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4. Contributors

Author

Adams, Axel, primary, Affun-Adegbulu, Clara, additional, Al-Rasheed, Rakan S., additional, Alaska, Yasser A., additional, Aldawas, Abdulaziz D., additional, Alesa, Saleh Ali, additional, Alexander, George A., additional, Alhadhira, Abdullah Ahmed, additional, Alhajjaj, Fahad Saleha, additional, Alhazmi, Hazem H., additional, Alhussaini, Zainab Abdullah, additional, Aljerian, Nawfal, additional, Aljohani, Majed, additional, AlKhaldi, Khaldoon H., additional, Alkhattabi, Eyad, additional, Allen, Bryant, additional, Almand, Austin, additional, Alnoaimi, Moza M., additional, Alotaibi, Mohammad, additional, Alpert, Evan Avraham, additional, Alrusayni, Yasir A., additional, Alshammari, Mai, additional, Alsulimani, Loui K., additional, Amanullah, Siraj, additional, Anderson, Arian, additional, Arastehmanesh, David, additional, Ardalan, Ali, additional, Argote-Araméndiz, Killiam A., additional, Artenstein, Andrew W., additional, Bailey, Olivia E., additional, Baker, Russell, additional, Balsari, Satchit, additional, Banner, Gregory T., additional, M, Fermin Barrueto, additional, Bartels, Susan A., additional, Baugh, Joshua J., additional, Berg, Frederic, additional, Bhola, Vijai, additional, Binder, William, additional, Bortolin, Michelangelo, additional, Bounes, Vincent, additional, Bouton, Michael, additional, Brown, Natasha, additional, Jr, Frederick M. Burkle,, additional, Burnett, Lynn Barkley, additional, Burns, Michele M., additional, Sr, Nicholas V. Cagliuso,, additional, Cahill, John, additional, Callaway, David W., additional, Caneva, Duane C., additional, Cattamanchi, Srihari, additional, Caycedo, Alejandra, additional, Cetaruk, Edward W., additional, Chacko, Sneha, additional, Chang, James C., additional, Chiang, Crystal, additional, Chiu, David T., additional, Ciottone, Gregory R., additional, Ciottone, Jonathan Peter, additional, Ciottone, Melissa A., additional, Ciottone, Robert A., additional, Ciottone, Robert G., additional, Ciottone, Vigen G., additional, Clark, Alexander, additional, Clark, Jonathan, additional, Conley, Sean P., additional, Cono, Joanne, additional, Cooper, Arthur, additional, Cormier, Scott B., additional, Court, Michael F., additional, Cunningham, Cord W., additional, Czarnecki, Fabrice, additional, Davis, Supriya, additional, Davis, Timothy E., additional, DeMers, Gerard, additional, Dilling, Sharon, additional, Djalali, Ahmadreza, additional, Donahoe, Timothy, additional, Donahue, Joseph, additional, Dresser, Caleb, additional, Dylik, Jason, additional, Easter, Benjamin, additional, Eastman, Alexander, additional, Ebbeling, Laura, additional, Emetarom, Chigozie, additional, Eyal, Nir, additional, Eyre, Andrew J., additional, Freeman, David J., additional, Friedman, Franklin D., additional, Fritz, Christie, additional, Fung, Frederick, additional, Gallahue, Fiona E., additional, Garbern, Stephanie Chow, additional, Gebhart, Mark E., additional, Gluckman, William A., additional, Goolsby, Craig, additional, Gougelet, Robert M., additional, Granholm, Fredrik, additional, Greenough, P. Gregg, additional, Grimes, Jennifer O., additional, Grosse, Steve, additional, Grossman, Shamai A., additional, Jr, John T. Groves, additional, Guidotti, Tee L., additional, Guo, George, additional, Haessler, Sarah, additional, Hall, Matthew M., additional, Hardin, John W., additional, Harrell, Mason, additional, Hart, MD, Alexander, additional, Harvey, Melissa, additional, Hertelendy, PhD, Attila J., additional, Hiremath, Nishanth S., additional, Hitchens, Jordan, additional, Holstege, Christopher P., additional, Horne, Simon T., additional, Horng, Steven, additional, Hosin, Amer, additional, House, Hans R., additional, Ingrassia, Pier Luigi, additional, Issa, Fadi