Innovative antifungal strategies: enhanced biofilm inhibition of by a modified tea tree oil formulation.

Introduction: is a significant human pathogen with the ability to form biofilms, a critical factor in its resistance to antifungal treatments. This study aims to evaluate the antifungal activity and biofilm inhibition potential of Tea Tree Oil (TTO) derived from cultivated in Vietnam.

Methods: The antifungal activity of TTO was assessed by determining the Minimum Inhibitory Concentration (MIC), Minimum Fungicidal Concentration (MFC), Minimum Biofilm Inhibitory Concentration (MBIC), and Minimum Biofilm Eradication Concentration (MBEC) using broth dilution methods.

Spectrophotometric analysis of purple urine secondary to methylene blue and hydroxocobalamin co-administration.

Background: The development of purple urine after methylene blue (methylthioninium chloride) and hydroxocobalamin co-administration is a rare clinical entity that has not been fully elucidated. A 47-year-old male presented to the emergency department with hypotension, cyanosis, and depressed mental status. The patient was noted to have profound peripheral and central cyanosis, as well as chocolate-colored arterial blood.

Impacts of United States Medical Licensing Examination Step 1 Scoring Change on Emergency Medicine Applicant Screening.

Background: The U.S. Medical Licensing Examination (USMLE) Step 1 has been used as a screening tool for residency selection.

Severe alcohol withdrawal in an adolescent male.

Ethanol remains one of the most frequently abused agents by adolescents, exceeding all others except for vaping nicotine, and use is rising. With increased ethanol use comes a greater risk for dependence and potential for alcohol withdrawal syndromes (AWS). Pediatric AWS is extremely rare and poorly characterized in the literature.

Phenytoin Toxicity After Transjugular Intrahepatic Portosystemic Shunt (TIPS).

Background: Transjugular intrahepatic portosystemic shunt (TIPS) alters portal blood flow and may impact drug metabolism and bioavailability. However, little evidence has been published to provide guidance on medication alterations after TIPS procedures.

Case Report: We report a patient who developed phenytoin toxicity requiring a prolonged readmission after a TIPS procedure.

A Case of Acute Pericarditis Following Intravenous Injection of Crushed Morphine Tablets.

A 37-year-old male presented with sharp, severe chest pain following seven days of intravenous injection of crushed morphine tablets. The chest pain was positional and pleuritic in nature and resolved with leaning forward. Work-up was notable for an ECG with inferior and anterolateral PR depressions as well as a CT chest with diffuse centrilobular nodules.

Internet-purchased ibogaine toxicity confirmed with serum, urine, and product content levels.

Unlabelled: Ibogaine, a psychotropic indole alkaloid, is gaining popularity among medical subcultures for its purported anti addictive properties. Its use has been associated with altered mental status, ataxia, gastrointestinal distress, ventricular arrhythmias, and sudden and unexplained deaths.Its pharmacokinetics in toxic states is not well understood.

Orbeez: the magic water absorbing bead--risk of pediatric bowel obstruction?

Objectives: In December 2012, the U.S. Consumer Product Safety Commission recalled the water-absorbing toy WaterBalz after reports of small intestine obstruction after ingestion by children.

Black urine due to urobilinogen in a patient with alcoholic pellagra.

Objectives: Systemic exposure to drugs, chemicals and foods can cause abnormally colored urine. Food exposures are typically benign, but urine discoloration due to chemicals or drugs may indicate a potentially dangerous condition. Discolored urine can also be caused by medical problems.

False-positive urine phencyclidine immunoassay screen result caused by interference by tramadol and its metabolites.

Phencyclidine is one of the drugs of abuse included in qualitative urine drug screens that are frequently ordered in the emergency department despite concerns about specificity and clinical utility. Many drugs have been described to cause false-positive results for phencyclidine. We present 2 cases of false-positive phencyclidine qualitative urine drug screen results in patients with seizures from tramadol misuse or abuse.

Mass sociogenic illness initially reported as carbon monoxide poisoning.

Background: Mass sociogenic illness (MSI) is a rare occurrence involving a constellation of physical signs and symptoms in a group of individuals that are exhibited subconsciously and have no corresponding organic etiology.

Objectives: To describe an outbreak of MSI initially attributed to carbon monoxide (CO) poisoning.

Case Reports: While attending a church service, one child fainted, followed by another.

"Spice" girls: synthetic cannabinoid intoxication.

Background: "Spice" refers to various synthetic cannabinoid-containing products that seem to have rapidly become popular recreational drugs of abuse. Very little medical literature currently exists detailing the adverse effects and emergency department (ED) presentations associated with "spice" use.

Objectives: To describe the presentation of 2 patients who recreationally used a "spice" product and to briefly summarize what is known about "spice" and synthetic cannabinoids.

Recurrent coagulopathy and thrombocytopenia in children treated with crotalidae polyvalent immune fab: a case series.

Objectives: Recurrent signs and symptoms after initial treatment and control of coagulopathy and thrombocytopenia after American pit viper (crotaline) envenomations have been previously described in patients treated with Crotalidae polyvalent immune Fab antivenom (FabAV). The significance and necessity of treatment of these recurrent abnormalities are uncertain. Our goal was to further characterize recurrent coagulopathy or thrombocytopenia in pediatric patients.

Prolonged coma in a child due to hashish ingestion with quantitation of THC metabolites in urine.

Background: Cannabinoid-containing substances are commonly abused worldwide. Significant toxicity from these substances is uncommon in adults but can result in significant symptoms in children; these symptoms are usually short-lived.

Objectives: To report a case of prolonged mental status alteration of more than 2 days in a child who ingested hashish.

A retrospective poison center review of varenicline-exposed patients.

Background: Varenicline was approved by the Food and Drug Administration (FDA) as a prescription smoking cessation aid in May 2006. Varenicline is both a partial nicotine agonist and an antagonist. Recent reports by the Institute of Safe Medication Practices identified safety problems associated with varenicline use, and the FDA recently issued a boxed warning.

A retrospective review of California poison control system data of sibutramine exposures.

Introduction: Sibutramine is a centrally acting neurotransmitter reuptake inhibitor used for the treatment of obesity. In doses of 10-15 mg/day, sibutramine has been shown to promote modest weight loss; however, the literature devoted to characterizing overdoses and abuses of sibutramine is limited.

Methods: We queried and retrospectively reviewed the California Poison Control System database between January 1998 and August 1, 2008.