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Biomedical subjects

C V Pollack

Publications and source records attributed to C V Pollack.

At least 73 records · Page 4Linked to original sources
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Gastric emptying in the acutely inebriated patient.

Fifty inebriated emergency department (ED) patients underwent evacuation of gastric contents via a nasogastric tube, in order to determine if a significant amount of ingested ethanol can be removed prior to absorption. Such a result could potentially reduce additional intoxicating effect. The gastric contents were assayed for total ethanol concentration, and a potential (postabsorption) additive blood alcohol level (PABAL) was projected and compared to the actual BAL on arrival. The type of beverage ingested and the time since last drink were recorded. BAL ranged from 108 to 637 mg/dL (mean +/- SD, 290 +/- 104.7). Gastric aspirate volume ranged from 50 to 700 mL (190 +/- 134), and contained alcohol in a range of 87 to 2271 mg/dL (475 +/- 479). Based on the distribution volume for alcohol calculated according to the patient's weight, this corresponded to a PABAL of 3 to 167 mg/dL (mean, 24.3 +/- 29.3). There was no significant correlation between the volume or concentration of gastric aspirate and the patient's stated drinking history. The authors conclude that a significant amount of ingested alcohol may occasionally be removed from absorption by the routine evacuation of gastric contents in intoxicated patients. These patients cannot be identified upon presentation, however, and these data cannot support routine use of gastric emptying in the detoxification of inebriated patients.

Adolescent↗
PubMedDate not supplied

Neurogenic pulmonary edema: case reports and review.

Neurogenic pulmonary edema (NPE) is a relatively common though often subclinical complication of a variety of central nervous system insults (trauma, hemorrhage, seizures, etc.) in children and adults. The syndrome probably results from massive centrally mediated sympathetic discharge and generalized vasoconstriction, and often presents in the emergency department (ED). The symptoms are likely to be mistaken for aspiration pneumonia. Treatment consists of ventilatory support, including positive end-expiratory pressure, and aggressive measures to reduce intracranial pressure. We present four cases of NPE and review its recognition and emergent management.

Adult↗
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Fat embolism syndrome in a child with muscular dystrophy.

Fat embolism syndrome is a relatively common complication of orthopedic trauma. Once thought to be rare in children, it probably occurs with a similar frequency as in adults, but is often subclinical. Clinically apparent fat embolism syndrome may exhibit neurologic, pulmonary, and cutaneous manifestations. It often resolves without sequelae if it is recognized promptly and supportive treatment is provided. We present a pediatric case of fat embolism syndrome and review the literature on its diagnosis and management in children.

Acute Disease↗
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Recognition and management of sarcoidosis in the emergency department.

Sarcoidosis is a chronic granulomatous disease of uncertain etiology. It can affect essentially every organ system in the human body and its manifestations are protean. Sarcoidosis can present in the emergency department (ED) as de novo disease, as preexisting disease with acute exacerbations, or as chronic debilitation. The authors provide a review of the various manifestations of this disease with emphasis on ED presentation and evaluation.

Adolescent↗
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Ketotic hypoglycemia: a case report.

Ketotic hypoglycemia (KH) is recognized in the pediatric literature as the most common cause of childhood hypoglycemia. Since the first manifestation of the syndrome is classically that of new onset seizures, initial emergency department presentation is likely. We describe a representative case and emphasize the importance of routine serum glucose and urine ketone measurements in young children with new onset seizures.

Child, Preschool↗
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Utility of glucagon in the emergency department.

Glucagon is a pancreatic polypeptide hormone that has diverse utility as both a therapeutic and diagnostic agent. Many of its pharmacologic actions are pertinent to the practice of emergency medicine. The author reviews the literature supporting each potential use of the drug and the purported physiologic mechanisms by which glucagon exerts these actions. The indications and proper dosages for glucagon in the acute care setting are summarized.

Adrenergic beta-Antagonists↗
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Hydropneumothorax due to tuberculosis.

Pulmonary tuberculosis, a disease largely limited to third-world populations only 15 years ago, is increasingly becoming a public health problem again in the U.S. We review an emergent presenting feature of tuberculosis--spontaneous pneumothorax--that may now be seen more commonly in emergency departments (EDs). Pneumothorax must be quickly and effectively managed in the ED. In addition, the emergency physician should readily consider tuberculosis as an etiology in any patient with a spontaneous pneumothorax and a significant prodromal illness or a history of exposure to tuberculosis so that contagion precautions may be instituted promptly.

Adult↗
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The utility of parenteral glucocorticoids in the emergency department.

Exogenous glucocorticoids have wide clinical applicability in emergency medicine. Many uses reported for this class of drugs are supported by only anecdotal evidence of efficacy, while others have been proven or disproven by well-designed studies; this evidence is evaluated here. Because adverse effects are relatively common and may be serious after initiation of steroid therapy in the emergency department, it is important for the emergency physician to review systematically the indications, contraindications, and precautions for the use of parenteral glucocorticoids.

Asthma↗
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Vogt-Koyanagi-Harada syndrome: case report and review.

The case of an adolescent male with a painful red eye is presented, and the emergency department differential diagnosis is reviewed. The patient had Vogt-Koyanagi-Harada (VKH) syndrome, a panuveitis with extraocular systemic manifestations. The syndrome may result in permanent visual loss but is quite sensitive to corticosteroid therapy. Early ophthalmologic consultation from the emergency department is essential for prompt institution of definitive therapy and preservation of vision. The salient features and diagnostic evaluation of VKH are reviewed.

Adolescent↗
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Emphysematous cystitis presenting as painless gross hematuria.

A case of emphysematous cystitis in an immunocompetent male is described. The diagnosis is generally rare, but may be made in the Emergency Department. A history of pneumaturia is highly suggestive of the entity, but is rarely offered by the patient. The evaluation and management of emphysematous cystitis are discussed.

Cystitis↗
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Antibiotic use in the emergency department: I. The penicillins and cephalosporins.

The penicillins and cephalosporins are beta-lactam agents that provide broad-spectrum antimicrobial coverage pertinent to many infectious diseases diagnosed in the emergency department. These groups of drugs also have in common their classification into subcategories or "generations" that delineate their usefulness in specific clinical scenarios such as infections with Gram-positive or -negative bacteria, Pseudomonas infections, or febrile neutropenic patients. Understanding these subcategories is essential to both efficacious and cost-effective use of these agents. This article reviews the pharmacology and clinical utility of the beta-lactams--including a new class of antibiotics, the carbacephams--for the emergency physician.

Ampicillin↗