S., additional, Jacoby, Irving “Jake”, additional, Jaiswal, Rajnish, additional, Jay, Gregory, additional, Jenkins, J. Lee, additional, Joseph, Josh W., additional, Kappler, Shane, additional, Keim, Mark E., additional, Kelman, Julie, additional, Ketterer, Andrew R., additional, Khan, Anas A., additional, Kharel, Ramu, additional, Kharod, Chetan U., additional, Kirsch, Thomas D., additional, Knopov, Anita, additional, Kravitz, Max, additional, Lee, J. Austin, additional, Lemery, Jay, additional, Leventhal, Evan L., additional, Loughlin, Jesse, additional, Ludy, Stephanie, additional, Maguire, Brian J., additional, Mahon, Selwyn E., additional, Maniscalco, Paul M., additional, Manners, Philip, additional, Marcus, Leonard Jay, additional, Margus, Colton, additional, Masri, Taha M., additional, Matthews, Jeff, additional, McKay, Sean D., additional, McKinney, Zeke J., additional, McLellan, Robert K., additional, McNulty, Eric J., additional, Mehkri, Faroukh, additional, Mehta, Mandana, additional, Mendelsohn, Rebecca A., additional, Merin, Ofer, additional, Milsten, Andrew, additional, Molé, Dale M., additional, Molloy, Michael Sean, additional, Morelli, Ilaria, additional, Mothershead, Jerry L., additional, Mulhern, John, additional, Mullendore, Nicole F., additional, Musisca, Nicholas J., additional, Naganathan, Sonya, additional, Nathanson, Larry A., additional, Nelson, Erica L., additional, Nelson, Lewis S., additional, Newbury, Bradford A., additional, Newbury, Kimberly, additional, O’Neill, Ansley, additional, Obernier, Robert, additional, Olagnero, Jacopo M., additional, Oostrom-Shah, Leonie, additional, Ordun, Catherine Y., additional, Parazynski, Scott, additional, Park, Andrew J., additional, Partridge, Robert, additional, S, Jeffrey, additional, Phillips, James P., additional, Pinter, Emily, additional, IV, David P. Polatty, additional, Popieluszko, Patrick, additional, Porcaro, William, additional, Proano, Lawrence, additional, Pruitt, Peter B., additional, Qureshi, Moiz, additional, Ragazzoni, Luca, additional, Rashid, Murtaza, additional, Rega, Paul Patrick, additional, Reilly, Michael J., additional, Restuccia, Marc C., additional, Rifino, James J., additional, Robben, Paul M., additional, Rosenblatt, Joy L., additional, Ryan, Kevin M., additional, Rybasack-Smith, Heather, additional, Salway, Richard James, additional, Samo, Daniel, additional, Sanchez, Leon D., additional, Sanford, Shawn M., additional, Sarin, Ritu R., additional, Sarma, Deesha, additional, Schacht, Jesse, additional, Schwind, Valarie, additional, Shapiro, Geoffrey L., additional, Sheehan, Joshua, additional, Shreve, Brian, additional, Simonyan, Grigor, additional, Smith, Devin M., additional, MD, E. Reed Smith,, additional, MA, Jack E. Smith,, additional, Smith, Montray, additional, Smulowitz, Peter B., additional, Snyder, Angela M., additional, Solano, Joshua J., additional, Stenson, Bryan A., additional, Stewart, Charles, additional, Stewart, M. Kathleen, additional, Sullivan, Patrick, additional, Supple, Jared S., additional, Tin, Derrick, additional, Valente, Jonathan Harris, additional, Vear, Kathryn M., additional, Vidyalakshmi, P.R., additional, Vilas, Faith, additional, Vilke, Gary M., additional, Villano, Janna H., additional, Voskanyan, Amalia, additional, Watson, C. James, additional, Weber, Nancy, additional, Weiner, Scott G., additional, Weinstein, Brielle, additional, Weinstein, Eric S., additional, Werner, Jordan R., additional, MD, Roy Karl Werner,, additional, Whitledge, James D., additional, Wiener, Sage W., additional, Wiesner, Lauren, additional, Williams, Kenneth A., additional, Wing, Robyn, additional, Wolfe, Richard E., additional, Wong, Wendy Hin-Wing, additional, Woolard, Robert, additional, Wuthisuthimethawee, Prasit, additional, and Youssef, Nadine A., additional

