Michael J Barker, John G Benitez, Sharon Ternullo, Gregory A Juhl
{"title":"Acute oxcarbazepine and atomoxetine overdose with quetiapine.","authors":"Michael J Barker, John G Benitez, Sharon Ternullo, Gregory A Juhl","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We present a case of acute oxcarbazepine and atomoxetine overdose combined with excess quetiapine in a 19-y-old male. The patient ingested approximately 36 g oxcarbazepine (514 mg/kg), 1.2 g atomoxetine (17 mg/kg), and 9 mg Quetiapine (128 mg/kg). Central nervous system (CNS) depression with initial unresponsiveness developed within 1 h of ingestion, necessitating intubation for airway protection. Despite aggressive therapy with whole bowel irrigation and charcoal administration, the patient's somnolence persisted for 4 d, punctuated by occasional violent outbursts. Prolonged QTc was noted initially, but normalized within 4 d. This case suggests that acute overdose of oxcarbazepine and atomoxetine combined with quetiapine is associated with rapid and prolonged CNS depression.</p>","PeriodicalId":23486,"journal":{"name":"Veterinary and human toxicology","volume":"46 3","pages":"130-2"},"PeriodicalIF":0.0,"publicationDate":"2004-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24542726","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":"Beware of canine Gorilla Glue ingestions.","authors":"Carol Lubich, Rita Mrvos, Edward P Krenzelok","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Household adhesive ingestions are considered relatively non-toxic. Gorilla Glue is a household glue containing a urethane polymer and a polymeric isocyanate liquid compound available in container sizes of 2 to 36 oz, and when applied will expand to 3-4 times its original volume. We report the ingestion of Gorilla Glue by 2 dogs that caused obstructive masses requiring surgical intervention. Dogs with a history of Gorilla Glue ingestion should be monitored closely by their owners and a veterinary referral made if signs of gastrointestinal distress develop.</p>","PeriodicalId":23486,"journal":{"name":"Veterinary and human toxicology","volume":"46 3","pages":"153-4"},"PeriodicalIF":0.0,"publicationDate":"2004-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24542678","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}
S J Bursian, R R Mitchell, B Yamini, S D Fitzgerald, P A Murphy, G Fernandez, G E Rottinghaus, L Moran, K Leefers, I Choi, G Fernadez
{"title":"Efficacy of a commercial mycotoxin binder in alleviating effects of ochratoxin A, fumonisin B1, moniliformin and zearalenone in adult mink.","authors":"S J Bursian, R R Mitchell, B Yamini, S D Fitzgerald, P A Murphy, G Fernandez, G E Rottinghaus, L Moran, K Leefers, I Choi, G Fernadez","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The addition of nutritionally inert adsorbents to mycotoxin-contaminated animal feed has been a popular approach to decreasing toxicity in animals and carryover of mycotoxins from contaminated feed to animal by-products. Some studies suggest that esterified glucomannan derived from the cell wall of Saccharomyces cerevisiae is effective in reducing the bioavailability of at least some of the mycotoxins occurring in contaminated feed. Because cereal grains are important components of ranch mink diets, mycotoxicoses in mink is a potential problem faced by mink ranchers. We conducted a series of studies to determine if inclusion of a commercially available esterified glucomannan in ranch mink feed was effective in alleviating clinical signs indicative of exposure to ochratoxin A, fumonisin B1, moniliformin or zearalenone in adult mink. In 4 separate trials, mink were fed diets that contained 2.5, 5 or 10 mg ochratoxin A/kg feed, 200 mg fumonisin B1/kg feed, 20 mg moniliformin/kg feed, or 30 mg zearalenone/kg feed with or without 2 g esterified glucomannan/kg feed. Male mink fed diets containing ochratoxin A had significantly decreased feed intake as well as renal lesions characteristic of exposure to that mycotoxin. Inclusion of the esterified glucomannan did not ameliorate these effects. Male mink exposed to fumonisin B1 had increased urinary sphinganine concentration, which was not significantly reduced by the mycotoxin adsorbent. Male mink that consumed monilformin-contaminated diets had characteristic ultrastructural changes in the heart that were not reduced in severity by the esterified glucomannan. Female mink exposed to zearalenone had increased uterine weight, which was not reversed by inclusion of commercial mycotoxin binder in the contaminated feed. The results of this study suggest that a commercial esterified glucomannan was generally ineffective in alleviating effects indicative of exposure to ochratoxin A, fumonisin B1, monilformin and zearalenone in mink.