natural therapy. J Herb Pharmacother 2006 ; 6: 93-100.
45. Acosta RD, Cash BD Clinical effects of colonic cleansing for general health promotion: a systematic review. Am J Gastroenterol 2009 ; 104: 2830-6.
46. Rogers CJ, Colbert LH, Greiner JW, Perkins SN, Hursting SD Physical activity and cancer prevention: pathways and targets for intervention. Sports Med 2008 ; 38: 271-296.
47. Nadeau V., Truchon G., Brochu M., Tardif R. Effect of physical exertion on the biological monitoring of exposure of various solvents following exposure by inhalation in human volunteers I. Toluene. J Occup Environ Hyg 2006 ; 3: 481-489.
48. Tardif R., Nadeau V., Truchon G., Brochu M. Effect of physical exertion on the biological monitoring of exposure to various solvents following exposure by inhalation in human volunteers: II. n-Hexane. J Occup Environ Hyg 2007 ; 4: 502-508 ; quiz D568-509.
49. Makino K., Kochi M., Nakamura H., et al. Effect of oral colestimide on the elimination of high-dose methotrexate in patients with primary central nervous system lymphoma - case report. Neurol Med Chir (Tokyo) 2005 ; 45: 650-652.
50. Cohn WJ, Boylan JJ, Blanke RV, Fariss MW, Howell JR, Guzelian PS Treatment of chlordecone (Kepone) toxicity with cholestyramine. Results of a controlled clinical trial. N Engl J Med 1978 ; 298: 243-248.
51. Depner T., Himmelfarb J. Uremic retention solutes: the free and the bound. J Am Soc Nephrol 2007 ; 18: 675-676.
52. Meyer TW, Peattie JW, Miller JD, et al. Increasing the clearance of protein-bound solutes by addition of a sorbent to the dialysate. J Am Soc Nephrol 2007 ; 18: 868-874.
53. Ibrahim F., Halttunen T., Tahvonen R., Salminen S. Probiotic bacteria as potential detoxification tools: assessing their heavy metal binding isotherms. Can J Microbiol 2006 ; 52: 877-885.
54. Bongaerts G., Severijnen R., Timmerman H. Effect of antibiotics, prebiotics and probiotics in treatment for hepatic encephalopathy. Med Hypotheses 2005 ; 64: 64-68.
55. Roy CC, Kien CL, Bouthillier L., Levy E. Short-chain fatty acids: ready for prime time ? Nutr Clin Pract. 2006 ; 21: 351-366.
56. Barnes AJ, Smith ML, Kacinko SL, et al. Excretion of methamphetamine and amphetamine in human sweat following controlled oral methamphetamine administration. Clin Chem 2008 ; 54: 172-180.
57. Fucci N., De Giovanni N., Scarlata S. Sweat testing in addicts under methadone treatment: an Italian experience. Forensic Sci Int 2008 ; 174: 107-110.
58. Rombout-Sestrienkova E., van Noord PA, Reuser E., et al. Therapeutic erythrocytapheresis (TE) versus phlebotomy (P) in the treatment of hereditary hemochromatosis (HH) patients: preliminary results from an ongoing randomized clinical trial (NCT 00202436). Transfus Apher Sci 2009 ; 40: 135-136.
59. Domingo JL, Gomez M., Llobet JM, Corbella J. Comparative effects of several chelating agents on the toxicity, distribution and excretion of aluminium. Hum Toxicol 1988 ; 7: 259-262.
60. Zhao ZY, Liang L., Fan X., et al. The role of modified citrus pectin as an effective chelator of lead in children hospitalized with toxic lead levels. Altern Ther Health Med 2008 ; 14: 34-38.
61. Papaioannou DS, Kyriakis SC, Papasteriadis A., Roumbies N., Yannakopoulos A., Alexopoulos C. Effect of in-feed inclusion of a natural zeolite (clinoptilolite) on certain vitamin, macro and trace element concentrations in the blood, liver and kidney tissues of sows. Res Vet Sci. 2002 ; 72: 61-68.
62. Papaioannou DS, Kyriakis SC, Papasteriadis A., Roumbies N., Yannakopoulos A., Alexopoulos C. A field study on the effect of in-feed inclusion of a natural zeolite (clinoptilolite) on health status and performance of sows/gilts and their litters. Res Vet Sci 2002 ; 72: 51-59.
