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poisoning by benzodiazepines

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https://www.readbyqxmd.com/read/28160345/does-exposure-to-opioid-substitution-treatment-in-prison-reduce-the-risk-of-death-after-release-a-national-prospective-observational-study-in-england
#1
John Marsden, Garry Stillwell, Hayley Jones, Alisha Cooper, Brian Eastwood, Michael Farrell, Tim Lowden, Nino Maddalena, Chris Metcalfe, Jenny Shaw, Matthew Hickman
BACKGROUND AND AIMS: People with opioid use disorder (OUD) in prison face an acute risk of death after release. We estimated whether prison-based opioid substitution treatment (OST) reduces this risk. DESIGN: Prospective observational cohort study using prison healthcare, national community drug misuse treatment and deaths registers. SETTING: Recruitment at 39 adult prisons in England (32 male; 7 female) accounting for 95% of OST treatment in England during study planning...
February 4, 2017: Addiction
https://www.readbyqxmd.com/read/28160051/characterization-and-identification-of-eight-designer-benzodiazepine-metabolites-by-incubation-with-human-liver-microsomes-and-analysis-by-a-triple-quadrupole-mass-spectrometer
#2
Souleiman El Balkhi, Maxime Chaslot, Nicolas Picard, Sylvain Dulaurent, Martine Delage, Olivier Mathieu, Franck Saint-Marcoux
Designer benzodiazepines (DBZDs) have become of particular importance in the past few years. The metabolite monitoring of DBZD in biological fluids could be of great interest in clinical and forensic toxicology. However, DBZD metabolites are not known or not commercially available. The identification of some DBZD metabolites has been mostly explored by self-administration studies or by in vitro studies followed by high-resolution mass spectrometry. The question arose whether a unit resolution instrument could be efficient enough to allow the identification of DBZD metabolites...
February 4, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28073114/a-study-of-acute-poisoning-cases-admitted-to-the-university-hospital-emergency-department-in-tabriz-iran
#3
Mehdi Oraie, Mir-Jamal Hosseini, Mina Islambulchilar, Seyed-Hasan Hosseini, Mehdi Ahadi-Barzoki, Habib Sadr, Hashem Yaghoubi
Chemical substances have an important threat due to extensive use in medicine, agriculture, industry and environment. In this retrospective study, etiological and demographic characteristics of acute poisoning cases admitted to a hospital in Iran were investigated. We compared these data with those reported from other parts of the country and the international experiences to evaluate any difference if exists. 7 052 poisoned cases admitted to the hospital from April 2006 to March 2013, by data collected from the medical record in poison center section...
January 10, 2017: Drug Research
https://www.readbyqxmd.com/read/28007369/pentobarbital-in-the-context-of-possible-suicides-analysis-of-a-case
#4
Paula Melo, Pedro Costa, Maria José Quintas, André Castro, Sónia Tarelho, João Miguel Franco, Helena M Teixeira
Pentobarbital is a barbiturate, acting as a central nervous system depressant (CNS), being used for its anticonvulsant, sedative, hypnotic and anaesthetic properties. Barbiturates were replaced by benzodiazepines, leading to a decrease in poisoning cases with these compounds. However, pentobarbital is still used in many countries as an anaesthetic in veterinary medicine. Due to its properties, this compound is sought after by people who wish to commit suicide, acquiring it on the black market. The authors present an unusual fatal pentobarbital intoxication case, in a 37 years-old male salesperson, with no known connection with the veterinary field, being more difficult to obtain this compound...
December 8, 2016: Forensic Science International
https://www.readbyqxmd.com/read/27753564/a-3-year-comparison-of-overdoses-treated-in-a-military-emergency-department-complications-admission-rates-and-health-care-resources-consumed
#5
Victoria J Ganem, Alejandra G Mora, Nina Nnamani, Vikhyat S Bebarta
BACKGROUND: Drug overdose has become a leading cause of death in the United States and is a growing issue in civilian and military populations. Increasing prescription drug misuse and poisonings translate into greater utilization of medical resources. Our objective was to describe the incidences of overdoses and their associated events and outcomes following emergency department consult. METHODS: We performed a retrospective cohort study on cases evaluated in 2 military hospital emergency departments over 3 years...
