bluuebunny/crossref_metadata_2025 huggingface dataset:
School-to-Work System Development Needs: Perspectives of Local Education Agencies
Authors: Eisenman Laura T. , Hughes Carolyn
Published: December 2008

The purpose of this study was to examine school-to-work system development from local education agency perspectives in order to inform state and local implementation activities. One hundred-seven district administrators responded to a statewide survey regarding school-to-work activities in regular and special education. Descriptive statistics and qualitative analyses were used to characterize participants' responses. Local education agencies identified the most pressing system needs as (a) enhanced partnerships with local businesses, (b) staff development, and (c) guidelines for implementation. The need for more substantive dialogue between state and local education agencies' business representatives, and the community regarding the goals of a comprehensive school-to-work system was discussed.
Research Issues in Career Development and Transition: An Exploratory Survey of Professionals in the Field
Authors: Bassett Diane S. , Patton James R. , White Warren , Blalock Ginger , Smith Tom E.C.
Published: December 2008

The Research Committee of the Council for Exceptional Children's Division of Career Development and Transition (DCDT) conducted an exploratory study with professionals in the field in an attempt to identify the research issues most important to the field of transition and career development. Twenty-nine items were prioritized as to their importance as research considerations. Results from 201 respondents yielded research priorities in the following areas: teacher training for transition; facilitation of student self-determination and self-esteem; transition plans, goals and objectives, and linkage activities; functional assessment to support transition planning; inclusion of students with special needs in vocational education; and models of K-12 career development and transition planning. Based on these results, recommendations developed by the committee are elaborated and discussed.
Crossing the Great Divide: Predicting Productive Engagement for Young Women with Disabilities
Authors: Benz Michael R. , Doren Bonnie , Yovanoff Paul
Published: December 2008

Recent research suggests that young women with disabilities are less likely then young men to be engaged productively in postschool employment and education activities. This study explored factors associated with better employment and education outcomes for both young women and young men with disabilities, and factors associated uniquely with better outcomes for young women. Findings indicated that three factors predicted better outcomes for both young women and young men with disabilities: student self-esteem at time of exit from school, continuing instructional needs in personal-social skills, and continuing instructional needs in vocational skills. Three variables predicted productive engagement for the young women with disabilities in our study. Young women who experienced early parenting responsibilities or who came from a family with a low annual household income were less likely to be engaged in productive work and education activities. Young women with disabilities were more likely to be productively engaged when these young women and their parents agreed on the student's postschool work and education goals. The implications of these findings for future research are discussed.
The Self Determination Focus of Transition Goals for Students with Mental Retardation
Authors: Wehmeyer Michael L. , Schwartz Michelle
Published: December 2008

Teaching students to become self-determined young people has gained wide acceptance as an important outcome of the transition process. There is, however, limited information regarding the degree to which students actually receive instruction enabling them to become self-determined. This study examined the transition goals of students with mental retardation to determine the degree to which these students were being taught skills related to self-determination. Results indicated that there was limited emphasis in transition goals on self-determination. Our discussion focuses on the need to provide systematic instruction in component elements of self-determination in order to achieve this outcome.
Self-Determination for Persons With Disabilities: A Position Statement of me Division on Career Development and Transition
Authors: Field Sharon , Martin James , Miller Robert , Ward Michael , Wehmeyer Michael
Published: December 2008

The concept of self-determination has become important in the field of special education and disability services over recent years. This emphasis has come about as a result of several factors, including a changing view of disability, legislation, research findings and advances in teaching technology. Self-determination is highly important to the career development and transition process and it needs to be encouraged throughout the lifespan. It is important for all students, with and without disabilities, including those students with the most severe disabilities. Self-determination instruction can be provided within an inclusive framework and is important for educators as well as students. Family participation is important to the development of self-determination. The Division on Career Development and Transition of the Council for Exceptional Children supports and affirms approaches rooted in self-determination for development and delivery of effective educational programs.
Mothers' Roles: A Comparison Between Mothers of Adolescents with Severe Disabilities and Mothers of Vocational Students
Authors: Lehmann Jean P.
Published: December 2008

The purpose of this qualitative study was to better understand the roles mothers play in shaping the future for their adolescents. A total of 40 mothers of adolescents completing high school were interviewed. Within this sample, 20 of the mothers had children labeled as having severe disabilities, and 20 were mothers whose children had no disability label but attended cooperative education (vocational) programs. The two groups of mothers performed many of the same child- rearing tasks, but there were differences in the amount of support adolescents with disabilities needed. Mothers of vocational students described their actions to support their children as minimal but expressed a desire to be more involved with the school system. Mothers of adolescents with disabilities spent a great deal of time acting as advocates and protectors of their children as well as assisting with their children's community integration. Implications drawn from the data are that (a) mothers of vocational students could benefit from some of the processes mandated through special education (e.g., annual, student planning meetings) and, (b) the perceptions mothers of adolescents with severe disabilities about the intensity of their roles poses a dilemma in regards to current initiatives on self-determination.
To Pay or Not To Pay: Differentiating Employment And Training Relationships Through Regulation And Litigation
Authors: Pumpian Ian , Fisher Douglas , Certo Nicholas J. , Engel Thomas , Mautz Denise
Published: December 2008

