Bupropion Overdose: QTc Prolongation and its Clinical Significance

2003 ◽  
Vol 37 (7-8) ◽  
pp. 999-1002 ◽  
Author(s):  
Geoffrey K Isbister ◽  
Corrine R Balit
Keyword(s):  
Cardiac Toxicity ◽  
New South ◽  
Clinical Effects ◽  
Qtc Prolongation ◽  
South Wales ◽  
Information Center ◽  
The Mean ◽  
A Prospective Study ◽  
Poisons Information

OBJECTIVE: To investigate the cardiotoxicity of bupropion hydrochloride in deliberate self-poisoning. METHODS: A prospective study was conducted in a national poisons information center (PIC) of cases of adult deliberate self-poisoning with medical record follow-up of the patients. Fifty-nine cases of bupropion deliberate self-poisoning managed in the hospital, in which the New South Wales PIC was contacted for advice, were evaluated from November 2000 through July 2001. Clinical effects and electrocardiographic (ECG) parameters (QRS, QT, QTc) were the main outcome measures. RESULTS: ECGs were available for 17 of the 59 patients for analysis, 9 patients (53%) were women, and median patient age was 28 years (interquartile range 22–37). The mean ± SD ingested bupropion dose was 3.8 ± 3.1 g. Tachycardia occurred in 13 patients (76%; 95% CI 50 to 93) and hypertension in 8 patients (47%). There were no reports of hypotension or arrhythmias. There was a significantly increased QTc of 461 ± 34 msec in the patients with bupropion overdose compared with previously developed controls; 13 of the 17 cases had a QTc >440 msec (76%; 95% CI 50 to 93). The uncorrected QT interval did not differ from that of controls. CONCLUSIONS: A moderately prolonged QTc (>440 msec) is common in bupropion overdose. However, this may not be a result of intrinsic cardiac toxicity, but overcorrection of the QTc due to the tachycardia that occurs. It is important that the QTc is interpreted with caution in overdoses of agents that cause significant tachycardia (>100 beats/min).

scholarly journals High risk groups for severe COVID-19 in a whole of population cohort in Australia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bette Liu ◽  
Paula Spokes ◽  
Wenqiang He ◽  
John Kaldor
Keyword(s):  
Socioeconomic Status ◽  
New South ◽  
Severe Disease ◽  
Risk Groups ◽  
Prevention Strategies ◽  
Complete Case ◽  
Relative Risks ◽  
South Wales ◽  
Hazard Ratios

Abstract Background Increasing age is the strongest known risk factor for severe COVID-19 disease but information on other factors is more limited. Methods All cases of COVID-19 diagnosed from January–October 2020 in New South Wales Australia were followed for COVID-19-related hospitalisations, intensive care unit (ICU) admissions and deaths through record linkage. Adjusted hazard ratios (aHR) for severe COVID-19 disease, measured by hospitalisation or death, or very severe COVID-19, measured by ICU admission or death according to age, sex, socioeconomic status and co-morbidities were estimated. Results Of 4054 confirmed cases, 468 (11.5%) were classified as having severe COVID-19 and 190 (4.7%) as having very severe disease. After adjusting for sex, socioeconomic status and comorbidities, increasing age led to the greatest risk of very severe disease. Compared to those 30–39 years, the aHR for ICU or death from COVID-19 was 4.45 in those 70–79 years; 8.43 in those 80–89 years; 16.19 in those 90+ years. After age, relative risks for very severe disease associated with other factors were more moderate: males vs females aHR 1.40 (95%CI 1.04–1.88); immunosuppressive conditions vs none aHR 2.20 (1.35–3.57); diabetes vs none aHR 1.88 (1.33–2.67); chronic lung disease vs none aHR 1.68 (1.18–2.38); obesity vs not obese aHR 1.52 (1.05–2.21). More comorbidities was associated with significantly greater risk; comparing those with 3+ comorbidities to those with none, aHR 5.34 (3.15–9.04). Conclusions In a setting with high COVID-19 case ascertainment and almost complete case follow-up, we found the risk of very severe disease varies by age, sex and presence of comorbidities. This variation should be considered in targeting prevention strategies.

scholarly journals Biological and clinical impact of hemangioblastoma-associated peritumoral cysts in von Hippel-Lindau disease

