Archive for the ‘Medical’ Category

Great new review of Novichok nerve agents

July 5, 2018, 11:09 am

April 25, 2018: Decontamination efforts in Salisbury U.K. [Photo credit: shutter stock.com]

★★★★☆

Novichok agents: a historical, current, and toxicological perspective. Chai PR et al. Toxicology Communications 2018;2:45-48. 

Full Text

British counter-terrorism officials confirmed yesterday that a critically ill couple who were admitted to hospital in Amesbury U.K. on June 30 had been exposed to Novichok, one of a group of …

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Acute cyanide poisoning: are skin findings and odors helpful in making the diagnosis?

June 19, 2018, 12:48 pm

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Challenges in the diagnosis of acute cyanide poisoning. Parker-Cote JL et al. Clin Toxicol 2018;56(7):609-617

Abstract

The stated goal of this somewhat confusing and unfocused article was to “identify isolated acute cyanide poison cases and to identify reported signs, symptoms and laboratory findings.”

The authors did a systematic literature review to retrieve cases reports and case series describing patients who …

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Novichok: a fourth-generation class of nerve agents

May 31, 2018, 11:55 am

Salisbury, U.K. April 25, 2018. Decontamination efforts where Sergei and Yulia Skripal were found poisoned. [shutterstock.com]

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Novichok: a murderous nerve agent attack in the UK. Vale JA et al. Clin Toxicol 2018 May 14 [Epub ahead of print]

Reference

In an article in yesterday’s New York Times, medical workers who treated Sergei and Yulia Skripal after they were found …

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Can cannabinoid hyperemesis syndrome be fatal?

May 30, 2018, 1:22 pm

shutterstock.com/Stanimir G. Stoev

★★½☆☆

Cannabinoid Hyperemesis Syndrome: Reports of Fatal Cases. Nourbakhsh M et al. J Forensic Sci 2018 May 15 [Epub ahead of print]

Abstract

This paper reports on 2 fatal cases that the authors argue were attributable to the effects of cannabinoid hyperemesis syndrome (CHS).

CASE #1: A 27-year-old woman is brought to hospital by ambulance after friend found …

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A case of life-threatening loperamide toxicity

May 24, 2018, 11:29 am

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Severe loperamide toxicity associated with the use of cimetidine to potentiate the “high.” Hughes A et al. AM J Emerg Med 2018 May 15 [Epub ahead of print]

Reference

The potential adverse effects of loperamide (Imodium) are often underestimated since, even though it is an opioid, it is available over-the-counter and has been since 1988.

Loperamide is used to treat …

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Finally! The “New England Journal of Medicine” discovers medical toxicology

May 22, 2018, 6:00 pm

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Case 12-2018: A 30-Year-Old Woman with Cardiac Arrest. Goldstein JN, Dudzinski DM, Erickson TB et al. N Engl J Med 2018 Apr 19;378:1538-1549.

Reference

In the past, we’ve complained that the New England Journal of Medicine never seemed to include a toxicologist or emergency physician as a discussant in relevant cases in their series “Case Records of the Massachusetts General …

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Must-read article: America’s Misguided War on Childhood Lead Exposures

March 23, 2018, 12:58 am

Photo: shutterstock/jamie hooper

Very soon, the Centers for Disease Control and Prevention “reference level” for blood lead concentration will be lowered from 5 μg/dL to 3.5 μg/dL. As Charles Schmidt  explains in his superb well-researched article “America’s Misguided War on Childhood Lead Exposures” just published by Undark Magazine, there are several crucially important things to realize about this …

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A diagnosis you can’t afford to miss

March 2, 2018, 1:14 pm

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Antibody-Mediated Encephalitis. Dalmau J, Graus F. N Engl J Med 2018 Mar 1;378:840-851.

Reference

TPR has posted before about anti-NMDA receptor encephalitis, a must-know, can’t-miss, humbling diagnosis that is distressingly easy to overlook. Although it is not a toxicologic condition, all toxicologists and emergency physicians should be thoroughly familiar with its presentation and clinical course. Let me explain why.…

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Flubromazolam: a potent designer benzodiazepine

February 27, 2018, 10:20 pm

Flubromazolam

★★★☆☆

Flubromazolam — A new life-threatening designer benzodiazepine. Lukasik-Glebocka M et al. Clin Toxicol 2016;54:66-68.

Abstract

Last month, the Peoria (IL) Journal-Star reported that local police had seized samples of two rarely seen designer sedatives: flubromazolam (alleged street name “liquid Xanax“) and etizolam.

This paper from Poland presents a case report of flubromazolam exposure. A 27-year-old male …

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