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Sample records for fatal fenazaquin intoxication

  1. [Fatal intoxication with paramethoxyamphetamine].

    PubMed

    Chodorowski, Zygmunt; Wiergowski, Marek; Sein Anand, Jacek

    2002-01-01

    From August to December of the year 2000 we ascertained 7 rapid deaths because of acute intoxication with tablets colloquially called Ufo. There were five men and two women aged from 20 to 29 (average 24) years. Analytic tests showed that one tablet of Ufo contains 40 mg of paramethoxyamphetamine, 1.0 mg of amphetamine, 0.05 mg of methamphetamine, 0.03 mg of 3-4-methylenedioxymethamphetamine. The levels of paramethoxyamphe-tamine in the blood of the deceased, determined by gas chromatography, were from 0.68 to 10.0 (approx. 3.2) mg/L and in the urine from 16 to 64 (approx. 35) mg/L. The press and television campaign caused elimination of fatal intoxications with parametoxy-amphetamine during the last 13 months. PMID:12184013

  2. Fatal intoxication with methoxetamine.

    PubMed

    Adamowicz, Piotr; Zuba, Dariusz

    2015-01-01

    Methoxetamine (MXE) is a new synthetic drug of abuse structurally related to ketamine and phencyclidine. A case of a 29-year-old male with acute toxicity related to the analytically confirmed use of MXE is reported. The man was found dead at his residence. Biological material was analyzed using liquid chromatography-tandem mass spectrometry. The concentration of MXE in urine of the deceased was 85 μg/mL. Despite the vial containing the blood sample being destroyed during transportation and the blood leaking out into the cardboard packaging, the blood level of MXE was estimated. After determination of the cardboard grammage (approx. 400 g/m(3) ) and the mean mass of the blood obtained after drying (0.1785 ± 0.0173 g per 1 mL), the estimated blood concentration of MXE was found to be 5.8 μg/mL. The high concentration of MXE in blood and urine and the circumstances of the case indicate an unintentional, fatal intoxication with this substance.

  3. [Biochemical diagnostics of fatal opium intoxication].

    PubMed

    Papyshev, I P; Astashkina, O G; Tuchik, E S; Nikolaev, B S; Cherniaev, A L

    2013-01-01

    Biochemical diagnostics of fatal opium intoxication remains a topical problem in forensic medical science and practice. We investigated materials obtained in the course of forensic medical expertise of the cases of fatal opium intoxication. The study revealed significant differences between myoglobin levels in blood, urine, myocardium, and skeletal muscles. The proposed approach to biochemical diagnostics of fatal opium intoxication enhances the accuracy and the level of evidence of expert conclusions.

  4. Fatal Intoxication with Acetyl Fentanyl.

    PubMed

    Cunningham, Susan M; Haikal, Nabila A; Kraner, James C

    2016-01-01

    Among the new psychoactive substances encountered in forensic investigations is the opioid, acetyl fentanyl. The death of a 28-year-old man from recreational use of this compound is reported. The decedent was found in the bathroom of his residence with a tourniquet secured around his arm and a syringe nearby. Postmortem examination findings included marked pulmonary and cerebral edema and needle track marks. Toxicological analysis revealed acetyl fentanyl in subclavian blood, liver, vitreous fluid, and urine at concentrations of 235 ng/mL, 2400 ng/g, 131 ng/mL, and 234 ng/mL, respectively. Acetyl fentanyl was also detected in the accompanying syringe. Death was attributed to recreational acetyl fentanyl abuse, likely through intravenous administration. The blood acetyl fentanyl concentration is considerably higher than typically found in fatal fentanyl intoxications. Analysis of this case underscores the need for consideration of a wide range of compounds with potential opioid-agonist activity when investigating apparent recreational drug-related deaths. PMID:26389815

  5. Fatal intoxication with tianeptine (Stablon).

    PubMed

    Proença, Paula; Teixeira, Helena; Pinheiro, João; Monsanto, Paula V; Vieira, Duarte Nuno

    2007-08-01

    Tianeptine (Stablon), although structurally similar to tricyclic antidepressants, acts by enhancing the reuptake of serotonin. A fatal case is presented involving a 26-year-old man, found lying in bed with a "mushroom of foam" around his mouth. Empty blister packs of Stablon and a suicide note were found next to the body. A liquid-liquid extraction procedure with n-hexane: ethyl acetate and n-hexane: 2-propanol, followed by LC-DAD-MS analysis, using positive mode electrospray ionization was performed. The detection limit was 0.001 microg/mL. The toxicological results revealed the following tianeptine concentrations in the post-mortem samples: blood 5.1 microg/mL; urine 2.0 microg/mL; liver 23 microg/g; stomach contents 22 mg. Femoral blood analyses also revealed an ethanol concentration of 0.53 g/L. The present method was also developed and validated for the other post-mortem specimens, since no previous published data had confirmed the post-mortem distribution of tianeptine. The absence of other suitable direct causes of death (macroscopic or histological) and the positive results achieved with the toxicological analysis led the pathologist to rule that death was due to an intoxication caused by the suicidal ingestion of tianeptine in combination with alcohol.

  6. Two Fatal Intoxications with Cyanohydrins.

    PubMed

    Zheng, Shuiqing; Yuan, Xiaoliang; Wang, Wei; Liang, Chen; Cao, Fangqi; Zhang, Runsheng

    2016-06-01

    Cyanohydrins, also be called cyanoalcohols, are important industrial precursors to carboxylic acids and some amino acids. Acetone cyanohydrin (ACH) and formaldehyde cyanohydrin (glycolonitrile, FCH), which are the typical examples of cyanohydrins, are classified as extremely hazardous substances. As the cyanohydrins can readily decompose, and it is hard to find cyanohydrins in gastric contents and heart blood, the determination study in biological samples can be divided into two parts: the first is the determination of HCN by using a Prussian blue reaction and the HS-GC-MSD after derivatization by chloramine-T. The second is the determination of acetone or formaldehyde. In this part, headspace gas chromatography with flame ionization detector (HS-GC-FID) and solid phase microextraction (SPME)-gas chromatography with mass spectrometric detectors (GC-MSD) had been used. In this report, we reported two fatal intoxication cases of ACH and FCH; one person was killed by his wife by poisoning his food and the other was suicide by poison. Two real cases of ACH and FCH in human blood and gastric contents have been analyzed by using the above-mentioned method. The Prussian blue reaction was positive in the two cases. The peaks of acetone with retention times of 0.998 min appear in specimens of the deceased are consistent with the retention times of pure acetone. The peaks of formaldehyde with a retention time of 1.658 min appear in heart blood of the deceased, and the retention time of formaldehyde of the liquid is 1.674 min, which are consistent with the retention times of pure formaldehyde (1.673 min). PMID:27026650

  7. Fatal mephedrone intoxication--a case report.

    PubMed

    Adamowicz, Piotr; Tokarczyk, Bogdan; Stanaszek, Roman; Slopianka, Markus

    2013-01-01

    A death caused by a new designer drug, 4-methylmethcathinone (mephedrone), is reported. Eight small plastic bags containing white powder were found in the jacket of a young dead male. Spot tests conducted by the police officer indicated the presence of 4-bromo-2,5-dimethoxyphenethylamine (2C-B) in the powders. Laboratory routine screening analyses of blood and vitreous humor did not reveal any positive results; therefore, 2C-B was excluded. Analysis of powders was conducted using gas chromatography-mass spectrometry and high-pressure liquid chromatography with diode array detection. The purity of mephedrone found in all powder samples was in the range of 80.4-87.3%. In connection with these findings, blood and vitreous humor samples were analyzed for mephedrone. Analyses were conducted using liquid chromatography-tandem mass spectrometry. Mephedrone was found in blood and vitreous humor at the concentrations of 5.5 and 7.1 µg/mL, respectively, revealing that this was a fatal mephedrone intoxication.

  8. An accidental fatal intoxication with methoxetamine.

    PubMed

    Wikström, Maria; Thelander, Gunilla; Dahlgren, Maria; Kronstrand, Robert

    2013-01-01

    This paper reports an unintentional death involving the administration of methoxetamine [2-(3-methoxyphenyl)-2-(ethylamino)-cyclohexanone] and offers some reference values from living drug abusers. Methoxetamine is a new recreational drug with a similar structure to ketamine. The deceased was a 26-year-old male with a history of drug abuse; he was found lying on the floor in his apartment. Several "red-line" plastic bags were found, one of which was labeled "2-(3-methoxyphenyl)-2-(ethylamino)-cyclohexanone" and another labeled "Haze." In four cases from living subjects with unknown doses, concentrations of methoxetamine were found from 0.13 to 0.49 µg/g. In three of the cases, the blood samples also contained natural or synthetic cannabinoids. In the autopsy case, a considerably higher concentration of methoxetamine, 8.6 µg/g, was found in femoral blood. In addition, tetrahydrocannabinol and the three different synthetic cannabinoids AM-694, AM-2201, and JWH-018, were present in femoral blood. The circumstances and the high femoral blood concentration of methoxetamine point toward an unintentional, acute fatal intoxication with methoxetamine, although the presence of the three synthetic cannabinoids may have contributed to the death.

  9. Fatal carbon monoxide intoxication after acetylene gas welding of pipes.

    PubMed

    Antonsson, Ann-Beth; Christensson, Bengt; Berge, Johan; Sjögren, Bengt

    2013-06-01

    Acetylene gas welding of district heating pipes can result in exposure to high concentrations of carbon monoxide. A fatal case due to intoxication is described. Measurements of carbon monoxide revealed high levels when gas welding a pipe with closed ends. This fatality and these measurements highlight a new hazard, which must be promptly prevented.

  10. Fatal doxepin intoxication--suicide or slow gradual intoxication?

    PubMed

    Neukamm, M A; Vogt, S; Hermanns-Clausen, M; Naue, J; Thierauf, A; Auwärter, V

    2013-04-10

    The differentiation of intoxication courses is one of the most difficult challenges for forensic pathologists and toxicologists. The case of a 52-year-old female inpatient of a psychiatric clinic with multiple medications who died from doxepin intoxication is reported. Concentrations of doxepin metabolites and isomers, pharmacokinetic modelling and genotyping of the doxepin-metabolizing cytochrome P450 (CYP) enzymes led to the following conclusion: the lethal doxepin concentration of 2100 ng/mL was more likely to have been reached due to drug interactions and genetic peculiarities leading to a reduction of the metabolic capacity and not by an acute (suicidal) overdose.

  11. Intoxications with the monoamine oxidase inhibitor tranylcypromine: an analysis of fatal and non-fatal events.

    PubMed

    Gahr, Maximilian; Schönfeldt-Lecuona, Carlos; Kölle, Markus A; Freudenmann, Roland W

    2013-11-01

    Tranylcypromine (TCP) is a non-selective and irreversible monoamine oxidase inhibitor and an effective agent in the treatment of major depression. It features a complex pharmacologic profile and overdoses might induce severe intoxications. To identify typical clinical presentations of TCP-intoxications, range of associated TCP-dosages and possible differences between fatal and non-fatal intoxications a systematic review of all previously published cases of TCP-intoxications was conducted. We detected n=20 reports of TCP-intoxications in the literature (fatalities n=10). Mean age was 36.7 years (median 37); the majority of patients were female (60%). Frequent findings in patients with TCP-intoxications were disturbance of consciousness/cognitive dysfunction (90%), cardio-vascular symptoms (55%), hyperthermia (50%), respiratory distress (45%), delirium (45%), muscular rigidity (30%) and renal failure (20%). Suicidal intent was present in n=18 (90%) patients. First clinical symptoms related to TCP-intoxication developed on average in less than 1 day. The average dosage related to TCP-intoxication was 677 mg. The highest survived TCP-dosage was 4000 mg and the lowest fatal dosage was 170 mg. Patients with fatal intoxications were on average older (40.5 vs. 32.8 years) and developed a more rapid onset of symptoms (0.2 vs. 0.8 days). Death occurred after a mean time of 0.6 days; symptom relief in patients with non-fatal intoxications developed on average after 3.2 days. Considering the large dose spectrum between survived and lethal TCP-dosages individual susceptibility factors might play a role regarding the severity of clinical symptoms independently of the ingested dosage.

  12. Fatal intoxication from 3,4-methylenedioxyamphetamine.

    PubMed

    Poklis, A; Mackell, M A; Drake, W K

    1979-01-01

    The symptoms of MDA intoxication exhibited by the decedent prior to death closely mimic those of acute amphetamine poisoning: profuse sweating, violent and irrational behavior, and stereotypically compulsive behavior. Therefore, if amphetamines are not detected in specimens from a person displaying classic symptoms of amphetamine poisoning, hallucinogenic amphetamine derivatives may be considered. In the case described, a divided dose of 850 mg of MDA ingested within 2 h and 15 min was sufficient to cause the death of a 24-year-old male, 4 h after the final dose. While the methaqualone may have contributed to the demise of the decedent, the authors think that the MDA itself was sufficient to cause death. Results of limited recovery studies of MDA extraction from blood and elution from TLC plates supported the observations of Cimbura [13]. Approximately 85% of MDA is extracted by the method described and its elution from TLC plates is quantitative. This case points out once again the dangers of false advertising in the illicit market. The decedent, himself a dealer in the illicit drug market, and all present at the party believed the ingested white powder to be a mixture of morphine, LSD, and amphetamine, hence MDA. They were totally unfamiliar with 3,4-methylenedioxyamphetamine, MDA. PMID:512617

  13. Hypothermia and undressing associated with non-fatal bromazepam intoxication.

    PubMed

    Michaud, K; Romain, N; Giroud, C; Brandt, C; Mangin, P

    2001-12-27

    A 42-year-old woman with a history of depression was found unconscious, lying near her car in an early autumn morning. The lower part of her body was undressed and there were multiple purple spots and excoriations on the body suggesting at first a sexual assault. On admission to the intensive care unit, she presented a hypothermia with a central temperature of 28.4 degrees C. The biological samples obtained at the hospital were analysed. Blood concentration of bromazepam was 7.7 mg/l, which is above the highest level reported till now in a case of fatal intoxication. PMID:11792498

  14. Fatal intoxication with synthetic cannabinoid MDMB-CHMICA.

    PubMed

    Adamowicz, Piotr

    2016-04-01

    MDMB-CHMICA is a synthetic cannabinoid that appeared on the European drug market in September 2014. This substance was found in Poland in the herbal mixture "Mocarz" ("Strongman"), which caused a large outbreak of intoxications at the beginning of July 2015. This paper describes the circumstances of death and toxicological findings in a fatal intoxication with MDMB-CHMICA (in combination with alcohol). Loss of consciousness and asystole occurred a few minutes after smoking the 'legal high'. The man died after 4 days of hospitalisation. The cause of death accepted by the medical examiner was multiple organ failure. MDMB-CHMICA was detected and quantified in blood (ante- and postmortem) and internal organs tissues. The samples were analysed using liquid chromatography with mass spectrometry (LC-MS/MS). The concentration of MDMB-CHMICA in antemortem blood was 5.6 ng/mL. Although the death occurred after 4 days from administration a relatively high concentration (2.6 ng/g) was estimated in the brain. Traces of this compound were also found in other postmortem materials (blood, stomach, liver, bile, and kidney). The presented case shows the health risks associated with MDMB-CHMICA use. The administration of this substance can lead to the number of organ failures, cardiac arrest and consequently death.

  15. Fatal and non-fatal outcome by accidental intoxication with paint thinner.

    PubMed

    Tsatsakis, A M; Dolapsakis, G; Troulakis, G; Christodoulou, P; Relakis, K; Trikilis, N; Michalodimitrakis, M N

    1997-09-01

    Although poisonings (fatal and non-fatal) due to intentional or accidental acute exposure to toluene or toluene mixture fumes have been previously reported in the literature, several issues concerning lethal doses or lasting post-exposure neuropathological impairments still remain unclear. Two male painters (18 and 30 years old) were accidentally exposed to toxic concentrations of paint diluent fumes containing toluene (TL), acetone (ACT) and methyl ethyl ketone (MEK) (60:15:15 w/w/w respectively) during their work in an underground reservoir. Both workers were found unresponsive by colleagues and were immediately transferred to the regional hospital. On admission, the younger man was pronounced dead, while the other remained in the intensive care unit for 3 days and then 4 days in the internal medicine ward. TL, ACT and MEK concentrations in blood samples taken from the survivor on admission were 6.3, 30.6 and 40.5 microg/mL. Postmortem toxicology of the dead worker revealed TL, ACT and MEK blood levels of 12.4, 90.8 and 80.4 microg/mL respectively. The solvent levels in the liver, kidney, lung, brain, testis and gland were also quantified and showed a somewhat similar distribution of the chemicals among these tissues with the highest levels found in the brain and the liver. The fatal and the non-fatal outcome that resulted despite similar intoxication conditions, most probably demonstrates the interindividual tolerance among the painters who also had similar body weights. The surviving painter did not develop any neuropsychological impairment in post-exposure time. The reported case strongly emphasizes the necessity to take precautions when using paint diluents in enclosed spaces. PMID:15335573

  16. A Rare Cause of Metabolic Acidosis: Fatal Transdermal Methanol Intoxication in an Infant.

    PubMed

    Sahbudak Bal, Zumrut; Can, Fulya Kamit; Anil, Ayse Berna; Bal, Alkan; Anil, Murat; Gokalp, Gamze; Yavascan, Onder; Aksu, Nejat

    2016-08-01

    Oral methanol intoxication is common, but dermal intoxication is rare. We report a previously healthy 19-month-old female infant admitted to the emergency department (ED) with vomiting and tonic-clonic seizure. On physical examination, she was comatose and presented signs of decompensated shock with Kussmaul breathing. Her left thigh was edematous, with purple coloration. Methanol intoxication was suspected due to high anion gap metabolic acidosis (pH, 6.89; HCO3, <3 meq/L) and exposure to spirit-soaked bandages (%96 methanol) for 24 hours and 3 days. The patient's serum methanol level was 20.4 mg/dL. She was treated with fomepizole and continuous venovenous hemodialysis (CVVHD) in the pediatric intensive care unit, and methanol levels decreased to 0 mg/dL after 12 hours. During follow-up, massive edema and subarachnoid hemorrhage in the occipital lobe were detected by computed tomography of the brain. The patient died after 7 days.Although methanol intoxication occurs predominantly in adults, it must be considered in children with high-anion gap metabolic acidosis. This case report demonstrates that fatal transdermal methanol intoxication can occur in children, and it is the second report in the English literature of transdermal methanol intoxication in an infant.

  17. Effect of household processing on fenazaquin residues in okra fruits.

    PubMed

    Duhan, Anil; Kumari, Beena; Gulati, Rachna

    2010-02-01

    Fenazaquin (4-[[4 (1,1-dimethylethyl) phenyl] ethoxy]quinazoline) is a new acaricide of the quinazoline class. Residue levels of fenazaquin were determined in unprocessed and processed okra fruits to evaluate the effect of different processes (washing, boiling and washing followed by boiling) in reduction of residues of this pesticide in okra. The study was carried out on okra crop (Variety, Varsha Uphar) in research farm of Chaudhary Charan Singh Haryana Agricultural University, Hisar with application of fenazaquin (Magister 10 EC) @ 125 ga.i./ha (Single Dose, T(1)) and 250 g a.i./ha (Double Dose, T(2)). Samples of okra fruits were collected on 0, 3, 7, 15 days after treatment and at harvest (30 days). Residues were estimated by gas chromatograph equipped with capillary column and nitrogen phosphorus detector. Residues reached below maximum residue limit of 0.01 mg/kg at harvest. The residues dissipated with half-life period of 3.13 days at lower dose and 4.43 days at higher dose. Processing is shown to be very effective in reducing the levels of fenazaquin residues in okra fruits. Maximum reduction (60-61%) was observed by washing + boiling followed by boiling/cooking (38-40%) and then by washing (31-32%).

  18. Fatal intoxication caused by the application of the multiple transdermals patchs of fentanyl.

    PubMed

    Serghini, Issam; Qamouss, Youssef; Zoubir, Mohamed; Lalaoui, Jaafar Salim; Boughalem, Mohamed

    2015-01-01

    Fentanyl (N-phenyl-N-(1-2-phenylethyl-4-piperidyl)propanamide) is a potent synthetic narcotic analgesic. He has an analgesic effect 100 times greater than that of morphine. The use of transdermal fentanyl delivrery systems has increased over recent years especially in patients with chronic pain who are already treated with high doses of morphine or it is derivate. However, many cases of fentanyl intoxication through a variety of transderrmal systems have been reported. This paper reports a fatality due to excessive administered Fentanyl Sandoz® Matrix 50 µg/h transdermal therapeutic systems.

  19. [Fatal intoxication with the new designer drug 25C-NBOMe].

    PubMed

    Tarpgaard, Maren; Mærkedahl, Rikke; Lauridsen, Karen Buch

    2015-08-24

    This is a case report of a 22-year-old man, who snorted the content of three capsules of the new designer drug 25C-NBOMe (2-(4-chloro-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine). 1-2 hours after the intake he became unconscious with generalized seizures, so he was intubated prehospitally and brought to the local hospital. At admission he had acute renal failure and was severely metabolic acidotic with potassium 8.6 mmol/l, lactate 28 mmol/l and pH 6.69. Despite maximal therapy he died ten hours after admission. 25C-NBOMe is currently legal in most parts of the world, and fatal intoxication with the drug has not yet been described in Scandinavia.

  20. Fatalities due to methyl alcohol intoxication in Turkey: an 8-year study.

    PubMed

    Yayci, Nesime; Ağritmiş, Hasan; Turla, Ahmet; Koç, Sermet

    2003-01-01

    The aim of this study is to examine methyl alcohol poisoning cases from the medico-legal point of view. The records of the Morgue Department of Council of the Forensic Medicine were reviewed retrospectively for all methyl alcohol poisonings for the period of 27.10.1992 and 30.05.2001. The victim's age, sex, death year, death place, methyl alcohol blood levels, the source of methyl alcohol, accompanying laboratory results and histopathologic tissue changes were recorded. The number of deaths due to the methyl alcohol poisoning was 271 during that period of time. Two hundred and forty-two of the (89.3%) total 271 methyl alcohol fatalities were men and 29 (10.7%) of were women. The largest age group was 36-40 years old, followed by 41-45. The methyl alcohol blood concentrations ranged widely from 50 to 755 mg for per 100 ml. There were 222 cases (81.9%) with the methyl alcohol blood concentrations over 100 mg/dl. Twenty-nine (10.7%) victims were poisoned through the consumption of cologne and three of them with alcoholic beverage named "Raki". Consumed products were not known in all other cases because of insufficient patient history and data. As a conclusion, regarding the distribution according to years, mortality due to methyl alcohol intoxication in our country have been proceeding on a certain level. In order to decrease the mortality due to methyl alcohol intoxication, some precautions should be developed that could prevent the production and consumption of alcoholic beverages illegally produced.

  1. Molecular pathology of natriuretic peptides in the myocardium with special regard to fatal intoxication, hypothermia, and hyperthermia.

    PubMed

    Chen, Jian-Hua; Michiue, Tomomi; Ishikawa, Takaki; Maeda, Hitoshi

    2012-09-01

    The present study investigated the molecular pathology of atrial and brain natriuretic peptides (ANP and BNP) in the myocardium to evaluate terminal cardiac function in routine forensic casework with particular regard to fatal drug intoxication (n = 18; sedative-hypnotics, n = 10; methamphetamine, n = 8), hypothermia (cold exposure, n = 13), and hyperthermia (heatstroke, n = 10), compared with that in acute ischemic heart disease (AIHD, n = 35) and congestive heart disease (CHD, n = 11) as controls (total n = 87; within 48 h postmortem). Quantitative analyses of myocardial ANP and BNP messenger RNA demonstrated that their expressions in bilateral atrial and ventricular walls were high in methamphetamine intoxication and hypothermia, comparable to those in AIHD and CHD, but were low in sedative-hypnotic intoxication and hyperthermia. In pericardial fluid, both ANP and BNP levels were increased in hypothermia, while CHD cases had an elevated BNP level, and ANP level showed a tendency to increase in hyperthermia; however, immunohistochemistry showed no evident differences in myocardial ANP and BNP among the causes of death. These findings suggest terminal high cardiac strain in methamphetamine intoxication, decreased cardiac strain in sedative-hypnotic intoxication and hyperthermia (heatstroke), and persistent congestion in hypothermia (cold exposure).

  2. A fatal case of serotonin syndrome after combined moclobemide-citalopram intoxication.

    PubMed

    Dams, R; Benijts, T H; Lambert, W E; Van Bocxlaer, J F; Van Varenbergh, D; Van Peteghem, C; De Leenheer, A P

    2001-03-01

    We present a case involving a fatality due to the combined ingestion of two different types of antidepressants. A 41-year-old Caucasian male, with a history of depression and suicide attempts, was found deceased at home. Multiple containers of medication, the MAO-inhibitor moclobemide (Aurorix), the SSRI citalopram (Cipramil), and the benzodiazepine lormetazepam (Noctamid) as active substance, as well as a bottle of whiskey were present at the scene. The autopsy findings were unremarkable, but systematic toxicological analysis (EMIT, radioimmunoassay, high-performance liquid chromatography-diode-array detection [HPLC-DAD], gas chromatography-nitrogen-phosphorus detection, and gas chromatography-mass spectrometry) revealed the following: ethanol (0.23 g/L blood, 0.67 g/L urine), lormetazepam (1.65 microg/mL urine), cotinine (0.63 microg/mL blood, 5.08 microg/mL urine), caffeine (1.20 microg/mL urine), moclobemide (and metabolites), and citalopram (and metabolite). There upon, we developed a new liquid chromatographic separation with optimized DAD, preceded by an automated solid-phase extraction, for the quantitation of the previously mentioned antidepressive drugs. The results obtained for blood and urine, respectively, were as follows: Ro 12-5637 (moclobemide N'-oxide) not detected and 424 microg/mL; Ro 12-8095 (3-keto-moclobemide) 2.26 microg/mL and 49.7 microg/mL; moclobemide 5.62 microg/mL and 204 microg/mL; desmethylcitalopram 0.42 microg/mL and 1.22 microg/mL; and citalopram 4.47 microg/mL and 19.7 microg/mL. The cause of death was attributed to the synergistic toxicity of moclobemide and citalopram, both antidepressants, which, by intentional or accidental combined ingestion, can produce a potentially lethal hyperserotoninergic state. Based on the history of the case and pharmacology of the drugs involved, the forensic pathologists ruled that the cause of death was multiple drug intoxication, resulting in a fatal "serotonin syndrome," and that the manner of

  3. Near-fatal persistent anion- and osmolal-gap acidosis due to massive gamma-butyrolactone/ethanol intoxication.

    PubMed

    Heytens, Luc; Neels, Hugo; Van Regenmortel, Niels; van den Brink, Wim; Henckes, Manu; Schouwers, Sofie; Dockx, Greet; Crunelle, Cleo L

    2015-03-01

    We report a case of an ethanol and massive gamma-butyrolactone (GBL) intoxication, the precursor of the recreational drug gamma-hydroxybutyric acid (GHB), resulting in life-threatening metabolic acidosis (pH 6.5) with a highly increased anion- and osmolal gap. Rapid analysis using gas chromatography revealed a GHB plasma concentration of 4400 mg/L, far above the upper limit concentration of 1000 mg/L found in adult fatalities attributed to GBL. Full recovery was established following supportive treatment including haemodialysis. This is the first report of a combined ethanol/GBL intoxication as a cause of high serum anion- and osmolal-gap metabolic acidosis.

  4. Fatal alcohol intoxication in women: A forensic autopsy study from Slovakia

    PubMed Central

    2011-01-01

    Background Plenty of information related to alcoholism can be found in the literature, however, the studies have mostly dealt with the predominance of male alcoholism and data related to addiction in women are desperately scarce and difficult to find. Basic demographic data focusing on the impact of acute alcohol intoxication on the circumstances of death and social behaviour in the alcohol addicted female population are needed especially in the prevention of alcohol related mortality. Methods A retrospective forensic autopsy study of all accidental deaths due to alcohol intoxication over a 12-year period was performed in order to evaluate the locations, circumstances, mechanisms and causes of death. Results A sample of 171 cases of intoxicated women who died due to blood alcohol concentration (BAC) equal to or higher than 2 g/kg was selected. Among them 36.26% (62/171) of women died due to acute alcohol intoxication (AAI). We noted an increase in the number of deaths in women due to AAI from 2 in 1994 up to 5 in 2005 (an elevation of 150% between the years 1994-2005). The age structure of deaths in women due to BAC and AAI followed the Gaussian distribution with a dominant group of women aged 41-50 years (45.16% and 35.09% respectively). The most frequent place of death (98%) among women intoxicated by alcohol was their own home. The study suggests a close connection between AAI and violence against women. Conclusions The increasing number of cases of death of women suffering from AAI has drawn attention to the serious problem of alcoholism in women in the Slovak Republic during the process of integration into "western" lifestyle and culture. PMID:22168833

  5. Fatal manganese intoxication due to an error in the elaboration of Epsom salts for a liver cleansing diet.

    PubMed

    Sánchez, Baltasar; Casalots-Casado, Jaume; Quintana, Salvador; Arroyo, Amparo; Martín-Fumadó, Carles; Galtés, Ignasi

    2012-11-30

    We describe the case of a 50-year-old man with a fatal intoxication after accidental massive oral ingestion of manganese. The patient presented with lethargy, diffuse abdominal pain, vomiting, and profuse diarrhea after ingesting Epsom salts (magnesium sulfate heptahydrate) during a liver cleansing diet. Despite intensive care management with intubation, prone position ventilation, continuous venovenous hemofiltration, and multiple transfusions, he progressed to refractory shock with multiple organ dysfunction resulting in death within 72 h. Similar patients arrived at several hospitals with identical epidemiology (all had ingested the same salt obtained in the same place). Clinical and forensic investigations (X-ray diffraction) discovered that the supplier had mistakenly prepared the salts with hydrated manganese sulfate instead of magnesium sulfate heptahydrate. The results enabled the other patients to be successfully treated for hydrated manganese sulfate intoxication with life support in the intensive care unit and chelation therapy (EDTA). We describe the clinical presentation of acute manganese poisoning and alert professionals to the risk of an increasingly popular diet. This case demonstrates the importance of collaboration between clinicians, pathologists, and forensic scientists to resolve a difficult-to-diagnose case. PMID:22884574

  6. Fatalities due to intoxicated arrestees jumping out of moving police vehicles.

    PubMed

    Jacobs, Werner

    2006-12-01

    Fatalities resulting from emergency vehicle crashes are relatively rare. Mortality, particularly in the case of unbelted occupants, is relatively high. Data on drunken (handcuffed) arrestees jumping out of a moving police vehicle or the circumstances of such events have not been published. Two cases of such fatalities are described in this paper. Since these cases should be considered as "death in custody," may give rise to significant covering and speculation in the media, and may raise liability questions, they require an in-depth medicolegal investigation, including investigation of the crime scene, complete medicolegal autopsy/toxicology, and reconstruction of the event in the presence of an experienced forensic pathologist. From the 2 cases described in this paper, it appears that mechanical malfunctioning of the locking device of the door of the police vehicle and lack of controlling the actual lock-tied closing of the vehicle door (instead just assuming that it happened) may precipitate such cases. Auditory control by the police officers of the arrestee tampering with or manipulating the car door may be hampered by the background noise of the police vehicle, the on-board radio, and the use of a siren. Regular visual control and adequate control of the actual locking of the vehicle door are of paramount importance to prevent such mishaps. Reconstruction of the event in the presence of the forensic experts is mandatory to test the different hypotheses of the fatal event. PMID:17133032

  7. Unintentional fatal intoxications with mitragynine and O-desmethyltramadol from the herbal blend Krypton.

    PubMed

    Kronstrand, Robert; Roman, Markus; Thelander, Gunilla; Eriksson, Anders

    2011-05-01

    The leaves of Kratom, a medicinal plant in Southeast Asia, have been used as an herbal drug for a long time. At least one of the alkaloids present in Kratom, mitragynine, is a mu-receptor agonist. Both Kratom and an additional preparation called Krypton are available via the internet. It seems to consist of powdered Kratom leaves with another mu-receptor agonist, O-desmethyltramadol, added. O-Desmethyltramadol is an active metabolite of tramadol, a commonly prescribed analgesic. We present nine cases of intoxication, occurring in a period of less than one year, where both mitragynine and O-desmethyltramadol were detected in the postmortem blood samples. Neither tramadol nor N-desmethyltramadol was present in these samples, which implies that the ingested drug was O-desmethyltramadol. The blood concentrations of mitragynine, determined by ultra-performance liquid chromatography-tandem mass spectrometry, ranged from 0.02 to 0.18 μg/g, and O-desmethyltramadol concentrations, determined by gas chromatography with nitrogen-specific detection, ranged from 0.4 to 4.3 μg/g. We believe that the addition of the potent mu-receptor agonist O-desmethyltramadol to powdered leaves from Kratom contributed to the unintentional death of the nine cases presented and conclude that intake of Krypton is not as harmless as it often is described on internet websites. PMID:21513619

  8. Fatal Intoxications with 25B-NBOMe and 25I-NBOMe in Indiana During 2014.

    PubMed

    Shanks, Kevin G; Sozio, Thomas; Behonick, George S

    2015-10-01

    Over the last few years, NBOMe substances have been used either as a legal alternative to lysergic acid diethylamide (LSD) or sold surreptitiously as LSD to unknown users. These NBOMe substances have been detected in blotter papers, powders, capsules and liquids. We report the deaths of two teenage male subjects that were related to 25B-NBOMe and 25I-NBOMe in Indiana during 2014. Samples were extracted via a solvent protein precipitation with acetonitrile and analyzed via ultra-performance liquid chromatography with tandem mass spectrometry. For these two cases, we describe the NBOMe instrumental analysis, toxicological results for postmortem heart blood and urine specimens and the relevant case history and pathological findings at autopsy. In the first case, 25B-NBOMe was detected in postmortem heart blood at 1.59 ng/mL; in the second case, 25I-NBOMe was detected in postmortem heart blood at 19.8 ng/mL. We also review relevant published casework from clinical toxicology and postmortem toxicology in which analytically confirmed 25B-NBOMe and 25I-NBOMe were determined to be causative agents in intoxications or deaths.

  9. Unintentional fatal intoxications with mitragynine and O-desmethyltramadol from the herbal blend Krypton.

    PubMed

    Kronstrand, Robert; Roman, Markus; Thelander, Gunilla; Eriksson, Anders

    2011-05-01

    The leaves of Kratom, a medicinal plant in Southeast Asia, have been used as an herbal drug for a long time. At least one of the alkaloids present in Kratom, mitragynine, is a mu-receptor agonist. Both Kratom and an additional preparation called Krypton are available via the internet. It seems to consist of powdered Kratom leaves with another mu-receptor agonist, O-desmethyltramadol, added. O-Desmethyltramadol is an active metabolite of tramadol, a commonly prescribed analgesic. We present nine cases of intoxication, occurring in a period of less than one year, where both mitragynine and O-desmethyltramadol were detected in the postmortem blood samples. Neither tramadol nor N-desmethyltramadol was present in these samples, which implies that the ingested drug was O-desmethyltramadol. The blood concentrations of mitragynine, determined by ultra-performance liquid chromatography-tandem mass spectrometry, ranged from 0.02 to 0.18 μg/g, and O-desmethyltramadol concentrations, determined by gas chromatography with nitrogen-specific detection, ranged from 0.4 to 4.3 μg/g. We believe that the addition of the potent mu-receptor agonist O-desmethyltramadol to powdered leaves from Kratom contributed to the unintentional death of the nine cases presented and conclude that intake of Krypton is not as harmless as it often is described on internet websites.

  10. Fatal Intoxications with 25B-NBOMe and 25I-NBOMe in Indiana During 2014.

    PubMed

    Shanks, Kevin G; Sozio, Thomas; Behonick, George S

    2015-10-01

    Over the last few years, NBOMe substances have been used either as a legal alternative to lysergic acid diethylamide (LSD) or sold surreptitiously as LSD to unknown users. These NBOMe substances have been detected in blotter papers, powders, capsules and liquids. We report the deaths of two teenage male subjects that were related to 25B-NBOMe and 25I-NBOMe in Indiana during 2014. Samples were extracted via a solvent protein precipitation with acetonitrile and analyzed via ultra-performance liquid chromatography with tandem mass spectrometry. For these two cases, we describe the NBOMe instrumental analysis, toxicological results for postmortem heart blood and urine specimens and the relevant case history and pathological findings at autopsy. In the first case, 25B-NBOMe was detected in postmortem heart blood at 1.59 ng/mL; in the second case, 25I-NBOMe was detected in postmortem heart blood at 19.8 ng/mL. We also review relevant published casework from clinical toxicology and postmortem toxicology in which analytically confirmed 25B-NBOMe and 25I-NBOMe were determined to be causative agents in intoxications or deaths. PMID:26378133

  11. Fatal non-accidental alpha-lipoic acid intoxication in an adolescent girl.

    PubMed

    Hadzik, B; Grass, H; Mayatepek, E; Daldrup, T; Hoehn, T

    2014-09-01

    The aim of our report is to increase awareness that the antioxidant alpha-lipoic acid, which is marketed primarily as weight loss and energy supplement, has potentially lethal effects. A 14-year-old girl ingested in suicidal intention a large amount of alpha-lipoic acid, which led to multiorgan failure and subsequent death within 24 h. Multiorgan failure consisted of decreased myocardial contractility, seizures, anuria, thrombocytopenia, and coagulopathy. Therapy consisted of ventilation, anticonvulsive treatment and circulatory support with high-dose catecholamines. According to alpha-lipoic acid serum levels following ingestion the girl must have ingested a minimum of 10 alpha-lipoic acid tablets of 600 mg each. This is the first report on a fatal case of alpha-lipoic acid ingestion, which is intended to inform physicians, pharmacists and patients about critical side effects of this allegedly innocuous drug.

  12. Fatal heroin intoxication in body packers in northern Thailand during the last decade: two case reports.

    PubMed

    Sribanditmongkol, Pongruk; Supasingsiripreecha, Wiroon; Thampitak, Subharat; Junkuy, Anongphan

    2006-01-01

    A body packer is an important means of drug trafficking. While drug packets are inside the body, they can leak or rupture causing acute substance toxicity. Most of the reports of body packer syndrome have come from Europe and North America, which are destination targets. In the present study, the authors reported two cases of fatal heroin body packers from the northern part of Thailand. Both cases were foreign tourists who came to Chiang Mai and stayed in a hotel or a guesthouse room in which the deaths occurred. The autopsy findings revealed rupturing of heroin packages in the stomach. The packaging used in both cases was not sophisticated. The powder was packed inside condoms without extra covering, as observed in some other professional packers. The amount of heroin transported was about 30-50 gm. The purity of heroin in this powder was about 50-90%. Their destinations were their home countries and not directly to Europe or North America. Deaths occurred just prior to their return. The cause of death was a heroin overdose. A significant level of heroin metabolites, 6-MAM and morphine were detected in the blood and urine. PMID:16583590

  13. Death by 'ice': fatal methamphetamine intoxication of a body packer case detected by postmortem computed tomography (PMCT) and validated by autopsy.

    PubMed

    Bin Abdul Rashid, Saiful Nizam; Rahim, Amir Saad Abdul; Thali, Michael J; Flach, Patricia M

    2013-03-01

    Fatal acute methamphetamine (MA) poisoning in cases of internal drug trafficking is rarely described in the literature. This case study reports an MA 'body packer' who died from fatal methamphetamine intoxication due to leaking drug packages in the alimentary tract. The deceased was examined by postmortem computed tomography (PMCT), and the results were correlated to subsequent autopsy and toxicological findings. The deceased was arrested by the police when he was found disoriented in the city of Kuala Lumpur. He was transferred to the emergency department on suspicion of drug abuse. The initial drug screening was reactive for amphetamines. Shortly after admission to the hospital, he died despite rigorous resuscitation attempts. The postmortem plain chest and abdominal radiographs revealed multiple suspicious opacities in the gastrointestinal tract attributable to body packages. An unenhanced whole body PMCT revealed twenty-five drug packages, twenty-four in the stomach and one in the transverse colon. At least two were disintegrating, and therefore leaking. The autopsy findings were consistent with the PMCT results. Toxicology confirmed the diagnosis of fatal methamphetamine intoxication. PMID:23404531

  14. Fatal cases of acute suicidal sodium and accidental zinc fluorosilicate poisoning. Review of acute intoxications due to fluoride compounds.

    PubMed

    Lech, Teresa

    2011-03-20

    Fluoride, of all inorganic substances, is among the least likely to be identified by a routine toxicological analysis. Acute poisonings with salts of hydrofluoric or fluorosilicic acid, however, although relatively uncommon, may occur. Some fluorosilicates, salts of fluorosilicic acid (e.g. Al, Zn, Pb, Mg) are used as stone consolidants, others (e.g. sodium fluorosilicate)--in the production of enamel and milk glass, or as insecticide. In this paper, two fatal cases of poisonings are presented: a suicide involving sodium fluorosilicate of a 39-year-old male who died in his flat, without hospitalization, and an accidental ingestion of zinc fluorosilicate solution (probably due to mistaking it for mineral water) by a 38-year-old male at his workplace (building), who died about 3h after ingestion of the liquid, in spite of intensive care at hospitals. Post-mortem samples were examined by the use of the spectrophotometric method with lanthanum nitrate and alizarin complexone for fluorine (after isolation of fluoride compounds by the microdiffusion method) and using a flame atomic absorption spectrometry method for zinc (after mineralization of biological material by sulfuric and nitric acids). In the first case, the results were: blood--130 μg F/ml, stomach--1150 μg F/g, small intestine content --19.6 μg F/g, kidney--56.0 μg F/g, and urine--1940 μg F/ml. In the second case, the contents of fluorine and zinc in blood and internal organs were the following: blood--6.03 μg F/ml, 23.8 μg Zn/ml; brain--1.39 μg F/g, 7.54 μg Zn/g; stomach--152 μg Zn/g; stomach content--293 μg F/g, 84.4 μg Zn/g; small intestine--37.5 μg Zn/g; small intestine content--63.4 μg F/g, 19.6 μg Zn/g; liver--9.49 μg F/g, 81.0 μg Zn/g; kidney--29.6 μg F/g, 39.2 μg Zn/g; and exceeded the normal levels of these elements in biological material many times. In addition, in stomach and liver large amounts of silica were detected. In the paper, a review of acute intoxications with various

  15. Une intoxication peut en cacher une autre plus grave. Exemple d'une intoxication fatale à l'éthylène glycol masquée par une intoxication à un insecticide pyréthrinoïde

    PubMed Central

    Aissaoui, Younès; Kichna, Hicham; Boughalem, Mohammed; Kamili, Noureddine Drissi

    2013-01-01

    Les pyréthrinoïdes sont des insecticides largement utilisés du fait de leur efficacité et de leur relative sécurité chez l'homme. Les intoxications mortelles liées à ces agents restent exceptionnelles. Leur métabolisme hépatique rapide limite considérablement leur toxicité chez l'homme. Cette observation relate une intoxication grave à un pyréthrinoïde (la cyperméthrine) dont le solvant était l'éthylène glycol. Ce dernier est un toxique nettement plus dangereux pour l'homme. Le tableau clinique consistait en une atteinte multiviscérale avec prédominance de la défaillance cardiovasculaire et neurologique. Le faible potentiel toxique des pyréthrinoïdes suggère l'implication évidente de l'éthylène glycol dans la gravité de cette intoxication. La prise en charge thérapeutique, essentiellement symptomatique, n'a pas pris en compte la présence d'éthylène glycol dans la formulation de l'insecticide. L'évolution clinique était défavorable. Devant toute intoxication grave à un insecticide pyréthrinoïde une intoxication associée au solvant tel que l'éthylène glycol doit être recherchée et traitée. PMID:23734273

  16. [Changes in the biochemical, chemical and toxicological characteristics of pericardial fluid in the case of fatal narcotic intoxication].

    PubMed

    Altaeva, A Zh; Zhunisov, S S; Aĭdarkulov, A Sh; Selivokhina, N V; Kidraliev, R R; Darikulova, B U; Zagumennikova, A A

    2014-01-01

    This article describes the biochemical and chemical-toxicological investigations into the properties of the pericardial fluid designed to improve the effectiveness of forensic medical examination of the cases of fatal drug poisoning. The objectives of the study were the detection and determination of the type of narcotic substances in the pericardial fluid, evaluation of the quantitative changes in enzyme activities (AST, ALT and CPK) in the pericardial fluid, and the development of the criteria for the forensic medical diagnostics of fatal drug poisoning. The materials used in the study were the pericardial fluid and blood taken during forensic medical examination of 247 corpses of men (87.04%) and women (12.96%) at the age from 13 to 35 years who died from different causes. They were divided into two groups. The study group was comprised of 142 subjects who died from drug poisoning, the control group consisted of 105 subjects who died from other causes. The methods used to study the pericardial fluid included gas-liquid chromatography to detect the presence and the type of the poisonous drugs, as well as biochemical and colorimetric methods to determine the amount of enzymes AST, ALT, and CPK. The study revealed no traces of drugs or their metabolites in the pericardial fluid from the 105 control corpses. Positive results of the forensic drug tests were obtained in all the 142 cases of the study group. The changes in the parameters and the biochemical composition of pericardial fluid and blood in fatal drug poisoning were reliably established including the alteration of the enzyme levels, such as AST, ALT, and CPK. In the control group, the quantitative parameters of the enzyme activities did not exceed the normal values whereas in the study group a significant increase of AST, ALT, and CPK levels in the pericardial fluid and blood in comparison with the normal values was documented. Conclusion: the results obtained in the studies of both groups provide a basis

  17. Acute 3,4-methylenedioxy-N-ethylcathinone (ethylone) intoxication and related fatality: a case report with postmortem concentrations.

    PubMed

    McIntyre, Iain M; Hamm, Catherine E; Sherrard, James L; Gary, Ray D; Burton, Christopher G; Mena, Othon

    2015-04-01

    A 30-year-old man reportedly ingested pills and used illicit drugs with another person. They both fell asleep that night and the following afternoon the other person found him dead. There were used hypodermic needles and a metal spoon with dark tarry substance at the death scene, and two recent puncture sites were found on his body. It was uncertain if he had a history of illicit drug use. Postmortem blood initially screened borderline positive for methamphetamine by ELISA. An alkaline drug screen-detected ethylone which was subsequently confirmed and quantified by a specific GC-MS SIM analysis following solid-phase extraction. Concentrations were determined in the peripheral blood (0.39 mg/L), central blood (0.38 mg/L), liver (1.4 mg/kg), vitreous (0.58 mg/L), urine (20 mg/L) and gastric contents (12 mg). Other compounds detected in peripheral blood were morphine (0.05 mg/L), alprazolam (<0.05 mg/L), delta-9-THC (<1 ng/mL), delta-9-carboxy-THC (3.6 ng/mL) and naproxen (<5 mg/L). A urine screen (GC-MS) also confirmed 6-monoacetylmorphine, codeine and sildenafil. The cause of death was certified due to mixed ethylone, heroin and alprazolam intoxication. The manner of death was certified as accident. PMID:25540061

  18. Marijuana intoxication

    MedlinePlus

    Cannabis intoxication; Intoxication - marijuana (cannabis); Pot; Mary Jane; Weed; Grass; Cannabis ... The intoxicating effects of marijuana include relaxation, ... to fast and predictable signs and symptoms. Eating marijuana ...

  19. Fatal intoxication because of trihexyphenidyl.

    PubMed

    Petković, Stojan; Durendić-Brenesel, Maja; Dolai, Matilda; Samojlik, Isidora

    2011-09-01

    Trihexyphenidyl (THP) is an anticholinergic agent with forensic toxicological interest. We present a case of a 59-year-old woman with a history of paranoid disorder, who was found dead in the house where she lived alone. The autopsy findings revealed no marked pathological changes. Toxicological analysis based on gas chromatography-mass spectrometry (GC-MS) analysis revealed THP and its major metabolite (hydroxy-THP) in blood and urine, with THP concentrations of 0.053 and 0.560 mg/L, respectively. The blood and urine ethanol concentrations were low 0.096 and 0.100 g/L, respectively. Based on these results, we determined the cause of death to be THP poisoning. It is suggested that rare case of death associated with THP overdosage should be taken in conjunction with central nervous system depressants (benzodiazepines, ethanol) and/or with other pathological disorders. Thus, our case could not be supportive for this allegation.

  20. Phenol burns and intoxications.

    PubMed

    Horch, R; Spilker, G; Stark, G B

    1994-02-01

    Phenol burns and intoxications are life-threatening injuries. Roughly 50 per cent of all reported cases have a fatal outcome. Only a small number of cases have been reported with high serum concentrations after phenol burns who survived. In our own experience a patient with 20.5 per cent total body surface area deep partial skin thickness phenol burns and serum concentrations of 17,400 micrograms/litre survived after immediate and repeated treatment of the scalds with polyethylene glycol (PEG) and silver sulphadiazine. A literature review of experiences with phenol intoxications reveals the advantages of PEG application. Questions on the need for enforced diuresis and haemodialysis as well as the initial treatment procedures are discussed. Advantages of different solutions for local therapy are reported.

  1. Opioid intoxication

    MedlinePlus

    ... develop. This is from the talc, cornstarch, or cellulose that is used to dilute or bind the ... McGraw-Hill; 2004:chap 167. Lank PM, Kusin S. Ethanol and opioid intoxication and withdrawal. In: Adams JG, ...

  2. Near fatal iron intoxication managed conservatively.

    PubMed

    Sankar, Jhuma; Shukla, Amelin; Khurana, Rohit; Dubey, Nandkishore

    2013-01-01

    We report here the case of an infant who presented to the emergency department after unintentional ingestion of almost 130 mg/kg of elemental iron. The infant had evidence of serious toxicity in the form of hypotension, metabolic acidosis and excessive irritability. Her serum iron levels were 360 µg/dl, which was well above the normal range for her age. Despite such high serum levels, the infant made an uneventful recovery with medical management alone and did not require exchange transfusion. We chose to report this case to highlight her uneventful recovery with conservative therapy alone. PMID:23376661

  3. Barbiturate intoxication and overdose

    MedlinePlus

    Intoxication - barbiturates ... Symptoms of barbiturate intoxication and overdose include: Altered level of consciousness Difficulty in thinking Drowsiness or coma Faulty judgment Lack of coordination Shallow ...

  4. Barbiturate Intoxication

    PubMed Central

    Goodman, Jay M.; Bischel, Margaret D.; Wagers, Park W.; Barbour, Benjamin H.

    1976-01-01

    The complications encountered in caring for 185 patients intoxicated with barbiturates were reviewed. The population consisted of 142 patients with long-acting barbiturate concentrations of 8 mg per 100 ml or greater, 20 patients with short-acting barbiturate concentrations of 3 mg per 100 ml or greater and 23 consecutive patients with short-acting barbiturate intoxication referred for monitoring. Pneumonia was the major cause of morbidity and mortality and correlated best with the initial depth of coma and the use of an endotracheal tube in treatment. Cardiovascular instability manifested by pulmonary edema was the next leading cause of morbidity and mortality and correlated best with the initial depth of coma and the quantity of intravenous fluid administered. In retrospect, use of eliminative measures such as dialysis would probably not have altered the outcome in most of the patients who died and attempts at forced diuresis may have contributed to several deaths. Particular emphasis should be placed on the problems of sepsis and fluid therapy in the management of these patients. PMID:1258466

  5. Manganese Intoxication

    PubMed Central

    Hine, Charles H.; Pasi, Aurelio

    1975-01-01

    We have reported two cases of chronic manganese poisoning. Case 1 followed exposure to manganese fumes in cutting and burning manganese steel. Case 2 resulted from exposure to dusts of manganese dioxide, an ingredient used in glazing of ceramics. There were initial difficulties in establishing the correct diagnosis. Prominent clinical features were severe and persistent chronic depressive psychosis (Case 1), transient acute brain syndrome (Case 2) and the presence of various extrapyramidal symptoms in both cases. Manganese intoxication has not previously been reported as occurring in California. With increasing use of the metal, the disease should be considered in the differential diagnosis of neurologic and psychiatric disease. Our observations were made in the period 1964 through 1968. Recently the prognosis of victims of manganese poisoning has been improved dramatically by the introduction of levodopa as a therapeutic agent. PMID:1179714

  6. [Fatal poisonings with propoxur].

    PubMed

    Pfordt, J; Magerl, H; Vock, R

    1987-01-01

    The insecticide propoxur (2-isopropoxyphenyl-N-methylcarbamate) acts by blocking cholinesterase. This inhibition is fast and, unlike that brought about by organophosphorus compounds, reversible. The toxicity of propoxur to man is stated to be low compared with that of parathion. Only a small number of fatal intoxications have been published; at the Würzburg University Institute of Legal Medicine eight cases have been observed since 1978. In seven cases death occurred after deliberate oral ingestion of solutions of propoxur with suicidal intent, while in the other, intoxication was accidental, following inhalation of an aerosol containing propoxur. Organs and body fluids were investigated toxicologically and histologically. The results are presented and discussed. Special attention is paid to the combination of propoxur and alcohol.

  7. Naloxone and ethanol intoxication.

    PubMed

    Askenasi, R; Fontaine, J

    1982-01-01

    Naloxone has been said to be an antidote of acute ethanol intoxication in man. Experimental and clinical studies are however not convincing and contradictory. We have used naloxone to antagonize the effect of ethanol in mice. Results are compared to those obtained with morphine intoxication. Even at high doses (5 mg/kg) naloxone is not a good antagonist of ethanol intoxication in mice.

  8. [Fatalities in the bathtub].

    PubMed

    Trübner, K; Püschel, K

    1991-01-01

    A retrospective analysis concerning deaths in the bathtub was carried out in the Institute of Legal Medicine in Hamburg. The study includes 245 death cases between 1971 and 1988 (1% of all autopsies). 66 cases proved to be natural deaths, 76 were classified as suicides, 39 as accidents and 13 as homicides; 51 fatalities remained unclear with respect to one of these groups. Among the natural deaths sudden cardiac deaths were dominating (n = 39), among the suicides the intoxications (n = 37) and electrocutions (n = 20), and among the accidents the intoxications by carbon monoxide (n = 17) and electrocutions (n = 12). Out of 13 homicides only 2 were committed directly in the bathtub: One by drowning of a child and one by electric current via a hair dryer; in the other cases the dead body was put into the bathtub post mortem. About 50% of the victims were alcoholized. Signs of drowning were present in about 40% of all cases; the most frequent finding was emphysema aquosum.

  9. Suicide attempt with a mix of synthetic cannabinoids and synthetic cathinones: Case report of non-fatal intoxication with AB-CHMINACA, AB-FUBINACA, alpha-PHP, alpha-PVP and 4-CMC.

    PubMed

    Klavž, Janez; Gorenjak, Maksimiljan; Marinšek, Martin

    2016-08-01

    We report on a case of intoxication with a mix of new psychoactive substances. A 38-year-old male was brought to the emergency department (ED) following the ingestion of an unknown drug in a suicide attempt. During the transport, he became progressively more somnolent and unresponsive to painful stimuli. Urine and stomach content were collected on admission to be screened for drugs of abuse and medicinal drugs. After admission, the patient's next of kin presented five small grip seal plastic bags containing different powders/crystals, and they were sent for analysis along with urine and stomach content to the toxicology laboratory. An easy and rapid sample preparation technique was applied for the extraction of urine and stomach content. Samples were extracted with liquid-liquid extraction (LLE) technique and analysed using gas chromatography-mass spectrometry (GC-MS). A small amount of powder material from the bags was diluted in methanol and injected directly into the GC-MS instrument. Obtained spectra (EI) were evaluated against SWGDRUG library. Five different designer drugs were identified in the powder material, including synthetic cannabinoids (AB-CHMINACA, AB-FUBINACA) and synthetic cathinones (alpha-PHP, alpha-PVP and 4-CMC). With the exception of 4-CMC, all of these substances were also detected in the stomach content along with the prescription drugs. This is the first time that a positive identification of these five drugs has been made by a clinical laboratory in Slovenia.

  10. [Acute intoxication by cosmetics].

    PubMed

    Larcan, A; Lambert, H; Laprevote-Heully, M C; Nida, F

    1975-01-01

    Intoxications due to cosmetics are of various types, but certain substances may be particularly harmful, especially when the constituants include acetone, boric acid and borates, ethyl alcohol, bromates, formol, methyl alcohol, propylene glycol, thallium, thioglycolate.. Every cosmetic substance may induce accidental intoxications. Most often, fluid cosmetics are absorbed either by children or by feeble-minded subjects. In all intoxication, one must take account of the age and weight of the patient, of the quantity absorbed, of the toxicity and of the constituants of the substance.

  11. A fatal case of menthol poisoning

    PubMed Central

    Kumar, Akshay; Baitha, Upendra; Aggarwal, Praveen; Jamshed, Nayer

    2016-01-01

    Menthol is a monocyclic terpene alcohol, which is present naturally in peppermint and can be synthesized artificially as well. Generally, it is considered as very safe and has wide usage in medicine and food. There are case reports of toxicity due to excessive consumption of menthol, but a fatal intoxication has never been reported in the medical literature. We present a case of fatal menthol intoxication in a worker, who accidently got exposed when he was working in a peppermint factory. Emergency physicians must keep in mind this extremely rare manifestation of menthol poisoning. All necessary precaution should be taken to reduce its intake or exposure, as it has no specific antidote. Early recognition and supportive treatment of this poisoning is the key for a successful outcome. PMID:27127746

  12. Thallium intoxication. Case Report.

    PubMed

    Sojáková, Michaela; Žigrai, Miroslav; Karaman, Andrej; Plačková, Silvia; Klepancová, Petra; Hrušovský, Štefan

    2015-01-01

    We report a rare case of serious voluntary intoxication by laboratory thallium monobromate combined with alcohol intake by a 24-years old man. The diagnosis of thallium intoxication was based on history, nonspecific but typical clinical symptoms including gastrointestinal complaints, painful polyneuropathy, alopecia, and confirmed by the finding of increased thallium concentration in the urine. The treatment, performed at the due time, consisted of decontamination of the stomach by irrigation, administration of active charcoal and Prussian blue, correction of water and mineral dysbalance, symptomatic treatment, and led to complete recovery. PMID:26454485

  13. Thallium intoxication. Case Report.

    PubMed

    Sojáková, Michaela; Žigrai, Miroslav; Karaman, Andrej; Plačková, Silvia; Klepancová, Petra; Hrušovský, Štefan

    2015-01-01

    We report a rare case of serious voluntary intoxication by laboratory thallium monobromate combined with alcohol intake by a 24-years old man. The diagnosis of thallium intoxication was based on history, nonspecific but typical clinical symptoms including gastrointestinal complaints, painful polyneuropathy, alopecia, and confirmed by the finding of increased thallium concentration in the urine. The treatment, performed at the due time, consisted of decontamination of the stomach by irrigation, administration of active charcoal and Prussian blue, correction of water and mineral dysbalance, symptomatic treatment, and led to complete recovery.

