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Treatment of long-acting, anticoagulant rodenticides (LAAR)-poisoned patients with high-dose oral vitamin K1 (VK1) is expensive and requires several months. The long duration can result in non-adherence leading to recurrent severe coagulopathy, bleeding, and hospitalizations. Cholestyramine (CSA) is an inexpensive, safe, and effective gut-restricted resin used to treat primary hypercholesterolemia or pruritus, and to accelerate clearance of teriflunomide. We propose using inexpensive CSA therapy in LAAR-poisoned patients while administering daily high-dose oral VK1 and periodically monitoring plasma LAAR concentrations until declining to a safe concentration. We suggest that this regimen should be available to public health clinics responding to outbreaks of LAAR poisoning. CSA treatment could improve patient adherence, shorten duration of high dose oral VK1 therapy, and reduce healthcare expenditures.

This study aimed to synthesize and analyze toxicological characteristics from reported cases of human anticoagulant rodenticide poisoning, providing reference data for clinical diagnosis and forensic practices. We systematically identified English-language case reports (published since 2000) of human anticoagulant rodenticide poisoning via PubMed and Web of Science. A retrospective analysis was performed on various characteristics, including year, age, gender, manner of poisoning, latency period, clinical symptoms and examination results, primary treatment methods, pathological changes in fatal cases, types and concentrations of rodenticides, and toxicological analysis methods. A total of 88 poisoning cases were identified, comprising 52 cases of accidental poisoning, 31 cases of suicidal poisoning, 3 cases of unknown poisoning and 2 cases of homicide. The median latency period was 4 days (range: 1 ∼ 30). Multi-organ hemorrhage was the predominant clinical manifestation, with hematuria being the most frequently reported symptom (n = 39). Coagulation function tests revealed average values of aPTT, PT, and INR of aPTT: 110 (3.71 ∼ 212) s, PT: 100 (11.6 ∼ 300) s and INR: 9 (0.98 ∼ 38.2), respectively, all significantly exceeding normal ranges. Vitamin K1 administration (intravenous or oral) was the primary treatment. Six fatalities occurred and autopsy findings in three cases primarily indicated multi-organ hemorrhage and necrosis. About the types of rodenticides, a total of 38 cases reported 7 distinct types, with brodifacoum and bromadiolone being the most common, presenting median concentrations of 0.15 μg/mL (0.05 ∼ 10) and 0.1215 μg/mL (0.00032 ∼ 1.665), respectively, which may be significant for clinical diagnosis and forensic identification. In Conclusion, this retrospective analysis characterized key features of 88 cases of anticoagulant rodenticide poisoning and may provide valuable reference to support clinical management and forensic investigation in suspected poisoning events. [Display omitted] •88 cases of poisoning by anticoagulant rodenticides were retrieved and analyzed.•The epidemiological and clinical characteristics of these cases were summarized.•The common types and concentrations of anticoagulant rodenticides were listed.•These data can be used as references and applied in forensic practice.

This manuscript explores whether co-formulation of the second-generation anticoagulant bromadiolone with additives such as ciprofloxacin, vitamin D, aspirin, and cinnamon can enhance rodenticidal efficacy at reduced doses, while assessing hepatic pathomorphology, oxidative stress, coagulation, DNA damage, and apoptosis in wild rats. The study is both timely and relevant, addressing ecological and public health concerns by investigating mechanistic pathways including the p53–p21–caspase axis, lipid peroxidation, comet assay, prothrombin time, and serum enzyme levels. A key strength lies in its novel strategy of combining bromadiolone with pharmacological and food-derived compounds, offering practical implications for minimizing environmental impact. The multidimensional dataset spanning biochemical, molecular, genotoxic, coagulation, and histopathological endpoints provides strong mechanistic depth. Findings suggest that certain additives, particularly cinnamon and aspirin, potentiate oxidative stress and apoptosis, correlating with increased mortality and liver damage. Overall, the integration with existing literature on vitamin K antagonism, cholecalciferol-induced hypercalcemia, NSAID-mediated apoptosis, and coumarin derivatives highlights the study’s mechanistic grounding and translational relevance.

