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Biomedical subjects

S C Dronen

Publications and source records attributed to S C Dronen.

44 records · Page 3Linked to original sources
PubMed1984

Antifibrillatory drugs: the case for bretylium tosylate.

The preferred treatment for ventricular fibrillation (VF) refractory to maximal electrical defibrillation remains controversial, as evidenced by recent changes in the American Heart Association's treatment algorithm. To date there have been no published studies conclusively proving one mode of therapy to be superior to another. There is, however, an abundance of animal and clinical data suggesting that bretylium tosylate (BT) is the drug of choice in this setting. In animal studies BT has been shown to lower the canine defibrillation threshold, to facilitate conversion of hypothermia-induced ventricular fibrillation, and to effect spontaneous defibrillation. In 15 years of clinical use as a drug of last resort, and more recently as a first-line drug, BT has developed an impressive track record. Most of the clinical reports are uncontrolled and/or retrospective, but they share a central theme: BT is effective in the treatment of VF refractory to standard therapy. Several small studies have reported successful conversion of VF to a stable rhythm with BT after failure of standard electrical and pharmacologic therapy. Recent studies suggest that earlier use of BT may be associated with improved outcome. Finally, as in animal studies, spontaneous defibrillation has been reported. It is important to note that no drug currently used in the treatment of countershock-refractory VF has been proven effective. The use of some of these drugs is based on tradition rather than scientific evidence. The bulk of currently available scientific data indicates that BT is superior to other commonly used antiarrhythmics in the treatment of VF resistant to countershock.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1983

Disorders of the chest wall and diaphragm.

The clinical presentations of chest wall and diaphragmatic disorders are extremely diverse, and the attention of the emergency physician is often directed to a more obvious problem. The common denominator of these disorders is their effect on respiratory mechanics, a discussion of which precedes the review of specific disorders.

Accidents, Traffic↗
PubMed1983

Diaphragmatic rupture during G-maneuvers in a T33 jet trainer.

A 26-year-old white male, radar operator, participated in a flight in a U.S. Air Force T33 jet trainer. The patient experienced nausea and vomiting followed by several episodes of retching during maneuvers of positive acceleration. Upon landing, he noted severe epigastric pain and shortness of breath. After 3 h of persistent symptoms, he presented to the base hospital's emergency department where he was diagnosed as having diaphragmatic herniation of abdominal viscera into the left hemithorax. At laparotomy, a large traumatic paraesophageal tear was discovered. The abdominal viscera were reduced and the defect repaired. The postoperative course was uncomplicated. The pathophysiology of blunt, nonpenetrating diaphragmatic herniation is discussed. Another mechanism for diaphragmatic rupture resulting from the forces of vomiting and acceleration is proposed.

Acceleration↗
PubMed1981

Proximal saphenous vein cutdown.

An anatomical review and venesection technique for the proximal greater saphenous vein is described. It is recommended as an additional intravenous approach for rapid volume resuscitation in the patient with profound hypovolemic shock.

Humans↗
PubMedDate not supplied

The scapular manipulation technique for the reduction of acute anterior shoulder dislocations.

Anterior shoulder dislocations are a common occurrence in busy emergency departments. Numerous techniques for treating this problem have been reported. The majority of these techniques use traction and leverage of the humerus, often requiring considerable force and causing significant patient discomfort. We report a simple, relatively painless, and atraumatic method of shoulder reduction involving manipulation of the scapula as well as the humerus. This technique has been used in our emergency department with considerable success and no complications.

Humans↗