Biomedical subjects

E L Tso

Publications and source records attributed to E L Tso.

5 recordsLinked to original sources

PubMed1993

Abdominal injuries in restrained pediatric passengers.

A statewide experience with pediatric abdominal visceral injury in restrained automobile passengers was compiled from the trauma registries of two academic institutions. Retrospective analysis of motor vehicle passenger injuries from 1987 to 1991 included age, sex, mechanism of injury, prehospital care, type of injury, therapeutic interventions, complications, and ultimate outcome. The records of over 2,000 patients evaluated for blunt trauma were reviewed, with 42 children fulfilling the following inclusion criteria: 15 years of age or younger, restrained in an automobile at the time of the accident, and diagnosed with an abdominal injury. Of the 42 patients studied, there were 20 boys and 22 girls; ages ranged from 2 months to 15 years (mean, 7.02 years). Six of 42 patients (14%) required extrication from the vehicle at the scene. Nineteen of 42 patients (45%) sustained belt-related abdominal wall bruising or erythema. The specific blunt visceral injuries noted were as follows: splenic 5, hepatic 5, bowel 6, renal 3, combined 6 (stomach, diaphragm, pancreas, or retroperitoneum). Twenty-three children (55%) had abdominal visceral injuries without external seat belt marks. Operative intervention was necessary in seven patients. A delay in diagnosing visceral injury occurred in 4 of 42 (10%) cases. One patient developed abdominal symptoms 72 hours after the accident. Length of hospital stay ranged from 1 to 45 days. Complications occurred in 4 (10%) of patients. There were two deaths due to injuries. Hollow and solid visceral injuries can occur in belted pediatric passengers during vehicular accidents. Both are a source of significant morbidity, and the patient should be evaluated carefully.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdominal Injuries↗

PubMed1993

Cranial computed tomography in the emergency department evaluation of HIV-infected patients with neurologic complaints.

STUDY OBJECTIVE: To demonstrate the usefulness of cranial computed tomography (CT) in the emergency department evaluation of HIV-infected patients and patients with risk factors for HIV infection who present with neurologic complaints. DESIGN: Retrospective review of imaging reports and medical records of patients who visited the ED from March 1991 through March 1992. SETTING: Urban university ED. PARTICIPANTS: Patients with HIV infection or risk factors for infection who underwent emergency cranial CT after presenting to the ED with headache, altered mental status, focal deficits, or other neurologic signs or symptoms. RESULTS: One hundred forty-six patients visited the ED 169 times. Of the 169 cranial CTs obtained, 85 (50%) were normal, 49 (29%) showed atrophy only, and 35 (21%) demonstrated focal lesions, with mass effect noted in ten (6%). Enhancing lesions were present in 13 scans. In 21 (12%) cases, CT revealed either an indication for admission, a contraindication to lumbar puncture, or both. In 25 instances, patients with lesions had nonfocal presentations and no papilledema. Two presentations--focal deficit and altered mental status--were each statistically significantly associated with lesions on CT. In seven patients with multiple ED visits, repeat CT showed new findings. Among patients who had risk factors but were of unknown HIV status, there was the same proportion of abnormal scans as in known HIV-infected patients. CONCLUSION: CT detected clinically significant neuropathology among our study patients. Because lesions and mass effect were associated with nonfocal as well as focal presentations, CT is indicated in every neurologically symptomatic patient with HIV infection or risk factors for infection. Because HIV-related diseases can progress rapidly, repeat CT is recommended even in patients with recent scans.

Adult↗

PubMed1993

Baseball bat assault injuries.

The baseball bat, according to Baltimore City police crime statistics, is a commonly used weapon. To assess the severity of injuries inflicted by this modern-day club, we retrospectively reviewed 75 charts of patients treated at the University of Maryland Medical Systems Hospital for baseball bat injuries from January 1990 through July 1991. Multisystem trauma was documented, with craniocerebral injury being the most frequent and the most frequent cause of death. Of the victims struck on the head, 26% sustained an intracranial hemorrhage. In our series, the history of loss of consciousness and the Glasgow Coma Scale score failed to reliably identify the patients with serious injuries. Seventeen percent of our patients with intracranial hemorrhages had both a negative or uncertain history of loss of consciousness and a normal Glasgow Coma Scale score on arrival.

Adolescent↗

PubMed1993

What's up in the management of high-altitude pulmonary edema?

Each year, millions of people travel to high-altitude locales. High-altitude pulmonary edema (HAPE), a severe form of acute mountain sickness, is a potentially fatal complication of acute exposure to high altitude. HAPE usually occurs at elevations above 2,500 meters and typically develops in the setting of a rapid ascent to high altitude with inadequate acclimatization and continued physical exertion. Although prompt descent to lower elevation and supplemental oxygen remain the definitive treatment for HAPE, recent investigations indicate that administration of nifedipine or phentolamine may be effective prophylactic or temporizing therapies.

Altitude↗

PubMedDate not supplied

Magnesium: clinical considerations.

Magnesium is gaining recognition as a clinically important electrolyte. Hypomagnesemia has been associated with a variety of disorders including seizures, malignant ventricular dysrhythmias, and sudden death. The emergency department patients who are most likely to be magnesium deficient include alcoholics, patients who take diuretics, and those in diabetic ketoacidosis. Hypokalemia and hypocalcemia may represent unrecognized hypomagnesemia. Clinical trials and case reports also document increasing interest in magnesium as an effective therapeutic agent for potentially life-threatening problems such as torsade de pointes, digitalis toxicity, bronchospasm, and alcohol withdrawal. We present an overview of hypomagnesemia, review the current literature, and focus on the role of magnesium in the acute care setting and the implications for the emergency physician.

Acute Disease↗