Journal of Clinical Toxicology最新文献

{"title":"Bilateral Posterior Dislocation of the Shoulder Caused by Seizure after Tramadol Usage; A Case Report And Literature Review","authors":"A. Abbas, Nabizadeh Navid, Saboori Shokoofe Hanie","doi":"10.4172/2161-0495.1000357","DOIUrl":"https://doi.org/10.4172/2161-0495.1000357","url":null,"abstract":"Posterior dislocation of the shoulder accounts for 2-4% of all shoulder dislocations. Non-epileptic seizures resulting from drug usage, is an important cause of posterior shoulder dislocation. In this case report, we described a case of bilateral posterior shoulder dislocation due to convulsion after tramadol usage and reviewed the literature recapitulating the causations of drug-induced seizures, non-traumatic shoulder dislocation, the mechanisms of dislocation related to seizure, and which are detected by imaging techniques.","PeriodicalId":15433,"journal":{"name":"Journal of Clinical Toxicology","volume":"19 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75376106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Pipazethate HCl (Selgon, Eipico Egypt, Egypt) Toxicity: Case Report","authors":"M. Abdelnaby, Ahmed M. Ibrahim, Muhammad Mahmoud Abdul Haleem","doi":"10.4172/2161-0495.1000356","DOIUrl":"https://doi.org/10.4172/2161-0495.1000356","url":null,"abstract":"Pipazethate HCl is a centrally acting non-narcotic antitussive which is infrequently used nowadays. The toxicity of this drug is rarely reported in the literature. We were encountered with a case of accidental ingestion of Pipazethate HCl in a 3-years-old child presented with neurological symptoms in the form of somnolence, disturbed sensorium, respiratory symptoms in the form of respiratory distress and cardiac dysrhythmias in the form of Torsade de pointes. The patient was managed at a critical care unit using supportive measures for neurological symptoms, shock state and respiratory distress. Arrhythmic complications were managed using magnesium sulphate and maintained on lidocaine infusion. After two days under observation, the child was discharged home safely.","PeriodicalId":15433,"journal":{"name":"Journal of Clinical Toxicology","volume":"7 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89655187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cannabinoid receptors and their ligands: Role in cancer proliferation","authors":"Anna Radominska-Pandya","doi":"10.4172/2161-0495-C1-023","DOIUrl":"https://doi.org/10.4172/2161-0495-C1-023","url":null,"abstract":"The primary mechanism of the biological effect of ionizing radiation has been known for more than 50 years: it is damage to DNA. In pharmaco-toxicological terms DNA is the “receptor” for radiation effects. Despite this knowledge, the current model for predicting or explaining health effects in populations exposed to internal exposures relies only upon quantifying radiation as average energy transfer to large masses of human tissue with no consideration whatever of the ionization density at the DNA relative to cytoplasm or non-DNA regions. This approach is equivalent to describing all chemical toxicological effects in terms of Mass and is clearly absurd. \u0000The concept of Radiochemical Genotoxicity is presented whereby biochemical affinity of internal radionuclides for DNA confers an excess genetic hazard which can be assessed. The most directly measurable effects of radiation exposure are heritable effects detectable around birth. Data enabling the development of a risk coefficient for internal exposures to Uranium fissionproducts is already available. By directly employing a meta-analysis of more than 19 epidemiological studies of post-Chernobyl birth outcomes in 10 different countries affected by contamination from Chernobyl a generalized risk coefficient for heritable damage is obtained. It is shown that the dose response is biphasic due to death of the foetus before term. The resulting coefficient is 20 per mSv internal exposure. Application of the new factor to the radionuclide exposures occurring during the period of atmospheric test contamination predicts the increases in infant mortality reported in the literature. The philosophical and ethical aspects are briefly discussed together with an account of the legal position in Europe.","PeriodicalId":15433,"journal":{"name":"Journal of Clinical Toxicology","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81109502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apache II Scoring as an Index of Severity in Organophosphorus Poisoning","authors":"Q. Jamal, A. S. Rahman, Muhammad A. Siddiqui, M. Riaz, M. Ansari, Saleem-Ullah","doi":"10.4172/2161-0495.1000354","DOIUrl":"https://doi.org/10.4172/2161-0495.1000354","url":null,"abstract":"Objectives: