WorldWideScience

Sample records for poison center procedures

  1. Poison Control Centers

    Science.gov (United States)

    ... Email not for emergency use. Ohio Central Texas Poison Center Address Scott and White Memorial Hospital 2401 South 31st Street Temple, TX 76508 Service area: Central Texas Mail donation to: Central Texas Poison Center (Above address) For questions contact: jennifer.watson@ ...

  2. 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 ...

  3. 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.…

  4. 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 ...

  5. American Association of Poison Control Centers

    Science.gov (United States)

    ... cause serious harm to young children. Opioid (Narcotic) Pain Medications Poison center data indicate that opioid and sedatives exposures are steadily increasing year over year. View all alerts right left NEW! Check out PoisonHelp.org Now there are two ...

  6. 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.

  7. 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.

  8. 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.

  9. Redotex ingestions reported to Texas poison centers.

    Science.gov (United States)

    Forrester, Mathias B

    2010-09-01

    Although the multi-component weight loss supplement Redotex is banned in the United States, the supplement can be obtained in Mexico. The intent of this report was to describe the pattern of Redotex calls received by a statewide poison center system. Cases were all Redotex calls received by Texas poison centers during 2000-2008. The distribution of total calls and those involving ingestion of the supplement were determined for selected demographic and clinical factors. Of 34 total Redotex calls received, 55.9% came from the 14 Texas counties that border Mexico. Of the 22 reported Redotex ingestions, 77.3% of the patients were female and 45.5% 20 years or more. Of the 17 ingestions involving no co-ingestants, 52.9% were already at or en route to a health care facility, 41.2% were managed on site, and 5.9% was referred to a health care facility. The final medical outcome was no effect in 23.5% cases, minor effect in 5.9%, moderate effect in 11.8%, not followed but minimal clinical effects possible in 47.1%, and unable to follow but judged to be potentially toxic in 11.8%. Most Redotex calls to the Texas poison center system originated from counties bordering Mexico.

  10. 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.

  11. Kratom exposures reported to Texas poison centers.

    Science.gov (United States)

    Forrester, Mathias B

    2013-01-01

    Kratom use is a growing problem in the United States. Kratom exposures reported to Texas poison centers between January 1998 and September 2013 were identified. No kratom exposures were reported from 1998 to 2008 and 14 exposures were reported from 2009 to September 2013. Eleven patients were male, and 11 patients were in their 20s. The kratom was ingested in 12 patients, inhaled in 1, and both ingested and inhaled in 1. Twelve patients were managed at a healthcare facility and the remaining 2 were managed at home.

  12. 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 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.

  13. 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.

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

    OpenAIRE

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

    2013-01-01

    Aim: 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. Settings and Design: This was a prospective observational study. Materials and Methods: 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 telephon...

  15. The role of Poison Control Centers in radiation accidents

    International Nuclear Information System (INIS)

    Savelkoul, T.J.; Leenhouts, H.P.; Sangster, B.

    1989-01-01

    In the days after the nuclear reactor accident at Chernobyl (USSR) in April 1986, the Dutch Poison Control Center had to answer questions concerning possible health effects caused by (over)exposure to ionizing radiation. These questions were similar to questions asked regarding exposure to toxic agents after chemical accidents. It is obvious that the experience and practical approach of a Poison Control Center in handling toxicological problems can be used in problems concerning ionizing radiation

  16. 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

  17. 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

  18. 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.

  19. Poison Control and the Drug Information Center: the Palestinian experience.

    Science.gov (United States)

    Sawalha, Ansam F

    2008-11-01

    The Palestinian Poison Control and Drug Information Center was established in 2006 to provide up-to-date information on medications and to help in the early diagnosis and management of poisoning cases. To summarize the activities carried out by the PCDIC in the past 2 years. Documented inquires received at the PCDIC were analyzed and the Center's activities were extracted from the files. During the first 2 years of the Center's existence, 323 enquiries were received, mainly (67.2%)from physicians; 70% of the calls were from the city of Nablus. Unintentional poisoning was the leading type of call (62.8%) followed by suicidal poisoning (20.7%). Medications were the major category of toxicants encountered (48.9%), followed by pesticides (23.5%). In 67.9% of the cases, the calls were initiated before any treatment was provided. The advice provided by the PCDIC was based on the nature of the call. During these 2 years the PCDIC has conducted both academic and non-academic activities. The Center introduced the concept of poison prevention weeks in Palestine and has conducted two so far. The PCDIC has published several articles in the fields of toxicology, rational drug use, complementary and herbal therapy, pharmacoepidemiology, and self-medication. Documentation of all enquiries is mandatory for analysis, evaluation, comparative purposes and quality assurance. More information campaigns are needed to encourage people to use the services provided by the PCDIC.

  20. The poison center role in biological and chemical terrorism.

    Science.gov (United States)

    Krenzelok, E P; Allswede, M P; Mrvos, R

    2000-10-01

    Nuclear, biological and chemical (NBC) terrorism countermeasures are a major priority with municipalities, healthcare providers, and the federal government. Significant resources are being invested to enhance civilian domestic preparedness by conducting education at every response level in anticipation of a NBC terroristic incident. The key to a successful response, in addition to education, is integration of efforts as well as thorough communication and understanding the role that each agency would play in an actual or impending NBC incident. In anticipation of a NBC event, a regional counter-terrorism task force was established to identify resources, establish responsibilities and coordinate the response to NBC terrorism. Members of the task force included first responders, hazmat, law enforcement (local, regional, national), government officials, the health department, and the regional poison information center. Response protocols were developed and education was conducted, culminating in all members of the response task force becoming certified NBC instructors. The poison center participated actively in 3 incidents of suspected biologic and chemical terrorism: an alleged anthrax-contaminated letter sent to a women's health clinic; a possible sarin gas release in a high school: and a potential anthrax/ebola contamination incident at an international airport. All incidents were determined hoaxes. The regional response plan establishes the poison information center as a common repository for all cases in a biological or chemical incident. The poison center is one of several critical components of a regional counterterrorism response force. It can conduct active and passive toxicosurveillance and identify sentinel events. To be responsive, the poison center staff must be knowledgeable about biological and chemical agents. The development of basic protocols and a standardized staff education program is essential. The use of the RaPiD-T (R-recognition, P

  1. Does prearrival communication from a poison center to an emergency department decrease time to activated charcoal for pediatric poisoning?

    Science.gov (United States)

    Tuuri, Rachel E; Wright, Joseph L; He, Jianping; McCarter, Robert J; Ryan, Leticia M

    2011-11-01

    A poison center plays an important role in directing appropriate care, which is critical in reducing morbidity due to poisoning. Activated charcoal (AC) is one intervention for some poisonings. This study examined whether children with a poisoning who were preannounced by a poison center received AC earlier than patients without a referral. A retrospective review of AC administration in children aged 0 to 18 years in a pediatric emergency department (ED) from 2000 to 2006 was performed. Abstracted covariates were poison center referral status, age, sex, acuity, disposition, transportation mode, triage time, and time of AC administration. Analysis of variance controlling for covariates tested the equality of mean time intervals between the groups with and without a poison center referral. Three hundred fifty-one cases met the inclusion criteria. One hundred thirty-five (39%) were male. Eighty cases (23%) had a poison center referral. Time from triage to charcoal administration for patients with a poison center referral was a mean of 59 (SD, 34) minutes. Time for the group without a referral was a mean of 71 (SD, 43) minutes (P = 0.0036). Advanced communication from a poison center was associated with earlier administration of AC in the ED for this population. Nevertheless, the duration to charcoal administration was frequently suboptimal. Triage and prehospital practices should be reexamined to improve timeliness of AC when indicated and consider exclusion of administration if beyond an appropriate time frame. Advanced notification should be the paradigm for all poison centers, and early response protocols for poison center referrals should be used by EDs.

  2. Toxic Agents Responsible for Acute Poisonings Treated at Four Medical Settings in Iran during 2012-2013: A Report from Iran's National Drug and Poison Information Center

    Directory of Open Access Journals (Sweden)

    Talat Ghane

    2016-03-01

    Conclusion: Pharmaceutical products, substances of abuse and pesticides are the most common causes of poisoning-related admissions to referral Iranian poison treatment centers. Effective measures to reduce poisoning with these substances should be done.

  3. Using poison center data for national public health surveillance for chemical and poison exposure and associated illness.

    Science.gov (United States)

    Wolkin, Amy F; Martin, Colleen A; Law, Royal K; Schier, Josh G; Bronstein, Alvin C

    2012-01-01

    The National Poison Data System (NPDS) is a national near-real-time surveillance system that improves situational awareness for chemical and poison exposures, according to data from US poison centers. NPDS is the successor to the Toxic Exposure Surveillance System. The Centers for Disease Control and Prevention (CDC) use these data, which are owned and managed by the American Association of Poison Control Centers, to improve public health surveillance for chemical and poison exposures and associated illness, identify early markers of chemical events, and enhance situational awareness during outbreaks. Information recorded in this database is from self-reported calls from the public or health care professionals. In 2009, NPDS detected 22 events of public health significance and CDC used the system to monitor several multistate outbreaks. One of the limitations of the system is that exposures do not necessarily represent a poisoning. Incorporating NPDS data into the public health surveillance network and subsequently using NPDS to rapidly identify chemical and poison exposures exemplifies the importance of the poison centers and NPDS to public health surveillance. This integration provides the opportunity to improve the public health response to chemical and poison exposures, minimizes morbidity and mortality, and serves as an important step forward in surveillance technology and integration. Copyright © 2011 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  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. Lead poisoning

    Science.gov (United States)

    ... help if this information is not immediately available. Poison Control If someone has severe symptoms from possible ... be caused by lead poisoning, call your local poison control center. Your local poison center can be ...

  6. Disaster preparedness education and a Midwest Regional Poison Center.

    Science.gov (United States)

    Lehman-Huskamp, Kathy; Rebmann, Terri; Walter, Frank G; Weber, Julie; Scalzo, Anthony

    2010-01-01

    To assess knowledge and comfort related to disaster preparedness and response gained and retained from a disaster medicine workshop given to Certified Specialists in Poison Information (CSPI). A pilot study with a pre-post intervention design. A Midwest Regional Poison Center. All CSPIs employed at the participating Poison Center (N = 27) were recruited. Participation ranged from 44 percent (n = 12) for the 4-month postworkshop knowledge quiz to 78 percent (n = 21) for the preworkshop survey. A disaster medicine workshop was given to the CSPIs. Quizzes and surveys were done preworkshop and then repeated at 1 week, 4 months, and 14 months postworkshop. CSPI knowledge and comfort pertaining to disaster-related calls. CSPIs' comfort levels with calls regarding major chemical or nuclear/radiation disasters significantly increased and stayed elevated during all follow-up periods [Kruskal-Wallis chi2 (3) = 13.1, p = 0.01]. The average preworkshop quiz score was 58.2 percent. A statistically significant increase in mean quiz score was demonstrated amongst preworkshop and postworkshop scores at all tested time intervals (F = 18.8, p educational competencies for CSPIs and disaster response would help to standardize this much needed education.

  7. Inaccuracy of ECG interpretations reported to the poison center.

    Science.gov (United States)

    Prosser, Jane M; Smith, Silas W; Rhim, Eugene S; Olsen, Dean; Nelson, Lewis S; Hoffman, Robert S

    2011-02-01

    The ECG is an essential tool in the care of poisoned patients. This study is designed to investigate the accuracy of ECG interpretation reported to a poison center. In this prospective study, all cases in which both an electronically faxed copy of the ECG and the caller's interpretation of the ECG were available were eligible for inclusion. ECG interpretation of callers was compared with that of a blinded electrophysiologist. In cases of disagreement, a Delphi panel of toxicologists decided whether the differences were clinically significant or would have changed recommendations. Two hundred cases were included, with complete agreement in 78. In 23 cases, the sole difference was nonspecific ST-T-wave changes, which were believed insignificant and classified as agreement for a total of 101. The Delphi panel reviewed the remaining 99. In 42 cases, the differences in ECG interpretations were thought to be clinically significant; 37 of these would have resulted in a change in management recommendations. Forty-five cases were thought not likely to be clinically significant and would not have resulted in a recommendation change. Twelve cases were thought not clinically significant but would still have resulted in a change in recommendations. Initial interpretation of the ECG reported by callers to the poison center is frequently inaccurate. In this study, the misinterpretation was clinically significant or would have resulted in a change in management recommendations in approximately one quarter of all calls. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  8. 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

  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. Evaluation of dabigatran exposures reported to poison control centers.

    Science.gov (United States)

    Conway, Susan E; Schaeffer, Scott E; Harrison, Donald L

    2014-03-01

    Dabigatran is a novel oral anticoagulant for which a well-defined range of toxicity and proven antidote has not been established. The primary objective of this study was to characterize dabigatran exposures reported to poison centers by dose ingested, clinical effects, treatments used, and managment sites to gain a better understanding of patient outcomes. A retrospective database review was conducted for dabigatran exposures reported to the National Poison Data System for the American Association of Poison Control Centers (AAPCC) over the period October 2010 to December 2012. There were 802 human dabigatran exposures involving adults predominantly (91% of cases). Exposure chronicity was acute in 43%, acute-on-chronic in 46%, and chronic in 11%, with the most common reason for an exposure call being an unintentional therapeutic error (70.6%). The most common management sites were on-site in 72% of cases and within a health care facility for 26%. Bleeding events and coagulopathies were the most commonly observed clinical effects. Treatments administered included activated charcoal, blood and coagulation products, hemodialysis, and supportive measures. Confirmed outcomes included death in 13 patients (1.6%), major effects in 23 (2.9%), and moderate effects in 50 (6.2%). More severe outcomes were significantly associated with adverse drug reactions, patients ≥65 years of age, those treated with blood and coagulation products and/or dialysis, and renal dysfunction (P < .05). Children experienced few moderate effects and no major effects or deaths. Severe outcomes from dabigatran exposures were not common, occurring in approximately 5% of cases.

  11. 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.

  12. Neonicotinoid insecticide exposures reported to six poison centers in Texas.

    Science.gov (United States)

    Forrester, M B

    2014-06-01

    Neonicotinoids are a relatively newer class of insecticide. Used primarily in agriculture, neonicotinoids are also used for flea control in domestic animals. Information on human exposures to neonicotinoids is limited. Neonicotinoid exposures reported to Texas poison centers during 2000-2012 were identified and the distribution by selected factors examined. Of 1,142 total exposures, most products contained imidacloprid (77%) or dinotefuran (17%). The exposures were seasonal with half reported during May-August. The most common routes of exposure were ingestion (51%), dermal (44%), and ocular (11%). The distribution by patient age was 5 years or less (28%), 6-19 years (9%), 20 years or more (61%), and unknown (2%); and 64% of the patients were female. Of all, 97% of the exposures were unintentional and 97% occurred at the patient's own residence. The management site was on-site (92%), already at/en route to a health care facility (6%), and referred to a health care facility (2%). The medical outcomes included no effect (22%), minor effect (11%), moderate effect (1%), not followed judged nontoxic (14%), not followed minimal effects (46%), unable to follow potentially toxic (1%), and unrelated effect (4%). The most commonly reported adverse clinical effects were ocular irritation (6%), dermal irritation (5%), nausea (3%), vomiting (2%), oral irritation (2%), erythema (2%), and red eye (2%). The most frequently reported treatments were dilution/wash (85%) and food (6%). In summary, these data suggest that the majority of neonicotinoid exposures reported to the poison centers may be managed outside of health care facilities with few clinical effects expected. © The Author(s) 2014.

  13. Transportation-related hazardous materials incidents and the role of poison control centers.

    Science.gov (United States)

    Sutter, Mark E; Hon, Stephanie L; Chang, Arthur S; Schwartz, Michael D; Algren, D Adam; Schier, Joshua G; Lando, James; Lewis, Lauren S

    2010-06-01

    Department of Transportation (DOT) mandates reporting of all serious hazardous materials incidents. Hazardous material exposures may result in secondary contamination of emergency departments, or delayed clinical effects. Poison control centers specialize in the management of patients exposed to toxic substances; however, poison control center notification is not required. The objective is to determine the frequency of poison control center notification after serious hazardous materials incidents when patients were transported to a hospital. A retrospective analysis was conducted of serious hazardous materials incidents as reported by DOT, matched with data from the American Association of Poison Control Centers from 2002 through 2006 that involved patient transport. Incidents were divided into four groups: those reported to a poison control center within 0-360 minutes of the incident; those reported within 361-1440 minutes of the incident; those reported within 1441-4320 minutes of the incident; and no poison control center notification. Analyses were performed on variables including date, time, substance, and time to notification. Data were received in January 2008. One hundred fifty-four serious incidents met inclusion criteria. One hundred thirty-four incidents (87%) occurred without poison control center notification. Poison control centers were notified in 20 incidents (12.9%); 15 incidents (9.7%) were reported within 0-360 minutes of the incident (M=115 minutes, range=5-359 minutes); four incidents (2.6%) were reported within 361-1440 minutes of the incident (M=652 minutes, range=566-750 minutes); and one incident (0.7%) was reported after 4320 minutes following the incident. Most serious hazardous materials incidents involving patient transport are not reported to poison control centers. Opportunities exist to increase utilization of poison control center resources without increasing financial burdens of the hazardous materials incident. Published by

  14. 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.

  15. Washington Poison Center as perceived by our state's emergency physicians.

    Science.gov (United States)

    Robertson, William O; Caffrey, Angela

    2008-03-01

    In 1986, we conducted the first survey of Washington emergency physicians about their perceptions of the performance of the Washington Poison Center (WPC); the results were summarized and published. The exercise was repeated in 1993, 1997 and in 2005. The original conventional 2-page survey was updated and distributed with an explanatory letter and return envelope to a mailing list obtained from the state chapter of the American College of Emergency Physicians. Responses were tallied, summarized and compared to prior surveys. For 2005, 612 surveys were distributed; 221 were returned. The average respondent had been in practice for 14 years, with more than 50% functioning in "urban" communities. They reported calling the WPC an average of 19 times per year, and particularly valued being able to consult with a board-certified medical toxicologist in a virtually "STAT'' manner. In more than 80% of calls, the information played a positive role in management of the patient. Washington's emergency physicians continue to highly value the WPC's services, with increasing numbers in favor of governmental support of the operation.

  16. 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 ...

  17. Copper poisoning

    Science.gov (United States)

    ... swallowed or inhaled The amount swallowed or inhaled 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 ...

  18. 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 ...

  19. 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 ...

  20. Malathion 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. Diazinon 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. 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 ...

  3. 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.

  4. 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

  5. Poisonings in animals: the 1993-1994 report of the American Association of Poison Control Centers.

    Science.gov (United States)

    Hornfeldt, C S; Murphy, M J

    1997-12-01

    More than 82% of the 140,614 animal poison exposures reported in 1993 and 1994 occurred in dogs and almost 14% occurred in cats. Almost all reported were acute exposures to a single product. Tables of detailed data are provided.

  6. 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.

  7. 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.

  8. 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.

  9. Poisoning in children and adolescents notified at a toxicology center in the Northeast of Brazil

    Directory of Open Access Journals (Sweden)

    Maria Lucineide Porto Amorim

    Full Text Available Abstract Objective: to analyze the clinical and epidemiological profile of poisoning in children and adolescents under 12years old. Methods: a crosssectional study with analytical component based on poisoning notifications at the Centro de Toxicologia de Pernambuco (Toxicological Center in Pernambuco, carried out in 2012 and 2014. Allergic reactions and contaminated food poisoning were excluded. Sociodemographic characteristics, type of toxic agent, circumstance, place of occurrence, time until care and patients' evolution were analyzed. The distribution of frequencies and associations among the variables through prevalence ratio and the chisquared test was determined. Results: Among 2,843 patients registered, 1,601 (56.3% were poisoned by chemical substances and 1,242 (43.7% by poisonous animals. Most lived in urban areas (90.6% and were attended for care after an hour of the incident (47.6%. The poisoning frequency of chemical substances was higher among children under five years old (PR=2.34; CI95%= 2.142.56 and there was no difference in the sexes (PR=1.00; CI95%= 0.941.07. The predominant medicine (45.0% for poisoning was between chemical substance and scorpions (77.0%. Poisoning occurred as accidental in 92.2% and 99.6% of chemical substance occurred at home. There were six deaths by chemical intake and two by scorpions.. Conclusions: poisoning in Pernambuco State is considered a public health issue given by its frequency and it occurred mostly with children under 5 years old accidentally and at home.

  10. Characteristics of acute occupational pesticide exposures reported to poison control centers in Texas, 2000-2015.

    Science.gov (United States)

    Trueblood, Amber B; Shipp, Eva M

    2017-06-12

    In the United States, there is limited literature on occupational pesticide exposures despite being associated with adverse health outcomes, including in large states such as Texas. The purpose of this article is to characterize occupational pesticide poison center exposures in Texas. Descriptive statistics were used to describe exposures (eg, exposure routes, type of pesticide, medical outcome, clinical effects, and temporal/seasonal patterns). From 2000 to 2015, there were 2,303 occupational pesticide poison center exposures. Common types of reported pesticides were insecticides (67.3%), herbicides (17.7%), and repellents (5.8%). The highest proportion of exposures were among those aged 20 to 29 years (24.9%). The top clinical effect categories were gastrointestinal (25.8%), neurological (19.2%), and dermal (14.9%). Characterizing occupational pesticide poison center exposures can support improved surveillance systems and guide future research or interventions.

  11. Poison centers as information resources for volunteer EMS in a suspected chemical exposure.

    Science.gov (United States)

    Martin-Gill, Christian; Baer, Alexander B; Holstege, Christopher P; Eldridge, David L; Pines, Jesse M; Kirk, Mark A

    2007-05-01

    In the early part of chemical terrorism or hazardous materials events, protective actions and patient care require empirical decisions because reliable and accurate information may not be readily available. It has become increasingly important to identify reliable information resources that are the most likely to be accessed for information during these events. We sought to identify information resources that volunteer Emergency Medical Services (EMS) providers would use during a suspected chemical exposure. Survey questionnaires were completed by 116 of 151 (76.8%) suburban and rural EMS providers. In the past 12 months, most participants used medical journals and textbooks (59.5%), internet sites (57.8%), and poison centers (55.2%) as information resources. For two hypothetical scenarios involving chemical exposures, poison centers were most frequently chosen as likely contacts for information regarding the identity of the agent (case 1: 52.6%, case 2: 48.3%), treatment (74.1%, 64.7%, respectively), and antidote (59.5%, 49.1%, respectively). Fire department hazardous materials team tied with poison centers as the highest for chemical agent in the second scenario (48.3%) and was ranked highest both for decontamination (75.0%, 64.7%, respectively) and personal protection (56.9%, 45.7%, respectively). Poison centers were selected as the best resource for timely information (70.7%), availability (69.0%), and ease of contact (72.4%), and second highest for knowledge of chemical agents (44.0%), after CHEMTREC (56.9%). Finally, poison centers and CHEMTREC received the highest overall ratings (28.4% and 26.7%, respectively). Poison centers are viewed as an important information resource by EMS providers and may be the most commonly sought resource for various information needs during a suspected chemical exposure.

  12. Review of Multi-Person Exposure Calls to a Regional Poison Control Center

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    Morgan, Brent W

    2010-08-01

    Full Text Available Objective: Poisoning events, including exposures to hazardous materials, can involve multiple victims. Regional poison centers often are contacted in such events involving multiple victims. Methods: We searched our poison center database over a nine-year time period for all calls involving a poisoning event in which more than two people were exposed to the same substance. We then matched each product to the generic category used by the National Poison Data System. We analyzed this data to find the most frequent substances reported as primary substances in the multiple exposures. Results: We identified 6,695 calls between 2000 and 2008 that had more than two people exposed to the same substance. In these calls, 25,926 people were exposed (3.6% of the 715,701 human exposure calls for this period. These calls involved 64 of the 67 NPDS substance group codes. Some substances were much more commonly involved than others. The top three categories causing the most exposures were Fumes/Gases/Vapors, Food Products/Food Poisoning and Pesticides. Of the patients exposed, 69.4 % were not followed due to minimal effects possible or judged as nontoxic, 0.3% had major effects, 8.6% had no effects, and 9.3% had minimal to moderate effects. Eight people expired. Conclusion: Fumes, gases, and vapors make up the majority of multi-exposure calls. The overall mortality from multi-exposures, based on our data, is low. Analysis of these calls can help poison centers better understand these events and direct training. [West J Emerg Med 2010; 11(3: 292-294.

  13. 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

  14. [Evaluation of 1st semester activity of the Algiers Poison Center].

    Science.gov (United States)

    Merad, R

    1992-12-01

    The Poisons Center located in Bab el Oued University Hospital of Algiers has been opened to the public since January 2, 1991. The staff is made of public health physicians and pharmacists residents trained in toxicology. Phone calls are a new means for obtaining advice on poisonings and the public must be informed on the modalities of use. The number of calls shows that people are willing to use this fast and effective medium. A specific data sheet was created. The analysis of calls includes the origin of call, the nature of products used, the age range the clinical condition of patients, the recommended treatment and the outcome when known.

  15. 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

  16. 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.

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

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    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.

  18. 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.

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

    Science.gov (United States)

    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.

  20. Poison control centers' role in glow product-related outbreak detection: implications for comprehensive surveillance system.

    Science.gov (United States)

    Chu, Alvin F; Marcus, Steven M; Ruck, Bruce

    2009-01-01

    The development of syndromic surveillance systems to detect bioterrorist attacks and emerging infectious diseases has become an important and challenging goal to many governmental agencies and healthcare authorities. This study utilized the sharp increase of glow product-related calls to demonstrate the utility of poison control data for early detection of potential outbreaks during the week of Halloween in 2007. A review was conducted of the electronic records of exposures reported to the New Jersey Poison Information and Education System (NJPIES) Poison Control Hotline from 2002 through 2007 with generic code number 0201027 (glow products) set by the American Association of Poison Control Centers (AAPCC). Key information such as age, gender, time of the call, exposure reason, clinical effects, and medical outcomes along with telephone number, zip code, and county location were used in the analyses to determine the extent of the outbreak. Analyses included a total of 139 glow product-related calls during the week of Halloween in 2007 with a single-day high of 59 calls on Halloween Day. More than 90% of the glow product exposures were in children 1-10 years of age. The glow product-related calls on Halloween Day increased from 14 calls in 2002 to 59 calls in 2007, a 321% increase during a six-year period. Poison control centers in the United States are equipped with a unique and uniform input data collection system -- the National Poison Data System -- that provides an important data source in the development of a comprehensive surveillance system for early outbreak detection.

  1. 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.

  2. 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.

  3. 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

  4. Pattern of chlorine gas exposures reported to Texas poison control centers, 2000 through 2005.

    Science.gov (United States)

    Becker, Marcia; Forrester, Mathias

    2008-03-01

    Exposure to chlorine gas can result in serious adverse effects including death. From 2000 through 2005, approximately 9000 chlorine gas exposures were reported annually to poison control centers in the United States. Because a review of the literature failed to produce any Texas-specific data concerning chlorine gas exposures, we conducted a retrospective review of Texas poison control center calls and found that 2643 calls related to human exposures to chlorine gas occurred during these 6 years. The number of these calls increased during this period. Of the exposures, 750% occurred at home and 65% occurred during the months of May through August. Inhalation was the primary mode of exposure. While most exposures resulted in no or minor affects, approximately one-fourth required that the affected person be seen at a health care facility. Preventive activities are needed to educate people about the potential dangers associated with products that contain chlorine.

  5. Trends in analgesic exposures reported to Texas Poison Centers following increased regulation of hydrocodone.

    Science.gov (United States)

    Haynes, Ashley; Kleinschmidt, Kurt; Forrester, Mathias B; Young, Amy

    2016-06-01

    In October 2014, the Drug Enforcement Administration reclassified hydrocodone to schedule II, increasing regulations on use. The impact of rescheduling hydrocodone on opioid exposures is unclear, especially in states with special restrictions required for prescribing schedule II agents. To assess whether changes in exposures to prescription opioid analgesics and heroin as reported to poison centers occurred in the 6 months after hydrocodone rescheduling. We hypothesized that hydrocodone exposures would decrease, while less tightly regulated opioids, such as codeine and tramadol, would increase. This study compares opioid analgesic exposures reported to Texas Poison Centers before and after this change in a state that requires special prescription pads for Schedule II agents. Cases included all opioid analgesic exposures reported to a statewide poison center network, comparing exposures from 6 months before to 6 months after heightened regulations. Specific opioids with large changes in reported exposures were further characterized by patient age and exposure intent. Hydrocodone exposures decreased from 1567 to 1135 (28%, p = 0.00017), decreasing for all ages. Codeine exposures increased significantly from 189 to 522 (176%, p = 0.00014), including a 263% increase for age >20 years. Codeine misuse increased 443% and adverse drug events 327%. Oxycodone exposures increased from 134 to 189 (39%, p = 0.0143), increasing only among patients age >20 years. Reported heroin exposures increased from 156 to 179 (15%, p = 0.2286) and tramadol from 666 to 708 (6%, p = 0.0193). Other opioid exposures changed little or had limited reports. The increased regulation of hydrocodone was followed temporally by a decrease in reported hydrocodone exposures, but also increases in codeine, oxycodone and tramadol exposures. This may reflect a shift in prescribing practices, changes in street availability of hydrocodone or decreased drug diversion. The increased

  6. 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.

  7. 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

  8. 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.

  9. 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.

  10. Poison ivy - oak - sumac

    Science.gov (United States)

    ... ingredient can be found in: Bruised roots, stems, flowers, leaves, fruit Pollen of poison ivy , poison oak, ... further instructions. This is a free and confidential service. All local poison control centers in the United ...

  11. Cuticle remover 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. Hair tonic 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 ...

  13. Hand lotion 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 ...

  14. Rhubarb leaves 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 ...

  15. Blue nightshade 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 ...

  16. Shaving cream 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 ...

  17. Lip moisturizer poisoning

    Science.gov (United States)

    ... The time it was swallowed The 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 ...

  18. Hair bleach 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 ...

  19. Face powder 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 ...

  20. Black nightshade 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. Jerusalem cherry 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. The cost of employee turnover to a regional poison information center.

    Science.gov (United States)

    Dean, B S; Krenzelok, E P

    1994-02-01

    The quality and effectiveness of a regional poison information center (RPIC) are directly related to the skills and experience of the professional staff of specialists in poison information and to having the appropriate number of individuals in order to accurately and concisely respond to the thousands of telephone calls concerning acute/chronic poisoning emergencies. Since RPICs are traditionally small departments, the loss of even 1 key staff member can cause devastating results. A realistic appraisal of the actual costs associated with employee turnover was done at our RPIC and considered the following items: Advertising and recruiting expenses; interviewing expenses; processing costs; orientation and training expenses; and overtime costs including fringe benefits and premium shift differentials. The over-all tangible costs related to turnover of an individual who is certified or qualified to be certified as a specialist in poison information is approximately $17,486. The specific cost categories included advertising/recruiting, $326; interviewing expenses, $360; orientation and training, $9,250; processing, $350; overtime monies, $7,200. The less tangible effects of turnover cannot be strictly measured in dollars, but can be reflected in reduced quality assurance factors, increased sick time, and decreased morale. While staff salaries and benefits usually account for 75% to 85% of a RPIC's operating budget, and since external sources of revenue do not offset the operational expenses, it is becoming increasingly difficult to remain competitive in today's current professional salary climate. While the loss of talent and its cumulative effect on quality is impossible to quantitatively measure, we have attempted to calculate the real financial burden associated with replacing personnel.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. A survey of poison center knowledge and utilization among urban and rural residents of Arizona.

    Science.gov (United States)

    Otaluka, Onyinye N; Corrado, Rachel; Brooks, Daniel E; Nelson, Deborah B

    2015-01-01

    Poison control centers (PCCs) hold great potential for saving health care resources particularly by preventing unnecessary medical evaluations. We developed a survey to better identify the needs and experiences of our service community. We hope to use these data to improve PCC outreach education and overall use of our services. A written questionnaire was developed in English and then translated into Spanish. Subjects agreeing to participate were then asked two verbal questions in English: are you at least 18 years of age? And; in what language would you like to complete the questionnaire; English or Spanish? All questionnaires completed by subjects ≥18 years of age were included. Questionnaires with missing responses, other than zip code, were included. Data collected include gender, age, zip code, primary language, ethnicity, education, health insurance status and experiences with the PCC. Subjects were not compensated for participation. Arizona zip codes were divided into "rural" or "urban" based on a census data website. Percentages and odds ratios were determined based on completed responses. Smaller subgroups, for some variables, were combined to increase sample sizes and improve statistical relevance. Overall, women and subjects with children at home (regardless of ethnicity) were significantly more likely to have heard of the PCC although Blacks and Spanish-speakers were significantly less likely to have heard of the PCC. Similarly, respondents with children at home and those reporting a prior home poisoning (regardless of ethnicity) were significantly more likely to have called the PCC. Blacks were significantly less likely to have called the PCC. These findings were similar among people living in urban zip codes but not statistically significant among rural responders. Based on a small survey, race and language spoken at home were variables identified as being associated with decreased awareness of poison centers. Focusing on these specific groups may

  8. 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

  9. 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.

  10. 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.

  11. An Epidemiological Study of Aluminum Phosphide Poisoning in Patients Admitted in a Specialized Poisoning Referral Center in Northern Iran

    Directory of Open Access Journals (Sweden)

    Ali Banagozar Mohammadi

    2015-07-01

    Full Text Available Background and objectives : In recent decades, aluminum phosphide pills are used for suicide attempts in Tehran and other parts of the country. Aluminum phosphide is a solid inorganic phosphide that because of its involvement in entire the body organs right after the use, it causes different clinical signs and symptoms. In this research, we studied the epidemiological factors of poisoned patients with aluminum phosphide who were admitted in Tehran Baharloo hospital over the two years. Material and Methods : In this retrospective case series study, we surveyed the poisoned patients with aluminum phosphide who were admitted in Tehran Baharloo hospital. After recording data in   pre-designed data collection forms, the collected data were analyzed using SPSS software. Results : Seventy one cases of poisoned patients with aluminum phosphide with an average age of 26.18 ± 11.29 years were included in this study. The average number of ingested pills was 1.27±0.73. Sixty eight (95.8% patients had a suicidal and deliberate attempt. In this study, the fatality rate of fresh aluminum phosphide tablets was 51.6%. Conclusion : Based on the fatality rate of aluminum phosphide pills, preventive health care actions, increasing the awareness and training of health and medical management personnel at medical universities seem necessary to reduce the tendency and access to aluminum phosphides.

  12. Absorption of salicylate powders versus tablets following overdose: a poison center observational study.

    Science.gov (United States)

    Rose, S Rutherfoord; Cumpston, Kirk L; Kim, Janice; Difranco, Danielle; Wills, Brandon K

    2016-11-01

    Salicylate absorption following overdose of aspirin (ASA) tablet formulations can be prolonged for greater than 24 h. Accordingly, serial serum concentrations are typically recommended to guide treatment. However, there are little published data on absorption following ingestion of powder ASA formulations, and it is not known if delayed ASA absorption occurs following overdose of powder formulations. The objective of this study is to compare the absorption characteristics of powder and tablet formulations of ASA in patients reported to a single poison center. Electronic records from an accredited poison center were searched for single substance acute or acute on chronic ingestions of ASA in powder form between 1 January 2002 and 31 January 2014. An identical search for ingestions of ASA tablet products between 1 January 2012 and 31 December 2013 was undertaken as the comparator group. Other inclusion criteria were age >12 years, documented time of ingestion, treatment in a health care facility within nine hours of ingestion and at least two detectable serum salicylate concentrations. 16 of 25 powder and 22 of 49 tablet cases met inclusion criteria for analysis. Repeat serum salicylate concentrations following ingestion of tablets increased or insignificantly changed in 11 of 22 (50%) cases, and median serum salicylate concentrations in followed cases remained elevated for up to 12 h in some cases. In comparison, serum salicylate concentrations following powder ingestions declined in 15 of 16 (94%) cases. One patient, who ingested a powder product, underwent hemodialysis pursuant to an initial serum salicylate concentration of 96 mg/dL. In contrast to persistent concentrations following overdose of tablets, the majority of serum salicylate concentrations declined following ingestion of powder formulations. In this small study population, these findings suggest that prolonged absorption is unlikely following ingestions of ASA powders.

  13. Referral of pediatric laundry detergent pack exposure reported to poison centers.

    Science.gov (United States)

    Forrester, Mathias B

    2014-11-01

    Concentrated laundry detergent packs are new products that may be more likely to cause adverse effects and serious medical outcomes among young children than traditional laundry detergent products. The intent of this study was to examine whether certain factors might be associated with the referral of pediatric laundry detergent pack exposures by poison centers. Cases were laundry detergent pack exposures involving patients age 5 years or younger reported to Texas poison centers during February 2012 to August 2013. The health care facility referral rate was calculated for selected factors. Of 912 exposures, 720 were managed on site and 192 were referred to a health care facility. The referral rate was 16.1% for patients with not serious outcomes and 71.6% for serious outcomes. The referral rate was 32.0% for patients age younger than 1 year and 14.3% to 22.1% for the older age groups. 31.0% of Purex(TM), 25.5% of All(TM), and 19.3% of Tide(TM) product exposures were referred. The referral rate was 33.3% for ocular exposures, 19.4% for dermal contact, and 20.2% for ingestions. The most common clinical effects and their referral rates were vomiting (30.5%), cough or choke (45.1%), ocular irritation (34.6%), red eye (25.4%), nausea (25.4%), drowsiness or lethargy (67.5%), oral irritation (16.7%), and dermal edema (68.4%). Pediatric exposures to laundry detergent packs were more likely to be referred to health care facilities if the laundry detergent pack brand was Purex(TM), the exposure was ocular, or particular ocular, respiratory, dermal, or neurologic clinical effects were present. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. 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

  15. The critical role of the Poison Center in the recognition, mitigation and management of biological and chemical terrorism.

    Science.gov (United States)

    Krenzelok, E P

    2001-01-01

    Nuclear, biological and chemical (NBC) terrorism counter measures are a major priority with healthcare providers, municipalities, states and the federal government. Significant resources are being invested to enhance civilian domestic preparedness through training in anticipation of a NBC terroristic incident. The key to a successful response, in addition to education, is integration of efforts as well as thorough communication and understanding the role that each agency would play in an actual or impending NBC incident. In anticipation of a NBC event, a regional counter-terrorism task force was established in southwestern Pennsylvania to identify resources, establish responsibilities and coordinate the response to NBC terrorism. Members of the task force include first responders, hazmat, law enforcement (local, regional, national), government officials, health departments, the statewide emergency management agency and the regional poison information center. The poison center is one of several critical components of a regional counter-terrorism response force. It can conduct active and passive toxicosurveillance and identify sentinel events. To be responsive, the poison center staff must be knowledgeable about biological and chemical agents. The development of basic protocols and a standardized staff education program is essential. The use of the RaPID-T (R-recognition, P-protection, D-detection, T-triage/treatment) course can provide basic staff education for responding to this important but rare consultation to the poison center.

  16. 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 ...

  17. Insecticide poisoning

    Science.gov (United States)

    ... pyrethrins. These chemicals were originally isolated from chrysanthemum flowers and are generally not harmful. However, they can ... further instructions. This is a free and confidential service. All local poison control centers in the United ...

  18. Tetrahydrozoline poisoning

    Science.gov (United States)

    ... you or someone you are with has an exposure, call your local emergency number (such as 911), or your local poison center can ... under the following brand names: Eyesine Geneye Murine Tears Plus Opti-Clear ...

