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Full-Text Articles in Medicine and Health Sciences
Antidotes 1 & 2, Alison Jones
Mechanism Of Action And Value Of N-Acetylcysteine In The Treatment Of Early And Late Acetaminophen Poisoning: A Critical Review, Alison Jones
Alison L Jones
Introduction: The mechanism of action of N-acetylcysteine in early acetaminophen poisoning is well understood, but much remains to be learned of the mechanism of its possible benefit in acetaminophen poisoning presenting beyond 15 hours. Methods: Selective review of medical literature. N-acetylcysteine should be used in all cases of early acetaminophen poisoning where the plasma acetaminophen concentration lies “above the line;” which line is chosen depends on individual preference and whether enzyme induction is suspected. Particular care should be taken with the use of the nomogram for patients with chronic excess ingestion of acetaminophen or for those who have taken slow-release …
Features And Management Of Poisoning With Modern Drugs Used To Treat Epilepsy, Alison Jones, A Proudfoot
Features And Management Of Poisoning With Modern Drugs Used To Treat Epilepsy, Alison Jones, A Proudfoot
Alison L Jones
Patients become poisoned with anticonvulsant drugs postulated to result from post-ictal depression which in a variety of ways (Table 1).1 The prevalence of may persist for several days after a seizure. self poisoning and suicide amongst epileptics is many Anticonvulsant poisoning in children is a significtimes higher than that of the non-epileptic popula- ant problem,4 and not surprisingly, epileptics usually tion.2 There are many possible reasons for this, ingest their own anticonvulsants.3,4 Thus the prevalincluding social stigma, employment and marital ence of acute, carbamazepine overdosage appears difficulties, frequent or poorly controlled seizures, to be rising as its role as a …
Antidotes 4. Deferoxamine And Other Iron/Aluminium Chelators, Robert Flanagan, Alison Jones
Antidotes 4. Deferoxamine And Other Iron/Aluminium Chelators, Robert Flanagan, Alison Jones
Alison L Jones
No abstract provided.
A Case Of Severe Iatrogenic Bismuth Poisoning, Paul Dargan, C Bailey, S Greene, Shona Murray, Alison Jones
A Case Of Severe Iatrogenic Bismuth Poisoning, Paul Dargan, C Bailey, S Greene, Shona Murray, Alison Jones
Alison L Jones
Background: In 1999, a new synthetic tryptamine, 5-MeO-DIPT, became known as a street drug, with the street name of ‘‘Foxy’’ or ‘‘Foxy Methoxy.’’ By February 2003, DEA reported law enforcement seizures and=or reports of abuse in 12 states. We report the first published case of toxicity. Methods: After an index case, AAPCC TESS data were examined to determine trends and extent of abuse of this agent. Case Report: A 19 year-old, multiple-pierced, male was brought to the emergency department following ingestion of ‘‘Foxy.’’ Upon arrival, he displayed hallucinations, hypertension, tachycardia, mydriasis, and catalepsy, inability to answer questions, and staring into …
Metaraminol (Aramine(R)) In The Management Of A Significant Amlodipine Overdose, David Wood, K Wright, Alison Jones, Paul Dargan
Metaraminol (Aramine(R)) In The Management Of A Significant Amlodipine Overdose, David Wood, K Wright, Alison Jones, Paul Dargan
Alison L Jones
Objective: To report a patient with a significant amlodipine self-poisoning who failed to clinically respond to conventional treatment and was managed with metaraminol (Aramine†). Patient: A 43-year old male presenting after ingestion of 560 mg amlodipine, who failed to respond clinically to treatment with fluid resuscitation, calcium salts, glucagon and norepinephrine/epinephrine inotropic support. Main results : Following a loading bolus of 2 mg and intravenous infusion (83 mg/min) of metaraminol (Aramine.R) there was improvement in his blood pressure, cardiac output and urine output. Conclusions: This is the first case report of the beneficial use of metaraminol (aramine) in the management …
Antidotes. Immunotherapy, Robert Flanagan, Alison Jones
Antidotes. Immunotherapy, Robert Flanagan, Alison Jones
Alison L Jones
No abstract provided.
