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Primary and Secondary Surveys
Published in Kajal Jain, Nidhi Bhatia, Acute Trauma Care in Developing Countries, 2023
The aim of a neurologic examination is to establish the patient's level of consciousness, determine pupillary size and reaction, identify lateralizing signs and to look for a spinal cord injury level.The GCS score is the go-to score for objectively monitoring patient consciousness.Be wary of drug and alcohol intoxication. Consult a neurosurgeon once brain injury is identified.
Fungi and Water
Published in Chuong Pham-Huy, Bruno Pham Huy, Food and Lifestyle in Health and Disease, 2022
Chuong Pham-Huy, Bruno Pham Huy
In addition, some species of amanita genus like Amanita pantherina and A. muscaria have hallucinogenic effects (96). They contain two constituents called ibotenic acid and muscimol which are responsible for the hallucinogenic effects. Ibotenic acid is a powerful agonist of N-methyl-D-aspartic-acid receptor and muscimol is a potent gamma-aminobutyric acid A agonist (96). The intoxications caused by A. muscaria were long believed to be due to muscarine, but it was demonstrated that muscarine is present in small amounts. People around the world have intentionally eaten A. muscaria or A. pantherina to evoke euphoria and hallucinations (96). The most common symptoms of intoxication are dizziness, drowsiness, motor depression, ataxia, changes in mood, gastrointestinal disturbances, and muscle twitches (96). Fatality due to Amanita pantherina and A. muscaria poisoning is rare. In most cases recovery is complete after 24 hours. The treatment is mainly symptomatic. Cholinesterase inhibitors, benzodiazepines, or phenobarbitone can be used in case of seizures (96).
Critical Review of Evidence for Neonatal Cocaine Intoxication and Withdrawal
Published in Richard J. Konkol, George D. Olsen, Prenatal Cocaine Exposure, 2020
Delia A. Dempsey, Donna M. Ferriero, Sarah N. Jacobson
The goal of this article is to discuss clinical effects of prenatal cocaine exposure during the newborn period. To conceptualize the mechanisms, a model of neonatal cocaine or metabolite intoxication, withdrawal, and fetopathic effects is presented graphically in Figure 7.1. This model will be developed later in the chapter. This pharmacodynamic model relates the plasma concentration of a drug or metabolite to its clinical effects. Specifically defined, intoxication is a clinical manifestation of the presence of the drug in the body. Withdrawal may develop after the drug is eliminated from the body. Fetopathic effects occur independent of the presence or elimination of a drug and may be evidence of permanent or long-term sequelae of drug exposure. This model has been developed because abnormal behaviors and clinical signs in cocaine-exposed newborns are commonly attributed to withdrawal.4–11 This may be a costly simplification because clinical markers identifying those newborns at highest risk for later developmental or language disabilities may be dismissed as withdrawal.
ToxNet: an artificial intelligence designed for decision support for toxin prediction
Published in Clinical Toxicology, 2023
Tobias Zellner, Katrin Romanek, Christian Rabe, Sabrina Schmoll, Stefanie Geith, Eva-Carina Heier, Raphael Stich, Hendrik Burwinkel, Matthias Keicher, David Bani-Harouni, Nassir Navab, Seyed-Ahmad Ahmadi, Florian Eyer
Intoxications are one of the most significant factors of global suffering and death. The abuse of ethanol alone accounted for 99.2 million DALYs (disability-adjusted life-years) in 2016 with an addition of 31.8 million DALYs from other drugs [5]. In case of an intoxication, fast diagnosis and treatment are essential to prevent permanent organ damage or even death [6]. Poison Control centers (PCCs) were established in most countries to provide quick diagnosis and give treatment recommendations to laymen or health professionals with medical doctors (MDs) trained in clinical toxicology staffing the PCCs. Most of the time, the substance responsible for the intoxication is known. However, when this is not the case, the MD working at the PCC must reach a diagnosis solely based on the reported symptoms, without seeing the patient face to face, and give treatment recommendations accordingly.
Susceptibility to the acute toxicity of acrylonitrile in streptozotocin-induced diabetic rats: protective effect of phenethyl isothiocyanate, a phytochemical CYP2E1 inhibitor
Published in Drug and Chemical Toxicology, 2021
Fang Li, Ying Dong, Rongzhu Lu, Bobo Yang, Suhua Wang, Guangwei Xing, Yuanyue Jiang
Acrylonitrile (AN) is a highly toxic compound that is widely used in many industrial and medical products, such as acrylic fibers, resins, and plastics (Wang et al. 2010). The primary routes of potential human industrial exposure to AN are inhalation and dermal contact. Potential nonindustrial AN exposures result from contact with AN-made industrial products as well as drinking contaminated water, inhaling burning biomass, and cigarette smoking (Marsh and Zimmerman 2015). AN has been classified as a possible human carcinogen and included in the priority list of hazardous substances by the Agency for Toxic Substances and Disease Registry (ATSDR). Globally, approximately 9 billion pounds of AN are produced annually (Yuanqing et al. 2013). Accidents associated with acute AN intoxication have occurred often. For example, there was an AN leak on a train transporting chemicals in Belgium in 2013 (De Smedt et al. 2014) and a fire outbreak at a chemical plant close to Cologne/Germany in 2008 (Leng and Gries 2014). The incidents resulted in high concentrations of AN in the air and the formation of more toxic AN vapors. The mean concentration of AN in the air of the disaster site was 7 ppm within 8 h and 1.6 ppm within 120 h, and the highest value was 20 ppm, while the maximum allowable value of AN is 3 ppm (7 mg/m3) according to the guidelines of the Ordinance for Hazardous Compounds (Leng and Gries 2014).
Drinking until Intoxication: A Qualitative Study among Underage Adolescents Admitted to the Emergency Room
Published in Alcoholism Treatment Quarterly, 2020
Nienke de Wit, Gera E. Nagelhout, Gert-Jan Meerkerk, Johanna Ooms, Annelieke P. Le Net-van Bruggen, Mariken Gruppen, Carole Lasham, Merel van Loon, Dike van de Mheen
Several risk factors that may have contributed to an alcohol intoxication were found in this study. First, the assumption of having your own limit instead of a standardized limit of drinks seemed to contribute to excessive drinking resulting in an intoxication among adolescents without them being aware of it. Thereby, binge drinking was unknowingly normalized or even romanticized, where some adolescents experienced being tipsy before in an enjoyable way. However, an alcohol intoxication caused by binge drinking was not something they imagined would happen to them. This might call for a focus on normsetting among adolescents (Lemmers, Mulder, Onrust, Verdurmen, & Van Hasselt, 2016) and for re-framing “binge drinking”, since this term may not reflect the reality of young people’s experiences involving alcohol use (Szmigin et al., 2008).