Pub Date : 2022-09-05DOI: 10.1080/24734306.2022.2117941
Al-Badriyeh Daoud, K. Dalhoff, T. Petersen
Abstract Paracetamol-induced nephrotoxicity in the absence of hepatotoxicity is only described in a few studies. The aim of this retrospective cohort study with data from the Capital Region of Denmark 2010-2017, was to examine the incidence of possible paracetamol-induced nephrotoxicity in absence of hepatotoxicity. Only one out of 5,827 admissions (0.02%) included in the study developed clinically relevant acute kidney injury (AKI) that could be attributed to paracetamol in absence of acute liver injury. This study demonstrates that clinically relevant AKI due to paracetamol overdose rarely occurs without concomitant hepatic injury when excluding other prerenal, renal, and postrenal causes of renal dysfunction, NAC interference and chronic kidney injury.
{"title":"Paracetamol-induced acute kidney injury in the absence of acute liver injury: a retrospective cohort study","authors":"Al-Badriyeh Daoud, K. Dalhoff, T. Petersen","doi":"10.1080/24734306.2022.2117941","DOIUrl":"https://doi.org/10.1080/24734306.2022.2117941","url":null,"abstract":"Abstract Paracetamol-induced nephrotoxicity in the absence of hepatotoxicity is only described in a few studies. The aim of this retrospective cohort study with data from the Capital Region of Denmark 2010-2017, was to examine the incidence of possible paracetamol-induced nephrotoxicity in absence of hepatotoxicity. Only one out of 5,827 admissions (0.02%) included in the study developed clinically relevant acute kidney injury (AKI) that could be attributed to paracetamol in absence of acute liver injury. This study demonstrates that clinically relevant AKI due to paracetamol overdose rarely occurs without concomitant hepatic injury when excluding other prerenal, renal, and postrenal causes of renal dysfunction, NAC interference and chronic kidney injury.","PeriodicalId":23139,"journal":{"name":"Toxicology communications","volume":"35 1","pages":"97 - 100"},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76358174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-14DOI: 10.1080/24734306.2022.2110201
Eric Clifford, P. Kilgore, U. Cvek, M. Trutschl, Stephen Baker, S. Conrad, Thomas Arnold, N. Korneeva
Abstract Louisiana State University Health Sciences Center at Shreveport (LSUHSC-S) serves a largely minority-based, urban population. This study aims to identify trends in urine drug screen (UDS) results among females aged 18–35 visiting State University during 1998–2011 and 2012–2019. Using two databases extracted from the electronic medical record system, we performed statistical analysis of demographics and UDS results. Young females aged 18–35 mostly tested positive for cannabinoids and opiates during both periods, 1998–2011 and 2012–2019. African-American females had a higher percentage of positive UDS for illicit drugs, such as cannabinoids and cocaine, while Caucasian females had a higher rate for prescription drugs such as opiates, benzodiazepines, and amphetamine. Between 1998–2011 and 2012–2019, trends in drug screen results changed in both populations, with Caucasian females showing a drastic increase in amphetamines and African-American females showing increase in opiates and cannabinoids during 2012–2019. GatewayNet analysis (sequential-rule mining for inducing causation) for 2012–2019 indicated that a positive screen for amphetamines is likely preceded by a positive screen for cannabinoids, and benzodiazepines may be preceded by opiates. Our results emphasize the importance of drug use monitoring among young females of childbearing age. GatewayNet analysis implies a sequential nature to drug positivity on urine drug screening in this population.
