Pattern of oseltamivir ingestions reported to Texas poison centers

2009 ◽  
Vol 29 (2) ◽  
pp. 137-140 ◽  
Author(s):  
Mathias B. Forrester
Keyword(s):  
Abdominal Pain ◽  
Clinical Effects ◽  
Influenza Outbreak ◽  
Poison Centers ◽  
Influenza Outbreaks

During serious influenza outbreaks, the number of oseltamivir exposures reported to poison centers might be expected to increase. This investigation describes the pattern of oseltamivir ingestions reported to Texas poison centers during 2000—2008. Of 298 total ingestions, 91.9% occurred in December—March, 76.8% involved patients aged 0—19 years, 72.5% resulted from therapeutic error, 90.0% were managed on-site, and 80.0% had no effect. The most frequently reported adverse clinical effects were vomiting (7.5%), nausea (3.8%), and abdominal pain (3.8%). Oseltamivir ingestions were reported to Texas poison centers primarily during periods of influenza outbreak. Most involved children, resulted from therapeutic error, and were managed on-site without serious outcome.

Pattern of ziprasidone exposures reported to Texas poison centers, 2001–2005

2008 ◽  
Vol 27 (4) ◽  
pp. 355-361 ◽  
Author(s):  
MB Forrester
Keyword(s):  
Health Care ◽  
Age Distribution ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
Poison Control ◽  
Clinical Effects ◽  
Poison Control Centers ◽  
Poison Centers ◽  
The Mean

Information on potentially adverse exposures to the atypical antipsychotic drug ziprasidone is limited. This study described the pattern of exposures involving only ziprasidone (isolated exposures) reported to Texas poison control centers during 2001–2005. The mean dose was 666 mg. The patient age distribution was ≤5 years (11%), 6–19 years (30%), and ≥20 years (60%). The exposures were intentional in 53% of the cases. Seventy-five percent of the exposures were managed at health care facilities. The final medical outcome was classified as no effect for 39% of the cases and minor effects for 40% of the cases. Adverse clinical effects were listed for 53% of the patients; the most frequently reported being neurological (42%), cardiovascular (13%), and gastrointestinal (5%). The most frequently listed treatment was decontamination by charcoal (34%) or cathartic (28%). Potentially adverse ziprasidone exposures reported to poison control centers are likely to involve management at a health care facility and involve some sort of adverse clinical effect. With proper treatment, the outcomes of such exposures are generally favorable.

scholarly journals A Novel Data-driven Methodology for Influenza Outbreak Detection and Prediction

2020 ◽  
Author(s):  
Lin Du ◽  
Yan Pang
Keyword(s):  
Model Performance ◽  
Resource Planning ◽  
Data Driven ◽  
Outbreak Detection ◽  
Severe Illness ◽  
Prescription Data ◽  
Influenza Outbreak ◽  
Real World Evidence ◽  
Efficient Resource ◽  
Influenza Outbreaks

Abstract Influenza is an infectious disease that leads to an estimated 5 million severe illness cases and 650,000 respiratory deaths worldwide each year. Early detection and prediction of influenza outbreaks are crucial to efficient resource planning to save patients’ lives and healthcare costs. This paper proposes a novel data-driven methodology for influenza outbreaks detection and prediction. The doctor’s diagnosis-based prescription dataset of Influenza-Like Illness (ILI) from more than 3,000 clinics in Malaysia is used in this study because the prescription data are reliable and can be captured timely. A new Region Index (RI) of the influenza outbreak is proposed based on the prescription dataset. With the newly proposed RI metric, statistical and machine learning models are developed to detect and predict influenza outbreaks. Cross-validation is conducted to evaluate the prediction model performance. The proposed methods are also validated by real-world evidence. It is proved to be sensitive and accurate in influenza outbreak prediction with 80-90% accuracy, 70-80% recall, and 70-80% precision scores.

scholarly journals Real-Time Forecast of Influenza Outbreak Using Dynamic Network Marker Based on Minimum Spanning Tree

