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The effects of sorbitol on gastric emptying half-times and small intestinal transit after drug overdose.
Adams BK, Mann MD, Aboo A, Isaacs S, Evans A.
Department of Nuclear Medicine, University of Cape Town and Groote Schuur Hospital, South Africa.
Publication Types:
PMID: 16338524 [PubMed - in process]
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Serial Bispectral index scores in patients undergoing observation for sedative overdose in the emergency department.
Miner JR, Fringer R, Siegel T, Gaetz A, Ling L, Biros M.
Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN 55415, USA.
STUDY OBJECTIVE: Many patients who overdose on sedatives experience a declining mental status and eventually require endotracheal intubation. The goal of this study was to determine if serial bedside Bispectral index (BIS) scores monitoring can be used to detect the eventual need for intubation in overdosed patients who are undergoing observation in the ED. METHODS: This was a prospective, observational study of a convenience sample of patients who presented to the Hennepin County Medical Center ED between June and November 2002. Patients being treated and observed for a suspected sedative ingestion were eligible. Upon presentation, a Bispectral electroencephalographic probe was applied to the patient's forehead, and a BIS score was recorded at 0 and 20 minutes. The Altered Mental Status scale was used to describe the patient's clinical status. Data were collected by trained research assistants. Data are described with descriptive statistics. The mean changes in BIS score between patients who did and did not require intubation are compared with t tests, and the outcome of patients with stable vs declining BIS scores were compared with chi(2) tests. RESULTS: Seventy-six patients were enrolled. The mean initial BIS score was 83.9 (95% CI, 79.7-88.1; range, 9-99). The mean change in BIS scores during the 20-minute observation period for the patients who required intubation was -13.5 (95% CI, -30.2 to 3.2) and was +6.7 (95% CI, 3.3-10.1) for those who were not intubated. Sixteen patients had an initial BIS score below 70. Of these patients, 6 were intubated. All intubations occurred during the 20 minutes, and this group had a mean initial BIS of 47.2 (95% CI, 35.6-58.8). The 10 patients with an initial BIS below 70 who were not intubated had a mean increase in BIS score of 23.3 (95% CI, 11.7-33.9) during the 20 minutes. Of the 60 patients whose first BIS score was above 70, 5 were eventually intubated during their ED treatment. The mean change in BIS was -36.4 (95% CI, -18.7 to -54.1) for the intubated patients vs +7.9 (95% CI, 4.4-11.3) for nonintubated patients during the first 20 minutes. CONCLUSION: The overdosed patients who required intubation during their ED treatment experienced a mean decrease in BIS during the first 20 minutes, compared with those who did not. Bispectral index scores monitoring may prove useful for earlier ED treatment and decision making regarding sedative overdose patients.
PMID: 16338510 [PubMed - in process]
Sibutramine use associated with reversible hepatotoxicity.
Chounta A, Tsiodras S, Zouridakis S, Doumas M, Giamarellou H.
Publication Types:
PMID: 16287809 [PubMed - indexed for MEDLINE]
Erythematous plaques on the flexural surfaces.
Davis DM, Otley CC, Witman PM.
Mayo Clinic, Rochester, Minn, USA.
Publication Types:
PMID: 16301396 [PubMed - indexed for MEDLINE]
Human and animal health: strengthening the links: preventing dog bites.
De Keuster TC.
Publication Types:
PMID: 16308399 [PubMed - indexed for MEDLINE]
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Treatment of bites by adders and exotic venomous snakes.
Warrell DA.
Nuffield Department of Clinical Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU. david.warrell@ndm.oxford.ac.uk
Publication Types:
PMID: 16308385 [PubMed - indexed for MEDLINE]
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Foodborne zoonoses.
O'Brien SJ.
Publication Types:
PMID: 16308359 [PubMed - indexed for MEDLINE]
Consensus statement on the safety profile of topical calcineurin inhibitors.