</p>","PeriodicalId":23486,"journal":{"name":"Veterinary and human toxicology","volume":"46 3","pages":"122-9"},"PeriodicalIF":0.0,"publicationDate":"2004-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24542725","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 metaldehyde poisoning in Taiwan.","authors":"Chi-Chung Shih, Shy-Shin Chang, Yi-Ling Chan, Jih-Chang Chen, Meng-Wei Chang, Meng-Sheng Tung, Jou-Fang Deng, Chen-Chang Yang","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Metaldehyde, a cyclic tetramer of acetaldehyde, is a widely used molluscicide. Although cases with acute metaldehyde poisoning have been reported, the occurrence of severe poisoning is uncommon. To provide more information on human metaldehyde poisoning, we reviewed 15 cases of metaldehyde exposure reported to the Taiwan National Poison Control Center at the Taipei Veterans General Hospital between 1991 and 2002. While 7 patients were asymptomatic, the other 8 patients, including 4 who coingested alcohol or other poisons, exhibited toxic manifestations of abdominal pain, dizziness, nausea, irritation of oral mucosa, and seizures after oral exposure. One patient died after ingesting 12 g (or 258.6 mg/kg) of metaldehyde. Although the toxicity from metaldehyde is largely mild, the clinical course of metaldehyde poisoning may be rapidly deteriorating and fatal on rare occasions. Physicians should therefore be cautious in managing patients with metaldehyde poisoning, and vigorous supportive measures should be promptly instituted in patients who manifest severe toxicity.</p>","PeriodicalId":23486,"journal":{"name":"Veterinary and human toxicology","volume":"46 3","pages":"140-3"},"PeriodicalIF":0.0,"publicationDate":"2004-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24542730","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}
C Hamouda, A Hédhili, N Ben Salah, M Zhioua, M Amamou
{"title":"A review of acute poisoning from Atractylis gummifera L.","authors":"C Hamouda, A Hédhili, N Ben Salah, M Zhioua, M Amamou","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Atractylis gummifera is a poisonous plant widely found in North Africa. The thistle grows commonly in dry areas, and the juice of the rhizome is poisonous. It provokes frequent poisoning, especially of children. Toxic glucosides have been isolated and their identified as atractyloside and carboxyatractyloside. Tissues of high metabolic activity are the main target organs. Atractylis gummifera glucosides cause a severe hepatitis with fatal liver failure common. The plant's poisonous compounds interact with detoxication and/or transformation systems in the liver even at doses not likely to induce cytolysis by blocking ADP-ATP conversion through inhibition of P450 cytochrome. Clinical manifestations are related to an induced hypoglycemia and neurovegetative disorders or subsequent renal failure. Liver transplantation or immunotherapy may improve the often fatal prognosis.</p>","PeriodicalId":23486,"journal":{"name":"Veterinary and human toxicology","volume":"46 3","pages":"144-6"},"PeriodicalIF":0.0,"publicationDate":"2004-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24542674","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":"Was it necessary to add Bitrex (denatonium benzoate) to automotive products?","authors":"Michael E Mullins, B Zane Horowitz","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Oregon was the first state to mandate the addition of a bitter aversive agent to consumer automotive products containing > or = 10% ethylene glycol (EG) or > or = 4% methanol (MeOH). The 1995 Toxic Household Products statute required the addition of denatonium benzoate at a concentration of 30-50 ppm with the intent to reduce the frequency of serious pediatric exposures to these products. Retrospective review included Oregon Poison Center (OPC) records of all reported pediatric (< 6 y) exposures to automotive antifreeze (EG) and windshield washer fluid (MeOH) from 1987 through 2003, OPC charts of children treated with ethanol, fomepizole, or hemodialysis for EG or MeOH poisoning from 1987 through 2002, and coroner reports of poisoning deaths for 1994-1997 to identify EG or MeOH deaths not reported to the OPC. OPC recorded 332 EG and 117 MeOH exposures among preschool children from 1987-2003 with no change in annual frequency after 1995. No child died or suffered \"major\" effects before or after 1995. Ten children received ethanol infusions until laboratory results were available; 9 had no detectable concentration of the suspected agent, and 1 had a sub-toxic concentration. Two children received fomepizole but had no detectable EG. No child underwent hemodialysis. Coroner reports detected no missed pediatric deaths from toxic alcohols in 1994-1997. The mandatory addition of denatonium benzoate was unnecessary as unintentional ethylene glycol or methanol exposures in pre-school age children did not cause measurable toxicity.</p>","PeriodicalId":23486,"journal":{"name":"Veterinary and human toxicology","volume":"46 3","pages":"150-2"},"PeriodicalIF":0.0,"publicationDate":"2004-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24542677","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}
Ilhani Unluoglu, Arif Alper Cevik, Ozcan Bor, Muhittin Tayfur, Adnan Sahin
