Document Detail


The Toxicology Investigators Consortium Case Registry--the 2011 experience.
MedLine Citation:
PMID:  23055123     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In 2010, the American College of Medical Toxicology established its Case Registry, the Toxicology Investigators Consortium (ToxIC). ToxIC is a prospective registry, which exclusively compiles suspected and confirmed toxic exposure cases cared for at the bedside by medical toxicologists at its participating sites. The Registry aims to fulfill two important gaps in the field: a real-time toxicosurveillance system to identify current poisoning trends and a powerful research tool in toxicology. ToxIC allows extraction of information from medical records making it the most robust multicenter database on chemical toxicities in existence. All cases seen by medical toxicologists at participating institutions were entered in a database. Information characterizing patients entered in 2011 was tabulated. 2010 data was also included so that cumulative total numbers could be described as well. The current report is a summary of the data collected in 2011 in comparison to 2010 entries and also includes cumulative data through December 31st, 2011. During 2011, 28 sites with 49 specific institutions contributed a total of 6,456 cases to the Registry. The total number of cases entered into the registry at the end of 2011 was 10,392. Emergency departments remained the most common source of consultations in 2011, accounting for 53 % of cases. The most common reason for consultation was for pharmaceutical overdoses, which occurred in 48 % of patients, including intentional (37 %) and unintentional (11 %) exposures. The most common classes of agents were sedative-hypnotics (1,492 entries in 23 % of cases), non-opioid analgesics (1,368 cases in 21 % of cases), opioids (17 %), antidepressants (16 %), stimulants/sympathomimetics (12 %), and ethanol (8 %). N-acetylcysteine was the most commonly administered antidote during 2011, similar to 2010, followed by the opioid antagonist naloxone, sodium bicarbonate, physostigmine and flumazenil. Anti-crotalid Fab fragments (CroFab) were administered in 106 out of 131 cases in which an envenomation occurred. There were 35 deaths recorded in the Registry during 2011. The most common associated agents, including when reported as sole agent or in combination with other agents, were opioids and analgesics (acetaminophen, aspirin, NSAIDS) with ten and eight deaths, respectively. Oxycodone was reported in six of the ten opioid-related deaths and heroin in three. Acetaminophen was the most common single agent reported overall being identified in all eight of the death cases attributed to analgesics. There were significant trends identified during 2011. Cases involving designer drugs including psychoactive bath salts and synthetic cannabinoids increased substantially from 2010 to 2011. The psychoactive bath salts were responsible for a large increase in stimulant/sympathomimetic-related cases reported to the Registry in 2011 with overall numbers doubling from 6 % of all Registry entries in 2010 to 12 % in 2011. Entries involving psychoactive drugs of abuse also increased twofold from 2010 to 2011 jumping 3 to 6 %, primarily due to increasing frequency of synthetic cannabinoid ("K2") related intoxications as 2011 progressed. The 2011 Registry included over 600 ADR's (10 % of Registry Cases) with 115 agents causing at least 2 ADR's. This is up from only 3 % of cases (116 total cases) in 2010. The ToxIC Case Registry continues to grow. At the end of 2011, over 10,000 cases had been entered into the Registry. As demonstrated by the trends identified in psychoactive bath salt and synthetic cannabinoid reports, the Registry is a valuable toxicosurveillance and research tool. The ToxIC Registry is a unique tool for identifying and characterizing confirmed cases of significant or potential toxicity or complexity to require bedside consultation by a medical toxicologist.
Authors:
Timothy J Wiegand; Paul M Wax; Tayler Schwartz; Yaron Finkelstein; Rachel Gorodetsky; Jeffrey Brent;
Related Documents :
2177103 - Sarcoidosis of the cauda equina: a report of three cases.
15990683 - The molecular characterization of clinical isolates from indian kala-azar patients by m...
19094133 - Two cases of factitial panniculitis induced by electroacupuncture.
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of medical toxicology : official journal of the American College of Medical Toxicology     Volume:  8     ISSN:  1937-6995     ISO Abbreviation:  J Med Toxicol     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-30     Completed Date:  2013-05-02     Revised Date:  2013-12-04    
Medline Journal Info:
Nlm Unique ID:  101284598     Medline TA:  J Med Toxicol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  360-77     Citation Subset:  IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Acetaminophen / poisoning
Acetylcysteine / therapeutic use
Adolescent
Adult
Aged
Analgesics, Non-Narcotic / poisoning
Analgesics, Opioid / poisoning*
Antidepressive Agents / poisoning
Child
Child, Preschool
Databases, Factual
Drug Overdose / epidemiology*
Emergency Service, Hospital
Female
Humans
Male
Middle Aged
Oxycodone / poisoning
Prospective Studies
Psychotropic Drugs / poisoning*
Registries*
Substance-Related Disorders / epidemiology
Young Adult
Chemical
Reg. No./Substance:
0/Analgesics, Non-Narcotic; 0/Analgesics, Opioid; 0/Antidepressive Agents; 0/Psychotropic Drugs; 362O9ITL9D/Acetaminophen; CD35PMG570/Oxycodone; WYQ7N0BPYC/Acetylcysteine
Investigator
Investigator/Affiliation:
Michele Burns-Ewald / ; Michael Beuhler / ; Kurt Kleinschmidt / ; Paul Wax / ; Jeffrey Brent / ; Kennon Heard / ; Jerold Leikin / ; Bradley Riley / ; Bryan Judge / ; J Ward Donovan / ; Charles McKay / ; Yedidia Bentur / ; Blake Froberg / ; Daniel Rusyniak / ; Gary Wasserman / ; Jennifer Lowry / ; D Adam Algren / ; Mark Su / ; David Gummin / ; Mark Kostic / ; Stephanie Hernandez / ; Alex Manini / ; Silas Smith / ; Lewis Nelson / ; Ann-Jeanette Geib / ; Steven Marcus / ; Ronald Kirschner / ; Nathaneal McKeown / ; Michael Levine / ; Anne-Michelle Ruha / ; Anthony Pizon / ; Brandon Wills / ; Timothy Wiegand / ; Rachel Gorodetsky / ; Shawn Varney / ; Vikhyat Bebarta / ; Craig Smollin / ; Samuel Stellpflug / ; Kristin Engebretsen / ; Yaron Finkelstein / ; Sean Rhyee / ; Steven Bird /
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Individual differences in adult foreign language learning: The mediating effect of metalinguistic aw...
Next Document:  Comparison of blood flow velocity through the internal carotid artery based on Doppler ultrasound an...