Celecoxib exposures reported to Texas poison control centers from 1999 to 2004

2006 ◽  
Vol 25 (5) ◽  
pp. 261-266 ◽  
Author(s):  
M B Forrester
Keyword(s):  
Health Care ◽  
Age Distribution ◽  
Health Care Facilities ◽  
Poison Control ◽  
Clinical Effects ◽  
Medical Outcome ◽  
Patient Age ◽  
Poison Control Centers ◽  
Care Facilities ◽  
The Mean

Concerns have been raised about the safety of celecoxib. This study described the pattern of exposures involving only celecoxib (isolated exposures) reported to Texas poison control centers from 1999 to 2004. The mean dose was 701 mg. The patient age distribution was 5 / 5 years (48%), 6 / 19 years (8%), and 20 years (44%). In 78% of cases, exposure was unintentional. Of the exposures, 74% were managed outside of health care facilities. The final medical outcome was classified as no effect for 82% of the cases, and minor effects for 12% of the cases. Adverse clinical effects were listed for 5% of the patients, the most frequently reported being rash (3%), drowsiness (3%), pruritis (2%), and vomiting (2%). The most frequently listed treatment was decontamination by dilution (43%) or food (32%). The majority of isolated celecoxib exposures could be managed outside of health care facilities, and the outcome was generally favorable.

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.

Adult metaxalone ingestions reported to Texas poison control centers, 2000-2006

2009 ◽  
Vol 29 (1) ◽  
pp. 55-62 ◽  
Author(s):  
Mathias B Forrester
Keyword(s):  
Health Care ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
Poison Control ◽  
Minor Effect ◽  
Clinical Effects ◽  
Medical Outcome ◽  
Poison Control Centers ◽  
Few Data

Few data exist on potentially adverse metaxalone (Skelaxin®) ingestions in adults. All metaxalone ingestions involving patients aged ≥20 years during 2000-2006 were retrieved from Texas poison control centers. Exclusion criteria were lack of follow-up or multiple substance ingestion. Cases were analyzed for selected demographic and clinical factors. Of the 142 patients, 66.2% were female. Dose ingested was reported for 61 patients. Of those cases with a reported dose, distribution by management site was 29.5% on-site, 59.0% already at/en route to health care facility, and 11.5% referred to health care facility. Final medical outcome was ‘no effect’ for 50.8% cases, ‘minor effect’ for 31.1%, and ‘moderate effect’ for 18.0%. The more common adverse clinical effects reported were drowsiness (27.9%), tachycardia (6.6%), agitation (6.6%), nausea (4.9%), dizziness (4.9%), slurred speech (4.9%), and tremor (4.9%). A moderate medical outcome occurred in 13.6% of ingestions of ≤2400 mg and 20.5% of ingestions of >2400 mg. Management involved a health care facility in 18.2% of ingestions of ≤2400 mg and 100.0% of ingestions of >2400 mg. This study found that adult ingestions of higher doses of metaxalone, particularly >2400 mg, were associated with more serious medical outcomes and were managed at health care facilities. This study also proposes triage guidelines for when ingestions can be safely managed at home.

Pediatric lisinopril ingestions reported to Texas poison control centers

2007 ◽  
Vol 26 (2) ◽  
pp. 83-89 ◽  
Author(s):  
M.B. Forrester
Keyword(s):  
Health Care ◽  
Statistical Significance ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
Poison Control ◽  
Medical Outcomes ◽  
Poison Control Centers ◽  
Factors Associated ◽  
Care Facilities

Lisinopril is not recommended for use by young children. This study attempted to identify factors associated with serious outcomes in pediatric lisinopril ingestions. Cases for this study were lisinopril ingestions by children age ≤5 years reported to Texas poison control centers during 1998- 2005. The percentage of cases involving serious medical outcomes was identified for selected variables and evaluated for statistical significance by calculating the rate ratio (RR) and 95% confidence interval (CI). Of 691 total cases, 26 (3.8%) involved a serious outcome. Higher serious outcome rates were found with a max imum dose of >4 mg/kg (RR: 2.54, CI: 0.05-25.62), or > 80 mg (RR: 7.85; CI: 1.73-29.29),or five or more tablets (RR: 8.18; CI: 2.73-22.54), or the patient was already at or en route to a health care facility when the poison control center was contacted (RR: 13.93; CI: 3.68-77.78),or referred to a health care facility by the poison control center (RR: 33.49; CI: 9.04-194.94). The management of patients with severe outcomes was more likely to involve health care facilities. This information is useful for drafting triage guidelines for the management of pediatric lisinopril ingestions. Human & Experimental Toxicology (2007) 26 , 83- 89

