Biomedical subjects
Publications and source records attributed to Mark Silverberg.
Foreign body ingestion is a common complaint in the pediatric emergency department. Here, we report an interesting case of a coin ingestion in which the radiographic findings were alarming and inconsistent with the history provided by our patient. A brief review of the diagnosis and management of gastrointestinal foreign bodies is presented, with particular focus on ingested coins and button batteries.
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UNLABELLED: Patients with essential hypertension (EH) have higher mortality rates from hemorrhage. How the complex physiologic changes seen in EH affect the response to uncontrolled hemorrhage has yet to be adequately described. OBJECTIVE: To test the null hypothesis that there would be no difference in the hemorrhage volumes and hemodynamic responses to uncontrolled hemorrhage between hypertensive rats (SHRs) and normotensive rats (WKYs). METHODS: Twenty-four adult rats (12 WKYs and 12 SHRs) were anesthetized with althesin via the intra-peritoneal route. The femoral artery was cannulated by cutdown for mean arterial pressure (MAP) measurement and blood gas sampling. Twelve rats (6 WKYs and 6 SHRs) underwent uncontrolled hemorrhage by 50% tail amputation. Twelve rats (6 WKYs and 6 SHRs) served as non-hemorrhage controls. The MAP, base excess (BE), and cumulative blood loss were measured pre-hemorrhage and then every 15 minutes post-hemorrhage for 90 minutes. Data were reported as mean +/- standard error of the mean. Comparisons between control and uncontrolled hemorrhage groups were analyzed by analysis of variance (ANOVA) with repeated-measures post-hoc testing by Bonferroni. Statistical significance was defined by an alpha = 0.05. RESULTS: Mortality rates were significantly higher (p < 0.05) for the SHRs (100%) as compared with the WKYs (33%). Changes in time-averaged MAP post-hemorrhage were significantly greater (p < 0.001) in the SHR group (88 +/- 10 mm Hg) as compared with the WKY group (48 +/- 4 mm Hg). Hemorrhage volume was significantly lower (p = 0.02) in the SHR group (3.7 +/- 0.5 mL) as compared with the WKY group (6.1 +/- 0.7 mL). CONCLUSIONS: Hypertensive rats had a higher mortality rate than normotensives from a comparable vascular injury with lower hemorrhage volumes.