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Sample records for poison center experience

  1. Poison Control Centers

    Science.gov (United States)

    ... 1222 immediately. Name State American Association of Poison Control Centers Address AAPCC Central Office NOT A POISON ... not for emergency use. Arkansas ASPCA Animal Poison Control Center Address 1717 S. Philo Road, Suite 36 Urbana, ...

  2. [Cocaine base paste: experience from the Montevideo Poison Control Center].

    Science.gov (United States)

    Pascale, Antonio; Negrin, Alba; Laborde, Amalia

    2010-01-01

    In Uruguay, cocaine base paste (CBP, pasta base) is a widely used form of cocaine. The aim of our study is to determine the main clinical characteristics of CBP abusers. Retrospective, single-center study of consultations at the Montevideo Poison Control Center between January 1, 2004 and December 31, 2005. One hundred and thirteen consultations were included, with an average age of 22 years (+ - 0.5 years) and a female-male sex ratio of 1:4.3. The consultations were related to drug overdose (77%), suicide attempt (16.8%), and wanting to give up CBP use (6.2%). In 48.1% the time elapsed since inhalation of CBP was less than 6 hours. Doses varied between 0.5 gr. and 25 gr. Use of other drugs at the same time, such as alcohol, marijuana or benzodiazepines, was common (51 cases). The symptoms most frequently observed were neuropsychiatric and cardiovascular, followed by respiratory symptoms. In 16.8% of patients, reason for the consultation was intentional acute ingestion of drugs, considered as a suicide attempt, occurring within a few hours of drug consumption. CBP users are mostly young males. Although clinical findings are compatible with those for cocaine abuse, euphoria is a major clinical feature in CBP abusers. The presence of respiratory symptoms reflects the complications associated with the ingestion route. Suicide attempts occurring within a few hours of CBP confirm the high prevalence of suicidal ideation reported by other authors. cocaine base paste, clinical features, suicide attempts.

  3. Hemodialysis for methyl alcohol poisoning: A single-center experience

    Directory of Open Access Journals (Sweden)

    Vivek B Kute

    2012-01-01

    Full Text Available Methanol is a cheap and potent adulterant of illicit liquors. Hemodialysis (HD is the best method to rapidly remove both toxic acid metabolites and parent alcohols, and it plays a fundamental role in treating severely poisoned patients. This retrospective study was carried out on 91 patients with detectable serum methanol levels who underwent HD. Because toxic alcohol levels were not immediately available, the initial diagnosis and treatment was based on clinical history with evidence of toxic alcohol intake, presence of high anion metabolic acidosis and/or end organ damage. Patients received bicarbonate, ethanol, according to clinical features and blood gases. Patients underwent HD in the setting of known methanol ingestion with high anion gap metabolic acidosis, or evidence of end-organ damage, regardless of methanol level. HD prescription included large surface area dialyzer (≥1.5 m2, blood flow rate of 250-350 mL/min and dialysate flow rate of 500 mL/min for 4-6 h. Between 9 and 11 July 2009, 91 males with mean age 40 ± 8.5 years underwent HD, and 13 patients required a second HD session. Patients consumed 100-500 mL illicit liquors, and symptoms appeared six and 60 h later. Clinical features were gastro-intestinal symptoms (83.5%, visual disturbances (60.4%, central nervous system symptoms (59.3% and dyspnea (43.9%. Before HD, mean pH was 7.11 ± 0.04 (range 6.70- 7.33 and mean bicarbonate levels were 8.5 ± 4.9 mmol/L (range 2-18. Three patients died due to methanol intoxication. Mortality was associated with severe metabolic acidosis (pH ≤ 6.90, ventilator requirement and coma/seizure on admission (P < 0.001. Timely HD, bicarbonate, ethanol and supportive therapy can be life-saving in methanol intoxication.

  4. Poison control center - emergency number

    Science.gov (United States)

    For a POISON EMERGENCY call: 1-800-222-1222 ANYWHERE IN THE UNITED STATES This national hotline number will let you ... is a free and confidential service. All local poison control centers in the United States use this ...

  5. Kratom abuse in Ramathibodi Poison Center, Thailand: a five-year experience.

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    Trakulsrichai, Satariya; Tongpo, Achara; Sriapha, Charuwan; Wongvisawakorn, Sunun; Rittilert, Panee; Kaojarern, Sming; Wananukul, Winai

    2013-01-01

    Kratom (Mitragyna speciosa Korth), a native tree in Southeast Asia, is misused as an abuse drug and becomes legally widespread to several countries. Currently, it is available through the online market or by some shops. The clinical manifestations of Kratom's effects are not well-defined and the clinical studies are limited. This study was designed to identify the characteristics of Kratom poisoning and withdrawal cases from Kratom exposure cases in Ramathibodi Poison Center (RPC), Thailand, during a five-year period. We used a retrospective review of Kratom exposure cases from the RPC toxic surveillance system. A total of 52 Kratom exposure cases were identified. The trend of case consultations has been increasing. There were Kratom poisoning cases (76.9%) and withdrawal cases (23.1%). Common presenting symptoms in the poisoning group were palpitation (22.5%), followed by seizure (17.5%). For the withdrawal group, the common presenting symptoms were myalgia (33.3%), insomnia (16.67%), fatigue (16.67%), and chest discomfort (16.67%). There was a baby with withdrawal symptoms who was delivered from a chronic Kratom-abusing mother, suggesting possible exposure via the transplacental route. There were no deaths in either group. Kratom abuse can cause either poisoning or withdrawal. Most cases in both groups had good prognostic outcome.

  6. Lionfish string experiences of an inland poison center: a retrospective study of 23 cases.

    Science.gov (United States)

    Trestrail, J H; al-Mahasneh, Q M

    1989-04-01

    From January 1979 through March 1988, our regional poison center, located many hundreds of miles from the nearest coastal salt water, documented 23 cases of envenomation by "Lionfish" (members of genus Pterois). All cases involved specimens which were maintained in the homes of amateur aquarists. A study of patient epidemiology showed the following: patient's sex 91.3% male, 8.7% female; patients ages ranged from 17 to 50 years with an average age for males of 29.8 years and 35 years for females; the site of the envenomation accident was always in the home; the only part of the body envenomated was the hand or finger; and all of the patients were symptomatic. Symptoms noted included sharp pain, swelling, redness, bleeding, nausea, numbness, joint pain, anxiety, headache, disorientation, and dizziness. One patient had a complication of cellulitis. Treatment provided included immersion of the effected area in hot water at 40 C for 60 to 90 min, analgesics, tetanus toxoid, and antibiotics. There were no deaths noted and treatment proved effective in all cases. This paper also discusses the natural history, clinical effects, and current treatment for envenomations from these beautiful but dangerous venomous fish, which can cause poisoning exposures that are likely to be encountered by poison centers anywhere in the world.

  7. The Poison Control Center--Its Role

    Science.gov (United States)

    Manoguerra, Anthony S.

    1976-01-01

    Poison Control Centers are being utilized by more schools of pharmacy each year as training sites for students. This paper discusses what such a center is, its services, changes anticipated in the poison center system in the next several years and how they may influence pharmacy education, specifically as it relates to clinical toxicology.…

  8. Clinical and laboratory findings in mad honey poisoning: a single center experience.

    Science.gov (United States)

    Yaylaci, S; Kocayigit, I; Aydin, E; Osken, A; Genc, A B; Cakar, M A; Tamer, A

    2014-01-01

    This study is aimed at analyzing the demographic and clinical characteristics, as well as the hematological-biochemical parameters of patients who admitted to the hospital with the diagnosis of mad honey poisoning. A total of 16 patients who were admitted with mad honey intoxication symptoms and treated in Emergency Department of Sakarya Education and Research Hospital between January 2009 and December 2012 were included in the study. Demographic and clinical characteristics of the patients and hematological, biochemical parameters were obtained from hospital records. Heart rate, systolic and diastolic blood pressure on admission and at discharge were obtained retrospectively. Sixteen patients (10 males and 6 females, mean age 58.5 ± 10 years, range between 41 and 79) were included in our study. Heart rate was 42 ± 6 beats/min, systolic blood pressure was 73 ± 19 mmHg, and diastolic blood pressure was 45 ± 17 mmHg on admission. In the evaluation of the patients' heart rhythms on admission to the emergency room, nine (56.3%) patients had sinus bradycardia, three (18.8%) patients had nodal rhythm, two (12.5%) patients had first degree atrioventricular block, and two (12.5%) patients had atrial fibrillation. Atropine 1.1 ± 0.4 mg and saline 1125 ± 465 ml were used to treat patients. Patients were discharged with a stable condition after an average 27.7 ± 7.2 h of follow-up. Heart rate was 75 ± 8 beats/min, systolic blood pressure was 132 ± 7 mmHg, and diastolic blood pressure was 82 ± 6 mmHg at discharge. Mortality was not observed. Hematological and biochemical parameters measured at the time of admission were within normal ranges. Mad honey poisoning should be considered in previously healthy patients with unexplained symptoms of bradycardia, hypotension, and cardiac dysrhythmias. Therefore, diet history should carefully be obtained from the patients admitted with bradycardia and hypotension, and mad honey intoxication should also be considered in the

  9. Using poison center exposure calls to predict methadone poisoning deaths.

    Directory of Open Access Journals (Sweden)

    Nabarun Dasgupta

    Full Text Available PURPOSE: There are more drug overdose deaths in the Untied States than motor vehicle fatalities. Yet the US vital statistics reporting system is of limited value because the data are delayed by four years. Poison centers report data within an hour of the event, but previous studies suggested a small proportion of poisoning deaths are reported to poison centers (PC. In an era of improved electronic surveillance capabilities, exposure calls to PCs may be an alternate indicator of trends in overdose mortality. METHODS: We used PC call counts for methadone that were reported to the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS® System in 2006 and 2007. US death certificate data were used to identify deaths due to methadone. Linear regression was used to quantify the relationship of deaths and poison center calls. RESULTS: Compared to decedents, poison center callers tended to be younger, more often female, at home and less likely to require medical attention. A strong association was found with PC calls and methadone mortality (b=0.88, se=0.42, t=9.5, df=1, p<0.0001, R(2 =0.77. These findings were robust to large changes in a sensitivity analysis assessing the impact of underreporting of methadone overdose deaths. CONCLUSIONS: Our results suggest that calls to poison centers for methadone are correlated with poisoning mortality as identified on death certificates. Calls received by poison centers may be used for timely surveillance of mortality due to methadone. In the midst of the prescription opioid overdose epidemic, electronic surveillance tools that report in real-time are powerful public health tools.

  10. Poison control center - Emergency number (image)

    Science.gov (United States)

    For a poison emergency call 1-800-222-1222 anywhere in the United States. This national hotline number will let you ... is a free and confidential service. All local poison control centers in the U.S. use this national ...

  11. Determinants of U.S. poison center utilization.

    Science.gov (United States)

    Litovitz, Toby; Benson, Blaine E; Youniss, Jessica; Metz, Edward

    2010-06-01

    High poison center utilization has been associated with decreased emergency department usage and hospitalization rates. However, utilization requires awareness of the poison center. Penetrance, defined as the number of human poison exposures reported to a poison center per 1,000 population, has been used as a marker of poison center awareness. To identify factors that influence poison center penetrance to optimize the life- and cost-saving benefits of poison control centers. Human poison exposures that were reported to the National Poison Data System in 2001 were analyzed to identify and rank factors affecting poison center penetrance. Overall penetrance correlated with pediatric penetrance (R(2) = 0.75, p poison center that were already in or en route to a healthcare facility at the time of the call to the poison center (R(2) = 0.41, p poison center service populations were associated with lower penetrance (R(2) = 0.23, p poison center (multiple regression). Positive predictors included the percentage of the population younger than 5 years, the percentage of the adult population with a bachelor's degree, poison center certification, poison center educator FTEs (full time equivalents), Asian population percentage, and population density. The inverse correlation between pediatric penetrance and healthcare facility utilization supports prior observations of excessive healthcare utilization when a poison center is not called. Since race, language and distance are barriers to poison center utilization, and since healthcare utilization increases when poison center penetrance declines, low penetrance suggests a lack of awareness of the poison center rather than a low incidence of poisonings. Strategies to raise penetrance should be informed by an understanding of the barriers to utilization - language, Black/African American race, distance from the poison center, poverty, and lower education levels.

  12. Iguana bites reported to Texas poison centers.

    Science.gov (United States)

    Forrester, Mathias B

    2010-09-01

    Although thousands of iguanas are kept as pets in the United States, information on their bites is limited. The intent of this investigation was to describe the pattern of iguana bites reported to Texas poison centers. Iguana bites reported during 1998-2008 were identified. The distribution of cases by various factors was determined. Of 59 total bites, 71% were managed on-site, 17% of the patients were at or en route to a health care facility when the poison center was contacted, and 10% were referred to a health care facility. The medical outcome was no effect in 9% of the cases, minor effect in 24%, moderate effect in 2%, not followed but minimal effects possible in 64%, and unable to follow but potentially toxic in 2%. Most iguana bites reported to Texas poison centers did not result in serious effects and were managed on-site. Copyright © 2010 Elsevier Inc. All rights reserved.

  13. Xylazine Exposures Reported to Texas Poison Centers.

    Science.gov (United States)

    Forrester, Mathias B

    2016-10-01

    Xylazine is a sedative, analgesic, anesthetic, and central muscle relaxant approved for animals but not humans. Although xylazine is an emerging drug of abuse, there are limited data on potentially adverse exposures to the drug. The intent of this study was to describe potentially adverse xylazine exposures reported to a large poison center system. All xylazine exposures reported to Texas poison centers between 2000 and 2014 were included. The distribution of cases by select variables was determined. Of 76 total cases, 93% of the patients were ≥20 years of age, and 54% were male. Fifty-one percent of the exposures occurred by injection, 28% by ingestion, 16% were dermal, 14% were ocular, and 3% by inhalation. Sixty-four percent of the exposures were unintentional, 32% were intentional, and 1% each was related to malicious use and adverse reaction. Sixty-seven percent of the patients were already at or en route to a health care facility when the poison center was contacted, 21% were managed on-site, and 9% were referred to a health care facility. The most common clinical effects were drowsiness or lethargy (47%), bradycardia (20%), hypotension (11%), hypertension (9%), puncture or wound (8%), and slurred speech (8%). Xylazine exposures tended to involve patients who were adult males, exposures were typically unintentional; and most often occurred by injection. Most of the patients were already at or en route to a health care facility when a poison center was contacted. The most frequently reported adverse effects were cardiovascular or neurologic in nature. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Analysis of intentional drug poisonings using Ohio Poison Control Center Data, 2002-2014.

    Science.gov (United States)

    Pringle, Kelsey; Caupp, Sarah; Shi, Junxin; Wheeler, Krista K; Spiller, Henry A; Casavant, Marcel J; Xiang, Henry

    2017-08-01

    Pharmaceutical drug poisonings, especially those that are intentional, are a serious problem for adolescents and young adults. Poison control center data is a viable tool to track intentional drug poisonings in near real-time. To determine intentional drug poisoning rates among adolescents and young adults in Ohio using poison control center data. We analyzed data from 2002 to 2014 obtained by Ohio's three poison control centers. Inclusion variables were calls made to the centers that had appropriate subject age (10-29 years old), subject sex, involved substance (all drug classes), and medical outcome (no effect, minor effect, moderate effect, major effect, and death). Intentional drug poisoning reports were also separated into subgroups to compare suspected suicide reports to misuse and abuse reports. Finally, resident population estimates were used to generate 2014 intentional drug poisoning rates for each county in Ohio. The most common age group for intentional drug poisonings was 18-24. Females reported more suspected suicide drug poisonings while males reported more misuse/abuse drug poisonings. The most reported drug class across all ages was analgesics. Of the 88 counties in Ohio, Hamilton, Williams, Washington, and Guernsey counties had the highest rates of intentional drug poisonings. The high report rate of suspected suicides and analgesic class drugs demonstrates the need for preventative measures for adolescents and young adults in Ohio. Any interventions, along with legislative changes, will need to take place in our local communities.

  15. [A relational database to store Poison Centers calls].

    Science.gov (United States)

    Barelli, Alessandro; Biondi, Immacolata; Tafani, Chiara; Pellegrini, Aristide; Soave, Maurizio; Gaspari, Rita; Annetta, Maria Giuseppina

    2006-01-01

    Italian Poison Centers answer to approximately 100,000 calls per year. Potentially, this activity is a huge source of data for toxicovigilance and for syndromic surveillance. During the last decade, surveillance systems for early detection of outbreaks have drawn the attention of public health institutions due to the threat of terrorism and high-profile disease outbreaks. Poisoning surveillance needs the ongoing, systematic collection, analysis, interpretation, and dissemination of harmonised data about poisonings from all Poison Centers for use in public health action to reduce morbidity and mortality and to improve health. The entity-relationship model for a Poison Center relational database is extremely complex and not studied in detail. For this reason, not harmonised data collection happens among Italian Poison Centers. Entities are recognizable concepts, either concrete or abstract, such as patients and poisons, or events which have relevance to the database, such as calls. Connectivity and cardinality of relationships are complex as well. A one-to-many relationship exist between calls and patients: for one instance of entity calls, there are zero, one, or many instances of entity patients. At the same time, a one-to-many relationship exist between patients and poisons: for one instance of entity patients, there are zero, one, or many instances of entity poisons. This paper shows a relational model for a poison center database which allows the harmonised data collection of poison centers calls.

  16. American Association of Poison Control Centers

    Science.gov (United States)

    ... add poison control as a contact in your smartphone. Take the pledge! National Poison Prevention Week is March 19-25! Be a part of the conversation by following #PreventPoison and #NPPW2017 on social media, and check out AAPCC's NPPW webpage and press ...

  17. Comparison of poisonings managed at military and Veterans Administration hospitals reported to Texas poison centers.

    Science.gov (United States)

    Forrester, M B

    2017-01-01

    There is little information on poisonings managed at military and Veterans Administration (VA) hospitals. This investigation described and compared poisonings reported to Texas poison centers that were managed at military and VA hospitals. Retrospective analysis of poison centre data. Cases were poisonings among patients aged 18 years or more reported to Texas poison centers during 2000-2015 where management occurred at a military or VA hospital. The distribution of exposures for various demographic and clinical factors was determined for military and veterans hospitals and comparisons were made between the two groups. There were 4353 and 1676 poisonings managed at military and VA hospitals, resepctively. Males accounted for 50.5% of the military hospital patients and 84.9% of the VA hospital patients. The mean age for military hospital patients was 31 years and for VA hospital patients was 50 years. The proportion of poisonings managed at military hospitals and VA hospitals, respectively, were intentional (70.0% vs 64.1%), particularly suspected attempted suicide (57.3% vs 47.7%), and unintentional (25.0% vs 30.5%). More than one substance was reported in 37.7% of military and 33.2% of VA hospital poisonings. The most commonly reported substance categories for poisonings managed at military and VA hospitals, respectively, were analgesics (28.4% vs 19.7%), sedatives/hypnotics/antipsychotics (24.7% vs 23.4%), antidepressants (18.7% vs 19.7%) and alcohol (11.3% vs 10.6%). A number of differences were observed between poisonings managed at military and VA hospitals. These differing patterns of poisonings may need to be taken into account in the education, prevention and treatment of poisonings at these hospitals and among the populations they serve. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  18. Do poison center triage guidelines affect healthcare facility referrals?

    Science.gov (United States)

    Benson, B E; Smith, C A; McKinney, P E; Litovitz, T L; Tandberg, W D

    2001-01-01

    The purpose of this study was to determine the extent to which poison center triage guidelines influence healthcare facility referral rates for acute, unintentional acetaminophen-only poisoning and acute, unintentional adult formulation iron poisoning. Managers of US poison centers were interviewed by telephone to determine their center's triage threshold value (mg/kg) for acute iron and acute acetaminophen poisoning in 1997. Triage threshold values and healthcare facility referral rates were fit to a univariate logistic regression model for acetaminophen and iron using maximum likelihood estimation. Triage threshold values ranged from 120-201 mg/kg (acetaminophen) and 16-61 mg/kg (iron). Referral rates ranged from 3.1% to 24% (acetaminophen) and 3.7% to 46.7% (iron). There was a statistically significant inverse relationship between the triage value and the referral rate for acetaminophen (p variability in poison center triage values and referral rates for iron and acetaminophen poisoning. Guidelines can account for a meaningful proportion of referral variation. Their influence appears to be substance dependent. These data suggest that efforts to determine and utilize the highest, safe, triage threshold value could substantially decrease healthcare costs for poisonings as long as patient medical outcomes are not compromised.

  19. Evaluation of poison information services provided by a new poison information center.

    Science.gov (United States)

    Churi, Shobha; Abraham, Lovin; Ramesh, M; Narahari, M G

    2013-01-01

    The aim of this study is to assess the nature and quality of services provided by poison information center established at a tertiary-care teaching hospital, Mysore. This was a prospective observational study. The poison information center was officially established in September 2010 and began its functioning thereafter. The center is equipped with required resources and facility (e.g., text books, Poisindex, Drugdex, toll free telephone service, internet and online services) to provide poison information services. The poison information services provided by the center were recorded in documentation forms. The documentation form consists of numerous sections to collect information on: (a) Type of population (children, adult, elderly or pregnant) (b) poisoning agents (c) route of exposure (d) type of poisoning (intentional, accidental or environmental) (e) demographic details of patient (age, gender and bodyweight) (f) enquirer details (background, place of call and mode of request) (g) category and purpose of query and (h) details of provided service (information provided, mode of provision, time taken to provide information and references consulted). The nature and quality of poison information services provided was assessed using a quality assessment checklist developed in accordance with DSE/World Health Organization guidelines. Chi-Square test (χ(2)). A total of 419 queries were received by the center. A majority (n = 333; 79.5%) of the queries were asked by the doctors to provide optimal care (n = 400; 95.5%). Most of the queries were received during ward rounds (n = 201; 48.0%), followed by direct access (n = 147; 35.1%). The poison information services were predominantly provided through verbal communication (n = 352; 84.0%). Upon receipt of queries, the required service was provided immediately (n = 103; 24.6%) or within 10-20 min (n = 296; 70.6%). The queries were mainly related to intentional poisoning (n = 258; 64.5%), followed by accidental poisoning

  20. Poisoning in Israel: annual report of the Israel Poison Information Center, 2012.

    Science.gov (United States)

    Bentur, Yedidia; Lurie, Yael; Cahana, Alfred; Kovler, Nona; Bloom-Krasik, Anna; Gurevych, Bella; Klein-Schwartz, Wendy

    2014-11-01

    The Israel National Poison Information Center (IPIC), Rambam Health Care Campus, provides 24 hour telephone consultations in clinical toxicology as well as drug and teratogen information. It participates in research, teaching and regulatory activities, and also provides laboratory services. To report data on the epidemiology of poisonings and poison exposures in Israel. We made computerized queries and descriptive analyses of the medical records database of the IPIC during 2012. A total of 31,519 poison exposure cases were recorded, a 157.6% increase compared with 1995. Children snake venom. Four fatalities were recorded; all were intentional exposures in adults (corrosive, medications, energy drink). Poison exposures and poisonings have increased significantly and have contributed substantially to morbidity and mortality in Israel. The IPIC database is a valuable national resource for the collection and monitoring of poisoning exposure cases. It can be used as a real-time surveillance system for the benefit of public health. It is recommended that reporting to the IPIC become mandatory and its activities be adequately supported by national resources.

  1. Poison exposures in young Israeli military personnel: a National Poison Center Data analysis.

    Science.gov (United States)

    Lavon, Ophir; Bentur, Yedidia

    2017-06-01

    To characterize poison exposures in young Israeli military personnel as reported to the national poison center. Retrospective poison center chart review over a 14-year period. Cases included were Israeli soldiers aged 18-21 years, the compulsory military service age required by the Israeli law. 1770 records of poison exposures in young military personnel were identified. Most exposed individuals involved males (n = 1268, 71.6%). Main routes of exposure were ingestion (n = 854, 48.3%), inhalation (n = 328, 18.6%) and ocular (n = 211, 11.9%). Accidents or misuse (n = 712, 40.2%) were the most frequently reported circumstances, followed by suicide attempts (370, 20.9%), and bites and stings (161, 9.1%). More than half of the cases involved chemicals (n = 939, 53.1%); hydrocarbons, gases and corrosives were the main causative agents. Pharmaceuticals (mainly analgesics) were involved in 519 (29.3%) cases, venomous animals (mainly scorpions, centipedes, and snakes) in 79 (4.5%). Clinical manifestations were reported in 666 (37.6%) cases, mostly gastrointestinal, neurologic, and respiratory. The vast majority of cases (1634, 92.3%) were asymptomatic or mildly affected; no fatalities were recorded. In 831 (46.9%) cases the clinical toxicologist recommended referral to an emergency department; ambulatory observation was recommended in 563 (31.8%) cases, and hospitalization in 86 (4.9%). Our data show that poison exposures among young soldiers involve mainly males, accidents, misuse and suicides, oral route and chemicals; most exposures were asymptomatic or with mild severity. Repeated evaluations of poison center data pertaining to military personnel is advised for identifying trends in poison exposure and characteristics in this particular population.

  2. [Poisoning with Jatropha curcas: 24 cases reported to Paris and Marseille Poisons Centers].

    Science.gov (United States)

    Langrand, J; Médernach, C; Schmitt, C; Blanc-Brisset, I; Villa, A F; de Haro, L; Garnier, R

    2015-03-01

    Jatropha curcas L. is an inedible plant belonging to the Euphorbiaceae family that is growing in subtropical zones of all continents. We report a series of 24 cases of poisoning with J. curcas seeds or fruits reported to poison centers in Paris and Marseille between December 2000 and June 2014. Fifteen adults and 9 children ingested J. curcas seeds or fruits. All patients experienced gastrointestinal disorders, within the first hours following ingestion: nausea, vomiting, diarrhea and abdominal pain. Laboratory investigations performed in 10 patients revealed minor abnormalities: CK elevation (8 cases), dehydration (5 cases) with moderate elevation of serum creatinine levels (3 cases), and mildly increased serum bilirubin (8 cases). Complete remission of all clinical signs was observed within 48 hours in the 20 cases for which the outcome was known. Previously published cases of J. curcas poisoning were very similar to ours: As in our series, gastrointestinal disorders were always present. They were sometimes associated with neurological or cardiovascular signs, and hepatic or renal disorders; these were generally interpreted as complications of severe gastroenteritis, although direct toxic effects could not be formally excluded. In most cases, simple supportive measures were sufficient to ensure complete recovery within 24-48 hours. J Curcas poisoning incidence is certainly increasing because the plant is cultivated to produce biodiesel and is now largely present in most subtropical countries. As a consequence, local health professionals should be informed of the toxic properties of this plant.

  3. Poison control centers in developing countries and Asia's need for toxicology education

    International Nuclear Information System (INIS)

    Makalinao, Irma R.; Awang, Rahmat

    2005-01-01

    Poison control centers (PCCs) in developing countries have been set up in response to the challenge of decreasing mortality and morbidity from poisoning. The services range from poison information to actual clinical treatment mostly of acute cases. Lately, PCCs have expanded from their traditional role to one that actively engages in community health studies, toxicovigilance along with treatment of chronic poisoning. Recognizing that types of poisoning and specific needs may vary from country to country, toxicology education that addresses these unique regional issues has become more necessary. Toxicology education, both formal and informal, exists in various stages of development in Asia. Clearly, there are gaps that need to be addressed especially in areas where there are no poison centers or where strengthening is necessary. Collaboration between PCCs in developing countries can help augment available resources including human, analytical and technical expertise. The critical mass of trained toxicologists will fill in the demand for clinical and regulatory specialists and educators as well. This paper highlights the experiences and resources available to the Philippine and Malaysian poison centers and the strengths generated by networking and collaboration. The role of Asia Pacific Association of Medical Toxicology (APAMT) as the Science NGO representative to the Intergovernmental Forum on Chemical Safety (IFCS) forum standing committee in promoting chemical safety at the regional level will be discussed. The 'Clearinghouse on the Sound Management of Chemicals', a platform for engaging multi-stakeholder and interdisciplinary partnerships, will be described as a possible model for capacity building to advance chemical safety through education and training not only in developing countries in Asia but globally as well

  4. Evaluation of completeness of selected poison control center data fields.

    Science.gov (United States)

    Jaramillo, Jeanie E; Marchbanks, Brenda; Willis, Branch; Forrester, Mathias B

    2010-08-01

    Poison control center data are used in research and surveillance. Due to the large volume of information, these efforts are dependent on data being recorded in machine readable format. However, poison center records include non-machine readable text fields and machine readable coded fields, some of which are duplicative. Duplicating this data increases the chance of inaccurate/incomplete coding. For surveillance efforts to be effective, coding should be complete and accurate. Investigators identified a convenience sample of 964 records and reviewed the substance code determining if it matched its text field. They also reviewed the coded clinical effects and treatments determining if they matched the notes text field. The substance code matched its text field for 91.4% of the substances. The clinical effects and treatments codes matched their text field for 72.6% and 82.4% of occurrences respectively. This under-reporting of clinical effects and treatments has surveillance and public health implications.

  5. Calls to Poison Centers for hookah smoking exposures.

    Science.gov (United States)

    Retzky, Sandra S; Spiller, Henry A; Callahan-Lyon, Priscilla

    2018-06-01

    Over the past decade, smoking behaviors have changed in the US. Hookah or waterpipe smoking is increasing, especially among youth and young adults. Social media sites describe the "hookah high" or "buzz", which may be related to nicotine, carbon monoxide, or other inhalants in hookah smoke. Most important is the risk of carbon monoxide poisoning. Case reports include a high number of victims presenting with loss of consciousness from either syncope or seizures. Anaphylaxis and a very rare respiratory hypersensitivity reaction, acute eosinophilic pneumonia, have also been reported from hookah smoking in previously healthy young adults. This article provides background information on hookah smoking, describes hookah-induced acute injuries that could precipitate poison center calls, and offers suggestions for exposure characterization.

  6. Neurologic Complications of Methanol Poisoning: A Clinicoepidemiological Report from Poisoning Treatment Centers in Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Hakimeh Eghbali

    2015-03-01

    Full Text Available Background: In this study we sought to investigate clinical findings (with a focus on neurologic effects and also to analyze outcomes of a series of patients with methanol poisoning admitted to two poisoning treatment centers in Tehran, Iran. Methods: In this prospective cross-sectional study, methanol-poisoned patients admitted to departments of forensic medicine and toxicology of Loghman Hakim and Baharloo hospitals in Tehran during October 2010 to October 2011 were included; and their data were recorded in predesigned checklists. Results: Twenty-eight methanol poisoned patients (82.1% men with mean age of 29.3±4.6 years were studied. Most patients (67.9% had metabolic acidosis at presentation. On admission, all patients had different degrees of decrease in consciousness, who the majority of them (57.1% were admitted with mildly reduced consciousness (grade I of Grady coma scale. Headache and vertigo were observed in 7.1% and 17.9% of patients, respectively. Most patients (53.6% had no ocular effects, while 46.6% of patients developed impaired vision. All patients received sodium bicarbonate. Ethanol as antidote and folic acid were given to 18 patients (64.2% and 16 patients (57.1%, respectively. Six patients (21.4% underwent hemodialysis. Over half of the patients (53.6% fully recovered and were discharged without complications. Four patients (14.3% developed total blindness. Four patients (14.3% left the hospital against medical advice by self-discharge (they had no significant complication at the time of discharge. Five patients (17.9% died; who compared to survived cases had significantly lower blood pH (P=0.028, higher coma grade (P

  7. Poisoning

    Science.gov (United States)

    ... your home. Regularly test and replace the batteries. Poisoning treatment Treatment depends on the person and the type ... Injury Prevention, Prevention and Wellness, Staying HealthyTags: chemical ... poison treatments, snakebite, syrup of ipecac July 12, 2017 Featured ...

  8. Comparing Syndromic Surveillance and Poison Center Data for Snake Bites in Missouri

    OpenAIRE

    Pugh, Karen H.; Kelsey, Amy; Tominack, Rebecca

    2013-01-01

    Objective This study intends to use two different surveillance systems available in Missouri to explore snake bite frequency and geographic distribution. Introduction In 2010, there were 4,796 snake bite exposures reported to Poison Centers nationwide (1). Health care providers frequently request help from poison centers regarding snake envenomations due to the unpredictability and complexity of prognosis and treatment. The Missouri Poison Center (MoPC) maintains a surveillance database keepi...

  9. The role of poison control centers in CBRN incidents

    International Nuclear Information System (INIS)

    Borron, S. W.; Haynes, J.; Young, P.

    2009-01-01

    Poison Control Centers (PCCs) have historically played a limited, parallel role in management of CBRN incidents; they are frequently called for advice by the public or health care providers when such incidents occur, but in many cases are not considered an integral part of the CBRN disaster emergency response team, lacking a 'place' in the Incident Command Structure (ICS). This is unfortunate, as PCCs represent an important public health resource. The roughly 60 centers in the U.S. are available 24/7, 365 days/year. Telephones are manned by professionals, including pharmacists and nurses with additional specialized training in poisoning response. PCC medical directors are generally trained in Emergency Medicine, Pediatrics or Preventive Medicine, with subspecialty training in Medical Toxicology. Many toxicologists attend specialized training in the radiation emergency management at REAC/TS. PCCs have extensive databases for poisoning management coupled with GIS surveillance. This combination of expertise and information renders PCCs well prepared to advice on decontamination and treatment of CBRN-contaminated victims. Their toxicology expertise allows their participation in risk assessment. PCCs are highly trusted by the community, enhancing their role in risk communication. We recently initiated a program that provides guidance on activation of PCCs by the Region 6 Regional Response Team (RRT6), Co-Chaired by the US Environmental Protection Agency (EPA) and the US Coast Guard, serving as the federal component of the National Response System for the states of Arkansas, Louisiana, New Mexico, Oklahoma, and Texas. The program will be described, with emphasis on how PCCs may work within ICS.(author)

  10. Trends in types of calls managed by U.S. poison centers 2000-2015.

    Science.gov (United States)

    Anderson, Bruce D; Seung, Hyunuk; Klein-Schwartz, Wendy

    2017-12-05

    The number of cases reported to poison centers has decreased since 2008 but there is evidence that the complexity of calls is increasing. The objectives are to evaluate national poison center data for trends in reason and how these changes effect management site, medical outcomes, and poison center workload. Data regarding reason, age, management site, and medical outcome were extracted from annual reports of the National Poison Data System from 2000 to 2015. The proportion of cases by year were determined for unintentional and intentional exposures. Analysis of data from a single poison center from 2005 to 2015 compared the number of interactions between poison center staff and callers for unintentional versus intentional reasons. Trend analyses found that from 2000 to 2015 the percent of unintentional cases decreased (from 85.9 to 78.4%, p Poison centers are managing more intentional exposures and fewer unintentional exposures. Intentional exposures require more poison center staff expertise and time. Looking only at poison center total call volume may not be an adequate method to gauge productivity.

  11. Paediatric organophosphate poisoning - a rural hospital experience ...

    African Journals Online (AJOL)

    Objectives. To document the presentation and course of organophosphate poisoning (OPP) in children and to record the frequency of atropine toxicity during treatment. Design. A retrospective observational study was conducted of all recorded paediatric cases of OPP admitted to a regional hospital over a 5-year period from ...

  12. The importance of interpersonal communication in poison centers.

    Science.gov (United States)

    Crouch, B I; Thomas, K C; Rothwell, E; Planalp, S; Ellington, L; Teemant, K

    2013-11-01

    Poison control center (PCC) personnel face many challenges in communicating with callers and with each other. The purpose of this study was to identify interpersonal communication issues that affect the work environment within PCCs. As part of a larger questionnaire study distributed electronically to members of the American Association of Poison Control Centers (AAPCC) to assess communication training needs for PCCs, three questions were included to assess interpersonal communication within the work environment: (1) How important is interpersonal communication within your center to a positive work environment? (not at all to extremely important, 1-7); (2) How disruptive is interpersonal communication to your work? (not at all to extremely disruptive, 1-7); and (3) What communication issues do you find most disruptive to your work? (free-text response). Descriptive and qualitative content analyses were used to identify themes in responses. A total of 537 responses were received from SPIs, directors, medical directors, and other PCC staff. Interpersonal communication within the PCC was rated as extremely important to a positive work environment (median = 7 and IQR = 6-7; 62.3% rated as extremely important). Interpersonal communication was rated as less than moderately disruptive on average (median = 3 and IQR = 2-4). Free-text responses were received from 335 (62%) respondents. Free-text comments were broadly categorized as relating to PCC personnel and work environment and issues related to PCC callers. Categories that emerged from the PCC personnel and work environment category included the following: poor interpersonal communication (n = 104; 31%); background noise (n = 96; 29%); poor work procedures (n = 51; 15%); and poor management communication (n = 38; 11%). Interpersonal communication within PCCs was considered to be important for a positive work environment. Although not found to be strongly disruptive by most respondents, several specific interpersonal

  13. Cartap hydrochloride poisoning: A clinical experience

    OpenAIRE

    Boorugu, Hari K.; Chrispal, Anugrah

    2012-01-01

    Cartap hydrochloride, a nereistoxin analog, is a commonly used low toxicity insecticide. We describe a patient who presented to the emergency department with alleged history of ingestion of Cartap hydrochloride as an act of deliberate self-harm. The patient was managed conservatively. To our knowledge this is the first case report of Cartap hydrochloride suicidal poisoning. Cartap toxicity has been considered to be minimal, but a number of animal models have shown significant neuromuscular to...

  14. Synthetic cannabinoid and marijuana exposures reported to poison centers.

    Science.gov (United States)

    Forrester, M B; Kleinschmidt, K; Schwarz, E; Young, A

    2012-10-01

    Synthetic cannabinoids have recently gained popularity as a recreational drug because they are believed to result in a marijuana-like high. This investigation compared synthetic cannabinoids and marijuana exposures reported to a large statewide poison center system. Synthetic cannabinoid and marijuana exposures reported to Texas poison centers during 2010 were identified. The distribution of exposures to the two agents with respect to various demographic and clinical factors were compared by calculating the rate ratio (RR) of the synthetic cannabinoid and marijuana percentages for each subgroup and 95% confidence interval (CI). The proportion of synthetic cannabinoid and marijuana exposures, respectively, were 87.3% and 46.5% via inhalation (RR 1.88, 95% CI 1.38-2.61), 74.9% and 65.7% in male (RR 1.14, 95% CI 0.87-1.51), 40.2% and 56.6% age ≤ 19 years (RR 0.71, 95% CI 0.52-0.98), 79.2% and 58.6% occurring at a residence (RR 1.35, 95% CI 1.02-1.82), 8.4% and 16.2% managed on-site (RR 0.52. 95% CI 0.28-1.00), and 59.3% and 41.4% with serious medical outcomes (RR 1.43, 95% CI 1.03-2.05). Compared to marijuana, synthetic cannabinoid exposures were more likely to be used through inhalation, to involve adults, to be used at a residence, and to result in serious outcomes.

  15. The Toxic Exposure Surveillance System (TESS): Risk assessment and real-time toxicovigilance across United States poison centers

    International Nuclear Information System (INIS)

    Watson, William A.; Litovitz, Toby L.; Belson, Martin G.; Funk Wolkin, Amy B.; Patel, Manish; Schier, Joshua G.; Reid, Nicole E.; Kilbourne, Edwin; Rubin, Carol

    2005-01-01

    The Toxic Exposure Surveillance System (TESS) is a uniform data set of US poison centers cases. Categories of information include the patient, the caller, the exposure, the substance(s), clinical toxicity, treatment, and medical outcome. The TESS database was initiated in 1985, and provides a baseline of more than 36.2 million cases through 2003. The database has been utilized for a number of safety evaluations. Consideration of the strengths and limitations of TESS data must be incorporated into data interpretation. Real-time toxicovigilance was initiated in 2003 with continuous uploading of new cases from all poison centers to a central database. Real-time toxicovigilance utilizing general and specific approaches is systematically run against TESS, further increasing the potential utility of poison center experiences as a means of early identification of potential public health threats

  16. The Toxic Exposure Surveillance System (TESS): risk assessment and real-time toxicovigilance across United States poison centers.

    Science.gov (United States)

    Watson, William A; Litovitz, Toby L; Belson, Martin G; Wolkin, Amy B Funk; Patel, Manish; Schier, Joshua G; Reid, Nicole E; Kilbourne, Edwin; Rubin, Carol

    2005-09-01

    The Toxic Exposure Surveillance System (TESS) is a uniform data set of US poison centers cases. Categories of information include the patient, the caller, the exposure, the substance(s), clinical toxicity, treatment, and medical outcome. The TESS database was initiated in 1985, and provides a baseline of more than 36.2 million cases through 2003. The database has been utilized for a number of safety evaluations. Consideration of the strengths and limitations of TESS data must be incorporated into data interpretation. Real-time toxicovigilance was initiated in 2003 with continuous uploading of new cases from all poison centers to a central database. Real-time toxicovigilance utilizing general and specific approaches is systematically run against TESS, further increasing the potential utility of poison center experiences as a means of early identification of potential public health threats.

  17. The role of clinical toxicologists and poison control centers in public health.

    Science.gov (United States)

    Sutter, Mark E; Bronstein, Alvin C; Heard, Stuart E; Barthold, Claudia L; Lando, James; Lewis, Lauren S; Schier, Joshua G

    2010-06-01

    Poison control centers and clinical toxicologists serve many roles within public health; however, the degree to which these entities collaborate is unknown. The objective of this survey was to identify successful collaborations of public health agencies with clinical toxicologists and poison control centers. Four areas including outbreak identification, syndromic surveillance, terrorism preparedness, and daily public health responsibilities amenable to poison control center resources were assessed. An online survey was sent to the directors of poison control centers, state epidemiologists, and the most senior public health official in each state and selected major metropolitan areas. This survey focused on three areas: service, structure within the local or state public health system, and remuneration. Questions regarding remuneration and poison control center location within the public health structure were asked to assess if these were critical factors of successful collaborations. Senior state and local public health officials were excluded because of a low response rate. The survey was completed in October 2007. A total of 111 respondents, 61 poison control centers and 50 state epidemiologists, were eligible for the survey. Sixty-nine (62%) of the 111 respondents, completed and returned the survey. Thirty-three (54%) of the 61 poison control centers responded, and 36 of the 50 state epidemiologists (72%) responded. The most frequent collaborations were terrorism preparedness and epidemic illness reporting. Additional collaborations also exist. Important collaborations exist outside of remuneration or poison control centers being a formal part of the public health structure. Poison control centers have expanded their efforts to include outbreak identification, syndromic surveillance, terrorism preparedness, and daily public health responsibilities amenable to poison control center resources. Collaboration in these areas and others should be expanded. Published

  18. Cartap hydrochloride poisoning: A clinical experience.

    Science.gov (United States)

    Boorugu, Hari K; Chrispal, Anugrah

    2012-01-01

    Cartap hydrochloride, a nereistoxin analog, is a commonly used low toxicity insecticide. We describe a patient who presented to the emergency department with alleged history of ingestion of Cartap hydrochloride as an act of deliberate self-harm. The patient was managed conservatively. To our knowledge this is the first case report of Cartap hydrochloride suicidal poisoning. Cartap toxicity has been considered to be minimal, but a number of animal models have shown significant neuromuscular toxicity resulting in respiratory failure. It is hypothesized that the primary effect of Cartap hydrochloride is through inhibition of the [(3)H]-ryanodine binding to the Ca(2+) release channel in the sarcoplasmic reticulum in a dose-dependent manner and promotion of extracellular Ca(2+) influx and induction of internal Ca(2+) release. This results in tonic diaphragmatic contraction rather than paralysis. This is the basis of the clinical presentation of acute Cartap poisoning as well as the treatment with chelators namely British Anti Lewisite and sodium dimercaptopropane sulfonate.

  19. The Institute for Safe Medication Practices and Poison Control Centers: Collaborating to Prevent Medication Errors and Unintentional Poisonings.

    Science.gov (United States)

    Vaida, Allen J

    2015-06-01

    This article provides an overview on the Institute for Safe Medication Practices (ISMP), the only independent nonprofit organization in the USA devoted to the prevention of medication errors. ISMP developed the national Medication Errors Reporting Program (MERP) and investigates and analyzes errors in order to formulate recommendations to prevent further occurrences. ISMP works closely with the US Food and Drug Administration (FDA), drug manufacturers, professional organizations, and others to promote changes in package design, practice standards, and healthcare practitioner and consumer education. By collaborating with ISMP to share and disseminate information, Poison Control centers, emergency departments, and toxicologists can help decrease unintentional and accidental poisonings.

  20. Mistletoe poisoning

    Science.gov (United States)

    ... if known Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  1. Detergent poisoning

    Science.gov (United States)

    ... if known) Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  2. Kerosene poisoning

    Science.gov (United States)

    ... if known) Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  3. Zinc poisoning

    Science.gov (United States)

    ... help if this information is not immediately available. Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  4. Foxglove poisoning

    Science.gov (United States)

    ... if known Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  5. Cologne poisoning

    Science.gov (United States)

    ... the product Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  6. Bee poison

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/002847.htm Bee poison To use the sharing features on this page, ... Time of the sting Location of the sting Poison Control Your local poison center can be reached ...

  7. Oleander poisoning

    Science.gov (United States)

    ... if known Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  8. Insecticide poisoning

    Science.gov (United States)

    ... if known) Time it was swallowed Amount swallowed Poison Control Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  9. Ammonia poisoning

    Science.gov (United States)

    ... if known) Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  10. Yew poisoning

    Science.gov (United States)

    ... if known Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  11. Philodendron poisoning

    Science.gov (United States)

    ... if known Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  12. Ciguatera Fish Poisoning and Climate Change: Analysis of National Poison Center Data in the United States, 2001–2011

    Science.gov (United States)

    Strickland, Matthew J.; Hess, Jeremy J.

    2014-01-01

    Background: Warm sea surface temperatures (SSTs) are positively related to incidence of ciguatera fish poisoning (CFP). Increased severe storm frequency may create more habitat for ciguatoxic organisms. Although climate change could expand the endemic range of CFP, the relationship between CFP incidence and specific environmental conditions is unknown. Objectives: We estimated associations between monthly CFP incidence in the contiguous United States and SST and storm frequency in the Caribbean basin. Methods: We obtained information on 1,102 CFP-related calls to U.S. poison control centers during 2001–2011 from the National Poison Data System. We performed a time-series analysis using Poisson regression to relate monthly CFP call incidence to SST and tropical storms. We investigated associations across a range of plausible lag structures. Results: Results showed associations between monthly CFP calls and both warmer SSTs and increased tropical storm frequency. The SST variable with the strongest association linked current monthly CFP calls to the peak August SST of the previous year. The lag period with the strongest association for storms was 18 months. If climate change increases SST in the Caribbean 2.5–3.5°C over the coming century as projected, this model implies that CFP incidence in the United States is likely to increase 200–400%. Conclusions: Using CFP calls as a marker of CFP incidence, these results clarify associations between climate variability and CFP incidence and suggest that, all other things equal, climate change could increase the burden of CFP. These findings have implications for disease prediction, surveillance, and public health preparedness for climate change. Citation: Gingold DB, Strickland MJ, Hess JJ. 2014. Ciguatera fish poisoning and climate change: analysis of National Poison Center data in the United States, 2001–2011. Environ Health Perspect 122:580–586; http://dx.doi.org/10.1289/ehp.1307196 PMID:24618280

  13. Online social networking and US poison control centers: Facebook as a means of information distribution.

    Science.gov (United States)

    Vo, Kathy; Smollin, Craig

    2015-06-01

    Online social networking services such as Facebook provide a novel medium for the dissemination of public health information by poison control centers in the United States. We performed a cross-sectional study of poison control center Facebook pages to describe and assess the use of this medium. Facebook pages associated with poison control centers were identified during a continuous two-week period from December 24, 2012 to January 7, 2013. Data were extracted from each page, including affiliated poison control center; page duration, measured in years since registration; number of subscribers; number of postings by general toxicological category; and measures of user-generated activity including "likes", "shares", and comments per posting. Among the 56 US poison control centers, 39 Facebook pages were identified, of which 29 were currently active. The total number of active pages has increased by 140% from 2009 to 2013 (average of 25% per year). The total number of all subscribers to active pages was 11,211, ranging from 40 to 2,456 (mean 387, SD 523), equal to 0.006% of all Facebook users in the United States. The number of subscribers per page was associated with page duration, number of postings, and type of postings. The types of toxicological postings were public education (45%), self-promotion (28%), childhood safety (12%), drugs of abuse (8%), environmental poisonings (6%), and general overdoses (1%). Slightly over half of all poison control centers in the United States are supplementing their outreach and education efforts through Facebook. In general, the more active the poison control center on Facebook, the more page followers and follower engagement gained.

  14. A model to improve the accuracy of US Poison Center data collection.

    Science.gov (United States)

    Krenzelok, E P; Reynolds, K M; Dart, R C; Green, J L

    2014-01-01

    Over 2 million human exposure calls are reported annually to United States regional poison information centers. All exposures are documented electronically and submitted to the American Association of Poison Control Center's National Poison Data System. This database represents the largest data source available on the epidemiology of pharmaceutical and non-pharmaceutical poisoning exposures. The accuracy of these data is critical; however, research has demonstrated that inconsistencies and inaccuracies exist. This study outlines the methods and results of a training program that was developed and implemented to enhance the quality of data collection using acetaminophen exposures as a model. Eleven poison centers were assigned randomly to receive either passive or interactive education to improve medical record documentation. A task force provided recommendations on educational and training strategies and the development of a quality-measurement scorecard to serve as a data collection tool to assess poison center data quality. Poison centers were recruited to participate in the study. Clinical researchers scored the documentation of each exposure record for accuracy. Results. Two thousand two hundred cases were reviewed and assessed for accuracy of data collection. After training, the overall mean quality scores were higher for both the passive (95.3%; + 1.6% change) and interactive intervention groups (95.3%; + 0.9% change). Data collection accuracy improved modestly for the overall accuracy score and significantly for the substance identification component. There was little difference in accuracy measures between the different training methods. Despite the diversity of poison centers, data accuracy, specifically substance identification data fields, can be improved by developing a standardized, systematic, targeted, and mandatory training process. This process should be considered for training on other important topics, thus enhancing the value of these data in

  15. Epidemiological trends in electronic cigarette exposures reported to U.S. Poison Centers.

    Science.gov (United States)

    Vakkalanka, J P; Hardison, L S; Holstege, C P

    2014-06-01

    The Centers for Disease Control and Prevention (CDC) has reported an increase in electronic cigarette (e-cigarette) use in both adults and adolescents. Poison Center calls provide data on exposures pertaining to e-cigarette devices and components (including nicotine-refill cartridges), potentially identifying epidemiological trends in reported exposures over time. To characterize the trends in e-cigarette exposures reported to United States (U.S.) Poison Centers between 01 June 2010 and 30 September 2013. We obtained data from the American Association of Poison Control Centers (AAPCC) for all exposures involving e-cigarettes reported to the National Poison Data System (NPDS) by U.S. Poison Centers and described trends in exposures over time, demographics, geographical characteristics, clinical effects and outcomes, management site, and exposure route. A total of 1,700 exposures were reported to Poison Centers during this time. The most frequent age groups were children 5 years or below with 717 (42.2%) exposures and adults ages 20-39 years with 466 (27.4%) exposures. Temporal trends showed an increase of 1.36 exposures per month [95% CI: 1.16-1.56] from June 2010 through December 2012, after which exposures increased by 9.60 per month [95% CI: 8.64-10.55] from January through September 2013. The majority of patients who were followed reported that they had only minor effects. The majority of exposures to e-cigarette devices and components occurred in children of 5 years or below due to accidental exposure. Based on the available data, the reported exposures have resulted in minimal toxicity. Calls to Poison Centers regarding these products have rapidly increased since 2010, and continued surveillance may show changes in the epidemiological trends surrounding e-cigarette exposures.

  16. Self-poisoning with baclofen in alcohol-dependent patients: national reports to French Poison Control Centers, 2008-2013.

    Science.gov (United States)

    Pelissier, Fanny; de Haro, Luc; Cardona, Florence; Picot, Cyndie; Puskarczyk, Emmanuel; Sapori, Jean-Marc; Tournoud, Christine; Franchitto, Nicolas

    2017-04-01

    Alcohol use disorders are frequently associated with self-intoxication in attempted suicide. In France since 2008, the off-label use of baclofen for treatment of alcohol dependence has greatly increased, leading to temporary regulation of use of the drug. At the request of the national authorities, the French Poison Control Centers carried out a retrospective survey to give an overview of baclofen exposure in this population. A retrospective study was carried out from January 2008 to December 2013, focusing on baclofen exposures in alcohol-dependent patients managed by the nine national French Poison Control Centers. 294 observations of baclofen exposures in alcohol-dependent patients were identified in our database. Of these, 220 were suicide attempts by self-poisoning and 74 were unintentional. The mean age of patients was 41.7 years, with a sex-ratio of 1.6. Patients attempting suicide with baclofen were younger than those with unintentional exposures, and 43.6% of them were women (vs 22.9%, p < 0.01). The mean supposed ingested dose was higher (480.7 mg) in patients who attempted suicide (vs 192.5 mg, p < 0.0001). 21.8% of intentional exposures involved baclofen alone. Psychiatric comorbidity (50.4%) was more frequent in the group of self-poisoning (p < 0.001). 132 patients were coded as severely exposed (60.0%). Nine victims died, but the causal link between self-poisoning with baclofen and fatal outcome should be interpreted with particular caution. Baclofen self-poisoning by alcohol-dependent patients is a serious concern for the French health authorities. Our results are similar to those previously published, suggesting that most patients with baclofen overdose should be admitted to an intermediate or intensive care unit as the clinical course requires close monitoring. Because suicidal ideation and suicide attempts are more prevalent in people with substance use disorders than in the general population, and because of the lack of

  17. POISON CONTROL—Operation of an Information Center in a Rural and Agricultural Community

    Science.gov (United States)

    Bocian, J. J.

    1960-01-01

    The Fresno Community Hospital Poison Control Center has been in operation for about three years, under the sole directorship of the pathologist. All expenses are paid by the hospital. It has served a definite need in the community. As an agricultural and more or less rural community, it shows more poison cases having to do with plants, insecticides, kerosene and fertilizers than do urban communities. PMID:13801875

  18. The Current State of Poison Control Centers in Pakistan and the Need for Capacity Building

    Directory of Open Access Journals (Sweden)

    Nadeem Khan

    2014-03-01

    Full Text Available Background: Chemical exposure is a major health problem globally. Poison control centers (PCCs play a leading role both in developed and developing countries in the prevention and control of poisonous chemical exposures. In this study, we aimed to assess the current state of PCCs in Pakistan and highlight capacity building needs in these centers. Methods: A cross-sectional survey of the two registered PCCs was done during August – December 2011. Necessary services of the PCCs were evaluated and the data were recorded on a predesigned checklist. Results: Both PCCs are affiliated to a tertiary care hospital. Clinical services to poisoned patients were available 24 hours a day / 7 days a week. Information on common local products was available to poison center staff. Both centers were involved in undergraduate and post graduate teaching. Telephone poison information service was not available in either of centers. There was a limited capacity for qualitative and analytical toxicology. Common antidotes were available. There were limited surveillance activities to capture toxic risks existing in the community and also a deficiency was observed in chemical disaster planning. Conclusion: PCCs in Pakistan need capacity building for specialized training in toxicology, toxicovigilance, chemical disaster planning, analytical laboratory tests and telephone service for consultation in poisoning cases.   How to cite this article: Khan NU, Mir MU, Khan UR, Khan AR, Ara J, Raja K, et al. The Current State of Poison Control Centers in Pakistan and the Need for Capacity Building. Asia Pac J Med Toxicol 2014;3:31-5.

  19. Mercury Poisoning at a Home Day Care Center - Hillsborough County, Florida, 2015.

    Science.gov (United States)

    Tewell, Mackenzie; Spoto, Samantha; Wiese, Michael; Aleguas, Alfred; Peredy, Tamas

    2017-05-05

    On November 12, 2015, the Florida Poison Information Center Tampa notified the Florida Department of Health in Hillsborough County of a boy aged 3 years with a urine mercury level of 79 μg/L (normal broken sphygmomanometer (blood pressure monitor) at the home day care center attended by the child.

  20. Ciguatera fish poisoning and climate change: analysis of National Poison Center Data in the United States, 2001-2011.

    Science.gov (United States)

    Gingold, Daniel B; Strickland, Matthew J; Hess, Jeremy J

    2014-06-01

    Warm sea surface temperatures (SSTs) are positively related to incidence of ciguatera fish poisoning (CFP). Increased severe storm frequency may create more habitat for ciguatoxic organisms. Although climate change could expand the endemic range of CFP, the relationship between CFP incidence and specific environmental conditions is unknown. We estimated associations between monthly CFP incidence in the contiguous United States and SST and storm frequency in the Caribbean basin. We obtained information on 1,102 CFP-related calls to U.S. poison control centers during 2001-2011 from the National Poison Data System. We performed a time-series analysis using Poisson regression to relate monthly CFP call incidence to SST and tropical storms. We investigated associations across a range of plausible lag structures. Results showed associations between monthly CFP calls and both warmer SSTs and increased tropical storm frequency. The SST variable with the strongest association linked current monthly CFP calls to the peak August SST of the previous year. The lag period with the strongest association for storms was 18 months. If climate change increases SST in the Caribbean 2.5-3.5 °C over the coming century as projected, this model implies that CFP incidence in the United States is likely to increase 200-400%. Using CFP calls as a marker of CFP incidence, these results clarify associations between climate variability and CFP incidence and suggest that, all other things equal, climate change could increase the burden of CFP. These findings have implications for disease prediction, surveillance, and public health preparedness for climate change.

  1. Epidemiology of acute poisoning in children presenting to the poisoning treatment center at Ain Shams University in Cairo, Egypt, 2009–2013

    Science.gov (United States)

    Azab, Sonya M. S.; Hirshon, Jon Mark; Hayes, Bryan D.; El-Setouhy, Maged; Smith, Gordon S.; Sakr, Mahmoud Lotfy; Tawfik, Hany; Klein-Schwartz, Wendy

    2016-01-01

    Introduction Pediatric poisonings represent a major and preventable cause of morbidity and mortality throughout the world. Epidemiologic information about poisoning among children in many lower- and middle-income countries is scarce. This study describes the epidemiology of acute poisonings in children presenting to Ain Shams University's Poisoning Treatment Center (ASU-PTC) in Cairo and determines the causative agents and characteristics of acute poisoning in several pediatric age groups. Methods This retrospective study involved acutely poisoned patients, 0 to 18 years of age, who presented to the ASU-PTC between 1/1/2009 and 12/31/2013. Data were extracted from electronic records maintained by the ASU-PTC. Collected data included demographics, substance of exposure, circumstances of the poisoning, patient disposition, and outcome. Results During the 5-year study period, 38,470 patients meeting our criteria were treated by the ASU-PTC; 19,987 (52%) were younger than 6 years of age; 4,196 (11%) were 6 to 12 years; and 14,287 (37%) were >12 years. Unintentional poisoning accounted for 68.5% of the ingestions, though among adolescents 84.1% of ingestions were with self-harm intent. In all age groups, the most frequent causative drugs were non-opioid analgesics, antipyretics, and antirheumatics. The most common nonpharmaceutical agents were corrosives in preschool children and pesticides in adolescents. Most patients had no/minor effects (29,174 [75.8%]); hospitalization rates were highest among adolescents. There were 119 deaths (case fatality rate of 0.3), primarily from pesticide ingestion. Conclusion Poisoning in preschool children is mainly unintentional and commonly due to nonpharmaceutical agents while poisoning in adolescents is mainly intentional (self-harm). Pesticides, mainly organophosphorous compounds and carbamates, were the most frequent agent leading to morbidity and mortality. PMID:26653953

  2. Epidemiology of acute poisoning in children presenting to the poisoning treatment center at Ain Shams University in Cairo, Egypt, 2009-2013.

    Science.gov (United States)

    Azab, Sonya M S; Hirshon, Jon Mark; Hirshon, John Mark; Hayes, Bryan D; El-Setouhy, Maged; Smith, Gordon S; Sakr, Mahmoud Lotfy; Tawfik, Hany; Klein-Schwartz, Wendy

    2016-01-01

    Pediatric poisonings represent a major and preventable cause of morbidity and mortality throughout the world. Epidemiologic information about poisoning among children in many lower- and middle-income countries is scarce. This study describes the epidemiology of acute poisonings in children presenting to Ain Shams University's Poisoning Treatment Center (ASU-PTC) in Cairo and determines the causative agents and characteristics of acute poisoning in several pediatric age groups. This retrospective study involved acutely poisoned patients, 0-18 years of age, who presented to the ASU-PTC between 1 January 2009 and 31 December 2013. Data were extracted from electronic records maintained by the ASU-PTC. Collected data included demographics, substance of exposure, circumstances of the poisoning, patient disposition, and outcome. During the 5-year study period, 38 470 patients meeting our criteria were treated by the ASU-PTC; 19 987 (52%) were younger than 6 years of age; 4196 (11%) were 6-12 years; and 14 287 (37%) were >12 years. Unintentional poisoning accounted for 68.5% of the ingestions, though among adolescents 84.1% of ingestions were with self-harm intent. In all age groups, the most frequent causative drugs were non-opioid analgesics, antipyretics, and antirheumatics. The most common nonpharmaceutical agents were corrosives in preschool children and pesticides in adolescents. Most patients had no/minor effects (29 174 [75.8%]); hospitalization rates were highest among adolescents. There were 119 deaths (case fatality rate of 0.3), primarily from pesticide ingestion. Poisoning in preschool children is mainly unintentional and commonly due to nonpharmaceutical agents whereas poisoning in adolescents is mainly intentional (self-harm). Pesticides, mainly organophosphorous compounds and carbamates, were the most frequent agents leading to morbidity and mortality.

  3. [Poisonings with paracetamol, salicylates and dextromethorphan – problem evaluation based on data from Toxicological Laboratory and Poison Information Center in Krakow in 2010-2015].

    Science.gov (United States)

    Gomółka, Ewa; Hydzik, Piotr; Szkolnicka, Beata

    The aim of the paper was to study frequency of laboratory determinations and toxicological information related to over-the-counter drugs (OTC): paracetamol (acetaminophen), salicylates and dextromethorphan. The research was based on data from Toxicological Laboratory and Poison Information Center UJ CM in Krakow in years 2010-2015. Paracetamol was determined averagely 102 times a year, more than 50% (57 cases) were positive with confirmation of poisoning. The least number of paracetamol poisoning was noted in 2011 (35 cases), the most were in 2015 (98 cases). In the time span there were averagely 40 salicylates check measurements a year, less than 50% (15 cases) were positive. Dextromethorphane was confirmed averagely in 31 patients a year, decrease of the drug intoxications was noted in 2013-2015. Paracetamol and dextromethorphan were the most often the cause of poisoning in group of patients 13-18 years old, salicylates – more than 30 years. In the group of small children there were only a few poisonings with paracetamol. Toxicological information data related to paracetamol, salicylates and dextromethorphan were similar to data from toxicological laboratory. Mean year numbers of drug poisoning information were: 90 (paracetamol), 14 (salicylates), 30 (dextromethorphan). The differences were in patients age distribution. Acute poisonings with OTC were related mainly to paracetamol, young patients (13- 18 years) and young adults (19-29 years). Salicylates poisoning information were related mainly to the group of adult patients (> 30 years), dextromethorphan was abused mainly by oung patients (13-18 years). There were no observed poisonings with salicylates and dextromethorphan in children, but there were toxicological information about paracetamol and salicylates poisoning and overdose in group of children (1-6 years).

  4. Descriptive Analysis of Recorded Phone Calls to Iran Drug and Poison Information Centers during 2011-2012

    Directory of Open Access Journals (Sweden)

    Talat Ghane

    2013-06-01

    Full Text Available Background: Poisoning is one of the main causes of visits to emergency departments and hospitals in Iran. Drug and Poison Information Centers (DPIC are reliable sources to guide poisoned patients and provide information about pharmaceutical agents. This study was designed to analyze recorded phone calls to Iran DPICs during 2011-2012.Methods: This was a retrospective study on phone calls to DPIC in Tehran between January 2011 and November 2012. Data including demographic features, type of poison (in case of poisoning and intention of poisoning were collected by reviewing the reported phone calls to central division of Iran DPICs in Tehran.Results: It was found that 98.5% of the phone calls were inquiries about pharmaceutical products and only 1.5% of them were associated with poisoning. 49% of poisonings reported from the DPICs in 2011was intentional, while this rate increased to 67% in 2012. Regarding toxic agents responsible for poisonings, pharmaceuticals were the most common consisting of 68.6% and 70.9% of cases in 2011 and 2012, respectively.Conclusion: Pharmaceutical products are the main causes of poisonings in Iran. Public education on safety and storage issues and also strict terms of sale should be implemented. In addition, the majority of poisonings occurred intentionally while the rate showed an increasing trend. Predisposing factors of this high rate should be studied.