{"title":"Trends in drug use among young adult females: a 22-year retrospective analysis","authors":"Eric Clifford, P. Kilgore, U. Cvek, M. Trutschl, Stephen Baker, S. Conrad, Thomas Arnold, N. Korneeva","doi":"10.1080/24734306.2022.2110201","DOIUrl":"https://doi.org/10.1080/24734306.2022.2110201","url":null,"abstract":"Abstract Louisiana State University Health Sciences Center at Shreveport (LSUHSC-S) serves a largely minority-based, urban population. This study aims to identify trends in urine drug screen (UDS) results among females aged 18–35 visiting State University during 1998–2011 and 2012–2019. Using two databases extracted from the electronic medical record system, we performed statistical analysis of demographics and UDS results. Young females aged 18–35 mostly tested positive for cannabinoids and opiates during both periods, 1998–2011 and 2012–2019. African-American females had a higher percentage of positive UDS for illicit drugs, such as cannabinoids and cocaine, while Caucasian females had a higher rate for prescription drugs such as opiates, benzodiazepines, and amphetamine. Between 1998–2011 and 2012–2019, trends in drug screen results changed in both populations, with Caucasian females showing a drastic increase in amphetamines and African-American females showing increase in opiates and cannabinoids during 2012–2019. GatewayNet analysis (sequential-rule mining for inducing causation) for 2012–2019 indicated that a positive screen for amphetamines is likely preceded by a positive screen for cannabinoids, and benzodiazepines may be preceded by opiates. Our results emphasize the importance of drug use monitoring among young females of childbearing age. GatewayNet analysis implies a sequential nature to drug positivity on urine drug screening in this population.","PeriodicalId":23139,"journal":{"name":"Toxicology communications","volume":"1 1","pages":"85 - 96"},"PeriodicalIF":0.0,"publicationDate":"2022-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78839731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-03DOI: 10.1080/24734306.2022.2106397
Adam Blumenberg
Abstract Background Cannabis is a schedule 1 substance that cannot be possessed within the United States according to federal law. On March 31 2021, New York State legalized cannabis for sale and consumption. This study assesses the safety labeling and packaging aimed at children of cannabis containers during the peri-legalization period in New York City. Methods This is a cross-sectional and descriptive comparative study in which sidewalks in New York City were inspected for labeled cannabis containers during the four months prior and four months post legalization, i.e. from December 2020 until July 2021. Packages were systematically analyzed using a scoring system based on advertising techniques that may appeal to children and the American College of Medical Toxicology’s (ACMT) recommendations on cannabis safety labeling. Results and DiscussionOf the 114 packages, none met ACMT’s recommended safety labeling guidelines. Only 52% of containers indicated their contents, 40% referenced food, and 85% included elements that may appeal to children. Conclusion Precautionary measures such as child-resistant packaging, warning labels, and avoiding marketing to children are uncommon. Policy makers should consider regulating the safety labeling and advertising which appeals to children on cannabis packaging.
{"title":"A cross-sectional assessment of package labels aimed at children of edible and leaf cannabis discarded in New York City","authors":"Adam Blumenberg","doi":"10.1080/24734306.2022.2106397","DOIUrl":"https://doi.org/10.1080/24734306.2022.2106397","url":null,"abstract":"Abstract Background Cannabis is a schedule 1 substance that cannot be possessed within the United States according to federal law. On March 31 2021, New York State legalized cannabis for sale and consumption. This study assesses the safety labeling and packaging aimed at children of cannabis containers during the peri-legalization period in New York City. Methods This is a cross-sectional and descriptive comparative study in which sidewalks in New York City were inspected for labeled cannabis containers during the four months prior and four months post legalization, i.e. from December 2020 until July 2021. Packages were systematically analyzed using a scoring system based on advertising techniques that may appeal to children and the American College of Medical Toxicology’s (ACMT) recommendations on cannabis safety labeling. Results and DiscussionOf the 114 packages, none met ACMT’s recommended safety labeling guidelines. Only 52% of containers indicated their contents, 40% referenced food, and 85% included elements that may appeal to children. Conclusion Precautionary measures such as child-resistant packaging, warning labels, and avoiding marketing to children are uncommon. Policy makers should consider regulating the safety labeling and advertising which appeals to children on cannabis packaging.","PeriodicalId":23139,"journal":{"name":"Toxicology communications","volume":"50 1","pages":"78 - 84"},"PeriodicalIF":0.0,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90945697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-14DOI: 10.1080/24734306.2022.2087019
J. M. Martinez Manzano, K. Elkholy, K. Lo
Abstract Ethylene glycol (EG) is a toxic alcohol that causes central nervous system depression and multiple metabolic abnormalities including a high anion gap metabolic acidosis (HAGMA), elevated osmolal gap (OG), and acute kidney injury. Few case reports of EG intoxication report brain MRI findings. We describe an elderly female who was brought to the hospital because of altered mentation. We diagnosed her with EG toxicity and treated with fomepizole based on metabolic abnormalities and presence of urine calcium oxalate crystals. Our patient’s brain MRI showed T2-hyperintense signals located in the midbrain, hippocampi, basal nuclei, and thalami consistent with previous MRI reports with confirmed EG toxicity. As in this case, a clear history of poisoning is not always available. However, antidote therapy with alcohol dehydrogenase blockade should be initiated if clinical data suggests EG intoxication. Our patient’s EG concentration returned elevated two days after admission blood draw confirming the initial diagnosis. MRI of the brain may add diagnostic support to laboratory findings while awaiting a definitive EG concentration.
