bluuebunny/crossref_metadata_2025 huggingface dataset:
Oxalic Acid, Epsom Salt and the Poison Bottle
Authors: Campbell W.A.
Published: December 2008

1 During the 19th century inadequate control of the sale of poisons, widespread illiteracy, and the English addiction to self-medication contributed to the high incidence of accidental poisoning by oxalic acid mistaken for Epsom salt.

2 Chemical methods for identifying oxalic acid failed when the product was adulterated.

3 Many mechanical devices were proposed to prevent careless dispensing; designs for poison bottles of distinctive shape, colour and texture appeared regularly for 40 years.
Solvent Abuse: Presentation and Clinical Diagnosis
Authors: Watson Joyce M.
Published: December 2008

1 Solvent abuse is not a new phenomenon-it has been practised by children and adolescents in America and elsewhere since the 1950s.

2 It was in November 1970 that police in the west of Scotland first identified the problem in a local industrial area. Since then there appears to have been an enormous increase in the size of the problem throughout Britain.

3 This paper deals with a review of 400 cases of solvent abuse referred to the investigator between 1975 and 1981. The substance used, the methods employed and the many and varied clinical effects resulting from solvent misuse in these cases are reviewed and discussed.
Solvent Abuse: An Educational Perspective
Authors: Ramsay Alistair W.
Published: December 2008

1 A survey of the extent and frequency of solvent abuse was carried out among 898 male pupils in a comprehensive school in Glasgow in September 1976 by means of a structured questionnaire.

2 The ages of the pupils who completed this questionnaire ranged from 11-16 years and the most vulnerable group was found to be aged 13-15 years. The overall involvement was 10% although the extent of use among 'the sniffers' varied widely from once only (50%) to regular use (21.5%).

3 It was concluded that schools should attempt to determine the existence and extent of pupils' involvement in solvent abuse so that appropriate strategies might then be introduced to define the nature of the problem, reduce the number of sniffers and assess the effectiveness of the strategy.

4 By educating young people in the dangers of solvent abuse, schools can in a positive way help to diminish this problem but they must not see this role as separate from that of other agencies.
The Use of Suggestion Techniques with Adolescents in the Treatment of Glue Sniffing and Solvent Abuse
Authors: O'Connor Denis
Published: December 2008

1 Various approaches to the treatment of adolescents who have developed long-term chronic dependency on the inhalation of solvent fumes are briefly outlined with regard to their effectiveness.

2 The importance of suggestion in the counselling relationship is emphasized as a feature which underlies the work of therapists from a wide range of systems of psychotherapy.

3 A method of treatment incorporating hypnosis is described and evaluated with reference to case reports.

4 The indications are that hypnotherapy has distinct advantages over other methods of treatment in the economy of time and effort needed to treat patients effectively in comparison with other methods; in reducing the observable and reported stress levels for patients undergoing treatment; and in improving the overall effectiveness of the therapy as measured by improvements in the patient's condition, e.g. severely reducing or ceasing the inhalation of solvent vapours.
A Review of Solvent Abusers and their Management by a Child Psychiatric Out-patient Service
Authors: Skuse David , Burrell Su
Published: December 2008

1 This study reviews 45 solvent abusers referred, over a 3-year period, to the Departments of Child Psychiatry attached to a large postgraduate teaching hospital.

2 Abusers are considered in 3 defined groups: chronic, periodic, experimental.

3 Boys predominate mainly in the group of chronic abusers, where a strong association is seen with delinquent behaviour and disrupted family backgrounds.

4 Many chronic users report transient symptoms of a toxic psychosis. A marked affective component may be evident, often depressive in character.

5 Systemic physical symptoms are common, especially amongst chronic users. Weight loss, nausea and vomiting, acute bronchospasm, cardiac arrhythmias have all been reported.

6 Other illicit drug use is widespread through the whole sample, but of little significance. Most children report alcohol and cigarette consumption, use of which can be very heavy.

7 Treatment was offered to most children, and comprised mainly family and individual work. A favourable outcome was correlated with high motivation, at least 6 months' duration of out-patient attendance, or with residential care and therapy. Approximately half the children who were chronic or periodic users had improved at follow-up.

8 Recommendations for more systematic recording of solvent abuse have been made as a result of these findings. All cases in the future will be separately registered, and their progress followed prospectively.
Treatment of Antidepressant Poisoning with Resin Hemoperfusion
Authors: Heath Andrew , Wickström Ingemar , MÅrtensson Erik , Ahlmén Jarl
Published: December 2008

1 The object of this study was to evaluate hemoperfusion in tricyclic antidepressant (TCA) poisoning.

2 Eight patients with severe TCA-poisoning and one patient with maprotiline poisoning were treated with resin hemoperfusion (HP). All patients were in Grade III or Grade IV coma with a QRS interval of 100 ms or greater. Hemoperfusion was started and continued until a satisfactory clinical response was obtained or for up to a maximum of 4 h.

3 Clearance values and extraction ratios were calculated during HP. The extraction ratio for all drugs was high (0.91-0.98) showing an effective clearance of these drugs from the blood compartment. After termination of HP a rebound effect of blood concentrations was seen in five cases. The total amount of the drug recovered was in no case greater than 3.1% of the estimated amount ingested.

4 It is therefore difficult to ascribe the clinical improvement seen in these patients during HP to the removal of significant amounts of the drug taken.
Treatment of Podophyllin Poisoning with Resin Hemoperfusion
Authors: Heath Andrew , Mellstrand Tore , Ahlmén Jarl
Published: December 2008

1 A 43-year-old man was admitted in a coma after oral ingestion of a suspected lethal dose of podophyllin solution in alcohol.

