Re: “Are One or Two Dangerous? Diphenoxylate-Atropine Exposure in Toddlers”

Abstract

We read with interest the article by Thomas et al. about diphenoxylate-atropine exposures in toddlers ( 1 Thomas T.J. Pauze D. Love J.N. Are one or two dangerous? Diphenoxylate-atropine exposure in toddlers. J Emerg Med. 2008; 34: 71-75 Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar ). Although we appreciate attempts to further the understanding and management of diphenoxylate-atropine exposures, we feel the study has several serious errors. The authors base their conclusions on a study done utilizing poison center data. They erroneously assume that exposures are the same as ingestions in this data set. Poison center data do not make the distinction between possible exposures and confirmed ingestions. The authors do not report attempts to confirm actual ingestions via chart review or confirmatory blood concentrations. About Ultrasound Diagnosis of Pulmonary Bullae vs. PneumothoraxJournal of Emergency MedicineVol. 38Issue 3PreviewOver the past year, we performed transthoracic chest sonography in 62 cases of thoracic surgical patients coming from the Emergency, Internal Medicine, and Cardiovascular Surgery Departments and scheduled for thoracentesis, tube thoracostomy, and video-assisted thoracoscopy. The diagnoses included pneumothorax or pulmonary bullous disease in 8 patients, pleural effusion or empyema in 48 patients, and pulmonary or pleural peripheral nodules in 6 patients. We read with interest the article by Simon and Paolinetti, which addressed the issue of differentiating pulmonary bullae and pneumothorax by ultrasound guidance in an emergency setting (1). Full-Text PDF