Published
2024
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7. Diagnosis of Acute Poisoning Using Explainable Artificial Intelligence

Author

Chary, Michael, Boyer, Ed W, and Burns, Michele M

Subjects
Computer Science - Artificial Intelligence, Computer Science - Human-Computer Interaction, Computer Science - Machine Learning
Abstract

Medical toxicology is the clinical specialty that treats the toxic effects of substances, be it an overdose, a medication error, or a scorpion sting. The volume of toxicological knowledge and research has, as with other medical specialties, outstripped the ability of the individual clinician to entirely master and stay current with it. The application of machine learning techniques to medical toxicology is challenging because initial treatment decisions are often based on a few pieces of textual data and rely heavily on prior knowledge. ML techniques often do not represent knowledge in a way that is transparent for the physician, raising barriers to usability. Rule-based systems and decision tree learning are more transparent approaches, but often generalize poorly and require expert curation to implement and maintain. Here, we construct a probabilistic logic network to represent a portion of the knowledge base of a medical toxicologist. Our approach transparently mimics the knowledge representation and clinical decision-making of practicing clinicians. The software, dubbed Tak, performs comparably to humans on straightforward cases and intermediate difficulty cases, but is outperformed by humans on challenging clinical cases. Tak outperforms a decision tree classifier at all levels of difficulty. Probabilistic logic provides one form of explainable artificial intelligence that may be more acceptable for use in healthcare, if it can achieve acceptable levels of performance., Comment: Parts submitted to HICSS 54

Published
2021

15. Evolving trends of pharmaceutical poisonings associated with QRS complex prolongation.

Author

Tang, Katherine B., Simpson, Michael D., and Burns, Michele M.

Subjects
FLECAINIDE, TRICYCLIC antidepressants, DRUG side effects, CARDIOTOXICITY, INTENSIVE care units
Abstract

Introduction: Tricyclic antidepressants often cause drug-induced QRS complex prolongation in overdose but are now less commonly prescribed. We sought to determine, among a contemporary cohort of patients, the pharmaceuticals independently associated with QRS complex prolongation in acute overdose. Methods: We performed secondary analysis of data from the Toxicology Investigators Consortium (ToxIC) Core Registry. We included adult patients presenting from January 2016 through March 2023 with acute or acute-on-chronic pharmaceutical exposures. The primary outcome was QRS complex prolongation >0.12 s. Secondary outcomes included cardiac arrest, death, ventricular dysrhythmia, intensive care unit admission, initiation of vasopressors, and treatment with sodium bicarbonate. We used a multivariable logistic regression model with QRS complex prolongation as the outcome and individual pharmaceuticals of interest as independent variables. We assessed yearly trends of the contribution of relevant pharmaceuticals to QRS complex prolongation since 2016. Results: Of 11,945 patients in the total cohort (median age 37 years, 6,652 [55.7%] female), 366 (3.1%) developed QRS complex prolongation. Of 9,417 patients included in the model, 290 (3.1%) developed QRS complex prolongation. Amitriptyline, nortriptyline, doxepin, imipramine, noxiptiline, bupropion, flecainide, carvedilol, propranolol, diphenhydramine, and lamotrigine poisonings were independent predictors of QRS complex prolongation. Flecainide poisoning conferred the greatest odds of QRS complex prolongation (OR 574.1; 95% CI: 88.3–12,747). The contribution of tricyclic antidepressants to QRS complex prolongation decreased from 38.8% to 17.6% of all patients with QRS complex prolongation from 2016 to 2022. In 2022, the proportion of QRS complex prolongation from diphenhydramine (20.6%) surpassed that of tricyclic antidepressants. Discussion: This study provides insights into contemporary pharmaceutical poisoning associated with QRS complex prolongation. Tricyclic antidepressants remain clinically relevant exposures but are no longer the most common cause of drug-induced QRS complex prolongation. Conclusions: Bupropion, diphenhydramine, and antidysrhythmics are increasingly common causes of QRS complex prolongation, each associated with numerous severe outcomes in poisoning. Greater safety measures to protect patients from cardiovascular toxicity from these pharmaceuticals are warranted. [ABSTRACT FROM AUTHOR]

Published
2024
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16. A Brush with Danger

Author

Hirsch, Alexander W., Popovsky, Erica Y., Nigrovic, Lise E., and Burns, Michele M.