  14. Fatal poisoning by vanadium.

    PubMed

    Boulassel, Brahim; Sadeg, Nouredine; Roussel, Olivier; Perrin, Martine; Belhadj-Tahar, Hafid

    2011-03-20

    We report here a fatal intoxication case involving ammonium vanadate. A 24-year-old woman was admitted to the Emergency Department for abdominal pain, nausea, vomiting, multiple daily diarrheas, hypoglycaemia (0.2g/L) and severe acute renal failure with glomerular filtration rate estimated at 21 ml/min. This patient had taken an undetermined amount of ammonium vanadate 12h after ingesting. She died next morning in the context of respiratory distress despite intensive care and oxygen therapy. The autopsy revealed widespread asphyxia syndrome and erosive gastritis. Determination of vanadium concentration in blood was carried out by means of mass spectrometer (ICP-MS) using rhodium ((103)Rh) as the internal standard. The vanadium concentration was 6.22 mg/L, corresponding to 6000 times higher than normal concentration in the general population. The latency and the brutality of clinical picture degradation seem to be in consideration of systemic poisoning by vanadium leading to inhibition of the cellular respiratory process.

  15. A case of survival after chlorfenapyr intoxication with acute pancreatitis

    PubMed Central

    Ku, Jae Eun; Joo, Young Seon; You, Je Sung; Chung, Sung Phil; Lee, Hahn Shick

    2015-01-01

    Chlorfenapyr is a moderately hazardous insecticide. There have been previous reports of chlorfenapyr intoxication, but none have reported patient survival or an association with pancreatitis. A 61-year-old woman was brought to the emergency department with vomiting after ingesting 10 mL chlorfenapyr in a suicide attempt 1 hour before. The patient was treated with gastric lavage and activated charcoal, then transferred to the intensive care unit. Initial laboratory data were unremarkable except for elevated amylase/lipase levels (134/222 U/L), which were even higher 7 days later and remained elevated for 2 weeks. Abdominal computed tomography showed diffuse pancreatic swelling. The patient improved with conservative care and was discharged to home 19 days after admission. This is the first reported case of survival after chlorfenapyr intoxication. We recommend early aggressive management in the emergency department and close monitoring in the intensive care unit to detect and treat potentially fatal deterioration after chlorfenapyr intoxication. PMID:27752575

  16. Surprising hair analysis results following acute carbofuran intoxication.

    PubMed

    Dulaurent, S; Gaulier, J M; Zouaoui, K; Moesch, C; François, B; Lachâtre, G

    2011-10-10

    We present two non fatal cases of intoxication with carbofuran (CBF) documented by hair analysis. Carbofuran and 3-hydroxycarbofuran (OHCBF, its main metabolite) hair concentrations were determined using a liquid chromatography-tandem mass spectrometry method. The obtained results were surprising if we consider several hair analyses previously published and based on a theory of the presence of xenobiotic in the only segment that comprised its intake. Among the two intoxication cases, we noticed the presence of CBF and OHCBF in hair segments corresponding to 45 days before, and more than 100 days after, the day of intoxication. Additionally, repeated hair samplings and subsequent analysis revealed a decrease of the carbofuran's concentration during the hair life.

  17. Chronic manganese intoxication

    SciTech Connect

    Huang, C.C.; Chu, N.S.; Lu, C.S.; Wang, J.D.; Tsai, J.L.; Tzeng, J.L.; Wolters, E.C.; Calne, D.B. )

    1989-10-01

    We report six cases of chronic manganese intoxication in workers at a ferromanganese factory in Taiwan. Diagnosis was confirmed by assessing increased manganese concentrations in the blood, scalp, and pubic hair. In addition, increased manganese levels in the environmental air were established. The patients showed a bradykinetic-rigid syndrome indistinguishable from Parkinson's disease that responded to treatment with levodopa.

  18. Driving While Intoxicated.

    ERIC Educational Resources Information Center

    Brick, John

    Alcohol intoxication increases the risk of highway accidents, the relative risk of crash probability increasing as a function of blood alcohol content (BAC). Because alcohol use is more prevalent than use of other drugs, more is known about the relationship between alcohol use and driving. Most states presume a BAC of .10% to be evidence of drunk…

  19. [Clozapine intoxication: theoretical aspects and forensic-medical examination ].

    PubMed

    Shigeev, S V; Ivanova, N A; Ivanov, S V

    2013-01-01

    This literature review is focused on diagnostics of acute clozapine intoxication with the fatal outcome. According to the Russian authors, clozapine intoxication ranks first in the structure of criminal poisoning and accounted for 99.7% of all the cases that occurred in Moscow during the period from 2003 to 2006. Toximetric investigations of clinical manifestations of clozapine intoxication revealed that the threshold clozapine concentration in blood is 0.12 ± 0.06 mg/I, the critical and lethal concentrations are 1.01 ± 0.2 mg/I and 3.5 ± 1.5 mg/I respectively. Autopsy on corpses of the victims of clozapine intoxication showed that most clozapine-induced pathological changes have a non-specific character (including largely circulatory disorders and dystrophic changes in parenchymatous organs). Clozapine poisoning is associated with the lengthening of QT-interval on ECG; at the values in excess of 500 ms, the risk of severe arrhythmia and sudden death significantly increases. Clozapine intake may lead to the development of potentially fatal myocarditis (the so-called clozapine-associated eosinophilic myocardium) in somatically healthy subjects. Foreign researchers report the possibility of a post-mortem increase of blood clozapine content compared with its antemortem level. They also showed that simultaneous use of substances stimulating activity of cytochrome P-450 enzymes (ethyl alcohol, finlepsin, fenitrin, nicotine) and clozapine accelerates metabolism and thereby reduces clozapine concentration in blood. It is concluded that comprehensive investigations of clozapine intoxication are needed taking into consideration pathomorphological changes induced by this agent, its potential interaction with other factors influencing human body, and the results of forensic chemical expertise of the fatal cases. PMID:25474921

  20. 1,1,1-trichloroethane: report of a fatal intoxication.

    PubMed

    Caplan, Y H; Backer, R C; Whitaker, J Q

    1976-01-01

    TCE was indicated in the accidental death of a woman cleaning up a paint spill in an enclosed, poorly ventilated room. Blood and tissue concentrations of TCE were measured by head-space gas chromatography. The concentrations found were compared with previously reported concentrations concluding that the demonstrable presence of TCE in blood at a concentration above 1.0 to 1.5 mg/100 ml would be consistent with death. However, the rapid dissipation of TCE from blood dictates that its presence in post mortem samples at any concentration must be considered as a factor in determining the cause of death. PMID:1277770

  1. Toxicological findings in a fatal multidrug intoxication involving mephedrone.

    PubMed

    Gerace, Enrico; Petrarulo, Michele; Bison, Fabrizio; Salomone, Alberto; Vincenti, Marco

    2014-10-01

    The distribution of mephedrone in the body fluids and tissues of a subject found dead after the concomitant intake of cocaine and mephedrone is reported. Mephedrone (4-methylmethcathinone) is a designer drug of the phenethylamine family that is able to cause central nervous system stimulation, psychoactivity and hallucinations and that is becoming popular among youth as a recreational drug. Mephedrone has been available in Europe since 2007, and it is sold through the internet and by local shops as bath salt or plant food. In the case reported here, a 25-year-old man was found dead in the apartment of a friend after a night spent in several local clubs. A fragment of a blue diamond-shaped pill was found in the pocket of the trousers worn by the decedent. During the autopsy, no evidence of natural disease or trauma was found to account for this death. Blood, urine and gastric content samples were collected and submitted for toxicological analysis. Moreover, bile, brain, lung and hair samples were collected as additional matrices. The content of the pill was submitted to a general screening analysis in order to determine its composition. Mephedrone was detected in the blood, urine, gastric contents and in the additional matrices using an expressly validated GC/MS method. The blood and urine concentrations were 1.33mg/L and 144mg/L, respectively. Contextually, cocaine and cocaethylene were found in the blood and urine specimens. The distribution of mephedrone in the body organs was evaluated by analyzing the brain, bile and lung specimens. Hair analysis revealed a past exposure to mephedrone, ketamine, MDMA and cocaine. Sildenafil was identified as the main component of the blue, diamond-shaped pill. The quantitative determination of mephedrone in several body fluids and tissues provides significant knowledge about the distribution of this new drug of abuse in the human body after massive ingestion. PMID:24846124

  2. Toxicological findings in a fatal multidrug intoxication involving mephedrone.

    PubMed

    Gerace, Enrico; Petrarulo, Michele; Bison, Fabrizio; Salomone, Alberto; Vincenti, Marco

    2014-10-01

    The distribution of mephedrone in the body fluids and tissues of a subject found dead after the concomitant intake of cocaine and mephedrone is reported. Mephedrone (4-methylmethcathinone) is a designer drug of the phenethylamine family that is able to cause central nervous system stimulation, psychoactivity and hallucinations and that is becoming popular among youth as a recreational drug. Mephedrone has been available in Europe since 2007, and it is sold through the internet and by local shops as bath salt or plant food. In the case reported here, a 25-year-old man was found dead in the apartment of a friend after a night spent in several local clubs. A fragment of a blue diamond-shaped pill was found in the pocket of the trousers worn by the decedent. During the autopsy, no evidence of natural disease or trauma was found to account for this death. Blood, urine and gastric content samples were collected and submitted for toxicological analysis. Moreover, bile, brain, lung and hair samples were collected as additional matrices. The content of the pill was submitted to a general screening analysis in order to determine its composition. Mephedrone was detected in the blood, urine, gastric contents and in the additional matrices using an expressly validated GC/MS method. The blood and urine concentrations were 1.33mg/L and 144mg/L, respectively. Contextually, cocaine and cocaethylene were found in the blood and urine specimens. The distribution of mephedrone in the body organs was evaluated by analyzing the brain, bile and lung specimens. Hair analysis revealed a past exposure to mephedrone, ketamine, MDMA and cocaine. Sildenafil was identified as the main component of the blue, diamond-shaped pill. The quantitative determination of mephedrone in several body fluids and tissues provides significant knowledge about the distribution of this new drug of abuse in the human body after massive ingestion.

  3. Fatal Wedelia glauca intoxication in calves following natural exposure.

    PubMed

    Giannitti, F; Margineda, C A; Cid, M S; Montobbio, C; Soteras, C I; Caffarena, R D; Diab, S S

    2013-05-01

    A group of 342 beef calves, corralled in the Patagonia region of Argentina, were fed alfalfa hay that had been inadvertently contaminated with Wedelia glauca. A total of 147 (43%) calves died within 4 days. Pathologic findings in 2 calves were diffuse centrilobular hepatic necrosis and hemorrhage with edema in the gallbladder, common bile duct, and choledochoduodenal junction. Epidermal fragments of W. glauca were identified in rumen contents by microscopy. Intact W. glauca plants and leaf fragments were found in the hay. Patches of defoliated W. glauca were also identified in the alfalfa pasture from which the hay had been baled. PMID:23355516

  4. [Intoxication of botulinum toxin].

    PubMed

    Chudzicka, Aleksandra

    2015-09-01

    Botulinum toxin is an egzotoxin produced by Gram positive bacteria Clostridium botulinum. It is among the most potent toxins known. The 3 main clinical presentations of botulism are as follows: foodborne botulism, infant botulism and wound botulism. The main symptom of intoxication is flat muscles paralysis. The treatment is supportive care and administration of antitoxin. In prevention the correct preparing of canned food is most important. Botulinum toxin is accepted as a biological weapon.

  5. [Intoxication of botulinum toxin].

    PubMed

    Chudzicka, Aleksandra

    2015-09-01

    Botulinum toxin is an egzotoxin produced by Gram positive bacteria Clostridium botulinum. It is among the most potent toxins known. The 3 main clinical presentations of botulism are as follows: foodborne botulism, infant botulism and wound botulism. The main symptom of intoxication is flat muscles paralysis. The treatment is supportive care and administration of antitoxin. In prevention the correct preparing of canned food is most important. Botulinum toxin is accepted as a biological weapon. PMID:26449577

  6. Odor and marijuana intoxication.

    PubMed

    Pihl, R O; Shea, D; Costa, L

    1978-07-01

    Assigned 48 volunteer adult males to four groups: a marijuana high dose, a marijuana low dose, a placebo, and a coltsfoot group. Each S participated in two 80-minute sessions; one involved listening to music, socializing, and smoking the drug, and the second was identical to the first with the addition of two extra placebo cigarettes which contained finely cut amounts of human hair. The odor of burning hair was rated previously as quite aversive by non-intoxicated Ss. Contrary to expectation, Ss in the odor condition indicated on self-ratings that they became significantly more intoxicated after the smoking of the hair cigarette. The opposite effect was found with a pulse rate measure. An additional 24 Ss were divided into high and low dose marijuana groups and run in an odor session, in which they were informed prior to smoking of the hair content. Heart rate for these Ss decreased significantly more than for the comparable uninformed Ss, although self-ratings continued to reflect increased intoxication.

  7. [Autoerotic fatalities in Greater Dusseldorf].

    PubMed

    Hartung, Benno; Hellen, Florence; Borchard, Nora; Huckenbeck, Wolfgang

    2011-01-01

    Autoerotic fatalities in the Greater Dusseldorf area correspond to the relevant medicolegal literature. Our results included exclusively young to middle-aged, usually single men who were found dead in their city apartments. Clothing and devices used showed a great variety. Women's or fetish clothing and complex shackling or hanging devices were disproportionately frequent. In most cases, death occurred due to hanging or ligature strangulation. There was no increased incidence of underlying psychiatric disorders. In most of the deceased no or at least no remarkable alcohol intoxication was found. Occasionally, it may be difficult to reliably differentiate autoerotic accidents, accidents occurring in connection with practices of bondage & discipline, dominance & submission (BDSM) from natural death, suicide or homicide. PMID:22039693

  8. [Arsenic intoxication: information and case report].

    PubMed

    Bucio Jurado, Wilfrido

    2005-01-01

    Arsine intoxication is a true medical emergency with a high fatality rate, characteristic of acute and massive hemolysis. Inhalation of 250 ppm of arsine gas is instantly lethal. Exposure to 25 to 50 ppm for 30 minutes is lethal. Arsine is a colorless gas with a garlic scent, entering the organism by breathing and passing directly into the circulation. Its hemolytic activity is due to its ability to cause a fall in erythrocyte-reduced glutathione content. Manifestations are suggestive of a general toxic state with alterations of consciousness, from confusion until delirium, crash, hematuria, jaundice and renal insufficiency. This can generate confusion and difficulty in the diagnosis and in the opportune treatment to avoid death or sequelae. This type of intoxication must be suspected in electrolysis process workers or those working with lead, copper, zinc, iron, gold, silver and tin. In the present case, sources for arsenic ingestion in the organism were discarded and the presence of arsine in the workplace was confirmed. In spite of the administered treatment, the patient experienced renal insufficiency.

  9. [Arsenic intoxication: information and case report].

    PubMed

    Bucio Jurado, Wilfrido

    2005-01-01

    Arsine intoxication is a true medical emergency with a high fatality rate, characteristic of acute and massive hemolysis. Inhalation of 250 ppm of arsine gas is instantly lethal. Exposure to 25 to 50 ppm for 30 minutes is lethal. Arsine is a colorless gas with a garlic scent, entering the organism by breathing and passing directly into the circulation. Its hemolytic activity is due to its ability to cause a fall in erythrocyte-reduced glutathione content. Manifestations are suggestive of a general toxic state with alterations of consciousness, from confusion until delirium, crash, hematuria, jaundice and renal insufficiency. This can generate confusion and difficulty in the diagnosis and in the opportune treatment to avoid death or sequelae. This type of intoxication must be suspected in electrolysis process workers or those working with lead, copper, zinc, iron, gold, silver and tin. In the present case, sources for arsenic ingestion in the organism were discarded and the presence of arsine in the workplace was confirmed. In spite of the administered treatment, the patient experienced renal insufficiency. PMID:15998481

  10. The disruption of marijuana intoxication.

    PubMed

    Pihl, R O; Spiers, P; Shea, D

    1977-05-01

    Ninety-six males Ss were divided into four drug conditions; coltsfoot, placebo, marijuana low dose, and marijuana high dose. Half of the Ss smoked marijuana while listening to music in a relaxing environment, and half smoked marijuana in the same environment but had two 10-min periods of aversive-noise superimposed over the music. A subjective measure of intoxication demonstrated significant drug and environmental group effects with suppression of self-report of intoxication being especially strong for the marijuana low dose noise group. The usual positive correlation between subjective measures and pulse rate measures of marijuana intoxication was interfered with by the noise effect. Although subjective ratings were suppressed, the noise group demonstrated significantly higher pulse rates than the music group. The results are discussed in terms of the effect of extraneous factors on marijuana intoxication, the significance of dosage in this type of research, and the nature of marijuana intoxication.

  11. Unpacking intoxication, racialising disability.

    PubMed

    Chen, Mel Y

    2015-06-01

    This article examines concepts whose strictly medical applications have only partly informed their widespread use and suggests that demonstrably shared logics motivate our thinking across domains in the interest of a politically just engagement. It considers exchanges between the culturally complex concepts of 'toxicity' and 'intoxication', assessing the racialised conditions of their animation in several geopolitically--and quite radically--distinct scenarios. First, the article sets the framework through considering the racial implications of impairment and disability language of 'non-toxic' finance capital in the contemporary US financial crisis. Shifting material foci from 'illiquid financial bodies' to opiates while insisting that neither is 'more' metaphorically toxic than the other, the article turns to address the role of opium and temporality in the interanimations of race and disability in two sites of 19th-century British empire: Langdon Down's clinic for idiocy, and China's retort on opium to Queen Victoria. The article concludes with a provocation that suggests yet another crossing of borders, that between researcher and researched: 'intoxicated method' is a hypothetical mode of approach that refuses idealised research positions by 'critically disabling' the idealised cognitive and conceptual lens of analysis.

  12. Unpacking intoxication, racialising disability.

    PubMed

    Chen, Mel Y

    2015-06-01

    This article examines concepts whose strictly medical applications have only partly informed their widespread use and suggests that demonstrably shared logics motivate our thinking across domains in the interest of a politically just engagement. It considers exchanges between the culturally complex concepts of 'toxicity' and 'intoxication', assessing the racialised conditions of their animation in several geopolitically--and quite radically--distinct scenarios. First, the article sets the framework through considering the racial implications of impairment and disability language of 'non-toxic' finance capital in the contemporary US financial crisis. Shifting material foci from 'illiquid financial bodies' to opiates while insisting that neither is 'more' metaphorically toxic than the other, the article turns to address the role of opium and temporality in the interanimations of race and disability in two sites of 19th-century British empire: Langdon Down's clinic for idiocy, and China's retort on opium to Queen Victoria. The article concludes with a provocation that suggests yet another crossing of borders, that between researcher and researched: 'intoxicated method' is a hypothetical mode of approach that refuses idealised research positions by 'critically disabling' the idealised cognitive and conceptual lens of analysis. PMID:26052116

  13. Inhibiting oral intoxication of botulinum neurotoxin A by carbohydrate receptor mimics

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Botulinum neurotoxins (BoNTs) cause the disease botulism manifested by flaccid paralysis that could be fatal to humans and animals. Oral ingestion of the toxin with contaminated food is one of the most common routes of BoNT intoxication, where BoNT assembles with several auxiliary proteins to surviv...

  14. Confronting death from drug self-intoxication (DDSI): prevention through a better definition.

    PubMed

    Rockett, Ian R H; Smith, Gordon S; Caine, Eric D; Kapusta, Nestor D; Hanzlick, Randy L; Larkin, G Luke; Naylor, Charles P E; Nolte, Kurt B; Miller, Ted R; Putnam, Sandra L; De Leo, Diego; Kleinig, John; Stack, Steven; Todd, Knox H; Fraser, David W

    2014-12-01

    Suicide and other self-directed violence deaths are likely grossly underestimated, reflecting inappropriate classification of many drug intoxication deaths as accidents or unintentional and heterogeneous ascertainment and coding practices across states. As the tide of prescription and illicit drug-poisoning deaths is rising, public health and research needs would be better satisfied by considering most of these deaths a result of self-intoxication. Epidemiologists and prevention scientists could design better intervention strategies by focusing on premorbid behavior. We propose incorporating deaths from drug self-intoxication and investigations of all poisoning deaths into the National Violent Death Reporting System, which contains misclassified homicides and undetermined intent deaths, to facilitate efforts to comprehend and reverse the surging rate of drug intoxication fatalities.

  15. Confronting Death From Drug Self-Intoxication (DDSI): Prevention Through a Better Definition

    PubMed Central

    Smith, Gordon S.; Caine, Eric D.; Kapusta, Nestor D.; Hanzlick, Randy L.; Larkin, G. Luke; Naylor, Charles P. E.; Nolte, Kurt B.; Miller, Ted R.; Putnam, Sandra L.; De Leo, Diego; Kleinig, John; Stack, Steven; Todd, Knox H.; Fraser, David W.

    2014-01-01

    Suicide and other self-directed violence deaths are likely grossly underestimated, reflecting inappropriate classification of many drug intoxication deaths as accidents or unintentional and heterogeneous ascertainment and coding practices across states. As the tide of prescription and illicit drug-poisoning deaths is rising, public health and research needs would be better satisfied by considering most of these deaths a result of self-intoxication. Epidemiologists and prevention scientists could design better intervention strategies by focusing on premorbid behavior. We propose incorporating deaths from drug self-intoxication and investigations of all poisoning deaths into the National Violent Death Reporting System, which contains misclassified homicides and undetermined intent deaths, to facilitate efforts to comprehend and reverse the surging rate of drug intoxication fatalities. PMID:25320874

  16. Confronting death from drug self-intoxication (DDSI): prevention through a better definition.

    PubMed

    Rockett, Ian R H; Smith, Gordon S; Caine, Eric D; Kapusta, Nestor D; Hanzlick, Randy L; Larkin, G Luke; Naylor, Charles P E; Nolte, Kurt B; Miller, Ted R; Putnam, Sandra L; De Leo, Diego; Kleinig, John; Stack, Steven; Todd, Knox H; Fraser, David W

    2014-12-01

    Suicide and other self-directed violence deaths are likely grossly underestimated, reflecting inappropriate classification of many drug intoxication deaths as accidents or unintentional and heterogeneous ascertainment and coding practices across states. As the tide of prescription and illicit drug-poisoning deaths is rising, public health and research needs would be better satisfied by considering most of these deaths a result of self-intoxication. Epidemiologists and prevention scientists could design better intervention strategies by focusing on premorbid behavior. We propose incorporating deaths from drug self-intoxication and investigations of all poisoning deaths into the National Violent Death Reporting System, which contains misclassified homicides and undetermined intent deaths, to facilitate efforts to comprehend and reverse the surging rate of drug intoxication fatalities. PMID:25320874

  17. Chelation in Metal Intoxication

    PubMed Central

    Flora, Swaran J.S.; Pachauri, Vidhu

    2010-01-01

    Chelation therapy is the preferred medical treatment for reducing the toxic effects of metals. Chelating agents are capable of binding to toxic metal ions to form complex structures which are easily excreted from the body removing them from intracellular or extracellular spaces. 2,3-Dimercaprol has long been the mainstay of chelation therapy for lead or arsenic poisoning, however its serious side effects have led researchers to develop less toxic analogues. Hydrophilic chelators like meso-2,3-dimercaptosuccinic acid effectively promote renal metal excretion, but their ability to access intracellular metals is weak. Newer strategies to address these drawbacks like combination therapy (use of structurally different chelating agents) or co-administration of antioxidants have been reported recently. In this review we provide an update of the existing chelating agents and the various strategies available for the treatment of heavy metals and metalloid intoxications. PMID:20717537

  18. Carbon monoxide intoxication

    SciTech Connect

    Kales, S.N. )

    1993-11-01

    Carbon monoxide poisoning usually results from inhalation of exhaust fumes from motor vehicles, smoke from fires or fumes from faulty heating systems. Carbon monoxide has a high affinity for hemoglobin, with which it forms carboxyhemoglobin. The resulting decrease in both oxygen-carrying capacity and oxygen release can lead to end-organ hypoxia. The clinical presentation is nonspecific. Headache, dizziness, fatigue and nausea are common in mild to moderate carbon monoxide poisoning. In more severe cases, tachycardia, tachypnea and central nervous system depression occur. When carbon monoxide intoxication is suspected, empiric treatment with 100 percent oxygen should be initiated immediately. The diagnosis is confirmed by documenting an elevated carboxyhemoglobin level. Hyperbaric oxygen therapy is recommended in patients with neurologic dysfunction, cardiac dysfunction or a history of unconsciousness. 26 refs.

  19. Biomarkers of manganese intoxication.

    PubMed

    Zheng, Wei; Fu, Sherleen X; Dydak, Ulrike; Cowan, Dallas M

    2011-01-01

    Manganese (Mn), upon absorption, is primarily sequestered in tissue and intracellular compartments. For this reason, blood Mn concentration does not always accurately reflect Mn concentration in the targeted tissue, particularly in the brain. The discrepancy between Mn concentrations in tissue or intracellular components means that blood Mn is a poor biomarker of Mn exposure or toxicity under many conditions and that other biomarkers must be established. For group comparisons of active workers, blood Mn has some utility for distinguishing exposed from unexposed subjects, although the large variability in mean values renders it insensitive for discriminating one individual from the rest of the study population. Mn exposure is known to alter iron (Fe) homeostasis. The Mn/Fe ratio (MIR) in plasma or erythrocytes reflects not only steady-state concentrations of Mn or Fe in tested individuals, but also a biological response (altered Fe homeostasis) to Mn exposure. Recent human studies support the potential value for using MIR to distinguish individuals with Mn exposure. Additionally, magnetic resonance imaging (MRI), in combination with noninvasive assessment of γ-aminobutyric acid (GABA) by magnetic resonance spectroscopy (MRS), provides convincing evidence of Mn exposure, even without clinical symptoms of Mn intoxication. For subjects with long-term, low-dose Mn exposure or for those exposed in the past but not the present, neither blood Mn nor MRI provides a confident distinction for Mn exposure or intoxication. While plasma or erythrocyte MIR is more likely a sensitive measure, the cut-off values for MIR among the general population need to be further tested and established. Considering the large accumulation of Mn in bone, developing an X-ray fluorescence spectroscopy or neutron-based spectroscopy method may create yet another novel non-invasive tool for assessing Mn exposure and toxicity. PMID:20946915

  20. [Crystalluria in ethylene glycol intoxication].

    PubMed

    Montagnac, Richard; Thouvenin, Maxime; Luxey, Grégoire; Schendel, Adeline; Parent, Xavier

    2014-11-01

    When seen, some habits of calcium oxalate monohydrate crystals (whewellite) are so typical of ethylene glycol intoxication that they may be helpful for its diagnosis when circumstances are not clearly established.

  1. NUTRITIONAL THERAPY IN THE TREATMENT OF ACUTE CORROSIVE INTOXICATION IN ADULTS

    PubMed Central

    Chibishev, Andon; Markoski, Velo; Smokovski, Ivica; Shikole, Emilija; Stevcevska, Aleksandra

    2016-01-01

    Introduction: Acute intoxications with corrosive substances can cause severe chemical injuries of the upper gastrointestinal tract, most often located in the mouth, pharynx, esophagus, stomach and duodenum. If a patient survives the acute phase of intoxication, regenerative response may result in esophageal and/or gastric stenosis, and increased risk of esophageal and gastric cancer. Such intoxication may be fatal due to perforation or tracheal necrosis. Enteral nutrition is a nutritional method when nutritional substances are administered through specially designed tubing placed through the nose or percutaneously, directly into the GIT. Aim: The aim of this study is to describe the methods of artificial nutrition in patients with acute corrosive intoxications and the importance of nutritional support in the treatment of these intoxications. Discussion: Nutrition in the treatment of acute corrosive intoxications is one of the most important therapeutic processes that largely contribute to faster recovery of the post-corrosive injuries of upper GIT, stabilization of biologic, immunologic and metabolic parameters, and reduction of length of stay in hospital Aim of the treatment of acute corrosive intoxications is to prevent perforation and progressive fibrosis, and esophageal and gastric stenosis. There are different and often conflicting positions, on the conservative treatment of acute corrosive intoxications in adults. Such treatment mainly consists of anti-secretory treatment, antibiotics and intensive hyper-alimentation, aiming to prevent late post-corrosive intoxications. Conclusion: It is considered that nutritional support plays a major role in maintenance of metabolic processes and prevention of severe metabolic complications that could additionally aggravate the condition and impair the treatment. PMID:27047272

  2. Intravenous naphazoline intoxication.

    PubMed

    van Montfrans, G A; van Steenwijk, R P; Vyth, A; Borst, C

    1981-01-01

    Nine pale perspiring drug addicts with drowsiness, nausea, headache, normal blood pressure and marked sinus bradycardia with premature ventricular beats were seen at the Casualty Department soon after alleged i.v. cocaine administration. Eight were treated with atropine, as the bradycardia suggested intoxication with a parasympathomimetic compound. Seven were discharged in good condition after a few hours' observation. One patient developed a blood pressure of 150/120 mmHg after atropine. Subsequently, a hemiparesis was found and an intracerebral haematoma was evaluated at surgery. Another patient was admitted forthwith to the CCU. He did not receive any medication and recovered within two days. Urinalysis of these two patients disclosed contents of naphazoline, a powerful alpha-adrenergic agent. Samples of the alleged cocaine contained 97% naphazoline HCl. A conscious rabbit was injected with naphazoline and thereafter with atropine. I.v. naphazoline doubled mean arterial pressure (MAP) and reduced heart rate (HR) from 167 to 30 beats/min. Atropine doubled HR, but caused a marked rise in MAP, too, stressing the adverse effects of atropine in these cases. When confronted with patients after alleged cocaine abuse, the role of substitute drugs, especially alpha-adrenergic compounds, should be considered as this should influence the therapeutic approach.

  3. Acute bromadiolone intoxication.

    PubMed

    Grobosch, Thomas; Angelow, Boris; Schönberg, Lena; Lampe, Dagmar

    2006-05-01

    A 55-year-old man came to the hospital with a bleeding wound on his tongue. The coating of his tongue was green, and his sputum was red. Because an increased international normalized ratio-value was measured, a blood sample was sent to our laboratory with the suspicion of coumarin intoxication. Liquid chromatography-electrospray ionization-mass spectrometry (LC-ESI-MS) analysis confirmed the poisoning was by bromadiolone, with its maximum serum concentration at 440 microg/L. The analysis of further samples resulted in a calculated elimination half-life of 140 h. The analytical method described was developed for the determination and quantitation of bromadialone using LC-MS. This method is suitable for the simultaneous identification and quantitation of 10 indirect anticoagulants in human serum, which include five superwarfarins (brodifacoum, bromadiolone, difenacoum, difethialone, and flocoumafen) as rodenticides licenced in Germany and five other vitamin K antagonists (acenocoumarol, coumatetralyl, coumachlor, phenprocoumon, and warfarin). The method is based on an acidic (pH 4.2) liquid-liquid extraction followed by LC-ESI-MS analysis. Analytical separation was carried out using an Atlantis C18 column (2.1 x 20 mm, 3 microm). The mobile phase consisted of methanol/0.1% formic acid; the flow rate was 0.6 mL/min, and the time needed for analysis was 5 min. The lower limit of quantitation was 5 microg/L (signal-to-noise > 10). PMID:16803669

  4. Osteoresorptive arsenic intoxication.

    PubMed

    Dani, Sergio Ulhoa

    2013-04-01

    A 47-year-old woman consulted her dermatologist complaining whole body dermatitis, urticaria and irritating bullous eruptions on the plantar and side surfaces of her feet. She had had multiple hypopigmented spots on her skin since her early adulthood. The patient was treated with topical medication without significant improvement of symptoms. One year later she suffered a myocardial infarction, accompanied by refractory anaemia. At the age of 49, a breast cancer was diagnosed and shortly thereafter her last menstruation occurred. At age 50years, upon complaint of weight loss despite normal food intake, Hashimoto thyroiditis with latent hyperthyroidism, vitamin D insufficiency with secondary hyperparathyroidism, and poikilocytic anaemia with anisochromia, hypochromia, anisocytosis, elliptocytes, drepanocytes, dacryocytes, acanthocytes, echinocytes, schizocytes, stomatocytes and target cells were diagnosed. The osteodensitometric and laboratory examinations revealed osteoporosis with sustained elevation of urinary Dipyridinolin-crosslinks (u-Dpd), and urinary arsenic (u-As) of 500μg/l (equivalent to 0.5 parts per million-ppm, 2.5μg/mg creatinine/dl, u-As: Phosphate of 26μg/mmol; the estimated bone As:P and As/kg body weight were 500μg/g and 11.3mg/kg, respectively). Thalassemia, immunoglobinopathy and iron deficiency were excluded. Supplementation with oral vitamin D and calcium, and antiresorptive therapy with intravenous zolendronate normalised the u-Dpd, significantly decreased the urinary arsenic concentration, and cured the anemia and the urticaria. A diagnosis of osteoresorptive arsenic intoxication (ORAI) was established. PMID:23337042

  5. Clinical cases in acute intoxication.

    PubMed

    Smith, Sean B; Maguire, Jennifer; Mauck, Karen F

    2009-12-01

    Over 2.5 million accidental and intentional drug-related poisonings are reported annually in the United States. Early diagnosis and management of patients who present with acute intoxication can significantly reduce both morbidity and mortality. The initial evaluation of patients with suspected or proven intoxications should focus on hemodynamic stability, mental status, and respiratory function. However, early recognition of toxic ingestion is paramount to implementing life-saving treatments. Important historical clues are often found in a social history that considers intravenous drug use, alcohol use, and any access or exposure to illicit substances. A patient's medication list should also be scrutinized for psychoactive or sedative medications, such as tricyclic antidepressants or opioids. In this article we present case-based discussions of the specific diagnosis and management of 5 commonly occurring acute intoxication syndromes. PMID:20877175

  6. [Acute intoxications by tricyclic antidepressants (author's transl)].

    PubMed

    Bourin, M; Ginies, G; Renard, J P; Lamisse, F; Choutet, P; Breteau, M

    The authors report 87 cases of acute voluntary intoxications with tricyclic antidepressants. They essentially studied the cardiac complications; and conclude that the prognosis is more severe than for other intoxications.

  7. Water intoxication in adult cattle.

    PubMed

    Kawahara, Naoya; Ofuji, Sosuke; Abe, Sakae; Tanaka, Ai; Uematsu, Masami; Ogata, Yoshimi

    2016-05-01

    Water intoxication is a common disorder in calves and is usually characterized by transient hemoglobinuria. In contrast, the condition is very rare in adult cattle, with few reports on naturally occurring cases. In the present report, four female Japanese Black cattle, aged 16-25 months, showed neurological signs when they drank water following a water outage. Hemoglobinuria was not grossly observed, while severe hyponatremia was revealed by laboratory tests. Autopsy indicated cerebral edema with accumulation of serous fluid in expanded Virchow-Robin spaces. These results indicate the possibility of water intoxication associated with cerebral edema due to severe dilutional hyponatremia in adult cattle.

  8. Voluntary intoxication and criminal responsibility.

    PubMed

    Marlowe, D B; Lambert, J B; Thompson, R G

    1999-01-01

    This paper reviews the law related to voluntary intoxication and criminal responsibility in the 50 United States, the District of Columbia, the US Virgin islands, and Puerto Rico. Statutory and case law citations are provided which govern the use of intoxication evidence in each jurisdiction to negate mens rea (i.e., to establish diminished capacity), to support an insanity defense, and to mitigate criminal sentencing. Factors that courts typically focus on when deciding whether to admit this evidence in a particular case are discussed, and these factors are related to clinically relevant criteria.

  9. Water intoxication in adult cattle.

    PubMed

    Kawahara, Naoya; Ofuji, Sosuke; Abe, Sakae; Tanaka, Ai; Uematsu, Masami; Ogata, Yoshimi

    2016-05-01

    Water intoxication is a common disorder in calves and is usually characterized by transient hemoglobinuria. In contrast, the condition is very rare in adult cattle, with few reports on naturally occurring cases. In the present report, four female Japanese Black cattle, aged 16-25 months, showed neurological signs when they drank water following a water outage. Hemoglobinuria was not grossly observed, while severe hyponatremia was revealed by laboratory tests. Autopsy indicated cerebral edema with accumulation of serous fluid in expanded Virchow-Robin spaces. These results indicate the possibility of water intoxication associated with cerebral edema due to severe dilutional hyponatremia in adult cattle. PMID:27506091

  10. [Barium intoxication: a case report].

    PubMed

    Jan, I S; Jong, Y S; Lo, H M

    1991-09-01

    Barium intoxication, a rare cause of hypokalemia, can sometimes result in respiratory paralysis and ventricular tachyarrhythmia. Herein, we report one such case. A 29-year-old man swallowed barium-contaminated fried flour-coated sweet potatoes. Then, abdominal discomfort, vomiting, diarrhea, progressive muscular weakness, apnea and ventricular tachycardia developed and laboratory data revealed profound hypokalemia. He regained his health after mechanical ventilation, anti-arrhythmic agent and aggressive potassium chloride supplement. Analysis of blood, urine and contaminated flour showed the presence of barium carbonate. Barium intoxication is a medical emergency which requires rapid therapy to prevent mortality.

  11. Occupational injury fatalities--1994.

    PubMed

    Toscano, G; Jack, T

    1996-01-01

    Factory workers caught in machinery and construction workers falling or struck by huge beams are images that typically come to mind when considering serious hazards in the workplace. But these types of events account for only a small portion of job-related fatalities each year. Transportation-related fatalities, along with assaults and violent acts during work, made up almost two-thirds of the 6,588 fatal work injuries recorded in 1994. The majority of job-related fatal work events occurred on the streets and highways and in public buildings and in areas such as grocery stores and parking lots. Today the most deadly jobs are found in outdoor occupations such as fishing and timber cutting. In fact, in all 10 jobs studied that have high fatality rates, most workers are affected by severe weather conditions while driving on highways, performing farm chores and working at construction sites. Highway crashes are the primary cause of trucker fatalities; falls are the leading cause of death for roofers, construction laborers and structural metal workers, while tractor rollovers account for a third of farm worker fatalities. Another deadly contributing factor for some workers is homicide, which accounted for 16 percent of job-related fatalities in 1994. Workers most at risk are those who work alone, work late at night and handle varying sums of money. Taxicab drivers are the most susceptible and have a work injury fatality rate nine times higher than the national rate of 5 deaths per 100,000 workers. Others at high risk of homicide include gas station cashiers, grocery store employees and workers in retail eating and drinking establishments. Although the risk of a fatal injury at work varies greatly by occupation and industry, no one is immune. For prevention, workers and employers need to know what jobs are risky, what equipment is dangerous and what activities are hazardous. They also should understand that a fatal incident can happen to anyone.

  12. Fatalities in Swedish skydiving.

    PubMed

    Westman, Anton; Björnstig, Ulf

    2005-11-01

    Exact risk patterns in skydiving fatalities are not well known, but incomplete world injury data indicate that many are preventable. A comprehensive national material for Sweden of 37 skydiving fatalities 1964-2003 were reviewed to identify risk factors. In relation to jump volume, the period 1994-2003 had a fatality rate 11 times lower than 1964-1973. Student skydivers had the highest risk of fatal outcome, often caused by instability in freefall leading to unstable parachute activation with subsequent line entanglement, or parachute activation failure. Unintentional water landings also contributed to student fatality, with life jacket malfunctions, neglect to use life jackets, and automatic reserve parachute activation devices activated by water as aggravating factors. One-third of all fatalities had an inflated and operational parachute at some point prior to injury. A drastic worldwide increase in fatal landing incidents with fast wing parachutes during the 1990s did not occur in Sweden. Every fourth fatality caused by rapid deceleration against ground or water survived impact and died during transports or in hospitals. Rescue units and health care providers can improve management of skydiving incidents from knowledge about the incident and injury mechanisms we have described, and the skydiving community can target risk factors in preventive safety work.

  13. Fatalities in Swedish skydiving.

    PubMed

    Westman, Anton; Björnstig, Ulf

    2005-11-01

    Exact risk patterns in skydiving fatalities are not well known, but incomplete world injury data indicate that many are preventable. A comprehensive national material for Sweden of 37 skydiving fatalities 1964-2003 were reviewed to identify risk factors. In relation to jump volume, the period 1994-2003 had a fatality rate 11 times lower than 1964-1973. Student skydivers had the highest risk of fatal outcome, often caused by instability in freefall leading to unstable parachute activation with subsequent line entanglement, or parachute activation failure. Unintentional water landings also contributed to student fatality, with life jacket malfunctions, neglect to use life jackets, and automatic reserve parachute activation devices activated by water as aggravating factors. One-third of all fatalities had an inflated and operational parachute at some point prior to injury. A drastic worldwide increase in fatal landing incidents with fast wing parachutes during the 1990s did not occur in Sweden. Every fourth fatality caused by rapid deceleration against ground or water survived impact and died during transports or in hospitals. Rescue units and health care providers can improve management of skydiving incidents from knowledge about the incident and injury mechanisms we have described, and the skydiving community can target risk factors in preventive safety work. PMID:16039597

  14. Unusual manifestations of arsenic intoxication.

    PubMed

    Zaloga, G P; Deal, J; Spurling, T; Richter, J; Chernow, B

    1985-05-01

    A patient with arsenic intoxication is reported, who presented with a variety of gastrointestinal and neurologic disturbances including unilateral facial nerve palsy and acute symptomatic pancreatitis, neither of which have been previously described as sequelae of arsenic poisoning. The patient also suffered hematologic, dermatologic, and cardiopulmonary complications. A review of the literature about this interesting problem is also presented.

  15. Autopsy report for a caffeine intoxication case and review of the current literature

    PubMed Central

    Yamamoto, Takuma; Yoshizawa, Katsuhiko; Kubo, Shin-ichi; Emoto, Yuko; Hara, Kenji; Waters, Brian; Umehara, Takahiro; Murase, Takehiko; Ikematsu, Kazuya

    2014-01-01

    Caffeine (1,3,7-trimethylxanthine) is a popular mild central nervous system stimulant found in the leaves, seeds and fruits of various plants and in foodstuffs such as coffee, tea, and chocolate, among others. Caffeine is widely used and is not associated with severe side effects when consumed at relatively low doses. Although rarely observed, overdoses can occur. However, only a few fatal caffeine intoxication cases have been reported in the literature. Herein, we report the pathological examination results and information on caffeine concentrations in the blood, urine and main organs in a fatal caffeine intoxication case. Even though high caffeine concentrations were found in the systemic organs, no caffeine-related pathological changes were detected. PMID:26023259

  16. Autopsy report for a caffeine intoxication case and review of the current literature.

    PubMed

    Yamamoto, Takuma; Yoshizawa, Katsuhiko; Kubo, Shin-Ichi; Emoto, Yuko; Hara, Kenji; Waters, Brian; Umehara, Takahiro; Murase, Takehiko; Ikematsu, Kazuya

    2015-01-01

    Caffeine (1,3,7-trimethylxanthine) is a popular mild central nervous system stimulant found in the leaves, seeds and fruits of various plants and in foodstuffs such as coffee, tea, and chocolate, among others. Caffeine is widely used and is not associated with severe side effects when consumed at relatively low doses. Although rarely observed, overdoses can occur. However, only a few fatal caffeine intoxication cases have been reported in the literature. Herein, we report the pathological examination results and information on caffeine concentrations in the blood, urine and main organs in a fatal caffeine intoxication case. Even though high caffeine concentrations were found in the systemic organs, no caffeine-related pathological changes were detected.

  17. Toad Intoxication in the Dog by Rhinella marina : The Clinical Syndrome and Current Treatment Recommendations.

    PubMed

    Johnnides, Stephanie; Green, Tiffany; Eubig, Paul

    2016-01-01

    Oral exposure to the secretions of Rhinella marina (formerly Bufo marinus ) can carry a high fatality rate without early and appropriate treatment. In dogs, the clinical syndrome, which is evident almost immediately, manifests in profuse ptyalism along with gastrointestinal, respiratory, and neurologic signs. Severe cardiac arrhythmias develop less frequently. This review will cover the history, toxicology, and clinical syndrome of Rhinella marina intoxication, and will discuss the recommended therapies for stabilization. PMID:27259028

  18. Proteinuria of industrial lead intoxication

    SciTech Connect

    Vacca, C.V.; Hines, J.D.; Hall, P.W. III

    1986-12-01

    Studies of protein excretion were undertaken in seven males, aged 35-42 years, who had more than 5 years exposure to industrial lead and had clinically established Pb intoxication. Heavy metal intoxication with Cd and Hg causes proximal tubular abnormalities, i.e., aminoaciduria, glycosuria, phosphaturia. Similar abnormalities occur in Pb intoxication except that the nature of the proteinuria remains controversial. Studies of urinary proteins included 24-hr urine protein excretion, dextran gel separations, sodium dodecyl sulfate-polyacryl-amide gel electrophoresis (SDS-PAGE), and ..beta../sub 2/ microglobulin (B/sub 2/M) measurements. Creatinine clearances, and serum B/sub 2/M concentrations were normal. Urine total protein distribution by SDS-PAGE and the B/sub 2/M excretion rate were also normal. These data imply that the nephrotoxicity of Cd and Hg are different than that of Pb. The authors speculate on what might account for this difference. This study suggests that when examining a population exposed to Pb, the finding of tubular proteinuria should alert investigators to search for the presence of other toxic agents.

  19. Variable Classification of Drug-Intoxication Suicides across US States: A Partial Artifact of Forensics?

    PubMed Central

    Rockett, Ian R. H.; Hobbs, Gerald R.; Wu, Dan; Jia, Haomiao; Nolte, Kurt B.; Smith, Gordon S.; Putnam, Sandra L.; Caine, Eric D.

    2015-01-01

    Background The 21st-century epidemic of pharmaceutical and other drug-intoxication deaths in the United States (US) has likely precipitated an increase in misclassified, undercounted suicides. Drug-intoxication suicides are highly prone to be misclassified as accident or undetermined. Misclassification adversely impacts suicide and other injury mortality surveillance, etiologic understanding, prevention, and hence clinical and public health policy formation and practice. Objective To evaluate whether observed variation in the relative magnitude of drug-intoxication suicides across US states is a partial artifact of the scope and quality of toxicological testing and type of medicolegal death investigation system. Methods This was a national, state-based, ecological study of 111,583 drug-intoxication fatalities, whose manner of death was suicide, accident, or undetermined. The proportion of (nonhomicide) drug-intoxication deaths classified by medical examiners and coroners as suicide was analyzed relative to the proportion of death certificates citing one or more specific drugs and two types of state death investigation systems. Our model incorporated five sociodemographic covariates. Data covered the period 2008–2010, and derived from NCHS’s Multiple Cause-of-Death public use files. Results Across states, the proportion of drug-intoxication suicides ranged from 0.058 in Louisiana to 0.286 in South Dakota and the rate from 1 per 100,000 population in North Dakota to 4 in New Mexico. There was a low correlation between combined accident and undetermined drug-intoxication death rates and corresponding suicide rates (Spearman’s rho = 0.38; p<0.01). Citation of 1 or more specific drugs on the death certificate was positively associated with the relative odds of a state classifying a nonhomicide drug-intoxication death as suicide rather than accident or undetermined, adjusting for region and type of state death investigation system (odds ratio, 1.062; 95% CI,1.016

  20. Characteristics of methadone-related fatalities in Norway.

    PubMed

    Bernard, Jean-Paul; Khiabani, Hassan Z; Hilberg, Thor; Karinen, Ritva; Slørdal, Lars; Waal, Helge; Mørland, Jørg

    2015-11-01

    There are currently over 7000 patients enrolled in opioid maintenance treatment (OMT) programs in Norway. A rise in methadone-related deaths proportional to increasing methadone sales over the period 2000-2006 has been observed, but the causative factors for these fatalities have been elusive. In the present study, individual characteristics, methadone concentrations and additional toxicological findings were analyzed. Methadone intoxication deaths (n = 264) were divided into 3 groups according to toxicological findings in whole blood: group 1 - methadone detected alone, or together with one additional drug at low or therapeutic levels, or a low concentration of ethanol (<1 g/L) (n = 21); group 2 - multiple additional drugs/substances detected below lethal levels (n = 175); group 3 - one or more additional drugs/substances detected at lethal levels, or ethanol >3 g/L (n = 55). Methadone blood concentrations in decedents who had been enrolled in OMT were higher than for decedents not in treatment, in all groups. Blood methadone concentrations around 1 mg/L were present in fatal multi-drug intoxications in OMT patients. Results suggest that some patients may be at risk of dying when combining therapeutic concentrations of methadone with other psychoactive substances. Somatic disease was a common finding among deceased OMT patients. Concentrations in methadone users not enrolled in OMT were predominantly between 0.3 and 0.4 mg/L and were not related to the presence of other drugs. However, methadone concentrations below 0.1 mg/L may be associated with intoxication following methadone use, both alone and in combination with other drugs. Younger male users (mean age 34 years) seemed to have a higher susceptibility to methadone intoxication.

  1. Characteristics of methadone-related fatalities in Norway.

    PubMed

    Bernard, Jean-Paul; Khiabani, Hassan Z; Hilberg, Thor; Karinen, Ritva; Slørdal, Lars; Waal, Helge; Mørland, Jørg

    2015-11-01

    There are currently over 7000 patients enrolled in opioid maintenance treatment (OMT) programs in Norway. A rise in methadone-related deaths proportional to increasing methadone sales over the period 2000-2006 has been observed, but the causative factors for these fatalities have been elusive. In the present study, individual characteristics, methadone concentrations and additional toxicological findings were analyzed. Methadone intoxication deaths (n = 264) were divided into 3 groups according to toxicological findings in whole blood: group 1 - methadone detected alone, or together with one additional drug at low or therapeutic levels, or a low concentration of ethanol (<1 g/L) (n = 21); group 2 - multiple additional drugs/substances detected below lethal levels (n = 175); group 3 - one or more additional drugs/substances detected at lethal levels, or ethanol >3 g/L (n = 55). Methadone blood concentrations in decedents who had been enrolled in OMT were higher than for decedents not in treatment, in all groups. Blood methadone concentrations around 1 mg/L were present in fatal multi-drug intoxications in OMT patients. Results suggest that some patients may be at risk of dying when combining therapeutic concentrations of methadone with other psychoactive substances. Somatic disease was a common finding among deceased OMT patients. Concentrations in methadone users not enrolled in OMT were predominantly between 0.3 and 0.4 mg/L and were not related to the presence of other drugs. However, methadone concentrations below 0.1 mg/L may be associated with intoxication following methadone use, both alone and in combination with other drugs. Younger male users (mean age 34 years) seemed to have a higher susceptibility to methadone intoxication. PMID:26439870

  2. Mad honey intoxication mimicking acute coronary syndrome.

    PubMed

    Dur, Ali; Sonmez, Ertan; Civelek, Cemil; AhmetTurkdogan, Kenan; AkifVatankulu, Mehmet; Sogut, Ozgur

    2014-09-01

    Mad honey intoxication or grayanotoxin poisoning is caused by consumption of grayanotoxin-containing toxic honey produced from leaves and flowers of the Rhododendron family. Despite the rarity of intoxication cases, the correct diagnosis and treatment are required because of the significance of haemodynamic disturbance and confounding of symptoms for disease identification. We report herein a case of a patient with mad honey intoxication mimicking acute non-ST segment elevation myocardial infarction and review the pathophysiology and diagnostic considerations.

  3. Alcohol as a risk factor for unintentional rail injury fatalities during daylight hours.

    PubMed

    Matzopoulos, Richard; Peden, Margie; Bradshaw, Debbie; Jordaan, Esme

    2006-06-01

    Railway fatalities account for approximately 10% of transport fatalities in Cape Town. The objective of this study was to examine alcohol intoxication as a risk factor during daylight hours by conducting a case - control study to compare rail passenger and pedestrian fatalities (cases) with motor vehicle passenger and pedestrian fatalities (controls). Rail passenger and rail pedestrian fatalities were defined as cases with motor vehicle passenger and pedestrian fatalities as the respective controls. Data were collected from post-mortem reports at two mortuaries from 1994 to 1996. Blood alcohol concentration was the dependent variable. The independent variables were age, gender, date of death, day of week, time of injury and external cause of death. The late afternoon and early evening period from 1600 hours to 1900 hours had the highest frequency of fatalities for all case and control groups. Of the 56 predominately male (89%) railway passenger cases with an average age of 34.5 (SD 12.5) years, Friday (27%) was the most frequent day of death. Railway pedestrian cases (89% male, average age 36.8 years (SD 13.3)) were more likely to be killed on a Monday (11% of cases). Among the controls, motor vehicle passengers (63% male, average age 39.9 (SD 15.5)) were more likely to die on a Sunday (25%) and pedestrians (82% male, average age 41 (SD 14.7)) on a Saturday (21%). The study showed that alcohol consumption is an important risk factor for rail fatalities during daylight hours, with rail passenger fatalities being 4.71 (1.72 - 12.88) and rail pedestrian fatalities 1.62 (0.98 - 2.69) times more likely to be intoxicated than the respective controls. The results provide more evidence for public health campaigners to tackle endemic alcohol abuse and to develop diverse interventions that do not exclusively target motor vehicle drivers.

  4. A fatality due to cyproheptadine and citalopram.

    PubMed

    Hargrove, Veronica; Molina, D Kimberley

    2009-10-01

    Cyproheptadine (Periactin) is a first-generation antihistamine available in over-the-counter cold medications and is used to treat allergic-type symptoms. Although antihistamines in general have long been known to cause serious side effects, especially when taken in overdose, few reports that specifically address cyproheptadine-related fatalities exist. A 42-year-old healthy female was found dead at her home with no anatomic cause of death and a recent history of suicidal ideations. Toxicology revealed cyproheptadine and citalopram in the femoral postmortem blood at concentrations of 0.49 and 2.3 mg/L, respectively. Vitreous, urine, and bile analysis were also performed, yielding concentrations of < 0.04 and 0.80 mg/L in the vitreous for cyproheptadine and citalopram, respectively; 0.23 and 8.2 mg/L in the urine; and 30.7 and 9.0 mg/L in the bile. The cause of death was determined to be cyproheptadine and citalopram intoxication, and the manner was ruled a suicide. Although cyproheptadine is widely available in the United States and Europe, there are only two published fatalities due to this antihistamine and only one that specifically cites blood and tissue concentrations. Therefore, this case study will be beneficial to the forensic toxicology community by providing additional information regarding postmortem interpretation.

  5. Acute colchicine intoxication in a child: a case report.

    PubMed

    Biçer, Suat; Soysal, Demet D; Ctak, Agop; Uçsel, Raif; Karaböcüoğlu, Metin; Uzel, Nedret

    2007-05-01

    Colchicine poisoning is an uncommon, but potentially life-threatening, toxicologic emergency. The clinical features associated with overdose and the options for treatment are discussed. Colchicine poisoning typically shows 3 phases: initially, gastrointestinal symptoms predominate; in the second phase, multiorgan failure may occur, possibly leading to death. If the patient survives, the third phase of recovery follows, during which the patient often presents with hair loss. Early fatality is due to cardiovascular collapse and respiratory failure; however, pancytopenia and overwhelming septicemia can occur later. All patients suspected of having colchicine intoxication because of its unpredictable outcome should be managed according to the principles of intensive care, irrespective of the actual degree of poisoning. In those patients who survive the initial phase of poisoning, filgrastim (granulocyte colony-stimulating factor) offers an effective method of treating pancytopenia and preventing overwhelming septicemia. Daily monitoring of the patients' hematological status is strongly recommended. We are reporting a case of previously healthy girl who developed a multisystem organ failure after colchicine intoxication. The patient recovered completely and had no residual outcome.

  6. [Metabolic therapy of postperitoneal intoxication].

    PubMed

    Vlasov, A P; Anaskin, S G; Vlasova, T I; Chivisov, S M; Shibitov, V A; Potyanova, I V; Selentsov, P V

    2012-01-01

    This clinico-laboratory study showed that antihypoxant remaxol promoted normalization of lipid metabolism in acute peritonitis and significantly reduced membrane-destabilizing events. This resulted in rapid elimination of the inflammatory process in the abdominal cavity and lowering of the intensity of endogenous intoxication. This beneficial effect decreased the severity of myocardial lesions and resulted in the normalization of erythrocyte function. It is concluded that the regulatory action of remaxol on lipid metabolism is due to its ability to control free radicals in lipid peroxidation and reduce phospholipase A2 activity. PMID:23285765

  7. 15 CFR 265.36 - Intoxicating beverages.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 15 Commerce and Foreign Trade 1 2012-01-01 2012-01-01 false Intoxicating beverages. 265.36 Section... beverages. Except as expressly authorized by the Director, the consumption or use on the site of intoxicating beverages is prohibited....

  8. 15 CFR 265.36 - Intoxicating beverages.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 15 Commerce and Foreign Trade 1 2013-01-01 2013-01-01 false Intoxicating beverages. 265.36 Section... beverages. Except as expressly authorized by the Director, the consumption or use on the site of intoxicating beverages is prohibited....

  9. 15 CFR 265.36 - Intoxicating beverages.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 15 Commerce and Foreign Trade 1 2014-01-01 2014-01-01 false Intoxicating beverages. 265.36 Section... beverages. Except as expressly authorized by the Director, the consumption or use on the site of intoxicating beverages is prohibited....

  10. 15 CFR 265.36 - Intoxicating beverages.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Intoxicating beverages. 265.36 Section... beverages. Except as expressly authorized by the Director, the consumption or use on the site of intoxicating beverages is prohibited....

  11. 15 CFR 265.36 - Intoxicating beverages.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 15 Commerce and Foreign Trade 1 2011-01-01 2011-01-01 false Intoxicating beverages. 265.36 Section... beverages. Except as expressly authorized by the Director, the consumption or use on the site of intoxicating beverages is prohibited....

  12. Perceived Intoxication: Implications for Alcohol Education.

    ERIC Educational Resources Information Center

    Nicholson, Mary E.; And Others

    1994-01-01

    This study examined the relationships among perceived levels of intoxication, blood alcohol levels, and impairment of selected psychomotor skills used in driving. Results reinforced previous findings which correlated perceptions of intoxication and other measures. These findings suggest that alcohol consumption tables, which calculate one's…

  13. 25 CFR 140.18 - Intoxicating liquors.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Intoxicating liquors. 140.18 Section 140.18 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR FINANCIAL ACTIVITIES LICENSED INDIAN TRADERS § 140.18 Intoxicating liquors. No trader shall use or permit to be used his premises for any unlawful conduct or purpose whatsoever. No trader shall use...

  14. Chelating agents and cadmium intoxication

    SciTech Connect

    Shinobu, L.A.

