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https://www.readbyqxmd.com/read/27932048/fatal-intravenous-injection-of-potassium-is-postmortem-biochemistry-useful-for-the-diagnosis
#1
Cristian Palmiere, Maria Pia Scarpelli, Vincent Varlet, Pia Baumann, Katarzyna Michaud, Marc Augsburger
Fatal cases of potassium overdoses have traditionally been considered indemonstrable due postmortem biochemical investigation limits (mainly potassium determination in postmortem serum and vitreous humor). Nevertheless, some authors have expressed a divergent opinion over the years based on the results of their own investigations. In this study, we investigated left vitreous, right vitreous, postmortem serum from peripheral blood, postmortem serum from cardiac blood, urine, pericardial and cerebrospinal fluid potassium concentrations in 21 forensic autopsy cases...
November 27, 2016: Forensic Science International
https://www.readbyqxmd.com/read/27910037/effect-of-activated-charcoal-on-rivaroxaban-complex-absorption
#2
Edouard Ollier, Sophie Hodin, Julien Lanoiselée, Jean Escal, Sandrine Accassat, Elodie De Magalhaes, Thierry Basset, Laurent Bertoletti, Patrick Mismetti, Xavier Delavenne
OBJECTIVE: To quantify the impact of activated charcoal (AC) on rivaroxaban exposure in healthy volunteers. METHODS: This was an open-label study with an incomplete cross-over design of single-dose rivaroxaban (40 mg) administered alone or with AC in 12 healthy volunteers. The study comprised three treatment periods in randomised sequence, one with rivaroxaban administered alone and two with AC given at 2, 5 or 8 h post-dose. Rivaroxaban plasma concentration was measured in blood samples drawn at 16 time points...
December 2, 2016: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/27877098/accidental-epidural-injection-of-rocuronium-in-a-pediatric-patient-a-case-report-and-literature-review
#3
Ting-Ting Wu, David S Hoff
Accidental administration of non-epidural drugs into the epidural or subarachnoid spaces may be associated with unexpected pain, morbidity, adverse effects, increased level of care, prolonged hospital stay, and mortality. We describe a 12-month-old admitted for secondary-stage hypospadias reconstruction. General anesthesia was induced with sevofiurane and a peripheral catheter was placed. Instead of ropivacaine, rocuronium (80 mg; 6.3 mg/kg) was injected into the epidural space by the caudal route. Surgery was uneventful and was completed 160 minutes after rocuronium was given...
September 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/27872609/panitumumab-associated-encephalopathy-after-accidental-intra-arterial-application-through-dislocated-central-venous-access-device
#4
Slaven Pikija, Georg Pilz, Gerald Gschwandtner, Cornelia Rösler, Konstantin Schlick, Richard Greil, Johann Sellner
Acute central nervous system (CNS) toxicity and immune-related side effects are increasingly recognized with the use of monoclonal antibodies for cancer therapy. Here, we report a patient who developed of acute-onset encephalopathy and coma, which began shortly after administration of panitumumab for the treatment of metastatic colorectal cancer. Echocardiography revealed that the drug had been infused into the left cardiac ventricle via a dislocated central venous line. Diffusion-weighted magnetic resonance imaging disclosed multiple cortical hyperintensities, which were preferentially located in the frontal lobes...
2016: Frontiers in Neurology
https://www.readbyqxmd.com/read/27869359/pitfalls-in-the-use-of-epinephrine-for-anaphylaxis-patient-and-provider-opportunities-for-improvement
#5
Michael B Cohen, Stefanie S Saunders, Sarah K Wise, Samih Nassif, Michael P Platt
BACKGROUND: Epinephrine remains the mainstay of treatment for life-threatening allergic reactions. A number of challenges are encountered with epinephrine, resulting in underutilization and misutilization of epinephrine. The purpose of this study was to identify the scope of epinephrine pitfalls and opportunities for improvement in the management of allergy emergencies. METHODS: A PubMed search from 1990 to 2015 was performed to identify all cases and reports pertaining to the use and misuse of epinephrine for anaphylaxis...
