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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/29907949/cholinergic-crisis-caused-by-cholinesterase-inhibitors-a-retrospective-nationwide-database-study
#1
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...
June 15, 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
#2
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...
June 1, 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
#3
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...
May 29, 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
#4
EDITORIAL
Louise Kao, Anthony Pizon
No abstract text is available yet for this article.
May 21, 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
#5
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...
May 10, 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29728907/in-memoriam-kristin-engebretsen-pharmd-dabat
#6
Mark B Mycyk
No abstract text is available yet for this article.
May 4, 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
#7
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...
April 23, 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
#8
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...
April 17, 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29687221/microplastics-and-human-health-our-great-future-to-think-about-now
#9
EDITORIAL
Amy V Kontrick
No abstract text is available yet for this article.
June 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29671244/assessment-of-the-availability-cost-and-motivations-for-use-over-time-of-the-new-psychoactive-substances-benzodiazepines-diclazepam-flubromazepam-and-pyrazolam-in-the-uk
#10
Rachelle Abouchedid, Thea Gilks, Paul I Dargan, John R H Archer, David M Wood
INTRODUCTION: There has been increasing interest in the availability of non-prescription benzodiazepines and their sale as new psychoactive substances. We wanted to determine UK availability from Internet suppliers and motivations for use of three benzodiazepines (diclazepam, flubromazepam, and pyrazolam). METHODS: In November 2014 and March 2016, using the European Monitoring Centre for Drugs and Drug Addiction Snapshot Methodology, Internet search engines ( google...
June 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29536431/translational-application-of-measuring-mitochondrial-functions-in-blood-cells-obtained-from-patients-with-acute-poisoning
#11
David H Jang, Utsha G Khatri, Anita Mudan, Jennifer S Love, Shawn Owiredu, David M Eckmann
It is conservatively estimated that 5,000 deaths per year and 20,000 injuries in the USA are due to poisonings caused by chemical exposures (e.g., carbon monoxide, cyanide, hydrogen sulfide, phosphides) that are cellular inhibitors. These chemical agents result in mitochondrial inhibition resulting in cardiac arrest and/or shock. These cellular inhibitors have multi-organ effects, but cardiovascular collapse is the primary cause of death marked by hypotension, lactic acidosis, and cardiac arrest. The mitochondria play a central role in cellular metabolism where oxygen consumption through the electron transport system is tightly coupled to ATP production and regulated by metabolic demands...
March 13, 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29532341/correction-to-anaphylactoid-reactions-to-intravenous-n-acetylcysteine-during-treatment-for-acetaminophen-poisoning
#12
Mark Yarema, Puja Chopra, Marco L A Sivilotti, David Johnson, Alberto Nettel-Aguirre, Benoit Bailey, Charlemaigne Victorino, Sophie Gosselin, Roy Purssell, Margaret Thompson, Daniel Spyker, Barry Rumack
The original article has been corrected. Table 4 in PDF version of this article has been corrected since the original publication of the article because the first column of numbers (under the heading "Female") in the original PDF version was typeset poorly.
March 12, 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29508161/acmt-2018-annual-scientific-meeting-abstracts-washington-dc
#13
(no author information available yet)
No abstract text is available yet for this article.
March 5, 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29388062/are-oximes-still-indicated-for-acute-organophosphorus-insecticide-self-poisoning
#14
EDITORIAL
Michael Eddleston
No abstract text is available yet for this article.
March 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29330731/human-plant-exposures-reported-to-a-regional-southwestern-poison-control-center-over-8-years
#15
Ben Enfield, Daniel E Brooks, Sharyn Welch, Maureen Roland, Jane Klemens, Kim Greenlief, Rachel Olson, Richard D Gerkin
BACKGROUND: There is little published data about human plant exposures reported to US poison control centers (PCCs). METHODS: A retrospective chart review of all reported plant exposures to a single regional PCC between January 1, 2003 and December 31, 2010 was done to understand better the characteristics of plant exposure cases. Specific generic plant codes were used to identify cases. Recorded variables included patient demographics, plant involved, exposure variables, symptoms, management site, treatments, and outcome...
March 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29318511/midazolam-efficacy-against-acute-hydrogen-sulfide-induced-mortality-and-neurotoxicity
#16
Poojya Anantharam, Dong-Suk Kim, Elizabeth M Whitley, Belinda Mahama, Paula Imerman, Piyush Padhi, Wilson K Rumbeiha
Hydrogen sulfide (H2 S) is a colorless, highly neurotoxic gas. It is not only an occupational and environmental hazard but also of concern to the Department of Homeland Security for potential nefarious use. Acute high-dose H2 S exposure causes death, while survivors may develop neurological sequelae. Currently, there is no suitable antidote for treatment of acute H2 S-induced neurotoxicity. Midazolam (MDZ), an anti-convulsant drug recommended for treatment of nerve agent intoxications, could also be of value in treating acute H2 S intoxication...
March 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29299761/comment-on-evaluation-of-a-food-and-drug-administration-mandate-to-limit-acetaminophen-in-prescription-combination-products
#17
LETTER
Michael E Mullins, S Eliza Dunn
No abstract text is available yet for this article.
March 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29299760/correction-to-utility-of-2-pyridine-aldoxime-methyl-chloride-2-pam-for-acute-organophosphate-poisoning-a-systematic-review-and-meta-analysis
#18
Adam Blumenberg, Roshank Benabbas, Ian de Souza, Alyssa Conigliaro, Lorenzo Paladino, Elliot Warman, Richard Sinert, Sage W Wiener
The names of coauthors Roshanak Benabbas and and Ian S. deSouza were given incorrectly (as "Roshnak Benabbas" and "Ian de Souza", respectively) in this article as originally published.
March 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29285649/carboxyhemoglobin-levels-induced-by-cigarette-smoking-outdoors-in-smokers
#19
Jonathan Schimmel, Naomi George, John Schwarz, Sami Yousif, Selim Suner, Jason B Hack
INTRODUCTION: Non-invasive screening of carboxyhemoglobin saturation (SpCO) in the emergency department to detect occult exposure is increasingly common. The SpCO threshold to consider exposure in smokers is up to 9%. The literature supporting this cutoff is inadequate, and the impact of active smoking on SpCO saturation remains unclear. The primary objective was to characterize baseline SpCO in a cohort of smokers outdoors. Secondary objectives were to explore the impact of active smoking on SpCO and to compare SpCO between smokers and non-smokers...
March 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29230717/utility-of-2-pyridine-aldoxime-methyl-chloride-2-pam-for-acute-organophosphate-poisoning-a-systematic-review-and-meta-analysis
#20
REVIEW
Adam Blumenberg, Roshanak Benabbas, Ian S deSouza, Alyssa Conigliaro, Lorenzo Paladino, Elliot Warman, Richard Sinert, Sage W Wiener
Organophosphates (OP) account for the majority of pesticide-related unintentional or intentional poisonings in lower- and middle-income countries. The therapeutic role of atropine is well-established for patients with acute OP poisoning. The benefit of adding 2-pyridine aldoxime methyl chloride (2-PAM), however, is controversial. We performed a systematic review and meta-analysis of available randomized controlled trials (RCT) to compare 2-PAM plus atropine in comparison to atropine alone for acute OP poisoning...
March 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
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