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Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology

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https://www.readbyqxmd.com/read/30276621/comment-on-pesticide-poisoned-patients-can-they-be-used-as-potential-organ-donors
#1
LETTER
Israel Rubinstein, Douglas L Feinstein
No abstract text is available yet for this article.
October 1, 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/30276620/correction-to-the-toxicology-investigators-consortium-case-registry-the-2017-annual-report
#2
Lynn A Farrugia, Sean H Rhyee, Sharan L Campleman, Bryan Judge, Louise Kao, Anthony Pizon, Lauren Porter, Anne M Riederer, Timothy Wiegand, Diane P Calello, Paul M Wax, Jeffrey Brent
Please note the Collaborators for this article listed in the Acknowledgements.
October 1, 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/30094773/monitoring-dose-response-of-cyanide-antidote-dimethyl-trisulfide-in-rabbits-using-diffuse-optical-spectroscopy
#3
Jangwoen Lee, Gary Rockwood, Brian Logue, Erica Manandhar, Ilona Petrikovics, Changhoon Han, Vik Bebarta, Sari B Mahon, Tanya Burney, Matthew Brenner
INTRODUCTION: Cyanide (CN) poisoning is a serious chemical threat from accidental or intentional exposures. Current CN exposure treatments, including direct binding agents, methemoglobin donors, and sulfur donors, have several limitations. Dimethyl trisulfide (DMTS) is capable of reacting with CN to form the less toxic thiocyanate with high efficiency, even without the sulfurtransferase rhodanese. We investigated a soluble DMTS formulation with the potential to provide a continuous supply of substrate for CN detoxification which could be delivered via intramuscular (IM) injection in a mass casualty situation...
August 9, 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/30073621/deliberate-self-poisoning-with-a-lethal-dose-of-pentobarbital-with-confirmatory-serum-drug-concentrations-survival-after-cardiac-arrest-with-supportive-care
#4
Dino F Druda, Santosh Gone, Andis Graudins
INTRODUCTION: Pentobarbital (PB) is a euthanasia drug in doses of 2 to 10 grams, causing death within 15-30 minutes. We report a case of recovery from lethal pentobarbital deliberate self-poisoning with confirmatory serum drug concentrations. CASE REPORT: A 45-year-old male purchased 20 grams of PB powder over the Internet. He ingested this powder and then alerted his mother 10 minutes later. She found him unresponsive and commenced cardiopulmonary resuscitation (CPR)...
August 2, 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/30066312/concurrent-use-of-benzodiazepine-by-heroin-users-what-are-the-prevalence-and-the-risks-associated-with-this-pattern-of-use
#5
T Yamamoto, P I Dargan, A Dines, C Yates, F Heyerdahl, K E Hovda, I Giraudon, R Sedefov, D M Wood
INTRODUCTION: Polydrug use involving heroin and benzodiazepines is common. The potential risk of additive pharmacological effects may be associated with poorer outcomes in patients who use benzodiazepines together with heroin. The aim of this study was to determine the clinical picture of patients presenting to the emergency department following acute drug toxicity involving heroin and benzodiazepines. METHODS: Exposure information, clinical data and outcome of acute drug toxicity presentations were collected between 1 October 2013 and 30 September 2014 as part of the European Drug Emergencies Network (Euro-DEN) project...
July 31, 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/30051204/dinitrophenol-dnp-fatality-associated-with-a-falsely-elevated-salicylate-level-a-case-report-with-verification-of-laboratory-cross-reactivity
#6
Kathryn T Kopec, Caroline Freiermuth, Susan Maynard, Michael Beuhler
INTRODUCTION: 2,4-Dinitrophenol (DNP) is a known uncoupler of oxidative phosphorylation that clinically leads to hyperthermia, tachycardia, tachypnea, and metabolic acidosis. Intentional overdoses of DNP are often fatal. We present an analytically confirmed fatal case of DNP overdose with a falsely positive elevated salicylate concentration. We further explored this cross reactivity of DNP with two salicylate assays. METHODS: Clinically relevant serial dilutions of DNP were prepared in drug-free serum and analyzed using two different colorimetric NADH/NAD-based analytical methodologies...
July 26, 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/30047044/barriers-and-facilitators-of-intensivists-adherence-to-hyperinsulinemia-euglycemia-therapy-in-the-treatment-of-calcium-channel-blocker-poisoning
#7
Eric Brassard, Patrick Archambault, Guillaume Lacombe, Maude St-Onge
INTRODUCTION: Adherence to poison center (PC) recommendations for the management of calcium channel blocker (CCB) poisoning is inconsistent. This study aimed to identify behaviors that determine adherence to hyperinsulinemia-euglycemia therapy (HIET) for CCB poisoning. METHODS: Semistructured interviews were conducted involving a convenience sample of 18 intensivists. Interview responses were analyzed using the theoretical domains framework (TDF) to identify relevant domains influencing physician adherence to HIET...
