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Biomedical subjects

G S Wasserman

Publications and source records attributed to G S Wasserman.

At least 19 recordsLinked to original sources
PubMed1991

Lomotil overdose.

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Atropine↗
PubMed1990

Chloroquine poisoning in a child.

Chloroquine poisoning in children, although infrequent, is extremely dangerous because of the narrow margin between therapeutic and toxic doses. Children clinically present with apnea, seizures, and cardiac arrhythmias. We present the case of a 12-month-old infant, the second-youngest patient reported in the US literature to die from chloroquine poisoning. A serum level of 4.4 mg/L (13.64 mumol/L) was obtained after the infant ingested only one tablet (300 mg). This establishes a new minimal lethal dose/blood level for children. Although some pediatric and adult pharmacokinetic and clinical similarities exist, the outcome is different. Pediatric mortality is 80%, whereas adult mortality is only 10%. Pediatric ingestion cases are primarily unintentional, and most adult cases are suicide attempts. Current treatment in adults includes a protocol of diazepam and epinephrine. Further studies involving children and these medications and other modalities are needed to improve survival.

Apnea↗
PubMed1990

TAC use and absorption of cocaine in a pediatric emergency department.

The topical anesthetic TAC (tetracaine 0.5%, adrenaline 0.05%, cocaine 11.8%) has been reported to be effective in pain control for local procedures. However, it has the potential for cocaine toxicity by absorption through an open wound. A study was undertaken to assess the systemic absorption of cocaine and its metabolites when TAC is used as a local anesthetic. Fifty-one children, 1 to 14 years of age, were enrolled in the study. Plasma for cocaine and/or its metabolite levels was available from 46 children and obtained 20 to 40 minutes after the topical anesthetic was applied. No plasma sample had detectable parent cocaine levels; however, 26 (56.5%) had cocaine metabolite levels. Ecgonine methylester levels were detected in plasma from six children and ranged from 59 to 985 ng/mL. Benzoylecgonine levels were detected in none of 19 specimens not preserved with sodium fluoride, and in 23 of 27 specimens to which sodium fluoride had been added. Benzoylecgonine levels ranged from 40 to more than 600 ng/mL. No clinical sign of cocaine toxicity was observed in any child.

Administration, Topical↗
PubMed1990

Pediatric clonidine intoxications.

Clonidine is an antihypertensive agent with central and peripheral alpha-2 adrenergic effects. One of the postulated mechanisms of action is the release of endogenous opioids and/or the stimulation of opioid receptors in the central nervous system (CNS). Naloxone, a pure opioid antagonist, has demonstrated reversal effects from clonidine intoxication. During the past 10 y, 25 children with a mean age of 2 y were admitted for clonidine intoxication. Dosage varied widely, but as little as 0.1 mg caused significant signs and symptoms. The most common presenting findings were somnolence-lethargy (96%), miosis (56%), and respiratory depression (48%), a paradoxical hypertensive response (44%) was more common than expected. Supportive management was the mainstay of therapy. Ten patients received naloxone, 50% demonstrated clinical improvement in vital signs and CNS depression. There were no complications as a result of naloxone therapy. Children seem to be unusually sensitive to the depressant effects of clonidine. Naloxone may be an important adjunct to therapy. Expect clonidine intoxications to become more common as the market for antihypertensive drugs expands.

Clonidine↗
PubMed1990

Spitting spider.

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Adolescent↗
PubMed1989

Intensity dependence of perceived duration: data, theories, and neural integration.

Evaluates 2 theoretical models suggested to explain studies of the effect of stimulus intensity on the perceived duration of brief light flashes. Some studies found a direct relationship between the 2 variables; others found an indirect relationship. Each model suggests that an additional variable interacts with stimulus intensity. Proposed variables have included the nature of the judgment and the absolute intensity. The present evaluation indicates that both of the proposed variables play a role and that a melding of the models could best account for this phenomenon. The melding incorporates known time- and intensity-dependent characteristics of neural integration into the behavioral performance. The evaluation also indicates that future experiments on this problem will be most informative if they (a) give particular attention to the role of instructions, (b) explore an adequate range of intensities, and (c) strictly control adaptive state.

Arousal↗
PubMed1988

Wound care of spider and snake envenomations.

Venomous bites and stings are numerous but severe local tissue damage is uncommon. Venoms may be simple substances or complex mixtures of many poorly characterized components whose interactions are still not fully understood. The best studied example of a dermonecrotic venom is that produced by the brown recluse spider (Loxosceles reclusa). Rattlesnake envenomation also causes significant wound injuries. Many spider and snake envenomation management modalities are controversial and the evidence is mounting against the use of a number of these treatments.

Animals↗
PubMed1988

Acute acetone intoxication in a pediatric patient.

The widespread presence of fingernail polish remover in the home makes the product a common source of ingestion, as evidenced by recent poison center data. Its principal component, acetone, is present in relatively high concentration. The syndrome of acetone intoxication presents as generalized central nervous system/respiratory depression, hyperglycemia, and ketosis. Despite its ubiquitous presence and high potential for severe intoxication, no reports are found describing the toxicity and supportive care following its ingestion by children. The authors present a 30-month-old patient with severe acetone intoxication secondary to fingernail polish remover ingestion. Also noted is the need to include acetone ingestion in the differential diagnosis of apparent diabetic ketoacidosis.

Acetone↗
PubMed1987

Near-fatal caffeine intoxication treated with peritoneal dialysis.

Caffeine is generally regarded as a safe drug, as evidenced by its wide availability in "over-the-counter" preparations and beverages. However, it is capable of producing a lethal outcome in cases of intoxication. The case of a two-year-old girl, who suffered major poisoning from caffeine, is presented. Her care, including the use of peritoneal dialysis, is discussed. Previous cases of caffeine intoxication meriting hospital care or resulting in death which have been reported in the English language medical literature are summarized. It is suggested that drug-drug interactions and the use of peritoneal dialysis and hemoperfusion be given particular consideration in such patients.

Caffeine↗
PubMed1987

Injuries associated with downhill sledding.

During the winter season of 1985 to 1986, 30 children presented to the emergency department with injuries related to downhill sledding. All of the patients were seen and treated during December 1985, which was an unusually cold and snowy month. The age range of the patients was six to 16 years. Six patients required admission, and all were related to head and/or abdominal trauma. The special characteristics of the sled, the environment, and the rider work in concert to produce injuries. The injury is most likely to occur under cold, icy conditions. After analysis of this series of patients, it is concluded that downhill sledding injuries can be minimized. The factors that make this activity dangerous are defined, and safety precautions are suggested.

Adolescent↗
PubMed1979

The psychophysical function: harmonizing Fechner and Stevens.

The methods of Fechner and Stevens for assessing sensation quantity usually yield different psychophysical functions even when all other factors are controlled. In this experiment, corresponding differences occurred when different features of the same sensory receptor signals were analyzed. In the visual system, the receptor potential saturated if the peak but not the area was measured; these results match visual psychophysical functions obtained with the methods of Fechner and Stevens, respectively. This result suggests that both methods are equally valid but that each method yields the particular psychophysical function appropriate for a particular kind of information processing. A novel factor in determining sensation quantity, namely the time used by the observer to make a judgment, is implicated by the data.

Animals↗