Faculty of Medicine
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Item type:Publication, Effect of the first wave of COVID-19 on Poison Control Centre activities in 21 European countries: an EAPCCT initiative(Informa UK Limited, 2022-10) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, FATAL INTOXICATION AFTER DELIBERATE INGESTION OF 2-METHYL-4- CHLOROPHENOXYACETIC ACID (MCPA)(Macedonian Association of Anatomists and Morphologists, 2024); ; ; ; Although intentional poisonings with 2-Methyl-4-chlorophenoxyacetic acid (MCPA) are relatively rare and in most cases cause moderate toxicity, deaths have been described, mainly due to cardiorespiratory arrest. Treatment is generally supportive, with opposing effects from the application of urinary alkalization and other methods for secondary elimination of the poison. Case report. Herein we report a case of an adult female who was admitted to theUniversity Clinic for Toxicology several hours after a suicidal ingestion of an unknown toxic agent that resulted in vomiting and loss of consciousness. After MCPA ingestion was confirmed, she received supportive care, urinary alkalinization, and hemodialysis. Despite this, the patient was hypotensive, after which signs of acute kidney injury, rhabdomyolysis, hyperamylasemia, hepatic lesion, electrolyte abnormalities, metabolic acidosis, disseminated intravascular coagulation, and respiratory failure developed. Despite applied mechanical ventilation and inotropic support, the patient died several days later. Conclusion: MCPA is a poisonous herbicide that can cause severe forms of poisoning and fatal outcome especially after large intentional ingestions. The availability of rapid qualitative toxicological confirmation of the xenobiotic can contribute to early etiological diagnosis and initiation of appropriate therapeutic measures that would improve survival even in more severe forms. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Acute severe poisoning with disinfectant in senior aged patient-case report and overview of literature considering age influence on treatment decision in alcohol-based intoxications(2021-09); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, ACUTE VENLAFAXINE OVERDOSE WITH POSITIVE URINE IMMUNOASSAY FOR TRAMADOL – CLINICAL AND DIAGNOSTIC OVERLAP - CASE REPORT AND LITERATURE OVERVIEW(2019-06); ; Objective. The overlapping of pharmacokinetics and/or the pharmacodynamics of medicines causes the occurrence of overlapping clinical syndromes and diagnostic issues, potentiated in overdoses. We report a case of severe venlafaxine poisoning where the clinical presentation and the results of rapid immunoassay test overlapped with tramadol intoxication. Case presentation. An unconscious women with recurrent seizers, hypertension and supposed acute medication poisoning in suicidal attempt was transported to our clinic. Previously, she had been lavaged, rehydrated and treated with 20 mg diazepam iv, 40 mg furosemide at the local general hospital. Her regular tablet therapy consisted of losartan, levothyroxine, venlafaxine, occasionally tramadol. At admission she was comatose, with isochoric normal pupils, BP 130/80 mm Hg, SaO2 86%, and recurrent episodes of seizures treated with 10mg diazepam iv, ocular clonus, hypertonus, temperature 38.9C, diaphoresis, facial hyperaemia, dark coloured urine, hyponatremia and rhabdomyolisis. The lateral flow immunoassay (AbuGnostR) was positive for tramadol, but the homogeneous enzyme immunoassay did not confirm it. After 36 hours of intensive treatment she became somnolent and reported ingestion of 2250 mg tbl Venlafaxine. The AbuGnost R test detects tramadol at cut off urine values 200ng/ml, but present cross reactivity with O-desmethylvenlafaxine at cut off values up to 25000ng/ml. The following days she complained of muscular weakness, headaches and cognitive impairment, which lasted for more then one month after release from hospital. Conclusion. High concentrations of venlafaxine metabolites induce false positive tramadol immunoassay (AbuGnostR) test. Overlapping clinical presentations and metabolic pathways of venlafaxine and tramadol should alert physicians when interpret rapid immunoassay test. The mandatory principle when making medical decisions should cover synthesis of critically interpreted toxicology analysis, interview data and clinical features of the poisoning, which may help to avoid misleading conclusions and improve the diagnostic and therapy decisions. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Pulmonary thrombosis in acute organophosphate poisoning - Case report and literature overview of prothrombotic preconditioning in organophosphate toxicity(Elsevier, 2019-06-15); ;