July 25, 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/30094774/the-toxicology-investigators-consortium-case-registry-the-2017-annual-report
#8
Lynn A Farrugia, Sean H Rhyee, Sharan L Campleman, Bryan Judge, Louise Kao, Anthony Pizon, Lauren Porter, Anne M Riederer, Timothy Wiegand, Diane Calello, Paul M Wax, Jeffrey Brent
The Toxicology Investigators Consortium (ToxIC) Case Registry was established by the American College of Medical Toxicology in 2010. The Registry collects data from participating sites with the agreement that all bedside medical toxicology consultations will be entered. The objective of this eighth annual report is to summarize the Registry's 2017 data and activity with its additional 7577 cases. Cases were identified for inclusion in this report by a query of the ToxIC database for any case entered from 1 January to 31 December 2017...
September 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/30066311/reviewing-the-record-medical-record-reviews-for-medical-toxicology-research
#9
EDITORIAL
Jaiva Larsen, Mark B Mycyk, Trevonne M Thompson
No abstract text is available yet for this article.
September 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29956117/extracorporeal-cardiopulmonary-resuscitation-after-diphenhydramine-ingestion
#10
Sonia Labarinas, Kristen Meulmester, Spencer Greene, James Thomas, Manpreet Virk, Gwen Erkonen
INTRODUCTION: Diphenhydramine is a widely used first-generation histamine (H1 ) antagonist that can be obtained without prescription in many countries. Massive ingestions can result in severe toxicity and even death. We describe a case of diphenhydramine overdose leading to cardiac arrest, cardiopulmonary resuscitation (CPR), and extracorporeal membrane oxygenation (ECMO) cannulation for refractory ventricular fibrillation, a process we refer to as extracorporeal cardiopulmonary resuscitation (ECPR)...
September 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29926389/the-virtual-toxicology-journal-club-the-dissemination-and-discussion-of-noteworthy-manuscripts-using-twitter
#11
Peter R Chai, Anne-Michelle Ruha, Kelly E Wong, Derek L Monette, Meghan B Spyres, Jeff Lapoint, Howard Greller, Mark B Mycyk
BACKGROUND: Twitter-based chat groups (tweetchats) structured as virtual journal clubs have been demonstrated to provide value to learners. In order to promote topics in medical toxicology, we developed the #firesidetox tweetchat as a virtual journal club to discuss and disseminate topics in medical toxicology. METHODS: A group of medical toxicologists from the American College of Medical Toxicology (ACMT) Public Affairs Committee and editorial board of the Journal of Medical Toxicology (JMT) developed a quarterly one hour tweetchat featuring JMT manuscripts...
September 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29907949/cholinergic-crisis-caused-by-cholinesterase-inhibitors-a-retrospective-nationwide-database-study
#12
Hiroyuki Ohbe, Taisuke Jo, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga
INTRODUCTION: In contrast to information on the effects of organophosphate, pesticide, or environmental exposures, data on cholinergic crisis caused by pharmaceutical cholinesterase inhibitors are sparse. The present study aimed to describe the characteristics, demographics, and mortality of patients with cholinergic crisis caused by pharmaceutical cholinesterase inhibitors using a nationwide inpatient database in Japan. METHODS: We identified patients diagnosed with cholinergic crisis as a result of taking cholinesterase inhibitor medications in the Japanese Diagnosis Procedure Combination inpatient database from July 2010 to March 2016...
September 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29858745/machine-learning-to-predict-detect-and-intervene-older-adults-vulnerable-for-adverse-drug-events-in-the-emergency-department
#13
Kei Ouchi, Charlotta Lindvall, Peter R Chai, Edward W Boyer
Adverse drug events (ADEs) are common and have serious consequences in older adults. ED visits are opportunities to identify and alter the course of such vulnerable patients. Current practice, however, is limited by inaccurate reporting of medication list, time-consuming medication reconciliation, and poor ADE assessment. This manuscript describes a novel approach to predict, detect, and intervene vulnerable older adults at risk of ADE using machine learning. Toxicologists' expertise in ADE is essential to creating the machine learning algorithm...
September 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29845507/telemedicine-delivery-and-successful-reimbursement-in-toxicology
#14
Peter W Crane, Timothy J Wiegand, Michael Kamali, Marilynn Reif, Rose Wratni, Ronald Montante, Tracey Loveland
INTRODUCTION: Telemedicine and its use in medical toxicology have existed for some time. There are varied definitions, but existing ones center on using currently available forms of audio, video, and internet communications to provide "real-time" patient care. Definitions have historically limited reimbursement but recently expanded CMS guidelines have improved this. Here we describe our experience with telemedicine and reimbursement. METHODS: A retrospective study was conducted of all toxicology and billing reimbursement for fiscal year 2016 for a solo Medical Toxicology service...