  5. Characteristics of hand sanitizer ingestions by adolescents reported to poison centers.

    Science.gov (United States)

    Forrester, Mathias B

    2015-02-01

    There had been reports of adolescents using hand sanitizers to obtain alcohol and ending up in emergency departments with alcohol poisoning. This study aimed to describe the pattern of adolescent ingestions of hand sanitizers reported to a statewide poison center system. Our study subjects included patients aged 13-19 years who reported hand sanitizer ingestions as reported to Texas poison centers during 2000-2013. The distribution of the ingestions was determined for various demographic and clinical factors. Of 385 total cases, 61% of the patients were male, and the mean age was 15.3 years. The ingestion reason was unintentional (61%), intentional abuse/misuse (18%), and malicious (10%). Ingestion site was most frequently reported to be the patient's own residence (53%), followed by school (35%). About 77% of the patients were managed on site. The medical outcome was serious (moderate effect or unable to follow-potentially toxic) in 5% of the cases. The most frequently reported adverse clinical effects were vomiting (5%), abdominal pain (4%), nausea (4%), throat irritation (4%), and drowsiness (2%). Adolescents who ingested hand sanitizers were more likely to be male and younger. One-third of the ingestions occurred at school, suggesting that school personnel might be made aware of the potential problem of hand sanitizer ingestions by adolescents. Nevertheless, despite the potential for serious outcomes from adolescent hand sanitizer ingestion, most of the ingestions reported to poison centers are not likely to be serious and can be successfully managed outside of a healthcare facility.

  6. Bibliometric analysis of poison center-related research published in peer-review journals.

    Science.gov (United States)

    Forrester, M B

    2016-07-01

    Poison centers advance knowledge in the field of toxicology through publication in peer-review journals. This investigation describes the pattern of poison center-related publications. Cases were poison center-related research published in peer-review journals during 1995-2014. These were identified through searching the PubMed database, reviewing the tables of contents of selected toxicology journals, and reviewing abstracts of various national and international meetings. The following variables for each publication were identified: year of publication, journal, type of publication (meeting abstract vs. other, i.e. full article or letter to the editor), and the country(ies) of the poison center(s) included in the research. Of the 3147 total publications, 62.1% were meeting abstracts. There were 263 publications in 1995-1999, 536 in 2000-2004, 999 in 2005-2009, and 1349 in 2010-2014. The publications were in 234 different journals. The journals in which the highest number of research was published were Clinical Toxicology (69.7%), Journal of Medical Toxicology (2.2%), and Veterinary and Human Toxicology (2.1%). The research was reported from 62 different countries. The countries with the highest number of publications were the United States (67.9%), United Kingdom (6.5%), Germany (3.9%), France (2.5%), and Italy (2.4%). The number of publications increased greatly over the 20 years. Although the publications were in a large number of journals, a high proportion of the publications were in one journal. While the research came from a large number of countries, the preponderance came from the United States. © The Author(s) 2015.

  7. Ayahuasca Exposure: Descriptive Analysis of Calls to US Poison Control Centers from 2005 to 2015.

    Science.gov (United States)

    Heise, C William; Brooks, Daniel E

    2017-09-01

    Ayahuasca is a hallucinogenic plant preparation which usually contains the vine Banisteriopsis caapi and the shrub Psychotria viridis. This tea originates from the Amazon Basin where it is used in religious ceremonies. Because interest in these religious groups spreading as well as awareness of use of ayahuasca for therapeutic and recreational purposes, its use is increasing. Banisteriopsis caapi is rich in β-carbolines, especially harmine, tetrahydroharmine and harmaline, which have monoamine oxidase inhibiting (MAOI) activity. Psychotria viridis contains the 5HT2A/2C/1A receptor agonist hallucinogen N,N-dimethyltryptamine (DMT). Usual desired effects include hallucination, dissociation, mood alteration and perception change. Undesired findings previously reported are nausea, vomiting, hypertension, and tachycardia. All human exposure calls reported to the American Association of Poison Controls Centers' (AAPCC) National Poison Data System (NPDS) between September 1, 2005 and September 1, 2015 were reviewed. Cases were filtered for specific plant derived ayahuasca-related product codes. Abstracted data included the following: case age and gender, exposure reason, exposure route, clinical manifestations, treatments given, medical outcomes and fatality. Five hundred and thirty-eight exposures to ayahuasca botanical products were reported. The majority of the calls to poison control centers came from healthcare facilities (83%). The most common route of exposure was ingestion. Most cases were men (437, 81%, 95% CI 77.7% - 84.3%). The median age was 21 (IQR 18-29). Most exposures were acute. Three hundred thirty-seven (63%) were reported to have a major or moderate clinical effect. The most common clinical manifestations reported were hallucinations (35%), tachycardia (34%), agitation (34%), hypertension (16%), mydriasis (13%) and vomiting (6%). Benzodiazepines were commonly given (30%). There were 28 cases in the series who required endotracheal intubation (5

  8. 2016 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 34th Annual Report.

    Science.gov (United States)

    Gummin, David D; Mowry, James B; Spyker, Daniel A; Brooks, Daniel E; Fraser, Michael O; Banner, William

    2017-12-01

    This is the 34th Annual Report of the American Association of Poison Control Centers' (AAPCC) National Poison Data System (NPDS). As of 1 January 2016, 55 of the nation's poison centers (PCs) uploaded case data automatically to NPDS. The upload interval was 9.50 [7.33, 14.6] (median [25%, 75%]) min, facilitating a near real-time national exposure and information database and surveillance system. We analyzed the case data tabulating specific indices from NPDS. The methodology was similar to that of previous years. Where changes were introduced, the differences are identified. Cases with medical outcomes of death were evaluated by a team of medical and clinical toxicologist reviewers using an ordinal scale of 1-6 to assess the Relative Contribution to Fatality (RCF) of the exposure. In 2016, 2,710,042 closed encounters were logged by NPDS: 2,159,032 human exposures, 54,019 animal exposures, 490,215 information cases, 6687 human confirmed non-exposures, and 89 animal confirmed non-exposures. US PCs also made 2,718,022 follow-up calls in 2016. Total encounters showed a 2.94% decline from 2015, while health care facility (HCF) human exposure cases increased by 3.63% from 2015. All information calls decreased by 12.5% but HCF information calls increased 0.454%, and while medication identification requests (Drug ID) decreased 29.6%, human exposure cases were essentially flat, decreasing by 0.431%. Human exposures with less serious outcomes have decreased 2.59% per year since 2008 while those with more serious outcomes (moderate, major or death) have increased by 4.39% per year since 2000. The top five substance classes most frequently involved in all human exposures were analgesics (11.2%), household cleaning substances (7.54%), cosmetics/personal care products (7.20%), sedatives/hypnotics/antipsychotics (5.84%), and antidepressants (4.74%). As a class, sedative/hypnotics/antipsychotics exposures increased most rapidly, by 10.7% per year (2088 cases/year), over the last

  9. Electronic Cigarette Exposure: Calls to Wisconsin Poison Control Centers, 2010–2015.

    Science.gov (United States)

    Weiss, Debora; Tomasallo, Carrie D; Meiman, Jon G; Creswell, Paul D; Melstrom, Paul C; Gummin, David D; Patel, Disa J; Michaud, Nancy T; Sebero, Heather A; Anderson, Henry A

    2016-12-01

    E-cigarettes are battery-powered devices that deliver nicotine and flavorings by aerosol and have been marketed in the United States since 2007. Because e-cigarettes have increased in popularity, toxicity potential from device misuse and malfunction also has increased. National data indicate that during 2010–2014, exposure calls to US poison control centers increased only 0.3% for conventional cigarette exposures, whereas calls increased 41.7% for e-cigarette exposures. We characterized cigarette and e-cigarette exposure calls to the Wisconsin Poison Center January 1, 2010 through October 10, 2015. We compared cigarette and e-cigarette exposure calls by exposure year, demographic characteristics, caller site, exposure site, exposure route, exposure reason, medical outcome, management site, and level of care at a health care facility. During January 2010 to October 2015, a total of 98 e-cigarette exposure calls were reported, and annual exposure calls increased approximately 17-fold, from 2 to 35. During the same period, 671 single-exposure cigarette calls with stable annual call volumes were reported. E-cigarette exposure calls were associated with children aged ≤5 years (57/98, 58.2%) and adults aged ≥20 years (30/98, 30.6%). Cigarette exposure calls predominated among children aged ≤5 years (643/671, 95.8%). The frequency of e-cigarette exposure calls to the Wisconsin Poison Center has increased and is highest among children aged ≤5 years and adults. Strategies are warranted to prevent future poisonings from these devices, including nicotine warning labels and public advisories to keep e-cigarettes away from children.

  10. Calls to Florida Poison Control Centers about mercury: Trends over 2003-2013.

    Science.gov (United States)

    Gribble, Matthew O; Deshpande, Aniruddha; Stephan, Wendy B; Hunter, Candis M; Weisman, Richard S

    2017-11-01

    The aim of this analysis was to contrast trends in exposure-report calls and informational queries (a measure of public interest) about mercury to the Florida Poison Control Centers over 2003-2013. Poison-control specialists coded calls to Florida Poison Control Centers by substance of concern, caller demographics, and whether the call pertained to an exposure event or was an informational query. For the present study, call records regarding mercury were de-identified and provided along with daily total number of calls for statistical analysis. We fit Poisson models using generalized estimating equations to summarize changes across years in counts of daily calls to Florida Poison Control Centers, adjusting for month. In a second stage of analysis, we further adjusted for the total number of calls each day. We also conducted analyses stratified by age of the exposed. There was an overall decrease over 2003-2013 in the number of total calls about mercury [Ratio per year: 0.89, 95% CI: (0.88, 0.90)], and calls about mercury exposure [Ratio per year: 0.84, 95% CI: (0.83, 0.85)], but the number of informational queries about mercury increased over this time [Ratio per year: 1.15 (95% CI: 1.12, 1.18)]. After adjusting for the number of calls of that type each day (e.g., call volume), the associations remained similar: a ratio of 0.88 (95% CI: 0.87, 0.89) per year for total calls, 0.85 (0.83, 0.86) for exposure-related calls, and 1.17 (1.14, 1.21) for informational queries. Although, the number of exposure-related calls decreased, informational queries increased over 2003-2013. This might suggest an increased public interest in mercury health risks despite a decrease in reported exposures over this time period. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Trends in Teenagers' Nonopiod Substance Exposures Reported to Poison Control Centers, 2010-2015.

    Science.gov (United States)

    Wright, Brad; Mestan, Samantha; Ahrens, Monica; Bottei, Edward

    2018-05-01

    To describe current trends in nonopioid substance exposures and associated outcomes among teenagers nationwide. In this cross-sectional study, we used 2010-2015 data from the American Association of Poison Control Centers' National Poison Data System and Poisson tests to document trends in the rate of calls to poison control centers involving adolescents stratified by sex, exposures by substance category, proportion of intentional exposures, and severity of exposures. The number of calls per 1000 persons increased from 5.7 to 6.8 for teenage girls and decreased from 4.7 to 4.3 for boys. Reported exposures to prescription and over-the-counter medications and illicit street drugs increased between 24% and 73%, and reported opioid exposures decreased by 16%. Among teenage girls, intentional exposures increased from 57% to 68%, with cases increasingly managed in health care facilities and more likely to result in worse health outcomes. The increase in intentional nonopioid substance exposures among teenage girls, with serious and potentially life-threatening consequences, is a matter of serious concern. Similar trends were not observed among teenage boys. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Bug spray poisoning

    Science.gov (United States)

    ... was swallowed or inhaled Amount swallowed or inhaled Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  13. Dietary supplement adverse events: report of a one-year poison center surveillance project.

    Science.gov (United States)

    Haller, Christine; Kearney, Tom; Bent, Stephen; Ko, Richard; Benowitz, Neal; Olson, Kent

    2008-06-01

    The safety and efficacy of dietary supplements is of growing concern to regulators, health-care providers and consumers. Few scientific data exist on clinical effects and potential toxicities of marketed products. Harmful supplements may not be identified for months or years with existing adverse event monitoring mechanisms. Retrospective review of poison center statistics to capture supplement-associated toxicity also has limitations. We collaborated with the FDA Center for Food Safety and Nutrition (CFSAN) to conduct a 1-year prospective surveillance study of dietary supplement-related poison control center calls in 2006. Prompt follow-up of symptomatic cases, laboratory analysis of implicated dietary supplements, and causality assessment by a case review expert panel were performed. Of 275 dietary supplements calls, 41% involved symptomatic exposures; and two-thirds were rated as probably or possibly related to supplement use. Eight adverse events required hospital admission. Sympathomimetic toxicity was most common, with caffeine products accounting for 47%, and yohimbe products accounting for 18% of supplement-related symptomatic cases. Suspected drug-herb interactions occurred in 6 cases, including yohimbe co-ingested with buproprion (1) and methamphetamine (3), and additive anticoagulant/antiplatelet effects of NSAIDs taken with fish oils (1) and ginkgo (1). Laboratory analysis identified a pharmacologically active substance in 4 cases; supplement toxicity was ruled unlikely when analytical testing was negative in 5 cases. Most supplement-related adverse events were minor. Clinically significant toxic effects were most frequently reported with caffeine and yohimbe-containing products. Active surveillance of poison control center reports of dietary supplement adverse events enables rapid detection of potentially harmful products, which may facilitate regulatory oversight.

  14. Ammonium Bifluoride Poisoning: Our Eight-year Experiences

    OpenAIRE

    Serkan Özsoylu; Başak Akyıldız; Adem Dursun

    2018-01-01

    Introduction: The aim of the study was to discuss clinical effects, treatment options and outcomes of pediatric ammonium bifluoride (ABF) poisoning. Methods: This study was designed as retrospective case series. We analyzed the medical records of children who were hospitalized for ABF poisoning between January 2009 and October 2017. Results: The median calcium level on arrival to the hospital was 9.26 mg/dL (minimum-maximum: 4.6-10.9). The median calcium level 2 hours after arrival was ...

  15. Texas Bull Nettle (Cnidoscolus texanus) Exposures Reported to Texas Poison Centers.

    Science.gov (United States)

    Forrester, Mathias B

    2017-06-01

    Texas bull nettle (Cnidoscolus texanus) is covered in bristly hairs similar to stinging nettle. Contact with the plant may result in intense dermal pain, burning, itching, cellulitis, and allergic reaction. This study characterizes C texanus exposures reported to a large state-wide poison center system. Cases were C texanus exposures reported to Texas poison centers during 2000-2015. The distribution of cases was determined for patient demographics, exposure circumstances, and patient outcome. A total of 140 C texanus exposures were identified. Twenty percent of the patients were aged ≤5 years, 21% were 6 to 12 years, 5% were 13 to 19 years, and 51% were ≥20years; and 51% of the patients were male. Eighty-one percent of the exposures occurred at the patient's own residence, 11% in a public area, 2% at another residence, and 1% at school. Seventy-eight percent of the patients were managed on site, 13% were already at or en route to a health care facility, and 6% were referred to a health care facility. Eighty-eight percent of the exposures resulted in dermal effects: irritation or pain (56%), erythema or flushing (31%), edema (27%), pruritus (24%), rash (19%), puncture or wound (19%), and hives or welts (11%). C texanus exposures reported to Texas poison centers were most likely to be unintentional and occur at the patient's own residence. The outcomes of the exposures tended not to be serious and could be managed successfully outside of health care facilities. Copyright © 2017 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  16. Assessing the public health impact of using poison center data for public health surveillance.

    Science.gov (United States)

    Wang, Alice; Law, Royal; Lyons, Rebecca; Choudhary, Ekta; Wolkin, Amy; Schier, Joshua

    2017-12-13

    The National Poison Data System (NPDS) is a database and surveillance system for US poison centers (PCs) call data. The Centers for Disease Control and Prevention (CDC) and American Association of Poison Control Centers (AAPCC) use NPDS to identify incidents of potential public health significance. State health departments are notified by CDC of incidents identified by NPDS to be of potential public health significance. Our objective was to describe the public health impact of CDC's notifications and the use of NPDS data for surveillance. We described how NPDS data informed three public health responses: the Deepwater Horizon incident, national exposures to laundry detergent pods, and national exposures to e-cigarettes. Additionally, we extracted survey results of state epidemiologists regarding NPDS incident notification follow-up from 1 January 2015 to 31 December 2016 to assess current public health application of NPDS data using Epi Info 7.2 and analyzed data using SAS 9.3. We assessed whether state health departments were aware of incidents before notification, what actions were taken, and whether CDC notifications contributed to actions. NPDS data provided evidence for industry changes to improve laundry detergent pod containers safety and highlighted the need to regulate e-cigarette sale and manufacturing. NPDS data were used to improve situational awareness during the 2010 Deepwater Horizon oil spill. Of 59 health departments and PCs who responded to CDC notifications about anomalies (response rate = 49.2%), 27 (46%) reported no previous awareness of the incident, and 20 (34%) said that notifications contributed to public health action. Monitoring NPDS data for anomalies can identify emerging public health threats and provide evidence-based science to support public health action and policy changes.

  17. Smoke Inhalation and Cyanide Poisoning: 20 Years of Paris Experience

    International Nuclear Information System (INIS)

    Baud, F. J.

    2007-01-01

    Hydroxocobalamin has been used as a cyanide poisoning antidote for many years in France. It has recently been approved by the US FDA. In Paris, hydroxocobalamin is carried by the Brigade de Sapeurs Pompiers (Paris Fire Brigade) in mobile intensive care vehicles and has been administered empirically to victims of enclosed-space fire smoke inhalation who meet the criteria of having soot in the nose, mouth, or throat, any alteration in mental status or disturbance in consciousness, and especially if any degree of hypotension is present (BP less than or equal to 100 mmHg systolic). The administration of hydroxocobalamin at the scene was shown to be safe. Hydroxocobalamin has also been efficacious and safe in 'pure' cyanide poisoning, as long as brain death has not already occurred. A 'toxidrome' of cyanide poisoning has been developed in our institution in Paris, and its application can assist in making the diagnosis of this life-threatening poisoning which cannot be emergent diagnosed by currently-available laboratory methods.(author)

  18. A Retrospective Study of Clinical Effects of Powdered Caffeine Exposures Reported to Three US Poison Control Centers.

    Science.gov (United States)

    Beauchamp, Gillian A; Johnson, Amberly R; Crouch, Barbara I; Valento, Matthew; Horowitz, B Zane; Hendrickson, Robert G

    2016-09-01

    Anhydrous caffeine, often sold on the Internet as a powdered caffeine product, is sold as "pure caffeine" to be used as an additive to beverages and has also been used as an ingredient in energy supplement products. This is a retrospective multiple-poison center chart review of calls regarding powdered caffeine to poison centers covering Oregon, Alaska, Guam, Washington, and Utah between January 1, 2013 and June 30, 2015. There were 40 calls to three poison centers over 30 months for powdered caffeine exposure. The majority of patients were over age 19 (52.5 %; 21/40) and male (70 %; 28/40). Sixty percent (24/40) of the patients were symptomatic but only 10 % (4/40) required admission; 52.5 % (21/40) of the patient calls were for inadvertent overdose of powdered caffeine; one patient overdosed in a self-harm attempt. Powdered caffeine calls to three poison centers during a 30-month study period were rare, and severe caffeine toxicity due to exposure was found in few patients. The majority of symptoms were reported after an inadvertent powdered caffeine overdose. An analysis of calls to three poison centers for powdered caffeine found that exposures were uncommon, but did result in toxicity, and highlighted that the lack of clear dosing instructions on product packaging may place patients at risk of inadvertent overdose.

  19. High call volume at poison control centers: identification and implications for communication.

    Science.gov (United States)

    Caravati, E M; Latimer, S; Reblin, M; Bennett, H K W; Cummins, M R; Crouch, B I; Ellington, L

    2012-09-01

    High volume surges in health care are uncommon and unpredictable events. Their impact on health system performance and capacity is difficult to study. To identify time periods that exhibited very busy conditions at a poison control center and to determine whether cases and communication during high volume call periods are different from cases during low volume periods. Call data from a US poison control center over twelve consecutive months was collected via a call logger and an electronic case database (Toxicall®).Variables evaluated for high call volume conditions were: (1) call duration; (2) number of cases; and (3) number of calls per staff member per 30 minute period. Statistical analyses identified peak periods as busier than 99% of all other 30 minute time periods and low volume periods as slower than 70% of all other 30 minute periods. Case and communication characteristics of high volume and low volume calls were compared using logistic regression. A total of 65,364 incoming calls occurred over 12 months. One hundred high call volume and 4885 low call volume 30 minute periods were identified. High volume periods were more common between 1500 and 2300 hours and during the winter months. Coded verbal communication data were evaluated for 42 high volume and 296 low volume calls. The mean (standard deviation) call length of these calls during high volume and low volume periods was 3 minutes 27 seconds (1 minute 46 seconds) and 3 minutes 57 seconds (2 minutes 11 seconds), respectively. Regression analyses revealed a trend for fewer overall verbal statements and fewer staff questions during peak periods, but no other significant differences for staff-caller communication behaviors were found. Peak activity for poison center call volume can be identified by statistical modeling. Calls during high volume periods were similar to low volume calls. Communication was more concise yet staff was able to maintain a good rapport with callers during busy call periods

  20. Abuse and Misuse of Selected Dietary Supplements Among Adolescents: a Look at Poison Center Data.

    Science.gov (United States)

    Biggs, Jessica M; Morgan, Jill A; Lardieri, Allison B; Kishk, Omayma A; Klein-Schwartz, Wendy

    2017-01-01

    The use of dietary supplements has increased and is associated with adverse effects. Indications for use include recreation, body image concerns, mood enhancement, or control of medical conditions. The risk of adverse effects may be enhanced if agents are used improperly. The objective of this study was to determine the frequency of abuse and misuse of 4 dietary substances among adolescents reported nationally to poison centers. Secondary outcomes included an assessment of medical outcomes, clinical effects, location of treatments provided, and treatments administered. This descriptive retrospective review assessed data concerning the use of garcinia (Garcinia cambogia), guarana (Paullinia cupana), salvia (Salvia divinorum), and St John's wort (Hypericum perforatum) among adolescents reported nationally to poison centers from 2003 to 2014. Adolescents with a singlesubstance exposure to one of the substances of interest coded as intentional abuse or misuse were included. Poison center calls for drug information or those with unrelated clinical effects were excluded. Data were collected from the National Poison Data System. There were 84 cases: 7 cases of Garcinia cambogia, 28 Paullinia cupana, 23 Salvia divinorum, and 26 Hypericum perforatum. Garcinia cambogia was used more frequently by females (100% versus 0%), and Paullinia cupana and Salvia divinorum were used more frequently by males (61% versus 36% and 91% versus 9%, respectively). Abuse, driven by Salvia divinorum, was more common overall than misuse. Abuse was also more common among males than females (p <0.001). Use of these agents fluctuated over time. Overall, use trended down since 2010, except for Garcinia cambogia use. In 62 cases (73.8%), the medical outcome was minor or had no effect or was judged as nontoxic or minimally toxic. Clinical effects were most common with Paullinia cupana and Salvia divinorum. Treatment sites included emergency department (n = 33; 39.3%), non-healthcare facility (n = 24

  1. Ammonium Bifluoride Poisoning: Our Eight-year Experiences

    Directory of Open Access Journals (Sweden)

    Serkan Özsoylu

    2018-04-01

    Full Text Available Introduction: The aim of the study was to discuss clinical effects, treatment options and outcomes of pediatric ammonium bifluoride (ABF poisoning. Methods: This study was designed as retrospective case series. We analyzed the medical records of children who were hospitalized for ABF poisoning between January 2009 and October 2017. Results: The median calcium level on arrival to the hospital was 9.26 mg/dL (minimum-maximum: 4.6-10.9. The median calcium level 2 hours after arrival was 6.44 mg/dL (minimum-maximum: 2-9.2. One patient arrived at the hospital within 3 hours after poisoning and the calcium level on arrival was 4.8 mg/dL. It means that the time elapsed between ABF ingestion and hospital arrival is one of the most important prognostic factors for survival. In our practice, we start 25-75 mg/kg calcium gluconate infusion for hypocalcemia. In our two cases inappropriate dose of calcium gluconate infusion was given to the patients (5 mg/kg in one and 20 mg/kg in the other patient and both of them died. Conclusion: Although it is a rare condition, this study probably represents the largest sample of patients with pediatric ABF poisoning. Patients, who received oral calcium lactate therapy in addition to intravenous calcium therapy, survived despite the presence of life-threatening ventricular dysrhtymias. We assume that oral calcium lactate therapy was associated with improved survival in ABF toxicity. Future studies on oral calcium lactate therapy and its effects on the survival are needed.

  2. Therapeutic plasma exchange in poisoning: 8 years' experience of a university hospital.

    Science.gov (United States)

    Dişel, Nezihat Rana; Akpınar, Ayça Açıkalın; Sebe, Ahmet; Karakoç, Emre; Sürer, Selen; Turhan, Ferda Tekin; Matyar, Selçuk

    2015-10-01

    This study examined the extracorporeal methods for the elimination of toxic substances in poisoned patients that are used by clinicians taking care of such patients. Here we present our experience in the use of therapeutic plasma exchange (TPE). To the best of our knowledge, this is the largest number of poisoning cases ever reported in a study. This is a retrospective study conducted at the Çukurova University Faculty of Medicine, Department of Emergency Medicine, with the permission of the ethical committee of the medical faculty. The study includes patients who had undergone TPE because of poisoning between January 2007 and May 2015. We summarize the clinical data and outcomes of the patients with available files. A total of 36 cases among the 42 patients who underwent TPE in this 8-year period were included in the study. More than 20 identified toxic substances, most of which were pesticides, were found to be the causes of poisoning. Twenty-three healthy discharges and 12 deaths are discussed in the study. We believe that our study reports the largest ever number of poisoning cases treated with TPE in the literature. When applicable, TPE may be a promising extracorporeal elimination and treatment technique in poisoned patients when performed in selected cases. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Thermal, thermoelectric, and cathode poisoning effects in cold fusion experiments

    International Nuclear Information System (INIS)

    Keesing, R.G.; Greenhow, R.C.; Cohler, M.D.; McQuillan, A.J.

    1991-01-01

    This paper reports on an unsuccessful attempt to repeat the observations by Fleischmann and Pons of cold nuclear fusion in deuterium-charged palladium; no excess heat is found, nor is any gamma or neutron activity identified. Peltier heating at the palladium/platinum junction is investigated, but no effects are seen; the possibility remains, however, that a large Peltier coefficient may arise for deuterium concentrations that render the palladium-deuterium semiconducting. Finally, the effects of poisoning the palladium with cyanide were investigated

  4. Relating calls to US poison centers for potential exposures to medications to Centers for Disease Control and Prevention reporting of influenza-like illness.

    Science.gov (United States)

    Beauchamp, Gillian A; McKeown, Nathanael J; Rodriguez, Sergio; Spyker, Daniel A

    2016-03-01

    The Centers for Disease Control (CDC) monitors influenza like illness (ILI) and the National Poison Data System (NPDS) warehouses call data uploaded by US poison centers regarding reported exposures to medication. We examined the relationship between calls to poison centers regarding reported exposures to medications commonly used to treat ILI and weekly reports of ILI. The CDC reports ILI, by age group, for each of 10 Health and Human Services (HHS) regions. We examined NPDS summary data from calls reported to poison centers regarding reported exposures to acetaminophen, cough/cold medications, and promethazine, for the same weeks, age groups, and HHS regions for influenza seasons 2000-2013. ILI and NPDS exposures were examined using graphical plots, descriptive statistics, stepwise regression analysis, and Geographic Information Systems (GIS). About 5,101,841 influenza-like illness cases were reported to the CDC, and 2,122,940 calls regarding reported exposures to medications commonly used to treat ILI, were reported by poison centers to the NPDS over the 13 flu seasons. Analysis of stepwise models of the linear untransformed data involving 24 NPDS data groups and for 60 ILI measures, over the 13 influenza seasons, demonstrated that reported exposures to medications used to treat ILI correlated with reported cases of ILI with a median R(2 )=( )0.489 (min R(2 )=( )0.248, max R(2 )=( )0.717), with mean ± SD of R(2 )=( )0.494 ± 0.121. Median number of parameters used (degrees of freedom - 1) was 7. NPDS data regarding poison center calls for selected ILI medication exposures were highly correlated with CDC ILI data. Since NPDS data are available in real time, it provides complimentary ILI monitoring. This approach may provide public health value in predicting other illnesses which are not currently as thoroughly monitored.

  5. Sachet poisoning

    Science.gov (United States)

    ... of perfumed powder or a mix of dried flowers, herbs, spices, and aromatic wood shavings (potpourri). Some ... further instructions. This is a free and confidential service. All local poison control centers in the United ...

  6. Characterization of edible marijuana product exposures reported to United States poison centers.

    Science.gov (United States)

    Cao, Dazhe; Srisuma, Sahaphume; Bronstein, Alvin C; Hoyte, Christopher O

    2016-11-01

    Edible marijuana products are sold as brownies, cookies, and candies, which may be indistinguishable from counterparts without marijuana and are palatable to children and adults. The consumption of an entire product containing multiple dose-units may result in overdose. To characterize edible marijuana exposures reported to US poison centers with subgroup analysis by age. We analyzed single substance, human exposure calls coded to marijuana brownies, candies, cookies, beverages, or other foods reported to the National Poison Data System from January 2013 to December 2015. Calls were analyzed by state, age, gender, exposure route, clinical effect, therapies, and level of healthcare facility utilization. Four-hundred and thirty calls were reported: Colorado (N = 166, 1.05/100,000 population/year) and Washington (96, 0.46) yielded the highest number of exposures. Three hundred and eighty-one (91%) calls occurred in states with decriminalized medical/recreational marijuana. The number of calls increased every year of the study. The most common age groups were: ≤5 years (N = 109, 0.15/100,000 population/year) and 13-19 (78, 0.09). The most frequent clinical effects were drowsiness/lethargy (N = 118, percentage = 43%), tachycardia (84, 31%), agitated/irritable (37, 14%), and confusion (37, 14%). Children ≤5 years have more drowsiness/lethargy, ataxia, and red eye/conjunctivitis. No deaths were reported. The most common therapies administered were intravenous fluids (85, 20%), dilute/irrigate/wash (48, 11 %), and benzodiazepines (47, 11%). Three patients (ages 4, 10, and 57 years) received intubation. 97 (23%), 217 (50%), and 12 (3%) calls were managed at home, treated/released, admitted to a critical care unit, respectively. Although most clinical effects are minor, ventilatory support may be necessary for children and adults. We speculate the increasing exposures may be related to a combination of delayed absorption kinetics of Δ9

  7. Use of antivenom for snakebites reported to United States poison centers.

    Science.gov (United States)

    Spiller, Henry A; Bosse, George M; Ryan, Mark L

    2010-09-01

    In 2001, a new antivenin was introduced to the United States and became widely available in the snakebite season of 2002. We investigated what impact this may have had on snakebite treatment and medical outcome. The study used a retrospective review of all snakebites to humans reported to the National Poison Center Database System from 2000 to 2007. During the 8 years, there were 37,760 snakebites, with a mean of 4720 bites per year. There was a 27% increase in bites reported to a Poison center for the 8-year period and an overall 13.5% increase in the use of antivenin. The 2 categories primarily responsible for the increased use of antivenin were copperhead and crotaline-unknown. Rattlesnake bites remained the category most frequently treated with antivenin with a mean 52.5% treatment rate and only moderate increase for the 8 years. There was no change in the percentage or number of patients with a major outcome (mean, 3.8%) or death (mean, 0.5%). There was a decrease in patients with a minor outcome and an increase in patients with a moderate outcome. The new antivenin is reported to have a reduced potential for adverse reactions. This may have had a role in the decision of which snakebite victims received antivenin. With the introduction of a new antivenin, there has been a dramatic increase in the number of snakebite patients treated with antivenin. This has been most noticeable in snake bite categories that were less frequently treated with antivenin in the past. Copyright © 2010 Elsevier Inc. All rights reserved.

  8. Exposure Calls to U. S. Poison Centers Involving Electronic Cigarettes and Conventional Cigarettes-September 2010-December 2014.

    Science.gov (United States)

    Chatham-Stephens, Kevin; Law, Royal; Taylor, Ethel; Kieszak, Stephanie; Melstrom, Paul; Bunnell, Rebecca; Wang, Baoguang; Day, Hannah; Apelberg, Benjamin; Cantrell, Lee; Foster, Howell; Schier, Joshua G

    2016-12-01

    E-cigarette use is increasing, and the long-term impact on public health is unclear. We described the acute adverse health effects from e-cigarette exposures reported to U.S. poison centers. We compared monthly counts and demographic, exposure, and health effects data of calls about e-cigarettes and conventional cigarettes made to poison centers from September 2010 through December 2014. Monthly e-cigarette calls increased from 1 in September 2010, peaked at 401 in April 2014, and declined to 295 in December 2014. Monthly conventional cigarette calls during the same period ranged from 302 to 514. E-cigarette calls were more likely than conventional cigarette calls to report adverse health effects, including vomiting, eye irritation, and nausea. Five e-cigarette calls reported major health effects, such as respiratory failure, and there were two deaths associated with e-cigarette calls. E-cigarette calls to U.S. poison centers increased over the study period, and were more likely than conventional cigarettes to report adverse health effects. It is important for health care providers and the public to be aware of potential acute health effects from e-cigarettes. Developing strategies to monitor and prevent poisonings from these novel devices is critical.

  9. Thirteen years of oxcarbazepine exposures reported to US poison centers: 2000 to 2012.

    Science.gov (United States)

    Spiller, H A; Strauch, J; Essing-Spiller, S J; Burns, G

    2016-10-01

    Oxcarbazepine (OXC) is a 10-keto analogue of carbamazepine used in patients with partial and secondary generalized seizures. We evaluated ingestions of OXC reported to US poison centers for adverse effects from supratherapeutic doses and/or overdose. Retrospective analysis of data reported to National Poison Data System from single-substance OXC ingestions between January 2000 and December 2012. There were 18,867cases with a mean of 1451 exposures/year. The patients were predominantly adults with 5464 exposures in children effects were drowsiness (n = 4703, 25%), vomiting (n = 1559, 8%), tachycardia (n = 590, 3%), agitated (n = 342, 1.8%), hypotension (n = 178, 0.9%), electrolyte disturbance (n = 153, 0.8%), coma (n = 156, 0.8%), and seizures (n = 121, 0.6%). There were 176 patients with a major effect of which 31 involved were children and 1728 (9%) patients with moderate effects of which 300 involved were children. Five deaths were reported in adults. Intentional exposure (e.g. suicide) was the reason for exposure in 68% of patients with major effects and in all fatalities. Fifty-three percent of adults and 38% of children were managed in a health-care facility (HCF). HCF utilization levels remained consistent. Severe outcomes appear to be infrequent (<1%). Unlike other anticonvulsants OXC does not appear to be proconvulsant in overdose. Serious outcomes for OXC overdoses are unlikely in the pediatric patient. With only mild symptoms likely, observation at home may be appropriate for the majority of cases. In the adult population there appears to be few neurologic and cardiovascular complications even in the intentional exposure. © The Author(s) 2015.

  10. Antivenom Therapy for Crotaline Snakebites: Has the Poison Control Center Provided Effective Guidelines?

    Directory of Open Access Journals (Sweden)

    Yen-Chia Chen

    2007-12-01

    Full Text Available Crotaline snakebites (Protobothrops mucrosquamatus and Trimeresurus stejnegeri are a common medical emergency in Taiwan that can be effectively treated by a bivalent F(ab'2 antivenom. We investigated the differences in the clinical outcomes of patients who received different therapeutic regimens of antivenom in a medical center where clinical toxicologists followed the poison control center (PCC guidelines (medical group and surgeons did not (surgical group. The medical records of inpatients with crotaline snakebites between 1991 and 2005 were reviewed and information on demographics, treatments, adverse effects of antivenom, and complications was abstracted and analyzed. A total of 179 patients (90 medical, 89 surgical were eligible for study. There was no significant intergroup difference in baseline characteristics except that the dose of antivenom and the probability of antibiotic use were both higher in the surgical group (5.9 ± 4.2 vials vs. 2.7 ± 1.6 vials; 93% vs. 60%. Multiple logistic regression adjusting for age, gender, calendar year of envenomation, severity of envenomation, and antibiotic use did not disclose evidence of any difference in various clinical outcomes between medical and surgical patients. The lower dose of antivenom recommended by the PCC may be as effective and safe as the higher dose used in the surgical group for the treatment of crotaline snakebites.

  11. Using secure web services to visualize poison center data for nationwide biosurveillance: a case study.

    Science.gov (United States)

    Savel, Thomas G; Bronstein, Alvin; Duck, William; Rhodes, M Barry; Lee, Brian; Stinn, John; Worthen, Katherine

    2010-01-01

    Real-time surveillance systems are valuable for timely response to public health emergencies. It has been challenging to leverage existing surveillance systems in state and local communities, and, using a centralized architecture, add new data sources and analytical capacity. Because this centralized model has proven to be difficult to maintain and enhance, the US Centers for Disease Control and Prevention (CDC) has been examining the ability to use a federated model based on secure web services architecture, with data stewardship remaining with the data provider. As a case study for this approach, the American Association of Poison Control Centers and the CDC extended an existing data warehouse via a secure web service, and shared aggregate clinical effects and case counts data by geographic region and time period. To visualize these data, CDC developed a web browser-based interface, Quicksilver, which leveraged the Google Maps API and Flot, a javascript plotting library. Two iterations of the NPDS web service were completed in 12 weeks. The visualization client, Quicksilver, was developed in four months. This implementation of web services combined with a visualization client represents incremental positive progress in transitioning national data sources like BioSense and NPDS to a federated data exchange model. Quicksilver effectively demonstrates how the use of secure web services in conjunction with a lightweight, rapidly deployed visualization client can easily integrate isolated data sources for biosurveillance.

  12. A controlled evaluation of case clinical effect coding by poison center specialists for detection of WMD scenarios.

    Science.gov (United States)

    Beuhler, Michael C; Wittler, Mary A; Ford, Marsha; Dulaney, Anna R

    2011-08-01

    Many public health entities employ computer-based syndromic surveillance to monitor for aberrations including possible exposures to weapons of mass destruction (WMD). Often, this is done by screening signs and symptoms reported for cases against syndromic definitions. Poison centers (PCs) may offer significant contributions to public health surveillance because of their detailed clinical effect data field coding and real-time data entry. Because improper clinical effect coding may impede syndromic surveillance, it is important to assess this accuracy for PCs. An AAPCC-certified regional PC assessed the accuracy of clinical effect coding by specialists in poison information (SPIs) listening to audio recordings of standard cases. Eighteen different standardized cases were used, consisting of six cyanide, six botulism, and six control cases. Cases were scripted to simulate clinically relevant telephone conversations and converted to audio recordings. Ten SPIs were randomly selected from the center's staff to listen to and code case information from the recorded cases. Kappa scores and the percentage of correctly coding a present clinical effect were calculated for individual clinical effects summed over all test cases along with corresponding 95% confidence intervals. The rate of the case coding by the SPIs triggering the PC's automated botulism and cyanide alerts was also determined. The kappa scores and the percentage of correctly coding a present clinical effect varied depending on the specific clinical effect, with greater accuracy observed for the clinical effects of vomiting and agitation/irritability, and poor accuracy observed for the clinical effects of visual defect and anion gap increase. Lack of correct coding resulted in only 60 and 86% of the cases that met the botulism and cyanide surveillance definitions, respectively, triggering the corresponding alert. There was no difference observed in the percentage of coding a present clinical effect between

  13. Pesticide-related poison center exposures in children and adolescents aged ≤19 years in Texas, 2000-2013.

    Science.gov (United States)

    Trueblood, Amber B; Forrester, Mathias B; Han, Daikwon; Shipp, Eva M; Cizmas, Leslie H

    2016-11-01

    Although national poison center data show that pesticides were the 8th most commonly reported substance category (3.27%) for children aged ≤5 years in 2014, there is limited information on childhood and adolescent pesticide exposures. This study assessed pesticide-related poison center exposures in children and adolescents aged ≤19 years from 2000-2013 in Texas to characterize the potential burden of pesticides. Pesticide-related poison center exposures among children and adolescents aged ≤19 years reported to Texas poison centers were identified. The distribution of exposures was estimated by gender, age category, medical outcome, management site, exposure route, and pesticide category. From 2000 to 2013, there were 61,147 pesticide-related poison center exposures in children and adolescents aged ≤19 years. The prevalence was highest among males at 864.24 per 100,000 population. The prevalence of unintentional exposures was highest among children aged ≤5 years at 2310.69 per 100,000 population, whereas the prevalence of intentional exposures was highest among adolescents aged 13-19 years at 13.82 per 100,000 population. A majority of medical outcomes reported were classified as having no effect (30.24%) and not followed, but minimal clinical effects possible (42.74%). Of all the exposures, 81.24% were managed on site. However, 57% of intentional exposures were referred to or treated at a health-care facility. The most common routes of exposure were ingestion (80.83%) and dermal (17.21%). The most common pesticide categories included rodenticides (30.02%), pyrethrins/pyrethroids (20.69%), and other and unspecified insecticides (18.14%). The study found differences in the frequency of exposures by intent for sex and age categories, and identified the most common medical outcomes, management site, exposure route, and pesticide category. Through characterizing pesticide-related poison center exposures, future interventions can be designed to address groups

  14. Experience based reliability centered maintenance

    International Nuclear Information System (INIS)

    Haenninen, S.; Laakso, K.

    1993-03-01

    The systematic analysis and documentation of operating experiences should be included in a living NPP life management program. Failure mode and effects and maintenance effects analyses are suitable methods for analysis of the failure and corrective maintenance experiences of equipment. Combined use of the information on occurred functional failures and the decision tree logic of the reliability centered maintenance identifies applicable and effective preventive maintenance tasks of equipment in an old plant. In this study the electrical motor drives of closing and isolation valves (MOV) of TVO and Loviisa nuclear power plants were selected to serve as pilot study objects. The study was limited to valve drives having actuators manufactured by AUMA in Germany. The fault and maintenance history of MOVs from 1981 up to and including October 1991 in different safety and process systems at TVO 1 and 2 nuclear power units was at first analyzed in a systematic way. The scope of the components studied was 81 MOVs in safety-related systems and 127 other MOVs per each TVO unit. In the case of the Loviisa plant, the observation period was limited to three years, i.e. from February 1989 up to February 1992. The scope of the Loviisa 1 and 2 components studied was 44 respectively 95 MOVs. (25 refs., 22 figs., 8 tabs.)

  15. Epidemiology of volatile substance abuse (VSA) cases reported to US poison centers.

    Science.gov (United States)

    Spiller, Henry A

    2004-01-01

    Volatile substance abuse (VSA) is believed to be widespread. The Toxic Exposure Surveillance System (TESS) of the American Association of Poison Control Systems offers an opportunity to evaluate the epidemiology of volatile substance abuse using a data set that captures data from a large geographic area covering a wide-ranging group of socioeconomic strata, ethnic groups, and demographics. To utilize this potential we analyzed a data set of TESS for the 6-year period of 1996 through 2001 involving all cases of intentional inhalational abuse of nonpharmaceutical substances. Over the study period there was a mean annual decline of 9% of reported VSA with an overall decline of 37% from 1996 to 2001. Volatile substance abuse was reported primarily in children, with 6358 cases (54%) in children 13-19 yr and 1803 (15%) cases in children 6-12 yr. Fifty-two cases were reported in children air fresheners (6%), and formalin (5%). Three categories were responsible for the majority of deaths: gasoline (45%), air fresheners (26%), and propane/butane (11%). While there was a decline in reported cases, there was no decline in major outcomes or fatalities. Volatile substance abuse was reported in all 50 states, with case distribution similar to population distribution. However, seven states had > 2 times the expected rate based on their population; three western states, two midwestern states, and two Appalachian states. The role of urban vs. rural population may possibly explain the difference in numbers, with a greater incidence of VSA cases reported in states with large rural populations. The mean monthly occurrence rate was 162 VSA cases/month (S.D. +/- 10.85). There were 4 months that were > 2 standard deviations from the mean, with two peak months (May, 192/month and March, 187/month) and two trough months (December, 126/month and January, 137/month). This report presents a broad picture of VSA in the United States. Volatile substance abuse, as reported to U.S. poison centers

  16. Characteristics and outcomes of e-cigarette exposure incidents reported to 10 European Poison Centers: a retrospective data analysis

    OpenAIRE

    Vardavas, Constantine I.; Girvalaki, Charis; Filippidis, Filippos T; Oder, Mare; Kastanje, Ruth; de Vries, Irma; Scholtens, Lies; Annas, Anita; Plackova, Silvia; Turk, Rajka; Gruzdyte, Laima; Rato, F?tima; Genser, Dieter; Schiel, Helmut; Bal?zs, Andrea

    2017-01-01

    BACKGROUND: The use of e-cigarettes has increased during the past few years. Exposure to e-cigarette liquids, whether intentional or accidental, may lead to adverse events our aim was to assess factors associated with e-cigarette exposures across European Union Member States (EU MS). METHODS: A retrospective analysis of exposures associated with e-cigarettes reported to national poison centers was performed covering incidents from 2012 to March 2015 from 10 EU MS. De-identified and anonymous ...

  17. Using Pill Identification Calls to Poison Centers as a Marker of Drug Abuse at Three Texas Military Bases.

    Science.gov (United States)

    Ng, Patrick C; Maddry, Joseph K; Sessions, Daniel; Borys, Douglas J; Bebarta, Vikhyat S

    2017-11-01

    Opioid abuse is a growing problem in civilian communities, and it has developed in the military as well. Telephone calls to poison centers requesting pill identification (ID) is a marker of drug abuse. This study identifies the number of pill ID calls made to the poison centers from areas containing and surrounding three Texas military bases during an 8-year period. We performed a retrospective observational study identifying calls to certified poison centers in Texas from 2002 to 2009 that identified hydrocodone tablets and other pain medications. We noted the calls made from ZIP codes containing and surrounding the three largest military bases in Texas. We reviewed 75,537 drug ID calls for any drug from the ZIP codes of interest. Total drug ID calls increased 105% and the number of calls for hydrocodone increased 463%. In our study most of the drug ID calls from military communities in Texas were for hydrocodone. The rate of calls for hydrocodone increased more than the rate of calls for other analgesics from 2002 to 2009. Using drug ID calls as a surrogate of drug abuse, our results suggest that hydrocodone abuse has increased within military communities and that poison center data can be a reliable surrogate for prescription drug abuse near military bases. Future studies are needed to further understand the extent of this problem in military and civilian communities. We can use this information to heighten awareness, influence prescription practices, establish practice guidelines, and develop educational programs to mitigate the increasing rate of prescription analgesic abuse in the United States.

  18. Syndrome surveillance of fentanyl-laced heroin outbreaks: Utilization of EMS, Medical Examiner and Poison Center databases.

    Science.gov (United States)

    Moore, P Quincy; Weber, Joseph; Cina, Steven; Aks, Steven

    2017-11-01

    Describe surveillance data from three existing surveillance systems during an unexpected fentanyl outbreak in a large metropolitan area. We performed a retrospective analysis of three data sets: Chicago Fire Department EMS, Cook County Medical Examiner, and Illinois Poison Center. Each included data from January 1, 2015 through December 31, 2015. EMS data included all EMS responses in Chicago, Illinois, for suspected opioid overdose in which naloxone was administered and EMS personnel documented other criteria indicative of opioid overdose. Medical Examiner data included all deaths in Cook County, Illinois, related to heroin, fentanyl or both. Illinois Poison Center data included all calls in Chicago, Illinois, related to fentanyl, heroin, and other prescription opioids. Descriptive statistics using Microsoft Excel® were used to analyze the data and create figures. We identified a spike in opioid-related EMS responses during an 11-day period from September 30-October 10, 2015. Medical Examiner data showed an increase in both fentanyl and mixed fentanyl/heroin related deaths during the months of September and October, 2015 (375% and 550% above the median, respectively.) Illinois Poison Center data showed no significant increase in heroin, fentanyl, or other opioid-related calls during September and October 2015. Our data suggests that EMS data is an effective real-time surveillance mechanism for changes in the rate of opioid overdoses. Medical Examiner's data was found to be valuable for confirmation of EMS surveillance data and identification of specific intoxicants. Poison Center data did not correlate with EMS or Medical Examiner data. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Occupational chemical exposures: a collaboration between the Georgia Poison Center and the Occupational Safety and Health Administration.

    Science.gov (United States)

    Tustin, Aaron W; Jones, Alison; Lopez, Gaylord P; Ketcham, Glenn R; Hodgson, Michael J

    2018-01-01

    In the United States, regional poison centers frequently receive calls about toxic workplace exposures. Most poison centers do not share call details routinely with governmental regulatory agencies. Worker health and safety could be enhanced if regulators such as the Occupational Safety and Health Administration (OSHA) had the ability to investigate these events and prevent similar incidents. With this goal in mind, the Georgia Poison Center (GPC) began referring occupational exposures to OSHA in July 2014. GPC began collecting additional employer details when handling occupational exposure calls. When workers granted permission, GPC forwarded call details to the OSHA Regional Office in Atlanta. These referrals enabled OSHA to initiate several investigations. We also analyzed all occupational exposures reported to GPC during the study period to characterize the events, detect violations of OSHA reporting requirements, and identify hazardous scenarios that could form the basis for future OSHA rulemaking or guidance. GPC was informed about 953 occupational exposures between 1 July, 2014 and 7 January, 2016. Workers were exposed to 217 unique substances, and 70.3% of victims received treatment in a healthcare facility. Hydrogen sulfide was responsible for the largest number of severe clinical effects. GPC obtained permission to refer 89 (9.3%) calls to OSHA. As a result of these referrals, OSHA conducted 39 investigations and cited 15 employers for "serious" violations. OSHA forwarded several other referrals to other regulatory agencies when OSHA did not have jurisdiction. At least one employer failed to comply with OSHA's new rule that mandates reporting of all work-related hospitalizations. This collaboration increased OSHA's awareness of dangerous job tasks including hydrofluoric acid exposure among auto detailers and carbon monoxide poisoning with indoor use of gasoline-powered tools. Collaboration with the GPC generated a useful source of referrals to OSHA. OSHA

  20. Neutronic performance of decoupled poisoned and unpoisoned composite moderators for high resolution experiments

    International Nuclear Information System (INIS)

    Kai, Tetsuya; Harada, Masahide; Watanabe, Noboru; Teshigawara, Makoto; Sakata, Hideaki; Ikeda, Yujiro

    2001-01-01

    We studied decoupled poisoned and un-poisoned composite moderators consisting of 20 mm thick hydrogen and 30 mm thick light water. The neutron pulses from un-poisoned one were much broader with longer decay times than a simple decoupled hydrogen moderator in 50 mm thickness. It was also found that the poisoned composite moderator provides higher pulse peak intensities relative to the hydrogen moderator (poisoned at 20 mm) below several tens meV with no penalty of pulse width. (author)

  1. Annual Report of Recorded Phone Calls to Iran's Drug and Poison Information Centers (2014-2015

    Directory of Open Access Journals (Sweden)

    Talat Ghane

    2015-09-01

    Conclusion: Iranian people seems to have numerous unmet drug information needs. This may especially be the case for antibiotics, nutrients and anti-depressants. Pharmaceutical products are the main subjects of poisoning-related calls to DPICs in Iran. Public education on usage, safety and storage of drugs as well as strict terms of sale should be implemented.

  2. Treatment strategies for early presenting acetaminophen overdose: a survey of medical directors of poison centers in North America and Europe.

    Science.gov (United States)

    Kozer, E; McGuigan, M

    2002-03-01

    Acetaminophen is frequently used in self-poisoning in Western countries. Although treatment with N-acetylcysteine (NAC) reduces liver injury, no consensus exists on the preferred management of acetaminophen toxicity. To describe the approach taken by toxicologists in North America and Europe toward the management of acetaminophen toxicity. Medical directors of poison centers in the US, Canada, and Europe were surveyed by means of a questionnaire presenting two clinical scenarios of acetaminophen overdose: a healthy adolescent with no risk factors who had an acute ingestion of acetaminophen, and an adult with both acute ingestion and possible risk factors. For each case, several questions about the management of these patients were asked. Questionnaires were sent to medical directors of 76 poison centers in North America and 48 in Europe, with response rates of 62% and 44%, respectively. Forty percent of responders suggested using charcoal 4 hours after ingestion of a potential toxic dose of acetaminophen, and 90% recommended treatment with NAC when levels were above 150 microg/mL but below 200 microg/mL 4 hours after ingestion. Duration of treatment with oral NAC ranged from 24 to 96 hours; 38 responders suggested a duration of 72 hours. Of 49 centers recommending oral NAC, 18 (36.7%) said they might consider treatment for less than 72 hours. Eleven of 29 (37.9%) responders suggested treatment with intravenous NAC for more than 20 hours as their usual protocol or a protocol for specific circumstances. Our study showed large variability in the management of acetaminophen overdose. Variations in treatment protocols should be addressed in clinical trials to optimize the treatment for this common problem.

  3. The Beneficial Auxiliary Role of Poison Information Centers: Stewardly Use of Rabies Post-Exposure Prophylaxis in a Time of Shortage

    Directory of Open Access Journals (Sweden)

    Rachel Gorodetsky

    2012-12-01

    Full Text Available Background: During the one-year period from May 2008 to May 2009, a nationwide shortage developed which rabies vaccine was not being produced by the manufacturers. In order to manage existing supply, a protocol was established wherein an authorization was required from the regional poison center before vaccine could be administered to a patient. Methods: The Georgia Poison Center internal database was accessed for information pertaining to rabies exposure calls for the time of the restriction, as well as the years before and after. Results were examined for the total number of human rabies exposure calls received by the poison center, as well as the number of cases in which PEP was recommended.  Results: During the restriction period, the number of rabies-related calls increased, while the percentage of cases in which PEP was recommended, remained consistent. The year following the restriction, the number of rabies related calls remained elevated. Conclusion: Our Regional Poison Center was able to make a positive impact by reducing unnecessary use of PEP in a time of shortage and thereby ensuring that all patients who needed the vaccine were able to receive it. This further shows the potential capacity of the poison information centers to optimize healthcare services.  

  4. [Electronic poison information management system].

    Science.gov (United States)

    Kabata, Piotr; Waldman, Wojciech; Kaletha, Krystian; Sein Anand, Jacek

    2013-01-01

    We describe deployment of electronic toxicological information database in poison control center of Pomeranian Center of Toxicology. System was based on Google Apps technology, by Google Inc., using electronic, web-based forms and data tables. During first 6 months from system deployment, we used it to archive 1471 poisoning cases, prepare monthly poisoning reports and facilitate statistical analysis of data. Electronic database usage made Poison Center work much easier.

  5. Energy drink exposures reported to Texas poison centers: Analysis of adverse incidents in relation to total sales, 2010-2014.

    Science.gov (United States)

    Borron, Stephen W; Watts, Susan H; Herrera, Jessica; Larson, Joshua; Baeza, Salvador; Kingston, Richard L

    2018-05-21

    The ill-defined term "energy drink" includes a disparate group of products (beverages, shots, concentrates, and workout powders) having large differences in caffeine content and concentration and intended use. Hence, inaccurate conclusions may be drawn when describing adverse events associated with "energy drinks". The FDA is considering new regulation of these products but product specificity is needed to evaluate safety. To help address this, we queried Texas Poison Center Network data for single substance exposures to "energy drinks" from 2010 to 2014, then analyzed adverse events by product type. We specifically compared energy beverage exposures with sales data for the same time period to evaluate the safety profile of this category of energy drinks. Among 855 documented "energy drink" exposures, poison center-determined outcome severity revealed 291 with no/minimal effects, 417 judged nontoxic or minor/not followed, 64 moderate and 4 major effects, and no deaths. Serious complications included 2 seizures and 1 episode of ventricular tachycardia. Outcome severity by category for beverages: 11 moderate/1 major effects (none in children energy drinks". Copyright © 2018 Elsevier Inc. All rights reserved.

  6. Poisoning - Multiple Languages

    Science.gov (United States)

    ... Well-Being 6 - Poison Safety - Amarɨñña / አማርኛ (Amharic) MP3 Siloam Family Health Center Arabic (العربية) Expand Section ... Well-Being 6 - Poison Safety - myanma bhasa (Burmese) MP3 Siloam Family Health Center Dari (دری) Expand Section ...

  7. Frequency of Poison Center Exposures for Pediatric Accidental Unsupervised Ingestions of Acetaminophen after the Introduction of Flow Restrictors.

    Science.gov (United States)

    Brass, Eric P; Reynolds, Kate M; Burnham, Randy I; Green, Jody L

    2018-04-02

    To assess the temporal association of flow restrictor introduction and the rate of accidental unsupervised ingestions (AUIs) of liquid acetaminophen products. The National Poison Data System was used to identify AUIs of single ingredient acetaminophen in patients aged poison centers obtained additional information using a structured telephone survey. Pediatric AUIs involving acetaminophen averaged 30 000 exposures per year between 2007 and 2012. From 2012 to 2015, after flow restrictor introduction, exposures steadily decreased at a rate of 2400 fewer exposures annually, reaching 21 877 exposures in 2015. Normalized to sales volume, exposures involving liquid acetaminophen products decreased by 40% from 2010 to 2015. Exposures involving products with flow restrictors tended to have a lower estimated ingestion per exposure, fewer exposures exceeding a 150 mg/kg acetaminophen threshold, and were associated with lower rates of hospital admissions when compared with products without restrictors. Caregivers reported improper storage and child confusion of the medicine with treats as common contributing factors to exposures. The introduction of flow restrictors was associated with a decrease in pediatric AUIs of liquid acetaminophen products. Decreases in the dose ingested and risk of hospital admission per exposure may also have resulted. Efforts to optimize flow restrictors and increase their use with medicines associated with high pediatric overdose risk should be encouraged. Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.

  8. The value of a poison control center in preventing unnecessary ED visits and hospital charges: A multi-year analysis.

    Science.gov (United States)

    Tak, Casey R; Malheiro, Marty C; Bennett, Heather K W; Crouch, Barbara I

    2017-03-01

    The purpose of this study is to determine the economic value of the Utah Poison Control Center (UPCC) by examining its contribution to the reduction of unnecessary emergency department (ED) visits and associated charges across multiple years. A multi-year (2009-2014) analysis of cross-sectional data was performed. Callers were asked what they would do for a poison emergency if the UPCC was not available. Healthcare charges for ED visits averted were calculated according to insurance status using charges obtained from a statewide database. Of the 10,656 survey attempts, 5018 were completed. Over 30,000 cases were managed on-site each year. Using the proportion of callers who noted they would call 911, visit an ED, or call a physician's office, between 20.0 and 24.2 thousand ED visits were potentially prevented each year of the survey. Between $16.6 and $24.4 million dollars in unnecessary healthcare charges were potentially averted annually. Compared to the cost of operation, the service UPCC provides demonstrates economic value by reducing ED visits and associated charges. As the majority of patients have private insurance, the largest benefit falls to private payers. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Near-Real-Time Surveillance of Illnesses Related to Shellfish Consumption in British Columbia: Analysis of Poison Center Data.

    Science.gov (United States)

    Wan, Victoria; McIntyre, Lorraine; Kent, Debra; Leong, Dennis; Henderson, Sarah B

    2018-02-23

    Data from poison centers have the potential to be valuable for public health surveillance of long-term trends, short-term aberrations from those trends, and poisonings occurring in near-real-time. This information can enable long-term prevention via programs and policies and short-term control via immediate public health response. Over the past decade, there has been an increasing use of poison control data for surveillance in the United States, Europe, and New Zealand, but this resource still remains widely underused. The British Columbia (BC) Drug and Poison Information Centre (DPIC) is one of five such services in Canada, and it is the only one nested within a public health agency. This study aimed to demonstrate how DPIC data are used for routine public health surveillance in near-real-time using the case study of its alerting system for illness related to consumption of shellfish (ASIRCS). Every hour, a connection is opened between the WBM software Visual Dotlab Enterprise, which holds the DPIC database, and the R statistical computing environment. This platform is used to extract, clean, and merge all necessary raw data tables into a single data file. ASIRCS automatically and retrospectively scans a 24-hour window within the data file for new cases related to illnesses from shellfish consumption. Detected cases are queried using a list of attributes: the caller location, exposure type, reasons for the exposure, and a list of keywords searched in the clinical notes. The alert generates a report that is tailored to the needs of food safety specialists, who then assess and respond to detected cases. The ASIRCS system alerted on 79 cases between January 2015 and December 2016, and retrospective analysis found 11 cases that were missed. All cases were reviewed by food safety specialists, and 58% (46/79) were referred to designated regional health authority contacts for follow-up. Of the 42% (33/79) cases that were not referred to health authorities, some were

  10. Understanding abuse of buprenorphine/naloxone film versus tablet products using data from ASI-MV® substance use disorder treatment centers and RADARS® System Poison Centers.

    Science.gov (United States)

    Butler, Stephen F; Black, Ryan A; Severtson, Stevan Geoffrey; Dart, Richard C; Green, Jody L

    2018-01-01

    The objectives were to examine the abuse prevalence and route-of-administration (ROA) profiles of sublingual buprenorphine/naloxone combination (BNX) film in comparison with the BNX tablet and to identify clinically-relevant subgroups of patients or geographic patterns. Between Q1 2015 through Q3 2015, data were collected from two major surveillance systems: (1) assessment of individuals in substance use disorder (SUD) treatment collected from the National Addictions Vigilance Intervention and Prevention Program (NAVIPPRO®) ASI-MV® system and (2) intentional abuse/misuse exposures in the RADARS® System Poison Center Program. Poisson regression models were tailored to each system's data characteristics by population (all SUD treatment patients, US census) and adjusted for prescription volume. Effects of gender, race, age and US region as well as ROA profile were examined. For the ASI-MV study, 45,695 assessments of unique adults evaluated for substance use problems were collected. The abuse rate unadjusted for prescription volume of BNX tablet formulation was 2.64 cases/100 ASI-MV respondents versus 7.01 cases for the film formulation (RR=0.390, pfilm) (RR=1.25, pfilm abuse (0.0364) were greater than for tablet (0.0161), while prescription-adjusted rates were greater for tablet (0.2114) than for film (0.1703) per 100,000 prescriptions. ASI-MV ROA analyses indicated less abuse of the film by any alternate route, insufflation or injection than the tablet. Poison center data found more injection of tablets than film, although insufflation was not significantly different. On a prescription-adjusted basis, overall abuse of the BNX tablet is greater than that of the sublingual film formulation. For those who continue to abuse BNX, use by alternate ROAs was, in general, lower for the film. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Dieffenbachia poisoning

    Science.gov (United States)

    Dumbcane poisoning; Leopard lily poisoning; Tuft root poisoning ... Get the following information: Person's age, weight, and condition Parts of the plant that were eaten, if known Time swallowed Amount swallowed

  12. Burnable poisons in the light water reactor design, microburnup experiments and calculations. Part of a coordinated programme on burnup calculations and experiments for thermal reactors

    International Nuclear Information System (INIS)

    Penndorf, K.

    1976-04-01

    Investigations on Research Agreement N 1519/CF (1.8.1974 - 31.7.1975) entitled ''Burnable poisons in light water reactor design, microburnup experiments and calculations'' were carried out in the frame of the IAEA's coordinated research programme on ''Burn-up calculation and experiments for thermal reactors''. The theoretical and experimental work on application of solid burnable poison used for reduction of the amount of boric acid necessary to control of PWR or to lower the number of control rods needed in a BWR. Solid burnable poisons are needed in present PWR designs for the reduction of the boron acid concentration in order to prevent positive coefficients of reactivity. The special operational conditions of a ship reactor lead to the application of this kind of poison for compensation of almost all burnup reactivity. This strengthens the necessity of a very accurate and many dimensional calculations because an appropriate binding of reactivity has to be kept over the whole cycle time. Several burnup experiments had been run in the 15 MW material test reactor FRG-II. The following devices have been irradiated: poison pins within and without PWR fuel pin lattice segments and fuel pins containing pellets with a poison core. Measurements of reactivity, fluence, fission product concentration have been performed. Methods applied were γ-scanning and neutron pulse, radiography and transmission measurement techniques. Evaluation of the experiments was done by one and two dimensional Ssub(N) transport burnup calculations. In parallel a collision probability transport burnup code for current PWR design work is being developed, the main feature of which is economy in manpower and computer time

  13. An Increase in Dietary Supplement Exposures Reported to US Poison Control Centers.

    Science.gov (United States)

    Rao, Nisha; Spiller, Henry A; Hodges, Nichole L; Chounthirath, Thiphalak; Casavant, Marcel J; Kamboj, Amrit K; Smith, Gary A

    2017-09-01

    The objective of this study was to investigate the epidemiology of dietary supplement exposures in the USA. A retrospective analysis was conducted of out-of-hospital dietary supplement exposures reported to the National Poison Data System from 2000 through 2012. There were 274,998 dietary supplement exposures from 2000 through 2012. The annual rate of dietary supplement exposures per 100,000 population increased by 46.1% during 2000-2002, decreased 8.8% during 2002-2005, and then increased again by 49.3% from 2005 to 2012. These trends were influenced by the decrease in ma huang exposures starting in 2002. Miscellaneous dietary supplements accounted for 43.9% of all exposures, followed by botanicals (31.9%), hormonal products (15.1%), and other supplements (5.1%). The majority of dietary supplement exposures (70.0%) occurred among children younger than 6 years old and were acute (94.0%) and unintentional (82.9%). Serious medical outcomes accounted for 4.5% of exposures and most (95.0%) occurred among individuals 6 years and older. Ma huang products, yohimbe, and energy products were the categories associated with the greatest toxicity. There was an overall increase in the rate of dietary supplement exposures from 2000 through 2012. Although the majority of these exposures did not require treatment at a health care facility or result in serious medical outcomes, exposures to yohimbe and energy products were associated with considerable toxicity. Our results demonstrate the success of the FDA ban on ma huang products and the need for FDA regulation of yohimbe and energy products in the USA.

