Biomedical subjects

Erik Andrew

Publications and source records attributed to Erik Andrew.

4 recordsLinked to original sources

PubMed2006

Comparison between eight poisons information centers in Europe.

AIM: To map and compare organization and activities of eight poisons information centers in Europe in order to learn and discuss future development. MATERIAL AND METHODS: In 2004, the following eight centers in six countries were visited and studied: Brussels, Lille, Munich, Cardiff, London, Utrecht, Stockholm and Zurich. Each center was visited for 1 or 2 days. All centers filled in the same questionnaire. RESULTS AND CONCLUSION: Although all centers had the same functions, they showed great differences in organization and activities. Several of the centers seemed to be understaffed for an optimum utilization of poisons information centers by the society. In order to increase harmonization and prepare the European poisons information centers for the future not only continuous voluntary collaboration, but also regulation by the European Union (EU), is proposed. It is advocated that the European Association of Poisons Centers and Clinical Toxicologists (EAPCCT) should take an active role, also towards EU.

Europe↗

PubMed2004

[Paracetamol poisonings in Norway 1990-2001].

BACKGROUND: After the introduction of new regulations in 1981 and 1990 in Norway, over-the-counter sales of paracetamol and acetylsalicylic acid have been limited to 10 grams. From 1990 the sale of paracetamol has increased dramatically; that of acetylsalicylic acid has accordingly been reduced. We have investigated the morbidity and mortality from overdoses of analgesics, especially paracetamol, in the period 1990-2001. MATERIAL AND METHOD: We collected data from the inquiries received by the National Poisons Information Centre in Norway. Data on hospital admissions and deaths have been recorded from the Norwegian Patient Register. These data have also been used to collect anonymous case records from all patients who died following intake of paracetamol. We also sent questionnaires to 57 hospital departments in a survey of deaths from paracetamol poisoning. RESULTS: Calls concerning paracetamol poisonings to the National Poisons Information Centre doubled to about 400 calls per year over the period. In 30% of cases serious poisoning was suspected. Hospital admissions diagnosed primarily as analgesic poisoning increased from 848 to 1162. On average, 52% of poisonings were caused by paracetamol, 13% by opioids, 5% by acetylsalicylic acid; in 27% the analgesic involved was not specified. 59 deaths were diagnosed as poisoning from analgesics as primary cause, 13 of them due to paracetamol, 26 to opioids, 2 to acetylsalicylic acid; in 18 cases the analgesic involved was not specified. The questionnaires gave insignificant additional information. INTERPRETATION: The number of paracetamol poisonings has increased since 1990 in accordance with the dramatic increase in sales of paracetamol in Norway. Although the mortality of paracetamol poisoning is low (1-2 deaths annually), it represents the most critical poisoning problem among non-opioid analgesics. It is important to monitor the morbidity and mortality of paracetamol poisoning, as new regulations introduced from 2003 will increase the availability of paracetamol and other selected non-opioid analgesics.

Acetaminophen↗

PubMed2004

Nephrotoxic effects of X-ray contrast media.

The annual sale of x-ray contrast media (CM) now represents 60 million doses, and contrast nephropathy (CN) has been the third-leading cause of hospital-acquired acute renal failure. In this review article, physicochemical, pharmacokinetic, and pharmacodynamic properties of CM are surveyed. The definition of CN is presented, as well as the mechanisms involved in the pathogenesis. Low osmolar monomeric CM (LOCM) are less nephrotoxic than the older ionic high osmolar CM (HOCM), but in risk patients the incidence of CN is still high after intravascular administration of LOCM. Non-ionic dimeric CM are iso-osmolar to plasma (IOCM), and they have reduced the nephrotoxicity even more than LOCM. The most important risk factors for CN are diabetes mellitus and impaired renal function. Selection of patients, hydration, and type of CM are essential for prevention and prophylaxis of CN. We do not recommend routine prophylaxis with N-acetylcysteine (NAC) during CM investigations, but its use in high-risk patients should be considered.

Acute Kidney Injury↗

PubMed2002

[Antidote availability in Norway].

BACKGROUND: Antidotes are therapeutic substances that are used primarily to counteract the toxic action of poisonous agents and thus have an important role in the treatment of poisoning. Antidote availability is crucial for the poisoned patient; it is important that hospitals keep antidotes in stock to treat these patients. Most antidotes are expensive, infrequently used, and have short shelf-lives. This makes hospital stocking economically difficult. In Norway, there is no national antidote programme. MATERIAL AND METHODS: The National Poisons Information Centre recently made an inquiry about antidote stocking in Norwegian hospitals. RESULTS AND INTERPRETATION: This survey showed that the antidote availability is not satisfactory. The availability of antidotes in Norwegian hospitals is discussed and recommendations are given.

Antidotes↗