  19. Notes from the Field: Kratom (Mitragyna speciosa) Exposures Reported to Poison Centers - United States, 2010-2015.

    Science.gov (United States)

    Anwar, Mehruba; Law, Royal; Schier, Josh

    2016-07-29

    Kratom (Mitragyna speciosa) is a plant consumed throughout the world for its stimulant effects and as an opioid substitute (1). It is typically brewed into a tea, chewed, smoked, or ingested in capsules (2). It is also known as Thang, Kakuam, Thom, Ketum, and Biak (3). The Drug Enforcement Administration includes kratom on its Drugs of Concern list (substances that are not currently regulated by the Controlled Substances Act, but that pose risks to persons who abuse them), and the National Institute of Drug Abuse has identified kratom as an emerging drug of abuse (3,4). Published case reports have associated kratom exposure with psychosis, seizures, and deaths (5,6). Because deaths have been attributed to kratom in the United States (7), some jurisdictions have passed or are considering legislation to make kratom use a felony (8). CDC characterized kratom exposures that were reported to poison centers and uploaded to the National Poison Data System (NPDS) during January 2010-December 2015. The NPDS is a national database of information logged by the country's regional poison centers serving all 50 United States, the District of Columbia, and Puerto Rico and is maintained by the American Association of Poison Control Centers. NPDS case records are the result of call reports made by the public and health care providers.

  20. 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.

  1. 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.

  2. [Characterization of paracetamol overdose: report of a poison information center in Chile].

    Science.gov (United States)

    Bravo, Victoria; Román, Matías; Bettini, Marli; Cerda, Patricia; Mieres, Juan José; Paris, Enrique; Ríos, Juan Carlos

    2012-03-01

    Paracetamol (acetaminophen) is an analgesic and antipyretic drug widely used across the world. Its ingestion is one of the most common causes of drug overdose. In the United States is the first cause of acute hepatitis in adults. To describe the epidemiological profile of paracetamol overdose in Chile. Cross sectional retrospective study that included all the phone call inquiries received at the Poison Control Center of the Pontificia Universidad Catolica de Chile (CITUC) during 2009. Nine hundred fifty nine inquiries involving acute paracetamol exposures were received. Women represented a 63.1% of the cases. Half of the cases were suicide attempts, of which 74.8% were women. Accidental exposures occurred mainly in children. In 29.3% of the patients, the exposure was considered to involve a hepatotoxic dose. Women had 2.7 times the risk of men to ingest a toxic dose of paracetamol with suicidal purpose (Odds ratio (OR) = 2.7; 95% confidence interval (Cl): 2.1-3.6; p Paracetamol overdose is common in Chile. Authorities should carry out preventive measures. Antidotes and the capacity to measure plasma levels of paracetamol should be available in healthcare centers.

  3. 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

  4. 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

  5. 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.

  6. 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.

  7. 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

  8. Treatment of pediatric black widow spider envenomation: A national poison center's experience.

    Science.gov (United States)

    Glatstein, Miguel; Carbell, Gary; Scolnik, Dennis; Rimon, Ayelet; Hoyte, Christopher

    2017-11-06

    Black widow species (Latrodectus species) envenomation can produce a syndrome characterized by painful muscle rigidity and autonomic disturbances. Symptoms tend to be more severe in young children and adults. We describe black widow spider exposures and treatment in the pediatric age group, and investigate reasons for not using antivenom in severe cases. All black widow exposures reported to the Rocky Mountain Poison Center between January 1, 2012, and December 31, 2015, were reviewed. Demographic data were recorded. Patients were divided into 2 groups. Group 1: contact through families from their place of residence, public schools and/or cases where patients were not referred to healthcare facilities. Group 2: patient contact through healthcare facilities. 93 patients were included. Forty (43%) calls were in Group 1 and 53 (57%) in Group 2. Symptoms were evident in all victims; 43 (46.2%) were grade 1, 16 (17.2%) grade 2 and 34 (36.5%) grade 3, but only 14 patients (41.1%) of this group received antivenom. Antivenom use was associated with improvement of symptoms within minutes, and all treated patients were discharged within hours, without an analgesic requirement or any complications. Reasons for not receiving antivenom included: skin test positive (2/20), strong history of asthma or allergies (2/20), physician preference (2/20), non-availability of the antivenom at the health care facility (14/20). In our study, most symptomatic black widow envenomations were minor. Relatively few patients received antivenom, but antivenom use was associated with shorter symptom duration among moderate and major outcome groups. Copyright © 2017. Published by Elsevier Inc.

  9. 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.

  10. 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.  

  11. Gila monster (Heloderma suspectum) envenomation: Descriptive analysis of calls to United States Poison Centers with focus on Arizona cases.

    Science.gov (United States)

    French, Robert; Brooks, Daniel; Ruha, Anne-Michelle; Shirazi, Farshad; Chase, Peter; Boesen, Keith; Walter, Frank

    2015-01-01

    The Gila monster (Heloderma suspectum) is a venomous lizard native to the deserts of southwestern United States (US) and northern Mexico. The purpose of this study was to describe human exposures to Gila monsters reported to US poison control centers (PCCs) with a focus on Arizona cases. The American Association of Poison Control Centers' National Poison Data System (NPDS) was used to access and retrospectively review all calls to US PCCs, concerning Gila monsters between January 1, 2000 and October 31, 2011. In addition, detailed records from the two Arizona PCCs were reviewed for the same time period. A total of 319 calls regarding Gila monsters were identified in the NPDS. Of these, 105 (33%) were human exposures; most (79%) occurred in males. A total of 71 (68%) of these 105 cases were referred to a health care facility (HCF); 30 (29%) were managed on-site. Of the 71 HCF referrals, 36 (51%) were discharged home and 17 (24%) were admitted. Most (65%) admissions were to an intensive care unit (ICU). Arizona's PCCs received 70 unique reports of Gila monster bite. Most (77%) of the bites in Arizona involved an upper extremity. Eight (11%) involved patients under the age of 18 years. Eleven (16%) Arizona cases were work-related. Twenty-eight (40%) of the 70 bites in Arizona were evaluated in a HCF, but not admitted. Eleven (16%) were admitted, of which five were to an ICU. Six patients had edema of airway structures; three required emergent airway management, one by cricothyrotomy. There were no deaths. Gila monster bites are uncommon. Many cases did not require hospitalization. Edema of airway structures is an infrequent, but life-threatening complication.

  12. [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.

  13. Jack-in-the-pulpit 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 ...

  14. 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.

  15. 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

  16. 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

  17. Analgesic-Related Medication Errors Reported to US Poison Control Centers.

    Science.gov (United States)

    Eluri, Madhulika; Spiller, Henry A; Casavant, Marcel J; Chounthirath, Thitphalak; Conner, Kristen A; Smith, Gary A

    2017-11-23

    This study investigates the characteristics and trends of medication errors involving analgesic medications. A retrospective analysis was conducted of analgesic-related medication errors reported to the National Poison Data System (NPDS) from 2000 through 2012. From 2000 through 2012, the NPDS received 533,763 reports of analgesic-related medication errors, averaging 41,059 medication errors annually. Overall, the rate of analgesic-related medication errors reported to the NPDS increased significantly by 82.6% from 2000 to 2009, followed by a 5.7% nonsignificant decrease from 2009 to 2012. Among the analgesic categories, rates of both acetaminophen-related and opioid-related medication errors reported to the NPDS increased during 2000-2009, but the opioid error rate leveled off during 2009-2012, while the acetaminophen error rate decreased by 17.9%. Analgesic-related medication errors involved nonsteroidal anti-inflammatory drugs (37.0%), acetaminophen (35.5%), and opioids (23.2%). Children five years or younger accounted for 38.8% of analgesics-related medication errors. Most (90.2%) analgesic-related medication errors were managed on-site, rather than at a health care facility; 1.6% were admitted to a hospital, and 1.5% experienced serious medical outcomes, including 145 deaths. The most common type of medication error was inadvertently taking/given the medication twice (26.6%). Analgesic-related medication errors are common, and although most do not result in clinical consequences, they can have serious adverse outcomes. Initiatives associated with the decrease in acetaminophen-related medication errors among young children merit additional research and potential replication as a model combining government policy and multisectoral collaboration.

  18. Poison Ivy

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Poison Ivy KidsHealth / For Kids / Poison Ivy What's in ... the leaves of the plants. Look Out for Poison Plants These plants can be anywhere — from the ...

  19. 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.

  20. I Can't Believe It's Not Toothpaste! Poison Control Center Calls Regarding Dental and Oral-Care Products

    Directory of Open Access Journals (Sweden)

    Suchard, Jeffrey R

    2003-01-01

    Full Text Available Background: A cluster of incidents in which non-toothpaste products were used to brush teeth prompted a review of all calls to one Poison Control Center (PCC regarding exposures to dental and oral-care products to determine if any resulted in significant toxicity. Methods: Retrospective review of 65,849 calls to one PCC during one calendar year. All inquiries about exposures to substances used as dental or oral-care products were analyzed by a single reviewer for reported adverse effects, including hospital admission or PCC referral for emergent medical evaluation. Results: 798 calls involved exposure to dental or oral-care products, comprising 1.21% of all calls received. Toothbrushing incidents with non-toothpaste products (122 cases did not result in any significant recognized toxicity. Twenty-four patients were either referred for emergent medical evaluation (14 or were admitted to the hospital (10. In 23 of these patients (96%, the toxic agent was either an over-the-counter analgesic or a local anesthetic used to treat dental pain. Conclusions: Among PCC calls received regarding dental and oral-care products, over-the-counter analgesics and local anesthetics used for dental pain resulted in the most frequent need for emergent medical evaluation or for hospital admission.

  1. [Exposure to liquid detergent capsules: a study of the cases reported to the Paris Poison Center, 2011-2012].

    Science.gov (United States)

    Villa, A; Médernach, C; Arropetian, N; Lagrange, F; Langrand, J; Garnier, R

    2014-06-01

    To evaluate the toxicity of liquid detergent capsules for children. Analysis of 684 consecutive cases from the Paris Poison Center (2011-2012). Most enquiries (97 %) concerned children 5 years of age or younger. The main circumstances of exposure were ingestion alone (72.4 %) or together with eye or skin contact (7.5 % and 7.3 %, respectively). The effects observed were generally due to the irritating properties of concentrated detergents: minor digestive disturbances (particularly vomiting in nearly 50 % of cases) after ingestion and conjunctivitis and/or keratitis after eye contact. The main complications were 24 cases of keratitis and one case of pulmonary toxicity after ingestion. A rash was observed in nine patients; it was delayed in two. The effects observed with liquid detergent capsules were very similar to those resulting from exposure to other detergents. However, exposure to these agents are very frequent and often results in eye contact, which may be responsible for keratitis, and after ingestion detergent inhalation is a possible complication. All cases with eye symptoms or cough after liquid detergent capsule exposure deserve prompt medical examination and assistance. Greater awareness of both health professionals and consumers on the dangers and risks of these laundry detergent pods is required for better treatment of exposure accidents and for their prevention. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  2. Bug spray poisoning

    Science.gov (United States)

    ... Pyrethrins are a pesticide made from the chrysanthemum flower. It is generally considered nonpoisonous, but it can ... further instructions. This is a free and confidential service. All local poison control centers in the United ...

  3. [Prevalence and epidemiology of Loxosceles laeta bite. Analysis of consultations to a poison control center].

    Science.gov (United States)

    Ríos, Juan Carlos; Pérez, Marcela; Sánchez, Paula; Bettini, Marli; Mieres, Juan José; Paris, Enrique

    2007-09-01

    Loxoscelism is caused by the bite of spider Loxosceles laeta. It can cause a cutaneous or systemic syndrome. To determine the epidemiológica! and clinical features of patients bitten by the Chilean recluse spider (Loxosceles laeta). All communications received at a telephonic orientation center for intoxications during 2005 were analyzed, selecting those who involved patients with symptoms that suggested loxoscelism (i.e., pain, burning sensation, blue area, hematuria, fever or myalgia). These were derived to the emergency room for confirmation of the diagnosis. Forty-eight hours after the initial communication, patients were contacted by phone to find out about the definitive diagnosis. The variables analyzed were: gender, age, geographical location, time since exposure, part of the body involved, clinical signs and definitive diagnosis. Of 2,831 telephonic consultations with suspected loxoscelism, the diagnosis was confirmed in 287. All of these patients had cutaneous loxoscelism and only 7.3% of them developed visceral loxoscelism. Fifty six percent of patients with loxoscelism presented two or more clinical signs. The most common were a blue area, pain and a burning sensation, in 69%, 58% and 38% of patients, respectively. Fifty-one percent of patients developed signs within the first 12 hours. All patients with visceral syndrome presented with hemoglobinuria. No cases of loxoscelism were registered in areas located southern than the Xth region of Chile. There were no fatalities attributed to loxoscelism. Most cases of loxoscelism of this series were cutaneous. The population must be educated about the clinical signs of spider bite to seek early and adequate medical treatment.

  4. Methadone toxicity: comparing tablet and syrup formulations during a decade in an academic poison center of Iran.

    Science.gov (United States)

    Shadnia, S; Rahimi, M; Hassanian-Moghaddam, H; Soltaninejad, K; Noroozi, A

    2013-01-01

    Due to an increase in the number of methadone maintenance clinics in the past decade in Iran, acute methadone overdose has become one of the common poisonings in our society. To compare the characteristics of methadone poisoning between syrup and tablet formulation as well as to discuss the relative advantages and disadvantages of poisoning from the perspective of toxicity. In a retrospective cross-sectional study from 2000 to 2010, sampled data of all hospitalized methadone-overdosed patients were collected through chart review of hospital records. Concurrently, the total number of methadone sales was gathered. A total of 1426 patients with methadone poisoning had been hospitalized, including 1072 cases who consumed syrup or tablet solely. Mean ± SD milligram ingested dose of syrup and tablet were 153 ± 339 and 88 ± 274, respectively (p syrup formulation, particularly by children under 12 years old after being mistaken for cough mixture or water. Conversely, exposure to methadone tablets was more common in patients with suicidal intent. There was no statistically significant difference between the rates of intubation and death between the two groups. Higher doses of methadone in the syrup form appear to exert a similar severity of poisoning and outcomes compared to lesser doses of that in the tablet form. Similarities in outcomes, despite differences in exposure history, may reflect relatively prompt transfer to hospital and adequate provision of clinical care, including supportive care and naloxone. In order to reduce the rate of poisoning, we recommend the use of child-resistant containers for dispensing syrup, reduction in methadone concentration, adding a coloring agent, special flavor, and education of patients on the safe storage of methadone in their home in order to reduce the occurrence of accidental poisonings.

  5. 76 FR 9585 - Poison Control Program

    Science.gov (United States)

    2011-02-18

    ... public education about poison prevention and clinical toxicology training for many different healthcare... Control Center. These transfers are necessary in order to maintain poison control services and education... currently provide poison center services to the citizens of New York, 24 hours a day, 7 days a week. These...

  6. Poisonous Plants

    Science.gov (United States)

    ... Publications and Products Programs Contact NIOSH NIOSH POISONOUS PLANTS Recommend on Facebook Tweet Share Compartir Photo courtesy ... U.S. Department of Agriculture Many native and exotic plants are poisonous to humans when ingested or if ...

  7. Deodorant poisoning

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002696.htm Deodorant poisoning To use the sharing features on this page, please enable JavaScript. Deodorant poisoning occurs when someone swallows deodorant. This article ...

  8. Starch poisoning

    Science.gov (United States)

    Cooking starch poisoning; Laundry starch poisoning ... Cooking and laundry starch are both made from vegetable products, most commonly: Corn Potatoes Rice Wheat Both are usually considered nonpoisonous (nontoxic), but ...

  9. Food Poisoning

    Science.gov (United States)

    ... serious. Let's find out how to avoid it. What Is Food Poisoning? Food poisoning comes from eating foods that ... you're feeling, when you first felt sick, what you ate in the past few days, and ... might have caused food poisoning. The type of treatment you'll get ...

  10. Poison Prevention

    Science.gov (United States)

    ... Prevention Listen Español Text Size Email Print Share Poison Prevention Page Content Article Body Post the Poison Help number 1-800-222-1222 on the ... or empty container of a toxic substance, call Poison Help immediately. More than a million American children ...

  11. Poisonous plants.

    Science.gov (United States)

    Kellerman, T S

    2009-03-01

    South Africa is blessed with one of the richest floras in the world, which--not surprisingly--includes many poisonous plants. Theiler in the founding years believed that plants could be involved in the aetiologies of many of the then unexplained conditions of stock, such as gousiekte and geeldikkop. His subsequent investigations of plant poisonings largely laid the foundation for the future Sections of Toxicology at the Institute and the Faculty of Veterinary Science (UP). The history of research into plant poisonings over the last 100 years is briefly outlined. Some examples of sustained research on important plant poisonings, such as cardiac glycoside poisoning and gousiekte, are given to illustrate our approach to the subject and the progress that has been made. The collation and transfer of information and the impact of plant poisonings on the livestock industry is discussed and possible avenues of future research are investigated.

  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. Outsmarting Poison Ivy and Other Poisonous Plants

    Science.gov (United States)

    ... Consumer Updates Outsmarting Poison Ivy and Other Poisonous Plants Share Tweet Linkedin Pin it More sharing options ... whitish-green fruits hang in loose clusters. Poison Plant Rashes Aren’t Contagious Poison ivy and other ...

  14. 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

  15. Paradichlorobenzene poisoning

    Science.gov (United States)

    ... this page, please enable JavaScript. Paradichlorobenzene is a white, solid chemical with a very strong odor. Poisoning can occur if you swallow this chemical. This article is for information only. DO NOT use it to treat or manage an actual poison exposure. If you or someone you are with ...

  16. Overview of Poisoning

    Science.gov (United States)

    ... sometimes used. With this procedure, a solution containing sodium bicarbonate (the chemical in baking soda) is given by vein to make the urine ... acetaminophen (antidote is N - acetylcysteine ), aspirin (antidote is sodium bicarbonate), and heroin (antidote is naloxone ). Some poisonous bites ...

  17. Nicotine poisoning

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002510.htm Nicotine poisoning To use the sharing features on this page, please enable JavaScript. Nicotine is a bitter-tasting compound that naturally occurs ...

  18. 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. ...

  19. Dieffenbachia poisoning

    Science.gov (United States)

    ... enough to prevent normal speaking and swallowing. Home Care Wipe out the mouth with a cold, wet cloth. Rinse the person's eyes and skin well if they touched the plant. Give milk to drink. Call poison control for more guidance. ...

  20. 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 ...

  1. Food poisoning

    Science.gov (United States)

    ... is more common after eating at picnics, school cafeterias, large social functions, or restaurants. When germs get ... the food poisoning. These may include: Arthritis Bleeding problems Damage to the nervous system Kidney problems Swelling ...

  2. Mistletoe poisoning

    Science.gov (United States)

    Aronson JK. Plant poisons and traditional medicines. In: Farrar J, Hotez PJ, Junghanss T, Kang G, Lalloo D, White NJ, eds. Manson's Tropical Diseases . 23rd ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 76. Davison K, Frank BL. Ethnobotany: ...

  3. Antifreeze poisoning

    Science.gov (United States)

    The poisonous ingredients in antifreeze are: Ethylene glycol Methanol Propylene glycol ... For ethylene glycol: Death may occur within the first 24 hours. If ... little as 2 tablespoons (1 ounce or 30 milliliters) can kill a ...

  4. 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.

  5. Current use of imaging and electromagnetic source localization procedures in epilepsy surgery centers across Europe.

    Science.gov (United States)

    Mouthaan, Brian E; Rados, Matea; Barsi, Péter; Boon, Paul; Carmichael, David W; Carrette, Evelien; Craiu, Dana; Cross, J Helen; Diehl, Beate; Dimova, Petia; Fabo, Daniel; Francione, Stefano; Gaskin, Vladislav; Gil-Nagel, Antonio; Grigoreva, Elena; Guekht, Alla; Hirsch, Edouard; Hecimovic, Hrvoje; Helmstaedter, Christoph; Jung, Julien; Kalviainen, Reetta; Kelemen, Anna; Kimiskidis, Vasilios; Kobulashvili, Teia; Krsek, Pavel; Kuchukhidze, Giorgi; Larsson, Pål G; Leitinger, Markus; Lossius, Morten I; Luzin, Roman; Malmgren, Kristina; Mameniskiene, Ruta; Marusic, Petr; Metin, Baris; Özkara, Cigdem; Pecina, Hrvoje; Quesada, Carlos M; Rugg-Gunn, Fergus; Rydenhag, Bertil; Ryvlin, Philippe; Scholly, Julia; Seeck, Margitta; Staack, Anke M; Steinhoff, Bernhard J; Stepanov, Valentin; Tarta-Arsene, Oana; Trinka, Eugen; Uzan, Mustafa; Vogt, Viola L; Vos, Sjoerd B; Vulliémoz, Serge; Huiskamp, Geertjan; Leijten, Frans S S; Van Eijsden, Pieter; Braun, Kees P J

    2016-05-01

    In 2014 the European Union-funded E-PILEPSY project was launched to improve awareness of, and accessibility to, epilepsy surgery across Europe. We aimed to investigate the current use of neuroimaging, electromagnetic source localization, and imaging postprocessing procedures in participating centers. A survey on the clinical use of imaging, electromagnetic source localization, and postprocessing methods in epilepsy surgery candidates was distributed among the 25 centers of the consortium. A descriptive analysis was performed, and results were compared to existing guidelines and recommendations. Response rate was 96%. Standard epilepsy magnetic resonance imaging (MRI) protocols are acquired at 3 Tesla by 15 centers and at 1.5 Tesla by 9 centers. Three centers perform 3T MRI only if indicated. Twenty-six different MRI sequences were reported. Six centers follow all guideline-recommended MRI sequences with the proposed slice orientation and slice thickness or voxel size. Additional sequences are used by 22 centers. MRI postprocessing methods are used in 16 centers. Interictal positron emission tomography (PET) is available in 22 centers; all using 18F-fluorodeoxyglucose (FDG). Seventeen centers perform PET postprocessing. Single-photon emission computed tomography (SPECT) is used by 19 centers, of which 15 perform postprocessing. Four centers perform neither PET nor SPECT in children. Seven centers apply magnetoencephalography (MEG) source localization, and nine apply electroencephalography (EEG) source localization. Fourteen combinations of inverse methods and volume conduction models are used. We report a large variation in the presurgical diagnostic workup among epilepsy surgery centers across Europe. This diversity underscores the need for high-quality systematic reviews, evidence-based recommendations, and harmonization of available diagnostic presurgical methods. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

  6. 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.

  7. A 29-year analysis of acute peak salicylate concentrations in fatalities reported to United States poison centers.

    Science.gov (United States)

    Warrick, Brandon J; King, Andrew; Smolinske, Susan; Thomas, Ronald; Aaron, Cynthia

    2018-02-12

    The threshold salicylate concentration commonly recommended to initiate extracorporeal elimination, in the absence of significant end-organ toxicity, is 100 mg/dL. Unfortunately, the grade of evidence to support this decision is low. Our primary aim is to describe highest reported salicylate concentrations in patients who died from acute salicylate ingestions. Our secondary aim is to determine if age or coingestants varied with highest reported salicylate concentration. We analyzed acute salicylate fatalities reported to the National Poison Data System (NPDS) between 1 January 1986 and 31 December 2014. Included were patients who died during the index hospitalization and for which acute salicylate toxicity was the primary cause of death. We used descriptive statistics with standard deviations (SD) or 95% confidence intervals (CI) where appropriate. We created a general linear model that evaluated the association of age and coingestions with salicylate concentrations. We divided the patients into age quartiles to assess a possible interaction between age and salicylate concentration. We identified 602 acute salicylate fatalities that fit inclusion criteria. The mean peak reported fatal salicylate concentration across all age groups was 99.19 mg/dL (± 50.2 mg/dL). The median peak fatal salicylate concentration was 97.0 mg/dL. The oldest quartile had a lower mean concentration (age >57 years; 90.4 mg/dL) than the youngest quartile (age salicylates alone (mean difference 13.4 mg/dL, 95%CI 21.4-5.3). Increasing age and the presence of any coingestions were negatively associated with fatal concentrations (estimates; 95%CI 0.41; 0.61-0.021 and -14.43; 22.45-6.42, respectively). When opioids were a coingestant, mean concentration was 72.8 (mean difference 32.1 95%CI 23.1-41.1). Using the current recommended hemodialysis threshold of 100 mg/dL, more than half of the patients would be deprived of this critical life-saving therapy. Additionally

  8. Poisoning in the United States: 2012 emergency medicine report of the National Poison Data System.

    Science.gov (United States)

    Dart, Richard C; Bronstein, Alvin C; Spyker, Daniel A; Cantilena, Louis R; Seifert, Steven A; Heard, Stuart E; Krenzelok, Edward P

    2015-04-01

    Deaths from drug overdose have become the leading cause of injury death in the United States, where the poison center system is available to provide real-time advice and collect data about a variety of poisonings. In 2012, emergency medical providers were confronted with new poisonings, such as bath salts (substituted cathinones) and Spice (synthetic cannabinoid drugs), as well as continued trends in established poisonings such as from prescription opioids. This article addresses current trends in opioid poisonings; new substances implicated in poisoning cases, including unit-dose laundry detergents, bath salts, Spice, and energy drinks; and the role of poison centers in public health emergencies such as the Fukushima radiation incident. Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  9. Lead poisoning in children.

    Science.gov (United States)

    Dapul, Heda; Laraque, Danielle

    2014-08-01

    There is no safe lead level in children. Primary prevention is the most effective way to bring about the complete removal of lead from the environment and eliminate lead poisoning as a public health concern. The National Lead Information Center can be reached via the Internet at www.epa.gov/lead and www.hud.gov/lead, or via phone at 1-800-424-LEAD (5323).

  10. [Charcoal, cocaine and rattlesnakes: evidence-based treatment of poisoning].

    Science.gov (United States)

    Schaper, A

    2013-10-01

    Since ancient times poisoning has been treated medicinally. Clinical toxicology, in the narrow sense of the term, developed from the foundation of specialized medical treatment units for poisoning and the formation of the first poison information centers in the second half of the twentieth century. Historically, the first poison information centers were often localized at pediatric clinics or departments of internal medicine. It became increasingly more obvious that this pooling of competences made sense. This article gives a general introduction in clinical toxicology and presents the functions and key activities of emergency poison centers. The organisation and work of a poisons centre is demonstrated on the basis of the Poisons Information Center (GIZ) North annual report for 2011. In a short summary the basic principles of clinical toxicology are elucidated: the primary removal of poisons by gastric lavage and administration of activated charcoal, secondary removal of poisons by enhanced elimination using hemodialysis, hemoperfusion, multi-dose activated charcoal and molecular adsorbent recirculating systems (MARS) and the indications for administration of specific antidotes or antivenins (antisera against poisoning by poisonous animals). Gastric lavage is indicated within 1 h after ingestion of a potentially life-threatening dose of a poison. In cases of poisoning with substances which penetrate the central nervous system (CNS) gastric lavage should be performed only after endotracheal intubation due to the risk of aspiration. The basic management of poisoned patients by emergency medicine personnel out of hospital and on the way to hospital is presented. The Bremen list, a compilation of the five antidotes, atropine, 4-dimethylaminophenol (4-DMAP), tolonium chloride, naloxone and activated charcoal for out of hospital treatment by emergency doctors is presented. In all, even questionable cases of poisoning consultation at emergency poison centers is

  11. Infection Rate after Cranial Neurosurgical Procedures: A Prospective Single-Center Study.

    Science.gov (United States)

    Strahm, Carol; Albrich, Werner C; Zdravkovic, Vilijam; Schöbi, Barbara; Hildebrandt, Gerhard; Schlegel, Matthias

    2018-03-01

    To determine infection rate (IR) and to identify modifiable risk factors (RF) in cranial neurosurgery in a neurosurgical department for tertiary referral as part of an infection control surveillance to reduce surgical site infections (SSI). A prospective SSI incidence cohort study from February 2013 to January 2014 was performed in a tertiary-care neurosurgical teaching hospital and referral center. All consecutive adults undergoing any cranial neurosurgical procedure were included. Data were collected by a trained member of the infection control staff during the twice-weekly visits of the hospitalized patients. Follow-up was 30 days (procedures without implant) and 1 year (procedures involving permanent implants). SSI was diagnosed according to criteria of CDC. A total of 317 patients undergoing 333 index procedures were included. The median age was 61 years (range, 17-91 years) and 46% were female. Survival in patients with completed follow-up was 76% (196/258). Overall, IR was 7.2% (24/333 index procedures); in 96% (23/24), a neurosurgical implant was involved. The IR of extraventricular drainage (EVD) was 12.5% (13.1/1000 EVD days). The main causative pathogens were Staphylococcus aureus followed by coagulase-negative staphylococci and Propionibacterium acnes. Independent RF for neurosurgical SSI were EVD as part of the index operation and body mass index >25 kg/m 2 . IR was in accordance with recent prospective single-center studies (reported IR between 1.6% and 9%). EVD placement was identified as the strongest modifiable RF for SSI in cranial neurosurgical procedures. The need for standard infection control procedures for the insertion and maintenance of EVDs to avoid their contamination is reinforced. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Iodine poisoning

    Science.gov (United States)

    ... medical tests or the treatment of thyroid disease Tincture of iodine Iodine is also used during the ... Seek immediate medical help. DO NOT make a person throw up unless told to do so by Poison Control or a health care professional. Give the person milk, or ...

  13. Kerosene 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. DO NOT ...

  14. Alcohol Poisoning

    Science.gov (United States)

    ... Get follow-up care. If you or your teen has been treated for alcohol poisoning, be sure to ask about follow-up care. Meeting with a health professional, particularly an experienced chemical dependency professional, can help you prevent future binge drinking. By Mayo Clinic Staff . Mayo Clinic ...

  15. Mushroom Poisonings

    Directory of Open Access Journals (Sweden)

    Emine Dibek Misirlioglu

    2009-06-01

    Full Text Available Mushroom poisonings are intoxications with high mortality. Toxic wild mushrooms usually grow up in spring and autumn and the intoxications of these mushrooms occur mostly in these seasons. Best treatment is to make the public conscious of this problem. [TAF Prev Med Bull 2009; 8(3.000: 281-284

  16. Oleander poisoning

    Science.gov (United States)

    Aronson JK. Plant poisons and traditional medicines. In: Farrar J, Hotez PJ, Junghanss T, Kang G, Lalloo D, White NJ, eds. Manson's Tropical Diseases . 23rd ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 76. Mofenson HC, Caraccio TR, McGuigan ...

  17. Using Learner-Centered, Simulation-Based Training to Improve Medical Students’ Procedural Skills

    Directory of Open Access Journals (Sweden)

    Serkan Toy

    2017-03-01

    Full Text Available Purpose: To evaluate the effectiveness of a learner-centered, simulation-based training developed to help medical students improve their procedural skills in intubation, arterial line placement, lumbar puncture, and central line insertion. Method: The study participants were second and third year medical students. Anesthesiology residents provided the training and evaluated students’ procedural skills. Two residents were present at each station to train the medical students who rotated through all 4 stations. Pre/posttraining assessment of confidence, knowledge, and procedural skills was done using a survey, a multiple-choice test, and procedural checklists, respectively. Results: In total, 24 students were trained in six 4-hour sessions. Students reported feeling significantly more confident, after training, in performing all 4 procedures on a real patient ( P < .001. Paired-samples t tests indicated statistically significant improvement in knowledge scores for intubation, t (23 = −2.92, P < .001, and arterial line placement, t (23 = −2.75, P < .001. Procedural performance scores for intubation ( t (23 = −17.29, P < .001, arterial line placement ( t (23 = −19.75, P < .001, lumbar puncture ( t (23 = −16.27, P < .001, and central line placement ( t (23 = −17.25, P < .001 showed significant improvement. Intraclass correlation coefficients indicated high reliability in checklist scores for all procedures. Conclusions: The simulation sessions allowed each medical student to receive individual attention from 2 residents for each procedure. Students’ written comments indicated that this training modality was well received. Results showed that medical students improved their self-confidence, knowledge, and skills in the aforementioned procedures.

  18. Utilization and outcome of laparoscopic versus robotic general and bariatric surgical procedures at Academic Medical Centers.

    Science.gov (United States)

    Villamere, James; Gebhart, Alana; Vu, Stephen; Nguyen, Ninh T

    2015-07-01

    Robotic-assisted general and bariatric surgery is gaining popularity among surgeons. The aim of this study was to analyze the utilization and outcome of laparoscopic versus robotic-assisted laparoscopic techniques for common elective general and bariatric surgical procedures performed at Academic Medical Centers. We analyzed data from University HealthSystem Consortium clinical database from October 2010 to February 2014 for all patients who underwent laparoscopic versus robotic techniques for eight common elective general and bariatric surgical procedures: gastric bypass, sleeve gastrectomy, gastric band, antireflux surgery, Heller myotomy (HM), cholecystectomy (LC), colectomy, rectal resection (RR). Utilization and outcome measures including demographics, in-hospital mortality, major complications, 30-day readmission, length of stay (LOS), and costs were compared between techniques. 96,694 laparoscopic and robotic procedures were analyzed. Utilization of the robotic approach was the highest for RR (21.4%), followed by HM (9.1%). There was no significant difference in in-hospital mortality or major complications between laparoscopic versus robotic techniques for all procedures. Only two procedures had improved outcome associated with the robotic approach: robotic HM and robotic LC had a shorter LOS compared to the laparoscopic approach (2.8 ± 3.6 vs. 2.3 ± 2.1; respectively, p bariatric surgical procedures with the highest utilization for rectal resection. Compared to conventional laparoscopy, there were no observed clinical benefits associated with the robotic approach, but there was a consistently higher cost.

  19. Risk evaluation and mitigation strategies: assessment of a medical center's policies and procedures.

    Science.gov (United States)

    Childs, Lindsey; Alexander, Earnest; Duong, Minh-Tri

    2012-05-15

    The results of a hospital's initiative to evaluate and improve compliance with federally mandated risk evaluation and mitigation strategies (REMS) are presented. Food and Drug Administration approved REMS plans are required for more than 145 drugs, but clear guidance on strategies for achieving REMS compliance is lacking. As a first step toward determining the extent of REMS compliance at a large medical center, a systematic assessment was conducted to ascertain existing policies and procedures for the use of drugs subject to REMS requirements applicable in the inpatient setting. About 123 drugs with such "inpatient-applicable" REMS requirements were identified; of those, 10 had been ordered by hospital providers during a specified 18-month time frame and were included in the assessment of policies and procedures. The assessment revealed that the hospital lacked a formal REMS policy and had no REMS-compliant procedures in place for 7 evaluated drugs (ambrisentan, buprenorphine-naloxone, darbepoetin alfa, epoetin alfa, oxycodone controlled-release tablets, prasugrel, and pregabalin). Pursuant to the compliance assessment, new procedures to help ensure the safe use of those 7 drugs were developed, and REMS-focused educational programs, order-entry system enhancements, and drug storage modifications were implemented. Quality-improvement initiatives including staff education, incorporation of REMS requirements into existing policy, development of an electronic resource, and creation of a separate storage section for drugs subject to REMS were implemented at a large academic medical center to help ensure compliance with inpatient-applicable REMS requirements.

  20. [Superwarfarine Poisoning].

    Science.gov (United States)

    Freixo, Ana; Lopes, Luís; Carvalho, Manuela; Araújo, Fernando

    2015-01-01

    The superwarfarin-type anticoagulant rodenticides are used throughout the world and distinguish themselves from warfarin for its high potency and long acting anticoagulant activity. Easy access to these products enables the accidental or deliberate human poisoning. A case of voluntary rodenticide poisoning (RATIBRONÂ) by a woman who ingested an estimated 27.5 mg of bromadiolone total quantity for two weeks, with minor bleeding episodes, whose reversal of the anticoagulant effect with the correction of the abnormal values of the clotting tests took about one month to reverse is reported here. The correction of the haemostasis defects takes usually a long time and there are no treatment guidelines, but a gradually vitamin K dosage reduction, as out patients, along with the monitoring of the International Normalized Ratio levels, allows a safe evaluation of the therapeutic response.

  1. Plastic casting resin poisoning

    Science.gov (United States)

    Epoxy poisoning; Resin poisoning ... Epoxy and resin can be poisonous if they are swallowed or their fumes are breathed in. ... Plastic casting resins are found in various plastic casting resin products.

  2. Overview of Poisoning

    Science.gov (United States)

    ... kidney transplantation may be needed. Prevent absorption of poison Stomach emptying (inducing vomiting or stomach pumping), once ... iron, or many household chemicals. Increase elimination of poison If a poison remains life threatening despite the ...

  3. The acces system: a procedure for evaluating children's services at community mental health centers.

    Science.gov (United States)

    Fiester, A R

    1978-01-01

    This paper describes the efforts made by one community mental health center to develop a system of program evaluation for children's treatment services. The approach described has the capability of objectively assessing (1) patterns of utilization of children's services; (2) satisfaction with services as well as the availability, accessibility, and acceptability of services; and (3) the quality of children's mental health services as measured by the attainment of individualized treatment goals. A rationale for the development of this system as well as a description of the modifications and automatization of the procedure are included. By way of illustration, initial results are presented which pertain to 500 goals written for 208 child clients receiving treatment within any one of three of the center's child direct-service programs.

  4. Variation in perioperative care across centers for infants undergoing the Norwood procedure.

    Science.gov (United States)

    Pasquali, Sara K; Ohye, Richard G; Lu, Minmin; Kaltman, Jonathan; Caldarone, Christopher A; Pizarro, Christian; Dunbar-Masterson, Carolyn; Gaynor, J William; Jacobs, Jeffrey P; Kaza, Aditya K; Newburger, Jane; Rhodes, John F; Scheurer, Mark; Silver, Eric; Sleeper, Lynn A; Tabbutt, Sarah; Tweddell, James; Uzark, Karen; Wells, Winfield; Mahle, William T; Pearson, Gail D

    2012-10-01

    In the Single Ventricle Reconstruction trial, infants undergoing the Norwood procedure were randomly allocated to undergo a right ventricle-to-pulmonary artery shunt or a modified Blalock-Taussig shunt. Apart from shunt type, subjects received the local standard of care. We evaluated variation in perioperative care during the Norwood hospitalization across 14 trial sites. Data on preoperative, operative, and postoperative variables for 546 enrolled subjects who underwent the Norwood procedure were collected prospectively on standardized case report forms, and variation across the centers was described. Gestational age, birth weight, and proportion with hypoplastic left heart syndrome were similar across sites. In contrast, all recorded variables related to preoperative care varied across centers, including fetal diagnosis (range, 55%-85%), preoperative intubation (range, 29%-91%), and enteral feeding. Perioperative and operative factors were also variable across sites, including median total support time (range, 74-189 minutes) and other perfusion variables, arch reconstruction technique, intraoperative medication use, and use of modified ultrafiltration (range, 48%-100%). Additional variation across centers was seen in variables related to postoperative care, including proportion with an open sternum (range, 35%-100%), median intensive care unit stay (range, 9-44 days), type of feeding at discharge, and enrollment in a home monitoring program (range, 1%-100%; 5 sites did not have a program). Overall, in-hospital death or transplant occurred in 18% (range across sites, 7%-39%). Perioperative care during the Norwood hospitalization varies across centers. Further analysis evaluating the underlying causes and relationship of this variation to outcome is needed to inform future studies and quality improvement efforts. Copyright © 2012 The American Association for Thoracic Surgery. All rights reserved.

