Archive for March 2012

Levamisole-adulterated cocaine: an excellent review

March 31, 2012, 3:00 pm

★★★½☆

Levamisole in cocaine: Unexpected news from an old acquaintance. Larocque A, Hoffman RS. Clin Toxicol 2012 Apr;50:231-241.

Abstract 

Since 2003, batches of cocaine seized by U.S. drug authorities have contained the drug levamisole. By 2009, almost 70%  of confiscated cocaine shipments were adulterated with this drug.

Levamisole in the past had been used in humans to treat both rheumatologic conditions …

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Case report: cobalt toxicity following implantation of a metal hip prosthesis

March 31, 2012, 12:36 am

★★½☆☆

Severe cobalt intoxication following hip replacement revision: Clinical features and outcome. Pelclova D et al. Clin Toxicol 2012 Apr;50:262-265.

Abstract

This case report, from the Czech Republic, describes a 56-year-old man who developed manifestations of severe cobalt intoxication after having ceramics-on-ceramics hip implant revised with insertion of a metal head containing cobalt, chromium, and titanium.

As TPR has reported before

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Is apple juice poisoning our children: update

March 29, 2012, 10:47 pm


On the current episode of the podcast ToxTalk, there is an interesting discussion about the kerfuffle caused by the Dr. Oz show claiming that potentially harmful amounts of arsenic are found in a large percentage of commercial apple juice products. (For TPR‘s coverage of this issue, click here and here). Similarly alarmist stories released by Consumer Reports

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Toxicity of high-caffeine “energy” drinks

March 28, 2012, 11:43 pm

★★★☆☆

Toxicity of Energy Drinks. Wolk BJ et al. Curr Opin Pediatr 2012 Apr;24:243-251.

Abstract

The market for energy drinks in the United States has grown rapidly, with nearly 6 billion units consumed in 2010 — more than double the amount 5 years before. The primary active and potentially toxic ingredient in these products is caffeine, but other components such as …

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Was Sgt. Robert Bales on mefloquine when he is alleged to have killed 17 Afghan civilians?

March 26, 2012, 8:22 pm

There has been increasing speculation that Robert Bales, the Army Staff Sergeant charged with killing 17 Afghan civilians in Kandahar Province on March 11, 2012, may have been suffering from  well-known neuropsychiatric effects of the anti-malaria drug mefloquine (Lariam).

Mefloquine had been widely used for malaria prophylaxis since its long half-life — 13-30 days — meant that it only …

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Clinical presentation after smoking products labeled as “Spice” or “K2”

March 25, 2012, 12:57 pm

★★½☆☆

Clinical Presentation of Intoxication Due to Synthetic Cannabinoids. Cohen J et al. Pediatrics 2012 March 19 [Epub ahead of print]

Abstract

This paper, from the Children’s National Medical Center in Washington D.C., presents three cases of teenagers who presented after smoking synthetic cannabinoid products labeled as either “Spice” or “K2”. Unfortunately, since there was no laboratory confirmation of what these …

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Don’t mess with EMCrit: brilliantly funny video

March 24, 2012, 12:20 pm

Anyone who follows the Emergency Medicine blogosphere will want to check out this absolutely hilarious video posted on Life in the Fast Lane.

BTW, we here in Chicago are eagerly looking forward to Scott Weingart’s visit this week.  He will be giving Grand Rounds at both Stroger Hospital and Northwestern.…

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Kratom: a unique leaf with stimulant and opiate-like effects

March 23, 2012, 12:58 am


MSNBC reported Tuesday on the “legal high” kratom, which is being associated with increasing numbers of emergency department visits in certain areas of the country. Unfortunately, scientific literature about the effects and toxicity of kratom is sparse.

Kratom is a psychoactive leaf from the southeast asian tree Mitragyna speciosa (picture).  This tree is related to the plants that produce coffee. …

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Suicidal cyanide ingestion in the Hmong community

March 22, 2012, 1:07 am

★★★☆☆

Poisoning and suicide by cyanide jewelry cleaner in the US Hmong community: A case series. Garlich FM et al. Clin Toxicol 2012;50:136-140.

Abstract

There are a quarter million ethnic Hmong now living in the United States.  Originally for Southeast Asia — especially Laos — this population lives largely in Minnesota, Wisconsin, and California. This article describes 8 cases — including …

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