  14. Shiitake dermatitis recorded by French Poison Control Centers - new case series with clinical observations.

    Science.gov (United States)

    Boels, D; Landreau, A; Bruneau, C; Garnier, R; Pulce, C; Labadie, M; de Haro, L; Harry, P

    2014-07-01

    Shiitake (Lentinula edodes) is an edible mushroom which was initially grown in Japan and China and is now sold on the European market. Flagellate erythema may arise following shiitake consumption and was first described in Japan in 1974. This paper reports a French shiitake dermatitis case series. The findings of retrospective study of shiitake dermatitis cases, reported to French Poison Control Centres (PCC) from January 2000 to December 2013, are reported. Among 32 exposed patients, 15 presented flagellate urticarial lesions after raw shiitake consumption. The first case of this series was reported in 2006 and the last nine cases were reported as of 2012. After shared meals, no symptoms were reported among guests, who preferred cooked shiitake to the raw mushroom. In this series, rashes appeared 12 h to 5 days (median: 24 h) after raw shiitake ingestion. Linear and itchy urticarial lesions formed on the trunk, arms, and legs within a few hours and persisted for 3-21 days. In four cases, rash and pruritus were either triggered or worsened by sun exposure. Eleven patients received corticosteroids, antihistamines, or both. All patients completely recovered. Due to the rapidly increasing consumption of exotic food in Western countries, it is no surprise that cases of shiitake dermatitis are now appearing in Europe. The mechanism of shiitake dermatitis is thought to be toxic and due to lentinan, a polysaccharide component of the mushroom. There is no specific validated treatment for shiitake dermatitis. Health professionals and the general population should be aware of both the risk associated with raw shiitake consumption and of the good prognosis of this very spectacular and uncomfortable toxic dermatitis.

  15. Drug overdosage and other poisoning in Hong Kong--the Prince of Wales Hospital (Shatin) experience.

    Science.gov (United States)

    Chan, T Y; Critchley, J A; Chan, M T; Yu, C M

    1994-07-01

    From 1988 to 1991, 732 patients (91.1% Chinese) were admitted to four general medical wards at the Prince of Wales Hospital in Hong Kong with acute poisoning. The patients were predominantly female (68.9%) and relatively young (86.3% below the age of 40). Further analysis of 655 patients indicates that the vast majority of patients (96%) were admitted after self-poisoning with drugs or chemicals while 4% of cases were due to accidental poisoning. The main agents used by the former group included hypnotics/sedatives (33.1%), household products (15.7%), and analgesics (13.7%). There were nine deaths (1.4%). When compared to other Western countries, two important variations in the pattern of acute poisoning were seen. A substantial proportion of drugs ingested by our patients were not precisely identified. 'Dettol', a household product, was commonly used for self-poisoning in Hong Kong. Territory-wide studies of longer duration are needed to provide the physicians in Hong Kong with much needed information on the incidence and the pattern of acute poisoning.

  16. Snakebites notified to the poison control center of Morocco between 2009 and 2013.

    Science.gov (United States)

    Chafiq, Fouad; El Hattimy, Faiçal; Rhalem, Naima; Chippaux, Jean-Philippe; Soulaymani, Abdelmajid; Mokhtari, Abdelrhani; Soulaymani-Bencheikh, Rachida

    2016-01-01

    Snakebites cause considerable death and injury throughout the globe, particularly in tropical regions, and pose an important yet neglected threat to public health. In 2008, the Centre Anti Poison et de Parmacovigilance du Maroc (CAPM) started to set up a specific strategy for the control of snakebites that was formalized in 2012. The aim of the present study is to describe and update the epidemiological characteristics of snakebites notified to CAPM between 2009 and 2013. This retrospective five-year study included all cases of snakebites notified to CAPM by mail or phone. During the study period, 873 snakebite cases were reported to CAPM, an average incidence of 2.65 cases per 100,000 inhabitants with 218 cases each year. The highest incidence was found in Tangier-Tetouan region with 357 cases (40.9 %) followed by Souss Massa Draa region with 128 cases (14.6 %). The average age of patients was 26.8 ± 17.2 years. The male to female sex ratio was 1.67:1 and 77 % of cases occurred in rural areas. The bites occurred mainly in spring (44 %) followed by summer (42 %). Snake species was identified in 54 cases (6.2 %): colubrids represented 31 % (n = 18) and vipers 67 % (n = 36), mainly Daboia mauritanica, Bitis arietans and Cerastes cerastes. In 311 cases (35.6 %), the patients showed viper syndrome. Thrombocytopenia was observed in 23.5 % of viper syndrome cases, whereas, compartment syndrome was observed in 7.6 % patients. FAV-Afrique® was administered in 41 patients (5 %). In patients treated with antivenom, 38 patients recovered and three died. Twenty-seven deaths were reported (3.9 %). Despite specific efforts to better understand the epidemiology of snakebites in Morocco (incidence, severity, snake species involved), it remains underestimated. Therefore, further work is still necessary to ensure accessibility of appropriate antivenom against venomous species and to improve the management of envenomation in Morocco.

  17. Analysis of Phone Calls Regarding Fluoride Exposure made to New Jersey Poison Control Center from 2010 to 2012.

    Science.gov (United States)

    Shah, Sneha; Quek, Samuel; Ruck, Bruce

    2016-02-01

    The American Association of Poison Control Center's annual reports demonstrate that acute fluoride exposure is not an uncommon occurrence. Despite its prevalence, there has been little published research on the topic in the last 10 years. The purpose of this study was to calculate the incidence of acute fluoride toxicity and lethality as it occurs in New Jersey and provide a descriptive epidemiology of acute fluoride exposures. The study design was retrospective in nature. Records of phone calls made by individuals reporting excessive fluoride exposure (in an amount greater than directed/prescribed) to New Jersey's poison control center, known as Poison Information and Education System from the years 2010 through 2012, were extracted from Toxicall® (Computer Automatic Systems, Inc.) database. A total of 2,476 human-only exposure records met the inclusion criteria and were analyzed. Incidence rates were calculated, and population characteristics, circumstances and medical outcomes of acute fluoride exposure cases were assessed and categorized. A total of 2,476 phone call records met the inclusion criteria. The fluoride exposures reported were from toothpaste with fluoride (49%, n=1,214), mouth rinse with fluoride (21.6%, n=536), multivitamin with fluoride (21.4%, n=530) and pure fluoride (0.08%, n=199). Medically speaking, 94.75% of calls were asymptomatic cases (n=2,346), 4.24% were symptomatic (n=105) and 1.01% were informational inquiries (n=25). Adverse symptoms reported were mostly minor (83.9% of symptomatic cases, n=88) and moderate (16.1% of symptomatic cases, n=17). The age group 18 months to 3 years of age showed the highest incidence of acute fluoride exposure (53.2%, n=1,317). There was a slightly higher incidence of acute fluoride exposures among males (n=1,317) vs. females (n=1,159). Most incidences occurred in the home (93.1% of records, n=2,305) and occurred unintentionally (96.7%, n=2,394). Calls were mainly made by the subject's mother (67.5%, n=1

  18. Notes from the field: calls to poison centers for exposures to electronic cigarettes--United States, September 2010-February 2014.

    Science.gov (United States)

    Chatham-Stephens, Kevin; Law, Royal; Taylor, Ethel; Melstrom, Paul; Bunnell, Rebecca; Wang, Baoguang; Apelberg, Benjamin; Schier, Joshua G

    2014-04-04

    Electronic nicotine delivery devices such as electronic cigarettes (e-cigarettes) are battery-powered devices that deliver nicotine, flavorings (e.g., fruit, mint, and chocolate), and other chemicals via an inhaled aerosol. E-cigarettes that are marketed without a therapeutic claim by the product manufacturer are currently not regulated by the Food and Drug Administration (FDA). In many states, there are no restrictions on the sale of e-cigarettes to minors. Although e-cigarette use is increasing among U.S. adolescents and adults, its overall impact on public health remains unclear. One area of concern is the potential of e-cigarettes to cause acute nicotine toxicity. To assess the frequency of exposures to e-cigarettes and characterize the reported adverse health effects associated with e-cigarettes, CDC analyzed data on calls to U.S. poison centers (PCs) about human exposures to e-cigarettes (exposure calls) for the period September 2010 (when new, unique codes were added specifically for capturing e-cigarette calls) through February 2014. To provide a comparison to a conventional product with known toxicity, the number and characteristics of e-cigarette exposure calls were compared with those of conventional tobacco cigarette exposure calls.

  19. Patterns and Trends in Accidental Poisoning Deaths: Pennsylvania's Experience 1979-2014.

    Directory of Open Access Journals (Sweden)

    Lauren C Balmert

    Full Text Available The purpose of this study was to examine county and state-level accidental poisoning mortality trends in Pennsylvania from 1979 to 2014.Crude and age-adjusted death rates were formed for age group, race, sex, and county for accidental poisonings (ICD 10 codes X40-X49 from 1979 to 2014 for ages 15+ using the Mortality and Population Data System housed at the University of Pittsburgh. Rate ratios were calculated comparing rates from 1979 to 2014, overall and by sex, age group, and race. Joinpoint regression was used to detect statistically significant changes in trends of age-adjusted mortality rates.Rate ratios for accidental poisoning mortality in Pennsylvania increased more than 14-fold from 1979 to 2014. The largest rate ratios were among 35-44 year olds, females, and White adults. The highest accidental poisoning mortality rates were found in the counties of Southwestern Pennsylvania, those surrounding Philadelphia, and those in Northeast Pennsylvania near Scranton.The patterns and locations of accidental poisoning mortality by race, sex, and age group provide direction for interventions and policy makers. In particular, this study found the highest rate ratios in PA among females, whites, and the age group 35-44.

  20. Laparoscopic isthmocele treatment - single center experience.

    Science.gov (United States)

    Ciebiera, Michał; Ciebiera, Magdalena; Czekańska-Rawska, Magdalena; Jakiel, Grzegorz

    2017-01-01

    A cesarean section is the most frequently performed surgery in modern obstetrics. In case of an incorrect wound healing process there is a risk of a persistent uterine wall defect. Nowadays, due to the high frequency of cesarean sections, obstetricians have to deal with the threat of uterine rupture due to pathological wound healing. It has been proven that isthmocele can cause abnormal uterine bleeding (AUB), pelvic pain (PP), and secondary infertility (SI), and can be a place of improper pregnancy placement. This article presents our experience with isthmocele treatment. We describe our diagnostic process scheme, method of corrective surgery and main therapeutic outcomes. In this manuscript we present a single center's experience in isthmocele therapy. We have operated on 16 patients who suffered from abnormal uterine bleeding, pain disorders or secondary infertility possibly due to a cesarean scar defect. The results obtained in our center are promising. In 9 of 11 (81.8%) women with abnormal bleeding we obtained complete resolution of symptoms. We had slightly worse results in the case of pelvic pain. In 4 (66.6%) of 6 patients the pain resolved completely. We have obtained 7 pregnancies in 11 (63.6%) patients operated on due to secondary infertility. In our opinion, laparoscopic treatment seems to be currently one of the most effective methods in isthmocele therapy. Further investigation is necessary to determine the indications for surgery, suitable treatment strategies and appropriate care.

  1. Poison control services in China

    International Nuclear Information System (INIS)

    Wu Yiqun; Sun Chengye

    2004-01-01

    The following aspects are discussed: the public health problems of acute poisoning in China in recent years; the characteristics of acute poisoning; the negative effects of poison cases on the society and economy. The four stages of development of a poison control system in China are: (1) clinical hospital as the only facility used for detoxification; (2) institutes and hospitals of occupational medicine got involved in the program; (3) the traditional model of poison control changed to the modern National Poison Control Center (NPCC), and its network got established and it began to play a key role; (4) establishment of a multi-disciplinary network for dealing with emergencies in which chemical poison control is an important component. Introduction of the operations of the NPCC: the functions of the center are a 24 h hotline service, clinical consultants service, poison identification and diagnosis, laboratory analysis, education for public, training for physicians, coordination of anti-dotes, and the development of a network of poison control centers for dealing with chemical emergencies. The work practice and achievement of NPCC and its network in the field of poison control during the last 3 years is discussed. Lessons from SARS infection: to extend the network, to strengthen multi-disciplinary cooperation, enhance communication between centers, to pay attention to capacity building, to improve reporting systems, and to share resources

  2. Review of Eastern coral snake (Micrurus fulvius fulvius) exposures managed by the Florida Poison Information Center Network: 1998-2010.

    Science.gov (United States)

    Wood, A; Schauben, J; Thundiyil, J; Kunisaki, T; Sollee, D; Lewis-Younger, C; Bernstein, J; Weisman, R

    2013-01-01

    Envenomation by the Eastern coral snake is rare but may be associated with significant morbidity. While effective, acquisition of North American Coral Snake Antivenin (NACSAV) is difficult because production was discontinued for many years. The purpose of this study is to characterize coral snake exposures in Florida and determine the effects of varying treatment paradigms on patient outcomes. This study is an observational case series of cases received at Florida poison centers. Included cases were Eastern coral snake exposures occurring between January 1, 1998 and October 31, 2010. Excluded cases included those found to be unrelated or those not followed for at least 24 h post envenomation. Case comments were reviewed to obtain data. Comparisons were made between asymptomatic patients receiving empiric antivenom therapy (empiric group) and those asymptomatic patients who received antivenom upon developing signs of systemic envenomation (withhold group). Of the 553 cases identified, 387 were included in the final analysis. According to case comments, 56.3% of patients had no reported systemic symptoms. Most commonly, patients were reported to have pain (40.6%), paresthesias (28.4%), nausea (12.7%), and emesis (11.4%). NACSAV was administered to 252 patients (65%). Of those patients receiving NACSAV, 18.25% were reported to have had an adverse reaction. Patients in the withhold group (n = 106) had significantly fewer minor, moderate, and major outcomes than patients in the empiric group (n = 134, p < 0.01). While patients in the withhold group had favorable outcomes compared with those in the empiric group, this strategy cannot be applied to all patients presenting asymptomatic to healthcare facilities due to study limitations. Further studies are needed to determine what treatment strategy is most appropriate for asymptomatic patients presenting to healthcare facilities.

  3. Airline experience with reliability-centered maintenance

    International Nuclear Information System (INIS)

    Matteson, T.D.

    1985-01-01

    Reliability-Centered Maintenance is a process for developing preventive maintenance programs. Its concepts evolved from the post WWII experience of the airline community. Its genesis was in a paper by F. Stanley Nowlan and Thomas D. Matteson of United Airlines for the American Institute of Aeronautics and Astronautics in 1967. Its first application was to the Boeing 747. It has subsequently been adopted by the FAA and the Department of Defense and applied to many new transport and military aircraft. Its objective is applicable and effective preventive maintenance and it has proven to be a highly effective replacement for the prior intuitive processes for selective preventive maintenance tasks. It focuses on system functions, functional failures, then dominant failure modes and effects. It then uses a decision tree to classify failure criticality and identify applicable and effective tasks. The result is a program focused on maintaining inherent safety and reliability at minimum cost. (orig.)

  4. Airline experience with reliability-centered maintenance

    Energy Technology Data Exchange (ETDEWEB)

    Matteson, T.D.

    1985-11-01

    Reliability-Centered Maintenance is a process for developing preventive maintenance programs. Its concepts evolved from the post WWII experience of the airline community. Its genesis was in a paper by F. Stanley Nowlan and Thomas D. Matteson of United Airlines for the American Institute of Aeronautics and Astronautics in 1967. Its first application was to the Boeing 747. It has subsequently been adopted by the FAA and the Department of Defense and applied to many new transport and military aircraft. Its objective is applicable and effective preventive maintenance and it has proven to be a highly effective replacement for the prior intuitive processes for selective preventive maintenance tasks. It focuses on system functions, functional failures, then dominant failure modes and effects. It then uses a decision tree to classify failure criticality and identify applicable and effective tasks. The result is a program focused on maintaining inherent safety and reliability at minimum cost. (orig.).

  5. Merthiolate poisoning

    Science.gov (United States)

    Merthiolate poisoning is difficult to treat. How well a person does depends on the amount of poison swallowed and how quickly treatment was received. The faster a person gets medical help, the better the chance for recovery. Kidney dialysis ( ...

  6. Benzene poisoning

    Science.gov (United States)

    ... may be admitted to the hospital if the poisoning is severe. ... benzene they swallowed and how quickly they receive treatment. The ... Poisoning can cause rapid death. However, deaths have occurred ...

  7. Malathion poisoning

    Science.gov (United States)

    ... Prolonged treatment often is needed to reverse the poisoning. This may include staying in the hospital intensive care unit and getting long-term therapy. Some effects of the poison may last for ...

  8. Diazinon poisoning

    Science.gov (United States)

    ... Prolonged treatment often is needed to reverse the poisoning. This may include staying in the hospital intensive care unit and getting long-term therapy. Some effects of the poison may last for ...

  9. Five years of poisons information on the internet: the UK experience of TOXBASE.

    Science.gov (United States)

    Bateman, D N; Good, A M

    2006-08-01

    In 1999, the UK adopted a policy of using TOXBASE, an internet service available free to registered National Health Service (NHS) departments and professionals, as the first point of information on poisoning. This was the first use worldwide of the internet for provision of clinical advice at a national level. We report the impact on database usage and NPIS telephone call loads. Trends in the pattern of TOXBASE usage from 2000-2004 are reported by user category. Information on the monographs accessed most frequently was also extracted from the webserver and sorted by user category. The numbers of telephone calls to the National Poisons Information Service (NPIS) were extracted from NPIS annual reports. Numbers of database logons increased 3.5 fold from 102,352 in 2000 to 368,079 in 2004, with a total of 789,295 accesses to product monographs in 2004. Registered users increased almost tenfold, with approximately half accessing the database at least once a year. Telephone calls to the NPIS dropped by over half. Total contacts with NPIS (web and telephone) increased 50%. Major users in 2004 were hospital emergency departments (60.5% of logons) and NHS public access helplines (NHS Direct and NHS24) (29.4%). Different user groups access different parts of the database. Emergency departments access printable fact sheets for about 10% of monographs they access. Provision of poisons information by the internet has been successful in reducing NPIS call loads. Provision of basic poisons information by this method appears to be acceptable to different professional groups, and to be effective in reducing telephone call loads and increasing service cost effectiveness.

  10. Suicidal Death due to Organophosphorus Compound Poisoning ─ an Experience of 67 Cases

    Directory of Open Access Journals (Sweden)

    Nashid Tabassum Khan

    2016-05-01

    Full Text Available Background: Bangladesh is an agro-based country. Suicide by agrochemical compounds are increasing day by day in this country. Organophosphorus compounds (OPC are commonly used for suicide. Mostly these are used for suicidal purpose in rural areas in our country due to low cost, toxicity and availability. Objective: To find out the relationship of age and sex variation along with the causes that influenced different income group people to ingest OPC for committing suicide. Materials and Methods: This study was conducted in the Department of Forensic Medicine, Dhaka Medical College during January to December 2010. Data were collected at the time of autopsy and from postmortem examination report of viscera. Viscera were preserved and sent to the Chief Chemical Examiner’s Office, Dhaka for toxicological analysis. Results: In this study, middle aged subjects (20–30 years were found to commit suicide using OPC in comparison to other age groups. Among the cases male were 57% and female 43%. Poverty was found as the most common cause (20% of OPC poisoning. Conclusion: Poverty is the leading cause of death of OPC poisoning followed by failure in love and adultery. Business failure, unhappiness in conjugal life, demand for dowry and violence against women are other causes to commit suicide by OPC.

  11. [Toxicological consultation data management system based on experience of Pomeranian Center of Toxicology].

    Science.gov (United States)

    Kabata, Piotr Maciej; Waldman, Wojciech; Sein Anand, Jacek

    2015-01-01

    In this paper the structure of poisonings is described, based on the material collected from tele-toxicology consults by the Pomeranian Center of Toxicology in Gdańsk and harvested from its Electronic Poison Information Management System. In addition, we analyzed conclusions drawn from a 27-month operation of the system. Data were harvested from the Electronic Poison Information Management System developed in 2012 and used by the Pomeranian Center of Toxicology since then. The research was based on 2550 tele-toxicology consults between January 1 and December 31, 2014. Subsequently the data were electronically cleaned and presented using R programming language. The Pomeranian voivodeship was the prevalent localisation of calls (N = 1879; 73.7%). Most of the calls came from emergency rooms (N = 1495; 58.63%). In the case of 1396 (54.7%) patients the time-lag between intoxication and the consult was less than 6 h. There were no differences in the age distribution between genders. Mean age was 26.3 years. Young people predominated among intoxicated individuals. The majority of intoxications were incidental (N = 888; 34.8%) or suicidal (N = 814; 31.9%) and the most of them took place in the patient's home. Information about Poison Control Center consultations access should be better spread among medical service providers. The extent of poison information collected by Polish Poison Control Centers should be limited and unified. This should contribute to the increased percentage of properly documented consultations. Additional duties stemming from the need of digital archiving of consults provided, require the involvement of additional staff, leading to the increased operation costs incurred by Poison Control Centers. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  12. Is Your Child Safe from Lead Poisoning?

    Centers for Disease Control (CDC) Podcasts

    2008-10-02

    In this podcast, Dr. Mary Jean Brown, chief of CDC's Lead Poisoning and Prevention Program, discusses the importance of testing children for lead poisoning, who should be tested, and what parents can do to prevent lead poisoning.  Created: 10/2/2008 by National Center for Environmental Health (NCEH).   Date Released: 10/2/2008.

  13. The Renewal Center: Time, Experience, Memory

    OpenAIRE

    Tennant, Mark

    2005-01-01

    Time, Experience, Memory Through experience we are conscious of time. Through time, our experiences become memories, influencing both conscious and unconscious thought. It is through our five senses; touch, sight, hearing, smell and taste, that these experiences are gathered. Humans are also born with inherent knowledge that our species has collected from generation to generation. This inherent knowledge, also called the collective unconscious, has a direct effect on the way we perce...

  14. Asp Viper (Vipera aspis) envenomation: experience of the Marseille Poison Centre from 1996 to 2008.

    Science.gov (United States)

    de Haro, Luc; Glaizal, Mathieu; Tichadou, Lucia; Blanc-Brisset, Ingrid; Hayek-Lanthois, Maryvonne

    2009-12-01

    A retrospective case review study of viper envenomations collected by the Marseille's Poison Centre between 1996 and 2008 was performed. 174 cases were studied (52 grade 1 = G1, 90 G2 and 32 G3). G1 patients received symptomatic treatments (average hospital stay 0.96 day). One hundred and six (106) of the G2/G3 patients were treated with the antivenom Viperfav* (2.1+/-0.9 days in hospital), while 15 of them received symptomatic treatments only (plus one immediate death) (8.1+/-4 days in hospital, 2 of them died). The hospital stay was significantly reduced in the antivenom treated group (p < 0.001), and none of the 106 antivenom treated patients had immediate (anaphylaxis) or delayed (serum sickness) allergic reactions. Viperfav* antivenom was safe and effective for treating asp viper venom-induced toxicity.

  15. Paracetamol poisoning and hepatotoxicity in Chinese--the Prince of Wales Hospital (Hong Kong) experience.

    Science.gov (United States)

    Chan, T Y; Chan, A Y; Critchley, J A

    1993-08-01

    From 1989 to 1991, 104 Chinese patients were admitted to the Prince of Wales Hospital with paracetamol poisoning. Only 11 subjects had a plasma paracetamol concentration above the published treatment line. Intravenous N-acetylcysteine (NAC) was completely effective when given within 8 hours (3 patients), while late treatment with NAC at 16 and 26 hours after overdose (2 patients) was ineffective in preventing liver damage as evidenced by elevations in plasma alanine transaminase concentrations. Of the 6 patients receiving NAC between 10 to 15 hours, two had liver damage. Two other subjects who presented late or in whom a plasma paracetamol concentration was not measured also developed liver damage. Fortunately, none of these 6 subjects developed hepatic encephalopathy. We recommend that a standard protocol be readily available for junior hospital staff to use when treating patients with paracetamol overdosage.

  16. Increasing Counseling Center Utilization: Yeshiva University's Experience

    Science.gov (United States)

    Schwartz, Victor; Nissel, Chaim; Eisenberg, Daniel; Kay, Jerald; Brown, Joshua T.

    2012-01-01

    Yeshiva University established a counseling center during the 2004-2005 academic year. As a religiously based institution, the administration recognized that there would likely be significant impediments to utilization of on-campus mental health services as a result of negative attitudes about mental illness and its treatment--stigma. To combat…

  17. Beryllium poisonings

    International Nuclear Information System (INIS)

    Alibert, S.

    1959-03-01

    This note reports a bibliographical study of beryllium toxicity. Thus, this bibliographical review addresses and outlines aspects and issues like aetiology, cases of acute poisoning (cutaneous manifestations, pulmonary manifestations), chronic poisoning (cutaneous, pulmonary and bone manifestations), excretion and localisation, and prognosis

  18. Mercurial poisoning

    Energy Technology Data Exchange (ETDEWEB)

    Gorton, B

    1924-01-01

    Cats which had been kept in a thermometer factory to catch rats were afflicted with mercury poisoning. So were the rats they were supposed to eat. The symptoms of mercury poisoning were the same in both species. The source of mercury for these animals is a fine film of the metal which coats floors, a result of accidental spills during the manufacturing process.

  19. Nuclear medicine: the Philippine Heart Center experience

    International Nuclear Information System (INIS)

    Cancino, E.L.

    1994-01-01

    The following is a report of a three (3) months on-the-job training in Nuclear Medicine at the Nuclear Medicine Department of the Philippine Heart Center. The hospital has current generation nuclear medicine instruments with data processor and is capable of a full range of in vivo and in vitro procedures. Gamma camera is the principal instrument for imaging in nuclear medicine used in the Philippine Heart Center. Thyroid scanning procedure is being performed with these instruments. Also the cardiovascular procedures, the pulmonary, skeletal, renal and hepatobiliary procedures were being performed with the use of gamma camera. Special emphasis is on nuclear cardiology since the PHC attends primarily to cardiovascular patients. (auth.)

  20. Baking soda misuse as a home remedy: case experience of the California Poison Control System.

    Science.gov (United States)

    Al-Abri, S A; Kearney, T

    2014-02-01

    Baking soda is a common household product promoted by the manufacturer as an antacid. It contains sodium bicarbonate and has the potential for significant toxicity when ingested in excessive amounts. Characterizing the patterns and outcomes from the misuse of baking soda as a home remedy can guide the clinical assessment and preventative counselling of patients at risk for use of this product. We conducted a retrospective review of all symptomatic cases involving ingestion and misuse of a baking soda powder product that were reported to the California Poison Control System between the years 2000 and 2012. Of the 192 cases we identified, 55·8% were female, ages ranged 2 months to 79 years, and the most common reasons for misuse included antacid (60·4%), 'beat a urine drug test' (11·5%) and treat a UTI (4·7%). Most cases (55·2%) had significant symptoms warranting a medical evaluation, whereas 12 patients required hospital admission developed either electrolyte imbalances, metabolic alkalosis or respiratory depression. Misuse of baking soda can result in serious electrolyte and acid/base imbalances. Patients at highest risk of toxicity may include those who chronically use an antacid, those who use the method to 'beat' urine drug screens, pregnant women and young children. Self-treatment with baking soda as a home remedy may also mask or delay medical care thereby complicating or exacerbating an existing medical problem. We suggest that healthcare providers counsel high-risk patients about the potential complications of misuse of baking soda as a home remedy. © 2013 John Wiley & Sons Ltd.

  1. Marginal ulcer perforation: a single center experience.

    Science.gov (United States)

    Natarajan, S K; Chua, D; Anbalakan, K; Shelat, V G

    2017-10-01

    Marginal ulcer (MU) is defined as ulcer on the jejunal side of the gastrojejunostomy (GJ) anastomosis. Most MUs are managed medically but those with complications like bleeding or perforation require intervention. It is recommended that GJ anastomosis be revised in patients with MU perforation (MUP). The aim of this case series is to study the clinical presentation and management of MUP. Three hundred and thirty-two patients who underwent emergency surgery for perforated peptic ulcer at a single center were studied over a period of 5 years. Nine patients (2.7 %) presented with MUP. GJ was previously done for either complicated peptic ulcer (n = 4) or for suspected gastric malignancy (n = 5). Two patients had previously completed H. pylori therapy. None of the patients presented with septic shock. MU was on the jejunal side of GJ in all patients. The median MUP size was 10 mm. Four patients (44.4 %) had omental patch repair, three (33.3 %) had primary closure, and one each had revision of GJ and jejunal serosal patch repair. There were no leaks, intra-abdominal abscess or reoperation and no malignancies. MUP patients do not present with septic shock. Omental patch repair or primary closure is sufficient enough. Revision of Billroth-II-GJ into Roux-en-Y-GJ is not mandatory.

  2. Bulgaria: INIS Center - 45 years experience

    International Nuclear Information System (INIS)

    Georgieva, Albena

    2015-01-01

    Bulgaria is one of 35 countries in the world operating nuclear power plants. Bulgaria's nuclear program was launched in 1956 with the construction of an IRT-2000 research reactor at the Institute for Nuclear Research and Nuclear Energy (INRNE), which was commissioned in 1961. The reactor is now under reconstruction. In 1960, construction of the first Bulgarian nuclear power plant started. At the moment, there are 6 power units at the Kozloduy NPP site; 4 of them (VVER-440/B-230) under decommissioning and 2 (VVER-1000/B-320) in operation. Several storage facilities for radioactive waste, mainly from the Kozloduy NPP and from various sources of ionizing radiation in medicine and industry are also in operation. The Kozloduy NPP, INRNE, Sofia University, the Technical University, and the State Enterprise Radioactive Waste are the main generators of nuclear information in Bulgaria and the main consumers of INIS products. The Bulgarian INIS Center, therefore, maintains continuous and effective cooperation with these Institutions

  3. Gasoline poisoning

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002806.htm Gasoline poisoning To use the sharing features on this ... This article discusses the harmful effects from swallowing gasoline or breathing in its fumes. This article is ...

  4. Poison Prevention

    Science.gov (United States)

    ... Safely , for more information . If you use an e-cigarette, keep the liquid nicotine refills locked up out ... to a child. See Liquid Nicotine Used in E-Cigarettes Can Kill Children . Never place poisonous products in ...

  5. Deodorant poisoning

    Science.gov (United States)

    ... Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 100. Farmer B, Seger DL. ... Textbook of Critical Care . 7th ed. Philadelphia, PA: Elsevier; 2017:chap 153. Meehan TJ. Approach to the ...

  6. Acetone poisoning

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002480.htm Acetone poisoning To use the sharing features on this page, please enable JavaScript. Acetone is a chemical used in many household products. ...

  7. Temporal analyses of coral snakebite severity published in the American Association of Poison Control Centers' Annual Reports from 1983 through 2007.

    Science.gov (United States)

    Walter, Frank G; Stolz, Uwe; Shirazi, Farshad; McNally, Jude

    2010-01-01

    The only U.S. Food and Drug Administration-approved coral snake antivenom was officially discontinued in 2007, causing ever-diminishing supplies. This study describes the severity of U.S. coral snakebites during the last 25 years to determine trends in annual rates of these bites' medical outcomes. This study retrospectively analyzed all human coral snakebites voluntarily reported by the public and/or health care professionals to poison centers that were subsequently published in the Annual Reports of the American Association of Poison Control Centers (AAPCC) from 1983 through 2007. Annual rates of medical outcomes from coral snakebites were calculated by dividing the annual number of people bitten by coral snakes who developed fatal, major, moderate, minor, or no effect outcomes by the total annual number of people bitten by coral snakes. Negative binomial regression was used to examine trends in annual rates. From 1983 through 2007, the incidence rate of coral snakebites producing no effects significantly decreased by 4.7% per year [incidence rate ratio (IRR) = 0.953; 95% confidence interval (CI) = 0.920-0.987]. From 1985 through 2007, the incidence rates of minor and major outcomes did not significantly change; however, moderate outcomes significantly increased by 3.4% per year (IRR = 1.034; 95% CI = 1.004-1.064). No fatalities were reported from 1983 through 2007. Annual rates of coral snakebites producing no effects significantly decreased and those producing moderate outcomes significantly increased in our analyses of data from the last 25 years of published AAPCC Annual Reports. This study has important limitations that must be considered when interpreting these conclusions.

  8. Effects of Teaching Health Care Workers on Diagnosis and Treatment of Pesticide Poisonings in Uganda.

    Science.gov (United States)

    Sibani, Claudia; Jessen, Kristian Kjaer; Tekin, Bircan; Nabankema, Victoria; Jørs, Erik

    2017-01-01

    Acute pesticide poisoning in developing countries is a considerable problem, requiring diagnosis and treatment. This study describes how training of health care workers in Uganda affects their ability to diagnose and manage acute pesticide poisoning. A postintervention cross-sectional study was conducted using a standardized questionnaire. A total of 326 health care workers in Uganda were interviewed on knowledge and handling of acute pesticide poisoning. Of those, 173 health care workers had received training, whereas 153 untrained health care workers from neighboring regions served as controls. Trained health care workers scored higher on knowledge of pesticide toxicity and handling of acute pesticide poisoning. Stratification by sex, profession, experience, and health center level did not have any influence on the outcome. Training health care workers can improve their knowledge and treatment of pesticide poisonings. Knowledge of the subject is still insufficient among health care workers and further training is needed.

  9. The power of poison: pesticide poisoning of Africa's wildlife.

    Science.gov (United States)

    Ogada, Darcy L

    2014-08-01

    Poisons have long been used to kill wildlife throughout the world. An evolution has occurred from the use of plant- and animal-based toxins to synthetic pesticides to kill wildlife, a method that is silent, cheap, easy, and effective. The use of pesticides to poison wildlife began in southern Africa, and predator populations were widely targeted and eliminated. A steep increase has recently been observed in the intensity of wildlife poisonings, with corresponding population declines. However, the majority of poisonings go unreported. Under national laws, it is illegal to hunt wildlife using poisons in 83% of African countries. Pesticide regulations are inadequate, and enforcement of existing legislation is poor. Few countries have forensic field protocols, and most lack storage and testing facilities. Methods used to poison wildlife include baiting carcasses, soaking grains in pesticide solution, mixing pesticides to form salt licks, and tainting waterholes. Carbofuran is the most widely abused pesticide in Africa. Common reasons for poisoning are control of damage-causing animals, harvesting fish and bushmeat, harvesting animals for traditional medicine, poaching for wildlife products, and killing wildlife sentinels (e.g., vultures because their aerial circling alerts authorities to poachers' activities). Populations of scavengers, particularly vultures, have been decimated by poisoning. Recommendations include banning pesticides, improving pesticide regulations and controlling distribution, better enforcement and stiffer penalties for offenders, increasing international support and awareness, and developing regional pesticide centers. © 2014 New York Academy of Sciences.

  10. Paradoxical embolism: Experiences from a single center

    Directory of Open Access Journals (Sweden)

    Hong-Liang Zhang

    2017-06-01

    Full Text Available Objective: To present our treatment experiences and the follow-up data of patients with paradoxical embolism (PDE. Methods: The clinical characteristics, management, and follow-up data of all included patients who were diagnosed with PDE at Fuwai Hospital from January 1994 to October 2015 were recorded. Results: Twelve patients were included; all had a pulmonary embolism, and 8 had deep venous thrombosis. The artery embolisms involved the cerebral artery (7 patients, renal artery (2 patients, mesentery artery (2 patients, popliteal artery (1 patient, descending aorta thrombus (1 patient, and thrombus-straddled patent foramen ovale (PFO (1 patient. PFO was found in 3 cases. One patient underwent thrombectomy and PFO closure; Six patients received thrombolysis; and 3 patients were implanted with a vena cava filter. Long-term anticoagulation with warfarin was recommended for each patient. One patient died from ventricular fibrillation despite cardiopulmonary resuscitation. Eleven patients were discharged with improvements. No late mortality occurred in 8 patients with a complete follow-up of 10.6–17.7 years. One had a recurrent deep venous thrombosis. No patient had a recurrent pulmonary or arterial embolism. Two patients changed their treatment from warfarin to aspirin; others remained on warfarin. Only 1 case had an occasional gum bleeding. Conclusions: PDE treatment including thrombolysis, anticoagulation, and embolectomy should be individualized. We recommend long-term anticoagulation therapy to prevent the recurrence of PDE, especially to those with an intracardiac communication or persistent risk factors for re-thrombosis. Keywords: Paradoxical embolism, Pulmonary embolism, Deep venous thrombosis, Patent foramen ovale

  11. Ultraviolet A1 phototherapy: One center's experience

    Directory of Open Access Journals (Sweden)

    Sasi Kiran Attili

    2017-01-01

    Full Text Available Background: Ultraviolet A1(UVA1 phototherapy is increasingly being used in the treatment of morphea, atopic dermatitis, lupus and some other recalcitrant dermatoses. We present a retrospective review of our experience with this modality. Aim: To evaluate the treatment response rates for various dermatoses and adverse effects of UVA1 phototherapy. Methods: We reviewed phototherapy notes along with electronic and/or paper case records for all patients treated with UVA1 phototherapy from October 1996 to December 2008. Results: A total of 269 patients (outcomes available for 247 had 361 treatment courses (treatment data available for 317 courses over this period. We found phototherapy to be beneficial in 28 (53% of 53 patients with atopic dermatitis and 19 (51% of 37 patients with morphea. A beneficial outcome was recorded in all six (100% cases of urticaria and six (85.7% of seven patients treated for a polymorphic light eruption. Benefit was also recorded in systemic lupus erythematosus (8 (44.4% of 18, lichen sclerosus (6 (42.9% of 14, mastocytosis (2 (33.3% of 6, necrobiosis lipoidica (4 (30.8% of 13, granuloma annulare (2 (25% of 8, scleroderma (2 (22.2% of 9 and keloids (1 (7.7% of 13. Overall, treatment was well tolerated with no patients having to stop treatment due to adverse effects. Limitations: This is a retrospective study with no control group. Subjective/recall bias is quite possible as a number of patients were followed up over the phone. Conclusions: Our data suggest that ultraviolet A1 can be considered for the treatment of selected dermatoses. However, long-term malignancy risk is as yet unknown.

  12. Poisoning - fish and shellfish

    Science.gov (United States)

    Fish poisoning; Dinoflagellate poisoning; Seafood contamination; Paralytic shellfish poisoning; Ciguatera poisoning ... algae and algae-like organisms called dinoflagellates. Small fish that eat the algae become contaminated. If larger ...

  13. Fomepizole in the treatment of acute methanol poisonings: experience from the Czech mass methanol outbreak 2012-2013

    Czech Academy of Sciences Publication Activity Database

    Zakharov, S.; Navrátil, Tomáš; Pelclová, D.

    2014-01-01

    Roč. 158, č. 4 (2014), s. 641-649 ISSN 1213-8118 Institutional support: RVO:61388955 Keywords : methanol poisoning * fomepizole * treatment outcome Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 1.200, year: 2014

  14. Poisoning Experiments Aimed at Discriminating Active and Less-Active Sites of Silica-Supported Tantalum Hydride for Alkane Metathesis

    KAUST Repository

    Saggio, Guillaume; Taoufik, Mostafa; Basset, Jean-Marie; Thivolle-Cazat, Jean

    2010-01-01

    Only 50% of the silica-supported tantalum hydride sites are active in the metathesis of propane. Indeed, more than 45% of the tantalum hydride can be eliminated by a selective oxygen poisoning of inactive sites with no significant decrease

  15. 76 FR 9585 - Poison Control Program

    Science.gov (United States)

    2011-02-18

    ... delay or gap in poison center services. The State of New York has determined that the Research... Noncompetitive Replacement Awards to the Research Foundation of SUNY and the New York City Health & Hospitals... the Research Foundation of SUNY d.b.a. the Upstate New York Poison Control Center. HRSA will also...

  16. Lithium Poisoning

    DEFF Research Database (Denmark)

    Baird-Gunning, Jonathan; Lea-Henry, Tom; Hoegberg, Lotte C G

    2017-01-01

    Lithium is a commonly prescribed treatment for bipolar affective disorder. However, treatment is complicated by lithium's narrow therapeutic index and the influence of kidney function, both of which increase the risk of toxicity. Therefore, careful attention to dosing, monitoring, and titration...... is required. The cause of lithium poisoning influences treatment and 3 patterns are described: acute, acute-on-chronic, and chronic. Chronic poisoning is the most common etiology, is usually unintentional, and results from lithium intake exceeding elimination. This is most commonly due to impaired kidney...... function caused by volume depletion from lithium-induced nephrogenic diabetes insipidus or intercurrent illnesses and is also drug-induced. Lithium poisoning can affect multiple organs; however, the primary site of toxicity is the central nervous system and clinical manifestations vary from asymptomatic...

  17. Alcohol Poisoning Deaths PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2015-01-06

    This 60 second Public Service Announcement is based on the January 2015 CDC Vital Signs report. In the United States, an average of six people die every day from alcohol poisoning. Learn what you can do to prevent binge drinking and alcohol poisoning.  Created: 1/6/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 1/6/2015.

  18. CUBED: South Dakota 2010 Research Center For Dusel Experiments

    International Nuclear Information System (INIS)

    Keller, Christina; Alton, Drew; Bai Xinhau; Durben, Dan; Heise, Jaret; Hong Haiping; Howard, Stan; Jiang Chaoyang; Keeter, Kara; McTaggart, Robert; Medlin, Dana; Mei Dongming; Petukhov, Andre; Rauber, Joel; Roggenthen, Bill; Spaans, Jason; Sun Yongchen; Szczerbinska, Barbara; Thomas, Keenan; Zehfus, Michael

    2010-01-01

    With the selection of the Homestake Mine in western South Dakota by the National Science Foundation (NSF) as the site for a national Deep Underground Science and Engineering Laboratory (DUSEL), the state of South Dakota has sought ways to engage its faculty and students in activities planned for DUSEL. One such effort is the creation of a 2010 Research Center focused on ultra-low background experiments or a Center for Ultra-low Background Experiments at DUSEL (CUBED). The goals of this center include to 1) bring together the current South Dakota faculty so that one may begin to develop a critical mass of expertise necessary for South Dakota's full participation in large-scale collaborations planned for DUSEL; 2) to increase the number of research faculty and other research personnel in South Dakota to complement and supplement existing expertise in nuclear physics and materials sciences; 3) to be competitive in pursuit of external funding through the creation of a center which focuses on areas of interest to experiments planned for DUSEL such as an underground crystal growth lab, a low background counting facility, a purification/depletion facility for noble liquids, and an electroforming copper facility underground; and 4) to train and educate graduate and undergraduate students as a way to develop the scientific workforce of the state. We will provide an update on the activities of the center and describe in more detail the scientific foci of the center.

  19. Heterogeneous burnable poisons:

    International Nuclear Information System (INIS)

    Leiva, Sergio; Agueda, Horacio; Russo, Diego

    1989-01-01

    The use of materials possessing high neutron absorption cross-section commonly known as 'burnable poisons' have its origin in BWR reactors with the purpose of improving the efficiency of the first fuel load. Later on, it was extended to PWR to compensate of initial reactivity without infringing the requirement of maintaining a negative moderator coefficient. The present tendency is to increase the use of solid burnable poisons to extend the fuel cycle life and discharge burnup. There are two concepts for the burnable poisons utilization: 1) heterogeneously distributions in the form of rods, plates, etc. and 2) homogeneous dispersions of burnable poisons in the fuel. The purpose of this work is to present the results of sinterability studies, performed on Al 2 O 3 -B 4 C and Al 2 O 3 -Gd 2 O 3 systems. Experiments were carried on pressing at room temperature mixtures of powders containing up to 5 wt % of B 4 C or Gd 2 O 3 in Al 2 O 3 and subsequently sintering at 1750 deg C in reducing atmosphere. Evaluation of density, porosity and microstructures were done and a comparison with previous experiences is shown. (Author) [es

  20. Poisoning Experiments Aimed at Discriminating Active and Less-Active Sites of Silica-Supported Tantalum Hydride for Alkane Metathesis

    KAUST Repository

    Saggio, Guillaume

    2010-10-04

    Only 50% of the silica-supported tantalum hydride sites are active in the metathesis of propane. Indeed, more than 45% of the tantalum hydride can be eliminated by a selective oxygen poisoning of inactive sites with no significant decrease in the global turnover. Conversely, cyclopentane induces no such selective poisoning. Hence, the active tantalum hydride sites that show greater resistance to oxygen poisoning correspond to the νTa-H bands of higher wavenumbers, particularly that at 1860cm-1. These active tantalum hydride sites should correspond to tris- or monohydride species relatively far from silica surface oxygen atoms. © 2010 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  1. Poison Ivy Rash

    Science.gov (United States)

    Poison ivy rash Overview Poison ivy rash is caused by an allergic reaction to an oily resin called urushiol (u-ROO-she-ol). This oil is in the leaves, stems and roots of poison ivy, poison oak and poison sumac. Wash your ...

  2. NASA Glenn Research Center Experience with "LENR Phenomenon"

    Science.gov (United States)

    Wrbanek, Susan Y.; Fralick, Gustave C.; Wrbanek, John D.; Niedra, Janis M.

    2012-01-01

    Since 1989 NASA Glenn Research Center (GRC) has performed some small-scale limited experiments that show evidence of effects claimed by some to be evidence of Low Energy Nuclear Reactions (LENR). The research at GRC has involved observations and work on measurement techniques for observing the temperature effects in reactions of isotopes of hydrogen with palladium hydrides. The various experiments performed involved loading Pd with gaseous H2 and D2, and exposing Pd thin films to multi-bubble sonoluminescence in regular and deuterated water. An overview of these experiments and their results will be presented.

  3. NASA Glenn Research Center Experience with LENR Phenomenon

    Science.gov (United States)

    Wrbanek, Susan Y.; Fralick, Gustave C.; Wrbanek, John D.; Niedra, Janis M.

    2012-01-01

    Since 1989 NASA Glenn Research Center (GRC) has performed some small-scale limited experiments that show evidence of effects claimed by some to be evidence of Low Energy Nuclear Reactions (LENR). The research at GRC has involved observations and work on measurement techniques for observing the temperature effects in reactions of isotopes of hydrogen with palladium hydrides. The various experiments performed involved loading Pd with gaseous H2 and D2, and exposing Pd thin films to multi-bubble sonoluminescence in regular and deuterated water. An overview of these experiments and their results will be presented.

  4. Lead poisoning

    Energy Technology Data Exchange (ETDEWEB)

    Beijers, J A

    1952-01-01

    Three cases of acute lead poisoning of cattle herds via ingestion are reported, and reference is made to several other incidents of lead in both humans and animals. The quantity of lead which was found in the livers of the dead cows varied from 6.5 to 19 mg/kg, while 1160 mg/kg of lead in the liver was found for a young cow which was poisoned experimentally with 5 gms of lead acetate per day; hence, there appears to be great variability in the amounts deposited that can lead to intoxication and death. No evidence was found for a lead seam around the teeth, prophyrinuria, or basophil granules in the erythrocytes during acute or chronic lead poisoning of cattle or horses examined. Reference is made to attempts of finding the boundary line between increased lead absorption and lead intoxication in humans, and an examination of 60 laborers in an offset-printing office containing a great deal of inhalable lead (0.16 to 1.9 mg/cu m air) is reviewed. Physical deviation, basophylic granulation of erythrocytes, increased lead content of the urine, and porphyrinuria only indicate an increased absorption of lead; the use of the term intoxication is justified if, in addition, there are complaints of lack of appetite, constipation, fatigue, abdominal pain, and emaciation.

  5. House of Poison: Poisons in the Home.

    Science.gov (United States)

    Keller, Rosanne

    One of a series of instructional materials produced by the Literacy Council of Alaska, this booklet provides information about common household poisons. Using a simplified vocabulary and shorter sentences, it provides statistics concerning accidental poisonings; a list of the places poisons are usually found in the home; steps to make the home…

  6. Common causes of poisoning: etiology, diagnosis and treatment.

    Science.gov (United States)

    Müller, Dieter; Desel, Herbert

    2013-10-01

    In 2011, German hospitals treated approximately 205 000 patients suffering from acute poisoning. Change is seen over time both in the types of poisoning that occur and in the indications for specific treatment. This article is based on a selective review of the literature, with special attention to the health reports of the German federal government, the annual reports of the GIZ-Nord Poisons Center (the poison information center for the four northwestern states of Germany, i.e. Bremen, Hamburg, Lower Saxony and Schleswig-Holstein), and the recommendations of international medical associations. From 1996 to 2011, the GIZ-Nord Poisons Center answered more than 450 000 inquiries, most of which involved exposures to medical drugs, chemicals, plants, foods, or cosmetics. Poisoning was clinically manifest in only a fraction of these cases. Ethanol intoxication is the commonest type of acute poisoning and suicide by medical drug overdose is the commonest type of suicide by poisoning. Death from acute poisoning is most commonly the result of either smoke inhalation or illegal drug use. Severe poisoning is only rarely due to the ingestion of chemicals (particularly detergents and cleaning products), cosmetics, or plant matter. Medical procedures that are intended to reduce the absorption of a poison or enhance its elimination are now only rarely indicated. Antidotes (e.g., atropine, 4-dimethylaminophenol, naloxone, toluidine blue) are available for only a few kinds of poisoning. Randomized clinical trials of treatment have been carried out for only a few substances. Most exposures to poisons can be treated with general emergency care and, if necessary, with symptomatic intensive-care measures. Poison information centers help ensure that cases of poisoning are dealt with efficiently. The data they collect are a useful aid to toxicological assessment and can serve as a point of departure for research projects.

  7. Experience with Server Self Service Center (S3C)

    CERN Multimedia

    Sucik, J

    2009-01-01

    CERN has a successful experience with running Server Self Service Center (S3C) for virtual server provisioning which is based on Microsoft® Virtual Server 2005. With the introduction of Windows Server 2008 and its built-in hypervisor based virtualization (Hyper-V) there are new possibilities for the expansion of the current service. This paper describes the architecture of the redesigned virtual Server Self Service based on Hyper-V which provides dynamically scalable virtualized resources on demand as needed and outlines the possible implications on the future use of virtual machines at CERN.

  8. Experience with Server Self Service Center (S3C)

    International Nuclear Information System (INIS)

    Sucik, Juraj; Bukowiec, Sebastian

    2010-01-01

    CERN has a successful experience with running Server Self Service Center (S3C) for virtual server provisioning which is based on Microsoft (registered) Virtual Server 2005. With the introduction of Windows Server 2008 and its built-in hypervisor based virtualization (Hyper-V) there are new possibilities for the expansion of the current service. This paper describes the architecture of the redesigned virtual Server Self Service based on Hyper-V which provides dynamically scalable virtualized resources on demand as needed and outlines the possible implications on the future use of virtual machines at CERN.

  9. Ciguatera poisoning.

    Science.gov (United States)

    Achaibar, Kira C; Moore, Simon; Bain, Peter G

    2007-10-01

    Ciguatera is a form of poisoning that occurs after eating tropical and subtropical ciguatoxic fish. The ciguatoxins are a family of heat stable, lipid soluble cyclic polyether compounds that bind to and open voltage-sensitive Na(+) channels at resting membrane potential, resulting in neural hyperexcitability, as well as swelling of the nodes of Ranvier. The authors describe a 45-year-old man who developed acute gastrointestinal symptoms in Antigua soon after eating red snapper and grouper, potentially "ciguatoxic fish". This was followed by neurological symptoms 24-48 hours later, including temperature reversal (paradoxical dysaesthesia), intense pruritus and increased nociception as a result of a small fibre peripheral neuropathy. The patient's symptoms and small fibre neuropathy improved over a period of 10 months.

  10. Are drowned donors marginal donors? A single pediatric center experience.

    Science.gov (United States)

    Kumm, Kayla R; Galván, N Thao N; Koohmaraie, Sarah; Rana, Abbas; Kueht, Michael; Baugh, Katherine; Hao, Liu; Yoeli, Dor; Cotton, Ronald; O'Mahony, Christine A; Goss, John A

    2017-09-01

    Drowning, a common cause of death in the pediatric population, is a potentially large donor pool for OLT. Anecdotally, transplant centers have deemed these organs high risk over concerns for infection and graft dysfunction. We theorized drowned donor liver allografts do not portend worse outcomes and therefore should not be excluded from the donation pool. We reviewed our single-center experience of pediatric OLTs between 1988 and 2015 and identified 33 drowned donor recipients. These OLTs were matched 1:2 to head trauma donor OLTs from our center. A chart review assessed postoperative peak AST and ALT, incidence of HAT, graft and recipient survival. Recipient survival at one year between patients with drowned donor vs head trauma donor allografts was not statistically significant (94% vs 97%, P=.63). HAT incidence was 6.1% in the drowned donor group vs 7.6% in the control group (P=.78). Mean postoperative peak AST and ALT was 683 U/L and 450 U/L for drowned donors vs 1119 U/L and 828 U/L in the matched cohort. These results suggest drowned donor liver allografts do not portend worse outcomes in comparison with those procured from head trauma donors. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Advanced Life Support Project: Crop Experiments at Kennedy Space Center

    Science.gov (United States)

    Sager, John C.; Stutte, Gary W.; Wheeler, Raymond M.; Yorio, Neil

    2004-01-01

    Crop production systems provide bioregenerative technologies to complement human crew life support requirements on long duration space missions. Kennedy Space Center has lead NASA's research on crop production systems that produce high value fresh foods, provide atmospheric regeneration, and perform water processing. As the emphasis on early missions to Mars has developed, our research focused on modular, scalable systems for transit missions, which can be developed into larger autonomous, bioregenerative systems for subsequent surface missions. Components of these scalable systems will include development of efficient light generating or collecting technologies, low mass plant growth chambers, and capability to operate in the high energy background radiation and reduced atmospheric pressures of space. These systems will be integrated with air, water, and thermal subsystems in an operational system. Extensive crop testing has been done for both staple and salad crops, but limited data is available on specific cultivar selection and breadboard testing to meet nominal Mars mission profiles of a 500-600 day surface mission. The recent research emphasis at Kennedy Space Center has shifted from staple crops, such as wheat, soybean and rice, toward short cycle salad crops such as lettuce, onion, radish, tomato, pepper, and strawberry. This paper will review the results of crop experiments to support the Exploration Initiative and the ongoing development of supporting technologies, and give an overview of capabilities of the newly opened Space Life Science (SLS) Lab at Kennedy Space Center. The 9662 square m (104,000 square ft) SLS Lab was built by the State of Florida and supports all NASA research that had been performed in Hanger-L. In addition to NASA research, the SLS Lab houses the Florida Space Research Institute (FSRI), responsible for co-managing the facility, and the University of Florida (UF) has established the Space Agriculture and Biotechnology Research and

  12. Characteristics of poisoning cases in Adiyaman city

    Directory of Open Access Journals (Sweden)

    Öznur Uludağ

    2015-09-01

    Full Text Available Objective: Aim of this study was to retrospectively evaluate poisoning cases in an intensive care unit (ICU in order to determine the profile of poisoning cases, update epidemiological data in Adiyaman, and contribute to data about poisoning in our country. Methods: Between 01-01-2012 and 31-12-2013 174 patients (116 males, 58 females with a mean age of 23.7 years were treated. Demographic characteristics, reasons and ways of poisoning, types of toxic substances, length of their ICU stay and prognosis were evaluated. Results: 2733 patients admitted to the intensive care unit were 174 poisoning cases. Poisoning ways were suicide by drug overdose (n=162, 93.1%, and accidental poisoning (n=12,6.9%.119 patients (66.5% had single drug intake, thirty-three patients (18.4% with multiple drug intake, and 16 (8.9% were poisoned by organic phosphates. The most common drug used for suicide was antidepressants (n=87.5%. 32 patients (18.4% took analgesics and anti-inflammatory drugs. A total of 152 patients taking the drug, 22 patients were poisoned by other means. The median length of patient stay was 2 days (range 1-20 days. Ninety-nine patients (56.9% recovered and were discharged.72 patients (41.4% were admitted to inpatient after intensive care unit. Patients were followed up by asking poisoning suicidal psychiatric consultation.1 patient was followed up for 20 days in intensive care due to alcohol poisoning but was died.2 patients (1.1% were referred to a center forward. Conclusion: Majority of the patients were females, who took drugs with suicidal intention. Frequent use of antidepressants, which are not subject to control by authorities, to commit suicide was remarkable.

  13. Pesticides poisoning

    International Nuclear Information System (INIS)

    Ahmad, I.

    1999-01-01

    Pesticides are chemical toxicants which are used to kill by their toxic actions, the pest organisms, known to incur significant economic losses or threaten human life, his health and that of his domesticated animals. These toxicants are seldom species-specific. The presence of these or their metabolites may scientific be vouched not only in the environment they are used, but in the entire ecosystem, in the subsoil, in the underwater reservoirs and in the food chain of all non-target species including man, his friends i.e. predator and parasite organisms which be uses against the pests, and in his cherished domesticated animals. In the present paper a survey is made of different groups of toxic chemicals generally used to manage pests, in the ecosystem, food chain and tissues and body parts of non-target species including man and the ones dear to him. Toxicology and biochemistry of these toxic materials and their important metabolites are also briefly discussed with special reference to ways and means through which these poison the above non-target species. (author)

  14. Pick your poison: what's new in poison control for the preschooler.

    Science.gov (United States)

    Glenn, Lauren

    2015-01-01

    Accidental childhood poisonings are a major public health concern despite many efforts to alleviate this problem. While the rate of pediatric fatalities due to poisonings have decreased over the last two decades, poison control centers around the US have collectively fielded over one million calls with regard to toxic exposures in the preschool age group. According to the American Association of Poison Control Centers nearly half of all human exposures reported last year involved children under six. By focusing poison prevention efforts on the preschooler, we can attempt to decrease morbidity and mortality in the most vulnerable age group affected. Although the subject is still prevalent, current discussion on this topic is limited. Newer literature discusses past initiatives such as child resistant packaging and sticker deterrent programs and addresses their efficacy. This article revisits older mechanisms of prevention as well as the science behind the human motivation to change one's own practice and behavior. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. CCSDS telemetry systems experience at the Goddard Space Flight Center

    Science.gov (United States)

    Carper, Richard D.; Stallings, William H., III

    1990-01-01

    NASA Goddard Space Flight Center (GSFC) designs, builds, manages, and operates science and applications spacecraft in near-earth orbit, and provides data capture, data processing, and flight control services for these spacecraft. In addition, GSFC has the responsibility of providing space-ground and ground-ground communications for near-earth orbiting spacecraft, including those of the manned spaceflight programs. The goal of reducing both the developmental and operating costs of the end-to-end information system has led the GSFC to support and participate in the standardization activities of the Consultative Committee for Space Data Systems (CCSDS), including those for packet telemetry. The environment in which such systems function is described, and the GSFC experience with CCSDS packet telemetry in the context of the Gamma-Ray Observatory project is discussed.

  16. Cadmium, an environmental poison

    Energy Technology Data Exchange (ETDEWEB)

    Oestergaard, A K

    1974-04-15

    In recent years, industrial employment of cadmium has increased considerably. Cadmium is now present in the environment and has caused acute and chronic poisoning. Inhalation of cadmium vapor or dust causes pulmonary damage while the kidney is the critical organ in absorption of cadmium. The element accumulates in the kidney and causes tubular damage or 200 ppm in the renal cortex. In animal experiments, cadmium may cause raised blood pressure, sterility and malignant tumors. On account of the pronounced tendency of cadmium to accumulate and its toxicity, it is important to trace sources and to reduce exposure of the population. 62 references.

  17. Trends in hepatic injury associated with unintentional overdose of paracetamol (Acetaminophen) in products with and without opioid: an analysis using the National Poison Data System of the American Association of Poison Control Centers, 2000-7.

    Science.gov (United States)

    Bond, G Randall; Ho, Mona; Woodward, Randall W

    2012-02-01

    Unintended hepatic injury associated with the use of paracetamol (acetaminophen)-containing products has been growing. The aim of the study was to seek a better understanding of the causes of this observation in order to evaluate the potential impact of proposed preventive measures. Retrospective analysis of a large database containing prospectively collected patient exposure data, clinical symptomatology and outcome. The National Poison Data System database for 2000-7 involving exposures to paracetamol and an opioid was obtained and analysed. This dataset was limited to non-suicidal cases in patients 13 years of age and older. For comparison, the parallel, mutually exclusive dataset involving exposures to one or more non-opioid containing paracetamol products was analysed. Trends in the numbers of patients exposed, treated, and mildly and severely injured were obtained and compared with each other and with trends calculated from publicly available data on sales and population. The association of injury with the number of paracetamol-containing products and the reason for taking them were also assessed. Comparators: During the study period, the US population of those 15 years of age and over rose 8.5%; all pharmaceutical-related calls to all US poison centres rose 25%. For the 8-year period from 2001 to 2008, sales of over-the-counter paracetamol products rose 5% (single-ingredient products fell 3%; paracetamol-containing combination cough and cold products rose 11%) and prescription paracetamol combination products rose 67%. Opioids with paracetamol: A total of 119 731 cases were identified, increasing 70% over the period. The exposure merited acetylcysteine treatment in 8995 cases (252% increase). In total, 2729 patients (2.3%) experienced some hepatic injury (500% increase). Minor injuries rose faster than severe injuries (833% vs 280%) and most injuries (73.0%) were from overuse of a single combination product only, but the injury rate increased with use of

  18. SINGLE-CENTER EXPERIENCE OF ABO-INCOMPATIBLE LIVER TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    S. V. Gautier

    2011-01-01

    Full Text Available Since 2008 up to 2010 eight ABO-incompatible liver transplantations have been performed in our center: one of them was urgent liver transplantation to adult patient from deceased donor, other seven were transplantations of left lateral segment to children from living relative donors. Own experience, as well as world one, proves, that barrier of ABO-incompatibility can be overcome more successfully in liver transplantation, particularly in pediatric population, that in other solid organs transplantation. Good results can be achieved even with less ag- gressive immunosuppressive therapy. Recipient conditioning before operation can significantly improve results of ABO-incompatible liver transplantation, but as own experience has shown, often there’s no need to hold some special preparation of children, because their anti-ABO antibodies are very low or absent before transplantation and do not increase after it. Thereby ABO-incompatible liver transplantation is reasonable in urgent cases and in pediatric population because of the limited pull of living relative donors for children. 

  19. [Merkel cell carcinoma experience in a reference medical center.

    Science.gov (United States)

    Roesch-Dietlen, Federico; Devezé-Bocardi, Raúl; Ruiz-Juárez, Isabel; Grube-Pagola, Peter; Romero-Sierra, Graciela; Remes-Troche, José María; Silva-Cañetas, Carmen Sofía; Lozoya-López Escalera, Hilda

    2013-01-01

    Background: Merkel cell carcinoma is a rare tumor that occurs on areas exposed to ultraviolet light. It is usually asymptomatic and it is diagnosed late often. The treatment is surgical, associated with adjuvant radiotherapy. The objective was to present the experience in the management of Merkel cell carcinoma in a reference medical center. Methods: all patients with Merkel cell carcinoma treated at the Instituto de Investigaciones Médico-Biológicas of the Universidad Veracruzana during the period 2008 to 2011 were studied. Sex, age, evolution time, tumor localization, size, metastases and treatment were analyzed. Results: of 3217 patients treated, three cases were Merkel cell carcinoma (0.09 %), their age was 52.1 ± 14.17, male predominance of 66.67 %; the evolution time was of 29.66 ± 35.36 months; the tumour localization was on inguinal region, anterior chest and left arm; the noodle size was of 6.0 ± 5.19 cm; two patients had lymph node metastases. In two cases, resection and lymphadenectomy were performed. They all received radiation therapy and chemotherapy in one case. Histologically the medium variant predominated; immunohistochemistry was positive in the three cases. One patient died ten months after the study was done. Conclusions: our experience is similar with others authors, Merkel cell carcinoma is a rare tumor, usually diagnosed late, and it has poor survival.

  20. Poisoning first aid

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007579.htm Poisoning first aid To use the sharing features on this page, ... burns Stupor Unconsciousness (coma) Unusual breath odor Weakness First Aid Seek immediate medical help. For poisoning by swallowing ...

  1. Bubble bath soap poisoning

    Science.gov (United States)

    ... medlineplus.gov/ency/article/002762.htm Bubble bath soap poisoning To use the sharing features on this page, please enable JavaScript. Bubble bath soap poisoning occurs when someone swallows bubble bath soap. ...

  2. Isopropanol alcohol poisoning

    Science.gov (United States)

    Rubbing alcohol poisoning; Isopropyl alcohol poisoning ... Isopropyl alcohol can be harmful if it is swallowed or gets in the eyes. ... These products contain isopropanol: Alcohol swabs Cleaning supplies ... Rubbing alcohol Other products may also contain isopropanol.

  3. Mercuric chloride poisoning

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/002474.htm Mercuric chloride poisoning To use the sharing features on this page, please enable JavaScript. Mercuric chloride is a very poisonous form of mercury. It ...

  4. Diagnosis of acute poisoning

    African Journals Online (AJOL)

    Chantel

    functional tissue damage in ... cury or alcohol) .... †The degree of poisoning, together with drug or poison levels, usually determines the .... monoxide, caffeine and the sym- .... the brain. It usually occurs when two or more drugs, which increase.

  5. Hair straightener poisoning

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002706.htm Hair straightener poisoning To use the sharing features on this page, please enable JavaScript. Hair straightener poisoning occurs when someone swallows products that ...

  6. Hair spray poisoning

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002705.htm Hair spray poisoning To use the sharing features on this page, please enable JavaScript. Hair spray poisoning occurs when someone breathes in (inhales) ...

  7. Hydrochloric acid poisoning

    Science.gov (United States)

    Hydrochloric acid is a clear, poisonous liquid. It is highly corrosive, which means it immediately causes severe damage, such ... poisoning due to swallowing or breathing in hydrochloric acid. This article is for information only. Do NOT ...

  8. Burnable poison rod

    International Nuclear Information System (INIS)

    Natsume, Tomohiro.