  5. Protecting Yourself from Poisonous Plants

    Science.gov (United States)

    ... NIOSH NIOSH Fast Facts: Protecting Yourself from Poisonous Plants Language: English Español (Spanish) Kreyol Haitien (Hatian Creole) ... outdoors is at risk of exposure to poisonous plants, such as poison ivy, poison oak, and poison ...

  6. Pylorus drainage procedures in thoracoabdominal esophagectomy - a single-center experience and review of the literature.

    Science.gov (United States)

    Fritz, Stefan; Feilhauer, Katharina; Schaudt, André; Killguss, Hansjörg; Esianu, Eduard; Hennig, René; Köninger, Jörg

    2018-03-01

    Pylorotomy and pyloroplasty in thoracoabdominal esophagectomy are routinely performed in many high-volume centers to prevent delayed gastric emptying (DGE) due to truncal vagotomy. Currently, controversy remains regarding the need for these practices. The present study aimed to determine the value and role of pyloric drainage procedures in esophagectomy with gastric replacement. A retrospective review of prospectively collected data was performed for all consecutive patients who underwent thoracoabdominal resection of the esophagus between January 2009 and December 2016 at the Katharinenhospital in Stuttgart, Germany. Clinicopathologic features and surgical outcomes were evaluated with a focus on postoperative nutrition and gastric emptying. The study group included 170 patients who underwent thoracoabdominal esophageal resection with a gastric conduit using the Ivor Lewis approach. The median age of the patients was 64 years. Most patients were male (81%), and most suffered from adenocarcinoma of the esophagus (75%). The median hospital stay was 20 days, and the 30-day hospital death rate was 2.9%. According to the department standard, pylorotomy, pyloroplasty, or other pyloric drainage procedures were not performed in any of the patients. Overall, 28/170 patients showed clinical signs of DGE (16.5%). In the literature, the rate of DGE after thoracoabdominal esophagectomy is reported to be approximately 15%, even with the use of pyloric drainage procedures. This rate is comparable to that reported in the present series in which no pyloric drainage procedures were performed. Therefore, we believe that pyloric drainage procedures may be unwarranted in thoracoabdominal esophagectomy. However, future randomized trials are needed to ultimately confirm this supposition.

  7. Perceived poisons.

    Science.gov (United States)

    Nañagas, Kristine A; Kirk, Mark A

    2005-11-01

    Perceived poisoning may manifest in numerous ways; however, all cases share certain characteristics. All are fostered by the wide availability of unreliable information about chemical safety, poor understanding of scientific principles, and ineffective risk communication. Although this problem is still incompletely understood, some approaches have been demonstrated to be useful, such as education about risk, appropriate reassurance, and empathy on the part of the practitioner. Successful management may curtail the spread or exacerbation of symptoms, whereas unsuccessful treatment may cause the problems to escalate, with detrimental effects on both society and patient.

  8. 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…

  9. Processes and Procedures of the Higher Education Programs at Marshall Space Flight Center

    Science.gov (United States)

    Heard, Pamala D.

    2002-01-01

    The purpose of my research was to investigate the policies, processes, procedures and timelines for the higher education programs at Marshall Space Flight Center. The three higher education programs that comprised this research included: the Graduate Student Researchers Program (GSRP), the National Research Council/Resident Research Associateships Program (NRC/RRA) and the Summer Faculty Fellowship Program (SFFP). The GSRP award fellowships each year to promising U.S. graduate students whose research interest coincides with NASA's mission. Fellowships are awarded for one year and are renewable for up to three years to competitively selected students. Each year, the award provides students the opportunity to spend a period in residence at a NASA center using that installation's unique facilities. This program is renewable for three years, students must reapply. The National Research Council conducts the Resident Research Associateships Program (NRC/RRA), a national competition to identify outstanding recent postdoctoral scientists and engineers and experience senior scientists and engineers, for tenure as guest researchers at NASA centers. The Resident Research Associateship Program provides an opportunity for recipients of doctoral degrees to concentrate their research in association with NASA personnel, often as a culmination to formal career preparation. The program also affords established scientists and engineers an opportunity for research without any interruptions and distracting assignments generated from permanent career positions. All opportunities for research at NASA Centers are open to citizens of the U.S. and to legal permanent residents. The Summer Faculty Fellowship Program (SFFP) is conducted each summer. NASA awards research fellowships to university faculty through the NASA/American Society for Engineering Education. The program is designed to promote an exchange of ideas between university faculties, NASA scientists and engineers. Selected

  10. Prevention of Food Poisoning.

    Science.gov (United States)

    Army Quartermaster School, Ft. Lee, VA.

    The programed text provides a single lesson, four-hour, correspondence subcourse on the prevention of food poisoning. It covers the following areas: a definition of food poisoning; chemical food poisoning; biological food poisoning; causes and prevention of trichinosis; six factors controlling bacteria growth; bacterial infection; prevention of…

  11. Revenue Increase following 2017 Multiple Procedures Payment Reduction Modification: Differential Impact on Neuroradiology-Report from an Academic Medical Center.

    Science.gov (United States)

    Noveiry, B B; Varzaneh, F N; Yousem, D M

    2018-02-22

    The Centers for Medicare and Medicaid Services imposed a 25% professional component multiple procedure payment reduction for the professional component of advanced diagnostic imaging modalities in January 2012. In 2017, the Centers for Medicare and Medicaid Services rolled back the multiple procedure payment reduction to 5% for subsequent imaging. To evaluate the effect of this change, we analyzed 5 months of Centers for Medicare and Medicaid Services procedures at Johns Hopkins Medical Institution. We analyzed the procedure codes and reimbursement rate for studies performed between January 1 and May 31, 2017. Patients with Medicare insurance who had multiple diagnostic procedures in a day were selected. Per the Centers for Medicare and Medicaid Services guidelines, procedures with the highest price were considered fully reimbursed and subsequent studies were marked for differences between 25% (2013-2016) and 5% reduction (2017). We included 8787 patients with 22,236 procedures (mean, 2.53 studies/day). CT, MR imaging, and ultrasound scans composed 75.9%, 21.5%, and 2.6% of all studies, with 61.2%, 54.9%, and 85.4% of the procedures of each technique subject to multiple procedure payment reduction, respectively. The projected reimbursement for these studies was $1,666,437, which translated to a $179,782 (12.1%) increase in revenue comparing 25%-versus-5% multiple procedure payment reduction rates for 5 months: $128,542 for CT, $47,802 for MR imaging, and $3439 for ultrasound. The annual overall prorated increase in revenue would be $431,476. The impact was maximal for neuroradiology. With the recent favorable adjustment in multiple procedure payment reduction regulations, CT-heavy subspecialties like neuroradiology benefit the most with revenue increases. Different practice settings might experience revenue increases to a different extent, depending on the procedure and payer mix. © 2018 by American Journal of Neuroradiology.

  12. 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

  13. 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.

  14. 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)

  15. Gastric lavage in patients with acute poisoning

    OpenAIRE

    Montserrat Amigó Tadín

    2012-01-01

    Acute poisonings are a frequent complaint in emergency departments and therapy which prevents the absorption of toxic products taken orally is often indicated: one such option is gastric lavage. Gastric lavage is a digestive decontamination technique whose goal is to remove the maximum amount of poison from the stomach and prevent its absorption. The procedure involves inserting a gastric tube into the stomach through the mouth or nose; firstly to aspirate all the stomach contents and then to...

  16. Preventing food poisoning

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007441.htm Preventing food poisoning To use the sharing features on this page, please enable JavaScript. To prevent food poisoning , take the following steps when preparing food: Carefully ...

  17. 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 ...

  18. 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. ...

  19. 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) ...

  20. 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 ...

  1. 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 ...

  2. Poison Ivy Dermatitis

    Science.gov (United States)

    ... Favorite Name: Category: Share: Yes No, Keep Private Poison Ivy Dermatitis Share | "Leaves of three - let it ... has a longer stem than the other two. Poison ivy clings to tree trunks and other vertical ...

  3. 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.

  4. 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.

  5. EDITORIAL POISONING PATTERN Human poisoning with ...

    African Journals Online (AJOL)

    pharm-chem

    Human poisoning with chemicals, including drugs, is emotive because of the real possibility that it often culminates in death. In acute poisoning, clinical symptoms such as vomiting, delirium, diarrhoea, convulsions, et cetera, are very dramatic, yet the onlookers with no medical background can only watch helplessly as the ...

  6. EDITORIAL POISONING PATTERN Human poisoning with ...

    African Journals Online (AJOL)

    pharm-chem

    Bioaccumulation of methylmercury then occurred in fish which were eventually eaten by humans. Thallium poisoning is characterized by alopecia often seen one to two weeks later when the patient is about to be discharged from hospital. Thus, in chronic poisoning, it is difficult to establish definitive cause-effect relationship.

  7. National carbon monoxide poisoning surveillance framework and recent estimates.

    Science.gov (United States)

    Iqbal, Shahed; Clower, Jacquelyn H; King, Michael; Bell, Jeneita; Yip, Fuyuen Y

    2012-01-01

    Unintentional, non-fire-related (UNFR) carbon monoxide (CO) poisoning is a leading cause of poisoning in the United States. A comprehensive national CO poisoning surveillance framework is needed to obtain accurate estimates of CO poisoning burden and guide prevention efforts. This article describes the current national CO poisoning surveillance framework and reports the most recent national estimates. We analyzed mortality data from the National Vital Statistics System multiple cause-of-death file, emergency department (ED) and hospitalization data from the Healthcare Cost and Utilization Project's Nationwide Emergency Department Sample and Nationwide Inpatient Sample, hyperbaric oxygen treatment (HBOT) data from HBOT facilities, exposure data from the National Poison Data System, and CO alarm prevalence data from the American Housing Survey and the National Health Interview Survey. In the United States, 2,631 UNFR CO deaths occurred from 1999 to 2004, an average of 439 deaths annually. In 2007, there were 21,304 (71 per one million population) ED visits and 2,302 (eight per one million population) hospitalizations for confirmed cases of CO poisoning. In 2009, 552 patients received HBOT, and from 2000 to 2009, 68,316 UNFR CO exposures were reported to poison centers. Most nonfatal poisonings were among children (65 years of age). More poisonings occurred during winter months and in the Midwest and Northeast. UNFR CO poisoning poses a significant public health burden. Systematic evaluation of data sources coupled with modification and expansion of the surveillance framework might assist in developing effective prevention strategies.

  8. 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.

  9. 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.

  10. Glyphosate poisoning.

    Science.gov (United States)

    Bradberry, Sally M; Proudfoot, Alex T; Vale, J Allister

    2004-01-01

    Glyphosate is used extensively as a non-selective herbicide by both professional applicators and consumers and its use is likely to increase further as it is one of the first herbicides against which crops have been genetically modified to increase their tolerance. Commercial glyphosate-based formulations most commonly range from concentrates containing 41% or more glyphosate to 1% glyphosate formulations marketed for domestic use. They generally consist of an aqueous mixture of the isopropylamine (IPA) salt of glyphosate, a surfactant, and various minor components including anti-foaming and colour agents, biocides and inorganic ions to produce pH adjustment. The mechanisms of toxicity of glyphosate formulations are complicated. Not only is glyphosate used as five different salts but commercial formulations of it contain surfactants, which vary in nature and concentration. As a result, human poisoning with this herbicide is not with the active ingredient alone but with complex and variable mixtures. Therefore, It is difficult to separate the toxicity of glyphosate from that of the formulation as a whole or to determine the contribution of surfactants to overall toxicity. Experimental studies suggest that the toxicity of the surfactant, polyoxyethyleneamine (POEA), is greater than the toxicity of glyphosate alone and commercial formulations alone. There is insufficient evidence to conclude that glyphosate preparations containing POEA are more toxic than those containing alternative surfactants. Although surfactants probably contribute to the acute toxicity of glyphosate formulations, the weight of evidence is against surfactants potentiating the toxicity of glyphosate. Accidental ingestion of glyphosate formulations is generally associated with only mild, transient, gastrointestinal features. Most reported cases have followed the deliberate ingestion of the concentrated formulation of Roundup (The use of trade names is for product identification purposes only and

  11. Statement of Accountability Reconciliation Procedures for Defense Finance and Accounting Service Columbus Center, Disbursing Station 6551

    National Research Council Canada - National Science Library

    1998-01-01

    .... Beginning in FY 1996, the Defense Finance and Accounting Service (DFAS) Indianapolis Center became responsible for preparing the financial statements for the Department 97 general fund appropriations...

  12. Procedural Portfolio Planning in Plastic Surgery, Part 2: Collaboration Between Surgeons and Hospital Administrators to Develop a Funds Flow Model for Procedures Performed at an Academic Medical Center.

    Science.gov (United States)

    Hultman, Charles Scott

    2016-06-01

    Although plastic surgeons make important contributions to the clinical, educational, and research missions of academic medical centers (AMCs), determining the financial value of a plastic surgery service can be difficult, due to complex cost accounting systems. We analyzed the financial impact of plastic surgery on an AMC, by examining the contribution margins and operating income of surgical procedures. We collaborated with hospital administrators to implement 3 types of strategic changes: (1) growth of areas with high contribution margin, (2) curtailment of high-risk procedures with negative contribution margin, (3) improved efficiency of mission-critical services with high resource consumption. Outcome measures included: facility charges, hospital collections, contribution margin, operating margin, and operating room times. We also studied the top 50 Current Procedural Terminology codes (total case number × charge/case), ranking procedures for profitability, as determined by operating margin. During the 2-year study period, we had no turnover in faculty; did not pursue any formal marketing; did not change our surgical fees, billing system, or payer mix; and maintained our commitment to indigent care. After rebalancing our case mix, through procedural portfolio planning, average hospital operating income/procedure increased from $-79 to $+816. Volume and diversity of cases increased, with no change in payer mix. Although charges/case decreased, both contribution margin and operating margin increased, due to improved throughput and decreased operating room times. The 5 most profitable procedures for the hospital were hernia repair, mandibular osteotomy, hand skin graft, free fibula flap, and head and neck flap, whereas the 5 least profitable were latissimus breast reconstruction, craniosynostosis repair, free-flap breast reconstruction, trunk skin graft, and cutaneous free flap. Total operating income for the hospital, from plastic surgery procedures, increased

  13. Self-expanding metal stents for colonic obstruction: experiences from 104 procedures in a single center

    DEFF Research Database (Denmark)

    Meisner, Søren; Hensler, Margaret; Knop, Filip Krag

    2004-01-01

    In the past, colonic obstruction caused by malignancy most often resulted in high-risk operations, usually involving two-step procedures or leaving the patient with a stoma in case of disseminated disease....

  14. Carbon Monoxide Information Center

    Medline Plus

    Full Text Available ... Center Carbon Monoxide Information Center En Español The Invisible Killer Carbon monoxide, also known as CO, is called the "Invisible Killer" because it's a colorless, odorless, poisonous gas. ...

  15. 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.

  16. 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.

  17. 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 ...

  18. Activity based costing of diagnostic procedures at a nuclear medicine center of a tertiary care hospital

    International Nuclear Information System (INIS)

    Hada, Mahesh Singh; Chakravarty, Abhijit; Mukherjee, Partha

    2014-01-01

    Escalating health care expenses pose a new challenge to the health care environment of becoming more cost-effective. There is an urgent need for more accurate data on the costs of health care procedures. Demographic changes, changing morbidity profile, and the rising impact of noncommunicable diseases are emphasizing the role of nuclear medicine (NM) in the future health care environment. However, the impact of emerging disease load and stagnant resource availability needs to be balanced by a strategic drive towards optimal utilization of available healthcare resources. The aim was to ascertain the cost of diagnostic procedures conducted at the NM Department of a tertiary health care facility by employing activity based costing (ABC) method. A descriptive cross-sectional study was carried out over a period of 1 year. ABC methodology was utilized for ascertaining unit cost of different diagnostic procedures and such costs were compared with prevalent market rates for estimating cost effectiveness of the department being studied. The cost per unit procedure for various procedures varied from Rs. 869 (USD 14.48) for a thyroid scan to Rs. 11230 (USD 187.16) for a meta-iodo-benzyl-guanidine (MIBG) scan, the most cost-effective investigations being the stress thallium, technetium-99 m myocardial perfusion imaging (MPI) and MIBG scan. The costs obtained from this study were observed to be competitive when compared to prevalent market rates. ABC methodology provides precise costing inputs and should be used for all future costing studies in NM Departments

  19. Activity based costing of diagnostic procedures at a nuclear medicine center of a tertiary care hospital.

    Science.gov (United States)

    Hada, Mahesh Singh; Chakravarty, Abhijit; Mukherjee, Partha

    2014-10-01

    Escalating health care expenses pose a new challenge to the health care environment of becoming more cost-effective. There is an urgent need for more accurate data on the costs of health care procedures. Demographic changes, changing morbidity profile, and the rising impact of noncommunicable diseases are emphasizing the role of nuclear medicine (NM) in the future health care environment. However, the impact of emerging disease load and stagnant resource availability needs to be balanced by a strategic drive towards optimal utilization of available healthcare resources. The aim was to ascertain the cost of diagnostic procedures conducted at the NM Department of a tertiary health care facility by employing activity based costing (ABC) method. A descriptive cross-sectional study was carried out over a period of 1 year. ABC methodology was utilized for ascertaining unit cost of different diagnostic procedures and such costs were compared with prevalent market rates for estimating cost effectiveness of the department being studied. The cost per unit procedure for various procedures varied from Rs. 869 (USD 14.48) for a thyroid scan to Rs. 11230 (USD 187.16) for a meta-iodo-benzyl-guanidine (MIBG) scan, the most cost-effective investigations being the stress thallium, technetium-99 m myocardial perfusion imaging (MPI) and MIBG scan. The costs obtained from this study were observed to be competitive when compared to prevalent market rates. ABC methodology provides precise costing inputs and should be used for all future costing studies in NM Departments.

  20. Acute Poisoning Surveillance in Thailand: The Current State of Affairs and a Vision for the Future

    OpenAIRE

    Saoraya, Jutamas; Inboriboon, Pholaphat Charles

    2013-01-01

    Acute poisoning is a major public health threat worldwide, including Thailand, a country in Southeast Asia with over 67 million inhabitants. The incidence and characteristics of poisoning in Thailand vary greatly depending on the reporting body. This systematic review aims to provide a comprehensive description of the state of poisoning in Thailand. It identifies common trends and differences in poisoning by reporting centers and regional studies. Almost half of the cases and three-fourths of...

  1. Outbreak investigation: Salmonella food poisoning.

    Science.gov (United States)

    Kunwar, R; Singh, Harpreet; Mangla, Vipra; Hiremath, R

    2013-10-01

    An outbreak of food poisoning was reported from a Military establishment on 29 May 2011 when 43 cases of food poisoning reported sick in a span of few hours. A retrospective-prospective study was conducted. Data regarding the onset of symptoms, presenting features and history of food items consumed was collected. A detailed inspection of the mess for hygiene and sanitary status, cooking and storage procedure, and rodent nuisance was also carried out. A total of 53 cases of food poisoning occurred between 29 and 31 May 2011. All cases had symptoms of diarrohea followed by fever (96.2%), headache (84.9%), abdominal pain (50.1%), nausea and vomiting (49.1%) and bodyache (39.6%) respectively. Based on the Attributable Risk (AR = 46.67%) and Relative Risk (RR = 4.5, 95% CI = 1.22-16.54) Potato-bitter gourd vegetable served during dinner on 28 May 2011 was incriminated as the food item responsible for outbreak. Symptomatology, incubation period and presence of rodent nuisance suggested contamination of Potato-bitter gourd vegetable with non-typhoidal Salmonella spp.

  2. 78 FR 54655 - Center for Devices and Radiological Health: Draft Standard Operating Procedure for Level 1...

    Science.gov (United States)

    2013-09-05

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND... challenging for the Center to communicate the change and its basis to all affected parties in a meaningful and... communication on regulatory matters, including establishing a standard practice for communicating to all...

  3. 76 FR 62072 - Center for Devices and Radiological Health; Standard Operating Procedures for Network of Experts...

    Science.gov (United States)

    2011-10-06

    ... gain access to scientific, engineering, and medical expertise when it is needed to supplement existing knowledge and expertise within the Center. DATES: Submit either electronic or written comments on the report... access to scientific, engineering, and medical expertise when it is needed to supplement existing...

  4. A single center's experience with pacemaker implantation after the Cox maze procedure for atrial fibrillation.

    Science.gov (United States)

    Ad, Niv; Holmes, Sari D; Ali, Rabia; Pritchard, Graciela; Lamont, Deborah

    2017-07-01

    The Cox maze procedure (CM) is safe and effective for all atrial fibrillation (AF) types. A recent randomized trial found alarming rates of pacemaker implantation (PMI) during hospitalization after CM. The purpose of this study was to assess the rate of PMI and its impact on outcomes after CM. Incidence of PMI was captured for all CM patients (2005-2015; N = 739). Data were collected prospectively. Multivariable logistic regression was conducted to determine risk factors for PMI. Propensity score matching was conducted between concomitant CM patients and patients without surgical ablation since 2011. Fifty-two patients (7.0%) had in-hospital PMI after CM. Most common primary indication for PMI was sick sinus syndrome (67%), followed by complete heart block (23%) and sinus bradycardia (10%). The only risk factor for in-hospital PMI was type of procedure (P = .020). Patients with multiple valve procedures were at greatest risk (P = .004-.035). STS-defined perioperative outcomes were similar for patients with and without in-hospital PMI. Sinus rhythm off antiarrhythmic drugs were similar by PMI. After propensity score matching (n = 180 per group), in-hospital PMI was similar in CM patients and those without surgical ablation (5% vs 4%, P = .609). This study demonstrated lower incidence of PMI after CM procedures than recently reported. When indicated, PMI was not associated with increased short- or long-term morbidity or inferior freedom from atrial arrhythmia. Efforts to increase surgeon training with the CM procedure and postoperative management awareness are warranted to improve rhythm outcome and minimize adverse events and PMI. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  5. Exclusion of fluoroscopy use in catheter ablation procedures: six years of experience at a single center.

    Science.gov (United States)

    Fernández-Gómez, Juan M; Moriña-Vázquez, Pablo; Morales, Elena Del Rio; Venegas-Gamero, José; Barba-Pichardo, Rafael; Carranza, Manuel Herrera

    2014-06-01

    Nonfluoroscopic mapping systems have demonstrated significant reduction of radiation exposure in radiofrequency (RF) catheter ablation procedures. However, their use as only imaging guide is still limited. To evaluate the usefulness of a completely nonfluoroscopic approach to catheter ablation of supraventricular arrhythmias using the Ensite-NavX™ electroanatomical navigation system. During 6 years, all consecutive patients referred for RF catheter ablation of regular supraventricular tachycardia (SVT) were admitted for a "zero-fluoroscopy" approach and studied prospectively. The only exclusion criterion was the need to perform a transseptal puncture. A total of 340 procedures were performed on 328 patients (179 men, age 55.7 ± 18.6 years). One hundred fifty-three patients had typical atrial flutter (AFL), 146 had AV nodal reentrant tachycardia (AVNRT), 35 had AV reciprocating tachycardia (AVRT), 4 patients had incisional atrial flutter (IAF), and 2 had focal atrial tachycardia (AT). Procedural success was achieved in 337 of the cases (99.1%). In 322 (94.7%), the procedure was completed without any fluoroscopy use. Mean procedure time was 110.5 ± 51.8 minutes. Mean RF application time was 9.8 ± 12.8 minutes and the number of RF lesions was 16.43 ± 15.8. Only 1 major complication related to vascular access was recorded. During follow-up, there were 12 recurrences (3.5%) (8 patients from the AVNRT group, 4 patients from the AP group). RF catheter ablation of SVT with an approach completely guided by the NavX system and without use of fluoroscopy is feasible, safe, and effective. © 2014 Wiley Periodicals, Inc.

  6. Anatomy of lead poisoning

    African Journals Online (AJOL)

    ABEOLUGBENGAS

    Abstract. Objective: Lead poisoning and lead toxicity is usually often interchangeably used by different Scientists. The Anatomy of lead poisoning encompasses its effects on different organ-systems of different species of organisms. It also includes environmental, functional and biochemical components associated with most.

  7. 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- ...

  8. 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...

  9. 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.

  10. 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.

  11. A 13-Year Retrospective Study on Toxic Alcohol Poisoning in Middle Urals, Russia

    Directory of Open Access Journals (Sweden)

    Konstantin M. Brusin

    2015-03-01

    Full Text Available Background: Toxic alcohol poisonings are responsible for high mortality and morbidity in Russia. This study was aimed to evaluate the trends of harmful ethanol (EtOH drinking as well as methanol (MeOH, isopropanol (IPA and ethylene glycol (EG poisonings in the Middle Urals region of Russia. Methods: In this retrospective study, the medical records of patients poisoned with MeOH, IPA and EG as well as those with harmful heavy EtOH drinking admitted to Regional Poison Treatment Center in Yekaterinburg during the period of 2002 to 2014 were reviewed. Results: During this 13-year period, 17482 patients with acute poisoning (due to various toxic agents were admitted, which 2244 of them (12.8% were due to alcohol poisoning. Of all patients with acute poisoning, 502 cases died which 61 of them (12.2% were due to alcohol poisoning. Most of the alcohol poisoned patients were men (1658, 73.9%. The male proportion of EG poisoned patients was higher than poisoned patients with other types of alcohol. Harmful EtOH drinking constituted the majority of alcohol poisoning cases (2076, 92.5%. Patients with EG poisoning were relatively older while patients with heavy EtOH intake were significantly younger (P < 0.001. The highest mortality rate (35.9% was seen in patients with EG poisoning. During this period, heavy EtOH drinking had a slight increasing trend and MeOH poisoning had a sharp increasing trend. On the other hand, IPA poisoning had a constant trend and the trend of EG poisoning was decreasing. The majority of MeOH and IPA poisonings were due to ingestion of surrogate alcohols. Conclusion: Particular attention of health authorities should be directed towards alcohol drinking prevention measures as well as production and availability of surrogate alcohols in the community.

  12. Right heart catheterization procedures in patients with suspicion of pulmonary hypertension – experiences of a tertiary center

    Directory of Open Access Journals (Sweden)

    Maciej Grymuza

    2017-11-01

    Full Text Available Introduction : Right heart catheterization (RHC is an invasive procedure providing direct and accurate measurements of hemodynamics of the cardiovascular system. Acute pulmonary vasoreactivity testing (APVT following basal RHC in some patients is an established tool evaluating the reversibility of hypertension in the pulmonary vasculature. Aim : We sought to assess the most common indications, vascular approaches and complications during RHC in a single high-volume center. Material and methods : A total of 534 RHC procedures in 348 patients (64% male were performed. The prospective registry was carried out for 28 months. Collected data included indications for RHC, vascular approaches, hemodynamic and clinical data, complications and response of pulmonary vessels in APVT. Results : In 401 (75% procedures pulmonary hypertension (mean pulmonary artery pressure (mPAP ≥ 25 mm Hg was confirmed. Left heart failure was the most common indication (55.8%, mainly ischemic (26% or dilated cardiomyopathy (19.9%. Other indications included a suspicion of arterial (21.7%, or chronic thromboembolic pulmonary hypertension (14.6%. The right internal jugular vein approach was used in 89.1% of procedures. Acute pulmonary vasoreactivity testing was performed in 143 patients, and it was positive in 67 (46.9% cases. Complications occurred in 21 (3.9% procedures and included pulmonary edema (0.2%, pneumothorax (0.2% and puncture of the artery followed by the insertion of a vascular sheath (0.4%, atrial arrhythmia (0.2%, superior vena cava dissection (0.2%, incidental artery puncture (1.1% and local hematoma (2.2%. Conclusions : The most frequent indication for RHC was left heart failure, and the most common approach was the right internal jugular vein. RHC is safe procedure with a low rate of major complications.

  13. Mothers' Knowledge Levels Related to Poisoning

    Directory of Open Access Journals (Sweden)

    Birsen BILGEN SIVRI

    2015-03-01

    Full Text Available SUMMARY: Objectives: This study was done to evaluate mothers’ level of knowledge regarding poisoning, to plan training for issues with an identified lack of knowledge, to collect required data regarding protection and approach issues on poisoning cases which may occur in children for various reasons. Methods: This descriptive study was performed after obtaining permission from the County Health Department and involved mothers who applied to Family Health Centers No. 1-7 between April 1st and May 31st 2012, and who agreed to participate in the study (n=290. The questionnaire was composed of three parts: “Personal Information Form,” “House Poisoning Evaluation Form” and “Home Poisoning Prevention Knowledge Level Form.” Results: Participant ages were between 16 and 50 years and the mean age was 33.09±7.10 years. The number of children ranged from 1 to 6, and 203 people had seven children under the age of six. 37.6% of the mothers were primary school graduates, while 74.5% were housewives. There was a significant relationship between the knowledge score of the mothers on poisoning and education, career, neighborhood, and social security (p<0.05. Conclusions: Childhood poisoning is the most common cause of admission to the hospital. Protective precautions such as family education, storage of medication out of reach of children and use of secure lids are thought to be important. Key words: First aid, level of knowledge, mother-child, nurses, poisoning

  14. 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.

  15. Psychological interventions helping pediatric oncology patients cope with medical procedures: a nurse-centered approach.

    Science.gov (United States)

    Weinstein, Aurélie G; Henrich, Christopher C

    2013-12-01

    This study explored whether psychological interventions are currently used by pediatric oncology nurses to help children cope with their treatment and, if so, which interventions were considered by oncology nurses to be the most effective. A web-based survey was developed to assess pediatric oncology nurses' impressions of psychological care for pediatric patients during their medical treatment. A sample of 88 pediatric oncologic nurses from twelve leading pediatric oncology departments in the US participated in the survey. The closed questions were analyzed through quantitative methods with statistics. The open questions were examined through qualitative methods with report narratives and discourse analysis. Pediatric oncology nurses identified three psychological interventions to reduce suffering: educating children by explaining the procedure; providing emotional support to children by listening, answering children's worries, or holding their hands; and distracting children through passive and active forms. The survey further showed that nurses spent on average 3 h per day providing emotional support, would be willing to be trained in additional interventions (93%), and could devote at least 10 min per treatment to provide support (77%). This work demonstrates the central role nurses play as emotional support caregivers. Since nurses would be willing to provide emotional support during treatments, training may be an approach to incorporate the use of psychological interventions. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. 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 ...

  17. Bracken fern poisoning

    Science.gov (United States)

    Bracken fern (Pteridium aquilinum) has worldwide distribution and in some areas dominated plant communities replacing desirable forages. Poisoning is identified as enzootic hematuria, bright blindness, and bracken staggers. This chapter reviews updates new information on the plant, the various poi...

  18. Poisoning - fish and shellfish

    Science.gov (United States)

    ... symptoms will be followed soon after by strange sensations that may include numbness or tingling in your mouth, headache, dizziness, and hot and cold temperature reversal. Amnesic shellfish poisoning: This is a ...

  19. Sodium carbonate poisoning

    Science.gov (United States)

    Sodium carbonate (known as washing soda or soda ash) is a chemical found in many household and ... products. This article focuses on poisoning due to sodium carbonate. This article is for information only. Do ...

  20. 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 ...

  1. The Poisons Project.

    Science.gov (United States)

    Crawford, Barbara A.

    1998-01-01

    Details a project in which students explore and study the poisons in their environment by asking and finding answers to their own research questions. Includes some suggestions for involving students successfully in inquiry-based learning. (DDR)

  2. Pine oil poisoning

    Science.gov (United States)

    ... K. General approach to the poisoned patient. In: Marx JA, Hockberger RS, Walls RM, et al, eds. ... Saunders; 2014:chap 147. Lee DC. Hydrocarbons. In: Marx JA, Hockberger RS, Walls RM, et al, eds. ...

  3. [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.

  4. 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 ...

  5. Poison Ivy Rash

    Science.gov (United States)

    ... and poison sumac: Farming Forestry Landscaping Gardening Firefighting Construction Camping Fishing from the shoreline or hunting Cable ... wash any other contaminated items — such as outdoor gear, garden tools, jewelry, shoes and even shoelaces — as ...

  6. Sulfuric acid poisoning

    Science.gov (United States)

    Sulfuric acid is a very strong chemical that is corrosive. Corrosive means it can cause severe burns and ... or mucous membranes. This article discusses poisoning from sulfuric acid. This article is for information only. Do NOT ...

  7. Neuropsychology of thallium poisoning

    OpenAIRE

    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 t...

  8. 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.

  9. Hydroxocobalamin in cyanide poisoning.

    Science.gov (United States)

    Thompson, John P; Marrs, Timothy C

    2012-12-01

    On theoretical grounds, hydroxocobalamin is an attractive antidote for cyanide poisoning as cobalt compounds have the ability to bind and detoxify cyanide. This paper reviews the pharmacokinetic and pharmacodynamic aspects of hydroxocobalamin, its efficacy in human cyanide poisoning and its adverse effects. PubMed was searched for the period 1952 to April 2012. A total of 71 papers were identified in this way; and none was excluded. PHARMACOKINETICS AND PHARMACODYNAMICS: Pharmacokinetic studies in dogs and humans suggest a two-compartment model, with first order elimination kinetics. Pharmacodynamic studies in animals suggest that hydroxocobalamin would be a satisfactory antidote for human cyanide poisoning. EFFICACY IN HUMAN POISONING: There is limited evidence that hydroxocobalamin alone is effective in severe poisoning by cyanide salts. The evidence for the efficacy of hydroxocobalamin in smoke inhalation is complicated by lack of evidence for the importance of cyanide exposure in fires and the effects of other chemicals as well as confounding effects of other therapeutic measures, including hyperbaric oxygen. Evidence that hydroxocobalamin is effective in poisoning due to hydrogen cyanide alone is lacking; extrapolation of efficacy from poisoning by ingested cyanide salts may not be valid. The rate of absorption may be greater with inhaled hydrogen cyanide and the recommended slow intravenous administration of hydroxocobalamin may severely limit its clinical effectiveness in these circumstances. Both animal and human data suggest that hydroxocobalamin is lacking in clinically significant adverse effects. However, in one human volunteer study, delayed but prolonged rashes were observed in one-sixth of subjects, appearing 7 to 25 days after administration of 5 g or more of hydroxocobalamin. Rare adverse effects have included dyspnoea, facial oedema, and urticaria. Limited data on human poisonings with cyanide salts suggest that hydroxocobalamin is an effective

  10. Pyopneumothorax following kerosene poisoning.

    Science.gov (United States)

    Chaudhary, Shyam Chand; Sawlani, Kamal Kumar; Yathish, B E; Singh, Ambukeshwar; Kumar, Suresh; Parihar, Anit

    2014-01-01

    Kerosene poisoning is a common poisoning in India especially in childhood, and clinical spectrum can range from meager chemical pneumonitis to grave complications such as hypoxia, pneumothorax, pneumomediastinum, and emphysema. Pyopneumothorax that may require aggressive management in the form of thoracotomy has not been reported in literature. We hereby report a 22-year young female who had developed series of respiratory complications including pyopneumothorax following ingestion of kerosene with suicidal intent and was treated successfully.

  11. Poisoning by organophosphorus insecticides

    OpenAIRE

    Martínez Parra, Pedro P.

    2014-01-01

    The agricultural and industrial development that is reaching our country has conditioned the emergence of numerous types of occupational diseases, among which stand out the poison in the work environment, and within poisoning organophosphorus insecticides. Substances acting on harmful insects transmit diseases to both the man and the vegetable kingdom. The recent and ever-increasing use of new insecticides, raises the need to know the physiological actions of these products so that their bene...

  12. 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.

  13. Burnable poison irradiation test

    International Nuclear Information System (INIS)

    1977-08-01

    The topical report describes the irradiation program developed to investigate different burnable poison rod material and designs. The purpose of the report is to present (1) technical support for the irradiation of several test burnable poison rod designs that have not been previously reviewed, and (2) describe the parameters that will be employed in the surveillance program for Combustion Engineering's (CE) standard burnable poison rod for 16 x 16 fuel assemblies. The test burnable poison rods will be placed in a CE reactor using 16 x 16 fuel assemblies, the first such reactor is Arkansas Nuclear One, Unit 2. The irradiation program has four phases. Phase I involves the irradiation of 48 standard burnable poison rods which (1) will be extensively precharacterized prior to irradiation and (2) will undergo interim performance evaluation and detailed post-irradiation examination. Phase II, III, and IV involve irradiation and performance evaluation of a small number of burnable poison rods of different proprietary designs. The report discusses the materials to be used in each phase, the methods of fabricating the rods, and the rods expected behavior in a reactor

  14. 21 CFR Appendix A to Part 101 - Monier-Williams Procedure (With Modifications) for Sulfites in Food, Center for Food Safety and...

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Monier-Williams Procedure (With Modifications) for...-Williams Procedure (With Modifications) for Sulfites in Food, Center for Food Safety and Applied Nutrition...-Williams apparatus. Component identification is given in text. ER01JA93.363 Figure 2. Diagram of bubbler (F...

  15. Carbon Monoxide Poisoning After an Ice Storm in Kentucky, 2009

    Science.gov (United States)

    Lutterloh, Emily C.; Iqbal, Shahed; Clower, Jacquelyn H.; Spillerr, Henry A.; Riggs, Margaret A.; Sugg, Tennis J.; Humbaugh, Kraig E.; Cadwell, Betsy L.; Thoroughman, Douglas A.

    2011-01-01

    Objectives. Carbon monoxide (CO) poisoning is a leading cause of morbidity and mortality during natural disasters. On January 26–27, 2009, a severe ice storm occurred in Kentucky, causing widespread, extended power outages and disrupting transportation and communications. After the storm, CO poisonings were reported throughout the state. The objectives of this investigation were to determine the extent of the problem, identify sources of CO poisoning, characterize cases, make recommendations to reduce morbidity and mortality, and develop prevention strategies. Methods. We obtained data from the Kentucky Regional Poison Center (KRPC), hyperbaric oxygen treatment (HBOT) facilities, and coroners. Additionally, the Kentucky Department for Public Health provided statewide emergency department (ED) and hospitalization data. Results. During the two weeks after the storm, KRPC identified 144 cases of CO poisoning; exposure sources included kerosene heaters, generators, and propane heaters. Hospitals reported 202 ED visits and 26 admissions. Twenty-eight people received HBOT. Ten deaths were attributed to CO poisoning, eight of which were related to inappropriate generator location. Higher rates of CO poisoning were reported in areas with the most ice accumulation. Conclusions. Although CO poisonings are preventable, they continue to occur in postdisaster situations. Recommendations include encouraging use of CO alarms, exploring use of engineering controls on generators to decrease CO exposure, providing specific information regarding safe use and placement of CO-producing devices, and using multiple communication methods to reach people without electricity. PMID:21563718

  16. 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

  17. A nationwide evidence-based study of factors associated with hospitalisations due to unintentional poisoning and poisoning mortality in Taiwan.