    1985-01-01

    A wide range of conventional chelating agents have been screened for (a) antidotal activity in acute cadmium poisoning and (b) ability to reduce aged liver and kidney deposits of cadmium. Chelating agents belonging to the dithiocarbamate class have been synthesized and tested in both the acute and chronic modes of cadmium intoxication. Several dithiocarbamates, not only provide antidotal rescue, but also substantially decrease the intracellular deposits of cadmium associated with chronic cadmium intoxication. Fractionating the cytosol from the livers and kidneys of control and treated animals by Sephadex G-25 gel filtration clearly demonstrates that the dithiocarbamates are reducing the level of metallothionein-bound cadmium. However, the results of cell culture (Ehrlich ascites) studies designed to investigate the removal of cadmium from metallothionein and subsequent transport of the resultant cadmium complex across the cell membrane were inconclusive. In other in vitro investigations, the interaction between isolated native Cd, Zn-metallothionein and several chelating agents was explored. Ultracentrifugation, equilibrium dialysis, and Sephadex G-25 gel filtration studies have been carried out in an attempt to determine the rate of removal of cadmium from metallothionein by these small molecules. Chemical shifts for the relevant cadmium-dithiocarbamate complexes have been determined using natural abundance Cd-NMR.

  15. Alcohol intoxication and post-burn complications.

    PubMed

    Choudhry, Mashkoor A; Chaudry, Irshad H

    2006-01-01

    Results from the studies discussed in this article suggest that alcohol (EtOH) intoxication is a major public health problem. While the effects of injury and EtOH intoxication independent of each other have been studied in detail, only few studies have evaluated the effect of a combined insult of EtOH intoxication and burn injury on host defense. An analysis of the studies conducted in the clinical setting suggests that intoxicated patients require frequent intubations, experience delayed wound healing and longer hospital stay. Furthermore, there is a greater risk of mortality in these patients compared to those who sustained injuries in the absence of EtOH intoxication. On the other hand, there are a few studies that do not support this notion. The results obtained in experimental models clearly suggest that acute EtOH intoxication before burn injury impairs host defense and increases susceptibility to infection. Additionally, experimental data from our laboratory also indicate that EtOH intoxication before burn injury suppresses intestinal immune defense, impairs gut barrier functions and increases bacterial growth. This results in increased bacterial translocation in EtOH and burn injury. In addition, a decrease in cardiac function is also reported following a combined insult of EtOH intoxication and burn injury. Altogether, these findings suggest that EtOH intoxication before burn injury diminishes host resistance resulting in increased susceptibility to infection. Moreover, the findings of a higher incidence of infectious complications in burn and trauma patients who sustained injury in the presence of EtOH compared to those in its absence suggest that EtOH intoxication at the time of injury is a risk factor. Therefore blood EtOH should be monitored in burn/trauma patients at the time of admission in the emergency room.

  16. Intoxications due to ingestion of gamma-butyrolactone: organ distribution of gamma-hydroxybutyric acid and gamma-butyrolactone.

    PubMed

    Lenz, Daniel; Rothschild, Markus A; Kröner, Lars

    2008-12-01

    In Europe, the misuse of gamma-hydroxybutyric acid (GHB) and its analogues has increased within the recent years. Here, 2 fatalities and 1 nonfatal intoxication resulting from ingestion of gamma-butyrolactone (GBL), a precursor of GHB, are presented. GHB was quantified involving the conversion to GBL by application of a gas chromatography-mass spectrometry (GC/MS) method. Besides quantitation of GHB equivalents ("total GBL"), all specimens of case 1 were analyzed for the metabolic precursor GBL itself (absolute GBL). The cause of death in each case was attributed to GHB intoxication; the manner of death was suicide in the first case and accidental in the second one. Another yet nonfatal GHB intoxication was reported by an emergency department concerning a 36-year-old woman who was hospitalized due to her comatose state and loss of adverse effects reflexes. Here nail polish remover pads were used as source for GBL. PMID:18824955

  17. A fatal case of paramethoxyamphetamine poisoning and its detection in hair.

    PubMed

    Jang, Moonhee; Yang, Wonkyung; Jeong, Sujin; Park, Sohyung; Kim, Jihyun

    2016-09-01

    Paramethoxyamphetamine (PMA) is a phenethylamine derivative that is structurally related to 3,4-methylenedioxymethamphetamine (MDMA), but has higher toxicity than MDMA. Here, we report a fatal intoxication case involving PMA. A 36-year-old man was found dead in a hotel room. Toxicological analysis revealed that PMA concentrations were 0.57 and 0.59mg/L in peripheral and heart blood, respectively. Ketamine and diazepam were also detected in his blood. Based on toxicological results and autopsy findings, the cause of death was determined to be acute fatal intoxication with PMA. Hair analysis using gas chromatography/mass spectrometry was performed and PMA was detected at a concentration of 20.1ng/mg after methanol extraction for 20h. This is the first report of the determination of PMA concentration in the hair from a drug abuser. PMID:27396905

  18. Van Gogh's vision. Digitalis intoxication?

    PubMed

    Lee, T C

    1981-02-20

    Vincent van Gogh, the Dutch postimpressionist painter, died in 1890. He was an uncommon man. Automutilation, depression, insanity, and suicide are part of his medical history. During the last few years of his life, his paintings were characterized by halos and the color yellow. Critics have ascribed these aberrations to innumerable causes, including chronic solar injury, glaucoma, and cataracts. Van Gogh may have been under the influence of digitalis intoxication and its side effects: xanthopsia and coronas. This hypothesis is based on his twice having painted his physician holding a foxglove plant; that this medicine was used in the latter part of the 19th century in the treatment of epilepsy; and that the toxic effects of digitalis may have, in part, dictated the artist's technique.

  19. Cocaine Intoxication and Thyroid Storm

    PubMed Central

    Lacy, Mary E.

    2014-01-01

    Introduction. Cocaine, a widely used sympathomimetic drug, causes thermoregulatory and cardiac manifestations that can mimic a life-threatening thyroid storm. Case. A man presented to the emergency department requesting only cocaine detoxification. He reported symptoms over the last few years including weight loss and diarrhea, which he attributed to ongoing cocaine use. On presentation he had an elevated temperature of 39.4°C and a heart rate up to 130 beats per minute. Examination revealed the presence of an enlarged, nontender goiter with bilateral continuous bruits. He was found to have thyrotoxicosis by labs and was treated for thyroid storm and cocaine intoxication concurrently. The patient was ultimately diagnosed with Graves’ disease and treated with iodine-131 therapy. Conclusion. Cocaine use should be considered a possible trigger for thyroid storm. Recognition of thyroid storm is critical because of the necessity for targeted therapy and the significant mortality associated with the condition if left untreated. PMID:26425625

  20. [Resuscitation after intoxication with amitriptylin].

    PubMed

    Fippel, A; Berkel, H; Finkemeyer, S; Knape, R; Hoitz, J

    2005-09-01

    Intoxications with tricyclic antidepressants are often life threatening situations. In consequence of interference with many organ systems specific treatment consists in transportation to hospital under cardiopulmonary monitoring by physicians. The multiple possibilities of complications require the following treatments: continuous monitoring of the cardiovascular system, gastrolavage, application of carbon through a nasogastric tube, intubation and controlled ventilation in case of coma and continuous stand by for defibrillation. Additionally patients with stable parameters should be monitored in intensive care units because often there are no precursors of cardiac or pulmonary complications. We report the case of a 49-year old women with ingestion of 2500 mg of amitriptyline who suffered from multiple cardiac arrhythmias with following cardiac arrests and who required multiple defibrillations and resuscitation.

  1. Alcohol and motorcycle fatalities.

    PubMed Central

    Baker, S P; Fisher, R S

    1977-01-01

    A series of 99 fatal motorcycle crashes in Maryland was studied retrospectively, using police and medical examiner records. Blood alcohol concentrations were determined for 62 motorcycle drivers; measurable amounts of alcohol were found in two-thirds (41), and one-half (31) had illegally high concentrations of 100 mg/100 ml or more. The police report mentioned alcohol in only 9 instances. High blood alcohol concentrations were found most commonly among drivers age 20-34. PMID:842762

  2. A fatal mongoose bite.

    PubMed

    Tumram, Nilesh Keshav; Bardale, Rajesh Vaijnathrao; Dixit, Pradeep Gangadhar; Deshmukh, Ashutosh Yashwant

    2012-01-01

    Animal bite is a bite wound from a pet, farm or wild animal. Dog bites make up 80-85% of all reported incidents. Cats amount for about 10% of reported bites and other animals such as rodents, rabbits, horses, raccoons, bats and monkeys amount to 5-10%. Bites by mongoose are uncommon. Here, we present a case of fatal mongoose bite to an elderly woman who died as a complication of streptococcal infection at the bite site. PMID:23166164

  3. Datura stramonium toxicity mistakenly diagnosed as "bath salt" intoxication: a case report.

    PubMed

    Melvin, Kelly; Hourani, David

    2014-01-01

    Datura stramonium is a wildly growing plant found in West Virginia and in temperate regions throughout the world that is sometimes abused by young people because of its hallucinogenic effects. D. Stramonium overdose produces a classic anticholinergic syndrome that can lead to severe and sometimes fatal complications. Poisoning can be confused with more commonly seen drugs of abuse, particularly synthetic drugs which are not revealed by standard drug screens. Misdiagnosis can delay appropriate care and potentially lead to poorer outcomes. We present a case of a 15 year-old male with acute D. Stramonium poisoning initially misdiagnosed with bath salt intoxication who required treatment by two emergency departments, a pediatric ICU, and who was ultimately transferred to an inpatient psychiatric facility. We then discuss differential diagnosis of D. Stramonium poisoning and bath salt intoxication and present management strategies for the two conditions. PMID:24640270

  4. [Abuse, dependence and intoxication of substances].

    PubMed

    Wada, Kiyoshi

    2015-09-01

    As for substance-related disorders, there were several differences between ICD-10 and DSM-IV, however, the concept of "dependence" had been essential for both criteria. DSM-5 published in 2013 had erased dependence. This confuses us. It is important to recognize dependence again. "Abuse" is the self-intake behavior of drug against the social norms. Repeated abuse results in dependence. Dependence is a state of loss of control against drug use due to craving. Abuse can produce "acute intoxication", and repeated abuse under dependence can produce "chronic intoxication". It is important to understand abuse, dependence and "intoxication" based on their relationship from the point of time course. PMID:26394503

  5. Alcohol intoxication: Ion channels and genetics

    SciTech Connect

    Harris, A.R.; Allan, A.M. )

    1989-04-01

    Acute in vitro exposure to ethanol and other intoxicant-anesthetics activates {gamma}-aminobutyric acid (GABA)-stimulated chloride channels and inhibits voltage-dependent calcium and sodium channels of isolated brain membranes. The question of whether these neurochemical actions are responsible for intoxication in vivo has been addressed using animal populations displaying genetic differences in sensitivity to alcohol and benzodiazepine intoxication. These genetic approaches include inbred strains, selected lines, recombinant inbred strains, and heterogeneous stocks. Genetic differences in ion channel function provide strong evidence for a role of the GABA-stimulated chloride channel in ethanol and benzodiazepine intoxication; the role of calcium and sodium channels is less clear.

  6. Illicit Opioid Intoxication: Diagnosis and Treatment

    PubMed Central

    Fareed, A.; Stout, S.; Casarella, J.; Vayalapalli, S.; Cox, J.; Drexler, K.

    2011-01-01

    Opioid intoxications and overdose are associated with high rates of morbidity and mortality. Opioid overdose may occur in the setting of intravenous or intranasal heroin use, illicit use of diverted opioid medications, intentional or accidental misuse of prescription pain medications, or iatrogenic overdose. In this review, we focused on the epidemiology of illict opioid use in the United States and on the mechanism of action of opioid drugs. We also described the signs and symptoms, and diagnoses of intoxication and overdose. Lastly, we updated the reader about the most recent recommendations for treatment and prevention of opioid intoxications and overdose. PMID:22879747

  7. [Abuse, dependence and intoxication of substances].

    PubMed

    Wada, Kiyoshi

    2015-09-01

    As for substance-related disorders, there were several differences between ICD-10 and DSM-IV, however, the concept of "dependence" had been essential for both criteria. DSM-5 published in 2013 had erased dependence. This confuses us. It is important to recognize dependence again. "Abuse" is the self-intake behavior of drug against the social norms. Repeated abuse results in dependence. Dependence is a state of loss of control against drug use due to craving. Abuse can produce "acute intoxication", and repeated abuse under dependence can produce "chronic intoxication". It is important to understand abuse, dependence and "intoxication" based on their relationship from the point of time course.

  8. Fatal Traffic Crashes Involving Drinking Drivers: What have we Learned?

    PubMed Central

    Fell, James C.; Tippetts, A. Scott; Voas, Robert B.

    2009-01-01

    Alcohol involvement in fatal crashes (any driver with a blood alcohol concentration [BAC] = .01g/dL or greater) in 2007 was more than three times higher at night (6 p.m.–6 a.m.) than during the day (6 a.m.–6 p.m.) (62% versus 19%). Alcohol involvement was 35% during weekdays compared to 54% on weekends. Nearly one in four drivers (23%) of personal vehicles (e.g., passenger cars or light trucks) and more than one in four motorcyclists (27%) in fatal crashes were intoxicated (i.e., had a BAC equal to or greater than the .08 g/dL illegal limit in the United States). In contrast, only 1% of the commercial drivers of heavy trucks had BACs equal to .08 g/dL or higher. More than a quarter (26%) of the drivers with high BACs (≥.15 g/dL) did not have valid licenses. The 21- to 24-age group had the highest proportion (35%) of drivers with BACs≥.08 g/dL, followed by the 25- to 34-age group (29%). The oldest and the youngest drivers had the lowest percentages of BACs≥ .08 g/dL: those aged 75 or older were at 4%, and those aged 16 to 20 were at 17%. Utah had the lowest rate of intoxicated drivers in fatal crashes at one in every eight drivers (12%), followed by Kentucky, Indiana, Iowa, New Hampshire, and Kansas, all at 17%. Montana (31%), South Carolina (31%), and North Dakota (39%) all had more than 3 in 10 drivers in fatal crashes who were intoxicated in 2007. The United States enjoyed a remarkable downward trend in alcohol-related crashes between 1982 and 1995, which has since leveled off. That trend coincided with a period during which per capita national alcohol consumption declined, the number of young drivers decreased, and the proportion of female drivers increased. Those factors alone, however, did not appear to account for the overall reduction. This provides further evidence that impaired-driving laws and safety program activity may have been responsible for at least some of the decline. However, there was a general worldwide decline in alcohol

  9. Fatal traffic crashes involving drinking drivers: what have we learned?

    PubMed

    Fell, James C; Tippetts, A Scott; Voas, Robert B

    2009-10-01

    Alcohol involvement in fatal crashes (any driver with a blood alcohol concentration [BAC] = .01g/dL or greater) in 2007 was more than three times higher at night (6 p.m.-6 a.m.) than during the day (6 a.m.-6 p.m.) (62% versus 19%). Alcohol involvement was 35% during weekdays compared to 54% on weekends. Nearly one in four drivers (23%) of personal vehicles (e.g., passenger cars or light trucks) and more than one in four motorcyclists (27%) in fatal crashes were intoxicated (i.e., had a BAC equal to or greater than the .08 g/dL illegal limit in the United States). In contrast, only 1% of the commercial drivers of heavy trucks had BACs equal to .08 g/dL or higher. More than a quarter (26%) of the drivers with high BACs (>or=.15 g/dL) did not have valid licenses. The 21- to 24-age group had the highest proportion (35%) of drivers with BACs>or=.08 g/dL, followed by the 25- to 34-age group (29%). The oldest and the youngest drivers had the lowest percentages of BACs>or= .08 g/dL: those aged 75 or older were at 4%, and those aged 16 to 20 were at 17%. Utah had the lowest rate of intoxicated drivers in fatal crashes at one in every eight drivers (12%), followed by Kentucky, Indiana, Iowa, New Hampshire, and Kansas, all at 17%. Montana (31%), South Carolina (31%), and North Dakota (39%) all had more than 3 in 10 drivers in fatal crashes who were intoxicated in 2007. The United States enjoyed a remarkable downward trend in alcohol-related crashes between 1982 and 1995, which has since leveled off. That trend coincided with a period during which per capita national alcohol consumption declined, the number of young drivers decreased, and the proportion of female drivers increased. Those factors alone, however, did not appear to account for the overall reduction. This provides further evidence that impaired-driving laws and safety program activity may have been responsible for at least some of the decline. However, there was a general worldwide decline in alcohol

  10. Vitamin D Intoxication Treated with Porcine Calcitonin

    PubMed Central

    Buckle, R. M.; Gamlen, T. R.; Pullen, I. M.

    1972-01-01

    Porcine calcitonin was used to treat three patients with hypercalcaemia due to vitamin D intoxication. In two patients a rapid and sustained fall to normal in serum calcium occurred within three days, in the third patient normocalcaemia was achieved in seven days. In view of its rapid and sustained effect calcitonin may be of value in the urgent treatment of hypercalcaemia due to vitamin D intoxication. PMID:4261142

  11. Effects of ethanol intoxication on speech suprasegmentals

    NASA Astrophysics Data System (ADS)

    Hollien, Harry; Dejong, Gea; Martin, Camilo A.; Schwartz, Reva; Liljegren, Kristen

    2001-12-01

    The effects of ingesting ethanol have been shown to be somewhat variable in humans. To date, there appear to be but few universals. Yet, the question often arises: is it possible to determine if a person is intoxicated by observing them in some manner? A closely related question is: can speech be used for this purpose and, if so, can the degree of intoxication be determined? One of the many issues associated with these questions involves the relationships between a person's paralinguistic characteristics and the presence and level of inebriation. To this end, young, healthy speakers of both sexes were carefully selected and sorted into roughly equal groups of light, moderate, and heavy drinkers. They were asked to produce four types of utterances during a learning phase, when sober and at four strictly controlled levels of intoxication (three ascending and one descending). The primary motor speech measures employed were speaking fundamental frequency, speech intensity, speaking rate and nonfluencies. Several statistically significant changes were found for increasing intoxication; the primary ones included rises in F0, in task duration and for nonfluencies. Minor gender differences were found but they lacked statistical significance. So did the small differences among the drinking category subgroups and the subject groupings related to levels of perceived intoxication. Finally, although it may be concluded that certain changes in speech suprasegmentals will occur as a function of increasing intoxication, these patterns cannot be viewed as universal since a few subjects (about 20%) exhibited no (or negative) changes.

  12. Arsenic intoxication, a hemorheologic view.

    PubMed

    Bollini, A; Huarte, M; Hernández, G; Bazzoni, G; Piehl, L; Mengarelli, G; de Celis, E Rubín; Rasia, M

    2010-01-01

    Arsenic (As) is a toxic semi-metal of wide distribution in nature. People living in regions where drinking water contains large quantities of arsenic, have an unusually high likelihood of developing blood-vessel diseases, but little is known about the mechanisms involved, i.e. the blood rheologic alterations that would contribute to the circulatory obstruction. Erythrocytes are the main target cells for arsenic compounds systemically absorbed and their cell membrane is the first place against the toxic. In this paper we have examined the in vitro effect of arsenic (As(V)) on the rheologic properties of human erythrocytes in relation with membrane fluidity and internal microviscosity. According to our present results, As(V) treatment produces oxidative degradation of membrane lipids and alteration of internal microviscosity. These red blood cells (RBCs) membrane and cytoplasmic structural damage consequently alters RBCs rheologic properties: an alteration of the RBCs discoid shape to stomatocytes, a diminution of erythrocyte deformability and an enhancement of osmotic fragility and cell aggregability. These effects impaired blood fluid behaviour that contribute to obstruct peripheral circulation and provides anemia, both clinic evidences typical of arsenic cronic intoxication.

  13. Histamine, histamine intoxication and intolerance.

    PubMed

    Kovacova-Hanuskova, E; Buday, T; Gavliakova, S; Plevkova, J

    2015-01-01

    Excessive accumulation of histamine in the body leads to miscellaneous symptoms mediated by its bond to corresponding receptors (H1-H4). Increased concentration of histamine in blood can occur in healthy individuals after ingestion of foods with high contents of histamine, leading to histamine intoxication. In individuals with histamine intolerance (HIT) ingestion of food with normal contents of histamine causes histamine-mediated symptoms. HIT is a pathological process, in which the enzymatic activity of histamine-degrading enzymes is decreased or inhibited and they are insufficient to inactivate histamine from food and to prevent its passage to blood-stream. Diagnosis of HIT is difficult. Multi-faced, non-specific clinical symptoms provoked by certain kinds of foods, beverages and drugs are often attributed to different diseases, such as allergy and food intolerance, mastocytosis, psychosomatic diseases, anorexia nervosa or adverse drug reactions. Correct diagnosis of HIT followed by therapy based on histamine-free diet and supplementation of diamine oxidase can improve patient's quality of life.

  14. Fatal crocodile attack.

    PubMed

    Chattopadhyay, Saurabh; Shee, Biplab; Sukul, Biswajit

    2013-11-01

    Attacks on human beings by various animals leading to varied types of injuries and even death in some cases are not uncommon. Crocodile attacks on humans have been reported from a number of countries across the globe. Deaths in such attacks are mostly due to mechanical injuries or drowning. Bites by the crocodiles often cause the limbs to be separated from the body. The present case refers to an incident of a fatal attack by a crocodile on a 35 years old female where only the mutilated head of the female was recovered. Multiple lacerated wounds over the face and scalp along with fracture of the cranial bones was detected on autopsy. Two distinct bite marks in the form of punched in holes were noted over the parietal and frontal bones. Injuries on the head with its traumatic amputation from the body were sufficient to cause death. However, the presence of other fatal injuries on the unrecovered body parts could not be ruled out.

  15. Air weapon fatalities.

    PubMed Central

    Milroy, C M; Clark, J C; Carter, N; Rutty, G; Rooney, N

    1998-01-01

    AIMS: To describe characteristics of a series of people accidentally and deliberately killed by air powered weapons. METHODS: Five cases of fatal airgun injury were identified by forensic pathologists and histopathologists. The circumstances surrounding the case, radiological examination, and pathological findings are described. The weapon characteristics are also reported. RESULTS: Three of the victims were adult men, one was a 16 year old boy, and one an eight year old child. Four of the airguns were .22 air rifles, the other a .177 air rifle. Two committed suicide, one person shooting himself in the head, the other in the chest. In both cases the guns were fired at contact range. Three of the cases were classified as accidents: in two the pellet penetrated into the head and in one the chest. CONCLUSIONS: One person each year dies from an air powered weapon injury in the United Kingdom. In addition there is considerable morbidity from airgun injuries. Fatalities and injuries are most commonly accidents, but deliberately inflicted injuries occur. Airguns are dangerous weapons when inappropriately handled and should not be considered as toys. Children should not play with airguns unsupervised. Images PMID:9797730

  16. A fatal leopard attack.

    PubMed

    Hejna, Petr

    2010-05-01

    A rare case of a big cat fatal attack is presented. A male leopard that had escaped from its unlocked cage attacked a 26-year-old male zoo worker. The man sustained penetrating injuries to the neck with consequent external bleeding. The man died while being transported to the hospital as a result of the injuries sustained. The wounds discovered on the victim's body corresponded with the known methods of leopard attacks and with findings on the carcasses of animals killed by leopards in the wild. The conclusion of the medicolegal investigation was that the underlying cause of death was a bite wound to the neck which lacerated the left internal jugular vein, the two main branches of the left external carotid artery, and the cervical spine. The cause of death was massive external bleeding. Special attention is paid to the general pattern of injuries sustained from big cat attacks.

  17. Traffic fatalities and economic growth.

    PubMed

    Kopits, Elizabeth; Cropper, Maureen

    2005-01-01

    This paper examines the relationship between traffic fatality risk and per capita income and uses it to forecast traffic fatalities by geographic region. Equations for the road death rate (fatalities/population) and its components--the rate of motorization (vehicles/population) and fatalities per vehicle (F/V)--are estimated using panel data from 1963 to 1999 for 88 countries. The natural logarithm of F/P, V/P, and F/V are expressed as spline (piecewise linear) functions of the logarithm of real per capita GDP (measured in 1985 international prices). Region-specific time trends during the period 1963-1999 are modeled in linear and log-linear form. These models are used to project traffic fatalities and the stock of motor vehicles to 2020. The per capita income at which traffic fatality risk (fatalities/population) begins to decline is 8600 US dollars (1985 international dollars) when separate time trends are used for each geographic region. This turning point is driven by the rate of decline in fatalities/vehicles as income rises since vehicles/population, while increasing with income at a decreasing rate, never declines with economic growth. Projections of future traffic fatalities suggest that the global road death toll will grow by approximately 66% over the next twenty years. This number, however, reflects divergent rates of change in different parts of the world: a decline in fatalities in high-income countries of approximately 28% versus an increase in fatalities of almost 92% in China and 147% in India. The road death rate is projected to rise to approximately 2 per 10,000 persons in developing countries by 2020, while it will fall to less than 1 per 10,000 in high-income countries.

  18. Candida lusitaniae causing fatal meningitis.

    PubMed Central

    Sarma, P. S.; Durairaj, P.; Padhye, A. A.

    1993-01-01

    Fatal meningitis due to Candida lusitaniae in a 35 year old previously healthy man is described. C. lusitaniae is an opportunistic fungal pathogen reported infrequently in the English literature. This is the third case report of meningitis and the first fatal infection in an adult from Central India due to C. lusitaniae known to the authors. PMID:8290437

  19. Inhibiting oral intoxication of botulinum neurotoxin A complex by carbohydrate receptor mimics.

    PubMed

    Lee, Kwangkook; Lam, Kwok-Ho; Kruel, Anna-Magdalena; Mahrhold, Stefan; Perry, Kay; Cheng, Luisa W; Rummel, Andreas; Jin, Rongsheng

    2015-12-01

    Botulinum neurotoxins (BoNTs) cause the disease botulism manifested by flaccid paralysis that could be fatal to humans and animals. Oral ingestion of the toxin with contaminated food is one of the most common routes for botulism. BoNT assembles with several auxiliary proteins to survive in the gastrointestinal tract and is subsequently transported through the intestinal epithelium into the general circulation. Several hemagglutinin proteins form a multi-protein complex (HA complex) that recognizes host glycans on the intestinal epithelial cell surface to facilitate BoNT absorption. Blocking carbohydrate binding to the HA complex could significantly inhibit the oral toxicity of BoNT. Here, we identify lactulose, a galactose-containing non-digestible sugar commonly used to treat constipation, as a prototype inhibitor against oral BoNT/A intoxication. As revealed by a crystal structure, lactulose binds to the HA complex at the same site where the host galactose-containing carbohydrate receptors bind. In vitro assays using intestinal Caco-2 cells demonstrated that lactulose inhibits HA from compromising the integrity of the epithelial cell monolayers and blocks the internalization of HA. Furthermore, co-administration of lactulose significantly protected mice against BoNT/A oral intoxication in vivo. Taken together, these data encourage the development of carbohydrate receptor mimics as a therapeutic intervention to prevent BoNT oral intoxication.

  20. Lithium intoxication: Incidence, clinical course and renal function – a population-based retrospective cohort study

    PubMed Central

    Ott, Michael; Stegmayr, Bernd; Salander Renberg, Ellinor; Werneke, Ursula

    2016-01-01

    When prescribing lithium, the risk of toxicity remains a concern. In this study, we examined a cohort of patients exposed to lithium between 1997 and 2013. The aims of this study were to determine the frequency of lithium intoxication and to evaluate the clinical course and changes in renal function. Of 1340 patients, 96 had experienced at least one episode of lithium levels ⩾1.5 mmol/L, yielding an incidence of 0.01 per patient-year. Seventy-seven patients available for review had experienced 91 episodes, of whom 34% required intensive care and 13% were treated with haemodialysis. There were no fatalities. Acute kidney injury occurred, but renal function at baseline was not different to renal function after the episode. Renal impairment was often associated with co-morbidities and other factors. Both intermittent and continuous-venovenous haemodialysis were used, but the clearance of continuous-venovenous haemodialysis can be too low in cases where large amounts of lithium have been ingested. Saline and forced diuresis have been used and are safe. Lithium intoxication seems rare and can be safely managed in most cases. Physicians should not withhold lithium for fear of intoxication in patients who benefit from it. Yet, physicians should have a low threshold to screen for toxicity. PMID:27307388

  1. [Metabolic encephalopathy secondary to vitamin D intoxication].

    PubMed

    Herrera Martínez, Aura; Viñals Torràs, Montserrat; Muñoz Jiménez, Ma Concepción; Arenas de Larriva, Antonio Pablo; Molina Puerta, Ma José; Manzano García, Gregorio; Gálvez Moreno, Ma Ángeles; Calañas-Continente, Alfonso

    2014-10-25

    The association between vitamin D deficiency and increased risk of, among others, cardiovascular and autoimmune diseases has lead in the last years to an enhanced interest in the usage of supplements to achieve the normalization of plasmatic values at 25(OH) D. Apparently this search for normalization is resulting in an higher incidence on vitamin D intoxication. We present the case of an 81 years old woman with metabolic encephalopathy and renal failure secondary to iatrogenic vitamin D intoxication. Calcium and vitamin D oral supplements were prescribed after an osteoporotic vertebral fracture. The patient improved clinically as well as analytically after receiving treatment with diuretics and hydration. We emphasize the importance of discarding hypercalcemia as a cause of metabolic encephalopathy; moreover we highly recommend keeping vitamin D intoxication in mind as an uncommon although always possible etiology of reversible hypercalcemia and renal failure.

  2. Children with alcohol intoxication in Cracow, Poland.

    PubMed

    Kościelniak, Barbara; Tomasik, Przemysław J

    2016-01-01

    Alcoholism among minors is a serious social problem. The aim of the current study was to analyze alcohol intoxication in children based on hospitalizations in the University Children's Hospital in Cracow between the years 2007 and 2015. During these 9 years, 381 patients were hospitalized due to excessive alcohol consumption. Most patients were junior high school or high school students. The highest blood alcohol concentrations in hospitalized patients were found in a 16-year-old boy (BAC .41%) and a 15-year-old girl (BAC .37%). Alcohol consumption and severe intoxication are linked to a wide variety of familial, social, and personal problems. PMID:26745242

  3. Gangliosides, or sialic acid, antagonize ethanol intoxication

    SciTech Connect

    Klemm, W.R.; Boyles, R.; Matthew, J.; Cherian, L.

    1988-01-01

    Because ethanol elicits a dose-dependent hydrolysis of brain sialogangliosides, the authors tested the possibility that injected gangliosides might antagonize intoxicating doses of ethanol. Clear anti-intoxication effects were seen at 24 hr post-injection of mixed mouse-brain gangliosides at 125-130 mg/kg, but not at lower or higher doses. Sleep time was reduced on the order of 50%, and roto-rod agility was significantly enhanced. Sialic acid (SA) similarly antagonized ethanol; however, the precursor of SA, N-acetyl-D-mannosamine, as well as ceramide and asialoganglioside did not.

  4. [Clinical cases of occupational chronic manganese intoxication].

    PubMed

    Konstantinova, T N; Lakhman, O L; Katamanova, E V; Kartapol'tseva, N V; Meshcheriagin, V A; Rusanova, D V; Andreeva, O K

    2009-01-01

    Classic symptoms of manganese intoxication are very rarely seen nowadays. Clinic in Angarsk Research Institute for Occupational medicine and Human ecology registered two cases of stage I and II chronic manganese intoxication over 10 years among electric welders. The cases were diagnosed with consideration of long length of exposure to manganese with the ambient air level exceeding the MAC 1.5 times, the disease manifestation at middle age, high manganese level in serum and urine, characteristic neurologic symptoms in association with organic psychopathologic defects and polyneuropathy of limbs.

  5. Effectiveness of Mandatory Alcohol Testing Programs in Reducing Alcohol Involvement in Fatal Motor Carrier Crashes

    PubMed Central

    Brady, Joanne E.; Baker, Susan P.; DiMaggio, Charles; McCarthy, Melissa L.; Rebok, George W.

    2009-01-01

    Mandatory alcohol testing programs for motor carrier drivers were implemented in the United States in 1995 and have not been adequately evaluated. Using data from the Fatality Analysis Reporting System during 1982–2006, the authors assessed the effectiveness of mandatory alcohol testing programs in reducing alcohol involvement in fatal motor carrier crashes. The study sample consisted of 69,295 motor carrier drivers and 83,436 non–motor-carrier drivers who were involved in 66,138 fatal multivehicle crashes. Overall, 2.7% of the motor carrier drivers and 19.4% of the non–motor-carrier drivers had positive blood alcohol concentrations. During the study period, the prevalence of alcohol involvement in fatal crashes decreased by 80% among motor carrier drivers and 41% among non–motor-carrier drivers. With adjustment for driver age, sex, history of driving while intoxicated, and survival status, implementation of the mandatory alcohol testing programs was found to be associated with a 23% reduced risk of alcohol involvement in fatal crashes by motor carrier drivers (odds ratio = 0.77, 95% confidence interval: 0.62, 0.94). Results from this study indicate that mandatory alcohol testing programs may have contributed to a significant reduction in alcohol involvement in fatal motor carrier crashes. PMID:19692328

  6. 30 CFR 57.20001 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Intoxicating beverages and narcotics. 57.20001... Miscellaneous § 57.20001 Intoxicating beverages and narcotics. Intoxicating beverages and narcotics shall not be permitted or used in or around mines. Persons under the influence of alcohol or narcotics shall not...

  7. 30 CFR 56.20001 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Intoxicating beverages and narcotics. 56.20001... § 56.20001 Intoxicating beverages and narcotics. Intoxicating beverages and narcotics shall not be permitted or used in or around mines. Persons under the influence of alcohol or narcotics shall not...

  8. 30 CFR 56.20001 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Intoxicating beverages and narcotics. 56.20001... § 56.20001 Intoxicating beverages and narcotics. Intoxicating beverages and narcotics shall not be permitted or used in or around mines. Persons under the influence of alcohol or narcotics shall not...

  9. 7 CFR 502.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 6 2012-01-01 2012-01-01 false Intoxicating beverages and narcotics. 502.8 Section..., MARYLAND § 502.8 Intoxicating beverages and narcotics. Entering BARC property or the operation of a motor vehicle thereon, by a person under the influence of intoxicating beverages or narcotic drug,...

  10. 31 CFR 407.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Intoxicating beverages and narcotics... TREASURY ANNEX § 407.8 Intoxicating beverages and narcotics. Entering or being on the property, or operating a motor vehicle thereon, by a person under the influence of intoxicating beverages or...

  11. 31 CFR 407.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance: Treasury 2 2014-07-01 2014-07-01 false Intoxicating beverages and narcotics... TREASURY ANNEX § 407.8 Intoxicating beverages and narcotics. Entering or being on the property, or operating a motor vehicle thereon, by a person under the influence of intoxicating beverages or...

  12. 30 CFR 57.20001 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Intoxicating beverages and narcotics. 57.20001... Miscellaneous § 57.20001 Intoxicating beverages and narcotics. Intoxicating beverages and narcotics shall not be permitted or used in or around mines. Persons under the influence of alcohol or narcotics shall not...

  13. 30 CFR 57.20001 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Intoxicating beverages and narcotics. 57.20001... Miscellaneous § 57.20001 Intoxicating beverages and narcotics. Intoxicating beverages and narcotics shall not be permitted or used in or around mines. Persons under the influence of alcohol or narcotics shall not...

  14. 30 CFR 56.20001 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Intoxicating beverages and narcotics. 56.20001... § 56.20001 Intoxicating beverages and narcotics. Intoxicating beverages and narcotics shall not be permitted or used in or around mines. Persons under the influence of alcohol or narcotics shall not...

  15. 30 CFR 57.20001 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Intoxicating beverages and narcotics. 57.20001... Miscellaneous § 57.20001 Intoxicating beverages and narcotics. Intoxicating beverages and narcotics shall not be permitted or used in or around mines. Persons under the influence of alcohol or narcotics shall not...

  16. 30 CFR 56.20001 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Intoxicating beverages and narcotics. 56.20001... § 56.20001 Intoxicating beverages and narcotics. Intoxicating beverages and narcotics shall not be permitted or used in or around mines. Persons under the influence of alcohol or narcotics shall not...

  17. 30 CFR 56.20001 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Intoxicating beverages and narcotics. 56.20001... § 56.20001 Intoxicating beverages and narcotics. Intoxicating beverages and narcotics shall not be permitted or used in or around mines. Persons under the influence of alcohol or narcotics shall not...

  18. 31 CFR 407.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 2 2013-07-01 2013-07-01 false Intoxicating beverages and narcotics... TREASURY ANNEX § 407.8 Intoxicating beverages and narcotics. Entering or being on the property, or operating a motor vehicle thereon, by a person under the influence of intoxicating beverages or...

  19. 7 CFR 502.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 6 2011-01-01 2011-01-01 false Intoxicating beverages and narcotics. 502.8 Section..., MARYLAND § 502.8 Intoxicating beverages and narcotics. Entering BARC property or the operation of a motor vehicle thereon, by a person under the influence of intoxicating beverages or narcotic drug,...

  20. 30 CFR 57.20001 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Intoxicating beverages and narcotics. 57.20001... Miscellaneous § 57.20001 Intoxicating beverages and narcotics. Intoxicating beverages and narcotics shall not be permitted or used in or around mines. Persons under the influence of alcohol or narcotics shall not...

  1. 7 CFR 502.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Intoxicating beverages and narcotics. 502.8 Section..., MARYLAND § 502.8 Intoxicating beverages and narcotics. Entering BARC property or the operation of a motor vehicle thereon, by a person under the influence of intoxicating beverages or narcotic drug,...

  2. 31 CFR 407.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 2 2012-07-01 2012-07-01 false Intoxicating beverages and narcotics... TREASURY ANNEX § 407.8 Intoxicating beverages and narcotics. Entering or being on the property, or operating a motor vehicle thereon, by a person under the influence of intoxicating beverages or...

  3. 31 CFR 407.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Intoxicating beverages and narcotics... TREASURY ANNEX § 407.8 Intoxicating beverages and narcotics. Entering or being on the property, or operating a motor vehicle thereon, by a person under the influence of intoxicating beverages or...

  4. 7 CFR 502.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 6 2013-01-01 2013-01-01 false Intoxicating beverages and narcotics. 502.8 Section..., MARYLAND § 502.8 Intoxicating beverages and narcotics. Entering BARC property or the operation of a motor vehicle thereon, by a person under the influence of intoxicating beverages or narcotic drug,...

  5. 7 CFR 502.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 6 2014-01-01 2014-01-01 false Intoxicating beverages and narcotics. 502.8 Section..., MARYLAND § 502.8 Intoxicating beverages and narcotics. Entering BARC property or the operation of a motor vehicle thereon, by a person under the influence of intoxicating beverages or narcotic drug,...

  6. Global earthquake fatalities and population

    USGS Publications Warehouse

    Holzer, Thomas L.; Savage, James C.

    2013-01-01

    Modern global earthquake fatalities can be separated into two components: (1) fatalities from an approximately constant annual background rate that is independent of world population growth and (2) fatalities caused by earthquakes with large human death tolls, the frequency of which is dependent on world population. Earthquakes with death tolls greater than 100,000 (and 50,000) have increased with world population and obey a nonstationary Poisson distribution with rate proportional to population. We predict that the number of earthquakes with death tolls greater than 100,000 (50,000) will increase in the 21st century to 8.7±3.3 (20.5±4.3) from 4 (7) observed in the 20th century if world population reaches 10.1 billion in 2100. Combining fatalities caused by the background rate with fatalities caused by catastrophic earthquakes (>100,000 fatalities) indicates global fatalities in the 21st century will be 2.57±0.64 million if the average post-1900 death toll for catastrophic earthquakes (193,000) is assumed.

  7. Non specific drug distribution in an autopsy case report of fatal caffeine intoxication.

    PubMed

    Ishikawa, Takaki; Yuasa, Isao; Endoh, Minoru

    2015-11-01

    Caffeine has long been recognized as an addictive substance that causes autonomic nerve effect, and is known to increase catecholamine secretion from the adrenal glands. In recent years, the risk of ingesting toxic levels of caffeine has increased because of the easy availability of analgesics, CNS (Central Nervous System) stimulant medicine and dietary supplements at shops, health stores and through online purchases. We report the death of a young female resulting from the ingestion for suicide of an online purchased sleepiness-preventing medicine containing caffeine. The autopsy findings included pulmonary edema and congestion plus cutaneous emphysema. The stomach contents included a dark-brown viscous fluid without tablet or food residue. Toxicological examination revealed the presence of caffeine in the right heart blood (154.2 μg/mL) and stomach contents (197.5 μg/mL) (lethal blood level, >80 μg/mL). The highest caffeine content was in the bile (852.3 μg/mL). Biochemical findings showed that catecholamine concentration in the peripheral blood in the iliac vein was elevated. Immunostaining of catecholamine was weak in the adrenal medulla. We recommend highlighting the toxicity risk of ingesting substances with a high caffeine concentration, and we propose that caffeine concentrations should be included in the comprehensive routine forensic toxicological tests for all cases.

  8. Fatal Intoxication Involving 3-MeO-PCP: A Case Report and Validated Method.

    PubMed

    Bakota, Erica; Arndt, Crystal; Romoser, Amelia A; Wilson, Stephen K

    2016-09-01

    We present in this case report a validated method for accurate quantitative analysis of 3-methoxy phencyclidine (3-MeO-PCP) to determine postmortem blood concentrations of this PCP analog. A 29-year-old male with a history of illicit drug use was found unresponsive in his bed with a bag of white powder next to him. Resuscitation efforts were unsuccessful and the individual was pronounced dead 9 minutes after arrival to the hospital. Initial ELISA screening suggested the presence of PCP in the decedent's blood. However, confirmatory testing revealed no detectable PCP. Instead, a large peak corresponding to a m/z 274.218 species with retention time similar to PCP was present on a LC-TOF-MS drug screen, suggesting a possible PCP analog. This mass corresponds specifically to a methoxy-PCP analog, several of which are available for purchase online. Standards for 3-MeO-PCP and 4-MeO-PCP were obtained and injected on the same instrument. Although the 3- and 4-MeO-PCP analogs have identical masses and retention times, they are still distinguishable through their mass spectra. The peak from the decedent's sample matched both the mass spectrum and the retention time of 3-MeO-PCP. A quantitative LC-MS-MS method was subsequently developed and validated for casework. Analysis using this method revealed a concentration of 139 ± 41 µg/L 3-MeO-PCP in the decedent's blood. Diphenhydramine (4.1 ± 0.7 mg/L), marijuana metabolite (presumptive positive, confirmation not performed) and a small amount of amphetamine (<0.10 mg/L) were also found in the decedent's blood. The cause of death was determined to be combined 3-MeO-PCP, diphenhydramine and amphetamine toxicity. The manner of death was certified as an accident. PMID:27339479

  9. Fatal intoxications in Denmark following intake of morphine from opium poppies.

    PubMed

    Steentoft, A; Kaa, E; Worm, K

    1988-01-01

    In Denmark it is legal to grow opium poppies for the production of poppy seeds and until 1986 for decoration purposes, too. Danish poppy capsules contain 0.3-5 mg morphine per capsule and the content of morphine in opium exuded from the capsules may amount to 24%. This has resulted in misuse as both fresh and dried poppy capsules have been used for the production of "opium tea". During the period 1982-1985, seven casualties occurred among drug addicts in Denmark which were solely or partly caused by these opium poppies. PMID:3227727

  10. Passive marijuana usage and water intoxication.

    PubMed Central

    Quinton, B. A.; Logan, S. J.; Ramdial, H. L.; Walton, S. A.

    1993-01-01

    This article reports a case of a 3-month-old male presenting with hyponatremic seizure and hypothermia. The presence of marijuana in the infant's urine was remarkable. An etiologic role for the drug is questioned. A review of the literature is provided and the hypothesis of child neglect in the genesis of water intoxication is explored. PMID:8478974

  11. Platelet aggregation associated with ethanol intoxication

    SciTech Connect

    Volk, S.; Walenga, J.; Fareed, J.; Schumacher, H. )

    1989-02-09

    Alcohol is known to produce profound effects on blood; during chronic intoxication, prolongation of bleeding time has been reported. Utilizing human platelet rich plasma, we have studied the effect of alcohol on epinephrine, arachidonic acid and ADP induced aggregation. Control responses were obtained with saline from which the relative inhibition by alcohol was calculated. These studies were carried out at a concentration of 1.25-5.0 mg/ml which represents 0.125-0.5% alcohol blood levels. From 25 normal male and female volunteers, without prior hemostatic defects or drug ingestion, a dose-dependent inhibition by alcohol of all three agonist induced aggregations was noted. Alcohol itself did not produce any aggregation response. These studies demonstrate that alcohol at levels which are reached during intoxication is capable of impairing platelet function. The implication of this finding on the bleeding complications in healthy intoxicated patients may be significant during traumatic events, and individuals taking antiplatelet drugs may present a more serious hemostatic deficit during alcohol intoxication.

  12. [Ebola: "a fatal syndrome"].

    PubMed

    Martínez, G A; Ramírez Ronda, C H

    1996-01-01

    No other clinical entity has attached more attention now-a-day than those precipitated by the infection with a Hemorrhagic Fever Virus. Potentially caused by Arena, Bunya, Flavi, and Filoviradae, only the latter has had such a major impact throughout the world. Two major genuses have been recognized since they become evident for the first time in 1967, the single-species Marburg, and the 3-species-Ebola (E. zaire, sudan and reston). With the exception of the 2 outbreaks of E. reston (Washington, USA 1989-1993), all of them have taken place in Africa, where the virus is still hiding among the wild-life of the Tropical Rain Forest. Currently (in April 1995) the reemergence of Ebola virus has once more proven its fatality, leaving around 170 deaths in Zaire, 250 miles from its capital, Kinshasa. There is worldwide alert, sponsored by the CDC in Atlanta, the World Health Organization and the authorities in Zaire regarding its potential spreading to naive regions, in and out of Africa. The characteristic clinical picture of a viral hemorrhagic fever has no match. After a 2-21 days incubation period a viral-like illness develops. As days go by, symptoms worsen, and by the 7th day, a severe and diffuse bleeding tendency ensues. The individual's death is the most likely outcome in the great majority of cases. As a lethal virus, without an available treatment and a possible airborne-route of transmission, Ebola virus will always be considered a persistent threat to the global health.

  13. Occupational Injuries, Illnesses and Fatalities

    MedlinePlus

    ... that was created by Act of Congress and publishes data related to safety, injuries, and fatalities that are both work-related and non-work related. National Highway Traffic Safety Administration (NHTSA) - a government organization that is part of ...

  14. Buprenorphine and buprenorphine/naloxone intoxication in children - how strong is the risk?

    PubMed

    Soyka, Michael

    2013-03-01

    Opioid maintenance therapy with methadone or buprenorphine is an established and first-line treatment for opioid dependence. Risk of diversion and toxicity of opioid prescription drugs, including buprenorphine, causes significant concerns. This is particularly the case in the United States, where the number of related emergency visits is increasing, especially in children. A systematic literature research (Medline, Pubmed) was performed to assess the risk associated with buprenorphine. The search, which was not limited to particular publication years, was performed with the key words buprenorphine AND toxicity (114 counts ) AND children (4 counts) and buprenorphine AND mortality AND children (5 counts). In addition, the author obtained information from relevant websites (NIDA, SAMSHA) and pharmacovigilance data from the manufacturer of buprenorphine. Clinical and toxicological data suggest a low risk for fatal intoxications associated with bupreorphine in adults. Data from emergency units indicate a dramatic, 20-fold increase in buprenorphine exposure in children over the past decade, mostly in those under 6. The US 'Researched Abuse, Diversion and Addiction-Related Surveillance' (RADARS) system indicates a lower risk of severe opioid intoxications with buprenorphine than with other opioids, with no fatal outcomes recorded. Correspondingly, data from spontaneous reports to the surveillance programme of the manufacturer of buprenorphine (13,600 buprenorphine exposures, 4879 of these in children under six) show a serious medical outcome in 34% of children under the age of six but only one fatal outcome. Although exposure to buprenorphine and other opioids remains a significant concern in children, the drug seems rather to be safe with respect to severe outcomes, in particular death. PMID:23489089

  15. Alcohol intoxication in road traffic accidents leads to higher impact speed difference, higher ISS and MAIS, and higher preclinical mortality.

    PubMed

    Stübig, Timo; Petri, Maximilian; Zeckey, Christian; Brand, Stephan; Müller, Christian; Otte, Dietmar; Krettek, Christian; Haasper, Carl

    2012-11-01

    Alcohol is one of the most important personal risk factors for serious and fatal injuries, contributing to approximately one third of all deaths from accidents. It is also described that alcohol intoxication leads to a higher mortality in the clinical course. In this study, we hypothesized that alcohol intoxication leads to different accident kinematics, a higher ISS (Injury Severity Score), and higher preclinical mortality compared to sober patients. A technical and medical investigation of alcohol intoxicated road users was performed on the scene of the crash and at the primary admitting hospital. Alcohol testing was performed with either breath alcohol tests or measurement of blood alcohol concentration (BAC) in a standard laboratory test. Between 1999 and 2010, 37,635 road traffic accidents were evaluated by the Accident Research Unit. Overall 20,741 patients were injured, 2.3% of the patients were killed. Among the injured patients, 2.2% with negative BAC were killed, compared to 4.6% fatal injuries in patients with a positive BAC (p < 0.0001). Of the patients with a positive BAC, 8.0% were severely injured, compared to 3.6% in the BAC negative group (p < 0.0001). Regarding the relative speed at impact (Δv for motorized drivers, vehicle collision speed for pedestrians and bikers), there was a significant higher difference for BAC positive patients (30 ± 20) compared to the BAC negative patients (25 ± 19, p < 0.0001). Alcohol intoxication in trauma patients leads to higher preclinical mortality, higher impact speed difference, and higher injury severity. The subgroup analysis for different alcohol concentrations shows no difference in ISS, MAIS, and relative speed, but a correlation of increasing age of patients with higher alcohol concentrations.

  16. Alcohol intoxication in road traffic accidents leads to higher impact speed difference, higher ISS and MAIS, and higher preclinical mortality.

    PubMed

    Stübig, Timo; Petri, Maximilian; Zeckey, Christian; Brand, Stephan; Müller, Christian; Otte, Dietmar; Krettek, Christian; Haasper, Carl

    2012-11-01

    Alcohol is one of the most important personal risk factors for serious and fatal injuries, contributing to approximately one third of all deaths from accidents. It is also described that alcohol intoxication leads to a higher mortality in the clinical course. In this study, we hypothesized that alcohol intoxication leads to different accident kinematics, a higher ISS (Injury Severity Score), and higher preclinical mortality compared to sober patients. A technical and medical investigation of alcohol intoxicated road users was performed on the scene of the crash and at the primary admitting hospital. Alcohol testing was performed with either breath alcohol tests or measurement of blood alcohol concentration (BAC) in a standard laboratory test. Between 1999 and 2010, 37,635 road traffic accidents were evaluated by the Accident Research Unit. Overall 20,741 patients were injured, 2.3% of the patients were killed. Among the injured patients, 2.2% with negative BAC were killed, compared to 4.6% fatal injuries in patients with a positive BAC (p < 0.0001). Of the patients with a positive BAC, 8.0% were severely injured, compared to 3.6% in the BAC negative group (p < 0.0001). Regarding the relative speed at impact (Δv for motorized drivers, vehicle collision speed for pedestrians and bikers), there was a significant higher difference for BAC positive patients (30 ± 20) compared to the BAC negative patients (25 ± 19, p < 0.0001). Alcohol intoxication in trauma patients leads to higher preclinical mortality, higher impact speed difference, and higher injury severity. The subgroup analysis for different alcohol concentrations shows no difference in ISS, MAIS, and relative speed, but a correlation of increasing age of patients with higher alcohol concentrations. PMID:22819121

  17. Gamma-hydroxybutyric acid (GHB) measurement by GC-MS in blood, urine and gastric contents, following an acute intoxication in Belgium.

    PubMed

    Bodson, Q; Denooz, R; Serpe, P; Charlier, C

    2008-01-01

    Gamma-hydroxybutyrate (GHB, sodium oxybate) is a compound related to neuromodulator gamma-aminobutyric acid (GABA), emerging as a recreational drug of abuse and as a rape drug. GHB-related emergencies have dramatically increased in the 1990s, but a decrease is observed since 2000. We describe the case of an acute GHB intoxication in a 28-year-old male who fell unconscious after ingestion of a mouthful of an unknown beverage, and required medical support for 2 days. A cocaine abuse was also detected by preliminary toxicological screening, but the clinical presentation was not typical of cocaine intoxication. A simple liquid-liquid extraction was used for quantitation of GHB, followed by disilyl-derivatization and analysis in selective ion monitoring (SIM) mode by gas chromatography-mass spectrometry (GC-MS), using GHB-d6 as internal standard. High concentrations of GHB were detected in urine (3020 mg/L) and gastric contents (71487 mg/L) at admission. After a 6-hours delay, GHB was still present in urine at 2324 mg/L and in blood at 43 mg/L. The clinical symptoms of cocaine intoxication were diminished by GHB consumption, and the cerebral scan was modified. Attention must thus be paid to acute intoxications with surprising clinical symptoms, and GHB has probably to be added to the preliminary toxicological screening. Data available regarding GHB are briefly reviewed, and our results are compared with previously published reports of non-fatal GHB intoxication.

  18. Main characteristics of train-pedestrian fatalities on Finnish railroads.

    PubMed

    Silla, Anne; Luoma, Juha

    2012-03-01

    The aim of this study was to describe the frequency of fatalities, timing of collisions and characteristics of persons killed in train-pedestrian collisions on Finnish railways during 2005-2009. In addition, the Finnish results were compared with those collected in Sweden. The Finnish data were combined from five different sources. The results showed that 311 pedestrians were killed in train-pedestrian collisions, including 264 suicides, 35 accidents and 12 unclassified events. For each event type, most of the victims were male. Most suicide victims were in the 20-29 year age group and on average younger than people who chose some other form of suicide. About half of all victims were intoxicated by alcohol, medicines and/or drugs. Both suicides and accidents occurred most often at the end of the week but no specific peak for time of year was found. Suicides occurred most frequently from afternoon to night and accidents during the rush hours. Most train-pedestrian fatalities happened in densely populated areas. In conclusion, the effective prevention of railway suicides and accidents calls for a systems approach involving effective measures introduced by authorities responsible for urban planning, railways, education and public health.

  19. Main characteristics of train-pedestrian fatalities on Finnish railroads.

    PubMed

    Silla, Anne; Luoma, Juha

    2012-03-01

    The aim of this study was to describe the frequency of fatalities, timing of collisions and characteristics of persons killed in train-pedestrian collisions on Finnish railways during 2005-2009. In addition, the Finnish results were compared with those collected in Sweden. The Finnish data were combined from five different sources. The results showed that 311 pedestrians were killed in train-pedestrian collisions, including 264 suicides, 35 accidents and 12 unclassified events. For each event type, most of the victims were male. Most suicide victims were in the 20-29 year age group and on average younger than people who chose some other form of suicide. About half of all victims were intoxicated by alcohol, medicines and/or drugs. Both suicides and accidents occurred most often at the end of the week but no specific peak for time of year was found. Suicides occurred most frequently from afternoon to night and accidents during the rush hours. Most train-pedestrian fatalities happened in densely populated areas. In conclusion, the effective prevention of railway suicides and accidents calls for a systems approach involving effective measures introduced by authorities responsible for urban planning, railways, education and public health. PMID:22269485

  20. Death by band-aid: fatal misuse of transdermal fentanyl patch.

    PubMed

    Bakovic, Marija; Nestic, Marina; Mayer, Davor

    2015-11-01

    We present a case of fatal intoxication by the application of a transdermal fentanyl patch upon a superficial bleeding abrasion of a 2-year-old girl. The grandmother discovered the body of the child in bed at approximately 7 a.m. External examination revealed a properly developed, nourished, and hydrated child, with some vomit in the nostrils and inside the mouth. There was no evidence of trauma besides small contusions and abrasions on the knees, with a patch placed over the largest abrasion. Closer inspection revealed that this was transdermal fentanyl patch. Internal examination and microscopic analysis revealed regurgitation of stomach content, cerebral and pulmonary edema, and liver congestion. Toxicology analysis revealed trace levels of fentanyl in the blood just above the limit of detection (2 ng/mL), while concentrations in the urine, liver, and kidney were approximately 102, 28, and 10 ng/mL, respectively. Investigation discovered that the child injured her knee while playing the evening before. The grandmother applied the patch to cover the injury, unaware that she had used a fentanyl transdermal patch instead of simple band-aid. Although fatal intoxications are uncommon among young children in high-income countries, it is of major interest to raise awareness of such events especially since a great majority of these are preventable. The presented case points at the need for more thorough education of users and more strict rules in prescribing and handling of this potent medicine. As well, we find this case to be a useful contribution to the evaluation of postmortem fentanyl concentrations in fatal intoxication in a small child.

  1. Death by band-aid: fatal misuse of transdermal fentanyl patch.

    PubMed

    Bakovic, Marija; Nestic, Marina; Mayer, Davor

    2015-11-01

    We present a case of fatal intoxication by the application of a transdermal fentanyl patch upon a superficial bleeding abrasion of a 2-year-old girl. The grandmother discovered the body of the child in bed at approximately 7 a.m. External examination revealed a properly developed, nourished, and hydrated child, with some vomit in the nostrils and inside the mouth. There was no evidence of trauma besides small contusions and abrasions on the knees, with a patch placed over the largest abrasion. Closer inspection revealed that this was transdermal fentanyl patch. Internal examination and microscopic analysis revealed regurgitation of stomach content, cerebral and pulmonary edema, and liver congestion. Toxicology analysis revealed trace levels of fentanyl in the blood just above the limit of detection (2 ng/mL), while concentrations in the urine, liver, and kidney were approximately 102, 28, and 10 ng/mL, respectively. Investigation discovered that the child injured her knee while playing the evening before. The grandmother applied the patch to cover the injury, unaware that she had used a fentanyl transdermal patch instead of simple band-aid. Although fatal intoxications are uncommon among young children in high-income countries, it is of major interest to raise awareness of such events especially since a great majority of these are preventable. The presented case points at the need for more thorough education of users and more strict rules in prescribing and handling of this potent medicine. As well, we find this case to be a useful contribution to the evaluation of postmortem fentanyl concentrations in fatal intoxication in a small child. PMID:26055040

  2. Clinically and electrophysiologically diagnosed botulinum intoxication.

    PubMed

    Kotan, Dilcan; Aygul, Recep; Ceylan, Mustafa; Yilikoglu, Yalcin

    2013-01-03

    In this case report, clinical and electrophysiological findings of 43-year-old female patient who developed Clostridium botulinum intoxication after consumption of home-made canned food are presented. Following the sudden onset of severe nausea and vomiting, diplopia, blurred vision, bilateral ptosis, weakness, speech and swallowing difficulties have developed and the patient declared that she has just tasted the canned beans after she had rinsed them several times. The case, where serological tests cannot be performed, was diagnosed clinically and treated with antitoxin immediately. During follow-up, consecutive nerve stimulation was performed and significant incremental response was observed. There was an improvement in symptoms within 2 weeks, and in 5 or 6 weeks the symptoms had disappeared completely. Electrodiagnostic studies revealed that the findings turned to normal. The case showed that immediate antitoxin treatment is life-saving even the diagnosis of botulinum intoxication is based on clinical findings.