Published
2018

18. Contributors

Author

Barbuto, Alexander F., primary, Bateman, D. Nicholas, additional, Bebarta, Vikhyat S., additional, Bentur, Yedidia, additional, Boyer, Edward W., additional, Brent, Jeffrey, additional, Brown, Mary Jean, additional, Burns, Michele M., additional, Dawson, Andrew, additional, Deng, Jou-Fang, additional, Descamps, Anne-Marie, additional, Desel, Herbert, additional, Dufol, Ana Ferrer, additional, Erickson, Timothy B., additional, Garnier, Robert, additional, Gaviola, Gabriel C., additional, Goldfarb, Yu. S., additional, Goldman, Rose, additional, Haines, John, additional, Hauptman, Marissa, additional, Hoegberg, Lotte C.G., additional, Howland, Mary Ann, additional, Jian, Xiangdong, additional, Kunzler, Nathan, additional, Kupferschmidt, Hugo, additional, Locatelli, Carlo Alessandro, additional, Maddry, Joseph K., additional, Makalinao, Irma Reyes, additional, McMartin, Kenneth E., additional, Mégarbane, Bruno, additional, Ng, Patrick C., additional, Nguyen, Nguyen Trung, additional, Ostapenko, Yu. N., additional, Panganiban, Lynn Crisanta del Rosario, additional, Pelclova, Daniela, additional, Perelman, Ronald O., additional, Proudfoot, Alex, additional, Rague, John, additional, van Riel, Antoinette, additional, Roh, Hyung-Keun, additional, Sriapha, Charuwan, additional, Stürer, Andreas, additional, Tempowski, Joanna, additional, Toomey, David, additional, Vandijck, Dominique, additional, de Vries, Irma, additional, Wananukul, Winai, additional, Whyte, Ian, additional, Woolf, Alan D., additional, Wright, Nicole, additional, Xarau, Santiago Nogué, additional, Yang, Chen-Chang, additional, and Zeng, Mei, additional

Published
2022
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24. Management of Pediatric Trauma

Author

Shook, Joan E, Chun, Thomas H, Conners, Gregory P, Conway, Edward E, Dudley, Nanette C, Fuchs, Susan M, Lane, Natalie E, Macias, Charles G, Moore, Brian R, Wright, Joseph L, Quinlan, Kyran, Agran, Phyllis F, Burns, Michele, Denny, Sarah, Hirsh, Michael, Johnston, Brian, Monroe, Kathy, Powell, Elizabeth C, Schaechter, Judith, Zonfrillo, Mark R, Agus, Michael SD, Hsu, Benson S, Hupp, Susan R, Poss, W Bradley, Stockwell, Jana A, Straumanis, John P, Vernon, Donald D, Otsuka, Norman Y, Abzug, Joshua M, Ganley, Theodore, Herman, Martin, Hyman, Joshua E, Segal, Lee, Shaw, Brian A, Schwend, Richard M, Caty, Michael G, Besner, Gail, Davidoff, Andrew, Fallat, Mary E, Heiss, Kurt F, Meyers, Rebecka L, Moss, R Lawrence, Meyer, Keith, Heiman, Howard S, Holcomb, Robert G, Meyer, Michael T, Pershad, Jay K, Stroud, Michael H, Walsh, Michele M, Moss, M Michele, Douglas, Webra Price, Falcone, Richard, Gaines, Barbara, Haas, Lynn, Cassidy, Laura, Elsbernd, Terri, Free, Garet, Gray, Lisa, Groner, Jonathan, Haley, Kathy, Letton, Robert, Millikan, William, Nance, Michael, Violano, Pina, Roney, Linda, McKenna, Chris, Pedicino, Mary Jo, Rzucidlo, Susan, Snow, Sally K, and Reichter, Lisa

Subjects
Physical Injury - Accidents and Adverse Effects, Traumatic Head and Spine Injury, Childhood Injury, Unintentional Childhood Injury, Pediatric, Injuries and accidents, Adolescent, Child, Child, Preschool, Emergency Medical Services, Humans, Infant, Trauma Centers, Wounds and Injuries, COMMITTEE ON PEDIATRIC EMERGENCY MEDICINE, COUNCIL ON INJURY, VIOLENCE, AND POISON PREVENTION, SECTION ON CRITICAL CARE, SECTION ON ORTHOPAEDICS, SECTION ON SURGERY, SECTION ON TRANSPORT MEDICINE, PEDIATRIC TRAUMA SOCIETY, AND SOCIETY OF TRAUMA NURSES PEDIATRIC COMMITTEE, Medical and Health Sciences, Psychology and Cognitive Sciences, Pediatrics
Abstract

