Advanced
Search

Browse Toxicology

Showing 1 to 20 of 47 Articles

Filter Results

Sort By:

  • Images in Clinical Medicine

    Botryoid White-Cell Nuclei

    Figure 1.

    • April 25, 2013
    • Chew E. and Juneja S.
    • N Engl J Med 2013; 368:e22
    • Free Full Text

    A 26-year-old man was found unresponsive at work. When examined at the hospital, he had a temperature of 41.9°C, a heart rate of 150 bpm, unrecordable blood pressure, and a score of 4 on the Glasgow Coma Scale.

  • Case Records of the Massachusetts General Hospital

    Case 10-2013 — A 30-Year-Old Man with Fever, Myalgias, Arthritis, and Rash

    The description of this case was presented as a Case Challenge. Readers were invited to review the case description, vote on the diagnosis, and submit comments. The full case discussion and final diagnosis now appear below, along with the poll results. Presentation of Case. Dr. Sheila F. Mitsuma…

    • March 28, 2013
    • Stone J.H. and Murali M.R.
    • N Engl J Med 2013; 368:1239-1245
    • Free Full Text
    • CME
    • Comments
    • Poll

    A 30-year-old man with a history of IV drug use was admitted to this hospital because of fever, myalgias, polyarthritis, and rash. Results of liver-function tests were notable for mildly elevated hepatic aminotransferase levels and a normal bilirubin level.

  • Perspective

    Safeguarding Children — Pediatric Research on Medical Countermeasures

    In 2011, a bioterrorism-preparedness exercise conducted by the U.S. government examined the likely result of a large-scale release of weaponized anthrax spores in a city such as San Francisco. Code-named Dark Zephyr, the simulation was sobering: nearly 8 million people would be affected, nearly a…

    • March 28, 2013
    • Gutmann A.
    • N Engl J Med 2013; 368:1171-1173
    • Free Full Text

    The Presidential Commission for the Study of Bioethical Issues has concluded that before pediatric trials of anthrax vaccine can be considered in the absence of an outbreak or attack, further steps must be taken, including additional research in adults, to reduce risks to participating children.

  • Images in Clinical Medicine

    Skeletal Fluorosis Due to Excessive Tea Drinking

    Figure 1.

    • March 21, 2013
    • Kakumanu N. and Rao S.D.
    • N Engl J Med 2013; 368:1140
    • Free Full Text

    A 47-year-old woman was referred for bone pain and abnormal findings on radiography. The patient reported that for the past 17 years she has habitually consumed a pitcher of tea made from 100 to 150 tea bags daily.

  • Images in Clinical Medicine

    Talc Retinopathy

    Figure 1.

    • February 28, 2013
    • Schoenberger S.D. and Agarwal A.
    • N Engl J Med 2013; 368:852
    • Free Full Text

    A 56-year-old woman who had undergone bilateral lung transplantation for COPD was found to have fine crystals in the inner retinal layer in the maculae of both eyes, although she was asymptomatic. A remote history of long-term IV drug use was confirmed.

  • Images in Clinical Medicine

    Perioral Myokymia

    Figure 1.

    • January 24, 2013
    • Kobayashi S.A.
    • N Engl J Med 2013; 368:e5
    • Free Full Text
    • Video

    A healthy 13-year-old boy presented to a San Diego emergency room after a rattlesnake bite. The patient had been attempting to pick up the snake when he was bitten on his left ring finger.

  • Case Records of the Massachusetts General Hospital

    Case 39-2012 — A 55-Year-Old Man with Alcoholism, Recurrent Seizures, and Agitation

    Presentation of Case. Dr. Benjamin C. Silverman (Psychiatry): A 55-year-old man with a history of alcoholism was admitted to the medical intensive care unit (ICU) at this hospital because of seizures and agitation. One day before admission, the patient discontinued his daily consumption of alcohol…

    • December 20, 2012
    • Nejad S.H.Schaefer P.W.Bajwa E.K.Smith F.A.
    • N Engl J Med 2012; 367:2428-2434
    • CME

    Presentation of Case

    Dr. Benjamin C. Silverman (Psychiatry): A 55-year-old man with a history of alcoholism was admitted to the medical intensive care unit (ICU) at this hospital because of seizures and agitation.

    One day before admission, the patient ...

  • Interactive Medical Case

    A Patient Found Unresponsive

    An 18-year-old woman was found in an unresponsive state in a park near her college campus. When paramedics arrived, the patient was not talking or communicating but her eyes were open, with the pupils equal in size and reactive to light. She was breathing, had a palpable and rapid pulse, and was…

    • December 13, 2012
    • Sacks Z.Vaidya A.Sharma N.Gottlieb B.
    • N Engl J Med 2012; 367:e36
    • Free Full Text
    • CME

    This interactive feature presents the case of an 18-year-old woman with a history of anorexia and depression who was found near her college campus in an unresponsive state. Test your diagnostic and therapeutic skills at NEJM.org.

