1/6. Delayed transient loss of consciousness in acute carbon monoxide intoxication.In acute carbon monoxide intoxication the presence of altered consciousness, ranging from transient loss of consciousness to coma, represents a poor prognostic factor and modifies the approach to therapy. Transient loss of consciousness is, as a rule, contemporaneous to the exposure, generally occurring at the scene of the intoxication. We report an unusual case of delayed transient loss of consciousness, occurring in the absence of any other evident aetiology, in one member of an orchestra composed of 110 members after a mass carbon monoxide poisoning.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
2/6. Spurious hyperchloremia and decreased anion gap in a patient with dextromethorphan bromide.Although cold syrup containing dextromethorpan bromide is widely administered, the bromism due to cold syrup has not been reported. We report a patient who had negative anion gap with hyperchloremia and conscious loss because of daily intake of cold complex syrup (containing dextromethorphan bromide 0.4 mg/ml, acetaminophen 8.33 mg/ml) for headache for 4-5 years. The bromide content in cold complex syrup resulted in serum levels of bromide that interfered with the automated analyzers for chloride content. When conscious change is due to bromism, hemodialysis instead of forced hydration and diuresis should be performed immediately. Therefore, patients with a markedly negative anion gap with hyperchloremia should be considered as having halide intoxication.- - - - - - - - - - ranking = 0.16666666666667keywords = intoxication (Clic here for more details about this article) |
3/6. Delayed hyperbaric oxygen therapy for carbon monoxide intoxication--two case reports.The severity of signs and symptoms following carbon monoxide intoxication often does not relate to admission carboxyhaemoglobin levels. Two cases are presented with severe neurological impairment despite carboxyhaemoglobin levels of 2% and 1.7% on admission to hospital, who responded well to hyperbaric oxygen therapy. In one case, symptoms recurred several days later, but responded to further hyperbaric oxygen therapy. The role of and possible mechanism of action of late hyperbaric oxygen treatment in carbon monoxide intoxication are discussed.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
4/6. Simultaneous recording of pupillary hippus and EEG. Report of a case.Pupillary hippus was observed and recorded in a man of 44 years, who had epileptic seizures, chronic alcoholism with liver disease and Primidon intoxication, during a period of unconsciousness of 24 h. During this time the simultaneous records of the EEG and pupillogram over a long period of time revealed that the basic EEG rhythm and hippus had the same frequency. Both recordings were temporarily in phase, time-locked, and could be blocked by painful and acoustic stimuli. The etiology and interpretation of hippus are discussed.- - - - - - - - - - ranking = 0.16666666666667keywords = intoxication (Clic here for more details about this article) |
5/6. Chronic salicylate intoxication and rhabdomyolysis in a patient with scleroderma and sjogren's syndrome.A 44-year-old woman with scleroderma and sjogren's syndrome developed altered consciousness, acute renal failure, and rhabdomyolysis. She had no history of trauma, seizures, alcohol abuse, hyperthermia, or other possible causative factors for rhabdomyolysis. A high serum salicylate level indicated a diagnosis of salicylate intoxication. Medical history after recovery revealed chronic salicylate ingestion for severe headaches. This is possibly the first reported case of rhabdomyolysis caused by chronic salicylate intoxication. Continuous hemodiafiltration early in hospitalization was an effective treatment.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
6/6. A case of severe hyperammonemia and unconsciousness following sodium valproate intoxication.Although valproic acid has gradually gained its popularity in the treatment of various seizure disorders, overdose of valproate is not common. An 18-y-old man with a history of epilepsy controlled by sodium valproate and clonazepam attempted suicide with an ingestion of 45 g sodium valproate. He presented to our service with drowsiness and irritability. Extremely high serum ammonia (623 ug/dL) and elevated serum valproate concentration (575 ug/mL) were found on admission. Several metabolic abnormalities, including hypernatremia, hypocalcemia and metabolic acidosis, as well as, increased serum transaminase levels were also recorded. With supportive measures, he became clear 24 h later and was discharged 6 d after ingestion. Serial follow-up of his serum valproate and ammonia levels disclosed a close relationship between these 2 measurables. After acute overdose of valproic acid, patients usually present with mild and generally reversible depression of the central nervous system. However, impairment of liver function, hyperammonemia, fluid-electrolyte disturbances, coma, seizures, hypotension and even death may occur following valproate overdose. Symptomatic and supportive measures are the mainstay in the treatment of valproic acid overdose. With prompt diagnosis and early institution of treatment, a complete recovery should be anticipated.- - - - - - - - - - ranking = 0.66666666666667keywords = intoxication (Clic here for more details about this article) |