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Biomedical subjects

T R Wolfe

Publications and source records attributed to T R Wolfe.

5 recordsLinked to original sources
PubMed1998

Ruptured renal angiomyolipoma presenting as renal colic.

The case of a patient with acute onset of flank pain and hematuria is presented. Initial therapy was directed toward relief of pain believed to be caused by renal colic. It was not until the patient developed atypical features that the true diagnosis, ruptured renal angiomyolipoma, was discovered. The case and discussion emphasize the need to carefully consider a complete differential diagnosis when evaluating patients with flank pain and hematuria who have atypical clinical features or an atypical course.

Adult↗
PubMed1995

Massive dextromethorphan ingestion and abuse.

The case of a 23-year-old man who was acutely intoxicated on dextromethorphan and who was chronically addicted to the drug is described. He consumed the highest daily dose for the longest duration yet reported in the world's English-language medical literature. Toxicity, abuse potential, and therapy of dextromethorphan intoxication are discussed.

Adult↗
PubMed1989

Terminal 40-ms frontal plane QRS axis as a marker for tricyclic antidepressant overdose.

Tricyclic antidepressant (TCA) poisoning has been reported to cause a right-axis deviation of 130 degrees to 270 degrees in the terminal 40-ms frontal plane QRS axis (T40-ms axis) of the ECG. This retrospective cohort study was designed to determine if the T40-ms axis could discriminate TCA-toxic patients from other overdose patients and whether a correlation exists between TCA plasma concentration and T40-ms axis rotation. Only symptomatic overdose patients with plasma and urine drug screens and an ECG obtained within two hours of each other were included in the study. Patients were divided into two groups: TCA overdose patients (TCA OD, n = 48) and nonTCA overdose patients (nonTCA OD, n = 30). The mean T40-ms axis was significantly more rightward in the TCA OD group compared with the nonTCA OD group (179 +/- 74 vs 86 +/- 87, P less than .001). A TCA OD patient was 8.6 times more likely to have a T40-ms axis of more than 120 degrees than was a nonTCA OD patient (odds ratio, 8.6; 95% confidence interval, 2.7 to 29.1). Eight of the TCA poisoned patients (17%) did not demonstrate a T40-ms axis between 120 degrees and 270 degrees. Receiver operating characteristics demonstrated that the T40-ms axis was a better indicator of TCA toxicity than the QRS interval (P less than .05). A T40-ms axis of 120 degrees or more was 83% sensitive and 63% specific for TCA overdose. A correlation between plasma TCA concentration and T40-ms axis deviation was not found (r = .04).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Syncope as an emergency department presentation of pulmonary embolism.

Pulmonary embolism presenting as an isolated syncopal spell can be a difficult clinical correlation to make. We present three cases of pulmonary embolism-induced syncope and review the pathophysiology and diagnostic considerations in this setting. Pulmonary embolism should be considered in the differential diagnosis of every syncopal event that presents to the emergency department, even in the face of cardiac dysrhythmias and normal pulse oximetry values.

Adult↗