Biomedical subjects

C C Mechem

Publications and source records attributed to C C Mechem.

4 recordsLinked to original sources

PubMed1994

Wound botulism.

All published cases of wound botulism were reviewed to describe the epidemiology, clinical manifestations, diagnosis, and treatment of this rare infection. The MEDLINE data base of English-language literature was searched from 1966 to 1992, using the keywords "wound botulism". Cases published during this period were identified, and the bibliographies of these articles were used to identify cases published before MEDLINE's search limit of 1966. Because of the limited number of published cases, all were reviewed. Data related to epidemiology, clinical manifestations, diagnosis and treatment were collected on each case. When possible, cross-references from case series or reviews were used to corroborate and supplement data for a given case. There were 40 cases identified as wound botulism. The case fatality rate was 10%. The 36 survivors had significant morbidity requiring prolonged medical care. Wound botulism is a rare life-threatening complication of trauma and i.v. drug abuse. The diagnosis should be considered in any patient with either of these risk factors who develop paresis of cranial nerves and a descending pattern of weakness. Treatment, including administration of antitoxin, should be initiated prior to definitive diagnosis by microbiologic laboratory tests.

Botulism↗

PubMed1992

Painless abruptio placentae associated with disseminated intravascular coagulation and syncope.

Abruptio placentae is a complication of pregnancy associated with significant morbidity and mortality for both fetus and mother. The presence of uterine pain and tenderness traditionally has been considered a useful criterion for distinguishing abruptio placentae from other causes of bleeding in pregnancy. We report the case of a 25-year-old woman who presented with painless abruptio placentae and coagulopathy during the second trimester. This case illustrates the importance of considering this diagnosis in pregnant patients with vaginal bleeding.

Abruptio Placentae↗

PubMed1984

Short-wave ultraviolet irradiation increases photo-affinity labeling of benzodiazepine sites.

Photoaffinity labeling of benzodiazepine sites with [3H]-flunitrazepam was examined using either long-wave (366 nm) or short-wave (254 nm) ultraviolet irradiation. A multiple exposure protocol was employed so that the time course of the process could be determined as well as the fraction of total sites labeled. At 366 nm, approximately 20% of the total sites present were labeled and the remainder showed reduced affinity for flunitrazepam, in agreement with published reports. When membranes from either cortex or cerebellum were irradiated at 254 nm, however, the fraction of sites labeled increased above 40%. The change in the ratio of labeled sites to those showing reduced affinity, as well as differences in the time courses of the two phenomena, are taken as evidence that the labeling and affinity change are independent processes rather than two effects of a single event. Inhibition of labeling by clonazepam and Ro15-1788 indicated the "central" nature of the labeled sites.

Affinity Labels↗

PubMedDate not supplied

Delayed cardiac tamponade in a patient with penetrating chest trauma.

We describe a case of cardiac tamponade due to pulmonary artery laceration as a late sequela in a patient who had sustained penetrating chest trauma. A 35-yr-old man presented to our emergency department complaining of pleuritic left chest pain, shortness of breath, and fever 19 days after being hospitalized for a stab wound to the left chest. During his first hospitalization, chest X-ray study, echocardiogram, and central venous pressure determination were all normal. On second presentation, he had a cardiac tamponade and underwent a median sternotomy. A pulmonary artery laceration was discovered and repaired. The postoperative course was complicated by readmission for postcardiotomy syndrome. This case demonstrates that late and unexpected complications can occur in patients with penetrating chest trauma and a normal initial evaluation.

Adult↗