Veterinary and human toxicology
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Comparative Study
A nationwide survey of poison control centers comparing 1999 to 1998 triage and management of asymptomatic children who ingested tricyclic antidepressant.
Triage of asymptomatic, unintentional pediatric (< 6y) tricyclic antidepressant (TCA) exposures has been based upon single cases or small studies involving large dose, symptomatic ingestions. This study evaluated patterns of triage for asymptomatic pediatric TCA exposures as practiced nationally by regional centers and compared them to 1998 patterns. It also evaluated the role of activated charcoal in the management of these exposures. ⋯ The lowest toxic dose reported in the literature is 6.7 mg/kg. This is consistent with poison control data during the past 6y where no child became toxic at doses < 5 mg/kg. This survey demonstrated significant changes in triage patterns for asymptomatic pediatric TCA exposures.
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Case Reports
Efficacy of hexafluorine for emergent decontamination of hydrofluoric acid eye and skin splashes.
Hexafluorine is an amphoteric, hypertonic, polyvalent compound for decontaminating hydrofluoric acid (HF) eye and skin splashes. In a German metallurgy facility during the period of 1994-1998, all eye or skin splashes with 40% HF alone or with a 6% HF/15% HNO3 mixture were initially decontaminated with Hexafluorine within 2 min following the splash at the accident site by the victims themselves or co-workers who witnessed the accident. ⋯ No further medical or surgical treatment was needed, no workers developed chemical burns, and none lost work time. These II cases demonstrate the efficacy of Hexafluorine in decontaminating HF or combined HF/HNO3 splashes.
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Snakebite may be complicated with bacteria infections, most of which are Gram-negative bacillus. Snakebite complicated with Vibrio vulnificus infection has not been reported previously. Vibrio vulnificus infection is characterized by a necrotizing wound infection similar to the local lesion of severe snakebite. ⋯ Vibrio vulnificuswas cultured from necrotic tissue after aggressive debridement and fasciotomy. The patient recovered from antibiotic treatment and several courses of reconstruction surgery. Severe bacteria infection, such as caused by Vibrio vulnificus, should be considered in snakebite cases refractory to antivenin dosage.