2 Hemoperfusion with a resin filter was started 7 h after ingestion. Hemoperfusion rapidly decreased plasma concentrations of podophyllotoxin with an extraction ratio of 0.76 over the filter. The relatively low plasma concentrations of podophyllotoxin and consequently small amount removed might be explained by the rapid metabolism of the drug to an unknown derivate.

3 This metabolite was completely cleared during passage over the filter, suggesting the removal of significant amounts of podophyllotoxin metabolites.

4 No neurological deficit was observed before or after hemoperfusion. At a two-month follow-up the patient remained healthy. Hemoperfusion may possibly prevent the development of coma and neurologic deficit with loss of deep tendon reflexes.
The Problem of Psilocybin Mushroom Abuse
Authors: Peden Norman R. , Pringle Stuart D. , Crooks James
Published: December 2008

1 We have reviewed the clinical features and management of 44 consecutive patients presenting to hospital over a 5 week period during an outbreak of ingestion of psilocybin containing mushrooms.

2 Patients presented to hospital usually because of dysphoric effects an average of 3.8 h after ingesting the mushrooms.

3 Mydriasis was present in 40 patients but fewer than half showed other sympathomimetic features - tachycardia, hypertension or hyperreflexia.

4 Twenty-three patients experienced nausea and vomiting.

5 Distortions of perception chiefly visual were frequent as were paraesthesiae and feelings of depersonalization.

6 The effects of the mushrooms were short-lived and had worn off within 12 h in all but one patient.

7 Inducing emesis did not appear to hasten recovery from the effects of the mushrooms.
Increased Drug Effect Induced by Surgery
Authors: Feely John
Published: December 2008

1 A thyrotoxic patient receiving a constant dose of propranolol and digoxin developed marked bradycardia postoperatively.

2 Compared to preoperative levels there was a considerable rise postoperatively in both plasma propranolol and serum digoxin steady-state concentrations.

3 Surgery by effecting drug disposition and disease processes may significantly alter drug handling in the perioperative period.
Dieldrin Pollution of a Human Food Chain
Authors: Bell D. , MacLeod A.F.
Published: December 2008

1 An incident is described in which excessive mortality amongst a poultry flock alerted veterinarians. Investigation revealed dieldrin in the carcasses and in the wood litter used in the nesting boxes.

2 Because high levels of dieldrin were found also in eggs the Department of Community Medicine was alerted.

3 Those most at risk were the workers who could have absorbed dieldrin by inhalation and percutaneously, and by eating contaminated eggs. A number of other people were at risk having eaten contaminated eggs.

4 Twenty-one workers or members of their families were investigated by case histories and blood levels. They were all clinically well. The highest estimated daily intake of dieldrin in the diet was 3.8 mgm. The highest blood dieldrin level found was 0.016μg/ml. This intake was of the same order as the upper limit of no-toxic-effect of long-term daily dosage, but the blood level is well below the level at which symptoms may be expected. The fall in mean blood level over a year is consistent with a long half-life of dieldrin in the human.

5 The conflict of interest in conducting a comprehensive investigation and preventing undue public alarm is discussed, and how this was resolved in this episode is described.
The Early Distribution of 239Pu, 241Am and 233U in the Soft Tissues and Skeleton of Old Rats. A Comparative Study
Authors: Sontag W.
Published: December 2008

1 Female and male rats of the Sprague-Dawley strain, aged about 13 months, were injected intravenously with monomeric 239Pu-(0.83 μCi/kg), 241Am-(1.48 μCi/kg) or 233U-citrate (1.53 μCi/kg) and sacrificed 7 days and 28 days after injection.

2 The wet weights and the radionuclide contents of the organs and the different bones were measured. Whereas in the soft tissue organs the radionuclide activity differs between female and male rats and between 7 days and 28 days, in the bones the relative radionuclide contents show no differences except in the femora of the 239Pu and 233U animals which are significantly different at 7 days and 28 days.
Activated Charcoal in Tricyclic Antidepressant Poisoning: Pilot Controlled Clinical Trial
Authors: Crome P. , Adams R. , Ali C. , Dallos V. , Dawling S.
Published: December 2008

1 A randomised clinical trial was carried out to assess the effects of activated charcoal in the management of suspected tricyclic antidepressant poisoning.

2 Forty-eight patients entered the study, twenty receiving supportive care plus activated charcoal (10 g) and twenty-eight supportive care alone.

3 Drug screening showed that only seventeen patients had taken tricyclic antidepressants alone.

4 Activated charcoal had no effect on either the rate of lightening of coma or the fall in plasma antidepressant concentrations in the 'pure' tricyclic antidepressant poisoning group.

5 No serious side-effects of activated charcoal were reported.
In Vitro and In Vivo Evaluation of Two Preparations of Activated Charcoal as Adsorbents of Aspirin
Authors: Dawling S. , Chand S. , Braithwaite R.A. , Crome P.
Published: December 2008

1 The adsorptive capacities of two preparations of activated charcoal have been studied both in vitro and in vivo using aspirin as a test compound.

2 The in vitro adsorptive capacities of the charcoal preparations were 477 mg of acetylsalicylic acid/g effervescent charcoal ('Medicoal'); 359 mg/g untreated standard charcoal ('Norit-A') and 482 mg/g reheated charcoal ('Norit A').

3 In vivo both charcoal preparations significantly reduced peak salicylate concentrations and salicylate availability, to a similar extent (analysis of variance P < 0.001).

