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Acetaminophen poisoning

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https://www.readbyqxmd.com/read/28293919/-extracorporeal-liver-support-of-liver-failure
#1
Hans Ulrich Gerth, Michele Pohlen, Hermann Pavenstädt, Hartmut Schmidt
Extracorporeal liver support can be classified into cell-free, artificial methods (artificial liver support, ALS) and cell-based bioartificial methods (bioartificial liver support, BLS). ALS improves biochemical parameters of liver failure by the simultaneous removal of protein-bound and water-soluble substances. Here, the MARS therapy belongs to the most studied methods with a proved beneficial effect on hepatic encephalopathy (HE), hepatorenal syndrome (HRS) or hyperbilirubinemia. However, a general survival advantage of any liver support for liver failure has not been shown yet and is restricted to meta-analyses or patient subgroups...
March 14, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28263541/phone-camera-detection-of-glucose-blood-level-based-on-magnetic-particles-entrapped-inside-bubble-wrap
#2
Pavla Martinkova, Miroslav Pohanka
OBJECTIVES: Glucose is an important diagnostic biochemical marker of diabetes but also for organophosphates, carbamates, acetaminophens or salicylates poisoning. Hence, innovation of accurate and fast detection assay is still one of priorities in biomedical research. METHODS: Glucose sensor based on magnetic particles (MPs) with immobilized enzymes glucose oxidase (GOx) and horseradish peroxidase (HRP) was developed and the GOx catalyzed reaction was visualized by a smart-phone-integrated camera...
December 18, 2016: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/28151858/epidemiologic-profile-and-triggering-factors-of-voluntary-poisoning-in-teenagers
#3
Nicolai Nistor, Cristina Jitareanu, Otilia Elena Frasinariu, Irina Mihaela Ciomaga, Aniela Luminita Rugina, Violeta Streanga
Self-poisoning is an important medical and social problem in adolescents.We performed an observational cross-sectional retrospective study on a group of 219 adolescents admitted for voluntary intoxications at "St. Mary" Children's Emergency Hospital, Iasi during 1 year period. Epidemiological aspects and triggering factors have been analyzed. Data collected from the patients' files were centralized in an SPSS 18.0 database and processed with confidence interval of 95%.We found that pharmaceutical drugs have been usually involved (34...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28128086/vesicular-contact-reaction-may-progress-into-erythema-multiforme
#4
Magdalena Czarnecka-Operacz, Dorota Jenerowicz, Joanna Szulczyńska-Gabor, Ewa Teresiak-Mikołajczak, Joanna Szyfter-Harris, Monika Bowszyc-Dmochowska
Dear Editor, Erythema multiforme is considered an acute skin condition, characterized by a self-limiting and sometimes recurrent course. It is regarded as a type IV hypersensitivity reaction associated with certain infections, medications, and other various triggers. Allergic contact dermatitis is in turn a delayed type of induced allergy as a result of cutaneous contact with a specific allergen to which the patient develops specific sensitivity. This type of cutaneous reaction is associated with inflammation manifesting with erythema, edema, and vesicles...
December 2016: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/28121975/international-epidemiological-differences-in-acute-poisonings-in-pediatric-emergency-departments
#5
Santiago Mintegi, Beatriz Azkunaga, Javier Prego, Nadeem Qureshi, Stuart R Dalziel, Eunate Arana-Arri, Yordana Acedo, Lorea Martinez-Indart, Arantza Urkaregi, Nerea Salmon, Javier Benito, Nathan Kuppermann
BACKGROUND AND OBJECTIVE: Identifying international differences in the epidemiology of acute poisonings in children may help in improving prevention. We sought to evaluate the international epidemiological differences in acute poisonings in children presenting to emergency departments (EDs) from 8 different global regions. METHODS: This was an international multicenter cross-sectional prospective study including children younger than 18 years with acute poisonings presenting to 105 EDs in 20 countries was conducted...