October 2016: Military Medicine
https://www.readbyqxmd.com/read/27749797/adolescent-intentional-abuse-ingestions-overall-10-year-trends-and-regional-variation
#6
David C Sheridan, Robert G Hendrickson, Gillian Beauchamp, Amber Laurie, Rongwei Fu, B Zane Horowitz
OBJECTIVE: Adolescent intentional ingestions remain a significant public health problem in the United States with little research to date on the over-the-counter or prescription medicines that adolescents abuse. These data are important for anticipatory guidance by primary care providers, preventive health, and poison center outreach. METHODS: This was an observational study using the American Association of Poison Control Centers National Poison Data System. The study population consisted of all cases of patients aged 13 to 19 years from 2004 to 2013 with a coding of "intentional abuse...
October 4, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27741141/a-subtle-mimicker-in-emergency-department-illustrated-case-reports-of-acute-drug-induced-dystonia
#7
Maria Vittoria De Angelis, Roberta Di Giacomo, Antonio Di Muzio, Marco Onofrj, Laura Bonanni
BACKGROUND: Movement disorder emergencies include any movement disorder which develops over hours to days, in which failure to appropriately diagnose and manage can result in patient morbidity or mortality.Movement disorder emergencies include acute dystonia: sustained or intermittent muscle contractions causing abnormal, often repetitive, movements. Acute dystonia is a serious challenge for emergency room doctors and neurologists, because of the high probability of misdiagnosis, due to the presence of several mimickers including partial seizures, meningitis, localized tetanus, serum electrolyte level abnormalities, strychnine poisoning, angioedema, malingering, catatonia, and conversion...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27642738/-consciousness-disorders-from-toxicological-view
#8
Lukas Bündgens, Frank Tacke, Christian Trautwein, Alexander Koch
Poisoning with impaired mental state is a frequent cause for hospital admission. The initial management includes assessment of vital functions and airway management followed by focussed diagnostics. Poison Emergency Centers can provide valuable assistance in acute intoxications. Clinically important agents causing mental state alterations include opiates, benzodiazepines, tricyclic antidepressants, alcohol, methanol and ethylene glycol, carbon monoxide and salicylates. Most important therapeutic measures comprise supportive care, decontamination or elimination...
September 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27641627/mechanisms-of-tramadol-related-neurotoxicity-in-the-rat-does-diazepam-tramadol-combination-play-a-worsening-role-in-overdose
#9
Camille Lagard, Lucie Chevillard, Isabelle Malissin, Patricia Risède, Jacques Callebert, Laurence Labat, Jean-Marie Launay, Jean-Louis Laplanche, Bruno Mégarbane
Poisoning with opioid analgesics including tramadol represents a challenge. Tramadol may induce respiratory depression, seizures and serotonin syndrome, possibly worsened when in combination to benzodiazepines. Our objectives were to investigate tramadol-related neurotoxicity, consequences of diazepam/tramadol combination, and mechanisms of drug-drug interactions in rats. Median lethal-doses were determined using Dixon-Bruce's up-and-down method. Sedation, seizures, electroencephalography and plethysmography parameters were studied...
November 1, 2016: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/27591717/post-mortem-concentrations-of-drugs-determined-in-femoral-blood-in-single-drug-fatalities-compared-with-multi-drug-poisoning-deaths
#10
Alan Wayne Jones, Anita Holmgren, Johan Ahlner
BACKGROUND: Reference concentrations of drugs in post-mortem femoral blood furnishes useful information when poisoning (intoxication) deaths are investigated. However, few publications compare the concentrations of drugs in single-drug fatalities with multi-drug intoxications. This article attempts to fill this gap in knowledge. METHODS: We searched a national forensic toxicology database (TOXBASE) and found N=13,963 deaths attributed by pathologists to intoxication by drugs (poisoning)...
