<html xmlns:v="urn:schemas-microsoft-com:vml" xmlns:o="urn:schemas-microsoft-com:office:office" xmlns:w="urn:schemas-microsoft-com:office:word" xmlns:m="http://schemas.microsoft.com/office/2004/12/omml" xmlns="http://www.w3.org/TR/REC-html40">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">
<meta name="Generator" content="Microsoft Word 15 (filtered medium)">
<style><!--
/* Font Definitions */
@font-face
{font-family:"Cambria Math";
panose-1:2 4 5 3 5 4 6 3 2 4;}
@font-face
{font-family:Calibri;
panose-1:2 15 5 2 2 2 4 3 2 4;}
@font-face
{font-family:"Script MT Bold";
panose-1:3 4 6 2 4 6 7 8 9 4;}
@font-face
{font-family:"Segoe UI";
panose-1:2 11 5 2 4 2 4 2 2 3;}
@font-face
{font-family:ArialUnicodeMS;
panose-1:0 0 0 0 0 0 0 0 0 0;}
/* Style Definitions */
p.MsoNormal, li.MsoNormal, div.MsoNormal
{margin:0in;
margin-bottom:.0001pt;
font-size:11.0pt;
font-family:"Calibri",sans-serif;}
p.MsoBodyText, li.MsoBodyText, div.MsoBodyText
{mso-style-priority:99;
mso-style-link:"Body Text Char";
margin-top:0in;
margin-right:0in;
margin-bottom:6.0pt;
margin-left:0in;
line-height:106%;
font-size:11.0pt;
font-family:"Calibri",sans-serif;}
a:link, span.MsoHyperlink
{mso-style-priority:99;
color:#0563C1;
text-decoration:underline;}
a:visited, span.MsoHyperlinkFollowed
{mso-style-priority:99;
color:#954F72;
text-decoration:underline;}
p.MsoListParagraph, li.MsoListParagraph, div.MsoListParagraph
{mso-style-priority:34;
margin-top:0in;
margin-right:0in;
margin-bottom:8.0pt;
margin-left:.5in;
mso-add-space:auto;
line-height:106%;
font-size:11.0pt;
font-family:"Calibri",sans-serif;}
p.MsoListParagraphCxSpFirst, li.MsoListParagraphCxSpFirst, div.MsoListParagraphCxSpFirst
{mso-style-priority:34;
mso-style-type:export-only;
margin-top:0in;
margin-right:0in;
margin-bottom:0in;
margin-left:.5in;
margin-bottom:.0001pt;
mso-add-space:auto;
line-height:106%;
font-size:11.0pt;
font-family:"Calibri",sans-serif;}
p.MsoListParagraphCxSpMiddle, li.MsoListParagraphCxSpMiddle, div.MsoListParagraphCxSpMiddle
{mso-style-priority:34;
mso-style-type:export-only;
margin-top:0in;
margin-right:0in;
margin-bottom:0in;
margin-left:.5in;
margin-bottom:.0001pt;
mso-add-space:auto;
line-height:106%;
font-size:11.0pt;
font-family:"Calibri",sans-serif;}
p.MsoListParagraphCxSpLast, li.MsoListParagraphCxSpLast, div.MsoListParagraphCxSpLast
{mso-style-priority:34;
mso-style-type:export-only;
margin-top:0in;
margin-right:0in;
margin-bottom:8.0pt;
margin-left:.5in;
mso-add-space:auto;
line-height:106%;
font-size:11.0pt;
font-family:"Calibri",sans-serif;}
p.MsoIntenseQuote, li.MsoIntenseQuote, div.MsoIntenseQuote
{mso-style-priority:30;
mso-style-link:"Intense Quote Char";
margin-top:.25in;
margin-right:.6in;
margin-bottom:.25in;
margin-left:.6in;
text-align:center;
line-height:106%;
border:none;
padding:0in;
font-size:11.0pt;
font-family:"Calibri",sans-serif;
color:#4472C4;
font-style:italic;}
span.EmailStyle17
{mso-style-type:personal-compose;
font-family:"Calibri",sans-serif;
color:windowtext;}
