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https://www.readbyqxmd.com/read/28709598/simplifying-the-hemodialysis-prescription-in-patients-with-ethylene-glycol-poisoning
#1
Darren M Roberts, Tom N Lea-Henry
The management of ethylene glycol poisoning is multimodal and usually includes hemodialysis. The usual approach for guiding treatment duration is iterative, based on serial measurements of ethylene glycol concentration and routine biochemistry. In this issue, Iliuta et al. present a simplified approach to determining the duration of hemodialysis based on a single ethylene glycol concentration. Although this appears reasonable in many cases, there are circumstances in which further consideration is warranted and it only applies to high-efficiency intermittent hemodialysis...
August 2017: Kidney International
https://www.readbyqxmd.com/read/28682565/-digoxin-poisoning-new-prospects-for-therapy
#2
Alfonsina Marino, Lorenzo Giordano, Francesco Ardu
The filter has been approved by the Food and Drug Administration for the removal of beta-2 microglobulin in patient undergoing hemodialysis. We used the filter (the patient agrees) off label, in the course of digitalis intoxication and we have shown that the filter is capable of removing the drug effectively.
April 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28666490/an-unusual-cause-of-asystole-insertion-of-a-central-venous-catheter
#3
Harun Gunes, Elif Nisa Unlu, Ozlem Suzer, Abdullah Ibrahim, Ahmet Afacan, Ayhan Saritas, Hayati Kandis
Central venous catheters are a commonly used medical device which may sometimes cause complications. We present first case who had an asystolic cardiac arrest during insertion of a central venous catheter, needed cardiopulmonary resuscitation (CPR), and was resuscitated successfully. A46-year lady presented to the emergency department due to mushroom poisoning. Acentral venous catheter was inserted through the internal jugular vein. However, the patient suddenly lost consciousness and asystole was seen on the monitor immediately after the insertion of the catheter...
November 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28656354/nonfatal-and-fatal-intoxications-with-pure-caffeine-report-of-three-different-cases
#4
Jan Magdalan, Marcin Zawadzki, Rafał Skowronek, Magdalena Czuba, Barbara Porębska, Tomasz Sozański, Paweł Szpot
Caffeine is not usually perceived as a drug by most people because it is found in many foods and drinks, including caffeinated energy drinks, as well as in over the counter analgesics and cold preparations. Recently in Poland it has become increasingly common to take pure caffeine, bought through online stores, as a psychoanaleptic. This creates a much higher risk of severe and even fatal poisoning in comparison with the risk associated with the abuse of food products and non-prescription medicines containing low doses of caffeine...
June 27, 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28640122/clinical-emergency-treatment-of-68-critical-patients-with-severe-organophosphorus-poisoning-and-prognosis-analysis-after-rescue
#5
Hui Dong, Yi-Bing Weng, Gen-Shen Zhen, Feng-Jie Li, Ai-Chun Jin, Jie Liu
This study reports the clinical emergency treatment of 68 critical patients with severe organophosphorus poisoning, and analyzes the prognosis after rescue.The general data of 68 patients with severe organophosphorus poisoning treated in our hospital were retrospectively analyzed. These patients were divided into 2 groups: treatment group, and control group. Patients in the control group received routine emergency treatment, while patients in the treatment group additionally received hemoperfusion plus hemodialysis on the basis of routine emergency treatment...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28616214/high-dose-hydroxocobalamin-for-vasoplegic-syndrome-causing-false-blood-leak-alarm
#6
Wisit Cheungpasitporn, John Hui, Kianoush B Kashani, Erica D Wittwer, Robert C Albright, John J Dillon
Blood leak alarms are important safety features in a hemodialysis machine to protect patients from loss of blood through a rupture in the dialyzer membrane (true alarms). A false blood leak alarm can be triggered by air bubbles or detector malfunction (such as deposits of grease or scale). Hydroxocobalamin is an injectable form of vitamin B12 approved by the US Food and Drug Administration for the treatment of confirmed or suspected cyanide toxicity. Due to observations of an increase in arterial pressure after high-dose hydroxocobalamin infusion for the treatment of acute cyanide poisoning, it has recently been reported as an off-label rescue treatment for post-cardiopulmonary bypass vasoplegic syndrome...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28591706/predictors-of-acute-kidney-injury-after-paraquat-intoxication
#7
Cheng-Hao Weng, Hui-Hsiang Chen, Ching-Chih Hu, Wen-Hung Huang, Ching-Wei Hsu, Jen-Fen Fu, Wey-Ran Lin, I-Kwan Wang, Tzung-Hai Yen
Paraquat intoxication is characterized by multi-organ failure, causing substantial mortality and morbidity. Many paraquat patients experience acute kidney injury (AKI), sometimes requiring hemodialysis. We observed 222 paraquat-intoxicated patients between 2000 and 2012, and divided them into AKI (n = 103) and non-AKI (n = 119) groups. The mortality rate was higher for AKI than non-AKI patients (70.1% vs. 40.0%, P < 0.001). Patients with AKI had a longer time to hospital arrival (P = 0.003), lower PaO2 (P = 0...