  3. Vestibular response in denatured rape oil intoxication.

    PubMed

    Gavilán, C; Gavilán, J; Abril, A

    1985-10-01

    During the spring of 1981 a massive intoxication broke out in Spain, which is presently attributed to the ingestion of denatured rape oil, and which has been called 'Toxic Syndrome' (TS). We studied 51 patients affected by the TS one year after the onset of their disease, analyzing their vestibular responses in the caloric test with the help of an analog-digital computer. A significant decrease in the number of nystagmic beats of the affected patients can be observed, while the rest of the parameters studied show similar values to those found simultaneously in 30 normal subjects. It is suggested that these differences are yet another manifestation of the polyneuropathy found in intoxication by denatured rape oil. PMID:3877134

  4. Cerebrovascular ischaemia after carbon monoxide intoxication.

    PubMed

    Kara, Hasan; Bayir, A; Ak, Ahmet; Degirmenci, Selim

    2015-02-01

    Carbon monoxide intoxication is the most prevalent cause of death from carbon monoxide poisoning. We herein report the case of a 56-year-old man who was found unconscious and smelled of smoke after exposure to carbon monoxide from a heater. He scored 5 on the Glasgow Coma Scale, and had respiratory insufficiency and elevated troponin I, creatine kinase-MB fraction and carboxyhaemoglobin levels. He was treated by mechanical ventilation. After regaining consciousness, brain magnetic resonance imaging showed diffusion restriction in the left occipital lobe; there was a loss of vision (right temporal hemianopsia), which improved by the follow-up session. Carbon monoxide intoxication may cause neurologic and cardiac sequelae, and the initial treatment includes oxygen therapy. Acute carbon monoxide poisoning can cause serious injury to the brain, heart and other organs; the most severe damages that could be inflicted to the brain include cerebral ischaemia and hypoxia, oedema, and neural cell degeneration and necrosis. PMID:25715861

  5. Cerebrovascular ischaemia after carbon monoxide intoxication.

    PubMed

    Kara, Hasan; Bayir, A; Ak, Ahmet; Degirmenci, Selim

    2015-02-01

    Carbon monoxide intoxication is the most prevalent cause of death from carbon monoxide poisoning. We herein report the case of a 56-year-old man who was found unconscious and smelled of smoke after exposure to carbon monoxide from a heater. He scored 5 on the Glasgow Coma Scale, and had respiratory insufficiency and elevated troponin I, creatine kinase-MB fraction and carboxyhaemoglobin levels. He was treated by mechanical ventilation. After regaining consciousness, brain magnetic resonance imaging showed diffusion restriction in the left occipital lobe; there was a loss of vision (right temporal hemianopsia), which improved by the follow-up session. Carbon monoxide intoxication may cause neurologic and cardiac sequelae, and the initial treatment includes oxygen therapy. Acute carbon monoxide poisoning can cause serious injury to the brain, heart and other organs; the most severe damages that could be inflicted to the brain include cerebral ischaemia and hypoxia, oedema, and neural cell degeneration and necrosis.

  6. Neuromuscular Functions on Experimental Acute Methanol Intoxication

    PubMed Central

    Moral, Ali Reşat; Çankayalı, İlkin; Sergin, Demet; Boyacılar, Özden

    2015-01-01

    Objective The incidence of accidental or suicidal ingestion of methyl alcohol is high and methyl alcohol intoxication has high mortality. Methyl alcohol intoxication causes severe neurological sequelae and appears to be a significant problem. Methyl alcohol causes acute metabolic acidosis, optic neuropathy leading to permanent blindness, respiratory failure, circulatory failure and death. It is metabolised in the liver, and its metabolite formic acid has direct toxic effects, causing oxidative stress, mitochondrial damage and increased lipid peroxidation associated with the mechanism of neurotoxicity. Methanol is known to cause acute toxicity of the central nervous system; however, the effects on peripheral neuromuscular transmission are unknown. In our study, we aimed to investigate the electrophysiological effects of experimentally induced acute methanol intoxication on neuromuscular transmission in the early period (first 24 h). Methods After approval by the Animal Experiment Ethics Committee of Ege University, the study was carried out on 10 Wistar rats, each weighing about 200 g. During electrophysiological recordings and orogastric tube insertion, the rats were anaesthetised using intra-peritoneal (IP) injection of ketamine 100 mg kg−1 and IP injection of xylazine 10 mg kg−1. The rats were given 3 g kg−1 methyl alcohol by the orogastric tube. Electrophysiological measurements from the gastrocnemius muscle were compared with baseline. Results Latency measurements before and 24 h after methanol injection were 0.81±0.11 ms and 0.76±0.12 ms, respectively. CMAP amplitude measurements before and 24 h after methanol injection were 9.85±0.98 mV and 9.99±0.40 mV, respectively. CMAP duration measurements before and 24 h after methanol injection were 9.86±0.03 ms and 9.86±0.045 ms, respectively. Conclusion It was concluded that experimental methanol intoxication in the acute phase (first 24 h) did not affect neuromuscular function. PMID:27366524

  7. [Intoxications specific to the Aquitaine region].

    PubMed

    Bédry, R; Gromb, S

    2009-07-01

    Some intoxications are more specifically linked to the Aquitaine region than to other regions of France, due to environmental circumstances (fauna, flora, climate) or traditional activities (gastronomy). Three types of intoxications are particular in this area. Pine processionary caterpillar envenomations (Thaumetopoea pityocampa), a Southern Europe pinewood parasite, are frequently encountered in the Landes' forest. They are responsible of ocular and/or skin lesions with urticaria or contact dermatitis, seldom associated with immediate IgE hypersensitivity. According to the south Atlantic coastal region geology and the marine streams, venomous marine animals are mainly located in Charente-Maritime for jellyfish, in Gironde and in Landes for weeverfish and in Atlantic Pyrenees for sea anemone. Usually not dangerous, first-aid workers treat most cases of these envenomations. Some endemic mushrooms (Tricholoma auratum) which grow on the dunes of the Atlantic coastal region, are usually considered as very good comestibles, but were recently responsible for serious intoxications: T.auratum was responsible of several cases of rhabdomyolysis, without neurological involvement, nor renal or hepatic lesion. Three deaths were notified. Animal studies confirmed the responsibility of the mushrooms.

  8. Cardiogenic shock due to acute tramadol intoxication.

    PubMed

    Perdreau, Elodie; Iriart, Xavier; Mouton, Jean-Baptiste; Jalal, Zakaria; Thambo, Jean-Benoît

    2015-01-01

    Tramadol is a common analgesic, widely prescribed because of its efficiency and safety. We report the case of a 7-year-old child admitted in cardiac intensive care unit for cardiogenic shock due to tramadol intoxication. Without any past history, the child was admitted at emergency room for generalised convulsion, followed by respiratory distress. Cardiogenic shock was suspected after clinical examination and chest X-ray and confirmed by transthoracic echocardiography showing low left ventricular ejection fraction (<30 %) with pulmonary hypertension. No evidence of cardiac infarction or myocarditis was found. Tramadol intoxication was suspected because of empty tramadol tablets found near the child and later confirmed by toxicologic analysis showing high blood concentration of tramadol (>1 mg/L) and O-desmethyltramadol (>1.5 mg/L). Hemodynamic support by inotropic drug infusion and diuretics was necessary. Left ventricular function normalised after 2 days of treatment allowing drug infusion weaning. Cardiac magnetic resonance imaging performed 3 days after admission confirmed normal left ventricular ejection fraction and volumes without evidence of late gadolinium enhancement. Cardiogenic shock due to tramadol intoxication is rare but exists. Negative inotropic effect of high doses of tramadol has been suspected. Quick recovery is possible.

  9. Parasailing fatalities in southwest Florida.

    PubMed

    Wolf, Barbara C; Harding, Brett E

    2009-12-01

    Parasailing is a recreational sport that is generally considered to be of little risk to the participants. Typically, the passenger launches from a motorboat with a specially designed winch that pulls him or her back to the boat at the end of the ride. The sport is not regulated at the federal, state, or county level. There have been few reports of injuries to parasailors. Additionally, there have been only 2 fatalities reported to the United States Coast Guard in a 10-year review. We report the details of these 2 deaths, those of a mother and daughter riding in a tandem parasail, which occurred on Fort Myers Beach in 2001, as well as an additional case of a parasailing fatality that occurred in southwest Florida in 1999. These cases illustrate the injuries seen in such fatalities and the hazards posed by adverse weather conditions and faulty equipment, as well as the impairment of passenger judgment by drugs and/or alcohol.

  10. A fatal poisoning involving 25C-NBOMe.

    PubMed

    Andreasen, Mette Findal; Telving, Rasmus; Rosendal, Ingrid; Eg, Marlene Beyer; Hasselstrøm, Jørgen Bo; Andersen, Ljubica Vukelic

    2015-06-01

    This paper reports on a fatal overdose case involving the potent hallucinogenic drug 25C-NBOMe (2-(4-chloro-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine). In the present case, a young male was hospitalized after the recreational use of this potent drug. He died at the hospital at approximately 12h after ingestion, with preceding signs of serotonin toxicity. Medico-legal autopsy was performed on the deceased, during which time peripheral whole blood, urine, vitreous humor, liver and gastric content samples were submitted for toxicological examination. Further, whole blood collected at the hospital at 2-4h following ingestion of the drug was analyzed. 25C-NBOMe and a demethylated and glucuronidated metabolite of 25C-NBOMe were identified in the urine and blood samples using ultra-performance liquid chromatography with high-resolution time-of-flight mass spectrometry (UPLC-HRTOF-MS). Subsequently, 25C-NBOMe was quantified in the peripheral whole blood (0.60μg/kg), urine (2.93μg/kg), vitreous humor (0.33μg/kg), liver (0.82μg/kg) and gastric content (0.32μg total) samples collected during autopsy and in the ante-mortem whole blood (0.81μg/kg) by ultra-performance liquid chromatography with tandem mass spectrometry (UPLC-MS/MS). The autopsy findings were consistent with acute poisoning. Based on the toxicological findings, the cause of death was determined to be a fatal overdose of 25C-NBOMe in combination with amphetamine intake. To our knowledge, the present paper reports the first quantification of 25C-NBOMe in biological specimens from a fatal intoxication case.

  11. The world's first automobile fatality.

    PubMed

    Fallon, Isabelle; O'Neill, Desmond

    2005-07-01

    The first recorded automobile fatality occurred in a small town in the Irish Midlands in 1869. Mary Ward, a celebrated microscopist, artist, astronomer and naturalist, fell from a steam carriage and died after crush injuries from its heavy iron wheels. The story of first automobile fatality characterizes the individual tragedy that is each premature death. It also illuminates the story of a remarkable Victorian scientific family. Among their many achievements was the building of a reflector telescope in the heart of rural Ireland that was the largest in the world for 74 years.

  12. A SCUBA-diving fatality.

    PubMed

    Haydon, J R; Williamson, J A; Ansford, A J; Sherif, S; Shapter, M J

    1985-11-11

    An investigation by a Naval Board of Inquiry into the circumstances of a fatal naval diving accident is presented. Although drowning contributed to the fatal outcome, massive arterial gas embolism is thought to have been the principal cause of death, and the value of post-mortem computed tomography scanning for its detection is demonstrated. The possibility is discussed of diver error due to unfamiliarity with equipment and procedures, compounded by nitrogen narcosis. The shortfall in expertise of coronial inquiries into diving deaths is emphasized against a background of increasing popularity of sports diving around Australia. The implications for the offshore industry are obvious and suggest the need for a federal diving inspectorate.

  13. The world's first automobile fatality.

    PubMed

    Fallon, Isabelle; O'Neill, Desmond

    2005-07-01

    The first recorded automobile fatality occurred in a small town in the Irish Midlands in 1869. Mary Ward, a celebrated microscopist, artist, astronomer and naturalist, fell from a steam carriage and died after crush injuries from its heavy iron wheels. The story of first automobile fatality characterizes the individual tragedy that is each premature death. It also illuminates the story of a remarkable Victorian scientific family. Among their many achievements was the building of a reflector telescope in the heart of rural Ireland that was the largest in the world for 74 years. PMID:15949449

  14. Self-intoxication with morphine obtained from an infusion pump.

    PubMed

    Gock, S B; Wong, S H; Stormo, K A; Jentzen, J M

    1999-01-01

    A 36-year-old Caucasian male was found unresponsive by his wife. He had white foam around his mouth and was pronounced dead shortly thereafter. He had a history of back pain and was treated with intrathecal morphine because of his previous addiction to oral opiate medications. Because of crimping of the pump catheter, it was replaced 4 days before his death. Toxicological findings included urine screen positive for amitriptyline, nortriptyline, opiates, hydrocodone metabolites, ibuprofen, acetaminophen, caffeine, nicotine, and metabolite. Drug concentrations were as follows: blood, 0.260 mg/L amitriptyline, 0.160 mg/L nortriptyline, 0.460 mg/L unconjugated morphine, and 0.624 mg/L total morphine; vitreous humor, 0.034 mg/L unconjugated morphine and 0.080 mg/L total morphine; and cerebrospinal fluid, 0.099 mg/L unconjugated morphine and 0.095 mg/L total morphine. Shortly after death, the volume of the residual pump reservoir was only 8 mL instead of the expected 17 mL. Testing by the FDA showed that the pump was functional. The residual content of the pump accounted for only 230 mg instead of the expected 488 mg. The high blood-morphine concentrations did not correlate with the intrathecal infusion dose. The symptoms were consistent with opiate overdose, possibly by injection of morphine withdrawn from the pump reservoir. The cause of death was determined to be fatal morphine self-intoxication, and the manner of death was accidental. This case is intended to alert regulatory agencies, pain management health professionals, pathologists, and toxicologists to the abuse potential of one of the newer analgesic-delivery systems. PMID:10192419

  15. Non-fatal mirtazapine overdose.

    PubMed

    Retz, W; Maier, S; Maris, F; Rösler, M

    1998-11-01

    We report the case of intoxication of a 41-year-old female patient suffering from major depression with mirtazapine complicated by severe hypothermia. The patient was brought to an intensive care unit 10 hours after intake of 1200 mg mirtazapine and 20 mg lorazepam and laying outside at outdoor temperatures below 0 degree C. The mirtazapine plasma-level was 368 ng/ml still after 41 hours. Body temperature was reduced to 26 degrees C and rhabdomyolysis due to hypothermia was observed. Cardial and respiratory function was compromised and intubation was necessary. The patient recovered without persisting somatic impairment. PMID:9861579

  16. The Mickey Finn defense: involuntary intoxication and insanity.

    PubMed

    Goldstein, R L

    1992-01-01

    The legal context of voluntary and involuntary intoxication is delineated. The author reports a case of involuntary intoxication involving scopolamine toxic psychosis or delirium, in which he testified as a psychiatric expert witness. The specific psychological and physiological symptomatology produced by scopolamine intoxication is outlined. The forensic psychiatrist should be alert to the involuntary intoxication defense in these cases and should familiarize himself with the specific toxicity of scopolamine, in view of the significant increase in the number of incidents in which it is utilized as "knockout" drops in certain jurisdictions.

  17. Fatal and near-fatal anaphylaxis: factors that can worsen or contribute to fatal outcomes.

    PubMed

    Greenberger, Paul A

    2015-05-01

    Anaphylaxis implies a risk of death even in patients whose prior episodes have been considered mild and managed easily. Anaphylaxis occurs in all age groups, from infants to the elderly, but most deaths occur in adults. Factors or circumstances associated with near-fatal or fatal anaphylaxis are reviewed from the following 10 perspectives: accidents and mishaps, adulterated products, age, allergens, atopy, comorbidities, Munchausen syndrome or contrived anaphylaxis, patient factors, route of administration, and treatment-related issues. There are no absolute contraindications to self-injectable epinephrine, and epinephrine can be administered for anaphylaxis to elderly patients or to those patients receiving beta-adrenergic blockers. PMID:25841558

  18. [Autopsy case of drowning caused by accidental carbon dioxide intoxication in a hold tank].

    PubMed

    Sato, Hiroaki; Tanaka, Toshiko; Kasai, Kentaro; Kita, Toshiro

    2009-12-01

    A 49-year-old male captain fell and unfortunately died in a hold tank where he had entered to rescue his fainting co-worker on the disposing waste fluid left there. An autopsy revealed that the captain died from drowning in the waste fluid. In order to clarify the cause of their falling in the tank, the gas in the hold tank was analyzed. The concentration of oxygen was 18.86 to 19.31%, carbon dioxide was 7.28 to 9.07% and the other gases, including hydrogen sulfide, were assessed to be under the normal level. It was concluded that the intoxication of carbon dioxide generated from the waste fluid fermentation was the cause of this fatal accident through loss of consciousness. It is necessary to recognize that carbon dioxide is a dangerous and deleterious gas in circumstances where the gas can be produced. PMID:20000009

  19. An autopsy case of acetyl fentanyl intoxication caused by insufflation of 'designer drugs'.

    PubMed

    Takase, Izumi; Koizumi, Takako; Fujimoto, Ihoko; Yanai, Aya; Fujimiya, Tatsuya

    2016-07-01

    We present a fatal case of intoxication due to insufflation of acetyl fentanyl. His blood concentration of acetyl fentanyl was 270ng/mL, and the manner of death was classified as an accident. This is the first report of an autopsy case of acetyl fentanyl delivered by insufflation, rather than intravenous administration. He had been snoring loudly for at least 12h prior to death, and transport to a hospital during this time and treatment with naloxone may have saved his life. In this sense, it can be said that his death was preventable. This case reemphasizes the risk of death associated with drug overdose and the narrow range of acetyl fentanyl between the effective dose (ED50) and lethal dose (LD50). The case should also raise awareness among medical professionals of the effectiveness of naloxone and the need to establish a comprehensive system for toxicological analysis while keeping the possibility of use of 'designer drugs' in mind. PMID:27497332

  20. Effect of MDR1 gene polymorphisms on mortality in paraquat intoxicated patients.

    PubMed

    Kim, Hak Jae; Kim, Hyung-Ki; Kwon, Jun-Tack; Lee, Sun-Hyo; El Park, Sam; Gil, Hyo-Wook; Song, Ho-Yeon; Hong, Sae-Yong

    2016-01-01

    Paraquat is a fatal herbicide following acute exposure. Previous studies have suggested that multidrug resistance protein 1 (MDR1) might help remove paraquat from the lungs and the kidney. MDR1 single-nucleotide polymorphisms (SNPs) are involved in the pharmacokinetics of many drugs. The purpose of this study was to determine whether MDR1 SNPs were associated with the mortality in paraquat intoxicated patients. We recruited 109 patients admitted with acute paraquat poisoning. They were genotyped for C1236T, G2677T/A, and C3435T single-nucleotide polymorphisms (SNPs) of MDR1 gene. Their effects on mortality of paraquat intoxicated patients were evaluated. Overall mortality rate was 66.1%. Regarding the C1236T of the MDR1 gene polymorphism, 21 (19.3%) had the wild type MDR1 while 88 (80.7%) had homozygous mutation. Regarding the C3435T MDR1 gene polymorphism, 37(33.9%) patients had the wild type, 23 (21.1%) had heterozygous mutation, and 49 (45.0%) had homozygous mutation. Regarding the G2677T/A MDR1 gene polymorphism, 38 (34.9%) patients had the wild type, 57 (52.3%) had heterozygous mutation, and 14 (12.8%) had homozygous mutation. None of the individual mutations or combination of mutations (two or three) of MDR1 SNP genotypes altered the morality rate. The mortality rate was not significantly different among SNP groups of patients with <4.0 μg/mL paraquat. In conclusion, MDR1 SNPs have no effect on the mortality rate of paraquat intoxicated patients. PMID:27545861

  1. Alcohol intoxication impairs mesopic rod and cone temporal processing in social drinkers

    PubMed Central

    Zhuang, Xiaohua; Kang, Para; King, Andrea; Cao, Dingcai

    2015-01-01

    Background Alcohol-related driving accidents and fatalities occur most frequently at nighttime and at dawn, i.e. a mesopic lighting condition in which visual processing depends on both rod and cone photoreceptors. The temporal functions of the rod and cone pathways are critical for driving in this lighting condition. However, how alcohol influences the temporal functions in the rod and cone pathways at mesopic light levels is inconclusive. To address this, the present study investigated whether an acute intoxicating dose of alcohol impairs rod- and/or cone-mediated critical fusion frequency (CFF, the lowest frequency of which an intermittent or flickering light stimulus is perceived as steady). Methods In Experiment I, we measured the CFFs for three types of visual stimuli (rod stimulus alone, cone stimulus alone, and the mixture of both stimuli types), under three illuminant light levels (dim illuminance: 2Td; low illuminance: 20Td; and medium illuminance 80Td) in moderate-heavy social drinkers before and after they consumed an intoxicating dose of alcohol (0.8g/kg) compared with a placebo beverage. In Experiment II, we examined if the illuminance level (dark versus light) of the visual area surrounding the test stimuli alters alcohol’s effect on the temporal processing of rods and cones. Results The results showed that compared with placebo, alcohol significantly reduced CFFs of all stimulus types at all illuminance levels. Furthermore, alcohol intoxication produced a larger impairment on rod-pathway-mediated CFFs under light versus dark surround. Conclusions These results indicate that alcohol intake slows down rod and cone-pathway-mediated temporal processing. Further research may elucidate if this effect may play a role in alcohol-related injury and accidents, which often occur under low light conditions. PMID:26247196

  2. Effect of MDR1 gene polymorphisms on mortality in paraquat intoxicated patients

    PubMed Central

    Kim, Hak Jae; Kim, Hyung-Ki; Kwon, Jun-Tack; Lee, Sun-hyo; el Park, Sam; Gil, Hyo-Wook; Song, Ho-yeon; Hong, Sae-yong

    2016-01-01

    Paraquat is a fatal herbicide following acute exposure. Previous studies have suggested that multidrug resistance protein 1 (MDR1) might help remove paraquat from the lungs and the kidney. MDR1 single-nucleotide polymorphisms (SNPs) are involved in the pharmacokinetics of many drugs. The purpose of this study was to determine whether MDR1 SNPs were associated with the mortality in paraquat intoxicated patients. We recruited 109 patients admitted with acute paraquat poisoning. They were genotyped for C1236T, G2677T/A, and C3435T single-nucleotide polymorphisms (SNPs) of MDR1 gene. Their effects on mortality of paraquat intoxicated patients were evaluated. Overall mortality rate was 66.1%. Regarding the C1236T of the MDR1 gene polymorphism, 21 (19.3%) had the wild type MDR1 while 88 (80.7%) had homozygous mutation. Regarding the C3435T MDR1 gene polymorphism, 37(33.9%) patients had the wild type, 23 (21.1%) had heterozygous mutation, and 49 (45.0%) had homozygous mutation. Regarding the G2677T/A MDR1 gene polymorphism, 38 (34.9%) patients had the wild type, 57 (52.3%) had heterozygous mutation, and 14 (12.8%) had homozygous mutation. None of the individual mutations or combination of mutations (two or three) of MDR1 SNP genotypes altered the morality rate. The mortality rate was not significantly different among SNP groups of patients with <4.0 μg/mL paraquat. In conclusion, MDR1 SNPs have no effect on the mortality rate of paraquat intoxicated patients. PMID:27545861

  3. Fulminant hepatic failure in woman with iron and non-steroidal anti-inflammatory drug intoxication.

    PubMed

    Magdalan, Jan; Zawadzki, Marcin; Sozanski, Tomasz

    2011-08-01

    A 17-year-old, previously healthy female ingested 16,000 mg iron sulphate (96.15 mg of iron ions per kg of b.wt.) with a suicidal intent. The patient was admitted to a toxicology unit 10 hours after the drug ingestion. Serum iron concentration at admission was 2351 μg% (421.0 μmol/L). In the course of the intoxication, hemorrhagic gastritis, renal insufficiency and increasing signs of fulminant hepatic failure complicated with coagulopathy and encephalopathy were observed. Treatment with deferoxamine was started immediately after admission to the hospital and continued for 15 hours until the serum concentration of iron decreased to 145 μg% (25.9 μmol/L). Patient was qualified for liver transplant, therefore albumin dialysis as a bridge to liver transplantation was performed. In spite of two procedures of albumin dialysis using the Prometheus system, deep coma, shock and respiratory insufficiency developed. The patient died 80 hours after iron ingestion. In the presented case, the ingestion of a very high dose of iron and late introduction of deferoxamine treatment contributed to fulminant liver failure and fatal outcome of the intoxication. PMID:20952452

  4. Metabolic acidosis in a patient with type 1 diabetes mellitus complicated by methanol and amitriptyline intoxication.

    PubMed

    Celik, Umit; Celik, Tamer; Avci, Akkan; Annagur, Ali; Yilmaz, Hayri Levent; Kucukosmanoglu, Osman; Topaloglu, Ali Kemal; Daglioglu, Nebile

    2009-02-01

    Diabetic ketoacidosis (DKA) is a widely known acute metabolic complication of diabetes mellitus (DM), which can be potentially fatal. It is not difficult to diagnose when a patient with DM comes with symptoms such as coma, fruity breath, hyperglycemia, acidosis, and tachypnea. If the patient has not been diagnosed with DM before, then other sicknesses characterized by an increased anion gap should be considered. A 12-year-old boy with type 1 DM and repeated earlier admissions for DKA was admitted to the emergency department in another apparent case of DKA with coma, hyperglycemia, and profound metabolic acidosis. When his condition did not improve with initial treatment, intoxication was suspected as an alternate cause of his condition. Further laboratory tests detected methanol and amitriptyline. The patient underwent hemodialysis and recovered completely. This case illustrates that a seemingly obvious medical condition can mask serious intoxication. This report is the only publication on two different entities characterized by an increased anion gap and at the end the patient has been cured completely without any complications. PMID:19106720

  5. [Lethal intoxication with arsenic using prepared butter].

    PubMed

    Weller, Jens-Peter; Larsch, Klaus-Peter; Teske, Jörg; Tröger, Hans Dieter

    2008-01-01

    The present case report deals with a lethal intoxication with arsenic mixed into butter. It describes the course of events over about two days on the basis of the statements by the persons involved, the clinical findings after the belated hospitalisation of the victim, the results of the first pathological autopsy, the forensic autopsy performed after exhumation and the results of the chemical-toxicological investigations. The results are discussed in relation to the later confession of the female perpetrator and her statements regarding a previous unsuccessful murder attempt by poisoning. It also presents the judgement pronounced by the court and the reasons given for it.

  6. Acute Alcohol Intoxication-Induced Microvascular Leakage

    PubMed Central

    Doggett, Travis M.; Breslin, Jerome W.

    2014-01-01

    Background Alcohol intoxication can increase inflammation and worsen injury, yet the mechanisms involved are not clear. We investigated whether acute alcohol intoxication elevates microvascular permeability, and investigated potential signaling mechanisms in endothelial cells that may be involved. Methods Conscious rats received a 2.5 g/kg alcohol bolus via gastric catheters to produce acute intoxication. Microvascular leakage of intravenously administered FITC-albumin from the mesenteric microcirculation was assessed by intravital microscopy. Endothelial-specific mechanisms were studied using cultured endothelial cell monolayers. Transendothelial electrical resistance (TER) served as an index of barrier function, before and after treatment with alcohol or its metabolite acetaldehyde. Pharmacologic agents were used to test the roles of alcohol metabolism, oxidative stress, p38 mitogen-activated protein (MAP) kinase, myosin light chain kinase (MLCK), rho kinase (ROCK), and exchange protein activated by cAMP (Epac). VE-cadherin localization was investigated to assess junctional integrity. Rac1 and RhoA activation were assessed by ELISA assays. Results Alcohol significantly increased FITC-albumin extravasation from the mesenteric microcirculation. Alcohol also significantly decreased TER and disrupted VE-cadherin organization at junctions. Acetaldehyde significantly decreased TER, but inhibition of ADH or application of a superoxide dismutase mimetic failed to prevent alcohol-induced decreases in TER. Inhibition of p38 MAP kinase, but not MLCK or ROCK, significantly attenuated the alcohol-induced barrier dysfunction. Alcohol rapidly decreased GTP-bound Rac1 but not RhoA during the drop in TER. Activation of Epac increased TER, but did not prevent alcohol from decreasing TER. However, activation of Epac after initiation of alcohol-induced barrier dysfunction quickly resolved TER to baseline levels. Conclusions Our results suggest that alcohol intoxication increases

  7. Possible unaware intoxication by anticoagulant rodenticide

    PubMed Central

    Dashti-Khavidaki, Simin; Ghaffari, Saba; Nassiri-Toossi, Mohsen; Amini, Mohsen; Edalatifard, Maryam

    2014-01-01

    Superwarfarin toxicity may be a serious problem. It needs high clinical suspicious in patients with bleeding diathesis without hematologic or liver diseases even in patients with apparent negative history of warfarin or other anticoagulant accessibility. Here we reported a patient with a negative history of any medical diseases or drug administration who was referred with generalized ecchymosis. Increased international normalized ratio and decreased vitamin K-dependent coagulation factors were detected in this patient. His hematologic and liver evaluations were normal. Clinical pharmacist emphasis in taking history revealed using anticoagulant rodenticide all over the farm the patient lived in that might result in unaware intoxication in this patient who suffered dementia. PMID:25535623

  8. Acute arsenic intoxication from environmental arsenic exposure

    SciTech Connect

    Franzblau, A.; Lilis, R. )

    1989-11-01

    Reports of acute arsenic poisoning arising from environmental exposure are rare. Two cases of acute arsenic intoxication resulting from ingestion of contaminated well water are described. These patients experienced a variety of problems: acute gastrointestinal symptoms, central and peripheral neurotoxicity, bone marrow suppression, hepatic toxicity, and mild mucous membrane and cutaneous changes. Although located adjacent to an abandoned mine, the well water had been tested for microorganisms only and was found to be safe. Regulations for testing of water from private wells for fitness to drink are frequently nonexistent, or only mandate biologic tests for microorganisms. Well water, particularly in areas near mining activity, should be tested for metals.

  9. Influence of essential elements on manganese intoxication

    SciTech Connect

    Khandelwal, S.; Ashquin, M.; Tandon, S.K.

    1984-01-01

    With a view to explore the influence of essential metals in manganese intoxication, the effect of calcium, iron or zinc supplementation on the uptake of manganese and on the activity of manganese sensitive enzymes, succinic dehydrogenase and cytochrome oxidase in brain and liver of rat was investigated. The choice of the two mitochondrial enzymes was based on the fact that the mitochondria are the chief site of manganese accumulation and their activity in brain, liver and blood of rats is significantly influenced by manganese.

  10. Datura stramonium intoxication in two children.

    PubMed

    Rakotomavo, Falihery; Andriamasy, Caroline; Rasamoelina, Ndrantoniaina; Raveloson, Nasolotsiry

    2014-06-01

    Datura stramonium is a toxic plant member of the Solanaceae family. Its consumption may result in severe anticholinergic toxicity. We report the intoxication of 5- and 4-year-old brothers with Datura stramonium, which presented in two different manners. The first child presented agitation, hallucination and mydriasis that improved rapidly with benzodiazepine medication. The second presented comatose, mydriasis and Babinski signs. Gastric lavage and activated charcoal administration were performed. The child was intubated and mechanically ventilated until consciousness improvement. Datura stramonium poisoning may be considered by physicians in case of acute onset of decreased consciousness or behaviour trouble associated with anticholinergic signs and symptoms. PMID:24894939

  11. Peganum Harmala (Aspand) Intoxication; a Case Report

    PubMed Central

    Sadr Mohammadi, Rezvan; Bidaki, Reza; Mirdrikvand, Fazlollah; Mostafavi Yazdi, Seyyed Nader; Yazdian Anari, Pouria

    2016-01-01

    There are several reports in the literature indicating a great variety of pharmacological effects for peganum harmala or aspand such as sedative anti-bacterial, anti-fungal, antiviral and antiprotozoal. Some people believe that can be used for treatment of some organic or psychiatric disorders. We introduce a woman with history of long time constipation that was disappointed in novel medical treatment and decided to use comminuted Aspand to relieve her problem. Two hours after use, the intoxication symptoms manifested as blurred vision, phonophobia, floating feeling, and tinnitus ringing. Here we report the treatment process and outcome of this case. PMID:27274523

  12. A tapentadol related fatality: Case report with postmortem concentrations.

    PubMed

    Cantrell, F Lee; Mallett, Phyllis; Aldridge, Lenore; Verilhac, Kimi; McIntyre, Iain M

    2016-09-01

    Tapentadol (TAP) is an analgesic agent indicated for the management of different types of pain. It has a novel mechanism of action in that it induces analgesia via both μ-opioid receptor agonism and norepinephrine reuptake inhibition. Although deaths associated with TAP use have been reported, there is a paucity of published literature regarding TAP concentrations in biological samples obtained from TAP-associated fatalities. We report a case of TAP toxicity resulting in death with postmortem peripheral and central blood concentrations, liver, vitreous, urine, and gastric contents. A 41-year-old female was found slumped over a sink at home following a welfare check by police. She was transported to a local hospital where she was pronounced dead despite all resuscitative measures. The autopsy was remarkable only for pulmonary edema and signs of aspiration pneumonia. Postmortem concentrations of TAP were confirmed in peripheral blood at 1.1mg/L, central blood 1.3mg/L, liver 9.9mg/kg, vitreous humor 0.94mg/L, urine 88mg/L, and the gastric contained 2mg. Also of note, oxycodone was found in the decedent's blood at a concentration of 0.58mg/L. We report a death related to an intentional ingestion of TAP and oxycodone-the cause and manner of death were determined to be mixed drug intoxication; suicide. We hope that the variety of TAP concentrations identified in this case provide valuable points of reference for future cases of TAP intoxication. PMID:27568082

  13. 36 CFR 520.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... narcotics. 520.8 Section 520.8 Parks, Forests, and Public Property SMITHSONIAN INSTITUTION RULES AND... § 520.8 Intoxicating beverages and narcotics. Entering the premises or the operating of a motor vehicle thereon by a person under the influence of any intoxicating beverage or narcotic drug or the use of...

  14. 36 CFR 520.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... narcotics. 520.8 Section 520.8 Parks, Forests, and Public Property SMITHSONIAN INSTITUTION RULES AND... § 520.8 Intoxicating beverages and narcotics. Entering the premises or the operating of a motor vehicle thereon by a person under the influence of any intoxicating beverage or narcotic drug or the use of...

  15. 36 CFR 520.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... narcotics. 520.8 Section 520.8 Parks, Forests, and Public Property SMITHSONIAN INSTITUTION RULES AND... § 520.8 Intoxicating beverages and narcotics. Entering the premises or the operating of a motor vehicle thereon by a person under the influence of any intoxicating beverage or narcotic drug or the use of...

  16. 36 CFR 520.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... narcotics. 520.8 Section 520.8 Parks, Forests, and Public Property SMITHSONIAN INSTITUTION RULES AND... § 520.8 Intoxicating beverages and narcotics. Entering the premises or the operating of a motor vehicle thereon by a person under the influence of any intoxicating beverage or narcotic drug or the use of...

  17. 36 CFR 520.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... narcotics. 520.8 Section 520.8 Parks, Forests, and Public Property SMITHSONIAN INSTITUTION RULES AND... § 520.8 Intoxicating beverages and narcotics. Entering the premises or the operating of a motor vehicle thereon by a person under the influence of any intoxicating beverage or narcotic drug or the use of...

  18. 32 CFR 1903.13 - Intoxicated on an Agency installation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 6 2011-07-01 2011-07-01 false Intoxicated on an Agency installation. 1903.13 Section 1903.13 National Defense Other Regulations Relating to National Defense CENTRAL INTELLIGENCE AGENCY CONDUCT ON AGENCY INSTALLATIONS § 1903.13 Intoxicated on an Agency installation. Presence on...

  19. 32 CFR 1903.13 - Intoxicated on an Agency installation.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 6 2014-07-01 2014-07-01 false Intoxicated on an Agency installation. 1903.13 Section 1903.13 National Defense Other Regulations Relating to National Defense CENTRAL INTELLIGENCE AGENCY CONDUCT ON AGENCY INSTALLATIONS § 1903.13 Intoxicated on an Agency installation. Presence on...

  20. 32 CFR 1903.13 - Intoxicated on an Agency installation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 6 2012-07-01 2012-07-01 false Intoxicated on an Agency installation. 1903.13 Section 1903.13 National Defense Other Regulations Relating to National Defense CENTRAL INTELLIGENCE AGENCY CONDUCT ON AGENCY INSTALLATIONS § 1903.13 Intoxicated on an Agency installation. Presence on...

  1. 32 CFR 1903.13 - Intoxicated on an Agency installation.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 6 2013-07-01 2013-07-01 false Intoxicated on an Agency installation. 1903.13 Section 1903.13 National Defense Other Regulations Relating to National Defense CENTRAL INTELLIGENCE AGENCY CONDUCT ON AGENCY INSTALLATIONS § 1903.13 Intoxicated on an Agency installation. Presence on...

  2. 7 CFR 500.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... USNA property is prohibited. (c) The sale of alcoholic beverages on the grounds of the USNA is... 7 Agriculture 6 2010-01-01 2010-01-01 false Intoxicating beverages and narcotics. 500.7 Section... Intoxicating beverages and narcotics. (a) Entering USNA property or the operation of a motor vehicle...

  3. 7 CFR 500.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... USNA property is prohibited. (c) The sale of alcoholic beverages on the grounds of the USNA is... 7 Agriculture 6 2014-01-01 2014-01-01 false Intoxicating beverages and narcotics. 500.7 Section... Intoxicating beverages and narcotics. (a) Entering USNA property or the operation of a motor vehicle...

  4. 7 CFR 500.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... USNA property is prohibited. (c) The sale of alcoholic beverages on the grounds of the USNA is... 7 Agriculture 6 2013-01-01 2013-01-01 false Intoxicating beverages and narcotics. 500.7 Section... Intoxicating beverages and narcotics. (a) Entering USNA property or the operation of a motor vehicle...

  5. 7 CFR 500.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... USNA property is prohibited. (c) The sale of alcoholic beverages on the grounds of the USNA is... 7 Agriculture 6 2011-01-01 2011-01-01 false Intoxicating beverages and narcotics. 500.7 Section... Intoxicating beverages and narcotics. (a) Entering USNA property or the operation of a motor vehicle...

  6. 7 CFR 500.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... USNA property is prohibited. (c) The sale of alcoholic beverages on the grounds of the USNA is... 7 Agriculture 6 2012-01-01 2012-01-01 false Intoxicating beverages and narcotics. 500.7 Section... Intoxicating beverages and narcotics. (a) Entering USNA property or the operation of a motor vehicle...

  7. ["Pathological intoxication."Diagnostic artefact or a reliable psychiatric diagnosis?].

    PubMed

    Winckler, P

    1999-09-01

    "Pathological intoxication" has been a matter of controversial discussions during the last years. On one hand diagnosis of "pathological intoxication" in forensic expertise often is associated with the assumption of legal insanity. On the other hand it has been suggested that the term "pathological intoxication" should be abandoned in favor of more accurate clinical diagnosis, and recently "alcoholic idiosyncratic intoxication" was canceled as a separate diagnosis in DSM-IV. In order to register the diagnostic habits connected with "pathological intoxication" we had sent a questionnaire to all psychiatric institutes (n = 541) in Germany. We were then able to evaluate 338 questionnaires (62.5%) relating to number of diagnoses and diagnostic criteria. In synopsis diagnostic habits turned out to be very inhomogeneous. Nearly two third of psychiatric institutes reported not to have used the diagnostic category between 1991 and 1993, whereas nearly 50% of diagnoses (210 out of 456) were reported by only 13 (3.9%) institutes. Diagnosis of "pathological intoxication" is based predominantly on vague and non-distinct criteria, such as "violent excitation" or "strange unusual behavior". In accordance to DSM-IV we therefore suggest that the diagnostic term "pathological intoxication" should be abandoned, especially in the context of forensic psychiatric expertise. Instead, assessment of intoxication must be based on individual somatic and psychopathological symptoms.

  8. 32 CFR 1903.13 - Intoxicated on an Agency installation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Intoxicated on an Agency installation. 1903.13 Section 1903.13 National Defense Other Regulations Relating to National Defense CENTRAL INTELLIGENCE AGENCY CONDUCT ON AGENCY INSTALLATIONS § 1903.13 Intoxicated on an Agency installation. Presence on...

  9. Fatal poisonings in Trabzon (Turkey).

    PubMed

    Birincioglu, Ismail; Karadeniz, Hulya; Teke, Hacer Yasar

    2011-05-01

    The aim of this study was to present the characteristics of medicolegal autopsies of fatal poisonings in Trabzon (Turkey), performed from 1998 to 2008, to contribute to the available data on this topic. A retrospective study of the forensic records and the toxicological data of all autopsies performed over that period revealed that 285 cases (6.34%) of the 4492 total autopsies performed were attributed to fatal poisoning. Major toxic substances were classified in five categories as follows: carbon monoxide (CO), insecticides, prescription medications, narcotic drugs, and alcohol (methyl and ethyl). CO was the most frequent cause of death (63.2%), followed by insecticides (17.2%), prescription medications and narcotic drugs (9.8%), alcohol (7.7%), and others (mushroom, rodenticide, and botulism) (2.1%). Ages of the patients ranged from 1 to 86 years (21.55 ± 36.56). PMID:21447071

  10. Naphazoline nasal drops intoxication in children.

    PubMed

    Vitezić, D; Rozmanić, V; Franulović, J; Ahel, V; Matesić, D

    1994-03-01

    Naphazoline, a sympathomimetic and an imidazoline derivative, is used as 0.05-0.1% solution for local decongestion of the nasal and ocular mucosa. In excessive dosage, or if ingested by accident, may cause depression of the central nervous system (disturbances of consciousness progressing to coma), hypothermia, bradycardia and sweating. These naphazoline effects are particularly strongly pronounced in children. Anglo-Saxon pharmacotherapy excludes the application of naphazoline nasal drops in children younger than six years, whereas the Croatian pharmacotherapeutic literature (and practice) allows its use even in infancy. At the Kantrida Paediatric Clinic, Clinical Hospital Centre in Rijeka, 11 children with signs of intoxication with naphazoline nasal drops were hospitalized from 1990 to 1992. The symptoms pertaining to the central nervous system i.e. disturbances of consciousness in the form of somnolence were clearly marked in all children. Some children developed skin pallor, bradycardia, bradypnoea and hypothermia. Resolution occurred within 24 hours and the findings returned to normal values. Clinical picture followed by rapid resolution and normal findings, with a personal history of drug taking, is a safe indication for diagnosis. There are several reasons to account for intoxication (drops difficult to use with children, containers inadequate for proper dosage), but the major factor is the age of the patient--all hospitalized children were younger than six years. It is pointed out that administration of naphazoline drops at an early age is not advisable.

  11. [Fatal exorcism. A case report].

    PubMed

    Vendura, K; Geserick, G

    1997-01-01

    A five-year-old girl was killed by her mother when she tried to pull the devil out of the girl's mouth by means of her hands. In that way the enlarged tonsils were pushed back and caused together with the woman's fingers a temporary closure of the hypopharynx and at least the suffocation of the child. About two years ago the woman began to show paranoic ideas exacerbating up to the fatal event.

  12. Molecular pathology of pulmonary surfactants and cytokines in drowning compared with other asphyxiation and fatal hypothermia.

    PubMed

    Miyazato, Takako; Ishikawa, Takaki; Michiue, Tomomi; Maeda, Hitoshi

    2012-07-01

    Drowning involves complex fatal factors, including asphyxiation and electrolyte/osmotic disturbances, as well as hypothermia in cold water. The present study investigated the molecular pathology of pulmonary injury due to drowning, using lung specimens from forensic autopsy cases of drowning (n = 21), acute mechanical asphyxia due to neck compression and smothering (n = 24), and hypothermia (cold exposure, n = 11), as well as those of injury (n = 23), intoxication (n = 13), fire fatality (n = 18), and acute cardiac death (n = 9) for comparison. TaqMan real-time reverse transcription polymerase chain reaction was used to quantify messenger RNA (mRNA) expressions of pulmonary surfactant-associated proteins A and D (SP-A and SP-D), tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-10. SP-A and SP-D mRNA levels were lower for drowning, mechanical asphyxiation, fire fatality, and acute cardiac deaths than for hypothermia and injury. TNF-α, IL-1β, and IL-10 mRNA levels were higher for drowning or for drowning and injury than for other groups; there was no significant difference between fire fatality, involving airway injury due to inhalation of hot/irritant gases, and other control groups. These observations suggest characteristic molecular biological patterns of pulmonary injury involving suppression of pulmonary surfactants and activation of early-phase mediators of inflammation in drowning, with high mRNA expression levels of pulmonary surfactants in fatal hypothermia; however, there was no significant difference among these markers in immunohistochemical detection, except for SP-A. These mRNA expressions can be used as markers of pulmonary injury to assist in investigations of the pathophysiology of drowning and fatal hypothermia in combination with other biochemical and biological markers.

  13. Chelation in metal intoxication XXI: chelation in lead intoxication during vitamin B complex deficiency

    SciTech Connect

    Not Available

    1986-09-01

    The vitamin B-complex deficiency increases the vulnerability to neuro- and systemic toxicity of Pb in young rats. Thus, the nutritional status of vitamins like that of protein or minerals seems to influence the etiology of Pb toxicity and may be expected to affect the response toward Pb chelators. 2,3 dimercaptosuccinic acid (DMSA) and N-(2-hydroxyethyl) ethylene-diamine triacetic acid (HEDTA) have been found to be effective antidotes to Pb intoxication. In the present study, these selective metal chelating agents were compared for their ability to reduce the body burden of Pb and restore the altered biochemical parameters in young developing Pb intoxicated rats maintained on normal or vitamin B-complex deficient diet. The investigation was aimed to suggest suitable prophylaxis of Pb poisoning prevalent among children who may also be suffering from vitamin deficiency in developing and poor countries.

  14. Toxicological and pathological findings in a series of buprenorphine related deaths. Possible risk factors for fatal outcome.

    PubMed

    Seldén, Tor; Ahlner, Johan; Druid, Henrik; Kronstrand, Robert

    2012-07-10

    Buprenorphine is considered to have little respiratory side effects at therapeutic doses and the partial agonistic properties should produce a "ceiling effect" for respiratory depression at higher doses. Still, there are several reports on buprenorphine related deaths. Most deaths involve drug users and the co-administration of other CNS depressant drugs as well as reduced tolerance have been suggested to be risk factors. The primary aims were to investigate if lack of tolerance and/or co-ingestion of other psychotropic drugs are significant risk factors in buprenorphine fatalities. From July 2005 to September 2009, all autopsy cases where buprenorphine or norbuprenorphine had been detected in femoral blood and where analysis of buprenorphine had been performed in urine were selected. Results from the postmortem examination and toxicology were compiled. Postmortem toxicology was performed using the routine methodology at the laboratory. In total, 97 subjects were included in the study. These were divided into four groups; Intoxication with buprenorphine (N=41), Possible intoxication with buprenorphine (N=24), Control cases where buprenorphine was not the cause of death (N=14), and Unclear (N=18). The metabolite to parent compound ratios in both blood and urine in the Intoxication group were significantly different from those in the Control and Unclear groups. An extensive poly-drug use was seen in all groups with several additional opioids in the Possible group (54%) and in the Unclear group (78%) and hypnotics or sedatives in more than 75% of the Intoxication, Possible, and Unclear cases. Illicit drugs were present in all groups but not to a great extent with amphetamine and tetrahydrocannabinol as the main findings. Interestingly, 4 cases in the Intoxication group presented with no other significant drugs in blood other than buprenorphine. We conclude that a lethal concentration of buprenorphine in blood cannot be defined. Instead the analysis of blood as well as

  15. Intracranial hemorrhage associated with methanol intoxication.

    PubMed

    Sebe, Ahmet; Satar, Salim; Uzun, Belkan; Topal, Metin; Yesilagac, Hasan; Avci, Andakkan

    2006-12-01

    Methanol is a common component of gasoline, antifreeze, washer fluid, perfume, household cleaners and various other industrial products. Acute methanol poisoning produces severe metabolic acidosis, serious neurologic sequelae and rarely imaging findings. In this paper, we describe a 35-year-old man with methanol intoxication who was in a comatose stage. Computed tomography (CT) showed widespread brain edema and hemorrhages localized in the supratentorial region of the temporal lobe, nearly 3 x 1 cm in a crescent shape, in the white matter surrounding the capsula externa and extending to the periventricular white matter and occipital lobes. Temporal lobe hemorrhage in our patient might also have been due to the effect of heparinization during hemodialysis, metabolic and lactic acidosis, or formate.

  16. Atropa Belladonna intoxication: a case report

    PubMed Central

    Berdai, Mohamed Adnane; Labib, Smael; Chetouani, Khadija; Harandou, Mustapha

    2012-01-01

    Atropa Belladonna is a poisonous plant also called deadly nightshade. Its roots, leaves and fruits contain alkaloids: atropine, hyocyamine and scopolamine. The risk of poisoning in children is important because of possible confusion with other berries. Atropa Belladonna acute intoxication is a severe condition, it's should be considered in the presence of anti-cholinergic toxidrome, the differential diagnosis include other plants or psychoactive drugs containing atropine. The treatment is mainly symptomatic including gastrointestinal decontamination with activated charcoal. In severe cases, physostigmine can be used as an antidote. We report the case of 11 year old girl with Atropa Belladonna poisoning which was administrated in a therapeutic purpose as a remedy to jaundice. The child presented essentially a central anti-cholinergic syndrome. She was admitted in the intensive care unit, the progression was favorable with symptomatic treatment. PMID:22655106

  17. Lithium intoxication: a coordinated treatment approach.

    PubMed

    Minden, S L; Bassuk, E L; Nadler, S P

    1993-01-01

    This case illustrates the clinical features of lithium intoxication and the problems in treating it that may arise as a result of lithium's effects on the kidney. It also demonstrates the difficulties that can develop when a delicate physiologic balance is inadvertently disrupted by nonpharmacologic interventions such as seclusion and consequent restriction of access to food and water. Patients with lithium-induced urine-concentrating defects are especially at risk for dehydration, and care must be taken to ensure adequate fluid and salt intake. This case also shows how intense negative feelings evoked by chronically mentally ill patients can adversely affect their psychiatric and medical care. While such feelings are inevitable, their impact may be lessened by improved communication and coordination between the medical and psychiatric systems of care and by the presence of psychiatrists in the general medical hospital. PMID:8419561

  18. Complete atrioventricular block caused by mad honey intoxication.

    PubMed

    Oguzturk, H; Ciftci, O; Turtay, M G; Yumrutepe, S

    2012-11-01

    The honey produced by the bees fed on Rhododendron family plants containing grayanotoxin is known as mad honey in our country. This intoxication is seen rarely. However, it may lead life-threatening hemoinstability mentioned above and may be confused with various diseases. For these reasons the exact diagnosis and treatment of this intoxication seems very important. We aim to describe a case admitted to the Emergency Department in consequence of mad honey intoxication and treated and discharged after hypotension and complete atrioventricular block development.

  19. Familial and sporadic fatal insomnia.

    PubMed

    Montagna, Pasquale; Gambetti, Pierluigi; Cortelli, Pietro; Lugaresi, Elio

    2003-03-01

    Familial fatal insomnia (FFI)--a hereditary prion disease caused by a mutation at codon 178 of the prion-protein (PrP) gene (PRNP) that leads to a D178N substitution in the protein--and its sporadic form, sporadic fatal insomnia (SFI), have similar disease phenotypes. Both disorders have clinical features of disrupted sleep (loss of sleep spindles and slow-wave sleep and enacted dreams during rapid-eye-movement sleep), autonomic hyperactivation, and motor abnormalities (myoclonus, ataxia, dysarthria, dysphagia, and pyramidal signs). PET shows pronounced thalamic and limbic hypometabolism that becomes more widespread in later stages. Neuropathological assessment reveals severe neuronal loss and astrogliosis of the anterior medial thalamus and inferior olives, with later cerebral cortical and cerebellar involvement. Accumulation of an isoform of protease-resistant PrP fragment in FFI distinct from that found in a familial form of Creutzfeldt-Jakob disease with the same D178N mutation, shows the effect of the polymorphism at codon 129 of PRNP on phenotypic expression and the possibility of distinct prion "strains" with diverse pathological potential. Intriguing clinicopathological correlations in FFI and SFI suggest a role for the thalamolimbic system in the regulation of sleep and other circadian functions.

  20. Fatal neglect of the elderly.

    PubMed

    Ortmann, C; Fechner, G; Bajanowski, T; Brinkmann, B

    2001-01-01

    Maltreatment of the elderly is a common problem that affects more than 3% of the elderly. We report on two cases of fatal neglect. Risk factors of victims and caregivers were analysed in the context of the social history. In both cases, the victims had a dominant personality and the abusers (the sons) had been strictly controlled and formed by the parent. The victims showed typical risk factors such as living together with the abuser, isolation, dependence on care, income and money administration. Initially, the victims declined help from outside and self-neglect occurred. The unemployed perpetrators lived in social isolation and depended financially and mentally on the victims. In both cases no mental illness was present but there was a decrease of social competence. Legal medicine is predominantly involved in fatal cases in connection with external post-mortem examinations and autopsies. Also in the living, the medico-legal expert can assist in the identification of findings in elderly persons in cases of suspected abuse.

  1. Severe childhood amitriptyline intoxication and plasmapheresis: a case report.

    PubMed

    Karacı, Mehmet; Özçetin, Mustafa; Dilsiz, Günter; Güçlü-Songür, Yaşar Gözde

    2013-01-01

    Tricyclic antidepressant intoxication is one of the most frequently encountered and life-threatening causes of intoxication among referrals to emergency departments due to drug intoxication. There is no known antidote against any of the tricyclic antidepressants. The American Society for Apheresis (ASFA) recommends plasmapheresis to support primary treatment in this type of drug poisoning, which does not respond to certain and traditional treatments. We present a 15-year-old girl who ingested amitriptyline with suicidal intent. On admission, she was in a comatose state (Glasgow Coma Scale score: 5), with no spontaneous respiration and presence of pathological reflexes. Due to the intake history of lethal doses and the severe clinical picture, plasmapheresis was performed. She was discharged on her fifth day of hospitalization.Due to the high plasma protein binding property of amitriptyline, plasma exchange therapy should be considered in cases of severe amitriptyline intoxication as a life-saving therapeutic modality.

  2. [Cognitive disorders in patients with chronic mercury intoxication].

    PubMed

    Katamanova, E V; Shevchenko, O I; Lakhman, O L; Denisova, I A

    2014-01-01

    To assess severity of cognitive disorders in chronic mercury intoxication, the authors performed claster and discrimination analysis of neuropsychologic and neurophysiologic research data from workers exposed to mercury during long length of service, from patients with early and marked stages of chronic mercurial intoxication. Cognitive disorders in chronic mercurial intoxication have three severity degrees, in the light degree disorders patients demonstrate lower amplitude of cognitive evoked potentials, poor long-term memory and associative thinking. Moderate cognitive disorders are characterized by decreased visual, long-term memory, concentration of attention, poor optic and spatial gnosis. Marked cognitive disorders with chronic mercurial intoxication present with more decreased long-term, short-term, picturesque memory, poor intellect, optic and spatial gnosis and associative thinking. PMID:25051667

  3. Heat fatalities in Pima County, Arizona.

    PubMed

    Keim, Samuel M; Mays, Mary Z; Parks, Bruce; Pytlak, Erik; Harris, Robin M; Kent, Michael A

    2007-03-01

    The most common cause of heat fatalities is environmental exposure during heat waves. Deserts of the southwestern USA are known for temperatures that exceed 32 degrees C for 30 days or more; yet, heat-related fatalities are rare among residents of the region. We compiled data from the National Weather Service and the Office of the Medical Examiner in order to determine the relationship between temperature and occurrence of heat fatalities in Pima County, AZ. Logistic regression indicated that for each degree of increase in temperature (degrees C), there was a 35% increase in the odds of a heat fatality occurring (p<0.001).

  4. Fatality estimator user’s guide

    USGS Publications Warehouse

    Huso, Manuela M.; Som, Nicholas; Ladd, Lew

    2012-01-01

    Only carcasses judged to have been killed after the previous search should be included in the fatality data set submitted to this estimator software. This estimator already corrects for carcasses missed in previous searches, so carcasses judged to have been missed at least once should be considered “incidental” and not included in the fatality data set used to estimate fatality. Note: When observed carcass count is <5 (including 0 for species known to be at risk, but not observed), USGS Data Series 881 (http://pubs.usgs.gov/ds/0881/) is recommended for fatality estimation.

  5. Fatality estimator user’s guide

    USGS Publications Warehouse

    Huso, Manuela M.; Som, Nicholas; Ladd, Lew

    2012-12-11

    Only carcasses judged to have been killed after the previous search should be included in the fatality data set submitted to this estimator software. This estimator already corrects for carcasses missed in previous searches, so carcasses judged to have been missed at least once should be considered “incidental” and not included in the fatality data set used to estimate fatality. Note: When observed carcass count is <5 (including 0 for species known to be at risk, but not observed), USGS Data Series 881 (http://pubs.usgs.gov/ds/0881/) is recommended for fatality estimation.

  6. Hemodialysis of acute arsenic intoxication with transient renal failure.

    PubMed

    Giberson, A; Vaziri, N D; Mirahamadi, K; Rosen, S M

    1976-11-01

    A striking reduction in serum arsenic level was achieved after four hours of hemodialysis in a patient with acute arsenic intoxication and transient renal failure. Quantitative dialysance of arsenic and a comparison of daily urinary excretion of arsenic with amount removed by dialysis suggested that hemodialysis is indicated in the treatment of acute arsenic intoxication if there is concomitant renal failure. In the presence of normal renal function, supportive measures, including dimercaprol (BAL in Oil) therapy, constitute the best available treatment.

  7. Minor heavy metal: A review on occupational and environmental intoxication

    PubMed Central

    Wiwanitkit, Viroj

    2008-01-01

    Heavy metal is widely used in industries and presents as a problematic environmental pollution. Some heavy metals, especially lead and mercury, are well described for their occupational and environmental intoxication whereas the other minor heavy metals are less concerned. In this article, the author will present the details of occupational and environmental minor heavy metal intoxication. This review focuses mainly on aluminum, tin, copper, manganese, chromium, cadmium and nickel. PMID:20040969

  8. Seizure disorders and anemia associated with chronic borax intoxication.

    PubMed

    Gordon, A S; Prichard, J S; Freedman, M H

    1973-03-17

    During the course of investigation of two infants with seizure disorders it was discovered that both had been given large amounts of a preparation of borax and honey which resulted in chronic borate intoxication. In one child a profound anemia developed as well. The symptoms of chronic borate intoxication are different from those of the acute poisoning with which we are more familiar. The borax and honey preparations are highly dangerous and should no longer be manufactured or distributed for sale.

