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Czerwiec A, Chevallier C, Grenet G, Patat AM, de Souza S, Lichtfouse J, Boucher A, Paret N. Exposure to ammonia solution due to substance use: a retrospective study from the French poison centres database (2009-2018). Clin Toxicol (Phila) 2024; 62:107-111. [PMID: 38416057 DOI: 10.1080/15563650.2024.2313088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 01/27/2024] [Indexed: 02/29/2024]
Abstract
INTRODUCTION Ammonia solution (ammonium hydroxide) is used to convert cocaine hydrochloride to freebase cocaine. Due to its causticity, unintentional exposure to ammonia in a substance use context can result in injury. The objective of this study was to describe the characteristics of unintentional oral and buccal ammonia solution exposure in a substance use context. METHODS A retrospective study was conducted using the French poison centres database over a 10-year period (2009-2018). RESULTS A total of 1,546 files were extracted, and 263 substance users were included. There was a significant increase in the number of these exposures between 2009 and 2018. Unintentional ingestion of ammonia solution was linked to product decanting in 89 per cent of cases. Substance use prior to the exposure and a festive context, such as free parties or teknivals, were identified in 25 per cent and 21 per cent of cases, respectively. Patients received a hospital examination in 87 per cent of cases. The severity of intoxication in substance users was graded as moderate (33 per cent) or severe (15 per cent) using the Poisoning Severity Score. DISCUSSION The increased number of ammonia solution cases reported was consistent with an increase in the number of crack users in Europe in the same period. Ammonia solution exposure can suggest the possibility of substance use disorders. In such cases, patients can be referred to receive appropriate treatment and support. This study had some limitations, such as the lack of available information due to the retrospective nature of the study and the non-standardized questions asked by the poison centre during the medical phone interviews. CONCLUSION Oral and buccal ammonia solution exposure in known substance users in France increased between 2009 and 2018. These users were mostly young men. A festive context and decanting were frequent. Patients were mainly referred to emergency departments to receive clinical examination and care. The potential severity of oral or buccal ammonia solution exposure in substance users requires increased vigilance among all healthcare professionals involved in the management of these intoxication cases.
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Affiliation(s)
- Aurore Czerwiec
- Centre antipoison de Lyon, SHUPT, Hospices Civils de Lyon, Lyon, France
| | - Cecile Chevallier
- Centre d'Addictovigilance de Lyon, SHUPT, Hospices Civils de Lyon, Lyon, France
| | - Guillaume Grenet
- Centre antipoison de Lyon, SHUPT, Hospices Civils de Lyon, Lyon, France
| | - Anne-Marie Patat
- Centre antipoison de Lyon, SHUPT, Hospices Civils de Lyon, Lyon, France
| | - Sander de Souza
- Centre antipoison de Lyon, SHUPT, Hospices Civils de Lyon, Lyon, France
| | - Jeanne Lichtfouse
- Centre antipoison de Lyon, SHUPT, Hospices Civils de Lyon, Lyon, France
| | - Alexandra Boucher
- Centre d'Addictovigilance de Lyon, SHUPT, Hospices Civils de Lyon, Lyon, France
| | - Nathalie Paret
- Centre antipoison de Lyon, SHUPT, Hospices Civils de Lyon, Lyon, France
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Labadie M, Vaucel JA, Courtois A, Nisse P, Legeay M, Medernach C, Patat AM, Von Fabeck K, Gallart JC, Tournoud C, Puskarczyk E. Button Battery Ingestion in Children (PilBouTox®): A Prospective Study Describing the Clinical Course and Identifying Factors Related to Esophageal Impaction or Severe Cases. Dysphagia 2023; 38:446-456. [PMID: 35841456 DOI: 10.1007/s00455-022-10485-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 06/13/2022] [Indexed: 01/27/2023]
