Clinical features and treatment in patients with acute 2,4-dinitrophenol poisoning. Lu Y et al. J Zhejiang Univ-Sci B (Biomed & Biotechnol) 2011;12:189-192.
Dinitrophenol (DNP) is an industrial chemical used in the manufacture of explosives, herbicides, dyes, and wood preservatives. When ingested, DNP uncouples mitochondrial oxidative phosphorylaation, interfering with the cell’s ability to store energy as ATP. Instead, the …
Metabolic Acidosis, Hypoglycemia, and Severe Myalgias: An Attempt to Mask Urine Drug Screen Results. Arcinegas-Rodriguez S et al. Pediatr Emer Care 2011 April;27:315-317.
This interesting case reports describes a massive niacin overdose that presented with metabolic acidosis (anion gap = 32 mMol/L), myalgias, and hypoglycemia (glucose – 29 mg/dL), along with abdominal and chest pain. The patient — …
Benzylpiperazine (BZP)
The clinical toxicology of the designer “party pills” benzylpiperazine and trifluoromethylphenylpiperazine. Schep LJ et al. Clin Toxicol 2011 Mar;49:131-141.
This article reviews the medical literature concerning — and tells you more than you probably want to know about — benzylpiperazine (BZP) and trifluoromethylphenylpiperazine (TFMPP), two chemicals with syngergistic actions often used together to mimic the effects of …
Management of Button Battery-induced Hemorrhage in Children. Brumbaugh DE et al. J Pediatr Gastroenterol Nutr 2011 May;52:585-589.
Ingestion of a button battery can cause fatal injury in a child. Potential complications include tracheoesophageal fistula, esophageal stricture and stenosis, vocal cord paralysis, and aspiration pneumonia. However, the most devastating sequela is exsanguination from erosion into the aorta or other major …
The spice of life: An analysis of nutmeg exposures in California. Carstairs SD, Cantrell FL. Clin Toxicol 2011;49:177-180.
Skip the methods and results sections of this paper and turn directly to the discussion, which is the best short treatment of nutmeg toxicity in the medical literature. (I recently reviewed that literature for an Emergency Medicine News column that should …
Police in Washington State now believe that “bath salts” may have been involved in a bizarre double murder-suicide that took the lives of an army medic, his wife, and their son. On April 5, according to a report in the Bellingham Herald, Army Sgt. David Stewart fatally shot his wife and then himself as police tried to pull him …
Review article: Intravenous lipid emulsion as antidote: A summary of published human experience. Cave G et al. Emerg Med Australasia 2011 April;23:123-141.
The goal of this paper was to report on a systematic comprehensive review of cases in the medical literature in which intravenous lipid emulsion (ILE) was used to treat drug toxicity, and summarize these reports. The …
. . . this mordantly funny cartoon is must-viewing for those with any contact with, or interest in, academic scientific research.
Thanks to the excellent Gary Schwitzer’s HealthNewsReview blog, where I first saw this clip. It had previously been posted by Carey Goldberg on the WBUR Boston “Common Health” blog.…
Falsely Normal Anion Gap in Severe Salicylate Poisoning Caused by Laboratory Interference. Jacob J, Lavonas EJ. Ann Emerg Med 2011 April 12 [Epub ahead of print]
Salicylate toxicity typically causes a high-anion-gap metabolic acidosis. This short paper presents 2 cases of moderate to severe salicylate toxicity with normal-low anion gaps. The authors suggest that the absence of an elevated …
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