  9. Autoerotic fatalities with power hydraulics.

    PubMed

    O'Halloran, R L; Dietz, P E

    1993-03-01

    We report two cases in which men used the hydraulic shovels on tractors to suspend themselves for masochistic sexual stimulation. One man developed a romantic attachment to a tractor, even giving it a name and writing poetry in its honor. He died accidentally while intentionally asphyxiating himself through suspension by the neck, leaving clues that he enjoyed perceptual distortions during asphyxiation. The other man engaged in sexual bondage and transvestic fetishism, but did not purposely asphyxiate himself. He died when accidentally pinned to the ground under a shovel after intentionally suspending himself by the ankles. We compare these cases with other autoerotic fatalities involving perceptual distortion, cross-dressing, machinery, and postural asphyxiation by chest compression. PMID:8454997

  10. Fatal food-induced anaphylaxis.

    PubMed

    Yunginger, J W; Sweeney, K G; Sturner, W Q; Giannandrea, L A; Teigland, J D; Bray, M; Benson, P A; York, J A; Biedrzycki, L; Squillace, D L

    1988-09-01

    Fatal food-induced anaphylaxis is rarely reported. In 16 months, we identified seven such cases involving five males and two females, aged 11 to 43 years. All victims were atopic with multiple prior anaphylactic episodes after ingestion of the incriminated food (peanut, four; pecan, one; crab, one; fish, one). In six cases the allergenic food was ingested away from home. Factors contributing to the severity of individual reactions included denial of symptoms, concomitant intake of alcohol, reliance on oral antihistamines alone to treat symptoms, and adrenal suppression by chronic glucocorticoid therapy for coexisting asthma. In no case was epinephrine administered immediately after onset of symptoms. Premortem or postmortem serum samples were available from six victims; in each case elevated levels of IgE antibodies to the incriminated food were demonstrated. Food-sensitive individuals must self-administer epinephrine promptly at the first sign of systemic reaction. Emergency care providers should be aware of cricothyrotomy as a life-saving procedure.

  11. [Management recommendations in patients with methotrexate intoxication].

    PubMed

    Schellens, J H M; Beijnen, J H

    2007-02-10

    Intoxication due to insufficient renal clearance developed in 2 patients, a 54-year-old man and a 61-year-old woman, who were under treatment with methotrexate (MTX) for a primary cerebral lymphoma and a recurrence of large-cell B-cell-non-Hodgkin lymphoma, respectively. Both were treated with folinic acid rescue, thymidine, and alkalisation of the urine. MTX is a cytotoxic drug that is often used in oncology and rheumatology. Significant and even lethal toxicity can develop when the elimination ofMTX is delayed or when supportive care, such as folinic acid rescue, is inadequate. Delayed elimination can be caused by reduced renal function, by the 'third space' phenomenon such as in case of ascites, pleural fluid accumulation and oedema, and by drug-drug interactions leading to reduced renal function or a disturbance in the plasma protein binding ofMTX. Once toxicity has developed, the therapy must be directed at protection of the normal tissues, restoration of renal function and hence the renal elimination ofMTX, restoration of the alkalisation of the urine, and general supportive therapy.

  12. An interesting thinner intoxication case: intrathoracic injection.

    PubMed

    Solak, Ilhami; Cankayali, Ilkin; Aksu, Hasim; Moral, Ali Resat

    2006-01-01

    Thinners, including aromatic hydrocarbons such as toluene, xylene, and N-hexane, are widely used in industry for the production of plastics, varnish, paint, and glue. Use of these toxic agents frequently leads to chronic intoxication caused by abuse or misuse of solvents, which are usually taken in through inhalation. Thinners may have neurotoxic, myotoxic, hepatotoxic, nephrotoxic, and cardiotoxic systemic effects. The patient described in this report attempted to commit suicide by injecting 10 cc thinner into the left hemithorax. Acute chemical empyema developed at the left hemithorax. No bacterial growth was noted in empyema liquid and blood samples. Empyema was treated with tube thoracostomy, and full remission was observed after 33 d. No systemic toxic signs were noted, other than a low level of hepatotoxicity. Although pleural effusion, atelectasis, and pleural thickening were observed at the acute phase on computed tomography (CT) of the thorax, only pleural thickening persisted on CT of the thorax after 1 y. Investigators could not find a documented case of parenteral use of thinners in the medical literature. PMID:16912033

  13. Antagonists for acute oral cadmium chloride intoxication

    SciTech Connect

    Basinger, M.A.; Jones, M.M.; Holscher, M.A.; Vaughn, W.K.

    1988-01-01

    An examination has been carried out on the relative efficacy of a number of chelating agents when acting as antagonists for oral cadmium chloride intoxication in mice. The compounds were administered orally after the oral administration of cadmium chloride at 1 mmol/kg. Of the compounds examined, several were useful in terms of enhancing survival, but by far the most effective in both enhancing survival and leaving minimal residual levels of cadmium in the liver and the kidney, was meso-2,3-dimercaptosuccinic acid (DMSA). Several polyaminocarboxylic acids also enhanced survival. The most effective of these in reducing liver and kidney levels of cadmium were diethylenetriaminepentaacetic acid (DTPA), trans-1,2-diaminocyclohexane-N,N,N'N'-tetraacetic acid (CDTA), and triethylenetetraminehexaacetic acid (TTHA). D-Penicillamine (DPA) was found to promote survival but also led to kidney cadmium levels higher than those found in the controls. Sodium 2,3-dimercaptopropane-1-sulfonate (DMPS) was as effective in promoting survival as DMSA but left levels of cadmium in the kidney and liver that were approximately four times greater than those found with DMSA.

  14. After-effects of acute alcohol intoxication.

    PubMed

    York, J L; Regan, S G

    1988-01-01

    Female, Long-Evans hooded rats (N = 10, 4 months of age) were given ethanol via intragastric intubation in doses of 2.0, 3.0 or 4.0 g/kg (repeated measures design). After-effects (hypothermia, free operant activity, motor performance) were measured at six, twelve and sixteen hours, respectively, for the above doses and were compared to the effects observed after the intubation of equivolume amounts of tap water. The after-effects of ethanol on rectal temperature were varied. Both rotarod performance and free operant activity were impaired after each of the above doses of ethanol. Blood ethanol analyses revealed low blood levels of ethanol (range 6.6 +/- 1.5 to 24.6 +/- 3.4 mg/100 ml) at the time behavioral tests were performed. Thus, quantifiable behavioral impairment was observed after blood ethanol values had declined following acute intoxication episodes. These changes may be related to "hangover" symptomatology in man and may serve as a model for investigating the influence of a variety of factors related to drug dosage, rate of ethanol ingestion, type of alcoholic beverage, and prophylactic or acute intervention therapeutics.

  15. Fatal diphenhydramine poisoning in a dog

    PubMed Central

    Buchweitz, John P.; Raverty, Stephen A.; Johnson, Margaret B.; Lehner, Andreas F.

    2014-01-01

    We report a fatal diphenhydramine poisoning of a 10-year-old, male poodle-cross dog with pre-existing conditions and suspected co-ingestion of ethanol. This case illustrates that diphenhydramine overdose can be fatal in certain circumstances and that analytical toxicology may play an important role in animal death investigations. PMID:25392554

  16. Fatal diphenhydramine poisoning in a dog.

    PubMed

    Buchweitz, John P; Raverty, Stephen A; Johnson, Margaret B; Lehner, Andreas F

    2014-11-01

    We report a fatal diphenhydramine poisoning of a 10-year-old, male poodle-cross dog with pre-existing conditions and suspected co-ingestion of ethanol. This case illustrates that diphenhydramine overdose can be fatal in certain circumstances and that analytical toxicology may play an important role in animal death investigations.

  17. Gasoline Prices and Motor Vehicle Fatalities

    ERIC Educational Resources Information Center

    Grabowski, David C.; Morrisey, Michael A.

    2004-01-01

    Fatal motor vehicle crashes per capita remained relatively stable over the 1990s, in spite of new traffic safety laws and vehicle innovations. One explanation for this stability is that the price of gasoline declined, which resulted in more vehicle miles traveled and potentially more fatalities. By using 1983-2000 monthly gasoline price and…

  18. Attention to advertising and memory for brands under alcohol intoxication.

    PubMed

    Orquin, Jacob L; Jeppesen, Heine B; Scholderer, Joachim; Haugtvedt, Curtis

    2014-01-01

    In an attempt to discover new possibilities for advertising in uncluttered environments marketers have recently begun using ambient advertising in, for instance, bars and pubs. However, advertising in such licensed premises have to deal with the fact that many consumers are under the influence of alcohol while viewing the ad. This paper examines the effect of alcohol intoxication on attention to and memory for advertisements in two experiments. Study 1 used a forced exposure manipulation and revealed increased attention to logos under alcohol intoxication consistent with the psychopharmacological prediction that alcohol intoxication narrows attention to the more salient features in the visual environment. Study 2 used a voluntary exposure manipulation in which ads were embedded in a magazine. The experiment revealed that alcohol intoxication reduces voluntary attention to ads and leads to a significant reduction in memory for the viewed ads. In popular terms consuming one or two beers reduces brand recall from 40 to 36% while being heavily intoxicated further reduces brand recall to 17%. PMID:24723899

  19. Attention to advertising and memory for brands under alcohol intoxication

    PubMed Central

    Orquin, Jacob L.; Jeppesen, Heine B.; Scholderer, Joachim; Haugtvedt, Curtis

    2014-01-01

    In an attempt to discover new possibilities for advertising in uncluttered environments marketers have recently begun using ambient advertising in, for instance, bars and pubs. However, advertising in such licensed premises have to deal with the fact that many consumers are under the influence of alcohol while viewing the ad. This paper examines the effect of alcohol intoxication on attention to and memory for advertisements in two experiments. Study 1 used a forced exposure manipulation and revealed increased attention to logos under alcohol intoxication consistent with the psychopharmacological prediction that alcohol intoxication narrows attention to the more salient features in the visual environment. Study 2 used a voluntary exposure manipulation in which ads were embedded in a magazine. The experiment revealed that alcohol intoxication reduces voluntary attention to ads and leads to a significant reduction in memory for the viewed ads. In popular terms consuming one or two beers reduces brand recall from 40 to 36% while being heavily intoxicated further reduces brand recall to 17%. PMID:24723899

  20. An Acute Acetyl Fentanyl Fatality: A Case Report With Postmortem Concentrations.

    PubMed

    McIntyre, Iain M; Trochta, Amber; Gary, Ray D; Malamatos, Mark; Lucas, Jonathan R

    2015-01-01

    In this case report, we present an evaluation of the distribution of postmortem concentrations of acetyl fentanyl in a fatality attributed to the drug. A young man who had a history of heroin abuse was found deceased at his parents' home. Toxicology testing, which initially screened positive for fentanyl by ELISA, subsequently confirmed acetyl fentanyl by gas chromatography-mass spectrometry specific ion monitoring (GC-MS SIM) analysis following liquid-liquid extraction. No other drugs or medications, including fentanyl, were detected. The acetyl fentanyl peripheral blood concentration was quantified at 260 ng/mL compared with the central blood concentration of 250 ng/mL. The liver concentration was 1,000 ng/kg, the vitreous was 240 ng/mL and the urine was 2,600 ng/mL. The cause of death was certified due to acute acetyl fentanyl intoxication, and the manner of death was certified as an accident.

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

    PubMed

    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.

  2. Lightning fatalities and injuries in Turkey

    NASA Astrophysics Data System (ADS)

    Tilev-Tanriover, Ş.; Kahraman, A.; Kadioğlu, M.; Schultz, D. M.

    2015-03-01

    A database of lightning-related fatalities and injuries in Turkey was constructed by collecting data from the Turkish State Meteorological Service, newspaper archives, European Severe Weather Database, and the internet. The database covers January 1930 to June 2014. In total, 742 lightning incidents causing human fatalities and injuries were found. Within these 742 incidents, there were 895 fatalities, 149 serious injuries, and 535 other injuries. Most of the incidents (89%) occurred during April through September, with a peak in May and June (26 and 28 %) followed by July (14%). Lightning-related fatalities and injuries were most frequent in the afternoon. Most of the incidents (86%) occurred in the rural areas, with only 14% in the urban areas. Approximately, two thirds of the victims with known gender were male. Because of the unrepresentativeness of the historical data, determining an average mortality rate over a long period is not possible. Nevertheless, there were 31 fatalities (0.42 per million) in 2012, 26 fatalities (0.35 per million) in 2013, and 25 fatalities (0.34 per million) in 2014 (as of June). There were 36 injuries (0.49 per million) in each of 2012 and 2013, and 62 injuries (0.84 per million) in 2014 (as of June).

  3. Lightning fatalities and injuries in Turkey

    NASA Astrophysics Data System (ADS)

    Tilev-Tanriover, Ş.; Kahraman, A.; Kadioğlu, M.; Schultz, D. M.

    2015-08-01

    A database of lightning-related fatalities and injuries in Turkey was constructed by collecting data from the Turkish State Meteorological Service, newspaper archives, European Severe Weather Database, and the internet. The database covers January 1930 to June 2014. In total, 742 lightning incidents causing human fatalities and injuries were found. Within these 742 incidents, there were 895 fatalities, 149 serious injuries, and 535 other injuries. Most of the incidents (89 %) occurred during April through September, with a peak in May and June (26 and 28 %) followed by July (14 %). Lightning-related fatalities and injuries were most frequent in the afternoon. Most of the incidents (86 %) occurred in rural areas, with only 14 % in the urban areas. Approximately, two thirds of the victims with known gender were male. Because of the unrepresentativeness of the historical data, determining an average mortality rate over a long period is not possible. Nevertheless, there were 31 fatalities (0.42 per million) in 2012, 26 fatalities (0.35 per million) in 2013, and 25 fatalities (0.34 per million) in 2014 (as of June). There were 36 injuries (0.49 per million) in each of 2012 and 2013, and 62 injuries (0.84 per million) in 2014 (as of June).

  4. Copper storage disease of the liver and chronic dietary copper intoxication in two further German infants mimicking Indian childhood cirrhosis.

    PubMed

    Müller-Höcker, J; Meyer, U; Wiebecke, B; Hübner, G; Eife, R; Kellner, M; Schramel, P

    1988-02-01

    A severe copper storage disease of the liver with micronodular cirrhosis resembling Indian childhood cirrhosis (ICC) was found in two siblings of a German family leading to death in one infant at the age of 13 months. The fatal outcome correlated with severe ballooning of hepatocytes and excessive formation of Mallory bodies. The copper content of the liver was 698 micrograms per gramme wet weight (control 5 micrograms) in the living patient and 2154 micrograms per gramme dry weight (controls 39, 54 micrograms) in the dead infant. In both cases copper was stored not only in hepatocytes but also to a high degree in mesenchymal cells. Chronic contamination of drinking water supplied from a well via copper pipes could be verified as the cause of copper intoxication, lending further support to ICC as an environmental, acquired disorder. Accumulation of exogenic copper already very early in infancy appears most important for the development of the disease, as both the parents and one child not exposed to copper intoxication during the first 9 months of its life are clinically healthy.

  5. Copper storage disease of the liver and chronic dietary copper intoxication in two further German infants mimicking Indian childhood cirrhosis.

    PubMed

    Müller-Höcker, J; Meyer, U; Wiebecke, B; Hübner, G; Eife, R; Kellner, M; Schramel, P

    1988-02-01

    A severe copper storage disease of the liver with micronodular cirrhosis resembling Indian childhood cirrhosis (ICC) was found in two siblings of a German family leading to death in one infant at the age of 13 months. The fatal outcome correlated with severe ballooning of hepatocytes and excessive formation of Mallory bodies. The copper content of the liver was 698 micrograms per gramme wet weight (control 5 micrograms) in the living patient and 2154 micrograms per gramme dry weight (controls 39, 54 micrograms) in the dead infant. In both cases copper was stored not only in hepatocytes but also to a high degree in mesenchymal cells. Chronic contamination of drinking water supplied from a well via copper pipes could be verified as the cause of copper intoxication, lending further support to ICC as an environmental, acquired disorder. Accumulation of exogenic copper already very early in infancy appears most important for the development of the disease, as both the parents and one child not exposed to copper intoxication during the first 9 months of its life are clinically healthy. PMID:3362750

  6. Estimating Side Underride Fatalities Using Field Data

    PubMed Central

    Padmanaban, Jeya

    2013-01-01

    There is evidence that underride events are undercounted by the Fatality Analysis Reporting System (FARS), a census of fatal crashes on public roads in the United States. This study’s principal objective was to develop accurate fatality estimates for side underride crashes involving “combination trucks” and light vehicles. Police reports from 29 states were used to estimate the incidence of fatal crashes in which light vehicles underrode the sides of large combination trucks. A protocol was developed to judge the presence of underride with passenger compartment intrusion (PCI), and an in-depth manual review of police reports was performed using scene diagrams, narratives, vehicle and occupant data. The incidence of fatal underride was then compared to that reported in FARS to determine the extent of underreporting in FARS. Further, a comprehensive review of side underride crashes resulting in fatalities and injuries was made using the Large Truck Crash Causation Study (LTCCS) data, the most comprehensive database on large truck crashes. Results show that only a small proportion of the light vehicle occupant fatalities resulting from collisions with combination trucks involve a side underride, and an even smaller proportion involve a side underride with PCI. An in-depth review shows the ratio of underreporting of side underride crashes in FARS is a factor of 3.1 (CI: 2.9–3.3); thus, the annual number of light vehicle side underride fatalities with PCI is estimated to be 202 (CI: 189–215). Comparison of FARS / LTCCS data shows results consistent with this underreporting estimate. LTCCS data also shows that non-fatal serious injuries to light vehicle occupants in side underride crashes involving combination trucks are extremely rare. PMID:24406960

  7. Rise in landing-related skydiving fatalities.

    PubMed

    Hart, Christian L; Griffith, James D

    2003-10-01

    The purpose was to assess whether adoption of potentially dangerous skydiving gear and skydiving practices has led to an increase in fatalities. Beginning in the early 1990s, civilian skydivers began to utilize high performance parachutes that fly much faster and are much more responsive than older style parachutes. Also, skydivers began to fly these parachutes in a more aggressive manner. An analysis of data from the 507 skydiving fatalities in the USA between 1986 and 2001 indicated that this shift toward high performance parachutes and aggressive flying techniques was temporally associated with an increase in parachute-landing deaths. During the same time period, the total number of fatalities remained fairly stable.

  8. Petechial Hemorrhages and Ethanol in Deaths from Intoxication.

    PubMed

    Flaagøy, Siren Helen; Morild, Inge; Maehle, Bjørn Ove; Lilleng, Peer Kaare

    2016-09-01

    Petechiae in conjunctivae and in the palpebrae/skin of the eyelids are of particular interest for the forensic pathologist, because of their association with pressure on the neck. They have been described in the eyelids of intoxicated persons both in case reports and in text books of forensic pathology. We studied 590 deaths caused by intoxication, and 75 had petechiae either in the conjunctivae, the eyelids, or in both locations. We examined the influence of drugs and ethanol on the location of the petechial hemorrhages in these deaths. Deaths with ethanol in blood and in urine/vitreous humor more often had petechiae in both locations than those without. This association was statistically significant, independent of body position and livor mortis. No association between the location of petechiae, medicinal drugs, or narcotics was found. These results suggest that ethanol may contribute to the development of petechial hemorrhages in deaths from intoxication. PMID:27341349

  9. Methyltin intoxication in six men; toxicologic and clinical aspects

    SciTech Connect

    Rey, C.; Reinecke, H.J.; Besser, R.

    1984-04-01

    Neurologic and psychiatric symptoms such as headache, tinnitus, defective hearing, changing desorientation and aggressiveness are initial symptoms of methyltin chloride intoxication. Some patients also developed epileptic equivalents, such as dreamy attacks and central ventilation transaminases. Laboratory findings included low levels of serum potassium, leucocytosis and elevated transaminases. The excretion rate of tin in the urine correlated with the severity of the intoxication. There was no measurable effect of plasma separation or d-penicillamine therapy on tin excretion in the urine or on the clinical picture. The long-term prognosis of severely intoxicated persons is poor. To prevent such events workers need to be warned of the risk and dangers of working with organo-metallic compounds. The effectiveness of protective clothes and gas masks should be checked. In exposed workers regular testing is advised of tin concentrations in the urine.

  10. Blood cyanide determination in two cases of fatal intoxication: comparison between headspace gas chromatography and a spectrophotometric method.

    PubMed

    Gambaro, Veniero; Arnoldi, Sebastiano; Casagni, Eleonora; Dell'acqua, Lucia; Pecoraro, Chiara; Froldi, Rino

    2007-11-01

    Blood samples of two cases were analyzed preliminarily by a classical spectrophotometric method (VIS) and by an automated headspace gas chromatographic method with nitrogen-phosphorus detector (HS-GC/NPD). In the former, hydrogen cyanide (HCN) was quantitatively determined by measuring the absorbance of chromophores forming as a result of interaction with chloramine T. In the automated HS-GC/NPD method, blood was placed in a headspace vial, internal standard (acetonitrile) and acetic acid were then added. This resulted in cyanide being liberated as HCN. The spectrophotometric (VIS) and HS-GC/NPD methods were validated on postmortem blood samples fortified with potassium cyanide in the ranges 0.5-10 and 0.05-5 mug/mL, respectively. Detection limits were 0.2 mug/mL for VIS and 0.05 mug/mL for HS-GC/NPD. This work shows that results obtained by means of the two procedures were insignificantly different and that they compared favorably. They are suitable for rapid diagnosis of cyanide in postmortem cases.

  11. Forensic application of ESEM and XRF-EDS techniques to a fatal case of sodium phosphate enema intoxication.

    PubMed

    Viel, G; Cecchetto, G; Fabbri, L D; Furlan, C; Ferrara, S D; Montisci, M

    2009-07-01

    Sodium phosphate enemas and laxatives are widely used for the treatment of constipation, even if a number of cases of significant toxicity due to alterations of the fluid and electrolyte equilibria (hypernatremia, hyperphosphatemia, and hypocalcemia) have been reported. We present the case of an 83-year-old man who died of fecal and chemical peritonitis secondary to an iatrogenic colon perforation (produced performing a Fleet enema through the patient's iliac colostomy) with peritoneal absorption of sodium phosphate. Environmental scanning electron microscopy coupled with an X-ray fluorescence energy dispersive spectrometry discovered multiple bright crystals formed of calcium, phosphorus, and oxygen in the brain, heart, lung, and kidney sections of the victim. The absence of these kinds of precipitates in two control samples chronically treated with Fleet enemas led us to assume that the deceased had adsorbed a great quantity of phosphorus ions from the peritoneal cavity with subsequent systemic dissemination and precipitation of calcium phosphate bindings. PMID:19347348

  12. State Occupational Injuries, Illnesses, and Fatalities

    MedlinePlus

    ... FAQS CONTACT IIF SEARCH IIF Contact Us State Occupational Injuries, Illnesses, and Fatalities Overview of State data available ... Texas Department of Insurance Division of Workers' Compensation Workplace Safety, MS-23 7551 Metro Center Drive, Suite 100 ...

  13. Peripheral neuropathy in lead-intoxicated sickle cell patients.

    PubMed

    Imbus, C E; Warner, J; Smith, E; Pegelow, C H; Allen, J P; Powars, D R

    1978-01-01

    Peripheral neuropathy and hypertension caused by lead intoxication are reported in two children with sickle cell anemia. One child had generalized weakness in the initial occurrence and distal paralysis during a relapse two years later. The second child had foot and wrist drop. Both had slow peripheral nerve conduction velocities during the episodes. Chelation therapy was successful and resulted in a return of strength (over a period of several months) and a normalization of the blood pressures. Children with sickle cell anemia who are subjected to lead intoxication appear to be predisposed to peripheral nerve damage.

  14. Arsenic intoxication presenting with macrocytosis and peripheral neuropathy, without anemia.

    PubMed

    Heaven, R; Duncan, M; Vukelja, S J

    1994-01-01

    A case of arsenic intoxication associated with macrocytosis and neuropathy, without anemia, is presented. Evaluation of a 68-year-old man with a long history of peripheral neuropathy and persistent macrocytosis revealed exposure to an insecticide. Analysis of urine and hair revealed elevated levels of arsenic. A short course of d-penicillamine failed to promote urinary excretion of arsenic. Removal of the insecticide resulted in resolution of macrocytosis and slight improvement of neuropathy. This case emphasizes that arsenic intoxication should be considered in patients with macrocytosis with peripheral neuropathy, even in the absence of anemia.

  15. Arsenic intoxication as a cause of megaloblastic anemia.

    PubMed

    Westhoff, D D; Samaha, R J; Barnes, A

    1975-02-01

    We have described a case of chronic arsenic intoxication associated with pancytopenia and megaloblastic erythropoiesis. The patient had the typical laboratory manifestations of effective erythorpoiesis due to a megaloblastic process, including macroovalocytes, mild pancytopenia, low reticulocyte index, increased marrow cellularity with erythroid hyperplasia, and morphologic evidence of megaloblastic maturation in the marrow. The patient's serum folate and vitamin B12 were normal, and the anemia regressed without therapy. Our case suggests that the combination of megaloblastosis with normoblastic or megaloblastic karyorrhexis,should raise the suspicion of arsenic intoxication in the mind of the observer. In addition, arsenic should be added to the list of agents causing a reversible megaloblastic anemia.

  16. Behavioral assessment of NIH Swiss mice acutely intoxicated with tetramethylenedisulfotetramine.

    PubMed

    Flannery, Brenna M; Silverman, Jill L; Bruun, Donald A; Puhger, Kyle R; McCoy, Mark R; Hammock, Bruce D; Crawley, Jacqueline N; Lein, Pamela J

    2015-01-01

    Tetramethylenedisulfotetramine (TETS) is a potent convulsant poison that is thought to trigger seizures by inhibiting the function of the type A gamma-aminobutyric acid receptor (GABAAR). Acute intoxication with TETS can cause vomiting, convulsions, status epilepticus (SE) and even death. Clinical case reports indicate that individuals who survive poisoning may exhibit long-term neuropsychological issues and cognitive deficits. Therefore, the objective of this research was to determine whether a recently described mouse model of acute TETS intoxication exhibits persistent behavioral deficits. Young adult male NIH Swiss mice received a seizure-inducing dose of TETS (0.15mg/kg, ip) and then were rescued from lethality by administration of diazepam (5mg/kg, ip) approximately 20min post-TETS-exposure. TETS-intoxicated mice typically exhibited 2 clonic seizures prior to administration of diazepam with no subsequent seizures post-diazepam injection as assessed using behavioral criteria. Seizures lasted an average of 72s. Locomotor activity, anxiety-like and depression-relevant behaviors and cognition were assessed at 1week, 1month and 2months post-TETS exposure using open field, elevated-plus maze, light↔dark transitions, tail suspension, forced swim and novel object recognition tasks. Interestingly, preliminary validation tests indicated that NIH Swiss mice do not respond to the shock in fear conditioning tasks. Subsequent evaluation of hot plate and tail flick nociception tasks revealed that this strain exhibits significantly decreased pain sensitivity relative to age- and sex-matched C57BL/6J mice, which displayed normal contextual fear conditioning. NIH Swiss mice acutely intoxicated with TETS exhibited no significant anxiety-related, depression-relevant, learning or memory deficits relative to vehicle controls at any of the time points assessed with the exception of significantly increased locomotor activity at 2months post-TETS intoxication. The general absence

  17. Seizure disorders and anemia associated with chronic borax intoxication

    PubMed Central

    Gordon, A. S.; Prichard, J. S.; Freedman, M. H.

    1973-01-01

    During the course of investigation of two infants with seizure disorders it was discovered that both had been given large amounts of a preparation of borax and honey which resulted in chronic borate intoxication. In one child a profound anemia developed as well. The symptoms of chronic borate intoxication are different from those of the acute poisoning with which we are more familiar. The borax and honey preparations are highly dangerous and should no longer be manufactured or distributed for sale. ImagesFIG. 1FIG. 2 PMID:4691106

  18. Copper intoxication inhibits aerobic nucleotide synthesis in Streptococcus pneumoniae

    PubMed Central

    Johnson, Michael D. L.; Kehl-Fie, Thomas E.; Rosch, Jason W.

    2015-01-01

    Copper is universally toxic in excess, a feature exploited by the human immune system to facilitate bacterial clearance. The mechanism of copper intoxication remains unknown for many bacterial species. Here, we demonstrate that copper toxicity in Streptococcus pneumoniae is independent from oxidative stress but, rather, is the result of copper inhibiting the aerobic dNTP biosynthetic pathway. Furthermore, we show that copper-intoxicated S. pneumoniae is rescued by manganese, which is an essential metal in the aerobic nucleotide synthesis pathway. These data provide insight into new targets to enhance copper-mediated toxicity during bacterial clearance. PMID:25730343

  19. We use Continuous Renal Replacement Therapy for Overdoses and Intoxications.

    PubMed

    Cabrera, Valerie Jorge; Shirali, Anushree C

    2016-07-01

    Extracorporeal modalities for the removal of drugs and toxins are indicated for the treatment of overdoses and intoxications. Well-established modalities include hemodialysis (HD), high-flux HD (HfD), and charcoal hemoperfusion (HP). Recently, there have been increasing reports on the use of continuous renal replacement therapy (CRRT), such as continuous veno-venous hemodialysis (CVVHD), continuous veno-venous hemofiltration (CVVH) or CVVH combined with dialysis (CVVHDF). In the present article, we will discuss the various factors that determine the clearance of drugs and toxins and accordingly, we will propose that with few exceptions, CRRT does not have a role in the routine management of intoxications.

  20. Fatalities due to anaphylactic reactions to foods.

    PubMed

    Bock, S A; Muñoz-Furlong, A; Sampson, H A

    2001-01-01

    Fatal anaphylactic reactions to foods are continuing to occur, and better characterization might lead to better prevention. The objective of this report is to document the ongoing deaths and characterize these fatalities. We analyzed 32 fatal cases reported to a national registry, which was established by the American Academy of Allergy, Asthma, and Immunology, with the assistance of the Food Allergy and Anaphylaxis Network, and for which adequate data could be collected. Data were collected from multiple sources including a structured questionnaire, which was used to determine the cause of death and associated factors. The 32 individuals could be divided into 2 groups. Group 1 had sufficient data to identify peanut as the responsible food in 14 (67%) and tree nuts in 7 (33%) of cases. In group 2 subjects, 6 (55%) of the fatalities were probably due to peanut, 3 (27%) to tree nuts, and the other 2 cases were probably due to milk and fish (1 [9%] each). The sexes were equally affected; most victims were adolescents or young adults, and all but 1 subject were known to have food allergy before the fatal event. In those subjects for whom data were available, all but 1 was known to have asthma, and most of these individuals did not have epinephrine available at the time of their fatal reaction. Fatalities due to ingestion of allergenic foods in susceptible individuals remain a major health problem. In this series, peanuts and tree nuts accounted for more than 90% of the fatalities. Improved education of the profession, allergic individuals, and the public will be necessary to stop these tragedies.

  1. Skin diving fatalities in New Zealand.

    PubMed

    Lewis, P R

    1979-06-27

    A review of skin diving fatalities in New Zealand for the period 1961--1973 revealed 28 deaths of which 21 were scuba divers. Two-thirds of the scuba deaths occurred in water less than 15m deep. Running out of air and lack of essential equipment were frequent contributory factors. The pathological findings are presented and show drowning to be the most common mode of death. Some deficiences in the assessment of these fatalities are discussed.

  2. Arcing injuries in a fatal electrocution.

    PubMed

    Nagesh, K R; Kanchan, Tanuj; Rastogi, Prateek; Arun, M

    2009-06-01

    Electric arc injuries tend to be very severe and can cause skin burns by direct heat exposure or by igniting clothes. It produces intense heat, and fatal lesions can occur even when the victim is several feet from the arc. A fatal case of accidental high-voltage electrocution is reported, where multiple skin to bone-deep oval and circular lesions of varying dimensions caused by arcing was present. PMID:19465814

  3. Evaluation of Cholinesterase Activities During in Vivo Intoxication Using an Electrochemical Sensor Strip – Correlation With Intoxication Symptoms

    PubMed Central

    Pohanka, Miroslav; Novotný, Ladislav; Misík, Jan; Kuca, Kamil; Zdarova-Karasova, Jana; Hrabinova, Martina

    2009-01-01

    Cholinesterase activity in blood of laboratory rats was monitored. Rats were intoxicated with paraoxon at dosis of 0 – 65 – 125 – 170 – 250 – 500 nmol. The 250 nmol dose was found to be the LD50. An electrochemical sensor was found useful to provide information about cholinesterase activity. The decrease of cholinesterase activity was correlated to intoxication symptoms and mortality level. It was found that the symptoms of intoxication are not observed while at least 50% of cholinesterase activity in blood remains. The minimal cholinesterase activity essential to survival is around 10%, when compared with the initial state. No changes in levels of low moleculary weight antioxidants were observed. PMID:22412329

  4. Prolonged neuropsychiatric effects following management of chloroquine intoxication with psychotropic polypharmacy

    PubMed Central

    Maxwell, Nicole M; Nevin, Remington L; Stahl, Stephen; Block, Jerald; Shugarts, Sarah; Wu, Alan H B; Dominy, Stephen; Solano-Blanco, Miguel Alonso; Kappelman-Culver, Sharon; Lee-Messer, Christopher; Maldonado, Jose; Maxwell, Andrew J

    2015-01-01

    Key Clinical Message Susceptibility to quinoline antimalarial intoxication may reflect individual genetic and drug-induced variation in neuropharmacokinetics. In this report, we describe a case of chloroquine intoxication that appeared to be prolonged by subsequent use of multiple psychotropic medications. This case highlights important new considerations for the management of quinoline antimalarial intoxication. PMID:26185633

  5. Atropine intoxication from the ingestion and smoking of jimson weed (Datura stramonium).

    PubMed

    Guharoy, S R; Barajas, M

    1991-12-01

    Anticholinergic effects occur due to jimson weed intoxication. The most common intoxication involves teenagers desiring mind-altering properties from the plant. We report 4 cases of jimson weed intoxication due to ingestion and inhalation (smoking) of jimson weed. Clinicians should be aware of the potential abuse of botanicals such as jimson weed. PMID:1808839

  6. 36 CFR 504.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... narcotics. 504.7 Section 504.7 Parks, Forests, and Public Property SMITHSONIAN INSTITUTION RULES AND... narcotics. Entering the premises or the operating of a motor vehicle thereon by a person under the influence of any intoxicating beverage or narcotic drug or the use of such drug in or on the premises...

  7. 36 CFR 504.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... narcotics. 504.7 Section 504.7 Parks, Forests, and Public Property SMITHSONIAN INSTITUTION RULES AND... narcotics. Entering the premises or the operating of a motor vehicle thereon by a person under the influence of any intoxicating beverage or narcotic drug or the use of such drug in or on the premises...

  8. 36 CFR 504.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... narcotics. 504.7 Section 504.7 Parks, Forests, and Public Property SMITHSONIAN INSTITUTION RULES AND... narcotics. Entering the premises or the operating of a motor vehicle thereon by a person under the influence of any intoxicating beverage or narcotic drug or the use of such drug in or on the premises...

  9. 36 CFR 504.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... narcotics. 504.7 Section 504.7 Parks, Forests, and Public Property SMITHSONIAN INSTITUTION RULES AND... narcotics. Entering the premises or the operating of a motor vehicle thereon by a person under the influence of any intoxicating beverage or narcotic drug or the use of such drug in or on the premises...

  10. 36 CFR 504.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... narcotics. 504.7 Section 504.7 Parks, Forests, and Public Property SMITHSONIAN INSTITUTION RULES AND... narcotics. Entering the premises or the operating of a motor vehicle thereon by a person under the influence of any intoxicating beverage or narcotic drug or the use of such drug in or on the premises...

  11. Superwarfarin intoxication: hematuria is a major clinical manifestation.

    PubMed

    Wu, Yi-Feng; Chang, Cheng-Shyong; Chung, Chih-Yuan; Lin, Hsuan-Yu; Wang, Chuan-Cheng; Shen, Ming-Ching

    2009-09-01

    Since superwarfarin is popular and readily available in stores, it may cause intoxication or overexposure, which can result in coagulopathy or abnormal bleeding in humans and, thus, is an important public health problem. We report our clinical experience with superwarfarin intoxication. Nine patients, including eight patients who had histories of ingesting superwarfarin, were studied. Of the patients, hematuria occurred in eight. Laboratory tests among the nine patients showed extremely prolonged prothrombin times and activated partial thromboplastin times, which could be corrected to normal by mixing 1:1 with normal pooled plasma; they also had very low functional levels of factor II, VII, IX, X, and proteins C and S, but normal functional levels of factors V, VIII, fibrinogen, and anti-thrombin III. Large doses of vitamin K1 were needed for 3 months or more to treat and correct the coagulopathy among the patients. The majority of the patients presented with gross hematuria, suggesting that hematuria is probably a major clinical manifestation of superwarfarin intoxication. Prolonged use of large doses of vitamin K1 is needed for the treatment of superwarfarin intoxication.

  12. Chronic Vitamin D Intoxication in Captive Iberian Lynx (Lynx pardinus).

    PubMed

    Lopez, Ignacio; Pineda, Carmen; Muñoz, Luis; Raya, Ana; Lopez, Guillermo; Aguilera-Tejero, Escolástico

    2016-01-01

    To document the biochemical and pathologic features of vitamin D intoxication in lynx and to characterize mineral metabolism in healthy lynx, blood samples were obtained from 40 captive lynx that had been receiving excessive (approximately 30 times the recommended dose) vitamin D3 in the diet, and from 29 healthy free ranging lynx. Tissue samples (kidney, stomach, lung, heart and aorta) were collected from 13 captive lynx that died as a result of renal disease and from 3 controls. Vitamin D intoxication resulted in renal failure in most lynx (n = 28), and widespread extraskeletal calcification was most severe in the kidneys and less prominent in cardiovascular tissues. Blood minerals and calciotropic hormones in healthy lynx were similar to values reported in domestic cats except for calcitriol which was higher in healthy lynx. Changes in mineral metabolism after vitamin D intoxication included hypercalcemia (12.0 ± 0.3 mg/dL), hyperphosphatemia (6.3 ± 0.4 mg/dL), increased plasma calcidiol (381.5 ± 28.2 ng/mL) and decreased plasma parathyroid hormone (1.2 ± 0.7 pg/mL). Hypercalcemia and, particularly, hyperphosphatemia were of lower magnitude that what has been previously reported in the course of vitamin D intoxication in other species. However, extraskeletal calcifications were severe. The data suggest that lynx are sensitive to excessive vitamin D and extreme care should be taken when supplementing this vitamin in captive lynx diets. PMID:27243456

  13. 7 CFR 503.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 6 2014-01-01 2014-01-01 false Intoxicating beverages and narcotics. 503.8 Section 503.8 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON PLUM ISLAND ANIMAL DISEASE CENTER § 503.8...

  14. 7 CFR 503.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 6 2011-01-01 2011-01-01 false Intoxicating beverages and narcotics. 503.8 Section 503.8 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON PLUM ISLAND ANIMAL DISEASE CENTER § 503.8...

  15. 7 CFR 503.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 6 2012-01-01 2012-01-01 false Intoxicating beverages and narcotics. 503.8 Section 503.8 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON PLUM ISLAND ANIMAL DISEASE CENTER § 503.8...

  16. 7 CFR 503.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 6 2013-01-01 2013-01-01 false Intoxicating beverages and narcotics. 503.8 Section 503.8 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON PLUM ISLAND ANIMAL DISEASE CENTER § 503.8...

  17. 7 CFR 503.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Intoxicating beverages and narcotics. 503.8 Section 503.8 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON PLUM ISLAND ANIMAL DISEASE CENTER § 503.8...

  18. Chronic Vitamin D Intoxication in Captive Iberian Lynx (Lynx pardinus).

    PubMed

    Lopez, Ignacio; Pineda, Carmen; Muñoz, Luis; Raya, Ana; Lopez, Guillermo; Aguilera-Tejero, Escolástico

    2016-01-01

    To document the biochemical and pathologic features of vitamin D intoxication in lynx and to characterize mineral metabolism in healthy lynx, blood samples were obtained from 40 captive lynx that had been receiving excessive (approximately 30 times the recommended dose) vitamin D3 in the diet, and from 29 healthy free ranging lynx. Tissue samples (kidney, stomach, lung, heart and aorta) were collected from 13 captive lynx that died as a result of renal disease and from 3 controls. Vitamin D intoxication resulted in renal failure in most lynx (n = 28), and widespread extraskeletal calcification was most severe in the kidneys and less prominent in cardiovascular tissues. Blood minerals and calciotropic hormones in healthy lynx were similar to values reported in domestic cats except for calcitriol which was higher in healthy lynx. Changes in mineral metabolism after vitamin D intoxication included hypercalcemia (12.0 ± 0.3 mg/dL), hyperphosphatemia (6.3 ± 0.4 mg/dL), increased plasma calcidiol (381.5 ± 28.2 ng/mL) and decreased plasma parathyroid hormone (1.2 ± 0.7 pg/mL). Hypercalcemia and, particularly, hyperphosphatemia were of lower magnitude that what has been previously reported in the course of vitamin D intoxication in other species. However, extraskeletal calcifications were severe. The data suggest that lynx are sensitive to excessive vitamin D and extreme care should be taken when supplementing this vitamin in captive lynx diets.

  19. The Impact of Behavioral Signs of Intoxication on Bartender Service

    ERIC Educational Resources Information Center

    Goodsite, Billie; Klear, Lacey; Rosenberg, Harold

    2008-01-01

    Objective: The present study was designed to assess whether the serving practices of a sample of bartenders in an American university town would vary as a function of the number of behavioral cues of intoxication displayed by apparently real patrons (who were actually experimental confederates). Method: We trained two male and three female…

  20. 7 CFR 501.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Intoxicating beverages and narcotics. 501.7 Section 501.7 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON U.S. MEAT ANIMAL RESEARCH CENTER, CLAY CENTER,...

  1. 7 CFR 501.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 6 2012-01-01 2012-01-01 false Intoxicating beverages and narcotics. 501.7 Section 501.7 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON U.S. MEAT ANIMAL RESEARCH CENTER, CLAY CENTER,...

  2. 7 CFR 501.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 6 2011-01-01 2011-01-01 false Intoxicating beverages and narcotics. 501.7 Section 501.7 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON U.S. MEAT ANIMAL RESEARCH CENTER, CLAY CENTER,...

  3. 7 CFR 501.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 6 2013-01-01 2013-01-01 false Intoxicating beverages and narcotics. 501.7 Section 501.7 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON U.S. MEAT ANIMAL RESEARCH CENTER, CLAY CENTER,...

  4. 7 CFR 501.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 6 2014-01-01 2014-01-01 false Intoxicating beverages and narcotics. 501.7 Section 501.7 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON U.S. MEAT ANIMAL RESEARCH CENTER, CLAY CENTER,...

  5. Chronic Vitamin D Intoxication in Captive Iberian Lynx (Lynx pardinus)

    PubMed Central

    Muñoz, Luis; Raya, Ana; Lopez, Guillermo; Aguilera-Tejero, Escolástico

    2016-01-01

    To document the biochemical and pathologic features of vitamin D intoxication in lynx and to characterize mineral metabolism in healthy lynx, blood samples were obtained from 40 captive lynx that had been receiving excessive (approximately 30 times the recommended dose) vitamin D3 in the diet, and from 29 healthy free ranging lynx. Tissue samples (kidney, stomach, lung, heart and aorta) were collected from 13 captive lynx that died as a result of renal disease and from 3 controls. Vitamin D intoxication resulted in renal failure in most lynx (n = 28), and widespread extraskeletal calcification was most severe in the kidneys and less prominent in cardiovascular tissues. Blood minerals and calciotropic hormones in healthy lynx were similar to values reported in domestic cats except for calcitriol which was higher in healthy lynx. Changes in mineral metabolism after vitamin D intoxication included hypercalcemia (12.0 ± 0.3 mg/dL), hyperphosphatemia (6.3 ± 0.4 mg/dL), increased plasma calcidiol (381.5 ± 28.2 ng/mL) and decreased plasma parathyroid hormone (1.2 ± 0.7 pg/mL). Hypercalcemia and, particularly, hyperphosphatemia were of lower magnitude that what has been previously reported in the course of vitamin D intoxication in other species. However, extraskeletal calcifications were severe. The data suggest that lynx are sensitive to excessive vitamin D and extreme care should be taken when supplementing this vitamin in captive lynx diets. PMID:27243456

  6. Celebratory Drinking and Intoxication: A Contextual Influence on Alcohol Consumption

    ERIC Educational Resources Information Center

    Glindemann, Kent E.; Wiegand, Douglas M.; Geller, E. Scott

    2007-01-01

    Two field studies measured college students' actual intoxication levels using handheld breathalyzers on Halloween and St. Patrick's Day and compared these celebration days to typical nights surrounding these events. In addition, across all nights of Study 2, participants were asked if they were celebrating any occasion or event that night, and…

  7. DWI [Driving While Intoxicated] Law Enforcement Training Project: Student Manual.

    ERIC Educational Resources Information Center

    Carnahan, James E.; And Others

    The student manual has been prepared to serve as a workbook to assist the student officer in successfully completing the Driving While Intoxicated (DWI) Law Enforcement Training Course. It is organized under 16 subject headings (orientation, alcohol and highway safety, preparation for alcohol enforcement task, detection of the drinking…

  8. DWI [Driving While Intoxicated] Law Enforcement Training Project: Instructor's Manual.

    ERIC Educational Resources Information Center

    Carnahan, James E.; And Others

    The Driving While Intoxicated (DWI) Law Enforcement Training Program has been developed to provide the alcohol enforcement officer trainee with working knowledge and skills which will enable him to effectively carry out his alcohol enforcement tasks. The instructor's manual has been prepared to serve as a text to assist the instructor in…

  9. Korean Patients with Superwarfarin Intoxication and Their Outcome

    PubMed Central

    Hong, Junshik; Yhim, Ho-Young; Bae, Sung Hwa; Yuh, Young Jin; Yoon, Sung-Soo; Yoon, Hwi-Joong; Kim, Seung Taik; Chi, Hyun-Sook

    2010-01-01

    This observational study aimed at evaluating recent superwarfarin intoxication of Korean patients. Ten patients were diagnosed as or highly suspicious for superwarfarin intoxication. Case report forms described by attending hematologists of the patients were collected and analyzed. Bleeding symptoms were varied among the patients. Patients uniformly showed prolonged prothrombin time (PT) and activated thromboplastin time (aPTT) with decreased activity of vitamin K dependent coagulation factors. Positive serum brodifacoum test results in 4 of 5 requested patients contributed to confirmatory diagnosis. Psychiatric interview revealed an attempted ingestion in one patient. High dose vitamin K1 therapy promptly corrected prolonged PT and aPTT, but hasty discontinuation caused repeated bleeding diathesis in 6 patients. Route of intoxication was unknown or not definite among 8 of 10 patients. Three patients had a possibility of environmental exposure considering their occupations: there might be intoxication by transdermal absorption or inhalation. Therefore, high dose and prolonged use of vitamin K1 therapy is necessary for effective detoxification. Further detailed investigation on environmental exposure and efforts to improve availability of the blood level test in clinic are requested. PMID:21165290

  10. Electroencephalographic study of naloxone effects in the recovery of an acute alcoholic intoxication.

    PubMed

    Dawid-Milner, M S; Díaz-Calavia, E J; Lara, J P; Fernández del Moral, R; Jiménez-Vargas, J

    1989-06-01

    Experimental assays analysing EEG changes during the recovery of an acute alcoholic intoxication were carried out in three groups of cats: 1) Recovery of acute alcoholic intoxication produced by continuous intravenous perfusion of ethanol, 0.06 g/kg/min, during 20 minutes. 2) Recovery of acute alcoholic intoxication by injecting naloxone (400 micrograms/kg), just after finishing alcohol perfusion. 3) Recovery of acute alcoholic intoxication by injecting naloxone (400 micrograms/kg), 15 min after finishing perfusion. Naloxone administered after an acute alcoholic intoxication worsens the recovery of EEG parameters; 1-2 (p less than 0.05), 1-3 (p less than 0.05).

  11. Spider Bite: A Rare Case of Acute Necrotic Arachnidism with Rapid and Fatal Evolution.

    PubMed

    Pezzi, Mario; Giglio, Anna Maria; Scozzafava, Annamaria; Filippelli, Orazio; Serafino, Giuseppe; Verre, Mario

    2016-01-01

    The spider bites are quite frequent and often resolve quickly without leaving outcomes; only some species are capable of causing necrotic and systematic lesions in humans. Among them, we should mention the genus Loxosceles. The venom released from the spider bite of Loxosceles species is composed of proteins, enzymes, and nonenzymatic polypeptides. The phospholipase D family was identified as the active component of the venom. This family of enzymes is responsible for the local and systemic effects observed in loxoscelism. Phospholipases D interact with cell membranes triggering alterations which involve the complement system and activation of neutrophils and they cause the dermonecrotic skin lesions and systemic effects. We describe a fatal case of acute intoxication caused by a spider bite probably belonging to the species Loxosceles. The initial lesion was localized to a finger of a hand. Clinical course was worsening with deep necrotic lesions on limb, shock, hemolysis, acute kidney failure, and disseminated intravascular coagulation. All therapies were ineffective. This is the first fatal case described in Europe. PMID:27651958

  12. Spider Bite: A Rare Case of Acute Necrotic Arachnidism with Rapid and Fatal Evolution

    PubMed Central

    Giglio, Anna Maria; Scozzafava, Annamaria; Filippelli, Orazio; Serafino, Giuseppe; Verre, Mario

    2016-01-01

    The spider bites are quite frequent and often resolve quickly without leaving outcomes; only some species are capable of causing necrotic and systematic lesions in humans. Among them, we should mention the genus Loxosceles. The venom released from the spider bite of Loxosceles species is composed of proteins, enzymes, and nonenzymatic polypeptides. The phospholipase D family was identified as the active component of the venom. This family of enzymes is responsible for the local and systemic effects observed in loxoscelism. Phospholipases D interact with cell membranes triggering alterations which involve the complement system and activation of neutrophils and they cause the dermonecrotic skin lesions and systemic effects. We describe a fatal case of acute intoxication caused by a spider bite probably belonging to the species Loxosceles. The initial lesion was localized to a finger of a hand. Clinical course was worsening with deep necrotic lesions on limb, shock, hemolysis, acute kidney failure, and disseminated intravascular coagulation. All therapies were ineffective. This is the first fatal case described in Europe. PMID:27651958

  13. Spider Bite: A Rare Case of Acute Necrotic Arachnidism with Rapid and Fatal Evolution.

    PubMed

    Pezzi, Mario; Giglio, Anna Maria; Scozzafava, Annamaria; Filippelli, Orazio; Serafino, Giuseppe; Verre, Mario

    2016-01-01

    The spider bites are quite frequent and often resolve quickly without leaving outcomes; only some species are capable of causing necrotic and systematic lesions in humans. Among them, we should mention the genus Loxosceles. The venom released from the spider bite of Loxosceles species is composed of proteins, enzymes, and nonenzymatic polypeptides. The phospholipase D family was identified as the active component of the venom. This family of enzymes is responsible for the local and systemic effects observed in loxoscelism. Phospholipases D interact with cell membranes triggering alterations which involve the complement system and activation of neutrophils and they cause the dermonecrotic skin lesions and systemic effects. We describe a fatal case of acute intoxication caused by a spider bite probably belonging to the species Loxosceles. The initial lesion was localized to a finger of a hand. Clinical course was worsening with deep necrotic lesions on limb, shock, hemolysis, acute kidney failure, and disseminated intravascular coagulation. All therapies were ineffective. This is the first fatal case described in Europe.

  14. Spider Bite: A Rare Case of Acute Necrotic Arachnidism with Rapid and Fatal Evolution

    PubMed Central

    Giglio, Anna Maria; Scozzafava, Annamaria; Filippelli, Orazio; Serafino, Giuseppe; Verre, Mario

    2016-01-01

    The spider bites are quite frequent and often resolve quickly without leaving outcomes; only some species are capable of causing necrotic and systematic lesions in humans. Among them, we should mention the genus Loxosceles. The venom released from the spider bite of Loxosceles species is composed of proteins, enzymes, and nonenzymatic polypeptides. The phospholipase D family was identified as the active component of the venom. This family of enzymes is responsible for the local and systemic effects observed in loxoscelism. Phospholipases D interact with cell membranes triggering alterations which involve the complement system and activation of neutrophils and they cause the dermonecrotic skin lesions and systemic effects. We describe a fatal case of acute intoxication caused by a spider bite probably belonging to the species Loxosceles. The initial lesion was localized to a finger of a hand. Clinical course was worsening with deep necrotic lesions on limb, shock, hemolysis, acute kidney failure, and disseminated intravascular coagulation. All therapies were ineffective. This is the first fatal case described in Europe.

  15. Antibody protection against botulinum neurotoxin intoxication in mice.

    PubMed

    Cheng, Luisa W; Stanker, Larry H; Henderson, Thomas D; Lou, Jianlong; Marks, James D

    2009-10-01

    Adulteration of food or feed with any of the seven serotypes of botulinum neurotoxin (BoNT) is a potential bioterrorism concern. Currently, there is strong interest in the development of detection reagents, vaccines, therapeutics, and other countermeasures. A sensitive immunoassay for detecting BoNT serotype A (BoNT/A), based on monoclonal antibodies (MAbs) F1-2 and F1-40, has been developed and used in complex matrices. The epitope for F1-2 has been mapped to the heavy chain of BoNT/A, and the epitope of F1-40 has been mapped to the light chain. The ability of these MAbs to provide therapeutic protection against BoNT/A intoxication in mouse intravenous and oral intoxication models was tested. High dosages of individual MAbs protected mice well both pre- and postexposure to BoNT/A holotoxin. A combination therapy consisting of antibodies against both the light and heavy chains of the toxin, however, significantly increased protection, even at a lower MAb dosage. An in vitro peptide assay for measuring toxin activity showed that pretreatment of toxin with these MAbs did not block catalytic activity but instead blocked toxin entry into primary and cultured neuronal cells. The timing of antibody rescue in the mouse intoxication models revealed windows of opportunity for antibody therapeutic treatment that correlated well with the biologic half-life of the toxin in the serum. Knowledge of BoNT intoxication and antibody clearance in these mouse models and understanding of the pharmacokinetics of BoNT are invaluable for future development of antibodies and therapeutics against intoxication by BoNT.

  16. Efficacy of chelation therapy to remove aluminium intoxication.

    PubMed

    Fulgenzi, Alessandro; De Giuseppe, Rachele; Bamonti, Fabrizia; Vietti, Daniele; Ferrero, Maria Elena

    2015-11-01

    There is a distinct correlation between aluminium (Al) intoxication and neurodegenerative diseases (ND). We demonstrated how patients affected by ND showing Al intoxication benefit from short-term treatment with calcium disodium ethylene diamine tetraacetic acid (EDTA) (chelation therapy). Such therapy further improved through daily treatment with the antioxidant Cellfood. In the present study we examined the efficacy of long-term treatment, using both EDTA and Cellfood. Slow intravenous treatment with the chelating agent EDTA (2 g/10 mL diluted in 500 mL physiological saline administered in 2 h) (chelation test) removed Al, which was detected (using inductively coupled plasma mass spectrometry) in urine samples collected from patients over 12 h. Patients that revealed Al intoxication (expressed in μg per g creatinine) underwent EDTA chelation therapy once a week for ten weeks, then once every two weeks for a further six or twelve months. At the end of treatment (a total of 22 or 34 chelation therapies, respectively), associated with daily assumption of Cellfood, Al levels in the urine samples were analysed. In addition, the following blood parameters were determined: homocysteine, vitamin B12, and folate, as well as the oxidative status e.g. reactive oxygen species (ROS), total antioxidant capacity (TAC), oxidized LDL (oxLDL), and glutathione. Our results showed that Al intoxication reduced significantly following EDTA and Cellfood treatment, and clinical symptoms improved. After treatment, ROS, oxLDL, and homocysteine decreased significantly, whereas vitamin B12, folate and TAC improved significantly. In conclusion, our data show the efficacy of chelation therapy associated with Cellfood in subjects affected by Al intoxication who have developed ND.

  17. Portrayal of Alcohol Intoxication on YouTube

    PubMed Central

    Primack, Brian A.; Colditz, Jason B.; Pang, Kevin C.; Jackson, Kristina M.

    2015-01-01

    Background We aimed to characterize the content of leading YouTube videos related to alcohol intoxication and to examine factors associated with alcohol intoxication in videos that were assessed positively by viewers. Methods We systematically captured the 70 most relevant and popular videos on YouTube related to alcohol intoxication. We employed an iterative process to codebook development which resulted in 42 codes in 6 categories: video characteristics, character socio-demographics, alcohol depiction, degree of alcohol use, characteristics associated with alcohol, and consequences of alcohol. Results There were a total of 333,246,875 views for all videos combined. While 89% of videos involved males, only 49% involved females. The videos had a median of 1646 (IQR 300-22,969) “like” designations and 33 (IQR 14-1,261) “dislike” designations each. Liquor was most frequently represented, followed by beer and then wine/champagne. Nearly one-half (44%) of videos contained a brand reference. Humor was juxtaposed with alcohol use in 79% of videos, and motor vehicle use was present in 24%. There were significantly more likes per dislike, indicating more positive sentiment, when there was representation of liquor (29.1 vs. 11.4, p = .008), brand references (32.1 vs. 19.2, p = .04), and/or physical attractiveness (67.5 vs. 17.8, p < .001). Conclusions Internet videos depicting alcohol intoxication are heavily viewed. Nearly half of these videos involve a brand-name reference. While these videos commonly juxtapose alcohol intoxication with characteristics such as humor and attractiveness, they infrequently depict negative clinical outcomes. The popularity of this site may provide an opportunity for public health intervention. PMID:25703135

  18. Fire fighter fatalities 1998–2001: overview with an emphasis on structure related traumatic fatalities

    PubMed Central

    Hodous, T; Pizatella, T; Braddee, R; Castillo, D

    2004-01-01

    Objective: To review the causes of all fire fighter line-of-duty-deaths from 1998 through 2001, and present recommendations for preventing fatalities within the specific subgroup of structure related events. Methods: Fire fighter fatality data from the United States Fire Administration were reviewed and classified into three main categories of injury. Investigations conducted through the National Institute for Occupational Safety and Health (NIOSH) Fire Fighter Fatality Investigation and Prevention Program provided the basis for the recommendations presented in this paper. Results: During the time period from 1998–2001, there were 410 line-of-duty deaths among fire fighters in the United States, excluding the 343 fire fighters who died at the World Trade Center on 11 September 2001. The 410 fatalities included 191 medical (non-traumatic) deaths (47%), 75 motor vehicle related fatalities (18%), and 144 other traumatic fatalities (35%). The latter group included 68 fatalities that were associated with structures which commonly involved structural collapse, rapid fire progression, and trapped fire fighters. Conclusions: Structural fires pose particular hazards to fire fighters. Additional efforts must be directed to more effectively use what we have learned through the NIOSH investigations and recommendations from published experts in the safety community, consensus standards, and national fire safety organizations to reduce fire fighter fatalities during structural fire fighting. PMID:15314049

  19. Clinical pharmacology of lysergic acid diethylamide: case reports and review of the treatment of intoxication.

    PubMed

    Blaho, K; Merigian, K; Winbery, S; Geraci, S A; Smartt, C

    1997-01-01

    Intoxication and overdose are common presenting complaints to the emergency department. Acute intoxication with lysergic acid diethylamide (LSD) has become a relatively rare event, especially when compared with the incidence of ethanol and cocaine intoxication. We recently had an outbreak of presumed LSD intoxications occurring over one weekend. All patients had attended a performance by the musical group The Grateful Dead. At present, LSD intoxication or overdose can only be suspected based on clinical findings because there are no readily available rapid laboratory tests for detecting either the parent compound or the metabolites of the drug. The clinical findings and outcomes of five patients with suspected LSD intoxication are presented. The pharmacological effects of LSD and treatment modalities of intoxication are reviewed. All patients were treated conservatively based on clinical signs and symptoms. Only one patient required hospital admission for combative behavior that was initially refractory to pharmacological restraint.