The purpose of the study was to determine the mortality rate in organophosphate poisoning patients \u0000 and relationship between the clinical severity of OPP with APACHE II score and serum cholinesterase levels. \u0000Methodology: This is a cross sectional study conducted in medical intensive care unit. Baseline variables and \u0000 clinical characteristics were summarized with frequencies (percentages) for categorical variables and mean \u0000 (standard deviation) for continuous variables. Receiver operating characteristic (ROC) curves were generated with a \u0000 95% CI to assess the relationship between individual APACHE II scores and mortality rates. \u0000Results: The patient’s average age was 25.16 ± 9.95 years. 56.6% were female and 78.8% patients were \u0000 suicidal. Patient who had stayed in the hospital >15 days had 33.3% mortality (p=0.13). Total 12 (10.6%) patients \u0000 required mechanical ventilation out of which only one (8.3%) patient expired (p=0.86). The average APACHE II \u0000 score was 3.73 ± 3.95. The APACHE II score for predicting death risk had fair discrimination as indicated by ROC \u0000 curve of 0.67 (CI. 0.512-0.833). There was no significant association (p=0.29) between serum cholinesterase level \u0000 and APACHE II score regarding the severity of poisoning. However, significant association (p<0.001) was found \u0000 between outcome and serum cholinesterase levels. \u0000Conclusion: The mortality rate reported was 9.7%. There was no significant association between serum \u0000 cholinesterase level and APACHE II score regarding the severity of poisoning. However, significant association was \u0000 found between outcome and serum cholinesterase levels.","PeriodicalId":15433,"journal":{"name":"Journal of Clinical Toxicology","volume":"6 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74653295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Black Stone Poisoning: A Case Report","authors":"M. Arshad, H. Inam, F. Karim, U. Khalid","doi":"10.4172/2161-0495.1000353","DOIUrl":"https://doi.org/10.4172/2161-0495.1000353","url":null,"abstract":"Introduction: Paraphenylenediamine (PPD) is the constituent of hair dyes that is responsible for toxicity. Hair dye \u0000 (PPD) poisoning is associated with high morbidity and mortality and dramatic increase in its incidence has been \u0000 seen in recent years. We share our experience of a case of complicated PPD poisoning and its management. \u0000Case Description: A 3 year old boy presented to A&E with extensive cervicofacial edema and difficulty breathing \u0000 for past 6 h. Patient underwent emergency tracheostomy and was kept under mechanical ventilation. Patient \u0000 responded well to corticosteroids and anti-allergic medications. There was a history of ingestion of hair dye mixed \u0000 water prior to the onset of symptoms. \u0000Conclusion: Paraphenylene diamine (PPD) (Kala Pathar) poisoning is associated with high morbidity & mortality. \u0000 It is emerging as a common form of poisoning both accidental and intentional among Asian and African countries \u0000 due its easy availability and low cost. PPD intoxication can have serious and lethal manifestation that require prompt \u0000 diagnosis and management. Therefore, we recommend public awareness and education regarding this toxin and \u0000 early recognition and aggressive airway management.","PeriodicalId":15433,"journal":{"name":"Journal of Clinical Toxicology","volume":"40 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85207356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation and Treatment of Acute Acquired Methemoglobinemia FollowingToxic Ingestion of Ammonium Nitrate in the Setting of Small Bowel Obstruction","authors":"Matthew Grujich, A. Romanoff, Kate Twelker, J. Dave, M. Su","doi":"10.4172/2161-0495.1000352","DOIUrl":"https://doi.org/10.4172/2161-0495.1000352","url":null,"abstract":"Methemoglobinemia after ingestion of ammonium nitrate can lead to significant morbidity and mortality in affected patients. Ammonium nitrate is a primary ingredient in synthetic “cold packs,” which are used in healthcare as a substitute for bags of ice. Acute or chronic ingestion can have serious consequences to patient health including isosmotic diuresis, metabolic acidosis, circulatory collapse and gastritis. Methemoglobinemia is a result of nitrite toxicity. This toxicity can be compounded by patient comorbidities, which may further complicate treatment. Rapid and accurate diagnosis is essential in the treatment of Methemoglobinemia following ammonium nitrate ingestion. \u0000We present the case of a 76 year-old woman who was admitted for small bowel obstruction (SBO) and unintentionally