Adult metformin ingestions reported to Texas poison control centers, 2000–2006

2008 ◽  
Vol 27 (7) ◽  
pp. 575-583 ◽  
Author(s):  
MB Forrester
Keyword(s):  
Health Care ◽  
Care Facility ◽  
Health Care Facility ◽  
Poison Control ◽  
Medical Outcome ◽  
Limited Information ◽  
Poison Control Centers ◽  
Hypoglycemic Agent ◽  
The Mean

Metformin is an oral hypoglycemic agent used in the management of type 2 diabetes mellitus. Limited information exists on adult metformin ingestions reported to poison control centers. The distribution of adult metformin ingestions reported to Texas poison control centers during 2000–2006 was determined for various factors. In addition, triage guidelines for the management of isolated ingestions were drafted. Of 1528 total metformin ingestions, 58% involved coingestants. Of the 264 ingestions of metformin alone, where the final medical outcome was known, dose ingested was reported for 66%. The mean reported dose was 4739 mg (range 500–60,000 mg). Ingestions of ≤2500 mg and >5000 mg reported doses differed with respect to the proportion involving suspected attempted suicide (6% versus 81%), serious final medical outcome (3% versus 19%), and referral to a health care facility (3% versus 83%). Using 5000 mg as a threshold dose for referral to a health care facility, 91% of cases not already at or en route to a health care facility were managed according drafted triage guidelines.

scholarly journals Disinfection efficacy studies on three different disinfection methods in health care facilities by ATP method

2015 ◽  
Author(s):  
Harry Zhuang ◽  
BCIT School of Health Sciences, Environmental Health ◽  
Helen Heacock ◽  
Fred Shaw
Keyword(s):  
Health Care ◽  
Medical Equipment ◽  
Health Care Facilities ◽  
Relative Light Unit ◽  
Monitoring Methods ◽  
Log Reduction ◽  
Disinfection Methods ◽  
Care Facilities ◽  
The Mean ◽  
High Level

  Objectives: Nosocomial infection has always been a significant topic in the field of public health. The disinfection procedures involved in health care facilities are extremely important to prevent potential transmission of diseases. Therefore, this study was performed to compare the disinfection efficacy between three different disinfection methods (Accel wipes, Hubscrub industrial washer, and Steam vapor) on three pieces of non-critical medical equipment: wheelchairs, mattresses and bath chairs. Methods: The method used to evaluate the disinfection efficacy compared the reduction of contaminants count in the relative light unit using ATP monitoring methods. 30 samples of each of the three types of medical equipment were swabbed pre-disinfection and post-disinfection using the three disinfection methods. The recorded reduction number was then converted using log transformation. Statistical analysis was conducted using NCSS to assess differences between the disinfection methods. Results: The mean log-reduction of disinfection for Accel wipes, Hubscrub, and steam vapor were 1.067, 1.490, and 1.485 respectively. Steam vapor and Hubscrub displayed statistically significantly better disinfection efficacy compared to Accel wipes in terms of log reduction (overall p=0.000002). Conclusion: Hubscrub and steam vapor are better disinfectants compared to Accel wipes in terms of mean log reduction values; however, all three disinfection methods demonstrated effectiveness when cleaning and disinfecting non-critical medical equipment. For critical medical equipment, steam vapor and Hubscrub industrial washing are effective while Accel wipes do not meet the standards of high-level disinfection. As a result, combination usages of all three disinfection methods are recommended at health care facilities based on the categories of the medical equipment.  

scholarly journals The Correlation Between ATP Measurement and Microbial Contamination of Inanimate Surfaces

2021 ◽  
Author(s):  
Andreas van Arkel ◽  
Ina Willemsen ◽  
Jan Kluytmans
Keyword(s):  
Health Care ◽  
Nursing Home ◽  
Microbial Contamination ◽  
Bacterial Load ◽  
Agar Plate ◽  
Health Care Facilities ◽  
Home Setting ◽  
Care Facilities ◽  
Nursing Home Setting ◽  
The Mean

