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Severe complications of tramadol overdose in Iran
Paria Habibollahi, Alireza Garjani, Samad Shams Vahdati, Seyyed-Reza Sadat-Ebrahimi, Neda Parnianfard
Epidemiol Health. 2019;41:e2019026.   Published online June 16, 2019
DOI: https://doi.org/10.4178/epih.e2019026
  • 21,219 View
  • 274 Download
  • 11 Web of Science
  • 13 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Severe complications of tramadol overdose have been reported; however, few large-scale studies have investigated this issue. Therefore, this study aimed to explore the presentation and complications of tramadol overdose in patients admitted to an intoxication referral center in northwestern Iran.
METHODS
Patients with tramadol overdose admitted to Sina Teaching Hospital in Tabriz, Iran during 2013-2017 were included. For each patient, the following data were collected: demographics, previous drug or medication overdose, whether the patient was in the process of quitting drug use, ingested dose of tramadol and co-ingestants, Glasgow Coma Scale (GCS) score, clinical symptoms at the time of admission, and admission characteristics. Serotonin toxicity was diagnosed in patients who fit the Hunter criteria. Multiple logistic regression was performed to identify variables associated with the incidence of severe complications of tramadol overdose.
RESULTS
In total, 512 cases of tramadol overdose were evaluated, of which 359 patients were included, with a median age of 41 years (range, 16-69) and a median tramadol dose of 1,500 mg (range, 500-4,000). The most frequent complications associated with tramadol overdose were hypertension (38.4%), tachycardia (24.8%), and seizure (14.5%). No serotonin toxicity was detected in patients. Having a GCS score <15, having taken a tramadol dose of >1,000 mg, being in the process of quitting drug use, being 30-49 years old, and male sex were significantly related to the incidence of severe complications of tramadol overdose.
CONCLUSIONS
Although seizure was prevalent among Iranian patients with tramadol poisoning, serotonin toxicity and cardiogenic shock were rare findings.
Summary

Citations

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    Pharmaceuticals.2024; 17(7): 838.     CrossRef
  • Investigation of clinical and paraclinical consequences of tramadol poisoning and related factors
    Pantea Ramezannezhad, Mahmoud Hashemzaei, Zohreh Pajohesh, Khadijeh Saravani, Omid Bameri
    Journal of Shahrekord University of Medical Sciences.2024; 26(3): 132.     CrossRef
  • Tramadol Abuse-associated Seizure: An Epidemiological and Electroencephalographic Study
    Farhad Iranmanesh, Hamide Arvan, Habibeh Ahmadipour, Faranak Gadari, Hussien Barzegar, Mahdiyeh Khazaneha
    International Journal of High Risk Behaviors and Addiction.2023;[Epub]     CrossRef
  • Clinical and Laboratory Factors Related to Seizure and Serotonin Toxicity in Tramadol Intoxication: An Egyptian Study
    Ahmed Amin Ali, Mahmoud Mohamed Abdeshafy, Khaled Abdelkawy, Ramy M. Elsabaa, Fawzy Elbarbry
    Clinical Drug Investigation.2023; 43(12): 963.     CrossRef
  • Lower uric acid and adequate hydration are associated with lower risk of febrile neutropenia following autologous bone marrow transplantation in patients with lymphoma
    Babak Nejati, Zohreh Kourehpaz, Roya Dolatkhah, Mojtaba Varshochi, Maryam Farmani, Alireza Parviz
    Journal of Medical Science.2023; 92(4): e836.     CrossRef
  • Increase of high‐risk tramadol use and harmful consequences in France from 2013 to 2018: Evidence from the triangulation of addictovigilance data
    Anne Roussin, Thomas Soeiro, Charlotte Fouque, Emilie Jouanjus, Elisabeth Frauger, Nathalie Fouilhé, Michel Mallaret, Joëlle Micallef, Maryse Lapeyre‐Mestre
    British Journal of Clinical Pharmacology.2022; 88(8): 3789.     CrossRef
  • Determination of Tramadol and Fluoxetine in Biological and Water Samples by Magnetic Dispersive Solid-Phase Microextraction (MDSPME) with Gas Chromatography – Mass Spectrometry (GC-MS)
    Banafsheh Sefaty, Mahboubeh Masrournia, Zarrin Es’haghi, Mohammad Reza Bozorgmehr
    Analytical Letters.2021; 54(5): 884.     CrossRef
  • Machine learning algorithms to predict seizure due to acute tramadol poisoning
    B Behnoush, E Bazmi, SH Nazari, S Khodakarim, MA Looha, H Soori
    Human & Experimental Toxicology.2021; 40(8): 1225.     CrossRef
  • Factors Associated with Tramadol Abuse: A Cross-Sectional Study Among Commercial Drivers and Assistants in the Accra Metropolitan Area of Ghana
    Mavis Danso, Francis Anto
    Drugs - Real World Outcomes.2021; 8(3): 337.     CrossRef
  • Evaluation of mitochondrial dysfunction due to oxidative stress in therapeutic, toxic and lethal concentrations of tramadol
    Leila Mohammadnejad, Kambiz Soltaninejad, Mohammad Seyedabadi, Seyed Khosro Ghasem Pouri, Mohammad Shokrzadeh, Hamidreza Mohammadi
    Toxicology Research.2021; 10(6): 1162.     CrossRef
  • Rapport de cas d’un choc cardiogénique et syndrome sérotoninergique sur une synergie entre tramadol et venlafaxine
    G. Barthélemy, D. Gusu, D. Glorieux
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  • Therapeutic levels of short-term tramadol administration negatively affect testis function in rats
    Jonah Sydney Aprioku, Benjamin Toochukwu Okpe, Doupere Ben
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  • Drug utilization review of tramadol hydrochloride in a regional hospital in South Africa; findings and implications
    Akhona Fynn, Elvera Helberg, Brian Godman, Johanna C Meyer
    Hospital Practice.2020; 48(2): 92.     CrossRef
Associations between diabetes self-management and microvascular complications in patients with type 2 diabetes
Fatemeh Mehravar, Mohammad Ali Mansournia, Kourosh Holakouie-Naieni, Ensie Nasli-Esfahani, Nasrin Mansournia, Amir Almasi-Hashiani
Epidemiol Health. 2016;38:e2016004.   Published online January 25, 2016
DOI: https://doi.org/10.4178/epih.e2016004
  • 22,483 View
  • 295 Download
  • 34 Web of Science
  • 26 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Diabetes is a major public health problem that is approaching epidemic proportions globally. Diabetes self-management can reduce complications and mortality in type 2 diabetic patients. The purpose of this study was to examine associations between diabetes self-management and microvascular complications in patients with type 2 diabetes.
METHODS
In this cross-sectional study, 562 Iranian patients older than 30 years of age with type 2 diabetes who received treatment at the Diabetes Research Center of the Endocrinology and Metabolism Research Institute of the Tehran University of Medical Sciences were identified. The participants were enrolled and completed questionnaires between January and April 2014. Patients’ diabetes self-management was assessed as an independent variable by using the Diabetes Self-Management Questionnaire translated into Persian. The outcomes were the microvascular complications of diabetes (retinopathy, nephropathy, and neuropathy), identified from the clinical records of each patient. A multiple logistic regression model was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) between diabetes self-management and the microvascular complications of type 2 diabetes, adjusting for potential confounders.
RESULTS
After adjusting for potential confounders, a significant association was found between the diabetes self-management sum scale and neuropathy (adjusted OR, 0.64; 95% CI, 0.45 to 0.92, p=0.01). Additionally, weak evidence was found of an association between the sum scale score of diabetes self-management and nephropathy (adjusted OR, 0.71; 95% CI, 0.47 to 1.05, p=0.09).
CONCLUSIONS
Among patients with type 2 diabetes, a lower diabetes self-management score was associated with higher rates of nephropathy and neuropathy.
Summary