Bieber T, Cork M, Ellis C, Girolomoni G, Groves R, Langley R, Luger T, Meurer M, Murrell D, Orlow S, Paller A, de Prost Y, Puig L, Ring J, Saurat JH, Schwarz T, Shear N, Stingl G, Taieb A, Thestrup-Pedersen K; Pediatric Advisory Committee of the Food and Drug Administration.
Publication Types:
PMID: 16088148 [PubMed - indexed for MEDLINE]
Forensic case profiling aspects on multiple homicides from the Cologne-Bonn metropolitan area 1985-2000.
Schmidt PH, Padosch SA, Rothschild MA, Madea B.
Department of Legal Medicine, University of Bonn, Stiftsplatz 12, D-53111 Bonn, Germany. p.schmidt@med.uni-frankfurt.de
The medicolegal and subsequent criminologic interpretation of forensic and pathological findings in cases of homicide makes up an important tool of case profiling. In a retrospective study of 26 cases of "multiple homicides" involving 31 perpetrators (30 males, 1 female, mean age 33.5 years) and 73 victims (33 males, 40 females, mean age 36 years, 68 fatalities, 5 survivors), autopsy reports and prosecution authorities' files were investigated with regard to individual characteristics of victims and offenders, circumstances as well as mode of commitment. The major aim of this study was to comprehensively elucidate and characterise relevant forensic and criminologic features, which may gain importance for forensic case profiling. Forty-six victims were found in the close social environment of the perpetrator and 45 homicides were committed either in the victim's, the perpetrator's or the shared domicile. The main motives included concealment of a crime (n=13), personal conflicts/domestic arguments (n=7) and greed (n=12). The relevant injuries with regard to the cause of death were attributable to sharp force (n=13), blunt force (n=7), gunshot wounds (n=24), ligature strangulation (n=3), smothering (n=5), fire/carbon monoxide (n=4) and combined impacts (n=11). In 15 cases, so called defence injuries were found. In 5 victims a post-mortem blood alcohol concentration >1.5 g/l was determined. In six perpetrators, a severe psychiatric impairment of juridical responsibility was ascertained (Section 20 German criminal code, n=2, psychosis; Section 21 German criminal code, n=4, acute alcohol intoxication). As far as conviction data were available, 27 crimes were juridically assessed as murder, 12 as manslaughter and one as bodily harm with fatal consequences.
PMID: 16139106 [PubMed - indexed for MEDLINE]
DHEA supplementation of systemic glucocorticoids for treatment of poison ivy dermatitis.
Geracioti TD Jr.
Publication Types:
PMID: 16336542 [PubMed - in process]
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Clopidogrel-induced hypersensitivity syndrome associated with febrile pancytopenia.
Comert A, Akgun S, Civelek A, Kavala M, Sarigul S, Yildirim T, Arsan S.
Publication Types:
PMID: 16207199 [PubMed - indexed for MEDLINE]
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Vesicular drug eruption due to stronger Neo-Minophagen C.
Kurokawa I, Umehara M, Hashimoto A, Hozu S.
Publication Types:
PMID: 16207198 [PubMed - indexed for MEDLINE]
Effects of antipsychotic treatment on tardive dyskinesia: a 6-month evaluation of patients from the European Schizophrenia Outpatient Health Outcomes (SOHO) Study.
Tenback DE, van Harten PN, Slooff CJ, Belger MA, van Os J; SOHO Study Group.
Psychiatric Centre Altrecht, Den Dolder, The Netherlands.
