Toxicology communications最新文献_第10页

Acute abamectin toxicity: a case report 急性阿维菌素中毒1例

Toxicology communications Pub Date : 2021-01-01 DOI: 10.1080/24734306.2021.1881233

S. Pirasath, B. Nageswaran, Rankiri Pathirannahalage Vasana Karunasena, Mathyasekeran Gevakaran

引用次数: 3

Wild mushroom exposures in Kansas, 2013–2018 2013-2018年，堪萨斯州野生蘑菇曝光

Toxicology communications Pub Date : 2021-01-01 DOI: 10.1080/24734306.2021.1893972

Sam Wagner, S. Thornton, L. Oller, Michelle L Wilson, M. Hudson

{"title":"Wild mushroom exposures in Kansas, 2013–2018","authors":"Sam Wagner, S. Thornton, L. Oller, Michelle L Wilson, M. Hudson","doi":"10.1080/24734306.2021.1893972","DOIUrl":"https://doi.org/10.1080/24734306.2021.1893972","url":null,"abstract":"Abstract Background Mushrooms exposures are uncommon, difficult to characterize, and occasionally cause serious morbidity and mortality. We describe mushroom exposures reported to the Kansas Poison Control Center (KSPCC). Methods We queried the KSPCC database for all mushroom exposures from 1 January 2013 to 31 December 2018. We abstracted age, sex, exposure date, reason, management site, laboratory values, medical outcome, GI symptoms, interventions, mycologist consultation, presence of mushroom picture, and identification of the mushroom. Results We identified 441 cases. Typical cases were young children with exploratory ingestion in summer managed at home (279) with no clinical effect (257). Vomiting or diarrhea occurred in 135 cases. Treatments included either no intervention or PO liquids (304), IV fluids (76), anti-emetics (59), or N-acetylcysteine (5). AST was normal in 52 of 55 cases. CPK was high in 3 of 7 patients. Care included hospital admission (56) including ICU in nine. There were no deaths. Most frequently identified were Chlorophyllum (29) and Psilocybe sp. (13). Conclusions Mushroom exposures reported to KPCC were most common in summer months and typically involved unintentional exposures in young children. Vomiting and diarrhea occurred in approximately one-third of cases. Morbidity was minimal. No deaths occurred. In most cases, the mushroom was never identified.","PeriodicalId":23139,"journal":{"name":"Toxicology communications","volume":"70 1","pages":"76 - 81"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79974696","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}

引用次数: 0

Life threatening hypokalaemia during treatment of severe diltiazem overdose with high dose insulin euglycemic therapy: a case report 高剂量胰岛素降糖治疗严重地尔硫卓过量治疗期间危及生命的低钾血症:1例报告

Toxicology communications Pub Date : 2021-01-01 DOI: 10.1080/24734306.2021.1962124

Andrew Kozman, Kerry Hoggett, J. Soderstrom

引用次数: 0

Unmet clinical laboratory need in patients hospitalized for acute poisoning from long-acting anticoagulant rodenticides. 长效抗凝血灭鼠剂急性中毒住院患者未满足的临床实验室需求。

Toxicology communications Pub Date : 2021-01-01 Epub Date: 2021-06-04 DOI: 10.1080/24734306.2021.1925444

Richard B van Breemen, John W Hafner, Daniel G Nosal, Douglas L Feinstein, Israel Rubinstein

