Gary W. Everson, K. Oudjhane, Lionel W. Young, Edward P. Krenzelok
DOI: http://dx.doi.org/10.1016/0735-6757(89)90245-3
Published in issue: September 1989
xThe purpose of this study was to determine the clinical effectiveness of visualizing chewable and nonchewable iron supplements remaining in the gastrointestinal tract following an overdose. A 5-year retrospective review of 93 pediatric patients who had ingested potentially toxic amounts of an iron supplement found that 58% had abdominal radiographs taken. Fifty-five percent of these patients had ingested chewable multiple vitamins with iron and 40% had ingested nonchewable tablets. After radiographic review, radiopaque densities could be marginally visualized in only one case of ingestion of a chewable iron supplement.
Robert W. Derlet, T.E. Albertson
DOI: http://dx.doi.org/10.1016/0735-6757(89)90246-5
Published in issue: September 1989
xThree calcium channel blockers were studied for efficacy in preventing seizures and death from cocaine intoxication. Rats were first pretreated with a test drug then subjected to high dose intraperitoneal cocaine. In this model, control animals developed seizures within six minutes, followed by death within ten minutes. Animals that were pretreated with diltiazem, nifedipine, or verapamil developed seizures significantly faster than controls, and at specific doses the death rate was higher than in controls for all three drugs.
Jonathan A. Finkelstein, J.Sanford Schwartz, Susan Torrey, Gary R. Fleisher
DOI: http://dx.doi.org/10.1016/0735-6757(89)90247-7
Published in issue: September 1989
xIdentification of infants with bacterial diarrhea during the first year of life is important to limit potentially serious complications, but indications for stool leukocyte examination and culture are not well defined. The ability of three clinical features-temperature, history of blood in the stool, and stool frequency-to predict the presence of bactrial gastroenteritis was analyzed. Over a 1-year period, 108 (10.4%) bacterial pathogens were isolated from 1,035 infants aged <1 year with diarrhea.
Howard K. Gogel, Dan Tandberg, Robert G. Strickland
DOI: http://dx.doi.org/10.1016/0735-6757(89)90248-9
Published in issue: September 1989
xPrevious studies have shown that acidic pH and several ingestible substances can cause misleading guaiac lests of gastric aspirates. In this in vitro study, over 100 foods, beverages, and drugs were diluted to concentrations potentially present in the stomachs of outpatients being evaluated for gastrointestinal bleeding. These were mixed with known concentrations of blood and tested with different brands of guaiac cards. Decreased guaiac test sensitivity was associated with activated charcoal, dimethylaminoethanol, red chile, n-acetylcysteine, rifampin, red Jell-o (General Foods Corp, White Plains, NY), orange juice, Pepto-Bismol (Norwich Eaton Pharmaceuticals, Norwich, NY), simethicone, spaghetti sauce, and several red wines.
Michael L. Maynor
DOI: http://dx.doi.org/10.1016/0735-6757(89)90249-0
Published in issue: September 1989
xThis case report illustrates neurological deficits as an unusual presentation of acute myelogenous leukemia. Neurological deficits are rare early in this disease. Our patient presented with anorexia, malaise, headache, and multiple cranial nerve palsies. A high WBC count and abnormal peripheral smear led to the diagnosis of leukemia. This report demonstrates that, although rare, CNS symptoms may be the initial manifestation of leukemia. Blood dyscrasias should not be overlooked in patients with the acute onset of neurological symptoms.
Steven B. Karch
DOI: http://dx.doi.org/10.1016/0735-6757(89)90250-7
Published in issue: September 1989
xA 27-year-old man was accidentally given 2 mg intravenous epinephrine instead of 2 mg naloxone. He immediately developed chest pain, nausea, and diaphoresis. An ECG taken shortly after the epinephrine administration showed widespread ischemia. Forty-five minutes later the tracing still showed an early repolarization pattern, but ST elevation was less marked and the patient was asymptomatic. Serum potassium was 3.2 mEq/L and serum catecholamines, drawn approximately 20 minutes after the epinephrine administration, were 10 times normal (dopamine, 173 ng/L; epinephrine, 1,628 ng/L; norepinephrine, 1,972 ng/L).
Thomas H. Strong Jr, Robert A. Lowe
DOI: http://dx.doi.org/10.1016/0735-6757(89)90251-9
Published in issue: September 1989
xPerimortem cesarean section probably represents an underem-phasized procedure on the skills list of the emergency physician. Although fraught with emotional and medicolegal overtones, the procedure can yield viable infants in at least 15% of cases and occasionally alters maternal hemodynamics so as to restore the pulse in a clinically dead woman. This article reviews the physiology and hemodynamics of the maternal-fetal unit and discusses prognostic factors for the survival of healthy mother and infant, leading to recommendations for when to perform a perimortem cesarean section.
Toby L. Litovitz, Barbara F. Schmitz, Karen C. Holm
DOI: http://dx.doi.org/10.1016/0735-6757(89)90252-0
Published in issue: September 1989
Steven F. Bierman
DOI: http://dx.doi.org/10.1016/0735-6757(89)90253-2
Published in issue: September 1989
DOI: http://dx.doi.org/10.1016/0735-6757(89)90255-6
Published in issue: September 1989
DOI: http://dx.doi.org/10.1016/0735-6757(89)90257-X
Published in issue: September 1989
DOI: http://dx.doi.org/10.1016/0735-6757(89)90258-1
Published in issue: September 1989
DOI: http://dx.doi.org/10.1016/0735-6757(89)90259-3
Published in issue: September 1989
DOI: http://dx.doi.org/10.1016/0735-6757(89)90260-X
Published in issue: September 1989
DOI: http://dx.doi.org/10.1016/0735-6757(89)90261-1
Published in issue: September 1989
DOI: http://dx.doi.org/10.1016/0735-6757(89)90262-3
Published in issue: September 1989
DOI: http://dx.doi.org/10.1016/0735-6757(89)90264-7
Published in issue: September 1989
Garret E. Foulke, Timothy E. Albertson
DOI: http://dx.doi.org/10.1016/0735-6757(89)90265-9
Published in issue: September 1989
Joseph P. Ornato
DOI: http://dx.doi.org/10.1016/0735-6757(89)90266-0
Published in issue: September 1989
Jur Strobos
DOI: http://dx.doi.org/10.1016/0735-6757(89)90267-2
Published in issue: September 1989
J.Douglas White
DOI: http://dx.doi.org/10.1016/0735-6757(89)90268-4
Published in issue: September 1989
Donald M. Yealy, Kevin H. Scruggs, Larry D. Weiss
DOI: http://dx.doi.org/10.1016/0735-6757(89)90269-6
Published in issue: September 1989
John K. Stene
DOI: http://dx.doi.org/10.1016/0735-6757(89)90270-2
Published in issue: September 1989
Ben Honigman
DOI: http://dx.doi.org/10.1016/0735-6757(89)90271-4
Published in issue: September 1989
Loren G. Yamamoto
DOI: http://dx.doi.org/10.1016/0735-6757(89)90272-6
Published in issue: September 1989
DOI: http://dx.doi.org/10.1016/0735-6757(89)90273-8
Published in issue: September 1989
