Severe reactions to “Spice” on rise, some associated with drug MAB-CHMINACA

April 24, 2015, 7:26 pm

AB-CHMINACA

AB-CHMINACA

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In vitro and in vivo human metabolism of the synthetic cannabinoid AB-CHMINACA Erratico C et al. Drug Test Analysis 2015 Apr 12 [Epub ahead of print]

Abstract

The New York Times reported today on the recent dramatic increase in emergency department visits related to use of synthetic cannabinoids (call colloquially, but somewhat inaccurately, “Spice”). This phenomenon has been seen …

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Even Dr. Oz can’t rebut John Oliver

April 24, 2015, 1:10 pm

Dr. Oz’s rebuttal yesterday to the letter from ten self-described “distinguished physicians” who demanded that Columbia Medical School cancel his faculty appointment was absolutely brilliant — recasting the narrative from the selling of snake oil to standing up for free speech and against the juggernaut agricultural-industrial complex.

But there’s no rebuttal to John Oliver.

See also Michael Specter’s New Yorker

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Proton pump inhibitors increase risk of acute kidney injury

April 22, 2015, 10:31 pm

lanzoprazole★★★☆☆

Proton pump inhibitors and the risk of acute kidney injury in older patients: a population-based cohort study. Antoniou T et al. CMAJ Open 2015;Apr;3:E166-E171.

Full Text

Previous studies have suggested that use of proton pump inhibitors (PPIs) increases risk of acute interstitial nephritis, especially in elderly patients. Using information from  several large computerized databases containing medical information about patients …

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Poisonous birds: what’s new

April 20, 2015, 11:17 pm

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Poisonous birds: A timely review. Ligabue-Braun R, Carlini CR. Toxicon 2015 Mar 31;99:102-108.

Abstract

It was just over two decades ago that Dumbacher et al published their landmark paper describing the presence of the alkaloid batrachotoxin (BTX, “frog poison”) in the skin and feathers of three species of Pitohui bird in New Guinea. This toxin binds to voltage-gated sodium channels …

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27 fatalities from laboratory-confirmed exposure to PMMA (“Dr. Death”)

April 18, 2015, 2:22 pm

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Deaths from exposure to paramethoxymethamphetamine in Alberta and British Columbia, Canada: a case series. Nicol JJE et al. CMAJ Open. 2015 Jan 13;3(1):E83-9

Full Text

From June 2011 through April 2012, 27 deaths in the Canadian provinces of Albert and British Columbia were attributed to the hallucinogenic stimulant para-methoxy-N-methylamphetamine (PMMA) as the primary toxic agent based …

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Predicting delirium tremens in patients with alcohol withdrawal seizures

April 13, 2015, 9:16 pm

delirium_tremens_label_2★★☆☆☆

Clinical predictors for delirium tremens in patients with alcohol withdrawal seizures. Kim DW et al. Am J Emerg Med 2015 Feb 23 [Epub ahead of print]

Abstract

Being able to predict which patients with alcohol withdrawal seizures will go on to develop delirium tremens (DTs) may lead to improved clinical outcomes and decreased morbidity and mortality.  The goal of this …

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Risk of completed suicide after initial hospitalization for deliberate overdose

April 11, 2015, 11:58 am

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Risk of Suicide Following Deliberate Self-poisoning. Finkelstein Y et al. JAMA Psychiatry 2015 Apr 1 [Epub ahead of print]

Abstract

The authors primary objective was to determine the risk of subsequent successful suicide in patients discharged from hospital after a first suicide attempt. They used multiple healthcare databases to identify patients hospitalized for first suicide attempt in Ontario, Canada from …

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Less is more: fatal C. difficile colitis after empiric antibiotics

April 9, 2015, 12:05 am

Aspiration pneumonitis

Aspiration pneumonitis

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Antibiotics “Just-In-Case” in a Patient With Aspiration Pneumonitis. Joundi RA et al. JAMA Intern Med 2015 Apr 1;175:489-490

Reference

This very brief but very important case report contains more key points than most papers 10 times as long. The case describes a 50-year-old man with cerebral palsy and a known seizure disorder who had several witnessed tonic-clonic seizure …

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Factors associated with emergency department opioid-related adverse drug events

April 7, 2015, 10:22 pm

hydromorphone★★★½☆

Preventing Iatrogenic Overdose: A Review of In-Emergency Department Opioid-Related Adverse Drug Events and Medication Errors. Beaudoin FL et al. Ann Emerg Med 2014 Apr;65:423-431.

Abstract 

The authors retrospectively reviewed records of patients from 2 academic urban hospitals who were treated with naloxone after receiving an opioid in the emergency department (ED). Their goal was to identify factors associated with opioid-related …

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