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Acute poisonings treated in hospitals in Oslo: a one-year prospective study (I): pattern of poisoning.

https://arctichealth.org/en/permalink/ahliterature93790
Source
Clin Toxicol (Phila). 2008 Jan;46(1):35-41
Publication Type
Article
Date
Jan-2008
Author
Hovda K E
Bjornaas M A
Skog K.
Opdahl A.
Drottning P.
Ekeberg O.
Jacobsen D.
Author Affiliation
Department of Acute Medicine, Ullevaal University Hospital, Oslo, Norway. kehovda@yahoo.no
Source
Clin Toxicol (Phila). 2008 Jan;46(1):35-41
Date
Jan-2008
Language
English
Publication Type
Article
Keywords
Acetaminophen - poisoning
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Analgesics, Opioid - poisoning
Benzodiazepines - poisoning
Cross-Sectional Studies
Ethanol - poisoning
Female
Hospitalization - statistics & numerical data
Humans
Hydroxybutyrates - poisoning
Incidence
Male
Middle Aged
Norway - epidemiology
Poisoning - epidemiology
Prospective Studies
Sex Factors
Suicide, Attempted - statistics & numerical data
Abstract
OBJECTIVES. Prospective design is mandatory to study pattern of poisoning and suicidal intention of patients. MATERIAL AND METHODS. Prospective cross-sectional multi-center study of all patients contacting health care services because of acute poisoning during one year in Oslo, irrespective of intention. Data on the adult hospitalized patients (> or = 16 years) are presented here. RESULTS. Of a total of 3,775 such adult contacts (3,025 episodes), there were 947 (31 %) hospitalizations; annual incidence 1.9 (per 1,000) in males and 2.1 in females. Median age was 36 years (range 16-89); 54% females. Benzodiazepines (18%), ethanol (17%), paracetamol (12%), opioids (7%), and gamma hydroxybutyric acid (GHB) (7%) were most frequently taken. Patients stated suicidal intention in 29% of the admissions; physicians in 10%. CONCLUSION. Benzodiazepines and ethanol were the most common agents, but newer illicit drugs were frequent, especially GHB. Males often took ethanol and drugs of abuse; females often used prescription drugs with suicidal intention.
PubMed ID
18167035 View in PubMed
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Adverse reactions to N-acetylcysteine in Inuit to paracetamol (acetaminophen) overdose.

https://arctichealth.org/en/permalink/ahliterature210885
Source
Arctic Med Res. 1996 Oct;55(4):204-5
Publication Type
Article
Date
Oct-1996

[A study of 355 consecutive acute poisoning cases admitted to an emergency ward at Copenhagen University Hospital, Bispebjerg in 2001]

https://arctichealth.org/en/permalink/ahliterature77553
Source
Ugeskr Laeger. 2007 May 7;169(19):1793-7
Publication Type
Article
Date
May-7-2007
Author
Gude Anne-Bolette Jill
Hoegberg Lotte C G
Pedersen Michael
Nielsen Jonas
Angelo Helle R
Christensen Hanne Rolighed
Author Affiliation
Bispebjerg Hospital, Klinisk Farmakologisk Enhed, Klinisk Biokemisk Afdeling, København NV. bg@stonesinvest.dk
Source
Ugeskr Laeger. 2007 May 7;169(19):1793-7
Date
May-7-2007
Language
Danish
Publication Type
Article
Keywords
Acetaminophen - poisoning
Acute Disease
Adolescent
Adult
Aged
Alcoholic Intoxication - epidemiology
Analgesics, Non-Narcotic - poisoning
Benzodiazepines - poisoning
Denmark - epidemiology - ethnology
Female
Humans
Hypnotics and Sedatives - poisoning
Male
Middle Aged
Overdose - epidemiology - mortality
Patient Admission
Poisoning - epidemiology - etiology - mortality
Retrospective Studies
Abstract
INTRODUCTION: Epidemiology describing poisoned patients treated at Copenhagen University Hospital, Bispebjerg has not been published since 1993. We wanted to describe the pattern of intoxications. MATERIALS AND METHODS: A retrospective study of poisoned patients admitted to the emergency ward during 2001. A computer search of patients discharged with codes T36.0-T65.9 was supplemented by a hand search of the daily admittance lists. RESULTS: 355 patients with confirmed poisonings were found. 97% were poisoned by medications, alcohol (ethanol) or drugs of abuse. Only 3% were poisoned by other agents such as CO. 55% of poisonings were intentional, where paracetamol and benzodiazepines were the preferred agents. Sedative-hypnotics, alcohol, opioids, and drugs of abuse dominated the unintentional overdoses. Patients poisoned by paracetamol were younger and female, with an overrepresentation of young women of foreign origin. Activated charcoal was the preferred method of gastric decontamination. In 52% of the cases various discrepancies between discharge codes and actual poisonings were found. There were 5 deaths, 2 of which were from mixed overdoses with benzodiazepines involving the administration of flumazenil. The 355 cases represented 6% of all patients admitted to the department. CONCLUSION: Paracetamol, sedative-hypnotics and alcohol were the most common poisoning agents. Mortality was 1%. A general problem of discharge coding was found, which might implicate unreliability in statistics in this field.
PubMed ID
17537355 View in PubMed
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[A survey of acetylsalicylic acid and paracetamol poisonings in Norway]

