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https://www.readbyqxmd.com/read/27898722/suicide-among-young-people-and-adults-in-ireland-method-characteristics-toxicological-analysis-and-substance-abuse-histories-compared
#1
Ella Arensman, Marco Bennardi, Celine Larkin, Amanda Wall, Carmel McAuliffe, Jacklyn McCarthy, Eileen Williamson, Ivan J Perry
OBJECTIVE: Information on factors associated with suicide among young individuals in Ireland is limited. The aim of this study was to identify socio-demographic characteristics and circumstances of death associated with age among individuals who died by suicide. METHODS: The study examined 121 consecutive suicides (2007-2012) occurring in the southern eastern part of Ireland (Cork city and county). Data were obtained from coroners, family informants, and health care professionals...
2016: PloS One
https://www.readbyqxmd.com/read/27889404/adolescent-suicidal-ingestion-national-trends-over-a-decade
#2
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...
November 23, 2016: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/27884585/the-successful-treatment-of-5-fluorouracil-5-fu-overdose-in-a-patient-with-malignancy-and-hiv-aids-with-uridine-triacetate
#3
Cynthia Santos, Brent W Morgan, Robert J Geller
According to the NIH, about 275000 patients receive treatment with 5-Fluorouracil (5-FU) and more than 1300 die from 5-FU toxicity every year from life-threatening myelosuppression, gastrointestinal complications, and neurotoxicity. Immunocompromised persons are at higher risk of developing toxicity. Recently uridine triacetate (Vistagard®) has been approved by the Food and Drug Administration (FDA) as the only specific antidote available for 5-FU poisoning. In a clinical trial (n=135), 96% of patients with 5-FU toxicity recovered after treatment, where as in a historical control group only 10% survived...
November 15, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27876395/massive-lamotrigine-poisoning-a-case-report
#4
Salvatore Grosso, Silvia Ferranti, Carla Gaggiano, Elisabetta Grande, Barbara Loi, Rosanna Di Bartolo
Lamotrigine (LTG) represents the most commonly prescribed of the so-called new generation antiepileptic drugs. We describe a child who was admitted to the emergency room because of generalized tonic-clonic status epilepticus followed by a complex neurological picture with hyperkinesia and acute ataxia as a result of a LTG intoxication. The experience on acute LTG intoxication is very limited in pediatrics. The present case provides information on the clinical picture related to LTG overdose and confirms that drug intoxications should be considered in the differential diagnosis strategy when severe and polymorphic neurological symptoms occur acutely...
November 19, 2016: Brain & Development
https://www.readbyqxmd.com/read/27876104/a-cohort-study-of-unstable-overdose-patients-treated-with-intravenous-lipid-emulsion-therapy
#5
Shazma Mithani, Kathryn Dong, Ashlea Wilmott, Heather Podmoroff, Nadim Lalani, Rhonda J Rosychuk, Ryan Chuang, Mark C Yarema
OBJECTIVES: Intravenous lipid emulsion (ILE) has been used increasingly over the last decade for a range of drug overdoses. Although the use of ILE in local anesthetic toxicity (LAST) is well established, the hemodynamic effectiveness of ILE in non-LAST poisonings is still unclear. Thus, the primary objective of this study was to examine a cohort of poisoned patients in whom ILE was administered. METHODS: Consecutive patients were identified by calls to a regional poison center from May 1, 2012 to May 30, 2014...
November 23, 2016: CJEM
https://www.readbyqxmd.com/read/27845815/%C3%A3-verdosering-av-paracetamol-med-modifierad-fris%C3%A3-ttning-%C3%A3-kar-etablerad-behandlingsregim-med-n-acetylcystein-otillr%C3%A3-cklig-%C3%A2-giftinformationscentralen-ger-ut-nya-behandlingsr%C3%A3-d
#6
Jonas Höjer, Helene Salmonson, Gunilla Sjöberg, Markus Tellerup, Jacob Brogren
Overdose of modified-release paracetamol calls for changed treatment routines. New guidelines from the Swedish Poisons Information Centre  The sales of modified-release paracetamol tablets are steadily increasing in Sweden as are the number of overdose cases with this formulation. The Swedish Poisons Information Centre has noted that the standard treatment protocol with N-acetylcysteine (NAC), which is based on overdoses with immediate-release paracetamol formulations, is often inadequate in this setting. In this paper, an adult who overdosed on 66...
