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) · Nov 2015
Review Meta Analysis Comparative StudyA Comparative Meta-Analysis of Tick Paralysis in the United States and Australia.
Tick paralysis is a neurotoxic envenoming that mimics polio and primarily afflicts children, especially in hyperendemic regions of the Western United States of America (US) and Eastern Australia. ⋯ Tick paralysis should be added to and quickly excluded from the differential diagnoses of acute ataxia with ascending flaccid paralysis, especially in children living in tick paralysis-endemic regions worldwide.
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Clin Toxicol (Phila) · Nov 2015
Observational StudyA descriptive analysis of aspartate and alanine aminotransferase rise and fall following acetaminophen overdose.
Risk prediction following acetaminophen (paracetamol, APAP) overdose is based on serum APAP, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) levels. One recently proposed risk stratification tool, the APAPxAT multiplication product, uses either AST or ALT, whichever is higher, yet their interrelation is not well known following APAP-induced hepatic injury. ⋯ Either AST or ALT can be used for early risk stratification tools when only one is known. Any criterion for N-AC discontinuation should be based on the decline of AST rather than ALT, with a potential benefit measured in days.
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Clin Toxicol (Phila) · Jul 2015
Observational StudyTramadol overdose causes seizures and respiratory depression but serotonin toxicity appears unlikely.
Tramadol is a commonly used centrally acting analgesic associated with seizures and suspected to cause serotonin toxicity in overdose. ⋯ Tramadol overdose is associated with seizures and respiratory depression, but is unlikely to cause serotonin toxicity.
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Clin Toxicol (Phila) · Jul 2015
Review Practice GuidelineMethodology for AACT evidence-based recommendations on the use of intravenous lipid emulsion therapy in poisoning.
Intravenous lipid emulsion (ILE) therapy is a novel treatment that was discovered in the last decade. Despite unclear understanding of its mechanisms of action, numerous and diverse publications attested to its clinical use. However, current evidence supporting its use is unclear and recommendations are inconsistent. ⋯ The evidence will be appraised using the GRADE system. A thorough and transparent process for consensus statements will be performed to provide recommendations, using a modified Delphi method with two rounds of voting. This process will allow for the production of useful practice recommendations for this therapy.
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Clin Toxicol (Phila) · Jul 2015
Pneumomediastinum predicts early mortality in acute paraquat poisoning.
In paraquat (PQ) poisoning, death often occurs after the appearance of pneumomediastinum (PM). However, the clinical features and eventual outcome of PM in PQ intoxication remains unclear. ⋯ Early PM, occurring within 8 days, is a specific predictor of mortality in PQ poisoning.