May 18, 2017: Oncotarget
https://www.readbyqxmd.com/read/28497450/the-role-of-hemodialysis-in-treatment-of-acute-acetic-acid-poisonings
#8
Andon Chibishev, Lidija Petkovska, Liljana Tozija, Milka Zdravkovska, Emilija Shikole
INTRODUCTION: The aim of this study is to show the importance of hemodialysis as an active method in treatment of acute acetic acid poisonings. Its main role is to support the renal function during the state of the intoxication when patients develop acute renal failure. METHODS: We analyzed data from a 10-year period, a total of 71 patients who ingested acetic acid, either intentionally or accidentally. Patients with a need of hemodialysis (HD) treatment underwent 3- to 4-hour HD sessions every day or every second day, according to clinical assessment, as needed, until recovery of kidney function...
May 10, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28481454/severe-acute-valproic-acid-intoxication-successfully-treated-with-liver-support-therapy
#9
Yongchun Ge, Bin Xu, Chuan Li, Qunpeng He, Tingting Zhu, Rong Fan, Dehua Gong
Valproic acid (VPA) is widely used for treatment of epilepsy. However, its overdose can cause intoxication and could be life-threatening. Due to lack of specific antidote and poorness of endogenous clearance, extracorporeal treatment for severe intoxication cases is indicated. Here, we report a case of severe intoxication of VPA which was successfully treated with liver support therapy. A previously healthy woman was admitted due to coma and hypotension after intentional ingestion of 20 g of sodium valproate...
May 8, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28446841/occupation-related-chromium-toxicity-a-rare-cause-of-renal-failure-and-rhabdomyolysis
#10
Manjeera Jagannati, I Ramya, Sowmya Sathyendra
A 21-year-old gentleman, a worker in a mobile phone shop, was admitted with rhabdomyolysis, renal failure, and pulmonary edema requiring mechanical ventilation and hemodialysis. After extensive workup and ruling out other causes, heavy metal poisoning was considered. Investigations during the course of the hospital stay revealed chromium poisoning. With repeated hemodialysis, his parameters normalized and he was discharged home in a stable condition. Diagnosis of chromium toxicity needs high index of suspicion...
September 2016: Indian Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28438446/the-association-of-hemodialysis-and-survival-in-intubated-salicylate-poisoned-patients
#11
Daniel J McCabe, Jenny J Lu
INTRODUCTION: Salicylate poisonings are common due to their multiple uses and wide availability. The variation of presenting symptoms contributes to inconsistent treatments in the emergency department. Patients with severe salicylate overdose require a high minute ventilation. Early in the course of an overdose, a patient will require hyperventilation. If they become too fatigued to compensate, mechanical ventilation may be needed. It can be impossible to recreate such a high minute ventilation with mechanical ventilation...
April 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28412021/prediction-and-validation-of-the-duration-of-hemodialysis-sessions-for-the-treatment-of-acute-ethylene-glycol-poisoning
#12
Ioan-Andrei Iliuta, Philippe Lachance, Marc Ghannoum, Yannick Bégin, Fabrice Mac-Way, Simon Desmeules, Sacha A De Serres, Anne-Sophie Julien, Pierre Douville, Mohsen Agharazii
The duration of hemodialysis (HD) sessions for the treatment of acute ethylene glycol poisoning is dependent on concentration, the operational parameters used during HD, and the presence and severity of metabolic acidosis. Ethylene glycol assays are not readily available, potentially leading to undue extension or premature termination of HD. We report a prediction model for the duration of high-efficiency HD sessions based retrospectively on a cohort study of 26 cases of acute ethylene glycol poisoning in 24 individuals treated by alcohol dehydrogenase competitive inhibitors, cofactors and HD...
April 12, 2017: Kidney International
https://www.readbyqxmd.com/read/28407445/lethal-bentazone-intoxication-a-report-of-two-cases
#13
Petar Škavić, Zijad Duraković, Marina Nestić
This study presents two cases of lethal bentazone poisonings, their clinical presentation, the course of the disease and the autopsy findings. The first is a 50-year-old male who had sprayed corn with a solution of bentazone and was admitted to the hospital with sweating, fever, nausea, vomiting of aqueous and hemorrhagic content, and bloody, watery stools. He was treated according to the symptoms including extracorporeal hemodialysis, but eventually suffered from multiorgan failure (acute respiratory failure, acute liver failure, coagulopathy, acute renal failure, metabolic acidosis, and gastrointestinal bleeding) and died 11...
April 13, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28405999/near-fatal-poisoning-by-isoniazid-and-rifampicin
#14
Arun Agarwal, Samiksha Sharma, Ritu Bansal, Meghraj Meena, Mala Airun
Since six decades, Isoniazid and Rifampicin are used as first line drugs for treatment of tuberculosis. The minimum acute lethal or toxic dose of Rifampicin is not well established. However, non-fatal acute overdoses in adults have been reported with doses ranging from 9 to 12 gm and fatal acute overdoses with doses ranging from 14 to 60 gm. Isoniazid, if acutely ingested, even 1.5 to 2 gram may cause toxicity in adults. We report a case of Pott's spine on ATT, who took massive overdose of Rifampicin (>18 gm) and Isoniazid (>12 gm) and reported late (almost 36 hours) after ingestion...