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Kun Yang ◽  
Jialiu Xie ◽  
Rong Xie ◽  
Yucong Pan ◽  
Rui Liu ◽  
...  
Keyword(s):  
Public Health ◽  
Real Time ◽  
Spanning Tree ◽  
Minimum Spanning Tree ◽  
Influenza Pandemic ◽  
Social Systems ◽  
Computational Method ◽  
Global Public Health ◽  
Influenza Outbreak ◽  
Influenza Outbreaks

The influenza pandemic is a wide-ranging threat to people’s health and property all over the world. Developing effective strategies for predicting the influenza outbreak which may prevent or at least get ready for a new influenza pandemic is now a top global public health priority. Owing to the complexity of influenza outbreaks that are usually involved with spatial and temporal characteristics of both biological and social systems, however, it is a challenging task to achieve the real-time monitoring of influenza outbreaks. In this study, by exploring the rich dynamical information of the city network during influenza outbreaks, we developed a computational method, the minimum-spanning-tree-based dynamical network marker (MST-DNM), to identify the tipping point or critical stage prior to the influenza outbreak. With historical records of influenza outpatients between 2009 and 2018, the MST-DNM strategy has been validated by accurate predictions of the influenza outbreaks in three Japanese cities/regions, respectively, i.e., Tokyo, Osaka, and Hokkaido. These successful applications show that the early-warning signal was detected 4 weeks on average ahead of each influenza outbreak. The results show that our method is of considerable potential in the practice of public health surveillance.

Review of toxicity and trends in the use of tiagabine as reported to US poison centers from 2000 to 2012

2015 ◽  
Vol 35 (2) ◽  
pp. 109-113 ◽  
Author(s):  
HA Spiller ◽  
D Wiles ◽  
JL Russell ◽  
MJ Casavant
Keyword(s):  
Suicide Attempt ◽  
Suicide Ideation ◽  
Temporal Trends ◽  
Care Facility ◽  
Health Care Facility ◽  
High Rate ◽  
Clinical Effects ◽  
Gamma Aminobutyric Acid ◽  
Poison Centers ◽  
National Poison Data System

Background: Tiagabine is a novel antiepileptic that acts by increasing synaptic and extracellular gamma-aminobutyric acid concentrations. Information concerning overdose of tiagabine is limited. After introduction, an increasing number of off-label uses suggested that tiagabine use would increase. However in 2005 and 2008, warnings from the Food and Drug Administration (FDA) were issued on the risk of seizures in non-epileptic and increased suicide ideation. We evaluated the temporal trends associated with these two warnings as well as clinical outcomes from tiagabine overdose. Method: A retrospective review of all single substance tiagabine exposures in National Poison Data System (NPDS) from 2000 to 2012. Results: A total of 2147 patients had ingested tiagabine, with a mean of 165 year−1. This was disproportionally distributed, with a steep rise leading up to 2004 (max 559 year−1) and then a significant decline ( p < 0.05) between 2005 and 2006. The number of cases reported to NPDS mirrored the sales of tiagabine. Clinical effects were predominantly neurological, with the most commonly reported effects being drowsiness (27%), agitation (19%), confusion (12%), seizures (11%), and tachycardia (10%). In all, 758 patients (35%) showed a major or moderate medical outcome, with no deaths reported. A disproportionate share of the major outcomes was in the suicide attempt group (73%). The majority of patients (75%) were treated in a health-care facility (HCF). Conclusions: The HCF usage is likely due to high rate of symptomatic patients (59%) and the large proportion of suicide attempt cases. The frequency of tiagabine cases in NPDS mirrored pharmaceutical sales, with steep declines temporally related to the 2005 FDA warning.

scholarly journals Lymphocyte monocyte ratio is an effective and simple predictor for nosocomial influenza outbreaks

2021 ◽  
Author(s):  
Fan Junping ◽  
Ke Fanhang ◽  
Sun Fangyan ◽  
Tian Xinlun ◽  
Xiao Meng ◽  
...  
Keyword(s):  
Blood Cell ◽  
Symptom Onset ◽  
Peripheral Blood Cell ◽  
Outbreak Detection ◽  
Receiver Operating Curve ◽  
Influenza Outbreak ◽  
Cell Parameters ◽  
Specificity And Sensitivity ◽  
Tertiary Teaching ◽  
Influenza Outbreaks