4 Both charcoal preparations have similar capacities for adsorbing aspirin both in vitro and in vivo.
Severe Acute Poisoning from the Ingestion of a Permanent Wave Solution of Mercuric Chloride
Authors: Giunta F. , Di Landro D. , Chiaranda M. , Zanardi L. , Dal Palù A. , Giron G.P. , Bressa G. , Cima L.
Published: December 2008

1 A woman developed severe mercury intoxication from ingestion of about 2.5 g of mercuric chloride.

2 Antidotal treatment with a dithiol (BAL i.m.) and a monothiol (tiopronin i.v.) was started promptly.

3 Dialysis treatment thereafter markedly increased the elimination of mercury, thus hastening recovery.

4 It is suggested that chelating agents associated with dialysis are an effective treatment for mercury poisoning.
Computers in Poisons Information
Authors: Vincent V.
Published: December 2008

Computers may be used by Poison Control Centres (PCCs) for literature retrieval, as answering aids and for case registration. Experience now shows that in each of these uses the computer may be valuable but many of these programs are still in their infancy and there is undoubtedly scope for further development both for service and research applications. The present debate about the role of computers in PCCs is of considerable importance since it must be hoped that it will be possible to make the best use of finances and develop an approach which assists rather than confounds international understanding.
Childhood Poisoning in a Paediatric Hospital: The Luebeck experience
Authors: Christen H.-J. , Zink C. , Zink A. , Korporal J.
Published: December 2008

1 Case documentations in Poison Control Centres represent today probably the most useful source of information on actual trends. They are generally restricted to toxicologically relevant information, but they do not describe true incidence patterns. Population based analyses of incidence therefore generally consist of retrospective studies of hospital data. The regional and historical limitations of such studies restrict their usefulness in prevention and intervention. A solution could be prospective studies in defined regions.

2 Such a prospective registration of poisoning in children was started in 1982 in the Luebeck Medical School's Paediatric Hospital. This hospital is the only institution treating acute poisoning in the region, so that regional representativity of the data can be expected. Based on the experiences of a previous retrospective analysis of 730 poisoning cases treated between 1976 and 1980, a documentation form was developed for the registration of clinically and epidemiologically relevant data. Information on the toxic substance and the poisoned child is complimented by data on the clinical treatment as well as on socio-demographic parameters.

3 The first months' experience with the documentation form, and the results of the registration of 95 cases are presented. Possibilities and limitations of such registration systems are discussed.
The Frequency of Children's Poisonings in Different Social Groups
Authors: Eskola J. , Poikolainen K.
Published: December 2008

1 Social stress has been emphasised as one of the major aetiologic factors in childhood poisonings. The clinical records of 188 children treated for acute poisoning in Helsinki during a six month period in 1980 were investigated.

2 The ratios of the observed number of poisonings to the expected ones calculated on the basis of the social group distribution in Helsinki were as follows: (I) 1.9, (II) 0.7, (III) 0.8, and (IV) 1.2. With respect to the poisonings classified as severe, the corresponding ratios were 0.7, 0.6, 1.4 and 1.4.

3 There were more accidental and less serious poisonings in the highest social group than in the other social groups, and they were relatively more often caused by plants or tobacco. The delay from the poisoning to the treatment was the shortest among the children of the highest social group. The differences in poisoning incidence rates among various social groups could partly be explained by different patterns of health service utilization.
Acute Intoxication with Nicotine Alkaloids and Cannabinoids in Children from Ingestion of Cigarettes
Authors: Malizia E. , Andreucci G. , Alfani F. , Smeriglio M. , Nicholai P.
Published: December 2008

The risks to children from tobacco and tobacco with cannabinoids have been described following ingestion of cigarettes, cigarette butts, reefers and joints (Arena, 1974; Schvartsman, 1971; Dreisbach, 1980; Garcia-Estrada & Fischman, 1977). Tobacco cigarettes contain about 15-20 mg of nicotine but this is poorly absorbed following ingestion. 4-8 mg of nicotine may cause nausea, while the estimated oral lethal dose for adults ranges between 40-60 mg. Joints and reefers are estimated to have tetrahydrocannabinol (THC) content of 3.6-15 mg.
Poisoning with Veratrum-containing Sneezing Powders
Authors: Carlier P. , Efthymiou M.-L. , Garnier R. , Hoffelt J. , Fournier E.
Published: December 2008

1 Nine cases of accidental poisoning of children with sneezing powder are reported. Symptoms, besides sneezing, included gastrointestinal disturbances and syncope, whilst examination demonstrated bradycardia and hypotension.

2 The powder, as supplied, carried no information on its constituents but Veratrum alkaloids were identified on analysis. The signs and symptoms observed were compatible with poisoning from these compounds.

3 As a result of these observations, it was possible to trace the manufacturers and a change was made to a safer formulation. This example emphasises the value of toxicovigilance by Poison Control Centres.
Acute Chlormethiazole Poisoning in Patients Notified to the Poisons Unit, Guy's Hospital, 1978-1981
Authors: Houston A. , Essex E.G. , Wiseman H.M. , Flanagan R.J.
Published: December 2008

1 Out of 493 patients with suspected acute chlormethiazole poisoning notified to the Poisons Unit, Guy's Hospital during 1978-1981, the diagnosis was confirmed either analytically or by detailed clinical information in 108 patients, 40 of whom had ingested chlormethiazole alone.

2 The principal signs reported indicate that the clinical features of acute chlormethiazole poisoning resemble those of barbiturate poisoning, with deep coma ( n = 66), respiratory depression ( n = 26) and hypotension ( n = 17) in the severe cases. Five patients died as a result of early, profound respiratory depression.