December 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28405068/hemodialysis-failure-secondary-to-hydroxocobalamin-exposure
#15
Kenneth Lim, Eliot Heher, David Steele, Andrew Z Fenves, John Kevin Tucker, Ravi Thadhani, Kenneth Christopher, Nina Tolkoff-Rubin
Hydroxocobalamin is a recently approved antidote for the treatment of cyanide poisoning. The case presented involves a young patient administered empiric hydroxocobalamin due to suspected cyanide overdose. Due to the development of acute kidney injury and severe metabolic derangement, emergent hemodialysis was initiated. Unfortunately, hemodialysis was confounded by a recurrent "blood leak" alarm. This unforeseen effect was secondary to interference from hydroxocobalamin. Hydroxocobalamin causes orange/red discoloration of bodily fluids and permeates the dialysate...
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28352354/antifreeze-poisoning-a-case-report
#16
Xiaofei Wu, Guoyu Lu, Benquan Qi, Ran Wang, Daohua Guo, Xiaolin Liu
The current study reported the case of a 35-year-old male that presented with antifreeze poisoning. The clinical manifestations, laboratory investigations and treatments were analyzed, and the obtained results were compared with those in previous reports. Subsequent to consuming antifreeze, the patient mainly presented nausea and agitation, without disturbance of consciousness. Laboratory investigations indicated severe metabolic acidosis, renal dysfunction and hyperkalemia. The patient underwent hemodialysis and his condition was significantly improved on the day of admission...
February 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28339843/availability-and-cost-of-extracorporeal-treatments-for-poisonings-and-other-emergency-indications-a-worldwide-survey
#17
Josée Bouchard, Valery Lavergne, Darren M Roberts, Monique Cormier, Genevieve Morissette, Marc Ghannoum
Background: Extracorporeal treatments (ECTRs) are used for different conditions, including replacement of organ function and poisoning. Current recommendations for ECTRs in various poisonings suggest that intermittent haemodialysis (IHD) is the most efficient technique. However, the practicality of these recommendations is poorly defined in view of limited information on availability and cost worldwide. Methods: A survey invitation to an Internet-based questionnaire was emailed between January 2014 and March 2015 to members of international societies to determine the availability, time to initiation and cost of ECTRs (including filters, dialysate, catheter, anticoagulant and nursing/physician salary)...
April 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28291652/cost-effectiveness-of-hospital-treatment-and-outcomes-of-acute-methanol-poisoning-during-the-czech-republic-mass-poisoning-outbreak
#18
Jan Rulisek, Martin Balik, Ferdinand Polak, Petr Waldauf, Daniela Pelclova, Jan Belohlavek, Sergey Zakharov
PURPOSE: During an outbreak of mass methanol poisoning in the Czech Republic in 2012-2014, we compared the total hospital costs and one-year medical costs in the patients treated with different antidotes (fomepizole versus ethanol) and modalities of hemodialysis (intermittent hemodialysis, IHD, versus continuous renal replacement therapy, CRRT). METHODS: Cross-sectional study in 106 patients with confirmed diagnosis treated in 30 ICU settings. For each patient, the following data were analyzed: admission laboratory data, GCS, PSS, ICU length of stay, organ failures, treatment, outcome, and total hospital costs...
June 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28261553/discernment-scheme-for-paraquat-poisoning-a-five-year-experience-in-shiraz-iran
#19
Saeed Kavousi-Gharbi, Reza Jalli, Akbar Rasekhi-Kazerouni, Zahra Habibagahi, Sayed Mahdi Marashi
AIM: To evaluate various schemes for paraquat poisoning and different variables that influence the outcome of acute paraquat poisoning. METHODS: In a cross-sectional study, the information about all cases of acute paraquat poisoning who were admitted to teaching hospitals affiliated to Shiraz University of Medical Sciences, in a five year period (September 2010 to September 2015) were evaluated. The variables included: Demographic data, medical assessment, therapeutic options, laboratory findings, and the outcomes...
February 20, 2017: World Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28212474/-zinc-phosphide-poisoning-in-pediatric-patients-from-a-toxicology-center-at-mexico-city
#20
María Carmen Socorro Sánchez-Villegas, Alejandro Bárcena-Ruiz
BACKGROUND: Zinc phosphide is a chemical compound that is frequently used as a rodenticide; it is a highly toxic product that is widely used, among other spaces, at home. Given that it is a highly commercialized pesticide and that there is no antidote, it is mandatory to establish favorably the clinical manifestations of the intoxication. The aim was to describe the epidemiological and clinical profile of children intoxicated with zinc phosphide attended in a toxicological center of a tertiary referral hospital...
2017: Revista Médica del Instituto Mexicano del Seguro Social
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