January 24, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28096230/haemodialysis-in-acute-paracetamol-poisoning
#6
L Serjeant, J Evans, F Sampaziotis, W G Petchey
A woman aged 23 years presented late with clinical and biochemical features of a life-threatening paracetamol (acetaminophen) overdose. Despite instigating N-acetylcysteine treatment, due to evidence of mitochondrial dysfunction together with an exceedingly high paracetamol level, the decision was made to dialyse the patient acutely to remove the parent drug. This was highly effective, and with on-going supportive care, the patient made a full recovery without the need for transplantation. This case highlights the role of extracorporeal therapy as a treatment option in selected cases of paracetamol overdose, consistent with the international guidelines...
January 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/27957731/development-of-rapid-and-economical-colorimetric-screening-method-for-p-phenylenediamine-in-variety-of-biological-matrices-and-its-application-to-eleven-fatal-cases-of-p-phenylenediamine-poisoning
#7
Muhammad Imran, Hafiz Faisal Usman, Humera Shafi, Muhammad Sarwar, Muhammad Ashraf Tahir
A rapid colorimetric method for detection of p-phenylenediamine (PPD) in various biological samples is developed. The o-cresol test for acetaminophen detection has been modified to detect PPD in blood, urine, gastric contents, and liver. After precipitating protein with trichloroacetic acid solution (2 mL, 10% w/v), biological specimens were required to convert PPD metabolites to PPD by acid hydrolysis. Finally, o-cresol solution (1 mL, 1% w/v), hydrogen peroxide (200 μL, 3%v/v), and concentrated ammonium hydroxide (0...
December 13, 2016: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27889404/adolescent-suicidal-ingestion-national-trends-over-a-decade
#8
David C Sheridan, Robert G Hendrickson, Amber L Lin, Rongwei Fu, B Zane Horowitz
PURPOSE: Suicide attempts by adolescents most commonly involve the overdose of medications. To date, there has been little information on the over-the-counter or prescription medicines that adolescents ingest for self-harm. Identification of medications chosen in suicide attempts may help guide anticipatory guidance to parents by primary care providers and Poison Centers in prevention programs. METHODS: This was a retrospective observational study using the American Association of Poison Control Center's National Poison Data System...
February 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/27788602/can-a-serum-acetaminophen-concentration-obtained-less-than-4-hours-post-ingestion-determine-which-patients-do-not-require-treatment-with-acetylcysteine
#9
Mark C Yarema, Jason P Green, Marco L A Sivilotti, David W Johnson, Alberto Nettel-Aguirre, Charlemaigne Victorino, Daniel A Spyker, Barry H Rumack
CONTEXT: The interpretation of acetaminophen concentrations obtained prior to 4 hours after an acute, single overdose remains unclear. Patient care decisions in the Emergency Department could be accelerated if such concentrations could reliably exclude the need for treatment. OBJECTIVE: To determine the agreement between a serum acetaminophen concentration obtained less than 4 hours after an acute ingestion and the subsequent 4 + hour concentration, and the predictive accuracy of early concentrations for identifying patients with potentially toxic exposures...
February 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/27604786/brown-tree-snake-boiga-irregularis-population-density-and-carcass-locations-following-exposure-to-acetaminophen
#10
Joshua B Smith, Kelsey L Turner, James C Beasley, Travis L DeVault, William C Pitt, Olin E Rhodes
Mass aerial delivery of dead mouse baits treated with acetaminophen has been evaluated as a means to reduce brown tree snake (Boiga irregularis) populations over large areas, increasing the likelihood of wide-scale eradication on Guam. Given the high density of snakes in some areas of their invasive range, eradication efforts could result in a resource pulse that may influence food web dynamics and the indirect transport of acetaminophen among trophic levels. We evaluated abundance, habitat type, and snake size (i...