    Science.gov (United States)

    Chien, Wu-Chien; Chung, Chi-Hsiang; Lin, Chia-Hsin; Lai, Ching-Huang

    2013-01-01

    The aim of this study was to explore the epidemiologic characteristics of unintentional poisoning cases and the factors associated with inpatient mortality. Data were retrieved from the National Health Insurance database from 2005 to 2007. Patients with diagnosis classifications of ICD-9-CM E850-E869 (unintentional poisoning) were selected. SPSS 18.0 software was used for the analysis. In Taiwan between 2005 and 2007, a total of 11,523 patients were hospitalised due to unintentional poisoning, with a hospitalisation rate of 16.83 per 100,000, of which 60.1% and 39.9% were attributable to drug poisoning and solid, liquid and gas substance poisoning, respectively. The hospitalisation rate in men was higher than that of women. The age group of 45-64 had the highest hospitalisation rate of 52.85 per 100,000. The inpatient mortality rate increased with the presence of the following factors: age of 65 or older, surgery or procedure, a higher Charlson Comorbidity Index (CCI), short length of hospital stays, acute respiratory failure, alcohol poisoning, pesticide poisoning and a higher-level hospital visited. Methanol, herbicides and organophosphorus pesticide intoxications are associated with higher mortality rates. Therefore, when caring for patients poisoned by the above agents, healthcare professionals should look out for their clinical development to ensure quality of care and to reduce mortality.

  18. Patients' and procedural characteristics of AV-block during slow pathway modulation for AVNRT-single center 10year experience.

    Science.gov (United States)

    Wasmer, Kristina; Dechering, Dirk G; Köbe, Julia; Leitz, Patrick; Frommeyer, Gerrit; Lange, Phillip S; Kochhäuser, Simon; Reinke, Florian; Pott, Christian; Mönnig, Gerold; Breithardt, Günter; Eckardt, Lars

    2017-10-01

    Permanent AV-block is a recognized and feared complication of slow pathway modulation for AVNRT. We aimed to assess incidence of transient and permanent AV-block as well as consequences of transient AV-block in a large contemporary AVNRT ablation cohort. We searched our single center prospective ablation database for occurrence of transient and permanent AV-block during slow pathway modulation between January 2004 and October 2015. We analyzed patients' and procedural characteristics as well as outcome of patients in whom transient or permanent AV-block occurred. Of 9170 patients who underwent a catheter ablation at our institution between January 2004 and October 2015, 2101 patients (64% women, mean age 50±18years) underwent slow pathway modulation. In three patients, permanent AV-block occurred during RF application. Additional two patients had transient AV-block that recovered (after a few minutes and 25min), but recurred within two days of the procedure. All five patients underwent dual chamber pacemaker implantation (0.2%). Transient AV-block related to RF delivery occurred in 44 patients (2%). Transient mechanical AV-block occurred in additional 17 patients (0.8%). In 12 patients, ablation was continued despite transient AV-block. One of these patients developed permanent AV-block. Permanent AV-block following slow pathway modulation is a rare event, occurring in 0.2% of patients in a large contemporary single center cohort. Transient AV-block is more frequent (2%). Copyright © 2017 Elsevier B.V. All rights reserved.

  19. 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.

  20. 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.

  1. 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.

  2. Assessment of the safety of injection practices and injection-related procedures in family health units and centers in Alexandria.

    Science.gov (United States)

    Elhoseeny, Taghareed A; Mourad, Juidan K

    2014-08-01

    The Safe Injection Global Network (SIGN) developed an intervention strategy for reducing overuse of injections and promoting the administration of safe injections. Tool C--Revised is designed to assess the safety of the most common procedures that puncture the skin within health services. The aim of the study was to assess injection safety within the primary healthcare facilities in Alexandria using Tool C--Revised. A total of 45 family health units and centers in Alexandria were selected by proportional allocation from the eight regions of Alexandria. The Tool C--Revised of the WHO was used for observation of the entire facility, injection practices and injection-related procedures, and sterilization practices. Interview of different health providers and immediate supervisor of injections was carried out. Indicators that reflect risk included: deficiency of alcohol-based hand rub for cleansing hands (13.3%), compliance with hand wash before preparing a procedure (56.9% before injection practices, 61.3% before phlebotomy, and 67.6% before lancet puncture), and wearing a new pair of gloves before new procedures (48.6% before injection practices, 9.7% for phlebotomy, 11.8% for lancet puncture, and 80% for both intravenous injections and infusions). Enough disposable equipment in all facilities for at least 2 weeks dependent on the statement of the average numbers of procedures per week was shown. Only 38% of the providers had received training regarding injection safety in the last 2 years and 62.5% had completed their three doses of hepatitis B vaccine. Only 42.2% of staffs who handled healthcare waste had access to heavy gloves. Indicators related to injection and injection-related practices that reflect risk to patients include deficiency of alcohol-based hand rub tools, nonadherence to hand hygiene before preparing an injection, and inadequate adherence to using a clean barrier when opening a glass ampule and use of gloves. Indicators that may reflect risk to

  3. 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 ...

  4. Carbon Monoxide (CO) Poisoning Prevention

    Science.gov (United States)

    ... build up in a home and poison the people and animals inside. Every year, at least 430 people die ... build up in enclosed or partially enclosed spaces. People and animals in these spaces can be poisoned and can ...

  5. Extracorporeal treatment for theophylline poisoning

    DEFF Research Database (Denmark)

    Ghannoum, Marc; Wiegand, Timothy J; Liu, Kathleen D

    2015-01-01

    BACKGROUND: The Extracorporeal Treatments in Poisoning workgroup was created to provide evidence-based recommendations on the use of extracorporeal treatments (ECTRs) in poisoning. Here, the workgroup presents its systematic review and recommendations for theophylline. METHODS: After a systematic...

  6. 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)....

  7. [Paralytic shellfish poisoning (author's transl)].

    Science.gov (United States)

    Imbert, J C; Essaïd el Feydi, A; Kadiri, A

    Different diseases as viral or bacterian gastro-enteritis, Tiphoid, viral hepatitis can come from shellfishes. Less known is the shellfish poisoning although recent outbreaks took place in Spain, France, England, Morocco. Toxic poisoning is caused by a poison produced by dinoflagelates of plankton which get developped in shells and make them dangerous, even cooked, to be eaten. A respiratory failure can result from this neurotropic poison.

  8. 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......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...

  9. 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.

  10. 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. 

  11. Thallium poisoning in Israel.

    Science.gov (United States)

    Atsmon, J; Taliansky, E; Landau, M; Neufeld, M Y

    2000-11-01

    We report the first case of thallium poisoning in Israel in almost 30 years. A 40-year-old man was apparently poisoned by a business associate when, on several occasions, he unknowingly drank an alcoholic beverage containing the toxic substance. Delayed admission and recurrent thallium ingestion resulted in both acute and chronic symptoms being present concomitantly. Conventional treatment modalities (Prussian blue and forced diuresis) were employed. The patient survived, although neurological sequelae ensued. The problems encountered in diagnosis and treatment of this relatively uncommon entity are discussed.

  12. Haemarthrosis after superwarfarin poisoning.

    Science.gov (United States)

    Kotsaftis, Panagiotis; Girtovitis, Fotios; Boutou, Afroditi; Ntaios, George; Makris, Pantelis E

    2007-09-01

    Superwarfarins are widely used as rodenticides. They are similar to warfarin, but they are more potent and act longer. In case of poisoning, they cause severe bleeding, usually from multiple sites. A 67-yr-old man was admitted with melaena, epistaxis and haemarthrosis in his left knee. PT, INR and aPTT were markedly increased. Initially, the patient was treated with blood and fresh frozen plasma (FFP) transfusions. However at the second day, PT, INR and aPTT were even worse. The combination of persistent coagulopathy, normal mixing studies, normal liver function tests and absence of hepatic failure or malabsorption syndromes lead to the suspicion of vitK dependent clotting factors deficiency due to superwarfarin poisoning. Indeed, the patient admitted a suicide attempt with rodenticide, although he had previously denied it. Psychiatric evaluation revealed a disturbed personality. Melaena stopped after 7 d. Then, the patient was administered 30 mg of vitK daily for a total period of 4 months. Superwarfarin poisoning leads to severe bleeding, usually from multiple sites. Prolonged treatment with high doses of vitK is necessary. Haemarthrosis, as a complication of superwarfarin poisoning, is presented here for the first time in literature.

  13. Ink remover poisoning

    Science.gov (United States)

    Ink remover is a chemical used to get out ink stains. Ink remover poisoning occurs when someone swallows this substance. ... These ingredients can be found in: Ink removers Liquid bleaches Note: This list may not include all sources of ink removers.

  14. 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

  15. 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 ...

  16. Caladium plant poisoning

    Science.gov (United States)

    ... enough to prevent normal speaking and swallowing. Home Care If the plant was eaten, wipe out the mouth with a cold, wet cloth, and give the person milk to drink. Call poison control for more treatment information. If the eyes or skin touched the plant, rinse them well with water. ...

  17. 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 ...

  18. Swimming pool cleaner poisoning

    Science.gov (United States)

    ... outcome will depend on the extent of this damage. Opening a large bucket of chlorine tablets can expose you to a powerful chlorine gas that can be very poisonous. Always open the container outdoors. Keep your face as far away from ...

  19. Kerosene poisoning in children

    Science.gov (United States)

    Nouri, L.; Al-Rahim, K.

    1970-01-01

    The epidemiological and clinical aspects of 100 cases of kerosene poisoning have been studied. The use of gastric lavage is discussed, and it is considered that this measure is probably valuable in treatment. The importance of preventive measures is stressed. PMID:5416507

  20. Evaluation and assessment methodology, standards, and procedures manual of the United States Federal Radiological Monitoring and Assessment Center

    International Nuclear Information System (INIS)

    Kerns, K.C.; Burson, Z.G.; Smith, J.M.; Blanchard, R.L.

    2000-01-01

    In the event of a major radiological emergency, the U.S. Federal Radiological Emergency Response Plan authorises the creation of the Federal Radiological Monitoring and Assessment Center (FRMAC). The FRMAC is established to co-ordinate the Federal off-site monitoring and assessment activities, and is comprised of representatives from several Federal agencies and Department of Energy contractors who provide assistance to the state(s) and Lead Federal Agency. The Evaluation and Assessment (E and A) Division of the FRMAC is responsible for receiving, storing, and interpreting environmental surveillance data to estimate the potential health consequences to the population in the vicinity of the accident site. The E and A Division has commissioned the preparation of a methodology and procedures manual which will result in a consistent approach by Division members in carrying out their duties. The first edition of this manual is nearing completion. In this paper, a brief review of the structure of the FRMAC is presented, with emphasis on the E and A Division. The contents of the E and A manual are briefly described, as are future plans for its expansion. (author)

  1. 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.

  2. Differential Staffing Patterns with Job Analyses and Operational Procedures for Salt Lake City School District Media Centers.

    Science.gov (United States)

    Hodkin, Katherine Story

    Duties of the staff of media centers in the Salt Lake City School District and an analysis of task performances by position are listed. Positions included are: (1) head of the school media center/school media specialist, (2) school media center technician, (3) school media center aide, and (4) student aides. Twenty general district operational…

  3. 42 CFR 488.61 - Special procedures for approval and re-approval of organ transplant centers.

    Science.gov (United States)

    2010-10-01

    ... organ transplant centers. 488.61 Section 488.61 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... kidney transplant centers or the pertinent national coverage decisions (NCDs) for extra-renal organ... CMS approves an extra-renal organ transplant center under the conditions of participation, the NCDs no...

  4. 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.

  5. Gastric lavage in patients with acute poisoning

    Directory of Open Access Journals (Sweden)

    Montserrat Amigó Tadín

    2012-05-01

    Full Text Available Acute poisonings are a frequent complaint in emergency departments and therapy which prevents the absorption of toxic products taken orally is often indicated: one such option is gastric lavage. Gastric lavage is a digestive decontamination technique whose goal is to remove the maximum amount of poison from the stomach and prevent its absorption. The procedure involves inserting a gastric tube into the stomach through the mouth or nose; firstly to aspirate all the stomach contents and then to perform gastric washing manoeuvres. The effectiveness of gastric lavage is limited and involves a risk of iatrogenesis, and therefore the indications and contraindications should be carefully considered and the technique carried out meticulously to increase its effectiveness and reduce complications, primarily bronchoaspiration. Gastric lavage may be used in conjunction with other digestive decontamination techniques such as administration of activated charcoal. This gastric lavage protocol is based on a review of the literature on this procedure and is supported by the expertise of our research group in gastrointestinal decontamination techniques in patients with acute poisoning.

  6. 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.

  7. Simultaneous resection for colorectal cancer with synchronous liver metastases is a safe procedure: Outcomes at a single center in Turkey.

    Science.gov (United States)

    Dulundu, Ender; Attaallah, Wafi; Tilki, Metin; Yegen, Cumhur; Coskun, Safak; Coskun, Mumin; Erdim, Aylin; Tanrikulu, Eda; Yardimci, Samet; Gunal, Omer

    2017-05-23

    The optimal surgical strategy for treating colorectal cancer with synchronous liver metastases is subject to debate. The current study sought to evaluate the outcomes of simultaneous colorectal cancer and liver metastases resection in a single center. Prospectively collected data on all patients with synchronous colorectal liver metastases who underwent simultaneous resection with curative intent were analyzed retrospectively. Patient outcomes were compared depending on the primary tumor location and type of liver resection (major or minor). Between January 2005 and August 2016, 108 patients underwent simultaneous resection of primary colorectal cancer and liver metastases. The tumor was localized to the right side of the colon in 24 patients (22%), to the left side in 40 (37%), and to the rectum in 44 (41%). Perioperative mortality occurred in 3 patients (3%). Postoperative complications were noted in 32 patients (30%), and most of these complications (75%) were grade 1 to 3 according to the Clavien-Dindo classification. Neither perioperative mortality nor the rate of postoperative complications after simultaneous resection differed among patients with cancer of the right side of the colon, those with cancer of the left side of the colon, and those with rectal cancer (4%, 2.5%, and 2%, respectively, p = 0.89) and (17%, 33%, and 34%, respectively; p = 0.29)]. The 5-year overall survival of the entire sample was 54% and the 3-year overall survival was 67 %. In conclusion, simultaneous resection for primary colorectal cancer and liver metastases is a safe procedure and can be performed without excess morbidity in carefully selected patients regardless of the location of the primary tumor and type of hepatectomy.

  8. 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.

  9. 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

  10. Neuropsychology of thallium poisoning.

    Science.gov (United States)

    McMillan, T M; Jacobson, R R; Gross, M

    1997-08-01

    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.

  11. Management of thallium poisoning.

    Science.gov (United States)

    Pau, P W

    2000-09-01

    A case of acute thallium poisoning in a 67-year-old Chinese woman is described. She presented with acute pain in the chest, abdomen, and lower limbs. The diagnosis was not made, however, until alopecia developed. Detoxification treatment, which included Prussian blue (potassium ferric hexacyanoferrate) was then given, but further neurological damage occurred. The patient's motor function recovered after 1 year, but residual sensory neuropathy remained. This case illustrates that tissue-bound thallium may cause prolonged neurological damage if detoxification therapy is not commenced within 72 hours of the onset of acute poisoning. Acute abdominal pain and painful neuropathy in the lower extremities are important early diagnostic clues for timely therapy. However, by the time alopecia develops-typically around 2 weeks after the onset of symptoms-detoxification therapy may not be able to prevent the development of prolonged neurological damage.

  12. 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.

  13. Epidemiology of organophosphate pesticide poisoning in Taiwan.

    Science.gov (United States)

    Lin, Tzeng Jih; Walter, Frank Gardner; Hung, Dong Zong; Tsai, Jin Lian; Hu, Sheng Chuan; Chang, Jung San; Deng, Jou-Fang; Chase, Jung San; Denninghoff, Kurt; Chan, Hon Man

    2008-11-01

    The nationwide epidemiology of organophosphate pesticide (OP) poisoning has never been reported in detail for Taiwan. This study retrospectively reviewed all human OP exposures reported to Taiwan's Poison Control Centers (PCCs) from July 1985 through December 2006. There were 4799 OP exposures. Most OP exposures were acute (98.37%) ingestions (74.50%) of a single OP (80.37%) to attempt suicide (64.72%) in adults (93.25%). Males were the most common gender (64.95%). Most patients (61.97%) received atropine and/or pralidoxime. The mortality rate for all 4799 OP exposures was 12.71%. Exposures to single OPs without co-intoxicants caused 524 deaths; of these, 63.36% were due to dimethyl OPs. Dimethyl OPs cause the majority of deaths in Taiwan.

  14. 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.

  15. 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-.

  16. [Toxic alcohol poisonings].

    Science.gov (United States)

    Kulicki, Paweł; Głogowski, Tomasz

    Accidental or intentional poisonings with ethylene glycol or methanol constitute a serious toxicological problem in many countries. Both alcohols are quickly metabolized by alcohol dehydrogenase to toxic metabolites responsible for high anion gap severe metabolic acidosis and profound neurological, cardiopulmonary, renal disturbances and death. In the early period, the competing inhibition the alcohol dehydrogenase with ethanol or fomepizol may successfully prevent the formation of the toxic metabolites. Once severe acidosis develops an emergency hemodialysis is required.

  17. Organophosphate poisoning : A review

    Directory of Open Access Journals (Sweden)

    Parmod K. Sinha

    2003-06-01

    Full Text Available Organophosphate pesticides are used extensively worldwide, and poisoning by these agents, particularly in developing nations is a public health problem. Organophosphorous nerve agents are still considered as potential threat in both military or terrorism situations. The mechanism of toxicity is the inhibition of acetylcholinesterase, resulting in accumulation of the neurotransmitter acetylcholine and continued stimulation of acetylcholine receptors both in central and peripheral nervous systems. Beside acute cholinergic crisis, organophosphates are capable of producing several subacute or chronic neurological syndromes. The well described intermediate syndrome (IMS emerges 1-4 days after an apparently well treated cholinergic crisis. The standard treatment consists of reactivation of inhibited acetylcholinesterase with an oxime antidote (pralidoxime, obidoxime, HI-6 and Hlo7 and reversal of the biochemical effects of acetylcholine with atropine. The newer oximes HI-6 and Hlo& are much more suitable and efficacious acetylcholinesterase reactivator for severe acute nerve agent induced poisoning than currently used pralidoxime or obidoxime. Patients who receive treatment promptly usually recover from acute toxicity but may suffer from neurologic sequelae. (Med J Indones 2003; 12: 120-6 Keywords: poisoning, insecticide, organophosphate (OP, carbamates, acetylcholinesterase, oxime, pralidoxime, obidoxime, HI-6, HLo7

  18. Metaldehyde poisoning in dogs

    Directory of Open Access Journals (Sweden)

    Aleksić Jelena

    2016-01-01

    Full Text Available Metaldehyde is an active substance used for extermination of slugs and snail population. This paper presents the very first case of metaldehyde intentional poisoning of dogs in Serbia. Three-year-old and a six-year-old Swiss white shepard dogs were poisoned. The owner noticed frequent defecation, skeletal muscles spasms and impossibility to put any weight on their back extremities. The vomit of the younger dog was made of green-turquoise colored gut content. Twenty minutes after the onset of the first clinical symptoms dogs died. Macroscopic examination showed congestion of lungs, in the liver and intestines, as well as chemorage in the pancreas, bladder and intestines. Nonspecific pathological lesions were present in the lungs, heart, kidneys, liver, gut, intestines and brain. Pathohistological examination showed dystrophic changes and necrosis in kidneys, brain and intestines. According to anamnestic data, clinical signs, macroscopic and microscopic examination as well as characteristic smell of gut content, one could say that metaldehyde poisoning is the case. Toxicological analysis of gut content samples was performed by using gas chromatography with mass spectrophotometry (GC-MS. Used diagnostic methodology and gut content toxicology results obtained was the base for crime case according to article 269. Republic of Serbia Crime law.

  19. Managing aluminum phosphide poisonings

    Science.gov (United States)

    Gurjar, Mohan; Baronia, Arvind K; Azim, Afzal; Sharma, Kalpana

    2011-01-01

    Aluminum phosphide (AlP) is a cheap, effective and commonly used pesticide. However, unfortunately, it is now one of the most common causes of poisoning among agricultural pesticides. It liberates lethal phosphine gas when it comes in contact either with atmospheric moisture or with hydrochloric acid in the stomach. The mechanism of toxicity includes cellular hypoxia due to the effect on mitochondria, inhibition of cytochrome C oxidase and formation of highly reactive hydroxyl radicals. The signs and symptoms are nonspecific and instantaneous. The toxicity of AlP particularly affects the cardiac and vascular tissues, which manifest as profound and refractory hypotension, congestive heart failure and electrocardiographic abnormalities. The diagnosis of AlP usually depends on clinical suspicion or history, but can be made easily by the simple silver nitrate test on gastric content or on breath. Due to no known specific antidote, management remains primarily supportive care. Early arrival, resuscitation, diagnosis, decrease the exposure of poison (by gastric lavage with KMnO4, coconut oil), intensive monitoring and supportive therapy may result in good outcome. Prompt and adequate cardiovascular support is important and core in the management to attain adequate tissue perfusion, oxygenation and physiologic metabolic milieu compatible with life until the tissue poison levels are reduced and spontaneous circulation is restored. In most of the studies, poor prognostic factors were presence of acidosis and shock. The overall outcome improved in the last decade due to better and advanced intensive care management. PMID:21887030

  20. Methanol poisoning: characteristic MRI findings.

    Science.gov (United States)

    Jain, Nirdesh; Himanshu, Dandu; Verma, Shailendra Prasad; Parihar, Anit

    2013-01-01

    Acute methanol intoxication is not an unusual poisoning. It can have serious neurological sequelae. We emphasize how neuroimaging can help in distinguishing methanol poisoning from other causes of acute unconsciousness in alcoholic patients such as hypoglycemic brain damage and carbon monoxide poisoning or head injury, which are frequently observed in alcoholic patients and are also responsible for altered sensorium. The most important findings in MR brain imaging in methanol poisoning have been bilateral putaminal hemorrhagic necrosis. Other less common findings are subcortical and deep white matter lesions, cerebral and cerebellar cortical lesions, and midbrain lesions, cerebral and intraventricular hemorrhage, and even enhancement of necrotic lesions, we found almost the entire spectrum of MRI findings in this patient with methanol poisoning. Neurological sequelae can entail the course and prognosis in methanol poisoning. The patient died because of ventilator-associated pneumonia that developed in the course of prolonged hospitalization.

  1. 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

  2. Mortality and morbidity of poisonings in the Nordic countries in 2002

    DEFF Research Database (Denmark)

    Andrew, E.; Irestedt, B.; Hurri, T.

    2008-01-01

    . Methods. Morbidity was for this study defined as acute poisonings treated in hospitals given the ICD-10 codes T36-T65 and F10-F19. The figures were extracted from the National Patient/Hospital Registers. Acute poisonings listed as main as well as side diagnoses were included. Deaths recorded as acute......Aim. To map and compare mortality and morbidity of poisonings in Denmark, Finland, Iceland, Norway, and Sweden in 2002 and to establish a common understanding of methods and procedures among the National Poisons Information Centres (NPIC) in order to create a Nordic toxico-epidemiological platform...... poisoning (using the same ICD-10 codes) were collected from the National Death Cause Registers. Results. Annual mortality of acute poisonings per 100,000 inhabitants (rate) was 16.6 in Finland and between 8.6 and 11.1 in the other Nordic countries. Morbidity rates varied between 150 and 255 per 100...

  3. Mortality and morbidity of poisonings in the Nordic countries in 2002

    DEFF Research Database (Denmark)

    Andrew, E.; Irestedt, B.; Hurri, T.

    2008-01-01

    Aim. To map and compare mortality and morbidity of poisonings in Denmark, Finland, Iceland, Norway, and Sweden in 2002 and to establish a common understanding of methods and procedures among the National Poisons Information Centres (NPIC) in order to create a Nordic toxico-epidemiological platform....... Methods. Morbidity was for this study defined as acute poisonings treated in hospitals given the ICD-10 codes T36-T65 and F10-F19. The figures were extracted from the National Patient/Hospital Registers. Acute poisonings listed as main as well as side diagnoses were included. Deaths recorded as acute...... poisoning (using the same ICD-10 codes) were collected from the National Death Cause Registers. Results. Annual mortality of acute poisonings per 100,000 inhabitants (rate) was 16.6 in Finland and between 8.6 and 11.1 in the other Nordic countries. Morbidity rates varied between 150 and 255 per 100...

  4. SPECTRUM OF POISONING IN CHILDREN: STUDY FROM TERTIARY CARE HOSPITAL IN SOUTH INDIA

    Directory of Open Access Journals (Sweden)

    Mallesh

    2015-08-01

    Full Text Available PURPOSE: To understand pattern of poisoning in different age group in tertiary child care center and quantify burden of poisoning in pediatric admissions and mortality. DESIGN: Retrospective observation study. SETTING: Tertiary care center for children. METHODS: All the children admitted with diagnosis of acute poisoning between January 2013 and June 2015 was studied. RESULTS: There were 332 admissions due to poisoning during the study period (5.4% of total admissions. Mortality due to poisoning was 7, i.e. , 1.97% of all - cause mortality. 2.1% of poisonings died during the study period where a s overall mortality from all causes was 5.71%. House hold Products topped the list with 112 cases, followed by agricultural products (88 cases, animal bites and stings (69 cases, drugs (48 cases and industrial compounds (7 cases. Majority of admissions were in summer seasons 31% of all poisoning followed by rainy season. CONCLUSIONS: Incidence of acute poisoning in childhood has not changed significantly over time. Organophosphorus compounds, phosphides and drugs poisoning peak during adolescence and is particularly alarming. Conditions such as free availability of these compounds, co morbid conditions of adolescents, adolescent stressors have to be addressed

  5. 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.

  6. 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 ...

  7. Classification tree methods for development of decision rules for botulism and cyanide poisoning.

    Science.gov (United States)

    Sasser, Howell; Nussbaum, Marcy; Beuhler, Michael; Ford, Marsha

    2008-06-01

    Identification of predictors of potential mass poisonings may increase the speed and accuracy with which patients are recognized, potentially reducing the number ultimately exposed and the degree to which they are affected. This analysis used a decision-tree method to sort such potential predictors. Data from the Toxic Exposure Surveillance System were used to select cyanide and botulism cases from 1993 to 2005 for analysis. Cases of other poisonings from a single poison center were used as controls. After duplication was omitted and removal of cases from the control sample was completed, there remained 1,122 cyanide cases, 262 botulism cases, and 70,804 controls available for both analyses. Classification trees for each poisoning type were constructed, using 131 standardized clinical effects. These decision rules were compared with the current case surveillance definitions of one active poison center and the American Association of Poison Control Centers (AAPCC). The botulism analysis produced a 4-item decision rule with sensitivity (Se) of 68% and specificity (Sp) of 90%. Use of the single poison center and AAPCC definitions produced Se of 19.5% and 16.8%, and Sp of 99.5% and 83.2%, respectively. The cyanide analysis produced a 9-item decision rule with Se of 74% and Sp of 77%. The single poison center and AAPCC case definitions produced Se of 10.2% and 8.6%, and Sp of 99.8% and 99.8%, respectively. These results suggest the possibility of improved poisoning case surveillance sensitivity using classification trees. This method produced substantially higher sensitivities, but not specificities, for both cyanide and botulism. Despite limitations, these results show the potential of a classification-tree approach in the detection of poisoning events.

  8. The management of abandoned sites at the basin collieries of center and southern France and the procedure of stoppage of mining works

    International Nuclear Information System (INIS)

    Barriere, J.P.

    2003-01-01

    The basin collieries of center and southern France (HBCM) have launched since 1993 the procedures of stoppage of mining works as foreseen by the mining rights and which will lead to the renunciation of their 148 concessions once the remediation of the sites has been completed. In order to cope with the enormous work of file and work follow up, a rigorous procedure and organization has been implemented in order to obtain all necessary prefecture by-laws by the end of 2005. (J.S.)

  9. The good and the bad of poisonous plants: an introduction to the USDA-ARS Poisonous Plant Research Laboratory.

    Science.gov (United States)

    Welch, Kevin D; Panter, Kip E; Gardner, Dale R; Stegelmeier, Bryan L

    2012-06-01

    This article provides an overview of the Poisonous Plant Research Laboratory (PPRL), about the unique services and activities of the PPRL and the potential assistance that they can provide to plant poisoning incidences. The PPRL is a federal research laboratory. It is part of the Agricultural Research Service, the in-house research arm of the U.S. Department of Agriculture. The mission of the PPRL is to identify toxic plants and their toxic compounds, determine how the plants poison animals, and develop diagnostic and prognostic procedures for poisoned animals. Furthermore, the PPRL's mission is to identify the conditions under which poisoning occurs and develop management strategies and treatments to reduce losses. Information obtained through research efforts at the PPRL is mostly used by the livestock industry, natural resource managers, veterinarians, chemists, plant and animal scientists, extension personnel, and other state and federal agencies. PPRL currently has 9 scientists and 17 support staff, representing various disciplines consisting of toxicology, reproductive toxicology, veterinary medicine, chemistry, animal science, range science, and plant physiology. This team of scientists provides an interdisciplinary approach to applied and basic research to develop solutions to plant intoxications. While the mission of the PPRL primarily impacts the livestock industry, spinoff benefits such as development of animal models, isolation and characterization of novel compounds, elucidation of biological and molecular mechanisms of action, national and international collaborations, and outreach efforts are significant to biomedical researchers. The staff at the PPRL has extensive knowledge regarding a number of poisonous plants. Although the focus of their knowledge is on plants that affect livestock, oftentimes, these plants are also poisonous to humans, and thus, similar principles could apply for cases of human poisonings. Consequently, the information provided

  10. Cyanide Self-poisoning

    Science.gov (United States)

    Lee-Jones, M.; Bennett, M. A.; Sherwell, Janet M.

    1970-01-01

    Four cases of cyanide self-poisoning were admitted to one hospital over a period of two years. Two of the patients died. The diagnosis in the unconscious patient may be suggested by the finding of bradycardia and the absence of cyanosis (despite inadequate ventilation). The diagnosis can be confirmed in 5 to 10 minutes by a simple test on gastric aspirate, performed by the casualty officer. Cardiac pacing was used in two patients and may have a place in the supportive management of severe cases. PMID:5497407

  11. 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.

  12. The prognosis following amphetamine poisoning

    DEFF Research Database (Denmark)

    Horwitz, Henrik; Dalhoff, Kim P.; Klemp, Marc

    2017-01-01

    the background population. Results: From August 2006 to December 2013 we identified 1444 patients (70% males) who experienced amphetamine poisoning; 52% of the cases were classified as mixed poisonings and the average age at first contact was 24.8 years (SD 8.6). The prevalence of psychiatric disorders, HIV...

  13. Poor procedures and quality control among non-affiliated blood centers in Burkina Faso: an argument for expanding the reach of the national blood transfusion center

    Science.gov (United States)

    Nébié, Koumpingnin; Ouattara, Siaka; Sanou, Mahamoudou; Kientega, Youssouphe; Dahourou, Honorine; Ky, Lassina; Kienou, Kisito; Diallo, Samba; Bigirimana, Françoise; Fretz, Catherine; Murphy, Edward L.; Lefrère, Jean-Jacques

    2011-01-01

    Introduction The World Health Organization (WHO) recommends the creation of national blood transfusion services. Burkina Faso has a CNTS (Centre national de transfusion sanguine - National Blood Transfusion Center) but it currently covers only 53% of the national blood supply versus 47% produced by independent hospital blood banks. Study design To evaluate blood collection, testing, preparation and prescription practices in the regions of Burkina Faso that are not covered by the CNTS, we conducted a cross-sectional survey. Methodology Data were collected by trained professionals from May to June 2009, at 42 autonomous blood centers not covered by the CNTS. Results Blood collection was supervised in all sites by laboratory technicians without specific training. There was no marketing of community blood donation nor mobile collection. Donation was restricted to replacement (family) donors in 21.4% of sites. Pre-donation screening of donors was performed in 63.4% of sites, but some did not use written questionnaires. Testing for HIV, hepatitis B virus and syphilis was universal, although some sites did not screen for hepatitis C virus. In 83.3% of the sites blood typing was performed without reverse ABO typing. In 97.6% of the sites, nurses acted alone or in conjunction with a physician to order blood transfusions. Conclusion Shortcomings in non-CNTS blood centers argue for the development of a truly national CNTS. Such a national center should coordinate and supervise all blood transfusion activities, and is the essential first step for improving and institutionalizing blood transfusion safety and efficacy in a developing country. PMID:21736582

  14. Poor procedures and quality control among nonaffiliated blood centers in Burkina Faso: an argument for expanding the reach of the national blood transfusion center.

    Science.gov (United States)

    Nébié, Koumpingnin; Ouattara, Siaka; Sanou, Mahamoudou; Kientega, Youssouphe; Dahourou, Honorine; Ky, Lassina; Kienou, Kisito; Diallo, Samba; Bigirimana, Françoise; Fretz, Catherine; Murphy, Edward L; Lefrère, Jean-Jacques

    2011-07-01

    The World Health Organization (WHO) recommends the creation of national blood transfusion services. Burkina Faso has a CNTS (Centre National de Transfusion Sanguine-National Blood Transfusion Center) but it currently covers only 53% of the national blood supply versus 47% produced by independent hospital blood banks. To evaluate blood collection, testing, preparation, and prescription practices in the regions of Burkina Faso that are not covered by the CNTS, a cross-sectional survey was conducted. Data were collected by trained professionals from May to June 2009 at 42 autonomous blood centers not covered by the CNTS. Blood collection was supervised in all sites by laboratory technicians without specific training. There was no marketing of community blood donation nor mobile collection. Donation was restricted to replacement (family) donors in 21.4% of sites. Predonation screening of donors was performed in 63.4% of sites, but some did not use written questionnaires. Testing for HIV, hepatitis B virus, and syphilis was universal, although some sites did not screen for hepatitis C virus. In 83.3% of the sites, blood typing was performed without reverse ABO typing. In 97.6% of the sites, nurses acted alone or in conjunction with a physician to order blood transfusions. Shortcomings in non-CNTS blood centers argue for the development of a truly national CNTS. Such a national center should coordinate and supervise all blood transfusion activities, and is the essential first step for improving and institutionalizing blood transfusion safety and efficacy in a developing country. © 2011 American Association of Blood Banks.

  15. The utilization of poisons information resources in Australasia.

    Science.gov (United States)

    Fountain, J S; Reith, D M; Holt, A

    2014-02-01

    To identify poisons information resources most commonly utilized by Australasian Emergency Department staff, and examine attitudes regarding the benefits and user experience of the electronic products used. A survey tool was mailed to six Emergency Departments each in New Zealand and Australia to be answered by medical and nursing staff. Eighty six (71.7%) responses were received from the 120 survey forms sent: 70 (81%) responders were medical staff, the remainder nursing. Electronic resources were the most accessed poisons information resource in New Zealand; Australians preferring discussion with a colleague; Poisons Information Centers were the least utilized resource in both countries. With regard to electronic resources, further differences were recognized between countries in: ease of access, ease of use, quality of information and quantity of information, with New Zealand better in all four themes. New Zealand ED staff favored electronic poisons information resources while Australians preferred discussion with a colleague. That Poisons Information Centers were the least utilized resource was surprising. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  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. [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.

  18. 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.

  19. 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...

  20. Application of statistical process control and process capability analysis procedures in orbiter processing activities at the Kennedy Space Center

    Science.gov (United States)

    Safford, Robert R.; Jackson, Andrew E.; Swart, William W.; Barth, Timothy S.

    1994-01-01

    Successful ground processing at KSC requires that flight hardware and ground support equipment conform to specifications at tens of thousands of checkpoints. Knowledge of conformance is an essential requirement for launch. That knowledge of conformance at every requisite point does not, however, enable identification of past problems with equipment, or potential problem areas. This paper describes how the introduction of Statistical Process Control and Process Capability Analysis identification procedures into existing shuttle processing procedures can enable identification of potential problem areas and candidates for improvements to increase processing performance measures. Results of a case study describing application of the analysis procedures to Thermal Protection System processing are used to illustrate the benefits of the approaches described in the paper.

  1. Glycemic Status in Organophosphorus Poisoning.

    Science.gov (United States)

    Panda, S; Nanda, R; Mangaraj, M; Rathod, P K; Mishra, P K

    2015-01-01

    Organophosphorus(OP) poisoning, in addition to its cholinergic manifestations shows metabolic derangements leading to hyperglycemia. Apart from inhibiting acetylcholinesterase it also induces oxidative stress to exhibit this manifestation. The present study aims to assess the glycemic status of OP poisoned patients and its association with various factors in OP poisoning like oxidative stress and dose of atropine. This is a prospective study which recruited 102 patients above 18 years of age with history of OP poisoning. They were categorized into 3 grades-mild, moderate and severe based on the Peradeniya Organophosphorus Poisining Scale. The routine biochemical parameters along with serum malondialdehyde (MDA) and cholinesterase were estimated in the study group. Hyperglycemia and glycosuria were observed, with majority cases of hyperglycemia (57%) noticed in the severe group. There was a rise in the random plasma glucose (RPG), serum malondialdehyde (MDA), total dose of atropine across the groups along with a fall in the serum cholinesterase with increase in severity of poisoning. The fall in plasma glucose at the time of discharge was significant in all three groups when compared to the admission random plasma glucose(RPG) level. This transient hyperglycemia exhibited a significant positive association with serum MDA and dose of atropine administered during treatment (p<0.05). Glycemic status in OP poisoning may play a role in identifying the severity of poisoning at the time of admission.

  2. [Venomous and poisonous animals. IV. Envenomations by venomous aquatic vertebrates].

    Science.gov (United States)

    Bédry, R; De Haro, L

    2007-04-01

    Epidemiological information on marine envenomation is generally less extensive in Europe than in tropical regions where these injuries are more severe and the need for medical advice is more frequent. For these reasons use of regional Poison Control Centers in the area where the injury occurs must be encouraged. The purpose of this review is to describe envenomation by bony fish (lion fish, stone fish, and catfish), cartilaginous fish (stingrays and poisonous sharks), or other venomous aquatic vertebrates (moray-eels and marine snakes). Understanding of these envenomation syndromes is important not only in tropical areas but also in Europe where importation of dangerous species has increased in recent years.

  3. [Venomous and poisonous animals. V. Envenomations by venomous marine invertebrates].

    Science.gov (United States)

    Bédry, R; de Haro, L

    2007-06-01

    Epidemiological information about marine envenomation is generally less extensive in Europe than in tropical countries where this type of injury is more severe and the need for medical attention is more frequent. For this reason use of the regional poison control centers in the areas where envenomation occurs must be encouraged. The purpose of this review is to describe envenomation by poisonous marine invertebrates (cephalopods, sea urchins, cone shells, jellyfish, anemones, star-fish, corals, and worms). Understanding of these envenomation syndromes is important not only in tropical areas but also in Europe where importation of dangerous species has increased in recent years.

  4. [Poisonous animals at bathing beaches].

    Science.gov (United States)

    Junghanss, T; Bodio, M

    2000-05-18

    Tourists and native inhabitants of tropical and subtropical regions differ significantly with regard to the risk and nature of incidents involving venomous and poisonous animals. While the indigenous population encounters such risks daily during work and other activities, tourists are usually endangered while swimming or diving, or by ingesting toxin-containing fish and/or other seafood. Whether abroad or at home, allergic reactions to the stings of bees, wasps and hornets are probably the most common manifestations of an encounter with a "poisonous animal". Travellers should be well acquainted with the dangers entailed in encountering or ingesting a venomous or poisonous animal--prevention is the most important measure.

  5. 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.

