https://ogma.newcastle.edu.au/vital/access/ /manager/Index en-au 5 https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:10027 Wed 11 Apr 2018 14:21:50 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:4377 Wed 11 Apr 2018 13:18:55 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:31242 Wed 11 Apr 2018 11:11:28 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:7661 Wed 11 Apr 2018 10:52:23 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:26405 Wed 11 Apr 2018 10:46:20 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:43060 Wed 07 Feb 2024 14:49:09 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:44312 Tue 11 Oct 2022 16:19:41 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:7994 Sat 24 Mar 2018 08:42:37 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:14776 Sat 24 Mar 2018 08:26:29 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:21447 Sat 24 Mar 2018 08:05:44 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:18281 Sat 24 Mar 2018 08:04:33 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:20572 Sat 24 Mar 2018 08:02:37 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:16889 Sat 24 Mar 2018 08:00:48 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:28180 400 mg) admitted to a tertiary toxicology unit from November 2000 to June 2013. Demographic details, information on ingestion (dose and co-ingestants), clinical effects, complications (seizures, serotonin toxicity and cardiovascular effects) and intensive care unit (ICU) admission were extracted from a clinical database. Results: There were 71 cases of tramadol overdose (median age: 41 years, range: 17-69 years; and median ingested dose: 1000 mg, interquartile range [IQR]: 800-2000 mg). Seizures were dose related and occurred in 8 patients, one of them co-ingested a benzodiazepine compared with 16 patients without seizures. There were no cases of serotonin toxicity meeting the Hunter Serotonin Toxicity Criteria. Tachycardia occurred in 27 and mild hypertension occurred in 32. The Glasgow Coma Score was < 15 in 29 and < 9 in 5 patients; three co-ingested tricyclic antidepressants and two tramadol alone (3000 mg and 900 mg). Respiratory depression occurred in 13, median dose: 2500 (IQR: 1600-3000) mg which was significantly different (p = 0.003) to patients without respiratory depression, median dose: 1000 (IQR: 750-1475) mg. Eight patients were admitted to ICU, five due to co-ingestant toxicity and three for respiratory depression. Discussion: Tramadol overdose was associated with a significant risk of seizures and respiratory depression in more severe cases, both which appear to be related to the ingested dose. There were no cases of serotonin toxicity, while opioid-like effects and adrenergic effects were prominent. Conclusion: Tramadol overdose is associated with seizures and respiratory depression, but is unlikely to cause serotonin toxicity.]]> Sat 24 Mar 2018 07:36:34 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:25578 Sat 24 Mar 2018 07:35:13 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:22197 8 weeks' duration) without active respiratory disease or infection were randomly assigned to receive gabapentin (maximum tolerable daily dose of 1800 mg) or matching placebo for 10 weeks. Block randomisation was done with randomisation generator software, stratified by sex. Patients and investigators were masked to assigned treatment. The primary endpoint was change in cough-specific quality of life (Leicester cough questionnaire [LCQ] score) from baseline to 8 weeks of treatment, analysed by intention to treat. 62 patients were randomly assigned to gabepentin (n=32) or placebo (n=30) and ten patients withdrew before the study end. Gabapentin significantly improved cough-specific quality of life compared with placebo (between-group difference in LCQ score during treatment period 1·80, 95% CI 0·56-3·04; p=0·004; number needed to treat of 3·58). Side-effects occurred in ten patients (31%) given gabapentin (the most common being nausea and fatigue) and three (10%) given placebo. The treatment of refractory chronic cough with gabapentin is both effective and well tolerated. These positive effects suggest that central reflex sensitisation is a relevant mechanism in refractory chronic cough.]]> Sat 24 Mar 2018 07:16:25 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:23107 Sat 24 Mar 2018 07:12:33 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:37203 Mon 31 Aug 2020 15:02:09 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:32502 4h. Median peak venom concentration in 25 patients with systemic envenoming and a sample available was 8.4ng/L (1-3212 ng/L). No venom was detected in post-antivenom samples, including 20 patients given one vial initially and five patients bitten by inland taipans. Discussion: Australian taipan envenoming is characterised by neurotoxicity, myotoxicity, coagulopathy, acute kidney injury and thrombocytopenia. One vial of antivenom binds all measurable venom and early antivenom was associated with a favourable outcome.]]> Mon 23 Sep 2019 13:46:15 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:32503 Mon 23 Sep 2019 12:51:03 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:30918 200 μg). Demographic information, clinical effects, treatment, complications (central nervous system and cardiovascular effects) and length of stay (LOS) were extracted from a clinical database or medical records. Results: From 133 admissions for clonidine poisoning (1988–2015), no medical record was available in 14 and 11 took staggered ingestions. Of 108 acute clonidine overdoses (median age 27 years; 14–65 years; 68 females), 40 were clonidine alone ingestions and 68 were clonidine with co-ingestants. Median dose taken was 2100 μg (interquartile range [IQR]: 400–15,000 μg). Median LOS was 21h (IQR: 14–35 h) and there were no deaths. Glasgow coma score [GCS] <15 occurred in 73/108 (68%), and more patients taking co-ingestants (8/68; 12%) had coma (GCS <9) compared to clonidine alone (2/40; 5%). Miosis occurred in 31/108 (29%) cases. Median minimum HR was 48 bpm (IQR: 40–57 bpm), similar between clonidine alone and co-ingestant overdoses. There was a significant association between dose and minimum HR for clonidine alone overdoses (p = 0.02). 82/108 (76%) had bradycardia, median onset 2.5 h post-ingestion (IQR: 1.7–5.5 h) and median duration 20 h (2.5–83 h), similar for clonidine alone and co-ingestant overdoses. There were no arrhythmias. Three patients ingesting 8000–12,000 μg developed early hypertension. Median minimum systolic BP was 96 mmHg (IQR: 90–105 mmHg) and hypotension occurred in 26/108 (24%). 12/108 patients were intubated, but only 2 were clonidine alone cases. Treatments included activated charcoal (24), atropine (8) and naloxone (23). The median total naloxone dose was 2 mg (IQR: 1.2–2.4 mg), but only one patient given naloxone was documented to respond with partial improvement in GCS. Discussion: Clonidine causes persistent but not life-threatening clinical effects. Most patients develop mild central nervous system depression and bradycardia. Naloxone was not associated with improved outcomes.]]> Mon 23 Sep 2019 12:03:58 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:31382 Mon 23 Sep 2019 11:16:26 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:41752 Fri 12 Aug 2022 11:35:18 AEST ]]>