Journal of toxicology. Clinical toxicology
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An accidental exposure due to reuse of containers of toluene diisocyanate to transport nontoxic substances and subsequent occupational toxic exposure caused illness among forty workers in a glove manufacturing plant. Examination and investigation of the patients and factory site inspection were carried out. ⋯ Thirty-two of forty patients had muscle pain and seven had elevated creatine phosphokinase activity. These features have not been reported previously as components of toluene diisocyanate toxicity and their underlying causation remains speculative.
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J. Toxicol. Clin. Toxicol. · Jan 1998
Comparative StudyUse of ondansetron and other antiemetics in the management of toxic acetaminophen ingestions.
Patients presenting with acetaminophen toxicity and vomiting are often treated with antiemetics so that orally administered N-acetylcysteine can be retained. The policy at the West Virginia Poison Center is to reserve ondansetron, an antiemetic with a higher cost than other antiemetics, as a second line agent for patients presenting within 8 hours of an acetaminophen ingestion. ⋯ Ondansetron should be utilized as a second-line agent in the management of acetaminophen toxic patients with vomiting. Because of its lower failure rate, ondansetron should be administered as a first-line agent in patients with a delay in N-acetylcysteine administration approaching 8 or more hours.
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J. Toxicol. Clin. Toxicol. · Jan 1998
Case ReportsProlonged formation of methemoglobin following nitroethane ingestion.
Artificial nail removers containing nitroethane pose a serious risk of toxicity when ingested. ⋯ We report 3 cases of children under 3 years of age who developed prolonged methemoglobinemia following ingestions of small quantities of these nitroethane-containing products. Methylene blue therapy reduced the methemoglobin level in all 3 children; however, in 2 of these children methemoglobin levels increased again several hours later and required additional methylene blue. Accurate substance identification is essential for appropriate management of ingestions of fingernail products. The availability of nitroethane products for home use should be questioned.
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J. Toxicol. Clin. Toxicol. · Jan 1998
Case ReportsAcute cerebral gas embolism from hydrogen peroxide ingestion successfully treated with hyperbaric oxygen.
We present a case of an adult who suffered an apparent stroke shortly after an accidental ingestion of concentrated hydrogen peroxide. Complete neurologic recovery occurred quickly with hyperbaric therapy. ⋯ Hyperbaric therapy is the definitive treatment for gas embolism from hydrogen peroxide ingestion as it is for all other causes of acute gas embolism. This is the first case reported in the literature of hyperbaric therapy used successfully to treat cerebral gas embolism caused by hydrogen peroxide.