  6. Corrosive Poisonings in Adults

    Science.gov (United States)

    Chibishev, Andon; Pereska, Zanina; Chibisheva, Vesna; Simonovska, Natasa

    2012-01-01

    Ingestion of corrosive substances may cause severe to serious injuries of the upper gastrointestinal tract and the poisoning can even result in death. Acute corrosive intoxications pose a major problem in clinical toxicology since the most commonly affected population are the young with psychic disorders, suicidal intent and alcohol addiction. The golden standard for determination of the grade and extent of the lesion is esophagogastroduodenoscopy performed in the first 12-24 hours following corrosive ingestion. The most common late complications are esophageal stenosis, gastric stenosis of the antrum and pyloris, and rarely carcinoma of the upper gastrointestinal tract. Treatment of the acute corrosive intoxications include: neutralization of corrosive agents, antibiotics, anti-secretory therapy, nutritional support, collagen synthesis inhibitors, esophageal dilation and stent placement, and surgery. PMID:23678319

  7. Neutronic analysis of Gd2O3 as burnable poison

    International Nuclear Information System (INIS)

    Lecot, C.A.

    1990-01-01

    For the reactors core design, the use of burnable poisons is one of the options for the control of in excess reactivity and the power form factor. As alternative procedures, the absorbing material may be included in pellets of an inert material or in fuel pellets. Besides, a cladding material and the locations of the fuel elements must be chosen for the first case. The CAREM reactor core design foresees the use of gadolinium oxide (Gd 2 O 3 ) as burnable poison. In this work, a comparative study was made, from the neutronic point of view, among the following alternatives for the poisons location: a) Gd 2 O 3 bars supports in alumina (Al 2 O 3 ), sheathed in steel; b) Gd 2 O 3 bars supports in alumina sheathed in Zry-4; c) Gd 2 O 3 in uranium dioxide (UO 2 ) fuel pellets. (Author) [es

  8. The need for unique risk adjustment for surgical site infections at a high-volume, tertiary care center with inherent high-risk colorectal procedures.

    Science.gov (United States)

    Gorgun, E; Benlice, C; Hammel, J; Hull, T; Stocchi, L

    2017-08-01

    The aim of the present study was to create a unique risk adjustment model for surgical site infection (SSI) in patients who underwent colorectal surgery (CRS) at the Cleveland Clinic (CC) with inherent high risk factors by using a nationwide database. The American College of Surgeons National Surgical Quality Improvement Program database was queried to identify patients who underwent CRS between 2005 and 2010. Initially, CC cases were identified from all NSQIP data according to case identifier and separated from the other NSQIP centers. Demographics, comorbidities, and outcomes were compared. Logistic regression analyses were used to assess the association between SSI and center-related factors. A total of 70,536 patients met the inclusion criteria and underwent CRS, 1090 patients (1.5%) at the CC and 69,446 patients (98.5%) at other centers. Male gender, work-relative value unit, diagnosis of inflammatory bowel disease, pouch formation, open surgery, steroid use, and preoperative radiotherapy rates were significantly higher in the CC cases. Overall morbidity and individual postoperative complication rates were found to be similar in the CC and other centers except for the following: organ-space SSI and sepsis rates (higher in the CC cases); and pneumonia and ventilator dependency rates (higher in the other centers). After covariate adjustment, the estimated degree of difference between the CC and other institutions with respect to organ-space SSI was reduced (OR 1.38, 95% CI 1.08-1.77). The unique risk adjustment strategy may provide center-specific comprehensive analysis, especially for hospitals that perform inherently high-risk procedures. Higher surgical complexity may be the reason for increased SSI rates in the NSQIP at tertiary care centers.

  9. Extracorporeal Treatment for Lithium Poisoning

    DEFF Research Database (Denmark)

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

    2015-01-01

    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......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 toxicokinetic data were extracted and summarized following a predetermined format. The entire workgroup voted through a two-round modified Delphi method to reach a consensus on voting statements. A RAND/UCLA Appropriateness Method was used to quantify disagreement, and anonymous votes were compiled...

  10. Extracorporeal Treatment for Salicylate Poisoning

    DEFF Research Database (Denmark)

    Juurlink, David N; Gosselin, Sophie; Kielstein, Jan T

    2015-01-01

    in poisoning. We conducted a systematic literature review followed by data extraction and summarized findings, following a predetermined format. The entire work group voted by a 2-round modified Delphi method to reach consensus on voting statements, using a RAND/UCLA Appropriateness Method to quantify......STUDY OBJECTIVE: Salicylate poisoning is a challenging clinical entity associated with substantial morbidity and mortality. The indications for extracorporeal treatments such as hemodialysis are poorly defined. We present a systematic review of the literature along with evidence- and consensus......-based recommendations on the use of extracorporeal treatment in salicylate poisoning. METHODS: The Extracorporeal Treatments in Poisoning (EXTRIP) Workgroup is a multidisciplinary group with international representation whose aim is to provide evidence-based recommendations on the use of extracorporeal treatments...

  11. 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...... articles, extracted data, summarized key findings, and proposed structured voting statements following a predetermined format. A 2-round modified Delphi method was used to reach a consensus on voting statements, and the RAND/UCLA Appropriateness Method was used to quantify disagreement. 617 articles met......-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...

  12. 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......CONTEXT: The Extracorporeal Treatments in Poisoning (EXTRIP) workgroup was created to provide evidence and consensus-based recommendations on the use of extracorporeal treatments (ECTRs) in poisoning. OBJECTIVES: To perform a systematic review and provide clinical recommendations for 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...

  13. FTIR analysis of food poisons

    Science.gov (United States)

    Yasui, Sritana C.

    1992-03-01

    Single and rapid analyses of chemical poisons or contaminants in different food matrices are explored. Various FT-IR accessories are utilized and compared for the detection sensitivity. Detection enhancements by combining with chromatographic techniques are investigated.

  14. 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)

  15. 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

  16. 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,

  17. Antidotes for acute cyanide poisoning.

    Science.gov (United States)

    Borron, Stephen W; Baud, Frederic J

    2012-08-01

    Cyanide poisoning can present in multiple ways, given its widespread industrial use, presence in combustion products, multiple physical forms, and chemical structures. The primary target of toxicity is mitochondrial cytochrome oxidase. The onset and severity of poisoning depend on the route, dose, physicochemical structure and other variables. Common poisoning features include dyspnea, altered respiratory patterns, abnormal vital signs, altered mental status, seizures, and lactic acidosis. Our present knowledge supports cyanide poisoning treatment based on excellent supportive care with adjunctive antidotal therapy. Multiple antidotes exist and vary in regional availability. All currently marketed antidotes appear to be effective. Antidotal mechanisms include chelation, formation of stable, less toxic complexes, methemoglobin induction, and sulfane sulfur supplementation for detoxification by endogenous rhodanese. Each antidote has advantages and disadvantages. For example, hydroxocobalamin is safer than the methemoglobin inducers in patients with smoke inhalation. Research for new, safer and more effective cyanide antidotes continues.

  18. Cyanide poisoning deaths in dogs.

    Science.gov (United States)

    Oruc, H H; Yilmaz, R; Bagdas, D; Ozyigit, M O

    2006-12-01

    In 2005, the deaths of three dogs were reported in Erdek, Turkey. Examining appropriate historical and clinical signs, postmortem findings and the discovery of cyanide in their stomachs and intestinal contents and livers supported a diagnosis of cyanide poisoning.

  19. 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 ...

  20. 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 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 should alert physicians to the possibility of scombroid fish poisoning. Unless complicated with shock or respiratory distress, supportive

  1. Amitraz poisoning treatment: still supportive?

    Science.gov (United States)

    Eizadi-Mood, Nastaran; Sabzghabaee, Ali Mohammad; Gheshlaghi, Farzad; Yaraghi, Ahmad

    2011-01-01

    Amitraz is a triazapentadiene, an α2 adrenergic agonist and a member of the amidine chemical family. A limited number of human intoxication cases have been published in the literature. Lack of a clear and specific protocol for the therapy of amitraz intoxication may make its successfully managed case reports useful and valuable for other clinical practitioners in poisoning departments. The case is about a 22 years old female, single, university student, ingested a glass of amitraz poison (about 100 mL of a 20% solution) as a suicidal attempt on 11:30 am which was about 3.5 h before her hospital admission. She found nausea, vomiting, and dizziness. Immediately, her family took her to a clinic near their house. At that clinic (13:30 pm) she had miosis and they did gastric lavage , one adult dose of activated charcoal (50 g) and referred her to our Poisoning Emergency Department, where she was managed supportively and successfully. Amitraz is a poisonous chemical which may cause central nervous system depression and also respiratory/cardiovascular symptoms as well. Several studies reported that using atropine for those amitraz poisoned patients with both miosis and bradycardia resolved the problem and recommend it as the first line of drug therapy when bradycardia occurs from vagal stimulation and atrioventricular block. Management of amitraz poisoning is still considered to be supportive and symptomatic. Although the effects of activated charcoal and cathartics have not been studied, they may still be considered for treatment.

  2. Methemoglobinemia in aluminum phosphide poisoning.

    Science.gov (United States)

    Shadnia, Shahin; Soltaninejad, Kambiz; Hassanian-Moghadam, Hossein; Sadeghi, Anahaita; Rahimzadeh, Hormat; Zamani, Nasim; Ghasemi-Toussi, Alireza; Abdollahi, Mohammad

    2011-03-01

    Acute aluminum phosphide (AlP) poisoning is one of the most common causes of acute pesticide poisoning in Iran. Hydrogen phosphide or phosphine gas is produced following reaction of AlP with water even at ambient humidity. Methemoglobinemia is a rare finding following phosphine poisoning. In this paper, two cases of fatal AlP poisoning complicated by methemoglobinemia are reported. Two patients presented following suicidal ingestion of AlP tablets. In the Emergency Department (ED), they received gastric lavage with sodium bicarbonate and potassium permanganate. Both of them received supportive care. In each case, hematuria and hemolysis were significant events. The patients also showed a decrease in O(2) saturation in spite of high FIO(2). Methemoglobin levels of 40% and 30% were detected by co-oximetry. Neither patient responded to treatment (ascorbic acid in one case, methylene blue in the other). Both patients died due to systemic effects of phosphine poisoning. Hemolysis and methemoglobinemia may complicate the course of phosphine poisoning that seems resistant to methylene blue and ascorbic acid. Therefore, other treatments including hyperbaric oxygen therapy and exchange blood transfusion should be considered.

  3. Risk-to-Benefit Ratio of Venous Thromboembolism Prophylaxis for Neurosurgical Procedures at a Quaternary Referral Center.

    Science.gov (United States)

    Agarwal, Nitin; Zenonos, Georgios A; Agarwal, Prateek; Walch, Frank J; Roach, Eileen; Stokes, Sandra J; Friedlander, Robert M; Gerszten, Peter C

    2018-03-09

    Pharmacological prophylaxis for venous thromboembolism (VTE) in the neurosurgical population is still a matter of debate, as the risk-to-benefit ratio is not well defined. To further evaluate the risk-to-benefit ratio of VTE prophylaxis (VTEP) for all neurosurgical procedures. A prospective evaluation was performed after the initiation of a VTEP protocol for 11 436 patients undergoing neurosurgical procedures over 24 mo. Unless a bleeding complication was present, 5000 international units of subcutaneous heparin every 8 h was ordered on postoperative day (POD) 1 for spine, POD2 for cranial, and by POD4 for subdural, intracerebral, and epidural hematoma cases. Incidence of VTE and any subsequent bleeding complications were noted. A total of 70 VTEs (0.6% overall) were documented (28 deep vein thrombosis, 42 pulmonary embnolism). The highest rates of VTE were associated with deformity (6.7%); open cerebrovascular (6.5%); subdural, intracerebral, and epidural hematoma (3.2%); spinal trauma (2.4%); and craniotomy for tumor (1.6%) cases. Seven cases of deep vein thrombosis progressed to pulmonary embolisms, and 66 of 70 VTEs occurred while on pharmacological VTEP. Fifty-four bleeding complications occurred on or after POD2 following initiation of VTEP. These bleeding complications consisted of any new clinically or radiographically observed hemorrhages. Twenty-eight of the 54 delayed bleeding complications required operative intervention with 1 mortality. Forty-five patients were on anticoagulation when the initial bleeding event occurred. Overall, an estimated 0.5% incidence of delayed bleeding complications was noted with 99.4% of patients within the study cohort remaining VTE free. This VTEP protocol was determined to afford a good risk-to-benefit ratio for a wide variety of neurosurgical procedures.

  4. A Case Report of Poisoning Caused by Incorrect Use of Salvia

    Science.gov (United States)

    Yang, Xianyi; Chen, Danyang; Chai, Lin; Duan, Hui; Guo, Hui; Li, Shuang; Xiao, Min; Chen, Hongxia

    2016-01-01

    Patient: Female, 54 Final Diagnosis: Salvia intoxication Symptoms: Frequent nausea Medication: Thyroxine Clinical Procedure: — Specialty: Hematology Objective: Unusual clinical course Background: Previous reports suggest that homoplantaginin, one of the compounds isolated from Salvia plebeia, has a protective and therapeutic effect on hepatocyte injury. We present a case of serious liver and kidney damage due to incorrect use of Salvia plebeia in a patient with a history of thyroid tumorectomy, who was successfully treated for poisoning with blood purification and systemic, comprehensive critical care. Case Report: A 54-year-old female patient with salvia intoxication combined with multiple organ dysfunction was transported to our emergency center by ambulance after presenting with nausea, vomiting, and skin yellowing. On arrival, she exhibited fatigue, dizziness, lightheadedness, yellowish discoloration of her skin, breathing difficulties, and low back pain, all of which was suggestive of salvia intoxication combined with multiple organ dysfunction. The treatment strategy was to immediately speed up the excretion of toxins and administered blood purification therapy. She also displayed disseminated intravascular coagulation (DIC), which was successfully treated with plasma infusion of blood coagulation factor combined with LMWH acupuncture therapy. Conclusions: Salvia plebeia should only be considered for use in patients who have infectious disease or oxidative stress related disease and only at an appropriate dose. In addition, for patients with salvia poisoning, prompt administration of blood purification therapy and systemic comprehensive measures involving multiple supportive therapies can save such patients. PMID:27523588

  5. 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

  6. Histamine Food Poisoning.

    Science.gov (United States)

    Schirone, Maria; Visciano, Pierina; Tofalo, Rosanna; Suzzi, Giovanna

    2017-01-01

    The consumption of food containing high amounts of histamine and other biogenic amines can cause food poisoning with different symptoms linked to the individual sensitivity and the detoxification activity. Histamine is the only biogenic amine with regulatory limits set by the European Commission in fish and fishery products, because it can lead to a fatal outcome. However, also fermented foods can be involved in outbreaks and sporadic cases of intoxication. The factors affecting the presence of histamine in food are variable and product specific including the availability of the precursor amino acid, the presence of microorganisms producing decarboxylases, and the conditions allowing their growth and enzyme production. Generally, the good quality of raw material and hygienic practices during food processing as well as the use of histidine decarboxylase-negative starter cultures can minimize the occurrence of histamine. Further studies are necessary to estimate the human exposure and the relationship between the total amount of the biogenic amines ingested with food and health effects.

  7. 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.

  8. Emetogenicity-risk procedures in same day surgery center of an academic university hospital in United States: a retrospective cost-audit of postoperative nausea vomiting management.

    Science.gov (United States)

    Gupta, Deepak; Haber, Halim

    2014-06-01

    Despite the variable results of published studies, it is imperative for ambulatory surgery centers to self-audit local cost-implications for post-operative nausea and vomiting (PONV) management. Our retrospective cost-audit assessed if there were comparative peri-anesthesia care cost-trends among patients who had undergone Low-Emetogenicity-Risk Procedures (LERP), Moderate-Emetogenicity-Risk Procedures (MERP) and Severe-Emetogenicity-Risk Procedures (SERP). This study was a review of Same Day Surgery Center practices in an academic university hospital setting during a three-year period (2010-2012). The patient lists were accessed from CIS and CITRIX App Bar for time audit and OR (operating room) schedule reports. Subsequently, OR pharmacy department ran a search for peri-operative anti-emetics and opioids that were billed for the patients at Same Day Surgery Center for the review period. The primary outcomes were the comparative costs/charges of these medications and comparative durations/ charges for these patients' stay in the post-anesthesia care unit (PACU). Secondary outcomes analyzed in the study included peri-anesthesia durations. A total of 8,657 patient records were analyzed. Almost all analyzed variables revealed statistically significant inter-variable positive correlations. The patients' age was significantly (P < 0.001) different among LERP/MERP/SERP patients (LERP: 48.8 +/- 14.7 years; MERP: 61.8 +/- 14.6 years; SERP: 51.3 +/- 14.5 years). In regards to primary and secondary outcomes, the statistical significant differences among LERP/MERP/SERP patients (after correcting for both patients' age as well as patients' sex) were only achieved for preoperative times (P = 0.002; Power = 0.9), operating room recovery times (P = 0.003; Power = 0.9), PACU stay times (P < 0.001; Power = 1.0), and PACU charges (P < 0.001; Power = 1.0). PACU stay times and PACU charges were significantly higher in patients who had undergone SERP as compared to patients who had

  9. Medicine poisoning in suicidal pathology

    Directory of Open Access Journals (Sweden)

    Ljušic Dragan

    2015-01-01

    Full Text Available Introduction: Investigations shows that on every realized suicide comes 8 to 25 non realized attempts. Individuals which tried suicide with medicine poisoning mostly quote that they have been overwhelmed with feelings and thoughts which was unbearable in that moment. They wished to escape from that unbearable situation or they lost self control. Between individuals whom tried suicide with medicine poisoning, desire to really die, to disappear was very rare. Mostly it was wish 'just to sleep a little, to take a rest, make pause'. Aim of work: to identified most frequently method for suicidal attempt in both sex and resources which was used in these purposes. Results: most frequently method for suicidal attempt for both sex in our investigation was medicine poisoning - 91,1%, veins cutting - 5,4% and jump from height - 3,6%. Mostly used medicines were anxiolytics - 55,4%, combination of different drugs - 25,0%, antidepressants - 8,9%, neuroleptics - 7,1%, drugs and alcohol - 3,6%. Most frequent method for suicidal attempt in both sex was medicine poisoning. From drugs most frequently used drugs were anxiolytics and in minimum percent combination of drugs and alcohol. After suicidal attempt 90% of individuals experienced relief because their suicidal attempt was unsuccessful. In 3% individuals there was new suicidal attempt on same way, medicine poisoning.

  10. Should excretory urography be used as a routine diagnostic procedure in patients with acute ureteric colic: A single center study

    Directory of Open Access Journals (Sweden)

    Osama A Samara

    2011-01-01

    Full Text Available The aim of this study was to find an accurate, easily available and safe imaging modality as an alternative to intravenous urography for the diagnosis of acute urinary obstruction. This retrospective study included 332 patients, who underwent both excretory urography (EU preceeded by plain radiograph as well as ultrasonography for evaluation of acute flank pain. There were 198 male and 134 female patients. The presence or absence of urinary stones, level of obstruction, excretion delay on EU and dilated excretory system on either or both techniques were recorded. The sensitivity, specificity, predictive values, and accuracy for plain radiograph, ultrasonography, and for both modalities together were measured considering EU as a standard reference. The sensitivity and specificity of combined plain radiograph and ultrasound were 97% and 67%, respectively, with positive and negative predictive values and accuracy rates of 92%, 99%, and 97%, respectively. Our study suggests that the combination of plain radiograph and ultrasonography yields a high sensitivity, negative predictive value, and accuracy in depiction of urinary stones. Thus, EU need not be used as a routine diagnostic procedure in patients with acute obstructive uropathy.

  11. Should excretory urography be used as a routine diagnostic procedure in patients with acute ureteric colic: a single center study.

    Science.gov (United States)

    Samara, Osama A; Haroun, Dina A; Ashour, Do'a Z; Tarawneh, Emad S; Haroun, Azmi A

    2011-05-01

    The aim of this study was to find an accurate, easily available and safe imaging modality as an alternative to intravenous urography for the diagnosis of acute urinary obstruction. This retrospective study included 332 patients, who underwent both excretory urography (EU) preceeded by plain radiograph as well as ultrasonography for evaluation of acute flank pain. There were 198 male and 134 female patients. The presence or absence of urinary stones, level of obstruction, excretion delay on EU and dilated excretory system on either or both techniques were recorded. The sensitivity, specificity, predictive values, and accuracy for plain radiograph, ultrasonography, and for both modalities together were measured considering EU as a standard reference. The sensitivity and specificity of combined plain radiograph and ultrasound were 97% and 67%, respectively, with positive and negative predictive values and accuracy rates of 92%, 99%, and 97%, respectively. Our study suggests that the combination of plain radiograph and ultrasonography yields a high sensitivity, negative predictive value, and accuracy in depiction of urinary stones. Thus, EU need not be used as a routine diagnostic procedure in patients with acute obstructive uropathy.

  12. An update on radiation absorbed dose to patients from diagnostic nuclear medicine procedures in Tehran: A study on four academic centers

    Science.gov (United States)

    Motazedian, Motahareh; Tabeie, F; Vatankhah, P; Shafiei, B; Amoui, M; Atefi, M; Ansari, M; Asli, I Neshandar

    2016-01-01

    Purpose: Use of radiopharmaceuticals for diagnostic nuclear medicine procedures is one of the main sources of radiation exposure. We performed this study with respect to the rapid growth in nuclear medicine in Iran and lack of updated statistics. Materials and Methods: The data were obtained for all active Nuclear Medicine Centers affiliated to Shahid Beheshti University of Medical Sciences during 2009 and 2010. Results: The most frequently performed procedures were bone (30.16%), cardiac (28.96%), renal (17.97%), and thyroid (7.93%) scans. There was a significant decrease in the number of thyroid scintigraphies with 131I and 99mTc-sulfur colloid liver/spleen scans and tremendous increase in the frequencies of cardiac and bone scintigraphies compared to one decade ago. Conclusion: Compared to previous studies, there were striking changes in trends of diagnostic nuclear medicine procedures in Tehran. This field is still evolving in the country, and this trend will further change with the introduction of positron emission tomography scanners in future. PMID:27095860

  13. 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.

  14. 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

  15. Evaluation of radiation protection and technical procedures in Wad Madani Heart Diseases and Surgery Center (WHDSC) (cardiac catheterization laboratory)

    International Nuclear Information System (INIS)

    Gesmallah, A. H. A.

    2013-07-01

    The purpose of this study is conducted in order to evaluate the application of radiation protection program, evaluate the design of cardiac catheterization laboratory, evaluate the effectiveness of radiation protection devices, evaluate personal monitoring, usage of G-Arm x-ray machine, to evaluate the responsibilities of radiation protection officer (RPO), to assess monitoring devices if available, and to assess patient patient dose in Wad Madani hear disease and surgery center in a period from march 2013 to june 2013. The most data in this study was obtained from the results of the team of quality assurance and control of radiation safety institute when they visited hospital on 14/2/2011 for inspection and calibration for issue of registration and licenses, except the data of patients dose which obtained from exposure parameters and dosimetric information's in the archive of G-arm x-ray fluoroscopic machine (which were 110 of cardiac catheterization diagnostic and therapeutic cases, 60 of adult patients and 50 of children. The patient data included age, weight, kv, mAs, DAP, air kerma, and fluoro time. The results of this study show that there is radiation protection program need correction and partially applied, the design of cardiac catheterization laboratory is accepted according to radiation safety institute team of quality control. Also the study shows that the radiation protection program devices are available and good condition and enough in number. The study shows that there are no personal monitoring devices and services and the radiological technologist are well trained to dial with the G-arm x-ray machine and to apply the radiation protection program effectively. Also the study states that the radiation protection officer could apply his responsibilities partially. Finally the study shows that there is a direct linear relationship between the patient's weight and (DAP, air kerma, kv, and mAs) concludes that there is excessive radiation dose in cardiac

  16. 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......, extracted data, summarized findings, and proposed structured voting statements following a predetermined format. A 2-round modified Delphi method was used to reach a consensus on voting statements, and the RAND/UCLA Appropriateness Method was used to quantify disagreement. 51 articles met the inclusion......) 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...

  17. Extracorporeal treatment for digoxin poisoning

    DEFF Research Database (Denmark)

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

    2016-01-01

    BACKGROUND: The Extracorporeal Treatments in Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatments (ECTR) in poisoning. Here, we present our results for digoxin. METHODS: After a systematic literature search, clinical and toxicokinetic data were...... extracted and summarized following a predetermined format. The entire workgroup voted through a two-round modified Delphi method to reach a consensus on voting statements. A RAND/UCLA Appropriateness Method was used to quantify disagreement, and anonymous votes were compiled and discussed in person...... recommended against the use of ECTR in cases of severe digoxin poisoning when Fab was available (1D) and also suggested against the use of ECTR when Fab was unavailable (2D). CONCLUSION: ECTR, in any form, is not indicated for either suspected or proven digoxin toxicity, regardless of the clinical context...

  18. 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......BACKGROUND: Metformin toxicity, a challenging clinical entity, is associated with a mortality of 30%. The role of extracorporeal treatments such as hemodialysis is poorly defined at present. Here, the Extracorporeal Treatments In Poisoning workgroup, comprising international experts representing......) and made the following recommendations: extracorporeal treatment is recommended in severe metformin poisoning (1D). Indications for extracorporeal treatment include lactate concentration greater than 20 mmol/L (1D), pH less than or equal to 7.0 (1D), shock (1D), failure of standard supportive measures (1D...

  19. [Acute poisoning with industrial products].

    Science.gov (United States)

    Garnier, R

    2000-02-15

    Poisonings with industrial products represent approximately 7% of the cases reported to the poison centres. Ingestion of petroleum distillates induces irritation of the gastrointestinal tract, central nervous system depression and aspiration pneumonitis which may be severe; treatment is mainly supportive. Ethylene and diethylene glycol poisonings produce central nervous system depression, anion gap metabolic acidosis, osmolar gap and acute tubular necrosis; in severe cases, hypocalcaemia, cerebral oedema and heart failure may be observed; treatment often associates supportive measures, haemodialysis and administration of competitive inhibitors of alcohol dehydrogenase (ethanol or 4-methylpyrazole). Glycol ethers induce central nervous system depression and metabolic acidosis; in addition, ethylene glycol monobutyl ether produces haemolysis; monomethyl and monoethyl ethers are responsible for bone marrow and lymphoid organ toxicity, they adversely affect spermatogenesis and are teratogens.

  20. Poisonous birds: A timely review.

    Science.gov (United States)

    Ligabue-Braun, Rodrigo; Carlini, Célia Regina

    2015-06-01

    Until very recently, toxicity was not considered a trait observed in birds, but works published in the last two decades started to shed light on this subject. Poisonous birds are rare (or little studied), and comprise Pitohui and Ifrita birds from Papua New Guinea, the European quail, the Spoor-winged goose, the Hoopees, the North American Ruffed grouse, the Bronzewings, and the Red warbler. A hundred more species are considered unpalatable or malodorous to humans and other animals. The present review intends to present the current understanding of bird toxicity, possibly pointing to an ignored research field. Whenever possible, biochemical characteristics of these poisons and their effects on humans and other animals are discussed, along with historical aspects of poison discovery and evolutionary hypothesis regarding their function. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Radiopharmaceutical activities administered for diagnostic procedures in nuclear medicine in the first six months of the gamma camera use in the Clinical Center of Montenegro - Podgorica

    International Nuclear Information System (INIS)

    Antovic, Nevenka; Aligrudic, Irena

    2008-01-01

    Nuclear medicine procedures have carried out in the Clinical Center of Montenegro - Podgorica since 2006 by the dual-headed SPECT and Digital gamma camera NUCLINE Spirit DH-V. In the first six months of the gamma camera use (from September 2006 to March 2007) examinations of skeleton, kidneys, thyroid and lung were performed. For diagnostic skeletal imaging (102 patients) the radiopharmaceutical 99m Tc-MDP is used, and administered activities were in the range from 555 to 740 MBq. For thyroid imaging (203 patients) 99m Tc-pertechnetate is used, and administered activities were in the range (37-111) MBq. Lung imaging is performed for 3 patients, using 99m Tc-MAA and administered activities in the range (111-185) MBq. Renal imaging is carried out for 72 patients: 42 dynamic studies of kidneys were performed with 99m Tc-DTPA and administered activities from 207 to 282 MBq, and 30 static kidneys scintigraphies were performed using the radiopharmaceutical 99m Tc-DMSA. 6 patients in the last mentioned group were children with year of birth between 2000 and 2006, and administered activities were from 16.6 to 55.5 MBq. In the same group, activities 28.5 MBq, 74.4 MBq and 120 MBq were administered to three patients with age between 6 and 18 years, and in the other cases, administered activities to the patients (adults) were in the range (59.2 to 196) MBq. The administered activities presented here are basis for further estimations of cumulated activity and absorbed dose to the various organs, which is useful for comparison of the average dose to patient organs in various nuclear medicine procedures and calculation of effective dose equivalent and total effective dose, significant for an estimation of potential risk due to the radioactivity administered to a patient during nuclear medicine procedures. It is very important for procedures optimization and improvement of the radiation protection. (author)

  2. 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.

  3. Performance predictions and manufacturing concerns of burnable poison rods

    International Nuclear Information System (INIS)

    Copeland, R.A.; Buescher, B.J.

    1977-01-01

    Burnable poison rods for reactors designed by B and W consist of low density pellets, composed of boron carbide dispersed in an alumina matrix (Al 2 O 3 --B 4 C), which are contained in Zircaloy-4 tubes. To predict reliable operation of these rods, the irradiation behavior of the components must be known. Performance models were developed based on experimental irradiation data. During rod fabrication, care must be taken to limit the amount of hydrogen in the rod because of the propensity of Zircaloy to hydride in the presence of high levels of hydrogen. Furthermore, the hygroscopic nature of alumina dictates that care must be taken to avoid moisture (a primary source of hydrogen) in the rods. Manufacturing and quality testing procedures have been developed to provide conformance to the design criteria. Examinations have been performed on irradiated burnable poison rods which verify the adequacy of both performance models and manufacturing procedures

  4. Acute Alopecia: Evidence to Thallium Poisoning

    OpenAIRE

    Senthilkumaran, Subramanian; Balamurugan, Namasivayam; Jena, Narendra Nath; Menezes, Ritesh G; Thirumalaikolundusubramanian, Ponniah

    2017-01-01

    Thallium is a toxic heavy metal often involved in criminal poisonings and occasionally in accidental poisoning. Here, we report a case of acute, nonintentional thallium poisoning due to thallium-contaminated alternative medicine for its rarity and to create awareness about the combination of rapid, diffuse alopecia with neurologic and gastrointestinal symptoms among practitioners, professionals, public, and policymakers.

  5. Accidental Datura stramonium poisoning in a dog.

    Science.gov (United States)

    Tostes, Raimundo A

    2002-02-01

    Datura stramonium is potentially poisonous to humans and livestock; however, there's little description of clinical and pathological findings in dogs naturally intoxicated. We report an accidental Datura stramonium poisoning in a dog emphasizing the importance of recognizing the classical signs of anticholinergic poisoning.

  6. Acute Alopecia: Evidence to Thallium Poisoning.

    Science.gov (United States)

    Senthilkumaran, Subramanian; Balamurugan, Namasivayam; Jena, Narendra Nath; Menezes, Ritesh G; Thirumalaikolundusubramanian, Ponniah

    2017-01-01

    Thallium is a toxic heavy metal often involved in criminal poisonings and occasionally in accidental poisoning. Here, we report a case of acute, nonintentional thallium poisoning due to thallium-contaminated alternative medicine for its rarity and to create awareness about the combination of rapid, diffuse alopecia with neurologic and gastrointestinal symptoms among practitioners, professionals, public, and policymakers.

  7. Pleural effusion in aluminum phosphide poisoning

    Directory of Open Access Journals (Sweden)

    Kranti Garg

    2012-01-01

    Full Text Available Aluminium phosphide (ALP is a common agrochemical pesticide poisoning with high mortality rate. Primary manifestations are due to myocardial and gastrointestinal involvement. Pleural effusion in ALP poisoning is occasionally reported. We report a case of pleural effusion that developed after ALP ingestion and resolved along with recovery from poisoning.

  8. Pleural effusion in aluminum phosphide poisoning.

    Science.gov (United States)

    Garg, Kranti; Mohapatra, Prasanta R; Sodhi, Mandeep K; Janmeja, Ashok K

    2012-10-01

    Aluminium phosphide (ALP) is a common agrochemical pesticide poisoning with high mortality rate. Primary manifestations are due to myocardial and gastrointestinal involvement. Pleural effusion in ALP poisoning is occasionally reported. We report a case of pleural effusion that developed after ALP ingestion and resolved along with recovery from poisoning.

  9. Pleural effusion in aluminum phosphide poisoning

    OpenAIRE

    Garg, Kranti; Mohapatra, Prasanta R.; Sodhi, Mandeep K.; Janmeja, Ashok K.

    2012-01-01

    Aluminium phosphide (ALP) is a common agrochemical pesticide poisoning with high mortality rate. Primary manifestations are due to myocardial and gastrointestinal involvement. Pleural effusion in ALP poisoning is occasionally reported. We report a case of pleural effusion that developed after ALP ingestion and resolved along with recovery from poisoning.

  10. 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,…

  11. Amitraz, an underrecognized poison: A systematic review

    OpenAIRE

    Sahajal Dhooria; Ritesh Agarwal

    2016-01-01

    Background & objectives: Amitraz is a member of formamidine family of pesticides. Poisoning from amitraz is underrecognized even in areas where it is widely available. It is frequently misdiagnosed as organophosphate poisoning. This systematic review provides information on the epidemiology, toxicokinetics, mechanisms of toxicity, clinical features, diagnosis and management of amitraz poisoning. Methods: Medline and Embase databases were searched systematically (since inception to January...

  12. 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.

  13. 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.

  14. Venomous bites, stings, and poisoning.

    Science.gov (United States)

    Warrell, David A

    2012-06-01

    This article discusses the epidemiology, prevention, clinical features, first aid and medical treatment of venomous bites by snakes, lizards, and spiders; stings by fish, jellyfish, echinoderms, and insects; and poisoning by fish and molluscs, in all parts of the world. Of these envenoming and poisonings, snake bite causes the greatest burden of human suffering, killing 46,000 people each year in India alone and more than 100,000 worldwide and resulting in physical handicap in many survivors. Specific antidotes (antivenoms/antivenins) are available to treat envenoming by many of these taxa but supply and distribution is inadequate in many tropical developing countries. Copyright © 2012. Published by Elsevier Inc.

  15. [Analysis of characteristics of acute poisoning caused by various poisons in Guangxi, China].

    Science.gov (United States)

    Hu, De-hong; Zhang, Zhen-ming; Liu, Qing-hua; Jiang, Dong-fang

    2013-11-01

    To investigate the characteristics of acute poisonings caused by various poisons in Guangxi, China. A retrospective investigation was performed in 5859 cases of acute poisonings who were admitted to 63 hospitals in 11 cities, as well as 531 types of poisons involved. The poisons were categorized into 6 groups; each group of cases was stratified by the rural or urban settings, frequency of poisoning, and cause of poisoning to analyze the numbers of cases and constituent ratios. Most types of poisons (68.74%) belonged to drugs (217 types) and pesticides (148 types). Most cases of poisonings (61.63%) were caused by pesticides (n = 2547) and chemicals (n = 1064). Pesticides, poisons of plant origins, and poisons of animal origins were responsible for most of the cases in rural settings; 88.46%, 79.10%, and 66.74% of the cases of these poison categories happened in rural settings. Chemicals, drugs, and other poisons were responsible for most of the cases in urban settings; 70.20%, 61.74%, and 63.73% of the cases of these poison categories happened in urban settings. The numbers of cases in 5-year-poisoning groups were the highest in all categories of poisons, accounting for 85.24%, 88.57%, 55.16%, 70.79%, 68.36%, and 66.44%of cases of respective categories. Most cases of poisonings by chemicals, poisons of animal origin, and other poisons were accident-related (86.24%, 72.66%, and 46.71%of the poison categories). Most cases of poisonings by pesticides and drugs were suicide-related (59.39% and 33.52% of the poison categories). Most cases by poisons of plant origin were caused by accidental ingestion (70.36% of the poison category). Most of the acute poisonings in Guangxi area are caused by pesticides and chemicals; the most common causes of poisoning are accidents, accidental ingestion, and suicide. There are significant differences in the causes of acute poisonings between the urban and rural settings.

  16. 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.

  17. Comparison of the Poisoning Severity Score and National Poison Data System schemes for the severity assessment of animal poisonings: a pilot study.

    Science.gov (United States)

    McFarland, Sarah E; Bronstein, Alvin C; Banerji, Shireen; LeBlond, Jane; Mischke, Reinhard H; Begemann, Kathrin; Desel, Herbert; Greiner, Matthias

    2017-08-01

    To date, there are no publicly available schemes designed and evaluated specifically for severity assessment of animal poisonings. This poses challenges for the evaluation and comparison of animal poisoning exposure data. Our objective for this pilot study was to evaluate agreement between raters using the Poisoning Severity Score (PSS) and National Poison Data System (NPDS) medical outcome scheme for severity assessment of canine exposures reported to a multistate poison center (PC) and to identify issues regarding their use for severity assessment of animal poisonings. Agreement between both schemes was also assessed. The first 196 canine exposures reported to a multistate PC between 1 January and 31 August 2016 were selected and initial inquiry data from exposures was scored by four independent raters. Interrater agreement and agreement between the severity systems was calculated using weighted kappa (Κ) (Light's kappa). Reported clinical effects were also described. Interrater agreement for both the PSS (Κ 0.31; 95% CI 0.19, 0.43) and NPDS schemes (Κ 0.34; 95% CI 0.22, 0.44) was low. Agreement between the schemes was slight (Κ 0.05; 95% CI -0.08, 0.16) for pooled results from all four raters. For the PSS, 71.7% (n = 281) of ratings were minor, 23.0% (n = 90) moderate, and 5.4% (n = 21) severe. For the NPDS, 69.6% (n = 273) of ratings were minor, 27.0% (n = 106) moderate, and 3.3% (n = 13) severe. The top three reported clinical effects included vomiting (n = 86, 29.9%) drowsiness/lethargy (n = 38, 13.2%), and diarrhea (n = 24, 8.3%). This study shows considerable variability between raters using either the PSS or NPDS schemes for canine exposures severity assessment. The subjective nature of the schemes, the influence of intra- and interrater variation, and predominance of minor cases on the study findings should be taken into account when interpreting this data. Further evaluation of these schemes is warranted and could

  18. Risk factors for surgical site infection following nonshunt pediatric neurosurgery: a review of 9296 procedures from a national database and comparison with a single-center experience

    Science.gov (United States)

    Sherrod, Brandon A.; Arynchyna, Anastasia A.; Johnston, James M.; Rozzelle, Curtis J.; Blount, Jeffrey P.; Oakes, W. Jerry; Rocque, Brandon G.

    2017-01-01

    operation (OR 1.843, 95% CI 1.011–3.360, p = 0.046), spine procedures (OR 1.673, 95% CI 1.036–2.702, p = 0.035), acquired CNS abnormality (OR 1.620, 95% CI 1.085–2.420, p = 0.018), and female sex (OR 1.475, 95% CI 1.062–2.049, p = 0.021). The only COA factor independently associated with SSI in the COA database included clean-contaminated wound classification (OR 3.887, 95% CI 1.354–11.153, p = 0.012), with public insurance (OR 1.966, 95% CI 0.957–4.041, p = 0.066) and spine procedures (OR 1.982, 95% CI 0.955–4.114, p = 0.066) approaching significance. Both NSQIP-P and COA multivariate model C-statistics were > 0.7. Conclusions NSQIP-P SSI rates, but not risk factors, were similar to data from a single center. PMID:28186476

  19. Risk factors for surgical site infection following nonshunt pediatric neurosurgery: a review of 9296 procedures from a national database and comparison with a single-center experience.