3 In 53 survivors in whom toxicological analyses were performed, poisoning with chlormethiazole alone had a better prognosis than when ethanol or other drugs were also present, except in patients with hepatic or pulmonary disease or in the elderly.

4 These results emphasise that although patients poisoned with chlormethiazole who survive to reach hospital generally have a good prognosis, fatal respiratory complications often occur before the patient can be treated.
Toxicological Investigations in the Detection of Drug-Induced Disease in Elderly Patients
Authors: Flanagan R.J. , Caldwell R. , Lewis R.R. , Corless D.
Published: December 2008

1 During 1978-1980 general toxicological investigations were performed on specimens from 211 patients (62 male, 149 female) aged 65 years and over.

2 The investigations were an important factor in establishing the diagnosis in 32 of 91 (28 male, 63 female aged 65-92 years, median 73 years) poisoned patients, most (75) of whom had deliberately taken overdoses.

3 Seventy-one patients were severely poisoned (grade 3-4 coma) and 10 died. Benzodiazepines (49%) and barbiturates (43%) were the drugs encountered most frequently, although 54% had ingested more than one pharmaceutical preparation.

4 In the survivors the depth of coma was usually greatest in patients poisoned principally with barbiturates, whilst the duration of coma and the incidence of respiratory complications were greater in those poisoned with benzodiazepines. However, there was considerable variability in the depth and duration of coma associated with a given initial plasma concentration within both groups.

5 Although general toxicological investigations can provide useful diagnostic information when poisoning is suspected in elderly patients, unequivocal interpretation of the results obtained is not always possible.
Acute Poisoning with Ibuprofen
Authors: Court H. , Streete P. , Volans G.N.
Published: December 2008

1 Seventy five cases of ibuprofen overdose were recorded during a two year survey.

2 Details of the symptoms, treatment and the eventual outcome are known for 64% of the cases. The majority of the patients had no symptoms or only mild symptoms such as nausea or vomiting.

3 In the three cases where more serious symptoms were reported, the role of ibuprofen was not certain.

4 Laboratory analyses available for 13 cases demonstrated that plasma ibuprofen concentrations of up to 704 mg/l could be associated with no symptoms.

5 The data suggest that ibuprofen is of low toxicity in acute overdose and that therapy used should be supportive only.
Application of I.R. Spectrophotometry in Emergency Analyses
Authors: Magalini S.I. , Pala F.
Published: December 2008

I.R. spectrophotometry has been applied in emergency toxicological analyses. Poisons and drugs are extracted into chloroform, potassium bromide is added to the extract and the solvent evaporated. Potassium bromide discs are prepared by compression and scanned in an I.R. spectrophotometer. A data bank of standard spectra has been prepared and computerized comparison of the spectral data of the sample extract with those of authentic compounds allows the identification of toxic agents in 'real time'.
Hair Regrowth after Cancer Therapy
Authors: George S.L. , Whitton A. , Plowman P.N.
Published: December 2008

1 Florid scalp hair regrowth following the depilatory effects of both whole cranial radiotherapy and cytotoxic chemotherapy is described in a patient who simultaneously exhibited acquired hypertrichosis lanuginosa in the head and neck region.

2 The regrowth of more youthful and more senile scalp hair following cranial radiotherapy are exemplified in two further case reports.
Plasma Mercury during Prolonged Acute Renal Failure after Mercuric Chloride Ingestion
Authors: Newton J.A. , House I.M. , Volans G.N. , Goodwin F.J.
Published: December 2008

1 Serial measurements of plasma mercury were made in a patient with severe and prolonged acute renal failure due to poisoning with mercuric chloride.

2 An initial mercury concentration in whole blood of 1200 μg/l (6 μmol/l) was recorded, and recovery of renal function coincided with a fall in plasma mercury concentration to below 100 μg/l (0.5 μmol/l).

3 The case demonstrates that survival and recovery of renal function is possible despite very high concentrations of mercury in the blood and oliguric renal failure of nearly six weeks' duration.
Study of Serum Levels, Venous Irritation and Gastrointestinal Side-effects with Intravenous Erythromycin Lactobionate in Patients with Bronchopulmonary Infection
Authors: Marlin G.E. , Thompson P.J. , Jenkins C.R. , Burgess K.R. , LaFranier D.A.J.
Published: December 2008

1 Sixteen patients with bronchopulmonary infection received 500 mg erythromycin lactobionate by intravenous infusion every 8 h for 2 days. The duration of infusion was either 30 (8 patients) or 60 min (8 patients). An inline filterset (0.22 μm) was included in the intravenous administration set in 4 patients of each infusion group.

2 Serum erythromycin levels were obtained before and at various times for 8 h after the first and fourth doses and before and immediately after the other doses. The incidence and severity of venous irritation and gastrointestinal side-effects were assessed.

3 Mean (S.D.) peak erythromycin levels for the 30 min infusion were 26.31 (6.89) μg/ml (first dose) and 26.85 (6.11) μg/ml (fourth dose) and for the 60min infusions, 23.96 (7.91) μg/ml (first dose) and 23.65 (6.55) μg/ml (fourth dose).

4 Venous irritation was experienced by 12 patients, ranging from localized discomfort to thrombophlebitis, but the severity was significantly reduced by inline filtration (P < 0.005).

