1/36. survival from profound alcohol-related lactic acidosis.We present the case of a patient with profound alcohol-related lactic acidosis (lactate = 16.1 mmol/L; pH = 6.67) associated with a multitude of metabolic derangements who made a remarkable recovery following aggressive management. The patient was in extremis upon arrival in the emergency department (ED), and resuscitation was begun immediately. While in the ED, the problem list generated included: acute alcohol intoxication, severe lactic acidosis, dehydration, hypothermia, hypoglycemia, acute renal insufficiency, and hepatic failure. resuscitation continued in the intensive care unit with remarkable improvement and satisfactory outcome. In this patient, the severe lactic acidosis and associated abnormalities were all attributed to acute and chronic effects of ethanol. A brief summary of the proposed mechanism by which these metabolic derangements developed and an outline of her management follows.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
2/36. Acute cardiomyopathy with rhabdomyolysis in chronic alcoholism.Of five chronic alcoholics with acute skeletal muscle necrosis (rhabdomyolysis) three developed acute heart failure with disturbances of rhythm and conduction. Symptoms came on abruptly after a period of intensified drinking. myocardial infarction, thiamine deficiency, and cobalt intoxication were excluded. Probably the whole spectrum of muscle disease in chronic alcoholism may be commoner than has been suspected.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
3/36. Subacute encephalopathy with seizures in alcoholism.Generalised seizures are a common manifestation of acute alcohol intoxication. Alcohol is known to precipitate generalised seizures in patients with focal brain pathology. A rare case of secondarily generalised seizures precipitated by alcohol in a patient without an underlying focal brain lesion is reported. Electroencephalopgraphy (EEG) showed periodic lateralised epileptiform discharges (PLEDs) on the side contralateral to the focal motor fits.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
4/36. Hospital treatment of addicts arrested for intoxication in finland.In the present study the treatment of addicts as performed by the Finnish police was investigated. The intention was to evaluate how the treatment procedure functioned in meeting the need for medical care and safety of the addict. The series was collected from the police district of Helsinki, the Finnish capital, and comprised all addicts arrested and transported to hospital during 1969. The series totalled 859 cases, which is about 2% of all addicts arrested in Helsinki during 1969. The reasons for transportation to hospital were: external injuries (60%) and the addict's complaints of an injury or illness (17%). Of all subjects, 44 were admitted to a hospital ward and of these, 2 died later on the ward. Furthermore, 7 addicts had died at the police station, on the way to hospital, or at the out-patients' department. Thus the number of deaths totalled 9. On investigating the cases of death in detail it was found that omission of or delay in the transport to hospital may have been of decisive influence on the addict's death in 4 cases. It was estimated that, had the police not transported any of the addicts to hospital, the number of deaths would have been about 20. When the cost of hospital treatment and transport to hospital is used as an evaluation factor the effort of the activity covered by the present study is 98 500 Fmk (U.S. $ 23 200). The output is the number of lives saved, i.e. 11. The efficiency of the activity is thus the saving of one life at the cost of about 9000 Fmk (about 2 100 U.S. $). The social characteristics of the addict were not found to have had a decisive bearing on the question of transportation to hospital. Differences between the various points of activity were observed in the relative numbers of the addicts arrested and transported to hospital.- - - - - - - - - - ranking = 4keywords = intoxication (Clic here for more details about this article) |
5/36. Sideroblastic anemia. A diagnosis to consider in alcoholic patients.Alcoholic patients who present with anemia can pose a diagnostic challenge. Although deficiencies of iron, vitamin B12, and folate commonly result in anemia, bone marrow suppression of red blood cell production related to the direct toxic effects of alcohol can cause a form called sideroblastic anemia. This case report describes a patient presenting with acute alcohol intoxication and anemia in whom extensive evaluation revealed a hematologic picture compatible with acquired sideroblastic anemia.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