OBJECTIVE: To compare the incidence and persistence of tardive dyskinesia between patients diagnosed with schizophrenia (ICD-10 and/or DSM-IV) who were treated with second-generation antipsychotics and first-generation antipsychotics in routine clinical practice. METHOD: The European Schizophrenia Outpatient Health Outcomes (SOHO) study is a 3-year, prospective, observational study. Each country had a start date for patient enrollment before October 2000. All enrollment was completed by June 30, 2001. A simple, global measure of tardive dyskinesia was rated by participating clinicians. For the current analysis, data at baseline, 3 months, and 6 months were analyzed using a generalized estimating equation model. RESULTS: Second-generation antipsychotics conferred a lower risk for tardive dyskinesia at 6 months than first-generation antipsychotics (0.9% vs. 3.8%, odds ratio [OR] = 0.29, 95% confidence interval [CI] = 0.18 to 0.46). In addition, patients with tardive dyskinesia at baseline who were receiving second-generation antipsychotics were less likely than patients receiving first-generation antipsychotics to have tardive dyskinesia symptoms at 6 months (43.6% vs. 60.8%, OR = 0.50, 95% CI = 0.30 to 0.85). A sensitivity analysis suggested no bias related to pharmaceutical industry financial support. CONCLUSION: The results suggest that the relative advantage of second-generation antipsychotics in terms of lower rates of incidence and persistence of tardive dyskinesia, observed in technical randomized controlled trials, generalizes to routine clinical care.
Publication Types:
PMID: 16187770 [PubMed - indexed for MEDLINE]
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Use of CroFab antivenin in the management of a very young pediatric copperhead envenomation.
Trinh HH, Hack JB.
Department of Emergency Medicine, East Carolina University, Pitt County Memorial Hospital, 800 Moye Boulevard, Greenville, NC 27858, USA.
The use of crotalid Fab antivenin (CroFab) in the treatment of snake envenomations in the pediatric population is still an underexplored area. There are very limited data to confirm the efficacy and safety of dosing children the same as adults and even less information available to evaluate this antivenin use in copperhead snake bites in children. We report the first use of crotalid Fab antivenin in an adult dose for a copperhead snake envenomation in a 2-year-old child. She had rapid resolution of symptoms with no adverse effects. The report serves to increase the literature supporting the current dosing recommendations of crotalid Fab antivenin in very young pediatric patients evidenced by its effectiveness in this patient.
Publication Types:
PMID: 16029826 [PubMed - indexed for MEDLINE]
Primary Central Nervous System Lymphoma (PCNSL) occurring in pregnancy.
O'Mahony D, Razak AR, Brett F, Grogan L.
Publication Types:
PMID: 16003500 [PubMed - indexed for MEDLINE]
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Development and evaluation of the Parkinson Psychosis Questionnaire A screening-instrument for the early diagnosis of drug-induced psychosis in Parkinson's disease.
Brandstaedter D, Spieker S, Ulm G, Siebert U, Eichhorn TE, Krieg JC, Oertel WH, Eggert K.
Dept. of Neurology, Philipps-University Marburg, Rudolf-Bultmann-Strasse 8, 35039 Marburg, Germany.
OBJECTIVE : Drug-induced psychosis is a frequent side-effect in the treatment of advanced Parkinson's disease (PD). We sought to develop and evaluate a brief instrument for early recognition of drug-induced psychosis in PD. METHODS : We developed the "Parkinson Psychosis Questionnaire" (PPQ), which consists of screening questions for typical early signs and psychotic symptoms in PD and which quantifies the frequency and severity of four clinical categories-sleep disturbances, hallucinations/illusions, delusions and orientation. We performed an internal validation of the PPQ in 50 unselected patients with parkinsonism. The Brief Psychiatric Rating Scale (BPRS) and the "Structurized Clinical Interview" (SCID) for DSM IV were applied to the same patients as external references. RESULTS : Of 50 subjects, 49 suffered from idiopathic PD and one from probable MSA-P. Hoehn and Yahr stages in "on" ranged from 1.5 to 4. Sensitivity of the PPQ test for drug-induced psychosis according to SCID was 100 % (95 % CI: 73.5%, 100%); while specificity was 92.1 % (95% CI: 78.6%, 98.3 %). The PPQ severity score was highly correlated with BPRS. We derived a linear prediction formula, which transformed PPQ into BPRS scores. CONCLUSION : The PPQ appears to be a suitable, and easily administered instrument for early diagnosis of drug induced psychosis in routine PD care. Whether the PPQ could also be a valuable tool for monitoring follow-up studies and therapeutic intervention trials remains to be tested.