ingested the contents of a cold pack. The patient subsequently became tachycardic, hypotensive, and unresponsive requiring urgent resuscitation and management in the ICU setting. Methemoglobin levels were elevated. The patient was treated with methylene blue (MB) and made a full recovery.","PeriodicalId":15433,"journal":{"name":"Journal of Clinical Toxicology","volume":"8 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83195438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Can Humans be Damaged from Sulfuric Acid","authors":"S. Oh, Heejun Shin, H. Lee, H. Chung","doi":"10.4172/2161-0495.1000351","DOIUrl":"https://doi.org/10.4172/2161-0495.1000351","url":null,"abstract":"Purpose: This study was conducted to identify the clinical characteristics associated with sulfuric acid injury evaluated in emergency department. \u0000Method: This study was retrospective multicenter study with sulfuric acid injured patients who were visited in 3 emergency departments during 10 years in South Korea. Data were collected retrospectively from Jan 2006 to Dec 2015 on all sulfuric acid injuries presenting to the 3 emergency departments. Collected data were those of demographic, exposure site, injury mechanism, final diagnosis and hospital care. \u0000Result: A total of 46 patients were enrolled. Most of the patients were male (88.5%). The face and eye were the most commonly injured body parts (53.4%) and most commonly injured mechanism was splashing injury (69.5%) in sulfuric acid burn patients. A total of 25 (54.3%) patients were identified as having lesions more than second degree burn. \u0000Conclusion: sulfuric acid can cause severe burns to the skin. When working with sulfuric acid, have to wear acid proof protect clothing, goggle and glove. And it is need to pay close attention when working with sulfuric acid.","PeriodicalId":15433,"journal":{"name":"Journal of Clinical Toxicology","volume":"121 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2017-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85496199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Ethanol Leaf Extract of Moringa oleifera on Oxidative Stress andAtherogenic Indices of Otapiapia-Exposed Albino Rats","authors":"Chidi Uzoma Igwe, L. Nwaogu, Emeka E. Ezeokeke, C. Iheme, L. Alison","doi":"10.4172/2161-0495.1000350","DOIUrl":"https://doi.org/10.4172/2161-0495.1000350","url":null,"abstract":"Objective: Otapiapia is a locally produced, easily accessible, non-regulated household pesticide, which could easily contaminate human food. The ameliorative effect of ethanol leaf extract of Moringa oliefera on otapiapiainduced changes in oxidative stress, lipid profile and atherogenic indices of albino rats was investigated using standard methods. \u0000Methodology: Twenty-four apparently healthy Wister male albino rats (150-180 g) were divided into 4 groups (IIV) of 6 animals each. Group I served as the control, while group II animals were given otapiapia contaminated feed and distilled water. Group III were fed uncontaminated diet and M. oleifera extract drink. Group IV animals were also given the contaminated diet and M. oliefera extract. The feed and drinks were provided ad libitum for a period of 14 days. \u0000Result: The results show that intake of otapiapia significantly (p<0.05) reduced serum superoxide dismutase and catalase activities and HDL-c concentration but increased significantly (p<0.05) the concentrations of malondialdehyde, total cholesterol, triacylglycerol, LDL-c and VLDL-c. The derangements were significantly more pronounced in the atherogenic predictor indices than with lipid profile values. The observed effects of otapiapia were significantly (p<0.05) countered by administration of M. oliefera leaf extract. \u0000Conclusion: The results indicate that M. oleifera is a potent anti-poison with ameliorative effect against otapiapia-induced changes in biomarkers of oxidative and atherogenic damages in animals.","PeriodicalId":15433,"journal":{"name":"Journal of Clinical Toxicology","volume":"31 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73613650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Glycine and Sodium Thiosulfate for Lethal Cyanide Ingestion.","authors":"Matthew Brenner,&nbsp;Sarah M Azer,&nbsp;Kyung-Jin Oh,&nbsp;Chang Hoon Han,&nbsp;Jangwoen Lee,&nbsp;Sari B Mahon,&nbsp;Xiaohua Du,&nbsp;David Mukai,&nbsp;Tanya Burney,&nbsp;Mayer Saidian,&nbsp;Adriano Chan,&nbsp;Derek I Straker,&nbsp;Vikhyat S Bebarta,&nbsp;Gerry R Boss","doi":"10.4172/2167-7972.1000355","DOIUrl":"https://doi.org/10.4172/2167-7972.1000355","url":null,"abstract":"<p><strong>Objective: </strong>Accidental or intentional cyanide ingestion is an-ever present danger. Rapidly acting, safe, inexpensive oral cyanide antidotes are needed that can neutralize large gastrointestinal cyanide reservoirs. Since humans cannot be exposed to cyanide experimentally, we studied oral cyanide poisoning in rabbits, testing oral sodium thiosulfate with and without gastric alkalization.