span.BodyTextChar
{mso-style-name:"Body Text Char";
mso-style-priority:99;
mso-style-link:"Body Text";}
span.IntenseQuoteChar
{mso-style-name:"Intense Quote Char";
mso-style-priority:30;
mso-style-link:"Intense Quote";
color:#4472C4;
font-style:italic;}
.MsoChpDefault
{mso-style-type:export-only;
font-family:"Calibri",sans-serif;}
@page WordSection1
{size:8.5in 11.0in;
margin:1.0in 1.0in 1.0in 1.0in;}
div.WordSection1
{page:WordSection1;}
/* List Definitions */
@list l0
{mso-list-id:405688147;
mso-list-type:hybrid;
mso-list-template-ids:2021667438 1621511010 67698713 67698715 67698703 67698713 67698715 67698703 67698713 67698715;}
@list l0:level1
{mso-level-tab-stop:none;
mso-level-number-position:left;
text-indent:-.25in;}
@list l0:level2
{mso-level-number-format:alpha-lower;
mso-level-tab-stop:none;
mso-level-number-position:left;
text-indent:-.25in;}
@list l0:level3
{mso-level-number-format:roman-lower;
mso-level-tab-stop:none;
mso-level-number-position:right;
text-indent:-9.0pt;}
@list l0:level4
{mso-level-tab-stop:none;
mso-level-number-position:left;
text-indent:-.25in;}
@list l0:level5
{mso-level-number-format:alpha-lower;
mso-level-tab-stop:none;
mso-level-number-position:left;
text-indent:-.25in;}
@list l0:level6
{mso-level-number-format:roman-lower;
mso-level-tab-stop:none;
mso-level-number-position:right;
text-indent:-9.0pt;}
@list l0:level7
{mso-level-tab-stop:none;
mso-level-number-position:left;
text-indent:-.25in;}
@list l0:level8
{mso-level-number-format:alpha-lower;
mso-level-tab-stop:none;
mso-level-number-position:left;
text-indent:-.25in;}
@list l0:level9
{mso-level-number-format:roman-lower;
mso-level-tab-stop:none;
mso-level-number-position:right;
text-indent:-9.0pt;}
ol
{margin-bottom:0in;}
ul
{margin-bottom:0in;}
--></style><!--[if gte mso 9]><xml>
<o:shapedefaults v:ext="edit" spidmax="1026" />
</xml><![endif]--><!--[if gte mso 9]><xml>
<o:shapelayout v:ext="edit">
<o:idmap v:ext="edit" data="1" />
</o:shapelayout></xml><![endif]-->
</head>
<body lang="EN-US" link="#0563C1" vlink="#954F72">
<div class="WordSection1">
<div style="mso-element:para-border-div;border-top:solid #4472C4 1.0pt;border-left:none;border-bottom:solid #4472C4 1.0pt;border-right:none;padding:10.0pt 0in 10.0pt 0in;margin-left:.6in;margin-right:.6in">
<p class="MsoIntenseQuote" style="mso-margin-top-alt:.25in;margin-right:0in;margin-bottom:.25in;margin-left:0in">
Upstate NY Poison Center<o:p></o:p></p>
<p class="MsoIntenseQuote" style="mso-margin-top-alt:.25in;margin-right:0in;margin-bottom:.25in;margin-left:0in">
<span style="font-family:"Arial",sans-serif">Toxicology Case Conference<o:p></o:p></span></p>
<p class="MsoIntenseQuote" style="mso-margin-top-alt:.25in;margin-right:0in;margin-bottom:.25in;margin-left:0in">
<span style="font-family:"Arial",sans-serif">September 29, 2022<o:p></o:p></span></p>
<p class="MsoIntenseQuote" style="mso-margin-top-alt:.25in;margin-right:0in;margin-bottom:.25in;margin-left:0in">
<span style="font-family:"Arial",sans-serif">Time: 1330-1530<o:p></o:p></span></p>