{"title":"Unmet clinical laboratory need in patients hospitalized for acute poisoning from long-acting anticoagulant rodenticides.","authors":"Richard B van Breemen, John W Hafner, Daniel G Nosal, Douglas L Feinstein, Israel Rubinstein","doi":"10.1080/24734306.2021.1925444","DOIUrl":"10.1080/24734306.2021.1925444","url":null,"abstract":"The importance of real-time, quantitative toxicology data available for physicians treating poisoned patients was illustrated during the 2018 outbreak in Illinois of severe coagulopathy caused by inhaling illicit synthetic cannabinoids products contaminated with commercially-available brodifacoum, difenacoum, and bromadiolone, three potent, long-acting anticoagulant rodenticides (LAARs). Identification and quantification of these life-threatening toxins in blood samples of hospitalized patients required toxicology testing with liquid chromatography-tandem mass spectrometry (LC-MS/MS) that was not available in clinical laboratories of hospitals at the time of the outbreak. This highly-sensitive, quantitative assay can provide critical information to guide patient care during and after hospitalization, including identification of offending LAARs, estimates of the ingested dose, and dosage and discontinuation of oral vitamin K1 therapy after hospital discharge once plasma LAARs concentrations decreased to a safe level (<10 ng/mL). Accordingly, we propose an action plan to enable treating physicians to quantify plasma concentrations of several LAARs simultaneously in poisoned patients. It involves rapid (<15 min), sensitive, and validated LC-MS/MS methods developed, tested and validated in our laboratory. This will allow treating physicians to request quantitative plasma LAARs testing, report test results in the patient's hospital discharge summary, and recommend regular monitoring of plasma LAARs concentrations in the outpatient setting.","PeriodicalId":23139,"journal":{"name":"Toxicology communications","volume":"5 1","pages":"93-96"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8388241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39365597","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}

引用次数: 0

Brodifacoum pharmacokinetics in acute human poisoning: implications for estimating duration of vitamin K therapy. 布罗迪呋喃在急性人体中毒中的药代动力学：对估算维生素 K 治疗持续时间的影响。

Toxicology communications Pub Date : 2021-01-01 Epub Date: 2021-03-01 DOI: 10.1080/24734306.2021.1887637

Daniel G Nosal, Richard B van Breemen, John W Haffner, Israel Rubinstein, Douglas L Feinstein

{"title":"Brodifacoum pharmacokinetics in acute human poisoning: implications for estimating duration of vitamin K therapy.","authors":"Daniel G Nosal, Richard B van Breemen, John W Haffner, Israel Rubinstein, Douglas L Feinstein","doi":"10.1080/24734306.2021.1887637","DOIUrl":"10.1080/24734306.2021.1887637","url":null,"abstract":"Standard of care follow-up therapy for patients poisoned by long-acting anticoagulant rodenticides (LAARs) is daily high-dose (up to 100 mg per day) oral vitamin K1 (VK1) for weeks to months to over a year. The availability of CLIA-certified quantitative testing for plasma LAAR concentrations can now assist health care providers in determining when to safely discontinue VK1 therapy. We present estimates of treatment duration required to reach safe concentrations (< =10ng/ml) using serial measurements of plasma brodifacoum (BDF, a potent LAAR) concentrations obtained from patients poisoned after inhaling synthetic cannabinoids containing BDF. We fit the data to zero-order (linear) and first-order (exponential) curves, the latter to account for enterohepatic circulation of BDF. The results show that estimates of therapy duration are significantly longer when exponential clearance is assumed. Accordingly, we recommend that plasma BDF concentrations be monitored simultaneously with international normalization ratio (INR) during follow-up of poisoned patients, and that concentrations be determined after VK1 therapy is discontinued to document persistence of safe concentrations.","PeriodicalId":23139,"journal":{"name":"Toxicology communications","volume":"5 1","pages":"69-72"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7990043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25531393","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}

引用次数: 0

Adverse reactions in patients treated with the one-bag method of N-acetylcysteine for acetaminophen ingestion n -乙酰半胱氨酸一袋法摄食对乙酰氨基酚的不良反应

Toxicology communications Pub Date : 2020-01-01 DOI: 10.1080/24734306.2020.1770498