Abstract ObjectivesNosocomial influenza outbreak detection remains challenging. We evaluated the diagnostic utility of blood cell parameters, along with their capacity to differentiate between hospital acquired influenza and coronavirus disease 2019 (COVID-19).MethodsWe retrospectively analyzed patients diagnosed with nosocomial influenza from January 2017 to December 2019, and patients with COVID-19 in early 2020 at a tertiary teaching hospital in Beijing, China. We compared the differences between blood cell count and ratios (lymphocyte-to-monocyte ratio [LMR], neutrophil-to-lymphocyte ratio [NLR], lymphocyte-to-platelet ratio [LPR]) at symptom onset, before (admission), and after (recovery) nosocomial influenza. We also compared the abovementioned parameters between influenza and COVID-19 patients.ResultsLymphocyte count, LMR, and LPR were significantly lower in the symptom onset than in the admission and recovery groups (p < 0.001), while NLR was higher (p < 0.001). LMR and NLR exhibited similar and consistent tendencies among different subgroups of patients with nosocomial influenza (p < 0.001). The area under the receiver operating curve (AUC) of LMR, NLR, LPR, and lymphocyte count were 0.914, 0.872, 0.806, and 0.866, respectively. The optimal LMR cut-off value was 2.50, with specificity and sensitivity of 92.0% and 81.3%, respectively. Peripheral blood cell ratios can help diagnose nosocomial influenza significantly earlier than conventional methods. For differentiating influenza and COVID-19, the AUCs of LMR was 0.825.ConclusionsLMR effectively predicts nosocomial influenza outbreaks, particularly during the COVID-19 pandemic when simultaneous transmission can be a substantial threat.

Influenza control in Australian prison settings: Cost ‐ benefit analysis of major strategies

2005 ◽  
Vol 1 (1) ◽  
pp. 31-38 ◽  
Author(s):  
Niyi Awofeso ◽  
William D. Rawlinson
Keyword(s):  
Health Care Services ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Average Frequency ◽  
Mass Vaccination ◽  
Influenza Outbreak ◽  
Care Services ◽  
South Wales ◽  
Antiviral Chemotherapy ◽  
Influenza Outbreaks

Repeated influenza outbreaks are surprisingly rare in prison settings worldwide, a factor that has made it superfluous, to date, to develop contingency plans for responding to prison‐based influenza epidemics. However, the influenza outbreak that occurred in an Australian prison in 2000 has highlighted the appropriateness of developing an outbreak plan, not least because of the security implications of a widespread prison influenza epidemic. Using reported attack rates and morbidity profiles of the 2000 Australian prison influenza outbreak to develop scenarios, the authors estimated the cost ‐ benefit of mass vaccination and antiviral chemotherapy approaches for the control of hypothetical widespread influenza outbreaks in New South Wales prisons, occurring at an average frequency of once every 10 years. It was concluded that, from the perspectives of maintaining prison security as well as health care services’ provision to prisoners, early antiviral chemotherapy for symptomatic individuals will have more favourable cost ‐ benefit ratios than a mass vaccination approach for controlling prison‐based influenza outbreaks that occur in line with this model.

Evaluation of Centrally Acting Cholinesterase Inhibitor Exposures in Adults

2007 ◽  
Vol 41 (10) ◽  
pp. 1632-1637 ◽  
Author(s):  
Keith R McCain ◽  
Tama S Sawyer ◽  
Henry A Spiller
Keyword(s):  
Healthcare Facility ◽  
Poison Control ◽  
Clinical Effects ◽  
Toxic Exposure ◽  
Lack Of Information ◽  
Number Of Patients ◽  
The Us ◽  
Poison Centers ◽  
Life Threatening ◽  
Toxic Exposure Surveillance System