    1988-01-01

    Purpose: To decrease the effect of water elimination and the effect of burn-up residue boron, thereby reduce the effect of burnable poison rods as the neutron poisons at the final stage of reactor core lifetime. Constitution: In a burnable poison rod according to the present invention, a hollow burnable poison material is filled in an external fuel can, an inner fuel can mounted with a carbon rod is inserted to the hollow portion of the burnable poison material and helium gases are charged in the outer fuel can. In such a burnable poison rod, the reactivity worths after the burning are reduced to one-half as compared with the conventional case. Accordingly, since the effect of the burnable poison as the neutron poisons is reduced at the final stage of the reactor core of lifetime, the excess reactivity of the reactor core is increased. (Horiuchi, T.)

  9. Adrenal trauma: Elvis Presley Memorial Trauma Center experience.

    Science.gov (United States)

    Mehrazin, Reza; Derweesh, Ithaar H; Kincade, Matthew C; Thomas, Adam C; Gold, Robert; Wake, Robert W

    2007-11-01

    Adrenal gland injury is a potentially devastating event if unrecognized in the treatment course of a trauma patient. We reviewed our single-center experience and outcomes in patients with adrenal gland trauma. We performed a retrospective review of all patients presenting with trauma to the Regional Medical Center at Memphis who had adrenal gland injuries from January 1991 through March 2006. Each chart was reviewed with attention to the demographics, associated injuries, complications, and outcomes. Patients were stratified into two subgroups according to age (35 years or younger and older than 35 years) to allow for an age-based comparison between the two groups. Of 58,000 patients presenting with trauma, 130 (0.22%) were identified with adrenal injuries, of which 8 (6.2%) were isolated and 122 (93.8%) were not. Of these 130 patients, 125 (96.2%) had their injury diagnosed by computed tomography and 5 (3.8%) had their injury diagnosed during exploratory laparotomy. Right-sided injuries predominated (78.5%), with six (4.6%) bilateral. Four patients (3.1%) underwent adrenalectomy. Seven patients (5.4%) with adrenal injuries died. One patient (0.77%) required chronic steroid therapy. Patients older than 35 years were more likely to have complications such as deep venous thrombosis, pneumonia, and urinary tract infections. Patient age of 35 years or younger was associated with a significantly increased incidence of liver lacerations. Adrenal gland injury is uncommon, although mostly associated with greater injury severity. Although adding to morbidity, most are self-limited and do not require intervention.

  10. Vital Signs-Alcohol Poisoning Deaths

    Centers for Disease Control (CDC) Podcasts

    2015-01-06

    This podcast is based on the January 2015 CDC Vital Signs report. In the United States, an average of six people die every day from alcohol poisoning. Learn what you can do to prevent binge drinking and alcohol poisoning.  Created: 1/6/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 1/6/2015.

  11. Lead Poisoning (For Parents)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Lead Poisoning KidsHealth / For Parents / Lead Poisoning What's in ... Print en español La intoxicación por plomo About Lead Poisoning If you have young kids, it's important ...

  12. Single-center experience in double kidney transplantation.

    Science.gov (United States)

    Fontana, I; Magoni Rossi, A; Gasloli, G; Santori, G; Giannone, A; Bertocchi, M; Piaggio, F; Bocci, E; Valente, Umberto

    2010-05-01

    Use of organs from marginal donors for transplantation is a current strategy to expand the organ donor pool. Its efficacy is universally accepted among data from multicenter studies. Herein, we have reviewed outcomes of double kidney transplantation (DKT) over an 9-year experience in our center. The aim of this study was to evaluate possible important differences between a monocenter versus multicenter studies. Between 1999 and 2008, we performed 59 DKT. Recipient mean age was 63 +/- 5 years. Mean HLA-A, -B, and -DR mismatches were 3.69 +/- 0.922. Donor mean age was 69 +/- 7 years and mean creatinine clearance was 69.8 +/- 30.8 mL/min. Proteinuria was detected in three donors (5%). Mean cold ischemia and warm ischemia times were 1130 +/- 216 and 48 +/- 11 minutes, respectively. The right and left kidney scores were 4.18 +/- 2 and 4.21 +/- 2, respectively. Thirty patients (51%) displayed good postoperative renal function; 22 (37%), acute tubular necrosis with postoperative dialysis; 3 (5%), acute rejection episodes; 4 (7%), single-graft transplantectomy due to vascular thrombosis; 1 (2%), a retransplantation; 5 (8%), a lymphocele; 3 (5%) vescicoureteral reflux or stenosis requiring surgical correction. Cytomegalovirus infection was detected in five patients (8%). In three patients (5%) displayed de novo neoplasia. Three patients showed chronic rejection (5%), whereas we observed a cyclosporine-related toxicity in 7 (12%). Nine patients (15%) developed iatrogenic diabetes. Patient and graft survivals after 3 years from DKT were 93% and 86.3%, respectively. In this study, we applied successfully a widespread score to allocate organs to single kidney transplantation or DKT. In our experience, the score is suitable for the organ allocation but it may be overprotective, excluding potentially suitable organs for a single transplantation. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  13. Mycophenolate mofetil in pediatric renal transplantation: A single center experience.

    LENUS (Irish Health Repository)

    Raheem, Omer A

    2011-05-01

    Raheem OA, Kamel MH, Daly PJ, Mohan P, Little DM, Awan A, Hickey DP. Mycophenolate mofetil in pediatric renal transplantation: A single center experience. Pediatr Transplantation 2011: 15:240-244. © 2009 John Wiley & Sons A\\/S. Abstract:  We assessed our long-term experience with regards to the safety and efficacy of MMF in our pediatric renal transplant population and compared it retrospectively to our previous non-MMF immunosuppressive regimen. Forty-seven pediatric renal transplants received MMF as part of their immunosuppressive protocol in the period from January 1997 till October 2006 (MMF group). A previously reported non-MMF group of 59 pediatric renal transplants was included for comparative analysis (non-MMF group). The MMF group comprised 29 boys and 18 girls, whereas the non-MMF group comprised 34 boys and 25 girls. Mean age was 11.7 and 12 yr in the MMF and non-MMF groups, respectively. The incidence of acute rejection episodes was 11 (23.4%) and 14 (24%) in the MMF and non-MMF group, respectively. Two (3.3%) grafts were lost in the non-MMF group compared with one (2.1%) in the MMF group. Twenty-one (44.68%) patients in the MMF group developed post-transplant infections compared with 12 (20.33%) in the non-MMF group (p < 0.0001). In conclusion, the use of MMF in pediatric renal transplantation was not associated with a lower rejection rate or immunological graft loss. It did, however, result in a significantly higher rate of viral infections.

  14. Ciguatera and scombroid fish poisoning in the United States.

    Science.gov (United States)

    Pennotti, Radha; Scallan, Elaine; Backer, Lorraine; Thomas, Jerry; Angulo, Frederick J

    2013-12-01

    Ciguatera and scombroid fish poisonings are common causes of fish-related foodborne illness in the United States; however, existing surveillance systems underestimate the overall human health impact. This study aimed to describe existing data on ciguatera and scombroid fish poisonings from outbreak and poison control center reports and to estimate the overall number of ciguatera and scombroid fish-poisoning illnesses, hospitalizations, and deaths in the United States. We analyzed outbreak data from the Foodborne Disease Outbreak Surveillance Systems (FDOSS) from 2000 to 2007 and poison control center call data from the National Poison Data System (NPDS) from 2005 to 2009 for reports of ciguatera and scombroid fish poisonings. Using a statistical model with many inputs, we adjusted the outbreak data for undercounting due to underreporting and underdiagnosis to generate estimates. Underreporting and underdiagnosis multipliers were derived from the poison control call data and the published literature. Annually, an average of 15 ciguatera and 28 scombroid fish-poisoning outbreaks, involving a total of 60 and 108 ill persons, respectively, were reported to FDOSS (2000-2007). NPDS reported an average of 173 exposure calls for ciguatoxin and 200 exposure calls for scombroid fish poisoning annually (2005-2009). After adjusting for undercounting, we estimated 15,910 (90% credible interval [CrI] 4140-37,408) ciguatera fish-poisoning illnesses annually, resulting in 343 (90% CrI 69-851) hospitalizations and three deaths (90% CrI 1-7). We estimated 35,142 (90% CrI: 10,496-78,128) scombroid fish-poisoning illnesses, resulting in 162 (90% CrI 0-558) hospitalizations and 0 deaths. Ciguatera and scombroid fish poisonings affect more Americans than reported in surveillance systems. Although additional data can improve these assessments, the estimated number of illnesses caused by seafood intoxication illuminates this public health problem. Efforts, including education, can reduce

  15. Marijuana poisoning.

    Science.gov (United States)

    Fitzgerald, Kevin T; Bronstein, Alvin C; Newquist, Kristin L

    2013-02-01

    , tremors, hypothermia, and bradycardia. Higher dosages may additionally cause nystagmus, agitation, tachypnea, tachycardia, ataxia, hyperexcitability, and seizures. Treatment of marijuana ingestion in animals is largely supportive. Vital signs including temperature and heart rate and rhythm must be continually monitored. Stomach content and urine can be tested for cannabinoids. Gas chromatography and mass spectrometry can be utilized for THC detection but usually may take several days and are not practical for initiation of therapy. Human urine drug-screening tests can be unreliable for confirmation of marijuana toxicosis in dogs owing to the interference of a large number of the metabolites in canine urine. False negatives may also arise if testing occurs too recently following THC ingestion. Thus, the use of human urine drug-screening tests in dogs remains controversial. No specific antidote presently exists for THC poisoning. Sedation with benzodiazepines may be necessary if dogs are severely agitated. Intravenous fluids may be employed to counter prolonged vomiting and to help control body temperature. Recently, the use of intralipid therapy to bind the highly lipophilic THC has been utilized to help reduce clinical signs. The majority of dogs experiencing intoxication after marijuana ingestion recover completely without sequellae. Differential diagnoses of canine THC toxicosis include human pharmaceuticals with central nervous system stimulatory effects, drugs with central nervous system depressant effects, macrolide parasiticides, xylitol, and hallucinogenic mushrooms. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Perioperative period in cardiac transplantation from donors with brain death due to methanol poisoning

    Directory of Open Access Journals (Sweden)

    V. N. Poptsov

    2017-01-01

    Full Text Available The successful use of donor hearts from people died of methanol poisoning helps reducing the deficit of donor organs for patients requiring urgent cardiac transplantation [3]. We present our experience of successful cardiac transplantations from 2 donors who died due to methanol poisoning. Given the possibility of performing a cardiac transplant from this group of donors a protocol has been developed at the V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs of the Ministry of Healthcare of the Russian Federation which includes clinical, laboratory and instrumental criteria for the selection of heart donor and recipient. The possibility of delayed onset myocardial contractile dysfunction due to methanol poisoning means that a longer conditioningperiod is vital as well as compulsory clinical, laboratory and expert chocardiographic examinations of the potential donor heart.

  17. Comparison of poison exposure data: NHIS and TESS data.

    Science.gov (United States)

    Polivka, Barbara J; Elliott, Michael B; Wolowich, William R

    2002-01-01

    To identify age-adjusted poisoning episode rates, and poison control center contacts due to poisonings in children under 6 years old based on 1997-1999 National Health Interview Survey data; and compare findings with 1997-1999 Toxic Exposure Surveillance System data. Secondary analysis of National Health Interview Survey poisoning episode data for children 5 years and younger. Respondents were asked about poison exposures during the previous 3 months. Based on National Health Interview Survey population weighted data there were 196/10,000 poisonings to young children < 6 years. These exposures resulted primarily from harmful solid or liquid substances. A poison control center was called in 86% of exposures to children < 4 years, but only in 70% of the 4-5 year old exposures. The odds of a poison control center not being called were 3.2 times greater for 4-5 year olds (compared to < or = 3 years) and 4.5 times greater for African-American (compared with White-Americans). Comparison of National Health Interview Survey data with data in the 1997-1999 Annual Reports of the Toxic Exposure Surveillance System revealed the number of estimated exposures in the National Health Interview Survey data were approximately half those reported in the Toxic Exposure Surveillance System data. In both datasets, children 1-2 years of age had the highest percent of poisoning exposures. Using multiple datasets to explore poisoning rates in young children provides a broader perspective. Differences in findings reflect divergent data collection methods and biases inherent in each database. Although the majority of National Health Interview Survey respondents reporting contacting a poison control center for a poisoning exposure, rates are lower in specific subgroups indicating a need for targeted educational efforts.

  18. Therapeutic plasma exchange in a single center: Ibni Sina experience.

    Science.gov (United States)

    Arslan, Onder; Arat, Mutlu; Tek, Ibrahim; Ayyildiz, Erol; Ilhan, Osman

    2004-06-01

    The number of therapeutic procedures is increasing steadily year by year with growing collaboration of departments other than Hematology. In the aim to demonstrate our single center activity we analyzed our data since four years. Between years 1998 and 2001, 658 therapeutic plasma exchange (TPE) procedures were performed on 158 patients. Median age and male/female ratio were 37 (range, 15-87) and 80/78, respectively. Main indications were myastenia gravis (n=55, 34%), TTP (n=13, 8.5%), post ABO mismatched allogeneic hematopoietic cell transplantation aregeneratoric anemia (n=6, 7.5%), progressive systemic sclerosis (n=10, 6.5%), multiple myeloma (n=10, 6.5%), Gullian Barre Syndrome (n=9, 5.9%), multiple sclerosis (n=7, 4.6%), Waldenström Macroglobulinemia (n=5, 3.4%), polymyositis (n=4, 2.7%), sepsis and disseminated intravascular coagulation (n=4, 2.7%). Departments who referred the majority of the patients for TPE were neurology (n=199), hematology (n=153), immunology (n=78), intensive care unit (n=78) and thorax surgery (n=51). The median TPE procedure per patient was 4 (range, 1-50). All the procedures were performed on continuous flow cell separators and median plasma volume processed per cycle was 2471 ml (range 436-5000). The replacement fluids used were 3% hydroxyethylstarch (HES) (24%), 5% albumin (35%), fresh frozen plasma (25%), and HES and albumin (16%). HES was tolerated well even as a sole replacement fluid with acceptable minor side effects. In three patients with progressing hypoalbuminemia HES was replaced or combined with 5% albumin. Close monitoring of serum albumin and fibrinogen levels after repeated procedures is mandatory. In our four years of TPE experience we have increased our collaboration with other departments. 3% HES+/-5% Albumin is a feasible, well tolerated and cost effective replacement fluid combination especially for short-term plasma exchange therapy.

  19. Sports hernias: experience in a sports medicine center.

    Science.gov (United States)

    Santilli, O L; Nardelli, N; Santilli, H A; Tripoloni, D E

    2016-02-01

    Chronic pain of the inguino-crural region or "pubalgia" explains the 0.5-6.2% of the consultations by athletes. Recently, areas of weakness in the posterior wall called "sports hernias," have been identified in some of these patients, capable of producing long-standing pain. Several authors use different image methods (CT, MRI, ultrasound) to identify the lesion and various techniques of repair, by open or laparoscopic approaches, have been proposed but there is no evidence about the superiority of one over others due to the difficulty for randomizing these patients. In our experience, diagnosis was based on clinical and ultrasound findings followed by laparoscopic exploration to confirm and repair the injury. The present study aims to assess the performance of our diagnostic and therapeutic management in a series of athletes affected by "pubalgia". 1450 athletes coming from the orthopedic office of a sport medicine center were evaluated. In 590 of them (414 amateur and 176 professionals) sports hernias were diagnosed through physical examination and ultrasound. We performed laparoscopic "TAPP" repair and, thirty days after, an assessment was performed to determine the evolution of pain and the degree of physical activity as a sign of the functional outcome. We used the U Mann-Whitney test for continuous scale variables and the chi-square test for dichotomous variables with p pubalgia". "Sports hernias" are often associated with adductor muscle strains and other injuries of the groin allowing speculate that these respond to a common mechanism of production. We believe that, considering the difficulty to design randomized trials, only a high coincidence among the diagnostic and therapeutic instances can ensure a rational health care.

  20. A Tale of two Systems: Poisoning Management in Iran and the United States

    Directory of Open Access Journals (Sweden)

    Omid Mehrpour

    2013-05-01

    Full Text Available Poisoning morbidity and mortality is high in the developing world. Systems for care of poisoned patients differ markedly between countries. In this paper a comparison of two very different systems for the care of poisoned patients, is presented. Specifically, the role of poison centers and poison treatment centers in the US and Iran are contrasted. A systematic literature search was undertaken utilizing the PubMed, Scopus, and Google Scholar and the keywords “poison centers”, “treatment” “Iran” “United States of America” and 100 publications were identified. From these, relevant data were found in 23 publications. The information was double-checked and data were summarized herein.We find that the system of the care of poisoned patients relies heavily on certified poison centers in the US and that only a few hospitals have well developed medical toxicology services. In contrast, in Iran, the poison center system is somehow less developed and the care of poisoned patients is provided in centralized high volume hospital poison units.Although both the US and Iran have highly developed systems for the care of poisoned patients they are distinctly different. Comparative studies based on these systems could provide important data for developing countries with more rudimentary poison control and treatment facilities.

  1. International Experience of the Establishing Technology Transfer Centers at the Universities

    Directory of Open Access Journals (Sweden)

    Lysenko, V.S.

    2015-01-01

    Full Text Available The analysis of the experience of creation and operation of technology transfer centers on the basis of US universities with the aim of using positive methods for the creation of such centers in Ukraine is presented.

  2. An Exploration of Hispanic Mothers' Culturally Sustaining Experiences at an Informal Science Center

    Science.gov (United States)

    Weiland, Ingrid

    2015-01-01

    Science education reform focuses on learner-centered instruction within contexts that support learners' sociocultural experiences. The purpose of this study was to explore Hispanic mothers' experiences as accompanying adults at an informal science center within the context of culturally sustaining experiences, which include the fluidity…

  3. Outsmarting Poison Ivy and Other Poisonous Plants

    Science.gov (United States)

    ... poison sumac. Protectants such as baking soda or colloidal oatmeal relieve minor irritation and itching. Aluminum acetate ... Food and Drug Administration 10903 New Hampshire Avenue Silver Spring, MD 20993 1-888-INFO-FDA (1- ...

  4. Encapsulating peritoneal sclerosis: experience of a tertiary referral center.

    LENUS (Irish Health Repository)

    Phelan, P J

    2010-05-01

    Encapsulating peritoneal sclerosis (EPS) is arguably the most serious complication of chronic peritoneal dialysis (PD) therapy with extremely high mortality rates. We aimed to establish the rates of EPS and factors associated with its development in a single center.

  5. National Spherical Torus Experiment (NSTX) Center Stack Upgrade

    International Nuclear Information System (INIS)

    Neumeyer, C.; Avasarala, S.; Chrzanowski, J.; Dudek, L.; Fan, H.; Hatcher, H.; Heitzenroeder, P.; Menard, J.; Ono, M.; Ramakrishnan, S.; Titus, P.; Woolley, R.; Zhan, H.

    2009-01-01

    The purpose of the NSTX Center Stack Upgrade project is to expand the NSTX operational space and thereby the physics basis for next-step ST facilities. The plasma aspect ratio (ratio of plasma major to minor radius) of the upgrade is increased to 1.5 from the original value of 1.26, which increases the cross sectional area of the center stack by a factor of ∼ 3 and makes possible higher levels of performance and pulse duration.

  6. Single-Center Experience Using Marginal Liver Grafts in Korea.

    Science.gov (United States)

    Park, P-J; Yu, Y-D; Yoon, Y-I; Kim, S-R; Kim, D-S

    2018-05-01

    Liver transplantation (LT) is an established therapeutic modality for patients with end-stage liver disease. The use of marginal donors has become more common worldwide due to the sharp increase in recipients, with a consequent shortage of suitable organs. We analyzed our single-center experience over the last 8 years in LT to evaluate the outcomes of using so-called "marginal donors." We retrospectively analyzed the database of all LTs performed at our institution from 2009 to 2017. Only patients undergoing deceased-donor LTs were analyzed. Marginal grafts were defined as livers from donors >60 years of age, livers from donors with serum sodium levels >155 mEq, graft steatosis >30%, livers with cold ischemia time ≥12 hours, livers from donors who were hepatitis B or C virus positive, livers recovered from donation after cardiac death, and livers split between 2 recipients. Patients receiving marginal grafts (marginal group) were compared with patients receiving standard grafts (standard group). A total of 106 patients underwent deceased-donor LT. There were 55 patients in the standard group and 51 patients in the marginal group. There were no significant differences in terms of age, sex, Model for End-Stage Liver Disease score, underlying liver disease, presence of hepatocellular carcinoma, and hospital stay between the 2 groups. Although the incidence of acute cellular rejection, cytomegalovirus infection, and postoperative complications was similar between the 2 groups, the incidence of early allograft dysfunction was higher in the marginal group. With a median follow-up of 26 months, the 1-, 3-, and 5-year overall and graft (death-censored) survivals in the marginal group were 85.5%, 75%, and 69.2% and 85.9%, 83.6%, and 77.2%, respectively. Patient overall survival and graft survival (death-censored) were significantly lower in the marginal group (P = .023 and P = .048, respectively). On multivariate analysis, receiving a marginal graft (hazard ratio [HR

  7. Phosphorus poisoning in waterfowl

    Science.gov (United States)

    Coburn, D.R.; DeWitt, J.B.; Derby, J.V.; Ediger, E.

    1950-01-01

    Black ducks and mallards were found to be highly susceptible to phosphorus poisoning. 3 mg. of white phosphorus per kg. of body weight given in a single dose resulted in death of a black duck in 6 hours. Pathologic changes in both acute and chronic poisoning were studied. Data are presented showing that diagnosis can be made accurately by chemical analysis of stored tissues in cases of phosphorus poisoning.

  8. Hair dye poisoning

    Science.gov (United States)

    Hair tint poisoning ... Different types of hair dye contain different harmful ingredients. The harmful ingredients in permanent dyes are: Naphthylamine Other aromatic amino compounds Phenylenediamines Toluene ...

  9. Prospects of poisoning – a multi facet study

    Directory of Open Access Journals (Sweden)

    Pradeep K. Mishra

    2017-06-01

    Full Text Available Aim of the study is to find out demographic profile, clinical characteristics and analysis of poison in clinical set up. The study carried out in Sri Aurobindo Medical College and PG Institute Indore, Madhya Pradesh. Total 75 cases of poisoning were studied for demographic profile, vitals (BP, pulse, heart rate, pupils, etc., clinical features (such as vomiting, salivation, consciousness, etc., type of poison and its analysis. Results : Poisoning was more common in cases between 15 and 25 years of age, in males than in females and in Hindu religion. Poisoning cases were predominantly from rural areas and in married people. Majority of cases were discharged after proper treatment and counseling. Altered vitals and clinical features were found in most of the cases. Organophosphate and aluminum phosphide compound were evaluated in most of the cases. Conclusions : Preventive measures should be applied through educating people, proper counseling, promoting poison information centers, and introducing separate toxicological units in hospitals.

  10. The Amistad Research Center: Documenting the African American Experience.

    Science.gov (United States)

    Chepesiuk, Ron

    1993-01-01

    Describes the Amistad Research Center housed at Tulane University which is a repository of primary documents on African-American history. Topics addressed include the development and growth of the collection; inclusion of the American Missionary Association archives; sources of support; civil rights; and collecting for the future. (LRW)

  11. User-Centered Design in Practice: The Brown University Experience

    Science.gov (United States)

    Bordac, Sarah; Rainwater, Jean

    2008-01-01

    This article presents a case study in user-centered design that explores the needs and preferences of undergraduate users. An analysis of LibQual+ and other user surveys, interviews with public service staff, and a formal American with Disabilities Act accessibility review served as the basis for planning a redesign of the Brown University…

  12. Early experiences with big data at an academic medical center.

    Science.gov (United States)

    Halamka, John D

    2014-07-01

    Beth Israel Deaconess Medical Center (BIDMC), an academic health care institution affiliated with Harvard University, has been an early adopter of electronic applications since the 1970s. Various departments of the medical center and the physician practice groups affiliated with it have implemented electronic health records, filmless imaging, and networked medical devices to such an extent that data storage at BIDMC now amounts to three petabytes and continues to grow at a rate of 25 percent a year. Initially, the greatest technical challenge was the cost and complexity of data storage. However, today the major focus is on transforming raw data into information, knowledge, and wisdom. This article discusses the data growth, increasing importance of analytics, and changing user requirements that have shaped the management of big data at BIDMC. Project HOPE—The People-to-People Health Foundation, Inc.

  13. Amnesic Shellfish Poisoning

    Science.gov (United States)

    ... Since then, the death or stranding of other marine animals, including whales, has been suspected or confirmed to ... sickened or die due to domoic acid poisoning. Animals poisoned by domoic acid include seabirds and marine mammals, including sea lions, sea otters, whales. Domoic- ...

  14. Arsenical poisoning of racehorses

    Energy Technology Data Exchange (ETDEWEB)

    Sutherland, G.N.; Fawell, E.V.; Brown, J.K.

    1964-03-07

    A case of arsenic poisoning in a training stable of Thoroughbred racehorses is described. This was due to the accidental spilling of an arsenical rat poison into the corn bin. Nine horses were affected. The mortality rate was 100 per cent. 1 table.

  15. Amnesic Shellfish Poisoning (ASP)

    DEFF Research Database (Denmark)

    Ravn, H.

    HAB Publ. Ser. vol 1 is a supplement to Chapter 7 Mehtods for Domoic Acid, the Amnesic Shellfish Poisons in the IOC Manual of Harmful Marine Microalgae......HAB Publ. Ser. vol 1 is a supplement to Chapter 7 Mehtods for Domoic Acid, the Amnesic Shellfish Poisons in the IOC Manual of Harmful Marine Microalgae...

  16. Gaseous poison injection device

    International Nuclear Information System (INIS)

    Kubota, Ryuji; Sugisaki, Toshihiko; Inada, Ikuo.

    1983-01-01

    Purpose: To rapidly control the chain reaction due to thermal neutrons in a reactor core by using gaseous poisons as back-up means for control rod drives. Constitution: Gaseous poisons having a large neutron absorption cross section are used as back-up means for control rod drives. Upon failure of control rod insertion, the gaseous poisons are injected into the lower portion of the reactor core to control the reactor power. As the gaseous poisons, vapors at a high temperature and a higher pressure than that of the coolants in the reactor core are injected to control the reactor power due to the void effects. Since the gaseous poisons thus employed rapidly reach the reactor core and form gas bubbles therein, the deccelerating effect of the thermal neutrons is decreased to reduce the chain reaction. (Moriyama, K.)

  17. Clinical spectrum of hypopituitarism in India: A single center experience

    Science.gov (United States)

    Gundgurthi, Abhay; Garg, M. K.; Bhardwaj, Reena; Brar, Karninder S.; Kharb, Sandeep; Pandit, Aditi

    2012-01-01

    Objectives: There is paucity of information regarding clinical profile of hypopituitarism from India. We report the clinical profile of hypopituitarism from a tertiary center in North India. Materials and Methods: This study was carried out in patients attending our endocrine center between January 2010 and December 2011. All new patients were studied prospectively and those registered before January 2010 retrospectively. Relevant clinical, hormonal, and imaging data were collected. Dynamic testing for pituitary functions was carried out as necessary. Hormonal deficiencies were defined as per prevailing recommendations. Results: This study included 113 subjects. The mean age was 38.6 ± 17.8 years (range, 4 – 76 years). There were 78 (69%) males and 35 females (31%). There were 22 subjects aged ≤18 years (childhood and adolescence) and 91 adults (>18 years). Visual disturbances were the most common presenting complaint (33%), though headache was the most common symptom (81%). Fifteen percent presented with pituitary apoplexy. Tumors comprised of 84% of cases. Hypogonadism (97%) was the most common abnormality seen followed by hypothyroidism (83.2%), hypoadrenalism (79.6%), growth hormone deficiency (88.1% of the 42 patients tested), and diabetes insipidus (13.3%). Panhypopituitarism was seen in 104 (92%) patients. There were no cases of hypopituitarism secondary to traumatic brain injury, subarachnoid hemorrhage, central nervous system infections, or cranial irradiation to extrasellar tumors. Conclusion: The most common cause of hypopituitarism at tertiary care center is pituitary tumors and the commonest presenting complaint is visual symptoms. Panhypopituitarism is present in 92% cases. PMID:23087868

  18. Clinical spectrum of hypopituitarism in India: A single center experience

    Directory of Open Access Journals (Sweden)

    Abhay Gundgurthi

    2012-01-01

    Full Text Available Objectives: There is paucity of information regarding clinical profile of hypopituitarism from India. We report the clinical profile of hypopituitarism from a tertiary center in North India. Materials and Methods: This study was carried out in patients attending our endocrine center between January 2010 and December 2011. All new patients were studied prospectively and those registered before January 2010 retrospectively. Relevant clinical, hormonal, and imaging data were collected. Dynamic testing for pituitary functions was carried out as necessary. Hormonal deficiencies were defined as per prevailing recommendations. Results: This study included 113 subjects. The mean age was 38.6 ± 17.8 years (range, 4 - 76 years. There were 78 (69% males and 35 females (31%. There were 22 subjects aged ≤18 years (childhood and adolescence and 91 adults (>18 years. Visual disturbances were the most common presenting complaint (33%, though headache was the most common symptom (81%. Fifteen percent presented with pituitary apoplexy. Tumors comprised of 84% of cases. Hypogonadism (97% was the most common abnormality seen followed by hypothyroidism (83.2%, hypoadrenalism (79.6%, growth hormone deficiency (88.1% of the 42 patients tested, and diabetes insipidus (13.3%. Panhypopituitarism was seen in 104 (92% patients. There were no cases of hypopituitarism secondary to traumatic brain injury, subarachnoid hemorrhage, central nervous system infections, or cranial irradiation to extrasellar tumors. Conclusion: The most common cause of hypopituitarism at tertiary care center is pituitary tumors and the commonest presenting complaint is visual symptoms. Panhypopituitarism is present in 92% cases.

  19. Experience of Client-centered Practice amongst Danish Occupational Therapists

    DEFF Research Database (Denmark)

    Larsen, Anette Enemark

    A client-centered approach is on the health care agenda in many European countries (1), and amongst these Denmark (2). It is described as the foundation for Occupational Therapy (OT) (3), a code of professional conduct (4,5), and defined as a partnership between client and therapist (3). The goal...... is to empower a client to fulfil his/her occupational roles in a variety of environments, leading to an increase in intervention efficacy and client perception of intervention quality (3). However, it is known to be challenging (1,3). Given the importance of this approach, there has been limited exploration...

  20. Intentional and unintentional poisoning in Pakistan: a pilot study using the Emergency Departments surveillance project.

    Science.gov (United States)

    Khan, Nadeem; Pérez-Núñez, Ricardo; Shamim, Nudrat; Khan, Uzma; Naseer, Naureen; Feroze, Asher; Razzak, Junaid; Hyder, Adnan A

    2015-01-01

    Acute poisoning is one of the most common reasons for emergency department visits around the world. In Pakistan, the epidemiological data on poisoning is limited due to an under developed poison information surveillance system. We aim to describe the characteristics associated with intentional and unintentional poisoning in Pakistan presenting to emergency departments. The data was extracted from the Pakistan National Emergency Department Surveillance (Pak-NEDS) which was an active surveillance conducted between November 2010 and March 2011. All patients, regardless of age, who presented with poisoning to any of Pakistan's seven major tertiary care centers' emergency departments, were included. Information about patient demographics, type of poisoning agent, reason for poisoning and outcomes were collected using a standard questionnaire. Acute poisoning contributed to 1.2% (n = 233) of patients with intentional and unintentional injuries presenting to EDs of participating centers. Of these, 68% were male, 54% were aged 19 to 44 and 19% were children and adolescents (<18 years). Types of poisoning included chemical/gas (43.8%), drug/medicine (27%), alcohol (16.7%) and food/plant (6%). In half of all patients the poisoning was intentional. A total of 11.6% of the patients were admitted and 6.6% died. Poisoning causes more morbidity and mortality in young adults in Pakistan compared to other age groups, half of which is intentional. Improving mental health, regulatory control for hazardous chemicals and better access to care through poison information centers and emergency departments will potentially help control the problem.

  1. Protect the Ones You Love From Poisoning

    Centers for Disease Control (CDC) Podcasts

    2008-12-10

    This podcast, developed as part of the Protect the Ones You Love initiative, discusses steps parents can take to help protect their children from poisoning, one of the leading causes of child injury.  Created: 12/10/2008 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 12/10/2008.

  2. Factor VII deficiency: a single-center experience.

    Science.gov (United States)

    Salcioglu, Zafer; Akcay, Arzu; Sen, Hulya Sayilan; Aydogan, Gonul; Akici, Ferhan; Tugcu, Deniz; Ayaz, Nuray Aktay; Baslar, Zafer

    2012-11-01

    Congenital factor VII deficiency is the most common form of rare coagulation factor deficiencies. This article presents a retrospective evaluation of 73 factor VII deficiency cases that had been followed at our center. The study consisted of 48 males and 25 females (2 months-19 years). Thirty-one (42.5%) of them were asymptomatic. Out of symptomatic patients, 17 had severe clinical symptoms, whereas 8 presented with moderate and 17 with mild symptoms. The symptoms listed in order of frequency were as follows: epistaxis, petechia or ecchymose, easy bruising, and oral cavity bleeding. The genotype was determined in 8 patients. Recombinant activated factor VII (rFVIIa) was used to treat 49 bleeding episodes in 8 patients after 2002. In 2 patients with repeated central nervous system bleeding prophylaxis with rFVIIa was administered. No allergic and thrombotic events were observed during both treatment and prophylaxis courses. Antibody occurrence was not detected in the patients during treatment.

  3. Changing structure to improve function: one academic health center's experience.

    Science.gov (United States)

    Alexander, B; Davis, L; Kohler, P O

    1997-04-01

    Academic health centers (AHCs) have been under siege for the past few years, with decreased federal and state funding for educational and research programs and increasing competition in the health care marketplace. In addition, many AHCs are burdened with the bureaucratic red tape of large educational institutions, which makes agility in responding to a demanding health care market difficult. The authors describe the response to these threats by Oregon Health Sciences University (OHSU), an approach that has been different from those of most similar institutions. OHSU chose to change its structure from being part of the state system of higher education to being an independent public corporation. The authors outline the political process of building widespread support for the legislation passed in 1995, the key features of the restructuring, the challenges faced before and after the transition to a public corporation, and lessons learned in this metamorphosis to a new form.

  4. Diversity leadership: the Rush University Medical Center experience.

    Science.gov (United States)

    Clapp, J R

    2010-01-01

    Meeting the challenges of diversity is crucial, and within healthcare organizations a particularly strong case exists for a diversity strategy. Rush University Medical Center in 2006 was at an important juncture. Since its founding, the organization had made notable progress toward advancing diversity and inclusiveness. On the other hand, many diversity-related problems continued. Rush convened a committee to review the work of the institution in this area. The committee's report called for changes, and a Diversity Leadership Group (DLG) model was established. This article documents the progress made since 2006 through implementation of the DLG model. The changes prescribed for Rush are presented as recommendations and challenges that other healthcare organizations may find applicable to their own institutions.

  5. Multidisciplinary Approach to Esophageal Achalasia: A Single Center Experience.

    Science.gov (United States)

    Schlottmann, Francisco; Andolfi, Ciro; Kavitt, Robert T; Konda, Vani J A; Patti, Marco G

    2017-04-01

    The treatment of achalasia is palliative. Pneumatic dilatation (PD) or laparoscopic Heller myotomy (LHM) just eliminates the outflow obstruction allowing easier emptying of the esophagus. The aim of this study was to evaluate the results of a multidisciplinary approach to esophageal achalasia. A consecutive series of patients with achalasia treated by a multidisciplinary esophageal team consisting of radiologists, gastroenterologists, and surgeons in a quaternary care center between May 2008 and April 2015 were analyzed. A total of 147 patients with achalasia underwent LHM and partial fundoplication. Sixty-two patients (42%) had been treated preoperatively with PD and/or botulinum toxin (BT). The preoperative Eckardt score (ES) was 6.4 ± 2. At a median follow-up of 22 months, 128 patients (87%) did well and required no further treatment (ES 0.1). The remaining 19 patients (13%) had recurrence of symptoms and required further treatment: 12 were treated with PD and improved (ES 0.7); 4 were treated with PD and BT and improved (ES 1.3); 3 failed PD. These 3 patients had been treated with multiple sessions of PD and BT before the myotomy. Overall, 144 patients (98%) did well with laparoscopic (87%) or laparoscopic and endoscopic treatment (11%). The results of this study show that (a) LHM is an effective treatment modality, (b) PD improved symptoms in the majority of patients with recurrent dysphagia after myotomy and (c) multiple preoperative endoscopic treatments seem to affect outcomes of LHM. Patients with achalasia should be treated in a quaternary care center by a multidisciplinary team.

  6. Lead poisoning in dogs

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, M R; Lewis, G

    1963-08-03

    Within a short period, 14 cases of lead poisoning in the dogs have been encountered. A detailed record appears justified as no published reference can be found to this condition occurring in Britain and because reports from other countries stress the similarity of the clinical manifestations of lead poisoning to those of the common infections of the dog. Five of the 14 clinical cases of lead poisoning are described. The available literature is reviewed and the diagnosis and significance of the condition discussed. 19 references, 2 tables.

  7. Laparoscopic treatment for esophageal achalasia: experience at a single center.

    Science.gov (United States)

    Agrusa, A; Romano, G; Bonventre, S; Salamone, G; Cocorullo, G; Gulotta, G

    2013-01-01

    Achalasia is a not frequent esophageal disorder characterized by the absence of esophageal peristalsis and incomplete relaxation of the lower esophageal sphincter (LES). Its cause is unknown. The aim of treatment is to improve the symptoms. We report the results of the treatment of this condition achieved in one center. We conducted a retrospective study of patients with esophageal achalasia. In the period 2010-2012 we observed 64 patients, of whom 19 were referred for medical treatment. Three of the remaining patients underwent botulinum toxin injection, 17 underwent multiple endoscopic dilation procedures and 25 underwent laparoscopic surgery. There were no complications in the group undergoing endoscopic therapy, but symptom remission was only temporary. Patients undergoing surgery showed a significant improvement in symptoms and no recurrence throughout the follow-up period, that is still ongoing (3 years). There were no major complications in any case and no morbidity or mortality. Surgical treatment of esophageal achalasia with laparoscopic Heller myotomy and Dor fundoplication gives the best and longest-lasting results in suitably selected patients. The extension of the myotomy and reduction in LES pressure are the most important parameters to achieve a good result.

  8. Adrenalectomy for metastases from hepatocellular carcinoma - a single center experience.

    Science.gov (United States)

    Popescu, Irinel; Alexandrescu, Sorin; Ciurea, Silviu; Brasoveanu, Vlad; Hrehoret, Doina; Gangone, Eliza; Boros, Mirela; Herlea, Vlad; Croitoru, Adina

    2007-05-01

    Adrenal metastases (AM) from hepatocellular carcinoma (HCC) are rarely seen in clinical practice. The treatment is not standardized, the indications and efficacy of different therapeutic approaches being still controversial. Between January 1995 and December 2005, 174 patients underwent liver resection for HCC in our center. AM were detected in four patients (2.3%): three of them had HCC and synchronous AM, and the remaining one developed AM 10 months after liver resection. All the patients with AM were treated by adrenalectomy (simultaneously with liver resection in synchronous metastases), followed by systemic chemotherapy. Non-resectable multifocal liver recurrences occurred in two patients, one of them having also a contralateral adrenal metastasis; these two patients are presently alive 26 and 43 months after adrenalectomy, respectively. Another patient died by liver recurrence 27 months postoperatively. The fourth patient is disease-free at 17 months after the initial operation. Adrenalectomy for AM from HCC should be performed whenever the primary tumor is well therapeutically controlled and the patient has a good performance status. Adrenalectomy offers the chance of more than 2 years survival in many patients. However, once AM are detected, the prognosis remains poor.

  9. Experience report: a training center for health response

    International Nuclear Information System (INIS)

    Maurmo, Alexandre M.; Leite, Teresa C.S.B.

    2009-01-01

    The Professor Nelson Valverde Training Center was created within FEAM (The ELETRONUCLEAR Medical Assistance Foundation) with the objective of capacitating Radio Nuclear Accident Responders for the Health Area in the Almirante Alvaro Alberto Nuclear Central (Angra dos Reis - RJ - Brazil). The first step was structuring the contents for this training using IAEA's Manuals as base (EPR Medical - 2005, EPR First Responders - 2006 and TMT - Handbook - 2009) and data from REAC/TS. The second step was to capacitate instructors. The third step was the integration with the Company's Radiological Protection Division, giving radiological assessment. Finally, the development of training applications, ending with Drills, Tests and Assessment, gathering data and suggestions, objectifying the constant improvement. Training Programs with pre and post evaluations have been started. Since 2004 training internal courses were ministered for 125 professionals with annual re-training and were ministered to 130 professionals from several external institutions. During the same period training courses were ministered to 140 trainees from the Radiological Protection Division of The Nuclear Power Plant of Angra dos Reis, as First Lay Responders, objectifying the improvement of the quality of the emergency response. (author)

  10. Volvulus without malposition--a single-center experience.

    Science.gov (United States)

    Kargl, Simon; Wagner, Oliver; Pumberger, Wolfgang

    2015-01-01

    This is a single-center case series about the rare condition of volvulus without malposition and/or malrotation (VWM) in preterm babies. We focus on diagnostic difficulties, and our results should help to distinguish VWM as a distinct entity different from classical volvulus and segmental volvulus. Medical chart review of infants with VWM from 2003-2012 was used. A total of 15 patients were identified. All of them had volvulus in the absence of intestinal malposition or other associated intestinal pathologies. All patients were born prematurely. Emergency laparotomy was necessary in all 15 patients. Two groups were identified. Group 1 includes four patients with typical signs of meconium obstruction of prematurity (MOP). Small bowel resection was only necessary in one of these four patients, all survived without residual intestinal lesions. Group 2 consists of 11 patients without signs of MOP-small bowel resection and temporary enterostomy were necessary in all these children. Four patients presented with pneumatosis intestinalis on the abdominal plain film, suggesting necrotizing enterocolitis. Although two infants died, the survivors showed complete recovery. VWM is a distinct disease of prematurity. When associated with MOP, VWM has a favorable outcome of treatment. In contrast, VWM occurring in the absence of signs of meconium obstruction requires small bowel resection. VWM primarily affects the top of the midgut (ileum). Because of absent malposition, presentation of VWM may be uncharacteristic. Pneumatosis intestinalis in advanced VWM may lead to diagnostic difficulties and a delay in treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Postpercutaneous Nephrolithotomy Nephrostogram: Is It Mandatory? A Single Center Experience

    Directory of Open Access Journals (Sweden)

    Abdul Rouf Khawaja

    2014-01-01

    Full Text Available Aims and Objective. “Postpercutaneous nephrolithotomy nephrostogram” (PPNN is routinely performed in most of the centers. No published series could be found in the literature without post percutaneous nephrolithotomy nephrostogram. Hence, the aim of our study is to highlight that post percutaneous nephrolithotomy nephrostogram is not mandatory and it only adds to cost and morbidity without adding any information in the management of such patients. Methods. It was a prospective study from 2005 to 2012, conducted in our institute. It included 119 patients of renal stones who underwent percutaneous nephrolithotomy performed under the guidance of a single surgeon. Postoperative nephrostogram was not done in any of the patients. Results. Complete stone clearance was achieved in 97.5% of patients and 2.5% of patients needed two to three sessions of ESWL later on. None of the patients needed second look percutaneous nephrolithotomy or nephrostogram. Conclusion. Postpercutaneous nephrolithotomy nephrostogram increases chances of infection, inconvenience, contrast related complications, and cost, with no added advantage over plain X-ray KUB, and it should not be done as a routine investigation prior to the removal of PCN tube in patients with complete stone clearance.

  12. Hypopharyngeal carcinoma: King Faisal Specialist Hospital and Research Center experience

    International Nuclear Information System (INIS)

    Mahasin, Z.; Khan, B.

    1996-01-01

    From 1975 to 1985, 202 patients with hypopharyngeal cancer were seen at King Faisal Specialist Hospital and Research Center (KFSHRC). The endoscopic investigation showed that 28.3% of these patients had postcricoid carcinoma; 19.85% had pyriform fossa carcinoma and 52.9% had involvement of both sites. The pathological diagnosis of all cases was squamous cell carcinoma type. The majority of the patients (62.98%) had T4 lesions, which showed a late presentation to KFSHRC. Information related to survival was available for a smaller number of patients to many lost-to-follow-up cases. The overall median survival time was 8.5 months (1-110 months). The survival rate for each site was calculated, as well as the staging of the disease and treatment modality used. It appeared that pyriform fossa (median 21 months) had the best survival rate. In addition the earlier the lesion was detected and the more aggressive the treatment applied, the better the survival rate. Fifty percent of the patients receiving radiation therapy and surgery had a five year survival arte. Factors other than smoking and/on drinking should be looked for in our community as predisposing to this disease in our population. (author)

  13. Occupational toxicant inhalation injury: the World Trade Center (WTC) experience.

    Science.gov (United States)

    de la Hoz, Rafael E; Shohet, Michael R; Chasan, Rachel; Bienenfeld, Laura A; Afilaka, Aboaba A; Levin, Stephen M; Herbert, Robin

    2008-02-01

    Clinical descriptive data is presented on a group of 554 former workers and volunteers (with more than 90 different occupations) at the World Trade Center (WTC) disaster site. A subsample of 168 workers (30% of the group) was selected to examine lower airway disease risk in relation to smoking and WTC exposure variables. Five diagnostic categories clearly predominate: upper airway disease (78.5%), gastroesophageal reflux disease (57.6%), lower airway disease (48.9%), psychological (41.9%) and chronic musculoskeletal illnesses (17.8%). The most frequent pattern of presentation was a combination of the first three of those categories (29.8%). Associations were found between arrival at the WTC site within the first 48 h of the terrorist attack and lower airway and gastroesophageal reflux disease, and between past or present cigarette smoking and lower airway disease. Occupational exposures at the WTC remain consistently associated with a disease profile, which includes five major diagnostic categories. These conditions often coexist in different combinations, which (as expected) mutually enhances their clinical expression, complicates medical management, and slows recovery. Cigarette smoking and early arrival at the WTC site appear to be risk factors for lower airway disease diagnosis.

  14. Training center of Rovenskaya NPP. The experience of creation

    International Nuclear Information System (INIS)

    Fedorov, O.M.; Aristov, B.N.

    1991-01-01

    Experience in creation of a teaching-training centre at the Rovno NPP, which uses means available at unified NPPs, at most is discussed. The centre hardware complex functions include the event filing and providing for user-friendly interface with NPP technical personnel under training. The system of personnel training at the Rovno NPP teaching-training centre gives an opportunity to analyze accidents and emergency conditions more completely and carefully. The taching analysis of failures and accidents by a NPP operators using the complex of the teaching-training centre hardware sufficiently improves knowledge of particular accidents

  15. Location-based solutions in the experience center

    DEFF Research Database (Denmark)

    Witzner Hansen, Dan; Alapetite, Alexandre; Holdgaard, Nanna

    2009-01-01

    In this paper we present a prototype system for location-based guiding. A user survey has been conducted and the observations are used to support design choices. The prototype allows for both indoor and outdoor navigation at and in the vicinity of the NaturBornholm [1] experience centre in Denmar...... using a combination of Bluetooth, Near field communication (NFC), GPS and QR-codes. Bluetooth, NFC, and GPS are used for location-based information and QR-codes are used to convey user preferences. [1] http://naturbornholm.dk...

  16. Poison Ivy Dermatitis

    Science.gov (United States)

    ... than the other two. Poison ivy clings to tree trunks and other vertical surfaces with hair-like ... urushiol". These are called Rhus plants after the old scientific name (it was changed to toxidendron). A ...

  17. Sodium hydroxide poisoning

    Science.gov (United States)

    Sodium hydroxide is a very strong chemical. It is also known as lye and caustic soda. This ... poisoning from touching, breathing in (inhaling), or swallowing sodium hydroxide. This article is for information only. Do ...

  18. Carbon Monoxide Poisoning

    Science.gov (United States)

    ... found in fumes produced any time you burn fuel in cars or trucks, small engines, stoves, lanterns, ... prevent CO poisoning in my home? Install a battery-operated or battery back-up CO detector in ...

  19. Swimming pool cleaner poisoning

    Science.gov (United States)

    Swimming pool cleaner poisoning occurs when someone swallows this type of cleaner, touches it, or breathes in ... The harmful substances in swimming pool cleaner are: Bromine ... copper Chlorine Soda ash Sodium bicarbonate Various mild acids

  20. Drain cleaner poisoning

    Science.gov (United States)

    ... Activated charcoal, which is used to treat other types of poisoning does not effectively treat (adsorb) sodium hydroxide. For skin exposure, treatment may include: Surgical removal of burned skin (debridement) Transfer to a hospital that specializes in burn ...

  1. Poison Ivy Dermatitis

    Science.gov (United States)

    ... Category: Share: Yes No, Keep Private Poison Ivy Dermatitis Share | "Leaves of three - let it be!" aptly ... is caused by an allergic reaction ( allergic contact dermatitis ) to the oily coating that covers of these ...

  2. Asphalt cement poisoning

    Science.gov (United States)

    ... petroleum material that hardens when it cools. Asphalt cement poisoning occurs when someone swallows asphalt. If hot ... found in: Road paving materials Roofing materials Tile cements Asphalt may also be used for other purposes.

  3. Jerusalem cherry poisoning

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002871.htm Jerusalem cherry poisoning To use the sharing features on this page, please enable JavaScript. The Jerusalem cherry is a plant that belongs to the ...

  4. Chicken and Food Poisoning

    Science.gov (United States)

    ... this? Submit What's this? Submit Button Past Emails Chicken and Food Poisoning Language: English (US) Español (Spanish) ... on Facebook Tweet Share Compartir Americans eat more chicken every year than any other meat. Chicken can ...

  5. Tips to Prevent Poisonings

    Science.gov (United States)

    ... hours a day, 7 days a week. Be Smart about Storage Store all medicines and household products ... call medicine "candy." Identify poisonous plants in your house and yard and place them out of reach ...

  6. Sodium hypochlorite poisoning

    Science.gov (United States)

    ... that can cause choking and serious breathing problems. Symptoms of sodium hypochlorite poisoning may include: Burning, red eyes Chest pain Coma Coughing (from the fumes) Delirium Gagging sensation Low blood pressure Pain in the ...

  7. Sodium carbonate poisoning

    Science.gov (United States)

    Sodium carbonate (known as washing soda or soda ash) is a chemical found in many household and industrial products. This article focuses on poisoning due to sodium carbonate. This article is for information only. Do NOT ...

  8. [Suicidal poisoning with benzodiazepines].

    Science.gov (United States)

    Chodorowski, Z; Sein Anand, J

    1997-01-01

    In the period from 1987 to 1996, 103 patients with suicidal benzodiazepines poisoning were treated, including 62 women and 41 men from 16 to 79 (mean 34) years old. 23 persons were poisoned only by benzodiazepines, in 80 remaining cases intoxications were mixed eg. including benzodiazepines and alcohol, tricyclic antidepressants, barbiturates, opioids, phenothiazines. The main causes of suicides were mainly depression, drug addiction and alcoholism. Nobody died in the benzodiazepines group, while mortality rate in the group of mixed poisoning was 4%. Prescribing benzodiazepines by physicians was quite often not justified and facilitated, among others, accumulation of the dose sufficient for suicide attempt. Flumazenil was efficient for leading out from coma in 86% of cases with poisoning only by benzodiazepines and 13% of cases with mixed intoxications mainly containing benzodiazepines and alcohol or carbamazepine.

  9. Lip moisturizer poisoning

    Science.gov (United States)

    ... Science of Poisons . 8th ed. New York, NY: McGraw-Hill Education/Medical; 2013:chap 6. Review Date ... urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows ...

  10. Nail polish poisoning

    Science.gov (United States)

    ... Science of Poisons . 8th ed. New York, NY: McGraw-Hill Medical; 2013:chap 24. Kulig K. General ... urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows ...

  11. Burnable poison rod

    International Nuclear Information System (INIS)

    Natsume, Tomohiro.

    1988-01-01

    Purpose: To increase the reactor core lifetime by decreasing the effect of neutron absorption of burnable poison rods by using material with less neutron absorbing effect. Constitution: Stainless steels used so far as the coating material for burnable poison rods have relatively great absorption in the thermal neutral region and are not preferred in view of the neutron economy. Burnable poison rods having fuel can made of zirconium alloy shows absorption the thermal neutron region lower by one digit than that of stainless steels but they shows absorption in the resonance region and the cost is higher. In view of the above, the fuel can of the burnable poison material is made of aluminum or aluminu alloy. This can reduce the neutron absorbing effect by stainless steel fuel can and effectively utilize neutrons that have been wastefully absorbed and consumed in stainless steels. (Takahashi, M.)

  12. Benzodiazepine poisoning in elderly

    OpenAIRE

    Perković-Vukčević Nataša; Vuković-Ercegović Gordana; Šegrt Zoran; Đorđević Snežana; Jović-Stošić Jasmina

    2016-01-01

    Background/Aim. Benzodiazepines are among the most frequently ingested drugs in self-poisonings. Elderly may be at greater risk compared with younger individuals due to impaired metabolism and increased sensitivity to benzodiazepines. The aim of this study was to assess toxicity of benzodiazepines in elderly attempted suicide. Methods. A retrospective study of consecutive presentations to hospital after self-poisoning with benzodiazepines was done. Collecte...

  13. Snakebite poisoning in Spain.

    Science.gov (United States)

    Martín-Sierra, Cristina; Nogué-Xarau, Santiago; Pinillos Echeverría, Miguel Ángel; Rey Pecharromán, José Miguel

    2018-01-01

    Emergencies due to snakebites, although unusual in Spain, are potentially serious. Of the 13 species native to the Iberian peninsula, only 5 are poisonous: 2 belong to the Colubridae family and 3 to the Viperidae family. Bites from these venemous snakes can be life-threatening, but the venomous species can be easily identified by attending to certain physical traits. Signs denoting poisoning from vipers, and the appropriate treatment to follow, have changed in recent years.

  14. Cartap Hydrochloride Poisoning.

    Science.gov (United States)

    Kalyaniwala, Kimmin; Abhilash, Kpp; Victor, Peter John

    2016-08-01

    Cartap hydrochloride is a moderately hazardous nereistoxin insecticide that is increasingly used for deliberate self-harm in India. It can cause neuromuscular weakness resulting in respiratory failure. We report a patient with 4% Cartap hydrochloride poisoning who required mechanical ventilation for 36-hours. He recovered without any neurological deficits. We also review literature on Cartap hydrochloride poisoning. © Journal of the Association of Physicians of India 2011.

  15. Capitalizing on a current fad to promote poison help: (1-800-222-1222).

    Science.gov (United States)

    Krenzelok, Edward P; Klick, Ross N; Burke, Thomas V; Mrvos, Rita

    2007-01-01

    The distinctive yellow Lance Armstrong 'Live Strong' silicon wristbands, which support cancer research, have reached iconic status and spawned substantial interest from other organizations seeking to capitalize on the same awareness opportunity. To promote the national toll-free Poison Help telephone number, a regional poison information center developed and introduced a Poison Help wristband. The RPIC worked with a marketing firm to design the Poison Help wristband, conduct a feasibility analysis to determine the financial viability of the project and develop a plan to market and sell the wristbands. The wristbands were a unique color, contained the words Poison Help and the national toll-free telephone number. Approximately 50,000 wristbands were distributed in the first four months. By developing a practical application for a popular item, the RPIC increased poison center awareness and, as a secondary benefit, generated revenue to support other poison prevention education endeavors.

  16. Mycophenolate mofetil in pediatric renal transplantation: a single center experience.

    LENUS (Irish Health Repository)

    Raheem, Omer A

    2012-02-01

    We assessed our long-term experience with regards to the safety and efficacy of MMF in our pediatric renal transplant population and compared it retrospectively to our previous non-MMF immunosuppressive regimen. Forty-seven pediatric renal transplants received MMF as part of their immunosuppressive protocol in the period from January 1997 till October 2006 (MMF group). A previously reported non-MMF group of 59 pediatric renal transplants was included for comparative analysis (non-MMF group). The MMF group comprised 29 boys and 18 girls, whereas the non-MMF group comprised 34 boys and 25 girls. Mean age was 11.7 and 12 yr in the MMF and non-MMF groups, respectively. The incidence of acute rejection episodes was 11 (23.4%) and 14 (24%) in the MMF and non-MMF group, respectively. Two (3.3%) grafts were lost in the non-MMF group compared with one (2.1%) in the MMF group. Twenty-one (44.68%) patients in the MMF group developed post-transplant infections compared with 12 (20.33%) in the non-MMF group (p < 0.0001). In conclusion, the use of MMF in pediatric renal transplantation was not associated with a lower rejection rate or immunological graft loss. It did, however, result in a significantly higher rate of viral infections.

  17. Adult prostate sarcoma: the M. D. Anderson Cancer Center Experience.

    Science.gov (United States)

    Sexton, W J; Lance, R E; Reyes, A O; Pisters, P W; Tu, S M; Pisters, L L

    2001-08-01

    Sarcoma of prostate origin is rare. Historically, long-term survival rates for adult patients with prostate sarcoma are poor. We analyzed the experience of 1 institution with prostate sarcoma during the last 3 decades. The records of 21 patients with prostate sarcoma were reviewed to identify symptoms at presentation, diagnostic procedures, presence and development of metastases, staging evaluation, histological subtype, grade and size of the primary tumor, and treatment sequence, including surgery, and preoperative and postoperative therapies. Several clinicopathological variables were assessed for prognostic importance. Most patients presented with urinary obstruction. The diagnosis of prostate sarcoma was usually established with ultrasound guided biopsy or transurethral resection. Histological subtypes were leiomyosarcoma in 12, rhabdomyosarcoma in 4, malignant fibrous histiocytoma in 1 and unclassified sarcoma in 4 patients. At last followup, 8 patients had no evidence of disease after a median of 81.5 months (range 10 to 197). The remaining 13 patients died of sarcoma (median survival 18 months, range 3 to 94). The 1, 3 and 5-year actuarial survival rates for all 21 patients were 81%, 43% and 38%, respectively. Factors predictive of long-term survival were negative surgical margins (p = 0.0005) and absence of metastatic disease at presentation (p = 0.0004). Tumor size and grade, and the histological subtype of prostate sarcoma had no significant influence on actuarial survival. The long-term disease specific survival rate for adults with prostate sarcoma is poor. Early diagnosis and complete surgical resection offer patients the best chance for cure.

  18. Surgical management of gynecomastia: experience of a general surgery center.

    Science.gov (United States)

    Longheu, A; Medas, F; Corrias, F; Farris, S; Tatti, A; Pisano, G; Erdas, E; Calò, P G

    2016-01-01

    Gynecomastia is a common finding in male population of all ages. The aim of our study was to present our experience and goals in surgical treatment of gynecomastia. Clinical records of patients affected by gynecomastia referred to our Department of Surgery between September 2008 and January 2015 were analyzed. 50 patients were included in this study. Gynecomastia was monolateral in 12 patients (24%) and bilateral in 38 (76%); idiopathic in 41 patients (82%) and secondary in 9 (18%). 39 patients (78%) underwent surgical operation under general anaesthesia, 11 (22%) under local anaesthesia. 3 patients (6%) presented recurrent disease. Webster technique was performed in 28 patients (56%), Davidson technique in 16 patients (32%); in 2 patients (4%) Pitanguy technique was performed and in 4 patients (8%) a mixed surgical technique was performed. Mean surgical time was 80.72±35.14 minutes, median postoperative stay was 1.46±0.88 days. 2 patients (4%) operated using Davidson technique developed a hematoma, 1 patient (2%) operated with the same technique developed hypertrophic scar. Several surgical techniques are described for surgical correction of gynecomastia. If performed by skilled general surgeons surgical treatment of gynecomastia is safe and permits to reach satisfactory aesthetic results.

  19. Factors affecting successful colonoscopy procedures: Single-center experience.

    Science.gov (United States)

    Kozan, Ramazan; Yılmaz, Tonguç Utku; Baştuğral, Uygar; Kerimoğlu, Umut; Yavuz, Yücel

    2018-01-01

    Colonoscopy is a gold standard procedure for several colon pathologies. Successful colonoscopy means demonstration of the ileocecal valve and determination of colon polyps. Here we aimed to evaluate our colonoscopy success and results. This retrospective descriptive study was performed in İstanbul Eren hospital endoscopy unit between 2012 and 2015. Colonoscopy results and patient demographics were obtained from the hospital database. All colonoscopy procedures were performed under general anesthesia and after full bowel preparation. In all, 870 patients were included to the study. We reached to the cecum in 850 (97.8%) patients. We were unable to reach the cecum in patients who were old and obese and those with previous lower abdominal operations. Angulation, inability to move forward, and tortuous colon were the reasons for inability to reach the cecum. Total 203 polyp samplings were performed in 139 patients. We performed 1, 2, and 3 polypectomies in 97, 28, and 10 patients, respectively. There were 29 (3.3%) colorectal cancers in our series. There was no mortality or morbidity in our study. General anesthesia and full bowel preparation may be the reason for increased success of colonoscopy. Increased experience and patient-endoscopist cooperation increased the rate of cecum access and polyp resection and decreased the complication rate.

  20. Pediatric Renal Transplantation in Oman: A Single-center Experience

    Directory of Open Access Journals (Sweden)

    Mohamed S. Al Riyami

    2018-01-01

    Full Text Available Objectives: This study sought to report 22 years experience in pediatric kidney transplantation in Oman. Methods: Electronic charts of all Omani children below 13 years of age who received a kidney transplant from January 1994 to December 2015 were reviewed. Data collected included patient demographics, etiology of end-stage kidney disease, modality and duration of dialysis, donor type, complication of kidney transplantation (including surgical complications, infections, graft rejection graft and patient survival, and duration of follow-up. Results: During the study period transplantation from 27 living related donors (LRDs, 42 living unrelated donors (LURDs, also referred to as commercial transplant, and one deceased donor were performed. The median age at transplantation was nine years for both groups. The most common primary diagnosis was congenital anomalies of the kidney and urinary tract in 32.8% of patients followed by familial nephrotic syndrome in 20.0% and polycystic kidney disease in 18.5%. Almost half the patients were on hemodialysis before transplantation, 35.7% were on peritoneal dialysis, and 14.2% received preemptive renal transplantation. Children who received LURD kidneys had high surgical complications (42.8% compared to the LRDs group (17.8%. Five patients from LURDs group had early graft nephrectomy and four patients developed non-graft function or delayed graft function. In addition, patients in the LURDs group had a higher incidence of hypertension and acute rejection. Graft and patient survival were both better in the LRDs than the LURDs group. Conclusions: Although our pediatric kidney transplant program is a young program it has had successful patient outcomes comparable to international programs. Our study provides evidence that in addition to legal and ethical issues with commercial transplant, it also carries significantly higher morbidity and reduced graft and patient survival.

  1. Single-center experience using the Freedom SOLO aortic bioprosthesis.

    Science.gov (United States)

    Iliopoulos, Dimitrios C; Deveja, Aris Rezar; Androutsopoulou, Vasiliki; Filias, Vasilios; Kastelanos, Eleftherios; Satratzemis, Vasilios; Khalpey, Zain; Koudoumas, Dimitrios

    2013-07-01

    This study reviews a single institution experience with the Freedom SOLO (Sorin Group, Saluggia, Italy) aortic bioprosthesis. Between October 2006 and February 2010, 128 patients (64 men, 64 women; mean age, 75.8 ± 5.1 years) underwent aortic valve replacement using the Freedom SOLO stentless aortic valve. The follow-up time was 36.7 ± 1.2 months and 100% complete. Concomitant procedures were performed in 77 patients (60%). The mean standard European System for Cardiac Operative Risk Evaluation was 9 ± 2.7. Grade 3 aortic stenosis was present in 73% of patients, mixed aortic stenosis and regurgitation were present in 40% of patients, and mitral regurgitation was present in 46% of patients. The mean crossclamp time was 53 ± 12 minutes for isolated Freedom SOLO aortic valve implantation and 80 ± 28 minutes for concomitant procedures, and the mean cardiopulmonary bypass time was 103 ± 31 minutes. The mean implanted valve size was 22.6 ± 1.4 mm. The mean intensive care unit and hospital stays were 2.4 ± 1.1 days and 8.8 ± 2.6 days, respectively. Three patients underwent reoperation for bleeding. The 15-day, 30-day, and perioperative mortality were all 4.6%. The 36-month survival was 95.4% ± 1.6% for the cohort with a low European System for Cardiac Operative Risk Evaluation (9). Echocardiographic data preoperatively, immediately postoperatively, and at 3, 6, and 12 months postoperatively showed peak transvalvular gradients of 75 ± 23, 17 ± 6, 18 ± 6.5, 16 ± 6, and 16 ± 9 mm Hg, respectively (P SOLO stentless aortic valve has excellent early and intermediate-term results. Published by Mosby, Inc.