November 21, 2016: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/27862374/safety-and-effectiveness-of-a-single-and-repeat-intramuscular-injection-of-a-gnrh-vaccine-gonacon%C3%A2-in-adult-female-domestic-cats
#6
L M Vansandt, M A Kutzler, A E Fischer, K N Morris, W F Swanson
Sterilization is a key strategy to reduce the number of domestic cats entering and killed in shelters each year. However, surgical sterilization is expensive and labour-intensive and cannot fully address the 70 million free-roaming cats estimated to exist in the United States. GonaCon™ is a gonadotropin-releasing hormone vaccine originally developed for use as a wildlife immunocontraceptive. An earlier formulation was tested in domestic cats and found to be safe and effective for long-term contraception. However, the current Environmental Protection Agency (EPA)-registered formulation consists of a different antigen-carrier protein and increased antigen concentration and has never been tested in cats...
November 15, 2016: Reproduction in Domestic Animals, Zuchthygiene
https://www.readbyqxmd.com/read/27853393/acute-abdomen-as-a-consequence-of-an-unusual-suicide-attempt-intra-abdominal-injection-of-sulfuric-acid
#7
Anna Lepore, Davide D'Antini, Pasquale Raimondo, Lucia Mirabella, Leonardo Pennisi, Giuseppe Carrillo, Antonella Cotoia, Michele Dambrosio, Gilda Cinnella
Caustic ingestion is a common cause of life-threatening upper gastrointestinal tract injuries. It mostly happens in children as accidental exposure, but may occur in adults as a result of suicide attempt. We present a case of an acute abdomen that occurred after a peculiar way of self-administration of sulfuric acid as a suicide attempt in an adult psychiatric male patient, already known for self-harm with caustic agents in the previous years. In a few hours, the patient developed diffuse peritonitis, pneumoperitoneum, and a rapid hemodynamic deterioration, as a consequence of ileum and sigmoid necrosis, requiring an emergency surgery with the application of a damage control strategy...
2016: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/27842957/clinical-validity-and-relevance-of-accidental-puncture-or-laceration-as-a-patient-safety-indicator-for-children
#8
Heather L Short, Kurt F Heiss, Mark L Wulkan, Mehul V Raval
PURPOSE: Accidental puncture or laceration (APL) has been endorsed as a patient safety indicator and is being used to compare hospital performance and for reimbursement. We sought to determine the positive predictive value (PPV) of APL as a quality metric in a pediatric population. METHODS: We retrospectively reviewed all cases that met APL administrative criteria over 5years in a quaternary pediatric hospital system. Events were categorized as false positive (FP) or true positive (TP)...
October 28, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27815173/stable-gastric-pentadecapeptide-bpc-157-and-bupivacaine
#9
Gordana Zivanovic-Posilovic, Diana Balenovic, Ivan Barisic, Dean Strinic, Vasilije Stambolija, Mario Udovicic, Sandra Uzun, Domagoj Drmic, Josipa Vlainic, Martina Lovric Bencic, Aleksandra Sindic, Sven Seiwerth, Predrag Sikiric
Bupivacaine toxicity following accidental overdose still lacks therapeutic solution. However, there are major arguments for testing BPC 157 against bupivacaine toxicity in vivo in rats, in particular, and then finally, in vitro. These are: the lack of any known BPC 157 toxicity, a lifesaving effect via the mitigation of arrhythmias in rats underwent hyperkalemia or digitalis toxicity, the elimination of hyperkalemia and arrhythmias in rats underwent succinylcholine toxicity and finally, the reduction of potassium-induced depolarization in vitro (in HEK293 cells) in severe hyperkalemia...
December 15, 2016: European Journal of Pharmacology
https://www.readbyqxmd.com/read/27805961/intraoperative-adverse-events-in-abdominal-surgery-what-happens-in-the-operating-room-does-not-stay-in-the-operating-room
#10
Jordan D Bohnen, Michael N Mavros, Elie P Ramly, Yuchiao Chang, D Dante Yeh, Jarone Lee, Marc de Moya, David R King, Peter J Fagenholz, Kathryn Butler, George C Velmahos, Haytham M A Kaafarani
OBJECTIVE: We sought to assess the impact of intraoperative adverse events (iAEs) on 30-day postoperative mortality, 30-day postoperative morbidity, and postoperative length of stay (LOS) among patients undergoing abdominal surgery. We hypothesized that iAEs would be associated with significant increases in each outcome. SUMMARY OF BACKGROUND DATA: The relationship between iAEs and postoperative clinical outcomes remains largely unknown. METHODS: The 2007 to 2012 institutional ACS-NSQIP and administrative databases for abdominal surgeries were matched then screened for iAEs using the Agency for Healthcare Research and Quality's 15 Patient Safety Indicator, "Accidental Puncture/Laceration"...