October 2016: Ecotoxicology
https://www.readbyqxmd.com/read/27595368/analysis-of-gastric-lavage-reported-to-a-statewide-poison-control-system
#11
Jimmy Donkor, Patil Armenian, Isaac N Hartman, Rais Vohra
BACKGROUND: As decontamination trends have evolved, gastric lavage (GL) has become a rare procedure. The current information regarding use, outcomes, and complications of GL could help refine indications for this invasive procedure. OBJECTIVES: We sought to determine case type, location, and complications of GL cases reported to a statewide poison control system. METHODS: This is a retrospective review of the California Poison Control System (CPCS) records from 2009 to 2012...
October 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27463118/double-peaked-acetaminophen-concentration-secondary-to-intestinal-trauma
#12
B Alyahya, S Tamur, S Aljenedil, A Larocuque, E Holody, S Gosselin
BackgroundReduced gastrointestinal motility can alter the toxicokinetics of acetaminophen poisoning. We report a case of altered acetaminophen toxicokinetics due to delayed gastrointestinal absorption, likely secondary to intestinal trauma/surgery.  Case ReportA 37-year-old woman ingested an unknown amount of acetaminophen and ethanol then stabbed herself in the abdomen. The initial acetaminophen was 1,285.9 μmol/L and the time of ingestion was not known. Intravenous acetylcysteine protocol was started. She developed an ileus post-surgery for the stab wounds...
2016: Journal of Population Therapeutics and Clinical Pharmacology
https://www.readbyqxmd.com/read/27383404/a-large-case-series-of-acute-pediatric-methotrexate-ingestions-significant-clinical-effects-are-rare
#13
Matthew D Hensley, Vikhyat S Bebarta, Douglas J Borys
OBJECTIVE: Significant adverse effects after acute pediatric methotrexate (MTX) exposures have been limited to parenteral exposures. Treatment recommendations for pediatric MTX exposures do not differentiate between routes of exposure. We report the incidence of significant clinical effects and drug-specific treatments reported in a large series of acute, pediatric MTX ingestions. METHODS: Poison center records of all MTX ingestions by patients younger than 17 years during 2000 to 2005 were collected from 6 poison centers...
October 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27350835/results-of-liver-transplantation-in-patients-with-acute-liver-failure-due-to-amanita-phalloides-and-paracetamol-acetaminophen-intoxication
#14
Maciej Krasnodębski, Michał Grąt, Wacław Hołówko, Łukasz Masior, Karolina M Wronka, Karolina Grąt, Jan Stypułkowski, Waldemar Patkowski, Marek Krawczyk
INTRODUCTION: Amanita phalloides and paracetamol intoxications are responsible for the majority of acute liver failures. AIM: To assess survival outcomes and to analyse risk factors affecting survival in the studied group. MATERIAL AND METHODS: Of 1369 liver transplantations performed in the Department of General, Transplant, and Liver Surgery, Medical University of Warsaw before December 2013, 20 (1.46%) patients with Amanita phalloides (n = 13, 0...
2016: Przegla̜d Gastroenterologiczny
https://www.readbyqxmd.com/read/27302828/chemokine-c-c-motif-receptor-2-positive-monocytes-aggravate-the-early-phase-of-acetaminophen-induced-acute-liver-injury
#15
Jana C Mossanen, Oliver Krenkel, Can Ergen, Olivier Govaere, Anke Liepelt, Tobias Puengel, Felix Heymann, Sandra Kalthoff, Eric Lefebvre, Dirk Eulberg, Tom Luedde, Gernot Marx, Christian P Strassburg, Tania Roskams, Christian Trautwein, Frank Tacke
Acetaminophen (APAP, paracetamol) poisoning is a leading cause of acute liver failure (ALF) in humans and induces hepatocyte necrosis, followed by activation of the innate immune system, further aggravating liver injury. The role of infiltrating monocytes during the early phase of ALF is still ambiguous. Upon experimental APAP overdose in mice, monocyte-derived macrophages (MoMFs) massively accumulated in injured liver within 12-24 hours, whereas the number of tissue-resident macrophages (Kupffer cells) decreased...
