Topical treatments for hydrofluoric acid burns: a blind controlled experimental study.

BACKGROUND: Calcium gluconate gel, applied after initial rinsing with water, has a documented effect as first aid treatment for hydrofluoric acid burns. Hexafluorine is a novel liquid compound developed especially for emergency decontamination of hydrofluoric acid eye and skin exposures. However, scientific documentation of the effect of Hexafluorine is insufficient. This study was undertaken to compare Hexafluorine with water rinsing plus topical calcium and with water rinsing alone. METHODS: Thirty-five Sprague-Dawley rats were anesthetized and their backs shaved. Four filter papers 10 mm in diameter were soaked in 50% hydrofluoric acid and applied on the shaved area of each rat for 3 minutes. Thirty seconds later, the acid-exposed skin areas were rinsed with 500 mL Hexafluorine for 3 minutes (group H, n = 10), 500 mL water for 3 minutes (group W, n = 10) or 500 mL water for 3 minutes followed by a single application of 2.5% calcium gluconate gel (group Ca, n = 10), or received no treatment (controls, n = 5). The animals were closely observed for 5 days. Daily at 4 P.M. each of the four burns on every rat was rated on a modified Draize scale graded from 0 to 5 (0 = no visible injury, 1 = diffuse erythema, 2 = distinct erythema, 3 = distinct erythema plus wounds or discolored spots, 4 = distinct erythema plus wounds or discolored areas covering >50% of the burn, 5 = a necrotic wound covering the whole burn). The mean of the four scores was then calculated for each animal and day. The rating procedure was performed by one laboratory assistant who was unaware of the treatment given. Kruskal-Wallis analysis was used to evaluate possible differences between treatment groups on each of the 5 days. If the p-value obtained was <0.05, correction for multiple comparisons was made. RESULTS: The mean severity score in group H was significantly higher than that in group Ca on days 2 and 3. Moreover, Hexafluorine showed a consistent trend towards a worse outcome, both in comparison to water plus topical calcium and to water rinsing alone. CONCLUSION: Based on these observations it is concluded that water rinsing followed by topical calcium should remain the standard first aid treatment for skin exposure to hydrofluoric acid.

[The men of the Andrée expedition probably died of botulism. A new hypothesis explains these mysterious deaths]. / Andrée-expeditionens män dog troligen av botulism. Ny hypotes förklarar de mystiska dödsfallen.

The last camp of the three members of the 1897 Swedish Andrée balloon expedition to the North Pole was found in Svalbard in 1930. The human remains and the paraphernalia of the expedition including diaries were brought to Sweden and are presently housed in a museum. The cause of the deaths has never been determined, but several hypotheses have been put forward over the years. Trichinosis, scurvy, and poisoning by carbon-monoxide, vitamin-A or lead are some of them. In this article it is argued that botulism is a plausible explanation which is in better accord with known facts.

[Serious effects of chloroquine overdose. Prescribe the smallest possible dosage-packages and inform about the risks]. / Allvarliga skador vid överdos av klorokin. Skriv ut minsta möjliga förpackning och informera om riskerna.

An increasing number of acute overdoses with chloroquine has been reported in Sweden--some with fatal outcome. This substance is clearly one of the most toxic pharmaceuticals on the Swedish market. Four cases are described. Travelling to the tropics has become very popular, and chloroquine is often given as a prophylactic antimalarial. This inexpensive drug is often prescribed in 100-tablet packages, and any surplus is often stored in the home. Awareness of toxicity is low among users and doctors in this country. Preventive measures are suggested.

[Risk of lung damage found in fire-eaters. Twelve Swedish hospital cases reported]. / Risk för lungskador vid eldslukning. Tolv svenska sjukhusfall rapporterade.

Twelve hospital cases and 69 telephone enquiries relating to fire-eating have been registered at the Swedish Poison Information Centre. Chemical pneumonitis with symptoms such as coughing, fever, dyspnoea and hypoxia is common after petroleum distillate ingestion with concomitant aspiration. Pleuritic chest pain is an additional characteristic symptom among fire-eaters. Pulmonary infiltrates and pleural effusions are also frequent findings.

[The rattlesnake is not more dangerous than the viper]. / Skallerormen inte farligare än huggormen.

The article consists of a comparison of the effects of snakebites inflicted by North American rattlesnakes and those of European vipers, based on a review of series of snake bite victims reported in the literature since 1980. The two groups of snakebites were found to manifest close similarity, even regarding the currently low fatality rates. Whereas local reactions seem to be more extensive after rattlesnake bites, circulatory symptoms including severe hypotension appear to be more common after viper bites. It is concluded that the two groups of snakes may be regarded as equally dangerous.

Citalopram overdose--review of cases treated in Swedish hospitals.

BACKGROUND: The toxic effects of acute citalopram overdose are reported by the Swedish Poisons Information Centre. DESIGN: Case reports received from Swedish hospitals during 1995 have been analyzed. Forty-four cases of pure citalopram intoxication have been studied in detail. RESULTS: At doses below 600 mg, mild symptoms were observed. Doses above 600 mg caused ECG abnormalities and convulsions in some patients, while doses greater than 1900 mg caused such symptoms in all patients. CONCLUSIONS: The findings are consistent with previous reports claiming that selective serotonin reuptake inhibitors are less toxic compared to tricyclic antidepressants. However, there is a risk of developing serious symptoms when large doses have been ingested.

High-dose prenalterol in beta-blockade intoxication.

This study presents a case of beta-blocker intoxication due to massive overdose of metoprolol (7.5 g). Prenalterol in a dose of 420 mg was given as antidote, in combination with epinephrine in intermittent doses. Resuscitation was performed during 4 hours because of mechanical asystole. The patient regained health in 24 hours after further repeated doses of 30 mg prenalterol. Prenalterol is valuable in the management of toxic doses of beta-blocking drugs, and a titration to extremely high doses of prenalterol might be necessary.