Archive for May 2011

ER Shift During an EF5 Tornado

May 31, 2011, 4:57 pm

This first-hand account by Dr. Kevin Kikta of being on duty in the emergency department at St. John’s Regional Medical Center in Joplin Missouri at the time it took a direct hit from an EF5 tornado last week is absolutely riveting.  A definite must-read.…

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Pediatric sulfonylurea exposure: do we know the optimal observation period?

May 31, 2011, 4:31 pm


Hypoglycemia in Pediatric Sulfonylurea Poisoning: An 8-year Poison Center Retrospective Study. Lung DD, Olson KR. Pediatrics 2011 May 23. [Epub ahead of print]


One still unresolved question in pediatric toxicology concerns the optimal and safe time period for observing a child who has ingested a sulfonylurea hypoglycemic agent.  As the authors of this study point out, recommendations in the …

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Post-publication peer review via Twitter: a new paradigm

May 30, 2011, 1:31 pm

In an illuminating article posted on Slate several days ago, Carl Zimmer reviews the process of post-publication peer review as it applied to a seemingly sensational pending article announced by NASA and the journal Science.

Briefly, in November of last year, Science put up an e-post prior to publication of an article claiming to have discovered bacteria that built …

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False morel poisoning in Michigan

May 29, 2011, 2:49 pm reports today that a cluster cases involving serious toxicity from false morel mushrooms has caused the Michigan Department of Commuunity Health to issue a warning to mushroom gathers.

So far this year, there have been 11 cases of such poisoning severe enough to require hospital admission; last year there were none.

The true morel — Morchella esculenta — is …

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NY Times on Suboxone Abuse in Prison

May 28, 2011, 12:00 am

The NY Times this morning had an interesting article on a problem of which I was completely unaware: the abuse of Suboxone in prisons. According to the report:

“Innovative smugglers have turned crushed Suboxone pills into a paste and spread it under stamps or over children’s artwork, including pages from a princess coloring book found in a New Jersey jail.”

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Hepatotoxicity from abuse of kratom: first reported case

May 26, 2011, 8:40 pm


Intrahepatic Cholestasis Following Abuse of Powdered Kratom (Mitragyna speciosa) Kapp FG et al. J Med Toxicol 2011 April 29. [Epub ahead of print]


Kratom is a psychoactive leaf from the southeast asian tree Mitragyna speciosa (picture).  This tree is related to the plants that produce coffee. Because there are a number of different alkaloids in kratom and …

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Tox Tunes #46: Rainy Day Women #12 & 35 (Bob Dylan)

May 24, 2011, 6:20 pm

Bob Dylan celebrates his 70th birthday today.  “Rainy Day Women #12 & 35” (from the album Blonde on Blonde), while certainly not one of his better songs, was in fact one of his biggest commercial hits and also one of his most controversial.  The song was banned by many radio stations — mostly because of the refrain “Everybody must …

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NBC’s Dateline goes undercover to investigate the “bath salt” industry

May 24, 2011, 12:48 am

Visit for breaking news, world news, and news about the economy

Visit for breaking news, world news, and news about the economy

Visit for breaking news, world news, and news about the economy

Dateline NBC's Hansen Files this weekend went undercover to investigate the distribution and marketing of "bath salts". The piece was powerful but . . .

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Superb review of high-dose insulin therapy in treating calcium channel-blocker overdose

May 23, 2011, 8:38 pm


High-dose insulin therapy in beta-blocker and calcium channel-blocker poisoning.  Engebretsen KM et al.  Clin Toxicol 2011;49:277-283.


This is a very well done review article of high dose insulin (HDI) therapy, and must-reading for anyone who treats poisoned patients.  I would have rated it even higher than 4 skulls had the authors not overreached in their goals and conclusions.  I’ll …

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