Injury is still the number 1 killer of children ages 1 to 18 years in the United States (http://www.cdc.gov/nchs/fastats/children.htm). Children who sustain injuries with resulting disabilities incur significant costs not only for their health care but also for productivity lost to the economy. The families of children who survive childhood injury with disability face years of emotional and financial hardship, along with a significant societal burden. The entire process of managing childhood injury is enormously complex and varies by region. Only the comprehensive cooperation of a broadly diverse trauma team will have a significant effect on improving the care of injured children.

Published
2016

25. The effect of spaced presentation of treatment information on recall and understanding of risk relating to medication in Multiple Sclerosis

Author

Burns, Michele

Subjects
616.8, Michele Burns, Multiple Sclerosis, Spaced presentation, risk awareness, recall
Abstract

Recent developments of more effective Multiple Sclerosis (MS) medications with severe side-effect profiles mean that patients with MS must recall and comprehend highly complex risk-benefit treatment information. Yet studies have shown reduced risk awareness in people with MS, which may be associated with MS-related cognitive impairments (e.g. reduced information-processing speed and learning). Spaced presentation, whereby information is presented over time and interspersed with breaks, can improve recall in patients with MS on simple paragraph and name-learning tasks. However the benefits of spaced presentation in patients with MS have not been explored for more complex, clinically-relevant information. The present study explored whether spaced presentation of treatment-related risk information leads to improved recall and understanding in patients with MS (n=30) and healthy controls (n=30). Participants heard information about fictitious drugs presented in three formats: with gaps (spaced condition), continuously (massed condition), and continuously followed by a 10-minute delay (massed-with-delay condition). Immediate recall and understanding was assessed. They also completed neuropsychological tests. Mixed design ANOVAs showed a main effect of group, with MS participants performing significantly worse than controls for both immediate recall and understanding of treatment-related risk information. There was also a main effect of presentation format for immediate recall. Participants recalled significantly more information in the spaced relative to both massed and massed-with-delay conditions and in the massed relative to the massed-with-delay condition. Cognitive deficits correlated with recall and comprehension in the MS group. This study provides initial support for the benefit of spacing for recall of risk information in MS. However, spaced presentation did not aid comprehension of treatment-related risk information in either group. The breaks in information presentation may ameliorate effects of reduced processing speed on recall. However, the complexity of comprehending medication risk information may be too great a challenge for a spacing intervention to overcome in the context of MS-related cognitive impairment. Clinical implications are discussed.

Published
2015

32. Management of Acetaminophen Poisoning in the US and Canada

Author

Dart, Richard C., primary, Mullins, Michael E., additional, Matoushek, Theresa, additional, Ruha, Anne-Michelle, additional, Burns, Michele M., additional, Simone, Karen, additional, Beuhler, Michael C., additional, Heard, Kennon J., additional, Mazer-Amirshahi, Maryann, additional, Stork, Christine M., additional, Varney, Shawn M., additional, Funk, Alexandra R., additional, Cantrell, Lee F., additional, Cole, Jon B., additional, Banner, William, additional, Stolbach, Andrew I., additional, Hendrickson, Robert G., additional, Lucyk, Scott N., additional, Sivilotti, Marco L. A., additional, Su, Mark K., additional, Nelson, Lewis S., additional, and Rumack, Barry H., additional

Published
2023
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33. Severe outcomes following pediatric cannabis intoxication: a prospective cohort study of an international toxicology surveillance registry

Author

Cohen, Neta, primary, Mathew, Mathew, additional, Brent, Jeffrey, additional, Wax, Paul, additional, Davis, Adrienne L., additional, Obilom, Cherie, additional, Burns, Michele M., additional, Canning, Joshua, additional, Baumgartner, Kevin, additional, Koons, Andrew L., additional, Wiegand, Timothy J., additional, Judge, Bryan, additional, Hoyte, Christopher, additional, Chenoweth, James A., additional, Froberg, Blake, additional, Farrar, Henry, additional, Carey, Jennifer L., additional, Hendrickson, Robert G., additional, Hodgman, Michael, additional, Caravati, E. Martin, additional, Christian, Michael R., additional, Wolk, Brian J., additional, Seifert, Steven A., additional, Bentur, Yedidia, additional, Levine, Michael, additional, Farrugia, Lynn A., additional, Vearrier, David, additional, Minns, Alicia B., additional, Kennedy, Joseph M., additional, Kirschner, Ron I., additional, Aldy, Kim, additional, Schuh, Suzanne, additional, Campleman, Sharan, additional, Li, Shao, additional, Myran, Daniel T., additional, Feng, Lisa, additional, Freedman, Stephen B., additional, and Finkelstein, Yaron, additional

