Journal of toxicology. Clinical toxicology
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J. Toxicol. Clin. Toxicol. · Jan 2002
Case ReportsAcute cyanide intoxication treated with a combination of hydroxycobalamin, sodium nitrite, and sodium thiosulfate.
An 80-year-old diabetic patient was admitted to the hospital because of sudden unconsciousness and severe metabolic acidosis. His son reported the possibility of cyanide poisoning. ⋯ Supportive therapy and the following antidotes--sodium nitrite two doses 300 mg i.v., sodium thiosulfate 3 g i.v., and hydroxocobalamin 4 g in 24 hours--were administered immediately and the patient completely recovered in 48 hours. Our observations suggest that timely and appropriate use of antidotes for cyanide intoxication may prevent death, even in aged diabetic patients.
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J. Toxicol. Clin. Toxicol. · Jan 2002
Acute wood or coal exposure with carbon monoxide intoxication induces sister chromatid exchange.
The object of this study was to investigate the genotoxic effect of acute overexposure to combustion products originating from coal or wood stoves in patients presenting with acute carbon monoxide intoxication. ⋯ These results suggest that acute exposure to combustion products of wood or coal is genotoxic to DNA. Potential causes of genotoxicity include known mutagenic compounds present in coal or wood smoke and ash, oxygen radicals formed during combustion, as well as hypoxic and reperfusion injury mechanisms initiated by carbon monoxide intoxication. Additional studies on separate carbon monoxide exposure from smoke and ash are needed to understand individual genotoxic contributions and mechanisms.
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J. Toxicol. Clin. Toxicol. · Jan 2002
Case ReportsEfficacy of charcoal hemoperfusion in massive carbamazepine poisoning.
Carbamazepine poisoning can be life threatening. The role and efficacy of extracorporeal drug clearance is not clearly defined. ⋯ The extraction ratio was linearly related to time, and ranged 0.46-0.02. The peak clearance was 69 mL/min. Cartridge saturation was defined as a clearance that was equal to an estimate of the patient's intrinsic clearance. In our patient, this was equivalent to an extraction ratio of 0.2 at a flow rate of 150 mL/min. By this definition, cartridge saturation appeared to occur at 7 hours. Charcoal hemoperfusion was associated with a significant reduction in the apparent half-life, which is most easily explained by clearance from the central vascular compartment, during a prolonged absorptive phase. The patient made full recovery without evidence of neurological deficit.
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J. Toxicol. Clin. Toxicol. · Jan 2001
Epidemiology of acute carbon monoxide poisoning in a Spanish region.
In Spain, as in most of the world, the incidence of acute carbon monoxide poisoning is probably underestimated. ⋯ Compared with previous Spanish series or with the antecedent year, acute carbon monoxide poisoning has a high prevalence in our region. Two factors appear to be essential to the accurate diagnosis of acute carbon monoxide poisoning: 1) the ability of emergency room physicians to recognize the clinical symptoms of carbon monoxide poisoning and 2) access to a carbon monoxide-oximeter.