September 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29785474/medical-toxicology-fellowship-training-is-available-to-applicants-from-many-specialties
#15
EDITORIAL
Louise Kao, Anthony Pizon
No abstract text is available yet for this article.
September 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29748926/adjunctive-use-of-ketamine-for-benzodiazepine-resistant-severe-alcohol-withdrawal-a-retrospective-evaluation
#16
Poorvi Shah, Marc McDowell, Reika Ebisu, Tabassum Hanif, Theodore Toerne
INTRODUCTION: Benzodiazepine (BZD)-resistant alcohol withdrawal remains a challenge for most institutions due to limited evidence with available agents. One published study currently exists utilizing the N-methyl-D-aspartate antagonist, ketamine, for alcohol withdrawal. OBJECTIVE: The purpose of our study was to evaluate the effect of adjunctive ketamine continuous infusion on symptom control and lorazepam infusion requirements for BZD-resistant alcohol withdrawal patients in the intensive care unit...
September 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29687220/retrospective-study-of-the-characteristics-of-anticoagulant-type-rodenticide-poisoning-in-hong-kong
#17
Wai Yan Ng, Chor Kwan Ching, Yeow Kuan Chong, Sau Wah Ng, Wing Lan Cheung, Tony Wing Lai Mak
INTRODUCTION: Warfarin- and superwarfarin-type anticoagulants are commonly used as rodenticides. Exposure to these agents, especially superwarfarins with long-acting anticoagulant effect, can cause life-threatening coagulopathy in humans. Most superwarfarin poisoning cases had an obvious history of exposure, though occult cases without exposure history have also been reported. The current study aims to examine anticoagulant-type rodenticide poisoning in Hong Kong and to identify the similarities and differences between patients with known exposure history and those whose exposure is recognized only through laboratory testing...
September 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29667118/acmt-position-statement-alternative-or-contingency-countermeasures-for-acetylcholinesterase-inhibiting-agents
#18
Andrew Stolbach, Vikhyat Bebarta, Michael Beuhler, Shaun Carstairs, Lewis Nelson, Michael Wahl, Paul M Wax, Charles McKay
First responders and health care providers must prepare to provide care for patients poisoned by acetylcholinesterase (AchE) inhibitor chemical warfare agents or pesticides. However, pre-deployed medical countermeasures (MCMs) may not be sufficient due to production and delivery interruption, rapid depletion of contents during a response, expiration of MCM components, or lack of local availability of approved MCMs. To augment supplies of community-based and forward-deployed nerve agent countermeasures, the American College of Medical Toxicology (ACMT) supports several strategies: (1) The use of expired atropine, diazepam, and pralidoxime auto-injectors and vials if non-expired drugs are unavailable; and (2) Investigation, development, and identification of alternative countermeasures-commonly stocked drugs that are not approved for nerve agent poisoning but are in the same therapeutic class as approved drugs...
September 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29987646/pesticide-poisoned-patients-can-they-be-used-as-potential-organ-donors
#19
Umesh Mistry, Paul I Dargan, David M Wood
INTRODUCTION: The gap between the number of patients on transplant waiting lists and patients receiving transplants is growing. Use of organs from donors who have died following pesticide exposure remains controversial. This study reviews the literature related to transplantation from this group. METHODS: A literature search was undertaken on PubMed using the following keywords: 'insecticide', 'pesticide', 'rodenticide', 'organophosphate', 'carbamate', 'paraquat', 'poisoning', 'toxicity', 'overdose', 'intoxication', 'ingestion', 'organ donation or procurement', 'transplant', 'allograft transplant', and 'expanded criteria organ donation'; 21 specific pesticides/insecticides were also added to the search; the indexes for EAPCCT/NACCT meeting abstracts 2008-2017 were also searched...
July 9, 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29968185/medication-allergy-and-adverse-drug-reaction-documentation-discrepancies-in-an-urban-academic-emergency-department
#20
Eric S Kiechle, Colleen M McKenna, Hannah Carter, Alexander Zeymo, Bradley W Gelfand, Lindsey M DeGeorge, Diane A Sauter, Maryann Mazer-Amirshahi
INTRODUCTION: Medication histories, including knowledge of allergies and adverse drug reactions (ADRs), are a nationally recognized quality measure. Medication histories in the emergency department (ED) are often inaccurate or incomplete. Our objective was to determine the prevalence and nature of medication allergy and ADR discrepancies in an urban ED. METHODS: This was a prospective observational descriptive study, enrolling a convenience sample of adults over 7 months at a single academic urban ED...
July 2, 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
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