63. Ortatatli M., Oguz H., Hatipoglu F., Karaman M. Evaluation of pathological changes in broilers during chronic aflatoxin (50 and 100 ppb) and clinoptilolite exposure. Res Vet Sci 2005 ; 78: 61-68.
64. Kabak B., Dobson AD, Var I. Strategies to prevent mycotoxin contamination of food and animal feed: a review. Crit Rev Food Sci Nutr 2006 ; 46: 593-619.
65. Zhou CF, Zhu JH Adsorption of nitrosamines in acidic solution by zeolites. Chemosphere 2005 ; 58: 109-114.
66. Wingenfelder U., Hansen C., Furrer G., Schulin R. Removal of heavy metals from mine waters by natural zeolites. Environ Sci Technol. 2005 ; 39: 4606-4613.
67. Erdem E., Karapinar N., Donat R. The removal of heavy metal cations by natural zeolites. J Colloid Interface Sci 2004 ; 280: 309-314.
68. Ponizovsky AA, Tsadilasc CD Lead(II) retention by Alfisol and clinoptilolite:cation balance and pH effect. Geoderma 2003 ; 115: 303-312.
69. Henderson GL, Wilson BK Excretion of methadone and metabolites in human sweat. Res Commun Chem Pathol Pharmacol 1973 ; 5: 1-8.
70. Vree TB, Muskens AT, van Rossum JM Excretion of amphetamines in human sweat. Arch Int Pharmacodyn Ther 1972 ; 199: 311-317.
71. Ishiyama I., Nagai T., Nagai T., Komuro E., Momose T., Akimori N. The significance of drug analysis of sweat in respect to rapid screening for drug abuse. Z Rechtsmed. 1979 ; 82: 251-256.
72. Hohnadel DC, Sunderman FW Jr, Nechay MW, McNeely MD Atomic absorption spectrometry of nickel, copper, zinc, and lead in sweat collected from healthy subjects during sauna bathing. Clin Chem 1973 ; 19: 1288-1292.
73. Rea WJ, Pan Y., Johnson AR, Ross GH, Suyama H., Fenyves EJ Reduction of chemical sensitivity by means of heat depuration, physical therapy and nutritional supplementation in a controlled environment. J Nutr Environ Med 1996 ; 7: 141-148.
74. Schnare DW, Ben M., Shields MG Body burden reduction of PCBs, PBBs and chlorinated pesticides in human subjects. Ambio 1984 ; 13: 378-380.
75. Dahlgren J., Cecchini M., Takhar H., Paepke O. Persistent organic pollutants in 9/11 world trade center rescue workers: reduction following detoxification. Chemosphere 2007 ; 69: 1320-1325.
76. Roehm DC Effects of a program of sauna baths and metavitamins on adipose DDE and PCBs and on clearing os symptoms of agnet orange (Dioxin) toxicity. Clin Res 1983 ; 31: 243.
77. Schnare DW, Robinson PC Reduction of human body burdens of hexachlorobenzene and polychlorinated biphenyls. In CR Morris, JRP Cabral (eds.) Hexachlorobenzene: Proceedings of an International Symposium. Lyon, France: International Agency for Research on Cancer, 1986, pp. 597-603.
78. Tretjak Z., Root DE, Tretjal A., et al. Xenobiotic reduction and clinical improvement in capacitor workers: a feasible method. J Env Sci Health 1990 ; A25: 731-751.
79. Tretjak Z., Shields M., Beckman SL PCB reduction and clinical improvement by detoxification: an unexploited approach. Hum Exp Toxicol 1990 ; 9: 235-244.
80. Schnare DW, Denk G., Shields M., Brunton S. Evaluation of a detoxification regimen for fat stored xenobiotics. Medical Hypothesis 1982 ; 9: 265-282.
81. Liao Y., Yu F., Jin Y., et al. Selection of micronutrients used along with DMSA in the treatment of moderately lead intoxicated mice. Arch Toxicol. 2008 ; 82: 37-43.
82. Kalia K., Flora SJ Strategies for safe and effective therapeutic measures for chronic arsenic and lead poisoning. J Occup Health. 2005 ; 47: 1-21.
83. Flora SJ, Mittal M., Mehta A. Heavy metal induced oxidative stress & its possible reversal. Indian J Med Res. 2008 ; 128: 501-523.