November 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27180426/serum-antioxidant-parameters-in-patients-poisoned-by-different-xenobiotics
#16
COMPARATIVE STUDY
Piotr Hydzik, Mirosław Krośniak, Renata Francik, Ewa Gomółka, Ebru Derici Ebru, Paweł Zagrodzki
There is a great diversity of the acute drugs overdose cases in clinical toxicology. Clinical situation is complicated by the coexistence of factors predisposing to the development of adverse drug reactions (chronic use of drugs, polypharmacy, alcohol or drugs dependence, nutritional disorders) and by the presence of chronic organ damage, especially the liver and the kidney. The aim of this study was to evaluate whether there are sensitive plasma markers belonging to the antioxidant system in patients exposed to various xenobiotics...
March 2016: Acta Poloniae Pharmaceutica
https://www.readbyqxmd.com/read/27123589/counterfeit-norco-poisoning-outbreak-san-francisco-bay-area-california-march-25-april-5-2016
#17
Kathy T Vo, Xander M R van Wijk, Kara L Lynch, Alan H B Wu, Craig G Smollin
On March 28, 2016, two patients were evaluated at the Contra Costa Regional Medical Center emergency department (ED) in Contra Costa County, California, for nausea, vomiting, central nervous system depression, and respiratory depression, 30 minutes after ingesting what appeared to be Norco, a prescription opioid pain medication that contains acetaminophen and hydrocodone. The patients purchased the drug from a friend a few days earlier. The two cases of drug intoxication were reported to a Contra Costa County Health Department public health official who subsequently notified the California State Health Department...
April 29, 2016: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/27118496/massive-acetaminophen-overdose-effect-of-hemodialysis-on-acetaminophen-and-acetylcysteine-kinetics
#18
Marc Ghannoum, Sara Kazim, Ami M Grunbaum, Eric Villeneuve, Sophie Gosselin
CONTEXT: Early onset acidosis from mitochondrial toxicity can be observed in massive acetaminophen poisoning prior to the development of hepatotoxicity. In this context, the efficacy of acetylcysteine to reverse mitochondrial toxicity remains unclear and hemodialysis may offer prompt correction of acidosis. Unfortunately, toxicokinetics of acetaminophen and acetylcysteine during extracorporeal treatments hemodialysis have seldom been described. CASE DETAILS: An 18-year-old woman presented to the emergency department 60 minutes after ingestion of 100 g of acetaminophen, and unknown amounts of ibuprofen and ethanol...
July 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27117657/routine-biological-tests-in-self-poisoning-patients-results-from-an-observational-prospective-multicenter-study
#19
MULTICENTER STUDY
Thomas Reydel, Jean-Christophe Callahan, Laurent Verley, Christelle Teiten, Christophe Andreotti, Yann Erick Claessens, David Missud, Erwan L'Her, Gael Le Roux, Nicolas Lerolle
CONTEXT: Routine biological tests are frequently ordered in self-poisoning patients, but their clinical relevance is poorly studied. MATERIALS AND METHODS: This is a prospective multicentric observational study conducted in the emergency departments and intensive care units of 5 university and nonuniversity French hospitals. Adult self-poisoning patients without severely altered vital status on admission were prospectively included. RESULTS: Routine biological test (serum electrolytes and creatinine, liver enzymes, bilirubin, blood cell count, prothrombin time) ordering and results were analyzed...
August 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27049274/deliberate-drug-poisonings-admitted-to-an-emergency-department-in-paris-area-a-descriptive-study-and-assessment-of-risk-factors-for-intensive-care-admission
#20
S Beaune, P Juvin, A Beauchet, E Casalino, B Megarbane
OBJECTIVE: Each year, approximately 165,000 poisonings are managed in the emergency departments (ED) in France. We performed a descriptive analysis of self-poisoned patients admitted to a university hospital ED in the Paris metropolitan area (France) aimed at investigating their outcome and the risk factors for transfer to the intensive care unit (ICU). PATIENTS AND METHODS: We retrospectively reviewed patients' records and performed multivariate logistic regression analysis to identify risk factors for ICU admission...
2016: European Review for Medical and Pharmacological Sciences
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