Invasive rats are one of the world's most successful animal groups that cause native species extinctions and ecosystem change, particularly on islands. On large islands, rat eradication is often impossible and population control, defined as the local limitation of rat abundance, is now routinely performed on many of the world's islands as an alternative management tool. However, a synthesis of the motivations, techniques, costs, and outcomes of such rat-control projects is lacking. We reviewed the literature, searched relevant websites, and conducted a survey via a questionnaire to synthesize the available information on rat-control projects in island natural areas worldwide to improve rat management and native species conservation. Data were collected from 136 projects conducted over the last 40 years; most were located in Australasia (46%) and the tropical Pacific (25%) in forest ecosystems (65%) and coastal strands (22%). Most of the projects targeted Rattus rattus and most (82%) were aimed at protecting birds and endangered ecosystems. Poisoning (35%) and a combination of trapping and poisoning (42%) were the most common methods. Poisoning allows for treatment of larger areas, and poison projects generally last longer than trapping projects. Second-generation anticoagulants (mainly brodifacoum and bromadiolone) were used most often. The median annual cost for rat-control projects was US$17,262 or US$227/ha. Median project duration was 4 years. For 58% of the projects, rat population reduction was reported, and 51% of projects showed evidence of positive effects on biodiversity. Our data were from few countries, revealing the need to expand rat-control distribution especially in some biodiversity hotspots. Improvement in control methods is needed as is regular monitoring to assess short- and long-term effectiveness of rat-control. Las ratas invasoras son uno de los grupos animales más exitosos a nivel mundial que ocasionan la extinción de especies nativas y cambios en los ecosistemas, particularmente en las islas. En las islas grandes, la erradicación de las ratas es generalmente imposible y el control de población, definido como la limitación local de la abundancia de ratas, hoy en día se practica rutinariamente en muchas de las islas del mundo como una herramienta alternativa de manejo. Sin embargo, se carece de una síntesis de motivaciones, técnicas, costos y resultados de dichos proyectos de control de ratas. Revisamos la literatura, buscamos sitios web relevantes, y realizamos una encuesta por medio de un cuestionario para sintetizar la información disponible sobre los proyectos de control de ratas en las áreas naturales isleñas en todo el mundo para así mejorar el manejo de ratas y la conservación de especies nativas. Se recolectaron datos de 136 proyectos que se realizaron en los últimos 40 años; la mayoría se ubicaron en Australasia (46 %) y el Pacífico tropical (25 %) en ecosistemas boscosos (65 %) y franjas costeras (22 %). La mayoría de los proyectos estaban enfocados en Rattus rattus, y la mayoría (82 %) estaban centrados en la protección de aves y ecosistemas en peligro de extinción. Los métodos más comunes fueron el envenenamiento (35 %) y una combinación de trampas y veneno (42 %). El envenenamiento permite tratar con áreas más grandes y generalmente dura más tiempo que el trampeo. Los anti-coagulantes de segunda generación (principalmente el brodifacoum y la briomadiolona) fueron los más usados. El costo medio anual de los proyectos de control de ratas fue de US$17,262 o de US$227/ha. La duración media de los proyectos fue de cuatro años. Para el 58 % de los proyectos, se reportó una reducción en la población de ratas, y el 51 % de los proyectos mostró evidencias de un efecto positivo sobre la biodiversidad. Nuestros datos provienen de pocos países, lo que revela la necesidad de expandir la distribución del control de ratas, especialmente en algunos puntos calientes de biodiversidad. Se necesita mejorar los métodos del control, así como un monitoreo regular para evaluar la efectividad del control de ratas a corto y largo plazo.

A rapid and sensitive high-performance liquid chromatography–high-resolution orbitrap mass spectrometry method was developed for the simultaneous screening of 354 organic poisons and metabolites in blood and urine, including drugs, medications, pesticides, rodenticides, veterinary drugs, alkaloids, and mycotoxins with a multi-toxicant chromatography-mass spectrometry information library. The method and library showed good prospects in clinical poisoning screening and forensic toxicological identification. Blood and urine samples were extracted successively with ethyl acetate in acidic and alkaline conditions; then, the extract was blown to nearly dry by nitrogen gas and redissolved with methanol-aqueous solution (v:v, 50:50), and the dissolved solution was analyzed by LC-MS/MS after filtering. Precursor ions’ m / z was set for identification, retention time, fragment ions, and isotopic pattern which were used for confirmation. No interference peaks were found in the blank samples, showing good specificity. The LODs of toxicants in urine and blood were 1.00×10 −3 –50.0 ng/mL and 2.07×10 −3 –50.0 ng/mL, respectively, while the LOQs were 3.30×10 −3 –1.67×10 2 ng/mL and 6.91×10 −3 –1.67×10 2 ng/mL. The intra-day precision and inter-day precision of urine samples were 2.31–9.13% and 4.75–12.3%, respectively, which were 1.92–10.8% and 2.01–12.1% in blood samples. The established method was applied to analyze 9 cases of clinical poisoning patients, and bromadiolone, carbofuran, and amanitins were detected, respectively. A total of 382 biospecimens from drug abusers were analyzed with the proposed method, which indicated that some drugs were detected in 62 cases, mainly including methamphetamine, heroin, and MDMA. The results were consistent with the information from traditional liquid chromatography-triple quadrupole mass spectrometry. Graphical abstract

The extensive use of rodenticides poses a severe threat to non-target species, particularly birds of prey and scavengers. In this study, a GC-MS/MS-based method was used to unlock the cause of bird deaths in Poland. Organs (liver, heart, kidney, and lungs) collected during autopsies of two rooks (Corvus frugilegus) and one carrion crow (Corvus corone corone), as well as fecal samples, were analyzed for the presence of anticoagulant coumarin derivatives, i.e., warfarin and bromadiolone. As for warfarin, the highest concentration was found in crow samples overall, with concentrations in the feces and lungs at 5.812 ± 0.368 µg/g and 4.840 ± 0.256 µg/g, respectively. The heart showed the lowest concentration of this compound (0.128 ± 0.01 µg/g). In the case of bromadiolone, the highest concentration was recorded in the liver of a rook (16.659 ± 1.499 µg/g) and this concentration significantly exceeded the levels in the other samples. By revealing the reality of the threat, these discoveries emphasize the need to regulate and monitor the trade in rodenticides.

