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) · Jun 2012
Postpartum maternal codeine therapy and the risk of adverse neonatal outcomes: a retrospective cohort study.
To examine whether postpartum maternal prescription of codeine was associated with an increased risk of harm to newborns. ⋯ In this large population-based study, maternal prescription of codeine following delivery was not associated with death or hospitalization in the early neonatal period.
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Clin Toxicol (Phila) · Jun 2012
Adherence to calcium channel blocker poisoning treatment recommendations in two Canadian cities.
No study has documented whether physicians call poison control centres (PCC) for calcium channel blocker (CCB) poisoning or if interventions suggested by the PCC are being applied. ⋯ In conclusion, the majority of the physicians did not follow PCC recommendations for the treatment of CCB poisoning. Further studies are ongoing as to evaluate the barriers to protocol adherence and to develop evidence based guidelines accompanied by an effective implementation strategy.
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Clin Toxicol (Phila) · Jun 2012
Comparative StudyComparison of citalopram and other selective serotonin reuptake inhibitor ingestions in children.
In adults, citalopram is more likely to cause seizures and ECG changes than other selective serotonin reuptake inhibitors (SSRIs). Data in children are lacking, yet the 2007 American Association of Poison Control Centers out-of-hospital citalopram consensus guideline mirrors the guideline for other SSRIs. ⋯ Children develop minimal toxicity with SSRI ingestions. Seizures and ECG changes, while uncommon, occur more frequently with citalopram. Doses associated with significant outcomes suggest that the triage guideline for citalopram does not need to be modified.
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Clin Toxicol (Phila) · Apr 2012
ReviewLevamisole in cocaine: unexpected news from an old acquaintance.
Levamisole is a pharmaceutical with anthelminthic and immunomodulatory properties that was previously used in both animals and humans to treat inflammatory conditions and cancer. Levamisole has been identified as a cocaine adulterant in the United States since 2003. By 2009, the United States Drug Enforcement Administration (DEA) estimated that 69% of the cocaine seized contained levamisole. ⋯ These potential effects make levamisole an interesting choice as a cocaine adulterant. It seems unlikely that levamisole use as a cocaine adulterant will soon reach an end. More information is needed about the diagnosis and treatment of levamisole-induced complications, and the efforts of the medical and public health community is needed to face this challenging problem.
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The hospital mortality from acute poisoning in the western world is approximately 0.6%. However, this figure is based on series of consecutive cases, including mild intoxications. The aim of this paper was to investigate the mortality among poisoned patients with CNS depression on admission. ⋯ Based on the findings in this report, and on a literature search, about 30% of hospitalized poisonings have a significant CNS depression on admission. Based on our experience, cases of poisoning with a GCS score of 7-10 on admission do not seem to have a worse prognosis than poisonings in general. However, cases of poisoning presenting with deeper coma (GCS score 3-6) have a mortality rate approximately seven times higher than the overall hospital mortality from acute poisoning.