Published
2023
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40. Characterization of pediatric beta‐adrenergic antagonist ingestions reported to the National Poison Data System from 2000 to 2020.

Author

Watson, C. James, Monuteaux, Michael C., and Burns, Michele M.

Subjects
EVALUATION of medical care, FOOD consumption, RETROSPECTIVE studies, ADRENERGIC beta blockers, POISON control centers, RESEARCH funding, DESCRIPTIVE statistics, HYPOGLYCEMIA, HYPOTENSION, BRADYCARDIA, CHILDREN
Abstract

Background: When ingested by children, small quantities of beta‐adrenergic antagonists (BAA) are described as dangerous and even potentially lethal ("one pill can kill"). We characterize demographics, clinical characteristics, and the rate of serious outcomes among pediatric patients with reported BAA ingestions. Methods: This study was a retrospective review of U.S. patients <20 years old with reported single‐agent BAA ingestions presenting to a health care facility between January 2000 and February 2020 for whom a poison control center was consulted. Data were abstracted from the National Poison Data System (NPDS). Medical outcomes were assessed by the NPDS scale of no effect, minor effect, moderate effect, major effect, and death. All relevant NPDS fatality narratives were reviewed. Results: A total of 35,436 reported exposures were identified. A total of 29,155 (82.3%) were <6 years old, of which 29,089 (99.8%) were unintentional. Twenty‐five patients (<0.1%) <6 years old had major effects. A total of 2316 (8.8%) of patients with no/mild effects were admitted to a critical care unit. Of all cases, 1460 (4.1%) had hypotension and 1403 (4.0%) had bradycardia. One hundred nineteen (0.3%) developed hypoglycemia. The only four fatalities resulted from intentional ingestions in patients >10 years old who sustained cardiac arrest in the prehospital setting. Conclusions: Reported BAA ingestions in this multiyear national pediatric cohort caused infrequent toxicity, and no fatalities resulted from an unintentional ingestion. The frequency of bradycardia, hypotension, and hypoglycemia were low. While severely poisoned patients require aggressive treatment, 8.8% of patients were admitted to a critical care unit despite having no or mild effects, which suggests an opportunity to reduce resource utilization. [ABSTRACT FROM AUTHOR]

Published
2023
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45. Clinical and electrocardiographic factors associated with adverse cardiovascular events in bupropion exposures.

Author

Simpson, Michael, Troger, Andrew, Feng, Chris, Whitledge, James D., Monuteaux, Michael, and Burns, Michele M.

Subjects
BUPROPION, MULTIVARIABLE testing, HEALTH facilities, CARDIOGENIC shock, MYOCARDIAL injury, ODDS ratio
Abstract

