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https://www.readbyqxmd.com/read/28541758/suicide-risk-in-young-men-and-women-after-substance-intoxication
#1
Marlene Stenbacka, Mats Samuelsson, Peter Nordström, Jussi Jokinen
This study investigates suicide and overdoses in 1119 consecutive patients (64% women), 15 to 34 years of age, presenting at the emergency department after self-poisoning from1994 to 2000 and followed regarding death up to 2006. Regression and Kaplan-Meier survival analyses were performed for suicide and other causes of death. The patients had about a 60 times higher risk (SMR = 61.95) of death due to suicide and 26 times higher (SMR = 26.47) for all-cause mortality. Men had a nearly two times higher risk for suicide than women and half of the suicides occurred during the first two years after admission...
May 25, 2017: Archives of Suicide Research: Official Journal of the International Academy for Suicide Research
https://www.readbyqxmd.com/read/28507634/multi-system-complications-after-intravenous-cocaine-abuse
#2
Lidija Petkovska, Andon Chibishev, Aleksandra Stevcevska, Ivica Smokovski, Dusan Petkovski, Emilija Antova
BACKGROUND: Use and abuse of cocaine are associated with numerous adverse effects, independent of the route of administration. More severe conditions of poisoning, however, are observed after cocaine intravenous administration. AIM: We present a case of severe poisoning after violent intravenous injection of cocaine, but with a good outcome. CASE PRESENTATION: Cocaine was intravenously (i.v.) administered in 16-years old female patient as a homicide attempt...
April 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28506507/syndrome-surveillance-of-fentanyl-laced-heroin-outbreaks-utilization-of-ems-medical-examiner-and-poison-center-databases
#3
P Quincy Moore, Joseph Weber, Steven Cina, Steven Aks
OBJECTIVE: Describe surveillance data from three existing surveillance systems during an unexpected fentanyl outbreak in a large metropolitan area. METHODS: We performed a retrospective analysis of three data sets: Chicago Fire Department EMS, Cook County Medical Examiner, and Illinois Poison Center. Each included data from January 1, 2015 through December 31, 2015. EMS data included all EMS responses in Chicago, Illinois, for suspected opioid overdose in which naloxone was administered and EMS personnel documented other criteria indicative of opioid overdose...
May 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28481828/analysis-of-interventions-required-in-12-021-children-with-acute-intoxications-admitted-to-picus
#4
Meral M Patel, Curtis D Travers, Jana A Stockwell, Robert J Geller, Pradip P Kamat, Jocelyn R Grunwell
OBJECTIVES: Acute intoxications in children account for 4.6% of annual admissions to the PICU. We aimed to describe the interventions and monitoring required for children admitted to the PICU following intoxications with the ultimate goal of determining patient and intoxication characteristics associated with the need for PICU interventions. DESIGN: Retrospective review of prospectively collected data from Virtual Pediatric Systems, LLC. SETTING: United States PICUs participating in the Virtual Pediatric Systems database from 2011 to 2014...
May 5, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28481656/multiple-naloxone-administrations-among-emergency-medical-service-providers-is-increasing
#5
Mark Faul, Peter Lurie, Jeremiah M Kinsman, Michael W Dailey, Charmaine Crabaugh, Scott M Sasser
BACKGROUND: Opioid overdoses are at epidemic levels in the United States. Emergency Medical Service (EMS) providers may administer naloxone to restore patient breathing and prevent respiratory arrest. There was a need for contemporary data to examine the number of naloxone administrations in an EMS encounter. METHODS: Using data from the National Emergency Medical Services Information System, we examined data from 2012-5 to determine trends in patients receiving multiple naloxone administrations (MNAs)...
May 8, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28481454/severe-acute-valproic-acid-intoxication-successfully-treated-with-liver-support-therapy
#6
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/28447858/risk-prediction-of-hepatotoxicity-in-paracetamol-poisoning
#7
Anselm Wong, Andis Graudins
CONTEXT: Paracetamol (acetaminophen) poisoning is the most common cause of acute liver failure in the developed world. A paracetamol treatment nomogram has been used for over four decades to help determine whether patients will develop hepatotoxicity without acetylcysteine treatment, and thus indicates those needing treatment. Despite this, a small proportion of patients still develop hepatotoxicity. More accurate risk predictors would be useful to increase the early detection of patients with the potential to develop hepatotoxicity despite acetylcysteine treatment...