  2. Experience with Evans syndrome in an academic referral center

    Directory of Open Access Journals (Sweden)

    José Carlos Jaime-Pérez

    2015-08-01

    Full Text Available OBJECTIVE: To document the experience of one referral service with patients diagnosed with Evans syndrome, the treatment and response and to briefly review current treatment strategies and results.METHODS: Patients enrolled in this study fulfilled criteria for Evans syndrome. Data were retrieved from the clinical files and electronic databases of the Department of Hematology, Hospital Universitario "Dr. José Eleuterio González". Treatment modalities and response and the use of additional therapies were evaluated. The literature was reviewed in the context of the clinical course of the studied patients.RESULTS: Six patients were diagnosed with Evans syndrome in the study period. Patient 1 was treated with steroids, relapsed twice and was again treated with steroids. Patient 2 treated initially with steroids plus intravenous immunoglobulin was subsequently lost to follow-up. A good response was achieved in Patients 3 and 4, who were treated with steroids plus rituximab; patient 4 also received danazol as a second-line therapy. However both relapsed and subsequently underwent splenectomy at ten and nine months, respectively. One patient, number 5, treated with steroids, danazol and rituximab did not relapse within four years of follow-up and Patient 6, who received steroids plus danazol did not relapse within three years of follow-up.CONCLUSION: Evans syndrome is an uncommon hematologic condition rarely diagnosed and not widely studied. Clinicians must have it in mind when evaluating a patient with a positive direct antiglobulin test, anemia and thrombocytopenia, since prognosis depends on its early recognition and opportune therapy, but even this leads to variable results.

  3. Single center experience in laparoscopic treatment of gallbladder perforation.

    Science.gov (United States)

    Sahbaz, Nuri Alper; Peker, Kivanc Derya; Kabuli, Hamit Ahmet; Gumusoglu, Alpen Yahya; Alis, Halil

    2017-12-01

    Gallbladder perforation (GBP) is a rare disease with potential mortality. Previous series have reported an incidence of approximately 2-11% and it still continues to be a significant problem for surgeons. To present our clinical experience with gallbladder perforation. The records of 2754 patients who received surgical treatment for cholelithiasis between 2010 and 2016 were reviewed retrospectively. One hundred thirty-three patients had gallbladder perforation. Age, gender, time from the onset of symptoms, diagnostic procedures, surgical treatment, morbidity and mortality rates were evaluated. 15.78% of patients had a body mass index > 35. 6.76% had chronic obstructive pulmonary disease, 6.76% had cardiac disease, 10.52% had diabetes and 4.51% had sepsis. American Society of Anesthesiology scores were I in 54.13%, II in 35.33%, III in 6.01% and IV in 4.51% of the patients. 27.81% of patients were diagnosed during surgery. The perforation site was the gallbladder fundus in 69.17%, body in 17.30%, Hartman's pouch in 10.53% and cystic duct in 3% of patients. Treatment modalities were laparoscopic cholecystectomy in 82.71%, open cholecystectomy in 3%, percutaneous drainage catheters + laparoscopic cholecystectomy in 3%, laparoscopic cholecystectomy + fistula repair in 10.53% and open cholecystectomy + fistula repair in 0.75% of patients. Mean length of hospital stay was 1.69 days. Mortality and morbidity rates were 8.27% and 10.52%, respectively. Histopathology results were acute cholecystitis in 69.93%, chronic cholecystitis in 20.30% and acute exacerbation over chronic cholecystitis in 9.77% of patients. Appropriate classification and management of perforated cholecystitis is essential. Laparoscopic cholecystectomy is a safe and feasible method to decrease morbidity in gallbladder perforations.

  4. MRI-guided stereotactic amygdalohippocampectomy: a single center experience

    Directory of Open Access Journals (Sweden)

    Vojtěch Z

    2015-02-01

    Full Text Available Zdenek Vojtěch,1 Hana Malíková,2 Lenka Krámská,3 Roman Liščák,4 Vilibald Vladyka41Department of Neurology, 2Department of Radiodiagnostics, 3Department of Psychology, 4Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech RepublicBackground: This paper presents our experience of stereotactic radiofrequency amygdalohippocampectomy performed for intractable mesial temporal lobe epilepsy.Methods: The article describes the cases of 61 patients who were treated during the period from 2004 to 2010. Mean postoperative follow-up was 5.3 years. Neuropsychological results were obtained for a subset of 31 patients.Results: At their last postsurgical visit, 43 (70.5% patients were Engel class I, six (9.8% class II, nine (14.8% class III, and three (4.9% class IV. The surgery was complicated by four intracranial hematomas. One of them caused acute hydrocephalus and was treated by shunting and resolved without sequelae, while another caused transitory aphasia. The remaining hematomas were asymptomatic. There were two cases of meningitis which required antibiotic treatment. One patient committed suicide due to postoperative depression. After the procedure, we performed open epilepsy surgery and rethermolesions in three and two patients, respectively (8.2%. Patients showed increases in their mean full scale, verbal, and performance intelligence quotient (IQ scores of 4, 3, and 4 IQ points, respectively (P<0.05. Five (17.2%, four (13.8%, and four (13.3% patients improved their full scale, verbal, and performance IQ scores, respectively. No significant changes were found in memory performance, with a mean increase of 1, 3, and 0 memory quotient points in global, verbal, and visual memory, respectively (P<0.05. Global memory improved in three (10.3% patients, verbal memory in one (3.4%, and one patient (3.3% showed deterioration in visual memory.Conclusion: Stereotactic radiofrequency amygdalohippocampectomy offers a

  5. Isolated Renal Hydatid Disease: Experience at the Queen Rania Urology Center, The King Hussein Medical Center

    International Nuclear Information System (INIS)

    Abu-Qamar, Adnan A.; Aljader, Khalaf M.; Habboub, Hazem

    2004-01-01

    In this retrospective study, we present our experience on the diagnosis and management of isolated Hydatid disease of kidneys. Between January 1999 and January 2003, eight patients were diagnosed to have Hydatid disease of kidney and constituted the subjects of this study. Their age ranged between 20 and 63 years age (mean 40); there were five males and three females. Loin pain was the commonest mode of presentation in these patients. Investigations performed included urine analysis, serological tests, eosinophil count and relevant radiological studies. Urine analysis showed hydatiduria in one patient, the Casoni's test was positive in two, Ghedini skin test was positive in three and esinophilia was noted in two other patients. All patients were treated surgically using loin supracoastal extra-peritoneal approach. Total nephrectomy was performed in five patients, partial nephrectomy in one while excision of the cyst was performed in two patients. Our report suggests that a combination of various investigative modalities with a high index of suspicion is necessary in establishing the correct diagnosis. Surgery remains the main option of treatment for renal hydatid disease. (author)

  6. Isolated renal hydatid disease: experience at the queen rania urology center, the king hussein medical center.

    Science.gov (United States)

    Abu-Qamar, Adnan A; Aljader, Khalaf M; Habboub, Hazem

    2004-01-01

    In this retrospective study, we present our experience on the diagnosis and management of isolated Hydatid disease of the kidneys. Between January 1999 and January 2003, eight patients were diagnosed to have Hydatid disease of the kidney and constituted the subjects of this study. Their age ranged between 20 and 63 years age (mean 40); there were five males and three females. Loin pain was the commonest mode of presentation in these patients. Investigations performed included urine analysis, serological tests, eosinophil count and relevant radiological studies. Urine analysis showed hydatiduria in one patient, the Casoni's test was positive in two, Ghedini skin test was positive in three and eosinophilia was noted in two other patients. All patients were treated surgically using loin supracostal extra-peritoneal approach. Total nephrectomy was performed in five patients, partial nephrectomy in one while excision of the cyst was performed in two patients. Our report suggests that a combination of various investigative modalities with a high index of suspicion is necessary in establishing the correct diagnosis. Surgery remains the main option of treatment for renal hydatid disease.

  7. Ecology-centered experiences among children and adolescents: A qualitative and quantitative analysis

    Science.gov (United States)

    Orton, Judy

    The present research involved two studies that considered ecology-centered experiences (i.e., experiences with living things) as a factor in children's environmental attitudes and behaviors and adolescents' ecological understanding. The first study (Study 1) examined how a community garden provides children in an urban setting the opportunity to learn about ecology through ecology-centered experiences. To do this, I carried out a yearlong ethnographic study at an urban community garden located in a large city in the Southeastern United States. Through participant observations and informal interviews of community garden staff and participants, I found children had opportunities to learn about ecology through ecology-centered experiences (e.g., interaction with animals) along with other experiences (e.g., playing games, reading books). In light of previous research that shows urban children have diminished ecological thought---a pattern of thought that privileges the relationship between living things---because of their lack of ecology-centered experiences (Coley, 2012), the present study may have implications for urban children to learn about ecology. As an extension of Study 1, I carried out a second study (Study 2) to investigate how ecology-centered experiences contribute to adolescents' environmental attitudes and behaviors in light of other contextual factors, namely environmental responsibility support, ecological thought, age and gender. Study 2 addressed three research questions. First, does ecological thought---a pattern of thought that privileges the relationship between living things---predict environmental attitudes and behaviors (EAB)? Results showed ecological thought did not predict EAB, an important finding considering the latent assumptions of previous research about the relationship between these two factors (e.g., Brugger, Kaiser, & Roczen, 2011). Second, do two types of contextual support, ecology-centered experiences (i.e., experiences with

  8. Ecology-Centered Experiences among Children and Adolescents: A Qualitative and Quantitative Analysis

    Science.gov (United States)

    Orton, Judy

    2013-01-01

    The present research involved two studies that considered "ecology-centered experiences" (i.e., experiences with living things) as a factor in children's environmental attitudes and behaviors and adolescents' ecological understanding. The first study (Study 1) examined how a community garden provides children in an urban setting the…

  9. Childhood pesticide poisoning in Zhejiang, China: a retrospective analysis from 2006 to 2015.

    Science.gov (United States)

    Yimaer, Aziguli; Chen, Guangdi; Zhang, Meibian; Zhou, Lifang; Fang, Xinglin; Jiang, Wei

    2017-06-28

    Pesticide poisoning in children has been a serious public health issue around the world, especially in the developing countries where agriculture is still one of the largest economic sectors. The purpose of this study was to analyze epidemiological characteristics of acute pesticide poisoning in children from Zhejiang province, China. The pesticide poisoning cases for children were retrieved from Occupational Disease Surveillance and Reporting System, Zhejiang Provincial Center for Disease Control and Prevention, China. The incident cases, deaths, and fatality rate of child pesticide poisoning from 2006 through 2015 were calculated. During the study period, totally 2952 children were poisoned by pesticides, with 66 deaths, resulting in a fatality rate of 2.24%. Among them, there were 1607 male cases with 28 deaths, and 1345 female cases with 38 deaths. Most of the cases occurred in preschool children (1349) and adolescent age group (1269). Organophosphate and carbamate insecticides were the cause of most poisonings (1130), leading to 34 deaths. The highest fatality rate (3.13%) was due to poisoning by herbicides and fungicides, causing 14 deaths out of 448 cases. Poisoning occurred mostly in rural areas (78%). And most pesticide poisoning occurred in the summer (896) and fall (811), while fewest poisoning cases in the winter (483) but with the highest fatality rate (3.52%). This study shows that pesticide poisoning of children is a major health problem in Zhejiang, suggesting preventive strategies should be conducted to control childhood pesticide poisoning.

  10. Childhood pesticide poisoning in Zhejiang, China: a retrospective analysis from 2006 to 2015

    Directory of Open Access Journals (Sweden)

    Aziguli Yimaer

    2017-06-01

    Full Text Available Abstract Background Pesticide poisoning in children has been a serious public health issue around the world, especially in the developing countries where agriculture is still one of the largest economic sectors. The purpose of this study was to analyze epidemiological characteristics of acute pesticide poisoning in children from Zhejiang province, China. Methods The pesticide poisoning cases for children were retrieved from Occupational Disease Surveillance and Reporting System, Zhejiang Provincial Center for Disease Control and Prevention, China. The incident cases, deaths, and fatality rate of child pesticide poisoning from 2006 through 2015 were calculated. Results During the study period, totally 2952 children were poisoned by pesticides, with 66 deaths, resulting in a fatality rate of 2.24%. Among them, there were 1607 male cases with 28 deaths, and 1345 female cases with 38 deaths. Most of the cases occurred in preschool children (1349 and adolescent age group (1269. Organophosphate and carbamate insecticides were the cause of most poisonings (1130, leading to 34 deaths. The highest fatality rate (3.13% was due to poisoning by herbicides and fungicides, causing 14 deaths out of 448 cases. Poisoning occurred mostly in rural areas (78%. And most pesticide poisoning occurred in the summer (896 and fall (811, while fewest poisoning cases in the winter (483 but with the highest fatality rate (3.52%. Conclusions This study shows that pesticide poisoning of children is a major health problem in Zhejiang, suggesting preventive strategies should be conducted to control childhood pesticide poisoning.

  11. Pattern of Acute Poisoning Attending a Tertiary Care Hospital of Western Nepal

    Directory of Open Access Journals (Sweden)

    Raju Prasad Shakya

    2016-12-01

    Full Text Available Introduction: Poisoning with various substances is a major public health problem and a reason for significant morbidity and mortality throughout the globe. It is one of the most common presentation in an emergency department. This study was conducted to determine the sociodemographic, poisoning types, and mode of poisoning in cases attending a tertiary hospital of Western Nepal. Methods: A retrospective observational study of two years was conducted from July 2014 to June 2016. Demography details, name of poisonous substance, and reasons for poisoning were reviewed and analyzed using descriptive statistics. Results: A total of 65 cases of poisoning were recorded. The occurrence was more common in female (n=44, 67.7% than in male (n=21, 32.3% with a F:M ratio of 2.1:1.  Poisoning  was most  common in the age group of 11-20 years (32.3%. Most of the cases were students (37% followed by farmers (26%. The most commonly abused poisoning substance were organophosphorous compounds, zinc-phosphate,  and  kerosene in adults, adolescents, and children respectively. Oral route was the most common (99% route of administration. Suicidal attempt, as a mode of poisoning, accounted for 70.8% of total poisoning cases. Conclusion: Female and young people are at greater risk of acute poisoning. Insecticide was the most common agent and self administer poisoning was the most common mode of poisoning. The occurrence of poisoning and its morbidity and mortality can be reduced by developing and implementation of effective prevention strategies like restricting easy poison sales, establishing drug and poison information centers,  and community awareness programs.

  12. Benzodiazepine poisoning in elderly.

    Science.gov (United States)

    Vukcević, Natasa Perković; Ercegović, Gordana Vuković; Segrt, Zoran; Djordjević, Snezana; Stosić, Jasmina Jović

    2016-03-01

    Benzodiazepines are among the most frequently ingested drugs in self-poisonings. Elderly may be at greater risk compared with younger individuals due to impaired metabolism and increased sensitivity to benzodiazepines. The aim of this study was to assess toxicity of benzodiazepines in elderly attempted suicide. A retrospective study of consecutive presentations to hospital after self-poisoning with benzodiazepines was done. Collected data consisted of patient's characteristics (age, gender), benzodiazepine ingested with its blood concentrations at admission, clinical findings including vital signs and Glasgow coma score, routine blood chemistry, complications of poisoning, details of management, length of hospital stay and outcome. According the age, patients are classified as young (15-40-year old), middle aged (41-65-year old) and elderly (older than 65). During a 2-year observational period 387 patients were admitted because of pure benzodiazepine poisoning. The most frequently ingested drug was bromazepam, the second was diazepam. The incidence of coma was significantly higher, and the length of hospital stay significantly longer in elderly. Respiratory failure and aspiration pneumonia occurred more frequently in old age. Also, flumazenil was more frequently required in the group of elderly patients. Massive benzodiazepines overdose in elderly may be associated with a significant morbidity, including deep coma with aspiration pneumonia, respiratory failure, and even death. Flumazenil is indicated more often to reduce CNS depression and prevent complications of prolonged unconsciousness, but supportive treatment and proper airway management of comatose patients is the mainstay of the treatment of acute benzodiazepine poisoning.

  13. Perfil das intoxicações na infância atendidas pelo Centro de Informação Toxicológica do Rio Grande do Sul (CIT/RS, Brasil Caseload of poisoning among children treated by the Rio Grande do Sul State Toxicology Information Center (CIT/RS, Brazil

    Directory of Open Access Journals (Sweden)

    Carla Luiza Job Ramos

    2005-08-01

    Full Text Available Estudo transversal descritivo analítico para estabelecer perfil das intoxicações em crianças de 0 a 4 anos, registradas no Centro de Informação Toxicológica do Rio Grande do Sul (CIT/RS, Porto Alegre, Brasil, 2003. Selecionados 1.311 casos, extraíram-se dados de crianças que sofreram intoxicação acidental individual dentro de suas residências. Em uma amostra do tipo aleatória sistemática de 286 pacientes, foram realizadas 21 entrevistas com responsáveis legais das crianças, utilizando-se instrumento estruturado. O perfil da intoxicação apresentou faixa etária de um ano; gênero masculino; via de exposição oral; agente tóxico localizado no chão da sala de estar ou no quarto; altura do móvel inferior a 30cm; horário da intoxicação entre 18h01-22h; tempo entre o acidente e a busca por uma conduta médica menor que 30 minutos; medicamento analgésico como agente tóxico; avaliação da intoxicação como não tóxica, evoluindo para a cura. Os dados indicam características relevantes quanto ao horário da intoxicação e local em que se encontravam os agentes tóxicos. A definição do perfil permite orientar e incrementar campanhas de prevenção de acidentes tóxicos na infância promovidas pelos órgãos públicos de saúde.This was an analytical, descriptive, cross-sectional study to establish the profile of poisonings among children 0 to 4 years of age reported to the Rio Grande do Sul State Toxicology Information Center (CIT/RS in Porto Alegre, Brazil, 2003. A total of 1,311 cases were selected and data were extracted on children who had suffered individual accidental poisoning inside the home. From a systematic random sample of 286 patients, 21 interviews were held with the children's parents or guardians, using a structured instrument. The typical profile of poisoning featured: < 1 year age bracket; male gender; oral exposure; poisonous agent located on living room or bedroom floor; furniture height < 30cm; time

  14. Oil-based paint poisoning

    Science.gov (United States)

    Paint - oil-based - poisoning ... Hydrocarbons are the primary poisonous ingredient in oil paints. Some oil paints have heavy metals such as lead, mercury, cobalt, and barium added as pigment. These heavy metals can cause additional ...

  15. Poison ivy - oak - sumac rash

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000027.htm Poison ivy - oak - sumac rash To use the sharing features on this page, please enable JavaScript. Poison ivy, oak, and sumac are plants that commonly ...

  16. Amitraz poisoning: case report

    Directory of Open Access Journals (Sweden)

    Jaime Alexander Molina-Bolaños

    2017-10-01

    Full Text Available Amitraz is an insecticide compound used worldwide for controlling pests, especially in agricultural and livestock areas. However, amitraz poisoning in Colombia is rare. This article reports the case of an 18-year-old female patient who was admitted in the emergency service 3 hours after the intake of an unknown amount of Triatox® (amitraz. The patient presented with a depressed level of consciousness, respiratory distress, hypotension, bradycardia, myosis and metabolic acidosis compensated with respiratory alkalosis. Initial treatment was provided using life support measures in the emergency ward, and subsequent transfer and support in the intensive care unit. She was discharged 24 hours after admission. This case considers the clinical similarity between amitraz poisoning and poisoning caused by other more frequent toxic compounds such as carbamates, organophosphates and opioids, which require different management.

  17. Carbon Monoxide Poisoning

    Directory of Open Access Journals (Sweden)

    Alisa Wray

    2016-07-01

    Full Text Available Audience: This oral boards case is appropriate for all emergency medicine learners (residents, interns, and medical students. Introduction: Carbon monoxide (CO is a colorless and odorless gas that typically results from combustion. It binds hemoglobin, dissociating oxygen, causing headache, weakness, confusion and possible seizure or coma. Pulse oxygen levels may be falsely elevated. Practitioners should maintain a high index of suspicion for carbon monoxide poisoning. If caught early CO poisoning is reversible with oxygen or hyperbaric oxygen therapy. Objectives: The learner will assess a patient with altered mental status and weakness, ultimately identifying that the patient has carbon monoxide poisoning. The learner will treat the patient with oxygen and admit/transfer the patient for hyperbaric oxygenation. Method: Oral boards case

  18. Extracorporeal treatment for thallium poisoning

    DEFF Research Database (Denmark)

    Ghannoum, Marc; Nolin, Thomas D; Goldfarb, David S

    2012-01-01

    The EXtracorporeal TReatments In Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatment (ECTR) in poisoning. To test and validate its methods, the workgroup reviewed data for thallium (Tl).......The EXtracorporeal TReatments In Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatment (ECTR) in poisoning. To test and validate its methods, the workgroup reviewed data for thallium (Tl)....

  19. A consolidation process for spent burnable poison rod assemblies

    International Nuclear Information System (INIS)

    Yamamoto, Y.; Harada, M.; Komatsu, Y.

    1985-01-01

    A new consolidation system for the spent burnable poison assembly utilizing a sequence control robot operated under water was proposed. A credible accident in the system was analyzed mainly from the viewpoint of tritium release, based on the diffusion analysis of tritium in borosilicate glass. It was found that the amount of tritium released would be small even after the rupture of burnable poison rods. An experiment on a new consolidation system was performed using spent burnable poison assemblies. The volume of burnable poison assemblies was reduced safely and securely by a factor of 7 to 14 for burnable poison rods and by 22 for hold-down portions. It was proved that the consolidation system is collectively feasible

  20. Carbon Monoxide (CO) Poisoning Prevention

    Science.gov (United States)

    ... family by acting wisely in case of a power outage and learning the symptoms of CO poisoning. How to Recognize CO Poisoning The most common symptoms of CO poisoning are headache, dizziness, weakness, nausea, vomiting, chest pain, and confusion. People who are sleeping or who ...

  1. Black-spot poison ivy.

    Science.gov (United States)

    Schram, Sarah E; Willey, Andrea; Lee, Peter K; Bohjanen, Kimberly A; Warshaw, Erin M

    2008-01-01

    In black-spot poison ivy dermatitis, a black lacquerlike substance forms on the skin when poison ivy resin is exposed to air. Although the Toxicodendron group of plants is estimated to be the most common cause of allergic contact dermatitis in the United States, black-spot poison ivy dermatitis is relatively rare.

  2. Carbon Monoxide Poisoning

    Directory of Open Access Journals (Sweden)

    Kamal Mishra

    2016-01-01

    Full Text Available Introduction: Carbon monoxide is known as the silent killer, being colorless, odourless, and tasteless. Initially non-irritating, it is very difficult for people to detect Carbon monoxide is a product of incomplete combustion of organic matter due to insufficient oxygen supply that prevents complete oxidation of carbon to C02. During World War II, Nazis used gas vans to kill an estimated over 700,000 prisoners by carbon monoxide poisoning. This method was also used in the gas chambers ofseveral death camps. The true number of incidents of carbon monoxide poisoning is unknown, since many non-lethal exposures go undetected From the available data, carbon monoxide poisoning is the most common cause of injury and death due to poisoning worldwide. Clinical features and management: The signs of carbon monoxide poisoning vary with concentration and length of exposure. Subtle cardiovascular or neurobehavioural effects occur at low concentration. The onset of chronic poisoning is usually insidious and easily mistaken for viral prodrome, depression, or gastroenteritis in children. The classic sign of carbon monoxide poisoning which is actually more often seen in the dead than the living is appearing red-cheeked and healthy. Cherry pink colour develops in nails, skin and mucosa. In acute poisoning, common abnormalities of posture and tone are cogwheel rigidity, opisthotonus, spasticity or flaccidity and seizures. Retinal haemorrhages and the classic cherry red skin colour are seldom seen. Different people andpopulations may have different carbon monoxide tolerance levels. On average, exposures at 100ppm or greater is dangerous to human health. Treatment and prevention: The mainstay of treatment is 100% oxygen administration until the COHb level is normal When the patient is stable enough to be transported, hyperbaric oxygen (HBOT should be considered This treatment is safe and well tolerated Public education about the danger of carbon monoxide, with

  3. Methadone Related Poisoning on the Rise in Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Kambiz Soltaninejad

    2014-09-01

    Full Text Available Background: In Iran, methadone has been used for methadone maintenance treatment (MMT as well as analgesic treatment in pain clinics. Recently, there are some reports regarding accidental and intentional methadone poisonings and deaths. The aim of this study was to evaluate the trend of methadone poisonings and deaths during a 10-year period in Tehran, Iran. Methods: This was a retrospective cross-sectional study over 2000 to 2010. Patients with a documented methadone poisoning who were admitted in Loghman Hakim Hospital Poison Center in Tehran, Iran were identified and included in the study. The data including patients’ age, gender, ingested dose, co-ingestants, intention of ingestion and outcome were extracted from the patients’ medical records. Results: During the study period, 1426 cases of methadone poisoning were recorded, of which, 1041 cases (73% were men. Thirty-six cases (2.5% died. Mean age of the patients was 29.9 ± 17 years. In 476 cases, the intention of poisoning could not be determined, and in the remaining, the intention was misuse (n = 273, 28.7%, suicide (n = 254, 26.7%, accidental (n = 245, 25.8% and abuse (n = 178, 18.8%. Mean of the ingested dose of methadone was 120.6 ± 306.8 mg. The incidence of acute methadone poisoning per one million population of Tehran was 0.43 in 2000 that rose to 37.62 in 2010. Conclusion: The results indicate that methadone poisoning and deaths have increased in Tehran. MMT clinics should be strictly run according to the national guideline to prevent methadone poisoning. With regard to high frequency of poly-drug use in methadone poisoning, it seems important to warn health care providers against prescription of other drugs with methadone. 

  4. Chelation Therapy for Mercury Poisoning

    Directory of Open Access Journals (Sweden)

    Rong Guan

    2009-01-01

    Full Text Available Chelation therapy has been the major treatment for heavy metal poisoning. Various chelating agents have been developed and tested for treatment of heavy metal intoxications, including mercury poisoning. It has been clearly shown that chelating agents could rescue the toxicity caused by heavy metal intoxication, but the potential preventive role of chelating agents against heavy metal poisoning has not been explored much. Recent paper by Siddiqi and colleagues has suggested a protective role of chelating agents against mercury poisoning, which provides a promising research direction for broader application of chelation therapy in prevention and treatment of mercury poisoning.

  5. Oven cleaner poisoning

    Science.gov (United States)

    ... do so by poison control or a health care provider. If the chemical is on the skin or in the eyes, flush with lots of water for at least 15 minutes. If the chemical was swallowed, immediately give the person water or milk, unless instructed otherwise by a provider. If the ...

  6. Metal cleaner poisoning

    Science.gov (United States)

    ... do so by poison control or a health care provider. If the chemical is on the skin or in the eyes, flush with lots of water for at least 15 minutes. If the person swallowed the metal cleaner, give them water or milk right away, unless a provider tells you not ...

  7. Carbon monoxide poisoning

    Science.gov (United States)

    ... Animals can also be poisoned by carbon monoxide. People who have pets at home may notice that their animals become ... or unresponsive from carbon monoxide exposure. Often the pets will ... these conditions. This can lead to a delay in getting help.

  8. Sulfur poisoning in cattle

    Energy Technology Data Exchange (ETDEWEB)

    Julian, R J; Harrison, K B

    1975-01-01

    A case of sulfur poisoning is described in which 12 of 20 cattle died following the feeding of sulfur. Respiratory distress and abdominal pain were the prominent signs. Examination of one animal revealed vasculitis and necrosis of the rumen and abomasal wall. The possible toxic effects of sulfur are discussed.

  9. Poison ivy - oak - sumac

    Science.gov (United States)

    ... done more than 1 hour after touching the plant's sap. Flush the eyes out with water. Take care to clean under the fingernails well to remove ... room. If you are concerned, call your health care provider or poison control. At the ... Take a sample of the plant with you to the doctor or hospital, if ...

  10. Poison Prevention Program

    Science.gov (United States)

    Office of Substance Misuse and Addiction Prevention Finance & Management Services Health Care , Technology: For more info about the national Poison Help program and to request materials visit: http Seniors & Disabilities Services Substance Misuse and Addiction Prevention State of Alaska myAlaska My

  11. Evaluation of accuracy of Monte Carlo code MVP with VHTRC experiments. Multiplication factor at criticality, burnable poison worth and void worth

    International Nuclear Information System (INIS)

    Nojiri, Naoki; Yamashita, Kiyonobu; Fiujimoto, Nozomu; Nakano, Masaaki , Yamane, Tsuyoshi; Akino, Fujiyoshi.

    1997-11-01

    Experimental data of VHTRC (Very High Temperature Reactor Critical Assembly) were analyzed using Monte Carlo code MVP (general purpose Monte Carlo code of neutron and photon transport calculations based on the continuous energy method). The calculation accuracy of the code was evaluated by the analysis for nuclear characteristics of a HTGR (high temperature gas-cooled reactor). The MVP code can analyze with a detailed three-dimensional core model with a few approximations. The HTGRs have following characteristics from view point of nuclear design : they have burnable poisons, many void holes, namely, the control insertion holes and so on. Taking account of these characteristics, multiplication factor at criticality, burnable poison worth, and void worth were evaluated. The maximum calculation errors were 0.8%Δk, 7%, and 25% respectively, From these results, it can be concluded that the MVP code is able to be applied to the nuclear characteristics analysis of the HTGR like the High Temperature Engineering Test Reactor (HTTR). (author)

  12. Contemporary Parenteral Antiplatelet Bridging Strategies: A Single-Center Real-World Experience at a Tertiary Care Center.

    Science.gov (United States)

    Stern, Gretchen; Rimsans, Jessica; Qamar, Arman; Vaduganathan, Muthiah; Bhatt, Deepak L

    2018-03-13

    Oral antiplatelet therapy may require interruption soon after percutaneous coronary intervention (PCI) or acute coronary syndrome. The optimal parenteral antiplatelet bridge strategy with glycoprotein IIb/IIIa inhibitors or cangrelor, a P2Y12 inhibitor, is unclear. We explore real-world use of cangrelor or eptifibatide for antiplatelet bridging at a large tertiary-care center. Thirty-one patients (9 eptifibatide, 20 cangrelor, and 2 both) received bridge therapy from October 2015 to June 2017. Primary bridge therapy indications included surgery (68%), limited enteral access/absorption (16%), and high-perceived bleed risk (16%). Median duration of bridge therapy was 61 (20-100) hours for cangrelor and 83 (19-98) hours for eptifibatide. Severe/life-threatening bleeding or stent thrombosis was not observed. GUSTO-defined bleeding occurred in 30% (cangrelor) and 27% (eptifibatide). Initial dosing errors occurred in 23% of patients. Death during hospitalization occurred in 16% of patients. Parenteral antiplatelet bridging was used for ~3 days in this single-center, tertiary care experience, commonly for unplanned surgery following PCI. Despite high-risk presentations with >15% in-hospital mortality, efficacy profiles were reassuring with no identified stent thrombosis, but bleeding and dosing errors were common. Antiplatelet bridging should only be used in well-selected patients at the appropriate dose for the minimal necessary duration.

  13. [Plant poisoning cases in Turkey].

    Science.gov (United States)

    Oztekin-Mat, A

    1994-01-01

    In Turkey, the majority of the population live in rural areas where they use wild plants as food and medicine. The confusion of an edible plant with a poisonous one give rise to serious poisoning which may even result in death. The incidence of plant poisoning in Turkey is about 6% and especially high among children between ages of 2 and 11 living in rural areas. The number of species that cause poisoning is around twenty and Hyoscyamus niger (Solanaceae), Colchicum species (Liliaceae), Conium maculatum (Umbelliferae) and Prunus species (Rosaceae) are the most important. Mushroom poisoning is more frequent in spring and fall. The main reasons are their widespread usage as food and the inexperience of the gatherers in distinguishing the edibles from the poisonous. Amanita phalloides, A. verna, A. muscaria, A. pantherina are responsible for severe cases of poisoning.

  14. Benzodiazepine poisoning in elderly

    Directory of Open Access Journals (Sweden)

    Perković-Vukčević Nataša

    2016-01-01

    Full Text Available Background/Aim. Benzodiazepines are among the most frequently ingested drugs in self-poisonings. Elderly may be at greater risk compared with younger individuals due to impaired metabolism and increased sensitivity to benzodiazepines. The aim of this study was to assess toxicity of benzodiazepines in elderly attempted suicide. Methods. A retrospective study of consecutive presentations to hospital after self-poisoning with benzodiazepines was done. Collected data consisted of patient's characteristics (age, gender, benzodiazepine ingested with its blood concentrations at admission, clinical findings including vital signs and Glasgow coma score, routine blood chemistry, complications of poisoning, details of management, length of hospital stay and outcome. According the age, patients are classified as young (15-40-year old, middle aged (41-65-year old and elderly (older than 65. Results. During a 2-year observational period 387 patients were admitted because of pure benzodiazepine poisoning. The most frequently ingested drug was bromazepam, the second was diazepam. The incidence of coma was significantly higher, and the length of hospital stay significantly longer in elderly. Respiratory failure and aspiration pneumonia occurred more frequently in old age. Also, flumazenil was more frequently required in the group of elderly patients. Conclusion. Massive benzodiazepines overdose in elderly may be associated with a significant morbidity, including deep coma with aspiration pneumonia, respiratory failure, and even death. Flumazenil is indicated more often to reduce CNS depression and prevent complications of prolonged unconsciousness, but supportive treatment and proper airway management of comatose patients is the mainstay of the treatment of acute benzodiazepine poisoning.

  15. A Qualitative Study of Information Technology Managers' Experiences and Perceptions Regarding Outsourced Data Centers

    Science.gov (United States)

    Reid, Eric Justin

    2015-01-01

    This qualitative study explored the perceptions and experiences of IT Managers in publicly traded companies within the San Antonio, Texas area about outsourced data centers. Narrative data was collected using open-ended questions and face-to-face interviews within semi-structured environments. The research questions guided the study: (1)…

  16. Leaders' Experiences with High School-College Writing Center Collaborations: A Qualitative Multiple-Case Study

    Science.gov (United States)

    Story, Julie A.

    2014-01-01

    The purpose of this qualitative multiple-case study was to explore academic leaders' experiences with the organizational elements of their own high school-college writing center collaborations. Conjoining theories framed this study: collaborative leadership theory, Kenneth Bruffee's notion of social constructionism and collaborative learning…

  17. [Management of Grave's disease in the tropics (experience at Bouffard Army Hospital Center in Djibouti].

    Science.gov (United States)

    Coulet, O; Kraemer, P; Leyral, G; Cloatre, G

    2004-01-01

    Based on their experience in managing Grave's disease at the Bouffard Army Hospital Center within the local health care context in Djibouti, the authors advocate surgery as the first line treatment. Medical and economical factors supporting this preference are discussed so that readers can adapt them to his own local context.

  18. High School Students' Experiences of Bullying and Victimization and the Association with School Health Center Use

    Science.gov (United States)

    Lewis, Catherine; Deardorff, Julianna; Lahiff, Maureen; Soleimanpour, Samira; Sakashita, Kimi; Brindis, Claire D.

    2015-01-01

    Background: Bullying and victimization are ongoing concerns in schools. School health centers (SHCs) are well situated to support affected students because they provide crisis intervention, mental health care, and broader interventions to improve school climate. This study examined the association between urban adolescents' experiences of…

  19. Initial Management of Poisoned Patients in Emergency Medical Services and Non-poisoning Hospitals in Tehran: The Comparison between Expected and Performed Managements

    Directory of Open Access Journals (Sweden)

    Hossein Hassanian-Moghadam

    2014-06-01

    Full Text Available Background: There is no clear data on the adherence of emergency medical services (EMS paramedics and hospital staff rather than those working in poisoning centers to the guidelines for managing acutely poisoned patients in developing countries. Methods: During a 6-month period, all EMS-managed poisoned patients along with those initially managed in a non-poisoning center before being referred to a poisoning hospital in Tehran, Iran, were instructed. Then the indications for administrating the activated charcoal (AC as well as performing gastric lavage (GL and tracheal intubation were studied and compared to the recommended guidelines. Results: A total of 3347 cases, including 1859 males (55.6%, were evaluated. There were significant differences between expected and performed endotracheal intubations in both EMS and other medical centers (P-value = 0.002 and 0.001, respectively as well as the administration of GL and AC in other medical centers (P-values= 0.003 and 0.03, respectively. Conclusion: More extensive educational programs should be established to improve the preliminary management of poisoned patients performed by EMS paramedics and staff of hospitals other than poisoning centers.

  20. Gunshot wounds to the face: level I urban trauma center: a 10-year level I urban trauma center experience.

    Science.gov (United States)

    Pereira, Clifford; Boyd, J Brian; Dickenson, Brian; Putnam, Brant

    2012-04-01

    Gunshot wounds (GSWs) to the face are an infrequent occurrence outside of a war zone. However, when they occur, they constitute a significant reconstructive challenge. We present our 10-year experience at an urban level I trauma center to define the patterns of injury, assess the morbidity and mortality, and estimate the cost to the health care system. A retrospective review was performed on all patients admitted to Harbor-UCLA Medical Center with GSWs to the head and neck region between January 1997 and January 2007. Those who had sustained GSWs to the face requiring operative intervention were closely reviewed. Between 1997 and 2007, a total of 702 patients were admitted to the Harbor UCLA Emergency Department having sustained GSWs to the head and neck region, of which 501 patients survived. Of the survivors, 28 patients (26 male, 2 female) sustained GSWs to their face requiring operative intervention. The mean age of these patients was 28 (±8.3) years. They generally presented within a few hours of the injury, but 1 individual arrived over 24 hours later. Low-velocity single gunshots (from handguns) were predominantly involved, with facial fractures occurring in all cases. Fractures were of a localized shattering type without the major displacement of bony complexes seen in motor vehicle accidents. Most required wound debridement and fracture fixation. A few patients (14.2%) underwent free tissue transfer for reconstruction (3 fibular flaps, 1 TRAM). Tracheostomy was performed in 35.7% of patients. Mean length of hospital stay was 8.3 (±7.1) days, with 50% of cases requiring admission to the intensive care unit. Mean length of intensive care unit stay was 5.2 (±5.7) days. The average cost per patient exceeded $100,000.

  1. A Clinico-Epidemiological Study on Poisonings due to Cardiovascular Drugs in Ahvaz, Iran

    Directory of Open Access Journals (Sweden)

    Marzie Zeinvand

    2017-03-01

    Full Text Available Background: Overdoses with cardiovascular drugs are related with significant morbidity and mortality. Beta-adrenergic blockers, calcium-channel blockers (CCBs, thiazide, digoxin and angiotensin converting enzyme (ACE inhibitors represent five of the most important classes of cardiovascular drugs. Overdoses with cardiovascular drugs are typically caused by exploratory ingestion by children or intentional ingestion by suicidal adults. As no study has been performed about poisoning with this kind of drug in Khuzestan, this study aimed to investigate the frequency of cardiovascular drug poisoning and its clinical features in patients presenting in Razi Hospital of Ahvaz from 2005 to 2009. Methods: A retrospective review of medical records of patients poisoned with cardiovascular who were treated at Clinical Toxicology Department was executed. A total of 70 poisoning cases referred to Razi Hospital were identified. These unselected cases included intentional, accidental, criminal and occupational circumstances. Beta-blocker poisoning, digital poisoning, calcium-channel blockers poisoning, ACE inhibitor poisoning, thiazide poisoning and poisoning with other cardiovascular drugs were evaluated on the basis of recorded data. Poisoning with one or several agents, time of admission, type of poisoned agents, sex, age, therapeutic intervention and mortality were investigated. Results: This study revealed that most of the people poisoned with cardiovascular drugs were females, single people and urban population. Most of the patients were 15-25 years old. Most poisoning was with beta blocker and calcium channel blockers. Their first symptom was headache and most of them needed ICU admission. Most of the patient ECGs were normal. There were 2 cases of death. Conclusion: This study revealed that continuous health care and the administration of the exact dose of drugs in the appropriate time and also developing of the toxicology centers seem necessary.

  2. Hemoperfusion for the treatment of poisoning: technology, determinants of poison clearance, and application in clinical practice.

    Science.gov (United States)

    Ghannoum, Marc; Bouchard, Josée; Nolin, Thomas D; Ouellet, Georges; Roberts, Darren M

    2014-01-01

    Hemoperfusion is an extracorporeal treatment based on adsorption, historically reserved for the treatment of acute poisonings. Its use was popularized in the 1970s after several in vitro and animal experiments had demonstrated its efficacy, and was even preferred over hemodialysis in the management of overdosed patients. With the advent of new and more efficient dialytic modalities, hemoperfusion is now less frequently performed in the Western world. However, hemoperfusion still remains popular in developing countries. The present article reviews the technique of hemoperfusion, the factors influencing poison clearance through adsorption and its current applications. © 2014 Wiley Periodicals, Inc.

  3. Ciguatera poisoning in Vanuatu.

    Science.gov (United States)

    Goodman, Anna; Williams, Thomas N; Maitland, Kathryn

    2003-02-01

    Ciguatera poisoning is endemic in many tropical and subtropical countries. We conducted a retrospective study of admissions to two hospitals on the islands of Vanuatu in the southwestern Pacific region. We estimated the annual hospital admission rate for fish poisoning to be 65 (95% confidence interval [CI] = 55-75)/100,000 population on the island of Santo and 29 (95% CI = 19-43)/100,000 population on the island of Ambae. Hospital admission was more common in males 20-29 years old. Death was a rare complication. In the face of increases in both tourism and in the global trade in tropical and exotic fish, physicians in both endemic and non-endemic areas should be familiar with the epidemiology and clinical features of this important condition.

  4. Calcium channel blocker poisoning

    Directory of Open Access Journals (Sweden)

    Miran Brvar

    2005-04-01

    Full Text Available Background: Calcium channel blockers act at L-type calcium channels in cardiac and vascular smooth muscles by preventing calcium influx into cells with resultant decrease in vascular tone and cardiac inotropy, chronotropy and dromotropy. Poisoning with calcium channel blockers results in reduced cardiac output, bradycardia, atrioventricular block, hypotension and shock. The findings of hypotension and bradycardia should suggest poisoning with calcium channel blockers.Conclusions: Treatment includes immediate gastric lavage and whole-bowel irrigation in case of ingestion of sustainedrelease products. All patients should receive an activated charcoal orally. Specific treatment includes calcium, glucagone and insulin, which proved especially useful in shocked patients. Supportive care including the use of catecholamines is not always effective. In the setting of failure of pharmacological therapy transvenous pacing, balloon pump and cardiopulmonary by-pass may be necessary.

  5. Neuropsychology of thallium poisoning

    Science.gov (United States)

    McMillan, T; Jacobson, R; Gross, M

    1997-01-01

    Cases of thallium poisoning are rare and neuropsychological assessment has only been reported in detail in one other case. In the case reported here, neuropsychological assessments were carried out three, 12, and 54 months after diagnosis of thallium poisoning in a man who had acutely shown a number of neurological signs including confusion and disorientation and generalised slowing of EEG which was more prominent on the left. Evidence suggested that he had been exposed to thallium over a period of weeks. Neuropsychological assessment indicated an unexpected weakness in verbal abilities which persisted. This finding is consistent with the only other published case report which details neuropsychological effects after a single large dose of thallium and which also found a lateralised impairment.

 PMID:9285467

  6. Small dose... big poison.

    Science.gov (United States)

    Braitberg, George; Oakley, Ed

    2010-11-01

    It is not possible to identify all toxic substances in a single journal article. However, there are some exposures that in small doses are potentially fatal. Many of these exposures are particularly toxic to children. Using data from poison control centres, it is possible to recognise this group of exposures. This article provides information to assist the general practitioner to identify potential toxic substance exposures in children. In this article the authors report the signs and symptoms of toxic exposures and identify the time of onset. Where clear recommendations on the period of observation and known fatal dose are available, these are provided. We do not discuss management or disposition, and advise readers to contact the Poison Information Service or a toxicologist for this advice.

  7. Presentations of patients of poisoning and predictors of poisoning-related fatality: Findings from a hospital-based prospective study

    Directory of Open Access Journals (Sweden)

    Lin Hung-Jung

    2008-01-01

    Full Text Available Abstract Background Poisoning is a significant public health problem worldwide and is one of the most common reasons for visiting emergency departments (EDs, but factors that help to predict overall poisoning-related fatality have rarely been elucidated. Using 1512 subjects from a hospital-based study, we sought to describe the demographic and clinical characteristics of poisoning patients and to identify predictors for poisoning-related fatality. Methods Between January 2001 and December 2002 we prospectively recruited poisoning patients through the EDs of two medical centers in southwest Taiwan. Interviews were conducted with patients within 24 hours after admission to collect relevant information. We made comparisons between survival and fatality cases, and used logistic regressions to identify predictors of fatality. Results A total of 1512 poisoning cases were recorded at the EDs during the study period, corresponding to an average of 4.2 poisonings per 1000 ED visits. These cases involved 828 women and 684 men with a mean age of 38.8 years, although most patients were between 19 and 50 years old (66.8%, and 29.4% were 19 to 30 years. Drugs were the dominant poisoning agents involved (49.9%, followed by pesticides (14.5%. Of the 1512 patients, 63 fatalities (4.2% occurred. Paraquat exposure was associated with an extremely high fatality rate (72.1%. The significant predictors for fatality included age over 61 years, insufficient respiration, shock status, abnormal heart rate, abnormal body temperature, suicidal intent and paraquat exposure. Conclusion In addition to well-recognized risk factors for fatality in clinical settings, such as old age and abnormal vital signs, we found that suicidal intent and ingestion of paraquat were significant predictors of poisoning-related fatality. Identification of these predictors may help risk stratification and the development of preventive interventions.

  8. Lead poisoning in mink

    Energy Technology Data Exchange (ETDEWEB)

    Purdy, J G

    1962-03-01

    This paper describes a case of lead poisoning in minks. The mink were housed in pens which had been painted with a bridge paint containing lead. They had chewed on the pen and ingested the paint. The animals that did not die were moved to new pens, and vitamin D and calcium gluconate were added to their diets. In three days, a marked improvement was seen in the food and water consumption, and convolutions became less frequent.

  9. Ethylene glycol poisoning

    African Journals Online (AJOL)

    Ethylene glycol poisoning. A 22-year-old male presented to the emergency centre after drinking 300 ml of antifreeze. Clinical examination was unremarkable except for a respiratory rate of 28 bpm, GCS of 9 and slight nystagmus. Arterial blood gas revealed: pH 7.167, pCO2. 3.01 kPa, pO2 13.0 kPa (on room air), HCO3-.

  10. Antidotes for Cyanide Poisoning

    Science.gov (United States)

    2013-01-01

    treatment, six task forces formulated recom- mendations for a national structure of prehospital EM by family physicians, ambulance nurses , and hospital...competencies between ambulance nurses and prehospital physicians. Eur J Emerg Med 2011; 18:322 327. Antidotes for cyanide poisoning Vikhyat S. Bebarta...the study model (limited to 60 min after the start of cyanide infusion) and the hemodynamic parameters as end points, instead of long-term sequelae

  11. Lead Poison Detection

    Science.gov (United States)

    1976-01-01

    With NASA contracts, Whittaker Corporations Space Science division has developed an electro-optical instrument to mass screen for lead poisoning. Device is portable and detects protoporphyrin in whole blood. Free corpuscular porphyrins occur as an early effect of lead ingestion. Also detects lead in urine used to confirm blood tests. Test is inexpensive and can be applied by relatively unskilled personnel. Similar Whittaker fluorometry device called "drug screen" can measure morphine and quinine in urine much faster and cheaper than other methods.

  12. Food poisoning. Pt. 2

    Energy Technology Data Exchange (ETDEWEB)

    Askar, A.; Treptow, H.

    1982-01-15

    In the present study information about food poisoning is compared and reviewed. From the viewpoint of a food technologist the toxic substances are represented in four sections: 1. Residues of substances used by plants and animals: pesticides, antibiotics, sexual hormones and psychopharmaces. 2. Environmental contaminants: heavy metals, radionuclides and polycyclic hydrocarbons. 3. Substances developing during the manufacture: food additives, asbest, parts of packing materials, and residual solvents. 4. Substances arising from processing: smoked and roasted food, non enzymatic reaction, oxidized and heated fats and irradiated foods. The mere presence of toxic substances does not make food unsafe or poisonous. Dangerous, because of their toxic or carcinogenic effects are: Pesticides (especially chlorinated organic pesticides), heavy metals (especially lead, mercury and cadmium), polycyclic hydrocarbons (3,4-benzpyren), nitrosamines and vinyl chloride. The other components are only dangerous if they are present in large ammounts. A good and responsible practise of agriculture and food manufacture processes, a watchful and competent official food control and well informed consumers can limit the danger of food poisoning and human health.

  13. Differences in perception of risk between people who have and have not experienced Salmonella food poisoning.

    Science.gov (United States)

    Parry, Sharon M; Miles, Susan; Tridente, Ascanio; Palmer, Stephen R

    2004-02-01

    It is believed that food hygiene precautions in domestic kitchens are an important strategy in efforts to reduce the incidence of sporadic food poisoning, but recent research has shown that people who have suffered food poisoning handle the same types of foods and adopt similar food hygiene precautions in their kitchens to the rest of the population. This suggests the need to examine other factors. A case-control study of sporadic Salmonella food poisoning was conducted to investigate several domestic kitchen risk factors. Measures of perception of risk, knowledge, and control associated with food poisoning in case and control respondents are reported here. It was found that perceived personal risk from food poisoning in the home was less than perceived risk to other people. In contrast, ratings of personal knowledge about food poisoning and personal control over food poisoning in the home were seen to be greater than other people's knowledge and control. There were no differences between the cases and the controls in their ratings of knowledge about food poisoning or their control over food poisoning. However, cases perceived their personal risk from food poisoning to be higher than controls. Both case and control samples exhibited optimistic bias but this was reduced in the case sample, suggesting that experience with food poisoning may reduce optimistic bias.

  14. Paraquat poisoning in the dog

    International Nuclear Information System (INIS)

    O'Sullivan, S.P.

    1989-01-01

    Recovery from paraquat poisoning in the dog is rare. This is a report of a case of recovery from confirmed paraquat poisoning in a clinical setting. The dog exhibited the usual signs of paraquat poisoning. The diagnosis was confirmed on toxicological analysis of urine using an ion exchange technique. The dog was treated with frusemide, nicotinamide, corticosteroids, α-tocopherol, vitamin A, etamiphylline camsylate and ampicillin. He recovered after seven weeks of intensive therapy. Alternative treatments are discussed

  15. Chelation Therapy for Mercury Poisoning

    OpenAIRE

    Rong Guan; Han Dai

    2009-01-01

    Chelation therapy has been the major treatment for heavy metal poisoning. Various chelating agents have been developed and tested for treatment of heavy metal intoxications, including mercury poisoning. It has been clearly shown that chelating agents could rescue the toxicity caused by heavy metal intoxication, but the potential preventive role of chelating agents against heavy metal poisoning has not been explored much. Recent paper by Siddiqi and colleagues has suggested a protective role o...

  16. Burnable poison option for DUPIC fuel

    International Nuclear Information System (INIS)

    Choi, Hang Bok; Cupta, H. P.

    1996-08-01

    The mechanisms of positive coolant void reactivity of CANDU natural uranium and DUPIC fuel have been studied. The design study of DUPIC fuel was performed using the burnable poison material in the center pin to reduce the coolant void reactivity. The amount of burnable poison was determined such that the prompt inverse period of DUPIC fuel upon full coolant voiding is the same as that of natural uranium fuel at equilibrium burnup. A parametric study on various burnable poisons has shown that natural dysprosium has more merit over other materials because it uniformly controls the void reactivity throughout the burnup with reasonable amount of poison. Additional studies on the option of using scattering or absorber material in the center pin position and the option using variable fuel density were performed. In any case of option using variable fuel density were performed. In any case of options to reduce the void reactivity, it was found that either the discharge burnup and/or the relative linear pin power are sacrificed. A preliminary study was performed for the evaluation of reference DUPIC fuel performance especially represented by Stress Corrosion Cracking(SCC) parameters which is mainly influenced by the refueling operations. For the reference 2-bundle shift refueling scheme, the predicted ramped power and power increment of the reference DUPIC fuel are below the SCC thresholds of CANDU natural uranium fuel. For a 4-bundle shift refueling scheme, the envelopes of element ramped power and power increment upon refueling are 8% and 44% higher than those of a 2-bundle shift refueling scheme on the average, respectively, but still have margins to the failure thresholds of natural uranium fuel. 23 tabs., 25 figs., 20 refs. (Author)

  17. NASA Glenn Research Center Solar Cell Experiment Onboard the International Space Station

    Science.gov (United States)

    Myers, Matthew G.; Wolford, David S.; Prokop, Norman F.; Krasowski, Michael J.; Parker, David S.; Cassidy, Justin C.; Davies , William E.; Vorreiter, Janelle O.; Piszczor, Michael F.; Mcnatt, Jeremiah S.; hide

    2016-01-01

    Accurate air mass zero (AM0) measurement is essential for the evaluation of new photovoltaic (PV) technology for space solar cells. The NASA Glenn Research Center (GRC) has flown an experiment designed to measure the electrical performance of several solar cells onboard NASA Goddard Space Flight Center's (GSFC) Robotic Refueling Missions (RRM) Task Board 4 (TB4) on the exterior of the International Space Station (ISS). Four industry and government partners provided advanced PV devices for measurement and orbital environment testing. The experiment was positioned on the exterior of the station for approximately eight months, and was completely self-contained, providing its own power and internal data storage. Several new cell technologies including four-junction (4J) Inverted Metamorphic Multi-junction (IMM) cells were evaluated and the results will be compared to ground-based measurement methods.

  18. Cyberattack analysis through Malaysian Nuclear Agency experience as nuclear research center

    International Nuclear Information System (INIS)

    Mohd Dzul Aiman Aslan; Mohd Fauzi Haris; Saaidi Ismail; Nurbahyah Hamdan

    2011-01-01

    As a nuclear research center, Nuclear Malaysia is one of the Critical National Information Infrastructure (CNII) in the country. One of the easiest way to launch a malicious attack is through the online system, whether main web site or online services. Recently, we also under port scanning and hack attempts from various sources. This paper will discuss on analysis based on Nuclear Malaysia experience regarding these attempts which keep arising nowadays. (author)

  19. Activities and experience of the Federal Resource Center for Organizing Comprehensive Support for Children with ASD

    Directory of Open Access Journals (Sweden)

    Khaustov A.V.

    2016-12-01

    Full Text Available This article presents basic activities and experience of the Federal Resource Center for Organizing Comprehensive Sup¬port for Children with ASD of Moscow state university of psychology & education, amassed during 22 years of practice. Some statistic data on the center’s activity are displayed. Emphasis is done on multidirectional work and developing ways of interdepartmental and networking interaction for the sake of founding a system of complex support for autistic children in Russian Federation.

  20. Is Your Child Safe from Lead Poisoning?

    Centers for Disease Control (CDC) Podcasts

    In this podcast, Dr. Mary Jean Brown, chief of CDC's Lead Poisoning and Prevention Program, discusses the importance of testing children for lead poisoning, who should be tested, and what parents can do to prevent lead poisoning.

  1. Burnable poison management in light water reactor lattices

    Energy Technology Data Exchange (ETDEWEB)

    Buenemann, D; Mueller, A

    1970-07-01

    For a better reactivity control and power flattening as well as for an increase in dynamic stability the use of burnable poisons in light water reactors has been considered. The main goals for a burnable poison management and its technological realisation are discussed. The poison is assumed to be in the form of separate poison rods or homogeneous or inhomogeneous poisoning in the fuel rods. A new concept with a central poison rod within the fuel rod is discussed. The balance-equation for the needed concentration of burnable poisons for reactivity central as well as the problems of optimization of lumped poisons are treated in connection with the fuel lattice burnup. A first approximation for the design is found. For the calculation of the microburnup of lumped poison and fuel the special code NEUTRA has been developed. The burnup-equation can be chosen either in a simplified burnup-version with 2 pseudo fission products for each fissionable isotope or with an extended system of burnup equations to be used at sophisticated calculations. These burnup equations are coupled to S{sub N}-routines optionally for cylindrical or x-y-geometry for the proper calculation of the microscopic isotope density-, flux-, and power distributions. The theoretical predictions have been checked by means of special experiments so as to determine the accuracy of the computations. Even for a relatively long burnup of the fuel the predicted values are found to be within the experimental error in the case of lumped rods containing a cadmium-alloy or boron carbide. (auth)

  2. Diagnosis of acute poisoning | Tygerberg Poison Information Centre ...

    African Journals Online (AJOL)

    Continuing Medical Education. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 21, No 8 (2003) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Diagnosis of acute poisoning. - Tygerberg Poison ...

  3. Poisoning by carbon monoxide in Morocco from 1991 to 2008.

    Science.gov (United States)

    Aghandous, Rachida; Chaoui, Hanane; Rhalem, Naima; Semllali, Ilham; Badri, Mohamed; Soulaymani, Abdelmajid; Ouammi, Lahcen; Soulaymani-Bencheikh, Rachida

    2012-04-01

    To describe the characteristics relating to the provenance of statements, patients and to evaluate the spatiotemporal evolution of carbon monoxide poisoning reported to Poison Control Center and Pharmacovigilance of Morocco (CAPM). This is a retrospective study over a period of 18 years from 1991 to 2008, for all cases of poisoning by carbon monoxide reported to CAPM. The epidemiological study focused on 12 976 cases of carbon monoxide poisoning reported to CAPM between 1991 and 2008. The average age of patients was 25.5 +/- 15.6 years, sex ratio was 0.5. The poisoning occurred by accident in 98.7% of cases, especially at home (96.7%) and in cold months. The urban population was the most affected (89.0%). The region of Meknes Tafilalt was the most concerned with 16.6% of cases. The symptomatology was characterized by the predominance of gastrointestinal tract diseases (37.1%). Deaths have reached a percentage of 0.9%. These qualitative and quantitative information is useful to highlight warnings and plan a strategy against carbon monoxide poisoning in Morocco.

  4. Effects of Patient-centered Medical Home Transformation on Child Patient Experience.

    Science.gov (United States)

    Harder, Valerie S; Krulewitz, Julianne; Jones, Craig; Wasserman, Richard C; Shaw, Judith S

    2016-01-01

    Patient experience, 1 of 3 aims for improving health care, is rarely included in studies of patient-centered medical home (PCMH) transformation. This study examines the association between patient experience and National Committee on Quality Assurance (NCQA) PCMH transformation. This was a cross-sectional study of parent-reported child patient experience from PCMH and non-PCMH practices. It used randomly sampled experience surveys completed by 2599 patients at 29 pediatric and family medicine PCMH (n = 21) and non-PCMH (n = 8) practices in Vermont from 2011 to 2013. Patient experiences related to child development and prevention were assessed using the Consumer Assessment of Health care Providers and Systems (CAHPS). A 10-point increase in NCQA score at PCMH practices is associated with a 3.1% higher CAHPS child prevention score (P = .004). Among pediatric practices, PCMH recognition is associated with 7.7% (P child development and prevention composite scores, respectively. Among family medicine practices, PCMH recognition is associated with 7.4% (P = .001) and 11.0% (P child development and prevention composite scores, respectively. Our results suggest that PCMH recognition may improve child patient experience at pediatric practices and worsen experience at family medicine practices. These findings warrant further investigation into the differential influence of NCQA PCMH transformation on family medicine and pediatric practices. © Copyright 2016 by the American Board of Family Medicine.

  5. CFD analysis of poison injection in AHWR calandria

    International Nuclear Information System (INIS)

    Kansal, A.K.; Kamble, M.T.; Maheshwari, N.K.; Vijayan, P.K.

    2014-01-01

    The present work intends to give details of design and performance validation of SDS-2. The performance is evaluated on the basis of dispersion of poison in calandria in a given period of time. Location of injection tube and injection holes, size of jet hole and number of holes are some of the design parameters which greatly affect dispersion of poison in calandria. A Computational Fluid Dynamic (CFD) study for axial and radial injection of poison was carried out using open source CFD code OpenFOAM. CFD benchmarking was done using experiments performed by Johari (Johari et al. 1997) to identify suitable turbulence model for this problem. An experimental facility simulating poison injection in moderator in presence of calandria tubes was used to further validate the CFD model is shown in the paper. CFD analysis was carried out for axial as well as radial injection for AHWR geometry. CFD analysis using OpenFOAM has been carried out to study high pressure poison injection for single jet of Shut Down System - 2 (SDS- 2) of Advanced Heavy Water Reactor (AHWR) for various design options. CFD model used in analysis have been validated with experimental data available in literature as well as experiments performed for AHWR specific geometry. Various turbulence models are tested and their adequacy for such flow problems has been established. The CFD model is then used to simulate poison injection for two design options for AHWR and their performance is compared. (author)

  6. Nicotinic plant poisoning.

    Science.gov (United States)

    Schep, Leo J; Slaughter, Robin J; Beasley, D Michael G

    2009-09-01

    A wide range of plants contain nicotinic and nicotinic-like alkaloids. Of this diverse group, those that have been reported to cause human poisoning appear to have similar mechanisms of toxicity and presenting patients therefore have comparable toxidromes. This review describes the taxonomy and principal alkaloids of plants that contain nicotinic and nicotinic-like alkaloids, with particular focus on those that are toxic to humans. The toxicokinetics and mechanisms of toxicity of these alkaloids are reviewed and the clinical features and management of poisoning due to these plants are described. This review was compiled by systematically searching OVID MEDLINE and ISI Web of Science. This identified 9,456 papers, excluding duplicates, all of which were screened. Reviewed plants and their principal alkaloids. Plants containing nicotine and nicotine-like alkaloids that have been reported to be poisonous to humans include Conium maculatum, Nicotiana glauca and Nicotiana tabacum, Laburnum anagyroides, and Caulophyllum thalictroides. They contain the toxic alkaloids nicotine, anabasine, cytisine, n-methylcytisine, coniine, n-methylconiine, and gamma-coniceine. These alkaloids act agonistically at nicotinic-type acetylcholine (cholinergic) receptors (nAChRs). The nicotinic-type acetylcholine receptor can vary both in its subunit composition and in its distribution within the body (the central and autonomic nervous systems, the neuromuscular junctions, and the adrenal medulla). Agonistic interaction at these variable sites may explain why the alkaloids have diverse effects depending on the administered dose and duration of exposure. Nicotine and nicotine-like alkaloids are absorbed readily across all routes of exposure and are rapidly and widely distributed, readily traversing the blood-brain barrier and the placenta, and are freely distributed in breast milk. Metabolism occurs predominantly in the liver followed by rapid renal elimination. Following acute exposure

  7. Organizational Processes and Patient Experiences in the Patient-centered Medical Home.

    Science.gov (United States)

    Aysola, Jaya; Schapira, Marilyn M; Huo, Hairong; Werner, Rachel M

    2018-06-01

    There is increasing emphasis on the use of patient-reported experience data to assess practice performance, particularly in the setting of patient-centered medical homes. Yet we lack understanding of what organizational processes relate to patient experiences. Examine associations between organizational processes practices adopt to become PCMH and patient experiences with care. We analyzed visit data from patients (n=8356) at adult primary care practices (n=22) in a large health system. We evaluated the associations between practice organizational processes and patient experience using generalized estimating equations (GEE) with an exchangeable correlation structure to account for patient clustering by practice in multivariate models, adjusting for several practice-level and patient-level characteristics. We evaluated if these associations varied by race/ethnicity, insurance type, and the degree of patient comorbidity MEASURES:: Predictors include overall PCMH adoption and adoption of six organizational processes: access and communications, patient tracking and registry, care management, test referral tracking, quality improvement and external coordination. Primary outcome was overall patient experience. In our full sample, overall PCMH adoption score was not significantly associated with patient experience outcomes. However, among subpopulations with higher comorbidities, the overall PCMH adoption score was positively associated with overall patient experience measures [0.2 (0.06, 0.4); P=0.006]. Differences by race/ethnicity and insurance type in associations between specific organizational processes and patient experience were noted. Although some organizational processes relate to patients' experiences with care irrespective of the background of the patient, further efforts are needed to align practice efforts with patient experience.

  8. Lead poisoning: The invisible disease

    Science.gov (United States)

    Friend, Milton

    1989-01-01

    Lead poisoning is an intoxication resulting from absorption of hazardous levels of lead into body tissues. Lead pellets from shot shells, when ingested, are the most common source of lead poisoning in migratory birds. Other far less common sources include lead fishing sinkers, mine wastes, paint pigments, bullets, and other lead objects that are swallowed.

  9. Carbon Monoxide Poisoning in Children

    Directory of Open Access Journals (Sweden)

    Chi-Hsiun Cho

    2008-08-01

    Conclusion: Children with CO poisoning had good outcomes in this series. Although improperly vented exhaust from water heaters and house fires were the most common causes, intentional poisoning by parents through charcoal burning was also an important factor. Early identification of DNS risk factors might help to provide better care.

  10. Alcohol Poisoning Deaths PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    This 60 second Public Service Announcement is based on the January 2015 CDC Vital Signs report. In the United States, an average of six people die every day from alcohol poisoning. Learn what you can do to prevent binge drinking and alcohol poisoning.

  11. Copper sulphate poisoning in horses

    Energy Technology Data Exchange (ETDEWEB)

    Bauer, M

    1975-01-01

    In the archives of the Clinic for Internal Diseases of Domestic Animals at the Veterinary Faculty of Zagreb University some thirty cases of horse disease diagnosed as copper sulphate poisoning were noted. The data correspond in many respects to the clinical findings of copper sulphate poisoning in other domestic animals. A series of experimental horse poisonings were undertaken in order to determine the toxicity of copper sulphate. The research results are as follows: Horses are sensitive to copper sulphate. Even a single application of 0.125 g/kg body weight in 1% concentration by means of incubation into the stomach causes stomach and gut disturbances and other poisoning symptoms. Poisoning occurs in two types: acute and chronic. The former appears after one to three applications of copper sulphate solution and is characterized by gastroenteritis, haemolysis, jaundice and haemoglobinuria with signs of consecutive damage of kidney, liver and other organs. The disease, from the first application to death lasts for two weeks. Chronic poisoning is caused by ingestion of dry copper sulphate in food (1% solution dried on hay or clover) for two or more months. There are chronic disturbances of stomach and gut and loss of weight, and consecutive (three to four) haemolytic crises similar to those of acute poisoning. From the beginning of poisoning to death six or more months can elapse.