</p><p><strong>Setting: </strong>University research laboratory.</p><p><strong>Subjects: </strong>New Zealand white rabbits.</p><p><strong>Interventions: </strong>Seven animal groups studied; Groups 1-5 received high dose oral NaCN (50 mg, >LD100) and were treated immediately with oral (<i>via</i> nasogastric tube): 1) saline, 2) glycine, 3) sodium thiosulfate or 4) sodium thiosulfate and glycine, or 5) after 2 min with intramuscular injection of sodium nitrite and sodium thiosulfate plus oral sodium thiosulfate and glycine. Groups 6-7 received moderate dose oral NaCN (25 mg, LD70) and delayed intramuscular 6) saline or 7) sodium nitrite-sodium thiosulfate.</p><p><strong>Measurements and main results: </strong>All animals in the high dose NaCN group receiving oral saline or glycine died very rapidly, with a trend towards delayed death in glycine-treated animals; saline <i>versus</i> glycine-treated animals died at 10.3+3.9 and 14.6+5.9 min, respectively (p=0.13). In contrast, all sodium thiosulfate-treated high dose cyanide animals survived (p<0.01), with more rapid recovery in animals receiving both thiosulfate and glycine, compared to thiosulfate alone (p<0.03). Delayed intramuscular treatment alone in the moderate cyanide dose animals increased survival over control animals from 30% to 71%. Delayed treatment in high dose cyanide animals was not as effective as immediate treatment, but did increase survival time and rescued 29% of animals (p<0.01 <i>versus</i> cyanide alone).</p><p><strong>Conclusions: </strong>Oral sodium thiosulfate with gastric alkalization rescued animals from lethal doses of ingested cyanide. The combination of oral glycine and sodium thiosulfate may have potential for treating high dose acute cyanide ingestion and merits further investigation. The combination of systemic and oral therapy may provide further options.</p>","PeriodicalId":15433,"journal":{"name":"Journal of Clinical Toxicology","volume":"7 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5578424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35322836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutrophil to Lymphocyte Ratio as a Predictor of Endoscopic Damage in CausticInjuries","authors":"S. Uyar, M. Kok","doi":"10.4172/2161-0495.1000349","DOIUrl":"https://doi.org/10.4172/2161-0495.1000349","url":null,"abstract":"Context: The endoscopic degree of injuries is the main finding for further management of caustic ingestions. However, if endoscopy cannot be performed quickly, clinicians decide on treatment and follow-up goals according to the signs and symptoms of the patient. The aim of this study was to determine the association of white blood cells (WBC), C-reactive protein (CRP) and neutrophil-lymphocyte ratio (NLR) with the degree of caustic injury and to evaluate whether NLR is able to predict the severity of injuries. \u0000Materials and methods: A retrospective evaluation was made of a total of 190 patients with a mean age of 38.6 years. WBC, neutrophil, lymphocyte and CRP values and endoscopic findings of all patients at hospital admission were retrieved from hospital files. The association between WBC, NLR, CRP and endoscopic findings was evaluated. \u0000Results: Endoscopy was normal in 28 of 119 patients (23.5%) and most patients (42 of 119 (35.3%) had only gastric involvement. NLR was significantly higher in patients with injuries than normal patients (p=0.010), whereas WBC and CRP not. NLR was also significantly higher in patients with both esophagus and gastric injuries compared to patients with no organ involvement (p<0.001). NLR, WBC and CRP were weakly correlated to the grade of involvement. In the ROC analysis, the AUC value was 0.914 (95% CI (0.85-0.96, p<0.001)) and the cut-off value for NLR was 8.71 with sensitivity of 90% and specificity of 91.7% for discriminating injuries as grade 0-1-2 from 3-4. \u0000Conclusions: Higher NLR values showed widespread and severe involvement of caustic ingestion. NLR also seems to be a more reliable method to make a distinction between severe and mild injuries. It is an easily derived and inexpensive marker of inflammation and might guide the management of patients before endoscopic evaluation in emergency departments.","PeriodicalId":15433,"journal":{"name":"Journal of Clinical Toxicology","volume":"90 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89061959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}