  • Images in Clinical Medicine

    Mydriasis in the Garden

    Figure 1.

    • October 4, 2012
    • Vunda A. and Alcoba G.
    • N Engl J Med 2012; 367:1341
    • Free Full Text

    A healthy 3-year old boy was brought to the emergency department because of an acutely dilated right pupil, which developed after he had played in the garden. Half an hour before presentation, his parents noticed he had been crying.

  • Correspondence

    Falsely Low Carboxyhemoglobin Level after Hydroxocobalamin Therapy

    To the Editor: Carbon monoxide poisoning that is not related to fire is an important cause of death and disability, accounting for approximately 15,000 emergency department visits and 500 deaths annually in the United States. Fire-related exposure to both cyanide and carbon monoxide necessitates…

    • September 27, 2012
    • N Engl J Med 2012; 367:1270-1271
    • Free Full Text

    Interference in laboratory testing can cause substantial confusion in clinical care. In this letter, the potential for hydroxocobalamin to interfere with the detection of carbon monoxide poisoning is discussed.

  • Clinical Problem-Solving

    The Eyes Have It

    Foreword. In this Journal feature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information, sharing his or her reasoning with the reader (regular type). The authors' commentary follows. Stage. A 69-year-old man presented to the…

    • September 6, 2012
    • Vasa M., Baudendistel T.E., Ohikhuare C.E., et al.
    • N Engl J Med 2012; 367:938-943
    • CME
    • Comments

    Foreword

    In this Journal feature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information, sharing his or her reasoning with the reader (regular type). The authors' commentary ...

  • Images in Clinical Medicine

    Burton's Line

    Figure 1.

    • September 6, 2012
    • Chawla M.P.S. and Sundriyal D.
    • N Engl J Med 2012; 367:937
    • Free Full Text

    An 18-year-old nonsmoking man presented to the emergency department with a 1-week history of diffuse, colicky abdominal pain. He had had no change in his bowel or bladder function.

  • Case Records of the Massachusetts General Hospital

    Case 22-2012 — A 34-Year-Old Man with Intractable Vomiting after Ingestion of an Unknown Substance

    Presentation of Case. Dr. Areej El-Jawahri (Internal Medicine): A 34-year-old man was seen in the emergency department at this hospital because of vomiting and abdominal pain. The patient had been well until the morning of admission. He had spent the night out with friends drinking alcohol, and…

    • July 19, 2012
    • Macías Konstantopoulos W.Burns Ewald M.Pratt D.S.
    • N Engl J Med 2012; 367:259-268
    • CME

    A 34-year-old man was seen in the emergency department because of abdominal pain and vomiting after his wife had given him a powder to cause him to stop drinking alcohol. The substance was identified, diagnostic tests were performed, and management decisions were made.

  • Perspective

    200th Anniversary Article: Two Centuries of Assessing Drug Risks

    The history of medicine is largely the story of medicines — a continuing tale of unfolding risks and benefits. Yet the medical world into which the Journal was born in 1812 did not systematically assess the side effects of treatments in relation to the good they did. Often, there was no…

    • July 19, 2012
    • Avorn J.
    • N Engl J Med 2012; 367:193-197
    • Free Full Text
    • Comments

    The history of medicine is largely the story of medicines — a continuing tale of unfolding risks and benefits. Since the Journal was launched, long before the systematic use of randomized, controlled trials, it has documented our evolving understanding of drug safety.

  • Review Article

    Drug Therapy: Management of Opioid Analgesic Overdose

    Opioid analgesic overdose is a preventable and potentially lethal condition that results from prescribing practices, inadequate understanding on the patient's part of the risks of medication misuse, errors in drug administration, and pharmaceutical abuse. Three features are key to an understanding…

    • July 12, 2012
    • Boyer E.W.
    • N Engl J Med 2012; 367:146-155
    • CME

    Opioid analgesic overdose is a preventable and potentially lethal condition that results from prescribing practices, inadequate understanding on the patient's part of the risks of medication misuse, errors in drug administration, and pharmaceutical abuse....

