911 Call: Marijuana Overdose (a TPR rerun)
September 30, 2010, 9:48 pm
httpv://www.youtube.com/watch?v=d-iBJQFMvgo
httpv://www.youtube.com/watch?v=d-iBJQFMvgo
Alberto Contador’s yellow jersey for winning the 2010 Tour de France is at risk following reports that he tested positive for the banned drug clenbuterolduring the race. Clenbuterol — illegal in the United States (except as a veterinary drug) but available in Europe — is a long-acting beta-2 agonist that also has considerable anabolic activity, increasing lean muscle mass as well as the …





RICIN AS A WEAPON OF MASS TERROR — SEPARATING FACT FROM FICTION. Schep LJ et al. Environ Int 2009;35:1267-1271.
Ricin, a toxic chemical derived form the castor bean plant Ricinus communis, is often called one of the most deadly chemicals in nature. It also often on the short list of substances that could be used as …





Cocaine-Related Vasculitis Causing Scrotal Gangrene. Chen SC et al. Ann Pharmacother 2009;43:375-378
This 2009 case report from Taiwan deserves attention and re-examination. The authors describe the case of a 22-year-old daily crack cocaine smoker who developed swelling and ulcerations of his scrotum. He was initial treated with IV antibiotics for presumed orchitis, but further testing excluded infectious causes, revealing …





MAD HONEY SEX: THERAPEUTIC MISADVENTURES FROM AN ANCIENT BIOLOGICAL WEAPON. Demircan A et al. Ann Emerg Med Dec 2009;54:824-829.
“Mad honey” — made from pollen of Rhododentron species – contains a grayanotoxin that opens sodium channels and maintains excitable cells in a state of depolarization. Signs and symptoms of intoxication include dizziness, nausea, vomiting, bradycardia, and hypotension. This …
Okay, it’s not really a Tox Tune. But this clip from Charlie Chaplin’s Modern Times is a fascinating example of the appearance of drugs in early twentieth-century American culture.…
[First posted January 22, 2010]
The Independent (U.K.) reported today that the potentially deadly funnel-web spider (Atrax robustus) has had a banner year in the area around Sydney, Australia, where a combination of unusual moisture and cool temperatures have created ideal conditions for the creatures to breed. Funnel-webs have not only long (4-5 mm) and extremely sharp fangs, …





Irukandji Syndrome Case Series From Australia’s Tropical Northern Territory Ann Emerg Med Sept 2009;54:395-403.
Irukandji sydrome is caused by the sting of a tiny (20-mm) jellyfish (Carukia barnesi) found predominantly in the waters off northern Australia. It is characterized by a relatively mild sting injury, followed within minutes or hours by severe manifestations of cathecholamine storm: hypertension, tachycardia, EKG changes, and occasional cardiomhyopathy. Fatalities are rare, but have been associated with subarchnoid hemorrhage secondary to marked hypertension. Similar syndromes caused by jellyfish stings have been seen as far away as Florida, although it is not clear if C. barnesi is the culprit in these cases. The key elements in treating these stings are general support and adequate analgesia with opiates. Dowsing the affected area with vinegar will deactivate the jellyfish’s stinging cells (nematocysts) that have not yet fired.
The Travel Channel’s Bite Me with Dr. Mike has an entertaining — if overdramatized — segment on C. barnesi and the even more toxic box jellyfish, Chironex fleckeri.
httpv://www.youtube.com/watch?v=uJg2yne715Y
Although this article discusses application of vinegar as a first aid measure, it doesn’t mention a commonly cited alternative for many jellyfish stings, which is urinating on the wound. An episode of the sitcom Friends was based on this well-known — but to my knowledge still unstudied — intervention.
httpv://www.youtube.com/watch?v=rVzNoSbu8yo
Life in the Fast Lane has a well-illustrated post discussing a mystery case that presents with paralysis and a bump on the head. Can you identify the diagnosis and specific treatment required so that the patient may rise and walk again?…