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https://www.readbyqxmd.com/read/28881461/overdoses-with-aripiprazole-signs-symptoms-and-outcomes-in-239-exposures-reported-to-the-danish-poison-information-center
#1
Amalie P Christensen, Soeren Boegevig, Mikkel B Christensen, Kasper M Petersen, Kim P Dalhoff, Tonny S Petersen
The aim of this study was to characterize the clinical signs and symptoms of exposures to aripiprazole overdoses. We retrospectively identified all aripiprazole exposures reported to the Danish Poisons Information Center (DPIC) from June 2007 to May 2015. Information concerning demographics, ingested dose and symptoms were extracted from the DPIC database and medical records. Information on death and admission to hospital was obtained from Danish national registers. We analysed 239 cases, 86 concerning single-drug exposures to aripiprazole, and 153 cases where aripiprazole had been taken with at least one other substance (mixed-drug)...
September 7, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28862044/acute-lamotrigine-overdose-a-systematic-review-of-published-adult-and-pediatric-cases
#2
Bader Alyahya, Marjorie Friesen, Bénédicte Nauche, Martin Laliberté
CONTEXT: Lamotrigine is a broad-spectrum anticonvulsant commonly used to treat seizure and bipolar mood disorders. Evidence from case series and retrospective studies indicate that lamotrigine overdose is usually benign. However, there are reported cases of cardiac arrest and mortality following lamotrigine overdose. We undertook a systematic review of the literature on lamotrigine overdoses to better understand the clinical severity, the relevance of serum concentrations, and therapeutic interventions for overdose...
September 1, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28839998/high-rate-of-arterial-complications-in-patients-supported-with-extracorporeal-life-support-for-drug-intoxication-induced-refractory-cardiogenic-shock-or-cardiac-arrest
#3
Matteo Pozzi, Catherine Koffel, Camelia Djaref, Daniel Grinberg, Jean Luc Fellahi, Elisabeth Hugon-Vallet, Cyril Prieur, Jacques Robin, Jean François Obadia
BACKGROUND: Cardiac failure is still a leading cause of death in drug intoxication. Extracorporeal life support (ECLS) could be used as a rescue therapeutic option in patients developing refractory cardiogenic shock or cardiac arrest. The aim of this report is to present our results of ECLS in the setting of poisoning from cardiotoxic drugs. METHODS: We included in this analysis consecutive patients who received an ECLS for refractory cardiogenic shock or in-hospital cardiac arrest due to drug intoxication...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28833472/youth-suicide-deaths-investigation-of-clinical-predictors-in-a-statewide-sample
#4
Brooks R Keeshin, Doug Gray, Chong Zhang, Angela P Presson, Hilary Coon
Death by suicide is a significant cause of mortality among youth. However, there is limited information on the demographic and clinical factors associated with youth suicide deaths. The objective of this study was to link large statewide databases to describe demographic, clinical, and cause of death characteristics among youth who died by suicide. We examined 1,218 decedents under age 26 who died by suicie between 2000 and 2014. Eighteen died before age 12, 53 died between ages 12 and 14, 292 died between ages 15 and 18, and 855 died between ages 19 and 25...
August 22, 2017: Suicide & Life-threatening Behavior
https://www.readbyqxmd.com/read/28828702/-intoxication-with-psychotropic-drugs
#5
R Bellmann, M Joannidis
Psychotropic drugs are medications that are indicated for treatment of psychiatric disorders. Attempted suicide is the major reason for intoxication but inadvertent overdosing may also occur. Other psychotropic agents are taken because of their stimulating and hallucinogenic effects and many have a high addictive potential. Poisoning is usually due to accidental overdosing. For treatment of benzodiazepine and opioid intoxication, flumazenil and naloxone, respectively, are used as specific antagonists. For intoxication by tricyclic antidepressants, sodium bicarbonate is the treatment of choice...