    Science.gov (United States)

    Sherrod, Brandon A; Arynchyna, Anastasia A; Johnston, James M; Rozzelle, Curtis J; Blount, Jeffrey P; Oakes, W Jerry; Rocque, Brandon G

    2017-04-01

    .843, 95% CI 1.011-3.360, p = 0.046), spine procedures (OR 1.673, 95% CI 1.036-2.702, p = 0.035), acquired CNS abnormality (OR 1.620, 95% CI 1.085-2.420, p = 0.018), and female sex (OR 1.475, 95% CI 1.062-2.049, p = 0.021). The only COA factor independently associated with SSI in the COA database included clean-contaminated wound classification (OR 3.887, 95% CI 1.354-11.153, p = 0.012), with public insurance (OR 1.966, 95% CI 0.957-4.041, p = 0.066) and spine procedures (OR 1.982, 95% CI 0.955-4.114, p = 0.066) approaching significance. Both NSQIP-P and COA multivariate model C-statistics were > 0.7. CONCLUSIONS The NSQIP-P SSI rates, but not risk factors, were similar to data from a single center.

  20. 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

  1. 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

  2. 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

  3. Fuel elements containing burnable poison

    International Nuclear Information System (INIS)

    Bamber, K.J.; Eaton, C.W.

    1989-01-01

    A burnable poison such as gadolinia is introduced into a nuclear fuel pin by way of thermal insulating pellets which serve to protect end caps from exposure to the intense heat generated by the fuel during irradiation. The pellets may comprise a sintered mixture of aluminia and gadolinia. (author)

  4. [Poisonous animals registration in Poland].

    Science.gov (United States)

    Mitrus, Małgorzata; Szkolnicka, Beata; Satora, Leszek; Morawska, Jowanka

    2005-01-01

    The Act on Nature Conservation of 16.04.2004 (Official Journal, 2004, No 92, item 880) imposes on private individuals the duty to register some animals. The data collected by Kraków municipal authorities and delivered to the Poison Information Centre (Colleglum Medicum, Jagiellonian University) indicate that there are following species in private hands in the city and its surroundings: 11 individuals of Naja naja, 2--Hydrodynates gigas and 55-- Dendrobates spp. According to these information the employees of the PIC elaborated the advice on the treatment of specific animals' poisoning. In the period May 2003 - May 2004 (before the above Act came into force) there were 143 individuals from Brachypelma genus and 3 scorpions (Pandinus imperator) registered in Krakow. These species produce venoms which take local effect. According to art. 64 (1) of the above Act it is compulsory to register amphibians, reptiles, birds and mammals. However, it would be desirable to introduce the duty to register also dangerous species of invertebrates and fishes. It would provide the complete list of poisonous animals kept in private hands. Thus, it would be possible to estimate any possible threats and to elaborate adequate treatment in case of specific animals' poisoning.

  5. Poisoning Safety Fact Sheet (2015)

    Science.gov (United States)

    ... and Control Website. Unintentional poisoning fatalities and nonfatal injuries, children ages 19 and under. Available from: http: / / www. cdc. gov/ injury/ wisqars/ . Accessed February 23, ... In-Depth Look at Keeping Young Children Safe Around Medicine. Washington, DC: Safe Kids Worldwide, ...

  6. Intensive therapy for chloroquine poisoning

    African Journals Online (AJOL)

    lavage, intravenous diazepam, mechanical ventilation when necessary, and occasionally inotropic infusions. Four patients suffered cardiac arrest during gastric lavage. There were 6 deaths (mortality 20.7%). Conclusions. This study indicates the common clinical features of acute chloroquine poisoning. A survival rate of.

  7. 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

  8. 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.

  9. [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.

  10. 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.

  11. 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

  12. General procedure for the calculation of accurate defect excitation energies from DFT-1/2 band structures: The case of the NV- center in diamond

    Science.gov (United States)

    Lucatto, Bruno; Assali, Lucy V. C.; Pela, Ronaldo Rodrigues; Marques, Marcelo; Teles, Lara K.

    2017-08-01

    A major challenge in creating a quantum computer is to find a quantum system that can be used to implement the qubits. For this purpose, deep centers are prominent candidates, and ab initio calculations are one of the most important tools to theoretically study their properties. However, these calculations are highly involved, due to the large supercell needed, and the computational cost can be even larger when one goes beyond the Kohn-Sham scheme to correct the band gap problem and achieve good accuracy. In this work, we present a method that overcomes these problems and provides the optical transition energies as a difference of Kohn-Sham eigenvalues; even more, provides a complete and accurate band structure of the defects in a semiconductor. Despite the original motivations, the presented methodology is a general procedure, which can be used to systematically study the optical transitions between localized levels within the band gap of any system. The method is an extension of the low-cost and parameter-free DFT-1/2 approximate quasiparticle correction, and allows it to be applied in the study of complex defects. As a benchmark, we apply the method to the NV- center in diamond. The agreement with experiments is remarkable, with an accuracy of 0.1 eV. The band structure agrees with the expected qualitative features of this system, and thus provides a good intuitive physical picture by itself.

  13. Definitive evidence for the acute sarin poisoning diagnosis in the Tokyo subway.

    Science.gov (United States)

    Nagao, M; Takatori, T; Matsuda, Y; Nakajima, M; Iwase, H; Iwadate, K

    1997-05-01

    A new method was developed to detect sarin hydrolysis products from erythrocytes of four victims of sarin (isopropylmethylphosphonofluoridate) poisoning resulting from the terrorist attack on the Tokyo subway. Sarin-bound acetylcholinesterase (AChE) was solubilized from erythrocyte membranes of sarin victims, digested with trypsin, the sarin hydrolysis products bound to AChE were released by alkaline phosphatase digestion, and the digested sarin hydrolysis products were subjected to trimethylsilyl derivatization and detected by gas chromatography-mass spectrometry. Isopropylmethylphosphonic acid, which is a sarin hydrolysis product, was detected in all sarin poisoning, victims we examined and methylphosphonic acid, which is a sarin and soman hydrolysis product, was determined in all victims. Postmortem examinations revealed no macroscopic and microscopic findings specific to sarin poisoning and sarin and its hydrolysis products were almost undetectable in their blood. We think that the procedure described below will be useful for the forensic diagnosis of acute sarin poisoning.

  14. 16 CFR 1700.20 - Testing procedure for special packaging.

    Science.gov (United States)

    2010-01-01

    .... 1700.20 Section 1700.20 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION POISON PREVENTION PACKAGING ACT OF 1970 REGULATIONS POISON PREVENTION PACKAGING § 1700.20 Testing procedure for special... and color(s) (e.g., white polypropylene). 8. Closure liner material. 9. TAC seal material. 10. Opening...

  15. Minimum patterns of initial assistance given on the toxicological emergency to approach a poisoned child

    Directory of Open Access Journals (Sweden)

    Erika Okuda Tavares

    2012-04-01

    Full Text Available The present study aimed at presenting the minimum patterns of initial assistance to be given to poisoned children in an emergency room of a University Hospital. The construction of the minimum patterns the module IV Initial Assistance to the Poisoned Patient, from the Course of Toxicology promoted by the National Agency of Sanitary Surveillance (ANVISA, documents and technician-scientific literature about the theme, and the authors' experience in a center of toxicological information were used as a guideline. The minimum pattern comprised the structure and the assistance process. One of the limitations found here was the inexistence of consistent references regarding the initial assistance to the poisoned; however it is believed that the established patterns in this study can contribute for the initial assistance to poisoned and their families in emergency room units.

  16. Fatal aluminum phosphide poisoning in Tehran-Iran from 2007 to 2010.

    Science.gov (United States)

    Soltaninejad, Kambiz; Nelson, Lewis S; Bahreini, Seyed Ali; Shadnia, Shahin

    2012-01-01

    Aluminum phosphide (AlP) is also known as "rice tablet" in Iran. Due to the high incidence of acute AlP poisoning and its associated mortality in Iran, the authorities banned AlP-containing tablets in 2007. The aim of this study is to evaluate the trend of acute fatal AlP poisoning subsequent to this restriction. 0 This is a retrospective chart review of patients with acute "rice tablet" poisoning who were admitted to Loghman Hakim Hospital Poison Center, Tehran, Iran, from 2007 to 2010. Collected information included gender, age, type of poisoning, marital status, duration of hospitalization, and outcome. There were 956 cases with a mortality rate of 24.06%. The incidence of fatal AlP poisoning was 2.1 and 5.81 per one million populations of Tehran in 2007 and 2010, respectively. In 223 of the fatal cases (97%) and 697 of the non-fatal cases (96%), the poisoning was intentional. The male to female ratio in the fatal and non-fatal cases was 1.04:1 and 1:1.3, respectively. Most of the fatal cases (n = 122, 53%) were unmarried. The mean age was 27.32 ± 11.31 and 24.5 ± 8.19 years in fatal and non-fatal cases, respectively. In 196 (85.2%) of the fatal cases and in 577 (79%) of non-fatal cases, the duration of hospitalization was less than 24 hours and between 48-72 hours, respectively. The results of this study showed the incidence of "rice tablet" poisoning, and its mortality increased since 2007 in spite of the ban. It seems that legislative means alone without other interventions, such as suicide prevention and public education, will not always be able to control or prevent acute intentional poisonings.

  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. Sepsis and Critical Illness Research Center investigators: protocols and standard operating procedures for a prospective cohort study of sepsis in critically ill surgical patients.

    Science.gov (United States)

    Loftus, Tyler J; Mira, Juan C; Ozrazgat-Baslanti, Tezcan; Ghita, Gabriella L; Wang, Zhongkai; Stortz, Julie A; Brumback, Babette A; Bihorac, Azra; Segal, Mark S; Anton, Stephen D; Leeuwenburgh, Christiaan; Mohr, Alicia M; Efron, Philip A; Moldawer, Lyle L; Moore, Frederick A; Brakenridge, Scott C

    2017-08-01

    Sepsis is a common, costly and morbid cause of critical illness in trauma and surgical patients. Ongoing advances in sepsis resuscitation and critical care support strategies have led to improved in-hospital mortality. However, these patients now survive to enter state of chronic critical illness (CCI), persistent low-grade organ dysfunction and poor long-term outcomes driven by the persistent inflammation, immunosuppression and catabolism syndrome (PICS). The Sepsis and Critical Illness Research Center (SCIRC) was created to provide a platform by which the prevalence and pathogenesis of CCI and PICS may be understood at a mechanistic level across multiple medical disciplines, leading to the development of novel management strategies and targeted therapies. Here, we describe the design, study cohort and standard operating procedures used in the prospective study of human sepsis at a level 1 trauma centre and tertiary care hospital providing care for over 2600 critically ill patients annually. These procedures include implementation of an automated sepsis surveillance initiative, augmentation of clinical decisions with a computerised sepsis protocol, strategies for direct exportation of quality-filtered data from the electronic medical record to a research database and robust long-term follow-up. This study has been registered at ClinicalTrials.gov, approved by the University of Florida Institutional Review Board and is actively enrolling subjects. Dissemination of results is forthcoming. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. The cyanide poisoning necropsy: an appraisal of risk factors.

    Science.gov (United States)

    Forrest, A. R.; Galloway, J. H.; Slater, D. N.

    1992-01-01

    Blood cyanide concentrations were measured in samples obtained from a pathologist before and after carrying out a necropsy on the body of a victim of cyanide poisoning. There was no significant increase in his blood cyanide concentration after carrying out the procedure. It is suggested that an important factor in determining the risk to those carrying out necropsies of the bodies of victims of cyanide poisoning is the amount of cyanide remaining in the stomach. There are several ways in which the theoretical risk inherent in carrying out such necropsies could be reduced, such as the use of a full face respirator, or the removal, intact, of the upper gastrointestinal tract to a fume cupboard for examination. PMID:1624609

  20. [Star anise poisoning in infants].

    Science.gov (United States)

    Minodier, P; Pommier, P; Moulène, E; Retornaz, K; Prost, N; Deharo, L

    2003-07-01

    Star anise is used as herbal tea, for the treatment of colicky pain in infants. It may cause neurological troubles. We report 2 cases of star anise poisoning in infants before 6 months of age. Star anise herbal tea was given by parents. Tremors or spasms, hypertonia, hyperexcitability with crying, nystagmus, and vomiting were observed. Contamination or adulteration of Chinese star anise (Illicium verum Hook), with Japanese star anise (Illicium religiosum) was proved in one child. Confusion or blending between Chinese and Japanese star anise may cause poisoning. Japanese star anise is a neurotoxic plant indeed, because it contains sesquiterpenic lactones. From November 2001, star anise products are theoretically prohibited in France, but they may be still available in some small groceries, or imported by families themselves.

  1. Datura stramonium poisoning in children.

    Science.gov (United States)

    Adegoke, S A; Alo, L A

    2013-01-01

    Although substance abuse is fairly common among adolescents, poisoning from Datura stramonium (a broadleaf annual erect herb with spine-covered seed capsule) is uncommon in children and has not been reported in our locality. We present the case of two children admitted at the Children Emergency Room of a teaching hospital following ingestion of extract of Datura stramonium. They developed neurotoxicity (confusion, agitation, mydriasis, and hallucination) and were managed symptomatically with good outcome. A high index of suspicion and early management of poison in children is imperative if a favorable outcome is expected. Early presentation and the presence of an eyewitness contributed to the very good outcome in these index cases. In this report, we discussed the symptomatology and management of Datura toxicity in children.

  2. 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)

  3. 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.

  4. Poisoning deaths in married women.

    Science.gov (United States)

    Kumar, Virendra

    2004-02-01

    Unnatural deaths of married women amongst the total female deaths have been an increasing trend in Indian society during the recent past years. These unnatural deaths may be suicide, homicide or even accidents. But these suicides and homicides are currently more commonly associated with the dowry disputes. In India, dowries are a continuing series of gifts endowed before and after the marriage. When dowry expectations are not met, the young bride may be killed or compelled to commit suicide, either by burning, poisoning or by some other means. Here, in the study, the main objective is to present the different epidemiological and medicolegal aspects of poisoning deaths in the married women. In a cohort of 200 married female deaths, 35 (18%) were poisoning deaths and these were analyzed from both epidemiological and medicolegal aspects. In this series, most of the women consumed organophosphorus compound and died within 10 days. The majority of the affected wives due to dowry problems were below 35 years of age. Most incidents occurred either during morning hour or during daytime.

  5. 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

  6. Childhood poisoning: a community hospital experience.

    Science.gov (United States)

    Gehlbach, S H; Wall, J B

    1977-06-01

    We reviewed medical records of 53 children who ingested poison and were treated as inpatients and 107 who were treated as outpatients in a Southeastern community hospital. Findings included a much higher incidence of petroleum distillate poisoning than is found nationally, and a low frequency of aspirin ingestions. Data on packaging of the poisons indicate that one third was stored in food containers. Of the products encountered, 33% currently require safety packaging but were found in obsolete containers.

  7. Role and functions of Poisons Information Centre.

    Science.gov (United States)

    Lall, S B; Peshin, S S

    1997-01-01

    The Poisons Information Centre (PIC) is a specialized unit providing information on prevention, early diagnosis and treatment of poisoning and hazard management. Most of the developed and many developing countries have well established poison control centres with poisons information service, patient management facility and analytical laboratory. In India, the National Poisons Information Centre (NPIC) was established in February, 1995 in the Department of Pharmacology at the All India Institute of Medical Sciences, New Delhi. The centre provides toxicological information and advice on the management of poisoned patients adopted to the level of the enquirer. The basis of this service are the databases on poisoning, drug reactions and also the continuous and systematic collection of data from the library. This information service is available round the clock. The PIC has the training responsibility extending to medical and other health professionals and community. The NPIC organized two successive training courses for medical professionals and para professionals at all health levels. Further, NPIC is a participant of INTOX project of IPCS/WHO, receiving regular yearly training on the use of INTOX database. Laboratory service is an essential component of a poisons control programme, providing analytical services on emergency basis to help in diagnosis and management. The NPIC is developing facilities for quick diagnosis of poisoning cases. Toxicovigilance and prevention of poisoning is another major function of PIC. The Centre has prepared manuals and leaflets on prevention and management cards on treatment of various poisonings. Thus the Centre provides a service with considerable health benefits, reducing morbidity and mortality from poisoning and gives significant financial savings to the community.

  8. Delayed cyanide poisoning following acetonitrile ingestion.

    OpenAIRE

    Mueller, M.; Borland, C.

    1997-01-01

    Acetonitrile (methyl cyanide) is a common industrial organic solvent but is a rare cause of poisoning. We report the first recorded UK case. Acetonitrile is slowly converted to cyanide, resulting in delayed toxicity. We describe a case of deliberate self-poisoning by a 39-year-old woman resulting in cyanide poisoning 11 hours later which was successfully treated by repeated boluses of sodium nitrite and thiosulphate. The half-life of conversion of acetonitrile was 40 hours and harmful blood c...

  9. 49 CFR 172.430 - POISON label.

    Science.gov (United States)

    2010-10-01

    ... be white. The word “TOXIC” may be used in lieu of the word “POISON”. [Amdt. 172-123, 56 FR 66258, Dec... 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...

  10. Potato plant poisoning - green tubers and sprouts

    Science.gov (United States)

    ... large ingestions. These poisonings can be very dangerous. Symptoms may include: Vomiting Stomach or abdominal pain Diarrhea Fever Delirium Dilated pupils Hallucinations Headache Loss of sensation Lower ...

  11. Impact of withdrawal of the analgesic Co-proxamol on nonfatal self-poisoning in the UK.

    Science.gov (United States)

    Hawton, Keith; Bergen, Helen; Waters, Keith; Murphy, Elizabeth; Cooper, Jayne; Kapur, Navneet

    2011-01-01

    In early 2005 the UK Committee on Safety of Medicines (CSM) announced gradual withdrawal of the analgesic co-proxamol because of its adverse benefit/safety ratio, especially its use for intentional and accidental fatal poisoning. Prescriptions of co-proxamol were reduced in the 3-year withdrawal phase (2005 to 2007) following the CSM announcement. To assess the impact of the CSM announcement in January 2005 to withdraw co-proxamol on nonfatal self-poisoning with co-proxamol and other analgesics. Interrupted time series analysis of general hospital presentations for nonfatal self-poisoning (five hospitals in three centers in England), comparing the 3-year withdrawal period 2005-2007 with 2000-2004. A marked reduction in the number of episodes of nonfatal self-poisoning episodes involving co-proxamol was found following the CSM announcement (an estimated 62% over the period 2005 to 2007 compared to 2000 to 2004). There was no evidence of an increase in nonfatal self-poisoning episodes involving other analgesics (co-codamol, codeine, co-dydramol, dihydrocodeine, and tramadol) in relation to the CSM announcement over the same period, nor a change in the number of all episodes of self-poisoning. Data were from three centers only. The impact of the policy appears to have reduced nonfatal self-poisoning with co-proxamol without significant substitution with other analgesics. This finding is in keeping with that for suicide.

  12. Sticky situations: cyanoacrylate exposures reported to a poison control system.

    Science.gov (United States)

    Carstairs, Shaun D; Koh, Cynthia; Qian, Lily; Qozi, Mariam; Seivard, Grant; Cantrell, F Lee

    2017-11-01

    Cyanoacrylate (Super Glue ® ) exposures are commonly reported to poison control centers, but little has been published in the medical literature regarding these exposures. We sought to characterize cyanoacrylate exposures reported to a poison control system. We performed a retrospective review of a poison system's database for all cases of single-substance human exposure to cyanoacrylate-containing products from 2005 to 2015. Data collected included age, gender, route of exposure, clinical effects, treatments recommended and medical outcome. There were a total of 893 patients, 505 (56.6%) of which were female. Patient ages ranged from 6 months to 88 years with a median of 11 years. The vast majority of exposures (n = 871, 97.5%) were unintentional, but a small number of exposures (n = 22, 2.5%) were due to intentional misuse (such as trying to stop a bleeding cut) or malicious intent (such as purposefully gluing a person's eyes shut as a prank). Routes of exposure included: ingestion, n = 337 (37.7%); ocular, n = 322 (36.1%); dermatologic, n = 285 (31.9%); inhalation, n = 16 (1.8%); nasal, n = 1 (0.1%); and otic, n = 1 (0.1%); some patients had multiple routes of exposure. Treatments recommended by the poison center included irrigation (n = 411), petroleum jelly (n = 143), mineral oil (n = 131), topical antibiotic ointment (n = 82), peanut butter (n = 6), acetone (n = 4) and WD-40 ® (n = 2). A total of 657 patients (73.6%) were managed on-site, while 236 (26.4%) were seen in a health care facility. Among all exposures, effects were classified as none (n = 287), minor (n = 529) and moderate (n = 77). No major effects or deaths were reported. In this case series, the majority of cases occurred in children and most exposures did not result in significant morbidity. Notably, there was wide variation in terms of recommended treatments; further study is needed to determine the optimal treatment

  13. [Acute poisonings and organ donation--case reports and literature review].

    Science.gov (United States)

    Klimaszyk, Dorota; Łukasik-Głebocka, Magdalena

    2013-01-01

    Poland is one of the European countries where serious problem of shortage of organ donors is observed. Organ donation from victims following fatal acute intoxications is extremely rare, and there's only several such case reports published in Poland. There's a need to establish guidelines of instrumental confirmatory tests of brain death determination according to acute poisonings. Authors present two cases of poisoned donors following acute poisonings with drugs. Current opinions concerning poisoned patients as a potential organ donors are also described. Case 1: A 36-years old male poisoned intentionally with insulin was admitted to Toxicology Department in Poznań. Patient was unconscious (GCS:3), hypoglycemic (glycaemia: 0). In 3rd day of treatment brain death was determined using clinical tests and instrumental confirmatory test (transcranial Doppler ultrasonography). Both kidneys were procured for transplantation. Case 2: A 23-years old male after prehospital sudden cardiac arrest in the course of suicidal carbamazepine intoxication was admitted to Toxicology Department. During whole hospitalization patient was unconscious, unresponsive to the pain (GCS:3), with circulatory and respiratory insufficiency. Despite intense treatment and decrease of carbamazepine level to therapeutic values there were no signs of patient recovery on the 9th day of treatment. After brain death determination patient was qualified as a kidneys and liver donor. Each patient diagnosed of brain death in the course of acute intoxication should be considered as a potential organ donor. Brain death determination in poisoned patients requires consultation by clinical toxicologist to exclude influence of neurotoxic xenobiotics on the central nervous system. Standards of instrumental confirmatory tests in victims following fatal poisonings should be established. Introduction of guidelines concerning donors intensive care procedures that allows successful organ procurement. All organ donations

  14. An Epidemiologic Study of Pediatric Poisoning; a Six-month Cross-sectional Study

    Directory of Open Access Journals (Sweden)

    Mohammad Manouchehrifar

    2016-01-01

    Full Text Available Introduction: Intentional and unintentional poisoning are among the most common reasons for referrals to emergency department (ED. Therefore, the present study was designed to evaluate epidemiologic features and effective risk factors of intentional and unintentional poisoning in children. Methods: This prospective cross-sectional study was carried out in ED of Loghman Hakim Hospital, greatest referral poison center of Iran, Tehran during March to August 2014. Demographic data, medical history, history of psychiatric disease in child, the cause of poisoning, parents’ educational level, household monthly income, location of residence, history of addiction or divorce in family, and the poisoning intentionality were gathered. Data were analyzed using SPSS 18 and appropriate statistical tests based on the purpose of study. Results: 414 participants with the mean age of 4.2 ± 3.43 years were included (57.5% male. Children in the 0-4 year(s age range had the most frequency with 281 (67.9% cases. 29 (7% cases were intentional (62% female, 76% in the 10-14 years old group. Methadone with 123 (29.7% cases was the most frequent toxic agent in general and in unintentional cases. 10-14 years of age (p = 0.001, and the history of psychiatric disease in children (p <0.001, had a direct correlation with probability of intentional poisoning. While, history of addiction in the family showed an indirect correlation with this probability (p = 0.045. Conclusion: Based on the results of this study, most cases of poisoning in the children were unintentional methadone intoxication in boys in the 0-4 age range with a history of a psychiatric disease, and those who had a history of addiction in the family. In addition, the most powerful risk factor for the children’s intentional poisoning was their history of psychiatric disease. The history of addiction in the child’s family had indirect correlation with intentional intoxications.

  15. Health information systems and pesticide poisoning at Pernambuco

    Directory of Open Access Journals (Sweden)

    Pedro Costa Cavalcanti de Albuquerque

    2015-09-01

    Full Text Available INTRODUCTION: Understanding the epidemiologic profile of a particular disease is key to undertake health actions. To that end, information systems that present quality data help in the decision-making process and demonstrate the impact of the problems.OBJECTIVE: To analyze the contribution of health information systems for the characterization of pesticide poisoning through SINAN, CEATOX and SIM in the State of Pernambuco.METHOD: In this study, the completeness and consistency of the data were assessed, as well as the epidemiological profile of pesticide poisoning in Pernambuco in the period from 2008 to 2012, based on the following Health Information Systems: Center for Toxicological Assistance of Pernambuco (CEATOX, Notifiable Diseases Information System (SINAN and Mortality Information System (SIM.RESULTS: The data revealed incompleteness and inconsistencies in information. Regarding the profile, females are more affected in the morbidity profile, and men have a higher mortality rate. Poisoning was more frequent in young adults with low educational level. With regard to the circumstances, most of the cases were suicide attempts, unique acute cases and not related to work. Despite suggesting underreporting, the data showed that persons engaged in agriculture are most commonly affected.CONCLUSION: The strengthening of these systems is necessary for the generation of consistent information that support health policies for the population groups involved.

  16. Health information systems and pesticide poisoning at Pernambuco.

    Science.gov (United States)

    de Albuquerque, Pedro Costa Cavalcanti; Gurgel, Idê Gomes Dantas; Gurgel, Aline do Monte; Augusto, Lia Giraldo da Silva; de Siqueira, Marília Teixeira

    2015-01-01

    Understanding the epidemiologic profile of a particular disease is key to undertake health actions. To that end, information systems that present quality data help in the decision-making process and demonstrate the impact of the problems. To analyze the contribution of health information systems for the characterization of pesticide poisoning through SINAN, CEATOX and SIM in the State of Pernambuco. In this study, the completeness and consistency of the data were assessed, as well as the epidemiological profile of pesticide poisoning in Pernambuco in the period from 2008 to 2012, based on the following Health Information Systems: Center for Toxicological Assistance of Pernambuco (CEATOX), Notifiable Diseases Information System (SINAN) and Mortality Information System (SIM). The data revealed incompleteness and inconsistencies in information. Regarding the profile, females are more affected in the morbidity profile, and men have a higher mortality rate. Poisoning was more frequent in young adults with low educational level. With regard to the circumstances, most of the cases were suicide attempts, unique acute cases and not related to work. Despite suggesting underreporting, the data showed that persons engaged in agriculture are most commonly affected. The strengthening of these systems is necessary for the generation of consistent information that support health policies for the population groups involved.

  17. Prediction of patient survival in cases of acute paraquat poisoning.

    Science.gov (United States)

    Hong, Sae-Yong; Lee, Ji-Sung; Sun, In O; Lee, Kwang-Young; Gil, Hyo-Wook

    2014-01-01

    Paraquat concentration-time data have been used to predict the clinical outcome following ingestion. However, these studies have included only small populations, although paraquat poisoning has a very high mortality rate. The purpose of this study was to develop a simple and reliable model to predict survival according to the time interval post-ingestion in patients with acute paraquat poisoning. Data were retrospectively collected for patients who were admitted with paraquat poisoning to Soonchunhyang University Choenan Hospital between January 2005 and December 2012. Plasma paraquat levels were measured using high-performance liquid chromatography. To validate the model we developed, we used external data from 788 subjects admitted to the Presbyterian Medical Center, Jeonju, Korea, between January 2007 and December 2012. Two thousand one hundred thirty six patients were included in this study. The overall survival rate was 44% (939/2136). The probability of survival for any specified time and concentration could be predicted as (exp(logit))/(1+exp(logit)), where logit = 1.3544+[-3.4688 × log10(plasma paraquat μg/M[Formula: see text])]+[-2.3169 × log10(hours since ingestion)]. The external validation study showed that our model was highly accurate for the prediction of survival (C statics 0.964; 95% CI [0.952-0.975]). We have developed a model that is effective for predicting survival after paraquat intoxication.

  18. [Fatal poisoning due to Indigofera].

    Science.gov (United States)

    Labib, S; Berdai, M-A; Bendadi, A; Achour, S; Harandou, M

    2012-01-01

    Indigo, also known in Morocco as Nila, is a dye widely used in the coloring of Moroccan handicrafts. It is obtained from fermentation reactions on the leaves and branches of true indigo, Indigofera tinctoria, which is a widespread plant in tropical Africa and Asia. We report a case of fatal poisoning in a 3-year-old child after administration of indigo for therapeutic purposes. Death resulted from multiple organ failure. The toxicity of this compound is little known in the literature and deserves to be explored through toxicokinetic and toxicodynamic studies, in order to better determine the toxic constituents of the dye. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  19. Intensive Care Management of Organophosphate Poisoned Patient ...

    African Journals Online (AJOL)

    challenging, more so in the setting of poor critical care facilities. The management requires the administration .... at the scene of the incident, signs and symptoms of organophosphate poisoning and improvement .... outcomes in human organophosphate poisoning: an evaluation using meta-analytic techniques. Crit.

  20. Heavy metal poisoning: clinical presentations and pathophysiology.

    Science.gov (United States)

    Ibrahim, Danyal; Froberg, Blake; Wolf, Andrea; Rusyniak, Daniel E

    2006-03-01

    Humans have had a long and tumultuous relationship with heavy metals. Their ubiquitous nature and our reliance on them for manufacturing have resulted at times in exposures sufficient to cause systemic toxicity. Their easy acquisition and potent toxicity have also made them popular choices for criminal poisonings. This article examines the clinical manifestation and pathophysiology of poisoning from lead, mercury, arsenic, and thallium.

  1. Mercury poisoning | Shamley | South African Medical Journal

    African Journals Online (AJOL)

    The diagnosis of mercury poisoning requires a high index of suspicion. Mercury poisoning in a patient involved in illicit gold extraction is reported and 6 other cases considered. Some of the clinical features and treatment of this condition are discussed. S Afr Med J 1989; 76: 114-116 ...

  2. NCHS Data on Drug-poisoning Deaths

    Science.gov (United States)

    ... Hispanic white persons, 12.2 for non-Hispanic black persons, and 7.7 for Hispanic persons. Age In 2015, the drug-poisoning death rate was highest for adults aged 45–54. SOURCE: NCHS, National Vital Statistics System, Mortality. Drug-poisoning death rates, by state ...

  3. Accidental Poisoning with Otapiapia: a Local Organophasphate ...

    African Journals Online (AJOL)

    Children are prone to accidental poisoning. We report this fatal organophosphate poisoning of a 3-year-old Nigerian boy following accidental ingestion of a homemade cocktail of kerosene and 'Otapiapia': a local rodenticide to highlight the dangers inherent in un-regulated production, home use and storage of this ...

  4. Validation of a Poison Prevention Program.

    Science.gov (United States)

    Gill, Noel C.; Braden, Barbara T.

    Two way analyses of variance and cross-group descriptive comparisons assessed the effectiveness of the Siop Poison Prevention Program, which included an educational program and the use of warning labels, on improving verbal and visual discrimination of poisonous and nonpoisonous products for preschool children. The study sample consisted of 156…

  5. Poisonings in the Nordic countries in 2007

    DEFF Research Database (Denmark)

    Andrew, Erik; Tellerup, Markus; Termälä, Anna-Mariia

    2012-01-01

    To map mortality and morbidity of poisonings in Denmark, Finland, Iceland, Norway and Sweden in 2007 and undertake a comparison with a corresponding study in 2002.......To map mortality and morbidity of poisonings in Denmark, Finland, Iceland, Norway and Sweden in 2007 and undertake a comparison with a corresponding study in 2002....

  6. Tropane alkaloids in food: poisoning incidents

    NARCIS (Netherlands)

    Adamse, P.; Egmond, van H.P.; Noordam, M.Y.; Mulder, P.P.J.; Nijs, de W.C.M.

    2014-01-01

    A large number of wild and cultured plants produce secondary metabolites that can be toxic to humans and animals. The present study aims to provide insight into the routes of (un)intentional poisonings of humans by tropane alkaloids. Poisonings of humans by tropane alkaloids occur as unintended

  7. Poison centre network saves lives | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2010-10-27

    Oct 27, 2010 ... Snakebites, food poisoning, exposure to toxic chemicals: all are potentially fatal if the correct antidote isn't identified and applied — fast. Since 1988, INTOX, a computer-based program involving a global network of poison centres, has been providing those life-saving capabilities in minutes.

  8. [Mushroom poisoning. New possibilities for treatment].

    Science.gov (United States)

    Bartels, O

    1976-04-08

    Poisonous species of fungi in Germany are very few. Dangerous is the ingestion of raw, spoiled or poisonous mushrooms. There exist no reliable tests to determine whether a mushroom is safe except by expert examination and identification of the mushroom. In clinical practice the classification of mushroom poisoning is possible in muscarine-syndrome, gastroenteritic syndrome and in two-phase-syndrome. 90-95% of lethal mushroom poisonings are due to ingestion of Amanita phalloides. In severe cases extensive hepatic necrosis occurs, characterized by profound abnormalities in liver function caused by hepatic coma. In deep coma mortality rates amount to 70% or more. A new therapeutic measure (coated charcoal hemoperfusion)-first applied in liver failure by Chang (1972) and Williams (1973)-has been performed in 3 patients with severe poisoning after ingestion of Amanita phalloides (each patient had eaten at least 7-10 fungi Amanita phalloides). Two of the patients survived.

  9. Levothyroxine Poisoning - Symptoms and Clinical Outcome

    DEFF Research Database (Denmark)

    Nygaard, Birgitte; Saedder, Eva A.; Dalhoff, Kim

    2015-01-01

    Levothyroxine (LT), T4, poisoning is rarely associated with a severe outcome. However, cases with significant complications have been reported. The aim of this study was to identify factors associated with symptoms of poisoning including late-onset symptoms. All enquiries to the Danish Poison...... Information Centre (DPIC) concerning LT poisoning between March 2007 and September 2012 were reviewed and the following parameters were recorded: age, dose, time from ingestion, multiple drug intake and symptoms. To evaluate the frequency of late-onset symptoms, a subgroup of patients without initial symptoms...... patients, neither in children nor in adults (age 16-92 years) (p poisoning at the time of enquiry; however, in 9 of 21 (43%) patients, we were able to contact, late-onset symptoms existed. In none of the cases...

  10. Delayed cyanide poisoning following acetonitrile ingestion.

    Science.gov (United States)

    Mueller, M.; Borland, C.

    1997-01-01

    Acetonitrile (methyl cyanide) is a common industrial organic solvent but is a rare cause of poisoning. We report the first recorded UK case. Acetonitrile is slowly converted to cyanide, resulting in delayed toxicity. We describe a case of deliberate self-poisoning by a 39-year-old woman resulting in cyanide poisoning 11 hours later which was successfully treated by repeated boluses of sodium nitrite and thiosulphate. The half-life of conversion of acetonitrile was 40 hours and harmful blood cyanide levels persisted for over 24 hours after ingestion. Departments treating or advising in cases of poisoning need to be aware of the delayed toxicity of acetonitrile. Monitoring in an intensive care unit of cases of acetonitrile poisoning should continue for 24-48 hours. PMID:9196706

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

    Directory of Open Access Journals (Sweden)

    Sana Muazzam

    2012-08-01

    Full Text Available 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 (rate¼8.18 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 (rate¼15.36, males(rate¼11.02 and whites (rate¼8.68. New Mexico (rate¼18.2 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 (rate¼1.97 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 (rate¼3.92, males (rate¼2.20 and whites (rate¼2.24. Nevada(rate¼3.9 had the highest rate. Mortality rate increased significantly among females and whites only (p,0.05 time-related trend for rate. There were 463 (rate¼0.03 homicidal poisoning

  12. Understanding the effect of steps, strain, poisons, and alloying: Methane activation on Ni surfaces

    DEFF Research Database (Denmark)

    Abild-Pedersen, Frank; Greeley, Jeffrey Philip; Nørskov, Jens Kehlet

    2005-01-01

    that variations in epsilon(d) can be used to quantitatively describe variations in the activation energy when the surface structure is changed, when the coverage of carbon is changed, when the surface is strained, when the surface is alloyed, and when the surface is poisoned by sulfur. The d-band center is...

  13. [Rapeseed poisoning of wild herbivores].

    Science.gov (United States)

    Schmid, A; Schmid, H

    1992-06-01

    Beginning with the simultaneous occurrence of the first extensive sowing of 00-rape and local increased losses among hares and roe deer in Western Germany and Austria at the end of 1986, the clinical and morphological symptoms of rape poisoning are discussed. They consist of damage to endo- and epithelium, cell membranes, blood, liver and in the so called "rape-blindness". Subsequently, the most important toxic agents of rape including their metabolites are presented. They consist in alkenyl- and indolyl-glucosinolates, leading to isothiocyanates (mustard oils), thiocyanates or thiocyanate ions resp., nitriles and antithyroid agents (e.g. goitrin) as well as S-methylcysteine sulphoxide and its metabolites, particularly dimethyl disulphide. Finally, the activity spectrum of the toxic agents or the metabolites and the clinical picture of the affected wildlife in 1986 are compared with the result that the losses of that period are most likely to be traced back to rape poisoning and that the rape-blindness mentioned is to be interpreted as a thiocyanate-psychosis.

  14. From poison ponds to pleasure spots.

    Science.gov (United States)

    Rao, E Nageswara

    2008-10-01

    The Hyderabad Metropolitan Area had 562 lakes at one time, but only 162 now remain. These are polluted to various degrees and pose environmental and health hazards. The Hussain Sagar Lake provided water for irrigation and drinking until 1930 and supported aquatic life till 1976. It is now contaminated by organic chemicals discharged by many industrial estates in its basin. An estimated 28,190 cmum of industrial effluents and domestic sewage are let into it daily. Phenols, benzenes, cyanides, and toxic metals make it poisonous. The ground water around the lake is also polluted. The polluted lakes ruin vegetable farms, kill fetuses in the womb, and cause mental retardation, still births, and infertility. In the city's outskirts, clinically confirmed cancer is 11 times higher and heart ailments 16 times more than elsewhere. The Hyderabad Urban Development Authority (HUDA) took up a Lake Conservation and Restoration Project as part of its Green Environment Program in 2002. Several lakes have been restored by setting up effluent (or sewage) treatment plants. HUDA also built lake parks with recreation facilities and environment education centers. HUDA also organized jointly with the World Water Institute, Pune, India, an international workshop on urban lake conservation and management in June 2003. It adopted the Hyderabad Declaration which, among other things, states the worthy aim of restoring all the water bodies by 2009. Even if it takes a few more years, the restoration of all the polluted lakes will usher in multiple benefits to Hyderabad citizens.

  15. Poisoning

    Science.gov (United States)

    ... and BodyGenetic Testing: What You Should KnowRead Article >>Genetic Testing: What You Should KnowSocial PhobiaRead Article >>Social Phobia Visit our interactive symptom checker Visit our interactive ...