Background: There are 4 centrally acting cholinesterase inhibitors (CA-ChEI) available in the US: tacrine, galantamina, rivastigmine, and donepezil. Documented clinical experience involving exposure to these agents is limited. The lack of information makes decisions involving excessive or unintended CA-ChEI exposure difficult. Objective: TO assess the effects, demographics, and outcomes of CA-ChEI exposures reported to US poison centers. Methods: A retrospective review of the Toxic Exposure Surveillance System of the American Association of Poison Control Centers data of acute and acute-on-chrontc exposures involving only a CA-ChEI in patients 19 years of age or older with documented medical outcomes from 2000–2005 was performed. Results: There were 1026 records that met criteria for this study. Patients aged 70–89 years made up 73% of reports; 69% of the patients were female. Moderate (197) and major outcomes (20) accounted for 21% of exposures. There were no deaths. Clinical effects that occurred in 5% or more of patients included vomiting (34%), nausea (28%), diarrhea (12%), dizziness/vertigo (9.9%), drowsiness/lethargy (7.7%), diaphoresis (7.4%), tremor (5.2%), and bradycardia (5%). Patients were admitted to the hospital in 19% of all exposures. Of those patients, 42% were admitted to a critical care unit. The majority (65%) of exposures were attributed to unintentional therapeutic error. Patients received at least one form of therapy In 47% of exposures, including intravenous fluid (111), antiemetic (46), atropine (17), benzodiazepine (15), oxygen (14), antihypertensive (4), pralidoxime (4), intubation (3), antihistamine (2), antiarrhythmic (1), anticonvulsant (1), and pacemaker (1). Conclusions: The majority of patients evaluated in this retrospective study experienced no or mild effect; however, significant or life-threatening effects were observed in a small group of patients and an appreciable number of patients were admitted to a healthcare facility.

Does getting high hurt? Characterization of cases of LSD and psilocybin-containing mushroom exposures to national poison centers between 2000 and 2016

2018 ◽  
Vol 32 (12) ◽  
pp. 1286-1294 ◽  
Author(s):  
James B Leonard ◽  
Bruce Anderson ◽  
Wendy Klein-Schwartz
Keyword(s):  
Emergency Department ◽  
Critical Care ◽  
Clinical Effects ◽  
Medical Outcomes ◽  
Critical Care Units ◽  
Large Populations ◽  
Emergency Department Management ◽  
Poison Centers ◽  
Psychiatric Conditions

Background: Lysergic acid diethylamide (LSD) and psilocybin are serotonergic hallucinogens that are used primarily for recreational abuse. Small studies evaluated the efficacy of LSD and psilocybin for several psychiatric conditions. There are limited safety or toxicity data for either of these substances, especially in large populations. Methods: This was a retrospective analysis of single-substance exposures of LSD or psilocybin-containing mushrooms (PcMs) reported to United States poison centers from 1 January 2000 to 31 December 2016. The study describes the most frequent toxicities, management sites, and medical outcomes. Results: A total of 5883 PcM and 3554 LSD exposures were included. Most patients were between 13 and 29 years of age (83.9% PcM, 88.9% LSD) and primarily male (77.9% PcM, 74.1% LSD). Most common clinical effects were hallucinations (45.8% PcM, 37.4% LSD), agitation (24.1% PcM, 42.4% LSD), and tachycardia (18.0% PcM, 38.6% LSD). Serious clinical effects were infrequent, but included hyperthermia, seizures, coma, increased serum creatinine, and cardiac arrest. Most patients were treated and released from the emergency department. More LSD patients were admitted to critical care and non-critical care units than PcM patients. Moderate effect was the most frequent outcome for both substances (61.0% PcM, 62.3% LSD). Conclusion: These data find that LSD and PcM use occurs primarily in adolescents and young adults, who experience mild to moderate adverse effects. Serious effects are infrequent but can occur. While most LSD and PcM users require only emergency department management, LSD use is more likely to require medical admission.

scholarly journals 1615. Influenza Outbreaks in Long-Term Care Facilities, 2017–2018 Influenza Season, Dallas, Texas

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S589-S589
Author(s):  
Wendy Chung ◽  
Kyoo Shim ◽  
David Jung ◽  
James Blackwell ◽  
Folasuyi Richardson ◽  
...  
Keyword(s):  
Public Health ◽  
Influenza Season ◽  
Health Department ◽  
Term Care ◽  
Influenza Outbreak ◽  
Dallas County ◽  
Time To Initiation ◽  
Care Facilities ◽  
Influenza Outbreaks

