Archive for February 2010

Cocaine mules: what to do with body packers

February 28, 2010, 8:49 pm

★★½☆☆

Clinical management of cocaine body packers: the Hillingdon experience. Beckley I et al.  Can J Surg 2009;52:417-421.

Full text

This retrospective observational study looked at 5-years of experience with patients suspected of being cocaine body packers referred to Hilldingdon Hospital in Uxbridge, England.  Since that hospital is located just outside of Heathrow Airport in London, the study population is considerable:  …

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GoLYTELY? or NoGO? Let’s be real about whole bowel irrigation

February 27, 2010, 2:03 pm

★★★★☆

Whole Bowel Irrigation and the Hemodynamically Unstable Calcium Channel Blocker Overdose: Primum non Nocere. Cumpston KL et al.  J Emerg Med 2010;38:171-174.

Abstract

As even its proponents admit, whole bowel irrigation (WBI) with high-molecular-weight polyethylene glycol (PEG) has never been proven to improve clinical outcomes in toxicology patients.  Despite this, some physicians argue that the procedure is safe, and recommend …

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Rational management of poisoned patients

February 26, 2010, 6:38 pm

Thanks to Michelle Lin’s blog Academic Life in Emergency Medicine for pointing out that “Emergency Medicine Practice” has just made all their issues from 2007 and earlier freely accessible online. As a result, a monograph describing “A Rational Approach To Managing The Poisoned Patient” — written almost a decade ago by Drs. Erickson, Aks, Williams, and myself …

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The Arsenic Century

February 26, 2010, 1:54 am

The Arsenic Century

The TimesOnline recently posted a review of James C. Whorton’s The Arsenic Century: How Victorian Britain was Poisoned at Home, Work, and Play. There seems to be a welcome spate of books looking at historical eras through specific poisons and the devastation they caused.  Several days ago I mentioned Deborah Blum’s The Poisoner’s Handbook: Murder and the Birth of

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Methylphenidate (Ritalin) and acute myocardial infarction

February 26, 2010, 1:20 am

★★★☆☆

Acute Myocardial Infarction Related to Methylphenidate for Adult Attention Deficit Disorder.  Thompson J et al.  J Emerg Med 2010;38:18-21.

Abstract

This case report describes at 27-year-old man who presented to the emergency department with an acute anterolateral myocardial infarction after taking several extra doses of methylphenidate (Ritalin®) prescribed for adult attention deficit disorder, along with pseudoephedrine.  Cardiac catheterization showed normal …

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Fatal caffeine overdose

February 23, 2010, 8:11 pm

★★½☆☆

A case of fatal caffeine poisoning. Rudolph T et al Acta Anaesthesiol Scand 2010 Jan 21. (Epub ahead of print).

This case report, from Sweden, describes a 21-year-old woman who overdosed on 10,000 mg of caffeine (the equivalent of approximately 83 cups of brewed coffee.)  She suffered multiple occurrences of v. fib arrest which initially responded to countershock, epinephrine, and …

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Just when you thought it was safe to go back to the ice rink . . .

February 23, 2010, 7:15 pm

Mark Mycyk’s Chicago Toxcast has released its February issue, a special edition in honor of the Olympics.  In it are reviews of several interesting studies addressing such topics as the hazards involved in waxing skis, and toxic gases present in ice rinks and at monster truck rallies.  The issue can be downloaded for free at the Toxcast site or from …

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Herbal products may pose danger for heart patients

February 23, 2010, 12:51 am

★★★½☆

Use of Herbal Products and Potential Interactions in Patients with Cardiovascular Diseases. Tachjian A et al.  J Am Coll Cardiol Feb 9, 2010;55:515-25.

Abstract

Use of unregulated herbal remedies is common and increasing dramatically among patients also taking prescription medicines. Unfortunately, these herbal products can have detrimental effects of their own, as well as potential interactions with other medications.  This …

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Tox Tunes #8 – Weed Smoker’s Dream (Harlem Hamfats)

February 22, 2010, 12:20 am

Despite the name, no member of the Harlem Hamfats was from New York.  The group was a well-known Chicago studio band that went on to record and perform on their own. (Wikipedia suggests that they might in fact be the first such group.) The term “hamfat” is slang for something mediocre or second-rate.  The use here is clearly …

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