SUNScholar - Browsing by Author "Muller, G. J."

Browsing by Author "Muller, G. J."

Now showing 1 - 10 of 10

Berg adder (Bitis atropos) : an unusual case of acute poisoning
(Health and Medical Publishing Group, 2017) Wium, C. A.; Marks, C. J.; Du Plessis, C. E.; Muller, G. J.
A 5-year-old boy presented to hospital with mild local cytotoxic and severe neurotoxic symptoms. The neurotoxic symptoms included ptosis, fixed dilated pupils and flaccid paralysis with respiratory failure. Mild hyponatraemia was also a clinical feature. After various unsuccessful treatment options were followed, the Tygerberg Poison Information Centre was contacted and a diagnosis of berg adder bite was made. Berg adder bites are uncommon and therefore not usually considered in the differential diagnosis of a patient presenting with an unexplained clinical picture. A timeous poison information helpline consultation is recommended in this situation.
Black and brown widow spider bites in South Africa. A series of 45 cases
(Health & Medical Publishing Group, 1993-6) Muller, G. J.
ENGLISH ABSTRACT: Cases of black widow (Latrodectus indistinctus) and brown widow (L. geometricus) spider bites referred to the Tygerberg Pharmacology and Toxicology Consultation Centre from the summer of 1987/88 to the summer of 1991/92 were entered into this series. Of a total of 45 patients, 30 had been bitten by black and 15 by brown widow spiders. It was evident that black widow spider bites caused a more severe form of envenomation than brown widow bites, characterised by generalised muscle pain and cramps, abdominal muscle rigidity, profuse sweating, raised blood pressure and tachycardia. The symptoms and signs of brown widow bites were mild and tended to be restricted to the bite site and surrounding tissues. Conditions which should be considered in the differential diagnosis include cytotoxic spider bite, scorpion sting, snakebite, acute abdominal conditions, myocardial infarction, alcohol withdrawal and organophospate poisoning. To prevent the development of complications, the administration of black widow spider antivenom is recommended in severe cases because untreated latrodectism could become protracted, without improvement, for several days.
Coronary spasm and thrombosis in a bodybuilder using a nutritional supplement containing synephrine, octopamine, tyramine and caffeine
(Health and Medical Publishing Group (HMPG), 2008-05) Smedema, J. P.; Muller, G. J.
Drug and poison information. The Tygerberg experience
(Health & Medical Publishing Group, 1993) Muller, G. J.; Hoffman, B. A.; Lamprecht, J. H.
This report is based on an analysis of 6411 consultations processed by the Tygerberg Pharmacology and Toxicology Consultation Centre. Seventy-five per cent of the consultations were of a toxicological nature: 47% related to non-drug chemicals, 37% to drugs and 16% to plants and animals. Pesticides utilised in the home environment featured most prominently in the non-drug chemical group, while queries about paracetamol overdose topped the list in the drug group. The most frequent queries in the biological category concerned potentially poisonous plants. Twenty-five per cent of the consultations related to pharmacotherapeutics. Most potentially toxic exposures to non-drug chemicals occurred in the household setting. Contrary to popular belief, few acute pesticide poisonings were encountered as a result of exposures during farming activities. Another important finding was that there is a frustrating lack of reliable and readily available information in respect of potentially toxic ingredients contained in household and industrial preparations. The large number of household exposures highlights the need for education in the safe storage and usage of non-drug chemicals. Legislation on the inclusion of basic toxicological information and warnings on labels of household and industrial non-drug chemical products should be considered. In addition, the Government should take responsibility for centralising information on all potentially toxic non-drug chemicals and make this information available to poison centres at all times. It is also imperative that more attention be given to the training of health care professionals in applied pharmacokinetics and toxicology.
Scombroid poisoning : case series of 10 incidents involving 22 patients
(Health & Medical Publishing Group, 1992) Muller, G. J.; Lamprecht, J. H.; Barnes, J. M.; De Villiers, R. V. P.; Honeth, B. R.; Hoffman, B. A.
Scombroid poisoning is a form of ichthyosarcotoxism caused by the consumption of 'spoiled' fish of the dark meat varieties. It can be considered a mild-to-moderate form of 'food poisoning' and it occurs world-wide. Ten incidents, involving 22 patients, were reported to Tygerberg Hospital Pharmacology and Toxicology Consultation Centre in the first quarter of 1990. Cape yellowtail (Seriola lalandii) was involved in all the cases. The presenting symptoms and signs (in order of frequency) were: skin rash, diarrhoea, palpitations, headache, nausea and abdominal cramps, paraesthesia, an unusual taste sensation and breathing difficulties. The patients responded well to antihistamines and, in most, the condition resolved within 12-24 hours. Although histamine plays an important role in the pathogenesis of scombroid poisoning, the exact mechanism is still unresolved. The condition should be recognised and not confused with a true seafood allergy. Health workers are urged to alert the authorities when outbreaks of suspected cases of scombroid poisoning are encountered in order to establish the possible cause and to prevent further cases.