October 2016: Forensic Science International
https://www.readbyqxmd.com/read/27560966/associations-of-adverse-clinical-course-and-ingested-substances-among-patients-with-deliberate-drug-poisoning-a-cohort-study-from-an-intensive-care-unit-in-japan
#11
Kanako Ichikura, Yasuyuki Okumura, Takashi Takeuchi
OBJECTIVES: Some patients with deliberate drug poisoning subsequently have an adverse clinical course. The present study aimed to examine whether the type of drugs ingested and psychiatric diagnoses were related to an adverse clinical course. METHODS: We conducted a cohort study of patients with deliberate drug poisoning admitted to the intensive care unit of a university hospital located in Tokyo, Japan, between September 2006 and June 2013. Intensive care unit (ICU) stay of ≥4 days was used as a primary outcome measure, while the incidence of aspiration pneumonitis was used as a secondary outcome measure...
2016: PloS One
https://www.readbyqxmd.com/read/27557947/medical-encounters-for-opioid-related-intoxications-in-southern-nevada-sociodemographic-and-clinical-correlates
#12
Jing Feng, Joseph P Iser, Wei Yang
BACKGROUND: Despite today's heightened concern over opioid overdose, the lack of population-based data examining clinical and contextual factors associated with opioid use represents a knowledge gap with relevance to prevention and treatment interventions. We sought to quantify rates of emergency department (ED) visits and inpatient hospitalizations for harmful opioid effects and their sociodemographic differentials as well as clinical correlates in Southern Nevada, using ED visit and hospital inpatient discharge records from 2011 to 2013...
2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27520885/understanding-opioid-overdose-characteristics-involving-prescription-and-illicit-opioids-a-mixed-methods-analysis
#13
Bobbi Jo H Yarborough, Scott P Stumbo, Shannon L Janoff, Micah T Yarborough, Dennis McCarty, Howard D Chilcoat, Paul M Coplan, Carla A Green
BACKGROUND: Opioid abuse and misuse are significant public health issues. The CDC estimated 72% of pharmaceutical-related overdose deaths in the US in 2012 involved opioids. While studies of opioid overdoses have identified sociodemographic characteristics, agents used, administration routes, and medication sources associated with overdoses, we know less about the context and life circumstances of the people who experience these events. METHODS: We analyzed interviews (n=87) with survivors of opioid overdoses or family members of decedents...
October 1, 2016: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/27491700/adverse-events-related-to-the-new-psychoactive-substance-3-fluorophenmetrazine-results-from-the-swedish-strida-project
#14
Matilda Bäckberg, Jenny Westerbergh, Olof Beck, Anders Helander
BACKGROUND: New psychoactive substances (NPS) are often poorly pharmacologically documented and the production is unregulated, implying high risks for toxic side effects. This report from the STRIDA project describes analytically confirmed non-fatal intoxications involving the phenmetrazine analogue 3-fluorophenmetrazine (3-FPM). STUDY DESIGN AND METHODS: Observational case series of patients with suspected acute NPS exposure requiring hospital care. Blood and urine samples were collected from patients presenting in emergency departments (ED) or intensive care units (ICU), after consultation with the Swedish Poisons Information Centre (PIC)...
November 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27448790/near-death-from-a-novel-synthetic-opioid-labeled-u-47700-emergence-of-a-new-opioid-class
#15
Aaron Schneir, Imir G Metushi, Christian Sloane, David J Benaron, Robert L Fitzgerald
BACKGROUND: In the last decade there has been a worldwide surge in the recreational abuse of novel psychoactive substances, particularly amphetamine derivatives and synthetic cannabinoids. Synthetic opioids such as AH-7921, MT-45, and U-47700, with structures distinct from those ever used therapeutically or described recreationally, have also recently emerged. CASE DETAILS: We report a patient who suffered respiratory failure and depressed level of consciousness after recreationally using a novel synthetic opioid labeled U-47700...