M. Mullins, Mary Yu, L. O'Grady, S. Khan, E. Schwarz

{"title":"Adverse reactions in patients treated with the one-bag method of N-acetylcysteine for acetaminophen ingestion","authors":"M. Mullins, Mary Yu, L. O'Grady, S. Khan, E. Schwarz","doi":"10.1080/24734306.2020.1770498","DOIUrl":"https://doi.org/10.1080/24734306.2020.1770498","url":null,"abstract":"Abstract Acetaminophen (paracetamol) remains the leading pharmaceutical agent in overdoses in North America. The three-bag Prescott protocol for intravenous (IV) acetylcysteine is complex and prone to errors. It has frequent adverse reactions, particularly non-allergic anaphylactoid reactions (NAARs). Over 15 years ago, we adopted a simplified, one-bag protocol using a standard concentration to reduce errors. We report the adverse reactions with this protocol. We used hospital pharmacy records to retrospectively identify patients who received IV acetylcysteine between 12 January 2005 and 20 June 2016. We excluded patients without acetaminophen overdose or with any part of their IV acetylcysteine at an outside hospital. We searched pharmacy records for diphenhydramine or any antiemetic after commencing IV acetylcysteine. We reviewed progress notes for descriptions of nausea, dyspnea, itching/pruritus, or rash. Out of 252 patients receiving IV acetylcysteine, 202 met our inclusion criteria. Thirty-three patients had at least one adverse reaction including nausea in 28 patients and any symptom of NAAR in 8 patients. Twenty-eight patients received an antiemetic. Eleven patients received diphenhydramine (nine for NAAR and two with prochlorperazine). Nausea was the most common adverse reaction. The rate of non-allergic anaphylactoid reactions with the one-bag protocol was 4%.","PeriodicalId":23139,"journal":{"name":"Toxicology communications","volume":"8 1","pages":"49 - 54"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82935455","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}

引用次数: 5

Fatal occupational selenomethionine poisoning with hazmat response: a case report 致死性职业性硒代蛋氨酸中毒伴危害反应1例报告

Toxicology communications Pub Date : 2020-01-01 DOI: 10.1080/24734306.2020.1731066

H. Spiller, Judd Shelton, A. Funk

{"title":"Fatal occupational selenomethionine poisoning with hazmat response: a case report","authors":"H. Spiller, Judd Shelton, A. Funk","doi":"10.1080/24734306.2020.1731066","DOIUrl":"https://doi.org/10.1080/24734306.2020.1731066","url":null,"abstract":"Abstract A 30-year-old male had an occupational exposure while measuring selenomethionine. He left work due to onset of nausea, weakness and vomiting. He showered and changed clothes at home. Due to continued worsening of symptoms, four hours post-exposure he was brought to an urgent care center (UCC), where he was immediately transported via ambulance to an emergency department (ED). He was noted by UCC and ED staff to have a strong noxious chemical odor. The patient deteriorated rapidly requiring intubation, and PEEP with 100% O2. Naloxone, dextrose, bicarbonate, fluid resuscitation and dopamine infusion were administered. Twenty minutes after arrival, the patient experienced asystole. Resuscitation was not successful. Postmortem blood selenium concentration was 11,000 µg/L. A multi-agency hazmat investigation occurred. The UCC and the patient’s home were locked down. Twenty-four personnel were quarantined on-site for 7 h. Eight employees of the UCC underwent decontamination and transport to an ED for evaluation. Family members and immediate responding officers were quarantined on-site. Volatile methylated forms of selenium excreted in breath and sweat and not residual selenomethionine powder likely caused the chemical odor reported by the ED staff. Secondary contamination of ED personnel is a risk from self-presentation by symptomatic patients after a chemical exposure. Secondary contamination of ED personnel is unlikely from a powdered substance after presentation of a patient who has showered and changed clothes but given the unknown nature at the time, Hazmat Incident Commanders may decide to exercise an abundance of precaution.","PeriodicalId":23139,"journal":{"name":"Toxicology communications","volume":"61 1","pages":"12 - 14"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84246710","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}

引用次数: 1

New psychoactive substances (NPS) escape routine drug testing: a case report of phenibut 新型精神活性物质(NPS)逃避常规药物检测:苯乙酯一例报告

Toxicology communications Pub Date : 2020-01-01 DOI: 10.1080/24734306.2020.1796342

T. Breindahl, P. Hindersson, A. Kimergård

引用次数: 3

A case of teriflunomide-induced hepatic injury: assessing causality using available rules 特立氟米特致肝损伤1例:利用现有规则评估因果关系

Toxicology communications Pub Date : 2020-01-01 DOI: 10.1080/24734306.2020.1835413

Kathy T. LeSaint, J. Waksman, C. Smollin

引用次数: 5

Neurological effects of chronic occupational exposure to alcohol mists and vapors in a machinist 机械师长期职业性暴露于酒精雾和蒸汽对神经系统的影响

Toxicology communications Pub Date : 2020-01-01 DOI: 10.1080/24734306.2020.1768341

Marcia H Ratner, W. M. Ewing, J. Rutchik

引用次数: 1