5 Gastrointestinal side-effects were reported by 8 patients and 1 patient withdrew because of severe abdominal pain and nausea. These symptoms were usually relieved by spasmolytic agents and possibly could be explained by high concentrations reaching the gut wall either by biliary excretion or direct transport from blood and stimulating smooth muscle motility.
Pharmacokinetic Aspects of Carbamazepine and its two Major Metabolites in Plasma During Overdosage
Authors: Hundt H.K.L. , Aucamp A.K. , Müller F.O.
Published: December 2008

1 In 10 out of 25 patients admitted with carbamazepine overdosage to local teaching hospitals sufficient plasma level data of carbamazepine and two of its main metabolites (expoxide and dihydroxy) were obtained to characterize their terminal elimination kinetics.

2 Some other pharmacokinetic aspects which could be useful in extrapolating to the amount and time of ingestion of the overdose are discussed.
Inhibition of Atropine Metabolism by Organophosphate Pesticides
Authors: Van Der Meer M.J. , Hundt H.K.L. , Müller F.O.
Published: December 2008

1 Urine specimens of 8 organophosphate-poisoned patients on treatment with large doses of atropine were screened for atropine metabolites using thin-layer chromatography. Only atropine was detected.

2 High performance liquid chromatography of urine specimens of a poisoned patient receiving large doses of atropine likewise detected only 3H-atropine after administration of 30 μCi 3H-atropine-sulphate. In the urine of a normal human volunteer treated with a single dose of 3H-atropine, 5 metabolic products were detected by this method.

3 It is concluded that acute organophosphate-poisoning blocks atropine metabolism by inhibiting the hepatic microsomal enzymes.
A Toxicological Study of the Pentasodium Salt of Puchel Using CBA Mice
Authors: Ellender M. , Payne S. , Godding K.L.
Published: December 2008

Animal experiments have suggested that Puchel, a lipophilic derivative of DTPA may be of use in removing plutonium from humans after an accidental intake. This study reports toxicological findings in mice. After the administration of Puchel, as single or repeated doses of the pentasodium salt, an LD50/ld value of 530 ± 44 mg kg-1 was obtained.
Monitoring of Adverse Drug Reactions by means of Autopsy Tissue Examination
Authors: Mikhael N.Z. , Kacew S.
Published: December 2008

Morphologic examination of autopsy tissue specimens was undertaken to establish the incidence of adverse drug reactions in a population of hospitalised patients. By removal of subjective bias recording of adverse reactions, the incidence of toxic tissue manifestations was 33%. In those reactions classified as definitely linked to a specific causative agent males between the ages of 41 and 60 displayed the highest frequency of adverse effects. In the probable and possible categories the incidence of toxic manifestations was equal amongst both sexes and highest in patients over 40 y. Regardless of the type of adverse reaction the most common causative agent identified was alcohol and hepatic tissue was primarily altered morphologically. Unlike the conventional mechanism used to monitor adverse drug reactions, autopsy tissue examination provides a system of measurement of toxic manifestations to both prescription as well as non-prescription compounds.
Ergotamine Toxicity and Serum Concentrations of Ergotamine in Migraine Patients
Authors: Graham A.N. , Johnson E.S. , Persaud N.P. , Turner P. , Wilkinson M.
Published: December 2008

1 Twenty-five migraine patients (9 males and 16 females) aged 22 - 71 who had used between 7 and 60 mg ergotamine tartrate per week for 1.5 - 30 y volunteered to participate in the study.

2 Side-effects attributable to ergotamine were wide ranging and included daily headache and pain in the limbs. Wide variation in sensitivity to the drug was observed and side-effects were not always proportional to the dose of ergotamine.

3 Random serum ergotamine concentrations were estimated in all patients and 10 of them volunteered to take a 2 mg oral challenge of ergotamine tartrate.

4 Ergotamine was not detected in 44% of the random estimations even though all patients exhibited clinical signs of ergotamine tartrate overdose. The remaining 56% estimations all showed low drug concentrations.

5 After the 2 mg oral challenge of ergotamine in the 10 patients, significantly higher concentrations, but still within therapeutic range, were detected in the sera when compared with mean concentrations achieved after the same oral dose of the drug in healthy, non-migrainous subjects.
Use of Absorbable Mesh to Displace Bowel and Avoid Radiation Enteropathy, during Therapy of Pelvic Ewing's Sarcoma
Authors: Plowman P.N. , Shand W.S. , Jackson D.B.
Published: December 2008

The use of absorbable polyglactin 910 mesh (Vicryl) is described in a case of Ewing's sarcoma of the pelvis. An operation was performed to hold the small bowel and colon out of the pelvis for a temporary period during which radical radiotherapy was delivered. The mesh allowed the temporary displacement of bowel and obviated bowel radiation morbidity.
Temporal Stability of Blood Lead Concentrations in Adults Exposed Only to Environmental Lead
Authors: Delves H.T. , Sherlock J.C. , Quinn M.J.
Published: December 2008

1 The temporal stability of blood lead concentrations of 21 healthy adults (14 men and 7 women) exposed only to environmental lead was assessed by analysis of 253 blood specimens collected serially over periods from 7 to 11 months.

2 Improved analytical sensitivity allowed detection of small (< 1.0 μg/ 100 ml) changes in blood lead concentrations and both within- and between-run analytical errors were minimized by a strict internal quality control protocol.

3 The women had lower blood lead concentrations (mean 8.5, range 7.4-10.8 μg/100 ml) than did the men (mean 12.2, range 8.6-15.8 μg/100 ml). These are within the expected ranges for non-occupationally exposed persons.