Abstract Background High rates of influenza-related hospitalizations and deaths occurred in the United States during the 2017–2018 influenza season. A record number of influenza outbreaks were reported in long-term care facilities (LTCF) in Dallas County. Public health surveillance of influenza-related intensive care unit (ICU) admissions and deaths in acute care hospitals improved early identification of outbreaks in LTCFs. Methods A confirmed LTCF influenza outbreak was defined as at least 1 lab-confirmed influenza case plus at least 1 case of influenza-like illness among residents or staff within 72 hours. Outbreaks were self-reported by facilities or identified by the health department during investigations of ICU hospitalizations and deaths. CDC guidance for influenza outbreak management was provided and daily active surveillance was continued for at least 1 week after the last case was identified. Data collected included: numbers of ill residents and staff, vaccination rates, dates of illness and chemoprophylaxis initiation, hospitalizations and deaths. Fisher exact tests and Chi-square were performed using SAS 9.4. Results During this influenza season, 32 confirmed influenza outbreaks were identified in Dallas County LTCFs: 17 in skilled nursing facilities (SNF), 13 in assisted-living facilities (ALF) and 2 in hybrid SNF/ALF. The average attack rate in residents was 9.8% (range: 1–35%). Influenza hospitalization rates were higher in ALF compared with SNF outbreaks (OR: 2.2). Influenza-associated mortality rates were higher in ALF compared with SNF (OR: 3.1). Of the 32 outbreaks, 20 (63%) were self-reported by facilities to public health and 12 (38%) were identified through health department review of influenza-associated ICU hospitalizations. Facilities where outbreak cases were identified through public health surveillance of ICU admissions had significantly lower overall attack rates (5.9% vs. 12.1%, P = 0.01) and shorter time to initiation of facility-wide chemoprophylaxis (0.4 vs. 2.4 days, P = 0.05). Conclusion Active surveillance of influenza-associated ICU admissions in acute-care hospitals facilitated the early identification of influenza outbreaks in LTCFs, which was associated with lower overall attack rates and shorter time to initiation of facility-wide chemoprophylaxis. Disclosures All authors: No reported disclosures.

scholarly journals Randomized Clinical Trial: The Clinical Effects of Herb-Partitioned Moxibustion in Patients with Diarrhoea-Predominant Irritable Bowel Syndrome

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Yu-xia Ma ◽  
Xiao Liu ◽  
Cun-zhi Liu ◽  
Lin-peng Wang ◽  
Gang Guo ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Adverse Events ◽  
Abdominal Distension ◽  
Clinical Effects ◽  
End Of Treatment ◽  
Significant Difference ◽  
Irritable Bowel

Objective. To explore the efficacy of Herb-partitioned moxibustion in treating IBS-D patients.Method. 210 IBS-D patients were randomly assigned on a3:3:2basis to group HM, group FM, or group PB for 4-week treatment. The change of GSRS total score at weeks 4 and 8, the changes of GSRS specific scores, and adverse events were evaluated.Results. Patients in group HM and group FM had lower GSRS total score at week 4 (1.98±0.303,2.93±0.302versus3.73±0.449) and at week 8 (2.75±0.306,3.56±0.329versus4.39±2.48) as compared with patients’ score in group PB. However, there was no significant difference of GSRS total score between group HM and group FM. The effect of HM was significantly greater than that of orally taking PB in ameliorating the symptoms of rugitus (0.38 versus 0.59,P<0.05), abdominal pain (0.28 versus 0.57,P<0.01), abdominal distension (0.4 versus 0.7,P<0.01), and increased passage of stools (0.06 versus 0.25,P<0.01) at the end of treatment period. In the follow-up period, patients’ therapeutic effect in group HM remained greater than that in group FM (in abdominal pain, abdominal distension, and increased passage of stools) and that in group PB (in loose stools).Conclusions. HM appears to be a promising, efficacious, and well-tolerated treatment for patients with IBS-D.

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