Am J Emerg Med 2001 Nov;19(7):561-5
Royal Darwin Hospital, Darwin, Northern Territory, Australia. gsbite@bigpond.com
Venomous fish stings are a common environment hazard worldwide. This study investigated the clinical effects and treatment of venomous fish stings. A prospective observational case series of patients presenting with venomous fish stings was conducted in tropical northern Australia. Twenty-two fish stings were included; subjects were 3 females and 19 males; mean age 35 (range 10-63). 9 by stingrays, 8 by catfish, 1 by a stonefish, 1 by a silver scat (Selenotocota multifasciata), and 3 by unknown fish. All patients had severe pain, but less commonly erythema, 3 cases (14%); swelling, 7 cases (33%); bleeding, 5 cases (24%); numbness, 4 cases (19%); and radiating pain, 3 cases (14%). Mild systemic effects occurred in one stingray injury. Treatment included hot water immersion, which was completely effective in 73% of cases, analgesia, wound exploration and prophylactic antibiotics. Stingray injuries should be explored and debrided with large wounds, while other stings only need appropriate cleaning. The routine use of antibiotics is not recommended.
PMID: 11699001, UI: 21554662
Order this document
Am J Psychiatry 2001 Dec;158(12):2088-9
Publication Types:
PMID: 11729039, UI: 21585173
Ann Emerg Med 2001 Dec;38(6):660-5
Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA. sivilotm@meds.queensu.ca
STUDY OBJECTIVE: Gamma-hydroxybutyrate (GHB) and gamma-butyrolactone (GBL) have become popular drugs of abuse. Acute overdose with either agent results in a well-recognized syndrome of central nervous system and respiratory depression. Recently, a withdrawal syndrome has been described for GHB. We report a severe form of GBL withdrawal, characterized by delirium, psychosis, autonomic instability, and resistance to benzodiazepine therapy. METHODS: We performed a chart review of consecutive admissions for GBL withdrawal in a regional toxicology treatment center. RESULTS: During a 6-month period, 5 patients presented with severe withdrawal attributed to abrupt GBL discontinuation. Patients manifested tachycardia, hypertension, paranoid delusions, hallucinations, and rapid fluctuations in sensorium. Test results for ethanol and routine drugs of abuse were negative. Initial treatment with high doses of lorazepam proved ineffective. Pentobarbital was then administered, resulting in excellent control of behavioral, autonomic, and psychiatric symptoms and in rapid reduction or avoidance of benzodiazepines. Median hospital stay was 5 days. No patient had respiratory depression or required mechanical ventilation. Patients were discharged on tapering doses of benzodiazepines or pentobarbital and were free of psychotic symptoms at follow-up. CONCLUSION: GBL discontinuation can result in severe withdrawal, necessitating ICU admission. Pentobarbital may be more effective than benzodiazepines at controlling delirium in patients with abnormal vital signs, paranoid delusions, and hallucinations as a result of GBL withdrawal.
PMID: 11719746, UI: 21575520
Ann Intern Med 2001 Nov 20;135(10):930
PMID: 11712893, UI: 21569783
Ann Intern Med 2001 Nov 20;135(10):927
PMID: 11712886, UI: 21569776
BMJ 2001 Nov 10;323(7321):1097-8
Gastrointestinal Diseases Division, Public Health Laboratory Service Communicable Disease Surveillance Centre, London NW9 5EQ.
PMID: 11701574, UI: 21558000
BMJ 2001 Sep 15;323(7313):628
PMID: 11697374, UI: 21552713
BMJ 2001 Oct 20;323(7318):935
PMID: 11693144, UI: 21544476
BMJ 2001 Oct 20;323(7318):934; discussion 935
PMID: 11693143, UI: 21544474
PMID: 11693142, UI: 21544473
BMJ 2001 Oct 20;323(7318):934-5; discussion 935
PMID: 11693141, UI: 21544475
Br J Dermatol 2001 Oct;145(4):680-2
PMID: 11703309, UI: 21560246
Br J Dermatol 2001 Oct;145(4):667-8
PMID: 11703300, UI: 21560237
Br J Dermatol 2001 Oct;145(4):650-2
Section of Anatomic Pathology, Department of Oncology, University of Bologna, Bellaria Hospital, via Altura 3, 40139 Bologna, Italy.
We describe a 69-year-old man with a non-small cell carcinoma of the lung, stage III B, who developed bilateral multiple erythematous lesions in the abdominal-inguinal area following treatment with gemcitabine. Histologically, the lesion was characterized by a heavy lymphocytic infiltrate with large CD30+ cells. The lesion was highly suggestive of cutaneous involvement by malignant lymphoma, but complete regression was observed after cessation of gemcitabine. Although rarely reported, gemcitabine therapy can induce skin lesions. Pathologists should be aware of this possibility in order to avoid a misdiagnosis.
PMID: 11703296, UI: 21560233
J Emerg Med 2001 Nov;21(4):411-3
Department of Emergency Medicine, East Carolina University, Greenville, North Carolina, USA.
A 41-year-old woman presented to the Emergency Department complaining of a 4-day history of worsening lower leg pain, pallor, and a sensation of coolness aggravated by exertion. Evaluation revealed severe lower extremity vasospasm. She recently had been prescribed clarithromycin for "flu-like" symptoms, and for many years had been taking a caffeine-ergotamine preparation for migraine headaches. Clarithromycin is known to interfere with ergotamine metabolism. This drug interaction is often not recognized. Ergot alkaloids are commonly used for migraine headaches and have vasoconstrictive properties. In a patient with ergotamine toxicity, these vasoconstrictive properties can lead to frank ischemia. We reviewed the literature for reports of ergotamine-associated ischemia and for reports of ergotamine toxicity caused by drug-drug interaction.
PMID: 11728770, UI: 21585950
Lancet 2001 Nov 17;358(9294):1694
Department of Medicine, Sir Mortimer B. Davis Jewish General Hospital, Montreal, H3T 1E2, Quebec, Canada.
PMID: 11728546, UI: 21586039
MMWR Morb Mortal Wkly Rep 2001 Nov 16;50(45):1011-3
Solvents, glues, spray paints, coatings, silicones, and other products contain normal (n-) hexane, a petroleum distillate and simple aliphatic hydrocarbon. n-Hexane is an isomer of hexane and was identified as a peripheral neurotoxin in 1964. Since then, many cases of n-hexane-related neurotoxicity have occurred in printing plants, sandal shops, and furniture factories in Asia, Europe, and the United States. This report describes an investigation of n-hexane-associated peripheral neuropathy in an automotive technician, an occupation in which this condition has not been reported, and summarizes the results of two other case investigations in the automotive repair industry. The findings suggest that solvent manufacturers should avoid using hexane when producing automotive degreasing products, and automotive technicians should avoid regular contact with hexane-based cleaning solvents.
PMID: 11724159, UI: 21580684
N Engl J Med 2001 Nov 29;345(22):1611
New York University Medical Center, NY 10016, USA.
PMID: 11704684, UI: 21568973
the above reports in Macintosh PC UNIX Text HTML format documents on this page through Loansome Doc