{"title":"Brain MRI abnormalities in acute ethylene glycol poisoning: a case report","authors":"J. M. Martinez Manzano, K. Elkholy, K. Lo","doi":"10.1080/24734306.2022.2087019","DOIUrl":"https://doi.org/10.1080/24734306.2022.2087019","url":null,"abstract":"Abstract Ethylene glycol (EG) is a toxic alcohol that causes central nervous system depression and multiple metabolic abnormalities including a high anion gap metabolic acidosis (HAGMA), elevated osmolal gap (OG), and acute kidney injury. Few case reports of EG intoxication report brain MRI findings. We describe an elderly female who was brought to the hospital because of altered mentation. We diagnosed her with EG toxicity and treated with fomepizole based on metabolic abnormalities and presence of urine calcium oxalate crystals. Our patient’s brain MRI showed T2-hyperintense signals located in the midbrain, hippocampi, basal nuclei, and thalami consistent with previous MRI reports with confirmed EG toxicity. As in this case, a clear history of poisoning is not always available. However, antidote therapy with alcohol dehydrogenase blockade should be initiated if clinical data suggests EG intoxication. Our patient’s EG concentration returned elevated two days after admission blood draw confirming the initial diagnosis. MRI of the brain may add diagnostic support to laboratory findings while awaiting a definitive EG concentration.","PeriodicalId":23139,"journal":{"name":"Toxicology communications","volume":"24 1","pages":"74 - 77"},"PeriodicalIF":0.0,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72721973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-15DOI: 10.1080/24734306.2022.2075182
S. Motawei, O. Shabka, Huimei Liu
Abstract Introduction Coronavirus disease 2019 (COVID-19), originated in late December 2019, in Wuhan, China. The World Health Organization declared a pandemic on 11 March 2020, with the rapidly rising number of cases and fatalities over hours and days all around the world. Aim To assess the number and the trend of the poisoning consultations to the Poison Unit in the Mansoura Emergency Hospital during the era of the COVID-19 pandemic in 2020. Methods We collected data from the database of the Poison Unit and the Statistics Department of the Mansoura Emergency Hospital of the cases and the calls coming to the Poison Unit in the period from January 2018 through December 2020. We compared 2020 exposures to 2018–2019 exposures by using simple logistic models to provide effect size with odds ratios. Results The Mansoura Emergency Hospital Poison Unit treated 1752 cases in 2020, compared to 2210 cases in 2018 and 2539 cases in 2019. The Poison Unit treated 26% fewer patients in 2020 than either 2018 or 2019), while calls increased nearly 50% in 2020 than in 2018 and 2019. Calls came more frequently from the general public than health professionals and more frequently in afternoon and evening than in the morning. There was a significant increase in the cases of pharmaceuticals ingestion, food poisoning, corrosives and households exposures in 2020 compared to 2018 and 2019 (p-value 0.004, 0.024, and 0.0002, respectively; odds ratio 1.224, 1.691, and 1.692, respectively). Conclusion The COVID-19 pandemic changed the pattern of poisoning exposure and use of the Poison Control Center services.