  12. Extracorporeal treatment for acetaminophen poisoning

    DEFF Research Database (Denmark)

    Gosselin, S; Juurlink, D N; Kielstein, J T

    2014-01-01

    BACKGROUND: The Extracorporeal Treatments in Poisoning (EXTRIP) workgroup was created to provide evidence-based recommendations on the use of extracorporeal treatments (ECTR) in poisoning and the results are presented here for acetaminophen (APAP). METHODS: After a systematic review of the litera...... of NAC has not been definitively demonstrated....

  13. Extracorporeal Treatment for Lithium Poisoning

    DEFF Research Database (Denmark)

    Decker, Brian S; Goldfarb, David S; Dargan, Paul I

    2015-01-01

    The Extracorporeal Treatments in Poisoning Workgroup was created to provide evidence-based recommendations on the use of extracorporeal treatments in poisoning. Here, the EXTRIP workgroup presents its recommendations for lithium poisoning. After a systematic literature search, clinical and toxico......The Extracorporeal Treatments in Poisoning Workgroup was created to provide evidence-based recommendations on the use of extracorporeal treatments in poisoning. Here, the EXTRIP workgroup presents its recommendations for lithium poisoning. After a systematic literature search, clinical...... extraction of patient-level data. The workgroup concluded that lithium is dialyzable (Level of evidence=A) and made the following recommendations: Extracorporeal treatment is recommended in severe lithium poisoning (1D). Extracorporeal treatment is recommended if kidney function is impaired and the [Li...... treatment (1D), but continuous RRT is an acceptable alternative (1D). The workgroup supported the use of extracorporeal treatment in severe lithium poisoning. Clinical decisions on when to use extracorporeal treatment should take into account the [Li(+)], kidney function, pattern of lithium toxicity...

  14. Forging successful academic-community partnerships with community health centers: the California statewide Area Health Education Center (AHEC) experience.

    Science.gov (United States)

    Fowkes, Virginia; Blossom, H John; Mitchell, Brenda; Herrera-Mata, Lydia

    2014-01-01

    Increased access to insurance under the Affordable Care Act will increase demands for clinical services in community health centers (CHCs). CHCs also have an increasingly important educational role to train clinicians who will remain to practice in community clinics. CHCs and Area Health Education Centers (AHECs) are logical partners to prepare the health workforce for the future. Both are sponsored by the Health Resources and Services Administration, and they share a mission to improve quality of care in medically underserved communities. AHECs emphasize the educational side of the mission, and CHCs the service side. Building stronger partnerships between them can facilitate a balance between education and service needs.From 2004 to 2011, the California Statewide AHEC program and its 12 community AHECs (centers) reorganized to align training with CHC workforce priorities. Eight centers merged into CHC consortia; others established close partnerships with CHCs in their respective regions. The authors discuss issues considered and approaches taken to make these changes. Collaborative innovative processes with program leadership, staff, and center directors revised the program mission, developed common training objectives with an evaluation plan, and defined organizational, functional, and impact characteristics for successful AHECs in California. During this planning, centers gained confidence as educational arms for the safety net and began collaborations with statewide programs as well as among themselves. The AHEC reorganization and the processes used to develop, strengthen, and identify standards for centers forged the development of new partnerships and established academic-community trust in planning and implementing programs with CHCs.

  15. Extracorporeal treatment for barbiturate poisoning

    DEFF Research Database (Denmark)

    Mactier, Robert; Laliberté, Martin; Mardini, Joelle

    2014-01-01

    The EXTRIP (Extracorporeal Treatments in Poisoning) Workgroup conducted a systematic review of barbiturate poisoning using a standardized evidence-based process to provide recommendations on the use of extracorporeal treatment (ECTR) in patients with barbiturate poisoning. The authors reviewed all...... treatment should be continued during ECTR. (4) Cessation of ECTR is indicated when clinical improvement is apparent. This report provides detailed descriptions of the rationale for all recommendations. In summary, patients with long-acting barbiturate poisoning should be treated with ECTR provided at least......-acting barbiturates are dialyzable and short-acting barbiturates are moderately dialyzable. Four key recommendations were made. (1) The use of ECTR should be restricted to cases of severe long-acting barbiturate poisoning. (2) The indications for ECTR in this setting are the presence of prolonged coma, respiratory...

  16. Lead poisoning in dogs

    International Nuclear Information System (INIS)

    Zook, B.C.; Carpenter, J.L.; Leeds, E.B.

    1969-01-01

    Lead poisoning was diagnosed and studied in 60 dogs. It was found that lead poisoning is a common disease of young dogs, especially in the summer and fall, and is related to their chewing and eating habits resulting in the ingestion of paint, linoleum, or other lead-containing materials. The signs were characterized by gastrointestinal dysfunction (colic, vomiting, and diarrhea) and nervous disorders (convulsions, hysteria, nervousness, behavioral changes). The blood findings, which the authors consider nearly pathognomonic, consisted of numerous stippled and immature (especially nucleated) erythrocytes in the absence of severe anemia. Protein and casts were frequently found in the urine. Radiography sometimes revealed lead-containing particles in the gastro-intestinal tract, and lead lines were occasionally detected in the metaphysis of long bones in immature dogs. Treatment with calcium ethylenediamine-tetraacetic acid resulted in rapid and often dramatic recoveries in nearly all instances. Removal of lead from the gastrointestinal tract and treatment to relieve pronounced central nervous disorders was sometimes necessary. 40 references, 6 figures, 7 tables

  17. Endosulfan poisoning: An overview.

    Science.gov (United States)

    Menezes, Ritesh G; Qadir, Tooba Fatima; Moin, Ariba; Fatima, Huda; Hussain, Syed Ather; Madadin, Mohammed; Pasha, Syed Bilal; Al Rubaish, Fatima A; Senthilkumaran, S

    2017-10-01

    Endosulfan, an organochlorine (OC) insecticide, is a widely used agricultural pesticide, despite its life threatening toxic effects. In this review, the pharmacokinetics of endosulfan, mechanism of endosulfan toxicity, clinical presentations and management, histopathological findings, and toxicological analysis are described, in addition to its environmental toxicity. The toxic effects of endosulfan can affect many organs and systems presenting in a wide array of signs and symptoms. Although termed a restricted OC-classed pesticide, it continues to be used, especially in the developing world, owing to its beneficial effects on agriculture. Several cases of endosulfan poisoning have been reported from different regions of the world. Whether accidental or intentional, endosulfan ingestion proves to be fatal unless immediate, aggressive treatment is initiated. Management is mainly supportive as no antidote exists for endosulfan poisoning as yet. The use of endosulfan needs to be strictly regulated and eventually banned worldwide altogether to lower the current morbidity and mortality resulting from this pesticide. Additionally, monitoring biological samples, using non-invasive techniques such as breast milk sampling, can provide an effective method of observing the elimination of this environmentally persistent organic pollutant from the general population. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  18. Organophosphorus poisoning (acute).

    Science.gov (United States)

    Blain, Peter G

    2011-05-17

    Acetylcholinesterase inhibition by organophosphorus pesticides or organophosphate nerve agents can cause acute parasympathetic system dysfunction, muscle weakness, seizures, coma, and respiratory failure. Prognosis depends on the dose and relative toxicity of the specific compound, as well as pharmacokinetic factors. We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for acute organophosphorus poisoning? We searched: Medline, Embase, The Cochrane Library, and other important databases up to April 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 62 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: activated charcoal (single or multiple doses), alpha(2) adrenergic receptor agonists, atropine, benzodiazepines, butyrylcholinesterase replacement therapy, cathartics, extracorporeal clearance, gastric lavage, glycopyrronium bromide (glycopyrrolate), ipecacuanha (ipecac), magnesium sulphate, milk or other home remedy immediately after ingestion, N-methyl-D-aspartate receptor antagonists, organophosphorus hydrolases, oximes, removing contaminated clothes and washing the poisoned person, and sodium bicarbonate.

  19. [Arsenic - Poison or medicine?].

    Science.gov (United States)

    Kulik-Kupka, Karolina; Koszowska, Aneta; Brończyk-Puzoń, Anna; Nowak, Justyna; Gwizdek, Katarzyna; Zubelewicz-Szkodzińska, Barbara

    2016-01-01

    Arsenic (As) is commonly known as a poison. Only a few people know that As has also been widely used in medicine. In the past years As and its compounds were used as a medicine for the treatment of such diseases as diabetes, psoriasis, syphilis, skin ulcers and joint diseases. Nowadays As is also used especially in the treatment of patients with acute promyelocytic leukemia. The International Agency for Research on Cancer (IARC) has recognized arsenic as an element with carcinogenic effect evidenced by epidemiological studies, but as previously mentioned it is also used in the treatment of neoplastic diseases. This underlines the specificity of the arsenic effects. Arsenic occurs widely in the natural environment, for example, it is present in soil and water, which contributes to its migration to food products. Long exposure to this element may lead to liver damages and also to changes in myocardium. Bearing in mind that such serious health problems can occur, monitoring of the As presence in the environmental media plays a very important role. In addition, the occupational risk of As exposure in the workplace should be identified and checked. Also the standards for As presence in food should be established. This paper presents a review of the 2015 publications based on the Medical database like PubMed and Polish Medical Bibliography. It includes the most important information about arsenic in both forms, poison and medicine. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  20. Experiments with Analytic Centers: A confluence of data, tools and help in using them.

    Science.gov (United States)

    Little, M. M.; Crichton, D. J.; Hines, K.; Cole, M.; Quam, B. M.

    2017-12-01

    Traditional repositories have been primarily focused on data stewardship. Over the past two decades, data scientists have attempted to overlay a superstructure to make these repositories more amenable to analysis tasks, with limited success. This poster will summarize lessons learned and some realizations regarding what it takes to create an analytic center. As the volume of Earth Science data grows and the sophistication of analytic tools improves, a pattern has emerged that indicates different science communities uniquely apply a selection of tools to the data to produce scientific results. Infrequently do the experiences of one group help steer other groups. How can the information technology community seed these domains with tools that conform to the thought processes and experiences of that particular science group? What types of succcessful technology infusions have occured and how does technology get adopted. AIST has been experimenting with the management of this analytic center process; this paper will summarize the results and indicate a direction for future infusion attempts.

  1. Variability in hyperbaric oxygen treatment for acute carbon monoxide poisoning.

    Science.gov (United States)

    Byrne, Brendan T; Lu, Jenny J; Valento, Matthew; Bryant, Sean M

    2012-01-01

    In patients with acute carbon monoxide (CO) poisoning, we have noted wide clinical variability in both criteria for hyperbaric oxygen (HBO2) treatment as well as HBO2 treatment regimens. Our aim was to survey Midwest hyperbaric centers for insight into specific criteria and protocols for treating acute CO toxicity with HBO2. Hyperbaric centers were identified from the published list of the Undersea and Hyperbaric Medical Society. Ninety-three centers from nine Midwestern states were contacted via telephone. A standard script was used to minimize surveyor bias. Thirty centers that treat CO poisonings were identified. One did not participate in the study. Nineteen reported a specific level of carboxyhemoglobin (COHb) that served as an independent indication for initiation of HBO2 treatment. Four centers used the COHb level as the exclusive indication for HBO2 treatment. Ten centers relied solely on reported symptoms, while the remaining centers used a combination of symptoms plus COHb levels. There were 19 separate treatment protocols. No uniform practice for either the initiation or implementation of HBO2 therapy for CO poisoning exists among U.S. Midwest hyperbaric centers responding to a survey. We see opportunity for specific targeted educational programs as well as further study.

  2. [Telematics equipment for poison control surveillance. Its applications in the health management of relevant chemical incidents].

    Science.gov (United States)

    Butera, R; Locatelli, C; Gandini, C; Minuco, G; Mazzoleni, M C; Giordano, A; Zanuti, M; Varango, C; Petrolini, V; Candura, S M; Manzo, L

    1997-01-01

    Health management of major chemical incidents requires a close collaboration between rescuers (on the disaster site and in the emergency department) and the poison center. The study tested telematic technologies allowing telepresence and teleconsulting, a real time and continuous connection among health care personnel and toxicologists involved in the management of the emergency. The link between the poison center (PC) and the emergency department in the local hospital is provided by a ISDN operating video conferencing system, while the data transmission from the site of the accident to the PC is achieved with a personal computer and GSM cellular data transmission. Toxicological databases and risk assessment software are integrated in the system, to support information sharing. To test such instruments in operative nearly realistic conditions, the main phase of the study has implemented simulated chemical disasters in different locations in Italy. Instruments for telepresence and teleconsulting have been effectively utilized to evaluate from a remote location the scenario and the severity of the accident, by inspecting either specific details or the whole scene, to enable PC guiding the triage of the victims before and after hospitalization, to utilize and share data, such as intervention protocols or patient records, and to document all the activities. In summary, this experience shows that the telematic link allows the toxicologists of the poison center to rapidly understand the situation, and to correctly learn about the conditions of patients with the help of images. The results of this study indicate the valuable benefits of telematic instruments for the health care in case of major chemical disasters occurring in a remote geographical location or in an area which lacks local toxicological experts, where specialized expertise can be achieved by the use of telematic technologies.

  3. Pattern of acute food, drug, and chemical poisoning in Sari City, Northern Iran.

    Science.gov (United States)

    Ahmadi, Amirhossein; Pakravan, Nasrin; Ghazizadeh, Zeynab

    2010-09-01

    This descriptive and retrospective study was conducted at the poisoning ward of Imam teaching hospital, Sari, Iran, with the aim of evaluating the pattern of poisoning. Hence, the medical profiles of 2057 patients, who were admitted, were carefully reviewed during the period from April 2006 to March 2008 for 2 years. During this period, 2057 cases, 53.9% female and 46.1% male, were admitted with the indication of acute poisoning. The greatest proportion of poisoning occurred between the ages of 18 and 29 years, with suicidal intentions. Most cases of poisoning were intentional (85%). The most common agents involved in acute poisoning were drugs (77.7%), especially sedatives/hypnotics such as benzodiazepines, followed by opioid analgesics. Organophosphate and carbamate insecticides were the third major agent that induced poisoning. Twenty-seven patients (1.3%) who were mostly females and young adults died. Death mostly occurred due to organophosphate and carbamate insecticides (19 cases) poisoning, followed by sedatives/hypnotics like benzodiazepines (3 cases). High prevalence of intentional overdose and mortality among young adults requires considerable attention and further studies to find out the underlying causes. In addition, strict rules must be followed regarding the sale of central nervous system drugs and pesticides, particularly organophosphate and carbamate insecticides. Establishing poison information centers in different parts of the country, preparing national treatment guidelines, training healthcare providers, and ensuring easy availability of the antidotes are also recommended.

  4. 49 CFR 172.554 - POISON placard.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false POISON placard. 172.554 Section 172.554... SECURITY PLANS Placarding § 172.554 POISON placard. (a) Except for size and color, the POISON placard must be as follows: EC02MR91.057 (b) In addition to complying with § 172.519, the background on the POISON...

  5. Cadmium poisoning of oxygen reduction on platinum electrode in potassium hydroxide

    Science.gov (United States)

    Miller, R. O.

    1972-01-01

    Experiment with a rotating disk and ring apparatus showed no poisoning by cadmium in 8.5 M KOH, alone or with Cl(-) or CO3(=). Poisoning does not occur either in 0.1 M KOH supernatant at CdO, but a partially reversible poisoning results from .0001 M CdCl2 and traces of fatty acid are present. Evidence indicates that the catastrophic poisoning affects the four-electron O2 reduction more than it does the one-electron H3O(+) discharge.

  6. Histamine fish poisoning revisited.

    Science.gov (United States)

    Lehane, L; Olley, J

    2000-06-30

    Histamine (or scombroid) fish poisoning (HFP) is reviewed in a risk-assessment framework in an attempt to arrive at an informed characterisation of risk. Histamine is the main toxin involved in HFP, but the disease is not uncomplicated histamine poisoning. Although it is generally associated with high levels of histamine (> or =50 mg/100 g) in bacterially contaminated fish of particular species, the pathogenesis of HFP has not been clearly elucidated. Various hypotheses have been put forward to explain why histamine consumed in spoiled fish is more toxic than pure histamine taken orally, but none has proved totally satisfactory. Urocanic acid, like histamine, an imidazole compound derived from histidine in spoiling fish, may be the "missing factor" in HFP. cis-Urocanic acid has recently been recognised as a mast cell degranulator, and endogenous histamine from mast cell degranulation may augment the exogenous histamine consumed in spoiled fish. HFP is a mild disease, but is important in relation to food safety and international trade. Consumers are becoming more demanding, and litigation following food poisoning incidents is becoming more common. Producers, distributors and restaurants are increasingly held liable for the quality of the products they handle and sell. Many countries have set guidelines for maximum permitted levels of histamine in fish. However, histamine concentrations within a spoiled fish are extremely variable, as is the threshold toxic dose. Until the identity, levels and potency of possible potentiators and/or mast-cell-degranulating factors are elucidated, it is difficult to establish regulatory limits for histamine in foods on the basis of potential health hazard. Histidine decarboxylating bacteria produce histamine from free histidine in spoiling fish. Although some are present in the normal microbial flora of live fish, most seem to be derived from post-catching contamination on board fishing vessels, at the processing plant or in the

  7. U.S. Experience and practices associated with the use of centralized rad waste processing centers

    International Nuclear Information System (INIS)

    Gibson, James D.

    1994-01-01

    This paper presents the experience and current practices employed within the United States (US) associated with the use of Centralized Rad waste Processing Centers for the processing of Low Level Radioactive Wastes (LLRW). Information is provided on the methods, technologies, and practices employed by Scientific Ecology Group, Inc. (SEG), which is the worlds largest processor of LLRW. SEG processes over 80,000 cubic meters of waste annually and achieves an overall volume reduction of 12 : 1. LLRW processing in the United States is currently performed primarily at Centralized Rad waste Processing Centers, such as SEG's Central Volume Reduction Facility (CVRF) in Oak Ridge, Tennessee. This is primarily due to the superior economical application of advanced waste processing technologies, equipment, and personnel maintained at these centers. Information is provided on how SEG uses supercompaction, incineration, metals recycling, vitrification, and various other waste processing techniques to process both dry and wet wastes from over 90 commercial nuclear power plants, government operated facilities, hospitals, universities, and various small generators of radioactive waste

  8. The International Experience of the State Support for Creating the Transport and Logistics Centers

    Directory of Open Access Journals (Sweden)

    Zharska Iryna O.

    2017-02-01

    Full Text Available The article is aimed at analysis and synthesis of the international experience as to the State support for creating the transport and logistics centers (TLCs. The causes for emergence of the first TLCs in Europe (60-80-ies of XX century were considered. Values of the LPI index for the countries occupying the first 40 positions of the ranking as of 2014 and of 2016 have been provided, and the major changes during this time have been analyzed. The ranking position of Ukraine is displayed separately. Features of the logistics infrastructure of nine countries with a high value of the LPI index have been considered, degree of the State involvement in the formation of the TLC network has been analyzed. It has been substantiated that creation of the transport and logistics centers allows to reduce the logistics costs of individual producers and contributes to enhancing the efficiency of operation of the national economy in general by attracting investments in the infrastructure development, increasing the number of jobs and tax revenues. The basic motifs that determine the interest of the State authorities in providing support for creating the transportation and logistics centers have been defined. Prospect for further research in this direction will be determining the efficiency of using the different models of the State support for creation and development of TLCs

  9. Some Aspects of Crystal Centering During X-ray High-throughput Protein Crystallography Experiment

    Science.gov (United States)

    Gaponov, Yu. A.; Matsugaki, N.; Sasajima, K.; Igarashi, N.; Wakatsuki, S.

    A set of algorithms and procedures of a crystal loop centering during X-ray high-throughput protein crystallography experiment has been designed and developed. A simple algorithm of the crystal loop detection and preliminary recognition has been designed and developed. The crystal loop detection algorithm is based on finding out the crystal loop ending point (opposite to the crystal loop pin) using image cross section (digital image column) profile analysis. The crystal loop preliminary recognition procedure is based on finding out the crystal loop sizes and position using image cross section profile analysis. The crystal loop fine recognition procedure based on Hooke-Jeeves pattern search method with an ellipse as a fitting pattern has been designed and developed. The procedure of restoring missing coordinate of the crystal loop is described. Based on developed algorithms and procedures the optimal auto-centering procedure has been designed and developed. A procedure of optimal manual crystal centering (Two Clicks Procedure) has been designed and developed. Developed procedures have been integrated into control software system PCCS installed at crystallography beamlines Photon Factory BL5A and PF-AR NW12, KEK.

  10. Implementation of laparoscopic approach in colorectal surgery - a single center's experience.

    Science.gov (United States)

    Kwiatkowski, Andrzej P; Stępińska, Gabriela; Stanowski, Edward; Paśnik, Krzysztof

    2018-03-01

    Implementation of the laparoscopic approach in colorectal surgery has not happened as rapidly as in cholecystectomy, because of concerns about oncological safety. The results of controlled trials in multiple centers showed the method to be safe. Consequently, surgeons decided to try the approach with colorectal surgery. This process, in our clinic, began in earnest about four years ago. To analyze and present the clinical outcomes of applying the laparoscopic approach to colorectal surgery in a single center. We retrospectively identified patients from a hospital database who underwent colorectal surgery - laparoscopic and open - between 2013 and 2016. Our focus was on laparoscopic cases. Study points included operative time, duration of the hospital stay, postoperative mortality and rates of complications, conversion, reoperation and readmission. Of 534 cases considered, the results showed that the relation between open and laparoscopic procedures had reversed, in favor of the latter method (2013: open: 82% vs. laparoscopic: 18%; 2016: open: 22.4% vs. laparoscopic: 77.6%). The most commonly performed procedure was right hemicolectomy. The total complication rate was 22%. The total rate of conversion to open surgery was 9.3%. The postoperative mortality rate was 3%. Use of the laparoscopic approach in colorectal surgery has increased in recent years world-wide - including in Poland - but the technique is still underused. Rapid implementation of the miniinvasive method in colorectal surgery, in centers with previous laparoscopic experience, is not only safe and feasible, but also highly recommended.

  11. Experimental lead poisoning in chickens

    Energy Technology Data Exchange (ETDEWEB)

    Silven, L.

    1967-01-01

    Poisoning of water fowl due to the intake of lead shot is not rare in the USA. In order to study this kind of poisoning more closely domestic fowl were given varying amounts of lead shot and lead powder. This treatment did not provoke any symptoms of poisoning. Chemical analyses of different organs, muscles, skeleton and eggs yielded low lead values. It is concluded that the low toxicity of lead administered as lead shot to the domestic fowl is due to a low absorption rate from the gastro-intestinal tract.

  12. Alcohol Withdrawal Mimicking Organophosphate Poisoning

    Directory of Open Access Journals (Sweden)

    Nezihat Rana Disel

    2014-02-01

    Full Text Available Organophosphates, which can cause occupational poisoning due to inappropriate personal protective measures, are widely used insecticides in agricultural regions of southern Turkey. Therefore, the classical clinical findings of this cholinergic poisoning are myosis, excessive secretions, bradicardia and fasciculations are easy to be recognized by local medical stuff. Diseases and conditions related to alcoholism such as mental and social impairments, coma, toxicity, withdrawal, and delirium are frequent causes of emergency visits of chronic alcoholic patients. Here we present a case diagnosed and treated as organophosphate poisoning although it was an alcohol withdrawal in the beginning and became delirium tremens, due to similar symptoms.

  13. Health professionals’ experiences of person-centered collaboration in mental health care

    Directory of Open Access Journals (Sweden)

    Rita Sommerseth

    2008-10-01

    Full Text Available Rita Sommerseth, Elin DysvikUniversity of Stavanger, Faculty of Social Sciences, Department of Health Studies, Stavanger, NorwayObjective: The basic aim in this paper is to discuss health care professionals’ experiences of person-centered collaboration and involvement in mental health rehabilitation and suggest ways of improving this perspective. Furthermore, the paper explains the supportive systems that are at work throughout the process of rehabilitation.Method: The study design is a qualitative approach using three focus group interviews with a total of 17 informants with different professional backgrounds such as nurses, social workers, and social pedagogies. In addition, one nurse and one social worker participated in a semistructured in-depth interview to judge validity.Results: Our results may demonstrate deficits concerning mental health care on several levels. This understanding suggests firstly, that a person-centered perspective and involvement still are uncommon. Secondly, multidisciplinary work seems uncommon and only sporadically follows recommendations. Thirdly, family support is seldom involved. Lastly, firm leadership and knowledge about laws and regulations seems not to be systematically integrated in daily care.Conclusion: Taking these matters together, the improvement of a person-centered perspective implies cooperation between different services and levels in mental health care. In order to bring about improvement the health care workers must critically consider their own culture, coordination of competence must be increased, and leadership at an institutional and organizational level must be improved so that scarce rehabilitation resources are used to the optimal benefit of people with a mental illness.Keywords: multidisciplinary teams, person-centered collaboration, supportive systems, rehabilitation

  14. Patient-centered medical home transformation with payment reform: patient experience outcomes.

    Science.gov (United States)

    Heyworth, Leonie; Bitton, Asaf; Lipsitz, Stuart R; Schilling, Thad; Schiff, Gordon D; Bates, David W; Simon, Steven R

    2014-01-01

    To examine changes in patient experience across key domains of the patient-centered medical home (PCMH) following practice transformation with Lean quality improvement methodology inclusive of payment reform. Pre-intervention/post-intervention analysis of intervention with a comparison group, a quasi-experimental design. We surveyed patients following office visits at the intervention (n = 2502) and control (n = 1622) practices during the 15-month period before and 14-month period after PCMH Lean transformation (April-October 2009). We measured and compared pre-intervention and post-intervention levels of patient satisfaction and other indicators of patient-centered care. Propensity weights adjusted for potential case-mix differences in intervention and control groups; propensity-adjusted proportions accounted for physician-level clustering. More intervention patients were very satisfied with their care after the PCMH Lean intervention (68%) compared with pre-intervention (62%). Among control patients, there was no corresponding increase in satisfaction (63% very satisfied pre-intervention vs 64% very satisfied post-intervention). This comparison resulted in a statistical trend (P = .10) toward greater overall satisfaction attributable to the intervention. Post-intervention, patients in the intervention practice consistently rated indicators of patient-centered care higher than patients in the control practice, particularly in the personal physician and communication domain. In this domain, intervention patients reported superior provider explanations, time spent, provider concern, and follow-up instructions compared with control participants, whereas control group ratings fell in the post-intervention period (P for difference Lean enhancement with payment reform, patient experience was sustained or improved across key PCMH domains.

  15. [Ciguatera fish poisoning].

    Science.gov (United States)

    Oehler, Erwan; Bouchut, Jérémie

    2014-09-01

    Ciguatera, an ichtyosarcotoxism linked to the consumption of usually healthy coral fish is a common poisoning in the Pacific, Caribbean and Indian Ocean where it is endemic. However, increased tourism and commercial transportation of tropical fish for consumption make it an unexceptional intoxication in countries away from its endemic area. Environmental stresses such as climate changes also contribute to the expansion of its geographical area. The non-specific clinical symptomatology is characterized by the occurrence of gastrointestinal, cardiovascular, nervous and general signs few hours after eating a ciguatoxic fish. The diagnosis is clinical and relatively easy in endemic areas but much less for physicians who are rarely confronted with, which is a source of prolonged diagnostic delays and a significant increase in spending. Treatment of ciguatera is symptomatic but new treatments, still experimental, give a real hope for the future. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  16. Occult carbon monoxide poisoning.

    Science.gov (United States)

    Kirkpatrick, J N

    1987-01-01

    A syndrome of headache, fatigue, dizziness, paresthesias, chest pain, palpitations and visual disturbances was associated with chronic occult carbon monoxide exposure in 26 patients in a primary care setting. A causal association was supported by finding a source of carbon monoxide in a patient's home, workplace or vehicle; results of screening tests that ruled out other illnesses; an abnormally high carboxyhemoglobin level in 11 of 14 patients tested, and abatement or resolution of symptoms when the source of carbon monoxide was removed. Exposed household pets provided an important clue to the diagnosis in some cases. Recurrent occult carbon monoxide poisoning may be a frequently overlooked cause of persistent or recurrent headache, fatigue, dizziness, paresthesias, abdominal pain, diarrhea and unusual spells.

  17. Fatal aluminium phosphide poisoning

    Directory of Open Access Journals (Sweden)

    Meena Mahesh Chand

    2015-06-01

    Full Text Available Aluminium phosphide (AlP is a cheap solid fumigant and a highly toxic pesticide which is commonly used for grain preservation. AlP has currently aroused interest with a rising number of cases in the past four decades due to increased use for agricultural and non-agricultural purposes. Its easy availability in the markets has increased also its misuse for committing suicide. Phosphine inhibits cellular oxygen utilization and can induce lipid peroxidation. Poisoning with AlP has often occurred in attempts to commit suicide, and that more often in adults than in teenagers. This is a case of suicidal consumption of aluminium phosphide by a 32-year-old young medical anesthetist. Toxicological analyses detected aluminium phosphide. We believe that free access of celphos tablets in grain markets should be prohibited by law.

  18. Group Violence and Migration Experience among Latin American Youths in Justice Enforcement Centers (Madrid, Spain).

    Science.gov (United States)

    Martínez García, José Manuel; Martín López, María Jesús

    2015-10-30

    Group violence among Latin American immigrant youth has led to ongoing debates in political, legal, and media circles, yet none of those many perspectives has arrived at a solid, empirically supported definition for the phenomenon. This study aims to explore the relationship between the immigrant experience and violent group behavior in youths from Latin America serving prison sentences in Justice Enforcement Centers in the Community of Madrid. Semi-structured interviews were conducted with 19 juveniles, and content analysis was applied to the resulting transcripts, employing Grounded Theory to create an axial codification of intra- and inter-categorical contents, and Delphi panels for quality control. The research team delved into 62 topics, addressing participants' perceptions of the immigrant experience and its effects on five socialization settings (neighborhood, school, family, peer group, and significant other), and each one's relationship to violent behavior. The results led us to believe the young people's immigration experiences had been systematically examined. Their personal and social development was influenced by negative socioeconomic conditions, ineffective parental supervision, maladjustment and conflict at school, and experiences of marginalization and xenophobia. All those conditions favored affiliation with violent groups that provided them instrumental (economic and material), expressive, or affective support.

  19. Mercury pOIsonIng

    African Journals Online (AJOL)

    A case of mercury poisoning is reported and clinical observations of 6 .... fish ingested and occupational exposure. .... exposed to mercury as a result of inadequate industrial safety standards, and ... WHO Tech Rep Ser 1980; No. 674: 102-115.

  20. Extracorporeal Treatment in Phenytoin Poisoning

    DEFF Research Database (Denmark)

    Anseeuw, Kurt; Mowry, James B; Burdmann, Emmanuel A

    2016-01-01

    The Extracorporeal Treatments in Poisoning (EXTRIP) Workgroup conducted a systematic literature review using a standardized process to develop evidence-based recommendations on the use of extracorporeal treatment (ECTR) in patients with phenytoin poisoning. The authors reviewed all articles......) despite its high protein binding and made the following recommendations. ECTR would be reasonable in select cases of severe phenytoin poisoning (neutral recommendation, 3D). ECTR is suggested if prolonged coma is present or expected (graded 2D) and it would be reasonable if prolonged incapacitating ataxia...... is present or expected (graded 3D). If ECTR is used, it should be discontinued when clinical improvement is apparent (graded 1D). The preferred ECTR modality in phenytoin poisoning is intermittent hemodialysis (graded 1D), but hemoperfusion is an acceptable alternative if hemodialysis is not available...

  1. Neurotoxic shellfish poisoning: A review

    NARCIS (Netherlands)

    Apeldoorn ME van; Egmond HP van; Speijers GJA; CSR; ARO

    2001-01-01

    This review contains information on the neurotoxic shellfish poisoning (NSP) syndrome and the provoking toxins called brevetoxins, produced by the dinoflagellate Gymnodinium breve. Data on chemical structures and detection methods for brevetoxins, sources for brevetoxins, marine organisms associated

  2. Neurotoxic shellfish poisoning: A review

    NARCIS (Netherlands)

    Apeldoorn ME van; Egmond HP van; Speijers GJA; CSR; ARO

    2001-01-01

    Dit literatuuroverzicht bevat informatie betreffende het "neurotoxic shellfish poisoning" (NSP) syndroom en de veroorzakende toxines, nl.de brevetoxines, welke geproduceerd worden door de dinoflagellaat Gymnodinium breve. Chemische structuren en detectie-methodes van de brevetoxines,

  3. RPV housed ATWS poison tank

    International Nuclear Information System (INIS)

    Oosterkamp, W.J.

    1992-01-01

    This patent describes a boiling water reactor (BWR) wherein housed within a reactor pressure vessel (RPV) is a nuclear core and an upper steam dome connected to a steam outlet in the RPV. The improvement comprises: a pressurized vessel disposed in the steam dome containing a neutron poison effective for inactivating the core and a first line for assaying the poison which first line runs to the outside of the RPV, the vessel being vented to the steam dome to pressurize the poison contained therein, the vessel being connected by a second line terminating beneath the core, the second line containing a valve which is actuable to release the poison through the line upon its actuation

  4. Grass and weed killer poisoning

    Science.gov (United States)

    ... medlineplus.gov/ency/article/002838.htm Grass and weed killer poisoning To use the sharing features on this page, please enable JavaScript. Many weed killers contain dangerous chemicals that are harmful if ...

  5. The poisoning of NRX pile

    International Nuclear Information System (INIS)

    Watson, W.H.

    1959-09-01

    The experimental methods used to study the poisoning of the NRX reactor are described and the operation of the reactor in relation to these methods is reviewed for the period February to September 1948. (author)

  6. Development of PET in Latin America. Experience of the first PET-Cyclotron Center

    International Nuclear Information System (INIS)

    Tutor, C.A.; Frias, L.

    2002-01-01

    Aim: Describe the experience of the first PET-Cyclotron Center in Latin America. Demonstrate the viability of running a PET Center in Argentina despite the economic crisis. Materials and Methods: For this study, we used a UGM/GE Quest 250 PET scan, a RDS 112 cyclotron and a Radiosynthesis Laboratory installed at the (FUESMEN) Nuclear Medicine School Foundation, located in Mendoza City, in the middle-west of Argentina. From January 1999 to March 2002, 741 studies were obtained, 731 were 18 FluorDeoxyGlucose-PET studies and 10 phantoms for calibration purposes. We used acquisition and imaging processing standard protocols, as well as research protocols designed according to the pathology under investigation. To better correlate anatomical and functional images, we used fusion techniques with (CT) Computed Tomography in some (WB) whole-body PET scans. Results: A total of 731 patients were retrospectively analyzed and classified according to statistics variables such as: 1-sex: 317 women and 414 men, 2-type of scan: 439 WB cases, 267 brain studies and 25 cardiac. From this data we divided them as PET indications and resulted in 17 cases as healthy volunteers, 422 oncological cases, 267 neurological studies and 25 cardiac for myocardial viability. According to the origin they were classified as patients coming from Mendoza 544, Buenos Aires 112, other argentine provinces 60 and foreign (Chile, Brazil and Uruguay) 15 cases. In terms of billing, 181 studies were done free of charge, 95 under research protocols were also done free of charge and 451 were charged. Conclusion: Not only the economical and political factors play an important role limiting the advances of PET Imaging in Latin America, but also the lack of a neighboring cyclotron that circumscribe many hospitals to have access to the radiopharmaceutical agent. FUESMEN was established in 1991 by three governmental entities: the (CONEA) National Commission of Atomic Energy, the (UNC) National University of Cuyo and

  7. Carbon monoxide poisoning from waterpipe smoking: a retrospective cohort study.

    Science.gov (United States)

    Eichhorn, Lars; Michaelis, Dirk; Kemmerer, Michael; Jüttner, Björn; Tetzlaff, Kay

    2018-04-01

    Waterpipe smoking may increasingly account for unintentional carbon monoxide poisoning, a serious health hazard with high morbidity and mortality. We aimed at identifying waterpipe smoking as a cause for carbon monoxide poisoning in a large critical care database of a specialty care referral center. This retrospective cohort study included patients with a history of exposure to waterpipe smoking and carbon monoxide blood gas levels >10% or presence of clinical symptoms compatible with CO poisoning admitted between January 2013 and December 2016. Patients' initial symptoms and carbon monoxide blood levels were retrieved from records and neurologic status was assessed before and after hyperbaric oxygen treatment. Sixty-one subjects with carbon monoxide poisoning were included [41 males, 20 females; mean age 23 (SD ± 6) years; range 13-45] with an initial mean carboxyhemoglobin of 26.93% (SD ± 9.72). Most common symptoms included syncope, dizziness, headache, and nausea; 75% had temporary syncope. Symptoms were not closely associated with blood COHb levels. CO poisoning after waterpipe smoking may present in young adults with a wide variability of symptoms from none to unconsciousness. Therefore diagnosis should be suspected even in the absence of symptoms.

  8. [A case of Veratrum poisoning].

    Science.gov (United States)

    Festa, M; Andreetto, B; Ballaris, M A; Panio, A; Piervittori, R

    1996-05-01

    A poisoning from a Veratrum album infusion mistaken for Gentiana lutea is described. Confusion between these two plants can easily occur because they are very similar, although flowers and disposition of leaves allow their botanic determinat: V. album leaves are alternate and flowers are white, while G. lutea leaves are opposite and flowers yellow. The poisoning involves gastrointestinal (pyrosis, vomiting) and cardiocirculatory systems (bradyarrhy-thmias, A-V dissociation, vasodilatation) Atropine is the drug of choice.

  9. Acute selenium poisoning in lambs

    Energy Technology Data Exchange (ETDEWEB)

    Gabbedy, B J; Dickson, J

    1969-10-01

    An outbreak of sodium selenite poisoning is reported in which 180 of 190 six-weeks-old lambs died. The estimated dose rate of the selenium was 6.4 mg/kg body weight. Liver concentrations of selenium at the time of poisoning averaged 64 ppM and 15 days later liver and kidney concentrations of selenium averaged 26 ppM and 7.4 ppM respectively.

  10. Scombroid fish poisoning: an overlooked marine food poisoning.

    Science.gov (United States)

    Wu, M L; Yang, C C; Yang, G Y; Ger, J; Deng, J F

    1997-08-01

    Scombroid fish poisoning is a food-borne chemical intoxication caused by certain spoiled fish that contain a large amount of histamine and some biogenic diamines. It has gradually become a world-wide medical problem and probably is the most common cause of fish poisoning. As the data on the incidents of scombroid fish poisoning in Taiwan remains scarce, we report 2 incidents of scombroid fish poisoning in Northern Taiwan. We collected data of the 2 outbreaks of suspected fish poisoning which were reported to us in 1996. An epidemiological investigation was undertaken. Questionnaire interviews were given to persons who ate lunch in the same cafeteria in outbreak 2. The leftover fish were sent for species identification and toxin analysis. The first incident involving 4 women occurred in March 1996. All cases experienced flush, dizziness, blurred vision and skin rashes after eating lunch. A non-scombroid fish of Makaira with histamine levels as high as 84.13 mg/100 g flesh was implicated in this incident. In August 1996, another incident involving some cases who ate lunch at the same cafeteria were investigated. A total of 146 questionnaires were distributed with a return of 132 questionnaires (90.4%). Fifty-five employees reported positive signs or symptoms; 48 persons who ate fish and 7 women who did not eat fish were ill. Fish was the only food associated with the illness with an attack rate of 73.8% (p < 0.001). The incriminated fish was later identified as a scombroid fish of Euthynnus with a histamine content of 271.9 mg/100 g flesh in 1 leftover piece and 118.5 mg/100 g flesh in another piece. Most cases in these 2 outbreaks received treatment with antihistamines and had rapid and complete recovery. The diagnosis of scombroid fish poisoning could be misdiagnosed as food allergy or bacterial food poisoning if physicians are not aware of such poisoning. The nonspecific but characteristic symptomatology of histamine food poisoning and previous consumption of fish

  11. The Manuel Lujan Jr. Neutron Scattering Center (LANSCE) experiment reports 1993 run cycle. Progress report

    Energy Technology Data Exchange (ETDEWEB)

    Farrer, R.; Longshore, A. [comps.

    1995-06-01

    This year the Manuel Lujan Jr. Neutron Scattering Center (LANSCE) ran an informal user program because the US Department of Energy planned to close LANSCE in FY1994. As a result, an advisory committee recommended that LANSCE scientists and their collaborators complete work in progress. At LANSCE, neutrons are produced by spallation when a pulsed, 800-MeV proton beam impinges on a tungsten target. The proton pulses are provided by the Clinton P. Anderson Meson Physics Facility (LAMPF) accelerator and a associated Proton Storage Ring (PSR), which can Iter the intensity, time structure, and repetition rate of the pulses. The LAMPF protons of Line D are shared between the LANSCE target and the Weapons Neutron Research (WNR) facility, which results in LANSCE spectrometers being available to external users for unclassified research about 80% of each annual LAMPF run cycle. Measurements of interest to the Los Alamos National Laboratory (LANL) may also be performed and may occupy up to an additional 20% of the available beam time. These experiments are reviewed by an internal program advisory committee. This year, a total of 127 proposals were submitted. The proposed experiments involved 229 scientists, 57 of whom visited LANSCE to participate in measurements. In addition, 3 (nuclear physics) participating research teams, comprising 44 scientists, carried out experiments at LANSCE. Instrument beam time was again oversubscribed, with 552 total days requested an 473 available for allocation.

  12. The Manuel Lujan Jr. Neutron Scattering Center (LANSCE) experiment reports 1993 run cycle. Progress report

    International Nuclear Information System (INIS)

    Farrer, R.; Longshore, A.

    1995-06-01

    This year the Manuel Lujan Jr. Neutron Scattering Center (LANSCE) ran an informal user program because the US Department of Energy planned to close LANSCE in FY1994. As a result, an advisory committee recommended that LANSCE scientists and their collaborators complete work in progress. At LANSCE, neutrons are produced by spallation when a pulsed, 800-MeV proton beam impinges on a tungsten target. The proton pulses are provided by the Clinton P. Anderson Meson Physics Facility (LAMPF) accelerator and a associated Proton Storage Ring (PSR), which can Iter the intensity, time structure, and repetition rate of the pulses. The LAMPF protons of Line D are shared between the LANSCE target and the Weapons Neutron Research (WNR) facility, which results in LANSCE spectrometers being available to external users for unclassified research about 80% of each annual LAMPF run cycle. Measurements of interest to the Los Alamos National Laboratory (LANL) may also be performed and may occupy up to an additional 20% of the available beam time. These experiments are reviewed by an internal program advisory committee. This year, a total of 127 proposals were submitted. The proposed experiments involved 229 scientists, 57 of whom visited LANSCE to participate in measurements. In addition, 3 (nuclear physics) participating research teams, comprising 44 scientists, carried out experiments at LANSCE. Instrument beam time was again oversubscribed, with 552 total days requested an 473 available for allocation

  13. Training for life science experiments in space at the NASA Ames Research Center

    Science.gov (United States)

    Rodrigues, Annette T.; Maese, A. Christopher

    1993-01-01

    As this country prepares for exploration to other planets, the need to understand the affects of long duration exposure to microgravity is evident. The National Aeronautics and Space Administration (NASA) Ames Research Center's Space Life Sciences Payloads Office is responsible for a number of non-human life sciences payloads on NASA's Space Shuttle's Spacelab. Included in this responsibility is the training of those individuals who will be conducting the experiments during flight, the astronauts. Preparing a crew to conduct such experiments requires training protocols that build on simple tasks. Once a defined degree of performance proficiency is met for each task, these tasks are combined to increase the complexity of the activities. As tasks are combined into in-flight operations, they are subjected to time constraints and the crew enhances their skills through repetition. The science objectives must be completely understood by the crew and are critical to the overall training program. Completion of the in-flight activities is proof of success. Because the crew is exposed to the background of early research and plans for post-flight analyses, they have a vested interest in the flight activities. The salient features of this training approach is that it allows for flexibility in implementation, consideration of individual differences, and a greater ability to retain experiment information. This training approach offers another effective alternative training tool to existing methodologies.

  14. Differences in Poisoning Mortality in the United States, 2003–2007: Epidemiology of Poisoning Deaths Classified as Unintentional, Suicide or Homicide

    Science.gov (United States)

    Muazzam, Sana; Swahn, Monica H.; Alamgir, Hasanat; Nasrullah, Muazzam

    2012-01-01

    Introduction Poisoning, specifically unintentional poisoning, is a major public health problem in the United States (U.S.). Published literature that presents epidemiology of all forms of poisoning mortalities (i.e., unintentional, suicide, homicide) together is limited. This report presents data and summarizes the evidence on poisoning mortality by demographic and geographic characteristics to describe the burden of poisoning mortality and the differences among sub-populations in the U.S. for a 5-year period. Methods Using mortality data from the Center for Disease Control and Prevention's Web-based Injury Statistics Query and Reporting System, we presented the age-specific and age-adjusted unintentional and intentional (suicide, homicide) poisoning mortality rates by sex, age, race, and state of residence for the most recent years (2003–2007) of available data. Annual percentage changes in deaths and rates were calculated, and linear regression using natural log were used for time-trend analysis. Results There were 121,367 (rate=8.18 per 100,000) unintentional poisoning deaths. Overall, the unintentional poisoning mortality rate increased by 46.9%, from 6.7 per 100,000 in 2003 to 9.8 per100.000 in 2007, with the highest mortality rate among those aged 40–59 (rate=15.36), males (rate=11.02) and whites (rate=8.68). New Mexico (rate=18.2) had the highest rate. Unintentional poisoning mortality rate increased significantly among both sexes, and all racial groups except blacks (p<0.05 time-related trend for rate). Among a total of 29,469 (rate=1.97) suicidal poisoning deaths, the rate increased by 9.9%, from 1.9 per 100,000 in 2003 to 2.1 per 100,000 in 2007, with the highest rate among those aged 40–59 (rate=3.92), males (rate=2.20) and whites (rate=2.24). Nevada (rate=3.9) had the highest rate. Mortality rate increased significantly among females and whites only (p<0.05 time-related trend for rate). There were 463 (rate=0.03) homicidal poisoning deaths and the

  15. Academic Career Selection and Retention in Radiation Oncology: The Joint Center for Radiation Therapy Experience

    International Nuclear Information System (INIS)

    Balboni, Tracy A.; Chen, M.-H.; Harris, Jay R.; Recht, Abram; Stevenson, Mary Ann; D'Amico, Anthony V.

    2007-01-01

    Purpose: The United States healthcare system has witnessed declining reimbursement and increasing documentation requirements for longer than 10 years. These have decreased the time available to academic faculty for teaching and mentorship. The impact of these changes on the career choices of residents is unknown. The purpose of this report was to determine whether changes have occurred during the past decade in the proportion of radiation oncology trainees from a single institution entering and staying in academic medicine. Methods and Materials: We performed a review of the resident employment experience of Harvard Joint Center for Radiation Therapy residents graduating during 13 recent consecutive years (n = 48 residents). The outcomes analyzed were the initial selection of an academic vs. nonacademic career and career changes during the first 3 years after graduation. Results: Of the 48 residents, 65% pursued an academic career immediately after graduation, and 44% remained in academics at the last follow-up, after a median of 6 years. A later graduation year was associated with a decrease in the proportion of graduates immediately entering academic medicine (odds ratio, 0.78; 95% confidence interval, 0.65-0.94). However, the retention rate at 3 years of those who did immediately enter academics increased with a later graduation year (p = 0.03). Conclusion: During a period marked by notable changes in the academic healthcare environment, the proportion of graduating Harvard Joint Center for Radiation Therapy residents pursuing academic careers has been declining; however, despite this decline, the retention rates in academia have increased

  16. Computed tomography-guided core-needle biopsy of lung lesions: an oncology center experience

    Energy Technology Data Exchange (ETDEWEB)

    Guimaraes, Marcos Duarte; Fonte, Alexandre Calabria da; Chojniak, Rubens, E-mail: marcosduarte@yahoo.com.b [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. of Radiology and Imaging Diagnosis; Andrade, Marcony Queiroz de [Hospital Alianca, Salvador, BA (Brazil); Gross, Jefferson Luiz [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. of Chest Surgery

    2011-03-15

    Objective: The present study is aimed at describing the experience of an oncology center with computed tomography guided core-needle biopsy of pulmonary lesions. Materials and Methods: Retrospective analysis of 97 computed tomography-guided core-needle biopsy of pulmonary lesions performed in the period between 1996 and 2004 in a Brazilian reference oncology center (Hospital do Cancer - A.C. Camargo). Information regarding material appropriateness and the specific diagnoses were collected and analyzed. Results: Among 97 lung biopsies, 94 (96.9%) supplied appropriate specimens for histological analyses, with 71 (73.2%) cases being diagnosed as malignant lesions and 23 (23.7%) diagnosed as benign lesions. Specimens were inappropriate for analysis in three cases. The frequency of specific diagnosis was 83 (85.6%) cases, with high rates for both malignant lesions with 63 (88.7%) cases and benign lesions with 20 (86.7%). As regards complications, a total of 12 cases were observed as follows: 7 (7.2%) cases of hematoma, 3 (3.1%) cases of pneumothorax and 2 (2.1%) cases of hemoptysis. Conclusion: Computed tomography-guided core needle biopsy of lung lesions demonstrated high rates of material appropriateness and diagnostic specificity, and low rates of complications in the present study. (author)

  17. [Auto-dialysis: an 11-year experience of a hemodialysis center in France].

    Science.gov (United States)

    Montagnac, R; Schillinger, F

    1996-03-30

    Report 11 years of experience with self-managed hemodialysis in patients medically apt for extra-hospital dialysis and living close enough to small outpatient hemodialysis units to become totally self-sufficient. Among the 276 patients with chronic renal failure managed at the hemodialysis center at the Troyes hospital during the 11-year study period from 1984 through 1994, self-managed hemodialysis at small outpatient units was initiated in 127 (46%). None of these 127 patients required medical assistance or specific care during dialysis sessions. At initial hospital admission, only 60/127 (47%) were totally self-sufficient: 52 (41%) were later graft recipients; and 21 (16.5%) had to return to the hospital for a medical or surgical condition incompatible with extra-hospital care but all of these 21 patients remained self-sufficient. Extra-hospital hemodialysis in units close to the patients residence offers patients a better quality of life, even when medical assistance is required. All patients who require hemodialysis can thus be treated at lower cost without compromising quality of treatment. Perfect self-sufficiency may not be a goal in itself, but self-managed hemodialysis can be a very useful technique for patients without major medical problems. Continuing contact with the organizing hemodialysis center guarantees the safety of the system.

  18. Local experience on radionuclide myocardial imaging in the Philippines at the Philippine Heart Center for Asia

    International Nuclear Information System (INIS)

    Villacorta, E.V.

    1977-01-01

    The Nuclear Medicine Department of the Philippine Heart Center has introduced the detection of coronary heart disease through myocardiac perfusion imaging. The cardiovascular procedures are availed of free-of-charge to registered PHCA patients excepting for the costly TI-201 imaging. In summary, coronary perfusion in imaging should be an integral part of coronary arteriography. Barring the expensive cost of TI-120, myocardial perfusion imaging is ideal for detection of coronary heart disease. Experience shows better sensitivity of TI-201 than exercise ECG for detection of ischemia. Another non-invasive procedure for the detection of acute infarction is the radionuclide imaging using a bone radiopharmaceutical Tc99m prophosphate. In conclusion, acute infarct imaging is a valuable adjunct to ECG and enzyme studies. (RTD)

  19. Management of complications arising from transvaginal mesh kit procedures: a tertiary referral center's experience.

    Science.gov (United States)

    Hurtado, Eric A; Appell, Rodney A

    2009-01-01

    This case series' purpose is to review a referral center's experience with complications from mesh kits. A chart review of 12 patients who presented with complications associated with transvaginal mesh kit procedures was performed. All patients underwent complete surgical removal of the mesh to treat mesh exposure, pain, or vaginal bleeding/discharge followed by an anterior or posterior repair. The mean follow-up time after surgery was 3.4 months. Eight of 12 patients had mesh that had formed a fibrotic band. Six of 12 patients had complete resolution of pain. Of the nine patients with mesh exposure, all required significant resection of the vaginal wall. No further mesh exposure occurred. The use of transvaginal mesh kits may cause previously undescribed complications such as pelvic/vaginal pain or large extrusions requiring complete removal. Removal of all mesh except the arms may cure or significantly improve these problems.

  20. What is the definition of a poisoning?

    Science.gov (United States)

    Uges, D R

    2001-03-01

    New insights in medicine and acceptable treatments necessitates an adjustment of the existing definition of clinical or forensic poisoning to: 'An individual's medical or social unacceptable condition as a consequence of being under influence of an exogenous substance in a dose too high for the person concerned'. For medical and legal purposes it is important to know how the victim became poisoned. In general, there are three ways of causing medical poisoning: accidental poisoning, including iatrogenic poisoning, experimental and intentional poisoning. Nowadays iatrogenic intoxication, poisoning caused by the Münchhausen's syndrome (by proxy) and experimental poisoning (designer drugs) have a major place in contemporary toxicology. Although some toxicologists use the word 'intoxication' only overdoses with central effects, in this article 'intoxication' and 'poisoning' are considered to be synonymous.

  1. Comparative analysis of stakeholder experiences with an online approach to prioritizing patient-centered research topics.

    Science.gov (United States)

    Khodyakov, Dmitry; Grant, Sean; Meeker, Daniella; Booth, Marika; Pacheco-Santivanez, Nathaly; Kim, Katherine K

    2017-05-01

    Little evidence exists about effective and scalable methods for meaningful stakeholder engagement in research. We explored patient/caregiver experiences with a high-tech online engagement approach for patient-centered research prioritization, compared their experiences with those of professional stakeholders, and identified factors associated with favorable participant experiences. We conducted 8 online modified-Delphi (OMD) panels. Panelists participated in 2 rating rounds with a statistical feedback/online discussion round in between. Panels focused on weight management/obesity, heart failure, and Kawasaki disease. We recruited a convenience sample of adults with any of the 3 conditions (or parents/guardians of Kawasaki disease patients), clinicians, and researchers. Measures included self-reported willingness to use OMD again, the panelists' study participation and online discussion experiences, the system's perceived ease of use, and active engagement metrics. Out of 349 panelists, 292 (84%) completed the study. Of those, 46% were patients, 36% were clinicians, and 19% were researchers. In multivariate models, patients were not significantly more actively engaged (Odds ratio (OR) = 1.69, 95% confidence interval (CI), 0.94-3.05) but had more favorable study participation (β = 0.49; P  ≤ .05) and online discussion (β = 0.18; P  ≤ .05) experiences and were more willing to use OMD again (β = 0.36; P  ≤ .05), compared to professional stakeholders. Positive perceptions of the OMD system's ease of use (β = 0.16; P  ≤ .05) and favorable study participation (β = 0.26; P  ≤ .05) and online discussion (β = 0.57; P  ≤ .05) experiences were also associated with increased willingness to use OMD in the future. Active engagement was not associated with online experience indices or willingness to use OMD again. Online approaches to engaging large numbers of stakeholders are a promising and efficient adjunct

  2. Sabatier Catalyst Poisoning Investigation

    Science.gov (United States)

    Nallette, Tim; Perry, Jay; Abney, Morgan; Knox, Jim; Goldblatt, Loel

    2013-01-01

    The Carbon Dioxide Reduction Assembly (CRA) on the International Space Station (ISS) has been operational since 2010. The CRA uses a Sabatier reactor to produce water and methane by reaction of the metabolic CO2 scrubbed from the cabin air and the hydrogen byproduct from the water electrolysis system used for metabolic oxygen generation. Incorporating the CRA into the overall air revitalization system has facilitated life support system loop closure on the ISS reducing resupply logistics and thereby enhancing longer term missions. The CRA utilizes CO2 which has been adsorbed in a 5A molecular sieve within the Carbon Dioxide Removal Assembly, CDRA. There is a potential of compounds with molecular dimensions similar to, or less than CO2 to also be adsorbed. In this fashion trace contaminants may be concentrated within the CDRA and subsequently desorbed with the CO2 to the CRA. Currently, there is no provision to remove contaminants prior to entering the Sabatier catalyst bed. The risk associated with this is potential catalyst degradation due to trace organic contaminants in the CRA carbon dioxide feed acting as catalyst poisons. To better understand this risk, United Technologies Aerospace System (UTAS) has teamed with MSFC to investigate the impact of various trace contaminants on the CRA catalyst performance at relative ISS cabin air concentrations and at about 200/400 times of ISS concentrations, representative of the potential concentrating effect of the CDRA molecular sieve. This paper summarizes our initial assessment results.

  3. Paracetamol (acetaminophen) poisoning.

    Science.gov (United States)

    Park, B Kevin; Dear, James W; Antoine, Daniel J

    2015-10-19

    Paracetamol directly causes around 150 deaths per year in UK. We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of treatments for acute paracetamol poisoning? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2014 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview). At this update, searching of electronic databases retrieved 127 studies. After deduplication and removal of conference abstracts, 64 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 46 studies and the further review of 18 full publications. Of the 18 full articles evaluated, one systematic review was updated and one RCT was added at this update. In addition, two systematic reviews and three RCTs not meeting our inclusion criteria were added to the Comment sections. We performed a GRADE evaluation for three PICO combinations. In this systematic overview we categorised the efficacy for six interventions, based on information about the effectiveness and safety of activated charcoal (single or multiple dose), gastric lavage, haemodialysis, liver transplant, methionine, and acetylcysteine.

  4. Lead poisoning in calves

    Energy Technology Data Exchange (ETDEWEB)

    Reeves, J E

    1964-01-01

    Over a three-year period a farmer lost seven calves in their second month of age. One year ago a tentative diagnosis of rabies was given and a brain was submitted to the Health of Animals Division for examination. No Negri bodies were found. The owner stated that the calves first appeared listless and later exhibited severe nervous signs. Deaths occurred in from one to 24 hours after onset of signs. Appetite and bowel movements were normal. There was no increase in temperature. The calf would lie quietly for an interval, then rise, run down the alley, press against a wall, and go into a convulsion. It acted as if it were in severe pain and during one of the intermittent convulsions, it jumped over a three-foot partition. This calf was sent to the Regional Veterinary Laboratory at Brighton for necropsy. The calf had been dead for 72 hours when submitted to the laboratory. The only gross findings were of mild pleurisy and hemorrhage on the kidney. A tentative diagnosis of lead poisoning was offered and specimens sent to the Division of Pharmacology and Toxicology, Ontario Veterinary College.

  5. High school students' experiences of bullying and victimization and the association with school health center use.

    Science.gov (United States)

    Lewis, Catherine; Deardorff, Julianna; Lahiff, Maureen; Soleimanpour, Samira; Sakashita, Kimi; Brindis, Claire D

    2015-05-01

    Bullying and victimization are ongoing concerns in schools. School health centers (SHCs) are well situated to support affected students because they provide crisis intervention, mental health care, and broader interventions to improve school climate. This study examined the association between urban adolescents' experiences of school-based bullying and victimization and their use of SHCs. Data was analyzed from 2063 high school students in 5 Northern California school districts using the 2009-2010 California Healthy Kids Survey. Chi-square tests and multivariate logistic regression were used to measure associations. Students who were bullied or victimized at school had significantly higher odds of using the SHCs compared with students who were not, and were also significantly more likely to report confidentiality concerns. The magnitude of associations was largest for Asian/Pacific Islander students, though this was likely due to greater statistical power. African American students reported victimization experiences at approximately the same rate as their peers, but were significantly less likely to indicate they experienced bullying. Findings suggest that SHCs may be an important place to address bullying and victimization at school, but confidentiality concerns are barriers that may be more common among bullied and victimized youth. © 2015, American School Health Association.

  6. STUDY OF PATTERN AND OUTCOME OF ACUTE POISONING CASES AT TERTIARY CARE HOSPITAL IN NORTH INDIA

    Directory of Open Access Journals (Sweden)

    Irteqa Ali

    2017-01-01

    Full Text Available BACKGROUND Poisoning is a global public health problem causing significant morbidity and mortality. It is important to know the pattern and outcome of acute poisoning cases for proper planning, prevention and management of these cases. The aim of the study is to determine the mode (suicidal, accidental, homicidal and type of poisoning in North Indian population; relation to age, sex, occupation, marital status; outcome of different type of poisons and requirement of ventilatory support in different type of poisonings. MATERIALS AND METHODS This observational study was conducted in Department of Medicine of a tertiary care hospital in North India. A total of 379 patients were enrolled in the study after obtaining informed consent. RESULTS Poisoning was more common among males (59.89%. Maximum number of patients were in the age group 21-30 years (40.63% and consumption was found to be more prevalent in rural population (75.99%. Most of the patients were farmers and students. Most common types of poisoning were organophosphate (n=95, 25.07%, snake bite (n=77, 20.32% followed by aluminium phosphide (n=71, 18.73%. Out of 379 patients, 318 (83.91% improved while 61 (16.09% expired. Mortality was highest in aluminium phosphide poisoning. Requirement of ventilatory support was most commonly associated with aluminium phosphide poisoning (37.89% followed by organophosphate poisoning (28.42%. CONCLUSION Poisoning was more common in young males. Pesticides and snake bite were major causes of poisoning. Of the total, 318 improved while rest of the 61 expired. Mortality was higher with use of aluminium phosphide poisoning (57.38%, snake bite (21.31% and organophosphate consumption (9.84%. Requirement of ventilator was most commonly associated with aluminium phosphide poisoning. We suggest strict statutory measures covering import, manufacture, sale, transport, distribution and use of pesticides. Training of peripheral health center personnel to manage cases

  7. Risk factors for mortality in Asian Taiwanese patients with methanol poisoning.

    Science.gov (United States)

    Lee, Chen-Yen; Chang, Eileen Kevyn; Lin, Ja-Liang; Weng, Cheng-Hao; Lee, Shen-Yang; Juan, Kuo-Chang; Yang, Huang-Yu; Lin, Chemin; Lee, Shwu-Hua; Wang, I-Kwan; Yen, Tzung-Hai

    2014-01-01

    Methanol poisoning continues to be a serious public health issue in Taiwan, but very little work has been done to study the outcomes of methanol toxicity in the Asian population. In this study, we examined the value of multiple clinical variables in predicting mortality after methanol exposure. We performed a retrospective observational study on patients with acute poisoning who were admitted to the Chang Gung Memorial Hospital over a period of 9 years (2000-2008). Out of the 6,347 patients, only 32 suffered methanol intoxication. The demographic, clinical, laboratory, and mortality data were obtained for analysis. Most patients were middle aged (46.1±13.8 years), male (87.5%), and habitual alcohol consumers (75.0%). All the poisonings were from an oral exposure (96.9%), except for one case of intentionally injected methanol (3.1%). After a latent period of 9.3±10.1 hours, many patients began to experience hypothermia (50.0%), hypotension (15.6%), renal failure (59.4%), respiratory failure (50.0%), and consciousness disturbance (Glasgow coma scale [GCS] score 10.5±5.4). Notably, the majority of patients were treated with ethanol antidote (59.4%) and hemodialysis (58.1%). The remaining 41.6% of patients did not meet the indications for ethanol therapy. At the end of analysis, there were six (18.8%), 15 (46.9%), and eleven (34.4%) patients alive, alive with chronic complications, and dead, respectively. In a multivariate Cox regression model, it was revealed that the GCS score (odds ratio [OR] 0.816, 95% confidence interval [CI] 0.682-0.976) (P=0.026), hypothermia (OR 168.686, 95% CI 2.685-10,595.977) (P=0.015), and serum creatinine level (OR 4.799, 95% CI 1.321-17.440) (P=0.017) were significant risk factors associated with mortality. The outcomes (mortality rate 34.4%) of the Taiwanese patients subjected to intensive detoxification protocols were comparable with published data from other international poison centers. Furthermore, the analytical results indicate

  8. Assessment of the Patient-Centered and Family-Centered Care Experience of Total Joint Replacement Patients Using a Shadowing Technique.

    Science.gov (United States)

    Marcus-Aiyeku, Ulanda; DeBari, Margaret; Salmond, Susan

    2015-01-01

    In 2030, when baby boomers reach 65 years of age and represent 18% of the population, it is anticipated that 67 million adults will have a diagnosis of arthritis increasing the demand for total hip and knee arthroplasty. With the growing emphasis on patient- and family-centered care, the aim of this project was to assess the patient experience of patients and families throughout the entire spectrum of the total joint replacement service line care at a university regional trauma hospital. A shadowing methodology as defined by the Institute for Health Improvement was utilized. Eight patient/family groups undergoing total joint replacements were shadowed. The mapped care experience included time, caregiver, activity, shadower observations, and impressions. Findings revealed inconsistencies in the delivery of patient- and family-centered care. Communication and interactions were predominantly provider-centric, with a focus on care routines versus the patient and family, and anticipation that care would be medically directed.

  9. Case-mix adjustment and the comparison of community health center performance on patient experience measures.

    Science.gov (United States)

    Johnson, M Laura; Rodriguez, Hector P; Solorio, M Rosa

    2010-06-01

    To assess the effect of case-mix adjustment on community health center (CHC) performance on patient experience measures. A Medicaid-managed care plan in Washington State collected patient survey data from 33 CHCs over three fiscal quarters during 2007-2008. The survey included three composite patient experience measures (6-month reports) and two overall ratings of care. The analytic sample includes 2,247 adult patients and 2,859 adults reporting for child patients. We compared the relative importance of patient case-mix adjusters by calculating each adjuster's predictive power and variability across CHCs. We then evaluated the impact of case-mix adjustment on the relative ranking of CHCs. Important case-mix adjusters included adult self-reported health status or parent-reported child health status, adult age, and educational attainment. The effects of case-mix adjustment on patient reports and ratings were different in the adult and child samples. Adjusting for race/ethnicity and language had a greater impact on parent reports than adult reports, but it impacted ratings similarly across the samples. The impact of adjustment on composites and ratings was modest, but it affected the relative ranking of CHCs. To ensure equitable comparison of CHC performance on patient experience measures, reports and ratings should be adjusted for adult self-reported health status or parent-reported child health status, adult age, education, race/ethnicity, and survey language. Because of the differential impact of case-mix adjusters for child and adult surveys, initiatives should consider measuring and reporting adult and child scores separately.

