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Biomedical subjects

G S Wasserman

Publications and source records attributed to G S Wasserman.

At least 37 records · Page 2Linked to original sources

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↗

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↗

Spitting spider.

Explore the source record for details and available documents.

Adolescent↗

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↗

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↗

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↗

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↗

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↗

Injuries associated with break dancing.

Twelve patients were seen with different injuries associated with break dancing. Analysis of the injuries indicated that they were all potentially preventable. All the injuries occurred during unsupervised activity and without the use of proper surfaces and techniques.

Adolescent↗

Direct intracellular measurement of non-linear postreceptor transfer functions in dark and light adaptation in Limulus.

Using one microelectrode inserted into a Limulus retinular cell, simultaneous recordings were made of the receptor potential evoked by light falling on that retinular cell and of the optic nerve action potentials generated in the eccentric cell coupled to that retinular cell. The postreceptor transfer function for sensory quantity was thereby examined directly between the retinular cell receptor potential and the eccentric cell action potentials over a more extended range than had been reported in previous studies. This transfer function exhibited a strong non-linearity; the function had 3 discrete linear segments. It is similar to the function relating extrinsic current to spike frequency in cat motoneuron. Light adaptation induced a shift of the transfer function. There were certain phenomenological similarities between the effect of light adaptation on the receptor and postreceptor transfer functions. But there were also enough dissimilarities to suggest that the mechanism of postreceptor adaptation is different than the receptor adaptation mechanism.

Action Potentials↗

Mineral seal oil excreted in urine--a case report.

There is a paucity of reported cases demonstrating the gastrointestinal absorption and renal excretion of mineral seal oil, a petroleum distillate. In 1972, a teenager attempted suicide by purposely ingesting an entire 8 oz bottle of furniture polish containing 99% mineral seal oil. She arrived in the ER two hours post-ingestion and was lavaged with two liters of normal saline, given 2 oz of mineral oil and 20 ml of 50% magnesium sulfate per gavage. The stomach contents were yellow, thick, oily and smelled like the furniture polish. She was admitted for psychiatric evaluation and observation for the ingestion. The patient did not suffer any respiratory or CNS complications. However, she excreted oil droplets which coalesced to form an oil layer in her urine. She suffered no kidney damage or abnormality as could be detected by routine renal function studies.

Child↗

Mineral seal oil excreted in urine.

There is a paucity of reported cases demonstrating the gastrointestinal absorption and renal excretion of mineral seal oil, a petroleum distillate. In 1972, a teenager attempted suicide by purposely ingesting an entire 8 ounce bottle of furniture polish containing 99% mineral seal oil. She arrived in the F.R. two hours post-ingestion and was lavaged with two liters of normal saline and given two ounces of mineral oil and 20 ml of 50% magnesium sulfate by the tube. The stomach contents were yellow, thick, oily, and smelled like furniture polish. She was admitted for psychiatric evaluation and observation for the ingestion. The patient did not suffer any respiratory or CNS complications. However, she excreted oil droplets which coalasced to form an oil layer in her urine! She suffered no kidney damage or abnormality as could be detected by routine renal function studies. Pictures revealing oil in the urine will be shown.

Child↗

Wavelength-discrimination behavior in the grasshopper Phlaeoba.

The grasshopper Phlaeoba sp. has ocular filters that are arranged in discrete retinal bands. These filters modify the spectra of some of its photoreceptors, all of which are apparently filled with the same resident photopigment. The receptor response differences produced by the ocular filters provide a potential basis for wavelength discrimination. Behavioral tests of wavelength discrimination in Phlaeoba were therefore run; they confirmed earlier qualitative findings that indicated that Phlaeoba can discriminate between visual stimuli on the basis of wavelength cues and quantitatively showed that the behavioral preference is proportional to the receptor spectral difference. Tests of animals with indistinct retinal bands indicated that wavelength discrimination was reduced in this variant but was still quantitatively related to the receptor spectra. These data suggest that the filter-mediated color vision hypothesis applies in the case of Phlaeoba.

Animals↗