{"title":"Poisoning during the COVID-19 pandemic and lockdown: retrospective analysis of exposures reported to the Poison Unit of the Mansoura Emergency Hospital","authors":"S. Motawei, O. Shabka, Huimei Liu","doi":"10.1080/24734306.2022.2075182","DOIUrl":"https://doi.org/10.1080/24734306.2022.2075182","url":null,"abstract":"Abstract Introduction Coronavirus disease 2019 (COVID-19), originated in late December 2019, in Wuhan, China. The World Health Organization declared a pandemic on 11 March 2020, with the rapidly rising number of cases and fatalities over hours and days all around the world. Aim To assess the number and the trend of the poisoning consultations to the Poison Unit in the Mansoura Emergency Hospital during the era of the COVID-19 pandemic in 2020. Methods We collected data from the database of the Poison Unit and the Statistics Department of the Mansoura Emergency Hospital of the cases and the calls coming to the Poison Unit in the period from January 2018 through December 2020. We compared 2020 exposures to 2018–2019 exposures by using simple logistic models to provide effect size with odds ratios. Results The Mansoura Emergency Hospital Poison Unit treated 1752 cases in 2020, compared to 2210 cases in 2018 and 2539 cases in 2019. The Poison Unit treated 26% fewer patients in 2020 than either 2018 or 2019), while calls increased nearly 50% in 2020 than in 2018 and 2019. Calls came more frequently from the general public than health professionals and more frequently in afternoon and evening than in the morning. There was a significant increase in the cases of pharmaceuticals ingestion, food poisoning, corrosives and households exposures in 2020 compared to 2018 and 2019 (p-value 0.004, 0.024, and 0.0002, respectively; odds ratio 1.224, 1.691, and 1.692, respectively). Conclusion The COVID-19 pandemic changed the pattern of poisoning exposure and use of the Poison Control Center services.","PeriodicalId":23139,"journal":{"name":"Toxicology communications","volume":"31 1","pages":"66 - 70"},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81098018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-04DOI: 10.1080/24734306.2022.2069967
Connie H. Yoon, Natalie I. Rine, Adam Smith, M. Casavant
Abstract This is a case of a 23-year-old female who presented to the emergency department (ED) comatose after ingesting 7.8 g of propafenone and 11.7 g of valsartan. Upon arrival to the ED, the patient had seizures and required intubation. Several boluses of sodium bicarbonate were given as well as a continuous infusion to normalize QRS intervals. Norepinephrine and intravenous lipid emulsion (ILE) therapy were initiated. In the intensive care unit (ICU), the patient experienced persistent seizures and a 5-minute period of pulseless ventricular tachycardia. Subsequently, hyperinsulinemic-euglycemic therapy (HIET) was initiated. The patient received a 1 unit/kg intravenous bolus of regular insulin followed by a continuous infusion starting at 1 unit/kg/hr. Norepinephrine infusion was weaned off after 27 h of HIET. Within 48 h of presentation, the patient was transferred out of the ICU. This case exhibits the successful management of a mixed overdose with propafenone and valsartan utilizing a multimodal approach. In addition to supportive care, the patient received sodium bicarbonate, HIET, ILE and vasopressors to manage the cardiovascular collapse associated with these toxicities.
{"title":"Propafenone and valsartan overdose with cardiovascular deterioration managed with lipid emulsion and high dose insulin: a case report","authors":"Connie H. Yoon, Natalie I. Rine, Adam Smith, M. Casavant","doi":"10.1080/24734306.2022.2069967","DOIUrl":"https://doi.org/10.1080/24734306.2022.2069967","url":null,"abstract":"Abstract This is a case of a 23-year-old female who presented to the emergency department (ED) comatose after ingesting 7.8 g of propafenone and 11.7 g of valsartan. Upon arrival to the ED, the patient had seizures and required intubation. Several boluses of sodium bicarbonate were given as well as a continuous infusion to normalize QRS intervals. Norepinephrine and intravenous lipid emulsion (ILE) therapy were initiated. In the intensive care unit (ICU), the patient experienced persistent seizures and a 5-minute period of pulseless ventricular tachycardia. Subsequently, hyperinsulinemic-euglycemic therapy (HIET) was initiated. The patient received a 1 unit/kg intravenous bolus of regular insulin followed by a continuous infusion starting at 1 unit/kg/hr. Norepinephrine infusion was weaned off after 27 h of HIET. Within 48 h of presentation, the patient was transferred out of the ICU. This case exhibits the successful management of a mixed overdose with propafenone and valsartan utilizing a multimodal approach. In addition to supportive care, the patient received sodium bicarbonate, HIET, ILE and vasopressors to manage the cardiovascular collapse associated with these toxicities.","PeriodicalId":23139,"journal":{"name":"Toxicology communications","volume":"9 1","pages":"62 - 65"},"PeriodicalIF":0.0,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79669017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Eye exposure to hexavalent chromium (Cr(VI)) acid can cause blindness. A 42-year-old man working in a plating operation presented to the emergency department following a workplace incident. He had unintentionally fallen into a tank containing a mixture of 25% Cr(VI) and sulfuric acid (2.0 g/L) at a temperature of approximately 40 °C. The tank dimensions tank were 8 (depth) × 4 (width) × 3 (length) meters. A colleague rescued him from the tank, and he underwent a full body wash at the worksite. Emergency services adequately flushed both eyes with a 0.9% saline solution. He had significant corneal injury; however, no other significant injuries occurred. Upon presentation at the emergency department, the patient underwent a whole-body shower, and both eyes were flushed with 0.9% saline solution. As a treatment for acute chromium poisoning, he received dimercaprol and ascorbic acid. Additionally, he received eye drops for chemical corneal injury. The patient later underwent bilateral corneal transplants for chemical corneal injury but remained nearly blind. We describe a case of severe chemical corneal injury with limbal stem cell deficiency, leading to blindness due to Cr (VI) acid exposure.
