-
Praxis 2018Cause of Death: 'Intoxication' - a Matter of the Concentration? Abstract. Elucidation of the cause of death is one of the main reasons for medico-legal investigations.... (Review)
Review
Cause of Death: 'Intoxication' - a Matter of the Concentration? Abstract. Elucidation of the cause of death is one of the main reasons for medico-legal investigations. In clinical toxicology, the severity of a given poisoning is typically assessed with the blood concentration of a pharmacologically or toxicologically active compound. Such an interpretation proves to be difficult or even impossible in postmortem toxicology. Numerous biochemical and biological processes beginning immediately after death may render the calculated drug concentration unreliable. Concentrations obtained from postmortem samples do not necessarily reflect the blood concentration at the time of death. A prediction if and to what extent such postmortem changes might have occurred is still impossible for individual cases. Interpretation therefore needs to be done with care, considering case circumstances and all available information.
Topics: Cause of Death; Dose-Response Relationship, Drug; Forensic Toxicology; Humans; Poisoning; Poisons
PubMed: 30376777
DOI: 10.1024/1661-8157/a003057 -
Toxicology and Applied Pharmacology Sep 2005The sarin gas attack in the Tokyo subway system is reviewed from a clinical toxicology perspective. Based on the lessons learned from this attack, the following areas... (Review)
Review
The sarin gas attack in the Tokyo subway system is reviewed from a clinical toxicology perspective. Based on the lessons learned from this attack, the following areas should be addressed on a global scale. First, an adequate supply of protective equipment is required, including level B protective equipment with a pressure demand breathing apparatus. In addition, a system should be established that enables a possible cause to be determined based on symptoms, physical findings, general laboratory tests, and a simple qualitative analysis for poisonous substances. If an antidote is needed, the system should enable it to be administered to the victims as quickly as possible. Preparation for a large-scale chemical attack by terrorists requires the prior establishment of a detailed decontamination plan that utilizes not only mass decontamination facilities but also public facilities in the area. A system should be established for summarizing, evaluating, and disseminating information on poisonous substances. Finally, a large-scale scientific investigation of the Tokyo sarin attack should be conducted to examine its long-term and subclinical effects and the effects of exposure to asymptomatic low levels of sarin.
Topics: Antidotes; Chemical Warfare Agents; Chromatography, Gas; Chromatography, High Pressure Liquid; Humans; Mass Spectrometry; Poisoning; Protective Devices; Sarin; Terrorism; Tokyo
PubMed: 15979676
DOI: 10.1016/j.taap.2005.02.032 -
Journal of Pharmacy Practice Apr 2011Clinicians are frequently confronted with toxicological emergencies and challenged with the task of correctly identifying the possible agents involved and providing... (Review)
Review
Clinicians are frequently confronted with toxicological emergencies and challenged with the task of correctly identifying the possible agents involved and providing appropriate treatments. In this review article, we describe the epidemiology of overdoses, provide a practical approach to the recognition and diagnosis of classic toxidromes, and discuss the initial management strategies that should be considered in all overdoses. In addition, we evaluate some of the most common agents involved in poisonings and present their respective treatments. Recognition of toxidromes with knowledge of indications for antidotes and their limitations for treating overdoses is crucial for the acute care of poisoned patients.
Topics: Antidotes; Critical Care; Drug Overdose; Emergency Treatment; Humans; Poisoning; Poisons; Toxicology
PubMed: 21712212
DOI: 10.1177/0897190011400552 -
Cahiers D'anesthesiologie Nov 1969
Review
Topics: Acute Kidney Injury; Bronchopneumonia; Heart Diseases; Humans; Kidney Concentrating Ability; Kidneys, Artificial; Peritoneal Dialysis; Poisoning; Poisons; Renal Dialysis
PubMed: 4911140
DOI: No ID Found -
Journal of Medical Toxicology :... Mar 2006
Topics: Evidence-Based Medicine; Humans; Periodicals as Topic; Poisoning; Poisons; Societies, Medical; Societies, Scientific; Terminology as Topic; Toxicology
PubMed: 18072103
DOI: 10.1007/BF03161004 -
Journal of Renal Care Mar 2012Cases of people presenting with poisoning are likely to develop acute renal failure (ARF), which may be due to multiple mechanisms/aetiologies. These cases need careful...
BACKGROUND
Cases of people presenting with poisoning are likely to develop acute renal failure (ARF), which may be due to multiple mechanisms/aetiologies. These cases need careful observation and appropriate treatment.
OBJECTIVE
To find the risk of ARF among acute poisoning cases, identify the underlying causes and to analyse the outcome.