</div>
<table class="MsoTableGrid" border="1" cellspacing="0" cellpadding="0" width="655" style="width:491.25pt;border-collapse:collapse;border:none">
<tbody>
<tr style="height:13.85pt">
<td width="89" valign="top" style="width:67.05pt;border:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:13.85pt">
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif;color:black">Location<o:p></o:p></span></p>
</td>
<td width="566" valign="top" style="width:424.2pt;border:solid windowtext 1.0pt;border-left:none;padding:0in 5.4pt 0in 5.4pt;height:13.85pt">
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:black">JH 5<sup>th</sup> Floor<o:p></o:p></span></p>
</td>
</tr>
<tr style="height:56.95pt">
<td width="89" valign="top" style="width:67.05pt;border:solid windowtext 1.0pt;border-top:none;padding:0in 5.4pt 0in 5.4pt;height:56.95pt">
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:black"><o:p> </o:p></span></p>
</td>
<td width="566" valign="top" style="width:424.2pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:56.95pt">
<p style="background:white"><span style="font-size:9.0pt;font-family:"Arial",sans-serif;color:black">Zoom:
<o:p></o:p></span></p>
<p style="background:white"><span style="font-size:9.0pt;font-family:"Arial",sans-serif;color:#3C4043;letter-spacing:.15pt"><a href="https://urldefense.com/v3/__https://upstate.zoom.us/j/94022814635?pwd=ZXdZOFN3OFMrN1FjWlhOTGRid3YyUT09__;!!GobTDDpD7A!I_eqU06MPbV8HhZA6Tilb3IO_oXORufBE3_UIvG52lploTql3bXkGbq0DlXI9ezuksTNBrNL1JVryTXYAmC2IXwO$">https://upstate.zoom.us/j/94022814635?pwd=ZXdZOFN3OFMrN1FjWlhOTGRid3YyUT09</a><o:p></o:p></span></p>
<p style="background:white"><span style="font-size:9.0pt;font-family:"Arial",sans-serif;color:#3C4043;letter-spacing:.15pt">password: caseconf</span><span style="font-size:10.5pt;font-family:"Arial",sans-serif;color:#3C4043;letter-spacing:.15pt"><o:p></o:p></span></p>
</td>
</tr>
<tr style="height:13.05pt">
<td width="89" valign="top" style="width:67.05pt;border:solid windowtext 1.0pt;border-top:none;padding:0in 5.4pt 0in 5.4pt;height:13.05pt">
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:black">Leader<o:p></o:p></span></p>
</td>
<td width="566" valign="top" style="width:424.2pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:13.05pt">
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:black">Michael Keenan, MD and Christine Stork, PharmD<o:p></o:p></span></p>
</td>
</tr>
</tbody>
</table>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><span style="font-size:14.0pt">Case Presentation<o:p></o:p></span></p>
<ol style="margin-top:0in" start="1" type="1">
<li class="MsoListParagraphCxSpFirst" style="margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;mso-add-space:auto;line-height:normal;mso-list:l0 level1 lfo1">
Patient is a 34 year old female who presents after an overdose of a product she bought online. She has a yellow discoloration to her fingers. She is agitated, tachycardic (160s) and hyperthermic (100.4oF).