Abstract
In this study, we aimed to identify the factors related to esophageal impaction following button battery (BB) ingestion in children. PilBouTox, a prospective multicentric observational cohort study, was conducted from French Poison Control Centers between June 1, 2016 and May 31, 2018. Children (0-12 years old) with BB ingestion were included. After ingestion, patients were monitored for 21 days or more if they remained symptomatic (maximum 1 year). Causes of ingestion, clinical manifestations, medical management, and the outcomes were recorded. In total, 415 patients were included; among them, 35 had esophageal impaction and 14 had severe complications or died. Seven symptoms were closely related (relative risk (RR) > 30) to esophageal impaction: anorexia, drooling, dyspnea, fever, hemodynamic instability, pallor, and pain. Furthermore, BBs > 15 mm were related to esophageal impaction (RR = 19, CI95% [4.1; 88]). The absence of initial symptoms was a protective factor for esophageal impaction (RR = 0.013, CI95% [0.002; 0.1]). Nine symptoms were closely related (RR > 30) to major effects and death: dyspnea, cough, dysphagia, drooling, fever, hemodynamic instability, pain, pallor, and vomiting. Seven symptoms were related to esophageal impaction and their rapid recognition could help to ensure that the patient is taken to a health care facility. Nine factors were related to the major effects of BB ingestion. We recommended an X-ray as soon as possible to determine the position of the BB.Trial Registry: Clinical Trial ID: NCT03708250, https://clinicaltrials.gov/ct2/show/NCT03708250.
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Affiliation(s)
- Magali Labadie
- Centre Hospitalier et Universitaire de Bordeaux, Centre Antipoison Nouvelle Aquitaine [Nouvelle Aquitaine Poison Control Center], 1 Place Amélie Rabat Léon, 33000, Bordeaux, Aquitaine, France.
| | - Jules-Antoine Vaucel
- Centre Hospitalier et Universitaire de Bordeaux, Centre Antipoison Nouvelle Aquitaine [Nouvelle Aquitaine Poison Control Center], 1 Place Amélie Rabat Léon, 33000, Bordeaux, Aquitaine, France
| | - Arnaud Courtois
- Centre Hospitalier et Universitaire de Bordeaux, Centre Antipoison Nouvelle Aquitaine [Nouvelle Aquitaine Poison Control Center], 1 Place Amélie Rabat Léon, 33000, Bordeaux, Aquitaine, France
| | - Patrick Nisse
- Centre Antipoison [Lille Poison Control Center], Centre Hospitalier et Universitaire de Lille, 59000, Lille, France
| | - Marion Legeay
- Centre Antipoison [Angers Poison Control Center], Centre Hospitalier et Universitaire de Angers, 49000, Angers, Pays de la Loire, France
| | - Chantal Medernach
- Centre Antipoison de Paris [Paris Poison Control Center]-Fédération de Toxicologie, Groupe Hospitalier Lariboisière Fernand-Widal, 75000, Paris, Île-de-France, France
| | - Anne-Marie Patat
- Centre Antipoison [Lyon Poison Control Center], Centre Hospitalier et Universitaire de Lyon, 69000, Lyon, Auvergne-Rhône-Alpes, France
| | - Katharina Von Fabeck
- Centre Antipoison [Marseille Poison Control Center], Centre Hospitalier et Universitaire de Marseille, 13000, Marseille, France
| | - Jean-Christophe Gallart
- Centre Antipoison-SAMU 31 [Toulouse Poison Control Center], Centre Hospitalier et Universitaire de Toulouse, 31000, Toulouse, Midi-Pyrénées, France
| | | | - Christine Tournoud
- Centre Antipoison [East Poison Control Center], Centre Hospitalier et Universitaire de Nancy, 54000, Nancy, Lorraine, France
| | - Emmanuel Puskarczyk
- Centre Antipoison [East Poison Control Center], Centre Hospitalier et Universitaire de Nancy, 54000, Nancy, Lorraine, France