August 21, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28822726/recurrent-out-of-hospital-cardiac-arrest
#6
Ziad Nehme, Emily Andrew, Resmi Nair, Stephen Bernard, Karen Smith
BACKGROUND: Little is known about the burden of recurrent out-of-hospital cardiac arrest (OHCA) episodes in initial survivors of OHCA. We sought to investigate the frequency of recurrent OHCA, describe time-to-event trends, and establish baseline predictors of occurrence. METHODS: Between January 2000 and June 2015, we included consecutive OHCA survivors to hospital discharge from the Victorian Ambulance Cardiac Arrest Registry. Patient identifiers were used to match index and recurrent episodes of OHCA, and death records from a government database...
August 16, 2017: Resuscitation
https://www.readbyqxmd.com/read/28797652/geographic-variation-in-opioid-and-heroin-involved-drug-poisoning-mortality-rates
#7
Christopher J Ruhm
INTRODUCTION: An important barrier to formulating effective policies to address the rapid rise in U.S. fatal overdoses is that the specific drugs involved are frequently not identified on death certificates. This analysis supplies improved estimates of state opioid and heroin involved drug fatality rates in 2014, and changes from 2008 to 2014. METHODS: Reported mortality rates were calculated directly from death certificates and compared to corrected rates that imputed drug involvement when no drug was specified...
August 1, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28777878/a-multi-analyte-approach-to-help-in-assessing-the-severity-of-acute-poisonings-development-and-validation-of-a-fast-lc-ms-ms-quantification-approach-for-45-drugs-and-relevant-metabolites-with-one-point-calibration
#8
Julian A Michely, Hans H Maurer
In emergency toxicology, diagnosis, monitoring of the efficiency of detoxification, and estimating the prognosis of acute poisonings are important tasks. Comprehensive screening and quantification of relevant substances by gas chromatography-mass spectrometry (GC-MS) or liquid chromatography-mass spectrometry (LC-MS) help in assessing the severity of most acute poisonings. Turnaround time for such analyses must be short enough for having impact on clinical decisions. Therefore, a multi-analyte LC-MS/MS approach with a 5-min gradient was developed and validated for 45 drugs and active metabolites as complement to an existing GC-MS approach using the same liquid-liquid extraction...
August 4, 2017: Drug Testing and Analysis
https://www.readbyqxmd.com/read/28772108/did-the-great-recession-affect-mortality-rates-in-the-metropolitan-united-states-effects-on-mortality-by-age-gender-and-cause-of-death
#9
Erin C Strumpf, Thomas J Charters, Sam Harper, Arijit Nandi
OBJECTIVES: Mortality rates generally decline during economic recessions in high-income countries, however gaps remain in our understanding of the underlying mechanisms. This study estimates the impacts of increases in unemployment rates on both all-cause and cause-specific mortality across U.S. metropolitan regions during the Great Recession. METHODS: We estimate the effects of economic conditions during the recent and severe recessionary period on mortality, including differences by age and gender subgroups, using fixed effects regression models...
July 21, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28749578/a-descriptive-study-of-intentional-self-poisoning-from-new-zealand-national-registry-data
#10
Eeva-Katri Kumpula, Shyamala Nada-Raja, Pauline Norris, Paul Quigley
OBJECTIVE: Understanding which population groups intentionally poison themselves by overdose and which substances are used are key to developing prevention efforts for such injuries. This paper uses Ministry of Health (MOH) data to explore the demographic characteristics of those who intentionally self-poison and the substances used, identifies limitations of existing data collections and makes recommendations for the future. METHODS: MOH mortality data from 2000 to 2012, and public hospital presentation data from 2000-2014 of cases of intentional self-poisoning (ISP), and poisoning of undetermined intent (UDP), were examined...