84. Aposhian HV, Zheng B., Aposhian MM, et al. DMPSarsenic challenge test. II. Modulation of arsenic species, including monomethylarsonous acid (MMA(III)), excreted in human urine. Toxicol Appl Pharmacol. 2000 ; 165: 74-83.
85. Navas-Acien A., Tellez-Plaza M., Guallar E., et al. Blood cadmium and lead and chronic kidney disease in US adults: a joint analysis. Am J Epidemiol 2009 ; 170: 1156-1164.
86. Findlay GM, DeFreitas AS DDT movement from adipocyte to muscle cell during lipid utilization. Nature 1971 ; 229: 63-65.
87. Scanlan N. Compromised hepatic detoxification in companion animals and its correction via nutritional supplementation and modified fasting. Altern Med Rev 2001 ; 6: S24 - S37.
88. Domingo JL, Gomez M., Llobet JM, Corbella J. Citric, malic and succinic acids as possible alternatives to deferoxamine in aluminum toxicity. J Toxicol Clin Toxicol 1988 ; 26: 67-79.
89. Meijer L., Hafkamp AM, Bosman WE, et al. Nonabsorbable dietary fat enhances disposal of 2,2',4,4'-tetrabromodiphenyl ether in rats through interruption of enterohepatic circulation. J Agric Food Chem 2006 ; 54: 6440-6444.
90. Moser GA, McLachlan MS A non-absorbable dietary fat substitute enhances elimination of persistent lipophilic contaminants in humans. Chemosphere 1999 ; 39: 1513-1521.
91. Jandacek RJ, Tso P. Factors affecting the storage and excretion of toxic lipophilic xenobiotics. Lipids 2001 ; 36: 1289-1305.
92. Hadvary P., Lengsfeld H., Wolfer H. Inhibition of pancreatic lipase in vitro by the covalent inhibitor tetrahydrolipstatin. Biochem J 1988 ; 256: 357-361.
93. Nageswara Rao SB, Chopra RC Influence of sodium bentonite and activated charcoal on aflatoxin M1 excretion in milk of goats. Small Ruminant Res 2001 ; 41: 203-213.
94. Ramos AJ, Fink-Gremmels J., Hernandez E. Prevention of toxic effects of mycotoxins by means of non-nutritive adsorbent commpounds. J Food Prot 1996 ; 59: 631-641.
95. Shoemaker RC, House DE Sick building syndrome (SBS) and exposure to water-damaged buildings: time series study, clinical trial and mechanisms. Neurotoxicol Teratol 2006 ; 28: 573-588.
96. Shoemaker RC, House DE A time-series study of sick building syndrome: chronic, biotoxin-associated illness from exposure to water-damaged buildings. Neurotoxicol Teratol 2005 ; 27: 29-46.
97. Mochida Y., Fukata H., Matsuno Y., Mori C. Reduction of dioxins and polychlorinated biphenyls (PCBs) in human body. Fukuoka Igaku Zasshi 2007 ; 98: 106-113.
98. Nolan JP, McDevitt JJ, Goldmann GS, Bishop C. Endotoxin binding by charged and uncharged resins. Proc Soc Exp Biol Med 1975 ; 149: 766-770.
99. Brouillard MY, Rateau JG [Cholestyramine adsorbs Escherichia coli and Vibrio cholerae toxins by way of ion exchange mechanism]. Ann Gastroenterol Hepatol (Paris) 1990 ; 26: 27-30.
100. Kerkadi A., Barriault C., Marquardt RR, et al. Cholestyramine protection against ochratoxin A toxicity: role of ochratoxin A sorption by the resin and bile acid enterohepatic circulation. J Food Prot 1999 ; 62 (12). 1461-1465.
101. Mullan NA, Burgess MN, Bywater RJ, Newsome PM The ability of cholestyramine resin and other adsorbents to bind Escherichia coli enterotoxins. J Med Microbiol 1979 ; 12: 487-496.
102. Takenaka S., Morita K., Tokiwa H., Takahashi K. Effects of rice bran fibre and cholestyramine on the faecal excretion of Kanechlor 600 (PCB) in rats. Xenobiotica 1991 ; 21: 351-357.
103. Hudnell HK Chronic biotoxin-associated illness: multiple-system symptoms, a vision deficit, and effective treatment. Neurotoxicol Teratol 2005 ; 27: 733-743.
104. Sakurai K., Fukata H., Todaka E., Saito Y., Bujo H., Mori C. Colestimide reduces blood polychlorinated biphenyl (PCB) levels. Intern Med 2006 ; 45: 327-328.