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Vaucel JA, Enaud N, Paradis C, Bragança C, Courtois A, Lan M, Gil-Jardine C, Enaud R, Labadie M, Deguigne M, Roux GL, Descatha A, Azzouz R, Nisse P, Patat AM, Paret N, Blanc-Brisset I, Nardon A, Haro LD, Simon N, Delcourt N, Pelissier F, Tournoud C, Puskarczyk E, Langrand J, Laborde-Casterot H, Care W, Vodovar D. Poison control centres and alternative forms of communication: comparison of response rates between text message and telephone follow-up. Clin Toxicol (Phila) 2022; 60:947-953. [PMID: 35311427 DOI: 10.1080/15563650.2022.2051537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION In recent years, the number of patients managed by poison control centres (PCCs) has increased without a proportional increase in the number of physicians. To improve efficiency without neglecting patient follow-up, some PCCs have begun using text messages. We evaluated the difference in response rates between text messaging and traditional telephone follow-up. MATERIALS AND METHODS This retrospective, monocentric, non-randomised cohort study was conducted using data from calls made by the New Aquitaine PCC between February 27, 2019, and March 31, 2019. Patients were contacted up to three times by a phone call or short message service (SMS). RESULTS For the analysis, 823 patients were included. At the end of follow-up, the response rates were similar in the phone call and SMS group (94 vs. 94%; p = 0.76) with median [interquartile range] response times of 0 min [0; 27 min] and 29 min [6; 120 min], respectively. The response rates did not differ in subgroups stratified according to sex, self-poisoning vs. relative response, age class, and solicitation during working hours vs. outside of working hours (all p > 0.5). Moreover, health practitioners required 2.4-fold more time to call than to send text messages (p < 0.001), and all practitioners were satisfied or very satisfied with text messaging implementation. CONCLUSION Patients had good adherence to text messages. Text messages are easy to use, rapid, and allow the physician to easily prioritise follow-up without occupying the emergency line. Additionally, the costs of installation and maintenance are low for text message systems; these low costs facilitate the implementation of such services in various medical situations.
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Affiliation(s)
- Jules-Antoine Vaucel
- Service des Urgences Adulte [Emergency Department], Centre Hospitalier et Universitaire Pellegrin, Bordeaux, France.,Centre Antipoison Nouvelle Aquitaine [Nouvelle Aquitaine Poison Control Center], Centre Hospitalier et Universitaire Pellegrin, Bordeaux Cedex, France
| | - Nicolas Enaud
- Service des Urgences [Emergency Department], Centre Hospitalier d'Arcachon, La Teste de Buch, France
| | - Camille Paradis
- Centre Antipoison Nouvelle Aquitaine [Nouvelle Aquitaine Poison Control Center], Centre Hospitalier et Universitaire Pellegrin, Bordeaux Cedex, France
| | - Coralie Bragança
- Centre Antipoison Nouvelle Aquitaine [Nouvelle Aquitaine Poison Control Center], Centre Hospitalier et Universitaire Pellegrin, Bordeaux Cedex, France
| | - Arnaud Courtois
- Centre Antipoison Nouvelle Aquitaine [Nouvelle Aquitaine Poison Control Center], Centre Hospitalier et Universitaire Pellegrin, Bordeaux Cedex, France
| | - Maxime Lan
- Centre Antipoison Nouvelle Aquitaine [Nouvelle Aquitaine Poison Control Center], Centre Hospitalier et Universitaire Pellegrin, Bordeaux Cedex, France
| | - Cédric Gil-Jardine
- Service des Urgences Adulte [Emergency Department], Centre Hospitalier et Universitaire Pellegrin, Bordeaux, France.,Bordeaux Population Health Research Center, IETO Team, Université de Bordeaux, Bordeaux, France
| | | | - Raphaël Enaud
- Service d'Hépato Gastroentérologie Pédiatrique [Pediatric Hepato Gastroenterology Department], Centre Hospitalier et Universitaire Pellegrin, Bordeaux Cedex, France
| | - Magali Labadie
- Centre Antipoison Nouvelle Aquitaine [Nouvelle Aquitaine Poison Control Center], Centre Hospitalier et Universitaire Pellegrin, Bordeaux Cedex, France