The Fair Labor Standards Act (1938), administered by the U.S. Department of Labor, utilizes criteria established in landmark Supreme Court cases to distinguish nonpaid instructional work experiences from paid employment. Special Education teachers involved in developing jobs for students with disabilities should understand this distinction in order to prevent problems that could accrue from providing employment-related instruction without pay, when payment may be required. Recent federal appellate and district court cases have interpreted these earlier Supreme Court cases and regulations, leading the U.S. Departments of Education and Labor to revise their guidelines relating to community-based employment instruction. This paper provides a careful description of the underlying themes and legal parameters within which nonpaid training programs can operate through a review and analysis of this litigation. We also review recent U.S. Department of Education and U.S. Department of Labor guidelines, in order to assist in the design and implementation of instruction that is both programmatically and legally sound.
An Evaluation of a Comprehensive System of Transition Services
Authors: Aspel Nellie , Bettis Gail , Test David W. , Wood Wendy M.
Published: December 2008

The purpose of this study was to evaluate a comprehensive transition model called TASSEL (Teaching All Students Skills for Employment and Life). We collected social validity (consumer satisfaction) data from students, parents, employers, adult service providers, and school personnel, and student outcome data from youth who exited school in 1995, 1996, and 1997. Results indicated that consumers are satisfied with TASSEL transition services and that student outcomes compared favorably with data from the National Longitudinal Transition Study.
Why Not Partner With Local Government?
Authors: Gazley Beth
Published: December 2008

Service delivery partnerships with local government offer both opportunities and challenges for nonprofit agencies, but the normative and institutionalist tendencies of the collaboration literature tend to downplay the rationales for avoiding partnerships and the influence of managerial characteristics on the decision to collaborate. Nonprofit executive directors across the state of Georgia were asked about factors that might inhibit them from collaborating with local government agencies. Principal components analysis created four dependent variables from these answers, which were regressed on various respondent, organizational, and community characteristics. The resulting analysis finds that managerial attitudes about collaboration are not monolithic: They reflect underlying political and social dynamics that should be understood as distinct constructs, linked to experience and personal background. The findings suggest that future research should specify the exact nature of collaborative barriers, examine the individual backgrounds of those charged with collaborative responsibility, and integrate theories of organizational and human behavior.
Influence of the Ratio of Epoxy/cyanate Ester on the Curing Behavior of Epoxy/dicyclopentadiene Bisphenol Cyanate Ester System
Authors: Wang Jin-He , Liang Guo-Zheng , Yan Hong-Xia , He Shao-Bo , Yang Lian-Li
Published: December 2008

The influence of the ratio of epoxy (EP) to dicyclopentadiene bisphenol cyanate ester (DCPDCE) on the curing behavior of EP/DCPDCE system was studied using differential scanning calorimetry and Fourier transform infrared spectroscopy. The conversion of —OCN groups and the formation of the reaction products in the different EP/DCPDCE systems and at different curing steps were determined. The results show that the epoxy resin has both a catalytic effect and a dilution effect on the trimerization reaction of —OCN groups. These two effects reach an approximate balance when the content of epoxy resin in the EP/DCPDCE system is 15 wt.%. In addition, the epoxy resin can improve the final conversion of —OCN groups, and the initial amount of epoxy resin has a significant influence on the final structure of the co-polymers.
Benzophenone-Type Unsymmetrical Substituted Aromatic Diamines and Organosoluble Polyimides Therefrom
Authors: Rusanov Alexander L. , Komarova Ludmila G. , Prigozhina Marina P. , Begunov Roman S. , Yakovleva Yulia S.
Published: December 2008

Benzophenone-type unsymmetrical substituted aromatic diamines of general formula were prepared starting with p-nitrobenzoyl chloride and substituted benzenes. Interaction of the diamines obtained with aromatic tetracarboxylic acids dianhydrides under the conditions of high-temperature solution polycyclocondensation in m-cresol led to the formation of new high molecular weight organosoluble polyimides.
Haemoperfusion in 'Late' Paracetamol Poisoning
Authors: Helliwell Michael , Vale Allister , Goulding Roy
Published: December 2008

1 Seven patients who presented to hospital later than 10 hours following an overdose of paracetamol were treated by charcoal haemoperfusion.

2 In all cases there was a rapid fall in the plasma paracetamol concentrations, although the total amounts of drug removed varied from 364.5 mg to 6699 mg.

3 One patient developed fulminant hepatic failure and died; the remainder recovered, sustaining only mild hepatic damage (maximum AST less than 1000 iu 1-1).

4 Charcoal haemoperfusion may be effective in mitigating the severity of liver injury in those patients who are not eligible to receive specific antidotal therapy.
Severe Renal Failure in Hydralazine-Induced Lupus
Authors: Sinclair A.J. , Warrington S.J.
Published: December 2008

1 An elderly hypertensive woman developed severe renal failure owin hydralazine-induced lupus, although the dose never exceeded 150 mg da

2 Renal biopsy appearances were consistent with an immune-comp mediated glomerulonephritis.

3 Withdrawal of the drug was followed by rapid recovery in spite structural damage to the kidney.
Non-occupational Exposure to Pentachlorophenol: Clinical Findings and Plasma-PCP-concentrations in Three Families
Authors: Sangster B. , Wegman R.C.C. , Hofstee A.W.M.
Published: December 2008

1 The clinical findings are reported of 15 members of three families living in houses where relatively large amounts of pentachlorophenol (PCP) solutions had been applied. To be able to interprete the plasma concentrations in the patients, plasma-PCP-concentrations in 99 draftees were measured. The clinical and toxicological-analytical results are discussed.

