Saturday with SMACC: Motorbike Mayhem
The lecture by John Hinds (@DocJohnHinds) last March at SMACC Gold in Brisbane was one of the most fascinating and unusual presentations I’ve ever seen at a medical conference. Hinds, a consultant anesthesiologist and intensivist at Craigavon Area Hospital in Northern Ireland, is also a motor bike racing enthusiast. His riveting account of the types of injuries that can occur in this sport — and how to manage them — should not be missed. To hear the lecture and access the slide set, click here.
And that brings us to breaking, very exciting news. The brochure for SMACC CHICAGO has just been released, with just an ...
Source: The Poison Review - November 1, 2014 Category: Toxicology Authors: Leon Tags: Medical john hinds motor bike injury SMACC Gold smack chicago Source Type: news
Tox Tunes #89: Strange Brew (Cream)
http://www.youtube.com/watch?v=rGvfm7eEFSw
“Strange brew — killin’ what’s inside of you”
It always seemed to me that the subtext of this song was about drugs, although the lyrics don’t explicitly reference psychedelics or any other recreational pharmaceuticals.
The song, found on Cream’s second album Disraeli Gears, is a reworking of Buddy Guy’s and Junior Wells’ version of an early blues song “Hey Lawdy Mama” that was in Cream’s early repertoire:
http://www.youtube.com/watch?v=cj0_D5IGtfM
Yesterday, Jack Bruce, Cream’s bass play...
Source: The Poison Review - October 26, 2014 Category: Toxicology Authors: Leon Tags: Medical cream disraeli gears eric clapton ginger baker jack bruce strange brew tox tunes Source Type: news
Saturday with SMACC: Evidence-Based Education — What Works
Victoria Brazil Evidence-Based Education — What Works– from Social Media and Critical Care on Vimeo.
From SMACC Gold: Victoria Brazil asks what educational modalities and interventions are effective in medical education, what does “effectiveness” really mean and how do we measure it. Here are links to some of the studies and resources she mentions:
The Great Dr. Fox Lecture: A Vintage Academic Hoax
Hunt et al: Pediatric resident resuscitation skills improve after “rapid cycle deliberate practice” training
Best Evidence Medical Education (BEME) Collaboration
BondVH: virtual hospital app (Sou...
Source: The Poison Review - October 11, 2014 Category: Toxicology Authors: Leon Tags: Medical dr. myron l. fox lecture medical education SMACC victoria brazil Source Type: news
More than you ever wanted to know about synthetic cannabinoids
This article is not really readable, but I’m not sure it was meant to be read. Rather, it’s a reference paper with (by my count) 228 citations through the year 2014. It will be invaluable for anyone surveying the medical literature on synthetic cannabinoids
The authors’ goals was to review comprehensively the pharmacology and toxicology of various chemicals found in synthetic cannabinoid products such as “Spice,” “K2,” and “Crazy Clown.” Their extensive literature search identified 215 relevant articles.
Because of the multiple substances covered and mix of laboratory, ...
Source: The Poison Review - October 9, 2014 Category: Toxicology Authors: Leon Tags: Medical crazy clown K2 literature review spice synthetic cannabinoid Source Type: news
TPR Podcast Episode #6: I’m tripping and I can’t get down
TPR Podcast Episode 6: I’ve Tripped and I Can’t Get Down
Written by Theresa Kim, MD
Outline
1) Synthetic cathinones
2) Piperazine compounds
3) Gamma-hydroxybutyric acid (GHB)
4) 25C-NBOMe
This month’s podcast was inspired by the New York Times article “A Year After Drug Deaths, the Electric Zoo Music Festival Tries Again” which covered designer drug related deaths associated with summer music festivals
Synthetic Cathinones
Derivatives of the Catha edulis (khat) plant’s psychoactive alkaloid (cathinone)
o examples: mephedrone, methedrone, MD...
