Archive for the ‘Best of TPR’ Category

There is no real evidence on treating calcium channel blocker overdose

November 6, 2014, 8:06 pm


Treatment of calcium channel blocker poisoning: A systematic review. St-Onge M et al. Clin Toxicol 2014 Nov;52:926-944.


This systematic review is massive, thorough, intimidating, and all but unreadable.

As a prelude to establishing a clinical guideline for treatment of calcium channel blocker (CCB) overdose, the 14 Canadian authors systematically searched and evaluated relevant literature. They initially identified 15,577(!) citations, …

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Must-read: marketing vs. medicine in the case of Pradaxa (dabigatran)

July 27, 2014, 8:01 pm


Dabigatran: how the drug company withheld important analyses. Cohen D. BMJ 2014 Jul 23;349:g4670. doi: 10.1136/bmj.g4670.

Full Text

As TPR has reported before, there has long been reason to doubt the claim that the anticoagulant dabigatran (Pradaxa) can be safely and effectively used for prevention of strokes in patients with non-valvular atrial fibrillation without laboratory monitoring.

This must-read investigative …

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Must-read: getting started in online emergency medicine education and FOAMed

June 28, 2014, 6:40 pm


Five Strategies to Effectively Use Online Resources in Emergency Medicine. Thoma B et al. Ann Emerg Med 2014 Jun 21 [Epub ahead of print]


FOAM (Free Open Access Meducation) was born, legend has it, in 2012 during an international conference in Dublin, as Dr. Mike Cadogan  stared into the dregs of a pint of …

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This makes it clear: stoned driving is indeed dangerous

May 4, 2014, 3:36 pm

This investigative report from KIRO-7 Eyewitness News in Seattle is a surprisingly good illustration of the effects of marijuana smoking on driving skills. It would have been even better if the piece was more clear on the concept of a “legal limit.”

There are some people on the internet and in print arguing that driving under the influence of THC …

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Effects of marijuana on driving ability

April 9, 2014, 6:31 pm



Medical Marijuana and Driving: a Review. Neavyn MJ et al. J Med Toxicol 2014 Mar 20 [Epub ahead of print]


This excellent and comprehensive review of literature related to the possible effects of marijuana on driving skills is a must-read for anyone dealing with forensics and medical-legal cases related to the topic, or consulting with government agencies on regulatory …

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Into the Wild: did a neurotoxin kill Chris McCandless?

January 6, 2014, 5:01 pm

In April 1992, Chris McCandless, aka “Alexander Supertramp,” hiked into the Alaskan wilderness with no map, no compass, and no means of communicating with the outside world. A 24-year-old from Fairfax, Virginia, he had graduated with honors with a double major (history, anthropology) from Emory University in Atlanta. However, as chronicled in Jon Krakauer’s book Into the Wild, he …

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Deaths in an Australian nursing home: murder by insulin?

November 2, 2013, 12:10 pm


The Australian Broadcasting Corporation reported this week that that two residents of the Summitcare Wallsend nursing home in Newcastle — an 83-year-old woman and an 80-year-old man — died of hypoglycemia under suspicious circumstances. An additional resident of that same home was sent to hospital with dangerously low blood glucose levels, but survived. Police have called in homicide experts from …

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Must-read: Anti-NMDA Receptor Encephalitis

August 28, 2013, 1:35 pm


Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis: an etiology worth considering in the differential of delirium. Punja M et al. Clin Toxicol 2013 Aug 20 [Epub ahead of print]


This important paper is a must-read, especially for toxicologists who have not heard of this under-appreciated neurological disorder. (I was not aware of it until several days ago, when I found out that …

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Official report about overdose patient who awoke in OR just before surgeons harvested her organs

July 11, 2013, 12:18 am

Several days ago TPR posted  about a distressing case from Syracuse (NY), in which an overdose patient woke up in the operating room just as surgeons were about to harvest her organs. There were some details in the Syracuse Post-Standard story. An astute reader sent a comment pointing out that the report investigating this case — produced by the …

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