Archive for August 2011

Does elevated blood glucose level indicate poor prognosis in methanol poisoning?

August 31, 2011, 7:45 pm


Hyperglycemia Is a Strong Prognostic Factor of Lethality in Methanol Poisoning. Sanaei-Zadeh H et al. J Med Toxicol 2011 Sep;7:189-194.


After noticing that patients they treated for methanol poisoning tended to have elevated blood glucose levels, the authors of this Iranian study set out to investigate this relationship and whether it might have prognostic significance. Retrospectively reviewing 7 years …

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Ethylene glycol, murder, and the media

August 30, 2011, 1:24 pm


Intentional Ethylene Glycol Poisoning Increase after Media Coverage of Antifreeze Murders. Morgan BW et al. West J Emerg Med 2011 Jul;12:296-299.

Full text

This article opens with details of a murder case that could have come straight from the pages of a novel:

In January 2001, a Forsyth County, Georgia, firefighter suddenly died. The Georgia Bureau of Investigation ruled the

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More on cannabinoid hyperemesis syndrome

August 30, 2011, 12:25 am


Grand Rounds June 2009 – Cannabis Hyperemesis Syndrome from Department of Emergency Medicine on Vimeo.

Last week we discussed the very interesting — but most certainly underdiagnosed — entity of cannabinoid hyperemesis syndrome. In this week’s Life in the Fast Lane Review, Kane Guthrie points out that this is a hot topic, having been featured recently both …

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Tox Tunes #48: Angel Dust (Gil Scott-Heron)

August 28, 2011, 12:29 pm

Gil Scott-Heron (1949 – 2011) was often called the godfather of rap, but invariably objected to that description: “I don’t know if I can take the blame for it” he told one interviewer. There is no doubt, however, that his work in the 1970s prefigured rap and hip hop. “Angel dust” is a street term for phencyclidine (PCP), a …

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Entourage and “The Whizzinator”

August 27, 2011, 12:43 pm

TPR just returned from vacation, finally caught up with episode 92 (titled “Whiz Kid”)¬†of the HBO series Entourage, and was interested to see that it contained plenty of material related to toxicology. In this episode Vince is required by his probation officer to take a urine drug test. Since he had smoked a joint the week before (in an …

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FDA Warnings: Black Box, or Black Hole

August 26, 2011, 11:32 am


A continuing black hole? The FDA boxed warning: An appeal to improve its clinical utility. Matlock A et al. Clin Toxicol 2011;49:443-447.


This important commentary discusses the problems, contradictions, and confusions generated by the FDA’s “black box” warnings, at least given the manner in which they are managed at present. Most importantly, the authors note that the warnings generally …

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The anti-munchies: cannabinoid hyperemesis syndrome

August 25, 2011, 11:14 pm


Cannabinoid Hyperemesis Syndrome: Literature Review and Proposed Diagnosis and Treatment Algorithm. Wallace EA et al. Southern Med J 2011 Sep;104:659-664.


Last month we reviewed a diagnosis TPR had not heard of before: narcotic bowel syndrome. This paper describes another diagnosis new to us: cannabinoid hyperemesis syndrome (CHS). Although cannabis has well-known anti-emetic properties, frequent chronic use can produce …

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Review of basic emergency toxicology management

August 24, 2011, 3:19 pm


Clinical Review: Emergency management of acute poisoning. van Hoving DJ et al. African Journal of Emergency Medicine (2011), doi:10.1016/j.afjem.2011.07.006

Complete text

[Note: this is an uncorrected proof of an article in press]

This article, from Stellenbosch University in South Africa, is a good, level-headed review of basic toxicology management. I especially like the way in which it emphasizes the importance …

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Case series: intoxication from alcoholic “energy” drink

August 23, 2011, 10:26 pm


Adolescents and Young Adults Presenting to the Emergency Department Intoxicated From a Caffeinated Alcoholic Beverage: A Case Series. Cleary K et al. Ann Emerg Med 08 Aug 2011 [Epub ahead of print]


Before it was reformulated by the manufacturer, Four Loko — a popular caffeinated alcoholic beverage — contained alcohol, caffeine, guarana, and taurine. Because the product contains …

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