Archive for December 2009

Life in the Fast Lane: Greatest Hits 2009

December 31, 2009, 3:28 pm

The great medical blog Life is the Fast Lane is based in Australia, so naturally their list of Greatest Hits from 2009 includes a post about the deadly box jellyfish (Chironex fleckeri), one of the many creatures down under that can make one’s remaining minutes on the planet short and unpleasant.  I was reminded of this passage …

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Health Care Journalism in the New Decade

December 31, 2009, 2:27 pm

Gary Schwitzer’s post on “10 trends in health care journalism going into 2010” is well worth a look.  Schwitzer’s HealthNewsReview blog itself is one of the most consistently interesting and valuable medical sites on the web.…

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Alcohol and Hypothermia

December 31, 2009, 2:03 pm

º★★★★☆

CASE 41-2009: A 16-YEAR-OLD BOY WITH HYPOTHERMIA AND FROSTBITE Sheridan RL et al. N Eng J Med 31 Dec 2009;361:2654-62.

Extract

This week’s “Case Records” discussion in the New England Journal of Medicinepresents a teenager who was found unconscious and partially unclothed in a snowbank approximately 7 hours after leaving a New Year’s Eve party at which he …

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Oral N-Acetylcysteine Treatment for Acetaminophen Toxicity – How Long?

December 29, 2009, 11:14 pm

★★½☆☆

A RETROSPECTIVE EVALUATION OF SHORTENED-DURATION ORAL N-ACETYLCYSTEINE FOR THE TREATMENT OF ACETAMINOPHEN POISONING Betten DP et al. J Med Toxicol 2009 Dec;5:183-190.

The tortuous argument this paper presents can be deduced from the hair-splitting language used in the abstract’s conclusion: “Treatment with shortened-course oral NAC [N-acetylcysteine] in patients meeting criteria for early discontinuation may be an effective treatment …

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Tylenol Lots Recalled – Musty Odor

December 29, 2009, 2:45 pm

The FDA and McNeil Consumer Healthcare announced that a recall of products initiated last month has been expanded to include all lots of Tylenol Arthritis Pain Caplets 100-count bottles with a red EZ-OPEN cap.  Consumers had complained of a strange musty, moldy, or mildewy odor that they associated with nausea, vomiting, abdominal pain, and diarrhea.  According to McNeil and the …

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It Ain’t Tox But . . .Thinking About Health Care Reform

December 29, 2009, 1:24 am

At the end of each year TPR eagerly awaits announcement of the Sidney Awards, honors handed out by David Brooks of the New York Times to recognize the best magazine essays of the year.  In naming this year’s winners, Brooks noted the importance of magazines in the health care debate, and called Atul Gawande’s New Yorker piece “The Cost

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Antidote Pearls and Pitfalls

December 27, 2009, 7:44 pm

★★★★☆

TOXICOLOGY: PEARLS AND PITFALLS IN THE USE OF ANTIDOTES Smollin CG. Emerg Clin North Amer 2010;28:149-161.

Abstract

This is a good, relatively brief update on current use of certain important antidotes: high dose insulin euglycemia therapy (HIET) for calcium channel blocker (CCB) overdose; intravenous lipid emulsion for fat-soluble cardiotoxic medications; hydroxocobalamin for cyanide; N-acetylcysteine (oral and intravenous) for acetaminophen …

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Podophyllin Toxicity Often Misdiagnosed

December 26, 2009, 3:20 pm

★★½☆☆

BAJIAOLIAN POISONING – A POISONING WITH HIGH MISDIAGNOSIS RATE Chou SL et al. Am J Emerg Med 2010 Jan;28:85-89.

Abstract

Bajiaolian, one of the species of mayapple plants, contains podophyllin and has long been used in Chinese herbal medicine to treat skin lesions, snake bites, generalized weakness, and other conditions.  Ingestion of podophyllotoxin produces early gastrointestinal manifestations (nausea, vomiting, diarrhea,  …

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Anthrax Deaths Possibly Linked to Heroin Abuse

December 24, 2009, 4:26 pm

The Independent (U.K.) reported today that two drug users Glasgow have died of anthrax infection, and a third death is thought to be anthrax-related.  Two additional drug users in Scotland have been diagnosed with the disease but are responding to treatment.

This is not unprecedented.  In 2000, physicians from Oslo Norway described a 49-year-old heroin skin popper who died after …

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