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) · Jun 2017
Self-reported cocaine use is not associated with elevations in high-sensitivity troponin I.
High-sensitivity troponin (hsTn) assays detect 10 times lower concentrations of cardiac troponin than conventional assays. We examined the effects of self-reported cocaine use to determine whether those with acute cocaine use being evaluated for ACS are more likely to have elevated hsTnI than those nonusers being evaluated for ACS. ⋯ In this first investigation of hsTn in patients with self-reported recent cocaine use, we have determined that hsTn does not lead to an increase in the prevalence of troponin elevation in cocaine users.
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Clin Toxicol (Phila) · Apr 2017
Case Reports Observational StudyL-Arginine in the treatment of valproate overdose - five clinical cases.
Valproic acid and its metabolites - particularly valproyl-CoA - are inhibitors of the enzyme N-acetylglutamate synthetase. The amino acid l-arginine can stimulate N-acetylglutamate synthetase activity and could be potentially used therapeutically to correct hyperammonemia caused by valproate therapy or overdose. Severely valproic-acid-poisoned patients are usually treated with l-carnitine or hemodialysis in order to decrease hyperammonemia. We herein report of five cases, in which l-arginine was administered. ⋯ The results suggest that l-arginine may be beneficial in selected cases of valproate overdose complicated by hyperammonemia. l-Arginine could extend our conventional treatment options for valproic acid overdose.
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Clin Toxicol (Phila) · Mar 2017
The impact of an international initiative on exposures to liquid laundry detergent capsules reported to the United Kingdom National Poisons Information Service between 2008 and 2015.
Although the majority of those exposed to liquid laundry detergent capsules remain asymptomatic or suffer only minor clinical features after exposure, a small proportion develop central nervous system depression, stridor, pulmonary aspiration and/or airway burns following ingestion or conjunctivitis and corneal ulceration following eye exposure. As a consequence, the International Association for Soaps, Detergents and Maintenance Products (AISE) established a Product Stewardship Programme in Europe, requiring that safety measures be implemented to reduce the visibility of, and restrict access to, these detergent capsules by small children. Implementation occurred in the United Kingdom over several months during the first half of 2013. ⋯ There is no evidence that the Product Stewardship Programme had a beneficial impact on the number of exposures reported to the National Poisons Information Service or their severity.
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Clin Toxicol (Phila) · Feb 2017
Comparative Study Observational StudyEfficiency of acidemia correction on intermittent versus continuous hemodialysis in acute methanol poisoning.
Acidemia is a marker of prognosis in methanol poisoning, as well as compounding formate-induced cytotoxicity. Prompt correction of acidemia is a key treatment of methanol toxicity and methods to optimize this are poorly defined. ⋯ Our study supports the superiority of IHD over CRRT in terms of the rate of acidemia correction.