Archive for October 2012

Hyperbaric oxygen for carbon monoxide poisoning? Eminence-based recommendations not evidence-based

October 31, 2012, 11:41 am


Practice Recommendations in the Diagnosis, Management and Prevention of Carbon Monoxide Poisoning. Hampson NB et al. Am J Respir Crit Care Med 2012 Oct 18 [Epub ahead of print]


When I first saw this paper I was really looking forward to reading it. I still find many aspects of managing carbon monoxide poisoning — especially those involving indications for …

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Death adder venom primarily neurotoxic

October 27, 2012, 1:24 pm


Death Adder Envenoming Causes Neurotoxicity Not Reversed by Antivenom – Australian Snakebite Project (ASP-16) Johnston CI et al. PLoS Negl Trop Dis 2012 Sep;6:e1841

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Despite their name,  Death Adders (Acanthosphis app) are not true vipers but Elapidae.  They are found in parts of Australia, Papua New Guinea, and the Indonesian archipelago. Limited clinical data suggests …

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F.D.A. investigating 5 deaths possibly associated with caffeinated “energy” drinks

October 25, 2012, 12:56 pm

Earlier this week, the New York Times reported that the Food and Drug Administration is investigating 5 deaths occurring in individuals shorty after they ingested Monster Energy drinks. Details of these cases were obtained under the Freedom of Information Act by a lawyer for the family of 14-year-old Anais Fournier, who developed a fatal cardiac arrhythmia which — according to …

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White matter destruction: was 2C-E (“Europa”) the culprit?

October 23, 2012, 10:46 pm


Fatal toxic leukoencephalopathy secondary to overdose of a new psychoactive designer drug 2C-E (“Europa”). Sacks J et al. Proc (Bayl Med Cent) 2012;25:374-376.

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This paper, from the Department of Radiology at Baylor University Medical Center, describes a 26-year-old male with a history of polysubstance abuse brought to the ER after being found down with an empty bottle of …

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“60 Minutes” on medical marijuana

October 21, 2012, 8:40 pm

The 60 Minutes piece on medical marijuana that aired tonight doesn’t contain much that is new, but is worth watching. It emphasizes the conflict between the laws of some states and federal statutes that still consider THC a controlled substance.

In additional footage from 60 Minutes Overtime, Steve Kroft talks to Tripp Keber, managing partner of Dixie Elixirs &

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Tox Tunes #65: A Spoonful Blues (Charley Patton)

October 21, 2012, 6:51 pm

Charley Patton (?1887-1934), sometimes called “The Father of the Delta Blues”, influenced a wide range of twentieth century American musicians, everyone from Robert Johnson and Son House to Howlin’ Wolf and Bob Dylan.

If the Delta country blues has a convenient source point, it would probably be Charley Patton, its first great star. His hoarse, impassioned singing style, fluid guitar

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Is magnesium beneficial in treating Irukandji jellyfish stings?

October 20, 2012, 5:06 pm


Randomized trial of magnesium in the treatment of Irukandji syndrome. McCullagh N et al. Emerg Med Australas 2012;24:560-565.


Irukandji Syndrome  is caused by stings from several jellyfish, primarily Carukia barnesiImportant symptoms include pain and cramping in trunk and extremities. In addition, catecholamine surge causes tachycardia and hypertension. Two deaths have been reported from intracranial hemorrhage associated with …

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Must-read article: everything you didn’t realize you wanted to know about narcotic bowel syndrome

October 19, 2012, 11:58 am



The Narcotic Bowel Syndrome: Clinical Features, Pathophysiology and Management. Grunkemeier DMS et al. Clin Gastrointerol Hepatol 2007 Oct;5:1126-1139.

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TPR has discussed in the past how the important diagnosis of narcotic bowel syndrome (NBS) is often missed, causing patients to undergo unnecessary procedures (CT scans, laparotomies, etc) and endure escalating gastrointestinal pain and distress. These patients also experience …

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Just when you thought it was safe to go back to the laundry room . . .

October 18, 2012, 7:18 pm

If the above video does not run, you can see it by clicking here.


Health Hazards Associated with Laundry Detergent Pods — United States, May-June 2012. MMWR 2012 Oct 19;61:825-829.

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First marketed in the U.S. in 2010, laundry detergent pods are capsules of concentrated liquid detergent packaged in a membrane that dissolves in water. Because these capsules …

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