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) · Jan 2006
Case ReportsThe role of calcium oxalate crystal deposition in cerebral vessels during ethylene glycol poisoning.
Ethylene glycol (EG) poisoning can lead to serious morbidity or death, which occurs following conversion of ethylene glycol to toxic metabolites. These metabolites affect multiple organ/systems leading to metabolic acidosis, cardiopulmonary depression, acute renal failure and central nervous system deficits. ⋯ We describe a case of fatal EG poisoning in which the development of rapid cerebral edema was documented by CT scan and was accompanied by definitive evidence of birefringent crystals within walls of CNS blood vessels, with associated inflammation and edema. This case and others in the literature suggest that cerebral edema, and perhaps injury to other organs, could result from oxalate crystal deposition in small blood vessels in the brain and other organs.
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Clin Toxicol (Phila) · Jan 2006
Comparative StudyA comparison of vasopressin and glucagon in beta-blocker induced toxicity.
We compared the efficacy of vasopressin and glucagon in a porcine model of beta-blocker toxicity. Our primary outcome was survival over 4 hours. ⋯ In this beta-blocker toxicity model, there were no differences in the survival curves between vasopressin- and glucagon-treated pigs during a 4-hour analysis period. No overall differences were noted in MAP, systolic BP, CO, HR, pH, or glucose levels, although vasopressin treatment yielded higher MAP and systolic BP early in resuscitation.
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Clin Toxicol (Phila) · Jan 2006
Prehospital administration of hydroxocobalamin for smoke inhalation-associated cyanide poisoning: 8 years of experience in the Paris Fire Brigade.
This article reports the results of a retrospective study of 8 years of experience of the Paris Fire Brigade with the prehospital use of hydroxocobalamin. ⋯ Hydroxocobalamin has a risk:benefit ratio rendering it suitable for prehospital use in the management of acute cyanide poisoning caused by smoke inhalation.
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Clin Toxicol (Phila) · Jan 2006
Case ReportsClinical course and toxicokinetic data following isolated citalopram overdose in an infant.
Despite the frequency of use of citalopram, its clinical effects and pharmacokinetics in overdose in the pediatric patient are not well described. We describe the clinical course and drug levels following the ingestion of citalopram by a 10-month-old female. ⋯ We report a case of citalopram poisoning in a 10-month-old infant with refractory seizures, and an absence of cardiovascular events with subsequent excellent outcome. The elimination of the parent drug corresponds to an approximate t1/2 of 15-20 h in this single case.
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Clin Toxicol (Phila) · Jan 2006
Evaluation of several clinical scoring tools in organophosphate poisoned patients.
The aim of this study was to evaluate the Acute Physiology and Chronic Health Evaluation (APACHE) II, III and Simplified Acute Physiology Score II (SAPS II) as predictors of severity of organophosphate poisoning (OPP). ⋯ The APACHE II, III and SAPS II clinical scoring tools seem to predict the severity of organophosphate poisoning, and may have prognostic value.