https://arctichealth.org/en/permalink/ahliterature39487
Source
Tidsskr Nor Laegeforen. 1985 Sep 20;105(26):1774-8
Publication Type
Article
Date
Sep-20-1985

Brief safety updates: acetaminophen, ASA and kava.

https://arctichealth.org/en/permalink/ahliterature187986
Source
CMAJ. 2002 Oct 29;167(9):1034
Publication Type
Article
Date
Oct-29-2002
Author
Eric Wooltorton
Source
CMAJ. 2002 Oct 29;167(9):1034
Date
Oct-29-2002
Language
English
Publication Type
Article
Keywords
Acetaminophen - poisoning
Aspirin - therapeutic use
Canada
Drug Overdose
Humans
Kava - adverse effects
Notes
Cites: CMAJ. 2002 Mar 19;166(6):77711944767
Comment In: CMAJ. 2003 May 27;168(11):139012771057
PubMed ID
12403745 View in PubMed
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Childhood suicide attempts with acetaminophen in Denmark: characteristics, social behaviour, trends and risk factors.

https://arctichealth.org/en/permalink/ahliterature116800
Source
Scand J Public Health. 2013 May;41(3):240-6
Publication Type
Article
Date
May-2013
Author
Rikke Lindgaard Hedeland
Marianne H Jørgensen
Grete Teilmann
Line R Thiesen
Mette Valentiner
Amne Iskandar
Britt Morthorst
Jesper Andersen
Author Affiliation
Department of Paediatrics, Hillerød Hospital, Hillerød, Denmark. rikke.hedeland@ regionh.dk
Source
Scand J Public Health. 2013 May;41(3):240-6
Date
May-2013
Language
English
Publication Type
Article
Keywords
Acetaminophen - poisoning
Adolescent
Case-Control Studies
Child
Denmark - epidemiology
Female
Friends - psychology
Humans
Interpersonal Relations
Male
Parent-Child Relations
Retrospective Studies
Risk factors
Self Mutilation - epidemiology
Social Behavior
Suicide, Attempted - psychology - trends
Abstract
To explore: (1) The relationship between children admitted to our paediatric department as a result of suicide attempts with acetaminophen and their parents and friends. (2) The extent to which the children had attempted to speak to their parents about their problems before their suicide attempts. (3) The frequency of self-mutilation among children with suicidal behaviour. (4) The purposes and reasons for childhood suicide attempts.
A retrospective case-control study based on medical records and in-hospital child psychiatric assessments at the Paediatric Department, Hillerød Hospital, Denmark, 2006-2011.
107 children, 11 to 15 years old.
59 age- and gender-matched children.
43.5% experienced a dissociated parental relationship characterized by the inability to speak to their parents about any problems, compared with 2% in the control group. There was a significant association between a dissociated parental relationship and 'the feeling of not being heard' (p = 0.004), the discovery of the suicide attempt (p = 0.008), the reasons for the suicide attempt (p = 0.006), academic school problems (p = 0.03), and the child's relationships with friends (p = 0.02). Prior to their suicide attempts, 41.5% of the children had attempted to speak to their parents about their problems but felt that they were not heard. There was a significant association among 'the feeling of not being heard' and the purpose of the suicide attempt (p = 0.002) and self-mutilation (p = 0.002). Forty percent mutilated themselves repeatedly.
A consistently impaired parent-child relationship, 'the feeling of not being heard', and self-mutilation are identifiable early risk factors that require increased concern and attention among professionals who work with children.
PubMed ID
23359129 View in PubMed
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Comparison of the 20-hour intravenous and 72-hour oral acetylcysteine protocols for the treatment of acute acetaminophen poisoning.