April 27, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28442873/anagen-effluvium-following-acute-colchicine-poisoning
#8
Andrea Combalia, Carola Baliu-Piqué, Adriana Fortea, Juan Ferrando
We present a case of a 17-year-old girl admitted to the Psychiatric Department recovering from a suicide attempt with colchicine. One week after poisoning, a sudden onset of hair loss was observed. Positive hair pull test and trichoscopy demonstrated the presence of anagen hairs with pigmented long roots covered by the root sheaths. Colchicine poisoning is an uncommon, but potentially life-threatening toxicologic emergency. An overdose of colchicine inhibits cell division, and thus the most affected organs are those which have a high rate of cell turnover...
October 2016: International Journal of Trichology
https://www.readbyqxmd.com/read/28438446/the-association-of-hemodialysis-and-survival-in-intubated-salicylate-poisoned-patients
#9
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/28425670/electroencephalographic-patterns-of-lithium-poisoning-a-study-of-the-effect-concentration-relationships-in-the-rat
#10
Anne-Sophie Hanak, Isabelle Malissin, Joël Poupon, Patricia Risède, Lucie Chevillard, Bruno Mégarbane
OBJECTIVES: Lithium overdose may result in encephalopathy and electroencephalographic abnormalities. Three poisoning patterns have been identified based on the ingested dose, previous treatment duration and renal function. Whether the severity of lithium-induced encephalopathy depends on the poisoning pattern has not been established. We designed a rat study to investigate lithium-induced encephalopathy and correlate its severity to plasma, erythrocyte, cerebrospinal fluid and brain lithium concentrations previously determined in rat models mimicking human poisoning patterns...
April 20, 2017: Bipolar Disorders
https://www.readbyqxmd.com/read/28425352/overdose-in-young-children-treated-with-anti-reflux-medications-poisons-enquiry-evidence-of-excess-10-fold-dosing-errors-with-ranitidine
#11
C Crawford, M Anderson, G Cooper, G Jackson, J Thompson, A Vale, Shl Thomas, M Eddleston, D N Bateman
BACKGROUND: Accidental drug overdose is a common problem in young children. We examined the influence of formulation and dose in enquiries for different gastro-oesophageal reflux disease treatments in children under 5 years to the UK's National Poisons Information Service. METHODS: Overdose characteristics with ranitidine, omeprazole or domperidone were compared with those of metoclopramide and the H-1 antagonist chlorphenamine, for the period 1 July 2007 to 30 June 2015...
January 1, 2017: Human & Experimental Toxicology
https://www.readbyqxmd.com/read/28405999/near-fatal-poisoning-by-isoniazid-and-rifampicin
#12
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
#13
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/28382261/olanzapine-overdose-presenting-with-acute-muscle-toxicity
#14
Niraj Keyal, Gentle Sunder Shrestha, Saurabh Pradhan, Ramesh Maharjan, Subhash Prasad Acharya, Moda Nath Marhatta
Olanzapine is an atypical antipsychotic drug that is being increasingly used as an intentional overdose. It usually presents with reduced and fluctuating level of consciousness and coma. It may rarely present with muscle toxicity by binding to HT2A receptor in skeletal muscle and increasing its permeability. We report a case of such poisoning which had no obvious symptoms but was brought to emergency due to overdose and was found to have acute muscle toxicity as evidenced by raised creatine phosphokinase (CPK) levels...
January 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28372595/orphan-medicinal-products-in-europe-and-united-states-to-cover-needs-of-patients-with-rare-diseases-an-increased-common-effort-is-to-be-foreseen
#15
Viviana Giannuzzi, Rosa Conte, Annalisa Landi, Serena Antonella Ottomano, Donato Bonifazi, Paola Baiardi, Fedele Bonifazi, Adriana Ceci
BACKGROUND: In the European Union (EU) and United States (US), specific regulations have been released to provide incentives to develop and sell orphan medicinal products. We analysed the status of orphan drugs designated that not yet received a marketing authorisation or already marketed for patients affected by rare diseases in the EU and US up to December 2015. For each drug, the following data were extracted: designation date, active substance(s), orphan condition and indication, trade name, approved therapeutic indication, approved ages, genetic nature of disease and if affects children...
