January 20, 2011, 10:24 pm
Unrecognized Acetaminophen Toxicity as a Cause of Indeterminate Acute Liver Failure. Khandelwal N et al. Hepatology 2010 Nov 4 [Epub ahead of print]
Abstract
This must-read paper uses a relatively new concept to make a very important point.
The concept: In acetaminophen (APAP) overdose, the toxic metabolite NAPQI binds to cysteine groups on hepatocellular proteins, causing necrosis. When the liver …
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December 5, 2010, 1:11 am
Neuroskeptic posted this week about the extremely strange events that took place in the French town of Pont St. Esprit.
These events took place in 1951, and were the subject of one of the weirdest news stories ever to appear in the New York Times.
Datelined Paris, Aug. 28, the dispatch was headlined: “3 Die, Many Stricken by …
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August 2, 2010, 8:07 pm
TPR received a number of comments about this weekend’s post reviewing a recent article about “Spice” and other smoking mixtures containing synthetic cannabinoids. Much of the interest centered on an incidental comment that the article referenced another paper from Journal of Mass Spectrometry, in which two of the researchers, in addition to running various mixtures through GC-MS and TLC to identify exactly what they contained, did a self-experiment by smoking a sample of “Spice Diamond” to assess its physiologic and psychotropic effects.
That got us thinking about the glorious history of self-experimentation in medicine, as described in Lawrence Altman’s wonderful book “Who Goes First?”. One reader pointed out the Altman left out the incredible episode of of Jack Barnes and his discovery of the cause of Irukandji syndome. This was a serious omission. But Altman also did not include what is without doubt the most bizarre example of self-experiementation ever published in the medical literature.
The year was 1884. . . .
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June 10, 2010, 12:15 pm
Several weeks ago I wrote about the controversy concerning what — if anything — is being held by the weird satyr in the lower-right corner of Botticelli’s great painting “Venus and Mars”. An art historian from Sotheby’s had claimed that the satyr was clutching Datura stromonium (Jimson Weed), suggesting that the sleeping Mars was not so much post-coital as stoned …
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June 6, 2010, 11:50 pm
Emerging Battery-Ingestion Hazard: Clinical Implications. Litovitz T et al. Pediatrics June 2010;125:1168-1177.
Abstract
This must-read article points out that with the growing popularity of 20-mm lithium batteries, the percentage of button battery ingestions involving major outcomes or fatalities is increasing. The authors, from the National Capital Poison Center in Washington, DC, analyzed data from 3 major sources concerning these ingestions. They make the following important points: . . .
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May 22, 2010, 2:44 pm
Cyanide Poisoning and Cardiac Disorders: 161 Cases. Fortin JL et al. J Emerg Med May 2010;38:467-476,
Abstract
This manufacturer-sponsored, multicenter retrospective study reviewed cases of patients with smoke inhalation or cyanide ingestion who received early hydroxocobalamin in the field, before arriving at hospital. The study period was from January 1995 to July 2008. The authors paid special attention to the …
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March 16, 2010, 8:31 pm
Adulterated Cocaine and Lessons Learned from the Jake Walk Blues. Wiegand TJ J Med Toxicol (published online 11 March 2010 ahead of print).
No abstract available online
In this very interesting short article, T.J. Wiegand from the Northern New England Poison Center uses recent reports that a large percentage of cocaine coming into the United States has been contaminated …
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March 7, 2010, 1:27 pm
Bromide Toxicity from Consumption of Dead Sea Salt. Sosa R, Stone W. Am J Med March 2010;123:e11-12.
Full text
Until the middle of the 20th century, when bromide was removed from such over-the-counter products as Dr. Miles’ Nervine and Bromo-Seltzer, chronic bromism was reported to be responsible for approximately 5-10% of admissions to psychiatric hospitals. Bromide has sedative and …
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February 27, 2010, 2:03 pm
Whole Bowel Irrigation and the Hemodynamically Unstable Calcium Channel Blocker Overdose: Primum non Nocere. Cumpston KL et al. J Emerg Med 2010;38:171-174.
Abstract
As even its proponents admit, whole bowel irrigation (WBI) with high-molecular-weight polyethylene glycol (PEG) has never been proven to improve clinical outcomes in toxicology patients. Despite this, some physicians argue that the procedure is safe, and …
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