https://arctichealth.org/en/permalink/ahliterature150059
Source
Ann Emerg Med. 2009 Oct;54(4):606-14
Publication Type
Article
Date
Oct-2009
Author
Mark C Yarema
David W Johnson
Randall J Berlin
Marco L A Sivilotti
Alberto Nettel-Aguirre
Rollin F Brant
Daniel A Spyker
Benoit Bailey
Dominic Chalut
Jacques S Lee
Amy C Plint
Roy A Purssell
Tim Rutledge
Catherine A Seviour
Ian G Stiell
Margaret Thompson
Jeffrey Tyberg
Richard C Dart
Barry H Rumack
Author Affiliation
Division of Emergency Medicine and Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada. mark.yarema@albertahealthservices.ca
Source
Ann Emerg Med. 2009 Oct;54(4):606-14
Date
Oct-2009
Language
English
Publication Type
Article
Keywords
Acetaminophen - poisoning
Acetylcysteine - administration & dosage
Administration, Oral
Adolescent
Adult
Antidotes
Canada
Child
Cohort Studies
Critical Pathways
Drug Administration Schedule
Drug Overdose - drug therapy - mortality
Drug-Induced Liver Injury - drug therapy - mortality
Female
Free Radical Scavengers - administration & dosage
Humans
Infusions, Intravenous
Male
Retrospective Studies
Risk
United States - epidemiology
Young Adult
Abstract
To compare outcomes after acute acetaminophen poisoning in 2 large cohorts of patients treated with either the 20-hour intravenous or 72-hour oral acetylcysteine protocol.
We conducted a retrospective cohort study with historical control comparing patients treated with one of 2 acetylcysteine regimens. Data for the 20-hour group were obtained from a medical record review of patients on whom the 20-hour intravenous protocol was initiated in Canadian hospitals from 1980 to 2005. The 72-hour group consisted of a historical cohort of patients treated in US hospitals with the 72-hour oral protocol from 1976 to 1985. The primary outcome was hepatotoxicity (aminotransferase levels >1,000 IU/L).
Of the 4,048 patients analyzed, 2,086 were in the 20-hour group and 1,962 were in the 72-hour group. The incidence of hepatotoxicity was 13.9% in the 20-hour group and 15.8% in the 72-hour group (-1.9% absolute difference; 95% confidence interval [CI] -4.2 to 0.3). The relative risk of hepatotoxicity was lower in the 20-hour group when acetylcysteine was initiated within 12 hours of ingestion. The relative risk was lower in the 72-hour group when acetylcysteine was initiated later than 18 hours after ingestion. There was no significant risk difference between groups when acetylcysteine treatment was started 12 to 18 hours after ingestion. One patient in the 20-hour group received a liver transplant and died because of acetaminophen toxicity compared with no liver transplants and 3 deaths in the 72-hour group. Anaphylactoid reactions to intravenous acetylcysteine were reported in 148 of 2,086 patients (7.1%; 95% CI 6.1% to 8.3%). This study is limited by comparison of 2 separate data sets from different countries and study years.
The risk of hepatotoxicity differed between the 20-hour and 72-hour protocols according to the time to initiation of acetylcysteine. It favored the 20-hour protocol for patients presenting early and favored the 72-hour protocol for patients presenting late after acute acetaminophen overdose.
Notes
Comment In: Ann Emerg Med. 2009 Dec;54(6):857-8; author reply 858-919942075
Comment In: Ann Emerg Med. 2009 Oct;54(4):615-719695740
Comment In: Ann Emerg Med. 2010 Apr;55(4):393-4; author reply 394-520346844
Comment In: Ann Emerg Med. 2009 Dec;54(6):856-719942074
PubMed ID
19556028 View in PubMed
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Concomitant overdosing of other drugs in patients with paracetamol poisoning.