4 Blood lead concentrations in the serial specimens from both men and women changed very little over the study period, with standard deviations of < 0.5 μg/100 ml for the majority of individual mean concentrations: for all except two subjects the standard deviations were < 0.8 μg/100 ml.

5 Two subjects showed significant changes in blood lead concentrations during the study (standard deviations of mean > 1.0 μg/100 ml). A temporary increase in oral lead intake was identified for one of these subjects.

6 In the absence of substantial changes in lead exposure blood lead levels in adults are remarkably stable and for their environmental monitoring a single blood lead concentration is an excellent biological indicator.
Inhalation Toxicity of a Smoke Containing Solvent Yellow 33, Disperse Red 9 and Solvent Green 3 in Laboratory Animals
Authors: Marrs T.C. , Colgrave H.F. , Gazzard M. , Brown R.F.R.
Published: December 2008

The repeated-dose inhalation toxicity of a smoke containing a mixture of three dyes was tested in female mice, rats and guinea pigs. The green component dye (Solvent Green 3) was retained in the lungs. Particularly in the rats marked collections of alveolar macrophages were found. In the same species several other adverse findings were noted: these included adenocarcinomas of the breast in the high-dose group and a dose-related incidence of biliary hyperplasia. Fatty change was noted in the livers of the test-group mice. A large proportion of the high-dose guinea pigs died during the exposure period, for which reason exposure was stopped early in that group, otherwise the guinea pigs were little affected. However, all test groups of all species showed reductions in growth during the exposure period.
Acute Renal Failure after Intoxication with Cortinarius Mushrooms
Authors: Holmdahl J. , Mulec H. , Ahlmén J.
Published: December 2008

Four previously healthy young adults developed the clinically recognised features of Cortinarius poisoning 3-4 days after intoxication.

Two patients treated with haemoperfusion and haemodialysis 5 days after ingestion of the mushrooms regained normal kidney function. Two patients treated late with single haemoperfusions or dialysis had irreversible renal failure.

The clinical results and our experimental studies on the toxic principle of the mushrooms indicate that early treatment with HP and HD may be important in order to avoid the development of irreversible renal failure.
Reduction in Exposure to Lead from Drinking Water and its Effect on Blood Lead Concentrations
Authors: Sherlock J.C. , Ashby D. , Delves H.T. , Forbes G.I. , Moore M.R. , Patterson W.J. , Pocock S.J. , Quinn M.J. , Richards W.N. , Wilson T.S.
Published: December 2008

1 The water supply in Ayr (Scotland, UK) was plumbosolvent and many dwellings in Ayr contained lead pipes. In 1981 treatment of the water supply to reduce its plumbosolvency was initiated. Measurements of water and blood lead concentrations were made before and subsequent to the treatment. Most of the measurements made before and after water treatment began were made on water samples from the same dwellings and blood samples from the same women.

2 Water treatment produced a sharp fall in water lead concentrations and a decrease in the median blood lead concentration from 21 to 13 μg/100 ml.

3 Two women had higher than expected blood lead concentrations, both these women had been removing old paint.

4 Women who had lead pipes removed from their dwellings all showed substantial decreases in their blood lead concentrations.

5 The curvilinearity of the relation between blood lead and water lead concentrations is confirmed. Even relatively low (<40 μg/l) water lead concentrations may make a substantial contribution to blood lead concentrations.
Resin Haemoperfusion in Levomepromazine Poisoning: Evaluation of Effect on Plasma Drug and Metabolite Levels
Authors: Hals P.-A. , Jacobsen D.
Published: December 2008

1 Plasma levels of levomepromazine and two of its major metabolites N-desmethyl-levomepromazine and levomepromazine sulphoxide were studied in two poisoned patients treated with resin haemoperfusion at a constant blood flow of 200 ml/min.

2 The mean haemoperfusion clearance of levomepromazine, N-desmethyl-levomepromazine and levomepromazine sulphoxide was 114, 123 and 151 ml/min, respectively, in patient no. 1, and 153, 148 and 184 ml/min, respectively, in patient no. 2. Patient no. 2 had also ingested amitriptyline, and the mean haemoperfusion clearance of amitriptyline and its metabolite nortriptyline was 183 and 183 ml/min respectively.

3 Haemoperfusion did not seem to alter the elimination profile of levomepromazine or the two metabolites in either patient.

4 We conclude that haemoperfusion is of little value in removing levomepromazine, N-desmethyl-levomepromazine or levomepromazine sulphoxide from the body. This is probably due to the large apparent volume of distribution and the high intrinsic hepatic metabolic clearance of these compounds.
Organochlorine Pesticide Residues in Mother's Milk: a Source of Toxic Chemicals in Suckling Infants
Authors: Ramakrishnan N. , Kaphalia B.S. , Seth T.D. , Roy N.K.
Published: December 2008

A total of 24 samples of mother's milk collected during the first week of lactation from four major cities in India (Karnal, Bangalore, Calcutta and Bombay) were analysed for the estimation of organochlorine pesticides (OCPs). α-HCH, p,p'-DDE, and p,p'-DDT were generally the main contaminants. The average total 1,1,1-trichloro-2,2-bis (p-chlorophenyl) ethane (DDT) levels stand at 0.05, 0.11, 0.19 and 0.22 p.p.m. (whole-milk basis) in the samples from Bangalore, Calcutta, Karnal and Bombay respectively. In the same order total hexachlorocyclohexane (HCH) levels were around 0.01, 0.03, 0.03 and 0.05 p.p.m. Wide variations among OCP levels observed in the present study have no relation with the fat content of the various samples. The samples from Calcutta and Bombay showed significantly high levels of OCPs. The daily intake of total HCH and DDT residues calculated for the suckling infant was significantly higher in the present study when compared with the WHO recommended value.
Effect of Chronic Anticonvulsant Monotherapy on Lymphocyte Subpopulations in Adult Epileptic Patients
Authors: Marcoli M. , Gatti G. , Ippoliti G. , Lombardi M. , Crema A. , Zocchi M.T. , De Ponti F. , Lecchini S. , Frigo G.M.
Published: December 2008

