J Toxicol Env Heal A
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J Toxicol Env Heal A · Jun 2007
Pediatric atomoxetine ingestions reported to Texas poison control centers, 2003-2005.
Limited information exists on potentially adverse consequences following pediatric atomoxetine ingestions reported to poison control centers. Using pediatric atomoxetine ingestions reported to Texas poison control centers during 2003-2005, the proportion of cases involving serious outcomes (medical outcomes classified as moderate effects, major effects, death, or judged as potentially toxic exposures) was determined for selected variables and evaluated for statistical significance by calculating the rate ratio (RR) and 95% confidence interval (CI). Of 501 cases identified, 31 (6%) involved serious outcomes. ⋯ The severity of the outcome associated with pediatric atomoxetine ingestions was dependent upon the dose and the circumstances of the ingestion (whether intentional self-harm was involved). The management of patients with serious outcomes was more likely to involve health care facilities. This information is useful for creating triage guidelines for the management of pediatric atomoxetine ingestions.
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J Toxicol Env Heal A · Apr 2007
Methods for bias reduction in time-series studies of particulate matter air pollution and mortality.
In many cities of the United States, measurements of ambient particulate matter air pollution (PM) are available only every sixth day. Time-series studies conducted in these cities that investigate the relationship between mortality and PM are restricted to using a single day's PM as the measure of PM exposure, rather than using measurements taken over several consecutive days. Studies showed that using a single-day PM as the measure of PM exposure can result in estimates that have a negative bias, sometimes in the order of over half of the value being estimated. ⋯ The corresponding effect estimates obtained using the single-day lag-1 PM concentration are 0.18% and 0.23%. The estimates obtained using the lag-1 PM concentration were the most widely reported results from the recent multicity National Morbidity, Mortality, and Air Pollution Study (NMMAPS) analyses. The more accurate estimates obtained from the methods introduced in this article will enable more accurate quantification of the increased incidence in mortality due to elevation in PM levels and the benefit of current or more stringent regulatory standards.
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J Toxicol Env Heal A · Apr 2007
Alteration of brain and interrenal StAR protein, P450scc, and Cyp11beta mRNA levels in atlantic salmon after nominal waterborne exposure to the synthetic pharmaceutical estrogen ethynylestradiol.
Pharmaceuticals are ubiquitous pollutants in the aquatic environment, where their potential effects on nontarget species like fish has only recently become subject of systematic investigations. Recently, it was shown that the documented xenoestrogen nonylphenol produced variations in brain steroidogenic acute regulatory (StAR) protein, cytochrome P-450-mediated cholesterol side-chain cleavage (P450scc), and cytochrome P-45011beta hydroxylase (CYP11beta) gene transcripts of exposed juvenile salmon (Arukwe, 2005). In the present study, experiments were undertaken to examine the effect of the synthetic pharmaceutical endocrine disruptor ethynylestradiol (EE2), given in water at 5 or 50 ng/L and sampled at d 0 (control), 3, and 7 after exposure, on these key and rate-limiting brain and interrenal steroidogenic pathways of juvenile salmon using quantitative (real-time) polymerase chain reaction (qPCR). ⋯ These changes in the levels of StAR, P450scc, and CYP11beta mRNA levels in important steroidogenic organs suggest that the experimental animals are experiencing a time-dependent impaired steroidogenesis. Thus, the StAR protein, P450scc, and CYP11beta might represent sensitive diagnostic tools for short-term and acute exposure to endocrine disrupting chemicals. In view of the present study and high concentrations of EE2 reported in effluents and surface waters from Europe and the United States, pharmaceuticals in the environment represent potentially more serious health concern both to humans and wildlife than earlier anticipated.
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J Toxicol Env Heal A · Dec 2006
Pattern of thiazolidinedione exposures reported to Texas poison centers during 1998-2004.
Information on the management of potentially adverse exposures to thiazolidinediones, a class of oral antihyperglycemic, is limited. This study examined the distribution of thiazolidinedione exposures reported to Texas poison control centers from 1998 through 2004. There were a total of 581 exposures reported, increasing from 31 in 1998 to 140 in 2004. ⋯ The most frequent treatments were decontamination by being given some sort of food (38%), dilution with substances such as milk (34%), and activated charcoal (20%). In conclusion, this study found that the number of reported potentially adverse thiazolidinedione exposures in Texas increased in recent years. Such exposures generally found few adverse clinical effects and were reversible, although some sort of treatment, particularly decontamination, was administered and a large proportion of exposures were managed at or referred to health care facilities.
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Zolpidem and zaleplon are used for the treatment of insomnia. The objective of this study was to compare the patterns of zolpidem and zaleplon exposures reported to Texas poison control centers during 1998-2004. There were 5842 total reported zolpidem exposures, of which 2918 (50%) were isolated exposures, and 467 total reported zaleplon exposures, of which 201 (43%) were isolated exposures. ⋯ The medical outcome involved no symptoms due to exposure for 29% of zolpidem and 44% of zaleplon exposures, a statistically significant difference. Although many of the most frequently reported adverse clinical effects for the two drugs were similar (drowsiness, slurred speech, hallucinations, ataxia, tachycardia, dizziness, confusion, vomiting), the proportion of exposures with a given adverse clinical effect was generally lower for zaleplon. Thus, although zolpidem and zaleplon exposures were generally similar with respect to patient gender and age, exposure reason and site, and management site, zaleplon exposures were less likely to result in minor medical outcomes or manifest as adverse clinical effects.