Latest Articles and News - Jul 22, 2025
post on 22 Jul 2025
Corrigendum to "Comparison of Biochemical Parameters between Mouse Model and Human after Paraquat Poisoning".
[This corrects the article DOI: 10.1155/2022/1254824.].
https://pubmed.ncbi.nlm.nih.gov/40693241/Minoxidil Overdose: A Case Report and Review of the Literature.
Minoxidil is a potent vasodilator originally used to treat severe refractory hypertension. Hypertrichosis is a common side effect of minoxidil, which led to the development and marketing of topical preparations for treating androgenetic alopecia (AGA). Minoxidil is primarily used to treat AGA; however, its inappropriate use can cause systemic side effects. Herein, we present the case of a 61-year-old Japanese man with an overdose of oral minoxidil that led to hypotension, breathlessness, edema, weight gain, and facial flushing. As the vital signs and results of laboratory and imaging tests were generally normal, no treatment was initiated. Two weeks after the initial visit, the patient's body weight decreased by approximately 10 kg, and the edema disappeared. To date, 14 patients have been reported to have developed systemic side effects following an overdose of minoxidil-containing medications. Our literature review identified that systemic symptoms related to minoxidil overdose occurred in 10 of 14 patients after ingestion of a topical formulation, three after tablet ingestion, and one after application of a large amount of topical solution to the scalp. All 14 patients experienced hypotension and/or tachycardia. These symptoms occurred within six hours of the ingestion of 100-3000 mg minoxidil. One of 14 patients presented with a complication of myocardial infarction, and no patient died. Interestingly, fluid therapy was ineffective in the treatment of hypotension related to minoxidil overdoses. Since the primary pathophysiological effect of minoxidil is a decrease in systemic vascular resistance by arteriolar vasodilation, peripherally acting alpha-adrenergic agonists, such as phenylephrine, midodrine, and norepinephrine, may be safer and more effective than dopamine and epinephrine.
https://pubmed.ncbi.nlm.nih.gov/40693100/Extracorporeal membrane oxygenation as a bridge to lung transplantation following paraquat poisoning.
Paraquat poisoning contributes to nearly 14.4% of the total poisoning cases in southern India. When ingested, it leads to renal and liver damage. It accumulates in alveolar cells and through reactive oxygen species damage, it can lead to pulmonary fibrosis. Once pulmonary fibrosis is established, the ensuing respiratory failure is irreversible. The previously reported duration of extracorporeal membrane oxygenation (ECMO) to support the respiratory function in paraquat poisoning, as a bridge to lung transplantation, ranged between 1 and 2 days. We demonstrate the use of long-term awake veno-venous (VV) ECMO in two patients (70 and 67 days), after paraquat poisoning as a bridge to lung transplantation. We describe the advantages of awake ECMO in patients requiring extended ECMO support mainly in the form of nutritional, physical, and psychiatric rehabilitation. This is of importance in these patients, and awake ECMO provides an excellent method to achieve an optimum physical status prior to lung transplantation.
https://pubmed.ncbi.nlm.nih.gov/40693006/Predictors of ICU Admission in Intentional Overdose Presentations to the Emergency Department.
To identify predictors of admission to ICU for patients attending the emergency department (ED) after intentional drug overdose. A retrospective study examining factors predictive of ICU admission for adults > 15 years presenting to Christchurch ED with intentional overdose between 1 July 2018 and 31 December 2020. Descriptive statistics were used by treating all presentations independently and on a per-patient basis to account for patients with repeat presentations or ICU admissions. Binary logistic models provided odds ratios with 95% confidence intervals. A multivariable logistic regression model which controlled for patients with ≥ 3 ED presentations in the past 365 days was used to determine predictors of ICU admission. There were 2682 presentations to ED with intentional overdose from 1795 individual patients, with 113 associated ICU admissions (4.2%) involving 103 patients. Overdose was more common in those who were younger, of female sex, or with a mental health history. The rate of overdose by Māori patients was double the rate expected. Older age, reduced level of consciousness, polypharmacy or cardiac drug overdose, and a history of depression, substance abuse or ADHD, ASD, learning difficulties or previous head injury were independently associated with an increased risk of ICU admission. Paracetamol ingestion and a history of ≥ 3 ED presentations in the preceding year were independently associated with a lower risk of ICU admission. The need for ICU admission in patients presenting with intentional overdose should be identified early to prevent deterioration, promote flow through the hospital, and ensure that ICU beds are utilised appropriately.
https://pubmed.ncbi.nlm.nih.gov/40691122/
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