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Clinical Toxicology

Benjamin W Hatten, Robert G Hendrickson
INTRODUCTION: Salicylate toxicity is a common cause of morbidity and hospitalization. Animal and human studies suggest that salicylates cause a dose-dependent inhibition of the activation of factors 2, 7, 9, and 10. However, limited reports of coagulopathy or major bleeding from salicylate toxicity exist. METHODS: This is a retrospective study examining subjects from January 1, 2001 to December 31, 2011 in whom at least one serum salicylate concentration was measured above 30 mg/dL...
March 22, 2019: Clinical Toxicology
Jocelyn R Grunwell, Courtney E McCracken, Curtis D Travers, Robert J Geller, Pradip P Kamat
AIM: To prospectively validate a pediatric clinical prediction model to identify children at low risk of clinically significant ingestions to prevent unnecessary pediatric intensive care unit (PICU) admissions. METHODS: Calls received by the Georgia Poison Center about children for acute ingestions between May 25, 2017 and May 17, 2018 were scored in real time using the full, age-stratified, and simplified clinical scoring tool to reduce childhood admissions to PICUs for poisoning (RECAP2 )...
March 22, 2019: Clinical Toxicology
Amit K J Mandal, Umar F Khan, Constantinos G Missouris
No abstract text is available yet for this article.
March 21, 2019: Clinical Toxicology
Yoshiyuki Haga, Yoshito Kamijo, Tomohiro Yoshizawa, Tomoki Hanazawa, Naoto Yokoyama, Tohru Kishino
No abstract text is available yet for this article.
March 21, 2019: Clinical Toxicology
Neeraj Chhabra, Erin M Pallasch, Michael Wahl, Sean M Bryant
No abstract text is available yet for this article.
March 21, 2019: Clinical Toxicology
Te-I Weng, Pei-I Su, Ju-Yu Chen, Pai-Shan Chen, Hsaio-Lin Hwa, Cheng-Chung Fang
No abstract text is available yet for this article.
March 21, 2019: Clinical Toxicology
Rachael Day, Sally M Bradberry, Gillian Jackson, David J Lupton, Euan A Sandilands, Simon H L Thomas, John P Thompson, J Allister Vale
INTRODUCTION: Liquid laundry detergent capsules contain concentrated liquid laundry detergent in a water-soluble polyvinyl alcohol membrane. OBJECTIVE: To review 4652 exposures reported to the United Kingdom National Poisons Information Service (NPIS) and to assess the impact of regulatory changes on potential toxicity. METHODS: Telephone enquiries to the NPIS and returned questionnaires for these products were analyzed for the period January 2008 to December 2018...
March 20, 2019: Clinical Toxicology
Ryan Feldman, Matthew Stanton, Douglas Borys, Mark Kostic, David Gummin
BACKGROUND: Exposures to bromethalin rodenticides have increased since restrictions were placed on long acting anticoagulant rodenticide (LAAR) registrations in 2008. Bromethalin works, in part, by uncoupling mitochondrial oxidative phosphorylation. Toxicity in humans is not well characterized and no antidote is available. METHODS: This retrospective observational study analyzed data from the National Poison Data System (NPDS). The data set was derived from single substance bromethalin ingestions followed to a known medical outcome that were reported to US poison centers from 01/01/2008 to 12/31/2017...
March 20, 2019: Clinical Toxicology
Bruno Mégarbane, Ahmed S Gouda, Nagla A El-Nabarawy
No abstract text is available yet for this article.
March 20, 2019: Clinical Toxicology
Thilini Madushanka Wijerathna, Indika Bandara Gawarammana, Fahim Mohamed, Dhammika Menike Dissanayaka, Paul I Dargan, Umesh Chathuranga, Chamila Jayathilaka, Nicholas Alan Buckley
INTRODUCTION: Gloriosa superba is a flowering plant that contains colchicine. Deliberate self-poisoning with this plant in Sri Lanka is common and potentially fatal. The objective of this study was to describe the epidemiology, toxicokinetics and selected biomarkers in these patients. MATERIALS AND METHODS: The study consisted of three parts; epidemiologic and outcome data (n = 297), concentrations and toxicokinetics (n = 72), evaluation of urinary and serum biomarkers (n = 45)...
March 19, 2019: Clinical Toxicology
Robert G Hendrickson, Peter Akpunonu, Adrienne R Hughes, Roy Gerona
CONTEXT: Fentanyl analogs are synthetic opioids that bind to mu receptors with high potency. We report two cases where users developed apnea and required naloxone reversal after exposure to small quantities of the fentanyl analogs, furanylfentanyl and ß-hydroxyfentanyl. CASE DETAILS: A 19 year-old woman reported insufflating a small number of granules of "fentanyl" powder and developed apnea. A 22 year-old woman touched her tongue to powdered "fentanyl" to treat a migraine headache and became apneic...