2 Signs of a systemic PCP-intoxication were not found in any patient.

3 Symptoms and objective changes of the uncovered skin were present in three patients (a burning painful sensation, erythema, dryness and scaling) possibly caused by a direct influence of PCP in the air.

4 The plasma-PCP-concentrations in the patients ranged from 25-660 μgl-1. The mean plasma-PCP-concentrations in the draftees was 128.6±134.9 μgl -1 (mean±s.d.); the median was 88 μg1-1, the 95% range was 330 μg1-1.

5 There was an association between patients' plasma-PCP-concentrations and their staying in the affected house.
An Investigation of 140 Deaths Associated with Volatile Substance Abuse in the United Kingdom (1971-1981)
Authors: Anderson H.R. , Dick B. , Macnair R.S. , Palmer J.C. , Ramsey J.D.
Published: December 2008

1 In the UK, from 1971 to 81,140 deaths associated with volatile substance abuse (VSA) were identified from press reports and a variety of other sources. Data about each death were obtained from inquest proceedings, post-mortem and toxicological reports, and death certificates.

2 Based on the year 1981, in which 39 deaths occurred, VSA deaths accounted for over 1 % of deaths from all causes, and nearly 2 % of deaths from injury and poisoning in males aged 10-19 years.

3 The median age was 16.8 years (range 11-63), and 79% were under age 20. The male to female ratio was 13: 1.

4 Death rates were highest in conurbations, and in Scotland, Northern Ireland and Northern England. Deaths tended to be more frequent among manual social classes but this association was not marked.

5 The chief substances were butane (28%), solvents in adhesives (23%), other solvents (26%), aerosols (15%) and fire extinguishing agent (5%). Solvents in adhesives were more important with increasing age.

6 Most deaths occurred alone, at home. In about 41 % of cases, death appeared to be only indirectly associated with VSA (trauma 8%, plastic bag over head 19%, and inhalation of stomach contents 14%). In 49% death was attributed to the direct toxic effects of the substance; this proportion was highest with aerosols and lowest with solvents in adhesives.

7 The implications of these findings for prevention, monitoring and research are discussed.
Drug Abuse Monitoring: a Survey of Solvent Abuse in the County of Avon
Authors: Gay Martyn , Meller Robert , Stanley Stephen
Published: December 2008

1 An attempt to identify the extent of solvent abuse in the County of Avon by means of a multidisciplinary reporting system is described.

2 Particular attention was given to identifying abusers thought to be most at risks.

3 Altogether 304 young persons involved in solvent abuse were identified within a 6-month period. The ages of the solvent abusers ranged from 9 to 21 years and 77% were aged between 14 and 17 years.

4 Thirty-nine of the sniffers were found to be solitary users and were thought to have multiple problems and possibly a poorer prognosis than the group sniffers.

5 The problems of confidentiality and inter-agency conflict are discussed.
The Role of the Laboratory in the Investigation of Solvent Abuse
Authors: Ramsey J.D. , Flanagan R.J.
Published: December 2008

1 A wide range of compounds which may be abused by inhalation such as butane, the halons, 1,1,1-trichloroethane, trichloroethylene and toluene can be detected and identified in blood specimens by means of headspace gas chromatography. Quantitative analysis of a number of the less volatile compounds of interest may also be accomplished .

2 The measurement of the urinary concentrations of benzoic and hippuric acids (metabolites of toluene) and of the toluric acids (metabolites of the xylenes) by high performance liquid chromatography may provide useful information. In general, a hippurate/creatinine ratio of greater than 1 is indicative of recent toluene exposure.

3 Analysis of the product abused by vapor-phase infra-red spectrophotometry and/or gas chromatography may also be valuable, especially since manufacturers' data as to the constituents of a given product are not always accurate.

4 Toxicological analyses can provide clinically valuable diagnostic information where inhalational abuse of volatile substances is suspected, and provide the only unequivocal means of defining the agent(s) abused by a given population.
Genotoxic Activity of the Aminophenols as Evidenced by the Induction of Sister Chromatid Exchanges
Authors: Kirchner G. , Bayer U.
Published: December 2008

1 Most hair dyes contain the structural isomers ortho-, meta- and para-aminophenol which were investigated concerning their ability to induce sister chromatid exchanges (SCE) in cultured human lymphocytes in vitro and in Chinese hamster bone marrow cells in vivo.

2 In vitro only ortho-aminophenol significantly induced SCE in a dose-dependent manner.

3 In vivo none of the structural isomers increased significantly the SCE frequency.

4 It is concluded that ortho-aminophenol is a weak directly acting compound which is detoxified during its metabolism.
Study of Sodium Bromide in Human Volunteers, with Special Emphasis on the Endocrine System
Authors: Sangster B. , Krajnc E.I. , Loeber J.G. , Rauws A.G. , van Logten M.J.
Published: December 2008

1 Bromide, 1 mg kg-1 daily, was administered to 21 healthy volunteers (11 females not using oral contraceptives and not pregnant and 10 males, during 8 weeks or 2 full cycles to determine whether ingestion of a dose equal to the acceptable daily intake might induce effects. Special attention was paid to the endocrine system because endocrine changes were predominant in rats receiving sodium bromide (NaBr) in their diets.

