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Biomedical subjects

L S Larsen

Publications and source records attributed to L S Larsen.

10 recordsLinked to original sources
PubMed1990

Labetalol in the treatment of epinephrine overdose.

A 31-year-old man being treated for asthma accidently received 3 mg SQ epinephrine. He began retching and vomiting and developed agitation and profuse diaphoresis. He was treated with 5 mg IV labetalol. His symptoms improved significantly, and he required no further treatment. Although he felt a transient increase in his respiratory effort shortly after administration of the drug, he did not develop wheezing or require additional therapy for bronchospasm. The beta-blocking effect of labetalol is greater than the alpha antagonism. The patient exhibited evidence of mild alpha stimulation due to incomplete blockade. This is consistent with previous studies in that labetalol tends to less completely antagonize the alpha effects of a mixed alpha/beta agonist, resulting in a net clinical picture of mild alpha agonism.

Adult↗
PubMed1988

Plasma fibronectin concentration associated with various types of canine neoplasia.

Fibronectin, a large glycoprotein found in soluble form in plasma and in insoluble form in connective tissue matrices, has been implicated in cell-to-cell and cell-to-substratum interactions, inflammation and tissue repair, phagocytosis, hemostasis, and oncogenic cell transformation. Because fibronectin concentration is diminished or lacking on cell surfaces of many transformed cell lines and because decreased concentration of plasma fibronectin is associated with suboptimal mononuclear phagocyte system function and host defense, plasma fibronectin concentration was evaluated in 119 dogs with various forms of neoplasia. Included were 43 dogs with neoplasia of the skin and soft tissue, 18 with gastrointestinal tract neoplasia, 29 with mammary gland neoplasia, and 29 with various other types of neoplasia. Of the dogs studied, 44 (37%) had evidence of metastatic disease. This group had fibronectin concentration that differed significantly (P less than 0.01) from the plasma fibronectin concentration reference interval. Within this group, 9 dogs (20% of this group) had plasma fibronectin values within the reference interval, 33 (75%) had significantly (P less than 0.01) lower values than the reference interval, and 2 (5%) had significantly (P less than 0.01) higher values than the reference interval. These data suggested that fibronectin concentration determination, when results are abnormal, may be of diagnostic and prognostic interest.

Animals↗
PubMed1986

Adjunctive therapy of phenytoin overdose--a case report using plasmaphoresis.

Phenytoin is widely used as an anticonvulsant. In overdose situations phenytoin demonstrates saturable metabolic kinetics making treatment difficult. Phenytoin's high protein binding makes it a poor candidate for hemodialysis or hemoperfusion. We report a case of an attempted suicide in which plasmaphoresis was used in an attempt to lower plasma levels and reduce toxicity. A review of the use of plasmaphoresis in acute intoxications is included.

Adult↗
PubMed1984

Pogotowie Ratunkowe: the emergency medical system of Poland.

In March 1983, in conjunction with the Columbia University Affiliated Hospitals Residency in Emergency Medicine, Overlook Hospital, and under the auspices of the Ministry of Health in Warsaw, we visited Poland to study the country's emergency medical system. The emergency medical service, Pogotowie Ratunkowe, is responsible for civilian acute care throughout the nation. Its domain includes operation of the freestanding emergency medical care centers, all emergency transport and ambulance services, and several short-stay emergency hospitals. The system utilizes a modular concept, and the same basic organization is employed in each of the 49 provinces and five largest cities. The heart of each module is a central dispatch station, ambulance base, and emergency treatment facility. A hub of substations, with treatment areas and ambulance bases, completes the system. All ambulance dispatches come from the central office. A toll-free number provides access. An integral part of the central dispatch station is the information bureau. Individuals seeking a missing person can, by calling a single number find out if they have been picked up by any ambulance, admitted to any hospital, or treated in any ambulatory emergency center within the province. Ambulances are staffed by physicians and equipped with medications. Once on the scene the physician may elect to treat the patient, transport him to an emergency station, or admit him to a hospital. A system of general and specialized ambulances makes the best use of limited resources, such as cardiac resuscitation and trauma vehicles. The need for such technology as telemetry is averted because a physician is on the scene to read the electrocardiographic monitor.(ABSTRACT TRUNCATED AT 250 WORDS)

Allied Health Personnel↗
PubMedDate not supplied

Clinical features and management of poisoning due to phenytoin.

The widespread use of phenytoin results in frequent accidental and intentional toxicity. Metabolism is enzymatic and can be described by Michaelis-Menten kinetics. This results in an increased half-life in overdose situations and a protracted clinical course which may last a week or more. The primary toxicity is on the central nervous system. The most common initial finding in mild toxicity is nystagmus. As concentrations increase ataxia, decreased coordination, hyper-reflexia, slurred speech and diplopia may develop. Progressive increases result in confusion, lethargy and coma. Various methods tried to increase elimination including dialysis, haemoperfusion, diuresis and plasmaphoresis have been ineffective and are not without risk. Meticulous supportive care including ventilation if necessary should provide a good clinical outcome. Multiple-dose activated charcoal may be helpful in shortening the duration of symptoms.

Animals↗