Citations

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    BMJ Open.2023; 13(8): e074739.     CrossRef
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    Guiyue Ma, Haiyan Fang, Xiang Wang, Yahui Meng, Yu Zhu, Chuanying Zhang
    Medicine.2023; 102(48): e36185.     CrossRef
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  • Indirect costs of non‐healing diabetic foot wounds in an African origin population in Barbados
    André R. Greenidge, Simon Naitram, Kim R. Quimby, Simon G. Anderson, R. Clive Landis
    Diabetic Medicine.2022;[Epub]     CrossRef
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    Maryam Binesh, Aliakbar Pahlevanian, Sajjad Rahimi Pordanjani, Zahra Ahmadizadeh
    Middle East Journal of Rehabilitation and Health Studies.2022;[Epub]     CrossRef
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    Endocrinología, Diabetes y Nutrición.2021; 68(7): 489.     CrossRef
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Incidence of complication and societal cost of measles in Korea, 2000.
Weon Young Lee, Moran Ki, Jin Kyoung Oh, Jong Koo Lee, Myung Bin Kim, Bo Youl Choi
Korean J Epidemiol. 2004;26(2):71-80.
  • 65,535 View
  • 18 Download
AbstractAbstract PDF
Abstract
OBJECTIVES
To estimate the complication rate and the societal cost of measles, a survey was conducted in Seoul, Jeonju city, and Kyonggi province in 2001.
METHODS
A telephone survey was conducted in Jeonju city (175/307) and four local areas of Kyonggi province (793/1,238) to gather information on the complications of measles. To estimate societal cost, the telephone survey was conducted for the sampled subject by complication type and the age group. The response rate was 78% (180/230). Paid bills were examined for direct cost estimation, and the time cost and the transportation expense were analyzed for indirect cost estimation.
RESULTS
The incidence of a complication of measles was 3.1% which found to be higher in younger age group. The incidence of pneumonia, otitis media, and encephalitis were 2.1%, 0.8%, and 0.2% respectively. Direct and indirect costs of in-patients without a complication were $417.00 (US $1.00 = 1,000 won) and $256.00 per case, respectively, and the out-patients who have no complication were $54.00 and $65.00, respectively. The average cost for a patient with measles without complication was $119.00 as the result. The societal cost of encephalitis was high as $6,660. Estimated total societal cost of measles ranges from $14 million to $69 million in the year 2000.
CONCLUSION
Complication rate of measles was fairly low compared to foreign countries. The lower rate could result from the difference in vaccination rate and the age distribution of the measles patients. The cost of measles without complication was not high. However, the cost for the complication and the total disease burden caused by measles shown to be high in the year 2000.
Summary

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