  10. Heidelberg Ion Therapy Center (HIT): Initial clinical experience in the first 80 patients

    Energy Technology Data Exchange (ETDEWEB)

    Combs, Stephanie E. (Univ. Hospital of Heidelberg, Dept. of Radiation Oncology, Heidelberg (Germany)), E-mail: Stephanie.Combs@med.uni-heidelberg.de; Ellerbrock, Malte; Haberer, Thomas (Heidelberger Ionenstrahl Therapiezentrum (HIT), Im Neuenheimer Feld 450, 69120 Heidelberg (Germany)) (and others)

    2010-10-15

    The Heidelberg Ion Therapy Center (HIT) started clinical operation in November 2009. In this report we present the first 80 patients treated with proton and carbon ion radiotherapy and describe patient selection, treatment planning and daily treatment for different indications. Patients and methods. Between November 15, 2009 and April 15, 2010, 80 patients were treated at the Heidelberg Ion Therapy Center (HIT) with carbon ion and proton radiotherapy. Main treated indications consisted of skull base chordoma (n = 9) and chondrosarcoma (n = 18), malignant salivary gland tumors (n=29), chordomas of the sacrum (n = 5), low grade glioma (n=3), primary and recurrent malignant astrocytoma and glioblastoma (n=7) and well as osteosarcoma (n = 3). Of these patients, four pediatric patients aged under 18 years were treated. Results. All patients were treated using the intensity-modulated rasterscanning technique. Seventy-six patients were treated with carbon ions (95%), and four patients were treated with protons. In all patients x-ray imaging was performed prior to each fraction. Treatment concepts were based on the initial experiences with carbon ion therapy at the Gesellschaft fuer Schwerionenforschung (GSI) including carbon-only treatments and carbon-boost treatments with photon-IMRT. The average time per fraction in the treatment room per patient was 29 minutes; for irradiation only, the mean time including all patients was 16 minutes. Position verification was performed prior to every treatment fraction with orthogonal x-ray imaging. Conclusion. Particle therapy could be included successfully into the clinical routine at the Dept. of Radiation Oncology in Heidelberg. Numerous clinical trials will subsequently be initiated to precisely define the role of proton and carbon ion radiotherapy in radiation oncology.

  11. A Three-Year Experience of Medical Thoracoscopy at A Tertiary Care Center of Himalayan Region

    Directory of Open Access Journals (Sweden)

    Rakhee Sodhi

    2016-03-01

    Full Text Available Introduction: Medical thoracoscopy is a minimally invasive procedure for diagnosing and treating pleural diseases. Despite its proven role in diagnostic and therapeutic purposes, it is infrequently used, which could be because of cost of equipment and lack of training. We analyzed our initial 3 years record of thoracoscopy at Himalayan Institute of Medical Sciences, a tertiary care center in Himalayan region of north India. Materials and Methods: This cross-sectional study was to analyze our experience of medical thoracoscopy which was started in Jan 2011 at our center. All patients who underwent thoracoscopy during the period between Jan 2011 to Dec 2013 were included in the study. Thoracoscopy was performed for diagnosis of undiagnosed pleural effusions. Clinical, radiological, cytological & histopathological data of the patients were collected prospectively and analysed. Results: The diagnostic yield for a pleuroscopic pleural biopsy in our study was 87.23% (41/47. Malignancy was diagnosed histopathologically in 70.2% (33/47 patients (both primary & metastatic pleural carcinoma and tuberculosis in 10.6% (5/47. There was no mortality related to procedure. Only three patients had minor complications like subcutaneous emphysema which was mild and resolved by second post-procedure day. Pain at intercostal drain site was observed in some patients. Conclusion: Thoracoscopy is an easy outpatient procedure and an excellent diagnostic tool for pleural effusion of uncertain etiology. It has low complication rate even in settings where the procedure is just started. It should be included in the armamentarium of tools for management of pleural effusion.

  12. Minimally invasive esophagectomy for cancer: Single center experience after 44 consecutive cases

    Directory of Open Access Journals (Sweden)

    Bjelović Miloš

    2015-01-01

    Full Text Available Introduction. At the Department of Minimally Invasive Upper Digestive Surgery of the Hospital for Digestive Surgery in Belgrade, hybrid minimally invasive esophagectomy (hMIE has been a standard of care for patients with resectable esophageal cancer since 2009. As a next and final step in the change management, from January 2015 we utilized total minimally invasive esophagectomy (tMIE as a standard of care. Objective. The aim of the study was to report initial experiences in hMIE (laparoscopic approach for cancer and analyze surgical technique, major morbidity and 30-day mortality. Methods. A retrospective cohort study included 44 patients who underwent elective hMIE for esophageal cancer at the Department for Minimally Invasive Upper Digestive Surgery, Hospital for Digestive Surgery, Clinical Center of Serbia in Belgrade from April 2009 to December 2014. Results. There were 16 (36% middle thoracic esophagus tumors and 28 (64% tumors of distal thoracic esophagus. Mean duration of the operation was 319 minutes (approximately five hours and 20 minutes. The average blood loss was 173.6 ml. A total of 12 (27% of patients had postoperative complications and mean intensive care unit stay was 2.8 days. Mean hospital stay after surgery was 16 days. The average number of harvested lymph nodes during surgery was 31.9. The overall 30-day mortality rate within 30 days after surgery was 2%. Conclusion. As long as MIE is an oncological equivalent to open esophagectomy (OE, better relation between cost savings and potentially increased effectiveness will make MIE the preferred approach in high-volume esophageal centers that are experienced in minimally invasive procedures.

  13. Long-term single-center experience of defibrillator therapy in children and adolescents.

    Science.gov (United States)

    Frommeyer, Gerrit; Feder, Sebastian; Bettin, Markus; Debus, Volker; Köbe, Julia; Reinke, Florian; Uebing, Anselm; Eckardt, Lars; Kehl, Hans Gerd

    2018-06-01

    Implantable cardioverter-defibrillator (ICD) systems are established therapy for prevention of sudden cardiac death. Long-term data on ICD systems in children and adolescents is rare. The present study displays a long-term single-center follow-up of children and adolescents with ICD systems. The present study represents a single-center experience of patients younger than 18 years who received an ICD (n = 58). Follow-up data included in-house follow-up as well as examinations of collaborating specialists. Mean age at implantation was 14.0 ± 3.3 years and 33 patients (56.9%) were male. A transvenous ICD system was implanted in 54 patients (93.1%). In 33 patients (56.9%) electrical heart disease or idiopathic ventricular fibrillation represented the underlying condition of ICD implantation. Median follow-up duration was 70 months (45; 94). 3 patients (5.2%) died during the observation period. None of these deaths was associated with ICD failure. Appropriate shocks occurred in 32 patients (55.2%). Inappropriate shock delivery was recorded in 17 patients (29.3%). Supraventricular tachycardia represented the most frequent cause of inappropriate shock delivery (9 patients, 52.9%). T-wave oversensing led to inappropriate shock delivery in 3 patients (17.6%). In 5 patients (29.4%), lead failure caused inappropriate shock delivery. Of note, during follow-up lead failure was reported in 15 patients (25.9%) leading to surgical revision. ICD therapy in children and adolescents is effective for prevention of sudden cardiac death. The rate of appropriate shock deliveries was significantly higher as compared with large ICD trials. Inappropriate therapies occurred frequently. In particular supraventricular tachycardia, T-wave oversensing and lead failures were responsible for these episodes. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Antidotes for poisoning by alcohols that form toxic metabolites.

    Science.gov (United States)

    McMartin, Kenneth; Jacobsen, Dag; Hovda, Knut Erik

    2016-03-01

    The alcohols, methanol, ethylene glycol and diethylene glycol, have many features in common, the most important of which is the fact that the compounds themselves are relatively non-toxic but are metabolized, initially by alcohol dehydrogenase, to various toxic intermediates. These compounds are readily available worldwide in commercial products as well as in homemade alcoholic beverages, both of which lead to most of the poisoning cases, from either unintentional or intentional ingestion. Although relatively infrequent in overall occurrence, poisonings by metabolically-toxic alcohols do unfortunately occur in outbreaks and can result in severe morbidity and mortality. These poisonings have traditionally been treated with ethanol since it competes for the active site of alcohol dehydrogenase and decreases the formation of toxic metabolites. Although ethanol can be effective in these poisonings, there are substantial practical problems with its use and so fomepizole, a potent competitive inhibitor of alcohol dehydrogenase, was developed for a hopefully better treatment for metabolically-toxic alcohol poisonings. Fomepizole has few side effects and is easy to use in practice and it may obviate the need for haemodialysis in some, but not all, patients. Hence, fomepizole has largely replaced ethanol as the toxic alcohol antidote in many countries. Nevertheless, ethanol remains an important alternative because access to fomepizole can be limited, the cost may appear excessive, or the physician may prefer ethanol due to experience. © 2015 The British Pharmacological Society.

  15. AN OBSERVATIONAL CLINICAL STUDY OF ASSESSING THE UTILITY OF PSS (POISON SEVERITY SCORE AND GCS (GLASGOW COMA SCALE SCORING SYSTEMS IN PREDICTING SEVERITY AND CLINICAL OUTCOMES IN OP POISONING

    Directory of Open Access Journals (Sweden)

    S. Chandrasekhar

    2017-05-01

    are effective in predicting severity and outcome of OP compound poisoning. Glasgow coma scale maybe more helpful as it is easy to use, does not require any laboratory investigations. GCS being less time consuming and can be done easily can be used in peripheral areas to identify high-risk patients for urgent referral to tertiary care centers.

  16. Carbon monoxide: The 21st century poison that goes unnoticed

    International Nuclear Information System (INIS)

    Hoskins, J.A.

    1999-01-01

    This editorial article describes the effects of carbon monoxide poisoning on human beings and the mechanisms involving carbon monoxide saturation of haemoglobin that are responsible for it. The initial research done in the mid-1800s by Claude Bernard is presented. Methods of treatment for persons poisoned by carbon monoxide are discussed and the experiments made by J.B.S. Haldane on himself by breathing in carbon monoxide are described. Acclimatisation effects observed by Haldane and his co-workers and concerning persons occupationally exposed to carbon monoxide emissions are described

  17. Carbon monoxide: The 21st century poison that goes unnoticed

    Energy Technology Data Exchange (ETDEWEB)

    Hoskins, J.A. [Reigate, Surrey (United Kingdom)

    1999-07-01

    This editorial article describes the effects of carbon monoxide poisoning on human beings and the mechanisms involving carbon monoxide saturation of haemoglobin that are responsible for it. The initial research done in the mid-1800s by Claude Bernard is presented. Methods of treatment for persons poisoned by carbon monoxide are discussed and the experiments made by J.B.S. Haldane on himself by breathing in carbon monoxide are described. Acclimatisation effects observed by Haldane and his co-workers and concerning persons occupationally exposed to carbon monoxide emissions are described.

  18. Successful transplantation of donor organs from a hemlock poisoning victim.

    Science.gov (United States)

    Foster, Preston F; McFadden, Robert; Trevino, Raul; Galliardt, Scott; Kopczewski, Lea Ann; Gugliuzza, Kristene; Gonzalez, Zulma; Wright, Francis

    2003-09-15

    The poison hemlock plant (Conium maculatum) has been a known poison since early in human history, most notably as the agent used for the execution/suicide of Socrates in ancient Greece. No experience has been reported regarding the suitability of a hemlock victim's organs for transplantation. This report documents successful transplantation of the liver, kidney, and pancreas from a 14-year-old girl who died of anoxic encephalopathy from asphyxia after the accidental ingestion of fresh hemlock while on a nature hike. Predonation laboratory values were not remarkable, and liver and kidney biopsy results were normal. All organs in the three recipients had immediate function, and no recipient had any clinical evidence of transmitted toxin. All recipients are well, with functioning transplants at greater than 6 months after transplantation. Poison hemlock intoxication does not seem to be a contraindication to organ donation.

  19. Poisoning of liquid membrane carriers in extraction of metal ions

    International Nuclear Information System (INIS)

    Wang, Yuchun; Wang, Dexian

    1992-01-01

    As means of effective separation and preconcentration, emulsion liquid membranes (ELMs) have found application in many fields including biochemical separation, wastewater treatment, hydrometallurgy, and preconcentration in analytical chemistry. In the extraction of desired metal (scandium, mixed rare earths) ions using chelating extractants (TTA, HDEHP) as liquid membrane carriers, the carriers will become poisoned owing to the presence of even minute quantity of certain high ionic potential ions in the feed solution. The reason for the poisoning of carriers is that those ions have so much greater affinity than the desired ions for the membrane carrier that the ion-carrier coordination compound cannot be stripped at the interior interface of the membrane and gradually no more free carrier transports any metal ions across the membrane. The calculated results are in agreement with the experiments, and methods to avoid the poisoning are given in the paper

  20. Organophosphorus pesticide poisoning : cases and developments

    NARCIS (Netherlands)

    Aardema, H.; Ligtenberg, J. J. M.; Peters-Polman, O. M.; Tulleken, J. E.; Zijlstra, J. G.; Meertens, John H. J. M.

    Self-poisoning with organophosphate pesticides is a major health problem world-wide. Through the inhibition of acetylcholinesterase, organophosphorus poisoning is characterised by the clinical picture of acute cholinergic crisis. Other manifestations are the intermediate neurotoxic syndrome and

  1. Vital Signs-Alcohol Poisoning Deaths

    Centers for Disease Control (CDC) Podcasts

    This podcast is based on the January 2015 CDC Vital Signs report. In the United States, an average of six people die every day from alcohol poisoning. Learn what you can do to prevent binge drinking and alcohol poisoning.

  2. WORRIES OF THE CANCER PATIENTS: THE EXPERIENCE OF THE EDUCATION CENTER OF THE INSTITUTO NACIONAL DE CANCEROLOGIA

    OpenAIRE

    Contreras-Cruz Ana Cecilia; Castro-Camargo Gladys Juliette; Puerto-Jiménez Devi Nereira

    2015-01-01

    Introduction: to know the characteristics and worries of the cancer patients allows imparting an adequate attention to their needs in order to answer the experience of living with cancer. Objective: to identify the main worries of the cancer patients expressed to contact the center. Methods: selection for one year of cancer patients who attended to the education center for the patients and their families of the Instituto Nacional de Cancerología (INC). Field diaries were ...

  3. Incidence and patterns of valvular heart disease in a tertiary care high-volume cardiac center: a single center experience.

    Science.gov (United States)

    Manjunath, C N; Srinivas, P; Ravindranath, K S; Dhanalakshmi, C

    2014-01-01

    Diseases of the heart valves constitute a major cause of cardiovascular morbidity and mortality worldwide with rheumatic heart disease (RHD) being the dominant form of valvular heart disease (VHD) in developing nations. The current study was undertaken at a tertiary care cardiac center with the objective of establishing the incidence and patterns of VHD by Echocardiography (Echo). Among the 136,098 first-time Echocardiograms performed between January 2010 and December 2012, an exclusion criterion of trivial and functional regurgitant lesions yielded a total of 13,289 cases of organic valvular heart disease as the study cohort. In RHD, the order of involvement of valves was mitral (60.2%), followed by aortic, tricuspid and pulmonary valves. Mitral stenosis, predominantly seen in females, was almost exclusively of rheumatic etiology (97.4%). The predominant form of isolated MR was rheumatic (41.1%) followed closely by myxomatous or mitral valve prolapse (40.8%). Isolated AS, more common in males, was the third most common valve lesion seen in 7.3% of cases. Degenerative calcification was the commonest cause of isolated AS (65.0%) followed by bicuspid aortic valve (BAV) (33.9%) and RHD (1.1%). Multiple valves were involved in more than a third of all cases (36.8%). The order of involvement was MS + MR > MS + AR > MR + AR > AS + AR > MR + AS > MS + AS. Overall, 9.7% of cases had organic tricuspid valve disease. RHD contributed most to the burden of VHD in the present study with calcific degeneration, myxomatous disease and BAV being the other major forms of VHD. Multiple valves were affected in more than a third of all cases. Copyright © 2014 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  4. [Ciguatera poisoning in Spanish travellers].

    Science.gov (United States)

    Gascón, Joaquim; Macià, Maria; Oliveira, Inés; Corachán, Manuel

    2003-05-31

    Ciguatera poisoning appears after ingestion of contaminated fish from tropical coral reefs. Due to the diversity of clinical symptoms and the absence of a specific test in humans, the diagnosis is often difficult. A retrospective study of 10 patients consulting for a clinical and epidemiological picture compatible with ciguatera poisoning after a trip to tropical countries between 1993 and 2000. Most infections but one were acquired in the Caribbean area and there were 8 females. Clinical manifestations started within the first 24 hours after fish ingestion. Chief symptoms were diarrhea and nausea, followed by neurological symptoms, mainly limbs paresthesias that persisted for several weeks. The severity of clinical symptoms was variable and not related to age or initial symptoms. Ciguatera poisoning has to be considered in the diagnosis of acute gastroenteritis affecting travellers to tropical areas.

  5. Nitric Acid Poisoning: Case Report

    International Nuclear Information System (INIS)

    Quintero Giraldo, Maria Paulina; Quiceno Calderon, William de Jesus; Melo Arango Catalina

    2011-01-01

    Nitric acid (HNO 3 ) is a corrosive fluid that, when in contact with reducing agents, generates nitrogen oxides that are responsible for inhalation poisoning. We present two cases of poisoning from nitric acid gas inhalation resulting from occupational exposure. Imaging findings were similar in both cases, consistent with adult respiratory distress syndrome (ARDS): bilaterally diffuse alveolar opacities on the chest X-ray and a cobblestone pattern on computed tomography (CT).one of the patients died while the other evolved satisfactorily after treatment with n-acetyl cysteine and mechanical ventilation. The diagnosis of nitric acid poisoning was made on the basis of the history of exposure and the way in which the radiological findings evolved.

  6. The CMS experiment workflows on StoRM based storage at Tier-1 and Tier-2 centers

    International Nuclear Information System (INIS)

    Bonacorsi, D; Bartolome, I Cabrillo; Matorras, F; Gonzalez Caballero, I; Sartirana, A

    2010-01-01

    Approaching LHC data taking, the CMS experiment is deploying, commissioning and operating the building tools of its grid-based computing infrastructure. The commissioning program includes testing, deployment and operation of various storage solutions to support the computing workflows of the experiment. Recently, some of the Tier-1 and Tier-2 centers supporting the collaboration have started to deploy StoRM based storage systems. These are POSIX-based disk storage systems on top of which StoRM implements the Storage Resource Manager (SRM) version 2 interface allowing for a standard-based access from the Grid. In this notes we briefly describe the experience so far achieved at the CNAF Tier-1 center and at the IFCA Tier-2 center.

  7. Interaction of different poisons with MgCl{sub 2}/TiCl{sub 4} based Ziegler-Natta catalysts

    Energy Technology Data Exchange (ETDEWEB)

    Bahri-Laleh, Naeimeh, E-mail: n.bahri@ippi.ac.ir

    2016-08-30

    Highlights: • The interactions between different classes of poison molecules and TiCl{sub 4}/MgCl{sub 2} type Ziegler-Natta catalyst is considered. • Poisons strongly stabilize MgCl{sub 2} crystal surfaces, mostly Ti active center relative to the unpoisoned solid. • Poison molecules decrease catalyst activity by increasing E{sub TS} in olefin polymerization. • Poison molecules do not have significant effect in stereospecifity of ZN catalysts in propylene polymerization. - Abstract: Adsorption of different poison molecules on activated MgCl{sub 2} is investigated within DFT using a cluster model of the MgCl{sub 2} surface with (MgCl{sub 2}){sub 16} formula containing four 4-coordinated and eight 5-coordinated Mg atoms as (110) and (104) surfaces, respectively. Studied poison molecules are chosen as possible impurities in hydrocarbon solvents and monomer feeds and contain water, hydrogensulfide, carbondioxide, molecular oxygen and methanol. First, adsorption of 1–4 molecules of different poisons to the (104) and (110) lateral cuts of MgCl{sub 2}, as well as their adsorption on [MgCl{sub 2}]/TiCl{sub 2}Et active center and AlEt{sub 3} cocatalyst is considered. Results reveal that poisons strongly stabilize both crystal surfaces, mostly Ti active center relative to the unpoisoned solid. Second, energy barrier (E{sub TS}) for ethylene insertion in the presence of different poisons located on the first and second Mg atom relative to the active Ti is calculated. While poison molecule located on the second Mg does not change E{sub TS}, coordination of it into the first Mg atom increases E{sub TS} by 0.9–1.2 kcal mol{sup −1}. In the last part of this manuscript, the stereoselective behavior of active Ti species, with and without poison molecules and external electron donor, is fully explored.

  8. 49 CFR 172.430 - POISON label.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false POISON label. 172.430 Section 172.430... SECURITY PLANS Labeling § 172.430 POISON label. (a) Except for size and color, the POISON label must be as follows: EC02MR91.029 (b) In addition to complying with § 172.407, the background on the POISON label must...

  9. Introducing sexual orientation and gender identity into the electronic health record: one academic health center's experience.

    Science.gov (United States)

    Callahan, Edward J; Sitkin, Nicole; Ton, Hendry; Eidson-Ton, W Suzanne; Weckstein, Julie; Latimore, Darin

    2015-02-01

    Many U.S. populations experience significant health disparities. Increasing health care providers' awareness of and education about sexual orientation (SO) and gender identity (GI) diversity could help reduce health disparities among lesbian, gay, bisexual, and transgender (LGBT) patients. The authors share the University of California, Davis, Health System's (UCDHS's) experience as it became the first U.S. academic health center to formally introduce patient SO/GI demographic data into its electronic health record (EHR) as a step toward reducing LGBT health disparities. Adding these data to the EHR initially met with resistance. The authors, members of the UCDHS Task Force for Inclusion of SO/GI in the EHR, viewed this resistance as an invitation to educate leaders, providers, and staff about LGBT health disparities and to expose providers to techniques for discussing SO/GI with patients. They describe the strategies they employed to effect institutional culture change, including involvement of senior leadership, key informant interviews, educational outreach via grand rounds and resident workshops, and creation of a patient safety net through inviting providers to self-identify as welcoming LGBT patients. The ongoing cultural change process has inspired spin-off projects contributing to an improved climate for LGBT individuals at UCDHS, including an employee organization supporting SO/GI diversity, support for and among LGBT medical learners through events and listservs, development and implementation of an LGBT health curriculum, and creation of peer navigator programs for LGBT patients with cancer. The authors reflect on lessons learned and on institutional pride in and commitment to providing quality care for LGBT patients.

  10. Uniportal video assisted thoracoscopic lobectomy: primary experience from an Eastern center.

    Science.gov (United States)

    Feng, Mingxiang; Shen, Yaxing; Wang, Hao; Tan, Lijie; Mao, Xuping; Liu, Yi; Wang, Qun

    2014-12-01

    Uniportal video-assisted thoracoscopic surgery (VATS) lobectomy is an emerging technique for the surgical resection of non-small cell lung cancer (NSCLC). Besides its wide debates on safety and efficacy throughout the world, there were few report on uniportal VATS from the Eastern countries. In this article, we summarized our primary experience on uniportal VATS lobectomy in an Eastern center. From October 2013 till February 2014, 54 consecutive uniportal VATS lobectomy were performed in the Department of Thoracic Surgery, Zhongshan Hospital of Fudan University. Patients' clinical features and operative details were recorded. Post-operatively, the morbidity and mortality were recorded to analyze the safety and efficacy of uniportal VATS lobectomy for NSCLCs. Among the 54 planned uniportal VATS lobectomy, there was one conversion to mini-thoracotomy due to lymph node sticking. Extra ports were required in two patients. The uniportal VATS lobectomy was achieved in 51 out of 54 patients (94.4%). The average operation duration was 122.2±37.5 min (90-160 min). The average volume of estimated blood loss during the operation was 88.8±47.1 mL (50-200 mL). The mean chest tube duration and hospital stay were 3.2±1.9 days and 4.6±2.0 days, respectively. There was no postoperative mortality in this study. Two patients suffered from prolonged air leakage (5 and 7 days), and one atrial fibrillation was observed in this cohort. Based on our primary experience, uniportal VATS lobectomy is a safe and effective procedure for the surgical resection of NSCLCs. The surgical refinements and instrumental improvements would facilitate the technique. Further studies based on larger population are required to determine its benefits towards patients with NSCLCs.

  11. Mental health and solidarity economy: the experience of users and workers of a Psychosocial Care Center

    Directory of Open Access Journals (Sweden)

    Ioneide de Oliveira Campos

    2015-07-01

    Full Text Available This work is within the context of discussions on mental health and solidarity economy. It is an account of the experience lived at the Tabatinga II Psychosocial Care Center (CAPS in the Federal District, Brazil, where projects designed to generate employment and income in the mental health area reaffirm their ability, as tools for social inclusion, to incorporate the principles and values of solidarity economy aiming at the empowerment and autonomy of citizens in mental distress. This work intended to support and encourage reflections on the possibilities for social inclusion arising from the generation of jobs and income through collective and cooperative actions developed and elaborated with the participation of users, family members, and workers of this service. Emphasis on participatory methodology guided the development of the experience, and the proposition of triggering actions on mental health and solidarity economy at different times, under the coordination of the performing team, afforded, concurrently, the realization of two actions/interventions: a group activity designed to service users and their relatives who gathered to learn and reflect on collective work and supportive venture; and three monthly training sessions, from August to December 2013, on cooperativism, solidarity economy, and mental health addressed to the professionals of that CAPS. At the end of these interventions, it was possible to observe that the involvement of people under mental distress in these projects contributes to overcome their current state of subordination and weakness. It is worth mentioning that, in general, the development of these actions favored reflections on the world of collective work and aggregated methodological knowledge on solidarity ventures.

  12. The Fernald Preserve Visitors Center The Fernald Experience-Revealing, Engaging, and Preserving

    International Nuclear Information System (INIS)

    Powell, J.; Griffiths, G.; Walpole, S.; Lutz, M.

    2009-01-01

    The U.S. Department of Energy (DOE) Office of Legacy Management's public involvement activities at the Fernald, Ohio, site include continued communication about groundwater remediation, the management of legacy waste, and the future of the Fernald site. The completion of the Fernald Preserve Visitors Center, in August 2008, ensures that information continues to be readily available and effectively communicated to the public. A primary goal of the Visitors Center is to function as an informational and educational center within the surrounding community, with the information available at the Visitors Center serving as an institutional control. By offering information on a variety of topics, from the site's history to its current condition, the Visitors Center increases public awareness and helps prevent unsafe disturbances to and uses of the site. The Office of Legacy Management maintains and operates the Visitors Center, continues to solicit stakeholder opinion, and will periodically reevaluate the use of the Visitors Center and its programming. (authors)

  13. OCCUPATIONAL THERAPY EXPERIENCES IN THE FAMILY HEALTH SUPPORT CENTERS (NASF IN THE DISTRITO FEDERAL

    Directory of Open Access Journals (Sweden)

    Kelly Ranyelle Alves Araujo

    2013-09-01

    Full Text Available To support and expand the care attention and the health management in primary care, in particular the Family Health Strategy, it was created the Family Health Support Centers (NASF. The NASF accounts with several professionals, including occupational therapists, who develop different activities, including health promotion, holistic care and psychosocial rehabilitation. The aim of this article is to discuss from practical experience in a NASF in the metropolitan region of Brasilia how students and practitioners of occupational therapy falls within that service, identifying the main limitations and the work that advances the health care setting. Results: The students and occupational therapist service sought to develop an integrated and intersectoral. Actions were part of the home visits, group approaches with different community groups, active search for users and partnerships in the community. Thus, the work is still very limited assistance and connected to the matricial point of view, as recommended. We conclude that, despite the NASF be a new field of labor for occupational therapists, the actions of social inclusion, empowerment and citizenship developed can encourage healthy habits, but practices need to be revised to follow the proposal of this device.

  14. Endovascular Aortic Aneurysm Repair for Abdominal Aortic Aneurysm: Single Center Experience in 122 Patients

    International Nuclear Information System (INIS)

    Lee, Yun Young; Song, Jang Hyeon; Kim, Yong Tae; Yim, Nam Yeol; Kim, Jae Kyu; Lee, Ho Kyun; Choi, Soo Jin Na; Chung, Sang Young; Kim, Soo Hyun; Chang, Nam Kyu

    2013-01-01

    To analyze a single center experience of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms. Results of 122 patients who underwent EVAR were analyzed, retrospectively. Sex, age, aneurysmal morphology, hostile neck anatomy, preprocedural and postprocedural sac-diameter, technical and clinical success, postprocedural complication and need of additional procedure were analyzed. A total of 111 male and 11 female patients were included. Morphology of the aneurysms was as follows: fusiform (n = 108), saccular (n = 3) and ruptured type (n = 11). Sixty-four patients had hostile neck anatomy. The preprocedural mean sac-diameter was 52.4 mm. Postprocedural sac-diameter was decreased or stable in 110 patients (90.2%) and increased in 8 patients (6.6%). Technical success rate was 100% and clinical success rate was 86.1%. Fifty-one patients showed endoleak (41.8%) and 15 patients (12.3%) underwent secondary intervention due to type I endoleak (n = 4), type II endoleak (n = 4) and stent-graft thrombosis (n = 7). EVAR is a safe and effective therapy for abdominal aortic aneurysm, and it has high technical success and clinical success rate, and low complication rate.

  15. Intermediate Photovoltaic System Application Experiment. Oklahoma Center for Science and Arts. Phase II. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1984-01-01

    This report presents the key results of the Phase II efforts for the Intermediate PV System Applications Experiment at the Oklahoma Center for Science and Arts (OCSA). This phase of the project involved fabrication, installation and integration of a nominal 140 kW flat panel PV system made up of large, square polycrystalline-silicon solar cell modules, each nominally 61 cm x 122 cm in size. The output of the PV modules, supplied by Solarex Corporation, was augmented, 1.35 to 1 at peak, by a row of glass reflectors, appropriately tilted northward. The PV system interfaces with the Oklahoma Gas and Electric Utility at the OCSA main switchgear. Any excess power generated by the system is fed into the utility under a one to one buyback arrangement. Except for a shortfall in the system output, presently suspected to be due to the poor performance of the modules, no serious problems were encountered. Certain value engineering changes implemented during construction and early operational failure events associated with the power conditioning system are also described. The system is currently undergoing extended testing and evaluation.

  16. Barriers to implementing the World Health Organization's Trauma Care Checklist: A Canadian single-center experience.

    Science.gov (United States)

    Nolan, Brodie; Zakirova, Rimma; Bridge, Jennifer; Nathens, Avery B

    2014-11-01

    Management of trauma patients is difficult because of their complexity and acuity. In an effort to improve patient care and reduce morbidity and mortality, the World Health Organization developed a trauma care checklist. Local stakeholder input led to a modified 16-item version that was subsequently piloted. Our study highlights the barriers and challenges associated with implementing this checklist at our hospital. The checklist was piloted over a 6-month period at St. Michael's Hospital, a Level 1 trauma center in Toronto, Canada. At the end of the pilot phase, individual, semistructured interviews were held with trauma team leaders and nursing staff regarding their experiences with the checklist. Axial coding was used to create a typology of attitudes and barriers toward the checklist, and then, vertical coding was used to further explore each identified barrier. Checklist compliance was assessed for the first 7 months. Checklist compliance throughout the pilot phase was 78%. Eight key barriers to implementing the checklist were identified as follows: perceived lack of time for the use of the checklist in critically ill patients, unclear roles, no memory trigger, no one to enforce completion, not understanding its importance or purpose, difficulty finding physicians at the end of resuscitation, staff/trainee changes, and professional hierarchy. The World Health Organization Trauma Care Checklist was a well-received tool; however, consideration of barriers to the implementation and staff adoption must be done for successful integration, with special attention to its use in critically ill patients. Therapeutic/care management, level V.

  17. Preimplantation genetic diagnosis for cystic fibrosis: the Montpellier center's 10-year experience.

    Science.gov (United States)

    Girardet, A; Ishmukhametova, A; Willems, M; Coubes, C; Hamamah, S; Anahory, T; Des Georges, M; Claustres, M

    2015-02-01

    This study provides an overview of 10 years of experience of preimplantation genetic diagnosis (PGD) for cystic fibrosis (CF) in our center. Owing to the high allelic heterogeneity of CF transmembrane conductance regulator (CFTR) mutations in south of France, we have set up a powerful universal test based on haplotyping eight short tandem repeats (STR) markers together with the major mutation p.Phe508del. Of 142 couples requesting PGD for CF, 76 have been so far enrolled in the genetic work-up, and 53 had 114 PGD cycles performed. Twenty-nine cycles were canceled upon in vitro fertilization (IVF) treatment because of hyper- or hypostimulation. Of the remaining 85 cycles, a total of 493 embryos were biopsied and a genetic diagnosis was obtained in 463 (93.9%), of which 262 (without or with a single CF-causing mutation) were transferable. Twenty-eight clinical pregnancies were established, yielding a pregnancy rate per transfer of 30.8% in the group of seven couples with one member affected with CF, and 38.3% in the group of couples whose both members are carriers of a CF-causing mutation [including six couples with congenital bilateral absence of the vas deferens (CBAVD)]. So far, 25 children were born free of CF and no misdiagnosis was recorded. Our test is applicable to 98% of couples at risk of transmitting CF. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Role of surgical treatment in breast cancer liver metastases: a single center experience.

    Science.gov (United States)

    Bacalbasa, Nicolae; Dima, Simona Olimpia; Purtan-Purnichescu, Raluca; Herlea, Vlad; Popescu, Irinel

    2014-10-01

    The aim of the present study was to review a single hepatobiliary center experience, the benefit of hepatic metastasectomy in breast cancer liver metastases (BCLM) patients and to identify predictors of survival. Fifty-two female patients underwent surgery for BCLM between 2002 and 2013. Only patients with liver resections (n=43) were included in the analysis. The median survival of the 43 patients with liver resection was 32.2 months. The factors significantly associated with overall post-hepatectomy survival were estrogen/progesteron receptor (ER/PR) status (p=0.002), node involvement of the primary tumor (p=0.049), size (p=0.005) and number (p=0.006) of the metastatic lesions. The 1-, 3- and 5-year survival rates after curative liver resection were 93.02%, 74.42%, 58.14%, respectively. BCLM resection is a safe procedure and offers survival benefit, especially in patients with reduced liver metastatic burden (solitary metastases, diameter of the metastases <5 cm) and positive ER/PR status. Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  19. First Indian single center experience with pipeline embolization device for complex intracranial aneurysms.

    Science.gov (United States)

    Cherian, Mathew P; Yadav, Manish Kumar; Mehta, Pankaj; Vijayan, K; Arulselvan, V; Jayabalan, Suresh

    2014-01-01

    Flow diversion is a novel method of therapy wherein an endoluminal sleeve, the flow diverter stent is placed across the neck of complex aneurysms to curatively reconstruct abnormal vasculature. We present the first Indian single center experience with the pipeline embolization device (PED) and 6 months follow-up results of 5 patients. Five complex or recurrent intracranial aneurysms in five patients were treated with PED. The patients were followed-up with magnetic resonance angiography (MRA) after 4 weeks and conventional angiography after 6 months. Feasibility, complications, clinical outcome, early 1-month MRA and 6 months conventional angiographic follow-up results were analyzed. Of the five aneurysms treated, four were in the anterior circulation and one in the posterior circulation. All five patients were treated with a single PED in each, and additionally coils were used in one patient. At 1-month MRA follow-up, complete occlusion was seen in 2 (40%) of the five cases. Post 6 months conventional angiography showed complete occlusion of the aneurysm sac in all five cases (100%). Side branch ostia were covered in three patients, all of which were patent (100%). There was no incidence of major neurological morbidity or mortality. One patient (20%) who had basilar top aneurysm experienced minor neurological disability after 5 days which partially improved. Pipeline embolization device for complex and recurrent aneurysms is technically feasible, safe, offers low complication rate, and definitive vascular reconstruction. PED can be used without fear of occlusion of covered eloquent side branches and perforators.

  20. Management of vestibular schwannomas with linear accelerator-based stereotactic radiosurgery: a single center experience.

    Science.gov (United States)

    Sager, Omer; Beyzadeoglu, Murat; Dincoglan, Ferrat; Demiral, Selcuk; Uysal, Bora; Gamsiz, Hakan; Oysul, Kaan; Dirican, Bahar; Sirin, Sait

    2013-01-01

    The primary goal of treatment for vestibular schwannoma is to achieve local control without comprimising regional cranial nerve function. Stereotactic radiosurgery has emerged as a viable therapeutic option for vestibular schwannoma. The aim of the study is to report our 15-year single center experience using linear accelerator-based stereotactic radiosurgery in the management of patients with vestibular schwannoma. Between July 1998 and January 2013, 68 patients with unilateral vestibular schwannoma were treated using stereotactic radiosurgery at the Department of Radiation Oncology, Gulhane Military Medical Academy. All patients underwent high-precision stereotactic radiosurgery using a linear accelerator with 6-MV photons. Median follow-up time was 51 months (range, 9-107). Median age was 45 years (range, 20-77). Median dose was 12 Gy (range, 10-13) prescribed to the 85%-95% isodose line encompassing the target volume. Local tumor control in patients with periodic follow-up imaging was 96.1%. Overall hearing preservation rate was 76.5%. Linear accelerator-based stereotactic radiosurgery offers a safe and effective treatment for patients with vestibular schwannoma by providing high local control rates along with improved quality of life through well-preserved hearing function.

  1. Hydroxyapatite ceramic implants for cranioplasty in children: a single-center experience.

    Science.gov (United States)

    Zaccaria, Laura; Tharakan, Sasha Job; Altermatt, Stefan

    2017-02-01

    The use of hydroxyapatite ceramic (HAC) implants for the treatment of skull defects in pediatric patients started 2010 at our institution. Ceramic implants facilitate osteoblast migration and therefore optimize osteointegration with the host bone. The purpose of this study is to report a single-center experience with this treatment modality. A retrospective review of all patients from July 2010 through June 2014 undergoing a cranioplasty using hydroxyapatite ceramic implant and managed at a single institution was performed. Indication for cranioplasty, the hospital course, and follow-up were reviewed. Bone density was measured in Hounsfield Units (HU) and osteointegration was calculated using Mimics Software® (Mimics Innovation Suite v17.0 Medical, Materialize, Leuven, Belgium). Over the 4-year period, six patients met criteria for the study. Five patients had an osteointegration of nearly 100%. One patient had an incomplete osteointegration with a total bone-implant contact area of 69%. The mean bone density was 2800 HU (2300-3000 HU). Bone density alone is estimated to have a Hounsfield value between 400 and 2000 HU depending on the body region and bone quality. There were no major complications, and the patients were highly satisfied with the esthetical result. Hydroxyapatite ceramic implants for cranioplasty in pediatric patients are a good choice for different indications. The implants show excellent osteointegration and esthetical results.

  2. Is poisoning a problem in South Sudan?

    African Journals Online (AJOL)

    2011-11-04

    Nov 4, 2011 ... (e.g. mesothelioma caused by contact with asbestos). Criminal act of poisoning: e.g. “spiking” of a drink at a party. Poisoning in uganda. When I was working in Uganda I saw several cases of poisoning with organophosphates and was horrified by the mortality. Almost ten years ago, we carried out a simple.

  3. National Poison Prevention Week Promotional Materials.

    Science.gov (United States)

    Poison Prevention Week Council, Washington, DC.

    This collection of materials for parents, early childhood workers, the elderly, and anyone in situations requiring safeguards against poisoning, spans the years 1993 and 1994 and is intended to promote National Poison Prevention Week. The materials included are: (1) the 31-page, illustrated report on National Poison Prevention Week for 1993,…

  4. Extracorporeal Treatment for Metformin Poisoning

    DEFF Research Database (Denmark)

    Calello, Diane P; Liu, Kathleen D; Wiegand, Timothy J

    2015-01-01

    diverse professions, presents its systematic review and clinical recommendations for extracorporeal treatment in metformin poisoning. METHODS: A systematic literature search was performed, data extracted, findings summarized, and structured voting statements developed. A two-round modified Delphi method...... was used to achieve consensus on voting statements and RAND/UCLA Appropriateness Method to quantify disagreement. Anonymized votes and opinions were compiled and discussed. A second vote determined the final recommendations. RESULTS: One hundred seventy-five articles were identified, including 63 deaths...... appears to be amenable to extracorporeal treatments. Despite clinical evidence comprised mostly of case reports and suboptimal toxicokinetic data, the workgroup recommended extracorporeal removal in the case of severe metformin poisoning....

  5. Accidental poisoning with autumn crocus.

    Science.gov (United States)

    Gabrscek, Lucija; Lesnicar, Gorazd; Krivec, Bojan; Voga, Gorazd; Sibanc, Branko; Blatnik, Janja; Jagodic, Boris

    2004-01-01

    We describe a case of a 43-yr-old female with severe multiorgan injury after accidental poisoning with Colchicum autumnale, which was mistaken for wild garlic (Allium ursinum). Both plants grow on damp meadows and can be confused in the spring when both plants have leaves but no blossoms. The autumn crocus contains colchicine, which inhibits cellular division. Treatment consisted of supportive care, antibiotic therapy, and granulocyte-directed growth factor. The patient was discharged from the hospital after three weeks. Three years after recovery from the acute poisoning, the patient continued to complain of muscle weakness and intermittent episodes of hair loss.

  6. Lipid resuscitation in acute poisoning

    DEFF Research Database (Denmark)

    Hoegberg, Lotte C G; Gosselin, Sophie

    2017-01-01

    PURPOSE OF REVIEW: The decision to provide intravenous lipid emulsion (ILE) therapy as a treatment modality for the reversal of various drug toxicity was discovered in the last decade. Numerous publications, in both humans and animals attest to its clinical use, but current supporting evidence...... is inconsistent. RECENT FINDINGS: A recent systematic review reported evidence for benefit of ILE in bupivacaine toxicity. Human randomized trials, large observational studies as well as animal models of orogastric poisoning failed to report a clear benefit of ILE for nonlocal anesthetics poisoning. SUMMARY: ILE...

  7. Acute Poisoning in Children: A Hospital-Based Study in Arak, Iran (2008-2012

    Directory of Open Access Journals (Sweden)

    Ali Arjmand Shabestari

    2014-09-01

    Full Text Available Background: Poisoning is one of the important reasons for children’s admission to hospital. Knowledge of epidemiology of poisoning in each region plays an important role in planning prevention, care, and treatment of patients. This study was conducted to determine the characteristics of acute poisoning epidemiology in children attending pediatric wards of Amirkabir Hospital in Arak in a five-year period (March 2008 to March 2012. Methods: This descriptive cross-sectional study was conducted on 224 children admitted for poisoning. Data were retrospectively collected from patients’ files and analyzed using SPSS 16 software. Results: Of the total population, 54.9% were boys and the rest were girls. Mean age of children was 3.54±2.99 years, and the most common age range was 1-3 years (50.9%. The highest rate of children’s admission due to poisoning was in the winter (30.8%. The most common causes of poisoning included drugs (65.2%, kerosene (7.1%, and food poisoning (5.4%. The most common poisoning drugs, included benzodiazepines (21.9%, gastrointestinal drugs (19.9%, opioid analgesics (15.1%. The most prevalent drugs were methadone, metoclopramide, and clonazepam. At admission, the most common presenting symptoms were neurological (51.3%, and gastrointestinal symptoms (38.4%. Conclusion: High prevalence of poisoning with groups of drugs mentioned could indicate community-wide excessive use of these drugs, as well as negligence of families in keeping them out of children’s reach. Therefore, raising knowledge and awareness about variety of poisoning and how to prevent them, through holding workshops, national media, schools, and health centers can be a valuable step toward upkeep of children’s health.

  8. A Rare but Potentially Fatal Poisoning; Aluminum Phosphide Poisoning

    Directory of Open Access Journals (Sweden)

    Orkun Tolunay

    2017-04-01

    Full Text Available Phosphide, a very toxic gas, is used in our country as aluminium phosphide tablets impregnated in clay. It is widely used since it has a very high diffusion capacity, whereby it can eradicate all living creatures in any form of their life cycle and does not leave any remnants in agricultural products. Aluminum phosphide poisoning is among intoxications for which there are still no true antidotes. Mortality rate varies between 30% and 100%. This paper presents a case of aluminum phosphide poisoning caused by the uncompleted suicide attempt. A 14-year-old girl, who swallowed aluminum phosphate tablets, was brought to the emergency department with the complaints of nausea and vomiting. The patient was treated with gastric lavage and activated charcoal. Since the patient ingested a lethal amount of aluminum phosphide, she was referred to the pediatric intensive care unit. The patient was discharged in stable condition after supportive care and monitoring. Specific antidotes are life-saving in poisonings. However, this case was presented to show how general treatment principles and quick access to health services affect the result of treatment. Also, we aimed to highlight the uncontrolled selling of aluminum phosphate, which results in high mortality rates in case of poisoning.

  9. Blunt hepatic and splenic trauma. A single Center experience using a multidisciplinary protocol.

    Science.gov (United States)

    Ruscelli, Paolo; Buccoliero, Farncesco; Mazzocato, Susanna; Belfiori, Giulio; Rabuini, Claudio; Sperti, Pierluigi; Rimini, Massimiliano

    2017-01-01

    The aim of this retrospective study was to describe more than 10 years experience of a single Trauma Center about non operative management of abdominal organ injuries in hemodynamically stable patients MATERIAL OF STUDY: Between January 2001 and December 2014 ,732 consecutive patients were admitted with blunt abdominal trauma, involving liver and/or spleen and/or kidney, at the Bufalini Cesena Hospital .Management of patients included a specific institutional developed protocol :hemodynamic stability was evaluated in shock room according to the patients response to fluid challenge and the patients were classified into three categories A,B,and C. Form 732 Trauma, 356(48.6%) of patients were submitted to a surgical procedure, all the other patient 376(51.4%) underwent an non operative management .Overall mortality was 9.8% (72), mortality in the surgery group was 15.4% eheras in the non operative group was 4.5%; the relative risk of mortality, measured by the odds ratio waith a 95% confidence interval, was 3.417(2.023-5.772) for rhe surgery group; patient over 40 years old has a statistically significant higher mortality. In our series the overall mortality rate of non operative management group was 4.5%, instead in unstable patients, the surgery group, the mortality was 15.3%; the overall mortality mortality rate after the application of our protocol is 9.8%, Although surgery continues to be the standard for hemodically unstable patients with blunt hepatic and splenic trauma. In our experience AAST Organ Injury Scale was useless for the therapeutic decision making process after the CT scan if a source of bleeding was detected and immediate angiography was performed in order to control and solve it. In our experience the AAST Organ Injury Scale was useless for the therapeutic decision making process, The results suggest that the only criteria of choice for therapeutici strategy was the hemodynamic stability, Nonoperative managem,ent can be applied only following

  10. Single center experience with percutaneous and laparoscopic cryoablation of small renal masses.

    Science.gov (United States)

    Malcolm, John B; Berry, Tristan T; Williams, Michael B; Logan, Joshua E; Given, Robert W; Lance, Raymond S; Barone, Bethany; Shaves, Sarah; Vingan, Harlan; Fabrizio, Michael D

    2009-06-01

    While partial nephrectomy remains the gold standard for the management of most small renal masses, increasing experience with renal cryoablation has suggested a viable alternative with a favorable morbidity profile and good efficacy. We report intermediate-term oncologic outcomes from a single-center experience with laparoscopic and percutaneous renal cryoablation. We performed a retrospective review of our laparoscopic renal cryoablation (LRC) and percutaneous renal cryoablation (PRC) experience between January 2003 and April 2007. Patients with at least 12 months of follow-up were included in the analysis. Follow-up consisted of imaging and laboratory studies at regular intervals. Persistent mass enhancement or interval tumor growth was considered a treatment failure. Sixty-six patients (44% women/56% men; 42% African-American/58% Caucasian/other; mean body mass index, 29.7) with 72 tumors underwent either LRC (n = 52) or PRC (n = 20) with a mean follow-up of 30 months (median 25.1 mos; range 13-63 mos). Average patient age was 66.5 years (range 34-82 yrs). Mean tumor size was 2.33 cm (range 1-4.6 cm). Comorbid conditions were prevalent: 76% hypertension, 36% hyperlipidemia, 24% chronic kidney disease, 29% diabetes mellitus, 36% tobacco use, and 32% heart disease. RESULTS of pretreatment biopsy were 62% renal-cell carcinoma and 38% benign or nondiagnostic. Overall cancer-specific and cancer-free survival were 100% and 97%, respectively. There were two treatment failures (3.8%) in the LRC group and five primary failures in the PRC group (25%) (P = 0.015), four of which were salvaged with repeated PRC with no evidence of recurrence at 6 to 36 months of follow-up. There has been no significant local or metastatic progression. LRC and PRC achieved good oncologic control with minimal morbidity at a mean follow-up of 30 months in a patient cohort characterized by numerous comorbid conditions. PRC had a significantly higher primary treatment failure rate than LRC, but

  11. Carbon monoxide poisoning in Beirut, Lebanon: Patient′s characteristics and exposure sources

    Directory of Open Access Journals (Sweden)

    Mazen J El Sayed

    2014-01-01

    Full Text Available Background: Carbon monoxide (CO poisoning is a preventable disease. Patients present with nonspecific symptoms post CO exposure. Causal factors are well described in developed countries, but less in developing countries. Objectives: This study examined the characteristics of patients with CO poisoning treated at a tertiary care center in Beirut, Lebanon, and their association with the CO poisoning source. Materials and Methods: A retrospective chart review of all patients who presented to the Emergency Department (ED of the American University of Beirut Medical Center (AUBMC over 4-year period and for whom a carboxyhemoglobin (CO-Hb level was available. Patients with CO poisoning diagnosis were included in the study. Patients′ characteristics and their association with CO poisoning source were described. Results: Twenty-seven patients were treated for CO poisoning during the study period, 55% of whom were males. Headache was the most common presenting symptom (51.9%. Burning charcoal indoors was the most common causal factor (44.4%, whereas fire-related smoke was another causal factor. The median arterial CO-Hb level on presentation for all cases was 12.0% (interquartile range (IQR 7.3-20.2. All patients received normobaric oxygen therapy. No complications were documented in the ED. All patients were discharged from the ED with a median ED length of stay of 255 min (IQR 210-270. Young females were more likely to present with CO poisoning from burning charcoal indoors than from another cause. Conclusion: CO poisoning in Beirut, Lebanon is mainly due to charcoal burning grills used indoors and to fire-related smoke. A clinically significant association was present between gender and CO poisoning source. An opportunity for prevention is present in terms of education and increased awareness regarding CO emission sources.

  12. Integration of the clinical engineering specialist at a high complexity children's hospital. Our professional experience at a surgical center

    International Nuclear Information System (INIS)

    Vargas Enriquez, M J; Chazarreta, B; Emilio, D G; Fernandez Sarda, E

    2007-01-01

    This document aims to find relating points between the current and future Clinical Engineer professional in order to discuss about the hospital environment, its characteristics and its realities which lead to our professional development. The main aim is to depict our experience through a retrospective analysis based on the underwriting experience and consequently to arrive at conclusions that will support the inclusion and active interaction of the Clinic Engineer Specialist as part of a Hospital's Surgical Center

  13. Pulmonary edema in acute carbon monoxide poisoning

    International Nuclear Information System (INIS)

    Kim, Kun Sang; Chang, Kee Hyun; Lee, Myung Uk

    1974-01-01

    Acute carbon monoxide poisoning has frequently occurred in Korean, because of the coal briquette being widely used as fuel in Korean residences. Carbon monoxide poisoning has been extensively studied, but it has been sparsely reported that pulmonary edema may develop in acute CO poisoning. We have noticed nine cases of pulmonary edema in acute CO poisoning last year. Other possible causes of pulmonary edema could be exclude in all cases but one. The purpose of this paper is to describe nine cases of pulmonary edema complicated in acute CO poisoning and discuss the pathogenesis and the prognosis

  14. Article Commentary: Chelation Therapy for Mercury Poisoning

    Directory of Open Access Journals (Sweden)

    Rong Guan

    2009-01-01

    Full Text Available Chelation therapy has been the major treatment for heavy metal poisoning. Various chelating agents have been developed and tested for treatment of heavy metal intoxications, including mercury poisoning. It has been clearly shown that chelating agents could rescue the toxicity caused by heavy metal intoxication, but the potential preventive role of chelating agents against heavy metal poisoning has not been explored much. Recent paper by Siddiqi and colleagues has suggested a protective role of chelating agents against mercury poisoning, which provides a promising research direction for broader application of chelation therapy in prevention and treatment of mercury poisoning.

  15. Usage of burnable poison on research reactors

    International Nuclear Information System (INIS)

    Villarino, Eduardo Anibal

    2002-01-01

    The fuel assemblies with burnable poison are widely used on power reactors, but there are not commonly used on research reactors. This paper shows a neutronic analysis of the advantages and disadvantages of the burnable poison usage on research reactors. This paper analyses both burnable poison design used on research reactors: Boron on the lateral wall and Cadmium wires. Both designs include a parametric study on the design parameters like the amount and geometry of the burnable poison. This paper presents the design flexibility using burnable poisons, it does not find an optimal or final design, which it will strongly depend on the core characteristics and fuel management strategy. (author)

  16. Pulmonary edema in acute carbon monoxide poisoning

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kun Sang; Chang, Kee Hyun; Lee, Myung Uk [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1974-10-15

    Acute carbon monoxide poisoning has frequently occurred in Korean, because of the coal briquette being widely used as fuel in Korean residences. Carbon monoxide poisoning has been extensively studied, but it has been sparsely reported that pulmonary edema may develop in acute CO poisoning. We have noticed nine cases of pulmonary edema in acute CO poisoning last year. Other possible causes of pulmonary edema could be exclude in all cases but one. The purpose of this paper is to describe nine cases of pulmonary edema complicated in acute CO poisoning and discuss the pathogenesis and the prognosis.

  17. The Role of Oxygen Therapies in Carbon Monoxide Poisoning

    Directory of Open Access Journals (Sweden)

    Suleyman Metin

    2011-08-01

    Full Text Available Due to climate and socio-economic issues in Turkey, the incidence of carbon monoxide (CO poisoning is high, especially in winter. Clinical manifestations may vary depending on the type of CO source, concentration and duration of exposure. The symptoms of CO poisoning predominantly manifest in lots of organs and systems with high oxygen utilization, especially the brain and the heart. The primary aim in oxygen therapy is to eliminate CO and to reduce its toxic effects. In this context, normobaric and hyperbaric oxygen therapy are used to achieve these goals. Normobaric oxygen (NBO treatment is an easily accessible and relatively not expensive modality, where hyperbaric oxygen (HBO therapy requires specific equipment, certified staff and is available only in some centers. Additionally, HBO treatment has several additional advantages over NBO treatment. Despite its benefits, it is compulsory to search for some criteria in selecting patients to be treated because of the limited availability and access of hyperbaric facilities. For an effective evaluation and an optimal treatment, advanced education of the healthcare professionals on the use of oxygen delivery modalities in the management of CO poisoning is imperative. In this review, it has been aimed to outline the significance of oxygen treatment modalities and to determine patient selection criteria for HBO treatment in the management of CO poisoning which continues to be an important threat to community health care. [TAF Prev Med Bull 2011; 10(4.000: 487-494

  18. [Outbreak due to butterfish consumption: keriorrhea and histamine poisoning].

    Science.gov (United States)

    Fariñas Cabrero, Maria Azucena; Berbel Hernández, Clara; Allué Tango, Marta; Díez Hillera, Margarita; Herrero Marcos, Juan Antonio

    2015-01-01

    The consumption of butterfish is spreading in our country; if appropriate standards of conservation and preparation of this type of food are not met may cause poisoning. The objective is to describe an outbreak of histamine poisoning and double cerous esters after consumption butterfish. A descriptive study of the double intoxication at a banquet held in July 2013 in Valladolid. It was studied by filling a specific survey, by phone or by the medical centers who treated the guests. The database and subsequent descriptive statistical analyzes were performed with Microsoft Excel Professional Plus 2010 program. Of the 27 cases reported in 24 we obtained information on symptoms. The attack rate was 22.5 %, with a clinical picture in which predominant diarrhea (75%), headache (46%), abdominal pain (38%) and sweating (38%), highlighting its specificity itching/burning of mouth (29%). Four patients had orange and oily stools (keriorrhea). The average time from the start of dinner to onset of symptoms was 119 minutes. The mean duration of symptoms was 14 hours. Analytical served fish showed histamine levels above 2,000 mg / kg. A double poisoning (histamine and cerous esters) was produced by consumption of butterfish. The picture was mild and self-limiting. You need to know this type of poison to properly handle avoiding unnecessary tests, and to notify the health authority for investigation and subsequent adoption of appropriate measures.

  19. Ciguatera fish poisoning: a review

    NARCIS (Netherlands)

    Fouw JC de; Egmond HP van; Speijers GJA; CSR

    2001-01-01

    This review on ciguatera fish poisoning contains information on the ciguatera intoxication syndrome and the provoking ciguatoxins (CTXs) and gambiertoxin-4b (GTX-4B), of which CTX-1 is a major component at the end of food chain (the carnivore fish). Data on chemical structures and detection methods

  20. Lead poisoning from souvenir earthenware.

    Science.gov (United States)

    Hellström-Lindberg, Eva; Björklund, Andreas; Karlson-Stiber, Christine; Harper, Pauline; Seldén, Anders I

    2006-02-01

    A case of massive lead poisoning from juice contained in a Greek earthenware jug as well as six satellite cases of high lead exposure of similar origin is reported. The intoxicated patient was successfully treated with dimercaptosuccinic acid. Ceramic producers should adhere to the longstanding European legislation.

  1. Therapeutic problems in cyanide poisoning

    NARCIS (Netherlands)

    van Heijst, A. N.; Douze, J. M.; van Kesteren, R. G.; van Bergen, J. E.; van Dijk, A.

    1987-01-01

    In three patients with severe acute cyanide poisoning, a cyanosis was observed instead of the bright pink skin coloration often mentioned as a sign in textbooks. Treatment of cardiopulmonary insufficiency is as essential as antidotal therapy and the use of sodium nitrite and 4-DMAP is not without

  2. Lead poisoning in domestic ducks

    Energy Technology Data Exchange (ETDEWEB)

    Rac, R; Crisp, C S

    1954-05-01

    The death of wild ducks, due to the ingestion of lead shop, occurs frequently and is well documented. This paper discusses the death of domestic ducks due to the ingestion of lead. It describes the symptoms, and pathology of the lead poisoning of a clutch of 11 ducklings which were being raised on a farm in Australia. 3 references, 1 table.

  3. Hemodialysis in the Poisoned Patient

    Directory of Open Access Journals (Sweden)

    Megan Boysen-Osborn

    2017-09-01

    Full Text Available Audience: This classic team based learning (cTBL didactic is aimed for emergency medicine residents and fourth year medical students entering emergency medicine. Introduction: Over one million visits per year to United States (US emergency departments (ED are related to poisonings.1 Extracorporeal treatment (ECTR, specifically hemodialysis (HD, is one potential method to enhance elimination of certain drugs and their toxic metabolites.2-12 While HD may be life-saving in certain poisonings, it may have no effect on others and it carries associated risks and costs. It is essential that emergency physicians know the indications for HD in the poisoned patient. This cTBL reviews many poisonings which may be managed by HD. Objectives: By the end of this cTBL, the learner will: 1 recognize laboratory abnormalities related to toxic alcohol ingestion; 2 calculate an anion gap and osmolal gap; 3 know the characteristics of drugs that are good candidates for HD; 4 discuss the management of patients with toxic alcohol ingestions; 5 discuss the management of patients with salicylate overdose; 6 know the indications for HD in patients with overdoses of antiepileptic drugs; 7 discuss the management of patients with lithium toxicity. Method: This didactic session is a cTBL (classic team based learning.

  4. Congenital bronchopulmonary malformations: A single-center experience and a review of literature

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    Kumar Basant

    2008-01-01

    Full Text Available Purpose: To present a single-center experience with 25 cases of bronchopulmonary malformations and the review the literature. Materials and Methods: We conducted a retrospective analysis of the medical records of patients with congenital bronchopulmonary malformations who were operated between July 1997 and July 2007 in our institute; we examined the modes of presentations, management, and outcome. Outcome of all patients was assessed over a short follow-up period (average 1.8 months. Results: Out of 25 patients, 18 (72% were male and 7 (28% were female. Age of patients ranged from 1 day to 11 years. The histopathological diagnosis was congenital cystic adenomatoid malformations [CCAM; n = 14 (56%], congenital lobar emphysema [CLE; n = 5 (20%], pulmonary sequestrations [PS; n = 3 (12%], and bronchogenic cysts [BC; n = 3 (12%]. Antenatal diagnosis was available in only 2 (8% patients. The common presenting symptoms were respiratory distress and chest infections. Lobectomy was the procedure of choice . Mortality was 16% (n = 4; M: F = 3: 1. Two patients died because of overwhelming sepsis, one from compromised cardiac function, and one from aspiration which might possibly have been prevented. Conclusion: Patients with progressive respiratory distress due to these anomalies may require urgent surgical intervention regardless of age. The surgical outcome is favorable, with manageable complications. Plain x-ray chest and CT of thorax are usually sufficient for diagnosis and planning of treatment. Pathological diagnosis may differ from the imaging diagnosis. Mortality is found to be more in neonates. Apart from initial stabilization, resection of lesion and careful postoperative care is necessary to reduce mortality and morbidity.

  5. Management of Placenta Invasion Anomaly and Cesarean Hysterectomy: Eight-year Experience of A Tertiary Center

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    İbrahim Kalelioğllu

    2013-09-01

    Full Text Available Objective: We aimed to present our experience with the management of placenta invasion anomaly by reviewing clinical and operative features of the cases of cesarean hysterectomy performed due to placenta invasion anomaly. Methods: In this retropective study, the charts of all patients who underwent cesarean hysterectomy with an indication of placenta invasion anomaly in Istanbul Faculty of Medicine Department of Obstetrics and Gynecology between 2005 and 2012 were reviewed. Results: In this period a total of 85 patients underwent cesarean hysterectomy. 81 (95.3% cases had experienced at least one cesarean delivery before. Majority of the operations (82.4% were performed in elective conditions. In 16 (18.8% cases bilateral hypogastric artery ligation was carried out because of profuse bleeding. There were no mortalities in the intra- or postoperative period. In 18 (21.2% cases, intraoperative urology consultation was needed. Full- thickness bladder laceration occured in 17 patients, and partial cyctectomy was performed in one patient due to the placenta percreata invading posterior wall of the bladder. Transfusion was needed in 72 (84.7% cases during and 50 (58.8% patients after operation. Dilutional trombocytopenia developed in 17 (20% patients due to massive transfusion. Histopathologically the diganosis was placenta accreata in 55 (64.7%, placenta increata in 1 (1.2% and placenta percreata in 25 (29.4% patients. The incidence of placenta invasion anomaly rose from 0.2% (7/3435 in 2005-2006 up to 0.8% (37/4344 in 2011-2012. Conclusion: The incidence of placenta invasion anomaly is increasing progressively. Cesarean hysterectomy being its classical treatment is an operation with a high risk of morbidity and it should be performed by experienced teams after appropriate preparations in tertiary centers where multidiciplinary approach is possible.

  6. Work Experiences of Patients Receiving Palliative Care at a Comprehensive Cancer Center: Exploratory Analysis.

    Science.gov (United States)

    Glare, Paul A; Nikolova, Tanya; Alickaj, Alberta; Patil, Sujata; Blinder, Victoria

    2017-07-01

    Employment-related issues have been largely overlooked in cancer patients needing palliative care. These issues may become more relevant as cancer evolves into more of a chronic illness and palliative care is provided independent of stage or prognosis. To characterize the employment situations of working-age palliative care patients. Cross-sectional survey setting/subjects: Consecutive sample of 112 patients followed in palliative care outpatient clinics at a comprehensive cancer center. Thirty-seven-item self-report questionnaire covering demographics, clinical status, and work experiences since diagnosis. The commonest cancer diagnoses were breast, colorectal, gynecological, and lung. Eighty-one percent had active disease. Seventy-four percent were on treatment. Eighty percent recalled being employed at the time of diagnosis, with 65% working full time. At the time of the survey, 44% were employed and 26% were working full time. Most participants said work was important, made them feel normal, and helped them feel they were "beating the cancer". Factors associated with being employed included male gender, self-employed, and taking less than three months off work. Respondents with pain and/or other symptoms were significantly less likely to be working. On multivariate analysis, only pain (odds ratio [OR] 8.16, p gender (OR 2.07), self-employed (OR 3.07), and current chemotherapy (OR 1.81) were included in the model, but were not statistically significant in this small sample. Work may be an important issue for some palliative care patients. Additional research is needed to facilitate ongoing employment for those who wish or need to continue working.

  7. Meningitis and Meningoencephalitis among Israel Defense Force Soldiers: 20 Years Experience at the Hadassah Medical Centers.

