Retrospective review of nutmeg toxicity

July 9, 2014, 10:55 pm


Nutmeg Poisonings: A Retrospective Review of 10 Years Experience from the Illinois Poison Center: 2001-2011. Ehrenpreis JE et al. J Med Toxicol 2014;10:148-151.


Just when you thought it was safe to go back to the eggnog bowl . . .

Nutmeg is the seed of the aromatic evergreen Myristica fragrans. It contains a number of volatile oils, …

Read More »

Tox on the web: intranasal naloxone, chloral hydrate toxicity, and more!

July 6, 2014, 10:43 pm


Legalized recreational marijuana in Colorado – the first six months: NPR’s talk show On Point recently had an interesting discussion of Colorado’s experience with recreational marijuana. Guests included Alicia Caldwell, an editorial writer for the Denver Post, and Dr. Richard Zane, Chair of Emergency Medicine at the University of Colorado Medical Center. Dr. Zane pointed out that many …

Read More »

Quiz: How much do you know about heparin-induced thrombocytopenia?

July 3, 2014, 12:01 pm

Heparin Sodium 1,000UmL MDV 30mL Vial★★★½☆

Heparin-induced thrombocytopenia. Lovecchio F. Clin Toxicol 2014 Jul;52:579-583.


This is a good up-to-date review of heparin-induced thrombocytopenia (HIT). The following are some questions based on the discussion in the paper (click on each question to reveal the answer):

Onset of HIT is generally within 5-10 days of heparin initiation, and is heralded by …

Read More »

Flagellate dermatitis — when the shiitake hits the fan

June 30, 2014, 1:41 pm

Flagellate dermatitis

Flagellate dermatitis


Shiitake dermatitis recorded by French Poison Control Centers — new case series with clinical observations. Boels D et al. Clin Toxicol 2014 Jul;52:625-628.


Just when you thought it was safe to go back to Whole Foods . . .

I must admit — I had not idea that eating raw shiitake mushrooms can cause a “very spectacular …

Read More »

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 …

Read More »

Does cannabis cause acute coronary syndromes?

June 24, 2014, 8:31 pm


Is recent cannabis use associated with acute coronary syndromes? An illustrative case series. Casier I et al. Acta Cardiol 2014 Apr;69:131-136.


Tetrahydrocannabinol (THC) has a number of well-documented effects on the cardiovascular system:

  • increased heart rate
  • increased blood pressure
  • decreased peripheral vascular resistance
  • orthostatic hypotension

THC may also be associated in rare cases with induction of ventricular arrhythmias. In …

Read More »

Overdose and death from pediatric chloral hydrate sedation

June 23, 2014, 7:06 pm

Chloral hydrate

Chloral hydrate


Pediatric Chloral Hydrate Poisonings and Death Following Outpatient Procedural Sedation. Nordt SP et al. J Med Toxicol 2014 Jun;10:219-222.


The medical use of chloral hydrate goes back to the 19th century. It is still used occasionally today for pediatric pre-procedural sedation. The risks inherent in this practice are illustrated in this excellent short article. The authors …

Read More »

An unusual complication of injecting paraffin oil to enhance body sculpting

June 20, 2014, 9:25 am


Severe hypercalcaemia, nephrocalcinosis, and multiple paraffinomas caused by paraffin oil injections in a young bodybuilder. Gyldenløve M et al. Lancet 2014 Jun14;383:2098


This short case report describes a 23-year-old male bodybuilder who presented with scrotal pain. The patient also admitted to shortness of breath and chest tightness. Workup for infection and nephrolithiasis was negative. Laboratory tests revealed anemia, renal …

Read More »

No, Craigslist is not a research tool

June 17, 2014, 8:22 pm

"wax" or "dab"

“wax” or “dab”


A new method of cannabis ingestion: The dangers of dabs? Loflin M, Earleywine M. Addict Behav 2014 May 28:39:1430-1433.


As TPR has reported before, “dab” (also called “butane hash oil” or “wax”) is a highly concentrated formulation of tehtrahydrocannabinol (THC) in a process using butane as a solvent. Whereas marijuana flowers can have a THC …

Read More »