2016 ◽  
Vol 124 (4) ◽  
pp. 971-976 ◽  
Author(s):  
Kristin Huntoon ◽  
Tianxia Wu ◽  
J. Bradley Elder ◽  
John A. Butman ◽  
Emily Y. Chew ◽  
...  
Keyword(s):  
Clinical Impact ◽  
Anatomical Location ◽  
Von Hippel Lindau ◽  
Study Enrollment ◽  
Common Location ◽  
Younger Age ◽  
The Mean ◽  
A Prospective Study ◽  
Vhl Disease

OBJECT Peritumoral cysts are frequently associated with CNS hemangioblastomas and often underlie neurological morbidity and mortality. To determine their natural history and clinical impact, the authors prospectively analyzed hemangioblastoma-associated peritumoral cysts in patients with von Hippel-Lindau (VHL) disease. METHODS Patients with VHL disease who had 2 or more years of follow-up and who were enrolled in a prospective study at the National Institutes of Health were included. Serial prospectively acquired laboratory, genetic, imaging, and clinical data were analyzed. RESULTS One hundred thirty-two patients (of 225 in the VHL study with at least 2 years of follow-up) had peritumoral cysts that were followed for more than 2 years (total of 292 CNS peritumoral cysts). The mean age at study entrance was 37.4 ± 13.1 years ([mean ± SD], median 37.9, range 12.3–65.1 years). The mean follow-up was 7.0 ± 1.7 years (median 7.3, range 2.1–9.0 years). Over the study period, 121 of the 292 peritumoral cysts (41.4%) became symptomatic. Development of new cysts was associated with a larger number cysts at study enrollment (p = 0.002) and younger age (p < 0.0001). Cyst growth rate was associated with anatomical location (cerebellum cysts grew faster than spine and brainstem cysts; p = 0.0002 and p = 0.0008), younger age (< 35 years of age; p = 0.0006), and development of new neurological symptoms (p < 0.0001). Cyst size at symptom production depended on anatomical location (p < 0.0001; largest to smallest were found, successively, in the cerebellum, spinal cord, and brainstem). The most common location for peritumoral cysts was the cerebellum (184 cysts [63%]; p < 0.0001). CONCLUSIONS Peritumoral cysts frequently underlie symptom formation that requires surgical intervention in patients with VHL disease. Development of new cysts was associated with a larger number of cysts at study enrollment and younger age. Total peritumoral cyst burden was associated with germline partial deletion of the VHL gene.

Vitamin and mineral supplement exposures: cases reported to Australia’s largest Poisons Information Centre, 2014-15 to 2018-19

2021 ◽  
pp. 1-15
Author(s):  
Usha Luckock ◽  
Joanna Harnett ◽  
Rose Cairns
Keyword(s):  
New South ◽  
High Strength ◽  
Mineral Supplement ◽  
Information Centre ◽  
The Public ◽  
Mineral Supplements ◽  
South Wales ◽  
Unit Dose ◽  
Potential Risks ◽  
Poisons Information

ABSTRACT Vitamin and mineral supplements (VMS) are widely available and commonly used. Little is known about patterns of poisoning exposures to VMS in the Australian population. We performed a retrospective study of calls to the New South Wales Poisons Information Centre (NSWPIC), July 2014-June 2019. NSWPIC is Australia’s largest PIC, taking approximately 100,000 calls/year (50% of Australian poisoning calls) from healthcare professionals and members of the public. We conducted additional analyses on iron exposures due to their high risk of acute toxicity. There were 10 944 VMS exposures reported to NSWPIC during the study period, increasing 9.6% per annum over a five year period (95%CI, 7.2 – 12.1%). Toddlers (1-4 years) accounted for 41.5% (4546) of cases. Agents most commonly involved were multivitamins (n=3610), Vitamin D (n=2080), iron (n=1533), and magnesium (n=804). In 17.7% (1934) of cases the call originated from hospital or the patient was referred to hospital by NSWPIC. Iron exposures increased by 14.0% per year (95%CI, 9.5 – 18.5%), and most were associated with high strength products (>45 mg elemental iron per unit dose, n=1036). Iron exposures were hospitalised in 38% of cases (n=583). We conclude that vitamin and mineral supplement exposures are increasing in Australia. Although most exposures can be managed at home, many required hospitalisation. Iron exposures are increasing and had higher rates of hospitalisation than other agents. Vitamin and mineral supplements are often considered safe and without the potential for adverse effects, highlighting the importance of public education into the potential risks of misuse of these products.

scholarly journals TOLTERODINE IMPROVES QUALITY OF LIFE IN PATIENTS WITH AN OVERACTIVE BLADDER, WITH OR WITHOUT URINARY INCONTINENCE: A PROSPECTIVE MULTICENTER STUDY