2 There was no difference between the results of a full medical history and physical examination at the start and at the end of the experiment.

3 The results from the measured haematological, biochemical and urine analyses did not change during the experiment.

4 In females the plasma bromide concentration rose from 0.08 ± 0.01 mmol 1-1 to 0.97 ± 0.18 mmol 1-1 and in males from 0.08 ± 0.01 mmol 1 -1 to 0.83 ± 0.09 mmol -1 (mean ± s.d.).

5 No changes were observed in the serum concentrations of thyroxine, free thyroxine, thyroxin binding globulin, triiodothyronine, cortisol, testosterone, estradiol and progesterone. Also no changes were observed in the serum concentrations of thyroid stimulating hormone (TSH), prolactin, luteinizing hormone (LH) and follicle stimulating hormone (FSH) before and after the administration of thyroid stimulating hormone releasing hormone (TRH) and luteinizing hormone releasing hormone (LHRH).
Effect of Minerals and Food on Uptake of Lead from the Gastrointestinal Tract in Humans
Authors: Heard M.J. , Chamberlain A.C.
Published: December 2008

1 Eight adult male volunteers ingested 203Pb as chloride with varying amounts of CaCO3 and NaH2PO4. The uptake from the gastrointestinal tract declined progressively as the amount of minerals taken simultaneously was increased, in agreement with the findings of Blake (1980).

2 With four of the volunteers, further tests were done to compare the effect of the two minerals together and separately. With no minerals, uptake averaged 63.3% (range 58.6-66.7%). The two together (200 mg Ca and 140 mg P) reduced it to 10.6% (range 8.6-12.8%), but neither mineral by itself was nearly so effective as the two together.

3 A lamb was injected with 203Pb and butchered after 6 days. Six volunteers ate the liver or kidneys as part of a meal. Uptake of 203Pb incorporated in the offal averaged 2.8% (range 1.6-4.7%). When 203Pb in solution was taken with inactive offal in a similar meal, uptake averaged 3.0% (range 1.7-3.6%). Thus incorporation of 203Pb in liver or kidney did not affect the uptake.
N-Acetylation Phenotype in Bladder Cancer
Authors: Woodhouse K.W. , Adams P.C. , Clothier A. , Mucklow J.C. , Rawlins M.D.
Published: December 2008

1 N-acetylation phenotype has been examined in 30 patients with bladder cancer and in 27 controls of similar age.

2 59% of controls and 70% of bladder cancer patients were phenotypically 'slow' acetylators. This difference was not significant ( P>0.30) .

3 Within phenotypes, isoniazed half life was similar in controls and bladder cancer patients.

4 N-acetylation phenotype is unlikely to be a major determinant in the pathogenesis of bladder cancer in the population studied.
Flicker Fusion Test and Occupational Toxicology: Performance Evaluation in Workers Exposed to Lead and Solvents
Authors: Betta Alberto , De Santa Azelio , Savonitto Cecilia , D'Andrea Franco
Published: December 2008

1 In a group of 108 workers professionally exposed to low lead levels and in 35 shoe factory workers exposed to a mixture of solvents, neurotoxic effects were evaluated by means of Critical Flicker Frequency, used as single test of psychophysiological performance.

2 A statistically significant lowering of CFF threshold was observed and, in the lead exposed group, this decrease is related to the biological parameter zinc protoporphyrin.

3 The usefulness of CFF measure in environmental toxicology, together with other neurophysiological tests, is considered.
Chronic Arsenic Poisoning in the North of Mexico
Authors: Cebrian Mariano E. , Albores Arnulfo , Aguilar Manuel , Blakely Enrique
Published: December 2008

1 We compared the prevalence of signs and symptoms of chronic arsenic poisoning in two rural populations.

2 The arsenic concentration in the drinking water of the exposed population was 0.41 mg/l, and 0.007 mg/l in the control population.

3 The arsenic was present mainly (70%) in its pentavalent form.

4 The objective was to quantitate health effects and risks derived from chronic ingestion of arsenic in contaminated water.

5 In the exposed population, 21.6% of the sample, showed at least one of the cutaneous signs of chronic arsenic poisoning against 2.2% in the control town.

6 Non-specific symptoms were more prevalent in the exposed population and they occurred more frequently in those individuals with skin signs.

7 The relative risk of suffering a particular manifestation of poisoning, ranged from 1.9 to 36 times higher in the exposed population.

8 We estimated the risks above mentioned, which were derived from exposure to minute quantities of arsenic in a known proportion of its oxidation states during a life time period.
Antithyroid Effect of Chlorpropamide?
Authors: Feely J. , McLaren S. , Shepherd A.M.M. , Maclean D. , Stevenson I.H. , Swift C.G. , Isles T.E.
Published: December 2008

1 The relationship between plasma chlorpropamide concentration and thyroid function was examined in 87 maturity onset diabetic patients receiving chronic therapy.

2 Although plasma chlorpropamide concentration was weakly negatively correlated with serum thyroxine (r= 0.33, P< 0.01) the mean serum thyroxine and thyrotrophin (TSH) were not different from that of a matched control group of diabetics treated with diet alone.