  • Case Records of the Massachusetts General Hospital

    Case 7-2012 — A 79-Year-Old Man with Pain and Weakness in the Legs

    Presentation of Case. Dr. Aida E. Kuri (Medicine): A 79-year-old man was admitted to this hospital because of pain and weakness in the legs. The patient had multiple medical problems but had been in his usual state of health until 6 days before admission, when progressive, generalized pain and…

    • March 8, 2012
    • David W.S.Chad D.A.Kambadakone A.Hedley-Whyte E.T.
    • N Engl J Med 2012; 366:944-954
    • CME
    • Video

    A 79-year-old man was admitted to the hospital because of pain and weakness in the legs. He had multiple chronic medical problems and took numerous medications, with no recent changes. Examination revealed leg weakness and decreased reflexes.

  • Case Records of the Massachusetts General Hospital

    Case 6-2012 — A 45-Year-Old Man with a History of Alcohol Abuse and Rapid Cognitive Decline

    Presentation of Case. Dr. Clayton Knox (Medicine): A 45-year-old man with a history of alcoholism was admitted to this hospital because of rapid cognitive decline and worsening jaundice. During the previous 3 months, increasing fatigue and cough productive of yellow sputum and flecks of blood had…

    • February 23, 2012
    • Cho T.A.Larvie M.Tian D.Mino-Kenudson M.
    • N Engl J Med 2012; 366:745-755
    • CME

    A 45-year-old man with a history of alcoholism was admitted to the hospital because of cognitive decline and jaundice. He had a 3-month history of cough, blood-tinged sputum, and vomiting. Imaging showed a peripherally enhancing brain lesion. A diagnostic procedure was performed.

  • Review Article

    Current Concepts: The Autosomal Recessive Cerebellar Ataxias

    The autosomal recessive cerebellar ataxias are a group of little known and often neglected diseases that are best understood by following a practical, multidisciplinary approach that focuses on clinical rather than molecular considerations. This review focuses on the main forms in which cerebellar…

    • February 16, 2012
    • Anheim M.Tranchant C.Koenig M.
    • N Engl J Med 2012; 366:636-646
    • CME
    • Video

    Autosomal recessive cerebellar ataxia must be considered in any child or young adult with a progressive disorder of gait or balance or with hypotonia or excessive clumsiness. This review presents a practical approach to these neurodegenerative diseases.

  • Special Article

    Emergency Hospitalizations for Adverse Drug Events in Older Americans

    Decreasing the number of preventable rehospitalizations by 20% by the end of 2013 is a goal of the $1 billion federal initiative Partnership for Patients, and the pursuit of this goal represents an opportunity to reduce harm to patients and reduce health care costs. Adverse drug events are a direct…

    • November 24, 2011
    • Budnitz D.S.Lovegrove M.C.Shehab N.Richards C.L.
    • N Engl J Med 2011; 365:2002-2012
    • Free Full Text

    This national study estimated that nearly 100,000 elderly patients were hospitalized for adverse drug events annually from 2007 through 2009. Most resulted from use of common medications such as warfarin and insulin, and only 1% from medications designated as high-risk.

  • Correspondence

    “Bath Salts” Intoxication

    To the Editor: The abuse of psychoactive "bath salts" (PABS) has become commonplace, and patients with PABS overdoses are presenting to emergency departments with increasing frequency. The primary ingredient of the synthetic designer drugs in these bath salts, which are not related to any hygiene…

    • September 8, 2011
    • N Engl J Med 2011; 365:967-968
    • Free Full Text

    This letter highlights recreational ingestion of bath salts containing methylenedioxypyrovalerone, a potent central nervous system stimulant. Intoxication that results in extreme sympathetic stimulation and profoundly alters mental status may be fatal.

Page

Medical Meetings Emergency Medicine Conferences and Meetings

A Primary Care Guide To Emergencies

The conference will be held in London, Dec. 28 and 29.

Contact Pascale Anthone, Medical-Credits, Heide 29, 2235 Westmeerbeek, Belgium; or call (32) 16438402; or e-mail info@medical-credits.com; or see http://www.medical-credits.com .

More Medical Meetings

Trends

Most Viewed (Last Week)

More Trends

Article Category
Research
Reviews
Clinical Cases
Perspective
Commentary
Other
Browse all articles
Multimedia
Videos in Clinical Medicine
Images in Clinical Medicine
Interactive Medical Cases
Weekly Audio Summaries
Browse all multimedia
This Week
Last Week
Browse full index
Selected Specialties
Cardiology
Endocrinology
Gastroenterology
Genetics
Hematology/Oncology
Infectious Disease
Nephrology
Neurology/Neurosurgery
Obstetrics/Gynecology
Pediatrics
Primary Care/Hospitalist
Pulmonary/Critical Care
Surgery
Browse all Specialties & Topics
Featured Topics
Clinical Practice Center
Health Policy and Reform
Medicine and Society
Global Health
Influenza A (H7N9)
Author Center
Submit a Manuscript or Letter
Track a Manuscript
Help