<o:p></o:p></li><ol style="margin-top:0in" start="1" type="a">
<li class="MsoListParagraphCxSpMiddle" style="margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;mso-add-space:auto;line-height:normal;mso-list:l0 level2 lfo1">
What could this be? <o:p></o:p></li><li class="MsoListParagraphCxSpMiddle" style="margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;mso-add-space:auto;line-height:normal;mso-list:l0 level2 lfo1">
Management approach?<o:p></o:p></li></ol>
<li class="MsoListParagraphCxSpMiddle" style="margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;mso-add-space:auto;line-height:normal;mso-list:l0 level1 lfo1">
Patient is a 37 year old Male who presented intoxicated. He states he had been drinking alcohol mixed with a product at work (works as a lawn keeper at a golf course). HR on arrival in the 150s. Temp 102oF. BP 92/63. Lactate 10.7.<o:p></o:p></li><ol style="margin-top:0in" start="1" type="a">
<li class="MsoListParagraphCxSpMiddle" style="margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;mso-add-space:auto;line-height:normal;mso-list:l0 level2 lfo1">
What could this be?<o:p></o:p></li><li class="MsoListParagraphCxSpMiddle" style="margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;mso-add-space:auto;line-height:normal;mso-list:l0 level2 lfo1">
Management approach?<o:p></o:p></li></ol>
<li class="MsoListParagraphCxSpMiddle" style="margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;mso-add-space:auto;line-height:normal;mso-list:l0 level1 lfo1">
Pt is a 92 year old Male who presented for routine lab work and was found to have digoxin level of 6.2. Cr is elevated at 1.81. He was otherwise asymptomatic. He was admitted and levels were trended. Digoxin decreased to 4.7, but then increased to 5.9. Cr has
improved to 1.35. PCC is called at this point<o:p></o:p></li><ol style="margin-top:0in" start="1" type="a">
<li class="MsoListParagraphCxSpLast" style="margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;mso-add-space:auto;line-height:normal;mso-list:l0 level2 lfo1">
What is going on?<o:p></o:p></li></ol>
</ol>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">Journal Club – Syracuse rotators, please read all articles and please let the fellow know who will briefly present each article.<o:p></o:p></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:12.0pt;font-family:"Segoe UI",sans-serif;color:black">1. </span><span style="font-size:10.0pt;font-family:ArialUnicodeMS">Emily K. Kershner, Natasha Tobarran, Andrew Chambers, Brandon K.<o:p></o:p></span></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:10.0pt;font-family:ArialUnicodeMS">Wills & Kirk L. Cumpston (2022): Retained bullets and lead toxicity: a systematic review, Clinical<o:p></o:p></span></p>
<p class="MsoBodyText" style="mso-margin-top-alt:1.3pt;margin-right:0in;margin-bottom:6.0pt;margin-left:2.0pt;punctuation-wrap:simple">
<span style="font-size:10.0pt;line-height:106%;font-family:ArialUnicodeMS">Toxicology, DOI: 10.1080/15563650.2022.2116336<o:p></o:p></span></p>
<p class="MsoBodyText" style="mso-margin-top-alt:1.3pt;margin-right:0in;margin-bottom:6.0pt;margin-left:2.0pt;punctuation-wrap:simple">
2. Duburcq T, Goutay J, Preau S, Mugnier A, Rousse N, Moussa MD, Vincentelli A, Cuny J, Parmentier-Decrucq E, Poissy J. Venoarterial Extracorporeal Membrane Oxygenation in Severe Drug Intoxication: A Retrospective Comparison of Survivors and Nonsurvivors. ASAIO
J. 2022 Jul 1;68(7):907-913. doi: 10.1097/MAT.0000000000001583. Epub 2022 Sep 20. PMID: 34560717.<o:p></o:p></p>
<p class="MsoBodyText" style="mso-margin-top-alt:1.3pt;margin-right:0in;margin-bottom:6.0pt;margin-left:2.0pt;punctuation-wrap:simple">
3. Vandroux D, Aujoulat T, Gaüzère BA, Puech B, Guihard B, Martinet O. Predicting factors for the need of extracorporeal membrane oxygenation for suicide attempts by cardiac medication: a single-center cohort study. World J Emerg Med. 2022;13(4):283-289. doi:
10.5847/wjem.j.1920-8642.2022.070. PMID: 35837565; PMCID: PMC9233975.<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><span style="font-family:"Script MT Bold"">Christine M. Stork, BSPharm, PharmD, MPH, DABAT, FAACT<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Script MT Bold"">Professor, Department of Emergency Medicine<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Script MT Bold"">Clinical Director, Upstate NY Poison Center<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Script MT Bold"">Upstate Medical University<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Script MT Bold"">Syracuse, NY<o:p></o:p></span></p>
<p class="MsoNormal"><o:p> </o:p></p>
</div>
</body>
</html>