Source: The Poison Review - October 7, 2014 Category: Toxicology Authors: LeonThe Poison Review Tags: Podcast Source Type: news
Rosary pea ingestion: no testing needed
A. precatorius seeds
2.5 out of 5 stars
A Case of Abrin Toxin Poisoning, Confirmed via Quantitation of L-Abrine (N-Methyl-L-Tryptophan) Biomarker. Wooten JV et al. J Med Toxicol 2014 Feb 13 [Epub ahead of print]
Abstract
The decorative rosary pea or jequirity pea (Abrus precatorius) contains the toxin abrin, a protein that inhibits the function of mRNA, leading to impaired protein synthesis and cell death. The mechanism is quite similar to that of the toxin ricin, found in castor beans.
This case report describes a 22-month-old girl who ingested approximately 20 rosary peas. She appeared asymptomatic until she started vom...
Source: The Poison Review - October 4, 2014 Category: Toxicology Authors: Leon Tags: Medical abrin jequirity pea rosary pea Source Type: news
Must-listen podcast: anti-NMDA receptor encephalitis
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As part of its “Best Case Ever” series, the Emergency Medicine Cases podcast has a superb discussion by Dr. David Carr of anti-NMDA receptor encephalitis, a relatively new but important diagnosis that is generally under-recognized and often missed. To listen to it, click here.
The reason this diagnosis is of interest to toxicologists is that during the early psychotic stage of the disease patients may be treated with a neuroleptic agent. During later stages when movement disorders and autonomic instability supervene, it is easy to misdiagnose the condition as neuroleptic malignant syndrome.
The tele...
Source: The Poison Review - September 29, 2014 Category: Toxicology Authors: Leon Tags: Medical anti-NMDA receptor encephalitis Source Type: news
Tox on the web: narcotic noodles, intranasal narcan, and much more!
The Antidote: A long piece in the The New Yorker by Ian Frazier describes the epidemic of overdoses from both prescription opiate analgesics and heroin, how that epidemic affects the New York City borough of Staten Island, and the potential role of intranasal naloxone in reducing the number of deaths. A little superficial regarding the origins of the epidemic and the medical use of naloxone, but well worth reading nevertheless. It is superb at portraying the human dimension of what Frazier justifiably calls an “iatrogenic disaster.”
By the way, the versatile Frazier is the author of one of the funniest parodi...
Source: The Poison Review - September 29, 2014 Category: Toxicology Authors: Leon Tags: Medical ian frazier intranasal naloxone medical overtreatment mind-altering plants narcan opium noodles tox on the web Source Type: news
Review: cobalt toxicity and artificial metal hips
4.5 out of 5 stars
Systemic toxicity related to metal hip prostheses. Bradberry SM et al. Clin Toxicol 2014;52:837-847.
Abstract
As TPR has reported before, cobalt poisoning can cause hypothyroidism, cardiomyopathy, and neurotoxicity. Neurological manifestations include:
optic nerve damage and retinopathy with reduced visual acuity
bilateral nerve deafness and tinnitus
polyneuropathy (sensory and motor)
cognitive impairment and memory loss
A number of papers and case reports have described clinical cobalt toxicity related to metal-on-metal hip prostheses or revision of a failed ceramic prosthesis with metal parts. Al...
Source: The Poison Review - September 25, 2014 Category: Toxicology Authors: Leon Tags: Medical cardiomyopathy cobalt toxicity hip replacement hypothyroidism neurotoxicity prosthesis Source Type: news
Avoid couchlock! Four things to know about cannabis pharmacology
With medical marijuana now legal in 23 states and the District of Columbia — and recreational weed available in Colorado and Washington State — knowing the pharmacokinetics of THC has never been more important, both for consumers and the physicians who must counsel and treat them. Recently, the New York Times’ Pulitzer Prize-winning columnist Maureen Dowd got into trouble in Denver when she overdosed on a cannabis candy bar and experienced 8 hours of paranoia and couchlock. My recent Emergency Medicine News column describing 4 things Maureen should have known about weed before venturing to the “mi...
Source: The Poison Review - September 18, 2014 Category: Toxicology Authors: Leon Tags: Medical cannabis edibles marijuana overdose pharmacokinetcis pharmacokinetics Source Type: news
Tox on the Web: sarin, lithium, strychnine, and much more!