2010 ◽  
Vol 22 (1) ◽  
pp. 5
Author(s):  
F. Mantovani ◽  
G. Bozzini ◽  
P. Acquati ◽  
S.S. Di Pierro ◽  
M.G. Spinelli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Overactive Bladder ◽  
Clinical Effects ◽  
Health Questionnaire ◽  
Prospective Multicenter Study ◽  
Study Materials ◽  
Trial Entry ◽  
The Mean

AIMS: In order to analyse the effect of tolterodine on the Quality of life (QoL) of patients with overactive bladder (OB) we conducted a prospective multicentre clinical study. MATERIALS AND METHODS: Subjects were questioned at entry and 4, 12 and 24 weeks later about the number of micturitions and incontinent and urgency episodes/day, using a micturition diary. The mean volume voided per micturition and the number of pads used per day was also recorded. The QoL was measured using the Kings Health Questionnaire (KHQ) and the Incontinence Impact Questionnaire (IIQ). A total of 179 patients entered the study: 59 dropped out (4 due to lack of efficacy, 10 due to adverse events, 25 because of lack of interest in the study/other reason and 20 were lost at follow up), leaving 120 patients for analysis. One hundred and eight patients (90%) were female, their mean age was 56.5 years (SD 11.2); 87 had never received treatment for OB/UI (80.6%) and their mean weight was 70.0 Kg (SD 12.7). RESULTS: The mean number of micturitions/day was 9.3 at trial entry and it decreased to 6.8 by the end of the study. The corresponding values for the number of urge episodes, incontinence episodes and number of pads used per day were 3.5, 2.7 and 1.2 and 0.8, 0.9 and 0.4 respectively. The mean volume voided per micturition increased from 146 ml. to 178 ml. All the differences between trial entry and end of study values were statistically significant (p&lt;0.05). Considering the results of the KHQ, the values of all the different areas/domini (?) decreased markedly and in a statistically significant way between the start of treatment and the end of study evaluations. Similar findings emerged when we considered values of the IIQ. The decrease was constant and marked during the first three months and remained constant thereafter. CONCLUSIONS: This study, conducted in a population of subjects with dry and wet OB, shows that tolterodine given for six months lowers the frequency of urgency episodes and incontinence episodes without troublesome adverse effects. These clinical effects are mirrored in the QoL, KHQ and IIQ questionnaire scores, which improved by about 50% over the same period.

How adolescents perceive that community-based exercise improves their well-being

2017 ◽  
Vol 25 (5) ◽  
pp. 456-459
Author(s):  
Kevin Rourke ◽  
Coralie J Wilson
Keyword(s):  
New South ◽  
Well Being ◽  
Parental Consent ◽  
Community Based ◽  
Team Games ◽  
South Wales ◽  
Perceived Benefit ◽  
The Mean ◽  
Mental Well Being ◽  
Energy Survey

Objectives: To determine if adolescents perceive community-based exercise as beneficial to their well-being and in what ways. Methods: A New South Wales Police Citizens Youth Club ran a four-week fitness course. The classes involved: 1) sports including basketball and soccer, 2) non-contact boxing drills, and 3) games, both team games such as dodgeball and non-team games such as line tag. Parental consent to offer a survey at the completion of the course was requested during registration. The survey was the Warwick Edinburgh Mental Well-being Scale; it was minimally modified to measure perceived benefit to mental well-being instead of actual benefit. Results: Thirty-one high school adolescents, ages 13–18, completed the survey. As a group, participants reported that they believed their well-being had improved after the course. The mean score for each survey item showed an improvement in every area of mental well-being for this sample of adolescents. Thirty-two per cent of adolescents reported having less energy. Survey scores indicated a statistically significant improvement in perceived well-being ( p<0.0001). Conclusions: The results of this study suggest that four weeks of community-based exercise improves perceived mental well-being in adolescent participants.