Sixty-five patients undergoing long-term monotherapy for at least 3 months with phenytoin, carbamazepine or phenobarbital were screened for lymphocyte and immunoglobulin abnormalities. In 57% of patients the duration of therapy was longer than 12 months. The control subjects were matched for sex and age and none of them was taking drugs. The average serum immunoglobulin (IgG, IgA, IgM) values did not differ in control and patient groups. A significant decrease of OKT4+ cells was seen with all drugs, while other lymphocyte subpopulations were differently affected depending on the drug used. It is concluded that long-term single-drug treatment with phenytoin, carbamazepine and phenobarbital exhibits immunosuppressant effects through a complex action which involves more than one lymphocyte subpopulation. Moreover, the possible interference of the disease state with the immune functions of epileptic patients is discussed.
Plasma Hydrazine Concentrations in Man after Isoniazid and Hydralazine Administration
Authors: Blair I.A. , Mansilla Tinoco R. , Brodie M.J. , Clare R.A. , Dollery C.T. , Timbrell J.A. , Beever I.A.
Published: December 2008

1 By using a specific sensitive stable-isotope dilution gas chromatography-mass spectrometry (GC-MS) assay, hydrazine was detected in the plasma of eight healthy male volunteer subjects taking isoniazid (300 mg daily) for 2 weeks.

2 Accumulation of hydrazine occurred in slow-acetylator phenotypes.

3 Hydrazine was also detected in the plasma of eight out of 14 hypertensive patients treated chronically with hydralazine (200 mg daily).

4 However, the concentrations of hydrazine observed were much lower than in the isoniazid study and were close to the limit of detection.

5 As hydrazine is hepatotoxic, mutagenic and carcinogenic in animals, its presence in human plasma has important toxicological implications.
Meprobamate Overdosage
Authors: Dennison J. , Edwards J.N. , Volans G.N.
Published: December 2008

Meprobamate is a non-barbiturate hypnotic/tranquillizer, first used clinically in 1955. One preparation (Tenavoid; Edwin Burgess) contains meprobamate and bendrofluazide and is prescribed for pre-menstrual tension.

In adults therapeutic plasma meprobamate concentrations range up to 10 mg/l and unwanted side-effects occur at greater than 40 mg/l. Light coma occurs at 60-120 mg/l and deep coma at 100-240 mg/l (Baselt, 1982). There are no data on toxic plasma concentrations in children. We report two cases of overdosage in children who regained consciousness at times when plasma meprobamate concentrations were greater than 100 mg/l.
Subjective Costs of Antihypertensive Treatment
Authors: Poloniecki J. , Hamilton M.
Published: December 2008

A method for surveying side-effects in the hypertension clinic of a district general hospital is described. A high frequency of complaints was confirmed. Impairment of sexual activity in the sexually active was reported by 23 (48%) men and 10 (23%) women. A previous lack of data from women on this subject may have led to the unsafe conclusion that drugs which can cause impotence in men are necessarily more suitable for women. The survey method is capable of identifying susceptible patients who may then be asked to co-operate in further research.
Studies on the Possible Central and Peripheral Effects in Man of a Cholinesterase Inhibitor (Pyridostigmine)
Authors: Borland R.G. , Brennan D.H. , Nicholson A.N. , Smith P.A.
Published: December 2008

1 The effect of a reversible cholinesterase inhibitor (pyridostigmine: 30 mg, 8-hourly for 3 days) on psychomotor performance and visual function and on the electrical activity of the brain was studied in healthy man.

2 It was not possible to detect any change during the six individual experimental sessions over the 3 days, but with pooling of the data there was a drug effect. The threshold for detection of a flickering light was increased and less responses were missed on a dynamic visual-acuity task. Visuo-motor coordination was impaired.

3 The observations were consistent with the known activity of the drug and suggest an increase in central arousal and minimal alteration in motor coordination.
Acute Poisoning Admissions in one of the Hospitals in Ankara
Authors: Karakaya A. , Vural N.
Published: December 2008

1 Emergency service admissions at the Numune Hospital, Ankara, have been investigated for one year.

2 Of the emergency admissions 5% were cases of poisoning; of these, 63.6% were due to drugs.
Organochlorine Pesticide Residues in Human Fat in the United Kingdom 1982-1983
Authors: Abbott D.C. , Goulding R. , Holmes D.C. , Hoodless R.A.
Published: December 2008

Between December 1982 and October 1983 samples of human body fat were taken during routine necropsies carried out on 187 persons aged over 5 years and four infants aged under 4 months. Comparison of the results of analysis with those from the previous studies in 1976-1977, and earlier, shows a continuing decline in residues of p,p'-dichlorodiphenyltrichloroethone (p,p'-DDT) and dieldrin (HEOD) and a reduction in the amounts of p,p'dichlorodiphenyldichloroethene (p,p'-DDE, a metabolite of p,p'-DDT] and hexachlorobenzene. The concentrations of other compounds were similar to those observed in the previous studies. The results show that the amounts of organochlorine pesticides and polychlorobiphenyl compounds contained in human fat samples from residents in the UK compare favourably with data obtained in other countries.
Screening the in vitro Sperm-immobilizing Effect of some Anticancer Drugs
Authors: Hong C.Y. , Chiang B.N. , Ku J. , Wu P.
Published: December 2008

1 The in vitro sperm-immobilizing effect of seven anticancer agents, namely cyclophosphamide, 5-fluorouracil, cytarabine, mitomycin-C, 6-mercaptopurine, doxorubicin and vinblastine were screened with a transmembrane migration method.