{"title":"Severe chemical corneal injury from hexavalent chromium exposure: a case report","authors":"Daisuke Ueno, Yasukazu Shiino, Hisataka Fujimoto, Takahiro Okane, Sachiko Yamada, Jiro Takahashi, Takahiro Inoue","doi":"10.1080/24734306.2022.2058253","DOIUrl":"https://doi.org/10.1080/24734306.2022.2058253","url":null,"abstract":"Abstract Eye exposure to hexavalent chromium (Cr(VI)) acid can cause blindness. A 42-year-old man working in a plating operation presented to the emergency department following a workplace incident. He had unintentionally fallen into a tank containing a mixture of 25% Cr(VI) and sulfuric acid (2.0 g/L) at a temperature of approximately 40 °C. The tank dimensions tank were 8 (depth) × 4 (width) × 3 (length) meters. A colleague rescued him from the tank, and he underwent a full body wash at the worksite. Emergency services adequately flushed both eyes with a 0.9% saline solution. He had significant corneal injury; however, no other significant injuries occurred. Upon presentation at the emergency department, the patient underwent a whole-body shower, and both eyes were flushed with 0.9% saline solution. As a treatment for acute chromium poisoning, he received dimercaprol and ascorbic acid. Additionally, he received eye drops for chemical corneal injury. The patient later underwent bilateral corneal transplants for chemical corneal injury but remained nearly blind. We describe a case of severe chemical corneal injury with limbal stem cell deficiency, leading to blindness due to Cr (VI) acid exposure.","PeriodicalId":23139,"journal":{"name":"Toxicology communications","volume":"8 1","pages":"58 - 61"},"PeriodicalIF":0.0,"publicationDate":"2022-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91185060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.1080/24734306.2022.2056374
P. Chai, Y. Berlyand, E. Goralnick, C. Goldfine, M. Vanrooyen, D. Hryhorczuk, T. Erickson
Abstract The unprovoked invasion of Ukraine by the Russian Federation has resulted in the largest humanitarian crisis in Europe since World War II. As fighting intensifies throughout Ukraine, there is an increasing concern that the Russian Federation may consider the direct use of chemical or radiological weapons against military personnel and civilians in Ukraine. Despite prohibition of chemical weapons from the Chemical Weapons Convention of 1997, recent evidence has demonstrated that state actors will continue to use these agents as weapons of war and terror, despite publicly denying their use. We review chemical weapons produced and used by the Russian Federation (or its allies) to identify plausible risks in the Russian war in Ukraine. We also provide rapid assessment and treatment guidelines to recognize and manage these acute exposures.