April 3, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28345440/the-economic-burden-of-opioid-abuse-updated-findings
#16
Noam Y Kirson, Lauren M Scarpati, Caroline J Enloe, Aliya P Dincer, Howard G Birnbaum, Tracy J Mayne
BACKGROUND: Opioid pain relievers can be highly effective in providing relief for patients suffering from pain. At the same time, prescription opioid abuse, dependence, overdose, and poisoning (hereinafter "abuse") have become a national public health concern. Opioid abuse is also costly: previous estimates of the annual excess costs of opioid abuse to payers range from approximately $10,000 to $20,000 per patient. OBJECTIVES: To (a) provide a comprehensive, current estimate of the economic burden of opioid abuse to commercial payers and (b) explore the drivers of these excess costs of abuse...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28336491/neurobehavioral-effects-of-lithium-in-the-rat-investigation-of-the-effect-concentration-relationships-and-the-contribution-of-the-poisoning-pattern
#17
Anne-Sophie Hanak, Lucie Chevillard, Rodolphe Lebeau, Patricia Risède, Jean-Louis Laplanche, Nadia Benturquia, Bruno Mégarbane
Severity of lithium poisoning depends on the ingested dose, previous treatment duration and renal function. No animal study has investigated neurobehavioral differences in relation to the lithium poisoning pattern observed in humans, while differences in lithium pharmacokinetics have been reported in lithium-pretreated rats mimicking chronic poisonings with enhanced brain accumulation in rats with renal failure. Our objectives were: 1)-to investigate lithium-related effects in overdose on locomotor activity, anxiety-like behavior, spatial recognition memory and anhedonia in the rat; 2)-to model the relationships between lithium-induced effects on locomotion and plasma, erythrocyte, cerebrospinal fluid and brain concentrations previously obtained according to the poisoning pattern...
March 20, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28336158/-acetaminophen-knowledge-use-and-overdose-risk-in-urban-patients-consulting-their-general-practitioner-a-prospective-descriptive-and-transversal-study
#18
Lauriane Cipolat, Ouriel Loeb, Clotilde Latarche, Elise Pape, Pierre Gillet, Nadine Petitpain
INTRODUCTION: Acetaminophen is the most involved active substance in both unintentional and intentional drug poisoning. However, its availability outside community pharmacies is being debated in France. METHODS: We made, via a self-administered questionnaire, a prospective assessment of knowledge, use and acetaminophen overdose risk in patients consulting their general practitioner, in the Metz Métropole urban area, between May 2015 and February 2016. We estimated the prevalence of potential unintentional overdosage by capture-recapture method...
February 20, 2017: Thérapie
https://www.readbyqxmd.com/read/28334840/review-of-caffeine-related-fatalities-along-with-postmortem-blood-concentrations-in-51-poisoning-deaths
#19
Alan Wayne Jones
Publications reporting concentrations of caffeine in postmortem blood were reviewed if the cause of death was attributed to overdosing (poisoning) with drugs. Age and gender of the deceased, the manner of death (accident, suicide or undetermined) and types of co-ingested drugs were evaluated in relation to the concentrations of caffeine in blood (N = 51). The mean age (±SD) of the victims was 39 ± 17.8 years (range 18-84 years) and most were female (N = 31 or 61%). The difference in mean age of males (42 ± 17...
April 1, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28320983/levetiracetam-and-topiramate-poisoning-two-overdoses-on-those-drugs-with-no-lasting-effects
#20
Moaziz Sarfaraz, Rana Hasan Syeda
Levetiracetam and topiramate are newer anticonvulsants, which is why international data on overdoses of these drugs are lacking. Only a few mild adverse reactions have been noted. These anticonvulsants have been the drug of choice for neurologists. Despite their wide usage, there is a dearth of literature on symptoms and signs of their toxicity. Presented here is the case of a 21-year-old female who overdosed twice on levetiracetam and topiramate. The woman was admitted and discharged after the first overdose...
March 19, 2017: Drug Discoveries & Therapeutics
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