  20. Global estimates of fatal occupational accidents.

    PubMed

    Takala, J

    1999-09-01

    Data on occupational accidents are not available from all countries in the world. Furthermore, underreporting, limited coverage by reporting and compensation schemes, and non-harmonized accident recording and notification systems undermine efforts to obtain worldwide information on occupational accidents. This paper presents a method and new estimated global figures of fatal accidents at work by region. The fatal occupational accident rates reported to the International Labour Office are extended to the total employed workforce in countries and regions. For areas not covered by the reported information, rates from other countries that have similar or comparable conditions are applied. In 1994, an average estimated fatal occupational accident rate in the whole world was 14.0 per 100,000 workers, and the total estimated number of fatal occupational accidents was 335,000. The rates are different for individual countries and regions and for separate branches of economic activity. In conclusion, fatal occupational accident figures are higher than previously estimated. The new estimates can be gradually improved by obtaining and adding data from countries where information is not yet available. Sectoral estimates for at least key economic branches in individual countries would further increase the accuracy.

  1. Fatal Spotted Fever Rickettsiosis, Minas Gerais, Brazil

    PubMed Central

    Dumler, J. Stephen; Mafra, Cláudio Lísias; Calic, Simone Berger; Chamone, Chequer Buffe; Filho, Gracco Cesarino; Olano, Juan Pablo; Walker, David H.

    2003-01-01

    The emergence and reemergence of a serious infectious disease are often associated with a high case-fatality rate because of misdiagnosis and inappropriate or delayed treatment. The current reemergence of spotted fever rickettsiosis caused by Rickettsia rickettsii in Brazil has resulted in a high proportion of fatal cases. We describe two familial clusters of Brazilian spotted fever in the state of Minas Gerais, involving six children 9 months to 15 years of age; five died. Immunohistochemical investigation of tissues obtained at necropsy of a child in each location, Novo Cruzeiro and Coronel Fabriciano municipalities, established the diagnosis by demonstration of disseminated endothelial infection with spotted fever group rickettsiae. The diagnosis in the two fatal cases from Coronel Fabriciano and the surviving patient from Novo Cruzeiro was further supported by immunofluorescence serologic tests. PMID:14718082

  2. Clinical features of sporadic fatal insomnia.

    PubMed

    Barash, Jed A

    2009-01-01

    Recent advances in neuropathology, genotyping, and physiochemical characterization of proteins have allowed for the classification and verification of MM2-thalamic Creutzfeldt-Jakob disease (CJD). CJD is a fatal neurodegenerative illness belonging to the transmissible spongiform encephalopathies, also known as prion diseases. Sporadic CJD is generally classified by the genotype at codon 129 of the prion protein gene and the distinct physiochemical features of the pathologic prion protein (PrP(sc)). The entity is characterized by methionine homozygosity at codon 129, type 2 PrP(sc), and, primarily, thalamic pathology (MM2-thalamic CJD). It shares clinical and pathologic similarities with the genetic prion disorder fatal familial insomnia; the MM2-thalamic phenotype has therefore been called sporadic fatal insomnia (SFI). SFI may also present like other neurodegenerative diseases, and common diagnostic findings that are seen in other forms of sporadic CJD may be absent.

  3. Rise in landing-related skydiving fatalities.

    PubMed

    Hart, Christian L; Griffith, James D

    2003-10-01

    The purpose was to assess whether adoption of potentially dangerous skydiving gear and skydiving practices has led to an increase in fatalities. Beginning in the early 1990s, civilian skydivers began to utilize high performance parachutes that fly much faster and are much more responsive than older style parachutes. Also, skydivers began to fly these parachutes in a more aggressive manner. An analysis of data from the 507 skydiving fatalities in the USA between 1986 and 2001 indicated that this shift toward high performance parachutes and aggressive flying techniques was temporally associated with an increase in parachute-landing deaths. During the same time period, the total number of fatalities remained fairly stable. PMID:14620223

  4. Methadone toxicity fatalities: a review of medical examiner cases in a large metropolitan area.

    PubMed

    Shields, Lisa B E; Hunsaker Iii, John C; Corey, Tracey S; Ward, Michael K; Stewart, Donna

    2007-11-01

    Over the past several years, Medical Examiners in Kentucky and around the nation have observed a dramatic rise in drug intoxication deaths involving the prescription medication methadone. This documented rise in methadone-related deaths requires a better understanding of methadone's pathophysiology and the ways it contributes to significantly increase morbidity and mortality. This study reviews 176 fatalities ascribed to methadone toxicity by the Office of the Chief Medical Examiner in Kentucky between 2000 and 2004. Postmortem toxicological analysis recorded a more than 10-fold increase in methadone toxicity fatalities, rising from 6 cases in 2000 to 68 cases in 2003. Of the 176 methadone-related fatalities, methadone was the only drug detected in postmortem blood and urine toxicological analyses in 11 (6.25%) cases. The mean methadone blood concentration of all 176 cases was 0.535 mg / L (0.02-4.0). The following psychoactive medications were detected: antidepressants (39.8%), benzodiazepines (32.4%), and other opioids in addition to methadone (27.8%). Cannabinoids were detected in 44 (28.4%) cases and cocaine or metabolite in 34 (21.9%) cases. Of the 95 cases with a known history of methadone use, 46 (48.4%) involved prescription by private physician. The interpretation of blood methadone concentrations alone or combined with other psychoactive drugs requires consideration of the subject's potential chronic use of and tolerance to the drug. A thorough investigation into the practices of procurement and use/abuse of methadone is essential to arrive at the proper designation of the cause of death.

  5. ECONOMIC LOSSES AND FATALITIES DUE TO LANDSLIDES.

    USGS Publications Warehouse

    Schuster, Robert L.; Fleming, Robert W.

    1986-01-01

    Annual losses in the United States, Japan, Italy, and India have been estimated at 1 billion or more each. During the period 1971-74, nearly 600 people per year were killed by landslides worldwide; about 90 percent of these deaths occurred in the Circum-Pacific region. From 1967-82, 150 people per year died in Japan as a result of slope failures. In the United States, the number of landslide-related fatalities per year exceeds 25. Japan leads other nations in development of comprehensive programs to reduce economic losses and fatalities due to landslides. The United States recently has proposed a national landslide hazard reduction program.

  6. An atypical case of sporadic fatal insomnia.

    PubMed

    Priano, L; Giaccone, G; Mangieri, M; Albani, G; Limido, L; Brioschi, A; Pradotto, L; Orsi, L; Mortara, P; Fociani, P; Mauro, A; Tagliavini, F

    2009-08-01

    Fatal insomnia is a rare human prion disease characterised by sleep-wake disturbances, thalamic degeneration and deposition of type 2 disease-specific prion protein (PrP(Sc)). This report details a patient with sporadic fatal insomnia who exhibited cerebral deposition of type 1 PrP(Sc) and neuropathological changes largely in the basal ganglia. Previous damage of this brain region by a surgically removed colloid cyst and the insertion of two intracerebral shunts may have influenced the distribution of PrP(Sc) through a chronic inflammatory process. These findings add to our knowledge of the phenotypic variability of human prion diseases with prominent sleep disturbances.

  7. Baking soda: a potentially fatal home remedy.

    PubMed

    Nichols, M H; Wason, S; Gonzalez del Rey, J; Benfield, M

    1995-04-01

    We present a case of a six-week-old infant who developed life-threatening complications after unintentional sodium bicarbonate intoxication. Baking soda was being used by the mother as a home remedy to "help the baby burp." A review of the literature regarding the use (or misuse) of baking soda follows. Our patient, along with the other noted case reports, emphasizes the need for warnings on baking soda products whose labels recommend its use as an antacid. Poisonings must be high in the differential diagnosis of any patient, regardless of age, who presents with altered mental status or status epilepticus.

  8. Anticipating early fatality: friends', schoolmates' and individual perceptions of fatality on adolescent risk behaviors.

    PubMed

    Haynie, Dana L; Soller, Brian; Williams, Kristi

    2014-02-01

    Past research indicates that anticipating adverse outcomes, such as early death (fatalism), is associated positively with adolescents' likelihood of engaging in risky behaviors. Health researchers and criminologists have argued that fatalism influences present risk taking in part by informing individuals' motivation for delaying gratification for the promise of future benefits. While past findings highlight the association between the anticipation of early death and a number of developmental outcomes, no known research has assessed the impact of location in a context characterized by high perceptions of fatality. Using data from Add Health and a sample of 9,584 adolescents (51% female and 71% white) nested in 113 schools, our study builds upon prior research by examining the association between friends', school mates', and individual perceptions of early fatality and adolescent risk behaviors. We test whether friends' anticipation of being killed prior to age 21 or location in a school where a high proportion of the student body subscribes to attitudes of high fatality, is associated with risky behaviors. Results indicate that friends' fatalism is positively associated with engaging in violent delinquency, non-violent delinquency, and drug use after controlling for individual covariates and prior individual risk-taking. Although friends' delinquency accounts for much of the effect of friends' fatalism on violence, none of the potential intervening variables fully explain the effect of friends' fatalism on youth involvement in non-violent delinquency and drug use. Our results underscore the importance of friendship contextual effects in shaping adolescent risk-taking behavior and the very serious consequences perceptions of fatality have for adolescents' involvement in delinquency and drug use.

  9. Anticipating Early Fatality: Friends', Schoolmates' and Individual Perceptions of Fatality on Adolescent Risk Behaviors

    PubMed Central

    Soller, Brian; Williams, Kristi

    2015-01-01

    Past research indicates that anticipating adverse outcomes, such as early death (fatalism), is associated positively with adolescents' likelihood of engaging in risky behaviors. Health researchers and criminologists have argued that fatalism influences present risk taking in part by informing individuals' motivation for delaying gratification for the promise of future benefits. While past findings highlight the association between the anticipation of early death and a number of developmental outcomes, no known research has assessed the impact of location in a context characterized by high perceptions of fatality. Using data from Add Health and a sample of 9,584 adolescents (51 % female and 71 % white) nested in 113 schools, our study builds upon prior research by examining the association between friends', school mates', and individual perceptions of early fatality and adolescent risk behaviors. We test whether friends' anticipation of being killed prior to age 21 or location in a school where a high proportion of the student body subscribes to attitudes of high fatality, is associated with risky behaviors. Results indicate that friends' fatalism is positively associated with engaging in violent delinquency, non-violent delinquency, and drug use after controlling for individual covariates and prior individual risk-taking. Although friends' delinquency accounts for much of the effect of friends' fatalism on violence, none of the potential intervening variables fully explain the effect of friends' fatalism on youth involvement in nonviolent delinquency and drug use. Our results underscore the importance of friendship contextual effects in shaping adolescent risk-taking behavior and the very serious consequences perceptions of fatality have for adolescents' involvement in delinquency and drug use. PMID:23828725

  10. Researching the intoxicated: informed consent implications for alcohol and drug research.

    PubMed

    Aldridge, Judith; Charles, Vikki

    2008-03-01

    This article considers the informed consent process in relation to carrying out research with intoxicated participants in 'field' research settings. There is little discussion in the literature of the potential problems that the intoxication of research participants may pose to research. Intoxication is a potential problem for all researchers but is heightened in field research that takes place in settings where participants are likely to be intoxicated, such as licensed venues, in drug consumption rooms, or police custody suites. The risks to research participants that intoxication poses should not be resolved by electing not to do research with intoxicated participants; it is argued that these risks can be managed to some extent, and are offset by the benefits of such research. Moreover, intoxication (and the impairment of cognitive functions relevant to valid informed consent) may not always be identifiable through behavioural or biochemical methods of detection. The search for accurate and field-practical methods for identifying intoxication amongst participants is useful, but not the only strategy for researchers who want to ensure the validity of the consent process. Suggestions are provided for devising research protocols that acknowledge and accept intoxication of research participants and attempt to protect them. One solution is to side-step identification of intoxication per se as a strategic objective in the consent process, and turn instead to established methods for ensuring that information has been understood by potential research participants.

  11. Estimating cost ratio distribution between fatal and non-fatal road accidents in Malaysia

    NASA Astrophysics Data System (ADS)

    Hamdan, Nurhidayah; Daud, Noorizam

    2014-07-01

    Road traffic crashes are a global major problem, and should be treated as a shared responsibility. In Malaysia, road accident tragedies kill 6,917 people and injure or disable 17,522 people in year 2012, and government spent about RM9.3 billion in 2009 which cost the nation approximately 1 to 2 percent loss of gross domestic product (GDP) reported annually. The current cost ratio for fatal and non-fatal accident used by Ministry of Works Malaysia simply based on arbitrary value of 6:4 or equivalent 1.5:1 depends on the fact that there are six factors involved in the calculation accident cost for fatal accident while four factors for non-fatal accident. The simple indication used by the authority to calculate the cost ratio is doubted since there is lack of mathematical and conceptual evidence to explain how this ratio is determined. The main aim of this study is to determine the new accident cost ratio for fatal and non-fatal accident in Malaysia based on quantitative statistical approach. The cost ratio distributions will be estimated based on Weibull distribution. Due to the unavailability of official accident cost data, insurance claim data both for fatal and non-fatal accident have been used as proxy information for the actual accident cost. There are two types of parameter estimates used in this study, which are maximum likelihood (MLE) and robust estimation. The findings of this study reveal that accident cost ratio for fatal and non-fatal claim when using MLE is 1.33, while, for robust estimates, the cost ratio is slightly higher which is 1.51. This study will help the authority to determine a more accurate cost ratio between fatal and non-fatal accident as compared to the official ratio set by the government, since cost ratio is an important element to be used as a weightage in modeling road accident related data. Therefore, this study provides some guidance tips to revise the insurance claim set by the Malaysia road authority, hence the appropriate method

  12. Comparison of two methodologies to measure agricultural occupational fatalities.

    PubMed

    Murphy, D J; Seltzer, B L; Yesalis, C E

    1990-02-01

    Agricultural occupational fatalities in Pennsylvania for the years 1985-87 were followed up. Supplemental data concerning the occupation of the deceased and circumstances of the fatal accident were obtained from a family member. The number of fatalities designated as agriculturally and occupationally related by the National Traumatic Occupational Fatality (NTOF) system was compared with the number of fatalities identified by using alternative criteria for classification of agriculturally and occupationally related fatalities. There may be nearly a 30 percent error in the NTOF method resulting in a 20 percent undercount. PMID:2297065

  13. [Evaluation of the endogenous intoxication syndrome in food toxic infections].

    PubMed

    Marzhokhova, M Iu; Zhelikhazheva, Zh M

    2009-01-01

    To study the endogenous intoxication syndrome in patients with food toxic infections is essential in revealing the pathogenetic mechanisms underlying this disease. For this, the authors measured the level of low and average molecular weight, as well as their protein component--oligopeptides in plasma, red blood cells, and urine in the course of the disease. There were increased levels of the study parameters, which depended on the stage and degree of a pathological process. The determination of the level of low and average molecular weight and oligopeptides in plasma, red blood cells, and urine may serve as a marker of the intoxication syndrome; the level of the study parameters may be used as additional criteria for the severity of the process, the prediction of disease development and comorbidity, and as a criterion for recovery completeness.

  14. Mind the gap: a case of severe methanol intoxication.

    PubMed

    Nazir, Salik; Melnick, Stephen; Ansari, Shabana; Kanneh, Haitham T

    2016-01-01

    We report a case of a 37-year-old woman with non-insulin-dependent diabetes on sitagliptin, an alcohol abuser who was brought unresponsive to the emergency department of our hospital. On arrival, the patient was intubated and mechanically ventilated due to a low Glasgow Coma score of 3/15. Initial laboratory testing identified profound high anion gap metabolic acidosis. Owing to the dubious circumstances and the depth of acidosis, methanol and ethylene glycol intoxication was suspected. Further evaluation revealed a significantly increased serum osmolal gap. Pending volatile compound screen, fomepizole was started and urgent haemodialysis undertaken. Subsequent brain MRI identified changes in putamen of bilateral basal ganglia, suggestive of methanol intoxication. The patient was later found to have an initial methanol level of 237 mg/dL. She was successfully extubated on day 2 of hospitalisation, with residual cognitive and visual deficits.

  15. Combined intoxication with methylone and 5-MeO-MIPT.

    PubMed

    Shimizu, Eiji; Watanabe, Hiroyuki; Kojima, Takashi; Hagiwara, Hiroko; Fujisaki, Mihisa; Miyatake, Ryosuke; Hashimoto, Kenji; Iyo, Masaomi

    2007-01-30

    Although preclinical studies suggest that methylone (2-methylamino-1-[3,4-methylenedioxyphenyl]propan-1-one) and 5-MeO-MIPT (5-methoxy-N-methyl,N-isopropyl tryptamine) may have psychostimulant properties, the scientific reports about the clinical effects of these agents are scant. We describe a 27-year-old male patient with substance intoxication after a single ingestion of the mixture of methylone and 5-MeO-MIPT. Though he bought the drug as pure methylone powder via an internet order, our chemical analyses indicated that the drug was composed of about 60% methylone (120 mg) and 38% 5-MeO-MIPT (76 mg). This case report suggests that clinicians should be alert to the possibility of the emergence of methylone or 5-MeO-MIPT intoxication, and substance-related mental disorder may be complicated by combined use of other psychoactive drugs.

  16. Alcohol-based hand sanitizers: severe intoxication in children.

    PubMed

    2012-07-01

    Alcohol-based hand sanitizers are an alternative to hand washing with soap and water when water is unavailable. Their use has increased over the last decade. Cases of acute intoxication have been reported in children after accidental ingestion of alcohol-based hand sanitizers, sometimes leading to inebriation, agitation, drowsiness, impaired consciousness, and blood alcohol levels sometimes exceeding 2 g/I. In practice, alcohol-based hand sanitizers should be kept out of reach of children and should only be used when hand washing with soap and water is not possible. The possibility of alcohol intoxication should be borne in mind when a child suddenly presents with behaviour problems or altered consciousness. PMID:22852289

  17. [Drugs of abuse acute intoxication in paediatric emergencies].

    PubMed

    García-Algar, O; Papaseit, E; Velasco, M; López, N; Martínez, L; Luaces, C; Vall, O

    2011-06-01

    Documented cases show that acute drugs of abuse intoxication in children usually is the Fritz clinical evidence of a chronic exposure. Published clinical reports of drugs of abuse acute poisonings in children are reviewed, above all those with an underlying chronic exposure to the same or another substance. Biological matrices and exposure biomarkers useful in toxicology analysis in Paediatrics are reviewed. In toxicology, biomarkers refer to original parental substances and its metabolites and matrices refer to body substances where biomarkers are detected. In these matrices acute and chronic (previous days, weeks or months) exposures can be detected. Hair analysis has become the gold standard of drugs of abuse chronic exposure. Recommendation includes to confirm previous chronic exposure to drugs of abuse by hair analysis of children and their parents. This protocol must be applied in all cases with suspicion of acute drugs of abuse intoxication, parental consumption and/or children living in a risk environment.

  18. Mind the gap: a case of severe methanol intoxication.

    PubMed

    Nazir, Salik; Melnick, Stephen; Ansari, Shabana; Kanneh, Haitham T

    2016-01-01

    We report a case of a 37-year-old woman with non-insulin-dependent diabetes on sitagliptin, an alcohol abuser who was brought unresponsive to the emergency department of our hospital. On arrival, the patient was intubated and mechanically ventilated due to a low Glasgow Coma score of 3/15. Initial laboratory testing identified profound high anion gap metabolic acidosis. Owing to the dubious circumstances and the depth of acidosis, methanol and ethylene glycol intoxication was suspected. Further evaluation revealed a significantly increased serum osmolal gap. Pending volatile compound screen, fomepizole was started and urgent haemodialysis undertaken. Subsequent brain MRI identified changes in putamen of bilateral basal ganglia, suggestive of methanol intoxication. The patient was later found to have an initial methanol level of 237 mg/dL. She was successfully extubated on day 2 of hospitalisation, with residual cognitive and visual deficits. PMID:26917798

  19. Accidental organophosphate insecticide intoxication in children: a reminder

    PubMed Central

    2011-01-01

    Misuse of organophosphate insecticides, even in case of domestic application, can be life threatening. We report the case of siblings admitted with respiratory distress, pinpoint pupils and slurred speech. The symptoms appear after spraying the skin by insecticides. Plasma pseudocholinesterase level appeared to be very low, consistent with acute intoxication with organophosphate insecticide. Management of organophosphate poisoning consists of airway management, administration of oxygen and fluid, as well as atropine in increasing doses and pralidoxime. Decontamination of the patient's skin and the removal of the patient's clothes are mandatory in order to avoid recontamination of the patient as well as the surrounding healthcare personnel. Plasma pseudocholinesterase analysis is a cheap and an easy indicator for organophosphate insecticides intoxications and could be used for diagnosis and treatment monitoring. PMID:21676238

  20. Fatal Monocytic Ehrlichiosis in Woman, Mexico, 2013

    PubMed Central

    Sosa-Gutierrez, Carolina G.; Solorzano-Santos, Fortino; Walker, David H.; Torres, Javier; Serrano, Carlos A.

    2016-01-01

    Human monocytic ehrlichiosis is a febrile illness caused by Ehrlichia chaffeensis, an intracellular bacterium transmitted by ticks. In Mexico, a case of E. chaffeensis infection in an immunocompetent 31-year-old woman without recognized tick bite was fatal. This diagnosis should be considered for patients with fever, leukopenia, thrombocytopenia, and elevated liver enzyme levels. PMID:27088220

  1. A fatal case of pure metaphyseal chondroblastoma.

    PubMed

    Binesh, Fariba; Moghadam, Reza Nafisi; Abrisham, Jalil

    2013-08-23

    The chondroblastoma (CB) is a rare cartilaginous tumour; it represents less than 1% of all bone tumours. It is mostly localised at the level of the epiphysis of long bones. We report a fatal case of pure metaphyseal CB of the tibia in a 9-year-old boy whose pulmonary metastases developed soon after operative therapy of the primary tumour.

  2. Fatal Case of Listeria innocua Bacteremia

    PubMed Central

    Perrin, Monique; Bemer, Michel; Delamare, Catherine

    2003-01-01

    Listeria innocua is widespread in the environment and in food. This species has to date never been described in association with human disease. We report a case of fatal bacteremia caused by L. innocua in a 62-year-old patient. PMID:14605191

  3. Fatal case of Listeria innocua bacteremia.

    PubMed

    Perrin, Monique; Bemer, Michel; Delamare, Catherine

    2003-11-01

    Listeria innocua is widespread in the environment and in food. This species has to date never been described in association with human disease. We report a case of fatal bacteremia caused by L. innocua in a 62-year-old patient.

  4. Fatal gunshot injuries in Benin City, Nigeria.

    PubMed

    Akhiwu, Wilson O; Igbe, Alex P

    2013-10-01

    An upsurge in gun violence in recent times in our environment necessitated this study, which aims to document the patterns of fatal gunshot injuries with the hope of finding a solution to this problem. The study was a retrospective analysis of cases of fatal gunshot injuries on which autopsies were carried out over the 5-year period from January 1998 to December 2002 at Police Medical Services, Benin City - a Nigerian ancient town located in the South-South zone of the country. Most cases of medico-legal death in Benin City and environs are referred to the Police Pathologist at the center for autopsy. A total of 210 cases representing 27.2% of all medico-legal deaths during the study period were reviewed. Males were far more affected than females (M:F = 10.7:1). The intent for the fatal gunshots was murder (88.5%), excusable homicide (4.8%), accident (4.3%) and suicide (0.5%). In 1.9% of the deaths, the circumstances were not clear. Armed robbers, thugs and assassins accounted for 88.1% of the fatal shots, while the Police accounted for 9.0%. The trunk was affected much more than the head, neck and limbs. There is a need to improve security in the country and reduce poverty. Illegal firearms should also be removed from circulation. An improvement in emergency health services will reduce deaths from gunshots.

  5. A fatal case of pure metaphyseal chondroblastoma.

    PubMed

    Binesh, Fariba; Moghadam, Reza Nafisi; Abrisham, Jalil

    2013-01-01

    The chondroblastoma (CB) is a rare cartilaginous tumour; it represents less than 1% of all bone tumours. It is mostly localised at the level of the epiphysis of long bones. We report a fatal case of pure metaphyseal CB of the tibia in a 9-year-old boy whose pulmonary metastases developed soon after operative therapy of the primary tumour. PMID:23975916

  6. [Fatal familial insomnia and prion diseases].

    PubMed

    Seilhean, D; Duyckaerts, C; Hauw, J J

    1995-04-01

    Fatal familial insomnia has recently enlarged the group of prion diseases. The disease starts between 35 and 60 years of age, is inherited as an autosomic dominant trait, and leads to death within 7 to 32 months. Clinical symptoms and signs include insomnia dysautonomia, cognitive and motor alteration. The discrete topography of the lesions in fatal familial insomnia underlines the role of the thalamus in the regulation of the sleep-wake cycle. Atrophy, neuronal loss and gliosis are prominent in the anterior and dorsomedial nuclei of the thalamus. Spongiosis, which is usually found in prion diseases, is absent in fatal familial insomnia. An abnormal prion protein (PrPsc) is detected in the brain. There is a mutation at codon 178 of the gene encoding this protein. Fatal insomnia is distinct from Creutzfeldt-Jakob disease on clinical, histopathologic and molecular grounds. It provides new information about genetics of prion diseases which share the characteristics of being altogether inherited and, in most cases, transmissible. The recent finding of abnormal PrP in diffuse subcortical gliosis suggests that other degenerative disorders could actually be prion diseases.

  7. [Report on a methemoglobin-associated fatality].

    PubMed

    Bungardt, Nikola; Pötsch, Lucia

    2003-01-01

    An autoerotic fatality due to mechanical compression of the neck by a sophisticated construction used for breath control games is reported. The presence of signs of methemoglobinemia as well as an empty "poppers" flask found beside the passed indicated the use of volatile nitrites to enhance sexual pleasure. It was assumed that vasodilatation had caused a sudden unconsciousness with consecutive hanging. PMID:14723125

  8. Skin cancer and arsenical intoxication from well water.

    PubMed

    Wagner, S L; Maliner, J S; Morton, W E; Braman, R S

    1979-10-01

    A case of acute arsenical intoxication arising from ingested well water containing only 1.2 ppm of arsenic is reported. After a latent period of 14 years, multiple cutaneous basal cell carcinomas developed. The water was analyzed for a variety of other trace elements and compounds and no evidence for the existence of other carcinogens was found. This study strengthens the concept that arsenic is a carcinogen. The role of a possible selenium deficiency is also discussed.

  9. Vitamin A intoxication from reef fish liver consumption in Bermuda.

    PubMed

    Dewailly, E; Rouja, P; Schultz, E; Julien, P; Tucker, T

    2011-09-01

    We report three historical cases of severe vitamin A intoxication in anglers who had consumed reef fish liver caught in Bermuda. The subsequent analyses of 35 fish livers from seven different fish species revealed that very high concentrations of vitamin A exist in tropical fish liver, even in noncarnivorous fish species. Large variations in concentrations were observed between specimens and between species. The angling population and (especially) pregnant women should be advised of this potential health threat.

  10. [Exchange reactions in brain tissue under chronic ethanol intoxication].

    PubMed

    Gil'miiarova, F N; Radomskaia, V M; Vinogradova, L N

    1982-01-01

    The paper deals with characterization of systems utilizing ethanol and reactions conjugated with its exchange in the brain tissue under chronic alcohol intoxication. The following is established: the absence of the alcoholdehydrogenase pathway of ethanol oxidation in rabbits, unbalanced splitting of carbohydrates under two-months ethanol load, disturbance of oxidative processes in the tricarboxylic acids cycle, a decrease in the pool of oxidized nicotin amide coenzymes. PMID:7036487

  11. Intoxication and bad behaviour: understanding cultural differences in the link.

    PubMed

    Room, R

    2001-07-01

    Research developments since the appearance of MacAndrew and Edgerton's landmark volume, Drunken Comportment (1969), are summarized. The challenge of moving beyond the book is to understand what lies behind cultural variations in drunken comportment. Four specific factors in variations in drunken comportment are discussed. (1) A common contrast is between "wet" societies, where drinking is banalized everyday, and "dry" societies, where alcohol is set apart as a special commodity. Problems with this contrast are discussed, and the need for cross-cultural studies comparing expectancies from intoxication. (2) There is a need to study variations in the definition of intoxication as a "time out" state. In some societies, intoxication is likened to possession by spirits; a rationalistic version of this can be found in Canadian court decisions viewing extreme intoxication as potentially "akin to automatism". (3) If bad behaviour is a foreseeable consequence of drinking, why do some societies nevertheless not hold the drinker responsible'? In Anglo-American and similar societies, drunkenness has some excuse value, but it is not a very good excuse. Compromises like this seem to be found also in other cultures. (4) Pseudointoxication is fairly widespread, and seems to mark social situations where alcohol has enhanced excuse value. It appears to be a stratagem of the weaker side across cultural boundaries, and of the young where age-grading favours older groups. Concerning the possibility of cultural changes in drunken comportment, it is argued that there are historical examples, but such a shift requires a substantial social change. PMID:11414386

  12. An undercovered health threat in Turkey: transdermal methanol intoxication.

    PubMed

    Uca, Ali Ulvi; Kozak, Hasan Hüseyin; Altaş, Mustafa

    2015-01-01

    Methanol is a clear, colorless solvent used in antifreeze solutions, varnishes, cologne, copying machine fluids, perfume, spirit, paint, and fuel. Even small amounts of ingested methanol can cause acute permanent neurological dysfunction and irreversible blindness. Although there are many reports of methanol poisoning due to suicidal or accidental ingestion, reports of transdermal absorption are rare. We present a 68-year-old man with transdermal methanol intoxication applied to our hospital's emergency department with weakness, loss of vision, and altered state of consciousness.

  13. [Acute oral suicidal intoxication with captan--a case report].

    PubMed

    Chodorowski, Zygmunt; Sein Anand, Jacek; Waldman, Wojciech

    2004-01-01

    According to the best of our knowledge the second case of acute intoxication with captan was described. In this paper a 22-year old female was admitted to the Department of Toxicology with a nausea, weakness, numbness of upper limbs and substernal pain. She said that these symptoms began two hours after suicidal ingestion of 5.0 g of captan. At admission the patient was alert. Temperature was 37 degrees C, heart rate 100-120 b/min., BP 100-120/60-70 mm Hg and breathing rate 17/min. WBC were slightly elevated 12.4 x 10(3)/microl as well as the creatine kinase activity 329 U/L. ECG showed inversion of a T segment in V1-V4 leads. ECHO-sound made in 4th and 120th day after the onset of intoxication showed no changes, with EF--70%. Temporary increase of creatine kinase activity as well as the presence of inverted T segment in V1-V4 leads may suggest cardiotoxic effects of captan during acute intoxication.

  14. Deleterious effects of magnesium intoxication upon the domestic broiler chick

    SciTech Connect

    Lee, S.R.

    1984-01-01

    Dietary levels of 0.6 to 0.8% magnesium in a corn-soy basal were rachitogenic. These rickets appeared most like phosphorus deficiency. Bone Ca/P ratios were numerically quite low implying a lack of transformation from amorphous calcium phosphate to hydroxyapatite. Bone alkaline phosphatase activity was elevated. Additional dietary phosphorus ameliorated, but could not overcome the rachitogenic effects of magnesium. Tibial dyschondroplasia (TD), induced by elevated dietary P, was decreased by high levels of dietary Mg, but with no decrease in plasma phosphorus. Anticoccidial ionophores fed in conjunction with a moderate dietary challenge of Mg (0.48%) produced no clear changes in plasma calcium or Mg, but did interact to reduce body weight. The diarrhea caused by magnesium intoxication is not due to hyperosmotic loads of Mg per se. Rather, Cl was observed to be the major ionic constituent of the gut osmotic load implying different gut ionic fluxes in control versus magnesium intoxicated chicks. These data imply that the cathartic action of Mg is due to hypersecretion of the gut. Effects mediated or modified by the CNS changed in magnesium intoxicated chicks. Such chicks appeared cold and stayed near the heat. When startled, they exhibited extreme avoidance behavior and seizures similar to epilepsy and/or Cl deficiency. Brain tissue Mg content did not concomitantly increase. Whether these effects are due to central signals is unclear.

  15. Vitamin K antagonism of coumarin intoxication in the rat.

    PubMed

    Wallin, R; Patrick, S D; Ballard, J O

    1986-04-30

    An in vitro system which expresses all enzyme activities related to vitamin K-dependent carboxylation of blood clotting factors was prepared from livers of rats overdosed with warfarin, difenacoum and dicumarol respectively. In this system, the activities of the two pathways that are known to produce active reduced vitamin K1 cofactor for the carboxylation reaction were measured. Also the ability of high concentrations of vitamin K1 to overcome inhibition of clotting factor synthesis was studied. In the systems prepared from livers of warfarin and difenacoum intoxicated rats, pathway I was inactive. Vitamin K epoxide reductase was also inactive which strongly suggests that this enzyme catalyzes the activity of pathway I in vivo. Reduction of vitamin K1 by pathway II bypassed the inactive pathway I and resulted in carboxylation activity. This pathway therefore mediates the antidotic effect of vitamin K1 in the coumarin intoxicated liver. In the in vitro system prepared from dicumarol intoxicated livers the activity of pathway I was not significantly affected. Dicumarol however was a strong inhibitor when added to liver microsomes in vitro. PMID:2424118

  16. Methanol intoxication: pathological changes of central nervous system (17 cases).

    PubMed

    Karayel, Ferah; Turan, Arzu A; Sav, Aydin; Pakis, Isil; Akyildiz, Elif U; Ersoy, Gokhan

    2010-03-01

    The nervous system has increased susceptibility for methanol intoxication. The aim of this study is to investigate various central nervous system lesions of methanol intoxication in 17 cases autopsied in the mortuary department of the Council of Forensic Medicine in Istanbul, Turkey. The reasons of methanol intoxication in the cases was likely the unwitting ingestion of methanol while drinking illegal alcohol. Survival times ranged from several hours to days. In 8 cases (47%), cerebral edema and in 9 cases (53%) at occipital, temporal and parietal cortex, basal ganglia and pons, petechial bleeding was observed. In addition to these findings, hemorrhagic necrosis were observed in thalamus, putamen, and globus pallidus in 5 cases (29.4%) and, in cerebral cortex in another 3 cases (17.6%). In 3 of the cases (17.6%) in which cerebral edema was found, herniation findings accompanied to the situation and in 2 cases (11.7%), pons bleeding was observed. Around the basal ganglia, in 2 of the cases with hemorrhagic necrosis, the situation ended with a ventricular compression. In 7 cases (41%), the associated findings of chronic ischemic changes in cortical neurons, lacunae formation, degeneration of granular cell layer of the cerebellum, and reactive gliosis were considered as the results of chronic alcoholism.

  17. Intraperitoneal N-acetylcysteine for acute iron intoxication in rats.

    PubMed

    Breitbart, Rachelle; Abu-Kishk, Ibrahim; Kozer, Eran; Ben-Assa, Eyal; Goldstein, Lee H; Youngster, Ilan; Berkovitch, Matitiahu

    2011-10-01

    Free radical formation and release of oxidant agents have been suggested as possible mechanisms for tissue damage in acute iron intoxication. N-acetylcysteine (NAC), a glutathione substitute and an antioxidant, is widely used as an antidote for various intoxications. Our aim was to determine whether intraperitoneal (i.p.) NAC would reduce the mortality of rats after acute, toxic oral doses of iron. Male Wistar rats were studied in three phases. In the first phase, animals were assigned to groups 1 (distilled water by gavage) and 2 (i.p. NAC) and observed for survival. In the second phase, rats were assigned to groups 3 (400 mg/kg elemental iron orally) and 4 (400 mg/kg elemental iron, followed by 150 mg/kg i.p. NAC). Survival was observed. Because most rats in Group 3 died within 90 minutes after iron administration, a third phase was conducted in order to allow for comparison of iron and transaminase serum levels after the administration of iron and NAC (group 5: n = 10). Mortality was significantly lower in rats treated with iron and NAC, compared to those treated with iron (P = 0.016). Median serum iron level was significantly lower among rats treated with iron and NAC, compared with rats treated with iron alone (P = 0.002). In a rat model of acute iron intoxication, i.p. administration of NAC may decrease serum iron levels and mortality. PMID:21740343

  18. Patterns of Drug Use in Fatal Crashes

    PubMed Central

    Romano, Eduardo; Pollini, Robin A.

    2013-01-01

    Aims To characterize drug prevalence among fatally injured drivers, identify significant associations (i.e., day of week, time of day, age, gender), and compare findings with those for alcohol. Design Descriptive and logistic mixed-model regression analyses of Fatality Analysis Reporting System data. Setting U.S. states with drug test results for >80% of fatally injured drivers, 1998-2010. Participants Drivers killed in single-vehicle crashes on public roads who died at the scene of the crash (N=16,942). Measurements Drug test results, blood alcohol concentration (BAC), gender, age, and day and time of crash. Findings Overall, 45.1% of fatally injured drivers tested positive for alcohol (39.9% BAC>0.08) and 25.9% for drugs. The most common drugs present were stimulants (7.2%) and cannabinols (7.1%), followed by “other” drugs (4.1%), multiple drugs (4.1%), narcotics (2.1%), and depressants (1.5%). Drug-involved crashes occurred with relative uniformity throughout the day while alcohol-involved crashes were more common at night (p<.01). The odds of testing positive for drugs varied depending upon drug class, driver characteristics, time of day, and the presence of alcohol. Conclusions Fatal single vehicle crashes involving drugs are less common than those involving alcohol and the characteristics of drug-involved crashes differ depending upon drug class and whether alcohol is present. Concerns about drug-impaired driving should not detract from the current law enforcement focus on alcohol-impaired driving. PMID:23600629

  19. Fatal Cases of Influenza A in Childhood

    PubMed Central

    Johnson, Benjamin F.; Wilson, Louise E.; Ellis, Joanna; Elliot, Alex J.; Barclay, Wendy S.; Pebody, Richard G.; McMenamin, Jim; Fleming, Douglas M.; Zambon, Maria C.

    2009-01-01

    Background In the northern hemisphere winter of 2003–04 antigenic variant strains (A/Fujian/411/02 –like) of influenza A H3N2 emerged. Circulation of these strains in the UK was accompanied by an unusually high number of laboratory confirmed influenza associated fatalities in children. This study was carried out to better understand risk factors associated with fatal cases of influenza in children. Methodology/Principal Findings Case histories, autopsy reports and death registration certificates for seventeen fatal cases of laboratory confirmed influenza in children were analyzed. None had a recognized pre-existing risk factor for severe influenza and none had been vaccinated. Three cases had evidence of significant bacterial co-infection. Influenza strains recovered from fatal cases were antigenically similar to those circulating in the community. A comparison of protective antibody titres in age stratified cohort sera taken before and after winter 2003–04 showed that young children had the highest attack rate during this season (21% difference, 95% confidence interval from 0.09 to 0.33, p = 0.0009). Clinical incidences of influenza-like illness (ILI) in young age groups were shown to be highest only in the years when novel antigenic drift variants emerged. Conclusions/Significance This work presents a rare insight into fatal influenza H3N2 in healthy children. It confirms that circulating seasonal influenza A H3N2 strains can cause severe disease and death in children in the apparent absence of associated bacterial infection or predisposing risk factors. This adds to the body of evidence demonstrating the burden of severe illness due to seasonal influenza A in childhood. PMID:19876396

  20. Husband/Partner Intoxication and Intimate Partner Violence Against Women in the Philippines.

    PubMed

    Kerridge, Bradley T; Tran, Phu

    2016-09-01

    This study examined husband/partner intoxication and experience with physical, sexual, and emotional intimate partner violence against women (IPVAW) using data derived from a nationally representative survey conducted in the Philippines in 2013. Multivariate logistic regression analyses were used to examine the association between intoxication and 3 different types of intimate partner violence against women. Multinomial logistic regression was used to examine intoxication and severity of violence. In this sample, 28.8% of women reported experiencing any form of intimate partner violence and 92.9% of women reported their partner being intoxicated at least sometimes. Intoxication was significantly associated with all 3 types of intimate partner violence, while the odds of experiencing one form of IPVAW versus no form of IPVAW and 2 forms of IPVAW versus 1 form of IPVAW was greater among women reporting frequency of husband/partner intoxication as often.

  1. [Mitochondrial dysfunction and compensatory mechanisms in liver cells during acute carbon tetrachloride-induced rat intoxication].

    PubMed

    Zavodnik, I B

    2015-01-01

    Electron-transport chain and redox-balance of mitochondria are important targets that are damaged during intoxication. The aim of the present work was to estimate the role of impairments in cellular bioenergetic function in the development of liver damage during acute carbon tetrachloride intoxication in rats and to elucidate possible compensatory mechanisms. Acute CCl4-induced rat intoxication (0.8 g/kg or 4 g/kg) resulted in considerable impairments of respiratory and synthetic mitochondrial functions; their manifestations depended on the dose of the toxic agent and the duration of the intoxication increased and accompanied by complete uncoupling of oxidation and phosphorylation processes in liver mitochondria. The intoxication induced considerable liver damage and accumulation of NO in blood plasma and liver tissue. The changes of some parameters of liver mitochondrial functional activity demonstrate an oscillative pattern, reflecting compensatory mechanisms during intoxication that involved increased reduced glutathione level and enhanced succinate dehydrogenase activity. PMID:26716745

  2. [Mitochondrial dysfunction and compensatory mechanisms in liver cells during acute carbon tetrachloride-induced rat intoxication].

    PubMed

    Zavodnik, I B

    2015-01-01

    Electron-transport chain and redox-balance of mitochondria are important targets that are damaged during intoxication. The aim of the present work was to estimate the role of impairments in cellular bioenergetic function in the development of liver damage during acute carbon tetrachloride intoxication in rats and to elucidate possible compensatory mechanisms. Acute CCl4-induced rat intoxication (0.8 g/kg or 4 g/kg) resulted in considerable impairments of respiratory and synthetic mitochondrial functions; their manifestations depended on the dose of the toxic agent and the duration of the intoxication increased and accompanied by complete uncoupling of oxidation and phosphorylation processes in liver mitochondria. The intoxication induced considerable liver damage and accumulation of NO in blood plasma and liver tissue. The changes of some parameters of liver mitochondrial functional activity demonstrate an oscillative pattern, reflecting compensatory mechanisms during intoxication that involved increased reduced glutathione level and enhanced succinate dehydrogenase activity.

  3. [Acute intoxication in adults - what you should know].

    PubMed

    Zilker, Th

    2014-01-01

    Ingestion of household products and plants are the leading cause for calls to the poison control centres as far as children are involved. Severe intoxication in children has become infrequent due to childproofed package and blister packs for drugs. Chemical accidents in adults give rise to hospital admission in only 5 %. Suicidal selfpoisonings are still a challenge for paramedics, emergency and hospital doctors. Natural toxins as amatoxins, cholchicine and snakebites can lead to severe intoxication. Sedatives, antidepressants and analgesics are the drugs which are often used for suicidal intent due to their availability. Quetiapine and paracetamol are the drugs which are ingested for attempted suicide/ suicide mostly. The treatment of poisoning centers on the severity which can be judged by the poison severity score, the Reed classification or the GCS.Most intoxicated patients can be treated symptomatically or by intensive care measurements. Antidotal treatment however is needed for some specific poisonings.Exact sample drawing is essential for diagnostic and forensic purposes. There is no evidence based proof for the effectiveness of primary detoxification from the gastrointestinal tract like forced emesis, gastric lavage or the use of cathartics. Early after the ingestion of a harmful substance the administration of activated charcoal seems advisable. Hemodialysis can remove water soluble substances with a small volume of distribution. Multiple charcoal administration may exhibit some influence on secondary detoxification. Provision of evidence of the efficacy for newer antidotes like hydroxocobalamin in smoke inhalation, fomepizol for toxic alcohols and silibinin for amanita poisoning are emerging. Two recently recommended therapeutic principles have still to demonstrate their ability: Firstly the treatment of patients with calcium receptor antagonistic and beta-receptor antagonistic agents poisoning by high dose of insulin plus glucose, secondly the

  4. [Acute intoxication in adults - what you should know].

    PubMed

    Zilker, Th

    2014-01-01

    Ingestion of household products and plants are the leading cause for calls to the poison control centres as far as children are involved. Severe intoxication in children has become infrequent due to childproofed package and blister packs for drugs. Chemical accidents in adults give rise to hospital admission in only 5 %. Suicidal selfpoisonings are still a challenge for paramedics, emergency and hospital doctors. Natural toxins as amatoxins, cholchicine and snakebites can lead to severe intoxication. Sedatives, antidepressants and analgesics are the drugs which are often used for suicidal intent due to their availability. Quetiapine and paracetamol are the drugs which are ingested for attempted suicide/ suicide mostly. The treatment of poisoning centers on the severity which can be judged by the poison severity score, the Reed classification or the GCS.Most intoxicated patients can be treated symptomatically or by intensive care measurements. Antidotal treatment however is needed for some specific poisonings.Exact sample drawing is essential for diagnostic and forensic purposes. There is no evidence based proof for the effectiveness of primary detoxification from the gastrointestinal tract like forced emesis, gastric lavage or the use of cathartics. Early after the ingestion of a harmful substance the administration of activated charcoal seems advisable. Hemodialysis can remove water soluble substances with a small volume of distribution. Multiple charcoal administration may exhibit some influence on secondary detoxification. Provision of evidence of the efficacy for newer antidotes like hydroxocobalamin in smoke inhalation, fomepizol for toxic alcohols and silibinin for amanita poisoning are emerging. Two recently recommended therapeutic principles have still to demonstrate their ability: Firstly the treatment of patients with calcium receptor antagonistic and beta-receptor antagonistic agents poisoning by high dose of insulin plus glucose, secondly the

  5. Child Abuse and Neglect Fatalities: Statistics and Interventions

    MedlinePlus

    ... Child Abuse and Neglect Fatalities 2014: Statistics and Interventions Series Title: Numbers and Trends Author(s): Child Welfare ... Child Abuse and Neglect Fatalities 2014: Statistics and Interventions Series: Numbers and Trends Year Published: 2016 https:// ...

  6. Barbiturate ingestion in three adult captive tigers (Panthera tigris) and concomitant fatal botulism of one.

    PubMed

    Williams, J H; Bester, L; Venter, L; Pretorius, D; Greyling, F

    2011-12-01

    Zoo animals, including tigers, have been reported to suffer from barbiturate intoxication, with pentabarbitone being most commonly recorded. Clinical signs range from mild ataxia to general anaesthesia with recovery over hours to days with several factors affecting hepatic barbiturate metabolism and tissue partitioning. Botulism is an often fatal intoxication in man, animals, birds and certain fish. The occurrence in carnivores is uncommon to rare, with only 2 reports found of botulism in felids. This report relates to 3 adult captive cohabiting tigers that simultaneously developed signs of abdominal discomfort, progressive ataxia, recumbency and comatose sleep resembling stage 2 anaesthesia, alternating with periods of distracted wakefulness and ataxic movements. These signs occurred 4 days after being fed the carcass of a horse that had ostensibly died of colic and not been euthanased. The male tiger that was the dominant animal in the feeding hierarchy was worst affected and had to be given intravenous fluids. The female that was lowest in hierarchy was unaffected. After 48-72 hours of treatment at the Onderstepoort Veterinary Academic Hospital the females could eat and made an uneventful recovery. The male tiger showed partial recovery but died during the night a few hours after drinking water on his return to the owner. Necropsy revealed severe oesophageal dilation and impaction with decaying grass; some of this material and water were present in the pharynx and trachea, and had been aspirated causing acute widespread bronchopneumonia. Colon content tested negative for common pesticides but, together with liver, tested positive for barbiturate. Serum taken on the day of admission had tested negative for barbiturate and the residual serum from the 3 animals later tested negative for botulinum toxin. Colon and oesophageal content from the male at necropsy were positive for Clostridium botulinum toxin type C by the mouse bioassay neutralisation test, confirming

  7. Acute alcohol intoxication in a child following ingestion of an ethyl-alcohol-based hand sanitizer.

    PubMed

    Hertzog, James H; Radwick, Allison

    2015-07-01

    While uncommon, ingestion of ethanol-based hand sanitizers by children may be associated with significant intoxication. We report the case of a 7-year-old with acute alcohol intoxication following hand sanitizer ingestion. Alcohol elimination in this patient followed zero-order kinetics with a clearance rate of 22.5 mg/kg/h, consistent with the limited pharmacokinetic information available for children who experience alcohol intoxication from more traditional sources. PMID:25943177

  8. A fatal case of trichlorofluoromethane (Freon 11) poisoning. Tissue distribution study by gas chromatography-mass spectrometry.

    PubMed

    Groppi, A; Polettini, A; Lunetta, P; Achille, G; Montagna, M

    1994-05-01

    A case of lethal poisoning due to trichlorofluoromethane (FC11) inhalation is described. The fluorocarbon was determined in biological tissues by headspace gas chromatography-mass spectrometry. FC11 was detected in all the examined tissues, with decreasing levels in heart, lung, brain, liver, blood, kidney, and spleen. The highest concentration measured in heart could be related to the mode of toxic action of fluorocarbons postulated by many authors, characterized by the sensitization of the myocardium to the catecholamines producing arrhythmia and cardiac arrest. Nevertheless the aspecific picture of the anatomo-pathological and histological findings does not exclude that the described accidental fatality may have been caused by the combination of direct from toxicity with hypoxemic asphyxiation, due to the saturation of the atmosphere by FC11 in the closed environment in which the intoxication occurred. PMID:8006631

  9. Party Characteristics, Drinking Settings, and College Students’ Risk of Intoxication: A Multi-Campus Study

    PubMed Central

    Marzell, Miesha; Bavarian, Niloofar; Paschall, Mallie J.; Mair, Christina; Saltz, Robert F.

    2015-01-01

    We examined party characteristics across different college drinking settings, associations between party characteristics and likelihood of drinking to intoxication, and the mediating role of perceived prevalence of intoxicated partygoers. Students (N = 6903) attending 14 public universities in California during the 2010 and 2011 fall semesters completed surveys on individual and party characteristics in six unique settings (e.g., residence hall). We used descriptive statistics to examine party characteristics by setting. We estimated multilevel logistic regression models to identify party characteristics associated with drinking to intoxication, and we used RMediation to determine significance of mediating effects. Individual and party characteristics varied by drinking context. Greater time at a party was associated with drinking to intoxication at five of six settings, while larger party size was significant only for outdoor settings. Enforcing the legal drinking age and refusing to serve intoxicated patrons were associated with lower likelihood of intoxication at Greek and off-campus parties. The presence of a keg was associated with drinking to intoxication at Greek, off-campus and outdoor parties; at bars, cover charges and drink promotions were positively associated with drinking to intoxication. In four of six settings, we found evidence of significant mediating effects through perceived prevalence of intoxicated partygoers. Findings highlight risk and protective characteristics of parties by drinking setting, and have prevention implications. PMID:25976418

  10. Risk factors for fatal crashes in rural Australia.

    PubMed

    Siskind, Victor; Steinhardt, Dale; Sheehan, Mary; O'Connor, Teresa; Hanks, Heather

    2011-05-01

    This paper presents findings from the rural and remote road safety study, conducted in Queensland, Australia, from March 2004 till June 2007, and compares fatal crashes and non-fatal but serious crashes in respect of their environmental, vehicle and operator factors. During the study period there were 613 non-fatal crashes resulting in 684 hospitalised casualties and 119 fatal crashes resulting in 130 fatalities. Additional information from police sources was available on 103 fatal and 309 non-fatal serious crashes. Over three quarters of both fatal and hospitalised casualties were male and the median age in both groups was 34 years. Fatal crashes were more likely to involve speed, alcohol and violations of road rules and fatal crash victims were 2½ times more likely to be unrestrained inside the vehicle than non-fatal casualties, consistent with current international evidence. After controlling for human factors, vehicle and road conditions made a minimal contribution to the seriousness of the crash outcome. Targeted interventions to prevent fatalities on rural and remote roads should focus on reducing speed and drink driving and promoting seatbelt wearing. PMID:21376905

  11. Diesel fumes do kill: a case of fatal carbon monoxide poisoning directly attributed to diesel fuel exhaust with a 10-year retrospective case and literature review*.

    PubMed

    Griffin, Sean M; Ward, Michael K; Terrell, Andrea R; Stewart, Donna

    2008-09-01

    While it is known that diesel fuel combustion engines produce much lower concentrations of carbon monoxide (CO) than gasoline engines, these emissions could certainly generate lethal ambient concentrations given a sufficient amount of time in an enclosed space and under suitable environmental conditions. The authors report a case of CO poisoning which was initially referred for autopsy as a presumed natural death of a truck driver found in the secure cab of a running diesel tractor trailer truck. Completion of the preliminary investigation ascribed death to complications of ischemic heart disease (IHD), pending toxicological analysis that included quantification of CO. When the toxicology results showed lethal blood COHbg, the cause of death was re-certified as CO intoxication secondary to inhalation of (diesel) vehicular exhaust fumes. Because of the unique source of fatal CO intoxication in this case, the contributory IHD and the possible contaminants in the putrefied blood, a 10-year retrospective review was conducted on all nonfire related CO deaths autopsied (n = 94) at the Office of the Chief Medical Examiner in Louisville, KY from 1994 to 2003. For validation of the COHbg detection method used by the Kentucky Office of Forensic Toxicology (KYOFT), blood samples from these cases along with controls were submitted to three laboratories using various analytical methods yielding no statistically significant differences. Lastly, an extensive literature review produced no scientifically reported cases of fatal CO poisoning attributed to diesel fuel exhaust.

  12. Fatal outbreak of botulism in Greenland.

    PubMed

    Hammer, Tóra Hedinsdottir; Jespersen, Sanne; Kanstrup, Jakob; Ballegaard, Vibe Cecilie; Kjerulf, Anne; Gelvan, Allan

    2015-03-01

    Botulism commonly occurs when the anaerobic, gram-positive bacterium Clostridium botulinum, under suitable conditions, produces botulinum neurotoxins. Named A-F, these toxins are the immediate causative agent of the clinical symptoms of symmetrical, descending neurological deficits, including respiratory muscle paralysis. We present five cases of foodborne botulism occurring in Greenland, two with fatal outcome, caused by ingestion of tradionally preserved eider fowl. In the cases of the survivors, antitoxin and supportive care, including mechanical ventilation, were administered. In these cases recovery was complete. Microbiological assays, including toxin neutralization bioassay, demonstrated the presence of neurotoxin E in two survivors. The third survivor was shown by PCR to have the BoNT type E gene in faeces. This is the first report of cases of fatal botulism in Greenland. It underscores the importance of prompt coordinated case management effort in a geographically isolated area such as Greenland.

  13. Case report of fatal Mycobacterium tilburgii infection.

    PubMed

    Akpinar, Timur; Bakkaloglu, Oguz K; Ince, Burak; Tufan, Fatih; Kose, Murat; Poda, Mehves; Tascioglu, Didem; Koksalan, O Kaya; Saka, Bulent; Erten, Nilgun; Buyukbabani, Nesimi; Kilicaslan, Zeki; Tascioglu, Cemil

    2015-07-01

    There are few reports concerning Mycobacterium tilburgii infection in humans because this bacterium is non-cultivatable. Herein, using new molecular techniques, we report the case of an immunocompromised patient with fatal disseminated lymphadenitis that was caused by M. tilburgii.26 years old Caucasian HIV negative female patient presented with abdominal pain. Her clinical assessment revealed disseminated lymphadenitis, that was acid fast bacilli positive. Further molecular evaluation showed the causative agent as M. tilburgii. Despite anti mycobacterial therapy and careful management of intervening complications patient died because of an intraabdominal sepsis. This is the first fatal M. tilburgii infection in the literature. This case points the importance of careful management of patient's immune status and intervening infections besides implementation of effective drug treatment.

  14. Tornado-associated fatalities--Arkansas, 1997.

    PubMed

    1997-05-16

    On March 1, 1997, approximately nine tornadoes originating from two separate thunderstorms swept across Arkansas, from Hempstead County in the southwest to Clay County in the northeast (approximately 260 miles). The tornadoes caused 26 deaths and an estimated $115 million in property damage, reflecting damage to residences, nonresidential buildings, bridges, and roads and agriculture and timber losses. The strongest tornadoes touched down southwest of Little Rock in Clark, Saline, and Pulaski counties; the estimated widths of the tornado paths ranged from 1/2 to 1 mile, and wind speeds were > 200 miles per hour (National Weather Service [NWS], unpublished data, 1997). This report summarizes circumstances of the tornado-associated fatalities from information collected by the American Red Cross (ARC); 14 of the 26 fatalities occurred among persons who were in mobile homes.

  15. Case report of fatal Mycobacterium tilburgii infection.

    PubMed

    Akpinar, Timur; Bakkaloglu, Oguz K; Ince, Burak; Tufan, Fatih; Kose, Murat; Poda, Mehves; Tascioglu, Didem; Koksalan, O Kaya; Saka, Bulent; Erten, Nilgun; Buyukbabani, Nesimi; Kilicaslan, Zeki; Tascioglu, Cemil

    2015-07-01

    There are few reports concerning Mycobacterium tilburgii infection in humans because this bacterium is non-cultivatable. Herein, using new molecular techniques, we report the case of an immunocompromised patient with fatal disseminated lymphadenitis that was caused by M. tilburgii.26 years old Caucasian HIV negative female patient presented with abdominal pain. Her clinical assessment revealed disseminated lymphadenitis, that was acid fast bacilli positive. Further molecular evaluation showed the causative agent as M. tilburgii. Despite anti mycobacterial therapy and careful management of intervening complications patient died because of an intraabdominal sepsis. This is the first fatal M. tilburgii infection in the literature. This case points the importance of careful management of patient's immune status and intervening infections besides implementation of effective drug treatment. PMID:25818194

  16. Fatal combination of moclobemide overdose and whisky.

    PubMed

    Bleumink, G S; van Vliet, A C M; van der Tholen, A; Stricker, B H Ch

    2003-03-01

    The antidepressant moclobemide (Aurorix) is a reversible inhibitor of monoamine oxidase-A. Pure moclobemide overdose is considered to be relatively safe. Mixed drug overdoses including moclobemide are potentially lethal, especially when serotonergical drugs are involved. So far, only one fatality due to moclobemide mono-overdose has been reported. We report here on a fatality following the ingestion of a moclobemide overdose in combination with half a bottle of whisky. Although dietary restrictions during moclobemide therapy are not considered necessary, the combination of large quantities of moclobemide and tyramine-containing products seems to be lethal, probably because monoamine oxidase-A selectivity is overwhelmed after massive overdoses. Since there is no specific antidote and treatment is only symptomatic, the severity of an overdose with moclobemide must not be underestimated.