November 10, 2016: Läkartidningen
https://www.readbyqxmd.com/read/27830905/-drug-safety-associated-with-the-change-of-digitalis-drug-in-norway
#7
Christian Haga, Mimi Stokke Opdal, Silja Skogstad Tuv, Per Henrik Zahl, Hanne Stenberg-Nilsen
BACKGROUND In 2011, following a period with delivery problems, the only registered digitoxin drug in Norway was replaced with digoxin. As a result, approximately 21 000 patients had to replace digitoxin with digoxin. There are important pharmacokinetic differences between digitoxin and digoxin (the general term for both drugs is digitalis), which must be taken into account when changing therapy. The aim of this study was to investigate compliance of drug security, during the transition from digitoxin to digoxin in Norway...
November 2016: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
https://www.readbyqxmd.com/read/27810724/age-related-differences-in-self-harm-presentations-and-subsequent-management-of-adolescents-and-young-adults-at-the-emergency-department
#8
Emma Diggins, Rachael Kelley, David Cottrell, Allan House, David Owens
BACKGROUND: Characteristics of self-harm differ across ages, but there is little work identifying age-related differences in younger people. Young people entering adolescence face emotionally and developmentally different challenges to those entering adulthood. This study investigates how Emergency Department (ED) presentations and management of self-harm differ through adolescence and early adulthood. METHODS: 3782 consecutive self-harm episodes involving 2559 people aged 12-25 years were identified from an existing database of Leeds ED attendances from 2004 to 2007...
October 21, 2016: Journal of Affective Disorders
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...
October 28, 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27788591/chloroform-ingestion-causing-severe-gastrointestinal-injury-hepatotoxicity-and-dermatitis-confirmed-with-plasma-chloroform-concentrations
#10
Dushan Jayaweera, Shawkat Islam, Naren Gunja, Chris Cowie, James Broska, Latesh Poojara, Michael S Roberts, Geoffrey K Isbister
CONTEXT: Poisoning due to chloroform ingestion is rare. The classic features of acute chloroform toxicity include central nervous system (CNS) and respiratory depression, and delayed hepatotoxicity. CASE DETAILS: A 30-year-old female ingested 20-30 mL of 99% chloroform solution, which caused rapid loss of consciousness, transient hypotension and severe respiratory depression requiring endotracheal intubation and ventilation. She was alert by 12 h and extubated 16 h post-overdose...
October 28, 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27785820/central-nervous-system-toxicity-of-mefenamic-acid-overdose-compared-to-other-nsaids-an-analysis-of-cases-reported-to-the-united-kingdom-national-poisons-information-service
#11
A Kamour, S Crichton, G Cooper, D J Lupton, M Eddleston, J A Vale, J P Thompson, S H L Thomas
AIMS: Case reports and small case series suggest increased Central Nervous System (CNS) toxicity especially convulsions, after overdose of mefenamic acid, compared with other NSAIDs, but comparative epidemiological studies have not been conducted. This study compared rates of CNS toxicity after overdose between mefenamic acid, ibuprofen, diclofenac and naproxen, as reported in telephone enquiries to the United Kingdom National Poisons Information Service (NPIS). METHODS: NPIS telephone enquiries related to the four NSAIDs received between January 2007 and December 2013 were analysed, comparing the frequency of reported CNS toxicity (convulsions, altered conscious level, agitation or aggression, confusion or disorientation) using multivariable logistic regression...
October 26, 2016: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27763703/performance-measures-of-diagnostic-codes-for-detecting-opioid-overdose-in-the-emergency-department
#12
Christopher Rowe, Eric Vittinghoff, Glenn-Milo Santos, Emily Behar, Caitlin Turner, Phillip Coffin
OBJECTIVES: Opioid overdose mortality has tripled in the USA since 2000 and opioids are responsible for more than half of all drug overdose deaths, which reached an all-time high in 2014. Opioid overdoses resulting in death, however, represent only a small fraction of all opioid overdose events and efforts to improve surveillance of this public health problem should include tracking nonfatal overdose events. International Classification of Disease (ICD) diagnosis codes, increasingly used for the surveillance of nonfatal drug overdose events, have not been rigorously assessed for validity in capturing overdose events...
October 20, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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
#13
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/27752614/clinical-outcomes-of-adverse-cardiovascular-events-in-patients-with-acute-dapsone-poisoning
#14
Kyung Sik Kang, Hyung Il Kim, Oh Hyun Kim, Kyoung Chul Cha, Hyun Kim, Kang Hyun Lee, Sung Oh Hwang, Yong Sung Cha
OBJECTIVE: Adverse cardiovascular events (ACVEs) account for a large proportion of the morbidities and mortalities associated with drug overdose emergencies. However, there are no published reports regarding outcomes of ACVEs associated with acute dapsone poisoning. Here, the authors retrospectively analyzed ACVEs reported within 48 hours of treatment in patients with acute dapsone poisoning and assessed the significance of ACVEs as early predictors of mortality. METHODS: Sixty-one consecutive cases of acute dapsone poisoning that were diagnosed and treated at a regional emergency center between 2006 and 2014 were included in the study...