July 27, 2017: Australian and New Zealand Journal of Public Health
https://www.readbyqxmd.com/read/28739777/establishment-of-a-comprehensive-drug-overdose-fatality-surveillance-system-in-kentucky-to-inform-drug-overdose-prevention-policies-interventions-and-best-practices
#11
Sarah L Hargrove, Terry L Bunn, Svetla Slavova, Dana Quesinberry, Tracey Corey, William Ralston, Michael D Singleton, Van Ingram
BACKGROUND: According to the National Center for Health Statistics, Kentucky had the third highest drug overdose fatality rate in the nation in 2015 at 29.9 drug overdose fatalities per 100 000 population. OBJECTIVE: The elevated drug overdose fatality rate necessitated the development and implementation of a comprehensive multisource drug overdose fatality surveillance system (DOFSS). METHODS: DOFSS stakeholder work group members and data sources were identified, and memorandums of understanding were established...
July 24, 2017: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
https://www.readbyqxmd.com/read/28730845/evaluation-of-toxicity-after-acute-accidental-methotrexate-ingestions-in-children-under-6-years-old-a-16-year-multi-center-review
#12
Hannah Hays, Michael C Beuhler, Henry A Spiller, Julie Weber, James B Mowry, Mark L Ryan, Natalie E Spiller, Ashley Webb
CONTEXT: There is little data on the frequency of adverse events following acute methotrexate ingestions in pediatric patients. Likewise, recommendations for observation length, site and management strategies in this population are not well established. Therefore, most recommendations are modeled after management of chronic overdose in patients with underlying medical conditions. OBJECTIVE: The primary objective of this study is to determine the frequency of acute toxicity after acute methotrexate accidental unsupervised ingestions in patients less than six years...
July 21, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28663066/successful-management-of-acute-liver-failure-in-italian-children-a-16-year-experience-at-a-referral-centre-for-paediatric-liver-transplantation
#13
A Di Giorgio, A Sonzogni, A Piccichè, G Alessio, E Bonanomi, M Colledan, L D'Antiga
BACKGROUND: Identifying the causes of acute liver failure (ALF) and predictors of death or liver transplantation (LTX) is crucial to decide its management. We aimed to describe features and outcome of ALF in Italian children. METHODS: Retrospective review of cases presenting between 1996-2012. ALF was defined by high transaminases, INR ≥2.0 regardless of hepatic encephalopathy (HE), no evidence of underlying chronic liver disease. RESULTS: 55 children (median age 2...
June 12, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28656354/nonfatal-and-fatal-intoxications-with-pure-caffeine-report-of-three-different-cases
#14
Jan Magdalan, Marcin Zawadzki, Rafał Skowronek, Magdalena Czuba, Barbara Porębska, Tomasz Sozański, Paweł Szpot
Caffeine is not usually perceived as a drug by most people because it is found in many foods and drinks, including caffeinated energy drinks, as well as in over the counter analgesics and cold preparations. Recently in Poland it has become increasingly common to take pure caffeine, bought through online stores, as a psychoanaleptic. This creates a much higher risk of severe and even fatal poisoning in comparison with the risk associated with the abuse of food products and non-prescription medicines containing low doses of caffeine...
June 27, 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28644687/massive-paracetamol-overdose-an-observational-study-of-the-effect-of-activated-charcoal-and-increased-acetylcysteine-dose-atom-2
#15
Angela L Chiew, Geoffrey K Isbister, Katharine A Kirby, Colin B Page, Betty S H Chan, Nicholas A Buckley
CONTEXT: Paracetamol is commonly taken in overdose, with increasing concerns that those taking "massive" overdoses have higher rates of hepatotoxicity and may require higher doses of acetylcysteine. The objective was to describe the clinical characteristics and outcomes of "massive" (≥ 40 g) paracetamol overdoses. METHODS: Patients were identified through the Australian Paracetamol Project, a prospective observational study through Poisons Information Centres in NSW and Queensland, over 3 and 1...