  16. Poisoning

    Science.gov (United States)

    ... Enghorm B, Flerlage J, eds. Johns Hopkins: The Harriet Lane Handbook . 20th ed. Philadelphia, PA: Elsevier Mosby; 2015:chap ... by: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason ...

  17. Food poisoning and house gecko: myth or reality?

    Science.gov (United States)

    Kotangale, J P

    2011-04-01

    The reason behind the food-poisoning due to felling of house geckos in eatables is described in this paper. House geckos are known to carry various types of pathogens in their bodies which cause food-poisoning after consuming the contaminated foods. Since these geckos are non-poisonous, the food poisoning due to their presence in food is not possible.

  18. Unearthing poison use and consequent anecdotal vulture mortalities ...

    African Journals Online (AJOL)

    Aldicarb or carbofuran were the most commonly used poisons, but strychnine is still used by about one farmer out of 10. Poison is typically used by means of distributing poisoned baits in the landscape. Furthermore, willingness to use poison in the future was highest for farmers who own large properties with high livestock ...

  19. 49 CFR 172.416 - POISON GAS label.

    Science.gov (United States)

    2010-10-01

    ... POISON GAS label and the symbol must be white. The background of the upper diamond must be black and the... 49 Transportation 2 2010-10-01 2010-10-01 false POISON GAS label. 172.416 Section 172.416... SECURITY PLANS Labeling § 172.416 POISON GAS label. (a) Except for size and color, the POISON GAS label...

  20. 49 CFR 172.540 - POISON GAS placard.

    Science.gov (United States)

    2010-10-01

    ... the POISON GAS placard and the symbol must be white. The background of the upper diamond must be black... 49 Transportation 2 2010-10-01 2010-10-01 false POISON GAS placard. 172.540 Section 172.540... SECURITY PLANS Placarding § 172.540 POISON GAS placard. (a) Except for size and color, the POISON GAS...

  1. Lead and eagles: demographic and pathological characteristics of poisoning, and exposure levels associated with other causes of mortality.

    Science.gov (United States)

    Franson, J Christian; Russell, Robin E

    2014-11-01

    We conducted a retrospective analysis to evaluate demographic and pathologic characteristics in 484 bald eagles (Haliaeetus leucocephalus) and 68 golden eagles (Aquila chrysaetos) diagnosed with lead poisoning at the U.S. Geological Survey National Wildlife Health Center. As part of our analysis, we compared characteristics of lead poisoned eagles with those that died of other causes. Odds of lead poisoning were greater for bald eagles versus golden eagles, females versus males, adults versus juveniles, and eagles from the Mississippi and Central flyways versus the Atlantic and Pacific flyways. In addition to spatial, species, and demographic associations, we detected a distinct temporal trend in the collection date of lead poisoned bald eagle carcasses. These carcasses were found at greater frequency in late autumn and winter than spring and summer. Lesions in lead poisoned birds included emaciation, evidence of bile stasis, myocardial degeneration and necrosis, and renal tubular nephrosis and necrosis. Ingested lead ammunition or fragments were found in 14.2% of bald eagles and 11.8% of golden eagles. The overall mean liver lead concentration (wet weight basis) for eagles diagnosed with lead poisoning was 28.9 ± 0.69 SE mg/kg in bald eagles and 19.4 ± 1.84 SE mg/kg in golden eagles. In eagles diagnosed with collision trauma, electrocution, poisoning (other than lead), emaciation, infectious disease, trapping death, other, and undetermined causes, average liver lead concentrations were low (eagles predisposed them to other causes of mortality.

  2. Simulation center training as a means to improve resident performance in percutaneous noncontinuous CT-guided fluoroscopic procedures with dose reduction.

    Science.gov (United States)

    Mendiratta-Lala, Mishal; Williams, Todd R; Mendiratta, Vivek; Ahmed, Hafeez; Bonnett, John W

    2015-04-01

    The purpose of this study was to evaluate the effectiveness of a multifaceted simulation-based resident training for CT-guided fluoroscopic procedures by measuring procedural and technical skills, radiation dose, and procedure times before and after simulation training. A prospective analysis included 40 radiology residents and eight staff radiologists. Residents took an online pretest to assess baseline procedural knowledge. Second-through fourth-year residents' baseline technical skills with a procedural phantom were evaluated. First-through third-year residents then underwent formal didactic and simulation-based procedural and technical training with one of two interventional radiologists and followed the training with 1 month of supervised phantom-based practice. Thereafter, residents underwent final written and practical examinations. The practical examination included essential items from a 20-point checklist, including site and side marking, consent, time-out, and sterile technique along with a technical skills portion assessing pedal steps, radiation dose, needle redirects, and procedure time. The results indicated statistically significant improvement in procedural and technical skills after simulation training. For residents, the median number of pedal steps decreased by three (p=0.001), median dose decreased by 15.4 mGy (p<0.001), median procedure time decreased by 4.0 minutes (p<0.001), median number of needle redirects decreased by 1.0 (p=0.005), and median number of 20-point checklist items successfully completed increased by three (p<0.001). The results suggest that procedural skills can be acquired and improved by simulation-based training of residents, regardless of experience. CT simulation training decreases procedural time, decreases radiation dose, and improves resident efficiency and confidence, which may transfer to clinical practice with improved patient care and safety.

  3. Risk factors for the development of pneumonia in acute psychotropic drugs poisoning

    Directory of Open Access Journals (Sweden)

    Vučinić Slavica

    2005-01-01

    following parameters: sex (p < 0.05, chronic alcohol intake (p < 0.05, underlying diseases (p < 0.01, central venous catheter (p < 0.05 vasopressors (p < 0.05, coma (p < 0.001, H2 blockers (p < 0.001 and corticosteroids (p < 0.001. The multivariate analysis retained endotracheal intubation and antidepressant drug poisoning as an independent risk factor for pneumonia. Conclusion. Using univariate and multivariate analysis, risk factors for developing pneumonia were disclosed. Some of these factors may be modified by simple medical procedures, thus the incidence and mortality rate of pneumonia in drug poisoning might be substantially reduced.

  4. Paraphenylenediamine Poisoning in Tunisia: A Case Report

    Directory of Open Access Journals (Sweden)

    Dorra Amira

    2015-05-01

    Full Text Available Paraphenylenediamine (PPD represents the main active substance in the color of hair dyes. In Tunisia, PPD poisoning is very common, especially in rural areas where the consequences linked to this toxic substance are still unknown. In this paper, we report a case of PPD poisoning and confirm the diagnosis by a qualitative method of analysis. We discuss the clinical manifestations and study the kinetics of biological parameters during the monitoring of the poisoning. The main complication was renal failure and the treatment was basically symptomatic.

  5. Toxicodendron dermatitis: poison ivy, oak, and sumac.

    Science.gov (United States)

    Gladman, Aaron C

    2006-01-01

    Allergic contact dermatitis caused by the Toxicodendron (formerly Rhus) species-poison ivy, poison oak, and poison sumac-affects millions of North Americans every year. In certain outdoor occupations, for example, agriculture and forestry, as well as among many outdoor enthusiasts, Toxicodendron dermatitis presents a significant hazard. This review considers the epidemiology, identification, immunochemistry, pathophysiology, clinical features, treatment, and prevention of this common dermatologic problem. Recent research in prevention is emphasized, and resources to help in the identification of plants are provided in the bibliography. The literature was searched using a MEDLINE query for "Toxicodendron dermatitis", and the identified article bibliographies were searched as well.

  6. Delayed encephalopathy after acute carbon monoxide poisoning

    Directory of Open Access Journals (Sweden)

    Mehmet İbrahim Turan

    2014-03-01

    Full Text Available Carbon monoxide poisoning is a major cause of death following attempted suicide and accidental exposures. Although clinical presentation depends on the duration and the intensity of exposure, the assessment of the severity of intoxication is difficult. A small percentage of patients who show complete initial recovery may develop delayed neurological deficits. Delayed encephalopathy after acute carbon monoxide poisoning is a rare and poor prognosis neurologic disorders and there is no specific treatment. We present a case with early onset of delayed encephalopathy after acute carbon monoxide poisoning with typical cranial imaging findings in a child with atypical history and clinical presentation.

  7. Lead poisoning in children: a case report.

    Science.gov (United States)

    Jouhadi, Zineb; Bensabbahia, Dalal; Chafiq, Fouad; Oukkache, Bouchra; Guebessi, Nisrine Bennani; Abdellah, El Abidi; Najib, Jilali

    2016-01-01

    Lead colic is a rare cause of abdominal pain. The diagnosis of lead poisoning is most often mentioned in at risk populations (children, psychotic). We report the case of a 2 year old child that was presented for acute abdomen. Abdominal plain radiograph showed multiple intra-colonic metallic particles and suggested lead poisoning diagnosis. Anamnesis found a notion of pica and consumption of peeling paint. Elevated blood lead levels (BLL) confirmed the diagnosis. The lead poisoning is a public health problem especially in children, but its manifestation by a lead colic is rare and could simulate an acute abdomen table.

  8. Five cases of arsine poisoning

    Energy Technology Data Exchange (ETDEWEB)

    Phoon, W.H.; Chan, M.O.; Goh, C.H.; Edmondson, R.P.; Kwek, Y.K.; Gan, S.L.; Ngui, S.J.; Kwok, S.F.

    1984-04-01

    Arsine is one of the most potent haemolytic agents found in industry. Four workers presented with abdominal pain, jaundice and passing tea-coloured urine. A fifth worker also passed dark urine but had no other symptoms. Investigation revealed that all five workers were from a tin smelting plant where they were involved in mixing tin ore with dross. They were exposed to arsine gas after mixing a particularly large quantity of dross with tin ore which was wet because of rain. Three of the cases developed renal impairment and also a mild sensory neuropathy. All survived with proper management in hospital which included exchange blood transfusions, and peritoneal dialysis where indicated. Prevention of such poisoning includes keeping dross away from all moisture, good ventilation in work areas, and adding dross directly to the furnace.

  9. Likelihood Estimation of the Systemic Poison-Induced Morbidity in an Adult North Eastern Romanian Population

    Directory of Open Access Journals (Sweden)

    Cătălina Lionte

    2016-12-01

    Full Text Available Purpose: Acute exposure to a systemic poison represents an important segment of medical emergencies. We aimed to estimate the likelihood of systemic poison-induced morbidity in a population admitted in a tertiary referral center from North East Romania, based on the determinant factors. Methodology: This was a prospective observational cohort study on adult poisoned patients. Demographic, clinical and laboratory characteristics were recorded in all patients. We analyzed three groups of patients, based on the associated morbidity during hospitalization. We identified significant differences between groups and predictors with significant effects on morbidity using multiple multinomial logistic regressions. ROC analysis proved that a combination of tests could improve diagnostic accuracy of poison-related morbidity. Main findings: Of the 180 patients included, aged 44.7 ± 17.2 years, 51.1% males, 49.4% had no poison-related morbidity, 28.9% developed a mild morbidity, and 21.7% had a severe morbidity, followed by death in 16 patients (8.9%. Multiple complications and deaths were recorded in patients aged 53.4 ± 17.6 years (p .001, with a lower Glasgow Coma Scale (GCS score upon admission and a significantly higher heart rate (101 ± 32 beats/min, p .011. Routine laboratory tests were significantly higher in patients with a recorded morbidity. Multiple logistic regression analysis demonstrated that a GCS < 8, a high white blood cells count (WBC, alanine aminotransferase (ALAT, myoglobin, glycemia and brain natriuretic peptide (BNP are strongly predictive for in-hospital severe morbidity. Originality: This is the first Romanian prospective study on adult poisoned patients, which identifies the factors responsible for in-hospital morbidity using logistic regression analyses, with resulting receiver operating characteristic (ROC curves. Conclusion: In acute intoxication with systemic poisons, we identified several clinical and laboratory variables

  10. A Narrative Review of Acute Adult Poisoning in Iran

    OpenAIRE

    Samira Alinejad; Nasim Zamani; Mohammad Abdollahi; Omid Mehrpour

    2017-01-01

    Poisoning is a frequent cause of referral to medical emergencies and a major health problem around the world, especially in developing countries. We aimed to review the epidemiology and pattern of adult poisoning in Iran in order to facilitate the early diagnosis and management of poisoning. The pattern of poisoning is different in various parts of Iran. Pharmaceutical compounds were the most common cause of poisoning in most parts of Iran. Pesticide-related toxicities were more common in nor...

  11. Organophosphorus and carbamate insecticide poisoning.

    Science.gov (United States)

    Vale, Allister; Lotti, Marcello

    2015-01-01

    Both organophosphorus (OP) and carbamate insecticides inhibit acetylcholinesterase (AChE), which results in accumulation of acetylcholine (ACh) at autonomic and some central synapses and at autonomic postganglionic and neuromuscular junctions. As a consequence, ACh binds to, and stimulates, muscarinic and nicotinic receptors, thereby producing characteristic features. With OP insecticides (but not carbamates), "aging" may also occur by partial dealkylation of the serine group at the active site of AChE; recovery of AChE activity requires synthesis of new enzyme in the liver. Relapse after apparent resolution of cholinergic symptoms has been reported with OP insecticides and is termed the intermediate syndrome. This involves the onset of muscle paralysis affecting particularly upper-limb muscles, neck flexors, and cranial nerves some 24-96 hours after OP exposure and is often associated with the development of respiratory failure. OP-induced delayed neuropathy results from phosphorylation and subsequent aging of at least 70% of neuropathy target esterase. Cramping muscle pain in the lower limbs, distal numbness, and paresthesiae are followed by progressive weakness, depression of deep tendon reflexes in the lower limbs and, in severe cases, in the upper limbs. The therapeutic combination of oxime, atropine, and diazepam is well established experimentally in the treatment of OP pesticide poisoning. However, there has been controversy as to whether oximes improve morbidity and mortality in human poisoning. The explanation may be that the solvents in many formulations are primarily responsible for the high morbidity and mortality; oximes would not be expected to reduce toxicity in these circumstances. even if given in appropriate dose. © 2015 Elsevier B.V. All rights reserved.

  12. Human fatality due to thallium poisoning: autopsy, microscopy, and mass spectrometry assays.

    Science.gov (United States)

    Li, Shangxun; Huang, Wen; Duan, Yijie; Xing, Jingjun; Zhou, Yiwu

    2015-01-01

    Thallium has been responsible for many intoxications since its discovery; however, toxicological profiles for thallium in human fatalities have not been updated recently. Autopsy, microscopic investigations, and toxicological analyses were performed on a married couple who died from thallium sulfate intended homicidal poisoning. The distribution of thallium was established by inductively coupled plasma mass spectrometry with hair samples showing the highest thallium concentration. Electron microscopy revealed a dystrophic condition of hair with disorganized cuticle and atrophy of the hair bulb. Thallium interacts with cells at different levels, with prominent ultrastructural injuries in the mitochondria and endoplasmic reticulum, and high concentration of electron dense granules observed in the cytoplasm and mitochondria of several organs. Alopecia, toxic encephalopathy, and peripheral neuropathy were diagnosed in the victims and suggested to be crucial implications for thallium poisoning. The analytical procedures used in this case are of considerable forensic importance in the diagnosis of thallium poisoning. © 2014 American Academy of Forensic Sciences.

  13. Pesticide Poisoning of Honeybees: A Review of Symptoms, Incident Classification, and Causes of Poisoning

    Directory of Open Access Journals (Sweden)

    Kiljanek Tomasz

    2016-12-01

    Full Text Available During the 2000s, the problem of pesticide poisoning of honeybees seemed to be almost solved. The number of cases has decreased in comparison to the 1970s. The problem of acute honeybee poisoning, however, has not disappeared, but instead has transformed into a problem of poisoning from ‘traditional’ pesticides like organophosphorus pesticides or pyrethroids, to poisoning from additional sources of ‘modern’ systemic neonicotinoids and fipronil. In this article, the biological activity of pesticides was reviewed. The poisoning symptoms, incident definitions, and monitoring systems, as well as the interpretation of the analytical results, were also reviewed. The range of pesticides, and the detected concentrations of pesticides in poisoned honeybee samples, were reviewed. And, for the first time, cases of poisoning related to neonicotinoids were reviewed. The latter especially is of practical importance and could be helpful to analysts and investigators of honeybee poisoning incidents. It is assumed that secondary poisoning induced by plant collected materials contaminated with systemic pesticides occurs. Food stored in a hive and contaminated with systemic pesticides consumed continuously by the same generation of winter bees, may result in sub-lethal intoxication. This leads to abnormal behaviour identified during acute intoxication. The final result is that the bees discontinue their social role in the honeybee colony super organism, and colony collapse disorder (CCD takes place. The process described above refers primarily to robust and strong colonies that were able to collect plenty of food due to effective plant protection.

  14. [The reporting system of acute pesticides poisoning and general situation of pesticides poisoning in China].

    Science.gov (United States)

    Chen, Shu-yang; Wang, Hong-fei; Yin, Yu

    2005-10-01

    To introduce the reporting system of acute pesticides poisoning and analyze epidemiologic characteristics of pesticides poisoning from reported cases in China. Case reports in the data base of reporting system for occupational diseases were computed by Excel for windows and statistical significance by SAS 6.12. A total of 108 372 cases were reported from 1997 to 2003. Among them, the incidence of occupational poisoning, and non-occupational poisoning accounted for 25.39%, and 74.61% respectively. The fatality rate was 6.86%. The average age was 36.83 years for all pesticides poisoning patients, and 15-59 years old patients accounted for 84.11%. Among 0-14 years old non-occupational poisoning patients, 0-4 years children accounted for 33.51%. Male patients were in the majority in occupational pesticides poisoning, female in non-occupational. Insecticides especially organophosphorus insecticides such as methamidophos, parathion, and omethoate comprised a higher proportion, accounting for 86.02% of the pesticides poisoning. More attention should be paid to pesticides poisoning by the government and medical workers engaged in public health.

  15. Two health information systems to characterize poisoning in Brazil-a descriptive study.

    Science.gov (United States)

    Magalhães, Andrea Franco Amoras; Caldas, Eloisa Dutra

    2018-03-02

    Poisoning is a worldwide public health problem that involves individuals of all ages and a wide range of chemicals. This study investigated the data from two health information systems to characterize poisoning events in the Federal District (DF), Brazil. Data related to the period from 2009 to 2013 were obtained from the poison information center (Centro de Informação Toxicológica, CIT) and the Notifiable Diseases Information System (Sistema Nacional de Agravos de Notificação, SINAN) of the DF. A total of 3622 cases were reported to CIT-DF and 5702 cases to SINAN-DF. Most of the cases in CIT-DF (53%) occurred with children up to 9 years old, while this corresponded to 33.9% in SINAN-DF. Unintentional poisoning was the main circumstance involved in the cases. Pharmaceuticals were the main agent (44.3-47.1% of the cases), mainly clonazepan and paracetamol, and pesticides the most fatal (2.4% fatality rate). Out of the 47 fatal cases reported to the systems, only four were reported to both; six cases occurred with children up to 6 years. Under-reporting and missing information were identified in both systems, but the data were complementary to describe the epidemiology of poisoning cases in the DF.

  16. Improving Outreach and Surveillance Efforts Following a Large-Scale Carbon Monoxide Poisoning in Wisconsin.

    Science.gov (United States)

    Creswell, Paul D; Vogt, Christy M; Wozniak, Ryan J; Camponeschi, Jenny; Werner, Mark A; Meiman, Jonathan G

    In December 2014, the largest carbon monoxide (CO) poisoning in Wisconsin's history occurred at an ice arena. Following this event, the Wisconsin Environmental Public Health Tracking (WI EPHT) Program sought to improve outreach and surveillance efforts. WI EPHT designed and distributed educational materials on CO poisoning prevention and surveyed stakeholders to gauge the effectiveness of outreach efforts. To enhance surveillance, WI EPHT utilized data from the Wisconsin Poison Center (WPC) to generate real-time alerts of anomalous numbers of CO-related calls. WI EPHT found that 42% of stakeholders reviewed the outreach materials, and 1 ice arena had installed a CO detector as a result. CO alerts were developed using WPC data and are now routinely used in statewide public health surveillance. WI EPHT staff improved CO poisoning prevention outreach and saw a positive response among stakeholders. This work demonstrates ways that health agencies can improve outreach and surveillance for CO poisoning. Improvements in these areas can bolster public health response and may prevent CO-related illness and injury.

  17. Experiences of a secondary laboratory of dosimetric calibration from the radiation protection and hygiene center CPHR in its first year of work and the procedures for quality assessment used in the calibration and quality control service

    International Nuclear Information System (INIS)

    Morales, J.A.; Campa, R.; Jova Sed, L.

    1996-01-01

    Experiences of a secondary laboratory of dosimetric calibration from the Radiation Protection and Hygiene Center (CPHR) in first year of work and the procedures for quality assessment used in the calibration and quality control service of radiotherapeutic equipment. For the yield calibration of the calibrated sources an ionometric method was used using ionizing chambers coupled to electrometers. Those determination were based on dosimetric American Association of Physicists in Medicine (AAPM)

  18. Extracorporeal treatment for tricyclic antidepressant poisoning

    DEFF Research Database (Denmark)

    Yates, Christopher; Galvao, Tais; Sowinski, Kevin M

    2014-01-01

    methodology, the subgroup responsible for this poison reviewed the articles, extracted the data, summarized findings, and proposed structured voting statements following a predetermined format. A two-round modified Delphi method was chosen to reach a consensus on voting statements and RAND......The Extracorporeal Treatments In Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatments (ECTR) in poisoning. Here, the workgroup presents its results for tricyclic antidepressants (TCAs). After an extensive literature search, using a predefined...... yielding a very low quality of evidence for all recommendations. Data on 108 patients, including 12 fatalities, were abstracted. The workgroup concluded that TCAs are not dialyzable and made the following recommendation: ECTR is not recommended in severe TCA poisoning (1D). The workgroup considers...

  19. Amitraz, an underrecognized poison: A systematic review

    Directory of Open Access Journals (Sweden)

    Sahajal Dhooria

    2016-01-01

    Results: The original search yielded 239 articles, of which 52 articles described human cases. After following the inclusion and exclusion criteria, 32 studies describing 310 cases (151 females, 175 children of human poisoning with amitraz were included in this systematic review. The most commonly reported clinical features of amitraz poisoning were altered sensorium, miosis, hyperglycaemia, bradycardia, vomiting, respiratory failure, hypotension and hypothermia. Amitraz poisoning carried a good prognosis with only six reported deaths (case fatality rate, 1.9%. Nearly 20 and 11.9 per cent of the patients required mechanical ventilation and inotropic support, respectively. The role of decontamination methods, namely, gastric lavage and activated charcoal was unclear. Interpretation & conclusions: Our review shows that amitraz is an important agent for accidental or suicidal poisoning in both adults and children. It has a good prognosis with supportive management.

  20. Food poisoning associated with Kudoa septempunctata.

    Science.gov (United States)

    Iwashita, Yoshiaki; Kamijo, Yoshito; Nakahashi, Susumu; Shindo, Akihiro; Yokoyama, Kazuto; Yamamoto, Akitaka; Omori, Yukinari; Ishikura, Ken; Fujioka, Masaki; Hatada, Tsuyoshi; Takeda, Taichi; Maruyama, Kazuo; Imai, Hiroshi

    2013-05-01

    Kudoa septempunctata is a recently identified cause of food poisoning. We report three cases of food poisoning due to ingestion of this parasite. Among the 358 people exposed during the same catered meal, 94 (including our 3 patients) developed vomiting and diarrhea within 1-9 h after ingestion of raw muscle from contaminated aquacultured olive flounders (Paralichthys olivaceus). These symptoms occurred frequently but were temporary; only 1 patient was hospitalized for dehydration and was discharged 2 days later. In Japan, cases of food poisoning due to eating olive flounder have increased during recent years. This increase should prompt heightened awareness among clinicians diagnosing food poisoning. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Blood Poisoning: When to See a Doctor

    Science.gov (United States)

    ... I suspect I have blood poisoning. Should I see my doctor? Answers from James M. Steckelberg, M. ... illness and requires prompt medical attention. When to see a doctor If you recently had a medical ...

  2. Poisoned after Dinner: Dolma with Datura Stramonium

    Directory of Open Access Journals (Sweden)

    Nezihat Rana DISEL

    2015-03-01

    Full Text Available SUMMARY: Datura stramonium, which is also known as Thorn Apple or Jimson Weed, is an alkaloid containing plant that is entirely toxic. The active toxic constituents of the plant are atropine, scopolamine and hyoscyamine. It has been abused worldwide for hundreds of years because of its hallucinogenic properties. Previous reports have shown that herbal medication overdose and accidental food contamination are ways it can cause poisoning. Herein we present a family that had three of its members poisoned after eating a traditional meal “dolma” made of datura flowers. None had fatal complications and all were discharged healthy. Datura stromonium may be used accidentally as a food ingredient. Since its poisonous effects are not known, people should be informed and warned about the effects of this plant. Key words: Anticholinergic effects, Datura stramonium, plant poisoning, rhabdomyolysis

  3. Drug Poisoning Mortality by County: United States

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset describes drug poisoning deaths at the U.S. and state level by selected demographic characteristics, and includes age-adjusted death rates for drug...

  4. Carbon monoxide poisoning: Medical students' knowledge towards ...

    African Journals Online (AJOL)

    , and poisonous gas produced by incomplete combustion of organic materials. It is particularly dangerous as it cannot be detected by man's natural sense organs. There is hardly a month without one or two newspaper reports of death ...

  5. Recognition and Management of Pesticide Poisonings

    Science.gov (United States)

    The Recognition and Management of Pesticide Poisonings: 6th Edition manual gives healthcare providers a quick reference resource for the best toxicology and treatment information for patients with pesticide exposures.

  6. Hemlock (Conium Maculatum Poisoning In A Child

    Directory of Open Access Journals (Sweden)

    Capan KONCA

    2014-03-01

    Full Text Available 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 ingestion of poison hemlock is presented here with clinical and laboratory features. In this case, we aim to report that accidental ingestion of plants resembling vegetables that are consumed daily can lead to serious complications and even death.

  7. Drug Poisoning Mortality by State: United States

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset describes drug poisoning deaths at the U.S. and state level by selected demographic characteristics, and includes age-adjusted death rates for drug...

  8. Mercury Poisoning Linked to Skin Products

    Science.gov (United States)

    ... Products For Consumers Home For Consumers Consumer Updates Mercury Poisoning Linked to Skin Products Share Tweet Linkedin ... and, in some situations, criminal prosecution. Dangers of Mercury Exposure to mercury can have serious health consequences. ...

  9. Nicotiana glauca poisoning in ostriches (Struthio camelus)

    CSIR Research Space (South Africa)

    Botha, CJ

    2011-01-01

    Full Text Available Putative Nicotiana glauca (wild tobacco) poisoning was diagnosed in a flock of ostriches near Oudtshoorn, South Africa. Post mortem examinations (n = 7) were performed on ostriches (Struthio camelus) that had died. Suspicious leaf remnants (weighing...

  10. The toxicology of honey bee poisoning.

    Science.gov (United States)

    Stefanidou, Maria; Athanaselis, Sotirios; Koutselinis, Antonios

    2003-10-01

    The use of insecticides continues to be a basic tool in pest management, since there are many pest situations for which there are no known alternative management methods. However, the harmful effects of insecticides against beneficial Insects continuous to be a serious problem. Poisoning of bee pollinators is a serious adverse effect of insecticide use which leads to a decrease in insect population, to reduction of honey yields, to destruction of plant communities, to insecticide residues in food, and to a significant loss of beekeepers' income. In bee poisoning, the identification of the responsible toxicant is necessary by both environmental and biological monitoring, to prevent bee poisoning and for the protection of public health. The different aspects of bee poisoning with anticholinesterase insecticides are discussed in detail.

  11. Toilet bowl cleaners and deodorizers poisoning

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002743.htm Toilet bowl cleaners and deodorizers poisoning To use the sharing features on this page, please enable JavaScript. Toilet bowl cleaners and deodorizers are substances used to ...

  12. A fatal case of creosote poisoning.

    Science.gov (United States)

    Bowman, C. E.; Muhleman, M. F.; Walters, E.

    1984-01-01

    A case of fatal creosote poisoning is described. On presentation, extensive oropharyngeal ulceration was noted and gastric lavage withheld. Post-mortem examination showed an intact oesophagus and stomach. PMID:6463007

  13. A fatal case of creosote poisoning.

    OpenAIRE

    Bowman, C. E.; Muhleman, M. F.; Walters, E.

    1984-01-01

    A case of fatal creosote poisoning is described. On presentation, extensive oropharyngeal ulceration was noted and gastric lavage withheld. Post-mortem examination showed an intact oesophagus and stomach.

  14. Naturally Occuring Fish Poisons from Plants

    Science.gov (United States)

    Cannon, Jonathan G.; Burton, Robert A.; Wood, Steven G.; Owen, Noel L.

    2004-10-01

    Since prehistoric times, cultures throughout the world have used piscicidal (fish poisoning) plants for fishing. In recent times, scientists have identified many of the plant compounds responsible for killing the fish and have found that these compounds possess other important biological properties, such as insecticidal and anti-cancer activities. This article reviews some of the chemical research that has been performed on naturally occurring fish poisons, including plant sources, methods of use, toxicity, and mechanisms of action of piscicides.

  15. [Peripheral neuropathy caused by thallium poisoning].

    Science.gov (United States)

    Kubis, N; Talamon, C; Smadja, D; Said, G

    1997-10-01

    A 20-year-old man developed over three weeks a sensory and painful neuropathy associated with diffuse alopecia. There was motor weakness, and superficial and deep hypoesthesia of the inferior limbs. Deep tendon reflexes were normal. Electrophysiological study mainly showed axonal motor neuropathy. This patient was admitted six weeks after the first symptoms. The clinical picture suggested thallium poisoning, which was confirmed by thallium concentrations in plasma, urine, hair and nails. After search, thallium was identified in a rat poison.

  16. Changing Spectrum Of Poisoning In Haryana

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    Yadav R.S

    1991-01-01

    Full Text Available This study involved 1504 patients admitted with acute poisoning (985 males and 519 females with a mean age of 24.5 + -8.3 years, belonging mainly to the rural population (72% and middle income group (65.8%. Aluminum phosphide was the commonest poison ingested followed by Organ phosphorus, Copper Sulphate and Barbiturates. The overall mortality rate was 36.3% and suicidal intent was present most commonly. The underlying socio- economic factors have been discussed.

  17. Renal Failure Prevalence in Poisoned Patients

    OpenAIRE

    Arefi, Mohammad; Taghaddosinejad, Fakhroddin; Salamaty, Peyman; Soroosh, Davood; Ashraf, Hami; Ebrahimi, Mohsen

    2014-01-01

    Background: Renal failure is an important adverse effect of drug poisoning. Determining the prevalence and etiology of this serious side effect could help us find appropriate strategies for the prevention of renal failure in most affected patients. Objectives: The present study is aimed to identify drugs that induce renal failure and also to find the prevalence of renal failure in patients referred to emergency departments with the chief complaint of drug poisoning, in order to plan better th...

  18. Acute Cyanide Poisoning from Jewelry Cleaning Solutions

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    Ines Bel Waer

    2015-05-01

    Full Text Available Cyanide is one of the most lethal and devastating poisons. It causes acute toxicity through smoke inhalation simultaneously with carbon monoxide, or by ingestion of cyanide salts that are commonly used in metallurgy and in jewelry or textile industries. Cyanide intoxication is an extremely rare event; in the present study, we report a case of cyanide poisoning involving a 25-year-old jeweler, who ingested a jewelry cleaning solution containing potassium cyanide in a suicide attempt.

  19. Cartap poisoning: A rare case report.

    Science.gov (United States)

    Kumar, A S Praveen; Amalnath, Deepak; Dutta, T K

    2011-10-01

    Cartap is a pesticide commonly used to control weevil and caterpillars. It is an analogue of nereistoxin, a neurotoxic substance isolated from the marine annelid Lumbriconereis heteropoda. It causes neuromuscular blockade. Poisoning with cartap is very rare and not yet reported from India. We report a 35-year-old lady with cartap poisoning who presented with nausea, vomiting, and dyspnea. She improved with N-acetyl cysteine and symptomatic management.

  20. Cartap poisoning: A rare case report

    OpenAIRE

    Kumar, A. S. Praveen; Amalnath, Deepak; Dutta, T. K.

    2011-01-01

    Cartap is a pesticide commonly used to control weevil and caterpillars. It is an analogue of nereistoxin, a neurotoxic substance isolated from the marine annelid Lumbriconereis heteropoda. It causes neuromuscular blockade. Poisoning with cartap is very rare and not yet reported from India. We report a 35-year-old lady with cartap poisoning who presented with nausea, vomiting, and dyspnea. She improved with N-acetyl cysteine and symptomatic management.

  1. Perfil das tentativas de suicídio por sobredose intencional de medicamentos atendidas por um Centro de Controle de Intoxicações do Paraná, Brasil Profile of suicide attempts using intentional overdose with medicines, treated by a poison control center in Paraná State, Brazil

    Directory of Open Access Journals (Sweden)

    Sara Santos Bernardes

    2010-07-01

    Full Text Available Este trabalho apresenta o perfil das tentativas de suicídio atendidas pelo Centro de Controle de Intoxicações da cidade de Londrina, Paraná, Brasil. Foi realizado um estudo retrospectivo dos casos atendidos entre 1997-2007. As tentativas de suicídio foram significativas entre homens desempregados e mulheres donas-de-casa/aposentadas, e houve associação com outras substâncias em 51,5% dos casos, sendo a freqüência maior entre os homens. 51,1% dos homens associaram o medicamento com bebida alcoólica, e entre as mulheres, 84,8% das associações se referiram a medicamentos. Os grupos farmacológicos de maior freqüência foram os tranqüilizantes (25,5%, antidepressivos (17%, anticonvulsivos (15% e AINES (11,9%, respectivamente. Os prescritores devem avaliar corretamente o paciente antes de receitar psicofármacos, uma vez que esse é o grupo farmacológico mais freqüente nas tentativas de suicídio. Campanhas de conscientização para o uso racional de medicamentos, juntamente com programas sociais de atendimento ao paciente suicida, também poderiam contribuir na diminuição da freqüência desses casos.This study presents the profile of suicide attempts using intentional overdose with medicines, treated at the Poison Control Center in Londrina, Paraná State, Brazil. A retrospective study of cases treated from 1997 to 2007 was performed. Suicide attempts were significant among unemployed men, housewives, and retired women, and there was an association with other substances in 51.5% of the cases, with a higher frequency among men. 51.1% of the men combined the medicine with an alcoholic beverage, while in women, 84.8% of the associations involved other medicines. The most frequent pharmacological groups were tranquilizers (25.5%, antidepressants (17%, anticonvulsants (15%, and NSAIDs (11.9%. Prescribers must evaluate patients correctly before prescribing psychoactive drugs, since this is the pharmacological group most frequently

  2. [Consequences of thallium poisoning in adolescent].

    Science.gov (United States)

    Steczkowska-Klucznik, Małgorzata; Kubik, Alicja; Pietrzyk, Jacek A; Gergont, Aleksandra

    2005-01-01

    Thallium poisoning appears very rare in developmental age and its consequences are quite different. The aim of this study was to characterised the course of thallium poisoning in adolescent and especially electroneurophysiological consequences of it. In a 15 year old boy with sensory-motor polyneuropathy thallium poisoning was recognised in the third week duration of the symptoms. Hemodialysis and hemodiaperfusion were used in the therapy. Data of the repeated electroneurographic and videoEEG examinations were collected. First electroneurographic data showed axonal motor polyneuropathy. Control after 1 year presented the largest form of the motor-sensory polyneuropathy. On videoEEG tape rejestered in the 5th month of clinical symptoms of poisoning, present were tonic seizures (although EEG pattern was flat with short low voltage theta activity). After next the 3 months of encephalopathy and phenobarbital therapy, voltage of the EEG pattern was slightly higher without any background and seizure activity. Thallium poisoning may result with catastrophic clinical consequences of polyneuropathy and encephalopathy. Electroneurographic and electroencephalographic changes 1 year after indicate that clinical consequences of the poisoning are un-remediable.

  3. Toad poisoning in three dogs: case reports

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    CM Barbosa

    2009-01-01

    Full Text Available Toad poisoning is frequent in dogs, but has been infrequently addressed in published case reports and review articles. Dogs can be poisoned when they bite a toad or otherwise ingest the venom. The venom effects manifest soon after the accident, since the toxin is rapidly absorbed by the mucous membrane of the digestive system. Hospital records of three dogs, diagnosed with toad poisoning, were retrospectively reviewed from January 2005 to July 2007. Poisoned dogs may present only local irritation or systemic signs in the gastrointestinal, cardiac and neurological systems. All three cases presented herein had clinical signs of gastrointestinal alterations including vomiting, sialorrhea and diarrhea. Two dogs developed abnormal cardiac rhythm and two exhibited neurological signs. A poisoned animal requires emergency care and symptomatic therapy with intense monitoring of its clinical parameters. Although there have been reports on the low mortality of dogs poisoned by toads, one animal died even after appropriate therapy. The severity of clinical signs and the risk of death must be considered by the veterinarian.

  4. Residential carbon monoxide poisoning from motor vehicles.

    Science.gov (United States)

    Hampson, Neil B

    2011-01-01

    Although morbidity and mortality from accidental carbon monoxide (CO) poisoning are high in the United States, identification of common but poorly recognized sources should help prevention efforts. The study aimed to describe CO poisoning of home occupants due to a vehicle left running in an attached garage. News stories reporting incidents of US CO poisoning were collected daily from March 2007 to September 2009 via a news.Google.com search and data extracted. Patients were individuals reported in the media to have been poisoned with CO in their home by a vehicle running in the attached garage. Main outcome measures were frequency of occurrence, geographic distribution, patient demographics, and mortality. Of 837 CO poisoning incidents reported in US news media over 2 and a half years, 59 (8%) were the result of a vehicle left running in the garage. The elderly were disproportionately affected, with incidents most common in states with larger elderly populations and 29% of cases with age specified occurring in individuals older than 80 years. Among those older than 80 years, 15 of 17 were found dead at the scene. Residential CO poisoning from a vehicle running in the garage is common, disproportionately affects the elderly, has a high mortality rate, and should be preventable with a residential CO alarm. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Cost Savings and Patient Experiences of a Clinic-Based, Wide-Awake Hand Surgery Program at a Military Medical Center: A Critical Analysis of the First 100 Procedures.

    Science.gov (United States)

    Rhee, Peter C; Fischer, Michelle M; Rhee, Laura S; McMillan, Ha; Johnson, Anthony E

    2017-03-01

    Wide-awake, local anesthesia, no tourniquet (WALANT) hand surgery was developed to improve access to hand surgery care while optimizing medical resources. Hand surgery in the clinic setting may result in substantial cost savings for the United States Military Health Care System (MHS) and provide a safe alternative to performing similar procedures in the operating room. A prospective cohort study was performed on the first 100 consecutive clinic-based WALANT hand surgery procedures performed at a military medical center from January 2014 to September 2015 by a single hand surgeon. Cost savings analysis was performed by using the Medical Expense and Performance Reporting System, the standard cost accounting system for the MHS, to compare procedures performed in the clinic versus the operating room during the study period. A study specific questionnaire was obtained for 66 procedures to evaluate the patient's experience. For carpal tunnel release (n = 34) and A1 pulley release (n = 33), there were 85% and 70% cost savings by having the procedures performed in clinic under WALANT compared with the main operating room, respectively. During the study period, carpal tunnel release, A1 pulley release, and de Quervain release performed in the clinic instead of the operating room amounted to $393,100 in cost savings for the MHS. There were no adverse events during the WALANT procedure. A clinic-based WALANT hand surgery program at a military medical center results in considerable cost savings for the MHS. Economic/Decision Analysis IV. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  6. [Development and application of poison databank and poisonous animal and plants sample databank].