The breeding behaviour of the endangered regent honeyeater, Xanthomyza phrygia, near Armidale, New South Wales

1998 ◽  
Vol 46 (2) ◽  
pp. 153 ◽  
Author(s):  
Damon L. Oliver
Keyword(s):  
New South ◽  
New South Wales ◽  
Population Level ◽  
Similar Rate ◽  
Nest Construction ◽  
Aggressive Interactions ◽  
Breeding Behaviour ◽  
South Wales ◽  
The Mean ◽  
Breeding Seasons

The regent honeyea ter, Xanthomyza phrygia, is an endangered woodland bird whose range and population size have decreased in the last thirty years. Suggested reasons for this decline include abnormal breeding behaviour, poor reproductive output, and excessive inter- and intra-specific aggression. This study investigated the breeding behaviour and aggressive interactions of regent honeyeaters during the nest construction, incubation, nestling, and fledgling stages in two consecutive breeding seasons in the Bundarra–Barraba region near Armidale, New South Wales. The female was entirely responsible for nest construction and incubation, which is typical of many honeyeaters. Both parents fed the nestlings, and at a similar rate, although only the female brooded chicks on the nest. Both parents fed the fledglings. The mean frequency at which nestlings (23 times per hour) and fledglings (29 times per hour) were fed is the highest published rate of any non-cooperative honeyeater. Breeding males were involved in significantly more aggressive interactions with conspecifics and other nectarivores than were females, although the overall percentage of day-time spent in aggression for both sexes was low (2.5%). It appears that abnormal breeding behaviour, poor reproductive effort, or excessive aggression are not experienced by this species in northern New South Wales, and that other factors are likely to be responsible for its current low population level.

scholarly journals Returning to Unpaid Work after Stroke: The Psychosocial Outcomes in Stroke Cohort Study

2019 ◽  
Vol 47 (1-2) ◽  
pp. 1-7
Author(s):  
Cheryl Carcel ◽  
Sara Farnbach ◽  
Beverley M. Essue ◽  
Qiang Li ◽  
Nick Glozier ◽  
...  
Keyword(s):  
Sex Differences ◽  
Cohort Study ◽  
New South ◽  
Psychosocial Outcomes ◽  
Unpaid Work ◽  
Stroke Recovery ◽  
Paid Work ◽  
Unpaid Care ◽  
South Wales

Background: While returning to paid work is a crucial marker of stroke recovery, little is known about the differences in unpaid work by sex following stroke. We aimed to determine the sex differences in participation in unpaid work 12 months after stroke. Methods: Psychosocial outcomes in stroke were a prospective, multicentre observational study that recruited individuals, 18–64 years, within 28 days of stroke from New South Wales, Australia. Unpaid work was defined as ≥5 h per week of one or more of: unpaid domestic work for the household; unpaid care of others; looking after own children without pay or looking after someone else’s children without pay. Data was collected before stroke, 28 days (baseline), 6 and 12 months follow-up. Results: Eighty per cent of women and 52% of men engaged in ≥5 h per week of unpaid work before stroke. At 12 months after, 69% of women and 53% of men completed ≥5 h of unpaid work per week. For women, there was a significant association between participation in unpaid work at 12 months and having financially dependent children (OR 2.67; 95% CI 1.08–6.59). A return to unpaid work in men was associated with participation in unpaid work before stroke (OR 3.74; 95% CI 2.14–6.53). Conclusions: More women are engaged in unpaid work before and at 12 months after stroke, but there is a reduction in the proportion of women returning to unpaid work at 12 months not seen in men. Consideration may need to be given to the development of rehabilitation strategies targeted at the specific needs of stroke survivors.

Characterisation of naturalised strains of Trifolium subterraneum var. brachycalycinum cv. Clare in northern New South Wales

1994 ◽  
Vol 34 (1) ◽  
pp. 33 ◽  
Author(s):  
GM Lodge
Keyword(s):  
Seed Weight ◽  
New South ◽  
New South Wales ◽  
Trifolium Subterraneum ◽  
Summer Rainfall ◽  
Median Number ◽  
South Wales ◽  
The Mean ◽  
Floral Characters ◽  
Number Of Seeds