{"title":"Wartime toxicology: the spectre of chemical and radiological warfare in Ukraine","authors":"P. Chai, Y. Berlyand, E. Goralnick, C. Goldfine, M. Vanrooyen, D. Hryhorczuk, T. Erickson","doi":"10.1080/24734306.2022.2056374","DOIUrl":"https://doi.org/10.1080/24734306.2022.2056374","url":null,"abstract":"Abstract The unprovoked invasion of Ukraine by the Russian Federation has resulted in the largest humanitarian crisis in Europe since World War II. As fighting intensifies throughout Ukraine, there is an increasing concern that the Russian Federation may consider the direct use of chemical or radiological weapons against military personnel and civilians in Ukraine. Despite prohibition of chemical weapons from the Chemical Weapons Convention of 1997, recent evidence has demonstrated that state actors will continue to use these agents as weapons of war and terror, despite publicly denying their use. We review chemical weapons produced and used by the Russian Federation (or its allies) to identify plausible risks in the Russian war in Ukraine. We also provide rapid assessment and treatment guidelines to recognize and manage these acute exposures.","PeriodicalId":23139,"journal":{"name":"Toxicology communications","volume":"51 Pt 5 1","pages":"52 - 58"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83904672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-02DOI: 10.1080/24734306.2022.2045788
Anita Mudan, J. Lebin, C. Smollin
{"title":"The poisoning of big data: using large data registries for research in toxicology","authors":"Anita Mudan, J. Lebin, C. Smollin","doi":"10.1080/24734306.2022.2045788","DOIUrl":"https://doi.org/10.1080/24734306.2022.2045788","url":null,"abstract":"","PeriodicalId":23139,"journal":{"name":"Toxicology communications","volume":"15 1","pages":"39 - 41"},"PeriodicalIF":0.0,"publicationDate":"2022-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88257866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-28DOI: 10.1080/24734306.2022.2045123
A. Nemanich, S. Bryant
ABSTRACT Background: Toxic alcohol poisoning may result in severe acidemia and death. Previous work from our regional poison center (RPC) revealed that most pediatric unintentional methanol exposures are benign and do not require alcohol dehydrogenase (ADH) blockade or hemodialysis. Methods: We retrospectively reviewed all ethylene glycol (EG) cases in patients less than 6 years of age reported to our RPC over a 19 year period. We included unintentional ingestions with measured EG concentrations. Results: Twenty-nine cases met inclusion criteria. EG concentrations were undetectable in 25 cases (86%). No patient became symptomatic or acidemic. No EG concentration warranted treatment with ADH inhibition or hemodialysis. However, 21 patients (72%) received fomepizole or ethanol. Fifteen patients (52%) transferred from a community hospital to a pediatric specialty hospital. All 27 children admitted to the hospital went to a pediatric intensive care unit (PICU) while awaiting EG results. Conclusions: No child during the 19-year period required either antidote or hemodialysis. Unintentional EG exposures in typical pediatric patients may warrant nothing more than repeat laboratory testing (electrolytes, pH) to exclude evolving toxicity. Timely availability of EG laboratory test results would likely reduce unnecessary and expensive use of antidote, transport, and PICU resources.
{"title":"Unintentional ethylene glycol ingestions in children","authors":"A. Nemanich, S. Bryant","doi":"10.1080/24734306.2022.2045123","DOIUrl":"https://doi.org/10.1080/24734306.2022.2045123","url":null,"abstract":"ABSTRACT Background: Toxic alcohol poisoning may result in severe acidemia and death. Previous work from our regional poison center (RPC) revealed that most pediatric unintentional methanol exposures are benign and do not require alcohol dehydrogenase (ADH) blockade or hemodialysis. Methods: We retrospectively reviewed all ethylene glycol (EG) cases in patients less than 6 years of age reported to our RPC over a 19 year period. We included unintentional ingestions with measured EG concentrations. Results: Twenty-nine cases met inclusion criteria. EG concentrations were undetectable in 25 cases (86%). No patient became symptomatic or acidemic. No EG concentration warranted treatment with ADH inhibition or hemodialysis. However, 21 patients (72%) received fomepizole or ethanol. Fifteen patients (52%) transferred from a community hospital to a pediatric specialty hospital. All 27 children admitted to the hospital went to a pediatric intensive care unit (PICU) while awaiting EG results. Conclusions: No child during the 19-year period required either antidote or hemodialysis. Unintentional EG exposures in typical pediatric patients may warrant nothing more than repeat laboratory testing (electrolytes, pH) to exclude evolving toxicity. Timely availability of EG laboratory test results would likely reduce unnecessary and expensive use of antidote, transport, and PICU resources.","PeriodicalId":23139,"journal":{"name":"Toxicology communications","volume":"9 1","pages":"42 - 45"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87306587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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