"To Guard Is Better Than To Heal" - The Prevention Of Accidental Poisoning And Injury To Children, Alison Jones
"To Guard Is Better Than To Heal" - The Prevention Of Accidental Poisoning And Injury To Children, Alison Jones
Alison L Jones
No abstract provided.
Dimethyl-P-Aminophenol (Dmap), Alison Jones, Robert Flanagan
Dimethyl-P-Aminophenol (Dmap), Alison Jones, Robert Flanagan
Alison L Jones
No abstract provided.
Hepatic Toxicology, Alison Jones, Paul Dargan
Hepatic Toxicology, Alison Jones, Paul Dargan
Alison L Jones
Many potentially toxic substances enter the body via the gastrointestinal tract. As the blood supply from the gastrointestinal tract (through the portal vein) drains into the liver, the liver comes into contact with them, and this exposure often is at a higher concentration than that received by other tissues. The liver is essential for the metabolic disposal of virtually all xenobiotics. This process is achieved mostly without injury to the liver itself or to other organs.
Can Medical Students Identify Recreational Drugs By Name?, Paul Dargan, C Bishop, C.A.A Chahal, Alison Jones, David Wood
Can Medical Students Identify Recreational Drugs By Name?, Paul Dargan, C Bishop, C.A.A Chahal, Alison Jones, David Wood
Alison L Jones
Background: Recreational drug toxicity is a common reason for presentation to the Emergency Department. Knowledge of recreational drug names is important to allow targeted assessment of patients presenting with recreational drug toxicity. Aims: To assess final year medical student knowledge of proper and street names for recreational drugs. Design: Questionnaire survey of final year medical students attending a revision lecture. Methods: There were two questionnaires used in this study. The first contained either proper names of recreational drugs or names sounding similar to recreational drugs or licensed pharmaceutical products; students were asked to identify which of these were recreational drugs. …
Improvement In The Management Of Acutely Poisoned Patients Using An Electronic Database, Prospective Audit And Targeted Educational Intervention, S Greene, David Wood, I Gawarammana, C Warren-Gash, Nick Drake, Alison Jones, Paul Dargan
Improvement In The Management Of Acutely Poisoned Patients Using An Electronic Database, Prospective Audit And Targeted Educational Intervention, S Greene, David Wood, I Gawarammana, C Warren-Gash, Nick Drake, Alison Jones, Paul Dargan
Alison L Jones
Problem: The need to improve the clinical assessment and management of acutely poisoned patients presenting to an NHS hospital emergency department (ED). Design: Creation of an electronic clinical toxicology database to prospectively collect all aspects of clinical information on poisoned-patient presentations. Systematic analysis of collated information to identify shortfalls in patient assessment and management. Bimonthly audit meetings, and design and implementation of educational interventions to address identified shortfalls. Ongoing audit to demonstrate continued improvement in patient care. Background and setting: ED in tertiary-level inner-city London teaching hospital. Study conducted by staff from the ED and clinical toxicology service. Key measures …
Fab Antibody Fragments: Some Applications In Clinical Toxicology, Robert Flanagan, Alison Jones
Fab Antibody Fragments: Some Applications In Clinical Toxicology, Robert Flanagan, Alison Jones
Alison L Jones
This review provides current information on the use of antigen-binding fragments (Fab) from cleaved antibodies to treat poisoning with digoxin and other potent, low formula mass poisons, such as colchicine and tricyclic antidepressants. Anti-digoxin Fab fragments have been used successfully for many years in the management of severe poisoning with digoxin, digitoxin, and a range of other structurally related compounds, including cardiotoxins from Nerium and Thevetia sp. (oleander) and Bufo sp. (toads). However, their main use remains treating digoxin poisoning. Equimolar doses of anti-digoxin Fab fragments completely bind digoxin in vivo. The approximate dose of Fab fragments (mg) is 80 …
