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Biomedical subjects

Christine Haller

Publications and source records attributed to Christine Haller.

6 recordsLinked to original sources
PubMed2005

Colchicine-related death presenting as an unknown case of multiple organ failure.

A 45-year-old man presented to the emergency department (ED) with acute renal and hepatic failure as well as hypotension and metabolic acidosis. Despite aggressive intensive care, he had continued hypotension, leukocytosis, fever, renal and hepatic failure, and lactic acidosis. On hospital day 3, pancytopenia was noted. Bone marrow biopsy showed marked aplasia without a specific etiology being elucidated. He received granulocyte colony-stimulating factor and antibiotics, but died on hospital day 12 after a cardiac arrest. The patient repeatedly denied intentional drug ingestion. Due to his clinical course, the poison center recommended obtaining a colchicine level. The plasma colchicine level, 72 h after admission, was 6.1 ng/mL (GC/MS). This level exceeds acute levels reported in some cases of prior fatalities. This case is novel in that the patient's multiple organ dysfunction remained unexplained for several days before occult colchicine toxicity was implicated as the probable cause by the colchicine level. Also, there was a paucity of gastrointestinal symptoms on presentation, the opposite of what is expected in colchicine toxicity.

Bone Marrow Diseases↗
PubMed2003

Adverse events associated with dietary supplements: an observational study.

BACKGROUND: Adverse events associated with dietary supplements are difficult to monitor in the USA, because such products are not registered before sale, and there is little information about their content and safety. METHODS: In 1998, 11 poison control centres in the USA recorded details of 2332 telephone calls about 1466 ingestions of dietary supplements, in 784 of which patients had symptoms. We used a multitiered review process (kappa 0.42) to select 489 cases for whom we were at least 50% certain that their negative events were associated with dietary supplements. We aimed to assess the effects of multiple ingredients and long-term use, and collated data for patterns of use and information resources. FINDINGS: A third of events were of greater than mild severity. We noted both new and previously reported associations that included myocardial infarction, liver failure, bleeding, seizures, and death. Increased symptom severity was associated with use of several ingredients, long-term use, and age. Paediatric exposures were more often unintentional than were adult ingestions, and treatment of disease was the reason for supplement use in at least 28% of reports. Most products and ingredients were not identified in the information database (Poisindex) used by poison control centres, and specific adverse events were reported variably among five additional sources. INTERPRETATION: Dietary supplements are associated with adverse events that include all levels of severity, organ systems, and age groups. Associations between adverse events and ingredients are difficult to verify if a product has more than one ingredient, and because of incomplete information systems. Research into hazards and risks of dietary supplements should be a priority.

Adolescent↗
PubMed2003

Photosensitivity reaction in a woman using an herbal supplement containing ginseng, goldenseal, and bee pollen.

Photosensitivity, an abnormal skin reaction to light, is a rare adverse event associated with herbal medicine use. Case reports in the literature most commonly implicate St. John's wort. In this report, we describe the case of a 32-year-old woman who suffered a phototoxic reaction after taking a dietary supplement containing ginseng, goldenseal, bee pollen, and other ingredients. On presentation, she had a pruritic, erythematous rash, localized to the sun-exposed surfaces of her neck and extremities. She had no significant past medical history and was not taking any other medications. The skin rash slowly resolved after discontinuation of the supplement and with treatment including subcutaneous and topical corticosteroids. Although the individual ingredients in this dietary supplement have not been associated with cases of photosensitivity, it is possible that the combination of ingredients may have interacted to cause this toxic reaction. Therefore, we recommend caution in the combining of multiple herbs and supplements into new formulations.

Adrenal Cortex Hormones↗
PubMedDate not supplied

GHB urine concentrations after single-dose administration in humans.

Gamma-hydroxybutyric acid (GHB) is used as an illicit drug and is implicated in drug-facilitated sexual assault, but it also has some therapeutic uses. Detection of GHB in urine is important for forensic testing and could be of clinical benefit in overdose management. Urine GHB concentration-time profiles have not been well-characterized or correlated with doses used therapeutically. GHB levels were measured by gas chromatography-mass spectrometry in urine collected over 24 h from 16 adults administered single doses of 50 mg/kg GHB (Xyrem) alone and combined with 0.6 g/kg ethanol. Peak GHB urine concentrations averaged 150-200 mg/L and occurred in the 0-3 h urine collection. Significant variability in GHB urine levels between individuals was observed. Caucasians had lower urine concentrations than other races/ethnicities (p = 0.03). Men had lower GHB levels than women in the first 3 h after dosing (p = 0.038). Coingestion of ethanol did not significantly affect renal clearance of GHB, but urine GHB concentrations were lower in the first 3 h when ethanol and GHB were coingested (p = 0.039). At a proposed cut-off of 10 mg/L to distinguish endogenous versus exogenous GHB levels, 12.5% of the samples collected from 3 to 6 h, 81.3% of samples collected from 6 to 12 h, and 100% of urine specimens collected from 12 to 24 h were below this level. We conclude that the detection time for GHB in urine may be shorter than the previously reported 12-h window in some people taking therapeutic doses of GHB.

Administration, Oral↗
PubMedDate not supplied

Pharmacologic agents for weight reduction.

Obesity is a major health problem in U.S. adults. Most successful weight loss programs have multiple components, including lifestyle modifications, reduced caloric intake, and exercise. Short-term use of medications for weight loss may be a part of such a plan. Currently, most medications are adrenergic stimulants and can produce adverse CNS and cardiovascular effects. Antiabsorptive agents appear to be safer but have significant GI side effects. An important finding is the potential for adverse life-threatening effects with over-the-counter products and dietary supplements that do not undergo evaluation similar to prescription drugs. The search continues for safe and effective pharmacologic agents to assist in weight loss.

Anti-Obesity Agents↗