6/36. death creates a bizarre scenery: a case report.The bodies of two men in their early forties were found lying in a peculiar position in an apartment. police and medical investigations suggested that both had, at the most, died 2 weeks earlier. One of the men was kneeling, holding on to the back of a chair-with his hand, and was bent over the second man lying on the floor. Both men were known as former addicts, but were assumed to be clean for a long period of time. The autopsy revealed that the two men died from an acute heroine intoxication in combination with alcohol. The man who lay on the floor additionally had chronic heart disease. It could be excluded that any other persons were involved in this case and that other causes of death had to be considered. The peculiar scene could be explained by the obvious order of death and as a consequence of mummification.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
7/36. An unusual accidental death from reverse suspension.Deaths involving prolonged suspension head downwards have received little or no attention in the English-language literature, doubtless because they are extremely rare. An example, involving alcoholic intoxication as the sole complicating factor, is reported. The mechanism of death is also considered since this is plainly a subject of some interest and likely to provoke further thought and discussion.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
8/36. Occidental beriberi and sudden death.beriberi, thiamine deficiency, is classified as "dry" (neurologic) or "wet" (cardiovascular) and may be mixed. Deficiency of this vitamin may be nutritional or secondary to alcohol intoxication. In Western societies (occidental beriberi), the disorder is more commonly observed in long-term alcohol abusers. However, it may go undiagnosed because it is relatively uncommon. In some cases (acute cardiovascular beriberi), early treatment with parenteral vitamin B1 is required to prevent the development of low-output state and sudden death. We report a case of occidental beriberi with fatal outcome despite therapy.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
9/36. Acute endosulfan poisoning with cerebral edema and cardiac failure.BACKGROUND: Organochlorine insecticides are highly toxic compounds that are responsible for a number of severe intoxications worldwide with several deaths. Despite their widespread use in agriculture during the 1940s to 1960s and the well-known signs and symptoms of intoxication, the clinical picture in case of poisoning varies. We report two cases of acute intentional endosulfan intoxication with cerebral edema and cardiac failure. case reports: Both cases developed life-threatening signs like epileptic state, respiratory insufficiency and hemodynamic instability soon after ingestion. The survivor developed severe myocardial insufficiency and pulmonary edema documented by echocardiography and x-ray of the chest. The deceased patient developed severe cerebral edema and multiorgan failure ten days after ingestion of Thiodan 35. The peak serum concentration of endosulfan in the survivor was 0.12 mg/L approximately 23 hours after ingestion, whereas the peak blood concentration in the fatal case was 0.86 mg/L approximately 25 hours post-ingestion. Post-mortem endosulfan levels in different organs were determined. CONCLUSION: endosulfan is a highly toxic organochlorine insecticide that produces well-known neurological symptoms of tonic-clonic convulsions, headache, dizziness and ataxia but also can cause gastrointestinal symptoms and metabolic disturbances. life-threatening cerebral edema and hemodynamic instability may occur. Treatment is symptomatic and supportive.- - - - - - - - - - ranking = 3keywords = intoxication (Clic here for more details about this article) |
10/36. A fatal clomipramine intoxication case of a chronic alcoholic patient: application of postmortem hair analysis method of clomipramine and ethyl glucuronide using LC/APCI/MS.Toxicological investigations of postmortem specimens of a 26-year-old man were performed with the use of LC/APCI/MS. They revealed in the blood of the deceased clomipramine (9.49 microg/g) and its main metabolite norclomipramine (1.10 microg/g) at concentrations explaining the fatal outcome. The presence of these xenobiotics in a 12-cm-long strand of hair (clomipramine, 7.60 ng/mg in I segment; 4.19 ng/mg in II segment; 1.86 ng/mg in III segment; norclomipramine, 5.71 ng/mg in I segment; 9.71 ng/mg in II segment; 4.13 ng/mg in III segment) confirmed the fact obtained from the medical history that the deceased had been receiving clomipramine as an antidepressant for 1 year prior to his death. The analysis demonstrated ethanol in autopsy blood (2.5mg/ml) and urine (3.2mg/ml); ethyl glucuronide as a marker of chronic alcohol abuse was detected in the deceased's hair (0.44 ng/mg in I segment; 0.07 ng/mg in II segment; n.d. in III segment). These findings may suggest the contribution of alcohol in the mechanism of drug-ethanol interaction, which in consequence might have affected the biotransformation of clomipramine in the final period of his life and evoked the ultimate toxic effect.- - - - - - - - - - ranking = 4keywords = intoxication (Clic here for more details about this article) |
| | Next -> |