Archive for April 2012

Tox Tunes #58: Acid Queen (The Who)

April 29, 2012, 9:00 pm

I never really was a fan of The Who’s rock opera Tommy. Part of the problem was that the very term “rock opera” reeked of pretension. Another big impediment was the story, the beginning of which is summarized in Wikipedia as follows:

British Army Captain Walker is reported missing, and is believed dead. His widow, Mrs. Walker, gives birth

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Occupational hazard among veterinary workers: exposure to phosphine gas

April 28, 2012, 2:34 pm

★★★☆☆

Occupational Phosphine Gas Poisoning at Veterinary Hospitals from Dogs that Ingested Zinc Phosphide — Michigan, Iowa, and Washington, 2006—2011. MMWR 2012 April 27;61:286-288.

Full Text

This article reports on the CDC National Institute  for Occupational Health (NIOSH) investigation into cases of phosphine (PH3) poisoning among veterinary workers treating dogs who had swallowed zinc phosphide rodenticide. A poisoning case …

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Don’t miss this important diagnosis

April 26, 2012, 11:42 pm

★★★☆☆

Case Records of the Massachusetts General Hospital: A 79-Year-Old Man with Pain and Weakness in the Legs. David WS et al. N Engl J Med 2012 Mar 8;366:944-954.

No abstract available

This interesting clinical-pathological conferences discuss a 79-yo male multiple medical problems and taking multiple medications, who presents with progressive pain and weakness in his legs, renal insufficiency, and a …

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Comprehensive review of bath salts

April 25, 2012, 11:12 pm

★★★½☆

Bath Salts: The Ivory Wave of Trouble. Olives TD et al. West J Emerg Med 2012 Feb;13:58-62.

Full Text

This review the synthetic cathinones mephedrone and MDPV — with 47 references — is available via open access and is well-worth downloading a reading. It is reasonably comprehensive, given the paucity of good clinical or experimental data. The authors describe the …

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Do all victims of crotalid snake bite need coagulation studies?

April 24, 2012, 2:43 pm

★★½☆☆

The Role for Coagulation Markers in Mild Snakebite Envenomations. Moriarity RS et al. West J Emerg Med 2012 Feb;13:68-74.

Full Text

Most review articles and chapters about crotalid snakebite envenomation recommend obtaining baseline coagulation studies (PT, platelet count, fibrinogen) on all patients. The authors of this study, from the University of Mississippi in Jackson, tried to determine if there was …

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Toxicology on the Web: recent postings

April 22, 2012, 12:20 am

Two recent educational posts that are worth checking out:

At Life in the Fast Lane, in their series of toxicology conundrums,  there is a good quick review of lithium toxicity organized in a question-and-answer format.

At the HQMedEd podcast, Dr. Jon B. Cole from Hennepin County Medical Center  presents a 30-minute lecture on “Pitfalls of the Urine Drug

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Epidemic of PMMA-associated deaths in Norway

April 20, 2012, 4:19 pm

PMMA can taint drugs sold as ecstasy

★★★½☆

The PMMA epidemic in Norway: Comparison of fatal and non-fatal intoxications. Vevelstad M et al.  Forensic Sci Int 2012 Jan 16 [Epub ahead of print]

Abstract

Several days ago, we reviewed a report of 24 deaths in Israel associated with the hallucinogenic stimulants PMMA and PMA. This paper reports on 12 fatal …

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Meet “Dr. Death”: PMMA and PMA

April 18, 2012, 10:50 pm

PMMA pills

★★★☆☆

Severe paramethoxymethamphetamine (PMMA) and paramethoxyamphetamine (PMA) outbreak in Israel. Lurie Y et al. Clin Toxicol 2012;50:39-43.

Abstract

PMMA and PMA are hallucinogenic stimulants with effects similar to those of mescaline and ecstasy (MDMA). Once absorbed into the system, PMMA is metabolized to PMA, a drug so dangerous its street names include “death” and “Dr. Death”. Animal data suggest …

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Thiamine before glucose? A myth that has long been debunked

April 18, 2012, 12:14 am

★★★☆☆

Glucose Before Thiamine for Wernicke Encephalopathy: A Literature Review. Schabelman E, Kuo D. J Emerg Med 2012 Apr;42:488-494.

Abstract

It had been an axiom long taught on medicine wards that before malnourished patients — especially alcoholics — are given intravenous glucose, they must first receive parenteral thiamine. The fear was that in the process of metabolizing the glucose a marginal …

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