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Biomedical subjects

J C Kolb

Publications and source records attributed to J C Kolb.

8 recordsLinked to original sources
PubMed1998

Role of technetium-99m sestamibi myocardial imaging in the emergency department evaluation of chest pain.

The use of technetium-99m sestamibi myocardial imaging is rapidly becoming a state of the art methodology for the emergency department evaluation of patients with chest pain. The following case report represents the first emergency department sestamibi scan ordered at the University of Mississippi Medical Center and is used to discuss the logistics and indications for such tests. A general guideline for ordering sestamibi scans has been developed for use in the emergency department.

Adult↗
PubMed1997

Gastric syphilis.

A sexually transmitted disease is seldom considered in the differential diagnosis of patients with clinical gastritis. A patient with gastric syphilis is reported to alert emergency department physicians to this entity. History and physical findings of syphilis should be sought and rapid plasma reagin tests should be obtained in the patient with severe or refractory gastritis.

Abdominal Pain↗
PubMed1993

Simultaneous asymmetric bilateral traumatic hip dislocation.

A 25-year-old man presented to the emergency department with simultaneous right anterior and left posterior hip dislocations resulting from a motor vehicle accident. Simultaneous bilateral traumatic hip dislocation is an uncommon occurrence. More rare is asymmetric simultaneous bilateral hip dislocation, with only ten cases documented in the English-language literature. The importance of an anteroposterior pelvic radiograph after significant major trauma is emphasized. Several serious complications can be associated with this condition, so expeditious management in the ED is warranted.

Accidents, Traffic↗
PubMed1991

Usefulness of empiric chest radiography and urinalysis testing in adults with acute sickle cell pain crisis.

STUDY OBJECTIVE: To determine the usefulness of obtaining routine chest radiographs and urinalyses on adults presenting to the emergency department in acute sickle cell pain crisis. The hypothesis tested is that in some adult sickle cell patients, sickle cell pain crises are precipitated or accompanied by acute infection that may be clinically occult and that routine screening for pulmonary or urinary tract infection would identify some of these precipitating illnesses. DESIGN: Prospective clinical study. SETTING: A university hospital ED. PATIENTS: All patients more than 14 years old with S-S, S-C, or S-beta-thalassemia sickle hemoglobinopathies who presented to the ED with acute nontraumatic painful complaints during a six-month period. INTERVENTIONS: All patients underwent posteroanterior and lateral chest radiography, routine urinalysis, and CBC count with reticulocyte count. A standard questionnaire for localizing symptoms of systemic, pulmonary, and urinary tract infection was completed for each patient. Urine cultures were ordered on all patients with voiding symptoms, flank pain, and/or more than 5 WBCs or RBCs per high-power field on urinalysis. Physical examination for evidence of pulmonary and urinary tract infection was carefully performed and recorded for subsequent analysis. RESULTS: Seventy-one patients with 134 ED presentations were studied over a six-month period. Eight diagnoses of acute pneumonia were made. Four of these patients complained of chest pain (50% vs 48% overall) and three had shortness of breath (38% vs 21%). None of these patients complained of fever or symptoms of upper respiratory illness. Ten diagnoses of urinary tract infection were made. Four of these patients complained of dysuria and frequency; three complained of flank pain. Eleven of the 18 infections (61.1%) did not have a typical history for or suggestive physical or laboratory findings of bacterial infection. CONCLUSION: In sickle cell disease patients with pain crisis, routine chest radiography and urinalysis may be clinically useful and cost effective in the early diagnosis of crisis-related infection.

Acute Disease↗
PubMed1990

Chylous drainage from a stab wound to the neck.

A 24-year-old man was assaulted and sustained a stab wound to the left lower neck. When he arrived at the emergency department, he was hemodynamically stable. Although the wound had penetrated the platysma, on initial evaluation the patient did not appear to have sustained significant injury. Closer examination of the wound revealed chylous drainage, indicating injury to the cervical portion of the thoracic duct. The patient was taken to the operating room for exploration of the wound, during which an injury to the left internal jugular vein was identified and repaired. The thoracic duct, which had been severed, was ligated. The remainder of the patient's hospital course was unremarkable. The consistent association between penetrating injury to the cervical portion of the thoracic duct and injury to neighboring vascular structures is discussed.

Adult↗
PubMed1989

Acute carbon monoxide poisoning: emergency management and hyperbaric oxygen therapy.

An ice storm in February 1989 resulted in numerous incidences of carbon monoxide poisoning in central Mississippi secondary to exposure to open fires in unventilated living spaces. Sixteen cases were treated during this period at the University of Mississippi Medical Center and 6 received Hyperbaric Oxygen therapy. These 6 cases and the mechanisms of CO poisoning are discussed and recommendations for emergency management are reviewed.

Acute Disease↗