{"title":"Mushroom poisonings in children in Central Anatolia.","authors":"Ilhani Unluoglu, Arif Alper Cevik, Ozcan Bor, Muhittin Tayfur, Adnan Sahin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The aim of this study was the analysis of mushroom poisonings (MP) in children in Central Anatolia. Cases younger than 18 y-of-age, who presented and were diagnosed as MP between January 1991 and December 2002 were evaluated for gender, age, presenting month, city of residence, first noticed symptoms, vital signs, laboratory studies, hospitalization period and outcome. Sixty-four cases were enrolled; 36 were female (56.3%). The mean age was 8.6 y. May and June were the most common presenting months, with 46 cases (71.8%); 61 cases (95.3%) were poisoned by wild mushrooms (WM). The most common first noticed symptoms were from the gastroinal system (GIS) (70.6%); 67.2% of cases presented to second level health centers when the first symptoms started; 92.2% were admitted to the hospital. Mean hospitalization period was 2.8 d. Five cases (7.8%) had a fatal outcome. All the fatal cases were from WM poisoning and from the same city. Their first noticed symptoms were GIS symptoms. All fatal cases had delayed presentations. Cultivated MP did not result in bad outcomes in the pediatric age group. WM were the main source of MP in children in our region in Turkey. Education of the public about consuming mushrooms, and health personnel working in health centers for early treatment and transfer to the appropriate facility are important to decrease mortality.</p>","PeriodicalId":23486,"journal":{"name":"Veterinary and human toxicology","volume":"46 3","pages":"134-7"},"PeriodicalIF":0.0,"publicationDate":"2004-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24542728","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":"Good things come three at a time--don't they?","authors":"William O Robertson","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":23486,"journal":{"name":"Veterinary and human toxicology","volume":"46 3","pages":"157-8"},"PeriodicalIF":0.0,"publicationDate":"2004-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24542680","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}
F Soler Rodríguez, A L Oropesa Jiménez, J P García Cambero, M Pérez López
{"title":"Lead exposition by gunshot ingestion in red-legged partridge (Alectoris rufa).","authors":"F Soler Rodríguez, A L Oropesa Jiménez, J P García Cambero, M Pérez López","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Absorption of low concentrations of lead may result in a wide range of sublethal effects in birds. Although waterfowl appear the most severely affected group for this heavy metal, leadpoisoning-mortality has been observed in a wide variety of bird species, ie raptors and upland game birds. In this present work, hepatic lead levels in different red-legged partridges are presented to indicate threshold values which could help in future toxicological studies when considering the lack of information about lead poisoning of such birds in the wild.</p>","PeriodicalId":23486,"journal":{"name":"Veterinary and human toxicology","volume":"46 3","pages":"133-4"},"PeriodicalIF":0.0,"publicationDate":"2004-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24542727","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}
Hakan Topacoglu, Ozgur Karcioglu, Murat Ozsarac, Deniz Oray, Dogac Niyazi Ozucelik, Yesim Tuncok
{"title":"Massive intracranial hemorrhage associated with the ingestion of dimethyl sulfoxide.","authors":"Hakan Topacoglu, Ozgur Karcioglu, Murat Ozsarac, Deniz Oray, Dogac Niyazi Ozucelik, Yesim Tuncok","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Dimethyl sulfoxide (DMSO) has been widely used in the treatment of arthritis and certain inflammatory diseases, and is also considered an alternative remedy for cancer even if not supported by concrete evidence. This report illustrates the first case of a fatal complication following the illicit use of this agent. A 55-y-old man who reportedly ingested 500 mg acetaminophen and approximately 1 ml DMSO solution was brought to the emergency department after experiencing 2 tonic-clonic seizures. He had been diagnosed with lung mesotelioma with brain metastases which caused no neurologic deficit. The ingested DMSO was the first dose within the last 3 mo. Examination revealed right-sided hemiplegia. Unenhanced computed tomography of the head showed 3 hemorrhagic areas with blood-cerebrospinal fluid at the left parietal, occipital and frontal regions accompanied by a midline shift. Despite initial resuscitation, 2 units of fresh frozen plasma and antiedema treatment, the patient experienced cardiac arrest that did not respond to resuscitative measures. DMSO can cause massive intrametastatic hemorrhage, and neurologic deterioration can be profound in patients with metastatic brain lesions.</p>","PeriodicalId":23486,"journal":{"name":"Veterinary and human toxicology","volume":"46 3","pages":"138-40"},"PeriodicalIF":0.0,"publicationDate":"2004-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24542729","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}