Abstract Background:The objective of this study was to determine the correlation between adenosine triphosphate (ATP) measurements and microbial contamination using a standardized method. Methods: ATP measurements and aerobic colony counts (ACC’s) were conducted on 10 pre-defined fomites in a hospital and nursing home setting. Per fomite two ATP measurements and two agar plate measurements were conducted, each measurement was conducted on a 25 cm2 surface. Both measurements were compared and analyzed for correlation. Results: In total 200 paired measurements were conducted, 200 ATP measurements and 200 ACC’s. The mean of all ATP measurements tested on the same surface was calculated, as was for all 200 ACC’s. There was a strong correlation between the mean of two ATP measurements on two different sites on the same fomite (R=0.800, p<0.001) as well as between two ACC measurements on the same fomite (R=0.667, p<0.001). A much weaker correlation was found between RLU values and ACC’s (R=0.244, p<0.001). Conclusions: Reproducibility of ATP measurements and ACC’s on the same fomite was good. However, the correlation between RLU values and ACC’s on hospital surfaces was much lower. This may be explained by the wide variety of biological material that is measured with ATP, of which the bacterial load is only one of many components. ATP measurement can be used to give a quantifiable outcome for the rating of cleanliness in health care facilities, however the results cannot be translated into the level of microbial contamination.

Eszopiclone ingestions reported to Texas poison control centers, 2005—2006

2007 ◽  
Vol 26 (10) ◽  
pp. 795-800 ◽  
Author(s):  
Mathias B. Forrester
Keyword(s):  
Attempted Suicide ◽  
Healthcare Facility ◽  
Threshold Dose ◽  
Poison Control ◽  
Medical Outcome ◽  
Limited Information ◽  
Poison Control Centers ◽  
Experimental Toxicology ◽  
The Mean ◽  
Moderate Effect

Eszopiclone is a nonbenzodiazepine hypnotic for the treatment of insomnia and classified as schedule IV controlled substance. Limited information exists on eszopiclone ingestions reported to poison control centers. The distribution of eszopiclone ingestions reported to Texas poison control centers during 2005—2006 was determined for various factors. In addition, triage guidelines for the management of such ingestions were drafted. Of 525 total eszopiclone ingestions, 259 involved coingestants. Of coingestant cases, 78.8% involved suspected attempted suicide and 90.7% were managed at a healthcare facility. Of 266 ingestions of eszopiclone alone, 40.2% were suspected attempted suicide and 62.0% were managed at a healthcare facility. A final medical outcome and dose ingested were known for 60 ingestions of eszopiclone alone. The mean dose was 28.3 mg (range 0.3—210 mg). Ingestions of eszopiclone alone of ≤6 and >6 mg differed with respect to the proportion involving suspected attempted suicide (0.0% versus 64.7%), final medical outcome of minor or moderate effect (38.5% versus 67.6%) and management at a healthcare facility (34.6% versus 91.2%). Using 6 mg as a threshold dose for referral to a healthcare facility, 78% of cases not already at/en route to a healthcare facility were managed according drafted triage guidelines. Human & Experimental Toxicology (2007) 26, 795— 800

Adult glyburide ingestions reported to Texas poison control centers, 1998—2005

2007 ◽  
Vol 26 (7) ◽  
pp. 563-571 ◽  
Author(s):  
MB Forrester
Keyword(s):  
Health Care ◽  
Statistical Significance ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
Poison Control ◽  
Poison Control Center ◽  
Limited Information ◽  
Control Center ◽  
Poison Control Centers

Limited information exists on potentially adverse adult glyburide ingestions reported to poison control centers. Using adult glyburide ingestions reported to Texas poison control centers during 1998—2005, the proportion of cases involving serious outcomes was determined for selected variables and evaluated for statistical significance by calculating the rate ratio (RR) and 95% confidence interval (CI). Of 126 cases identified, 49 (39%) involved serious outcomes. Serious outcomes were significantly more likely to occur with a maximum dose > 24 mg (RR 4.74, 95% CI 1.74—14.90) or >4 tablets (RR 3.27, CI 1.57—7.31), where the circumstances of the exposures involved self-harm or malicious intent (RR 2.44, CI 1.33—4.46), or the patient was already at or en route to a health care facility when the poison control center was contacted (RR 12.89, CI 4.00—66.12) or referred to a health care facility by the poison control center (RR 12.21, CI 3.53—65.01). The severity of the outcome associated with adult glyburide ingestions depended on the dose and the circumstances of the ingestion. The management of patients with severe outcomes was more likely to involve health care facilities. Such information is useful for creating triage guidelines for the management of adult glyburide ingestions. Human & Experimental Toxicology (2007) 26: 563—571.

