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Biomedical subjects

P A Dahlin

Publications and source records attributed to P A Dahlin.

12 recordsLinked to original sources
PubMed1985

Self-biting with multiple finger amputations following spinal cord injury.

We have observed mutilative self-biting leading to multiple finger amputations in two patients following C4 complete spinal cord injury (SCI). Both men were of normal intelligence without psychosis and each had a neurotic personality and history of fingernail biting. They related the self-biting to anxiety and depression. We believe these to be the first English language reports of multiple finger amputations due to self-biting following SCI.

Adult↗
PubMed1984

Baclofen toxicity associated with declining renal clearance after ibuprofen.

A 64-year-old male with an incomplete spinal cord injury had been taking baclofen 20 mg tid for 2 1/2 months without side effects. His blood urea nitrogen and serum creatinine rose from 13 and 0.9 mg%, respectively, to 59 and 2.8 mg% after ibuprofen 600 mg tid was begun. The patient displayed baclofen toxicity, developing confusion, disorientation, bradycardia, and hypothermia. His blood pressure dropped and he complained of blurred vision. Ibuprofen discontinuation and fluid repletion corrected the renal indices. Rapid tapering of baclofen was accompanied by reversal of baclofen toxicity. Patients taking baclofen must be monitored closely for toxicity when declining renal function is present. Clinicians should be alert to the possibility of renal insufficiency developing when ibuprofen is initiated. This case demonstrates the potential for ibuprofen-induced renal insufficiency to reduce baclofen clearance, thereby leading to baclofen toxicity. Published reports of ibuprofen-induced renal insufficiency are reviewed and pertinent pharmacokinetics of baclofen discussed.

Acute Kidney Injury↗
PubMed1984

Telogen effluvium: hair loss after spinal cord injury.

A 26-year-old man sustained a C5 complete spinal cord injury (SCI) and displayed hysteric behavior which continued into the fourth month of hospitalization. Four months after injury, sudden loss of scalp hair was noted, consistent with psychogenic telogen effluvium. Other causes of hair loss were ruled out. During the sixth month, peak hair loss was noted over the back of the head. Four months after peak shedding, the loss of young club hairs was no longer observed. Recovery was complete seven months after peak loss, leaving a smaller permanent area of diffuse hair loss over the occiput. This pattern of hair loss has not been described previously in association with SCI.

Adult↗
PubMedDate not supplied

Views of pharmacy supportive personnel in Florida.

Forty-eight supportive personnel, employed in Florida hospital and community pharmacies, were surveyed by written questionnaire to identify their views on the role of the supportive person in relation to other staff roles, to determine the confidence these individuals have in their abilities, and to establish the educational backgrounds and views on educational needs of supportive personnel. Results of the questionnaire are presented and discussed. Although most of the respondents were trained on the job and were confident in designated technical functions, 81.1 percent felt that a community college program for supportive personnel would be of benefit.

Attitude of Health Personnel↗
PubMedDate not supplied

Intraspinal hematoma as a complication of anticoagulant therapy.

Two patients who developed intraspinal hematomas associated with anticoagulation therapy are described, and the pathology, clinical presentation, risks, evaluation and management of this rare hemorrhagic consequence, which results in spinal cord injury (SCI), are discussed. A 49-year-old man was taking warfarin sodium 7.5 mg orally every day for two weeks for thrombophlebitis. Prothrombin time (PT) was 24 sec (control = 17 sec). Two days after a dosage reduction for a PT of 36.5 sec (control = 11 sec), he developed severe neck pain, numbness and weakness of the legs, and then quadriplegia. Warfarin therapy was discontinued, and 25 mg of phytonadione was administered intravenously. An epidural hematoma was removed via a C3-C6 laminectomy, and the patient remains a C3 complete quadriplegic. The second patient was a 64-year-old man who was taking warfarin sodium 5 mg and 7.5 mg orally on alternate days following an aortic-valve replacement. PT was maintained at 1.5 times the control value. Four years later, he fell and sustained flexion distraction and compression injuries of the spine at the L1-L2 level. He complained of severe neck pain and headache. Warfarin therapy was stopped, and 10 mg of phytonadione was administered i.v. During a hospital transfer he developed complete paraplegia. PT was 12.4 sec (control = 10.8 sec). Twelve days later, a laminectomy was performed to remove the T6-L1 subdural hematoma revealed by computed tomography (CT). The patient remains a T5 complete paraplegic. Unlike intracranial hemorrhage, intraspinal hemorrhage usually occurs in the epidural space, most often in the dorsal thoracic spine.(ABSTRACT TRUNCATED AT 250 WORDS)

Anticoagulants↗