MATERIAL AND METHODS
In this prospective study with nested case control, 1,250 cases admitted to the Poison Control, Training and Research Centre of Government General Hospital, Madras Medical College were monitored and evaluated for development of ARF. Patients with history of diabetes/hypertension, known chronic kidney disease, chronic NSAID therapy, those on drugs that increase serum creatinine by inhibiting creatinine secretion and other co-morbid illnesses were excluded. Data were interpreted after subjecting them to bivariate logistic regression and then step wise multivariate analysis.
RESULTS
Thirty-two cases developed ARF. Twenty-four were due to snake bite, the rest due to chemical poisons. Chances of developing ARF were greater (6.15%) among the poisoning due to bites and stings than chemical poisoning (0.9%). Five in the former and seven in the latter expired. Among cases bitten by snakes, only 22 (7%) cases bitten by Russell Viper Daboia russelii developed renal failure. Copper sulphate and rat killer poisonings were the commonest causes of chemical induced ARF, dichromate, indigenous medicines and vasmol 33 (paraphenelyne diamine) were the least causes for ARF. None of the patients with organophosphate developed ARF nor did any of the 150 admitted for overdose of medicines developed ARF.
CONCLUSION
The risk of ARF among the cases of poisoning was 2.5%. The outcome of ARF among bites and stings was better than chemical poisoning, and the difference was highly significant (p= 0.005, OR = 0.04-1.0, 95% CI = 0.004-0.38). Early recognition and appropriate measures reduce the occurrence of ARF.
Topics: Acute Kidney Injury; Animals; Case-Control Studies; Humans; India; Logistic Models; Multivariate Analysis; Poisoning; Poisons; Prospective Studies; Risk Factors; Snake Bites
PubMed: 21951386
DOI: 10.1111/j.1755-6686.2011.00255.x -
BMC Pharmacology & Toxicology Dec 2022Several studies worldwide have investigated household product poisoning. We conducted a toxico-clinical study on the two-year prevalence of poisoning with household...
BACKGROUND
Several studies worldwide have investigated household product poisoning. We conducted a toxico-clinical study on the two-year prevalence of poisoning with household products.
METHODS
This cross-sectional study was performed in Khorshid Hospital, the main referral center for poisoning cases in Isfahan, affiliated to Isfahan University of Medical Sciences, Isfahan, central Iran. All patients with intentional or unintentional household substance poisoning, referring to the poisoning emergency center of the hospital, were evaluated with respect to epidemiological and toxico-clinical features and outcomes.
RESULTS
During the study period, 5946 patients were hospitalized, of which 83 (1.39%) had been poisoned with household products including 48 (57.8%) men and 35 (42.2%) women with a mean ± SD age of 34.40 ± 17.71 years. Most patients (54.2%) were in the 20-40-year-old age group. Accidental poisoning (63.9%) was the most common type of exposure (P = 0.02) predominantly in men (57.8%, P = 0.51). The most common household products were sodium hypochlorite (32.53%) followed by petroleum hydrocarbon (21.68%). Most of the accidental poisonings (77.8%) were due to petroleum hydrocarbon. 59% of cases were poisoned at home (P < 0.0001). No patient died.
CONCLUSION
Household products were not common means of poisoning in our referral center. Sodium hypochlorite and petroleum hydrocarbon were the most common substances. Most of the patients were men with accidental exposure at home. Because of the availability of the household product, the frequency and outcomes may be varied in different societies.
Topics: Male; Humans; Female; Adolescent; Young Adult; Adult; Middle Aged; Cross-Sectional Studies; Poisons; Sodium Hypochlorite; Household Products; Petroleum; Retrospective Studies; Poisoning
PubMed: 36581950
DOI: 10.1186/s40360-022-00640-z -
Kinderarztliche Praxis Apr 1989We could demonstrate the possibilities and limitations of the extracorporal detoxications by accidental poisonings in children. The effective use of hemodialysis,... (Review)
Review
We could demonstrate the possibilities and limitations of the extracorporal detoxications by accidental poisonings in children. The effective use of hemodialysis, hemoperfusion, and plasmapheresis in poisonings during childhood under special consideration of the parameters such as molecular weights, half time rate, proteinbinding, distribution volume, pattern of solubility, and metabolism is shown and critically discussed.
Topics: Child; Hemoperfusion; Humans; Plasmapheresis; Poisoning; Poisons; Renal Dialysis
PubMed: 2661897
DOI: No ID Found -
British Medical Journal Aug 1969
Topics: Adolescent; Adult; Aged; Female; Humans; Male; Mental Disorders; Organization and Administration; Poison Control Centers; Poisoning; Poisons; Scotland; Statistics as Topic; Suicide; Workforce
PubMed: 5801344
DOI: 10.1136/bmj.3.5669.489 -
Pakistan Journal of Health Oct 1954
Topics: Poisoning; Poisons
PubMed: 14370823
DOI: No ID Found