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Biomedical subjects

P E Goodman

Publications and source records attributed to P E Goodman.

9 recordsLinked to original sources

An unusual case of clarithromycin associated ergotism.

A 41-year-old woman presented to the Emergency Department complaining of a 4-day history of worsening lower leg pain, pallor, and a sensation of coolness aggravated by exertion. Evaluation revealed severe lower extremity vasospasm. She recently had been prescribed clarithromycin for "flu-like" symptoms, and for many years had been taking a caffeine-ergotamine preparation for migraine headaches. Clarithromycin is known to interfere with ergotamine metabolism. This drug interaction is often not recognized. Ergot alkaloids are commonly used for migraine headaches and have vasoconstrictive properties. In a patient with ergotamine toxicity, these vasoconstrictive properties can lead to frank ischemia. We reviewed the literature for reports of ergotamine-associated ischemia and for reports of ergotamine toxicity caused by drug-drug interaction.

Adult↗

Black widow spider bite in a child.

An 8-year-old boy who was bitten by a black widow spider was seen in the emergency department twice, as well as by his private family physician, within a 24-hour period of time before being admitted to the hospital. This patient should have been observed for a longer period of time in the emergency department or admitted to the hospital on the day of presentation for observation with conservative management. The current literature is reviewed with special emphasis on the pediatric patient, and management guidelines are recommended.

Abdomen, Acute↗

Renal infarction secondary to nasal insufflation of cocaine.

Cocaine abuse has resulted in complications involving an increasing number of organ systems. This article presents a case report and discussion of renal infarction occurring in association with nasal insufflation of cocaine powder. Possible etiology and suggested workup of such patients is also discussed.

Adult↗

Prevalence and nature of allergy and chemical sensitivity in a general population.

The objectives of this study were (a) to determine the self-reported prevalence of allergy and chemical sensitivity in a rural population of eastern North Carolina, (b) to determine the type and frequency of symptoms for each condition, and (c) to determine the demographic groups affected. A random general telephone survey was conducted during the period May 14, 1993, to September 10, 1993, and questions about allergy and chemical sensitivity were asked. Of the 1 446 households contacted, 1 027 (71%) individuals agreed to participate. Allergies were reported by 365 (35%) individuals. Thirty percent of allergic individuals reported that symptoms occurred once or more each week, whereas 61% reported that symptoms occurred, at most, once each month. Allergic symptoms that occurred daily were reported by 5.3% of the total population. Chemical sensitivity was reported by 336 (33%) individuals. Thirty-five per cent of chemically sensitive individuals reported symptoms at least once each week, whereas 53% reported that symptoms occurred once (or less) each month. Symptoms of chemical sensitivity that occurred daily were reported by 3.9% of the total population. Both allergy and chemical sensitivity were distributed widely across age, income, race, and educational groups. Simultaneous allergy and chemical sensitivity were reported by 16.9% of the population, allergy without chemical sensitivity by 16.0%, chemical sensitivity without allergy by 18.2%, and neither condition by 48.9%. If the prevalence of sensitivity to chemical irritants is, in fact, equivalent to that of allergy, as was found in this study, then support for the scientific investigation of chemical sensitivity is justified.

Adolescent↗