November 1, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27796819/sulfonylurea-poisoning-in-a-healthy-toddler
#11
Suresh Kumar, Abhijit Choudhary, Mahammad Ali, Vipul Gupta, Jayashree Muralidharan, Sunit C Singhi
Ingestion of sulfonylureas is life-threatening in toddlers and children due to its strong and prolonged hypoglycemic effect. The authors present a 15-mo-old boy with accidental ingestion of Glipizide who presented with encephalopathy, seizure and severe hypoglycemia. The management included parenteral dextrose and octreotide administration to maintain euglycemia, followed by complete neurological recovery within 24 h. Sulphonylurea intoxication should be considered in previously healthy toddlers and children presenting with hypoglycemia especially if any caregiver is on sulfonylurea drugs...
October 31, 2016: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/27796581/treatment-of-accidental-perianal-injection-of-topical-thrombin-with-intravenous-antithrombin
#12
Vance G Nielsen, Samata R Paidy, Whitney McLeod, Alexandra Fox, Valentine N Nfonsam
While topical thrombin application can markedly improve surgical hemostasis, rapid absorption of thrombin can result in pulmonary embolism and death. We report a case of accidental interstitial infiltration of topical thrombin after hemorrhoidectomy that was treated with administration of human antithrombin and heparin anticoagulation. Except for a marked decrease in antithrombin activity from super normal to normal values, the patient exhibited no laboratory or clinical signs of pulmonary embolism, thrombin mediated consumptive loss of procoagulants, or regional thrombosis...
October 28, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27765939/inadvertent-methylergonovine-administration-to-a-neonate
#13
Bryan M Corbett, Charles O'Connell, Mallory A Boutin, Nabil I Fatayerji, Charles W Sauer
BACKGROUND Methylergonovine is an ergot alkaloid used to treat post-partum hemorrhage secondary to uterine atony. Mistaking methylergonovine for vitamin K with accidental administration to the neonate is a rare iatrogenic illness occurring almost exclusively in the delivery room setting. Complications of ergot alkaloids in neonates include respiratory depression, seizures, and death. CASE REPORT A term infant was inadvertently given 0.1 mg of methylergonovine intramuscularly in the right thigh. The error was only noted when the vial of medication was scanned, after administration, identifying it as methylergonovine rather than vitamin K...
October 21, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27747732/accidental-overdose-of-oral-cyclosporine-in-haematopoietic-stem-cell-transplantation-a-case-report-and-literature-review
#14
Ali Tafazoli
A 26-year-old woman developed symptoms of acute toxicity during cyclosporine (CsA) therapy for graft-versus-host disease prophylaxis. The standard regimen included CsA in a dose of 1.5 mg/kg (120 mg) every 12 h, but, as a medication error, she received a high dose of 500 mg of oral CsA. After 2 h, she developed nausea and vomiting and, subsequently, flushing, chest tightness, tremor and vertigo. Laboratory and clinical examinations revealed high blood CsA concentrations (1000 ng/mL after 12 h) with a mild increase in blood pressure...
December 2015: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/27745972/advances-in-food-allergy-oral-immunotherapy-toward-tolerance
#15
Deborah M Hussey Freeland, Hua Fan-Minogue, Jonathan M Spergel, Talal A Chatila, Kari C Nadeau
The incidence of food allergy, a disease characterized by adverse immune responses that can render common foods life-threatening, is rising. Yet our current standard of care is simply avoidance of allergenic foods and administration of emergency medications upon accidental exposure. Significant advances have been made in food allergy oral immunotherapy, which is emerging as a potential preventive and curative treatment for this disease. The fundamental strategy of oral immunotherapy is to mitigate adverse immune responses to allergenic food proteins through repeated exposure; reduced reactivity to food allergens (desensitization) often results, but the establishment of sustained immune unresponsiveness or of permanent resolution (tolerance) is not certain...