2 Only doxorubicin and vinblastine inhibited human sperm motility.

3 Because colchicine, a microtubular inhibitor, had no sperm-immobilizing effect, we suggest that the sperm membrane is the site of action of these two anticancer drugs to inhibit human sperm motility.
Gastric Perforation after Acute Aspirin Overdose
Authors: Robins J.B. , Turnbull J.A. , Robertson C.
Published: December 2008

A case is presented of gastric perforation complicating acute aspirin overdose in a patient without previous evidence of peptic ulcer disease.
Use of DTPA for Increasing the Rate of Elimination of Plutonium-238 and Americium-241 from Rodents after their Inhalation as the Nitrates
Authors: Stather J.W. , Stradling G.N. , Gray S.A. , Moody J. , Hodgson A.
Published: December 2008

This study has shown that:

1 both inhaled (2 μmol/kg) and injected (30 μmol/kg) diethylenetriaminepentaacetic acid (DTPA) can reduce the lung deposit of 238Pu and 241 Am inhaled as nitrate to about 1% of that in untreated controls;

2 injection of DTPA is more effective than aerosolized DTPA for reducing deposits of 238 Pu and 241Am in the liver and skelton;

3 combined treatment involving early inhalation of DTPA followed by repeated intravenous injections is likely to be the most effective treatment for workers who have accidentally inhaled plutonium and americium nitrates.
4-Dimethylaminophenol and Dicobalt Edetate (Kelocyanor) in the Treatment of Experimental Cyanide Poisoning
Authors: Marrs T.C. , Swanston D.W. , Bright J.E.
Published: December 2008

1 The efficacy of dicobalt edetate (Kelocyanor) was compared against that of 4-dimethylaminophenol (DMAP) in experimental cyanide poisoning.

2 DMAP gave better survival.

3 The efficacy has been related to the toxicity of the two compounds.
HPLC Method for Determination of Ergot Alkaloids and Some Derivatives in Human Plasma
Authors: Žorž M. , Culig J. , Kopitar Z. , Milivojevic D. , Marušič A. , Bano M.
Published: December 2008

1 Ergot alkaloids and their dihydrogenated methanesulphonate (ms) salts were determined and measured in human plasma.

2 High-performance liquid chromatography (HPLC) with fluorometric detection was used for separation of ergot alkaloids in plasma.

3 Several ergot alkaloids and their derivatives, including lysergide (LSD), can be identified in cases of poisoning.
Seasonal Variation and Recurring Peaks of Reported Poisonings During a 3-year Period
Authors: Eskola J. , Poikolainen K.
Published: December 2008

1 Seasonality of poisonings was studied among 28 692 cases reported during the years 1980-1982 in Finland with special reference to recurring peak months over years. Poisonings predominated in the summer. For all age-groups peaks of envenomations, plant poisonings and pesticide poisonings recurred between June and September.

2 Among children aged 0-6 years, there were in addition recurrent peaks in poisonings by tobacco between June and August, by corrosive agents in September and by vitamins, trace elements and external medicines in October. Among children aged 7-15 years, fertilizer poisonings peaked recurrently in August. Among adults, poisonings by petroleum products peaked recurrently in July and December, psychopharmacologic drugs in July and October, paints, glues and plastics in November, alcohols in December and antimicrobial drugs in August and October.

3 Of all poisonings, 33% occurred in July, August or September in contrast to the expected 25%. Preventive efforts should thus be intensified during the summer.
Survival after Massive Ingestion of Carbon Tetrachloride Treated by Intravenous Infusion of Acetyleysteine
Authors: Mathieson P.W. , Williams G. , MacSweeney J.E.
Published: December 2008

1 A 61-year-old man ingested a large amount of carbon tetrachloride, well in excess of the adult lethal dose.

2 The level of the compound was assayed in his blood and the levels were the highest ever recorded by the Guy's Hospital Poisons Unit.

3 He was treated by intravenous infusion of acetylcysteine and survived with relatively mild clinical and biochemical evidence of toxicity.

4 Possible reasons for his survival are discussed, as are the implications for the management of future cases.
Interindividual Differences in the Activation of Two Hepatic Carcinogens to Mutagens by Human Liver
Authors: Harries G.C. , Boobis A.R. , Collier N. , Davies D.S.
Published: December 2008

The possibility that the presence of malignant disease can influence the metabolic activation of two carcinogens, 2-acetylaminofluorene and aflatoxin B1, has been investigated in a group of patients with secondary carcinoma of the liver. Mutagenic activation by subcellular fractions from biopsy samples from the patients was determined in the Ames/Salmonella test and the results compared with those obtained from a group of control patients. No significant differences were observed between the groups of patients in their ability to activate the two compounds to mutagenic metabolites. A tenfold range in ability to activate aflatoxin B1was observed whereas only a threefold range was obtained with 2-acetylaminofluorene. Human liver activates aflatoxin B1 approximately 100 times more efficiently than 2-acetylaminofluorene, a proven carcinogen in many species. This raises the question of the true risk to man from hepatocarcinogenicity from aflatoxin B1.