Spontaneous activity of autonomie functions in coma due to drug overdose

Spontaneous heart rate, respiration rate and electrodermal activity were studied in 32 patients with different grades of severe poisoning by ingestion of various drugs. The degree of their behavioural impairment was determined with the Munich Coma Scale (MCS) which measures stimulus evoked somatomotor responses. There was a significant reduction of spontaneous variations of heart rate and respiration rate with increasing severety of coma. Spontaneous electrodermal fluctuations were present only at the least severe grades of impairment. Thus, cardiorespiratory and electrodermal activity can provide significant information on the level of behavioural impairment in severe poisoning.     

Endophthalmitis due to Bacillus cereus: case report

An acute case of endophthalmitis following ocular trauma involving barbary branches is presented. Bacillus cereus var. mycoides was cultured from lens material obtained via a limbal incision.     

Spontaneous activity of autonomic functions in coma due to drug overdose.

Spontaneous heart rate, respiration rate and electrodermal activity were studied in 32 patients with different grades of severe poisoning by ingestion of various drugs. The degree of their behavioural impairment was determined with the Munich Coma Scale (MCS) which measures stimulus evoked somatomotor responses. There was a significant reduction of spontaneous variations of heart rate and respiration rate with increasing severity of coma. Spontaneous electrodermal fluctuations were present only at the least severe grades of impairment. Thus, cardiorespiratory and electrodermal activity can provide significant information on the level of behavioural impairment in severe poisoning.     

Onychomycosis due to Aspergillus candidus: case report.

A patient is described who suffered from chronic fungal involvement of right great toe nail. Serial cultures of the removed nail demonstrated a non-dermatophyte, Aspergillus candidus, as the causative agent.     

Citalopram-induced severe hyponatraemia with coma and seizure. Case report with literature and spontaneous reports review

Numerous case reports of hyponatraemia followed increasing use of selective serotonin re-uptake inhibitors (SSRIs) but this adverse effect was only rarely observed in relation to citalopram. We report a case of severe hyponatraemia associated with deep coma, seizure, atrial fibrillation and muscle damage in a 92-year-old woman after only two doses of citalopram, and review 14 cases previously published in the literature and 28 cases spontaneously reported to Australian Drug Reaction Advisory Committee (ADRAC). The data presented suggest that citalopram, as well as SSRIs may cause hyponatraemia secondary to syndrome of inappropriate secretion of antidiuretic hormone (SIADH). The majority of symptomatic cases occurred in elderly patients (79% were older than 70 years) and in women (74%). Polymedication and concomitant use of another psychotropic drug or thiazide diuretic may precipitate and/or augment the development of hyponatraemia/SIADH. In 84% of cases, the hyponatraemia associated with citalopram was detected during the first month of treatment. High level of suspicion, close and careful monitoring of serum sodium concentration particularly in elderly patients and especially in the first month of therapy with citalopram may reduce the incidence of this serious and likely not rare adverse effect.     

药物所致糖尿病非酮症高渗性昏迷患儿的抢救

糖尿病酮症酸中毒是儿科急诊 ,如果治疗处理不当 ,可出现各种严重并发症 ,甚至危及病儿的生命 ,本文介绍的一例糖尿病患儿就是由于基层医院处理不当造成了非酮症高渗性昏迷、碱中毒、低血糖等各种严重并发症。现报告如下。1病例介绍患儿、女、12岁 ,因咽痛、头昏、多饮、多尿、消瘦6ｄ ,昏迷 2ｄ入院。在当地县医院入院时测血糖 :33 3ｍｍｏｌ/Ｌ ,呼吸有烂苹果味 ,神志不清 ,呈昏睡状 ,尿酮体 + + ,诊断为Ⅰ型糖尿病酮症酸中毒 ,给胰岛素 5 0ｕ加入生理盐水 5 0 0ｍｌ静滴 ,胰岛素 3ｕ静脉推注ｑ12ｈ ,5 %碳酸氢钠 2 5 0ｍｌ+ 10 %氯化钾 2…     

对乙酰氨基酚过量致精神异常、肾损害及低血糖昏迷

1例29岁男性患者,1 d 内服用对乙酰氨基酚片(0.5 g)共20片后出现语无伦次,行为异常.入院后实验室检查:ALT 26 U/L,AST 16 U/L;BUN 43 mmol/L,SCr 235 μmol/L,血糖4.2 mmol/L.第2天患者出现昏迷,血糖1.2 mmol/L.经对症治疗,2周后血糖及肾功能均恢复正常.     