PMID: 15789127 [PubMed - indexed for MEDLINE]
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Parkinsonism-hyperpyrexia syndrome not related to antiparkinsonian treatment withdrawal during the 2003 summer heat wave.
Gaig C, Marti MJ, Tolosa E, Gomez-Choco MJ, Amaro S.
Publication Types:
PMID: 15778809 [PubMed - indexed for MEDLINE]
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Recurrent spontaneous "neuroleptic malignant syndrome" in the absence of neuroleptic medication in probable dementia with Lewy bodies.
Weber KE, Linker RA, Lorenz R, Muellges W, Naumann M, Reiners K, Classen J.
Publication Types:
PMID: 15765193 [PubMed - indexed for MEDLINE]
Surveillance and coordination key to reducing foodborne illness.
Kuehn BM.
Publication Types:
PMID: 16332996 [PubMed - indexed for MEDLINE]
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Comment on:
Pesticide exposure at schools and acute illnesses.
Kirrane BM, Hoffman RS.
Publication Types:
PMID: 16287947 [PubMed - indexed for MEDLINE]
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Delayed motor and visual complications after attempted suicide.
Larner AJ.
Walton Centre for Neurology and Neurosurgery, Fazakerley, Liverpool L9 7LJ, UK. a.larner@thewaltoncentre.nhs.uk
Publication Types:
PMID: 16298223 [PubMed - indexed for MEDLINE]
"Mystery illness" at Melbourne Airport: toxic poisoning or mass hysteria?
Bartholomew RE.
Department of Social Sciences, The Batchelor Institute, Darwin Annex, 37 Gregory Street, Parap, NT 0820, Australia. robert.bartholomew@batchelor.edu.au.
A government report concluded that the cause of the recent cluster of illness affecting 57 people at Melbourne Airport was a "mystery". On reviewing the evidence, I noted the appearance of a constellation of distinct psychogenic features (in the absence of an identifiable pathogenic agent or source), and non-specific symptoms not correlated with any particular illness, strongly suggesting a diagnosis of mass psychogenic illness. Given the time differential between the illness onset in the index case and the initiation of air sampling, and the added factor of the air-conditioning in the terminal being switched to exhaust mode, the possibility that a toxic agent was responsible for making some of the victims ill cannot be completely excluded. Future investigations of similar incidents should, in the absence of clinical or laboratory findings, consider the diagnosis of mass psychogenic illness. Failure to do so can engender avoidable confusion and unease among the Australian public. The issue of diagnosing collective psychogenic illness will continue to be a major public health challenge, exacerbated by widespread anxieties over the threat of chemical and biological weapons and fears of contamination.
PMID: 16336130 [PubMed - as supplied by publisher]
Comment on:
Hepatitis A associated with green onions.
Vale S.
Publication Types:
PMID: 16312062 [PubMed - indexed for MEDLINE]
Comment on:
Hepatitis A associated with green onions.
Milazzo L.
Publication Types:
PMID: 16306531 [PubMed - indexed for MEDLINE]
Case records of the Massachusetts General Hospital. Case 34-2005. A 10-year-old girl with a bullous skin eruption and acute respiratory failure.
Sheridan RL, Liu V, Anupindi S.
Burn Surgical Service, Shriners Hospital for Children, Boston, USA.
Publication Types:
PMID: 16282181 [PubMed - indexed for MEDLINE]
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Images in clinical medicine. Cetuximab-associated acneiform eruption.
Moss JE, Burtness B.
Yale University, New Haven, CT 06520-8032, USA.