    Science.gov (United States)

    Pikkel, Yoav Y; Ben-Hur, Tamir; Eliahou, Ruth; Honig, Asaf

    2015-11-01

    Meningitis and meningoencephalitis pose major risks of morbidity and mortality. To describe 20 years of experience treating infections of the central nervous system in Israel Defense Force (IDF) soldiers, including the common presentations, pathogens and sequelae, and to identify risk groups among soldiers. All soldiers who were admitted to the Hadassah University Medical Center (both campuses: Ein Kerem and Mt. Scopus) due to meningitis and meningoencephalitis from January 1993 to January 2014 were included in this retrospective study. Clinical, laboratory and radiologic data were reviewed from their hospital and army medical corps files. Attention was given to patients' military job description, i.e., combat vs. non-combat soldier, soldiers in training, and medical personnel. We identified 97 cases of suspected meningitis or meningoencephalitis. Six were mistakenly filed and these patients were found to have other disorders. Four soldiers were diagnosed with epidural abscess and five with meningitis due to non-infectious in flammatory diseases. Eighty-two soldiers in active and reserve duty had infectious meningitis or meningoencephalitis. Of these, 46 (56.1%) were combat soldiers and 31 (37.8%) non-combat; 20 (29.2%) were soldiers in training, 10 (12.2%) were training staff and 8 (9.8%) were medical staff. The main pathogens were enteroviruses, Epstein-Barr virus an d Neisseria meningitidis. In our series, soldiers in training, combat soldiers and medical personnel had meningitis and meningoencephalitis more than other soldiers. Enteroviruses are highly infectious pathogens and can cause outbreaks. N. meningitidis among IDF soldiers is still a concern. Early and aggressive treatment with steroids should be considered especially in robust meningoencephalitis cases.

  8. Outcome of deceased donor renal transplantation - A single-center experience from developing country

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    Himanshu V Patel

    2013-01-01

    Full Text Available Renal transplantation (RTx is considered as the best therapeutic modality for patient suffering from end-stage renal disease (ESRD. Dearth of donor kidneys is a major problem everywhere, and deceased donor renal transplantation (DDRTx is seen as at least a partial solution. Even so, DDRTx accounts for only less than 4% of RTx in India. We report our 6-year single-center experience on DDRTx vis-à-vis patient/graft survival, graft function in terms of serum creatinine (SCr, rejection episodes, and delayed graft function (DGF. Between January 2005 and March 2011, 236 DDRTx were performed. Majority of the donors were those with brain death due to road traffic/cerebrovascular accidents. The commonest recipient diseases leading to ESRD were chronic glomerulonephritis (42.8%, diabetes (12.7%, and hypertension (10.6%. Mean recipient age was 36.2 ± 14.2 years; 162 were males and 74 were females. Mean donor age was 45.3 ± 17.13 years; 144 were males and 92 were females. Mean dialysis duration pre-transplantation was 18.5 ± 2.5 months. All recipients received single-dose rabbit-anti-thymocyte globulin induction and steroids, calcinueurin inhibitor, and mycophenolate mofetil/azathioprine for maintenance immunosuppression. Delayed graft function was observed in 29.6% patients and 22% had biopsy-proven acute rejection. Over the mean follow-up of 2.18 ± 1.75 years, patient and graft survival rates were 74.57% and 86.8%, respectively, with mean SCr of 1.42 ± 0.66 mg%. DDRTx achieves acceptable graft function with patient/graft survival, encouraging the use of this approach in view of organ shortage.

  9. Outcome of liver transplantation for hepatocellular carcinoma -- a single center experience.

    Science.gov (United States)

    Iacob, R; Iacob, S; Gheorghe, L; Gheorghe, C; Hrehoreţ, D; Brașoveanu, V; Croitoru, A; Herlea, V; Popescu, I

    2013-01-01

    Liver transplantation (LT) is a promising treatment for patients with liver cirrhosis associated with hepatocellular carcinoma (HCC). The aim of our study was to evaluate our experience regarding the clinical and pathological staging of HCC in patients who underwent LT, as well as recurrence free and overall survival. From January 2006 to December 2011, 38 patients with diagnosis of HCC, underwent LT in our Center. Demographic, clinical, imaging and pathologic information were recorded. A Cox proportional hazards survival analysis was performed in order to identify significant predictors of tumor recurrence and patient's death after LT. Eighteen patients (47.4%) in our study group were within Milan criteria. The mean follow-up was 22 months and the recurrence rate of HCC after LT was 13.2%. The 1, 3- year recurrence free survival rates were 85%, 74.3% respectively. The 1 and 3-year overall survival rates were 83.5% and 63.6% respectively. No significant predictor for HCC recurrence was identified in our study group by survival analysis, taking into account 13 different variables. As independent predictors of patient'ss death after LT for HCC however, the presence of diabetes mellitus (p=0.001), presence of more than 3 HCC nodules (p=0.03) and tumor recurrence after LT (p=0.03) were identified by multivariate Cox proportional hazards survival analysis. In our cohort HCC recurrence rate after LT was 13.2%. Diabetes mellitus, presence of more than 3 HCC nodules and HCC recurrence were significant predictors of poor overall survival after LT. Celsius.

  10. 47. A cardiac center experience with Brugada syndrome who survived sudden cardiac death

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    I. Suliman

    2016-07-01

    Full Text Available Brugada syndrome is a heritable arrhythmia syndrome that is characterized by an electrocardiographic pattern consisting of coved-type ST-segment elevation (2 mm followed by a negative T wave in the right precordial leads, V1 through V3 (often referred to as type 1 Brugada electrocardiographic pattern, here we describe 3 cases of Brugada who survived sudden cardiac death (SCD cardiac center experience with survived Brugada syndrome patients – case series. First Case: The Father 45 years old male, presented in 2005 after involvement in unprovoked motor vehicle accident, the patient was the driver who lost consciousness and rushed to the hospital. On arrival to our ER and putting the patient on the bed, the ER doctor observed a brief episode of VF on the monitor. The patient was taken to the catheterization Lab , his coronaries were normal. The diagnosis of Brugada was established and the patient received a defibrillator. At That Time all family members were screened and were negative. Second Case: The Son of the first patient 5 years later his 23 years old male rushed to our ER after he lost consciousness, he was passenger in the car of his friend. Third Case: The pilot A military pilot aged a male 35 years old was in very good health when he lost consciousness and brought to the hospital after resuscitation in 2005. He had full invasive cardiac evaluation, subsequently he received a defibrillator in the same admission period, till 2015 he is doing fine. Brugada syndrome is associated with high tendency for sudden cardiac death. In our three cases the first clinical presentation was survived sudden cardiac death (SCD and all three male patients survived. We did not encounter a female patient who survived sudden cardiac death.

  11. Safety of infliximab in Crohn's disease: a large single-center experience.

    Science.gov (United States)

    Hamzaoglu, H; Cooper, J; Alsahli, M; Falchuk, K R; Peppercorn, M A; Farrell, R J

    2010-12-01

    The aim of this study was to evaluate the short- and long-term safety experience of infliximab treatment in patients with Crohn's disease (CD) in clinical practice. The medical records of 297 consecutive patients with CD treated with infliximab at the Beth Israel Deaconess Medical Center were reviewed for demographic features and adverse events. The 297 patients received a total of 1794 infusions. Patients received a median of four infusions and had a median follow-up of 14.3 months. Forty-four patients (15%) experienced a serious adverse event, requiring the infusion to be stopped in 33 patients (11%). Acute infusion reactions occurred in 18 patients (6%) including respiratory problems in 10 patients (3%) and an anaphylactoid reaction in 1 patient (0.3%). Serum sickness-like disease occurred in one patient (0.3%) and three patients (1%) developed drug-induced lupus. One patient developed a probable new demyelination disorder. Eight patients (2.7%), all of whom were on concurrent immunosuppressants, developed a serious infection, one resulting in fatal sepsis. Six patients (2%) developed malignancies including two lymphomas and two skin cancers. A total of four (1.3%) deaths were observed (median age 72.5 years); two due to gastrointestinal bleeding, one due to sepsis, and one due to malignancy. While short- and long-term infliximab therapy was generally well tolerated, serious adverse events occurred in 15% of patients including drug-induced lupus, fatal sepsis, and malignancy. Concomitant immunosuppressants were significantly associated with infections and deaths, particularly among elderly patients. Copyright © 2010 Crohn's & Colitis Foundation of America, Inc.

  12. Image-guided chemoport insertion by interventional radiologists: A single-center experience on periprocedural complications

    International Nuclear Information System (INIS)

    Yaacob, Yazmin; Nguyen, Dang V; Mohamed, Zahiah; Ralib, A Razali A; Zakaria, Rozman; Muda, Sobri

    2013-01-01

    To report our early experience in image-guided chemoport insertions by interventional radiologists. This was a cross-sectional study conducted in a tertiary center with 161 chemoport insertions done from June 2008 to June 2010. The chemoports were inserted either at the angiography suite or at the mobile operation theater unit. Ninety percent of the chemoports had right internal jugular vein (IJV) as the entry site. Other entry sites included the left IJV, subclavian veins and the inferior vena cava. Immediate and early complications were recorded. All insertions were performed under image guidance with the aid of ultrasound and fluoroscopy. The technical success rate was 99.4%. In terms of immediate complications, there were only two cases of arterial puncture that resolved with local compression. No pneumothorax or air embolism was documented. Twenty-six early complications were recorded. The most common early complication was catheter blockage (12/161; 7.4%), followed by catheter-related infection (9/161; 5.6%). Other complications were catheter malposition, venous thrombosis and catheter dislodgement or leak. A total of 11 (6.8%) chemoports had to be removed within 30 days; most of them were due to infections that failed to respond to systemic antibiotic therapy. In terms of place of procedure, there were no significant differences in complication rates between the angiography suite and the mobile operation theater unit. Image-guided chemoport insertion by interventional radiologist gives low periprocedural complication rates. Using right IJV as the entry site, the image guidance gives good success rate with least complication

  13. Women's experiences accessing a women-centered cardiac rehabilitation program: a qualitative study.

    Science.gov (United States)

    Rolfe, Danielle E; Sutton, Erica J; Landry, Mireille; Sternberg, Len; Price, Jennifer A D

    2010-01-01

    The health benefits of cardiac rehabilitation (CR) for women living with heart disease are well documented, yet women remain underrepresented in traditionally structured CR programs. This health service delivery gap has been attributed to a number of sex-related factors experienced by women, including lower rates of physician referral, travel-related barriers, competing work and caregiving responsibilities, greater cardiovascular disease severity, and number of comorbid health conditions. Whether a program specifically designed for women is able to address these barriers and facilitate women's participation is a question that has seldom been explored in the CR literature. As part of a larger study exploring whether 6 predefined principles of women's health (empowerment of women, accessible programs, broad definition of health care, high-quality of care, collaborative planning, and innovative and creative approaches) are reflected in the practices of the Women's Cardiovascular Health Initiative (WCHI) (a comprehensive CR and primary prevention program designed for women), the objective of this analysis was to explore how the principle of "accessible programs" is experienced by women participating in the WCHI. Fourteen women previously enrolled in the WCHI program participated in a single, in-person qualitative interview. Transcripts were analyzed using a constant-comparative approach to identify relevant themes related to program accessibility. Key themes identified included participants' experiences with acquiring physician referral, negotiating transportation issues, and navigating program schedules. Women discussed how peer support and staff members' willingness to address their health-related concerns facilitated their participation. While a women-centered CR/primary prevention program may facilitate and encourage women's participation by providing flexible program schedules as well as peer and professional support, efforts are still required to address

  14. Robotic surgery for rectal cancer: a single center experience of 100 consecutive cases.

    Science.gov (United States)

    Stănciulea, O; Eftimie, M; David, L; Tomulescu, V; Vasilescu, C; Popescu, I

    2013-01-01

    Minimally invasive techniques have revolutionized the field of general surgery over the few last decades. Despite its advantages, in complex procedures such as rectal surgery, laparoscopy has not achieved a high penetration rate because of its steep learning curve, its relatively high conversion rate and technical challenges. The aim of this study was to present a single center experience with robotic surgery for rectal cancer focusing mainly on early and mid-term postoperative outcome. A series of 100 consecutive patients who underwent robotic rectal surgery between January 2008 and June 2012 was analyzed retrospectively in terms of demographics, pathological data, surgical and oncological outcomes. Seventy-seven patients underwent robotic sphincter-saving resection, and 23 patients underwent robotic abdominoperineal resection. There were 4 conversions. The median operative time for sphincter-saving procedures was 180 min. The median time for robotic abdominoperineal resection was 160 min. The median distal resection margin of the operative specimen was 3 cm. The median number of retrieved lymph nodes was 14. The median hospital stay was 10 days. In-hospital mortality was nil. The overall morbidity was 30%. Four patients presented transitory postoperative urinary dysfunction. Severe erectile dysfunction was reported by 3 patients. The median length of follow-up was 24 months. The 3-year overall survival rate was 90%. Robotic surgery is advantageous for both surgeons (in that it facilitates dissection in a narrow pelvis) and patients (in that it affords a very good quality of life via the preservation of sexual and urinary function in the vast majority of patients and it has low morbidity and good midterm oncological outcomes). In rectal cancer surgery, the robotic approach is a promising alternative and is expected to overcome the low penetration rate of laparoscopy in this field. Celsius.

  15. Living Related Donor Kidney Transplantation in Libya: A Single Center Experience

    Directory of Open Access Journals (Sweden)

    Elusta Ahmed

    2008-01-01

    Full Text Available The aim of this study is to report the experience from a single center in Libya, on the prevailing live-related kidney transplantation program. The results of three years work on kidney transplantation at the Tripoli Central Hospital (National Organ Transplant Program in Libya were evaluated. The transplant program was launched on 17 th August, 2004 and 135 patients have been transplanted since then till 17 th August, 2007. All donors and recipients were screened thoroughly prior to transplant and monitored closely in the post-transplant period. Our immuno-suppressive protocol was cyclosporine-based. Among the 135 accepted pairs, donors and reci-pients were genetically-related in 133 cases (98.5% and emotionally-related in two others. The mean donor age was 37 ± 9.5 years (range 18-56 years and recipient age 37 ± 13.6 years (range 7-67 years. There were 95 males (70.4% and 40 females (29.6% among the recipients while among the donors, there were 102 males (75.6% and 33 females (24.4%. Delayed graft function was seen in three patients (2.2%, acute rejection in six (4.4%, post-transplant urinary tract infection in six (4.4%, pneumonia in three (2.2%, ureteric kink in two (1.5% and urine leak in four (3.0%. Graft survival at 36 months was 93.3% while patient survival at the same period was 96.3%. This report indicates that the results of our transplant program are good and comparable with other international programs.

  16. Predictors of clinical outcome in fibromyalgia after a brief interdisciplinary fibromyalgia treatment program: single center experience.

    Science.gov (United States)

    Oh, Terry H; Hoskin, Tanya L; Luedtke, Connie A; Weingarten, Toby N; Vincent, Ann; Kim, Chul H; Thompson, Jeffrey M

    2012-04-01

    To determine which patient characteristics are closely associated with a positive response to a brief interdisciplinary fibromyalgia treatment program (FTP). A prospective cohort study. FTP at a tertiary medical center. A total of 536 patients with a confirmed diagnosis of fibromyalgia who underwent the FTP and completed the Fibromyalgia Impact Questionnaire (FIQ) at baseline and 6-12 months after treatment. A brief 1.5-day interdisciplinary FTP, which included evaluation with a registered nurse and a physician for a diagnosis or confirmation of fibromyalgia, fibromyalgia education, interactive self management session, and physical and occupational therapy. The responder definition was an improvement of 14% or more in the FIQ total score from their baseline to 6-12 months after treatment. Mean (standard deviation) age of our patients was 50.3 ± 13.0 years; 515 women (96%) and 23 men (4%). Two hundred forty-eight patients (46%) met the responder definition at 6-12 months follow-up. In an univariate analysis, younger age (P = .008), college or higher education (P = .02), fewer tender points (P = .048), and higher FIQ depression subscore (P = .02) significantly predicted positive response. In a multivariate analysis, these factors all remained statistically significant. In addition, a positive abuse history became significant (P = .03). There was no significant association for gender, duration of symptoms, marital status, employment, smoking status, or 3 numeric rating scale pain scores. Patients with younger age, more years of education (with college or graduate degree), higher baseline FIQ depression score, lower tender point count, and absent abuse history experience greater benefit from a brief FTP. Copyright © 2012 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  17. Bituminization of radioactive wastes at the Nuclear Research Center Karlsruhe. Experience from plant operation and development work

    Energy Technology Data Exchange (ETDEWEB)

    Hild, W; Kluger, W; Krause, H

    1976-05-01

    A summary is given of the main operational experience gained at the Nuclear Research Center Karlsruhe in 4 years operation of the bituminization plant for evaporator concentrates from low- and medium level wastes. At the same time some of the essential results are compiled that have been obtained in the R + D activities on bituminization.

  18. The Brave New World of GEC Evaluation: The Experience of the Rhode Island Geriatric Education Center

    Science.gov (United States)

    Filinson, Rachel; Clark, Phillip G.; Evans, Joann; Padula, Cynthia; Willey, Cynthia

    2012-01-01

    In 2007, the Health Resources Services Administration introduced new mandates that raised the standards on program evaluation for Geriatric Education Centers. Described in this article are the primary and secondary evaluation efforts undertaken for one program within the Rhode Island Geriatric Education Center (RIGEC), the findings from these…

  19. Detecting spatiotemporal clusters of accidental poisoning mortality among Texas counties, U.S., 1980 – 2001

    Directory of Open Access Journals (Sweden)

    Harris Ann

    2004-10-01

    Full Text Available Abstract Background Accidental poisoning is one of the leading causes of injury in the United States, second only to motor vehicle accidents. According to the Centers for Disease Control and Prevention, the rates of accidental poisoning mortality have been increasing in the past fourteen years nationally. In Texas, mortality rates from accidental poisoning have mirrored national trends, increasing linearly from 1981 to 2001. The purpose of this study was to determine if there are spatiotemporal clusters of accidental poisoning mortality among Texas counties, and if so, whether there are variations in clustering and risk according to gender and race/ethnicity. The Spatial Scan Statistic in combination with GIS software was used to identify potential clusters between 1980 and 2001 among Texas counties, and Poisson regression was used to evaluate risk differences. Results Several significant (p Conclusion The findings of the present study provide evidence for the existence of accidental poisoning mortality clusters in Texas, demonstrate the persistence of these clusters into the present decade, and show the spatiotemporal variations in risk and clustering of accidental poisoning deaths by gender and race/ethnicity. By quantifying disparities in accidental poisoning mortality by place, time and person, this study demonstrates the utility of the spatial scan statistic combined with GIS and regression methods in identifying priority areas for public health planning and resource allocation.

  20. Epidemiology and risk factors of voluntary pesticide poisoning in Morocco (2008-2014)

    Science.gov (United States)

    2017-01-01

    OBJECTIVES To determine the epidemiological profile and risk factors of voluntary poisoning by pesticides. METHODS A retrospective analysis was conducted of all cases of voluntary poisoning by pesticides registered at the AntiPoison and Pharmacovigilance Center of Morocco between January 2008 and December 2014. RESULTS During the study period, 2,690 cases of acute pesticide poisoning were registered. The region of Rabat-Salé-Zemmour-Zaer accounted for the largest proportion, with 598 cases. The average age of the patients was 24.63±10.29 years. The sex ratio (female-to-male) was 0.45. Adults and teenagers were most affected by this type of poisoning, with 1,667 cases (62.0%) and 806 cases (30.0%), respectively. Suicide attempts accounted for 98.4% of the cases (2,469 cases). Pesticide poisoning occurred more often in urban zones (64.8%). Insecticides were incriminated in 14.0% of cases, with a mortality rate of 4.2%. Among the 1,635 patients for whom the outcomes were known, 154 died, corresponding to a mortality rate of 5.7%. CONCLUSIONS Voluntary intoxication by pesticides presents a real scourge that affects public health, and in this study, we developed an epidemiological profile of this phenomenon. Nevertheless, this study has limitations in that it did not evaluate the impact of the socioeconomic and psychological factors that are important contributors to this type of poisoning. PMID:28882026

  1. Epidemiology and risk factors of voluntary pesticide poisoning in Morocco (2008-2014).

    Science.gov (United States)

    Nabih, Zineb; Amiar, Latifa; Abidli, Zakaria; Windy, Maria; Soulaymani, Abdelmajid; Mokhtari, Abdelrhani; Soulaymani-Bencheikh, Rachida

    2017-01-01

    To determine the epidemiological profile and risk factors of voluntary poisoning by pesticides. A retrospective analysis was conducted of all cases of voluntary poisoning by pesticides registered at the AntiPoison and Pharmacovigilance Center of Morocco between January 2008 and December 2014. During the study period, 2,690 cases of acute pesticide poisoning were registered. The region of Rabat-Salé-Zemmour-Zaer accounted for the largest proportion, with 598 cases. The average age of the patients was 24.63±10.29 years. The sex ratio (female-to-male) was 0.45. Adults and teenagers were most affected by this type of poisoning, with 1,667 cases (62.0%) and 806 cases (30.0%), respectively. Suicide attempts accounted for 98.4% of the cases (2,469 cases). Pesticide poisoning occurred more often in urban zones (64.8%). Insecticides were incriminated in 14.0% of cases, with a mortality rate of 4.2%. Among the 1,635 patients for whom the outcomes were known, 154 died, corresponding to a mortality rate of 5.7%. Voluntary intoxication by pesticides presents a real scourge that affects public health, and in this study, we developed an epidemiological profile of this phenomenon. Nevertheless, this study has limitations in that it did not evaluate the impact of the socioeconomic and psychological factors that are important contributors to this type of poisoning.

  2. Epidemiology and risk factors of voluntary pesticide poisoning in Morocco (2008-2014

    Directory of Open Access Journals (Sweden)

    Zineb Nabih

    2017-09-01

    Full Text Available OBJECTIVES To determine the epidemiological profile and risk factors of voluntary poisoning by pesticides. METHODS A retrospective analysis was conducted of all cases of voluntary poisoning by pesticides registered at the AntiPoison and Pharmacovigilance Center of Morocco between January 2008 and December 2014. RESULTS During the study period, 2,690 cases of acute pesticide poisoning were registered. The region of Rabat-Salé-Zemmour-Zaer accounted for the largest proportion, with 598 cases. The average age of the patients was 24.63±10.29 years. The sex ratio (female-to-male was 0.45. Adults and teenagers were most affected by this type of poisoning, with 1,667 cases (62.0% and 806 cases (30.0%, respectively. Suicide attempts accounted for 98.4% of the cases (2,469 cases. Pesticide poisoning occurred more often in urban zones (64.8%. Insecticides were incriminated in 14.0% of cases, with a mortality rate of 4.2%. Among the 1,635 patients for whom the outcomes were known, 154 died, corresponding to a mortality rate of 5.7%. CONCLUSIONS Voluntary intoxication by pesticides presents a real scourge that affects public health, and in this study, we developed an epidemiological profile of this phenomenon. Nevertheless, this study has limitations in that it did not evaluate the impact of the socioeconomic and psychological factors that are important contributors to this type of poisoning.

  3. [Pesticide poisoning in Moroccan children: epidemiological and prognostic aspects (1990-2008)].

    Science.gov (United States)

    Achour, Sanae; Khattabi, Asmae; Rhalem, Naïma; Ouammi, Lahcen; Mokhtari, Abdelrhani; Soulaymani, Abdelmajid; Bencheikh, Rachida Soulaymani

    2011-01-01

    The purpose of this paper is to describe the epidemiological profile of acute pesticide poisoning in children (APP) treated by the Moroccan Poison Control Center (CAPM) and to analyze death cases in order to determine factors predictive of severity. the study is based on a retrospective study of all cases of APP collected by the CAPM over a period of eighteen years (January 1990 to December 2008). Univariate analysis was performed to identify risk factors. 2,672 cases of childhood poisoning by pesticide were collected. The mean age was 5.6 ± 4.57 years. The sex ratio was 1.12. The cause of poisoning was accidental in 87.1% of cases, followed by attempted suicide (12.1%). Organophosphates were the most frequent poison (50.7%), followed by alpha-chloralose (26.5%). The case fatality rate was 3.3%. Mortality was attributed to organophosphates in 30 cases, followed by inorganic derivatives (7 cases) and carbamates (6 cases). A univariate analysis comparing survivors and groups who died showed that rural origin (p = 0.04), voluntary circumstances (p = 0.001), and the type of chemical class of pesticide (p < 0.001) significantly influence fatal poisoning. Acute pesticide poisoning among children is a reality in Morocco. Preventive measures may be needed.

  4. Development and validation of a model for high pressure liquid poison injection for CANDU-6 shutdown system no.2

    International Nuclear Information System (INIS)

    Rhee, B.-W.; Jeong, C.J.; Choi, J.H.; Yoo, S.-Y.

    2002-01-01

    In CANDU reactor one of the two reactor shutdown systems is the liquid poison injection system which injects the highly pressurized liquid neutron poison into the moderator tank via small holes on the nozzle pipes. To ensure the safe shutdown of a reactor it is necessary for the poison curtains generated by jets provide quick, and enough negative reactivity to the reactor during the early stage of the accident. In order to produce the neutron cross section necessary to perform this work, the poison concentration distribution during the transient is necessary. In this study, a set of models for analyzing the transient poison concentration induced by this high pressure poison injection jet activated upon the reactor trip in a CANDU-6 reactor moderator tank has been developed and used to generate the poison concentration distribution of the poison curtains induced by the high pressure jets injected into the vacant region between the calandria tube banks. The poison injection rate through the jet holes drilled on the nozzle pipes is obtained by a 1-D transient hydrodynamic code called, ALITRIG, and this injection rate is used to provide the inlet boundary condition to a 3-D CFD model of the moderator tank based on CFX4.3, an AEA Technology CFD code, to simulate the formation and growth of the poison jet curtain inside the moderator tank. For validation, the current model is validated against a poison injection experiment performed at BARC, India and another poison jet experiment for Generic CANDU-6 performed at AECL, Canada. In conclusion this set of models is considered to predict the experimental results in a physically reasonable and consistent manner. (author)

  5. Antiepileptic drug poisoning: Three-year experience

    Directory of Open Access Journals (Sweden)

    Yahya Kemal Günaydın

    2015-01-01

    Conclusion: First generation antiepileptics are more toxic than SGAEs. In patients with serum carbamazepine level, particularly those over 30 mg/L, serious disorders of consciousness, cardiovascular toxicity, and metabolic disorders may occur. In VPA intoxication, there is a positive correlation between the serum VPA levels and ammonia levels. On account of this finding, one should be more careful about hyperammonemic hepatic encephalopathy as the serum VPA level rises.

  6. MILITARY CONSTRUCTION: Kaiserslautern Military Community Center Project Continues to Experience Problems

    National Research Council Canada - National Science Library

    Kutz, Gregory D; Causseaux, Bruce A; Dorn, Terrell G

    2008-01-01

    The Kaiserslautern Military Community Center (KMCC) is one of many projects initiated at Ramstein Air Base to upgrade capabilities of the base as a result of the consolidation of military bases in Europe...

  7. Spent fuel storage facility at science and technical center 'Sosny': Experience of ten years activity

    International Nuclear Information System (INIS)

    Chigrinov, S.; Goulo, V.; Lunev, A.; Belousov, N.; Salnikov, L.; Boiko, L.

    2000-01-01

    Spent fuel storage of the Academic Science and Technical Center in Minsk is in operation already more then 10 years. In the paper aspects of its design, operation practice, problems and decisions for future are discussed. (author)

  8. [POISONING BY PSYCHOPHARMACOLOGICAL DRUGS IN AZERBAIJAN: THE RESULTS OF 8-YEAR PROSPECTIVE OBSERVATION].

    Science.gov (United States)

    Afandiyev, I; Azizov, V

    2017-11-01

    Acute poisoning of chemical etiology is a significant global public health problem. The aim of this study was the analysis of the toxicoepidemiological structure of psychopharmacological drugs poisoning in Azerbaijan. We collected and analyzed the data on all cases of acute poisoning by psychopharmacological drugs (codes of categories T42/T43 ICD-10) undergoing inpatient treatment at the Center of Clinical Toxicology in Baku, Azerbaijan in 2009-2016. The total number of patients with acute intoxication by psychopharmacological drugs was 3,413, which was 48.3% of all cases of poisoning by drugs, medicaments and biological substances (T36-T50). The predominance of women was registered in all age groups. 1114 patients or 32.6% were in 15-24 years old age group. The highest percentage of poisonings at category T42 of ICD-10 were benzodiazepine-type drugs (35.8%), and at category T43 - antipsychotic and neuroleptic drugs (19.2%). In the structure of benzodiazepine poisoning, the first and second ranked places belonged to phenazepam (71.0%) and clonazepam - 16.6%. In addition, another 120 cases (5.5%) of poisonings in the T42 cohort were caused by "Z drugs", which have similar therapeutic effect to benzodiazepines (zolpidem and zopiclone). Among the antipsychotic and neuroleptic poisonings, thioridazine, trifluoperazine, levomepromazine, chlorpromazine, and periciazine accounted for 91% of all cases of intoxication in this cohort. Barbiturates, in view of their toxicity and narrow range of therapeutic dosages, now lost their importance as antiepileptic and hypnotic drugs. Only 4.9% of all cases of poisoning, classified under category T42, was due to the use of barbiturates (mainly phenobarbital). Poisonings with iminostilbenes were presented by carbamazepine poisoning only. Most patients in this cohort received this anticonvulsant drug as prescribed by a doctor. Acute intoxications by tricyclic antidepressants in 91.5% were presented by cases of amitriptyline poisoning

  9. Evaluating trauma center structural performance: The experience of a Canadian provincial trauma system

    Directory of Open Access Journals (Sweden)

    Lynne Moore

    2013-01-01

    Full Text Available Background: Indicators of structure, process, and outcome are required to evaluate the performance of trauma centers to improve the quality and efficiency of care. While periodic external accreditation visits are part of most trauma systems, a quantitative indicator of structural performance has yet to be proposed. The objective of this study was to develop and validate a trauma center structural performance indicator using accreditation report data. Materials and Methods: Analyses were based on accreditation reports completed during on-site visits in the Quebec trauma system (1994-2005. Qualitative report data was retrospectively transposed onto an evaluation grid and the weighted average of grid items was used to quantify performance. The indicator of structural performance was evaluated in terms of test-retest reliability (kappa statistic, discrimination between centers (coefficient of variation, content validity (correlation with accreditation decision, designation level, and patient volume and forecasting (correlation between visits performed in 1994-1999 and 1998-2005. Results: Kappa statistics were >0.8 for 66 of the 73 (90% grid items. Mean structural performance score over 59 trauma centers was 47.4 (95% CI: 43.6-51.1. Two centers were flagged as outliers and the coefficient of variation was 31.2% (95% CI: 25.5% to 37.6%, showing good discrimination. Correlation coefficients of associations with accreditation decision, designation level, and volume were all statistically significant (r = 0.61, -0.40, and 0.24, respectively. No correlation was observed over time (r = 0.03. Conclusion: This study demonstrates the feasibility of quantifying trauma center structural performance using accreditation reports. The proposed performance indicator shows good test-retest reliability, between-center discrimination, and construct validity. The observed variability in structural performance across centers and over-time underlines the importance of

  10. Axial lumbar interbody fusion: a 6-year single-center experience

    Directory of Open Access Journals (Sweden)

    Zeilstra DJ

    2013-08-01

    Full Text Available Dick J Zeilstra,1 Larry E Miller,2,3 Jon E Block3 1Bergman Clinics, Naarden and NedSpine, Ede, The Netherlands; 2Miller Scientific Consulting, Inc, Arden, NC, USA; 3The Jon Block Group, San Francisco, CA, USA Introduction: The aim of this study is to report our 6-year single-center experience with L5–S1 axial lumbar interbody fusion (AxiaLIF. Methods: A total of 131 patients with symptomatic degenerative disc disease refractory to nonsurgical treatment were treated with AxiaLIF at L5–S1, and were followed for a minimum of 1 year (mean: 21 months. Main outcomes included back and leg pain severity, Oswestry Disability Index score, working status, analgesic medication use, patient satisfaction, and complications. Computed tomography was used to determine postoperative fusion status. Results: No intraoperative complications, including vascular, neural, urologic, or bowel injuries, were reported. Back and leg pain severity decreased by 51% and 42%, respectively, during the follow-up period (both P < 0.001. Back function scores improved 50% compared to baseline. Clinical success, defined as improvement ≥30%, was 67% for back pain severity, 65% for leg pain severity, and 71% for back function. The employment rate increased from 47% before surgery to 64% at final follow-up (P < 0.001. Less than one in four patients regularly used analgesic medications postsurgery. Patient satisfaction with the AxiaLIF procedure was 83%. The fusion rate was 87.8% at final follow-up. During follow-up, 17 (13.0% patients underwent 18 reoperations on the lumbar spine, including pedicle screw fixation (n = 10, total disc replacement of an uninvolved level (n = 3, facet screw fixation (n = 3, facet screw removal (n = 1, and interbody fusion at L4–L5 (n = 1. Eight (6.1% reoperations were at the index level. Conclusion: Single-level AxiaLIF is a safe and effective means to achieve lumbosacral fusion in patients with symptomatic degenerative disc disease. Keywords: Axia

  11. Retinoblastoma: experience of a referral center in the North Region of Portugal

    Directory of Open Access Journals (Sweden)

    Rocha-Bastos R

    2014-05-01

    Full Text Available RA da Rocha-Bastos,1 JR Araújo,1 RS Silva,2 MJ Gil-da-Costa,2 E Brandão,1 NJ Farinha,2,3 F Falcão-Reis,1,4 T Dinah-Bragança1 1Department of Ophthalmology, Hospital São João, 2Hematology and Oncology Unit, Pediatric Hospital, Hospital São João, 3Pediatrics Department, Faculty of Medicine, University of Porto, 4Department of Sense Organs, Faculty of Medicine, University of Porto, Porto, Portugal Purpose: To describe the experience of the Ophthalmology Department of Hospital São João (HSJ, a tertiary health care center in North Region, Portugal, in terms of the diagnosis, treatment, and follow-up of retinoblastoma. Methods: This was a retrospective study of patients diagnosed with retinoblastoma in Hospital São João, between 1978 and 2012. Results: Fifty patients with retinoblastoma were evaluated in our institution between 1978 and 2012. Four patients were excluded due to loss of follow-up. Among the 46 retinoblastoma cases, 33 (71.7% were unilateral and 13 (28.3% bilateral, with a mean age at diagnosis of 22.19 months and 6.92 months, respectively (P<0.001. Leukocoria was the most common presenting sign (36.9%, followed by strabismus (19.6%, a combination of leukocoria and strabismus (8.7%, and buphthalmia (2.2%. Between 1978 and 1992, nine retinoblastoma cases were referred to our hospital, all of them unilateral, and, in each case, enucleation was performed, with or without salvage therapy. Between 1993 and 2012, 18 eyes with retinoblastoma were successfully managed with conservative treatment. Conclusion: Demographic results were generally coincident with previous reports. It is crucial to screen leukocoria in pediatric practice, even in asymptomatic children. The outcome of retinoblastoma treatment in our hospital is similar to other series in developed countries. Keywords: retinoblastoma, leukocoria, strabismus, enucleation, pediatric cancer

  12. Aortic Root Surgery in Marfan Syndrome: Medium-Term Outcome in a Single-Center Experience.

    Science.gov (United States)

    Attenhofer Jost, Christine H; Connolly, Heidi M; Scott, Christopher G; Ammash, Naser M; Bowen, Juan M; Schaff, Hartzell V

    2017-01-01

    The study aim was to analyze the authors' experience with aortic root surgery in Marfan syndrome (MFS), and to expand the surgical outcome data of patients meeting the Ghent criteria (Marfan registry). Analyses were performed of data acquired from MFS patients (who met the Ghent criteria), including an aortic root surgery and Kaplan-Meier survival. Between April 2004 and February 2012, a total of 59 MFS patients (mean age at surgery 36 ± 13 years) underwent 67 operations for aortic root aneurysm (n = 52), aortic valve (AV) regurgitation (n = 15), acute aortic dissection (n = 2), and/or mitral valve (MV) regurgitation resulting from MV prolapse (n = 7). Of 59 initial operations, 21 (36%) involved AV-replacing root surgery, 38 (64%) AV-sparing root surgery, seven (12%) aortic arch or hemi-arch repair, and five (8%) simultaneous MV surgery. There were no early mortalities. The mean follow up was 6.8 ± 1.2 years, with five deaths (8%) and a relatively low reoperation rate (10 reoperations in nine patients; 14%). Seven reoperations involved AV or aortic root surgery (including four for AV regurgitation following failed AV-sparing surgery), two MV repair/replacements, and one coronary artery bypass graft. Eight patients (21%) with AV-sparing surgery had moderate/severe AV regurgitation at the last follow up before re-intervention. The mean five-year freedom from postoperative death was 91.2 ± 8.8%, from cardiac reoperation 86.3 ± 4.5%, and more-than-moderate AV regurgitation 90.3 ± 4.8%. Prophylactic aortic surgery in MFS patients with AV-replacing root or AV-sparing root surgery carries a low risk of operative morbidity and death when performed at an experienced center. AV-sparing root surgery increases the risk of AV regurgitation and, possibly, of re-intervention. Regular clinical follow up is important after any aortic root surgery in MFS patients, with a delineation of risk factors for AV regurgitation after AV rootsparing surgery.

  13. ECTOPIC CUSHING SYNDROME: A 10-YEAR EXPERIENCE FROM A TERTIARY CARE CENTER IN SOUTHERN INDIA.

    Science.gov (United States)

    Sathyakumar, Samantha; Paul, Thomas Vizhalil; Asha, Hesargatta Shyamsunder; Gnanamuthu, Birla Roy; Paul, M J; Abraham, Deepak Thomas; Rajaratnam, Simon; Thomas, Nihal

    2017-08-01

    Ectopic adrenocorticotropic hormone (ACTH) secretion is a less common cause of Cushing syndrome and is seen in 5 to 10% of cases with endogenous hypercortisolemia. We hereby describe our experience of patients with ectopic ACTH syndrome, who have been managed over the past 10 years at a tertiary care center in Southern India. The inpatient and outpatient records of patients from 2006 to 2015 were retrospectively reviewed. The clinical features, clinical history, biochemical values, imaging features, including radiologic findings and positron emission tomography scans, management, details of follow-up, and outcomes, were documented. We compared the biochemical findings in these patients with 20 consecutive patients with Cushing disease (Cushing syndrome of pituitary origin). A total of 21 patients were studied. The median age at presentation was 34 years (range, 19 to 55 years). Seven patients had thymic carcinoid, 7 had bronchial carcinoid, 3 had lung malignancies, 2 had medullary carcinoma thyroid, 1 patient had a pancreatic neuroendocrine tumor, and 1 patient had an occult source of ACTH. The most common clinical features at presentation were muscle weakness (95%), hyperpigmentation (90%), facial puffiness (76%), easy bruising (61%), edema (57%), and striae (52%). Extensive acne was seen in a large number of patients (43%). Only 3 patients (14%) had central obesity. The median 8 am cortisol was 55.5 μg/dL (range, 3.8 to 131 μg/dL), median 8 am ACTH was 207 pg/mL (range, 31.1 to 703 pg/mL), and the median 24-hour urinary free cortisol was 2,484 μg (range, 248 to 25,438 μg). Basal cortisol and ACTH, as well as midnight cortisol and ACTH level, were markedly higher in patients with ectopic Cushing syndrome as compared to patients with Cushing disease. Twelve of 21 patients had developed life-threatening infections by follow-up. Nine patients had undergone surgical intervention to address the primary tumor. However, only 1 patient exhibited a complete cure on

  14. Design and test of the borosilicate glass burnable poison rod for Qinshan nuclear power plant core

    International Nuclear Information System (INIS)

    Huang Jinhua; Sun Hanhong

    1988-08-01

    Material for the burnable poison of Qinshan Nuclear Power Plant core is GG-17 borosilicate glass. The chemical composition and physico-chemical properties of GG-17 is very close to Pyrex-7740 glass used by Westinghouse. It is expected from the results of the experiments that the borosilicate glass burnable poison rod can be successfully used in Qinshan Nuclear Power Plant due to good physical, mechanical, corrosion-resistant and irradiaton properties for both GG-17 glass and cold-worked stainless steel cladding. Change of material for burnable poison from boron-bearing stainless steel to borosilicate glass will bring about much more economic benefit to Qinshan Naclear Power Plant

  15. Review of the status of reactor physics predictive methods for burnable poisons in CAGRs

    International Nuclear Information System (INIS)

    Edens, D.J.; McEllin, M.

    1983-01-01

    An essential component of the design of Commercial Advanced Gas Cooled Reactor fuel necessary to achieve higher discharge irradiations is the incorporation of burnable poisons. The poisons enable the more highly enriched fuel required to reach higher irradiation to be loaded without increasing the peak channel power. The optimum choice of fuel enrichment and poison loading will be made using reactor physics predictive methods developed by Berkeley Nuclear Laboratories. These methods and the evidence available to support them from theoretical comparisons, zero energy experiments, WAGR irradiations, and measurements on operating CAGRs are described. (author)

  16. Review of the status of reactor physics predictive methods for burnable poisons in CAGRs

    International Nuclear Information System (INIS)

    Edens, D.J.; McEllin, M.

    1983-01-01

    An essential component of the design of Commercial Advanced Gas Cooled Reactor fuel necessary to achieve higher discharge irradiations is the incorporation of burnable poisons. The poisons enable the more highly enriched fuel required to reach higher irradiation to be loaded without increasing the peak channel power. The optimum choice of fuel enrichment and poison loading will be made using reactor physics predictive methods developed by Berkeley Nuclear Laboratories. The paper describes these methods and the evidence available to support them from theoretical comparisons, zero energy experiments, WAGR irradiations, and measurements on operating CAGR's. (author)

  17. Most common poisonings and their management--data from Tbilisi.

    Science.gov (United States)

    Kobidze, T S; Gerzmava, O Kh; Areshidze, T Kh; Tsintsadze, M A; Dikhamindzhiia, O B

    2009-01-01

    The purpose of the present study was to evaluate the toxicological aid and efficiency of preventive measures and methods in treatment of acute exogenous intoxications in hospitals in Tbilisi in 1990-2005. Structure of poisoning accidents in Tbilisi, its trends in last decade is analyzed and explained. The data were obtained in Georgian National Center for Disease Control and Medical statistics in Tbilisi. The study revealed that total number of hospitalizations due to acute poisoning in Tbilisi exceeded the number of hospitalizations due to acute myocardial infarction. In 1992-1994 Georgia was in severe social-economic crisis: the cases of acute poisoning increased and the number of hospitalizations had been reduced with concomitant longer hospital stay (in 1992--10.7 hospital days; in 1993-1994--13.7 hospital days), and higher mortality (in 1992--4%; in 1993--5.5%; 1994--5.2%). Low hospitalization rates in 1992-1994 should be explained by late patient referral to hospitals. Longer hospital stay was available due to free hospital care at that time. In 1995 with termination of free medical care number of hospitalized patients with acute intoxication raised annually; hospital stay shortened and mortality rate decreased. In 2003 mortality was reduced by 0.74% in Tbilisi. The prevalence of acute alcoholic intoxication incidence was noticed. Therefore hospital stay decreases. High prevalence of acute alcoholic intoxication was explained by the growth of alcohol consumption; lack of quality control of beverage production resulting in huge amount of unconditioned and counterfeit substances in the market, etc. As to poisonings due to medical substances 42% of cases were intoxications with anticonvulsants, sedative and psychotropic preparations; 17% with cardiovascular drugs; and 10% with narcotic substances. It was found, that poisoning incidence and their outcome significantly depend on social-economical conditions in Georgia. Measures to improve toxicology care in the

  18. Extracorporeal treatment for carbamazepine poisoning

    DEFF Research Database (Denmark)

    Ghannoum, Marc; Yates, Christopher; Galvao, Tais F

    2014-01-01

    in carbamazepine poisoning. METHODS: After a systematic literature search, the subgroup extracted the data and summarized the findings following a pre-determined format. The entire workgroup voted via a two-round modified Delphi method to reach a consensus on voting statements, using a RAND/UCLA Appropriateness......-vitro studies; two poor-quality observational studies were identified, yielding a very low quality of evidence for all recommendations. Data on 173 patients, including 6 fatalities, were reviewed. The workgroup concluded that carbamazepine is moderately dialyzable and made the following recommendations: ECTR...... is suggested in severe carbamazepine poisoning (2D). ECTR is recommended if multiple seizures occur and are refractory to treatment (1D), or if life-threatening dysrhythmias occur (1D). ECTR is suggested if prolonged coma or respiratory depression requiring mechanical ventilation are present (2D...

  19. The Manuel Lujan, Jr. Neutron Scattering Center (LANSCE) experiment reports, 1991 run cycle

    International Nuclear Information System (INIS)

    DiStravolo, M.A.

    1992-12-01

    This report briefly discusses experiments conducted at the Lansce neutron source facility. The experiments were conducted on the following instruments: high intensity powder diffractometer; neutron powder diffractometer; single crystal diffractometer; low-q diffractometer; surface profile analysis reflectometer; filter difference spectrometer; experiment reports, and pharos

  20. Absorber management using burnable poisons

    International Nuclear Information System (INIS)

    Mortensen, L.

    1977-06-01

    An investigation of the problem of optimal control carried out by means of a two-dimensional model of a PWR reactor. A solution is found to the problem, and the possibility of achieving optimal control with burnable poisons such as boron, cadmium and gadolinium is discussed. Further, an attempt is made to solve the control problem of BWR, but no final solution is found. (author)

  1. Innovation in Innovation Management: The Experience of Petrobras Centers and Networks of Excellence Program

    Directory of Open Access Journals (Sweden)

    Ana Maria de Britto Pires

    2013-04-01

    Full Text Available Since 1996, Petrobras – Petróleo Brasileiro S.A., the biggest company in Latin America, has supported the development of a method to structure networks of partnerships called Centers and Networks of Excellence Practice (PCREX. It aims to support the establishment of centers and networks of excellence in areas in which innovation depends heavily on the articulation of various players from outside the company and different internal areas. This article presents the results of the analysis of the PCREX method, including its characterization and field research carried out in eight Centers and Networks of Excellence developed by Petrobras. The field research and subsequent analysis helped identify (i the alignment between the PCREX method and the best innovation management practices and (ii the difficulties faced by new management models based on resource and knowledge sharing, which highlights that organizational innovations need to be able to count on strong institutional support to succeed.

  2. Poison hemlock (Conium maculatum L.).

    Science.gov (United States)

    Vetter, J

    2004-09-01

    One of the most poisonous species amongst higher plants is Conium maculatum. It is a very common nitrophile weed species, belonging to the Apiaceae (formerly Umbelliferae) family. It contains some piperidine alkaloids (coniine, N-methyl-coniine, conhydrine, pseudoconhydrine, gamma-coniceine), which are formed by the cyclisation of an eight-carbon chain derived from four acetate units. gamma-Coniceine is the precursor of the other hemlock alkaloids. All vegetative organs, flowers and fruits contain alkaloids. The concentrations (both absolute and relative) of the different alkaloids depend on plant varieties, on ecological conditions and on the age of the plant. The characteristic biological effects of the plants are summarised on cattle, sheep, goat, swine, rabbit, elk, birds and insects and the symptoms of the human toxicosis (some cases of poisonings) are discussed according to the literature data. The general symptoms of hemlock poisoning are effects on nervous system (stimulation followed by paralysis of motor nerve endings and CNS stimulation and later depression), vomiting, trembling, problems in movement, slow and weak later rapid pulse, rapid respiration, salivation, urination, nausea, convulsions, coma and death.

  3. Experiences of CFD simulations at Foster Wheeler Energia Oy`s Karhula R and D center

    Energy Technology Data Exchange (ETDEWEB)

    Hyppaenen, T. [Foster Wheeler Energia Oy, Karhula (Finland). Karhula R and D Center

    1996-12-31

    Karhula R and D Center is specialized in the research of solid fuel combustion based on circulating fluidized bed technology. Since the 1970`s, numerical models have been utilized in process development to enhance fundamental understanding of the technology. Both own and commercial computer models have been used. Until now, a special problem in circulating fluidized beds has been the modeling of dense phase multiphase flow, especially for industrial solid-fuel boilers. This has prevented the Karhula R and D Center from using commercial codes, and as a consequence, own modeling approaches have been necessary. This presentation describes some main points of the modeling activities in circulating fluidized bed boilers. (author)

  4. Experiences of CFD simulations at Foster Wheeler Energia Oy`s Karhula R and D center

    Energy Technology Data Exchange (ETDEWEB)

    Hyppaenen, T [Foster Wheeler Energia Oy, Karhula (Finland). Karhula R and D Center

    1997-12-31

    Karhula R and D Center is specialized in the research of solid fuel combustion based on circulating fluidized bed technology. Since the 1970`s, numerical models have been utilized in process development to enhance fundamental understanding of the technology. Both own and commercial computer models have been used. Until now, a special problem in circulating fluidized beds has been the modeling of dense phase multiphase flow, especially for industrial solid-fuel boilers. This has prevented the Karhula R and D Center from using commercial codes, and as a consequence, own modeling approaches have been necessary. This presentation describes some main points of the modeling activities in circulating fluidized bed boilers. (author)

  5. The brave new world of GEC evaluation: the experience of the Rhode Island Geriatric Education Center.

    Science.gov (United States)

    Filinson, Rachel; Clark, Phillip G; Evans, Joann; Padula, Cynthia; Willey, Cynthia

    2012-01-01

    In 2007, the Health Resources Services Administration introduced new mandates that raised the standards on program evaluation for Geriatric Education Centers. Described in this article are the primary and secondary evaluation efforts undertaken for one program within the Rhode Island Geriatric Education Center (RIGEC), the findings from these efforts, and the modifications to assessment that ensued in response to the increased accountability requirements. The evaluation focused on RIGEC's series of continuing education, day-long workshops for health and social service professionals, the completion of all seven of which leads to a Certificate in Interdisciplinary Practice in Geriatrics.

  6. Potential for erroneous interpretation of poisoning outcomes due to changes in National Poison Data System reporting.

    Science.gov (United States)

    Anderson, Bruce; Ke, Xuehua; Klein-Schwartz, Wendy

    2010-08-01

    In 2006, the annual report of poison centers in the United States changed the method of reporting profiles for generic substance categories from all exposures to single-substance exposures only. The objective of this study is to describe the potential impact of this reporting change on longitudinal analysis of outcomes. Generic substance categories with data available for all years of the study were manually extracted from Table 22 of the National Poison Data System (NPDS) annual reports for 2002-2007. For each generic substance category, the following data were extracted for each of the 6 years: total number of substance mentions (2002-2005) or single-substance exposures (2006-2007), reason (unintentional or intentional), pediatric exposures (children age average annual number of reported deaths by substance category decreased by 80.8%, from 2,229 in year 2002-2005 to 428 after the 2006 reporting change (p average annual number of reported major outcomes by substance category dropped by 76.0% (p average number of deaths and major effects by substance category decreased by about 50% from 394 and 4,639 per year during 2002-2005 to 198 deaths (p average rates of reported deaths (61.7 and 35.9%) and major effects (36.3 and 11.2%) for drug categories and nondrug categories, respectively (p change in 2006 will yield inaccurate results if the change in reporting methodology is not taken into account.

  7. Health Status and Health Care Experiences among Homeless Patients in Federally Supported Health Centers: Findings from the 2009 Patient Survey

    Science.gov (United States)

    Lebrun-Harris, Lydie A; Baggett, Travis P; Jenkins, Darlene M; Sripipatana, Alek; Sharma, Ravi; Hayashi, A Seiji; Daly, Charles A; Ngo-Metzger, Quyen

    2013-01-01

    Objective To examine health status and health care experiences of homeless patients in health centers and to compare them with their nonhomeless counterparts. Data Sources/Study Setting Nationally representative data from the 2009 Health Center Patient Survey. Study Design Cross-sectional analyses were limited to adults (n = 2,683). We compared sociodemographic characteristics, health conditions, access to health care, and utilization of services among homeless and nonhomeless patients. We also examined the independent effect of homelessness on health care access and utilization, as well as factors that influenced homeless patients' health care experiences. Data Collection Computer-assisted personal interviews were conducted with health center patients. Principal Findings Homeless patients had worse health status—lifetime burden of chronic conditions, mental health problems, and substance use problems—compared with housed respondents. In adjusted analyses, homeless patients had twice the odds as housed patients of having unmet medical care needs in the past year (OR = 1.98, 95 percent CI: 1.24–3.16) and twice the odds of having an ED visit in the past year (OR = 2.00, 95 percent CI: 1.37–2.92). Conclusions There is an ongoing need to focus on the health issues that disproportionately affect homeless populations. Among health center patients, homelessness is an independent risk factor for unmet medical needs and ED use. PMID:23134588

  8. Further Analyses of the NASA Glenn Research Center Solar Cell and Photovoltaic Materials Experiment Onboard the International Space Station

    Science.gov (United States)

    Myers, Matthew G.; Prokop, Norman F.; Krasowski, Michael J.; Piszczor, Michael F.; McNatt, Jeremiah S.

    2016-01-01

    Accurate air mass zero (AM0) measurement is essential for the evaluation of new photovoltaic (PV) technology for space solar cells. The NASA Glenn Research Center (GRC) has flown an experiment designed to measure the electrical performance of several solar cells onboard NASA Goddard Space Flight Center's (GSFC) Robotic Refueling Mission's (RRM) Task Board 4 (TB4) on the exterior of the International Space Station (ISS). Four industry and government partners provided advanced PV devices for measurement and orbital environment testing. The experiment was positioned on the exterior of the station for approximately eight months, and was completely self-contained, providing its own power and internal data storage. Several new cell technologies including four-junction (4J) Inverted Metamorphic Multi-Junction (IMM) cells were evaluated and the results will be compared to ground-based measurement methods.

  9. Self-adhesive mesh for Lichtenstein inguinal hernia repair. Experience of a single center.

    Science.gov (United States)

    Tarchi, P; Cosola, D; Germani, P; Troian, M; De Manzini, N

    2014-06-01

    Lichtenstein tension-free mesh repair is the most frequently performed procedure for inguinal hernioplasty. In the past surgery aimed to control recurrences. Nowadays it is important to avoid postoperative chronic pain and thus several studies have examined the potential role of meshes in causing postoperative pain. The purpose of this study was to retrospectively assess the early and long-term results after Lichtenstein tension-free repair using a self-adhesive mesh (Parietex ProgripTM - Covidien, Germany) in a single center. The study enrolled 211 patients, 199 males (94.3%) and 12 females (5.7%), mean age 62 years (28-90 years), between January 2008 and December 2011. Of these, 206 had primary inguinal hernias while 5 were recurrences following previous tension repair. Ten different general surgeons, including residents, performed Lichtenstein hernia repair using a 12 x 8-cm Parietex ProgripTM mesh. In 88.1% of patients no additional fixation was used, while in 11.9% a single 2-0 polypropylene stitch was placed on the pubic bone. A 1-10 visual analog scale (VAS) was used to assess postoperative pain, evaluating it at 1 week, 1 month and 12, 24 and 36 months. Local paresthesia was assessed at same intervals. Any pain sensation lasting longer than 3 months postoperatively, or requiring injection of analgesics was defined as chronic pain. Mean operating time was 64.1 minutes (SD ± 21.14). There were no intraoperative complications. Early postoperative complications included hematoma-seroma (5.7% cases), superficial wound infection (1%), urinary retention (0.5%), and scrotal swelling (1%). The main follow-up period was 3 years, although patients operated between 2009 and 2011 underwent a shorter follow-up. At one-year follow-up, 17 patients reported groin discomfort, but did not require analgesics. Three patients reported moderate pain, requiring occasional use of oral analgesics, and 2 of these described a discontinuous pain mainly during movement. One patient

  10. The Bridge: Experiments in Science and Art, Experiences from the 2017 SciArt Center Cross-Disciplinary Residency Program

    Science.gov (United States)

    Shipman, J. S.; Chalmers, R.; Buntaine, J.

    2017-12-01

    Cross-disciplinary programs create the opportunity to explore new realms for scientists and artists alike. Through the collaborative process, artistic insights enable innovative approaches to emotionally connect to and visualize the world around us. Likewise, engagement across the art-science spectrum can lead to shifts in scientific thinking that create new connections in data and drive discoveries in research. The SciArt Center "The Bridge Residency Program" is a four-month long virtual residency open internationally for professionals in the arts and sciences to facilitate cross-disciplinary work and to bring together like-minded participants. The SciArt Center provides a virtual space to record and showcase the process and products of each collaboration. The work is facilitated with biweekly Skype calls and documented with weekly blog posts. Residents create either digital or physical products and share via video, images, or direct mailing with their collaborators. Past projects have produced call and response discussion, websites, skills and conference presentations, science-art studies, virtual exhibits, art shows, dance performances, and research exchange. Here we present the creative process and outcomes of one of the four collaborative teams selected for the 2017 residency. Jill Shipman, a Ph.D. Candidate in Volcanology who is also active in filmmaking and theatrical productions and Rosemary Chalmers, a UK-based lecturer, concept artist, and illustrator with a specialty in creature design. They were paired together for their shared interest in storytelling, illustration, and unique geological and environmental habitats and the life that occupies them. We will discuss the collaborative project developed by this team during their recent residency and illustrate how a virtual program can bridge the distance between geographical location to foster science and art collaboration. To follow the progress of the residency please visit: http://www.sciartcenter.org/the-bridge.html

  11. Suicide and unintentional poisoning mortality trends in the United States, 1987-2006: two unrelated phenomena?

    Directory of Open Access Journals (Sweden)

    Frost James L

    2010-11-01

    Full Text Available Abstract Background Two counter trends in injury mortality have been separately reported in the US in recent times - a declining suicide rate and a rapidly rising unintentional poisoning mortality rate. Poisoning suicides are especially difficult to detect, and injury of undetermined intent is the underlying cause-of-death category most likely to reflect this difficulty. We compare suicide and poisoning mortality trends over two decades in a preliminary assessment of their independence and implications for suicide misclassification. Methods Description of overall and gender- and age-specific trends using national mortality data from WISQARS, the Web-based Injury Statistics Query and Reporting System, maintained by the Centers for Disease Control and Prevention (CDC. Subjects were the 936,633 residents dying in the 50 states and the District of Columbia between 1987 and 2006 whose underlying cause of death was classified as suicide, unintentional poisoning, or injury mortality of undetermined intent. Results The official US suicide rate declined 18% between 1987 and 2000, from 12.71 to 10.43 deaths per 100,000 population. It then increased to 11.15 deaths per 100,000 by 2006, a 7% rise. By contrast to these much smaller rate changes for suicide, the unintentional poisoning mortality rate rose more than fourfold between 1987 and 2006, from 2.19 to 9.22 deaths per 100,000. Only the population aged 65 years and older showed a sustained decline in the suicide rate over the entire observation period. Consistently highest in gender-age comparisons, the elderly male rate declined by 35%. The elderly female rate declined by 43%. Unlike rate trends for the non-elderly, both declines appeared independent of corresponding mortality trends for unintentional poisoning and poisoning of undetermined intent. The elderly also deviated from younger counterparts by having a smaller proportion of their injury deaths of undetermined intent classified as poisoning

  12. Preliminary analysis of the results and description of the meteorological experiments I and II performed at Aramar Experimental Center

    International Nuclear Information System (INIS)

    Molnary, L. de

    1992-01-01

    This paper describes the experimental program in Applied Meteorology that has been developed at Aramar Experimental Center (CEA) located in Ipero, S.P - Brazil. The program intends to study the meteorological systems and the regional circulation around Aramar to use the information in atmospheric transport and diffusion of radionuclides studies, as soon, analysis of impacts on the environment at Aramar site. The results collected during the first and second Meteorological Experiment are examined. (author)

  13. Hemlock (Conium Maculatum) Poisoning In A Child

    OpenAIRE

    KONCA, Capan; KAHRAMANER, Zelal; BOSNAK, Mehmet; KOCAMAZ, Halil

    2016-01-01

    SUMMARY Poison hemlock (Conium maculatum) is a plant that is poisonous for humans and animals. Accidental ingestion of the plant may result in central nervous system depression, respiratory failure, acute rhabdomyolysis, acute renal failure and even death. The main treatment of hemlock poisoning is supportive care. The case of a 6-year-old girl who was admitted to the emergency department with complaints of burning sensation in mouth, hypersalivation, tremor in hands and ataxia after ingestio...

  14. Personality traits in persons with manganese poisoning

    Energy Technology Data Exchange (ETDEWEB)

    Platonov, A A

    1976-10-01

    Results of studies with the Minnesota Multiphasic Personality Inventory (MMPI) in 3 groups of arc welders with various degrees of manganese poisoning (22 symptom-free, 23 with functional disturbances, 55 with organic symptoms) and 50 controls were discussed. There was a close relation between the severity of the poisoning and quantitative and qualitative personality changes. Personality tests are considered a useful addition to the clinical diagnosis of chronic manganese poisoning.

  15. Metal Poisons for Criticality in Waste Streams

    International Nuclear Information System (INIS)

    Williamson, T.G.; Goslen, A.Q.

    1996-01-01

    Many of the wastes from processing fissile materials contain metals which may serve as nuclear criticality poisons. It would be advantageous to the criticality evaluation of these wastes to demonstrate that the poisons remain with the fissile materials and to demonstrate an always safe poison-to-fissile ratio. The first task, demonstrating that the materials stay together, is the job of the chemist, the second, calculating an always safe ratio, is an object of this paper

  16. Use of APTIMA Combo 2: The Experience of a Child Advocacy Center

    Science.gov (United States)

    Leder, M. Ranee; Leber, Amy L.; Marcon, Mario J.; Scribano, Philip V.

    2013-01-01

    The Centers for Disease Control and Prevention recommends nucleic acid amplification testing for chlamydia and gonorrhea in sexually abused girls. No studies describe performance of APTIMA Combo 2 Assay with second target confirmation on the same testing platform. This nucleic acid amplification testing is evaluated within a large child advocacy…

  17. Social and Architectural Aspects of Revitalization of Historic Urban Centers: Foreign Experience

    Directory of Open Access Journals (Sweden)

    Indrė Gražulevičiutė-Vileniškė

    2011-03-01

    Full Text Available The structure and architecture of many European cities has started their development during the Middle Ages or even earlier. The historic cores gradually had become centers of contemporary cities and are constantly evolving. They are affected by the tendencies of destruction, initiatives and movements of preservation are also taking place there. The comprehensive works of rehabilitation of Lithuanian historic urban centers were carried out during the period of soviet occupation. The insularity of the Soviet empire, ideological reasons and the absence of the private property has determined certain architectural expressions and solutions for the social problems. After the restoration of the country‘s independence the problems and tendencies typical to Western city centers, such as commercialization and gentrification, started to appear in Lithuanian historic urban cores. This justifies the aim of the article which is to analyze the tendencies of revitalization of historic city centers in Western countries with the main attention to the social and architectural aspects.Article in Lithuanian

  18. Collected world and single center experience with endovascular treatment of ruptured abdominal aortic aneurysms.

    NARCIS (Netherlands)

    Veith, F.J.; Lachat, M.; Mayer, D.; Malina, M.; Holst, J.; Mehta, M.; Verhoeven, E.L.; Larzon, T.; Gennai, S.; Coppi, G.; Lipsitz, E.C.; Gargiulo, N.J.; Vliet, J.A. van der; Blankensteijn, J.D.; Buth, J.; Lee, W.A.; Biasiol, G.; Deleo, G.; Kasirajan, K.; Moore, R.; Soong, C.V.; Cayne, N.S.; Farber, M.A.; Raithel, D.; Greenberg, R.K.; Sambeek, M.R. van; Brunkwall, J.S.; Rockman, C.B.; Hinchliffe, R.J.

    2009-01-01

    BACKGROUND: Case and single center reports have documented the feasibility and suggested the effectiveness of endovascular aneurysm repair (EVAR) of ruptured abdominal aortic aneurysms (RAAAs), but the role and value of such treatment remain controversial. OBJECTIVE: To clarify these we examined a

  19. Collected World and Single Center Experience With Endovascular Treatment of Ruptured Abdominal Aortic Aneurysms

    NARCIS (Netherlands)

    Veith, Frank J.; Lachat, Mario; Mayer, Dieter; Malina, Martin; Holst, Jan; Mehta, Manish; Verhoeven, Eric L. G.; Larzon, Thomas; Gennai, Stefano; Coppi, Gioacchino; Lipsitz, Evan C.; Gargiulo, Nicholas J.; van der Vliet, J. Adam; Blankensteijn, Jan; Buth, Jacob; Lee, W. Anthony; Biasi, Giorgio; Deleo, Gaetano; Kasirajan, Karthikeshwar; Moore, Randy; Soong, Chee V.; Cayne, Neal S.; Farber, Mark A.; Raithel, Dieter; Greenberg, Roy K.; van Sambeek, Marc R. H. M.; Brunkwall, Jan S.; Rockman, Caron B.; Hinchliffe, Robert J.

    2009-01-01

    Background: Case and single center reports have documented the feasibility and suggested the effectiveness of endovascular aneurysm repair (EVAR) of ruptured abdominal aortic aneurysms (RAAAs), but the role and value of such treatment remain controversial. Objective: To clarify these we examined a

  20. Intergenerational Learning at a Nature Center: Families Using Prior Experiences and Participation Frameworks to Understand Raptors

    Science.gov (United States)

    Zimmerman, Heather Toomey; McClain, Lucy Richardson

    2014-01-01

    Using a sociocultural framework to approach intergenerational learning, this inquiry examines learning processes used by families during visits to one nature center. Data were collected from videotaped observations of families participating in an environmental education program and a follow-up task to draw the habitat of raptors. Based on a…