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) · Aug 2013
Multicenter Study Comparative StudyBehavioral and physiologic adverse effects in adolescent and young adult emergency department patients reporting use of energy drinks and caffeine.
This pilot study assessed the prevalence of physiologic and behavioral adverse effects among adolescent (13-17 years) and adult (18-25 years) emergency department patients who reported energy drink and/or caffeinated-only beverage use within the 30 days prior to emergency department presentation. It was hypothesized that energy drink users would report more adverse effects than those who used only traditional caffeinated beverages such as coffee, tea, or soft drinks. ⋯ Energy drink users and substance users are more likely to report specific physiologic and behavioral adverse effects. Emergency department clinicians should consider asking patients about energy drink and traditional caffeine usage and substance use when assessing patient symptoms.
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Clin Toxicol (Phila) · Jun 2013
Multicenter StudyA multicenter retrospective survey on a suicide trend using hydrogen sulfide in Japan.
In Japan, suicide by inhaling hydrogen sulfide (H2S) by mixing commercial products escalated into a nationwide trend in April 2008. ⋯ Mortality (58%) among patients who attempted H2S suicide was very high, likely resulting from inhaling high concentrations of H2S after mixing commercial products in a sealed and confined space.
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Clin Toxicol (Phila) · Mar 2012
Multicenter StudyMulticenter assessment of the revisit risk for a further drug-related problem in the emergency department in cocaine users (MARRIED-cocaine study).
Emergency departments (EDs) in Spanish hospitals daily attend a large number of patients for adverse reactions or clinical complications resulting from cocaine use. After discharge, some of these patients revisit the ED for the same reason within a year. The objective of the present study was to quantify the rate of such revisits and identify the factors associated with them. ⋯ The study included 807 patients, of whom 6.7% revisited the ED within 30 days, 11.9% within 3 months and 18.9% within 1 year. The variables significantly associated with ED revisits were: presence of clinical manifestations directly related to cocaine (p < 0.05), ED attendance on a working day (p < 0.05), history of ED visits related with the consumption of alcohol (p < 0.001) or drugs (p < 0.001), and the need for urgent consultation with a psychiatrist (p < 0.001), although only the last four were independent predictors in multivariate analysis. We derived a score based on these variables to predict risk of revisits (MARRIED-score, ranging from 0 to 400 points), which had a reasonably good predictive value for revisit (area under ROC of 0.75; 95% CI 0.71-0.79).
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Clin Toxicol (Phila) · Oct 2010
Multicenter StudyMultiplying the serum aminotransferase by the acetaminophen concentration to predict toxicity following overdose.
The first available predictors of hepatic injury following acetaminophen (APAP) overdose are the serum APAP and aminotransferases [AT, i.e., aspartate (AST) aminotransferase or alanine (ALT) aminotransferase]. ⋯ The APAP × AT multiplication product, calculated at the time of presentation and after several h of antidotal therapy, holds promise as a new risk predictor following APAP overdose. It requires neither graphical interpretation nor accurate time of ingestion, two limitations to current risk stratification.
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Clin Toxicol (Phila) · Feb 2009
Multicenter StudyCarbon monoxide poisoning in Jerusalem: epidemiology and risk factors.
To describe the epidemiology of carbon monoxide (CO) poisoning in Jerusalem and identify risk factors for such poisoning. ⋯ Males exposed to CO may have a more severe intoxication. The lower risk in patients presenting in clusters could be explained by the assumption that severe presentation in one patient alerts the others who are less severely affected. The implementation of safer standards for residential heating systems and CO detectors together with the public education may explain the decline in the incidence of CO poisoning.