3 Serum thyroxine was negatively correlated with the duration of diabetes in both groups.

4 These results suggest that chlorpropamide does not have a clinically significant antithyroid effect.
Haemodynamic Studies in Eight Cases of Acute Colchicine Poisoning
Authors: Sauder Ph. , Kopferschmitt J. , Jaeger A. , Mantz J.M.
Published: December 2008

1 The authors performed haemodynamic studies in 8 cases of colchicine poisoning. The doses absorbed ranged between 9 and 160 mg (mean dose 39 mg). The haemodynamic study was performed between the 6th and 72nd h after intoxication, before and after plasma infusion (370 ml over a period of 20 minutes).

2 Four patients had severe shock with decreased cardiac index (CI) and increased systemic vascular resistance (SVR). Four patients had a hyperkinetic state with increased CI and decreased SVR. The four patients with cardiac failure died, the others recovered.

3 Haemodynamic study of acute colchicine poisoning is of therapeutic and prognostic interest. Hypovolaemia is always present. An initial decrease of cardiac performance is an index of severity with a lethal outcome.
Chemotherapy of Amanita phalloides Poisoning with Intravenous Silibinin
Authors: Hruby K. , Csomos G. , Fuhrmann M. , Thaler H.
Published: December 2008

1 A total of 18 cases of Amanita phalloides intoxication was treated by combined chemotherapy during 1980 and 1981. After attempted primary elimination of the toxin all patients received silibinin as basic therapy mainly by infusion and in two instances orally.

2 In order to evaluate the effect of silibinin therapy a retrospective study of the followed-up case records was made. The cases were arbitrarily classified into three groups according to the severity of liver damage (light, medium and severe).

3 There was found a close relationship between the severity of liver injury and the delay between mushroom ingestion and the onset of silibinin therapy. With the exception of one fatality in a particularly high dosage suicidal intoxication, all patients survived.

4 Administration of silibinin even up to 48 h after mushroom ingestion appears to be an effective measure to prevent severe liver damage in Amanita phalloides poisoning. Contrarily, the onset of general supportive treatment together with penicillin therapy which was throughout several hours before silibinin adminstration did not correlate with the severity of liver damage.
Naloxone and Alcohol Intoxication in the Dog
Authors: Lignian Hervé , Fontaine Jeanine , Askenasi Robert
Published: December 2008

1 The effects of naloxone upon ethanol-induced coma have been investigated in dogs. In a double blind study, 15 mongrel dogs received ethanol i.v. (4 g/kg) followed by a single dose of naloxone (12 ?g/kg).

2 Naloxone failed to affect either the duration of respiratory arrest or the time to recovery of motor coordination. In similar animals treated with the narcotic analgesic, fentanyl, naloxone induced a dramatic and complete reversal of the narcotic effects within 30 seconds.

3 It is concluded that, if naloxone has any effect in alcoholic coma, it is not comparable with its dramatic action in narcotic coma.
An Investigation of the Role of the Specific Opioid Antagonist Naloxone in Clinical Toxicology
Authors: Jefferys D.B. , Volans G.N.
Published: December 2008

1 An assessment of the current role of naloxone in clinical toxicology has been made in a series of three separate epidemiological studies.

2 Through the National Poisons Information Service we found that the role of naloxone in opioid poisoning is often not appreciated by the enquirer and that toxicological screening is often requested before the diagnostic use of naloxone.

3 The recommended dose of naloxone (0.4-1.2 mg i.v.) is not always adequate. In 51 cases where naloxone was effective, doses of up to 3.2 mg were necessary (mean 1.8 ± 0.3 mg SEM i.v.).

4 In 31 cases of non-opioid poisoning, naloxone in doses of 0.4-1.2 mg i.v. caused no deterioration, whilst six patients in whom no opioids were detected showed clinical improvement.

5 In 300 cases of suspected ethanol-induced coma, 49 showed reversal of coma with naloxone, and in 38 cases ethanol was the sole cause of coma (mean plasma concentration 3.54 ± 0.62 g/l SEM).

6 These results suggest that the role of naloxone in clinical toxicology is not fully appreciated. There is a need for further education as to its indications in opioid poisoning, together with additional studies to define more accurately the dose/response relationship. In addition, the role of naloxone in coma induced by ethanol and certain other non-opioids needs to be evaluated further.
Acute Voluntary Intoxication by Ricin
Authors: Kopferschmitt J. , Flesch F. , Lugnier A. , Sauder Ph. , Jaeger A. , Mantz J.M.
Published: December 2008

1 A 21 year-old student ingested thirty ricin seeds in a suicidal attempt, some of which were masticated. Three hours later he developed severe diarrhoea with vomiting and abdominal cramps, followed by extracellular dehydration and circulatory collapse.

2 Biological changes included haemoconcentration. He recovered following symptomatic treatment by infusion of saline and glucose solutions.

3 Ricin was quantified by a radioimmunologic method using Iodine 125, and showed that only a small part of the ricin contained in the seeds was absorbed.
Recent Advance in the Therapy of Metal Poisonings with Chelating Agents
Authors: Aaseth J.
Published: December 2008

A survey is given of the use of chelating agents in the treatment of metal poisonings.