Eosinophilic pustular folliculitis due to naltrexone: A case report

BackgroundThe effectiveness of naltrexone in treating both alcohol and opioid use disorders is unique when compared with other agents used for substance use disorder (SUD). It is estimated that 2 million Americans suffer from opioid use disorder, and 14.5 million have alcohol use disorder, underscoring the need for medication-supported SUD treatment. The aims of this case report are 2-fold: (1) to underscore the importance of conducting a thorough medication history when considering a recent adverse drug reaction and(2) to report a novel cutaneous reaction to naltrexone oral tablet.Case summaryA 20-year-old female with a medical history significant for bipolar disorder, obsessive compulsive disorder, major depression disorder, and polysubstance use disorder experienced a drug-induced cutaneous adverse reaction on 2 separate occasions, about 3 months apart. Drug-induced adverse reactions can lead to treatment modifications, resulting in differences in efficacy and undesirable adverse effects. The purpose of this case report is to introduce naltrexone-induced skin reactions and emphasize the importance of a careful medication history when determining which medication is related to an adverse reaction.Practice implicationsNaltrexone will continue to be used to manage cravings related to SUD. This case brings awareness to severe cutaneous adverse reactions associated with enteral naltrexone. Monitoring upon initiation for any adverse effects should be part of a holistic treatment plan. In addition to conducting a complete and thorough medication history, adverse drug reactions can be correctly attributed to the offending agent and prevent future adverse reactions.     

Toxic neuropathy due to N-hexane: report of three cases

Chronic exposure to n-hexane is one of the well known causes of peripheral neuropathy. This type of neuropathy is commonly seen among individuals employed in shoe and bag factories with inadequate ventilation. We describe three patients with acute and sub-acute neuropathy following n-hexane exposure via inhalation of glue. All of the patients had history of working in the same place. The results of laboratory examinations were in normal ranges except the electroneuromyographic (ENMG) findings which were showing the neuropathy. All patients were hospitalized and rehabilitation programs were carried out. Symptomatic relief was achieved following this treatment, however the pathologic ENMG findings still persisted.     

Case reports: cutaneous small vessel vasculitis due to famciclovir therapy

Cutaneous hypersensitivity vasculitis is often idiopathic, but may be the result of therapeutic drugs. It is important to be aware of previously unreported drugs that may be associated with this complication. We report a case of cutaneous hypersensitivity vasculitis due to famciclovir therapy. To our knowledge, this is the first report of this interaction in the medical literature in English.     

非酮症高渗性糖尿病昏迷的水化治疗(附23例报告)

目的 探讨非酮症高渗性糖尿病昏迷的水化疗法。方法 8年来我们对23例非酮症高渗性糖尿病昏迷患者采用了水化治疗方法,在常规内科治疗方法的基础上同时口服或胃管灌注温开水进行消化道补液治疗。结果 采用水化治疗12小时后,血糖、血钠及血浆渗透压即开始下降,24小时后明显下降。除3例死于严重的多系统器官功能衰竭外,其余均治愈。结论 水化治疗方法简单、安全、有效。     

A farmworker death due to pesticide toxicity: a case report

In the state of California, the use of pesticides is closely regulated. Physicians are required to report all occupational illness attributable to pesticide use. The case of a death involving the handling of aldicarb, a potent methylcarbamate insecticide, is presented. Although the autopsy indicated trauma as the cause of death, subsequent analysis of tissue residues of aldicarb and its metabolites suggested that pesticide toxicity may have been a contributing cause.