March 19, 2019: Clinical Toxicology
Hernán F Gómez, Dominic A Borgialli, Mahesh Sharman, Keneil K Shah, Anthony J Scolpino, James M Oleske, John D Bogden
BACKGROUND: The toxicity of lead, like any xenobiotic, is directly linked to the duration of exposure and toxin concentration in the body. The elevation in blood lead levels (BLLs) in young Flint, Michigan children noted in time-periods before, and during the 18-month exposure to Flint River water (FRW) from 25 April 2014 to 15 October 2015 is well-known internationally. The length of time BLLs were elevated is unknown, yet key in understanding the potential health impact of the event...
March 14, 2019: Clinical Toxicology
Rachel Aldridge, Loretta Ford, Sally Bradberry
No abstract text is available yet for this article.
March 12, 2019: Clinical Toxicology
Bishav Mohan, Vivek Gupta, Sarju Ralhan, Dinesh Gupta, Sandeep Puri, Rajesh Mahajan, Abhishek Goyal, Shibba Chhabra, Rohit Tandon, Naved Aslam, Gurpreet Singh Wander, Bhupinder Singh
BACKGROUND: Aluminium phosphide (AlP) poisoning is associated with a high mortality rate when patients are complicated with myocardial dysfunction and refractory shock or severe metabolic acidosis. We studied the role of veno-arterial extra-corporeal membrane oxygenation (VA-ECMO) in patients of AlP poisoning induced myocardial dysfunction. METHODS AND RESULTS: This is a tertiary care, single-centre, retrospective study. Between January 2011 and June 2016, total of 107 patients with AlP poisoning were identified and of those 67 were categorised in high-risk category as per the criteria...
March 11, 2019: Clinical Toxicology
Adrienne Hughes, Robert G Hendrickson
No abstract text is available yet for this article.
March 11, 2019: Clinical Toxicology
Monica Abadier, Anselm Wong, Paul Stathakis, John Singsit, Melanie Pillay, Andis Graudins
INTRODUCTION: Limited data exist regarding paracetamol metabolism after overdose in the neonate. We report a case of repeated supratherapeutic overdose in a neonate with paracetamol metabolite concentrations. CASE REPORT: A 10-day-old male neonate presented to hospital after repeated supratherapeutic dosing of paracetamol. Paracetamol concentration 19.5 h post-last dose was 381 μmol/L and 236 μmol/L, 9 h later. Initial alanine aminotransferase (ALT) was normal (18 IU/L) and total bilirubin was 262 μmol/L (N < 300)...
March 11, 2019: Clinical Toxicology
J Langrand, L Dufayet, I Dridi, F Lagrange, N Leture, T Lopes De Oliveira, F Sagnelonge, F Vergondy, C Mazaud, H Laborde-Casterot, D Vodovar
No abstract text is available yet for this article.
March 11, 2019: Clinical Toxicology
Evan Stuart Bradley, David Liss, Stephanie Pepper Carriero, David Eric Brush, Kavita Babu
INTRODUCTION: Despite widespread recognition of the opioid crisis, opioid overdose remains a common reason for Emergency Department (ED) utilization. Treatment for these patients after stabilization often involves the provision of information for outpatient treatment options. Ideally, an ED visit for overdose would present an opportunity to start treatment for opioid use disorder (OUD) immediately. Although widely recognized as effective, opioid agonist therapy with methadone and buprenorphine commonly referred to as "medication-assisted therapy" but more correctly as "medication for addiction treatment" (MAT), can be difficult to access even for motivated individuals due to shortages of prescribers and treatment programs...
March 4, 2019: Clinical Toxicology
Chuan-Huang Liu, Wei-Lan Chu, Shu-Chen Liao, Chen-Chang Yang, Chih-Chuan Lin
INTRODUCTION: Illicit substance use is an increasing problem all over the world, especially in adolescents and young adults. It is a challenge to make a definitive diagnosis of a specific substance in a poisoning case without toxicology laboratory confirmation. We confirmed the presence of N,N-dimethyltryptamine (DMT) by liquid chromatograph tandem mass spectrometer (LC/MS/MS) in biologic samples from two patients who presented with signs and symptoms consistent with sympathomimetic toxicity following the consumption of an herbal stew...
March 4, 2019: Clinical Toxicology
Simon John Hume, Joe Anthony Rotella, James J Gome, Anselm Y Wong
No abstract text is available yet for this article.
February 26, 2019: Clinical Toxicology
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