Burrs were collected from paddocks on 3 properties in northern New South Wales where the age of the Trifolium subterraneum var. brachycalycinum cv. Clare swards varied from 19 to 28 years. At 1 site burrs were also sampled from swards sown 2 and 10 years previously. Twenty seedlings from these burrs and 20 plants of certified cv. Clare were grown as spaced plants in a nursery. These were assessed for vegetative and floral characters, flowering time, number of seeds per burr, seed weight, and percentage hardseed after storage at 25/25�C for 6 months and 25/45�C for a further 6 months. For most plants the mean number of days from sowing to first flower was similar to that of Clare. Compared with the naturalised strains, Clare had the lowest (P<0.05) mean number of seeds per burr: about 25% below the mean of the strains (2.7 seeds per burr). While the lowest mean seed weights of the strains were not significantly different from those of Clare, the seed weights of plants from 3 sites were higher (P<0.05) than those of Clare. After storage for either 6 or 12 months, hardseed levels were also lowest (P<0.05) for Clare. Plants from the 2-year-old sward had the same median number of seeds per burr (2.0) as Clare. As sward age increased, the median number of seeds per burr increased to 2.8. Hardseed percentages were lowest for plants of Clare and for those from the 2-year-old sward after 6 months, and for Clare after 12 months. These studies indicated the presence of divergent strains in old swards of Clare in a summer rainfall environment. Natural selection among variability within Clare is the most likely reason for the development of these strains in an environment marginal for the long-term persistence of this softseeded cultivar. Although strains had the same vegetative and floral markings as Clare, differences in ecologically important characters such as number of seeds per burr, seed weight, and hardseededness may result in plants that are better adapted to the environment in which they evolved. From these studies 23 plants of T. subterraneum var. brachycalycinum were selected for further evaluation.

Effect of prolonged undernutrition on the recovery and reproductive performance of maiden Merino ewes

1967 ◽  
Vol 7 (24) ◽  
pp. 7 ◽  
Author(s):  
P McInnes ◽  
TJ Grainger ◽  
MD Smith
Keyword(s):  
Body Weight ◽  
Reproductive Performance ◽  
New South ◽  
New South Wales ◽  
The Other ◽  
First Year ◽  
Treatment Groups ◽  
South Wales ◽  
Feeding Trials ◽  
The Mean

Data are presented on the recovery and reproductive performance of 2 1/2-year-old maiden Merino ewes after a prolonged period of undernutrition. The 217 sheep had been hand-fed on a submaintenance ration in pen feeding trials at Glenfield, New South Wales. During the seven months of the trials they had lost 6 kg (28 to 22 kg) body weight. They were transported to Condobolin in south-western New South Wales, divided into two treatment groups and run on good quality pastures. One group was joined immediately (May 1959) and again ten months later, and the other group was mated after six months at Condobolin (in October 1959) and again 12 months later. The ewes recovered rapidly. The mean weight of both groups had reached 30 kg within six weeks and 40 kg within six months. In the first year 73 of the 100 May-mated ewes bore lambs, but only 38 of these lambs were weaned. Ewes bearing lambs had a higher body weight at the start of joining and gained more during joining than the barren ewes. At the other three joinings (October 1959, May 1960, October 1960) lambing percentage was from 86-89 and weaning percentage from 62-69-both normal for the district. The proportion of twin lambs (3-6 per cent) was low. Wool weight in 1959 was not affected by time of mating or by pregnancy.

Survey of paddock size and stock water supplies in the Western Riverina District of New South Wales.

1978 ◽  
Vol 1 (2) ◽  
pp. 167
Author(s):  
VR Squires
Keyword(s):  
Fresh Water ◽  
Vegetation Type ◽  
New South ◽  
New South Wales ◽  
Current Level ◽  
Vegetation Types ◽  
Temporary Waters ◽  
South Wales ◽  
Saline Waters ◽  
The Mean

In order to assess the current level of stock watering facilities on pastoral properties within the western Riverina district of New South Wales and to relate this information to paddock size and vegetation type, large of areas of land (785,000 ha) within the region were surveyed. Paddock boundaries and the location of watering points were plotted. Watering points were classified as to type. Three broad vegetation types were represented: chenopod shrublands (Atriplex and Maireana spp.) degraded grasslands (Stipal Danthonia spp.), and mallee woodlands (Eucalyptus socinlis F. Meull., E, oleosa, F. Meull.) Size of paddocks was related to the dominant vegetation type. On the degraded grasslands in the eastern part of the study area the mean paddock size was 746 ha; on the chenopod shrublands it was 780 ha, and in the Malleedominated areas it was 1,553 ha. The number of permanent watering points per paddock varied from one to four. Less than half the paddocks (43%) had fresh water available as well as saline waters from sub-artesian bores. Almost half the paddocks (47%) were so large, or the watering points so positioned, that the sheep would need to walk more than 3 km to reach the most remote parts of the paddock when temporary waters had dried up. Overall 18% of the land in the non- mallee areas was more than 3 km from permanent water. Therefore the majority of the land could be used in all seasons. Generally the central and northern Riverina district is adequately watered. It would be uneconomic to supply permanent water in the mallee woodlands. In some paddocks in the chenopod dominated area extra watering points may be justified.

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