https://arctichealth.org/en/permalink/ahliterature31588
Source
Br J Clin Pharmacol. 2002 May;53(5):535-41
Publication Type
Article
Date
May-2002
Author
Lars E Schmidt
Kim Dalhoff
Author Affiliation
Department of Hepatology A, Rigshospitalet, Copenhagen, Denmark. lars.schmidt@dadlnet.dk
Source
Br J Clin Pharmacol. 2002 May;53(5):535-41
Date
May-2002
Language
English
Publication Type
Article
Keywords
Acetaminophen - poisoning
Adolescent
Adult
Aged
Aged, 80 and over
Analgesics, Non-Narcotic - poisoning
Child
Denmark - epidemiology
Drug Interactions
Female
Humans
Kidney Diseases - chemically induced - epidemiology - mortality
Liver Diseases - chemically induced - epidemiology - mortality
Male
Middle Aged
Overdose
Abstract
AIMS: Paracetamol is frequently involved in intended self-poisoning, and concomitant overdosing of other drugs is commonly reported. The purpose of the study was to investigate further concomitant drug overdose in patients with paracetamol poisoning and to evaluate its effects on the outcome of the paracetamol intoxication. METHODS: Six hundred and seventy-one consecutive patients admitted with paracetamol poisoning were studied and concomitant drug intake was recorded. The relative risk of hepatic encephalopathy, death or liver transplantation, hepatic dysfunction, liver cell damage, and renal dysfunction associated with concomitant overdosing of other drugs was evaluated by multivariate analysis. RESULTS: Concomitant drug overdose was found in 207 patients (31%, 95% confidence interval [CI] 27, 34%). Concomitant overdosing of benzodiazepines (99 cases), opioid analgesics (38 cases), acetylsalicylic acid (33 cases), and NSAID (32 cases) predominated. Concomitant benzodiazepine overdose was an independent risk factor in the development of hepatic encephalopathy (odds ratio [OR] 1.91; CI 1.00, 3.65) and renal dysfunction (OR 1.81; CI 1.00, 3.22). Concomitant overdosing of opioid analgesics was a protective factor in the development of hepatic encephalopathy (OR 0.26; CI 0.07, 0.96). Concomitant acetylsalicylic acid overdose was a risk factor in the development of hepatic encephalopathy (OR 4.87; CI 1.52, 15.7) and death or liver transplantation (OR 6.04; CI 1.69, 21.6). A tendency towards a more favourable outcome was observed in patients with concomitant NSAID overdose. CONCLUSIONS: Concomitant overdosing of benzodiazepines or analgesics is frequent in patients admitted with paracetamol poisoning. Concomitant benzodiazepine or acetylsalicylic acid overdose was associated with more severe toxicity, whereas concomitant overdosing of opioid analgesics was associated with less toxicity.
Notes
Comment In: Br J Clin Pharmacol. 2003 Mar;55(3):325; author reply 32612630987
PubMed ID
11994060 View in PubMed
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Consumption, overdose and death from analgesics during a period of over-the-counter availability of paracetamol in Denmark.

https://arctichealth.org/en/permalink/ahliterature68606
Source
J Intern Med. 1990 Jun;227(6):423-8
Publication Type
Article
Date
Jun-1990
Author
P. Ott
K. Dalhoff
P B Hansen
S. Loft
H E Poulsen
Author Affiliation
Department of Medicine A, Rigshospitalet, Copenhagen, Denmark.
Source
J Intern Med. 1990 Jun;227(6):423-8
Date
Jun-1990
Language
English
Publication Type
Article
Keywords
Acetaminophen - poisoning
Analgesics - poisoning
Comparative Study
Denmark
Drug Utilization
Drugs, Non-Prescription
Hospitalization
Humans
Narcotics - poisoning
Overdose - epidemiology - mortality
Propoxyphene - poisoning
Salicylates - poisoning
Suicide - statistics & numerical data
Abstract
During the period 1978-1986, annual sales of paracetamol in Denmark increased from 1 million defined daily doses (DDD) (3 g) to 47 million DDD, while the number of admissions and deaths from overdose increased from 26 to 202 and from 1 to 3-4, respectively. The corresponding figures for salicylates are a decrease in sales from 113 to 94 million DDD, an increase in admissions from 282 to 595, and an increase in deaths from 5 to 22. From 1 January 1984 paracetamol became available on an over-the-counter basis. The figures for 1983 and 1984 were an increase in sales from 14 to 28 million DDD, an increase in admissions from 114 to 198, and an increase in deaths from 0 to 4. The number of deaths from opioid overdose remained constant at a value of about fifty during this period, the mortality per dose being about 20-fold higher than for paracetamol and salicylates. Dextropropoxyphene-related deaths increased twofold to 121 in 1986, with unchanged sales figures. A campaign launched by the National Board of Health resulted in a reduction in the number of deaths from dextropropoxyphene to 66 in 1987. The main effect of over-the-counter release of paracetamol was a dramatic increase in sales, without the epidemic of deaths observed a decade ago in the UK. It is suggested that the higher mortality of paracetamol poisonings in the UK compared to Denmark is related to the dextropropoxyphene content of the combination product, which is not available in Denmark. From an epidemiological toxicological viewpoint such combinations are not justified.
PubMed ID
2351928 View in PubMed
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The Danish liver transplantation program and patients with serious acetaminophen intoxication.

https://arctichealth.org/en/permalink/ahliterature35086
Source
Transplant Proc. 1995 Dec;27(6):3519-20
Publication Type
Article
Date
Dec-1995

39 records – page 1 of 4.