Toxicology communications最新文献_第8页

National Poison Data System (NPDS) review of intentional sodium nitrite ingestions 2009–2019 国家毒物数据系统(NPDS)对2009-2019年故意摄入亚硝酸钠的审查

Toxicology communications Pub Date : 2021-01-01 DOI: 10.1080/24734306.2021.1972691

Anita Mudan, J. Lebin, C. Smollin

{"title":"National Poison Data System (NPDS) review of intentional sodium nitrite ingestions 2009–2019","authors":"Anita Mudan, J. Lebin, C. Smollin","doi":"10.1080/24734306.2021.1972691","DOIUrl":"https://doi.org/10.1080/24734306.2021.1972691","url":null,"abstract":"Abstract Ingesting sodium nitrite as a suicide method appears to be gaining popularity, spurred by online suicide blogs and an easily obtainable product. However, the exact nature of this trend has not been studied. We conducted an 11-year retrospective review of intentional sodium nitrite ingestions reported to the National Poison Data System from January 1, 2009-December 31, 2019. We included all cases coded as “nitrite or nitrate” in the initial request. We requested full case records for the initial cohort to confirm details. NPDS recorded 390 individual “nitrite or nitrate” exposures during the study period, and 42 met inclusion criteria. We received full case records for 35/42 patients, and 17 were included in the final cohort (N = 17). The mean age was 23.2 years old. Visible cyanosis was present in 13/17 patients with a mean oxygen saturation of 85%. Methylene blue was administered in 14/17 cases with 8/17 requiring advanced cardiac life support. The overall mortality rate was 41% (7/17). All patients presented in the final two years of the study period. Intentionally ingesting sodium nitrite represents a novel, growing trend and carries a high mortality rate among young adults. Abbreviations: AAPCC, American Association of Poison Control Center; ACLS, Advanced Cardiac Life Support; CPCS, California Poison Control System; NPDS, National Poison Data System; PCC, Poison Control Center; SPI, Specialist in Poison Information.","PeriodicalId":23139,"journal":{"name":"Toxicology communications","volume":"10 1","pages":"147 - 152"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88596948","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: 2

Care cascade for patients with opioid use disorder and serious injection related infections. 阿片类药物使用障碍和严重注射相关感染患者的护理级联。

Toxicology communications Pub Date : 2021-01-01 Epub Date: 2021-02-10 DOI: 10.1080/24734306.2020.1869899

Anand Upadhyaya, Laura R Marks, Evan S Schwarz, Stephen Y Liang, Michael J Durkin, David B Liss

{"title":"Care cascade for patients with opioid use disorder and serious injection related infections.","authors":"Anand Upadhyaya, Laura R Marks, Evan S Schwarz, Stephen Y Liang, Michael J Durkin, David B Liss","doi":"10.1080/24734306.2020.1869899","DOIUrl":"https://doi.org/10.1080/24734306.2020.1869899","url":null,"abstract":"Objectives: To define the care cascade for patients with serious injection drug use related infections (SIRI) in a tertiary hospital system and compare outcomes of those who did and did not participate in an opioid use disorder (OUD) treatment referral program.Methods: The medical records of patients admitted with both OUD and SIRI including endocarditis, osteomyelitis, septic arthritis, epidural abscess, thrombophlebitis, myositis, bacteremia, and fungemia from 2016-2019 were retrospectively reviewed. Patient demographics, clinical covariates, 90-day readmission rates, and outcomes data were collected. We compared data from those who were successfully referred to outpatient care through Engaging Patients in Care Coordination (EPICC), a peer recovery specialist-run OUD treatment referral program, to those who did not receive outpatient referral.Results: During the study period 334 persons who inject opioids were admitted with SIRI. Fourteen admitted patients died and were excluded from the analysis. The all-cause readmission rate was lower among patients referred to the EPICC program (18/76 [23.7%]) compared to those not referred to EPICC (100/244 [41.0%]) (OR 0.44; 95% CI 0.25 - 0.80).Conclusion: An OUD care cascade evaluation for patients with SIRI demonstrated that referral to peer recovery services with outpatient OUD treatment was associated with reduced 90-day readmission rate.","PeriodicalId":23139,"journal":{"name":"Toxicology communications","volume":"5 1","pages":"6-10"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24734306.2020.1869899","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25499670","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: 8

Re: Antagonizing the errors of history: bedside experience with flumazenil 对历史错误的对抗:氟马西尼的床边经验

Toxicology communications Pub Date : 2021-01-01 DOI: 10.1080/24734306.2020.1871550