June 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28644049/the-standard-treatment-protocol-for-paracetamol-poisoning-may-be-inadequate-following-overdose-with-modified-release-formulation-a-pharmacokinetic-and-clinical-analysis-of-53-cases
#16
Heléne Salmonson, Gunilla Sjöberg, Jacob Brogren
OBJECTIVE: The use of the standard procedure for managing overdoses with immediate release (IR) paracetamol is questionable when applied to overdoses with modified release (MR) formulations. This study describes the pharmacokinetics of paracetamol and the clinical outcomes following overdoses with a MR formulation. METHODS: Medical records including laboratory analyses concerning overdoses of MR paracetamol from 2009 to 2015 were collected retrospectively. Inclusion criteria were ingestion of a toxic dose, known time of intake and documented measurements of serum paracetamol and liver function tests...
June 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28633003/assessment-of-selected-overdose-poisoning-indicators-in-health-care-administrative-data-in-4-states-2012
#17
Beth Hume, Barbara Gabella, Jeanne Hathaway, Scott Proescholdbell, Cristy Sneddon, Elizabeth Brutsch, Riley Hedin, Christopher J Drucker
OBJECTIVES: In 2012, a consensus document was developed on drug overdose poisoning definitions. We took the opportunity to apply these new definitions to health care administrative data in 4 states. Our objective was to calculate and compare drug (particularly opioid) poisoning rates in these 4 states for 4 selected Injury Surveillance Workgroup 7 (ISW7) drug poisoning indicators, using 2 ISW7 surveillance definitions, Option A and Option B. We also identified factors related to the health care administrative data used by each state that might contribute to poisoning rate variations...
July 2017: Public Health Reports
https://www.readbyqxmd.com/read/28624886/pharmacokinetic-modelling-of-modified-acetylcysteine-infusion-regimens-used-in-the-treatment-of-paracetamol-poisoning
#18
Anselm Wong, Cornelia Landersdorfer, Andis Graudins
PURPOSE: Paracetamol overdose is common and is treated with acetylcysteine to prevent the development of hepatotoxicity. N-acetyl-p-benzoquinone imine (NAPQI) is the toxic metabolite of paracetamol overdose. We aimed to assess the expected acetylcysteine concentration time profiles following delivery of modified acetylcysteine regimens proposed for those at high and low risk of hepatotoxicity. In addition, we will determine acetylcysteine concentrations post-cessation of abbreviated infusions...
September 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28621023/pediatric-liver-transplantation-for-fulminant-hepatic-failure-secondary-to-intentional-iron-overdose
#19
Joanne Lai, Jaime Chu, Ronen Arnon
Acute iron poisoning may lead to life-threatening hepatotoxicity. We present the cases of two pediatric patients with hepatotoxicity following intentional iron ingestion that progressed rapidly to fulminant hepatic failure despite treatment with deferoxamine. Liver transplantation was lifesaving in both patients. These cases emphasize the need for a high index of suspicion for iron ingestion, close monitoring for liver toxicity, and timely consideration for liver transplantation.
September 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28612472/federation-internationale-de-football-association-fifa-2014-world-cup-impact-on-hospital-treated-suicide-attempt-overdose-in-tehran
#20
Hossein Hassanian-Moghaddam, Fatemeh Ghorbani, Afsaneh Rahimi, Tayyebeh Farmahini Farahani, Parvane Sadat Vafaei Sani, Terry J Lewin, Gregory L Carter
Social influences on suicidal behaviors may be important but are less frequently studied than the influences of mental illness, physical illness, and demographic variables. Major international sporting events may have an impact on suicidal behaviors at the national and local level, an effect possibly mediated by gender and age. We examined the association of hospital-treated deliberate self-poisoning episodes (by gender and by age) in Tehran: before, during, and after the 2014 FIFA World Cup held in Brazil, in which the Iranian national team participated and was eliminated after the pool games...
June 13, 2017: Suicide & Life-threatening Behavior
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