Relative toxicity of selective serotonin reuptake inhibitors (SSRIs) in overdose

BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) have increasingly replaced tricyclic antidepressants (TCAs) in the treatment of depression. They appear to be safer in overdose, but there is little information on their spectrum of toxicity in overdose, or relative toxicity of each agent. OBJECTIVE: To determine the effect of SSRIs in overdose, as a group, and the relative toxicity of five different SSRIs. METHODS: A review of consecutive SSRI poisoning admissions to a single toxicology unit. Outcomes examined were length of stay [LOS], intensive care [ICU] admission rate, coma, seizures, electrocardiographic [ECG] abnormalities, and presence of serotonin syndrome [SS]. Logistic regression was used to model the outcome QTc >440 msec. RESULTS: There were 469 SSRI poisoning admissions analyzed after exclusions. The median LOS for all SSRI overdose admissions was 15.3 h (IQR: 10.5-21.3) and 30 of 469 (6.4%; 95% CI 4.3-9.0%) cases were admitted to ICU. The incidence of seizures was 1.9% and coma was 2.4%. Serotonin syndrome occurred in 14% of overdoses. Comparison of median QTc intervals of the five SSRIs was significantly different (p=0.0002); citalopram (450 IQR: 436-484) was individually different to fluoxetine (p=0.045), fluvoxamine (p=0.022), paroxetine (p=0.0002), and sertraline (p=0.001). The proportion of citalopram overdoses with a QTc >440 msec was 68%, differing significantly from sertraline (adjusted OR: 5.11 95% CI 2.32-11.27). Comparison of median QT intervals of the five SSRIs was statistically different (p=0.026); citalopram (400 IQR: 380-440) was individually different from sertraline (p=0.023). CONCLUSIONS: This study shows SSRIs are relatively safe in overdose despite serotonin syndrome being common. The exception was citalopram, which was significantly associated with QTc prolongation. We believe that cardiac monitoring should be considered in citalopram overdose, particularly with large ingestions and patients with associated cardiac disease.

Innovators or inhibitors? Accounting faculty resistance to new educational technologies in higher education

While technology affords new opportunities and benefits for educators in their teaching practice, a significant number of faculty are resistant to adopting new technologies. Unprompted, 93% of faculty interviewed in the Australian study to be discussed in this paper pointed to accounting educator resistance as a key barrier to technology adoption and use. Adopting the Technology Acceptance Model (TAM) as a framework, this paper argues that one of the greatest challenges facing business schools and Higher Education Institutions (HEIs) in the 21st century is not new technologies themselves, but the ability of educators to embrace educational technologies. Drawing on the qualitative data to emerge from interviews with accounting educators recognised as exemplary in their use of innovative technologies, this paper explores the reasons for lack of faculty uptake and argues for academics to become innovators rather than inhibitors. The findings offer a timely insight into a twenty-first century issue affecting HEIs and, specifically, accounting academics. While carried out in the Accounting discipline, the findings may be relatable and applicable to all disciplines. A suite of recommendations are proposed for institutions, business schools and academics to consider.

Multifunctional rare earth organic corrosion inhibitors

All rights reserved.Chromium (VI) compounds are commonly used in paint systems to provide corrosion protection, particularly for aerospace alloys. These compounds are toxic, carcinogenic and environmentally detrimental, therefore alternatives that are safe, environmentally benign and meet or exceed current levels of corrosion protection are vital. Multifunctional rare earth organic compounds incorporate known inhibitor species, achieving synergistic inhibition in corrosive environments. The mechanism, efficiency and surface interactions of these complexes are explored. The complexes were effective inhibitors for steel and aluminium alloys, through mixed inhibition. Advantages and limitations of these inhibitor complexes, along with applications and future research direction, are discussed.

Rare earth-based corrosion inhibitors

Corrosion inhibitors are an important method for minimizing corrosion; however traditional inhibitors such as chromates pose environmental problems. Rare earth metals provide an important, environmentally-friendly alternative. This book provides a comprehensive review of current research and examines how rare earth metals can be used to prevent corrosion and applied to protect metals in such industries as aerospace and construction. Chapter 1 begins by examining the important need to replace chromate, and then goes on to discuss the chemistry of the rare earth metals and their related compounds. Chapter 2 considers the techniques that can be used to identify corrosion inhibition mechanisms and to test the levels of protection offered to different metals by rare earth compounds. Subsequent chapters consider in more detail how rare earth elements can be used as corrosion inhibitors in different forms and for different metals. This includes discussion on the potential of rare earth elements for self-healing, tunable and multifunctional coatings. Finally, chapter 10 considers the cost and availability of the rare earths and the potential health and environmental risks associated with extracting them. Provides a review of current research and examines how rare earth metals can be used to prevent corrosion and applied to protect metals in such industries as aerospace and construction. Includes discussion on the potential of rare earth elements for self-healing, tunable and multifunctional coatings. Considers the cost and availability of the rare earths and the potential health and environmental risks associated with extracting them.