Archive for January 2014

Ethylene glycol intoxication can cause falsely elevated lactate levels

January 30, 2014, 8:38 pm


The importance of the osmolality gap in ethylene glycol intoxication. Oostvogels R et al. BMJ 2013 Dec 7;347:31-33.

Reference – no abstract available

This brief case report teaches a key lesson. A 32-year-old woman on multiple sedative and antipsychotic medications presented to the emergency department with decreased mental status. Initially, the treating physicians suspected overdose from one or more of …

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Bruce Springsteen on Pete Seeger

January 28, 2014, 1:24 pm

Wonderful tribute by The Boss at Seeger’s 90th birthday celebration. Pete’s and his music were a lifelong inspiration for me, from “Goodnight, Irene” to “The Weavers at Carnegie Hall” to his environmental work with the Hudson River Sloop Clearwater Foundation.

And there was, always, his unwavering and indomitable political courage. This incredible performance was aired …

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Epidemic of heroin/fentanyl overdose deaths in Western Pennsylvania

January 28, 2014, 12:27 pm

KDKA-TV, the local CBS station in Pittsburgh, reported yesterday that at least 22 people have died recently from narcotic overdoses in Western Pennsylvania. Authorities believe the deaths are related to products containing heroin and/or  fentanyl sold on the street and derived from supplies stamped with the labels “Theraflu,” “Bud Ice,” or “Income Tax.’

This outbreak is reminiscent of previous events. …

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Case series: toxicity from a new synthetic cannabinoid

January 27, 2014, 5:12 pm


An Outbreak of Exposure to a Novel Synthetic Cannabinoid. Monte AA et al. New Engl J Med 2014 Jan 23;370:389-390.

Full Text

Last month, TPR posted about an MMWR report describing a markedly increased number of visits to Colorado emergency departments by patients related to smoking synthetic cannabinoid products. This spike in visits occurred in August-September 2013.

This letter to …

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Tox Tunes #77: Cooksferry Queen (Richard Thompson)

January 26, 2014, 6:09 pm

The narrative of this song is somewhat murky, but seems to involve a gangster or politician (Mulvaney) in a dingy town “with no future” who gets turned on by psychedelic drugs given to him by his “Cooksferry Queen”

She gave me one pill to get bigger
She gave me one pill to get small
I saw snakes dancing all around …

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Justin Bieber arrest refocuses spotlight on “sizzurp”

January 24, 2014, 2:07 pm

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[In the video above, the Today show’s Jeff Rossen explains why “sizzurp” — a drug favored by some rap music and pop stars — is so dangerous.]

Reports describing the arrest of pop star Justin Bieber, 19,  this week for driving under the influence — …

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Drug overdose deaths surge in Rhode Island: Tox on the Web

January 22, 2014, 8:28 pm


Overdose deaths spike in Rhode Island: The Providence Journal reported that during the first 13 days of this year, 22 people in Rhode Island died of drug overdose. Tests on 13 victims revealed the presence of fentanyl — but not acetylfentanyl, a potent analog that 1n 2013 caused at least 14 overdose deaths in the state over the

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Dabigatran-related bleeding: a case series

January 21, 2014, 1:40 pm


Clinical Experience of Life-threatening Dabigatran-Related Bleeding at a Large, Tertiary Care, Academic Medical Center: a Case Series. Ross B et al. J Med Toxicol  2014 Jan 3 [Epub ahead of print]


The authors retrospectively reviewed patients on dabigatran (Pradaxa) admitted to UMass Memorial Medical Center (Worcester) for bleeding.

They identified 7 patients with intracranial hemorrhage (ICH) and 4 patients …

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The Poison Review Podcast

January 18, 2014, 3:02 pm

Microphone-iconThe Poison Review is pleased to announce that the long-planned TPR podcast has finally arrived.  Actually, this is a resurrection of a project that began back in 1992, when TPR was a hard-copy newsletter with an accompanying audio program that was sent out on cassette tape. We were, of course, inspired by the masters of innovative medical education — …

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