Journal of toxicology. Clinical toxicology
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J. Toxicol. Clin. Toxicol. · Jan 1995
Case ReportsLiver transplantation after severe poisoning due to amatoxin-containing Lepiota--report of three cases.
Four cases of severe Lepiota poisoning, including three which developed toxic fulminant hepatitis treated by orthotopic hepatic transplantation, are reported here. The toxicity of the Lepiota is discussed as well as the indications for hepatic transplantation in poisonings due to amatoxin-containing mushrooms.
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J. Toxicol. Clin. Toxicol. · Jan 1995
Case ReportsColchicine toxicity--clinical features and treatment. Massive overdose case report.
This is a report of colchicine poisoning in a 24-year-old woman. She developed multiple organ failure and bone marrow suppression after the suicidal ingestion of 50 (1 mg) colchicine tablets. The pancytopenia responded to granulocyte colony-stimulating factor 300 micrograms on days 4, 5, 6, and 8. Although anticolchicine monoclonal antibody administration is the only specific therapy described, intensive supportive care including granulocyte colony-stimulating factor administration can facilitate recovery from severe colchicine intoxication.
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J. Toxicol. Clin. Toxicol. · Jan 1995
ReviewOutcome following organ removal from poisoned donors in brain death status: a report of 12 cases and review of the literature.
Experience with organ procurement from poisoned donors in brain death status is still limited in comparison with other etiologies. From 1963 to 1993, 2769 grafts (heart 141, kidney 1922, liver 623, pancreas 43) were performed in our University Hospital. Since 1975, among 1174 patients admitted to the ICU for acute poisoning, 12 patients who developed brain death status were considered for organ donation. ⋯ The one year survival rate of 75% is similar to that observed in the population who received organs from nonpoisoned donors. Organ procurement can be considered in few selected cases of acute poisoning. The accuracy of the diagnosis of irreversible brain damage is essential in this setting.
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J. Toxicol. Clin. Toxicol. · Jan 1995
Case ReportsProlonged neuromuscular blockade when mivacurium and pancuronium were administered in series.
Long acting non-depolarizing neuromuscular blockade is useful in many clinical circumstances, especially during surgical procedures. Reinstitution of the blockade for short periods to facilitate the completion of clinical tasks can be accomplished in different ways. We present a case wherein a short-acting non-depolarizing neuromuscular blocker used after a long-acting one resulted in an unusual prolongation of the neuromuscular blockade.
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For many physicians an antidote is an antidote. According to the International Programme on Chemical Safety definition, an antidote is a therapeutic substance used to counteract the toxic action(s) of a specified xenobiotic. Given this wide definition, the efficacy of an antidote may vary considerably depending on which toxic action(s) being counteracted and the level of counteracting power. ⋯ This may be particularly important in severe poisoning when the antidote may only be considered as an important adjunct to supportive care, e.g. deferoxamine in acute iron poisoning. Unless this is stressed, the unexperienced physician may rely too much on the antidote and pay insufficient attention to the supportive care. The varying efficacy levels will be discussed based on the presently ongoing International Programme on Chemical Safety/Commission of the European Communities evaluation program on antidotes.