Toxicologist as Man on Couch with Laptop: This video shows a short presentation by Larissa Laskowski a first year fellow at the NYC Poison Control Center, describing the work of Eliot Higgins and the Brown Moses blog. Higgins — an unemployed finance worker several years ago with no knowledge about weapons of warfare — started blogging about the use of different weapons in Syria, and posting online videos appearing on sites such as YouTube that demonstrated use of these weapons. He is now an acknowledge expert in the field. His work led to the identification of sarin as the agent used in the Ghouta chemical at...
Source: The Poison Review - September 18, 2014 Category: Toxicology Authors: Leon Tags: Medical albert hoffman brown moses eliot higgins lithium LSD nicotine sarin strychnine syria toledo ohio tox on the web toxic algae Source Type: news
Case Report: Synthetic Cannabinoid K2 and Myocardial Infarction
This article describes 16-year-old male who presented to hospital with 1 day of substernal chest pressure associated with nausea, vomiting, and dyspnea that started 2 hours after he smoked the synthetic cannabinoid K2. Workup revealed elevated ST segments in the inferolateral leads and elevated troponin that peaked at 8.29 ng/ml (normal 0-0.3 ng/ml). Echocardiogram and cardiac catheterization were unremarkable. Urine drug screen was positive only for opiates and benzodiazepines, both of which the patient received in the hospital before the specimen was obtained. Specimens for additional toxicology tests were sent to an out...
Source: The Poison Review - September 17, 2014 Category: Toxicology Authors: Leon Tags: Medical coronary syndrome K2 myocardial infarction synthetic cannabinoid Source Type: news
Conservative treatment for asymptomatic body packers?
Body packer
2 out of 5 stars
Asymptomatic body packers should be treated conservatively. Glovinski PV et al. Dan Med J 2013 Nov;60:A4723
Abstract
Kudos to the authors for putting their general conclusion in the title. Unfortunately, there’ s less here than meets the eye.
This is a retrospective review of 57 patients suspected of body packing, seen at Hvidovre Hospital in Denmark. However, actual body packing was confirmed in only a little over half of these cases, meaning this is really a study of only 29 patients.
All confirmed body packers were admitted, given a laxative and “monitored using a scope.”...
Source: The Poison Review - September 10, 2014 Category: Toxicology Authors: Leon Tags: Medical body packers CT imaging Source Type: news
Do pediatric patients require endoscopy after ingesting a laundry pod?
3 out of 5 stars
Laundry Detergent Pod Ingestions: Is There a Need for Endoscopy? Smith E et al. J Med Toxicol 2014 Sep;10(3):286-91
Abstract
The authors never answer their title question definitively, but you wouldn’t expect that they’d be able to on the basis of this small case series and the limited data published to date.
Ingestion of laundry detergent pod (LDP) ingredients can present with manifestations affecting a number of systems:
Gastrointestinal
Pulmonary
Neurological
Metabolic
The paper presents 3 cases of pediatric LDP ingestion in patients ages 13 months to 3 years. Presenting signs and sympt...
Source: The Poison Review - September 8, 2014 Category: Toxicology Authors: Leon Tags: Medical caustic ingestion esophageal stricture laundry pod detergent Source Type: news
Tox Tunes #88: Junco Partner (Professor Longhair)
http://www.youtube.com/watch?v=DG6gPe1plWQ
Professor Longhair (Henry “Roy” Byrd, 1918-1980) combined classic New Orleans rhythm and blues piano with Afro-Cuban funk to produce music that was exciting and utterly original. Many years ago, I was working in a research lab in New York City, living in a West Village studio that rented for $78 a month. (Yes, it was that long ago.) I hated killing rabbits for their prostaglandin, and it was sort of a bleak time.
But during that period I came across an oddly compelling record — New Orleans Piano by Professor Longhair. It was magical, and taught me that the ...
Source: The Poison Review - September 8, 2014 Category: Toxicology Authors: Leon Tags: Medical henry byrd junco partner junko partner professor longhair tox tunes Source Type: news