1 The complexing agents in established clinical use are the polyaminopolycarboxylic acid EDTA (ethylenediamine tetraacetate) and the thiols BAL (2, 3-dimercaptopropanol) and D-penicillamine. Desferrioxamine is useful in the treatment of iron overloading.

2 The theoretical foundation of the metal-ligand interaction and some general principles of value in the search for new metal antidotes are outlined.

3 Recent research has shown that 2, 3-dimercaptosuccinic acid (DMS) and 2, 3-dimercaptopropane-1-sulphonate (DMPS) are effective in mercury and arsenic poisonings.

4 DMS and DMPS are of significantly lower toxicity than BAL, and they can be administered orally or intravenously.

5 A particularly low toxicity of DMS is reported from clinical and experimental studies, and this agent may be useful against several metal poisonings including mercury, lead and gold.
Non-accidental Paracetamol Poisoning in an Eleven Month-old Child
Authors: Taylor C.J. , Betts A.M.
Published: December 2008

1 Although accidental poisoning of children with drugs and chemicals is a common precipitant for admission to hospital, the possibility of deliberate poisoning as an extension of 'the battered baby syndrome' is rarely considered.

2 Most children admitted following accidental ingestions require little active management other than induction of emesis. Reports of relatively large overdoses in infancy are rare, and protocols for management of such cases largely untried. This case report demonstrates the successful application of a current treatment regimen to an infant who had ingested a substantial quantity of paracetamol.
Short-term Experience of the Newly Established Poison Control Centre of Cairo
Authors: Fahim Bahira A. , El-Semary Laila M.
Published: December 2008

1 During the first 31 weeks of operation, the Cairo Poison Control Centre received 463 enquiries.

2 Accidental poisoning predominated with 54% of cases involving children under 5 years of age whilst attempted suicide was reported in only 21 %.

3 When these early experiences are compared with the observations from the European Poison Control Centres, there are a number of marked differences including the types of drugs and chemicals involved.

4 Problems associated with drugs considered obsolete in Europe, inadequately labelled chemicals and inappropriate treatments have already been highlighted, and preventive measures are being considered.
Review of Enquiries made to the NPIS Concerning Psilocybe Mushroom Ingestion, 1978-1981
Authors: Francis J. , Murray V.S.G.
Published: December 2008

The historical, botanical and chemical aspects of hallucinogenic mushroom are well described (Lincoff & Mitchell, 1977; Cooper, 1980). The use of hallucinogenic mushroom stretches back as far as ancient Aztec civilisation and it has become fashionable in the West since the 1950s, with publicity from popular writers such as Aldous Huxley and Carlos Castenada (Huxley, 1976; Castenada, 1970). Recently, increasing use has given rise to calls for control (Young et al., 1982). In Britain, Psilocybe semilanceata is the most commonly occurring species of hallucinogenic mushrooms (Peden & Pringle, 1982; Peden et al., 1981; Harries & Evans, 1981) containing the hallucinogenic compounds psilocin and psilocybon, indolalkylamines, similar to LSD but only about 1 % as potent (Bowman & Rand, 1980).
Paracetamol Overdose: Protective Effect of Concomitantly Ingested Antimuscarinic Drugs and Codeine
Authors: Müller F.O. , van Achterbergh S.M. , Hundt H.K.L.
Published: December 2008

1 Twelve cases of paracetamol overdose are reported.

2 Nine patients ingested antimuscarinic agents and/or codeine concomitantly. Our findings indicate that 'mixed' overdose of this type gives rise to marked attenuation of the rate of paracetamol absorption and, apparently, reduced morbidity associated with paracetamol poisoning. It is speculated that suitable antimuscarinic agents may be incorporated into paracetamol formulations to achieve inhibition of gastric emptying and to confer a degree of protection in case of overdose.
Apparent Half-life of Excretion of Cannabinoids in Man
Authors: Cridland J.S. , Rottanburg D. , Robins A.H.
Published: December 2008

The apparent half-life of excretion of cannabinoids was calculated from their concentration in the urine of 27 psychotic patients. The best estimate was about 4 days but the range was too wide to be of use in predicting time to total clearance from the body of any randomly chosen patient.
The Uptake by Man of Cadmium Ingested in Crab Meat
Authors: Newton D. , Johnson P. , Lally A.E. , Pentreath R.J. , Swift D.J.
Published: December 2008

Seven male volunteers with normal iron stores ate the brown meat from crabs whose diet had contained radioactive cadmium-115m. Systemic uptake of cadmium by the volunteers, derived from measurements of their residual body radioactivity several weeks after intake, averaged 2.7 ± 0.9 (se)%, essentially as found by others in studies with extrinsically labelled food.
Pharmacokinetic Considerations of Misonidazole in Therapeutics
Authors: Matheson I. , Plowman P.N. , Johnston A.
Published: December 2008

The pharmacokinetics of misonidazole have been studied in 6 patients with special emphasis on determination of the peak concentration in plasma and saliva. Frequent sampling was performed over 4 h and a marked variation in absorption half-life (range 4 - 125 min) and time to peak range (0.5 - 6.5 h) was found. The optimal timing of irradiation is discussed. In addition to a conventional dose, one of the patients received high dose misonidazole; the pharmacokinetics are compared.
Effect of Meptazinol and Ethanol on Human Psychomotor Performance and Mood Ratings
Authors: Tedeschi G. , Smith A.T. , Richens A.
Published: December 2008

