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Items 1 - 11 of 11 |
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Allergic reactions from insect bites.
Lo Vecchio F, Tran TV.
Publication Types:
PMID: 15666286 [PubMed - indexed for MEDLINE]
Serotonin syndrome resulting from an herbal detox cocktail.
Bryant SM, Kolodchak J.
Publication Types:
PMID: 15666281 [PubMed - indexed for MEDLINE]
Comment on:
Commentary on: Severe manifestations of coricidin intoxication.
Bobo WV, Fulton RB.
Publication Types:
PMID: 15666279 [PubMed - indexed for MEDLINE]
Comment on:
GCS and AVPU: the alphabet soup doesn't spell "C-O-M-A" in toxicology.
Fulton JA, Greller HA, Hoffman RS.
Publication Types:
PMID: 15671986 [PubMed - indexed for MEDLINE]
Out-of-hospital administration of activated charcoal by emergency medical services.
Alaspaa AO, Kuisma MJ, Hoppu K, Neuvonen PJ.
Helsinki Emergency Medical Services, Poison Information Centre, and Department of Clinical Pharmacology, Helsinki University Central Hospital, Helsinki, Finland. ari.alaspaa@luukku.com <ari.alaspaa@luukku.com>
STUDY OBJECTIVE: We assess the feasibility of activated charcoal provided by emergency medical services (EMS). METHODS: This was a 12-month follow-up study on the feasibility of a newly introduced protocol to administer activated charcoal by EMS to acutely poisoned patients before arrival at the hospital. Administration of activated charcoal (50 g or 1 g/kg orally or by nasogastric tube) was considered in 2,047 patients with acute poisoning. Main outcome measures were success rate and elapsed times in and adverse effects of administering charcoal. RESULTS: Activated charcoal was considered to be an indication for 722 patients (35% of the study population) and was administered to 555 patients. Median elapsed time from poison ingestion to activated charcoal administration was 88 minutes, and median time from activated charcoal administration to hospital arrival was 20 minutes. Activated charcoal was not given to 101 (15.4%) patients, although considered indicated, because of patient refusal (n=72), inability to ingest a charcoal mixture (n=23), technical problems (n=4), or recommendation by the hospital after telephone consultation (n=2). Charcoal caused no reported adverse effects. CONCLUSION: Out-of-hospital activated charcoal administration by EMS is feasible, even in severe poisonings. Adverse events were rare.
PMID: 15671978 [PubMed - indexed for MEDLINE]
Emergency department visits for outpatient adverse drug events: demonstration for a national surveillance system.
Budnitz DS, Pollock DA, Mendelsohn AB, Weidenbach KN, McDonald AK, Annest JL.
Epidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. dbudnitz@cdc.gov <dbudnitz@cdc.gov>
STUDY OBJECTIVE: This project demonstrates the operational feasibility and epidemiologic usefulness of modifying a national injury surveillance system for active surveillance of outpatient adverse drug events treated in hospital emergency departments (EDs). METHODS: Coders were trained to identify and report physician-documented adverse drug events in 9 of 64 National Electronic Injury Surveillance System-All Injury Program hospital EDs (occurring July 17, 2002, to September 30, 2002). Feasibility was measured by timeliness and completeness of adverse drug event reporting. Outcomes (ED discharge disposition and injury type) and associated variables (age, sex, drug category, and adverse drug event mechanism) were measured. RESULTS: There were 598 patients with physician-documented adverse drug events (7 per 1,000 visits). Nearly 70% of adverse drug event cases were reported within 7 days of the ED visit; key data elements (drug name, disposition from ED, and event description) were completed for more than 98% of cases. Nine percent of patients with adverse drug events were hospitalized, and unintentional overdoses was the most common mechanism of adverse drug events (39%). Patients with unintentional overdoses were more likely to be hospitalized than those with adverse drug reactions (adjusted odds ratio [OR] 5.9, 95% confidence interval [CI] 2.2 to 16; adverse-effects referent; allergic reactions, adjusted OR 0.7, 95% CI 0.2 to 2.4). Warfarin and insulins were associated with 16% of adverse drug events overall and 33% of adverse drug events in patients aged 50 years or older. CONCLUSION: Active surveillance for outpatient adverse drug events using the National Electronic Injury Surveillance System-All Injury Program is feasible. Ongoing, population-based ED surveillance can help characterize the burden of outpatient adverse drug events, prioritize areas for further research and intervention, and monitor progress on adverse drug event prevention.
Publication Types:
PMID: 15671977 [PubMed - indexed for MEDLINE]
Toxic epidermal necrolysis: an image case.