S. Ebrahimi, H. Hassanian‐Moghaddam

引用次数: 0

Dying to be with yew 渴望和紫杉在一起

Toxicology communications Pub Date : 2021-01-01 DOI: 10.1080/24734306.2021.1918898

Eric Y. Du, Aditya Nellore, C. Pfeifer, Gershom Norfleet, A. Scalzo, Sarah B Riley

引用次数: 2

Rethinking treatment of mercury poisoning: the roles of selenium, acetylcysteine, and thiol chelators in the treatment of mercury poisoning: a narrative review 汞中毒治疗的再思考:硒、乙酰半胱氨酸和硫醇螯合剂在汞中毒治疗中的作用:叙述性综述

Toxicology communications Pub Date : 2021-01-01 DOI: 10.1080/24734306.2020.1870077

H. Spiller, Hannah L. Hays, M. Casavant

{"title":"Rethinking treatment of mercury poisoning: the roles of selenium, acetylcysteine, and thiol chelators in the treatment of mercury poisoning: a narrative review","authors":"H. Spiller, Hannah L. Hays, M. Casavant","doi":"10.1080/24734306.2020.1870077","DOIUrl":"https://doi.org/10.1080/24734306.2020.1870077","url":null,"abstract":"Abstract We reevaluate the treatment of mercury poisoning, incorporating recent advances in understanding of mercury toxicity and the mercury:selenium interaction. This review focuses on: 1) the role, limitations and benefits of chelation (Unithiol, succimer and N-Acetylcysteine); 2) the role of selenium supplementation; and 3) how the different forms of mercury are impacted by use of chelation and selenium. Unithiol and succimer produce increases in urinary excretion of mercury and to a lesser degree blood and total body mercury. The primary role of N-acetylcysteine is increasing renal mercury excretion, similar to the thiol-chelators. Additional unique features of acetylcysteine include increased efflux of methylmercury from the brain, and reduced oxidative stress via increased glutathione production. The role of selenium includes: 1) restoration of selenoprotein activity, 2) protection against mitochondrial injury and DNA damage, 3) demethylation of methylmercury, 4) sequestering of mercury via Hg:Se complexes, and 5) redistribution of Hg inside organisms. Selenium may increase blood Hg, via a “sink” effect, causing a redistribution of mercury away from the brain. A combined approach for mercury poisoning treatment was developed focusing on restoration of selenoprotein function, reduction of oxidative stress and increased mercury elimination.","PeriodicalId":23139,"journal":{"name":"Toxicology communications","volume":"135 11 1","pages":"19 - 59"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82979628","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: 4

Folic acid in methanol toxicity: a retrospective cohort study 叶酸对甲醇的毒性:一项回顾性队列研究

Toxicology communications Pub Date : 2021-01-01 DOI: 10.1080/24734306.2021.1997013

M. Scanlon, R. Marino, A. Sidlak

{"title":"Folic acid in methanol toxicity: a retrospective cohort study","authors":"M. Scanlon, R. Marino, A. Sidlak","doi":"10.1080/24734306.2021.1997013","DOIUrl":"https://doi.org/10.1080/24734306.2021.1997013","url":null,"abstract":"Abstract Folic acid is a proposed adjunct to alcohol dehydrogenase inhibitors and hemodialysis (HD) in the treatment of methanol toxicity. Although animal models have shown increased formate clearance, human data regarding its efficacy are lacking. We performed a 7-year retrospective chart review of patients with methanol concentrations >10 mg/dL. We compared patients receiving scheduled dosing of 50 mg of folic acid (folate group) to those receiving no folic/folinic acid or <50 mg folic or folinic acid (low/no folate). We excluded patients who did not require hospitalization, those with alternative causes of acidosis, and those who died prior to therapy. The primary outcome measures were worsening metabolic acidosis, length of stay (LOS), and half-life of methanol. Of 27 patient visits with methanol concentration >10 mg/dL, 14 visits (11 patients) met inclusion criteria. Initial pH and methanol concentrations were similar between the two groups. There was no difference in LOS. No patients had worsening metabolic acidosis during therapy. In patients treated with and without HD, median half-lives of methanol were similar in both groups. Folic acid treatment provided no additional benefit to standard therapy for methanol toxicity. We cannot exclude potential benefit of folic acid on formate clearance.","PeriodicalId":23139,"journal":{"name":"Toxicology communications","volume":"s3-33 1","pages":"153 - 157"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90824496","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: 2

Analytical toxicology service model at the subregional center level for severe acute poisoning 分区域中心一级严重急性中毒分析毒理学服务模式

Toxicology communications Pub Date : 2021-01-01 DOI: 10.1080/24734306.2021.1913913