105. Rao AV, Gurfinkel DM The bioactivity of saponins: triterpenoid and steroidal glycosides. Drug Metabol Drug Interact 2000 ; 17: 211-235.
106. Rao AV, Kendall CW Dietary saponins and serum lipids. Food Chem Toxicol 1986 ; 24: 441.
107. Kaplan AA Therapeutic plasma exchange: core curriculum 2008. Am J Kidney Dis 2008 ; 52: 1180-1196.
108. McLeod BC Introduction to the third special issue: clinical applications of therapeutic apheresis. J Clin Apher 2000 ; 15: 1-5.
109. Nenov VD, Marinov P., Sabeva J., Nenov DS Current applications of plasmapheresis in clinical toxicology. Nephrol Dial Transplant 2003 ; 18: v56 - v58.
110. Duzova A., Baskin E., Usta Y., Ozen S. Carbamazepine poisoning: treatment with plasma exchange. Hum Exp Toxicol 2001 ; 20: 175-177.
111. Gutschmidt HJ [Successful plasmapheresis in severe diltiazem poisoning]. Dtsch Med Wochenschr 1995 ; 120: 81-82.
112. Kuhlmann U., Schoenemann H., Muller T., Keuchel M., Lange H. Plasmapheresis in life-threatening verapamil intoxication. Artif Cells Blood Substit Immobil Biotechnol 2000 ; 28: 429-440.
113. Binimelis J., Bassas L., Marruecos L., et al. Massive thyroxine intoxication: evaluation of plasma extraction. Intensive Care Med 1987 ; 13: 33-38.
114. Yoshida M., Satoh H., Igarashi M., Akashi K., Yamamura Y., Yoshida K. Acute mercury poisoning by intentional ingestion of mercuric chloride. Tohoku J Exp Med 1997 ; 182: 347-352.
115. Sauder P., Livardjani F., Jaeger A., et al. Acute mercury chloride intoxication. Effects of hemodialysis and plasma exchange on mercury kinetic. J Toxicol Clin Toxicol. 1988 ; 26 (3-4). 189-197.
116. Schlake HP, Bertram HP, Husstedt IW, Schuierer G. Acute systemic vanadate poisoning presenting as cerebrovascular ischemia with prolonged reversible neurological deficits (PRIND). Clin Neurol Neurosurg 1994 ; 96: 92-95.
117. Illner N., Gerth J., Pfeiffer R., Bruns T., Wolf G. "Nearly a stairway to heaven"-severe dichromate intoxication in a young man. Clin Nephrol 2009 ; 71: 338-341.
118. Kalabalikis P., Hatzis T., Papadatos J., Gionis D., Danou F., Vlachos P. Paraquat poisoning in a family. Vet Hum Toxicol 2001 ; 43: 31-33.
119. Miller J., Sanders E., Webb D. Plasmapheresis for paraquat poisoning. Lancet 1978 ; 1: 875-876.
120. Guven M., Sungur M., Eser B. The effect of plasmapheresis on plasma cholinesterase levels in a patient with organophosphate poisoning. Hum Exp Toxicol 2004 ; 23: 365-368. (Pubitemid 39117534)
121. Doherty S. History of evidence-based medicine. Oranges, chloride of lime and leeches: barriers to teaching old dogs new tricks. Emerg Med Australas 2005 ; 17: 314-321.
122. Grol R., Grimshaw J. From best evidence to best practice: effective implementation of change in patients' care. Lancet 2003 ; 362: 1225-1230.
123. Genuis SJ Toxicant exposure and mental health-individual, social, and public health considerations. J Forensic Sci 2009 ; 54: 474-477.
124. Genuis SJ, Genuis SK Human exposure assessment and relief from neuropsychiatric symptoms. J Am Board Fam Pract 2004 ; 17: 136-141.
125. Dumont MP Psychotoxicology: the return of the mad hatter. Soc Sci Med 1989 ; 29: 1077-1082.
126. Genuis SJ Health issues and the environment - an emerging paradigm for providers of obstetrical and gynecological healthcare. Hum Reprod 2006 ; 21: 2201-2208.
127. Genuis SJ Fielding a current idea: exploring the public health impact of electromagnetic radiation. Public Health 2008 ; 122: 113-124.
128. Genuis SJ Medical practice and community health care in the 21st century: a time of change. Public Health 2008 ; 122: 671-680.