Ashworth SW.
Emergency Medicine Residency, University of Washington/Madigan Army Medical Center, Seattle/Tacoma, WA, USA.
Publication Types:
PMID: 15671964 [PubMed - indexed for MEDLINE]
Outcomes following abuse of methanol-containing carburetor cleaners.
LoVecchio F, Sawyers B, Thole D, Beuler MC, Winchell J, Curry SC.
Banner Good Samaritan Regional Poison Center, Department of Medical Toxicology, Phoenix, AZ 85006, USA. Frank.LoVecchio@bannerhealth.com
INTRODUCTION: Carbureter cleaners may contain methanol and are abused via inhalation. Toxicity resulting from the methanol component of these products is poorly described. METHODS: We conducted a retrospective poison center chart review over a four-year period (3/98-3/02) of outcomes following methanol-containing carbureter cleaners (MCC) exposure. Inclusion criteria were: (1) use of MCC, (2) evaluation in health care facility (HCF), (3) no known co-ingestion exposure and (4) at least 12 hour follow-up. RESULTS: 33 cases were reviewed with 11 cases excluded because of significant co-ingestions. Of the remaining 22 cases the mean age was 17 [range: 14-41] years old with 90% of cases between 14 and 17 years old. Six women and 16 men were in the study. Six of 22 cases had acidosis (serum bicarbonate < or =22 mmol/L or pH < or =7.35), 100% of patients had neurological symptoms (ataxia, etc.) and 14/22 had vomiting on presentation. Three patients received treatment with ethanol (1) and fomepizole (2). All others received intravenous fluids (15) or no treatment (4). Mean serum methanol concentration was 28mg/dl [range: 0-341 with 17/22 developing acidosis. Serum methanol was obtained at a mean of 3.5 hours [range 1-7 hours] post use. All metabolic disturbances resolved within 24 hours except in one patient (41 years old) in which her disturbances resolved within 72 hours. No patient developed visual disturbances or neurological sequealae. CONCLUSIONS: Significant toxicity following inhalation of MCC was rare with symptoms improving without aggressive care (dialysis, alcohol dehydrogenase blockade).
PMID: 15553172 [PubMed - indexed for MEDLINE]
Drug-induced hyperthermia in Huntington's disease.
Gaasbeek D, Naarding P, Stor T, Kremer HP.
Nursing Home Heemhof, Apeldoorn, The Netherlands.
Until now, only three patients with Huntington's disease (HD) and a neuroleptic malignant syndrome (NMS) have been reported in the literature. We describe four cases with advanced stage Huntington's disease who within a period of one year developed drug-induced hyperthermia, either the neuroleptic malignant syndrome, or the serotonin syndrome. Possible contributing factors that may have been specific for HD patients could be identified and included advanced neurological disease with severe illness, occurrence in summer, with possible infectious disease, dehydration, and pre-existing extra-pyramidal signs that may mask incipient NMS/serotonin syndrome. Measures to avoid these potentially lifethreatening conditions are discussed.
Publication Types:
PMID: 15083292 [PubMed - indexed for MEDLINE]
Tularemia transmitted by insect bites--Wyoming, 2001-2003.
Centers for Disease Control and Prevention (CDC).
Tularemia is a zoonotic disease caused by Francisella tularensis, a fastidious, gram-negative coccobacillus that infects vertebrates, especially rabbits and rodents. In humans, tularemia is classified into six major syndromes: ulceroglandular (the most common form), glandular, typhoidal, oculoglandular, oropharyngeal, and pneumonic. The case-fatality rate among humans can reach 30%-60% in untreated typhoidal cases. Although bites from ticks and handling infected animals are considered the most common modes of tularemia transmission in the United States, the disease also is spread through ingestion of contaminated food or water, inhalation, and insect bites. During 2001-2003, Wyoming experienced an increase in reported human cases of tularemia. This report describes the subsequent investigation by the Wyoming Department of Health (WDH), which indicated that 1) insect bites (particularly from deerflies and other horseflies) were the most commonly reported likely mode of transmission, and 2) the increase in cases was geographically and temporally associated with an outbreak of tularemia among rabbits in southwestern Wyoming. To obtain a timely diagnosis and provide information on appropriate preventive measures, health-care providers and public health officials should have knowledge of the local epidemiology of tularemia, particularly regarding modes of transmission and resultant clinical syndromes.
PMID: 15729218 [PubMed - indexed for MEDLINE]
Comment on:
Getting the lead out.
Harris P.
Publication Types:
PMID: 15728825 [PubMed - indexed for MEDLINE]
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