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Systemic ketamine toxicity following dermal application of a compounded pain cream.
Am J Emerg Med
December 2024
Cook County Health, Chicago, IL, USA.
Ketamine is an NMDA receptor antagonist commonly used as a dissociative anesthetic and analgesic. Though it is conventionally administered via the intravenous, intramuscular, or intranasal route, use as a compounded analgesic cream is becoming increasingly common. This is a case report of a 61-year-old man who was detained by the police for erratic driving.
View Article and Find Full Text PDFPhenobarbital use in pediatric perampanel overdose with coma, respiratory compromise.
Toxicol Rep
December 2024
University of Pittsburgh School of Medicine, Department of Critical Care Medicine, St Joseph's Children's Hospital, Tampa, FL, USA.
Article Synopsis
- Perampanel (Fycompa) is an antiepileptic drug used to treat generalized seizures, but there's limited knowledge on how to handle overdoses, especially in kids.
- A case study describes a pediatric patient who experienced severe symptoms, including respiratory failure and coma, after ingesting a high dose of perampanel.
- Clinicians need to recognize overdose symptoms and be ready for immediate interventions like resuscitation, as there are no known reversal agents and the medication has a very long half-life of 105 hours.
Burning gig, rewarding risk: Effects of dual exposure to incentive structure and heat condition on risky driving among on-demand food-delivery motorcyclists in Kaohsiung, Taiwan.
Accid Anal Prev
February 2025
Department of City and Regional Planning and Institute of Transportation Studies, University of California, Berkeley, CA 94720, USA. Electronic address:
The gig economy, characterized by short-term, task-based work facilitated via digital platforms, has raised various occupational safety concerns, including road safety risks and heat exposure faced by on-demand food delivery (ODFD) workers. Often using open modes of transportation, such as motorcycles and bicycles, these workers have minimal physical protection and direct environmental exposure while working long hours on the road, interacting with larger vehicles. Prior research has suggested that their road risks result from prevalent risky driving incentivized by platform-established business models, but quantitative evidence is lacking.
View Article and Find Full Text PDFA 75-year-old male with a history of Waldenström macroglobulinemia (WM), diagnosed in 2022, presented with several months of progressive blurred vision and floaters in his right eye, impairing his ability to drive, particularly at night. The ophthalmologic evaluation revealed vitreous haemorrhage and sub-retinal pigment epithelial lesions in the superonasal and inferonasal quadrants of the right eye. A pars plana vitrectomy with vitreous biopsy was performed, which was consistent with ocular involvement by WM.
View Article and Find Full Text PDFPhosphate Binder Impairs Levothyroxine Absorption in a Hypothyroid Patient With End-Stage Renal Disease.
Cureus
October 2024
Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA.
End-stage renal disease (ESRD) patients have an increased incidence of hypothyroidism, and those with serum thyroid stimulating hormone (TSH) levels above the reference range have excess mortality, increased cardiovascular disease, impaired health-related quality of life, and altered body composition. We report a patient with ESRD on chronic hemodialysis and Hashimoto's disease, who is on chronic levothyroxine therapy. Despite a high levothyroxine dose of 2.
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