  17. Fatal propeller injuries: three autopsy case reports.

    PubMed

    Ihama, Yoko; Ninomiya, Kenji; Noguchi, Masamichi; Fuke, Chiaki; Miyazaki, Tetsuji

    2009-10-01

    Most propeller injuries occur at water recreational facilities such as those with provision for water skiing, boat racing, skin and scuba diving. Propeller injuries resulting from nautical accidents can be fatal. The sharp blades of propellers rotating at high speeds cause multiple and serious injuries such as deep laceration, chop wounds, bone fractures and mutilation of extremities. We present the autopsy reports of three people who died after colliding with boat propellers.

  18. Scuba divers' pulmonary oedema: recurrences and fatalities.

    PubMed

    Edmonds, Carl; Lippmann, John; Lockley, Sarah; Wolfers, Darren

    2012-03-01

    Scuba divers' pulmonary oedema (SDPE) is an increasingly recognised disorder in divers. We report three fatal cases of SDPE, demonstrating its potential serious nature even in the absence of underlying cardiac disease demonstrable clinically or at autopsy. This, together with the frequency of recurrences, has implications on assessing fitness for subsequent diving, snorkelling and swimming. The differential diagnosis of this disorder is also considered, as is its possible inducement by salt water aspiration and its relationship to drowning.

  19. Unusual cause of fatal anthrax meningitis.

    PubMed

    Parlak, Emine; Parlak, Mehmet; Atli, Seval Bilgiç

    2015-03-01

    We report the case of fatal anthrax meningoencephalitis in the province of Muş located in eastern Anatolia, Turkey. The organism isolated from cerebrospinal fluid was identified as Bacillus anthracis. The patient was treated with crystallized penicillin G (24 MU/day IV) and ciprofloxacin (2 × 400/day IV), but died 5 days after hospitalization. Although it is a rare case, we consider that the patients who have skin, respiratory and neurological systems might also have hemorrhagic meningitis.

  20. Contextual Determinants of Adolescent Perceived Early Fatality.

    PubMed

    Zimmerman, Gregory M; Rees, Carter; Farrell, Chelsea

    2016-08-01

    Adolescents overestimate their risk for early or premature death. In turn, perceived early fatality is associated with a host of adverse developmental outcomes. Research on the correlates of perceived early fatality is nascent, and an examination of the contextual determinants of perceived early fatality is largely absent from the literature. Using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), this study examines whether friendship networks and the school climate impact youth's perceptions of premature death. Analysis using hierarchical linear models on 9617 youth (52.0 % female) within 113 middle and high schools across the U.S. assess the extent to which peer and school future orientation climate and friendship network characteristics (network size, density, popularity, and centrality) impact respondents' life expectancy. Consistent with hypotheses: (1) higher levels of life expectancy in respondents' friendship networks and schools are associated with more optimistic expectations about the future among sample respondents; and (2) youth embedded in larger and denser friendship networks report higher levels of life expectancy. The results are consistent with the literature on peer effects, studies documenting the insulating effects of extensive and closely knit peer networks, and research on the contextual effects of the school environment. More generally, the results suggest that adolescent friendship networks and the school climate are key contexts in which youth develop expectations for the future. PMID:27325518

  1. Contextual Determinants of Adolescent Perceived Early Fatality.

    PubMed

    Zimmerman, Gregory M; Rees, Carter; Farrell, Chelsea

    2016-08-01

    Adolescents overestimate their risk for early or premature death. In turn, perceived early fatality is associated with a host of adverse developmental outcomes. Research on the correlates of perceived early fatality is nascent, and an examination of the contextual determinants of perceived early fatality is largely absent from the literature. Using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), this study examines whether friendship networks and the school climate impact youth's perceptions of premature death. Analysis using hierarchical linear models on 9617 youth (52.0 % female) within 113 middle and high schools across the U.S. assess the extent to which peer and school future orientation climate and friendship network characteristics (network size, density, popularity, and centrality) impact respondents' life expectancy. Consistent with hypotheses: (1) higher levels of life expectancy in respondents' friendship networks and schools are associated with more optimistic expectations about the future among sample respondents; and (2) youth embedded in larger and denser friendship networks report higher levels of life expectancy. The results are consistent with the literature on peer effects, studies documenting the insulating effects of extensive and closely knit peer networks, and research on the contextual effects of the school environment. More generally, the results suggest that adolescent friendship networks and the school climate are key contexts in which youth develop expectations for the future.

  2. Idiopathic Fatal Pancytopenia: A Case Report.

    PubMed

    Goyal, Hema; Tilak, Vijai

    2016-06-01

    Pancytopenia is defined as decrease in red blood cells, white blood cells and platelets. Many disease processes involve the bone marrow primarily or secondarily resulting in pancytopenia. A 55-year-old male presented with generalized body weakness and few episodes of malena for last one year. Physical and systemic examination was unremarkable. CBC report revealed pancytopenia. Other haematological parameters were within normal limit. Stool for occult blood was positive. USG and CECT abdomen showed no abnormality. The patient was evaluated for any evidence of malignancy but no clue was found. Bone marrow examination was done as patient was having pancytopenia. Bone marrow smears, clot sections and bone marrow biopsy was normal. Immunohistochemistry and cytogenetics study was unremarkable. Patient was admitted in hospital for 1 month and his condition rapidly deteriorated. The cause of pancytopenia remained unexplained and therefore it was named as Idiopathic fatal pancytopenia. "Idiopathic Fatal Pancytopenia (IFP)" is an emerging new entity with a grave prognosis. We wish to sensitize the medical community and the scientists to this rapidly fatal condition. PMID:27504300

  3. Near fatal asthma: treatment and prevention.

    PubMed

    D'Amato, G; Vitale, C; Lanza, M; Sanduzzi, A; Molino, A; Mormile, M; Vatrella, A; Bilò, M B; Antonicelli, L; Bresciani, M; Micheletto, C; Vaghi, A; D'Amato, M

    2016-07-01

    Near-fatal asthma (NFA) is described as acute asthma associated with a respiratory arrest or arterial carbon dioxide tension greater than 50 mmHg, with or without altered consciousness, requiring mechanical ventilation. Risk factors for near fatal asthma have not been fully elucidated. In 80-85% of all fatal events, a phenotype, characterized by eosinophilic inflammation associated with gradual deterioration occurring in patients with severe and poorly controlled asthma, has been identified. Regarding to the management, acute severe asthma remains a significant clinical problem, which needs to be identified to facilitate early and appropriate therapeutic interventions. The assessment relies on clinical signs, but additional information might be obtained from chest radiography or blood gas analysis. No investigation should delay the initiation of appropriate therapy. The goals of therapy are the maintenance of oxygenation, relief of airflow obstruction, reduction of airways edema and mucus plugging (with Increased use of medications such as beta-agonists via metered dose inhalers and nebulizers, oral and/or intravenous (other than by inhalation) corticosteroids and oral or intravenous theophylline) whereas supporting ventilation as clinically indicated. Of course, the emergency physician needs to consider the wide range of potential complications, as attention to these problems when managing severe acute asthma might significantly improve outcome. An understanding of the available agents and potential pitfalls in the management of NFA is mandatory for the emergency physician. PMID:27425166

  4. Fatality following a suicidal overdose with varenicline.

    PubMed

    Stove, Christophe P; De Letter, Els A; Piette, Michel H; Lambert, Willy E

    2013-01-01

    The smoking cessation agent varenicline acts as a partial agonist on α(4)β(2) nicotinic acetylcholine receptors. Although debated, several reports have linked varenicline therapy to an increased risk of suicidal thoughts and/or suicide. In addition, several non-fatal overdose cases have been reported. In this report, we utilised a sample preparation procedure suitable for postmortem samples and gas chromatography coupled to mass spectrometry to analyse samples obtained from a suicidal case in which ingestion of an overdose of varenicline had occurred. Extremely high concentrations of varenicline (>250 ng/ml) were detected in the blood of the deceased, in addition to high concentrations in urine and vitreous humour. To the best of our knowledge, similar high concentrations have not been reported yet. Although, with respect to the mechanism of death in this case, confounding factors were concomitant ethanol consumption and, importantly, potentially fatal hypothermia, this is the first report of a fatality associated with the ingestion of an overdose of varenicline.

  5. [CHRONIC FLUORIDE INTOXICATION AS A RISK FACTOR FOR THE DEVELOPMENT OF ATHEROSCLEROSIS].

    PubMed

    Korotenko, O Yu; Panev, N I; Zakharenkov, V V; Filimonov, S N; Semenova, E A; Panev, R N

    2015-01-01

    In workers employed in the aluminum industry, the main harmful production factor is exposure to fluoride salts, which can cause chronic fluoride intoxication. For the assessment of the impact of chronic fluoride intoxication on the development of atherosclerosis, we conducted a comprehensive survey of 87 aluminum-metal makers with chronic fluoride intoxication and 43 aluminum-metal makers without occupational diseases, mean age--52.1 ± 0.4 years. There were considered the presence and severity of atherosclerosis of brachiocephalic arteries, and the arteries of the lower extremities in the studied group, there was evaluated the effect of other risk factors for atherosclerosis (smoking, presence of hypertension, diabetes, dyslipidemia). With the use of Doppler ultrasound of the arteries it was revealed that in metallurgists with chronic fluoride intoxication atherosclerosis was detected in 73.6% versus 55.8% in persons of the comparison group. The performed analysis of the prevalence of main risk factors for atherosclerosis showed that in metal makers with chronic fluoride intoxication in combination with atherosclerosis hypertension is more common (in 54.7%) than in metallurgists with chronic fluoride intoxication without atherosclerosis--only 26.1%. According to the frequency of occurrence of smoking, diabetes mellitus, hypercholesterolemia, and hypertriglyceridemia, there were no significant differences between the metallurgists with chronic fluoride intoxication, with and without atherosclerosis, and the control group, the increase in LDL cholesterol occurs significantly more often in metal-makers with chronic fluoride intoxication in combination with atherosclerosis if compared to workers without occupational diseases. Thus, chronic fluoride intoxication acts as a risk factor in the development of atherosclerosis: atherosclerosis in metal-makers with chronic fluoride intoxication occurs more frequently than in workers who do not have professional pathology

  6. Characterization of a Mouse Model of Oral Potassium Cyanide Intoxication.

    PubMed

    Sabourin, Patrick J; Kobs, Christina L; Gibbs, Seth T; Hong, Peter; Matthews, Claire M; Patton, Kristen M; Sabourin, Carol L; Wakayama, Edgar J

    2016-09-01

    Potassium cyanide (KCN) is an inhibitor of cytochrome C oxidase causing rapid death due to hypoxia. A well-characterized model of oral KCN intoxication is needed to test new therapeutics under the Food and Drug Administration Animal Rule. Clinical signs, plasma pH and lactate concentrations, biomarkers, histopathology, and cyanide and thiocyanate toxicokinetics were used to characterize the pathology of KCN intoxication in adult and juvenile mice. The acute oral LD50s were determined to be 11.8, 11.0, 10.9, and 9.9 mg/kg in water for adult male, adult female, juvenile male, and juvenile female mice, respectively. The time to death was rapid and dose dependent; juvenile mice had a shorter mean time to death. Juvenile mice displayed a more rapid onset and higher incidence of seizures. The time to observance of respiratory signs and prostration was rapid, but mice surviving beyond 2 hours generally recovered fully within 8 hours. At doses up to the LD50, there were no gross necropsy or microscopic findings clearly attributed to administration of KCN in juvenile or adult CD-1 mice from 24 hours to 28 days post-KCN challenge. Toxicokinetic analysis indicated rapid uptake, metabolism, and clearance of plasma cyanide. Potassium cyanide caused a rapid, dose-related decrease in blood pH and increase in serum lactate concentration. An increase in fatty acid-binding protein 3 was observed at 11.5 mg/kg KCN in adult but not in juvenile mice. These studies provide a characterization of KCN intoxication in adult and juvenile mice that can be used to screen or conduct preclinical efficacy studies of potential countermeasures.

  7. Severe methemoglobinemia due to food intoxication in infants.

    PubMed

    Murone, Anne-Joëlle Bosset; Stucki, Pascal; Roback, Mark G; Gehri, Mario

    2005-08-01

    The purpose of this case report is to illustrate food intoxication in infants as a consequence of fennel ingestion. Four cases of methemoglobinemia (MetHb) are presented here. Each patient ate homemade fennel purée a few hours prior to arriving to the emergency department with cyanosis unresponsive to oxygen, in the absence of suspected cyanotic heart disease. All 4 patients received treatment with methylene blue and fully recovered. Our cases emphasize that improper handling and storing of vegetables can lead to life-threatening MetHb.

  8. Perceived Danger while Intoxicated Uniquely Contributes to Driving after Drinking

    PubMed Central

    Morris, David H.; Treloar, Hayley R.; Niculete, Maria E.; McCarthy, Denis M.

    2013-01-01

    Background Previous findings suggest that alcohol alters perceptions of risky behaviors such as drinking and driving. However, studies testing these perceptions as a predictor of drinking and driving typically measure these perceptions while participants are sober. The present study tested whether the perceived danger of driving after drinking assessed while intoxicated was associated with increased willingness to drive and self-reported drinking-and-driving behavior over and above perceptions assessed while sober. Additionally, we tested the effect of acute tolerance on the perceived danger of driving after drinking assessed on the ascending and descending limbs of the breath alcohol concentration (BrAC) curve. Methods Eighty-two young adults attended two counterbalanced laboratory sessions. In one session, participants consumed a moderate dose of alcohol (men: .72 g/kg, women: .65 g/kg) and reported the perceived danger of driving and their willingness to drive at multiple points across the BrAC curve. On a separate occasion, participants remained sober and appraised the dangerousness of driving at a hypothetical, illegal BrAC. Results Perceptions of the dangerousness of driving following alcohol administration were associated with increased willingness to drive and higher rates of self-reported drinking-and-driving behavior over and above perceptions reported when sober. Furthermore, perceived danger was reduced on the descending limb of the BrAC curve, compared to the ascending limb, suggesting the occurrence of acute tolerance. Conclusions Results from this study suggest that intoxicated perceptions are uniquely associated with drinking-and-driving decisions and that the perceived danger of drinking and driving is lower on the descending limb of the BrAC curve. Efforts to prevent alcohol-impaired driving have focused on increasing awareness of the danger of driving after drinking. Prevention efforts may be enhanced by educating drivers about how intoxication

  9. [Role of hemodialysis in the management of acute lithium intoxication].

    PubMed

    Maghraoui, Jaouad El; Kabbali, Nadia; Arrayhani, Mohamed; Houssaini, Tarik Sqalli

    2016-01-01

    We report the case of a 47-years old patient, traited with lithium for manic-depressive psychosis over a period of twenty and admitted to hospital with a disorder of consciousness after suicide attempt with lithium overdose (ingestion of 30 tablets of Téralithe(®) LP 400, delayed action galenic forms corresponding to 12 g of lithium carbonate), clinically improved after three hemodialysis sessions. This study illustrates the therapeutic role of hemodialysis in voluntary intoxications with extended release lithium even a week after the ingestion and the therapeutic insufficiency of a single hemodialysis session. PMID:27583091

  10. Transient proteinuria and aminoaciduria in rodents following uranium intoxication

    SciTech Connect

    Bentley, K.W.; Stockwell, D.R.; Britt, K.A.; Kerr, C.B.

    1985-03-01

    Alternative human bioassay procedures for uranium are being investigated. Aminoaciduria in uranium hexafluoride and uranium mill employees has been examined. Although not conclusive, the results suggest that chronic human urinary uranium concentrations of 30-50 ..mu..g L/sup -1/ produce marked changes in the amino acid excretion profile although no consistent patterns emerged. As part of a program to examine alternative bioassay techniques for occupationally exposed uranium workers and to assist in interpretation of amino acid obtained from human incident exposures, the authors have examined the occurrence of transient aminoaciduria following uranium intoxication in female rats.

  11. [Intoxication from accidental ingestion of cannabis: analysis of eight cases].

    PubMed

    Patissier, C; Akdhar, M; Manin, C; Rosellini, D; Tambat, A; Tiprez, C; Wendremaire, P; Renoux, M-C

    2015-01-01

    Consultations at pediatric emergency units for acute consciousness alterations is frequent. Miscellaneous causes include cranial trauma, meningoencephalitis, metabolic disorders, drugs, or other intoxications. We report here eight cases of infants who were brought to the emergency division due to acute consciousness failure after accidental ingestion of hashish, confirmed by urinary dosage of Δ9-tetrahydrocannabinol. This series of under 24-month-old infants only emphasizes the value of screening for cannabis in urine in cases of abnormal consciousness and/or abnormal behavior in an infant. PMID:25466782

  12. Fungating Bowen's disease with presumed arsenic intoxication. A case report.

    PubMed

    Leibowitz, M R; Rippey, J J; Thompson, P

    1982-11-01

    A patient with a bizarre fungating tumour of the anterior abdominal wall is described. The lesion had the histological features of Bowen's disease and also had the appearance of a basal cell carcinoma with sebaceous differentiation. In addition, the patient had 'raindrop' pigmentation typical of chronic arsenic intoxication. As far as we know, Bowen's disease has once previously been reported in a Black patient in South Africa. We have not encountered any other description in the literature of Bowen's disease presenting as a fungating tumour.

  13. The effects of daylight and daylight saving time on US pedestrian fatalities and motor vehicle occupant fatalities.

    PubMed

    Coate, Douglas; Markowitz, Sara

    2004-05-01

    This paper analyzes the effects of daylight and daylight saving time (DST) on pedestrian and motor vehicle occupant fatalities in the United States. Multivariate analyses of county level data from the Fatality Analysis Reporting System for 2-week periods in 1998 and 1999 are used. Results show that full year daylight saving time would reduce pedestrian fatalities by 171 per year, or by 13% of all pedestrian fatalities in the 5:00-10.00 a.m. and in the 4:00-9:00 p.m. time periods. Motor vehicle occupant fatalities would be reduced by 195 per year, or 3%, during the same time periods.

  14. 49 CFR 384.221 - Out-of-service regulations (intoxicating beverage).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 CFR part 350 and applicable policy and guidelines. ... 49 Transportation 5 2011-10-01 2011-10-01 false Out-of-service regulations (intoxicating beverage... Compliance by States § 384.221 Out-of-service regulations (intoxicating beverage). The State shall adopt,...

  15. 49 CFR 384.221 - Out-of-service regulations (intoxicating beverage).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 CFR part 350 and applicable policy and guidelines. ... 49 Transportation 5 2010-10-01 2010-10-01 false Out-of-service regulations (intoxicating beverage... Compliance by States § 384.221 Out-of-service regulations (intoxicating beverage). The State shall adopt,...

  16. 49 CFR 384.221 - Out-of-service regulations (intoxicating beverage).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 CFR part 350 and applicable policy and guidelines. ... 49 Transportation 5 2012-10-01 2012-10-01 false Out-of-service regulations (intoxicating beverage... Compliance by States § 384.221 Out-of-service regulations (intoxicating beverage). The State shall adopt,...

  17. 49 CFR 384.221 - Out-of-service regulations (intoxicating beverage).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 CFR part 350 and applicable policy and guidelines. ... 49 Transportation 5 2013-10-01 2013-10-01 false Out-of-service regulations (intoxicating beverage... Compliance by States § 384.221 Out-of-service regulations (intoxicating beverage). The State shall adopt,...

  18. 49 CFR 384.221 - Out-of-service regulations (intoxicating beverage).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 CFR part 350 and applicable policy and guidelines. ... 49 Transportation 5 2014-10-01 2014-10-01 false Out-of-service regulations (intoxicating beverage... Compliance by States § 384.221 Out-of-service regulations (intoxicating beverage). The State shall adopt,...

  19. Acute care for alcohol intoxication. Be prepared to consider clinical dilemmas.

    PubMed

    Yost, David A

    2002-12-01

    The clinical assessment of an acutely intoxicated patient should be performed with meticulous care and include repetitive examinations to properly determine the patient's condition. Multiple factors, such as trauma and concomitant use of other drugs, can confuse the diagnostic picture and affect the choice of therapy. In this article, Dr Yost reviews the diagnostic considerations, appropriate treatment, and clinic discharge for the intoxicated patient.

  20. Star fruit (Averrhoa carambola) intoxication: an important cause of consciousness disturbance in patients with renal failure.

    PubMed

    Chang, Chin-Tung; Chen, Yung-Chang; Fang, Ji-Tseng; Huang, Chiu-Ching

    2002-05-01

    Star fruit intoxication is a rare cause of consciousness disturbance in patients with renal failure. Most cases in the literature are uremic patients on maintenance dialysis. We present a patient with chronic renal failure, who was not on dialysis program yet, suffered from star fruit intoxication with presentation of consciousness disturbance and successfully managed by a session of hemodialysis.

  1. [Method and empirical results from expert opinions on 90 offenders concerning the question of complete intoxication].

    PubMed

    Mitterauer, Bernhard; Griebnitz, Ernst; Rothuber, Helfried

    2010-01-01

    Based on a 3-year sample of expert opinions concerning the question of complete intoxication (n = 90), methodology and results are presented. Since more than half of the offenders (n = 53) claim amnesia regarding the circumstances of the offence, this subjective amnesia is considered methodologically. If the file contains observations on the offender's behaviour, it is generally possible to assess if the offender was still able to self-reflect and act in a purposeful way. If so, complete intoxication must be negated independent of the objective degree of alcohol or drug intoxication, and the subjective amnesia claimed by the offender is implausible. In the assessment procedure of complete intoxication a decision tree is used. 37/90 offenders showed no significant memory impairment as well as no psychiatric diagnosis, thus excluding both criminal irresponsibility and complete intoxication. The assessment of subjective amnesia and total intoxication was based on the following information from the decision tree: in 51 (47 males, 4 females) of the 53 offenders claiming subjective amnesia the file contained behavioural observations at the time of the offence. Only in two cases, a considerable lack of information prevented a clear decision regarding the question of complete intoxication. Despite the fact that only in about 50% of the offenders claiming subjective amnesia evidence of alcohol or drug influence was demonstrated according to the files, the question of complete intoxication could be successfully evaluated in all but two cases according to the decision tree.

  2. 32 CFR 634.12 - Army administrative actions against intoxicated drivers.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 4 2011-07-01 2011-07-01 false Army administrative actions against intoxicated drivers. 634.12 Section 634.12 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY... § 634.12 Army administrative actions against intoxicated drivers. Army commanders will take...

  3. 32 CFR 634.12 - Army administrative actions against intoxicated drivers.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Army administrative actions against intoxicated drivers. 634.12 Section 634.12 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY... § 634.12 Army administrative actions against intoxicated drivers. Army commanders will take...

  4. 32 CFR 636.5 - Army administrative actions against intoxicated drivers.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 4 2011-07-01 2011-07-01 false Army administrative actions against intoxicated drivers. 636.5 Section 636.5 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY... INSTALLATIONS) Fort Stewart, Georgia § 636.5 Army administrative actions against intoxicated drivers. For...

  5. 32 CFR 636.5 - Army administrative actions against intoxicated drivers.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Army administrative actions against intoxicated drivers. 636.5 Section 636.5 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY... INSTALLATIONS) Fort Stewart, Georgia § 636.5 Army administrative actions against intoxicated drivers. For...

  6. Regulatory Self-Efficacy as a Moderator of Peer Socialization Relating to Italian Adolescents' Alcohol Intoxication

    ERIC Educational Resources Information Center

    Rabaglietti, Emanuela; Burk, William J.; Giletta, Matteo

    2012-01-01

    The present study investigated regulatory self-efficacy (RSE) as a predictor of friendship and adolescent alcohol intoxication and as a moderator of peer socialization processes related to alcohol intoxication. The longitudinal sample included 457 Italian adolescents (262 females and 195 males) ranging in age of 14 to 20 years (M = 16.1 years of…

  7. Alcohol intoxication and condom use self-efficacy effects on women's condom use intentions.

    PubMed

    Davis, Kelly Cue; Masters, N Tatiana; Eakins, Danielle; Danube, Cinnamon L; George, William H; Norris, Jeanette; Heiman, Julia R

    2014-01-01

    Although research has consistently demonstrated that condom use self-efficacy significantly predicts condom use, there has been little investigation of whether acute alcohol intoxication moderates this relationship. Because alcohol intoxication is often associated with increased sexual risk taking, further examination of such moderating effects is warranted. Using a community sample of young heterosexual women (n=436) with a history of heavy episodic drinking, this alcohol administration experiment examined the effects of intoxication and condom use self-efficacy on women's condom negotiation and future condom use intentions. After a questionnaire session, alcohol condition (control, .10% target peak BAL) was experimentally manipulated between subjects. Participants then read and responded to a hypothetical risky sexual decision-making scenario. SEM analyses revealed that alcohol intoxication directly decreased women's intentions to use condoms in the future. Women with greater condom use self-efficacy had stronger intentions to engage in condom negotiation; however, this effect was moderated by intoxication. Specifically, the association between condom use self-efficacy and condom negotiation intentions was stronger for intoxicated women than for sober women. These novel findings regarding the synergistic effects of alcohol intoxication and condom use self-efficacy support continued prevention efforts aimed at strengthening women's condom use self-efficacy, which may reduce even those sexual risk decisions made during states of intoxication. PMID:24129265

  8. 15 CFR 265.38 - Intoxication or other impairment of function.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Intoxication or other impairment of function. 265.38 Section 265.38 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign... § 265.38 Intoxication or other impairment of function. No person shall enter or remain on the site...

  9. 15 CFR 265.38 - Intoxication or other impairment of function.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 15 Commerce and Foreign Trade 1 2011-01-01 2011-01-01 false Intoxication or other impairment of function. 265.38 Section 265.38 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign... § 265.38 Intoxication or other impairment of function. No person shall enter or remain on the site...

  10. 32 CFR 636.5 - Army administrative actions against intoxicated drivers.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 4 2014-07-01 2013-07-01 true Army administrative actions against intoxicated drivers. 636.5 Section 636.5 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY... INSTALLATIONS) Fort Stewart, Georgia § 636.5 Army administrative actions against intoxicated drivers. For...

  11. 32 CFR 636.5 - Army administrative actions against intoxicated drivers.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 4 2012-07-01 2011-07-01 true Army administrative actions against intoxicated drivers. 636.5 Section 636.5 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY... INSTALLATIONS) Fort Stewart, Georgia § 636.5 Army administrative actions against intoxicated drivers. For...

  12. 32 CFR 636.5 - Army administrative actions against intoxicated drivers.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 4 2013-07-01 2013-07-01 false Army administrative actions against intoxicated drivers. 636.5 Section 636.5 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY... INSTALLATIONS) Fort Stewart, Georgia § 636.5 Army administrative actions against intoxicated drivers. For...

  13. [Treatment of intoxication with new psychoactive substances and methamphetamine].

    PubMed

    Flüchter, Peter; Pajonk, Frank-Gerald Bernhard

    2015-03-01

    Fatal outcomes subsequent to the use of new psychoactive suostances are increasingly common in Germany. In this article, we present the clinical effects and associated side effects of the different classes of substances, as synthetic cannabinoids, synthetic cathinones, phenylethylamines, piperazines and methamphetamine, as well as diagnostic aspects and treatment options in case of symptoms of poisoning. PMID:26364395

  14. Reported fatal and non-fatal incidents involving tourists in Thailand, July 1997-June 1999.

    PubMed

    Leggat, Peter A; Leggat, Frances W

    2003-05-01

    Objectives. To examine fatal and non-fatal incidents involving tourists in Thailand. Methods. Press records from a major English language newspaper for the period from July 1997 to June 1999 were examined for reports of fatal and non-fatal incidents involving tourists. Results. From July 1997 to June 1999, up to 233 deaths were reported and up to a further 216 were reported injured in incidents involving tourists. One hundred and one deaths and 45 injured were reported following one major domestic jet aircraft crash in southern Thailand, however, it was not stated what proportion of casualties were tourists. Approximately 90 people perished in a single hotel fire in southeast Thailand. Most of the victims were local travellers attending meetings of two Thai companies. Sixteen deaths and 86 injured resulted from five road accidents. The majority of deaths and injuries involved foreigners. Twelve deaths and at least 33 injured resulted from three ferry and tour boat accidents. Most victims were reported to be foreigners. Three deaths and 35 injured resulted from a single cable car accident in northern Thailand. Most of these were Thai tourists, however, four of the injured were foreigners. Eight deaths and six injured resulted from 11 muggings and other violent incidents. All were foreigners. Six deaths were reportedly connected to a scam at the airport in Bangkok involving unlicensed airport taxis. Three deaths and four injured were due to other reported incidents. Conclusions. Newspaper reports of fatal and non-fatal incidents involving tourists in Thailand were probably uncommon, particularly given the volume of tourists entering the Kingdom, although better reporting mechanisms are needed. With the exception of the unusual major incidents, most reported fatal and non-fatal incidents involving tourists were due to road trauma and other transportation accidents, muggings, and occasional water sports and other accidents, which could occur at any major tourist

  15. The Fatality Assessment and Control Evaluation program's role in the prevention of occupational fatalities

    PubMed Central

    Higgins, D; Casini, V; Bost, P; Johnson, W; Rautiainen, R

    2001-01-01

    Objectives—The objective of the Fatality Assessment and Control Evaluation (FACE) program is to prevent traumatic occupational fatalities in the United States by identifying and investigating work situations at high risk for injury and formulating and disseminating prevention strategies to those who can intervene in the workplace. Setting—The FACE program is a research program located in the Division of Safety Research, a division of the National Institute for Occupational Safety and Health (NIOSH). NIOSH is an agency of the United States government and is part of the Centers for Disease Control and Prevention. NIOSH is responsible for conducting research and making recommendations for prevention of work related illnesses and injuries. FACE investigators conduct traumatic occupational fatality investigations throughout the United States and provide technical assistance to 15 state health or labor departments who have cooperative agreements with NIOSH to conduct traumatic fatality surveillance, targeted investigations, and prevention activities at the state level. Methods—Investigations are conducted at the worksite using the FACE model, an approach derived from the research conducted by William Haddon Jr. This approach reflects the public health perspective that the etiology of injuries is multifactorial and largely preventable. FACE investigators gather information on multiple factors that may have contributed to traumatic occupational fatalities. Information on factors associated with the agent (energy exchange, for example, thermal energy, mechanical energy, electrical energy, chemical energy), host (worker who died), and the environment (the physical and social aspects of the workplace), during the pre-event, event, and post-event time phases of the fatal incident are collected and analyzed. Organizational, behavioral, and environmental factors contributing to the death are detailed and prevention recommendations formulated and disseminated to help

  16. Methocarbamol CRI for symptomatic treatment of pyrethroid intoxication: a report of three cases.

    PubMed

    Draper, William E; Bolfer, Luiz; Cottam, Emily; McMichael, Maureen; Schubert, Thomas

    2013-01-01

    Pyrethroids are popular for use in companion animals due to their relatively low mammalian toxicity and efficacy against arthropods. Nonetheless, pyrethroid intoxication has been reported in cats and dogs, and cats appear to be more susceptible due to difficulty in biotransformation and excretion of pyrethroids. Pyrethroid intoxications are generally due to either the improper use or accidental ingestion of approved products. Methocarbamol, given as intermittent injections, is a common first-line treatment choice for the tremors associated with pyrethroid intoxication. Two cats and one dog were treated with a methocarbamol continuous rate infusion (CRI) for pyrethroid intoxication. Clinical signs of toxicity resolved within a few hr in all three cases, with no adverse drug effects. A methocarbamol CRI can be considered in animals presenting with pyrethroid intoxication. PMID:23535756

  17. Is pornography consumption associated with condom use and intoxication during hookups?

    PubMed

    Braithwaite, Scott R; Givens, Anneli; Brown, Jacob; Fincham, Frank

    2015-01-01

    In order to examine whether pornography consumption is associated with risky sexual behaviour among emerging adults, we examined two large samples of those who reported hooking up in the past 12 months (combined n =  1216). Pornography use was associated with a higher likelihood of having a penetrative hookup; a higher incidence of intoxication during hookups for men (but a lower incidence of intoxication during hookups for women); increasing levels of intoxication during hookups for men but decreasing levels of intoxication for women; and a higher likelihood of being in the riskiest category of having a penetrative hookup, without a condom, while intoxicated. For each of these outcomes, our point estimates for Study 2 fell within the 95% confidence intervals from Study 1. Controlling for trait self-control, binge drinking frequency, broader problematic patterns of alcohol use, openness to experience, and attitudes toward casual sex did not change the pattern of results. Implications for interventions to reduce sexual risk are discussed.

  18. AMPA receptor potentiation can prevent ethanol-induced intoxication.

    PubMed

    Jones, Nicholas; Messenger, Marcus J; O'Neill, Michael J; Oldershaw, Anna; Gilmour, Gary; Simmons, Rosa M A; Iyengar, Smriti; Libri, Vincenzo; Tricklebank, Mark; Williams, Steve C R

    2008-06-01

    We present a substantial series of behavioral and imaging experiments, which demonstrate, for the first time, that increasing AMPA receptor-mediated neurotransmission via administration of potent and selective biarylsulfonamide AMPA potentiators LY404187 and LY451395 reverses the central effects of an acutely intoxicating dose of ethanol in the rat. Using pharmacological magnetic resonance imaging (phMRI), we observed that LY404187 attenuated ethanol-induced reductions in blood oxygenation level dependent (BOLD) in the anesthetized rat brain. A similar attenuation was apparent when measuring local cerebral glucose utilization (LCGU) via C14-2-deoxyglucose autoradiography in freely moving conscious rats. Both LY404187 and LY451395 significantly and dose-dependently reversed ethanol-induced deficits in both motor coordination and disruptions in an operant task where animals were trained to press a lever for food reward. Both prophylactic and acute intervention treatment with LY404187 reversed ethanol-induced deficits in motor coordination. Given that LY451395 and related AMPA receptor potentiators/ampakines are tolerated in both healthy volunteers and elderly patients, these data suggest that such compounds may form a potential management strategy for acute alcohol intoxication.

  19. [Minoxidil intoxication, the pharmacological agent of a hair lotion].

    PubMed

    Aprahamian, A; Escoda, S; Patteau, G; Merckx, A; Chéron, G

    2011-12-01

    Accidental intoxications in children are frequent but most of them are without serious consequences. We describe herein the case of a young girl who drank 100 mg of a topical hair lotion with minoxidil. On arrival, she had no symptoms except flush on the face and ears. Four and half hours after ingestion, tachycardia appeared with a pulse above 170 beats per min with hypotension at 76/24 mmHg. The heart rate remained between 170 and 190 beats per min for 12 h and then lowered to between 140 and 160 beats per min. Thirty-six hours after ingestion, the heart beat was at 140 beats per min. Minoxidil is a strong vasodilator used first in the 1970s for severe hypertension. It produces hypotension by direct arteriolar vasodilatation. Only a few cases of minoxidil intoxication have been described in the literature, including only one pediatric case. This young boy had only tachycardia of 160 beats per min for 40 h. Most serious cases have been described in adults. They suffered long-lasting tachycardia, hypotension, and ECG changes. Most patients need a bolus of normal saline fluid and some with hemodynamic problems need vasoactive drugs such as dopamine and/or phenylephrine. All patients need to be under medical supervision for a long time because of the product's very long action.

  20. Serial ricinine levels in serum and urine after ricin intoxication.

    PubMed

    Røen, Bent Tore; Opstad, Aase Mari; Haavind, Anniken; Tønsager, Janne

    2013-06-01

    Ricinine is an alkaloid present in the castor bean plant (Ricinus communis) that can be used as a biomarker for ricin poisoning. Serial ricinine levels are reported in the serum and urine of a patient suffering from intentional ricin intoxication. The patient was brought to the hospital 4 h after injection and oral intake of a castor bean extract, but died 38 h later, despite intensive medical care. Ricinine was isolated from the samples by solid-phase extraction and quantitatively determined by isotopic dilution liquid chromatography-mass spectrometry. The ricinine level in serum declined from 33 to 23 ng/mL between 10 and 29 h post-exposure. Three urine samples collected from 12 to 41 h after ricin intoxication showed ricinine concentrations in the range of 20-58 ng/mL. The creatinine corrected values (21-30 µg/g) indicated a concentration-time profile with a maximum ricinine level in urine between 12 and 29 h after exposure.

  1. Lead intoxication from an unexpected source. [Fruit drink dispensers

    SciTech Connect

    Kleinfeld, M.J.

    1982-02-01

    A case of lead intoxication from an unexpected source is reported. An 18-year-old man came to the Divisin of Safety and Health, New York City, complaining of periodic cramping abdominal pain and weakness of several weeks' duration. In view of clinical laboratory findings, lead intoxication was considered in the differential diagnosis and determination of blood lead and urinary amino levulinic acid (ALA) were done. The blood lead value was 70 ..mu..g/100 g of whole blood. The urinary ALA value was 3.61 mg/100 of creatinine (normal, < 2.0 mg/100 mg of creatinine). A repeated urinary ALA test on the following day gave a value of 3.50 mg/100 mg of creatinine. An industrial hygiene survey was made to ascertain the patient's exposure to lead. The work place was a luncheonette that served flavored fruit drinks. The fruit drinks were dispensed from 12 tanks, and a sampling of these tanks showed that six of them were made of metal and had been soldered in the past. In one tank a chunk of lead was found. An analysis of this chunk of lead revealed that the lead content was 50.1%. Only two of the 12 tanks showed levels of lead that were excessively high; these were made of metal and had been soldered in the past. It was recommended to the owner that acid-containing drinks should be stored in tanks constructed of stainless steel,plastic, or other lead-free materials.

  2. Combined dextromethorphan and chlorpheniramine intoxication in impaired drivers.

    PubMed

    Logan, Barry K

    2009-09-01

    Dextromethorphan is a nonprescription antitussive which has been gaining in popularity as an abused drug, because of the hallucinogenic, dissociative, and intoxicating effects it produces at high doses. This report describes a series of eight drivers arrested for driving under the influence of the combined effects of dextromethorphan and chlorpheniramine, and a further four drivers under the influence of dextromethorphan alone. In the combined dextromethorphan/chlorpheniramine cases, blood dextromethorphan concentrations ranged from 150 to 1220 ng/mL (n = 8; mean 676 ng/mL, median 670 ng/mL), and chlorpheniramine concentrations ranged from 70 to 270 ng/mL (n = 8; mean 200 ng/mL, median 180 ng/mL). The four cases without chlorpheniramine present had blood dextromethorphan concentrations between 190 and 1000 ng/mL (mean 570 ng/mL, median 545 ng/mL). Some drivers had therapeutic concentrations of other drugs present. Drivers generally displayed symptoms of central nervous system (CNS) depressant intoxication, and there was gross evidence of impairment in their driving, including weaving, leaving the lane of travel, failing to obey traffic signals, and involvement in collisions. Drug Recognition Expert opinions confirmed that the subjects were under the influence of a drug in the CNS-depressant category.

  3. Death due to acute tetrachloroethylene intoxication in a chronic abuser.

    PubMed

    Amadasi, Alberto; Mastroluca, Lavinia; Marasciuolo, Laura; Caligara, Marina; Sironi, Luca; Gentile, Guendalina; Zoja, Riccardo

    2015-05-01

    Volatile substances are used widespread, especially among young people, as a cheap and easily accessible drug. Tetrachloroethylene is one of the solvents exerting effects on the central nervous system with experiences of disinhibition and euphoria. The case presented is that of a 27-year-old female, found dead by her father at home with cotton swabs dipped in the nostrils. She was already known for this type of abuse and previously admitted twice to the hospital for nonfatal acute poisonings. The swabs were still soaked in tetrachloroethylene. Toxicological and histological investigations demonstrated the presence of an overlap between chronic intake of the substance (with high concentrations in sites of accumulation, e.g., the adipose tissue, and contemporary tissue damage, as histologically highlighted) and acute intoxication as final cause of death, with a concentration of 158 mg/L in cardiac blood and 4915 mg/kg in the adipose tissue. No other drugs or medicines were detected in body fluids or tissues, and to our knowledge, this is the highest concentration ever detected in forensic cases. This peculiar case confirms the toxicity of this substance and focuses on the importance of complete histological and toxicological investigations in the distinction between chronic abuse and acute intoxication.

  4. Characteristic manifestations of acute paint thinner-intoxicated children.

    PubMed

    Agin, Khosrow; Hassanian-Moghaddam, Hossein; Shadnia, Shahin; Rahimi, Hamid Reza

    2016-07-01

    In this study, we evaluated the acute clinical and para-clinical abnormalities arising from paint thinner (PT) poisoning in children. Data were collected from 2008 to 2013, and sourced from the medical records of PT-intoxicated children and through questionnaires. A total of 42 children were enrolled in the study. The mean age was 37.2±2.4 months. The participants ranged from10 to 96 months of age; with a median age of 3 months; and a modal age of 24 months. The sex ratio in the study was 22 males (64.9%) to 20 females (35.1%). Clinical biochemistry results of participants revealed the significant presence of alkaline phosphatase (ALP, 569.25±151.58U/L), and lactate dehydrogenase (LDH, 576.14±164.97 IU/L). Arterial blood gas (ABG) analysis was also carried out. Chest X-ray predominantly revealed right side alveolar air space consolidation. These results confirmed hepatotoxicity and pneumonia in PT-intoxicated children. The study also revealed that positive outcomes were achieved in patients with early treatment and management. In addition, the current finding confirmed the timely transfer of the victim to the poisoning center. PMID:27235798

  5. Death due to acute tetrachloroethylene intoxication in a chronic abuser.

    PubMed

    Amadasi, Alberto; Mastroluca, Lavinia; Marasciuolo, Laura; Caligara, Marina; Sironi, Luca; Gentile, Guendalina; Zoja, Riccardo

    2015-05-01

    Volatile substances are used widespread, especially among young people, as a cheap and easily accessible drug. Tetrachloroethylene is one of the solvents exerting effects on the central nervous system with experiences of disinhibition and euphoria. The case presented is that of a 27-year-old female, found dead by her father at home with cotton swabs dipped in the nostrils. She was already known for this type of abuse and previously admitted twice to the hospital for nonfatal acute poisonings. The swabs were still soaked in tetrachloroethylene. Toxicological and histological investigations demonstrated the presence of an overlap between chronic intake of the substance (with high concentrations in sites of accumulation, e.g., the adipose tissue, and contemporary tissue damage, as histologically highlighted) and acute intoxication as final cause of death, with a concentration of 158 mg/L in cardiac blood and 4915 mg/kg in the adipose tissue. No other drugs or medicines were detected in body fluids or tissues, and to our knowledge, this is the highest concentration ever detected in forensic cases. This peculiar case confirms the toxicity of this substance and focuses on the importance of complete histological and toxicological investigations in the distinction between chronic abuse and acute intoxication. PMID:25605280

  6. Alcohol intoxication and hangover: modification of hangover by chlormethiazole.

    PubMed

    Myrsten, A L; Rydberg, U; Ideström, C M; Lamble, R

    1980-01-01

    Alcohol intoxication and hangover were studied in 12 healthy male subjects who participated in three 18-h experimental sessions; two sessions in which they consumed 1.43 g alcohol/kg body weight as mixed beverages together with food, and one control session when mineral water was substituted for the alcoholic beverages. In one of the alcohol sessions they received chlormethiazole, 1 g at bedtime and 0.5 g early the following morning, in the other, they were given placebo tablets. The following variables were studied: blood-alcohol concentration; blood pressure; heart rate; blood lactate; blood pyruvate; urinary catecholamines (only during hangover); psychomotor and cognitive capacities; as well as subjective reactions. During intoxication, heart rate and lactate-pyruvate ratio were significantly increased and performance efficiency was significantly deteriorated in comparison with the control condition. During hangover, heart rate, blood pressure, and lactate-pyruvate ratio were significantly elevated, and cognitive performance was still affected, in some tests to a significant degree. During this stage there was a great variation between subjects as regards subjective hangover. Chlormethiazole was found to lower blood pressure and adrenaline output and, furthermore, to relieve unpleasant physical symptoms, but did not affect fatigue and drowsiness. The cognitive test results were only slightly influenced by this agent, while psychomotor performance was significantly impaired. Subjects with severe subjective hangover seemed to benefit more from the chlormethiazole treatment than subjects with a mild hangover.

  7. Opportunities for Reduction of Fatalities in Vehicle-Guardrail Collisions

    PubMed Central

    Gabler, Hampton C.; Gabauer, Douglas J.; Tech, Virginia

    2007-01-01

    In the United States in 2005, there were 1,189 fatal crashes and 35,000 injurious crashes into guardrails. Current efforts to reduce fatalities occurring in guardrail collisions have focused on frontal oblique collisions of cars and light trucks into guardrail. These crashes however represent a diminishing target population for fatality reduction. This paper examines the current opportunities for reducing fatalities in guardrail collisions in the United States. The analysis was based upon crash data from the Fatality Analysis Reporting System (FARS) and the National Automotive Sampling System General Estimates System (GES) for the years 2000–2005. The greatest opportunity for fatality reduction is the protection of motorcyclists, who now account for 32% of guardrail fatalities, and car and light truck occupants in side impact, who now comprise 14% of all guardrail fatalities. Together, protection of motorcycle riders and protection of car and light truck occupants in side impacts account for nearly half of all fatalities (46%) which occur in vehicle-guardrail collisions. Additional targets for fatality reduction include light truck rollover and collisions with guardrail ends. PMID:18184483

  8. Surveillance of Traumatic Firefighter Fatalities: An Assessment of Four Systems

    PubMed Central

    Estes, Chris R.; Marsh, Suzanne M.; Castillo, Dawn N.

    2011-01-01

    Objectives Firefighters regularly respond to hazardous situations that put them at risk for fatal occupational injuries. Traumatic occupational fatality surveillance is a foundation for understanding the problem and developing prevention strategies. We assessed four surveillance systems for their utility in characterizing firefighter fatalities and informing prevention measures. Methods We examined three population-based systems (the Bureau of Labor Statistics' Census of Fatal Occupational Injuries and systems maintained by the United States Fire Administration and the National Fire Protection Association) and one case-based system (data collected through the National Institute for Occupational Safety and Health Fire Fighter Fatality Investigation and Prevention Program). From each system, we selected traumatic fatalities among firefighters for 2003–2006. Then we compared case definitions, methods for case ascertainment, variables collected, and rate calculation methods. Results Overall magnitude of fatalities differed among systems. The population-based systems were effective in characterizing the circumstances of traumatic firefighter fatalities. The case-based surveillance system was effective in formulating detailed prevention recommendations, which could not be made based on the population-based data alone. Methods for estimating risk were disparate and limited fatality rate comparisons between firefighters and other workers. Conclusions The systems included in this study contribute toward a greater understanding of firefighter fatalities. Areas of improvement for these systems should continue to be identified as they are used to direct research and prevention efforts. PMID:21800748

  9. Sexual fatalities: behavioral reconstruction in equivocal cases.

    PubMed

    Hazelwood, R R; Dietz, P E; Burgess, A W

    1982-10-01

    A few sexual fatalities show ambiguous or conflicting evidence of manner of death or, in cases involving partners, of the partner's intent. In such equivocal cases, postmortem behavioral analysis and reconstruction aid in understanding what happened and provide an explainable basis for expert judgment and opinion, even though some cases can never be resolved with certainty. Behavioral analysis and reconstruction are enhanced by experience with related cases that have been solved, detailed investigation of the death scene and other relevant settings, and interviews with survivors. PMID:7175460

  10. Fatal measles pneumonitis during Hodgkin's lymphoma.

    PubMed

    Wyplosz, Benjamin; Lafarge, Marion; Escaut, Lélia; Stern, Jean-Baptiste

    2013-10-08

    The treatment of measles pneumonitis in immunocompromised adults is not established. We describe a patient with Hodgkin's lymphoma who developed acute pneumonia during a measles infection. On day 13, intravenous ribavirin and immunoglobulins were administrated. On day 18, the patient developed acute respiratory failure. An examination of transbronchial pulmonary biopsies showed Warthin-Finkeldey giant cells that are pathognomonic of measles pneumonitis. The patient died despite aggressive supportive care. Our case and a review of literature show that measles pneumonitis is routinely fatal in patients with cancer. We suggest that antiviral drugs should be considered as soon as the diagnosis has been established.

  11. Sporadic fatal insomnia in an adolescent.

    PubMed

    Blase, Jennifer L; Cracco, Laura; Schonberger, Lawrence B; Maddox, Ryan A; Cohen, Yvonne; Cali, Ignazio; Belay, Ermias D

    2014-03-01

    The occurrence of sporadic prion disease among adolescents is extremely rare. A prion disease was confirmed in an adolescent with disease onset at 13 years of age. Genetic, neuropathologic, and biochemical analyses of the patient's autopsy brain tissue were consistent with sporadic fatal insomnia, a type of sporadic prion disease. There was no evidence of an environmental source of infection, and this patient represents the youngest documented case of sporadic prion disease. Although rare, a prion disease diagnosis should not be discounted in adolescents exhibiting neurologic signs. Brain tissue testing is necessary for disease confirmation and is particularly beneficial in cases with an unusual clinical presentation.

  12. Fatal familial insomnia and agrypnia excitata.

    PubMed

    Lugaresi, Elio; Provini, Federica

    2007-01-01

    This review summarizes the pioneering steps culminating in the identification of a novel disease, fatal familial insomnia (FFI), a hereditary prion disease. Together with Morvan's chorea and delirium tremens, FFI is characterized by an inability to sleep associated with motor and autonomic overactivation. We named this pattern agrypnia excitata, a syndrome caused by a dysfunction in thalamolimbic circuits. This review highlights the strategic role of the limbic thalamus in the central autonomic network running from the limbic cortex to the lower brainstem and regulating sleep and wakefulness.

  13. Fatal dengue hemorrhagic fever imported into Germany.

    PubMed

    Schmidt-Chanasit, J; Tenner-Racz, K; Poppert, D; Emmerich, P; Frank, C; Dinges, C; Penning, R; Nerlich, A; Racz, P; Günther, S

    2012-08-01

    Dengue virus (DENV) is an arthropod-borne virus (family Flaviviridae) causing dengue fever or dengue hemorrhagic fever. Here, we report the first fatal DENV infection imported into Germany. A female traveler was hospitalized with fever and abdominal pain after returning from Ecuador. Due to a suspected acute acalculous cholecystitis, cholecystectomy was performed. After cholecystectomy, severe spontaneous bleeding from the abdominal wound occurred and the patient died. Postmortem analysis of transudate and tissue demonstrated a DENV secondary infection of the patient and a gallbladder wall thickening (GBWT) due to an extensive edema.

  14. Non-fatal overdose of duloxetine in combination with other antidepressants and benzodiazepines.

    PubMed

    Menchetti, Marco; Gozzi, Beatrice Ferrari; Saracino, Maria Addolorata; Mercolini, Laura; Petio, Carmine; Raggi, Maria Augusta

    2009-01-01

    The pharmaco-toxicological profile of duloxetine, a novel SNRI antidepressant, is still not completely known; in particular, intoxication cases have been scarcely studied. Here a duloxetine overdose case, in combination with other antidepressants and benzodiazepines, is reported and the chemical-clinical correlations discussed; this is probably the first detailed report of such a case. The patient referred to have ingested nine tablets of Cymbalta (more than 500 mg of duloxetine) and high amounts of four other drugs (venlafaxine, trazodone, sertraline and clonazepam). The patient was dozy and confused and some electrolyte imbalances were found. After gastrolavage, toxicological analyses revealed high plasma levels of duloxetine (384 ng/ml) and low levels of the other supposedly involved drugs. The overdose resulted to be not fatal and the outcome was relatively benign, also thanks to the fast emergency assistance. This case suggests that clinicians should be alerted to the possibility of toxic effects caused by simultaneous overdoses of duloxetine and other antidepressants and that caution should be used when prescribing more than one of these drugs to patients at risk of suicide.

  15. Analysis of fatal pedestrian injuries in King County, WA, and prospects for prevention.

    PubMed Central

    Rivara, F P; Reay, D T; Bergman, A B

    1989-01-01

    Pedestrian fatalities caused by motor vehicles in King County, WA, over a 12-month period were reviewed to examine the potential for prevention by various strategies. Cases were identified through the King County Medical Examiner's Office. Between April 1, 1985, and March 31, 1986, a total of 38 pedestrians died of motor vehicle injuries. The victims were generally children (N = 11), the elderly (N = 13), or intoxicated adults (N = 9). Supervision of the child was inadequate in 64 percent of the children's deaths. The driver was at fault in deaths of seven children, five adults, and three elderly persons. None of the children and only one of the elderly victims was injured at night. The majority of injuries occurred on major thorough-fares; only 16 percent occurred on residential streets. Possible strategies for prevention appear to include improved enforcement of pedestrian right-of-way laws, changes in vehicle design, modification of the environment (particularly in urban areas), and improved training programs for children. PMID:2498980

  16. An Acute Butyr-Fentanyl Fatality: A Case Report with Postmortem Concentrations.

    PubMed

    McIntyre, Iain M; Trochta, Amber; Gary, Ray D; Wright, Jennifer; Mena, Othon

    2016-03-01

    In this case report, we present an evaluation of the distribution of postmortem concentrations of butyr-fentanyl in a fatality attributed principally to the drug. A man who had a history of intravenous drug abuse was found unresponsive on the bathroom floor of his home. Drug paraphernalia was located on the bathroom counter. Toxicology testing, which initially screened positive for fentanyl by enzyme-linked immunosorbent assay, subsequently confirmed butyr-fentanyl, which was then quantitated by gas chromatography-mass spectrometry-specific ion monitoring (GC-MS SIM) analysis following liquid-liquid extraction. The butyr-fentanyl peripheral blood concentration was quantitated at 58 ng/mL compared with the central blood concentration of 97 ng/mL. The liver concentration was 320 ng/g, the vitreous was 40 ng/mL, the urine was 670 ng/mL and the gastric contained 170 mg. Acetyl-fentanyl was also detected in all biological specimens tested. Peripheral blood concentration was quantitated at 38 ng/mL compared with the central blood concentration of 32 ng/mL. The liver concentration was 110 ng/g, the vitreous was 38 ng/mL, the urine was 540 ng/mL and the gastric contained <70 mg. The only other drug detected was a relatively low concentration of benzoylecgonine. The cause of death was certified as acute butyr-fentanyl, acetyl-fentanyl and cocaine intoxication, and the manner of death was certified as accident.

  17. Fatal and Near-Fatal Asthma in Children: the Critical Care Perspective

    PubMed Central

    Newth, Christopher J. L.; Meert, Kathleen L.; Clark, Amy E.; Moler, Frank W.; Zuppa, Athena F.; Berg, Robert A.; Pollack, Murray M.; Sward, Katherine A.; Berger, John T.; Wessel, David L.; Harrison, Rick E.; Reardon, Jean; Carcillo, Joseph A.; Shanley, Thomas P.; Holubkov, Richard; Dean, J. Michael; Doctor, Allan; Nicholson, Carol E.

    2012-01-01

    Objective To characterize the clinical course, therapies, and outcomes of children with fatal and near-fatal asthma admitted to the pediatric intensive care unit (PICU). Study design Retrospective chart abstraction across the eight tertiary-care PICUs in the Collaborative Pediatric Critical Care Research Network (CPCCRN). Inclusion criteria: children (1–18 years) admitted 2005 to 2009 (inclusive) for asthma receiving ventilation (near-fatal) or died (fatal). Data collected included medications, ventilator strategies, concomitant therapies, demographics and risk variables. Results Of 261 eligible children, 33 (13%) had no previous history of asthma, 218 (84%) survived with no known complications, and 32 (12%) had complications. Eleven (4%) died, 10 having had cardiac arrest before admission. Patients intubated outside the PICU had shorter ventilation (median 25 vs. 84 hours, p<0.001). African-Americans were disproportionately represented by numbers intubated and had shorter durations of intubation. Barotrauma occurred in 15 (6%) children before admission. Pharmacological therapies were highly variable with similar outcomes. Conclusions Of children ventilated in CPCCRN PICUs, 96% survived to hospital discharge. Most children who died experienced cardiac arrest prior to admission. Intubation outside the PICU was correlated with shorter ventilation duration. The complications of barotrauma and neuromyopathy were uncommon. Practice patterns varied widely between CPCCRN sites. PMID:22494876

  18. Reported fatal and non-fatal incidents involving tourists in Hawaii Volcanoes National Park, 1992-2002.

    PubMed

    Heggie, Travis W

    2005-08-01

    Objectives. To examine fatal and non-fatal incidents involving tourists in Hawaii Volcanoes National Park. Methods. Official press releases from the public relations office at Hawaii Volcanoes National Park were examined for reports of fatal and non-fatal incidents involving tourists. Results. Between 1992 and 2002 there were 65 press releases reporting 40 fatalities, 45 serious injuries, 53 minor injuries, and 25 no injury events. Severity information was unavailable for four additional tourists. Aircraft and backcountry incidents each accounted for 30% of all incidents followed by road incidents (22%) and frontcountry incidents (17%). Aircraft incidents reported 17 fatalities, backcountry incidents accounted for 10 fatalities, frontcountry incidents reported seven fatalities, and road incidents totaled six fatalities. One fatality was classified as a suicide. Backcountry (23) and road (10) incidents had the highest number of serious incidents. Male tourists (62) were more frequently involved in incidents than female tourists (41) and tourists aged 20-29 years and 40-49 years accounted for the highest number of fatalities and total incidents. Conclusions. Helicopter tours, hiking in areas with active lava flows, falls into steam vents and earthcracks, and driving unfamiliar rental cars in unfamiliar locations are the major activities resulting in death and serious injury. Additional factors such as tourists ignoring warning signs, wandering off-trail or hiking at night, tourists misinformed by guidebooks and other tourists, and tourists with pre-existing heart and asthma conditions are contributing causes in many incidents. The findings of this study provide information that allows prospective tourists, tourism managers, and travel health providers make informed decisions that promote safe tourism and can aid future efforts in developing preventative strategies at tourist destinations with similar environments and activities. However, in order for preventative

  19. Reported fatal and non-fatal incidents involving tourists in Hawaii Volcanoes National Park, 1992-2002.

    PubMed

    Heggie, Travis W

    2005-08-01

    Objectives. To examine fatal and non-fatal incidents involving tourists in Hawaii Volcanoes National Park. Methods. Official press releases from the public relations office at Hawaii Volcanoes National Park were examined for reports of fatal and non-fatal incidents involving tourists. Results. Between 1992 and 2002 there were 65 press releases reporting 40 fatalities, 45 serious injuries, 53 minor injuries, and 25 no injury events. Severity information was unavailable for four additional tourists. Aircraft and backcountry incidents each accounted for 30% of all incidents followed by road incidents (22%) and frontcountry incidents (17%). Aircraft incidents reported 17 fatalities, backcountry incidents accounted for 10 fatalities, frontcountry incidents reported seven fatalities, and road incidents totaled six fatalities. One fatality was classified as a suicide. Backcountry (23) and road (10) incidents had the highest number of serious incidents. Male tourists (62) were more frequently involved in incidents than female tourists (41) and tourists aged 20-29 years and 40-49 years accounted for the highest number of fatalities and total incidents. Conclusions. Helicopter tours, hiking in areas with active lava flows, falls into steam vents and earthcracks, and driving unfamiliar rental cars in unfamiliar locations are the major activities resulting in death and serious injury. Additional factors such as tourists ignoring warning signs, wandering off-trail or hiking at night, tourists misinformed by guidebooks and other tourists, and tourists with pre-existing heart and asthma conditions are contributing causes in many incidents. The findings of this study provide information that allows prospective tourists, tourism managers, and travel health providers make informed decisions that promote safe tourism and can aid future efforts in developing preventative strategies at tourist destinations with similar environments and activities. However, in order for preventative

  20. Fatal falls and jumps from motor vehicles.

    PubMed Central

    Williams, A F; Goins, S E

    1981-01-01

    In 1978, 345 persons were killed in the United States in jumps and falls from non-crashing motor vehicles: 64 per cent fell; 15 per cent jumped; and it was not known whether the other 21 per cent jumped or fell. Two hundred and one people had been traveling on the exterior of vehicles, especially truck beds, and almost all of these people fell from their vehicles. The other 144 fatalities involved people in passenger compartments. Many of the falls from compartments occurred when occupants opened doors, or when vehicles changed direction. Seventy-seven per cent of those who fell from passenger compartments were males, and 44 per cent were less than five years old. Among those who jumped from vehicle compartments, 62 per cent were women and all were older than 14 years. Fatal falls and jumps from vehicles could be reduced in a variety of ways. These include legislation to prohibit travel on vehicle exteriors, designing vehicles so that doors cannot be opened when in motion, improving door designs, installing signals that provide warning if doors are not closed completely, and using occupant restraints. PMID:7468860

  1. Illegal drugs-related fatalities in Slovenia.

    PubMed

    Karlovsek, M Zorec

    2004-12-01

    The study includes 122 medico-legally examined fatal poisonings with illegal drugs in Slovenia (1.96 million inhabitants) in years 1997-2003. The highest death rate expressed per 10(5) inhabitants per year was observed in the year 2002 with 1.17, the average value over 1997-2003 was 0.89; the trend line shows a stabilisation. Heroine/morphine dominated as the cause of death and were responsible for 71.3% of the fatal poisonings. Methadone was found to cause or contributed to death in 28 cases (22.9%). One death by cocaine and two by MDMA were caused in the time observed. Males represent 98.4% of the direct illegal drug-related deaths. The main ages of heroine/morphine group, heroine/morphine only and methadone group were 27.6, 24.1 and 26.8, respectively. Between 1997 and 2003, there was a downward trend in the average age in the group heroine/morphine only. Since 2001, we are the part of the national working group on key indicator "drug-related mortality" applying EMCDDA methodology.