January 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/27418198/characterization-of-edible-marijuana-product-exposures-reported-to-united-states-poison-centers
#16
Dazhe Cao, Sahaphume Srisuma, Alvin C Bronstein, Christopher O Hoyte
CONTEXT: Edible marijuana products are sold as brownies, cookies, and candies, which may be indistinguishable from counterparts without marijuana and are palatable to children and adults. The consumption of an entire product containing multiple dose-units may result in overdose. OBJECTIVE: To characterize edible marijuana exposures reported to US poison centers with subgroup analysis by age. METHODS: We analyzed single substance, human exposure calls coded to marijuana brownies, candies, cookies, beverages, or other foods reported to the National Poison Data System from January 2013 to December 2015...
November 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27412885/toxicity-evaluation-of-%C3%AE-pyrrolidinovalerophenone-%C3%AE-pvp-results-from-intoxication-cases-within-the-strida-project
#17
Olof Beck, Lisa Franzén, Matilda Bäckberg, Patrick Signell, Anders Helander
CONTEXT: An increasing number of new psychoactive substances (NPS) of different chemical classes have become available through marketing and sale over the Internet. This report from the Swedish STRIDA project presents the prevalence, laboratory results, and clinical features in a series of intoxications involving the stimulant NPS α-pyrrolidinovalerophenone (α-PVP), a potent dopamine re-uptake inhibitor, over a 4-year period. STUDY DESIGN: Observational case series of consecutive patients with admitted or suspected intake of NPS presenting to hospitals in Sweden from 2012 to 2015...
August 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27249421/increase-in-self-injury-as-a-method-of-self-harm-in-ghent-belgium-1987-2013
#18
Nikita Vancayseele, Gwendolyn Portzky, Kees van Heeringen
BACKGROUND: Self-harm is a major health care problem and changes in its prevalence and characteristics can have important implications for suicide prevention. The objective was to describe trends in the epidemiology of self-harm based on emergency department (A&E departments) visits over a 26-year period in Ghent, Belgium. METHODS: We analyzed data on all self-harm presentations from the three large general hospitals in Ghent between 1987 and 2013. We investigated trends in prevalence (events by year per 100...
2016: PloS One
https://www.readbyqxmd.com/read/27249075/benzodiazepine-use-and-risk-of-mortality-among-patients-with-schizophrenia-a-retrospective-longitudinal-study
#19
Cynthia A Fontanella, John V Campo, Gary S Phillips, Danielle L Hiance-Steelesmith, Helen Anne Sweeney, Kwok Tam, Douglas Lehrer, Robert Klein, Mark Hurst
OBJECTIVE: This study examined the association between benzodiazepine use alone or in combination with antipsychotics and risk of mortality in patients with schizophrenia. METHODS: A retrospective longitudinal analysis was performed using Medicaid claims data merged with death certificate data for 18,953 patients (aged 18-58 years) with ICD-9-diagnosed schizophrenia followed from July 1, 2006, to December 31, 2013. Cox proportional hazard analyses were used to estimate the risk of all-cause mortality associated with benzodiazepine use; adjustment was made for a wide array of fixed and time-varying confounders, including demographics, psychiatric and medical comorbidities, and other psychotropic medications...
May 2016: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/27222239/retrospective-case-series-analysis-of-characteristics-and-trends-in-unintentional-pharmaceutical-drug-poisoning-by-methadone-opioid-analgesics-antidepressants-and-benzodiazepines-in-clark-county-nv-2009-13
#20
Tamara Bruno, Jennifer R Pharr
BACKGROUND: Poisoning has become the leading cause of injury death in the USA-with opioid analgesic involved in more fatal poisonings than any other drug, including cocaine and heroin. The epidemic of prescription drug poisonings is a public health concern. This study aimed to define potential high-risk groups for unintentional prescription drug poisoning by methadone, opioid analgesics, antidepressants or benzodiazepines. METHODS: A hospital-based retrospective case series analysis of admissions related to prescription drug poisonings associated with methadone, opioid analgesics, antidepressants or benzodiazepines for hospitals in Clark County, Nevada between 2009 and 2013 was employed...
May 24, 2016: Journal of Public Health
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