Bupropion toxicity can cause cardiogenic shock, ventricular dysrhythmias, and death. Clinical and electrocardiographic factors associated with adverse cardiovascular events in bupropion toxicity have not been well-studied. This study aimed to identify factors associated with adverse cardiovascular events in adult patients with isolated bupropion exposures. This retrospective cohort study queried the National Poison Data System from 2019 through 2020. We included patients 20 years or older with acute or acute-on-chronic single-agent bupropion exposures evaluated in a healthcare facility. Exclusion criteria were confirmed non-exposure, withdrawal as a reason for exposure, lack of follow-up, documentation that exposure was probably not responsible for the effects, and missing data. The primary outcome was adverse cardiovascular events, defined as the presence of any of the following: vasopressor use, ventricular dysrhythmia, myocardial injury, or cardiac arrest. Independent variables were age, the intentionality of exposure, seizures, tachycardia, QRS widening, and QTc prolongation. Multivariable logistic regression was performed to test for independent associations between independent variables and adverse cardiovascular events. Of 4,640 patients included in the final analysis (56.7% female, 56.5% suspected suicidal intent), 68 (1.47%) experienced an adverse cardiovascular event. Age (odds ratio 1.03; 95% confidence intervals 1.02–1.05), single seizure (odds ratio 9.18; 95% confidence intervals 4.24–19.9) and complicated seizures (odds ratio 38.9; 95% confidence intervals 19.3–78.1), QRS widening (odds ratio 3.01; 95% confidence intervals 1.62–5.59), and QTc prolongation (odds ratio 1.76; 95% confidence intervals 1.00–3.10) were independently associated with adverse cardiovascular events. No patients with unintentional exposure experienced adverse cardiovascular events, prohibiting intentionality from inclusion in the regression model. In the post hoc subgroup analysis of intentional exposures, age, single and complicated seizures, and QRS widening remained independently associated with adverse cardiovascular events. Increasing age, seizures, QRS widening, and QTc prolongation were associated with adverse cardiovascular events in bupropion exposures. Adverse cardiovascular events did not occur in unintentional exposures. Further research is needed to develop screening tools and treatments for bupropion cardiotoxicity. [ABSTRACT FROM AUTHOR]

Published
2023
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46. Pulmonary Agents

Author

Geib, Ann-Jeannette, Burns, Michele M., Antosia, Robert E., editor, and Cahill, John D., editor

Published
2006
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48. The Toxicology Investigators Consortium Case Registry—the 2015 Experience

Author

Farrugia, Lynn A., Rhyee, Sean H., Campleman, Sharan L., Ruha, Anne-Michelle, Weigand, Timothy, Wax, Paul M., Brent, Jeffrey, Seifert, Steven, Pomerleau, Adam, Kazzi, Ziad, Ganetsky, Michael, Burns, Michele, Beuhler, Michael, King, Joshua D., Aks, Steven, Furmaga, Jakub, Wax, Paul, Brent, Jeffrey, Hoyte, Christopher, Leikin, Jerrold, Vohra, Rais, Judge, Bryan, Riley, Brad, Meggs, William J., Bentur, Didi, Moore, Phil, Farrugia, Lynn, Greene, Spencer, Rusyniak, Daniel, Lowry, Jennifer, Algren, Adam, Wolk, Brian, Levine, Michael, Nogar, Josh, Kostic, Mark, Gummin, David, Calello, Diane, Geib, Ann-Jeannette, Hernandez, Stephanie, Smith, Silas, Nelson, Lewis, Marcus, Steven, Kirschner, Ronald, Rowden, Adam, Vearrier, David, McKeever, Rita, Ruha, Michelle, Pizon, Anthony, Hendrickson, Robert, McKeown, Nate, Wills, Brandon, Cumpston, Kirk, Alhelail, Mohammed, Wiegand, Timothy, Caravati, E. Martin, Sessions, Daniel, Maddry, Joseph, Minns, Alicia, Lung, Derrick, Smollin, Craig, Kibby, Thomas, Schwarz, Evan, Stellpflug, Samuel, Engebretsen, Kristin, Majlesi, Nima, Sullivan, Ross, Peredy, Tamas, Finkelstiein, Yaron, Carey, Jennifer, and On behalf of the Toxicology Investigators Consortium

Published
2016
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50. The Things (We Think) We (Ought To) Do: Ideological Processes and Practices in Teaching

Author

Pachler, Norbert, Makoe, Pinky, Burns, Michele, and Blommaert, Jan

Abstract

Ideologies of education and of teaching are complex and layered, and they contain macro-social, institutional as well as micro-ideological levels. Building on cases from the UK and South Africa, this paper argues that notions of "professionalism" among teachers display such ideological layering, and that such notions are heavily invested with interests that transcend the operational or institutional scales. In the case of the UK, we discuss the way in which a teacher described her experience of taking a degree course, exposing a rift between individual, experiential knowledge and institutional, organisational knowledge, characteristic of the large-scale transformations of the educational field in the UK. In the South African case, we show how a white teacher instructing black township children deploys images of the disciplined body that derive from the Apartheid "old order". In both cases we see that views of professionalism are infused with micro-ideological, practical beliefs as well as with macro-ideological social and political views. In terms of the implications of our line of argument for teacher education we conclude that student teachers should be taught explicitly about the discourses by which teaching is constructed so that they are able to reflect more critically on their professional practice.

Published
2008
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