Antidotes, Robert Flanagan, Alison Jones
Hepatotoxicity, Alison Jones
Hepatotoxicity, Alison Jones
Alison L Jones
Many potentially toxic substances enter the body via the gastrointestinal tract (gut). As the blood supply from the gastrointestinal tract (through the portal vein) drains into the liver, the liver comes into contact with the potentially toxic substances, and this exposure will often be at a higher concentration than in other tissues. The liver is essential for the metabolic disposal of virtually all xenobiotics (foreign substances). This process is mostly achieved without injury to the liver itself or to other organs. A few compounds such as carbon tetrachloride are toxic themselves or produce metabolites that cause liver injury in a …
Soluble Adhesion Molecules And Interleukin-2 Receptor Concentrations In Patients With Autoimmune Chronic Hepatitis, K Simpson, Alison Jones, A. Howie Forbes, P Hayes
Soluble Adhesion Molecules And Interleukin-2 Receptor Concentrations In Patients With Autoimmune Chronic Hepatitis, K Simpson, Alison Jones, A. Howie Forbes, P Hayes
Alison L Jones
To test the hypothesis that elevated serum levels of intercellular adhesion molecule-1 (sICAM-1), vascular cell adhesion molecule-1 (sVCAM-1), (s)E-selectin, (s)P-selectin and soluble interleukin-2 receptor (sIL-2R) occur in patients with biochemically inactive autoimmune hepatitis (AICH) compared with controls. Such a finding would suggest continued immune activation, which in the long-term would contribute to the development of cirrhosis in such patients.
Glucagon Use In B Blocker Overdose, Niall O'Connor, S Greene, Paul Dargan, Alison Jones
Glucagon Use In B Blocker Overdose, Niall O'Connor, S Greene, Paul Dargan, Alison Jones
Alison L Jones
The Best Evidence Topic Reports series is intended to provide evidence-based answers to clinical questions. The recent best evidence topic report by Boyd1 concluded that there is not enough evidence to support the use of glucagon in b blocker overdose. However, clinical toxicology is an area in which the evidence basis is often lacking and one therefore needs to rely on a combination of practical experience, case reports and assessment of biological plausibility
The Association Of Hepatitis C Viral Infection With Porphyria Cutanea Tarda In The Lothian Region Of Scotland, I Hussain, N Hepburn, Alison Jones, K O'Rourke, P Hayes
The Association Of Hepatitis C Viral Infection With Porphyria Cutanea Tarda In The Lothian Region Of Scotland, I Hussain, N Hepburn, Alison Jones, K O'Rourke, P Hayes
Alison L Jones
Porphyria cutanea tarda (PCT) is believed to be associated with reduced hepatic uroporphyrinogen decarboxylase activity and risk factors such as alcohol abuse and medication with oral contraceptives and certain other drugs. Recently it has been suggested that hepatitis C virus (HCV) infection may also be associated with PCT. We have therefore reviewed the prevalence of HCV infection in a series of patients with PCT in the Lothian region of Scotland. We identified 12 patients with PCT, all of whom had abnormal liver function tests. Liver histology revealed chronic active hepatitis in six patients, micronodular cirrhosis in four patients, hepatocellular carcinoma …
Use Of An Ivc Filter In The Management Of Ivc Thrombosis Occurring As A Complication Of Acute Pancreatitis, Alison Jones, D Ojar, D Redhead, A Proudfoot
Use Of An Ivc Filter In The Management Of Ivc Thrombosis Occurring As A Complication Of Acute Pancreatitis, Alison Jones, D Ojar, D Redhead, A Proudfoot
Alison L Jones
Vascular thrombosis and hypercoagulable states complicating pancreatitis are thought to be due to release of proteolytic enzymes from the pancreas and direct vasculitis. Inferior vena cava (IVC) thrombosis is an extremely rare complication o f chronic [1] and acute [2,3] pancreatitis.
Churchill's Pocketbook Of Toxicology, Alison Jones, Paul Dargan
Churchill's Pocketbook Of Toxicology, Alison Jones, Paul Dargan
Alison L Jones
No abstract provided.