Publication Types:
PMID: 16282170 [PubMed - indexed for MEDLINE]
Interactions of chronic lead exposure and intermittent stress: consequences for brain catecholamine systems and associated behaviors and HPA axis function.
Virgolini MB, Chen K, Weston DD, Bauter MR, Cory-Slechta DA.
Environmental and Occupational Health Sciences Institute, a Joint Institute of the Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, Piscataway, 08854, USA. dcs@eohsi.rutgers.edu
Elevated lead (Pb) burden and high stress levels are co-occurring risk factors in low socioeconomic status (SES) children. Our previous work demonstrated that maternal Pb exposure can permanently alter hypothalamic-pituitary-adrenal (HPA) axis function and responsivity to stress challenges in offspring. The current study sought to determine the consequences of chronic Pb exposures initiated later in development combined with variable intermittent stress challenges. Male rats were exposed chronically from weaning to 0, 50, or 150 ppm Pb acetate drinking solutions (producing blood Pb levels of <5, 9-15, and 23-27 mug/dl, respectively). Pb itself decreased basal plasma corticosterone, with greater effects at 50 than 150 ppm; 150 ppm reduced both cytosolic and nuclear glucocorticoid receptor binding. Responsivity to stress challenges including novelty, cold, and restraint, was measured as changes in Fixed Interval (FI) schedule-controlled behavior in a subset of rats within each group. FI performance was modified by novelty stress only in Pb-treated rats, whereas cold and restraint stress effects were comparable across groups. Novelty elevated corticosterone equivalently across groups, but cold stress markedly increased corticosterone only in Pb-treated groups. The pattern of Pb-induced changes in serotonin (5-HT) or its metabolite 5-HIAA in frontal cortex, nucleus accumbens, striatum, and hypothalamus resembled that observed for basal corticosterone levels indicating a relationship between these variables. In addition to suggesting the potential for HPA axis-mediated effects of Pb on the central nervous system, these findings also raise questions about whether single chemicals studied in isolation from other relevant risk factors can adequately identify neurotoxic hazards.
PMID: 16049266 [PubMed - indexed for MEDLINE]
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In vitro detection of differential and cell-specific hepatobiliary toxicity induced by geldanamycin and 17-allylaminogeldanamycin using dog liver slices.
Amin K, Ip C, Jimenez L, Tyson C, Behrsing H.
SRI International, Menlo Park, California 94025, USA.
Experiments on rat liver slices demonstrated the differential hepatobiliary toxic potency of two anticancer agents, geldanamycin (GEL) and 17-allylaminogeldanamycin (17-AAG), over a 5-day period. This report describes the pattern of toxicity of these agents in dog liver tissue, using the in vitro liver slice culture model. Liver slices (200 microm thick) from male beagle dogs were cultured for 5 days in chemically defined culture medium containing a range of GEL and 17-AAG concentrations (0.1-5 microM). Tissues were evaluated using a panel of clinically relevant biomarkers and histological endpoints. GEL-induced reduction of alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) slice levels, indicators of biliary epithelial cell (BEC) viability, was supported by histological findings showing an increasing loss of BEC as higher concentrations were applied. At the highest concentrations studied, GEL caused both hepatocellular necrosis and BEC loss. Biomarker pattern results in the medium concurred with those from slice biochemistry measurements and histology. 17-AAG, a less potent compound in vivo, elicited more biomarker retention at higher concentrations than did GEL. Histological analysis revealed higher BEC viability and significant retention of BEC proliferation as compared with GEL. However, at the highest concentration, the toxic insult caused a marked decrease in BEC viability and proliferation. Comparison of responses with both compounds indicated that slices exposed to the same concentrations were more sensitive to GEL than to 17-AAG. Dog liver slices can thus be used to evaluate species-, compound-, and concentration-dependent differences in toxicity.
PMID: 16014738 [PubMed - indexed for MEDLINE]
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