    Science.gov (United States)

    Yin, Yu; Jiang, Shao-Feng; Cai, Jun; Luo, Tao; Xie, Li-Jing; Zhou, Jing; Sun, Cheng-Ye

    2008-03-01

    To establish a comprehensive,easily approached, operated, and searched internet poison databank as to providing professional poison data and knowledge of effective treatment for those consented such as medical staff, and emergency response team in the shortest time. We established a computer poison databank, by adopting B/S structure, using SQL Server databank, and explore technology, in which all information may easily be explored and obtained by users. The database integrated the information in relating to the substances identifiers, physical and chemical properties, toxicology data, clinical manifestation while intoxication, emergency response guides, effective treatment, anything related to the special antidotes, preventive measures, poison analysis, and manufacturers of chemicals, pharmaceuticals, herbs, pesticides, animal, plant, bacteria, fungi, productions and toxins. Otherwise some information about poison control organizations and experts, literatures about poison case reports, poison incidents, were also involved in the system, which can also provide a shortcut, convenient, and exact search. The databank might be easily used on several fields, providing important information with acute poison incidents disposal and clinic treatment.

  7. Analysis of nine cases of acute thallium poisoning.

    Science.gov (United States)

    Wang, Qiwei; Huang, Xiaojiang; Liu, Liang

    2007-04-01

    In this study nine cases of thallium poisoning in a series of homicidal poisoning were analyzed in order to provide more information concerning thallium poisoning. It was found that the most common clinical feature of thallium poisoning was peripheral neuropathy and paraesthesia was more common than amyasthenia. Understanding of these clinical characteristics of thallium poisoning was helpful to early identification and differential diagnosis. Since the early administration of Prussian Blue, as a specific antidote for thallium poisoning, can substantially improve the prognosis, it is of great importance to establish a correct and early diagnosis.

  8. New syndromes in mushroom poisoning.

    Science.gov (United States)

    Saviuc, Philippe; Danel, Vincent

    2006-01-01

    Several new mushroom poisoning syndromes have been described since the early 1990s. In these syndromes, the onset of symptoms generally occurs >6 hours after ingestion. Treatment is mainly supportive. The syndrome induced by Amanita smithiana/proxima consists of acute tubulopathy, which appears earlier and does not have the same poor prognosis as the orellanine-induced syndrome. It has been described since 1992 in the US and Canada with A. smithiana; in France, Spain and Italy with A. proxima; and in Japan with A. pseudoporphyria. The responsible toxin is probably 2-amino-4,5-hexadienoic acid. The erythromelalgia syndrome has been described as early as the late 19th century in Japan and South Korea with Clitocybe acromelalga, and since 1996 in France and then Italy with C. amoenolens. Responsible toxins are probably acromelic acids identified in both species. Several cases of massive rhabdomyolysis have been reported since 1993 in France and 2001 in Poland after ingestion of large amounts of an edible and, until then, valuable species called Tricholoma equestre. These cases of rhabdomyolysis are associated with respiratory and cardiac (myocarditis) complications leading to death. Rhabdomyolysis with an apparently different mechanism was described in Taiwan in 2001 with Russula subnigricans. Finally, cases of encephalopathy were observed twice after ingestion of Hapalopilus rutilans in Germany in 1992 and Pleurocybella porrigens in Japan in 2004, where a convulsive encephalopathy outbreak was reported in patients with history of chronic renal failure.

  9. Lead Poisoning in Wild Birds

    Science.gov (United States)

    Lahner, Lesanna L.; Franson, J. Christian

    2009-01-01

    Lead in its various forms has been used for thousands of years, originally in cooking utensils and glazes and more recently in many industrial and commercial applications. However, lead is a potent, potentially deadly toxin that damages many organs in the body and can affect all animals, including humans. By the mid 1990s, lead had been removed from many products in the United States, such as paint and fuel, but it is still commonly used in ammunition for hunting upland game birds, small mammals, and large game animals, as well as in fishing tackle. Wild birds, such as mourning doves, bald eagles, California condors, and loons, can die from the ingestion of one lead shot, bullet fragment, or sinker. According to a recent study on loon mortality, nearly half of adult loons found sick or dead during the breeding season in New England were diagnosed with confirmed or suspected lead poisoning from ingestion of lead fishing weights. Recent regulations in some states have restricted the use of lead ammunition on certain upland game hunting areas, as well as lead fishing tackle in areas frequented by common loons and trumpeter swans. A variety of alternatives to lead are available for use in hunting, shooting sports, and fishing activities.

  10. Poisoning cases and their management in emergency centres of government hospitals in northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Getnet Mequanint Adinew

    2017-06-01

    Discussion: Young females comprise a group at increased risk for suicidal poisonings. As a developing nation, pesticide and bleaching agents remain a significant cause of acute poisonings in Ethiopia. Intentional poisoning remains the most significant identified cause of poisoning overall.

  11. A case of localized retinal damage in thallium poisoning.

    Science.gov (United States)

    Schmidt, D; Bach, M; Gerling, J

    1997-01-01

    To determine the cause of visual impairment and to document the late eye disturbances in a case of thallium poisoning. A 44-year-old woman presented with a history of repeated attacks of complete alopecia over a period of several months, diffuse pain in both legs, transient gastrointestinal disturbances, abasia with a progressive paraparesis, paresthesia in the fingertips, and polyneuropathy. She complained of slowly progressive visual deterioration in both eyes which began about six months after the first attack of alopecia. The optic discs showed distinct signs of temporal atrophy together with a deep temporal excavation. The Goldmann perimetry revealed an absolute central scotoma. Traces of thallium were found in the urine and in the serum. The district attorney later discovered that her husband had been trying to poison her with thallium. The clinical and electrophysiological examinations included visual evoked potentials (VEP) and electroretinography (flash ERG, multifocal ERG and pattern ERG). The VEP showed a reduction in amplitude and a prolonged latency indicating a conduction block. The pattern ERG was initially normal. At a follow-up examination 6 years later, a slight amplitude reduction in the pattern ERG was found. The multifocal ERG showed a diminished amplitude in the center of the retina (up to +/- 10 degrees visual angle). The electrophysiological investigations in our patient--who had an optic atrophy--indicated a conduction block of the retinal nerve fibers (VEP) and an additional lesion at or before the retinal bipolar cells (multifocal ERG), localized in the central +/- 10 degrees. These findings suggest that thallium poisoning can lead to a combined lesion of the retinal nerve fibers and the neural retina.

  12. Toxicoepidemiology of acute poisoning cases in a secondary care hospital in rural South India: A five-year analysis

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    T H Indu

    2015-01-01

    Full Text Available Objective: To ascertain the trend of poisoning cases admitted to the Government District Headquarters Hospital, a secondary care center in Udhagamandalam, Nilgiris District, Tamil Nadu, India, over a five-year period. Materials and Methods: The number of cases that presented to the hospital annually (incidence, mortality, and case fatality rates, socio-demographic pattern, and the nature of the poison were noted. Results: A total of 1860 poisoning cases (80 deaths were reported during the period from October 2008 to September 2013. The incidence of poisoning was found to increase every year. The average incidence was 1.60 per 1000 population, while the average case fatality rate and mortality rates were 40.51 and 0.07, respectively. A total of 1148 (62% were males. The majority of cases were seen in the 21-30 age group (41.24%. The poisonings were largely deliberate self-harm (n = 1,755; 94.35%, followed by accidental (n = 85; 4.57%. Agrochemicals were the main choice of poisoning agents and among these, organophosphates were the major cause. Conclusion: The data generated can help policy makers take decisions on the sale and availability of pesticides in this region.

  13. Plant Poisoning among Children in Rural Sri Lanka

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    M. B. Kavinda Chandimal Dayasiri

    2017-01-01

    Full Text Available Plant poisoning is a common presentation in paediatric practice and an important cause of preventable mortality and morbidity in Sri Lanka. The burden of plant poisoning is largely underexplored. The current multicenter study based in rural Sri Lanka assessed clinical profiles, poison related factors, clinical management, complications, outcomes, and risk factors associated with plant poisoning in the paediatric age group. Among 325 children, 57% were male with 64% being below five years of age. 99.4% had ingested the poison. Transfer rate was 66.4%. Most had unintentional poisoning. Commonest poison plant was Jatropha circus and poisoning event happened mostly in home garden. 29% of parents practiced harmful first-aid practices. 32% of children had delayed presentations to which the commonest reason was lack of parental concern regarding urgency of seeking medical care. Presence of poisonous plants in home garden was the strongest risk factor for plant poisoning. Mortality rate was 1.2% and all cases had Oleander poisoning. The study revealed the value of community awareness regarding risk factors and awareness among healthcare workers regarding the mostly benign nature of plant poisoning in children in view of limiting incidence of plant poisoning and reducing expenditure on patient management.

  14. Suspected poisoning of domestic animals by pesticides.

    Science.gov (United States)

    Caloni, Francesca; Cortinovis, Cristina; Rivolta, Marina; Davanzo, Franca

    2016-01-01

    A retrospective study was carried out by reviewing all suspected cases of domestic animal poisoning attributed to pesticides, reported to the Milan Poison Control Centre (MPCC) between January 2011 and December 2013. During this period, pesticides were found to be responsible for 37.3% of all suspected poisoning enquiries received (815). The most commonly species involved was the dog (71.1% of calls) followed by the cat (15.8%), while a limited number of cases involved horses, goats and sheep. Most cases of exposure (47.1%) resulted in mild to moderate clinical signs. The outcome was reported in 59.9% of these cases, with death occurring in 10.4% of them. Insecticides (40.8%) proved to be the most common group of pesticides involved and exposure to pyrethrins-pyrethroids accounted for the majority of calls. According to the MPCC data, there has been a decrease in the number of suspected poisonings cases attributed to pesticides that have been banned by the EU, including aldicarb, carbofuran, endosulfan and paraquat. In contrast, there has been an increase of suspected poisoning cases attributed to the neonicotinoids, imidacloprid and acetamiprid, probably due to their widespread use in recent years. Cases of suspected poisoning that involved exposure to rodenticides accounted for 27.6% of calls received by the MPCC and anticoagulant rodenticides were the primary cause of calls, with many cases involving brodifacoum and bromadiolone. Herbicides were involved in 14.2% of calls related to pesticides and glyphosate was the main culprit in cases involving dogs, cats, horses, goats and sheep. As far as exposure to molluscicides (11.5%) and fungicides (5.9%), most of the cases involved dogs and the suspected poisoning agents were metaldehyde and copper compounds respectively. The data collected are useful in determining trends in poisoning episodes and identifying newly emerging toxicants, thus demonstrating the prevalence of pesticides as causative agents in animal

  15. Epidemiologic aspects of deliberate self-poisoning in adolescents: a hospital-based study in Tehran

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    Mohammadi N

    2007-08-01

    Full Text Available Background: The object of this study was to determine the epidemiological characteristics of deliberate self-poisoning in adolescents referred to the only poisoning center in Tehran. Methods: In a cross-sectional study, all cases of acute poisoning at the Loghman Hakim Hospital from May to December 2003 were reviewed. Data for adolescents (13-19 years of age were analyzed by SPSS for Windows, version 13 and STATA, version 8. Results: From a total of 9203 cases of deliberate self-poisoning, 28.5% were adolescents (2626 cases. The male/female ratio was 1/2.2. Approximately 87% were unmarried and 56% were students, while a total of 4859 different drugs/agents were used for self-poisoning (an average of 1.85 for each case. The majority of patients was from urban areas and had no history of attempted suicide. There was no difference between males and females regarding history of psychiatric and somatic disorders, though there was a significant difference in the average of age between male and female adolescents. Conclusions: Among adolescents, self-poisoning is more common in girls while the mean of age is younger in boys. Although the prevalence of psychiatric disorders in adolescents appears to be less than the general population, this may be related to differences in their situations or due to underestimation of their frequencies. Psychiatric care should be a necessary component of the care administered to adolescents who attempt suicide and must be based on the needs and basic assessment of the patient’s status. Research regarding the familial history of abuse, neglect, self-harm/ poi- soning should be undertaken so that such social issues can be prioritized and addressed.

  16. Pancreatitis in wild zinc-poisoned waterfowl

    Science.gov (United States)

    Sileo, Louis; Beyer, W. Nelson; Mateo, Rafael

    2003-01-01

    Four waterfowl were collected in the TriState Mining District (Oklahoma, Kansas and Missouri, USA), an area known to be contaminated with lead, cadmium and zinc (Zn). They were part of a larger group of 20 waterfowl collected to determine the exposure of birds to metal contamination at the site. The four waterfowl (three Branta canadensis, one Anas platyrhynchos) had mild to severe degenerative abnormalities of the exocrine pancreas, as well as tissue (pancreas, liver) concentrations of Zn that were considered toxic. The mildest condition was characterized by generalized atrophy of exocrine cells that exhibited cytoplasmic vacuoles and a relative lack of zymogen. The most severe condition was characterized by acini with distended lumens and hyperplastic exocrine tissue that completely lacked zymogen; these acini were widely separated by immature fibrous tissue. Because the lesions were nearly identical to the lesions reported in chickens and captive waterfowl that had been poisoned with ingested Zn, and because the concentrations of Zn in the pancreas and liver of the four birds were consistent with the concentrations measured in Zn-poisoned birds, we concluded that these waterfowl were poisoned by Zn. This may be the first reported case of zinc poisoning in free-ranging wild birds poisoned by environmental Zn.

  17. Histamine (Scombroid) Fish Poisoning: a Comprehensive Review.

    Science.gov (United States)

    Feng, Charles; Teuber, Suzanne; Gershwin, M Eric

    2016-02-01

    Histamine fish poisoning, also known as scombroid poisoning, is the most common cause of ichythyotoxicosis worldwide and results from the ingestion of histamine-contaminated fish in the Scombroidae and Scomberesocidae families, including mackerel, bonito, albacore, and skipjack. This disease was first described in 1799 in Britain and re-emerged in the medical literature in the 1950s when outbreaks were reported in Japan. The symptoms associated with histamine fish poisoning are similar to that of an allergic reaction. In fact, such histamine-induced reactions are often misdiagnosed as IgE-mediated fish allergy. Indeed, histamine fish poisoning is still an underrecognized disease. In this review, we discuss the epidemiology, pathophysiology, evaluation, and treatment of scombroid disease. Because more than 80% of fish consumed in the USA is now imported from other countries, the disease is intimately linked with the global fish trade (National Marine Fisheries Service, 2012). Preventing future scombroid outbreaks will require that fishermen, public health officials, restaurant workers, and medical professionals work together to devise international safety standards and increase awareness of the disease. The implications of scombroid poisoning go far beyond that of fish and have broader implications for the important issues of food safety.

  18. [Lead poisoning from traditional Indian medicines].

    Science.gov (United States)

    Garnier, Robert; Poupon, Joël

    2006-01-01

    The use of traditional remedies is spreading rapidly in developed countries. Although it is commonly thought that such medications are not harmful because they are of natural origin, they often contain dangerous ingredients, especially heavy metals. Several cases of poisoning, mainly lead poisoning, have been published, but none to our knowledge in France. We recently observed a case of lead poisoning in a man who had been taking ayurvedic remedies. A 32-year-old man was repeatedly hospitalized for paroxysmal abdominal pain with constipation, weight loss, anemia, and mild elevation of liver enzyme levels. Four months after the initial admission, blood lead measurement showed heavy metal poisoning. The patient was treated with a chelating agent and recovered uneventfully. Investigation revealed that the lead source was self-medication with an ayurvedic remedy, a powder used for four weeks before the first hospitalization. To our knowledge this is the first reported French case of lead poisoning due to a traditional remedy. The problem is undoubtedly more widespread, however, for use of traditional remedies is growing more here, and many of them contain dangerous ingredients. Patients from communities known to use traditional medicines or recently returned from countries where such treatments are widespread should be directly questioned about their use of these remedies, because this information will not usually be volunteered. Information directed at populations at risk is also advisable, for most users are unaware that so-called 'natural' medicines can be dangerous.

  19. An outbreak of foxglove leaf poisoning.

    Science.gov (United States)

    Lin, Chun-Chi; Yang, Chen-Chang; Phua, Dong-Haur; Deng, Jou-Fang; Lu, Li-Hua

    2010-02-01

    Comfrey (Symphytum officinale) leaves resemble those of foxglove (Digitalis purpurea) when the plant is not in bloom and, therefore, cardiac glycoside poisoning may occur when people confuse foxglove with comfrey. We report an outbreak of foxglove leaf poisoning following the use of alleged "comfrey" herbal tea. Nine patients were involved and initially presented with nausea, vomiting, diarrhea and dizziness. Significant cardiotoxicity developed later among the 3 patients who also had mild hyperkalemia. Peak serum digoxin concentration measured by immunoassay was elevated in all patients and ranged from 4.4 ng/mL to 139.5 ng/mL. Patients with severe cardiotoxicity were treated with temporary cardiac pacing. Moreover, 40-80 mg of digoxin-specific antibody therapy was given without any effect. All patients recovered uneventfully. Our report highlights the potential risk of misidentification of herbs; in this case, D. purpurea was mistaken for S. officinale. Physicians should be aware that cardiac glycoside poisoning could arise from such misidentification. Public education about the toxicity of D. purpurea poisoning may reduce the risk of misidentification and subsequent poisoning. Copyright 2010 Elsevier. Published by Elsevier B.V. All rights reserved.

  20. An Outbreak of Foxglove Leaf Poisoning

    Directory of Open Access Journals (Sweden)

    Chun-Chi Lin

    2010-02-01

    Full Text Available Comfrey (Symphytum officinale leaves resemble those of foxglove (Digitalis purpurea when the plant is not in bloom and, therefore, cardiac glycoside poisoning may occur when people confuse foxglove with comfrey. We report an outbreak of foxglove leaf poisoning following the use of alleged “comfrey” herbal tea. Nine patients were involved and initially presented with nausea, vomiting, diarrhea and dizziness. Significant cardiotoxicity developed later among the 3 patients who also had mild hyperkalemia. Peak serum digoxin concentration measured by immunoassay was elevated in all patients and ranged from 4.4 ng/mL to 139.5 ng/mL. Patients with severe cardiotoxicity were treated with temporary cardiac pacing. Moreover, 40–80 mg of digoxin-specific antibody therapy was given without any effect. All patients recovered uneventfully. Our report highlights the potential risk of misidentification of herbs; in this case, D. purpurea was mistaken for S. officinale. Physicians should be aware that cardiac glycoside poisoning could arise from such misidentification. Public education about the toxicity of D. purpurea poisoning may reduce the risk of misidentification and subsequent poisoning.

  1. Alexander Mikhailovich Zakharov and his works on the venom apparatus and venoms of some poisonous snakes

    Directory of Open Access Journals (Sweden)

    Cherlin Vladimir Alexandrovich

    2013-10-01

    Full Text Available The article gives brief biographical information about a very talented herpetologist Alexander M. Zakharov, and describes the general results of his works on the structure and function of venom glands of some poisonous snakes and their venoms. In his studies, he got the results, which are fundamentally different from the conventional concept of 30s - 70s of the XX century. Unfortunately, among physicians this concept has not changed up today. At that time it was thought that the poisons of Viperidae snakes are almost completely hemotoxic, and poisons of Elapidae (cobra are almost neurotoxic. But A.M.Zaharov found out, that poisons of both types of snakes (Viperidae and Elapidae include three groups of substances: hemotoxins, neurotoxins and non-toxic component – hyaluronidase. Each of these groups of substances is produced by independent part of venom glands and has its own special effect. Neurotoxins act on the central nervous system (mainly the respiratory center, but are greatly destroyed by means of the blood antigen properties and cannot pass through the hematoencephalic barrier. Hyaluronidase , connecting with neurotoxins, has an important property – to "smuggle" neurotoxins through the hematoencephalic barrier exactly into the target organ – the respiratory center in the central nervous system. In this case, neurotoxin enters the respiratory center not through the blood and lymph vessels, but directly through the nerve channel, through synapsis. The main function of hemotoxins is not to kill the victim, but to protect neurotoxins and hyaluronidase from the destructive activity of the victim's blood. Therefore, the target of the poisons of Viperidae and Elapidae snakes is the central nervous system of victims, but Elapidae has almost no hemotoxins. That’s why their striking effect can be achieved only by a strong increase in the amount of neurotoxins and hyaluronidase. Hemotoxins of Viperidae venoms permits to reduce the amount of

  2. Poison Ivy, Oak, and Sumac

    Science.gov (United States)

    ... Registration General information Housing & travel Education Exhibit hall Mobile app 2019 Annual Meeting Derm Exam Prep Course ... SkinPAC State societies Scope of practice Truth in advertising NP/PA laws Action center Public and patients ...

  3. [Poisonous plants: An ongoing problem].

    Science.gov (United States)

    Martínez Monseny, A; Martínez Sánchez, L; Margarit Soler, A; Trenchs Sainz de la Maza, V; Luaces Cubells, C

    2015-05-01

    A medical visit for plant ingestion is rare in the pediatric emergency services but may involve a high toxicity. The botanical toxicology training of health staff is often very limited, and it can be difficult to make a diagnosis or decide on the appropriate treatment. To study the epidemiological and clinical characteristics of poisoning due to plant ingestion in order to increase the knowledge of the health professional. A descriptive retrospective study was conducted on patients seen in a pediatric emergency department after the ingestion of plant substances from January 2008 to December 2012. During the period of study, 18 patients had ingested possible toxic plants. In 14 cases, it was considered to be potentially toxic: broom, oleander, mistletoe, butcher's-broom, and vulgar bean (2), Jerusalem tomato, castor (2), Jimson weed, potus, marijuana, and mushrooms with digestive toxicity (2). Among the potentially toxic cases, the ingestion was accidental in 10 patients, 2 cases were classed as infantile mistreatment, 1 case had recreational intention, and another one suicidal intentions. The ingestion of oleander, castor and Jimson weed had major toxicity. The potential gravity of the ingestion of plant substances and the variety of the exposure mechanism requires the pediatrician to bear in mind this possibility, and to be prepared for its diagnosis and management. Specific preventive information measures need to be designed for the families and for the regulation of toxic plants in playgrounds. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  4. An accidental poisoning with mitragynine.

    Science.gov (United States)

    Karinen, Ritva; Fosen, Jan Toralf; Rogde, Sidsel; Vindenes, Vigdis

    2014-12-01

    An increasing number of drugs of abuse are sold word wide over the internet. Names like "legal highs", "herbal highs" etc. give the impression that these are safe products, although the risk of fatal reactions might be substantial. Leaves from the plant Mitragyna speciosa, contain active compounds like mitragynine and 7-hydroxymitragynine. It has been reported that the potency of 7-hydroxymitragynine at the μ-opioid receptor is 30 times higher than that of mitragynine and 17 times higher than that of morphine. Case reports regarding poisoning with Kratom are reported, but the toxic or lethal ranges for the concentrations of the active substances have not been established, and concentrations of 7-hydroxymitragynine have not been reported previously. We present a case report where a middle aged man was found dead at home. The deceased had a history of drug abuse and mental illness for several years. At autopsy, there were no significant pathological findings. Post-mortem analysis of peripheral blood revealed: zopiclone 0.043mg/L, citalopram 0.36mg/L and lamotrigine 5.4mg/L, i.e. concentrations regularly seen after therapeutic ingestion of these drugs. Additionally mitragynine 1.06mg/L and 7-hydroxymitragynine 0.15mg/L were detected in blood and both also in urine. The high concentrations of mitragynine and 7-hydroxymitragynine indicate that the cause of death is intoxication by these substances; and the circumstances point toward the manner of death being accidental. We recommend that both mitragynine and 7-hydroxymitragynine are analyzed for in cases with suspected Kratom intoxication. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. [The most popular poisons from Graeco-Roman world].

    Science.gov (United States)

    Siek, Bartlomiej; Rys, Anna; Sein Anand, Jacek

    2013-01-01

    Article presents the most popular antique poisons. Information from encyclopaedic literature and literary texts of the Roman Empire period has been compared with the etymology of the names of some poisons of plant and animal origin.

  6. NCHS - Drug Poisoning Mortality by County: United States

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset describes drug poisoning deaths at the county level by selected demographic characteristics and includes age-adjusted death rates for drug poisoning...

  7. Poison blamed for decline of Spain's majestic Black Vultures

    African Journals Online (AJOL)

    2007-03-01

    catastrophic” decline in numbers because of illegal poisoning by hunters. The use of poisoned bait to kill foxes, badgers, wild dogs, feral cats and smaller birds of prey has reduced the population by almost a half in the past decade,.

  8. Poison prevention practices and medically attended poisoning in young children: multicentre case-control study.

    Science.gov (United States)

    Kendrick, Denise; Majsak-Newman, Gosia; Benford, Penny; Coupland, Carol; Timblin, Clare; Hayes, Mike; Goodenough, Trudy; Hawkins, Adrian; Reading, Richard

    2017-04-01

    Childhood poisonings are common, placing a substantial burden on health services. Case-control studies have found inconsistent evidence about modifiable risk factors for poisonings among children aged 0-4 years. This study quantifies associations between poison prevention practices and medically attended poisonings in children aged 0-4 years. Multicentre case-control study conducted at hospitals, minor injury units and family practices from four study centres in England between 2010 and 2013. Participants comprised 567 children presenting with unintentional poisoning occurring at home and 2320 community control participants matched on age, sex, date of event and study centre. Parents/caregivers provided data on safety practices, safety equipment use, home hazards and potential confounders by means of self-completion questionnaires. Data were analysed using conditional logistic regression. Compared with community controls, parents of poisoned children were significantly more likely not to store medicines out of reach (adjusted OR (AOR) 1.59; 95% CI 1.21 to 2.09; population attributable fraction (PAF) 15%), not to store medicines safely (locked or out of reach (AOR 1.83; 95% CI 1.38 to 2.42; PAF 16%) and not to have put all medicines (AOR 2.11; 95% CI 1.54 to 2.90; PAF 20%) or household products (AOR 1.79, 95% CI 1.29 to 2.48; PAF 11%) away immediately after use. Not storing medicines out of reach or locked away and not putting medicines and household products away immediately after use increased the odds of secondary care attended poisonings in children aged 0-4 years. If associations are causal, implementing these poison prevention practices could each prevent between 11% and 20% of poisonings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  9. Acute Anterolateral Myocardial Infarction Due to Aluminum Phosphide Poisoning

    Directory of Open Access Journals (Sweden)

    2013-08-01

    Full Text Available Aluminum phosphide (AlP is a highly effective rodenticide which is used as a suicide poison. Herein, a 24 year-old man who’d intentionally ingested about 1liter of alcohol and one tablet of AlP is reported. Acute myocardial infarction due to AlP poisoning has been occurred secondary to AIP poisoning. Cardiovascular complications are poor prognostic factors in AlP poisoning

  10. Pattern of Poisoning Cases in a Tertiary Hospital in Bangladesh

    OpenAIRE

    AKM Rafique Uddin; Md Imran Ali; Nazmul Haque; Naser Ahmed; Rukhsana Parvin

    2011-01-01

    Background: Poisoning with various substances is a global problem. It is one of the most important reasons for emergency admission in the hospital. The earlier the initial resuscitations, gastric decontamination and use of specific antidotes, the better is the outcome. Epidemiology of poisoning differs from region to region. This study was carried out to determine the pattern and severity of poisoning in a tertiary care hospital. Objective: To characterize the poisoning cases admitted in Enam...

  11. Extracorporeal treatment for valproic acid poisoning

    DEFF Research Database (Denmark)

    Ghannoum, Marc; Laliberté, Martin; Nolin, Thomas D

    2015-01-01

    BACKGROUND: The EXtracorporeal TReatments In Poisoning (EXTRIP) workgroup presents its systematic review and clinical recommendations on the use of extracorporeal treatment (ECTR) in valproic acid (VPA) poisoning. METHODS: The lead authors reviewed all of the articles from a systematic literature...... search, extracted the data, summarized the key findings, and proposed structured voting statements following a predetermined format. A two-round modified Delphi method was chosen to reach a consensus on voting statements and the RAND/UCLA Appropriateness Method was used to quantify disagreement....... The workgroup concluded that VPA is moderately dialyzable (level of evidence = B) and made the following recommendations: ECTR is recommended in severe VPA poisoning (1D); recommendations for ECTR include a VPA concentration > 1300 mg/L (9000 μmol/L)(1D), the presence of cerebral edema (1D) or shock (1D...

  12. Zebrafish Models for Human Acute Organophosphorus Poisoning.

    Science.gov (United States)

    Faria, Melissa; Garcia-Reyero, Natàlia; Padrós, Francesc; Babin, Patrick J; Sebastián, David; Cachot, Jérôme; Prats, Eva; Arick Ii, Mark; Rial, Eduardo; Knoll-Gellida, Anja; Mathieu, Guilaine; Le Bihanic, Florane; Escalon, B Lynn; Zorzano, Antonio; Soares, Amadeu M V M; Raldúa, Demetrio

    2015-10-22

    Terrorist use of organophosphorus-based nerve agents and toxic industrial chemicals against civilian populations constitutes a real threat, as demonstrated by the terrorist attacks in Japan in the 1990 s or, even more recently, in the Syrian civil war. Thus, development of more effective countermeasures against acute organophosphorus poisoning is urgently needed. Here, we have generated and validated zebrafish models for mild, moderate and severe acute organophosphorus poisoning by exposing zebrafish larvae to different concentrations of the prototypic organophosphorus compound chlorpyrifos-oxon. Our results show that zebrafish models mimic most of the pathophysiological mechanisms behind this toxidrome in humans, including acetylcholinesterase inhibition, N-methyl-D-aspartate receptor activation, and calcium dysregulation as well as inflammatory and immune responses. The suitability of the zebrafish larvae to in vivo high-throughput screenings of small molecule libraries makes these models a valuable tool for identifying new drugs for multifunctional drug therapy against acute organophosphorus poisoning.

  13. Thallium poisoning from maliciously contaminated food.

    Science.gov (United States)

    Meggs, W J; Hoffman, R S; Shih, R D; Weisman, R S; Goldfrank, L R

    1994-01-01

    Four young adults presented two days after one of them had received marzipan balls packaged in a box from an expensive candy manufacturer. Two ate one candy ball, while two others shared a third. The next day, variable gastrointestinal symptoms developed. On the third day, two patients developed painful paresthesiae of the hands and feet, an early but nonspecific clinical marker of thallium poisoning. A tentative diagnosis of thallium poisoning was made based on symptoms, and treatment was initiated. The remaining candies were radiographed. Metallic densities in the candies supported the diagnosis, and atomic absorption spectroscopy was used to quantitate thallium content. Each candy contained a potentially fatal dose. Five to seven days later, hypertension and tachycardia developed in the two patients who had ingested an entire candy. All patients developed alopecia but recovered without overt neurologic or other sequelae. While the diagnosis of thallium poisoning is often delayed until alopecia develops, an early diagnosis favors an effective treatment strategy.

  14. Poisoned after Dinner: Dolma with Datura Stramonium.

    Science.gov (United States)

    Disel, Nezihat Rana; Yilmaz, Mustafa; Kekec, Zeynep; Karanlik, Meryem

    2015-03-01

    Datura stramonium, which is also known as Thorn Apple or Jimson Weed, is an alkaloid containing plant that is entirely toxic. The active toxic constituents of the plant are atropine, scopolamine and hyoscyamine. It has been abused worldwide for hundreds of years because of its hallucinogenic properties. Previous reports have shown that herbal medication overdose and accidental food contamination are ways it can cause poisoning. Herein we present a family that had three of its members poisoned after eating a traditional meal "dolma" made of datura flowers. None had fatal complications and all were discharged healthy. Datura stromonium may be used accidentally as a food ingredient. Since its poisonous effects are not known, people should be informed and warned about the effects of this plant.

  15. Teenagers with Jimson weed (Datura stramonium) poisoning.

    Science.gov (United States)

    Spina, Sean P; Taddei, Anthony

    2007-11-01

    We report 2 cases of teenagers who were poisoned with Jimson weed (Datura stramonium) and presented to the emergency department with a severe acute anticholinergic toxidrome after ingestion of several hundred seeds. The patients presented with visual hallucinations, disorientation, incomprehensible and nonsensical speech, and dilated sluggish pupils. Both patients required restraints for combativeness until adequate sedation with lorazepam and haloperidol was achieved. Jimson weed is found in southern Canada and the United States and can cause acute anticholinergic poisoning and death in humans and animals. The treatment of choice for anticholinergic poisoning is mainly supportive care and gastrointestinal decontamination with activated charcoal. Jimson weed intoxication should be considered in cases of patients presenting with unexplained peripheral and central anticholinergic symptoms including delirium, agitation and seizures, especially among younger patients and partygoers. It is important that health care professionals recognize that Jimson weed is a toxic, indigenous, "wild" growing plant, subject to misuse and potentially serious intoxication requiring hospitalization.

  16. Hyperamylasaemia and acute pancreatitis in paracetamol poisoning

    DEFF Research Database (Denmark)

    Schmidt, L E; Dalhoff, K

    2004-01-01

    BACKGROUND: Hyperamylasaemia and even acute pancreatitis have been reported in patients with paracetamol poisoning. AIMS: To describe the incidence, clinical characteristics, and prognostic implications of hyperamylasaemia in paracetamol poisoning. PATIENTS: Six hundred and two patients transferred...... to a specialized unit with severe paracetamol poisoning and 212 unselected patients admitted from the local region. METHODS: Retrospective study based on hospital charts. The optimum threshold of serum amylase to discriminate non-survivors was identified. RESULTS: An elevated serum amylase (>100 U/L) occurred...... in 28 of the unselected patients (13%), in 218 of the transferred patients (36%), and in 118 of 148 patients (80%) with fulminant hepatic failure. Only 33 cases of paracetamol-associated acute pancreatitis were diagnosed. A threshold serum amylase of 150 U/L to discriminate non-survivors had sensitivity...

  17. Peripheral blood stem cells collection on spectra optia apheresis system using the continuous mononuclear cell collection protocol: A single center report of 39 procedures.

    Science.gov (United States)

    Sanderson, F; Poullin, P; Smith, R; Nicolino-Brunet, C; Philip, P; Chaib, A; Costello, R

    2017-06-01

    The aim of the study was to assess the performance of the new Continuous Mononuclear Cell Collection (CMNC) protocol on the Spectra Optia Apheresis System for collecting autologous Peripheral Blood Stem Cells (PBSC) in adult patients with respect to collection variables, CD34+ cells harvest prediction and engraftment data. In this retrospective study, 39 CMNC procedures on 23 mobilized patients with multiple myeloma and lymphoma were analyzed. CD34+ cells and blood cells yields, collection efficiencies (CE1 and CE2), cell losses were calculated. Engraftment data of 17 autologous transplantations were collected. Apheresis duration was 239 min for a product volume of 220 mL. Cell product haematocrit, MNC and platelets counts were acceptable (respectively 2.4%, 65%, 834 x 109/L). Median platelet loss was 27.3%. Median CD34+ CE1 and CE2 were 64.6% and 48.5% respectively. We harvested 2.92 × 10 6 CD34+ cells/kg, with a CD34 dose ≥ 2 × 10 6 /kg for 67% of the procedures. Linear correlation between preapheresis CD34 count and the CP CD34 dose/kg allowed a prediction model with a decrease trend for high WBC precount. Procedures were well tolerated. For 17 autologous transplantations, median time to neutrophils and platelets reconstitutions were 12 and 13 days respectively. Spectra Optia CMNC protocol successfully collected CD34+ cells with yields permitting the harvest of sufficient enriched grafts for autologous transplantation. The CD34+ cell yield prediction was excellent. PBSC collection with CMNC protocol had advantages of high processing rate, low product volume, and acceptable contamination by platelets. J. Clin. Apheresis 32:182-190, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  18. Aluminum phosphide poisoning: an unsolved riddle.

    Science.gov (United States)

    Anand, R; Binukumar, B K; Gill, Kiran Dip

    2011-08-01

    Aluminum phosphide (ALP), a widely used insecticide and rodenticide, is also infamous for the mortality and morbidity it causes in ALP-poisoned individuals. The toxicity of metal phosphides is due to phosphine liberated when ingested phosphides come into contact with gut fluids. ALP poisoning is lethal, having a mortality rate in excess of 70%. Circulatory failure and severe hypotension are common features of ALP poisoning and frequent cause of death. Severe poisoning also has the potential to induce multi-organ failure. The exact site or mechanism of its action has not been proved in humans. Rather than targeting a single organ to cause gross damage, ALP seems to work at the cellular level, resulting in widespread damage leading to multiorgan dysfunction (MOD) and death. There has been proof in vitro that phosphine inhibits cytochrome c oxidase. However, it is unlikely that this interaction is the primary cause of its toxicity. Mitochondria could be the possible site of maximum damage in ALP poisoning, resulting in low ATP production followed by metabolic shutdown and MOD; also, owing to impairment in electron flow, there could be free radical generation and damage, again producing MOD. Evidence of reactive oxygen species-induced toxicity owing to ALP has been observed in insects and rats. A similar mechanism could also play a role in humans and contribute to the missing link in the pathogenesis of ALP toxicity. There is no specific antidote for ALP poisoning and supportive measures are all that are currently available. Copyright © 2011 John Wiley & Sons, Ltd.

  19. Comparison of US population and live birth rates with poison exposures reported to the National Poison Data System (NPDS): children ages 0-5 years from 2000 to 2012.

    Science.gov (United States)

    Spiller, H A; Spyker, D A; Casavant, M J

    2013-03-01

    Monitoring of poison control center data has provided an important public health surveillance tool. Previous work has identified the population with the greatest risk of poisoning as children of poison center volume. Therefore, one would expect population changes to be reflected in corresponding National Poison Data system (NPDS) call volume changes. We examined this relationship. This was a retrospective comparison of young children's poison exposures reported to NPDS with changes in US population as reported by the US Census Bureau and by live birth counts in the United States. We examined the relation of population and live birth counts to NPDS exposures in children of 0-5 years and for the total (children of 0-5 years). There was a statistically significant relation between exposures and population for the three of the seven age groups (1-3 years old) and between exposures and live birth counts for the five of the seven age groups (1-4 years old and total (0-5)). The highest correlation was seen with the age groups of 2-year olds (r = 0.815; slope, 4.7373; 95% CI, 2.36-7.11) and 1-year olds (r = 0.785; slope, 4.878; 95% CI, 2.163-7.592). Live birth count was more closely related than population for all but the 1-year-old age groups. Our study reports a number of interesting findings including 1) live birth counts and population are closely associated with each other, 2) poison exposures in NPDS were more strongly associated with live birth counts than with population, 3) the population at greatest risk is the 1- and 2-year-old age groups and the strongest associations between exposures and population and exposures and live birth counts occurred in these two age groups, and 4) changes occurring in the live birth counts, both positive and negative, were reflected in annual changes reported in NPDS human exposures in children poison exposures and suggests that the population at risk should be considered in monitoring poisoning injuries in the future. These results

  20. Fight Homemade Poisons: Home Food Care and Preservation.

    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 food poisoning. Using a simplified vocabulary and shorter sentences, it explains the various kinds of food poisoning, how people get food poisoning, and how to prevent it. (FL)