Advances, Challenges, And Controversies In Poisoning, Alison Jones, Paul Dargan
Advances, Challenges, And Controversies In Poisoning, Alison Jones, Paul Dargan
Alison L Jones
Patients presenting with self poisoning constitute a significant and increasing workload in emergency medicine departments and rates in the UK (up to 347 per 100 000 per year) are among the highest in Europe.1 2 The severity of poisoning has decreased over the past decade with the introduction of safer drugs such as serotonin reuptake inhibitors over tricyclic antidepressants, but there are still more than 2000 deaths per year in the UK from self poisoning.
Amfetamine Overdose, Alison Jones, Sheree Kable
Amfetamine Overdose, Alison Jones, Sheree Kable
Alison L Jones
Large burden of dependency and toxicity worldwide stems from both legitimate and recreational ingestion of drug by nearly 25 million users annually. Overdose and toxicity strike inconsistently among new, occasional, chronic, and binge users. Intentional overdose is also encountered. Tachycardia, hyperthermia, volume depletion, agitation, seizures, and rhabdomyolysis are sentinel findings. Diagnosis facilitated by high index of suspicion and urine amfetamine screening. Treatment is initiated before receiving laboratory results. Hyperthermia often requires close monitoring and pharmacotherapy appropriate to an intensive care setting. Despite relative lack of short-term consequences (most victims recover fully), there are legitimate concerns that chronic use may lead …
Unusual Complications Of Paracetamol Poisoning, Alison Jones, L Prescott
Unusual Complications Of Paracetamol Poisoning, Alison Jones, L Prescott
Alison L Jones
Every physician is only too familiar with acute hepatic necrosis as the most common complication of severe paracetamol poisoning. The frequency with which paracetamol is used for self-poisoning may, however, give rise to complacency through familiarity, and the less common complications may be missed. The purpose of this review is to act as a reminder of these more unusual complications. Although there have been many reports of toxic occurred in the presence of hepatic or multi-organ failure, and in such circumstances it is difficult to distinguish between cause and effect.
N-Acetylcysteine, Richard Dart, Alison Jones
Prolonged Clinical Effects In Modified-Release Amitriptyline Poisoning, Niall O'Connor, S Greene, Paul Dargan, Duncan Wyncoll, Alison Jones
Prolonged Clinical Effects In Modified-Release Amitriptyline Poisoning, Niall O'Connor, S Greene, Paul Dargan, Duncan Wyncoll, Alison Jones
Alison L Jones
Background. Tricyclic antidepressant poisoning is often associated with significant cardiovascular and central nervous system toxicity. Effective treatment includes the use of appropriate gastric decontamination techniques, the administration of sodium bicarbonate, and meticulous supportive care. Tricylcic antidepressant toxicity typically lasts 24–48 hours following a significant overdose. Case Report. We describe a case of tricyclic antidepressant poisoning where significant clinical toxicity (QRS prolongation, metabolic acidosis) was observed for up to 4 days following ingestion of a modified-release preparation of amitriptyline. Successful patient recovery was associated with the use of multidose activated charcoal and repeated administration of intravenous sodium bicarbonate. Conclusions. Clinicians should …
School-Based Cancer Education Programs: An Opportunity To Affect The National Cancer Problem, Donald Iverson, J Scheer
School-Based Cancer Education Programs: An Opportunity To Affect The National Cancer Problem, Donald Iverson, J Scheer
Don C. Iverson
No abstract provided.
Evaluation Of Health Education And Promotion Programs:, P Mullen, R Mccuan, Donald Iverson
Evaluation Of Health Education And Promotion Programs:, P Mullen, R Mccuan, Donald Iverson
Don C. Iverson
No abstract provided.
Making A Case For Health Promotion., Donald Iverson
Making A Case For Health Promotion., Donald Iverson
Don C. Iverson
No abstract provided.
Go To Ruth's House: Ruth Lubic And Public Advocacy, Julie Fairman
Go To Ruth's House: Ruth Lubic And Public Advocacy, Julie Fairman
Julie A Fairman
No abstract provided.
Context And Contingency: The Post World War Ii History Of Nursing Scholarship, Julie Fairman
Context And Contingency: The Post World War Ii History Of Nursing Scholarship, Julie Fairman
Julie A Fairman
No abstract provided.