Anticoagulant rodenticides (ARs) have been used for decades for rodent control worldwide. Research on the exposure of the environment and accumulation of these active substances in biota has been focused on terrestrial food webs, but few data are available on the impact of ARs on aquatic systems and water organisms. To fill this gap, we analyzed liver samples of bream ( Abramis brama ) and co-located suspended particulate matter (SPM) from the German Environmental Specimen Bank (ESB). An appropriate method was developed for the determination of eight different ARs, including first- and second-generation ARs, in fish liver and SPM. Applying this method to bream liver samples from 17 and 18 sampling locations of the years 2011 and 2015, respectively, five ARs were found at levels above limits of quantifications (LOQs, 0.2 to 2 μg kg −1 ). For 2015, brodifacoum was detected in 88% of the samples with a maximum concentration of 12.5 μg kg −1 . Moreover, difenacoum, bromadiolone, difethialone, and flocoumafen were detected in some samples above LOQ. In contrast, no first generation AR was detected in the ESB samples. In SPM, only bromadiolone could be detected in 56% of the samples at levels up to 9.24 μg kg −1 . A temporal trend analysis of bream liver from two sampling locations over a period of up to 23 years revealed a significant trend for brodifacoum at one of the sampling locations.

Exposure of wildlife to anticoagulant rodenticides from sewer baiting and bait application is poorly understood. We analyzed residues of eight anticoagulant rodenticides in liver samples of 96 great cormorants, 29 common mergansers, various fish species, and coypu, in different German regions. Results show that hepatic residues of anticoagulant rodenticides were found in almost half of the investigated cormorants and mergansers due to the uptake of contaminated fish from effluent-receiving surface waters. By contrast, exposure of coypu to rodenticides via aquatic emissions was not observed. The maximum total hepatic anticoagulant rodenticide concentration measured in waterfowl specimens was 35 ng per g based on liver wet weight. Second-generation anticoagulant rodenticide active ingredients brodifacoum, difenacoum, and bromadiolone were detected almost exclusively, reflecting their estimated market share in Germany and their continuing release into the aquatic compartment. Overall, our findings reveal that second-generation anticoagulant rodenticides accumulating in wild fish are transferred to piscivorous predators via the aquatic food chain.

Anticoagulant rodenticides (ARs) are used globally to control rodent pest infestations in both urban and agricultural settings. It is well documented that non-target wildlife, including predatory birds, are at risk for secondary anticoagulant exposure and toxicosis through the prey they consume. However, there have been no large-scale studies of AR exposure in raptors in Ontario, Canada since new Health Canada legislation was implemented in 2013 in an attempt to limit exposure in non-target wildlife. Our objective was to measure levels of ARs in wild raptors in southern Ontario to assess their exposure. We collected liver samples from 133 raptors representing 17 species submitted to the Canadian Wildlife Health Cooperative (CWHC) in Ontario, Canada, between 2017 and 2019. Liquid chromatography-tandem mass spectrometry (LC–MS/MS) was used to quantitatively assess the level of exposure to 14 first- and second-generation ARs. Detectable levels of one or more ARs were found in 82 of 133 (62%) tested raptors, representing 12 species. The most commonly detected ARs were bromadiolone (54/133), difethialone (40/133), and brodifacoum (33/133). Of AR-positive birds, 34/82 (42%) contained residues of multiple (> 1) anticoagulant compounds. Our results indicate that AR exposure is common in raptors living in southern Ontario, Canada. Our finding that brodifacoum, difethialone, and bromadiolone were observed alone or in combination with one another in the majority of our sampled raptors indicates that legislative changes in Canada may not be protecting non-target wildlife as intended.

The wide use of anticoagulant rodenticides for rat control has led to indirect poisoning of non-target birds, mammals, and vertebrates by anticoagulant rodenticides, yet contamination of insects is poorly known. We studied the behavior of two cockroach species feeding on commercial rodenticide bait formulations under laboratory conditions. Rodenticides comprised brodifacoum, difenacoum, and bromadiolone. We measured bait uptake by cockroaches, mortality, and their anticoagulant rodenticide body burden after 21 days of exposure. Results show that rodenticide residue levels in cockroaches ranged between 0.01 and 1.32 ± 0.15 µg/g dry weight. No mortality associated with rodenticide bait consumption was observed over a 21 days exposure period. Cockroaches consumed up to 50% of offered bait when attracted by this formulation, otherwise close to none. Overall, insects such as cockroaches may contribute to the environmental spread of anticoagulant rodenticides.