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Czerwiec A, Chevallier C, Grenet G, Patat AM, De Souza S, Lichtfouse J, Manel J, Boucher A, Paret N. Exposition accidentelle à l’ammoniaque par voie orale ou buccale dans un contexte de toxicomanie : étude rétrospective des cas rapportés aux Centres Antipoison en France (2009-2018). Toxicologie Analytique et Clinique 2021. [DOI: 10.1016/j.toxac.2021.06.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pizzoglio V, Patat AM, Boucher A. Cocaïne basée et chlorhydrate de cocaïne : pharmaco-toxicologie comparée. Therapie 2018. [DOI: 10.1016/j.therap.2018.09.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Vial T, Patat AM, Paret N, Boels D, Torrents R, Nisse P, Villa A, Kassai B. Risperidone medication errors in children: an analysis of French poison centres data. Clin Toxicol (Phila) 2018; 57:362-367. [PMID: 30449187 DOI: 10.1080/15563650.2018.1523424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To describe clinical consequences of risperidone medication errors in children of less than 13 years and to estimate a clinically relevant toxic dose. METHODS All cases of risperidone medication errors managed by French Poison Centres from 2001 to 2012 were analyzed. Inclusion criteria were a delay of at least 2 hours between ingestion and request to the FPC in asymptomatic children, an ingested dose above two-fold the maximal daily dose for children above 5 years or any symptomatic patient at the time of first contact. RESULTS One hundred and sixty cases met our criteria. Median age was 8 years (range 0.9-12) and 28.1% were aged 5 years or less. Causes of the error were an incorrect dose in treated children (84.2%) or a dose given to a wrong child (15.8%). The median ingested dose was 0.1 mg/kg or 3.3-fold the maximum recommended dose. Overall, 59 children had no symptoms, 95 experienced minor symptoms and six moderate symptoms. Somnolence/sedation was the most common (73.3%). Of the 17 children who developed extrapyramidal disorders, all had minor or moderate symptoms and only five required a symptomatic treatment. CONCLUSIONS Risperidone medication errors in children cause minimal effects. Somnolence and mild to moderate extrapyramidal reactions were the main features of toxicity, and significant cardiac or other neurological features were not observed. No case with severe toxicity was noted. At home surveillance can be proposed for children exposed to a dose ≤0.15 mg/kg.
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Affiliation(s)
- Thierry Vial
- a Department of Pharmacotoxicology , Lyon University Hospital, Hospices Civils de Lyon , France
| | - Anne-Marie Patat
- a Department of Pharmacotoxicology , Lyon University Hospital, Hospices Civils de Lyon , France
| | - Nathalie Paret
- a Department of Pharmacotoxicology , Lyon University Hospital, Hospices Civils de Lyon , France
| | - David Boels
- b Poison Control Center , Angers University Hospital , France
| | - Romain Torrents
- c Poison Control Center, Marseille University Hospital, Assistance Publique Hôpitaux de Marseille , France
| | - Patrick Nisse
- d Poison Control Center, Lille University Hospital , France
| | - Antoine Villa
- e Poison Control Center, Paris University Hospital, Assitance Publique Hôpitaux de Paris , France
| | - Behrouz Kassai
- f Department of Pharmacotoxicology and UMR 5588-CNRS, Lyon University Hospital , France
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Rigaux-Barry F, Patat AM, Cordier L, Manel J, Sinno-Tellier S. Risks related to pods exposure compared to traditional laundry detergent products: Study of cases recorded by French PCC from 2005 to 2012. Toxicologie Analytique et Clinique 2017. [DOI: 10.1016/j.toxac.2017.03.122] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Zagagnoni C, Colomb S, Claud B, Brenas F, Patat AM, Payen C, Frantz P, Descotes J. [Acute intoxication by dextropropoxyphene. Review of the literature about one case]. Therapie 2007; 62:61-4. [PMID: 17474186 DOI: 10.2515/therapie:2006086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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