Clinical toxicology : the official journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists
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Clin Toxicol (Phila) · Jan 2006
Analysis of 8000 hospital admissions for acute poisoning in a rural area of Sri Lanka.
Acute poisoning, especially deliberate self-poisoning with agricultural pesticides, is an emerging global public health problem, but reliable incidence estimates are lacking. Only a few previous studies have assessed the impact of regulatory or other preventive measures. ⋯ Regulatory control of highly toxic pesticides provides important health benefits, especially in terms of lower number of deaths from self-poisoning. However, despite the positive effect of these bans, many deaths from pesticide self-poisoning still occur after ingestion of agricultural pesticides classified as only moderately poisonous.
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Clin Toxicol (Phila) · Jan 2006
Evaluation of several clinical scoring tools in organophosphate poisoned patients.
The aim of this study was to evaluate the Acute Physiology and Chronic Health Evaluation (APACHE) II, III and Simplified Acute Physiology Score II (SAPS II) as predictors of severity of organophosphate poisoning (OPP). ⋯ The APACHE II, III and SAPS II clinical scoring tools seem to predict the severity of organophosphate poisoning, and may have prognostic value.
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Clin Toxicol (Phila) · Jan 2006
Comparative StudyEfficacy of hydroxocobalamin for the treatment of acute cyanide poisoning in adult beagle dogs.
The efficacy of hydroxocobalamin for acute cyanide poisoning was compared with that of saline vehicle in dogs. ⋯ Hydroxocobalamin reversed cyanide toxicity and reduced mortality in a canine model.
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Methanol is metabolized by alcohol dehydrogenase to formaldehyde, and further to formic acid, which is responsible for the toxicity in methanol poisoning. Fomepizole (4-methylpyrazole) is a potent competitive inhibitor of alcohol dehydrogenase and is used as an antidote to treat methanol poisonings. We report serum methanol kinetics in eight patients treated with bicarbonate and fomepizole only. ⋯ Based on our data, methanol-poisoned patients with moderate metabolic acidosis and methanol levels up to 19 mmol/L (60 mg/L) may safely be treated with bicarbonate and fomepizole only, without dialysis.
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Clin Toxicol (Phila) · Jan 2005
Case ReportsConservative management of delayed, multicomponent coagulopathy following rattlesnake envenomation.
Crotaline Fab therapy is recommended for controlling local tissue effects, coagulation abnormalities, and other systemic signs following mild-to-moderate N American Crotaline envenomations. Occasionally, coagulation abnormalities emerge after control of tissue effects has been achieved. These coagulation changes range from minor, single parameter abnormalities to multicomponent, critical value derangements. The bleeding risk associated with these abnormalities is unknown, and dosing guidelines for Crotaline Fab therapy in treating coagulation abnormalities that are severe or delayed-in-onset have not been clearly established. ⋯ We report a case of rattlesnake envenomation with profound, delayed hematologic effects that were resistant to 32 vials of Crotaline Fab given over post-envenomation days 1 to 4. After day 4, no further attempt was made to achieve normal lab indices using antivenom. Close observation alone may be adequate in cases of multicomponent, critical value coagulopathies following rattlesnake envenomation as long as there is no evidence of bleeding and local tissue effects and systemic effects have been adequately controlled.