March 2016: Clin Exp Emerg Med
https://www.readbyqxmd.com/read/27749631/complete-recovery-after-acute-zonisamide-overdose-in-an-adolescent-female
#15
Charlayne McStay, Richard Pierce, Carley Riley
Zonisamide is a sulfonamide drug used primarily for the treatment of partial seizures in adults. We describe the case of a 15-year-old woman with a mood disorder who survived without complications after ingestion of an estimated 7.5 g of zonisamide. To the best of our knowledge, there are 4 case reports of individuals with intentional ingestion of more than 4 g of zonisamide as a single agent. Our patient developed coma and hypotension 4 hours after ingestion and was treated with a catecholamine infusion, endotracheal intubation, and mechanical ventilation...
September 30, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27736263/adverse-events-associated-with-pediatric-exposures-to-dextromethorphan
#16
Ian M Paul, Kate M Reynolds, Ralph E Kauffman, William Banner, G Randall Bond, Robert B Palmer, Randy I Burnham, Jody L Green
STUDY OBJECTIVE: Dextromethorphan is the most common over-the-counter (OTC) antitussive medication. We sought to characterize adverse events associated with dextromethorphan in children <12 years old from a surveillance program of OTC cough/cold medication exposures. METHODS: This is a retrospective case series of oral exposures to dextromethorphan with ≥1 adverse event from multiple U.S. sources (National Poison Data System, FDA Adverse Event Reporting System, manufacturer safety reports, news/media, medical literature) reported between 2008 and 2014...
October 13, 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27718162/impact-of-the-use-of-regional-poison-control-centers-in-an-urban-ems-dispatch-system
#17
Michael Levine, John Flores, Seth A Seabury, Stephen Sanko, Marc Eckstein
BACKGROUND: The public commonly calls 911 for unintentional ingestions, rather than calling the local poison center. By utilizing a series of scripted questions, 911 dispatchers in Los Angeles determine if an ingestion meets "omega-1" classification. Under such circumstances, the regional poison center is contacted prior to dispatch of paramedics. If the poison center advises that the patient can remain at home, EMS is not dispatched and the patient is followed at home by the poison center...
October 7, 2016: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/27673424/drugs-guns-and-cars-how-far-we-have-come-to-improve-safety-in-the-united-states-yet-we-still-have-far-to-go
#18
James Dodington, Pina Violano, Carl R Baum, Kirsten Bechtel
Significant breakthroughs in the field of injury prevention and childhood safety have occurred during the past half-century. For example, the Poison Prevention Packaging Act of 1970 and the institution of child passenger safety laws are responsible for a significant reduction in injuries among children and adolescents. This review will focus on the following three topics because of their significant contribution to pediatric injury morbidity, especially among adolescents, and their promise for further effective prevention research...
September 27, 2016: Pediatric Research
https://www.readbyqxmd.com/read/27641930/an-observational-study-using-english-syndromic-surveillance-data-collected-during-the-2012-london-olympics-what-did-syndromic-surveillance-show-and-what-can-we-learn-for-future-mass-gathering-events
#19
Dan Todkill, Helen E Hughes, Alex J Elliot, Roger A Morbey, Obaghe Edeghere, Sally Harcourt, Tom Hughes, Tina Endericks, Brian McCloskey, Mike Catchpole, Sue Ibbotson, Gillian Smith
: Introduction In preparation for the London 2012 Olympic Games, existing syndromic surveillance systems operating in England were expanded to include daily general practitioner (GP) out-of-hours (OOH) contacts and emergency department (ED) attendances at sentinel sites (the GP OOH and ED syndromic surveillance systems: GPOOHS and EDSSS). Hypothesis/Problem The further development of syndromic surveillance systems in time for the London 2012 Olympic Games provided a unique opportunity to investigate the impact of a large mass-gathering event on public health and health services as monitored in near real-time by syndromic surveillance of GP OOH contacts and ED attendances...
December 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27641627/mechanisms-of-tramadol-related-neurotoxicity-in-the-rat-does-diazepam-tramadol-combination-play-a-worsening-role-in-overdose
#20
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
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