The effect of meptazinol and/or ethanol on human psychomotor performance and mood ratings has been investigated in 8 healthy volunteers in a double blind randomised study. Meptazinol (200 mg 3 hourly for 4 doses) or placebo were administered orally and ethanol (0.8 g/kg) or placebo were given 30 min after the last tablet. Peak saccadic velocity (PSV), saccade duration at 30° of amplitude (SD), smooth pursuit velocity (SPV), critical flicker fusion threshold (CFF), choice reaction time (CRT) and visual analogue scales were assessed. PSV (p < 0.01), SD (p < 0.001) and SPV (p < 0.01) were significantly impaired after ethanol, while CFF, CFT and visual analogue scales showed no significant effect. None of the tests was affected by the meptazinol treatment alone. No changes were observed in the ethanol-induced impairment of PSV, SD and SPV when meptazinol was given in combination with ethanol.
Survival without Sequelae following Exposure to 500 mg/m3 of Hydrogen Cyanide
Authors: Bonsall J.L.
Published: December 2008

A case of severe over-exposure to hydrogen cyanide is presented. The toxicology of cyanide is briefly reviewed and a description of events leading to the poisoning is given. Details of clinical signs and treatment are presented.
Clinical Course in Acute Self-poisonings: A Prospective Study of 1125 Consecutively Hospitalised Adults
Authors: Jacobsen D. , Frederichsen P.S. , Knutsen K.M. , Sørum Y. , Talseth T. , Ødegaard O.R.
Published: December 2008

1 The clinical course in an unselected group of 1125 consecutively hospitalised self-poisonings was studied during 1 year in Oslo.

2 Mortality was 0.5%, but only 0.3% in those admitted without cardiac and respiratory arrest. Mortality among those in grade IV coma was 4.2%.

3 The deepest comas (grade III or IV) occurred in 25.1% of the admissions with a mean duration of the coma of 5.8 h (range 1-80).

4 Complications occurred in 21.7% of the admissions and 6.9% suffered more than one complication of which the most frequent were respiratory depression (13.5%), hypotension (5.3%), pneumonia (4.4%), and hypothermia (1.6%). The complication rate was highest in poisonings with opiates (60.7%), meprobamate (37.5%) and antihistamines (30.0%).

5 Arrhythmias and respiratory depression were closely associated with poisonings with antidepressants and opiates, respectively. Owing to frequent polydrug overdoses it was difficult to associate other complications with other main toxic agents.

6 Administration of antidotes (20.6%), cuffed intubation (4.4%) and forced alkaline diuresis (3.4%) were the most frequent special therapeutic measures taken.

7 The change in pattern of self-poisonings in Oslo focuses on antidote therapy and intensive care, especially outside hospital, but limits the need for haemodialysis and haemoperfusion which were performed in only 1.0% of the admissions.
Elevation of Mercury in Human Blood from Controlled Chronic Ingestion of Methylmercury in Fish
Authors: Sherlock J. , Hislop J. , Newton D. , Topping G. , Whittle K.
Published: December 2008

1 The relationship between the intake of methylmercury in fish and mercury in blood has been investigated in man.

2 The intakes of methylmercury were carefully controlled and lay in the range 40 - 230 μg/day, the Provisional Tolerable Weekly Intake is equivalent to about 30 μg/day.

3 The results indicate that a daily intake of 1 μg methylmercury would, at equilibrium, produce a blood mercury concentration of 0.8 μg/kg.

4 There is a good close-to-linear correlation between methylmercury intake and blood mercury concentrations within the wide range of intakes employed.
Zimeldine Induced Neuropathies
Authors: Dexter S.L.
Published: December 2008

Zimeldine is a recently-introduced antidepressant drug. It has a novel pyridylallylamine structure and acts by selective inhibition of 5-hydroxytryptamine re-uptake at central nerve synapses. This communication reports 2 patients who developed neuropathies within 1 week of starting treatment with this drug. This has hitherto not been described.
Lidocaine and Amitriptyline Interaction during Experimental Haemoperfusion
Authors: Heath A. , Löfström B. , MÅrtensson E.
Published: December 2008

1 Displacement of amitriptyline by lidocaine was studied during haemoperfusion (HP) in five beagle dogs.

2 Clearance of amitriptyline during HP was 0.93, although the amount of amitriptyline removed was only 2% of the given dose. Lidocaine does therefore not improve amitriptyline yield during HP. Clearance of lidocaine during HP was 0.99. Almost 13% of the lidocaine given intravenously was removed by HP.

3 Lidocaine did not improve myocardial performance during HP in amitriptyline-intoxicated dogs.

4 At necropsy the highest concentrations of amitriptyline in this model were found in the brain and the lung. The amitriptyline/nortriptyline ratio was lowest in the liver and lung, suggesting that these two organs are major sites of metabolism.
Poisoning-associated Deaths for England and Wales between 1973 and 1980
Authors: Osselton M.D. , Blackmore R.C. , King L.A. , Moffat A.C.
Published: December 2008

1 The annual number of deaths in England and Wales associated with poisoning by solids and liquids over the 8-year period between 1973 and 1980 has remained fairly constant with an average of 2897.

2 Marked trends in the number of deaths associated with specific drugs are evident and apparently reflect prescription trends and drug availability.