October 13, 2016: Current Opinion in Immunology
https://www.readbyqxmd.com/read/27732129/new-pharmaceutical-approaches-for-the-treatment-of-food-allergies
#16
Ana Brotons-Canto, Nekane Martín-Arbella, Carlos Gamazo, Juan M Irache
Allergic diseases constitute one of the most common causes of chronic illness in developed countries. The main mechanism determining allergy is an imbalance between Th1 and Th2 response towards Th2. Areas covered: This review describes the mechanisms underlying the natural tolerance to food components and the development of an allergic response in sensitized individuals. Furthermore, therapeutic approaches proposed to manage these abnormal immunologic responses food are also presented and discussed. Expert opinion: In the past, management of food allergies has consisted of the education of patients to avoid the ingestion of the culprit food and to initiate the therapy (e...
October 12, 2016: Expert Opinion on Drug Delivery
https://www.readbyqxmd.com/read/27692553/-accidental-mercury-poisoning-in-a-12-year-old-girl
#17
F Alby-Laurent, N Honoré-Goldman, A Cavau, N Bellon, S Allali, V Abadie
INTRODUCTION: Exposure to metallic mercury can cause severe accidental intoxications in children, whose clinical symptoms can vary depending on the route of administration, the dose, as well as the time and duration of the exposure. It has become unusual in France, yet it must be considered when taking a patient's medical history in cases of multisystemic involvement without a clear explanation. CLINICAL CASE: We report the case of a 12-year-old patient hospitalized because of a cough, poor general condition, chills, night sweats, psychomotor retardation, and skin lesions that had been developing for several weeks...
September 27, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27637905/protection-of-mice-against-the-highly-pathogenic-vvihd-j-by-dna-and-fowlpox-recombinant-vaccines-administered-by-electroporation-and-intranasal-routes-correlates-with-serum-neutralizing-activity
#18
Massimiliano Bissa, Elena Quaglino, Carlo Zanotto, Elena Illiano, Valeria Rolih, Sole Pacchioni, Federica Cavallo, Carlo De Giuli Morghen, Antonia Radaelli
The control of smallpox was achieved using live vaccinia virus (VV) vaccine, which successfully eradicated the disease worldwide. As the variola virus no longer exists as a natural infection agent, mass vaccination was discontinued after 1980. However, emergence of smallpox outbreaks caused by accidental or deliberate release of variola virus has stimulated new research for second-generation vaccine development based on attenuated VV strains. Considering the closely related animal poxviruses that also arise as zoonoses, and the increasing number of unvaccinated or immunocompromised people, a safer and more effective vaccine is still required...
October 2016: Antiviral Research
https://www.readbyqxmd.com/read/27612910/an-unusual-case-of-suicide-attempt-using-intravenous-injection-of-kerosene
#19
M N Hasan, S R Sutradhar, S M Ahmed, I H Chowdhury
Kerosene belongs to the hydrocarbon group of compounds, used as a fuel for lamps, as well as heating and cooking in developing countries. Accidental kerosene poisoning and intoxication usually occur by inhalation or by occupational percutaneous absorption. Adults usually ingest kerosene for the purpose of self-harm, and children may ingest accidentally. Suicidal attempt using intravenous kerosene is an extra ordinary and very rare occurrence. A very few data are available regarding effects of intravenous administration of kerosene and its management...
July 2016: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/27600296/increased-time-to-pregnancy-is-associated-with-domestic-work-in-south-africa
#20
Braimoh Bello, Dick Heederik, Danuta Kielkowski, Kerry Wilson
BACKGROUND: The effects of female occupational exposures on fecundity have not been evaluated in South Africa. The aim of this study was to assess the effects of three specific occupational groups on time-to-pregnancy (TTP). METHODS: This cross-sectional study collected data, by means of a questionnaire, on 1210 women representative of a South African population, and sought information on: TTP for the most recent pregnancy, time-specific information on maternal factors and occupational exposures, as well as some paternal factors...
2016: Reproductive Health
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