Biomedical subjects

H A Bessen

Publications and source records attributed to H A Bessen.

23 records · Page 2Linked to original sources

PubMed1982

Futility of skull radiography for nontraumatic conditions.

Indications for post-traumatic skull radiographs have been well publicized, and "high-yield" criteria have been established. Such criteria have not been established for patients without trauma. We report a review of 157 consecutive skull series taken for nontraumatic conditions. Skull radiography was found to be extremely "low yield" in the evaluation of the nontraumatized patient--only 4.5% of the films showed significant abnormalities related to the patient's diagnosis. Moreover, regardless of radiographic results, skull films had little impact on further diagnostic workup or on patient management. Our results suggest that more stringent criteria should be considered in ordering skull radiographs for nontraumatic indications.

Evaluation Studies as Topic↗

PubMedDate not supplied

Falsely elevated salicylate levels due to diflunisal overdose.

A 33-year-old man ingested 14 g of diflunisal (Dolobid, a NSAID), 3 propoxyphene-acetaminophen tablets, and ethanol. Although salicylate ingestion was specifically denied, toxicology screening revealed markedly elevated salicylate levels (176 mg/dL, 100 mg/dL, 41 mg/dL at 4 1/2, 10 and 24 hours postingestion). Blood ethanol level was 450 mg/dL. There was no respiratory alkalosis, metabolic acidosis, or increased anion gap to suggest salicylate toxicity. The patient recovered fully. Comparison testing of the salicylate assay technique used in the case (TDx fluorescence polarization immunoassay) and another commonly used technique (Trinder colorimetric assay) revealed marked cross-reactivity between salicylate and diflunisal. Samples of known diflunisal concentration were tested using the TDx salicylate assay. Percent cross-reactivity [(reported salicylate concentration/actual diflunisal concentration) x 100] was found to be 130 to 152.8% over the concentration range tested. Cross-reactivity between diflunisal and salicylate using the Trinder colorimetric assay was 20 to 52.5% over the concentration range tested. Diflunisal is not metabolized to salicylate and thus this cross-reactivity represents a significant drug-laboratory interaction. Salicylate levels measured by these methods appear to be unreliable when diflunisal is present.

Adult↗

PubMedDate not supplied

Aortoenteric fistula in a 21-year-old.

We present the case of a 21-year-old male with recurrent, severe gastrointestinal hemorrhage, who eventually proved to have an aortoduodenal fistula. The fistula arose from an aortic repair done after a stab wound four years previously. The diagnosis of aortoenteric fistula was not initially suspected because of the patient's age, inability to provide details of his previous surgery, and false-negative endoscopic and radiologic studies. We believe that this is the youngest reported patient who developed an aortoenteric fistula after aortic surgery. The presence of an aortoenteric fistula should be suspected in any patient with a GI bleed and previous aortic surgery, regardless of the patient's age.

Adult↗

PubMedDate not supplied

Statistical concepts and methods for the reader of clinical studies in emergency medicine.

An understanding of statistical concepts and methods is essential for the clinician who wishes to interpret the results of clinical studies. In this article the concepts of descriptive statistics, classical hypothesis testing, P values, a priori information, and Type I and Type II errors are discussed with examples to illustrate their application to the interpretation of clinical trials. In addition, descriptions of Student's t test, the chi-squared test, Fisher's exact test, the rank sum test, and sequential methods are given.

Bias↗

PubMedDate not supplied

Improvement of cardiac conduction after hyperventilation in tricyclic antidepressant overdose.

Three patients wtih severe cardiotoxicity secondary to tricyclic antidepressant (TCA) overdosage were treated with induced mechanical hyperventilation. All three demonstrated marked QRS narrowing, reflecting improved intracardiac conduction, after hyperventilation therapy. Such therapy may help to prevent or abolish ventricular dysrhythmias, often a feature of life-threatening TCA overdoses.

Adult↗