scholarly journals Burn Injuries Related to E-Cigarettes Reported to Poison Control Centers in the United States, 2010-2019

2020 ◽  
Author(s):  
BAOGUANG WANG ◽  
Sherry T. Liu ◽  
Brian Rostron ◽  
Camille Hayslett
Keyword(s):  
United States ◽  
Health Care ◽  
Young Adults ◽  
The United States ◽  
Health Care Facilities ◽  
Burn Injuries ◽  
Poison Control ◽  
Poison Control Centers ◽  
Life Threatening ◽  
The U.S

Abstract Background: United States (U.S.) national data indicate that 2,035 individuals with burn injuries from e-cigarette explosions presented to U.S. hospital emergency departments (EDs) in 2015-2017. This national estimate is valuable for understanding the burden of burn injuries from e-cigarette explosions among individuals who presented to EDs. However, little is known about individuals who experienced e-cigarette-related burns but may not present to EDs or health care facilities.Findings: We analyzed data from the National Poison Data System (NPDS) to describe frequency and characteristics of e-cigarette-related burn cases in the U.S. in 2010-2019. NPDS contains information collected during telephone calls to poison control centers (PCCs) across the U.S., including e-cigarette-related burns and other unintended events. During 2010-2019, 19,306 exposure cases involving e-cigarettes were documented in NPDS. Of those, 69 were burn cases. The number of burn cases increased from one in 2011 to a peak of 26 in 2016, then decreased to three in 2019. The majority of the burn cases occurred among young adults aged 18-24 years (29.0%; n=20) and adults aged 25 years or older (43.5%; n=30); 14.4% occurred among individuals ≤ 17 years old. Of the 69 burn cases, 5.8% (n=4) were admitted to a hospital; 65.2% (n=45) were treated and released; 15.9 % (n=11) were not referred to a health care facility (HCF); 4.4% (n=3) refused referral or did not arrive at an HCF; and 8.7% (n=6) were lost to follow-up or left the HCF against medical advice. Nearly one-third (30.4%; n=21) of the cases had a minor effect (symptoms resolved quickly), 47.8% (n=33) had a moderate effect (symptoms were more pronounced and prolonged than in minor cases, but not life-threatening), and 2.9% (n=2) had a major effect (life-threatening symptoms).Conclusions: Approximately one-fifth of e-cigarette-related burn cases reported to PCCs were not referred to or did not arrive at an HCF. Some burn cases had serious medical outcomes. The burn cases mostly affected young adults and adults aged 25 years or older. The number of burn cases in NPDS represents a small portion of e-cigarette-related burn cases but it can serve as a complementary data source to traditional injury surveillance systems.

Cases of pediatric ingestion of celecoxib reported to Texas poison control centers in 2000–2007

2009 ◽  
Vol 28 (4) ◽  
pp. 191-194 ◽  
Author(s):  
MB Forrester
Keyword(s):  
Abdominal Pain ◽  
Healthcare Facility ◽  
Poison Control ◽  
Minor Effect ◽  
Clinical Effects ◽  
Medical Outcome ◽  
Clinical Factors ◽  
Poison Control Centers

Little data exist regarding pediatric celecoxib ingestions. This study described the pattern of pediatric celecoxib ingestions reported to poison control centers. Cases were isolated celecoxib ingestions by patients aged 0–5 years during 2000–2007 reported to Texas poison control centers. The distribution of cases was described with respect to demographic and clinical factors. Of the 177 total patients, dose ingested in milligrams was reported for 92 patients. Mean reported dose was 305.5 mg (range 10–2300 mg). Of those 92 cases, distribution by management site was 89.1% on site, 6.5% already at/en route to healthcare facility and 4.3% referred to healthcare facility. Final medical outcome was no effect for 95.7% cases and minor effect for 4.3% cases. Specific clinical effects reported (in only one case each) were rash, abdominal pain, vomiting, agitation/irritability, and drowsiness. All of the pediatric celecoxib ingestions reported to Texas poison control centers resulted in no or minor effect.

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