Scorpion sting in Southern Africa : diagnosis and management
(Health and Medical Publishing Group (HMPG), 2012-10) Muller, G. J.; Modler, H.; Wium, C. A.; Veale, D. J. H.
Most southern African scorpions are relatively harmless to humans, and although they can inflict quite a painful sting, no other toxic effects are expected to develop. However, a small number of scorpion species can cause life-threatening systemic envenoming. Children are especially vulnerable, with a mortality rate of close to 20%. Most deaths are attributable to one species, namely Parabuthus granulatus. In order for medical personnel to provide optimal patient management after a scorpion sting, they should be familiar with the clinical picture and management.
Scorpionism in South Africa : a report of 42 serious scorpion envenomations
(Health & Medical Publishing Group, 1993) Muller, G. J.
Forty-two cases of serious scorpion envenomation, of which 4 had a fatal outcome, are presented. The clinical profile, differential diagnosis and management of scorpionism are discussed. Most envenomations occurred in the summer months, peaking in January and February. An immediate local burning pain was the most prominent symptom. Systemic symptoms and signs developed within 4 hours of the sting in most instances, characterised by general paraesthesia, hyperaesthesia, muscle pain and cramps. Other striking features included dysphagia, dysarthria and sialorrhoea with varying degrees of loss of pharyngeal reflexes. The blood pressure and the temperature were often raised and the tendon reflexes increased, while motor power was often impaired. In a considerable number of patients the course was complicated by varying degrees of respiratory dysfunction, which tended to be more serious in children. The outstanding feature in children was an extreme form of restlessness characterised by excessive neuromuscular activity. Victims of scorpion sting, particularly in high risk localities, should be closely observed for 12-24 hours. Children and other high-risk patients should be hospitalised. All patients with symptoms and signs of systemic envenomation should receive antivenom. Parabuthus granulatus (Hemprich and Ehrenberg, 1828) has been identified as the most important venomous species in the western Cape. The antivenom is produced from the venom of the medically less important P. transvaalicus Purcell, 1899. A strong case can therefore be made for the inclusion of P. granulatus venom in the production of a polyvalent antivenom.
Snake bite in southern Africa : diagnosis and management
(Health and Medical Publications Group (HMPG), 2012-10) Muller, G. J.; Modler, H.; Wium, C. A.; Veale, D. J. H.; Marks, C. J.
Venomous snakes in southern Africa can, in broad terms, be divided into 3 groups: cytotoxic, neurotoxic and those that can induce haemostatic toxic effects. However, significant overlap of these effects may occur. Some snake species may, for example, display both cytotoxicity and neurotoxicity.
Spider bite in southern Africa : diagnosis and management
(Health and Medical Publications Group (HMPG), 2012-10) Muller, G. J.; Wium, C. A.; Marks, C. J.; Du Plessis, C. E.; Veale, D. J.
The medically important spiders of southern Africa can be divided into neurotoxic and cytotoxic groups. The neurotoxic spiders belong to the genus Latrodectus (button or widow spiders) and the cytotoxic spiders are represented chiefly by the genera Cheiracanthium (sac spiders) and Loxosceles (violin or recluse spiders).
Therapeutic monitoring as an aid in rationalising aminoglycoside dosage techniques in the neonate
(Health & Medical Publishing Group, 1987) Spruyt, L. L.; Kirsten, G. F.; Parkin, D. P.; Muller, G. J.; Kriegler, A.
General pharmacokinetic parameters applicable to adults are not suitable in neonatal practice owing to wide interpatient variations in respect of fluid balance, renal clearance and metabolic rates. We attempted to determine whether acceptable blood levels of gentamicin or tobramycin are obtained with dosage regimens and dosage techniques which are generally recommended. Forty neonates receiving aminoglycosides were studied. After administration of the drug as a slow, constant intravenous infusion into the 'Y' connection of the infusion set, peak levels were found to be subtherapeutic. Trough levels were also very low. After administration of the same dose of gentamicin or tobramycin as a bolus into the butterfly connection of the infusion set, however, high therapeutic levels were obtained. We therefore recommend that gentamicin and tobramycin be administered as an intravenous bolus injection and that blood levels be monitored constantly in order to individualise therapy.

Browsing by Author "Muller, G. J."

Results Per Page

Sort Options