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Glaizal M.,Center Antipoison Et Of Toxicovigilance Cap Tv | Lucciardi J.,Service de Chirurgie Thoracique et Viscerale | Tichadou L.,Center Antipoison Et Of Toxicovigilance Cap Tv | Spadari M.,Marseille University Hospital Center | And 3 more authors.

High dosage buprenorphine (HDB) is a sublingual maintenance treatment of opioid dependence which have proved its substantial Public Health results, but it is also known to be frequently abused and diverted, in particular for intravenous injection, with deleterious consequences. Intra-arterial use is more rarely reported with this substance, just like its complications, mainly ischemic, potentially necrotic, phenomena. We report here such a case, with a 30 years-old man suffering from severe ischemia of the thumb, the forefinger and the middle finger few hours after direct injection of a suspension of buprenorphine crushed tablets in right radial arteria. A treatment combining surgery (video-thoracoscopic thoracic sympathectomy) and medicines (heparin, iloprost and piribedil mesilate), permitted a semi-complete digital rehabilitation (only forefinger pulp necrosis persisted and requiried a distal amputation), and the patient was discharged after 2 weeks. © 2011 Société Française de Pharmacologie et de Thérapeutique. Source

Glaizal M.,Center Antipoison Et Of Toxicovigilance Cap Tv | Schmitt C.,Center Antipoison Et Of Toxicovigilance Cap Tv | Tichadou L.,Center Antipoison Et Of Toxicovigilance Cap Tv | Hayek-Lanthois M.,Center Antipoison Et Of Toxicovigilance Cap Tv | De Haro L.,Center Antipoison Et Of Toxicovigilance Cap Tv
Toxicologie Analytique et Clinique

Aims After 11 years coding in the same data base, to make a descriptive analysis of 24 hours/24 7 days/7 calls managed by the poison center of Marseille (CAPM), to help complete the rare French epidemiological data in clinical toxicology. Methods Retrospective study of all cases treated by the CAPM from 01/01/2002 to 31/12/2012, all encoded in SICAP, the French poison centers' common software. The analysis focused on the description and the evolution of enquirers, type of request and, if applicable, patients' demographics, circumstances of exposure, and classes of implicated products. Results Two hundred and seventy-three thousand four hundred and nine files were collected (61% from public, 34% from health professionals), including 256,875 cases of exposure for 269,001 people (median age: 13 years old - 40% under 4 -; 53% women). Eighty-three percent were accidentally exposed, 12% in a suicidal situation. The most commonly found agents are pharmaceutical drugs (concerning 33% of accidentally exposed subjects, 80% of deliberately ones), followed by chemicals and household products. Three hundred and thirty-six fatal cases were collected (56% male, median age: 49 years), of which 67% in voluntary poisoning context. Concerning time trends, there is a decline in professionals' requests vs. public ones, an increase in accidental exposures part, and a lower part of exposure to drugs, primarily anxiolytics, hypnotics and antidepressants; at the opposite, paracetamol poisonings are steadily rising. Conclusion This report highlights the richness and potential of data from poison centers to explain, treat and prevent poisonings. However, this efficient tool remains very fragile and requires a rapid and significant support. © 2014 Société Française de Toxicologie Analytique. Published by Elsevier Masson SAS. Allrights reserved. Source

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