PubMed Health⌕ Search

Biomedical subjects

M J Bresler

Publications and source records attributed to M J Bresler.

12 recordsLinked to original sources
PubMed1989

Future role of thrombolytic therapy in emergency medicine.

Thrombolytic therapy offers the promise of major therapeutic intervention in many areas as well as in the treatment of patients with acute myocardial infarction who present to the emergency department. Infusion of tissue-type plasminogen activator (tPA) during field transport has been proven safe, but optimal methods for reliably diagnosing acute myocardial infarction in the prehospital setting have yet to be delineated. A major advance would be achieved if thrombolysis were proven effective in preventing the progression of unstable angina to actual infarction. However, early studies have yielded contradictory results. The use of tPA in dissolving peripheral arterial clots appears very promising, but long-term limb survival has yet to be demonstrated. Unlike heparin, thrombolytic agents can also lyse clot in peripheral deep veins and possibly lessen the tendency toward postphlebitic syndrome. The proper dosage regimen to minimize hemorrhage has not been determined. Pulmonary emboli can be lysed by tPA. IV infusion is as effective as intrapulmonary. Significant complications can be minimized, particularly if major vessel catheterization can be avoided for diagnosis. Even after catheterization for pulmonary angiography, however, thrombolytic therapy appears quite promising. The use of thrombolytic agents for embolic-thrombotic stroke is less promising: therefore, the risk of hemorrhagic complication may not outweigh the potential benefit. Thrombolytic therapy thus offers the potential for significant impact on the practice of emergency medicine.

Embolism↗
PubMed1989

The adult respiratory distress syndrome.

ARDS is a pulmonary injury syndrome associated with a variety of clinical disorders. The pathophysiology of ARDS has been clarified substantially in the past several years. Neutrophils are probably the chief mediators of pulmonary injury, serving as the focus for release of several toxic substances that cause capillary endothelial and alveolar epithelial damage. The mortality rate in ARDS remains high despite advances in elucidating of pathogenesis. Newer approaches to management stress earlier identification of patients and specific therapy aimed at interfering with the damage produced by toxic mediators of pulmonary injury.

Combined Modality Therapy↗
PubMed1982

Occult cervical spine fracture in an ambulatory patients.

Significant injury to the cervical spine many not be obvious in patients whose mental status is decreased. We present the case of a fully conscious, ambulatory patient with no complaint of neck pain and only mild tenderness on examination who nevertheless had sustained an unstable fracture-dislocation of the cervical spine. Following surgery, the patient recovered without permanent neurologic sequelae. Criteria are suggested for ordering radiographic studies of the cervical spine for victims of trauma.

Adult↗
PubMed1981

Prevention of iatrogenic acute narrow-angle glaucoma.

The pathophysiology of glaucoma is reviewed, and the risks of pharmacologic pupillary dilation are discussed. A simple transillumination screening test for identifying patients in whom mydriasis presents a risk is described.

Eye↗
PubMed1981

Preceptorships for emergency physicians.

We describe a preceptorship developed in response to needs identified by surveys of emergency physicians in our community. The policies and procedures necessary to establish the program and the problems encountered are described. Major factors influencing the success of these programs include commitment by the institution's faculty, availability of administrative staff, financial support, and ongoing evaluation and feedback. A set of recommendations is offered for educational institutions considering the establishment of preceptorships.

California↗