3 Barbiturate poisonings dropped steadily following the downward trend in barbiturate prescriptions.

4 Deaths associated with dextropropoxyphene, paracetamol and certain benzodiazepines increased dramatically.
Lactic Acidosis, Hyperglycaemia and Convulsions following Nalidixic Acid Overdosage
Authors: Leslie P.J.A. , Cregeen R.J. , Proudfoot A.T.
Published: December 2008

1 A woman survived ingestion of 32 g nalidixic acid despite developing lactic acidosis, hyperglycaemia, convulsions and abnormal behaviour.

2 The maximum recorded plasma concentration of nalidixic acid was 185 mg/l and the elimination half-life was 3.2 h.

3 Carboxy-nalidixic acid was demonstrated in the plasma.

4 Previously reported cases of nalidixic acid overdosage are reviewed.
Inherent Limitations of the Yellow Card System for the Detection of Unsuspected Adverse Drug Reactions
Authors: Crombie I.
Published: December 2008

The number of cases of an adverse reaction which could be seen by individual doctors was investigated taking realistic values for the frequency of drug prescribing and a range of frequencies of adverse drug reactions. The results indicated that, for almost all drugs, general practitioners (GPs) will seldom see other than single cases of an adverse reaction. It is argued that doctors will be unlikely to recognize an adverse reaction from a single case (unless it presented with some striking clinical features) so that potential new adverse reactions will rarely be reported by GPs under the Yellow Card scheme. A similar analysis for hospital doctors indicated that clinicians working in some specialities, may have a greater chance of seeing more than one case of an adverse reaction. A review of the identification of several important adverse reactions revealed that all the reports from British doctors were submitted by clinicians with hospital appointments. This study suggests that the major part of the operation of the Yellow Card system will contribute little to the identification of adverse reactions and that its organization and activities need to be reassessed. A modified system designed to encourage reporting by hospital clinicians could be of greater value.
Cardiovascular Toxicity of Diuretics Related to Magnesium Depletion
Authors: Reyes A.J. , Leary W.P.
Published: December 2008

The chronic administration of common loop or distal tubular diuretics may lead to somatic depletion of Mg2+. The resultant deficiency of this cation causes an increase in intramyocardial cytosolic Ca2+and aggravates the decrease in intramyocardial K+provoked by diuretics through their hyperkaliuretic effect. Thus the myocardium is electrically destabilized and cardiac arrhythmias may develop. Mg2+deficiency positively contributes to the development of atherogenic alterations in lipid metabolism, vasospastic phenomena in the coronary and cerebrovascular territories, myocardial infarction and to the retardation of infarct healing and the occurrence of ventricular arrhythmias during the acute phase of infarction.
Combined and Individual Effects of Isoniazid and Thiacetazone on Human Lymphocyte Chromosomes in vitro and in vivo
Authors: Jaju Madhuri , Jaju Manjula , Ahuja Y.R.
Published: December 2008

1 Genetic effects of the drugs, isoniazid and thiacetazone used for antituberculosis chemotherapy were investigated on human lymphocyte chromosomes in vitro and in vivo.

2. Therapeutic concentrations of these drugs did not induce chromosome aberrations in vitro both in combination and individually during any of the treatment period in 72 h lymphocyte cultures. At higher concentrations both the drugs were found to be cytotoxic.

3 The frequency of chromosome damage was increased significantly in first-division metaphases of the patients, i.e. in vivo during treatment with isoniazid (300 mg) + thiacetazone (150 mg); this could be due to the synergistic action between the metabolites of the two drugs in the body or due to the metabolites of thiacetazone since isoniazid was found to be nonclastogenic in vivo.

4 The frequency of sister chromatid exchanges was not increased in any of the patients except in one, who probably had a higher baseline level. These results suggest that chromosome aberrations and sister chromatid exchanges represent two different lesions.

5 Chromosome damage induced by drugs could lead to congenital malformations, cancer, ageing and therefore contributes to the overall toxicology of the drugs and hazard to human genetic health. Hence drugs like isoniazid and thiacetazone which induce chromosome damage, should be used with caution.
Diurnal Variations in Urinary Mercury Excretion
Authors: Calder I.M. , Kelman G.R. , Mason H.
Published: December 2008

A consistent diurnal variation of urinary mercury concentration (expressed as nmol of mercury/mmol of creatinine) has been demonstrated in 36 occupationally exposed workers, the concentration being highest in the morning and lowest in the late evening. This variation is partly intrinsic and partly an artifact because creatinine excretion also varies diurnally, but in the opposite direction. The implications of these findings in relation to the biological monitoring of mercury workers is discussed.
Unsuspected Caffeine Toxicity Complicating Theophylline Therapy
Authors: Iversen S.A. , Murphy P.G. , Leakey T.E.B. , Rydlewski A. , Levy R.D. , Gertner D.
Published: December 2008

1 A 58-year-old man with a history of alcoholic liver disease and chronic airflow obstruction presented with heart failure and acute bronchitis.

2 Plasma methylxanthines were estimated as a guide to further theophylline therapy and serious caffeine accumulation was noted in the presence of a subtherapeutic concentration of theophylline.

3 After 3 weeks on a caffeine-free diet theophylline and caffeine challenge tests were performed which demonstrated the ease with which caffeine could accumulate.

4 The importance of caffeine accumulation during theophylline therapy is discussed.