  2. Traumatic work related fatalities in commercial fishermen in Australia.

    PubMed Central

    Driscoll, T R; Ansari, G; Harrison, J E; Frommer, M S; Ruck, E A

    1994-01-01

    OBJECTIVES--To describe the types and circumstances of traumatic work related fatalities in Australian commercial fishermen. METHODS--Work related traumatic fishing fatalities were studied as part of a larger study of all work related traumatic fatalities in Australia from 1982 to 1984. Data on 47 cases were obtained from inspection of coroners' files. RESULTS--The incidence of fatality of 143/100,000 person-years was 18 times higher than the incidence of fatality for the entire workforce, and considerably higher than that of the mining and agricultural workforces. 68% of decedents drowned and 13% died from physical trauma. Rough weather, non-seaworthy vessels, inadequate use of personal flotation devices, and inexperience were associated with many of the fatal incidents. DISCUSSION--Improved vessel and equipment maintenance, better training of workers, greater use of personal flotation devices, and development of improved clothing and personal flotation devices are recommended. PMID:7951793

  3. Fatal choking in infants and children.

    PubMed

    Mittleman, R E

    1984-09-01

    Food asphyxiation in infants/children follows a different pattern from the adult "cafe coronary." In the absence of ethanol intoxication, infants/children are prone to mishandling nonfriable, firm, slippery foods/objects with a rounded contour. The Dade County Medical Examiner's files were searched from 1956 to mid-1983 for accidental pediatric choking deaths. Seventeen food and six foreign body asphyxiations were found. The male/female ratio was 1.4/1 and 1/1, respectively. The white/black ratio was 0.9/1 for food asphyxiation whereas no black victims were encountered choking upon foreign objects. Seventy-eight percent of all victims were between 2 months and 4 years of age. Infants/children asphyxiated on items such as a hot dog, hard candy, peanut, toy rattle, tissue paper, balloon, marble, etc. The choking event was recognized by nearby adults in most instances. Risk factors include the availability of riskful foods/objects, natural diseases with difficulty feeding, poor eating habits, and uneducated or ignorant parents/others at the scene. Although public education, package labeling, and changes in food/object design may be appropriate, the ubiquituous risk foods and small foreign objects will, on occasion, escape the eye of even the most watchful parent.

  4. Significance of toxic interactions in medicolegal evidence. Complex fatal poisoning with drugs of abuse in the material of the Chair of Forensic Medicine, Collegium Medicum, Jagiellonian University in Kraków.

    PubMed

    Kłys, M; Bystrowska, B; Bujak-Gizycka, B; Nowak, G

    2001-01-01

    The subject of the study was fatal complex poisonings with drugs of abuse in two young men. In the first case, postmortem investigation revealed cardiotoxic death as the result of an interaction between opiates, amphetamine derivatives and oxazepam. In the second case, death followed the administration of amphetamine derivatives and cocaine (xenobiotics known on the illicit drug market as "UFO"). Based on the toxicological postmortem analysis the authors discuss the interpretation of the results in the light of general problems of interactions taking place in toxicokinetic and toxicodynamic phases of intoxication processes. PMID:11985341

  5. Drinking histories of fatally injured drivers

    PubMed Central

    Baker, S; Braver, E; Chen, L; Li, G; Williams, A

    2002-01-01

    Context: About 30% of drivers killed in crashes have high blood alcohol concentrations (BACs) of 0.10+ g/dl. There is a question about whether these drivers primarily are problem drinkers who chronically drink and drive—the so-called hard core drinking drivers. Objective: To investigate drinking histories of fatally injured drivers in relation to their BACs. Design and participants: Retrospective cohort study of 818 fatally injured drivers who were included in the 1993 National Mortality Followback Survey (a national sample of US deaths in which next of kin were interviewed) and whose BACs were recorded by the Fatality Analysis Reporting System, a census of US traffic deaths. Main outcome measure: Problem drinking indicators. Results: At least one indicator of potential problem drinking, primarily heavy drinking, was reported for 68% of drivers with very high BACs (0.15+ g/dl), 41% with BACs of 0.10–0.14 g/dl, 32% with BACs of 0.01–0.09 g/dl, and 7% with zero BACs. Spouses provided more credible responses than other relatives: they were more likely to report at least occasional drinking and driving among deceased drivers with high BACs. For the most direct signs of problem drinking (described as a problem drinker during the last month of life or frequently driving after having five or more drinks), spousal reports suggested the prevalence of problem drinking among drivers with very high BACs was 22% (having both indicators), 32% (frequently driving after having five or more drinks), 44% (described as problem drinker), or 57% (having either indicator). Conclusions: Drivers with BACs of 0.10+ g/dl were far more likely than sober drivers to be described as having markers of problem drinking. However, many did not have indicators suggestive of problem drinking. In addition to programs focused on repeat offenders or problem drinkers, countermeasures such as sobriety checkpoints that target a broader spectrum of drinking drivers are appropriate. PMID:12226120

  6. A Survival Case in a Severe Amlodipine Intoxication

    PubMed Central

    El Houari, T.; Haddiya, I.; El Ouafi, N.; Bazid, Z.

    2013-01-01

    Calcium channel blockers (CCBs) are prescribed in a wide variety of cardiovascular conditions. Nevertheless, they remain a major cause of cardiovascular drug overdose that often leads to a lethal outcome. We report the case of an intoxication with amlodipine, which caused severe hypotension, in a young woman. The patient was initially treated with fluids, calcium gluconate, and Dobutamine without effect. She then received hyperinsulinemia euglycemia therapy. A rise in blood pressure (BP) was observed two hours after insulin was started. The next day, the insulin infusion was stopped and seven days later the patient was discharged from the hospital after psychiatric consultation. The positive inotropic effect of insulin therapy in our patient supports previous findings that suggest its use as a first-line therapy in the management of CCBs overdose. PMID:24826296

  7. A survival case in a severe amlodipine intoxication.

    PubMed

    El Houari, T; Haddiya, I; El Ouafi, N; Bazid, Z

    2013-01-01

    Calcium channel blockers (CCBs) are prescribed in a wide variety of cardiovascular conditions. Nevertheless, they remain a major cause of cardiovascular drug overdose that often leads to a lethal outcome. We report the case of an intoxication with amlodipine, which caused severe hypotension, in a young woman. The patient was initially treated with fluids, calcium gluconate, and Dobutamine without effect. She then received hyperinsulinemia euglycemia therapy. A rise in blood pressure (BP) was observed two hours after insulin was started. The next day, the insulin infusion was stopped and seven days later the patient was discharged from the hospital after psychiatric consultation. The positive inotropic effect of insulin therapy in our patient supports previous findings that suggest its use as a first-line therapy in the management of CCBs overdose. PMID:24826296

  8. Effect expectancies for cocaine intoxication: initial vs. descendent phases.

    PubMed

    Schafer, J; Fals-Stewart, W

    1993-01-01

    This study examined the association between proximal vs. distal effect expectancies for cocaine consumption in a college student population with (N = 26) and without (N = 69) cocaine experience. Participants completed the Cocaine Effect Expectancy Questionnaire-Likert (CEEQL) and were asked to respond to each item twice: first, their belief about that specific effect during the initial phase of cocaine intoxication; and second, in relation to their belief about that effect during the descendent period. Positive and negative scales were scored for each subject. Positive expectancies were not associated between the two time points, while negative expectancies were. Users reported significantly less negative expected effects of cocaine, while nonusers and users held similar beliefs about the positive effects of cocaine. This latter effect was replicated in an independent sample (N = 140).

  9. Multiple outbreaks of puffer fish intoxication in Bangladesh, 2008.

    PubMed

    Homaira, Nusrat; Rahman, Mahmudur; Luby, Stephen P; Rahman, Mostafizur; Haider, Mohammad Sabbir; Faruque, Labib Imran; Khan, Dawlat; Parveen, Shahana; Gurley, Emily S

    2010-08-01

    During April and June 2008, we investigated three outbreaks of marine puffer fish intoxication in three districts of Bangladesh (Narshingdi, Natore, and Dhaka). We also explored trade of marine puffer fish in Cox's Bazaar, a coastal area of the country. We identified 95 people who had consumed puffer fish; 63 (66%) developed toxicity characterized by tingling sensation in the body, perioral numbness, dizziness, and weakness, 14 of them died. All three outbreaks were caused by consumption of large (0.2-1.5 kg) marine puffer fish, sold in communities where people were unfamiliar with the marine variety of the fish and its toxicity. Coastal fishermen reported that some local businessmen distributed the fresh fish to non-coastal parts of the country, where people were unfamiliar with the larger variety, to make a quick profit. Lack of knowledge about marine puffer toxicity contributed to the outbreaks. Health communication campaigns will enhance people's knowledge and may prevent future outbreaks.

  10. Tyrosine aminotransferase activity in the benzene intoxicated rat

    SciTech Connect

    Bong, M.; Michalska, A.; Laskowska-Klita, T.; Szymczyk, T.

    1985-01-01

    The toxic effect of hydrocarbon solvents on hepatic metabolism manifests itself by changes in the enzymatic pattern of blood serum. Changes in the activity of phosphatases as well as leucine aminopeptidase, glutamine aminotransferase, sorbitol dehydrogenase and ..gamma..-glutamyltransferase were observed in rats intoxicated with different fractions of benzene. Therefore it seemed reasonable to investigate the effect of benzene fraction of petroleum on cellular metabolism. The results of the present work concern the activity of tyrosine aminotransferase, the enzyme involved in catabolism of aromatic amino acid which is known to be under both hormonal and stress dependent control. Changes in tyrosine aminotransferase activity effect the level of tyrosine oxidation as well as the metabolic conversion of this amino acid into tyramine, tyroxin, adrenaline and noradrenaline.

  11. Papaverine intoxication in a newborn: an unusual case report.

    PubMed

    Kahramaner, Zelal; Erdemir, Aydın; Türkoğlu, Ebru; Coşar, Hese; Sütçüoğlu, Sümer; Özer, Esra Arun

    2014-01-01

    Herbal agents are increasingly used for medicinal purposes, but there is a lack of knowledge about the content of these agents. Indiscriminate use of herbal agents may cause severe side effects and also death. We report a newborn who developed convulsions and respiratory arrest after oral intake of an opium poppy preparation containing papaverine for its antitussive effect. The infant experienced a good outcome with supportive treatment. To the best of our knowledge, this is the first time a newborn with papaverine intoxication has been described. Parents should avoid self-medication of their children, and the possibility of exposure to foreign products should be kept in mind in any seizure of a newborn with unexplained origin.

  12. Infections and Intoxications from the Ocean: Risks of the Shore.

    PubMed

    Clemence, Mark A; Guerrant, Richard L

    2015-12-01

    Marine and coastal regions provide a diverse range of foods and serve as recreation and leisure areas for large numbers of people in many parts of the world. However, they also serve as environments associated with numerous hazards. The number of cases of fish- and shellfish-related food poisonings in the United States has increased in recent years, accounting for over 600,000 illnesses, with 3,000 hospitalizations and 94 deaths annually. Human diseases due to pathogenic Vibrio species can result from both ingestion of contaminated shellfish and exposure of open wounds to contaminated seawater. A variety of infections may result from human interactions with marine life, including sharks, barracudas, and moray eels. This chapter covers some of the risks of the shore, including fish and shellfish intoxications, infections related to Vibrio species, and infections resulting from marine trauma. PMID:27337286

  13. A novel recombinant vaccine protecting mice against abrin intoxication

    PubMed Central

    Wang, Junhong; Gao, Shan; Xin, Wenwen; Kang, Lin; Xu, Na; Zhang, Tao; Liu, Wensen; Wang, Jinglin

    2015-01-01

    Abrin toxin (AT) consisting of an A chain and a B chain is a potential agent for bioterrorism and an effective vaccine against AT poisoning is urgently required. In this study, AT B chain (ATB) was successfully expressed in the Escherichia coli (E. coli) and assessed the protection capacity against AT intoxication. The recombinant ATB (rATB) subunit induces a good immune response after 4 immunizations. All BALB/c mice immunized intraperitoneally (i.p.) with the purified rATB protein survived after challenged with 5 × LD50 of AT. Transfusion of sera from immunized mice provided passive protection in naive mice. Furthermore, histological findings showed that immunization with rATB decreased the severity of toxin-related tissue damage. This work indicates that the rATB protein may be a promising vaccine candidate against human exposure to AT. PMID:26086588

  14. Chelation therapy in intoxications with mercury, lead and copper.

    PubMed

    Cao, Yang; Skaug, Marit Aralt; Andersen, Ole; Aaseth, Jan

    2015-01-01

    In the present review we provide an update of the appropriate use of chelating agents in the treatment of intoxications with compounds of mercury, lead and copper. The relatively new chelators meso-2,3-dimercaptosuccinic acid (DMSA) and 2,3-dimercapto-propanesulphonate (DMPS) can effectively mobilize deposits of mercury as well as of lead into the urine. These drugs can be administered orally and have relatively low toxicity compared to the classical antidote dimercaptopropanol (BAL). d-Penicillamine has been widely used in copper overload, although 2,3-dimercaptosuccinic acid or tetrathiomolybdate may be more suitable alternatives today. In copper-toxicity, a free radical scavenger might be recommended as adjuvant to the chelator therapy.

  15. Hemodialysis as an alternative treatment of mexiletine intoxication.

    PubMed

    Akıncı, Emine; Yüzbaşıoglu, Yücel; Coşkun, Figen

    2011-11-01

    Mexiletine is a class IB antiarrhythmic agent. Although it is primarily used in treating ventricular arrhythmias, recent indications for use of mexiletine include chronic and neuropathic pains. At high doses, mexiletine causes drowsiness, confusion, nausea, hypotension, sinus bradycardia, paresthesia, seizures, bundle branch block, atrioventricular heart block, ventricular arrhythmias, asystole, cardiovascular collapse, and coma. A 23-year-old male patient presented to the emergency department with intentional ingestion of high-dose mexiletine. Despite decontamination and supportive treatment, his vitals deteriorated during the observation period; and he developed stupor and dysarthria. Patient then underwent hemodialysis. His vital signs and overall condition improved rapidly following hemodialysis treatment. In this case report, we aimed to emphasize hemodialysis as a useful alternative therapy for severe mexiletine intoxications. PMID:20971596

  16. [Biological activity of selenorganic compounds at heavy metal salts intoxication].

    PubMed

    Rusetskaya, N Y; Borodulin, V B

    2015-01-01

    Possible mechanisms of the antitoxic action of organoselenium compounds in heavy metal poisoning have been considered. Heavy metal toxicity associated with intensification of free radical oxidation, suppression of the antioxidant system, damage to macromolecules, mitochondria and the genetic material can cause apoptotic cell death or the development of carcinogenesis. Organic selenium compounds are effective antioxidants during heavy metal poisoning; they exhibit higher bioavailability in mammals than inorganic ones and they are able to activate antioxidant defense, bind heavy metal ions and reactive oxygen species formed during metal-induced oxidative stress. One of promising organoselenium compounds is diacetophenonyl selenide (DAPS-25), which is characterized by antioxidant and antitoxic activity, under conditions including heavy metal intoxication.

  17. Intoxication of nontarget wildlife with rodenticides in northwestern Kansas.

    PubMed

    Ruder, Mark G; Poppenga, Robert H; Bryan, John A; Bain, Matt; Pitman, Jim; Keel, M Kevin

    2011-01-01

    The perception of prairie dogs (Cynomys spp.) both as a nuisance species and a keystone species presents a significant challenge to land, livestock, and wildlife managers. Anticoagulant and nonanticoagulant rodenticides are commonly employed to control prairie dog populations throughout their range. Chlorophacinone, and to a lesser extent zinc phosphide, are widely used in northwestern Kansas for controlling black-tailed prairie dog (Cynomys ludovicianus) populations. Although zinc phosphide poisoning of gallinaceous birds is not uncommon, there are few published accounts of nontarget chlorophacinone poisoning of wildlife. We report three mortality events involving nontarget rodenticide poisoning in several species, including wild turkeys (Meleagris gallopavo), a raccoon (Procyon lotor), and an American badger (Taxidea taxus). This includes the first documentation of chlorophacinone intoxication in wild turkeys and an American badger in the literature. The extent of nontarget poisoning in this area is currently unknown and warrants further investigation. PMID:21270011

  18. Zinc phosphide intoxication of wild turkeys (Meleagris gallopavo).

    PubMed

    Poppenga, Robert H; Ziegler, Andre F; Habecker, Perry L; Singletary, Don L; Walter, Mark K; Miller, Paul G

    2005-01-01

    Zinc phosphide (Zn3P2) is a rodenticide used to control a variety of small mammal species. It is available over-the-counter or as a restricted-use pesticide depending on how it is to be applied. The toxicity of Zn3P2 is dependent on the species exposed, whether the animal is able to vomit or not, and whether it is ingested on a full or empty stomach. Nontarget species can be exposed through inadvertent or intentional product misapplication. In this article we describe four mortality events in which wild turkeys (Meleagris gallopavo) were believed to have been intoxicated following the ingestion of baits containing Zn3P2.

  19. Intoxication of nontarget wildlife with rodenticides in northwestern Kansas.

    PubMed

    Ruder, Mark G; Poppenga, Robert H; Bryan, John A; Bain, Matt; Pitman, Jim; Keel, M Kevin

    2011-01-01

    The perception of prairie dogs (Cynomys spp.) both as a nuisance species and a keystone species presents a significant challenge to land, livestock, and wildlife managers. Anticoagulant and nonanticoagulant rodenticides are commonly employed to control prairie dog populations throughout their range. Chlorophacinone, and to a lesser extent zinc phosphide, are widely used in northwestern Kansas for controlling black-tailed prairie dog (Cynomys ludovicianus) populations. Although zinc phosphide poisoning of gallinaceous birds is not uncommon, there are few published accounts of nontarget chlorophacinone poisoning of wildlife. We report three mortality events involving nontarget rodenticide poisoning in several species, including wild turkeys (Meleagris gallopavo), a raccoon (Procyon lotor), and an American badger (Taxidea taxus). This includes the first documentation of chlorophacinone intoxication in wild turkeys and an American badger in the literature. The extent of nontarget poisoning in this area is currently unknown and warrants further investigation.

  20. Metallobiology of host-pathogen interactions: an intoxicating new insight.

    PubMed

    Botella, Hélène; Stadthagen, Gustavo; Lugo-Villarino, Geanncarlo; de Chastellier, Chantal; Neyrolles, Olivier

    2012-03-01

    Iron, zinc and copper, among others, are transition metals with multiple biological roles that make them essential elements for life. Beyond the strict requirement of transition metals by the vertebrate immune system for its proper functioning, novel mechanisms involving direct metal intoxication of microorganisms are starting to be unveiled as important components of the immune system, in particular against Mycobacterium tuberculosis. In parallel, metal detoxification systems in bacteria have been recently characterized as crucial microbial virulence determinants. Here, we will focus on these exciting advancements implicating copper- and zinc-mediated microbial poisoning as a novel innate immune mechanism against microbial pathogens, shedding light on an emerging field in the metallobiology of host-pathogen interactions. PMID:22305804

  1. Effect expectancies for cocaine intoxication: initial vs. descendent phases.

    PubMed

    Schafer, J; Fals-Stewart, W

    1993-01-01

    This study examined the association between proximal vs. distal effect expectancies for cocaine consumption in a college student population with (N = 26) and without (N = 69) cocaine experience. Participants completed the Cocaine Effect Expectancy Questionnaire-Likert (CEEQL) and were asked to respond to each item twice: first, their belief about that specific effect during the initial phase of cocaine intoxication; and second, in relation to their belief about that effect during the descendent period. Positive and negative scales were scored for each subject. Positive expectancies were not associated between the two time points, while negative expectancies were. Users reported significantly less negative expected effects of cocaine, while nonusers and users held similar beliefs about the positive effects of cocaine. This latter effect was replicated in an independent sample (N = 140). PMID:8506788

  2. Papaverine intoxication in a newborn: an unusual case report.

    PubMed

    Kahramaner, Zelal; Erdemir, Aydın; Türkoğlu, Ebru; Coşar, Hese; Sütçüoğlu, Sümer; Özer, Esra Arun

    2014-01-01

    Herbal agents are increasingly used for medicinal purposes, but there is a lack of knowledge about the content of these agents. Indiscriminate use of herbal agents may cause severe side effects and also death. We report a newborn who developed convulsions and respiratory arrest after oral intake of an opium poppy preparation containing papaverine for its antitussive effect. The infant experienced a good outcome with supportive treatment. To the best of our knowledge, this is the first time a newborn with papaverine intoxication has been described. Parents should avoid self-medication of their children, and the possibility of exposure to foreign products should be kept in mind in any seizure of a newborn with unexplained origin. PMID:26022590

  3. [Fatal poisoning with paraquat: report of a new case].

    PubMed

    Ochoa Gómez, F J; Gil Paraíso, A

    1993-07-01

    Intoxication with paraquat has been rarely described in our country. We present a case of a 66-years-old man admitted to our hospital five hours after an accidental ingestion of a sip of paraquat. Despite therapy with gastric lavage, Füller's Soil, Magnesium Sulphate, liquids and hemoperfusion, the patient developed Multiple Organic Failure and died 48 hours after his hospitalization. Plasmatic levels of the herbicide were very high. Typical clinical data, prognosis factors and therapeutical management of this intoxication are described.

  4. Suicidal chemistry: combined intoxication with carbon monoxide and formic acid.

    PubMed

    Bakovic, Marija; Nestic, Marina; Mayer, Davor

    2016-05-01

    Herein, we present a rare case of suicidal intoxication with carbon monoxide produced via reaction of formic and sulphuric acid with additional toxic effect of formic acid. The deceased was a 22-year-old men found dead in the bathroom locked from the inside. A bucket filled with liquid was found next to him, together with an almost empty canister labeled "formic acid" and another empty unlabeled canister. The postmortem examination revealed corrosive burns of the face, neck and chest, cherry-pink livor mortis, corrosive injury to the oropharyngeal area and trachea, subpleural petechiae, 100 mL of blood in stomach and superficial erosions of stomach mucosa. Toxicology analysis revealed 30% of carboxyhemoglobin in the femoral blood and the presence of the formic acid in various samples. Quantitative analysis of formic acid was performed by measuring methyl ester derivative of formic acid by using headspace gas chromatography with flame ionization detection. The highest concentration of formic acid was measured in the lungs (0.55 g/kg), gastric content (0.39 g/L), and blood (0.28 g/L). In addition, it was established that content of the unlabeled canister had a pH value of 0.79 and contained sulphuric ions. Morphological and toxicology findings suggested that the main route of exposure to formic acid was inhalation of vapors with a possible ingestion of only small amount of liquid acid. The cause of death was determined to be combined intoxication with carbon monoxide and formic acid. PMID:26041513

  5. Suicidal chemistry: combined intoxication with carbon monoxide and formic acid.

    PubMed

    Bakovic, Marija; Nestic, Marina; Mayer, Davor

    2016-05-01

    Herein, we present a rare case of suicidal intoxication with carbon monoxide produced via reaction of formic and sulphuric acid with additional toxic effect of formic acid. The deceased was a 22-year-old men found dead in the bathroom locked from the inside. A bucket filled with liquid was found next to him, together with an almost empty canister labeled "formic acid" and another empty unlabeled canister. The postmortem examination revealed corrosive burns of the face, neck and chest, cherry-pink livor mortis, corrosive injury to the oropharyngeal area and trachea, subpleural petechiae, 100 mL of blood in stomach and superficial erosions of stomach mucosa. Toxicology analysis revealed 30% of carboxyhemoglobin in the femoral blood and the presence of the formic acid in various samples. Quantitative analysis of formic acid was performed by measuring methyl ester derivative of formic acid by using headspace gas chromatography with flame ionization detection. The highest concentration of formic acid was measured in the lungs (0.55 g/kg), gastric content (0.39 g/L), and blood (0.28 g/L). In addition, it was established that content of the unlabeled canister had a pH value of 0.79 and contained sulphuric ions. Morphological and toxicology findings suggested that the main route of exposure to formic acid was inhalation of vapors with a possible ingestion of only small amount of liquid acid. The cause of death was determined to be combined intoxication with carbon monoxide and formic acid.

  6. Fatal primary meningoencephalitis caused by Naegleria fowleri.

    PubMed

    Shariq, Ali; Afridi, Faisal Iqbal; Farooqi, Badar Jahan; Ahmed, Sumaira; Hussain, Arif

    2014-07-01

    Naegleria fowleri is a free living parasite which habitats in fresh water reservoirs. It causes a fatal nervous system infection known as primary amoebic meningoencephalitis by invading through cribriform plate of nose and gaining entry into brain. We report a case of primary amoebic meningoencephalitis caused by Naegleria fowleri in Karachi, Pakistan, in a 42 years old male poultry farm worker having no history of swimming. Clinical course was fulminant and death occurred within one week of hospital admission. Naegleria fowleri was detected by wet mount technique in the sample of cerebrospinal fluid collected by lumbar puncture of patient. This is a serious problem and requires immediate steps to prevent general population to get affected by this lethal neurological infection. PMID:25052979

  7. Penile strangulation: report of a fatal case.

    PubMed

    Morentin, Benito; Biritxinaga, Begoña; Crespo, Lourdes

    2011-12-01

    Penile strangulation or entrapment is an unusual entity that requires urgent treatment due to its potential complications. Several cases have been reported in the medical literature, some of them describing serious injuries such as necrosis, gangrene, and amputation of the penis. However, as far as we know, no fatal cases have been described before. We present the death of an adult male secondary to the complications due to penile strangulation with a plastic bottle neck. The time of incarceration was unknown, but according to a witness it could be about 10 to 14 days. The findings of autopsy were penile strangulation, necrosis of the penis, acute pyelonephritis, and bronchopneumonia. The subject's refusal to ask for medical help was the cause of this atypical evolution. PMID:22101437

  8. Fatal falls from bicycles: a case report.

    PubMed

    Venara, A; Mauillon, D; Gaudin, A; Rouge-Maillart, C; Jousset, N

    2013-03-10

    Though rare occurrences, fatal falls from bicycles are generally linked to the absence of a protective helmet and/or a collision with another vehicle. The case presented here is exceptional due to its circumstances and the consequences of the accident: a fall with no obstacle at a low speed that brought about multiple traumas and the death of a cyclist wearing a protective helmet. Comparing this against a review of cyclist accidentology literature, this case is unique. The increased use of autopsy in terms of forensic accidentology is to be encouraged so as not to misunderstand the possibility of such lesion-based consequences following a simple fall from a bicycle. PMID:23312586

  9. Fatal overdose of iron tablets in adults.

    PubMed

    Abhilash, Kundavaram P P; Arul, J Jonathan; Bala, Divya

    2013-09-01

    Acute iron toxicity is usually seen in children with accidental ingestion of iron-containing syrups. However, the literature on acute iron toxicity with suicidal intent in adults is scant. We report, the first instance of two adults with fatal ingestion of a single drug overdose with iron tablets from India. Two young adults developed severe gastro-intestinal bleeding and fulminant hepatic failure 48 h after deliberate consumption of large doses of iron tablets. Serum iron levels measured 36 h after ingestion were normal presumably due to the redistribution of iron to the intracellular compartment. Despite aggressive supportive management in medical intensive care unit of a tertiary care hospital, the patients succumbed to the toxic doses of iron.

  10. Two fatal tiger attacks in zoos.

    PubMed

    Tantius, Britta; Wittschieber, Daniel; Schmidt, Sven; Rothschild, Markus A; Banaschak, Sibylle

    2016-01-01

    Two captive tiger attacks are presented that took place in Cologne and Münster zoos. Both attacks occurred when the handlers, intent on cleaning the enclosures, entered whilst the tigers accidently retained access to the location, and thus defended their territory against the perceived intruders. Both victims suffered fatal neck injuries from the bites. At Münster, colleagues managed to lure the tiger away from its victim to enable treatment, whilst the Cologne zoo tiger had to be shot in order to allow access to be gained. Whilst it was judged that human error led to the deaths of the experienced zookeepers, the investigation in Münster was closed as no third party was found to be at fault, whereas the Cologne zoo director was initially charged with being negligent. These charges were subsequently dismissed as safety regulations were found to be up to date.

  11. When attempts at robbing prey turn fatal.

    PubMed

    Dejean, Alain; Corbara, Bruno; Azémar, Frédéric; Carpenter, James M

    2012-07-01

    Because group-hunting arboreal ants spread-eagle insect prey for a long time before retrieving them, these prey can be coveted by predatory flying insects. Yet, attempting to rob these prey is risky if the ant species is also an effective predator. Here, we show that trying to rob prey from Azteca andreae workers is a fatal error as 268 out of 276 potential cleptobionts (97.1 %) were captured in turn. The ant workers hunt in a group and use the "Velcro®" principle to cling firmly to the leaves of their host tree, permitting them to capture very large prey. Exceptions were one social wasp, plus some Trigona spp. workers and flies that landed directly on the prey and were able to take off immediately when attacked. We conclude that in this situation, previously captured prey attract potential cleptobionts that are captured in turn in most of the cases.

  12. A fatal case of thiacloprid poisoning.

    PubMed

    Vinod, Kolar Vishwanath; Srikant, Sadashivan; Thiruvikramaprakash, Gnanavel; Dutta, Tarun Kumar

    2015-02-01

    Neonicotinoid insecticides are considered to be less toxic to humans compared to older insecticides such as organophosphates, carbamates, pyrethroids, and organochlorine compounds. However,reports of severe human toxicity with neonicotinoids are emerging. Acute human thiacloprid poisoning and death as a result have not been reported in the literature so far. Here we report a case of thiacloprid poisoning resulting from deliberate ingestion in a 23-year-old man, manifesting with status epilepticus, respiratory paralysis,rhabdomyolysis, metabolic acidosis, and acute kidney injury (AKI), and ultimately giving rise to refractory shock and death. Thiacloprid can cause fatal human toxicity when ingested heavily, and absence of an effective antidote raises concern in this regard.

  13. Fatal overdose of iron tablets in adults.

    PubMed

    Abhilash, Kundavaram P P; Arul, J Jonathan; Bala, Divya

    2013-09-01

    Acute iron toxicity is usually seen in children with accidental ingestion of iron-containing syrups. However, the literature on acute iron toxicity with suicidal intent in adults is scant. We report, the first instance of two adults with fatal ingestion of a single drug overdose with iron tablets from India. Two young adults developed severe gastro-intestinal bleeding and fulminant hepatic failure 48 h after deliberate consumption of large doses of iron tablets. Serum iron levels measured 36 h after ingestion were normal presumably due to the redistribution of iron to the intracellular compartment. Despite aggressive supportive management in medical intensive care unit of a tertiary care hospital, the patients succumbed to the toxic doses of iron. PMID:24339645

  14. Fatal rhabdomyolysis in a flame burn patient.

    PubMed

    Lazarus, D; Hudson, D A

    1997-08-01

    Rhabdomyolysis due to flame burns is not well described. A case of fatal rhabdomyolysis in an epileptic patient who sustained 65 per cent body surface area, very deep, flame burns is described. It appears as if the sustained muscle compression from the restrictive, circumferential eschar was the major factor in the aetiology of the rhabdomyolysis. Despite aggressive fluid management, the patient died of acute renal failure and adult respiratory distress syndrome. We have subsequently identified three other cases of pigmenturia occurring following burns. It would seem as if rhabdomyolysis following extensive full thickness burns may be more common than previously suggested. Fluid requirements are in excess of those proposed by traditional protocols. Rhabdomyolysis in flame burn patients indicates a poor prognosis. PMID:9426917

  15. A deadly prion disease: fatal familial insomnia.

    PubMed

    Sundstrom, Dianne G; Dreher, H Michael

    2003-12-01

    Fatal familial insomnia (FFI) is an inherited disease caused by a mutation in the protein prion gene. Symptoms of FFI closely resemble those of familial Creutzfeldt-Jakob disease, making genetic testing and histological examination of brain tissue the only means to determine a definitive diagnosis. The disease is rare--approximately 60 cases have been detected worldwide since 1986. Incubation time of the disease may be as long as 30 years; death generally occurs within 1 year of the onset of symptoms. There is no known procedure or treatment for delaying the onset of symptoms or modifying the disease course. Nurses who confront patients with FFI will be challenged to provide care to a patient and family who are facing certain death.

  16. When attempts at robbing prey turn fatal.

    PubMed

    Dejean, Alain; Corbara, Bruno; Azémar, Frédéric; Carpenter, James M

    2012-07-01

    Because group-hunting arboreal ants spread-eagle insect prey for a long time before retrieving them, these prey can be coveted by predatory flying insects. Yet, attempting to rob these prey is risky if the ant species is also an effective predator. Here, we show that trying to rob prey from Azteca andreae workers is a fatal error as 268 out of 276 potential cleptobionts (97.1 %) were captured in turn. The ant workers hunt in a group and use the "Velcro®" principle to cling firmly to the leaves of their host tree, permitting them to capture very large prey. Exceptions were one social wasp, plus some Trigona spp. workers and flies that landed directly on the prey and were able to take off immediately when attacked. We conclude that in this situation, previously captured prey attract potential cleptobionts that are captured in turn in most of the cases. PMID:22710934

  17. Fatal primary meningoencephalitis caused by Naegleria fowleri.

    PubMed

    Shariq, Ali; Afridi, Faisal Iqbal; Farooqi, Badar Jahan; Ahmed, Sumaira; Hussain, Arif

    2014-07-01

    Naegleria fowleri is a free living parasite which habitats in fresh water reservoirs. It causes a fatal nervous system infection known as primary amoebic meningoencephalitis by invading through cribriform plate of nose and gaining entry into brain. We report a case of primary amoebic meningoencephalitis caused by Naegleria fowleri in Karachi, Pakistan, in a 42 years old male poultry farm worker having no history of swimming. Clinical course was fulminant and death occurred within one week of hospital admission. Naegleria fowleri was detected by wet mount technique in the sample of cerebrospinal fluid collected by lumbar puncture of patient. This is a serious problem and requires immediate steps to prevent general population to get affected by this lethal neurological infection.

  18. Fatal parathion poisoning in Sierra Leone

    PubMed Central

    Etzel, R. A.; Forthal, D. N.; Hill, R. H.; Demby, A.

    1987-01-01

    In May and June 1986, 49 persons in Sierra Leone were acutely poisoned by the organothiophosphate insecticide, parathion. Fourteen people died. Illness occurred in three episodes at two different locations that were 44 km apart. A study of 21 cases and 22 household controls was undertaken to explore which factors were associated with the development of the symptoms. Cases were more likely than controls to have eaten bread in the 4 hours before becoming ill (odds ratio, 12.7; 95% confidence interval, 2.4-83.8). Scrapings of residue from the floor of the truck that had brought the wheat flour from the mill to the general store where the baker purchased it were positive for parathion, suggesting that the flour had been contaminated during transport. Pesticide poisoning is a common problem in the developing world, and public health measures such as restricting the use of parathion may help to prevent fatal poisonings. PMID:3501344

  19. Firearm fatalities in Edirne, 1984-1997.

    PubMed

    Azmak, D; Altun, G; Bilgi, S; Yilmaz, A

    1998-08-12

    During the 14-year period from 1984 to 1997 there were 85 firearm fatalities investigated by the Department of Forensic Medicine and the Department of Pathology in Edirne, Turkey. We determined the characteristics of these 85 firearm deaths which comprised 17.03% of all medicolegal autopsies. The overall incidence was 1.58 per 100,000 population. The median age was 35.5 years. Fifty-four percent of the victims were aged between 20 and 40 years. Males constituted 82% of the victims. The most frequent manner of death was homicide (68.3%). Handguns accounted for 62.4% of the weapons used. The most common sites for the firearm entrance wounds were both head-neck-nape (32.8%) and chest (32%). In conclusion, our study shows that, in spite of legal restrictions, illegal access to firearms is easy and deaths by firearms are still increasing.

  20. Measurement and dimension of road fatality in Brunei.

    PubMed

    Haque, Mohammed Ohidul

    2011-03-01

    In this article, we have investigated the pattern of road fatality in Brunei. It is seen from this analysis that road fatality in Brunei was one of the highest in the world in the early 1990s, but has been significantly reduced over the years, and is now one of the lowest in the world. Preliminary investigation shows that young male drivers are responsible for most road fatalities in Brunei. We have also fitted a linear regression model and found that road fatality is significantly positively related to people aged 18-24 years and new registered vehicles, both of which are expected to grow with the growth of population and economic development. Hence, road fatality in Brunei is also expected to grow unless additional effective road safety countermeasures are introduced and implemented to reduce road toll. Negative coefficient is observed for trend variable, indicating the reduction of road fatality due to the combined effects of improvements of vehicle safety, road design, medical facilities and road safety awareness among road user groups. However, short-term road fatality analysis based on monthly data indicates that the coefficient of the trend variable is positive, implying that in recent months road fatalities are increasing in Brunei, which is supported by media reports. We have compared Brunei's road fatality data with Australia, Singapore and Malaysia and found that Brunei's road fatality rate is lower than Singapore and Malaysia, but higher than Australia. This indicates that there are still opportunities to reduce road fatalities in Brunei if additional effective road safety strategies are implemented like in Australia without interfering in the economic and social development of Brunei.

  1. Causes and prevention of boating fatalities.

    PubMed

    O'Connor, Peter J; O'Connor, Nina

    2005-07-01

    The aim of this study was to investigate the causes and prevention of the 333 boating deaths that occurred in Australia over the period 1992-1998. It involved: assessment of the Coroner's findings; review of witness statements, police reports, autopsy findings, search and rescue reports, weather maps and reports; analysis of forensic and scientific data; assessment of photographic evidence; review of other related information. The data were coded according to a recently developed national data standard. It was found that nearly half of the vessels involved had an insufficient number of personal flotation devices for the number of people on board; of all people killed only 9% were wearing them, and survivors were more than two times more likely to have been wearing them. If usage could be increased to 75%, five lives could be saved each year with a cost saving to the Australian community of nearly $8 million. The contribution of alcohol to boating deaths (28% in excess of 0.05g/100ml) was similar to its contribution to road deaths. The sequence of events resulting in a boating death was initiated most often by capsize (36%). Capsize was more likely to involve overloading or improper loading, hazardous wind or sea conditions, and dinghies. Twenty-five percent of the vessels involved in fatalities were dinghies and they were more likely to be overloaded, involve capsize, alcohol, and failure to wear a personal flotation device. Fatalities involving personal watercraft were mainly caused by human factors. Boating causes a significant level of harm to the Australian community measured in terms of mortality. This can be reduced by a concerted effort to address the identified hazards and protective factors.

  2. Bordetella bronchiseptica and fatal pneumonia of dogs and cats

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Bordetella bronchiseptica frequently causes nonfatal tracheobronchitis, but its role in fatal pneumonia is less well-studied. The objectives of this study were to identify the frequency of Bordetella bronchiseptica infection in fatal cases of bronchopneumonia in dogs and cats and to compare the diag...

  3. Fatal Child Maltreatment in England, 2005-2009

    ERIC Educational Resources Information Center

    Sidebotham, Peter; Bailey, Sue; Belderson, Pippa; Brandon, Marian

    2011-01-01

    Objective: This paper presents comprehensive and up-to-date data covering 4 years of Serious Case Reviews into fatal child maltreatment in England. Methods: Information on all notified cases of fatal maltreatment between April 2005 and March 2009 was examined to obtain case characteristics related to a systemic classification of 5 broad groups of…

  4. Combined quinacrine and chlorpromazine therapy in fatal familial insomnia.

    PubMed

    Benito-León, Julián

    2004-01-01

    Prion diseases are invariably fatal. Recently, quinacrine and chlorpromazine have been suggested as immediate candidates for the treatment of Creutzfeldt-Jakob disease and other prion diseases. The objective of this paper was to report on 2 fatal familial insomnia patients whose overall condition worsened despite quinacrine and chlorpromazine treatment.

  5. Teenaged Drivers and Fatal Crash Responsibility. Preliminary Report.

    ERIC Educational Resources Information Center

    Williams, Allan F.; Karpf, Ronald S.

    According to data obtained for the year 1978 from the Fatal Accident Reporting System (FARS) and from state governments under contract to the National Highway Traffic Safety Administration, teenaged drivers (especially males) have much higher rates of fatal crash involvement than older drivers. In addition, teenaged drivers are more likely than…

  6. Analysis of fatal road traffic crashes in Ghana.

    PubMed

    Ackaah, Williams; Adonteng, David O

    2011-03-01

    The major objective of this study was to identify the risk factors associated with fatal road traffic crashes (RTCs) and to propose remedial measures to address them. Fatal RTC data for the period 2005-2007 in Ghana were analysed using the Micro-computer Accident Analysis Package (MAAP) software. Other transport-related research works were reviewed and incorporated in the article. The study showed that pedestrians accounted for 42% of all road traffic fatalities and nearly one-third (33%) of these crashes occurred during the early night-time hours. Children alone constituted almost one-third of all pedestrian fatalities. The occupants of goods vehicles accounted for 12% of all road traffic fatalities although goods vehicles constitute just about 9% of the total motor vehicle population in Ghana. Pedestrians, especially children bear a disproportionately high share of road traffic fatalities in Ghana. The risk of being killed as a pedestrian in traffic is exacerbated during night time. Excessive vehicular speeds, inappropriate use of goods vehicles for passenger transport, excessive loading and inadequate trauma care are the key contributory risk factors to the high number of road traffic fatalities. Concerted efforts spanning education, engineering, enforcement and trauma care are needed to stem the rise in fatal crashes in Ghana.

  7. Fatality Analysis Reporting System, General Estimates System: 2001 Data Summary.

    ERIC Educational Resources Information Center

    2003

    The Fatality Analysis Reporting System (FARS), which became operational in 1975, contains data on a census of fatal traffic crashes within the 50 states, the District of Columbia, and Puerto Rico. The General Estimates System (GES), which began in 1988, provides data from a nationally representative probability sample selected from all…

  8. Restraint effectiveness, occupant ejection from cars, and fatality reductions.

    PubMed

    Evans, L

    1990-04-01

    The effectiveness of air cushion restraint systems, or airbags, in preventing fatalities is estimated by assuming that they do not affect ejection probability, and protect only in frontal, or near frontal, crashes with impact-reducing effectiveness equal to that of lap/shoulder belts. In order to compute airbag effectiveness, lap/shoulder belt effectiveness and the fraction of fatalities preventable by eliminating ejection are estimated using Fatal Accident Reporting System (FARS) data. Ejection prevention is found to account for almost half of the effectiveness of lap/shoulder belts (essentially all for lap belts only). Airbag effectiveness is estimated as (18 +/- 4)% in preventing fatalities to drivers and (13 +/- 4)% to right front passengers. Drivers switching from lap/shoulder belt to airbag-only protection increase their fatality risk by 41%. PMID:2331291

  9. Uber and Metropolitan Traffic Fatalities in the United States.

    PubMed

    Brazil, Noli; Kirk, David S

    2016-08-01

    Uber and similar rideshare services are rapidly dispersing in cities across the United States and beyond. Given the convenience and low cost, Uber has been characterized as a potential countermeasure for reducing the estimated 121 million episodes of drunk driving and the 10,000 resulting traffic fatalities that occur annually in the United States. We exploited differences in the timing of the deployment of Uber in US metropolitan counties from 2005 to 2014 to test the association between the availability of Uber's rideshare services and total, drunk driving-related, and weekend- and holiday-specific traffic fatalities in the 100 most populated metropolitan areas in the United States using negative binomial and Poisson regression models. We found that the deployment of Uber services in a given metropolitan county had no association with the number of subsequent traffic fatalities, whether measured in aggregate or specific to drunk-driving fatalities or fatalities during weekends and holidays.

  10. Uber and Metropolitan Traffic Fatalities in the United States.

    PubMed

    Brazil, Noli; Kirk, David S

    2016-08-01

    Uber and similar rideshare services are rapidly dispersing in cities across the United States and beyond. Given the convenience and low cost, Uber has been characterized as a potential countermeasure for reducing the estimated 121 million episodes of drunk driving and the 10,000 resulting traffic fatalities that occur annually in the United States. We exploited differences in the timing of the deployment of Uber in US metropolitan counties from 2005 to 2014 to test the association between the availability of Uber's rideshare services and total, drunk driving-related, and weekend- and holiday-specific traffic fatalities in the 100 most populated metropolitan areas in the United States using negative binomial and Poisson regression models. We found that the deployment of Uber services in a given metropolitan county had no association with the number of subsequent traffic fatalities, whether measured in aggregate or specific to drunk-driving fatalities or fatalities during weekends and holidays. PMID:27449416

  11. Firearm-related fatalities: an epidemiologic assessment of violent death.

    PubMed Central

    Alexander, G R; Massey, R M; Gibbs, T; Altekruse, J M

    1985-01-01

    This study examines 1970-78 South Carolina firearm fatalities utilizing vital record data. During this period, 5,808 firearm deaths, classified as accident, homicide, suicide, or undetermined, were reported with an average annual fatality rate of 23.35 deaths per 100,000 estimated population. Firearm fatalities in South Carolina were the sixth leading cause of death in 1975 and accounted for 2.9 per cent of all deaths to residents. A significant period decline in the firearm fatality rate was observed and was attributed mainly to decreases in the non-White rate. In 1978, the fatality rate for non-Whites (18.5) fell below the rate for Whites (19.1) for the first time in the years investigated. Firearm deaths represent a major community health problem and, as such, warrant attention and direct involvement by state and local health professionals. PMID:3966623

  12. Acute renal failure and metabolic acidosis due to oxalic acid intoxication: a case report.

    PubMed

    Yamamoto, Rie; Morita, Seiji; Aoki, Hiromichi; Nakagawa, Yoshihide; Yamamoto, Isotoshi; Inokuchi, Sadaki

    2011-12-01

    Most of the reports of oxalic acid intoxication are in cases of ethylene glycol intoxication. These symptoms are known to be central nerve system manifestations, cardiopulmonary manifestations and acute renal failure. There have been only a few reports of direct oxalic acid intoxication. However, there have been a few recent reports of oxalic acid intoxication due to the ingestion of star fruit and ascorbic acid. We herein report the case of a patient with acute renal failure and metabolic acidosis caused directly by consumption of oxalic acid. During the initial examination by the physician at our hospital, the patient presented with tachypnea, a precordinal burning sensation, nausea and metabolic acidosis. After admission, the patient developed renal failure and anion gap high metabolic acidosis, but did not develop any CNS or cardio-pulmonary manifestations in the clinical course. The patient benefitted symptomatically from hemodialysis.

  13. Glycoconjugate histochemistry in the small and large intestine of normal and Solanum glaucophyllum-intoxicated rabbits.

    PubMed

    Zanuzzi, C N; Barbeito, C G; Ortíz, M L; Lozza, F A; Fontana, P A; Portiansky, E L; Gimeno, E J

    2010-10-01

    Vitamin D participates in mineral homeostasis, immunomodulation, cell growth and differentiation. The leaves of Solanum glaucophyllum contain high levels of 1,25-dihydroxyvitamin D3 as glycoside derivatives and their chronic ingestion generates a hypervitaminosis D-like state. We analyzed changes on carbohydrate expression as a cell differentiation indicator on samples of the small and large intestine of S. glaucophyllum-intoxicated rabbits, using conventional and lectin histochemistry. Male New Zealand white rabbits were intoxicated with S. glaucophyllum during two or four weeks and killed the day after. A group of animals ("possibly recovered group") were intoxicated during 15 days and killed at day 45 of the beginning of the experiment. We found changes in the lectin binding pattern in the small and large intestine of the intoxicated rabbits. Some of these changes were reverted in the possibly recovered group. Vitamin D could be a new regulator factor of the intestinal glycosylation process. PMID:20350732

  14. Is Central Europe Safe from Environmental Lead Intoxications? A Case Series.

    PubMed

    Pelclová, Daniela; Šťastná, Jana; Vlčková, Štěpánka; Vlček, Kamil; Urban, Michal; Laštovková, Andrea; Doležel, Zdeněk

    2016-06-01

    Preventive measures in Central Europe were successful in suppressing both occupational and environmental lead exposure so that they did not constitute a severe public health problem. However, rare lead intoxications still appear. We report on lead intoxication in four family members where the source was removed lead ceiling paint. The symptoms of the lead intoxication started several weeks after removal and the inhalational exposure to the minimum dust residues lasted for more than three months before the poisoning was diagnosed. Father developed anaemia and saturnine colics. He and his two daughters received antidotal treatment which had to be repeated in the children. Finally, all recovered completely.Lead intoxication may be easily overlooked due to the unspecific symptoms. It is necessary to think of this rare poisoning which may be caused by old paints, historical ceramics and lead shots, in addition to commercial products imported from abroad. PMID:27434242

  15. Levosimendan as treatment option in severe verapamil intoxication: a case report and review of the literature.

    PubMed

    Osthoff, Mirjam; Bernsmeier, Christine; Marsch, Stephan C; Hunziker, Patrick R

    2010-01-01

    Cardiovascular shock due to verapamil intoxication is often refractory to standard resuscitation methods. Recommended therapy includes prevention of further absorption of the drug, inotropic therapy, calcium gluconate, and hyperinsulinemia/euglycemia therapy. Often further measures are needed such as ventricular pacing or mechanical circulatory support. Still, mortality remains high. Levosimendan, an inotropic agent, that enhances myofilament response to calcium, increases myocardial contraction and could therefore be beneficial in verapamil intoxication. Here, we report the case of a 60-year-old patient with clinically severe verapamil poisoning who presented with shock, bradycardia, and sopor. Standard therapy including high-dose inotropes failed to ameliorate the signs of intoxication. But additional therapy with levosimendan led to rapid improvement. Based on this observation, the literature is reviewed focusing on utilization of levosimendan in the treatment of calcium channel blocker overdose. We suggest to consider levosimendan as additional treatment option in patients with cardiovascular shock due to verapamil intoxication that are refractory to standard management.

  16. Susceptibility-weighted imaging findings of subacute delayed carbon monoxide intoxication: a report of five cases.

    PubMed

    Bae, Jin-Won; Cha, Seong-Yi; Kang, Tae-Ho; Lee, Jae-Hyeok; Kim, Hak-Jin; Jung, Dae Soo; Kim, Eun-Joo

    2012-01-15

    Brain injury from carbon monoxide (CO) poisoning occurs due to tissue hypoxia and direct CO-mediated histotoxicity. Recently developed susceptibility-weighted imaging (SWI) is sensitive for the detection of accumulated hemosiderin and iron secondary to cerebral hemorrhage. Therefore, we hypothesized that SWI may be helpful for identifying petechial hemorrhagic transformation secondary to acute hypoxic damage during subacute CO intoxication. Our case series with subacute CO intoxication revealed that the SWIs of all patients showed low signal intensities in the globus pallidus, representing the accumulation of iron or calcium secondary to hypoxic damage from acute CO intoxication. These results suggest that SWI may be a useful MR technique for illustrating brain damage in subacute delayed CO intoxication. PMID:21914555

  17. Work-related fatalities in the People's Republic of China.

    PubMed

    Jin, Kezhi; Courtney, Theodore K

    2009-07-01

    Over the past several decades, work-related fatal incident reporting in China has become faster, more publicly accessible and, hence, a potentially more valuable process in support of the decision-making and enforcement actions of the government and safety professionals. A study was conducted to examine the characteristics of work-related fatalities in the People's Republic of China (PRC) available from the State Work Accident Briefing (SWAB) system. Injury incident records related to industries other than coal mining were downloaded from the SWAB system (April 2001 to March 2003). The findings were compared with a previously published regional work fatality study in China, data from the U.S. Census of Fatal Occupational Injuries, and estimates from the International Labor Organization (ILO). During the 2-year period, 1538 work-related events (7046 worker fatalities) were recorded. Collisions (25.6%), drownings (14.6%), and structural collapses (12.5%) were the most frequently reported fatal events. Collisions (24.5%) and falls (14.5%) were the most frequent causes of cited fatal events. Transportation (105.87 per 100 000); mining industries other than coal mining and quarrying (73.28); and electricity, gas, and water supply (14.88) were the industries with the highest estimated fatality rates. Generally, regions with lower economic activity reported more fatalities. The fatal injury rate estimated from the SWAB system was 4.80 per 100,000 (U.S. rate 4.00). ILO estimates for 1994 and 2002 were substantially higher than the estimates derived from the SWAB system. SWAB system differences with other data sources analyzed herein indicate that there remains room for system refinement. PMID:19401909

  18. Work-related fatalities in the People's Republic of China.

    PubMed

    Jin, Kezhi; Courtney, Theodore K

    2009-07-01

    Over the past several decades, work-related fatal incident reporting in China has become faster, more publicly accessible and, hence, a potentially more valuable process in support of the decision-making and enforcement actions of the government and safety professionals. A study was conducted to examine the characteristics of work-related fatalities in the People's Republic of China (PRC) available from the State Work Accident Briefing (SWAB) system. Injury incident records related to industries other than coal mining were downloaded from the SWAB system (April 2001 to March 2003). The findings were compared with a previously published regional work fatality study in China, data from the U.S. Census of Fatal Occupational Injuries, and estimates from the International Labor Organization (ILO). During the 2-year period, 1538 work-related events (7046 worker fatalities) were recorded. Collisions (25.6%), drownings (14.6%), and structural collapses (12.5%) were the most frequently reported fatal events. Collisions (24.5%) and falls (14.5%) were the most frequent causes of cited fatal events. Transportation (105.87 per 100 000); mining industries other than coal mining and quarrying (73.28); and electricity, gas, and water supply (14.88) were the industries with the highest estimated fatality rates. Generally, regions with lower economic activity reported more fatalities. The fatal injury rate estimated from the SWAB system was 4.80 per 100,000 (U.S. rate 4.00). ILO estimates for 1994 and 2002 were substantially higher than the estimates derived from the SWAB system. SWAB system differences with other data sources analyzed herein indicate that there remains room for system refinement.

  19. [Early Detection of Manganese Intoxication Based on Occupational History and T1-weighted MRI].

    PubMed

    Fukutake, Toshio; Yano, Hajime; Kushida, Ryutaro; Sunada, Yoshihide

    2016-02-01

    Manganese regulates many enzymes and is essential for normal cell function. Chronic manganese intoxication has an insidious and progressive course terminating to atypical parkinsonism with little therapeutic efficacy. For subjects with chronic manganese exposure such as welders, manganese intoxication can be detected early based on the presence of hyperintensity in the globus pallidus on T(1)-weighted MRI and abnormally high urinary excretion of manganese with a chelating agent even in cases of normal serum/urine level of manganese.

  20. Radiology of Fractures in Intoxicated Emergency Department Patients: Locations, Mechanisms, Presentation, and Initial Interpretation Accuracy

    PubMed Central

    Morita, Yuka; Nozaki, Taiki; Starkey, Jay; Okajima, Yuka; Ohde, Sachiko; Matsusako, Masaki; Yoshioka, Hiroshi; Saida, Yukihisa; Kurihara, Yasuyuki

    2015-01-01

    Abstract The purpose of this study was to investigate the relationship of alcohol intoxication to time-to-presentation following injury, fracture type, mechanism of injury leading to fracture, and initial diagnostic radiology interpretation performance of emergency physicians versus diagnostic radiologists in patients who present to the emergency department (ED) and are subsequently diagnosed with fracture. Medical records of 1286 patients who presented to the ED and were diagnosed with fracture who also underwent plain film or computed tomography (CT) imaging were retrospectively reviewed. The subjects were divided into intoxicated and sober groups. Patient characteristics, injury-to-presentation time, fracture location, and discrepancies between initial clinical and radiological evaluations were compared. Of 1286 subjects, 181 patients were included in the intoxicated group. Only intoxicated patients presented with head/neck fractures more than 24 hours after injury. The intoxicated group showed a higher rate of head/neck fractures (skull 23.2% vs 5.8%, face and orbit 30.4% vs 9.5%; P < 0.001) and a lower rate of extremity injuries. The rate of nondiagnosis of fractures by emergency physicians later identified by radiologists was the same in both groups (7.7% vs 7.7%, P = 0.984). While the same proportion of intoxicated patients presented more than 24 hours following injury, only intoxicated patients presented with craniofacial and cervical spinal fractures during this period. Alcohol-related injuries are more often associated with head/neck fractures but less extremity injuries. The rate of fractures missed by emergency physicians but later diagnosed by radiologists was the same in intoxicated and sober patients.