M. J. Lee, J. Cho, Haewon Jung, J. Park, Yun-Jeong Kim, J. Seo, Hanseok Chang, Si-Yeon Won

{"title":"Analytical toxicology service model at the subregional center level for severe acute poisoning","authors":"M. J. Lee, J. Cho, Haewon Jung, J. Park, Yun-Jeong Kim, J. Seo, Hanseok Chang, Si-Yeon Won","doi":"10.1080/24734306.2021.1913913","DOIUrl":"https://doi.org/10.1080/24734306.2021.1913913","url":null,"abstract":"Abstract Acute poisoning may necessitate identification of the toxic agent; however, several acutely poisoned patients are treated with minimal laboratory assistance. We investigated whether focused reference to laboratory toxicology tests conducted during a pilot project for a subregional analytical toxicology service influences treatment decisions. Patients with acute poisoning presented to the level 1 regional emergency medical center from May 2018 to April 2019 were initially reviewed. Poison samples were referred to the subregional toxicological analytical service. In total, 253 substance samples were tested among 111 patients during the study. According to the reported drug levels, 3 (1.2%) samples contained lethal doses, 49 (19%) had toxic levels, and 28 (11%) contained detectable levels of a lethal toxin or pesticide. Disagreement between the clinical assessment and laboratory analyses was found for 62 patients (fair kappa = 0.24, 56%), and they often had lower Glasgow Coma Scale, higher severity scores, older age, and less likelihood of receiving gastrointestinal decontamination. The regional analytical toxicology services were helpful for diagnostic planning and therapeutic management of acute poisoning. For seriously poisoned patients with inconsistent histories, it is necessary to reevaluate the classic therapeutic process based on the medical history.","PeriodicalId":23139,"journal":{"name":"Toxicology communications","volume":"32 1","pages":"102 - 108"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76017714","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

In-vitro study of lithium binding by sodium zirconium cyclosilicate (Lokelma®) or patiromer (Veltassa®) 环硅酸锆钠(Lokelma®)或patiromer (Veltassa®)结合锂的体外研究

Toxicology communications Pub Date : 2021-01-01 DOI: 10.1080/24734306.2021.2007602

D. Liss, Stephen M Roper, D. Dietzen, M. Mullins

{"title":"In-vitro study of lithium binding by sodium zirconium cyclosilicate (Lokelma®) or patiromer (Veltassa®)","authors":"D. Liss, Stephen M Roper, D. Dietzen, M. Mullins","doi":"10.1080/24734306.2021.2007602","DOIUrl":"https://doi.org/10.1080/24734306.2021.2007602","url":null,"abstract":"Abstract Lithium poisoning remains common. Symptomatic lithium poisonings often require hemodialysis, especially when the patient has impaired renal function. An effective and non-invasive treatment to remove excess lithium would be desirable. We tested two recently approved, orally administered potassium binders in an in-vitro model. We used lithium-heparin tubes as both the source of lithium based prior studies showing the different volumes of serum in lithium-heparin tubes will produce apparent lithium concentrations in the range of toxicity (2.5 mmol/L and 5 mmol/L). We added three different volumes (0.5 mL, 0.75 mL, or 1.0 mL) of normal saline (NS) to the tubes. We calculated concentrations of sodium zirconium cyclosilicate (SZC, Lokelma®) and patiromer (Veltassa®) to simulate the ratio of drug to total body water for a 70 kg human. We prepared stock suspensions with different concentrations above and below the estimated ratios. We added varying concentrations of SZC or patiromer to tubes containing of NS. We measured sodium and lithium concentrations in duplicate for each concentration. Neither SZC nor patiromer reduced the lithium concentration across the range of concentrations in this in-vitro study.","PeriodicalId":23139,"journal":{"name":"Toxicology communications","volume":"33 1","pages":"161 - 164"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79130111","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

Triad of obstructive uropathy, cholestasis, and pneumomediastinum associated with chronic ketamine abuse: a case report 慢性氯胺酮滥用引起的阻塞性尿路病变、胆汁淤积和纵隔气肿三联征:1例报告

Toxicology communications Pub Date : 2021-01-01 DOI: 10.1080/24734306.2021.1925443

Inês Ferraz de Oliveira, Jean-Baptiste Mesland, P. Laterre, P. Hantson

引用次数: 2

Continuous renal replacement therapy combined with fomepizole is effective in the clearance of ethylene glycol: a case report 持续肾替代治疗联合福美唑对清除乙二醇有效:1例报告

Toxicology communications Pub Date : 2021-01-01 DOI: 10.1080/24734306.2021.1973818

Jamie Prashek, Adham M. Mohamed, Tyler E. Barnes, Andrew B. Schlachter

引用次数: 2