Biomedical subjects

Jerrold Leikin

Publications and source records attributed to Jerrold Leikin.

4 recordsLinked to original sources

PubMed2005

Visual system side effects caused by parasympathetic dysfunction after botulinum toxin type B injections.

Botulinum toxin type B (BTX-B) has been approved by the Food and Drug Administration for the treatment of cervical dystonia. However, as with botulinum toxin type A (BTX-A) it has off-label uses, such as for hyperhidrosis, focal dystonias, spasticity, and facial wrinkles. BTX-B has also been shown to be a safe and effective alternative for patients who are resistant to BTX-A. The most commonly reported side effects include dry mouth and dysphagia. To date, there have been few reports of visual disturbances associated with BTX-B use. In this study, we report on three individual patients who received BTX-B and who subsequently developed parasympathetic dysfunction of the visual system after injections of BTX-B at remote sites.

Adult↗

PubMed2002

An approach to dialysis for ethylene glycol intoxication.

Eleven cases of ethylene glycol ingestion were retrospectively analyzed for presentation, treatment, and outcome. Patients were grouped according to the time it took to receive medical attention, and whether or not they received I continuous hemodialysis (CHD) versus intermittent hemodialysis (IHD). Six patients presented within 12 h of exposure (Group 1), whereas 5 patients presented later (Group 2; range 48-120 h). Comparisons were made for age, ethylene glycol level, anion gap, osmolar gap, pH, admission creatinine level, time from ingestion to presentation, total time spent on hemodialysis, number of dialysis treatments, recovery time, recovery creatinine, hospital length of stay, and status. Significant differences were observed for ethylene glycol level, osmolar gap, and presentation time. Ten of the 11 patients received single pass hemodialysis, and 5 of these received I CHD. Of the 5 patients who received CHD versus the 5 patients who received IHD, none developed complications (p=0.004). Patients who presented within 10 h of exposure had fewer complications than those who presented > 12 h after exposure Timely CHD is superior to IHD in treating ethylene glycol intoxication. An adeQuate time course of hemodialysis can be approximated using the ethylene gycol index, and may eliminate reliance on ethylene glycol levels in determining adequate endpoints of dialysis in treating poisoned patients.

Acid-Base Equilibrium↗

PubMed1994

Evaluation and Management of Sickle Cell Disease in the Emergency Department (An 18-year Experience): 1974--1992.

Painful episodes are the most frequent complaints of patients with sickle cell disease. The Emergency Department (ED) has provided management for acute events using the usual triage format for emergencies. A prospective study evaluated the role of the ED in the care of adults with sickle cell disease (SCD). The protocol, thus, addressed issues of acute events related to SCD and provided better care for patients with SCD in the ED. Approximately 37% of ED visits were for painful events. An inciting cause was identified in 35% of painful events and 75% of these required admission to the hospital. A 15-year follow-up prospectively showed similar results and that uncomplicated pain crisis can be treated with ED protocols. Outpatient clinics and urgent centers could reduce these visits. Absolute indications for admission include sepsis, fever >102 degreeF, white cell counts >20 000, worsening anemia, hypoxemia, acute chest syndrome and new CNS events. Patient database in the ED must be revised annually to avoid extensive workup in the ED and a complete history/physical examination, and a CBC could be sufficient for triage in an uncomplicated pain crisis. An acceptable protocol for care should be available at all EDs and a registry and information system for SCD will discourage overutilization of investigational tests and visits to multiple EDs.

Journal Article↗

PubMedDate not supplied

Acute chorea associated with metoclopramide use.

Metoclopramide is a dopamine receptor antagonist that is used to treat diabetic gastroparesis, chemotherapy-induced nausea, and migraines. It is known to cause extrapyramidal side effects such as tardive dyskinesia, parkinsonism, dystonia, and akithisia, but not chorea. We describe a patient who presented with choreiform movements shortly after the administration of intravenous metoclopramide. Her work-up for secondary causes of chorea was otherwise negative and her symptoms abated with the administration of oral quetiapine and intravenous diazepam.

Acute Disease↗