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Biomedical subjects

W A Wingert

Publications and source records attributed to W A Wingert.

At least 19 recordsLinked to original sources

Snake venom poisoning in the United States: a review of therapeutic practice.

Snake venom poisoning constitutes a medical emergency. It is a complex type of poisoning that not only affects the local bite site but may involve multiple organ systems as well. In the United States, poisonous snakes account for approximately 8,000 bites annually, resulting in about 9 to 15 fatalities. The majority of deaths occur in children, the elderly, and untreated or mistreated individuals. Pit vipers account for almost all bites. Diagnosis and treatment are based on clinical signs and symptoms of envenomation along with identification of the snake. First aid treatment should focus on transporting the victim to the nearest medical facility as soon as possible. Previously advocated first aid measures such as tourniquet, incision and suction, cryotherapy, and electric shock should be avoided. The mainstay of treatment for envenomation is the prompt administration of sufficient quantities of the appropriate antivenin.

Adult↗

What happens to babies exposed to phencyclidine (PCP) in utero?

Fifty-seven infants exposed to phencyclidine (PCP) in utero were followed for the first year of life. Thirty-six (65%) of the 55 for whom birth records were available manifested symptoms of neonatal narcotic withdrawal syndrome, including 16 (52%) of those whose mothers denied opiate abuse during pregnancy. Temperament problems were noted in 47% of the babies and sleep problems in 14%. The majority of infants grew normally, but a larger than expected number started out small and remained small. Testing using the Bayley Scales of Infant Development at age one year revealed a mental development index (mean +/- SD) of 94 +/- 10 and a psychomotor development index of 98 +/- 10. Attachment behavior was abnormal in 17%. Most infants were cared for by their natural mother. Further studies are needed to determine later effects of in utero PCP exposure, as well as effects on the infants being raised by women who have used PCP. Phencyclidine toxicity needs to be considered when evaluating babies with signs of neonatal narcotic withdrawal syndrome.

Birth Weight↗

Rattlesnake bites in southern California and rationale for recommended treatment.

Rattlesnake bite is most common in young men who often are intoxicated and have purposely handled a venomous snake. The incidence of bites is highest in the spring and early summer months, and they most often occur in the afternoon. The hands and feet only are involved in 95% of all bites. First-aid therapy should be limited to splinting the extremity and transporting the victim to a medical facility. Definitive therapy is administering antivenin (Crotalidae) polyvalent intravenously in adequate initial doses and repeating every two hours until the venom is completely neutralized. Serum sickness usually follows all doses of more than five vials but is readily controlled by giving corticosteroids. Bites are avoided by protecting the hands and feet, not handling venomous snakes, and using utmost caution while in the snakes' habitat.

Adolescent↗

Differences between dropouts and active participants in a pediatric clinic for substance abuse mothers.

We compared the maternal and birth characteristics of 87 first-year dropouts with 103 active participants of a pediatric clinic which provides long-term follow-up care to offspring exposed in utero to substance abuse mothers. The age, ethnicity, and marital status of the mother; the type of drug used during pregnancy; and the length, gender, number, and type of addiction problems of the newborn were not significantly different between the two groups. However, the dropouts differed significantly from the active participants in many other aspects. More dropout mothers received no prenatal care and did not have children at home at the time of the present birth. More of them were smokers; had gonorrhea, heart, and kidney problems; and had infections complicating their pregnancy. The dropout newborns were found to have lower birthweight and shorter gestation. These clinical parameters defined a suboptimal group of mothers and children requiring more attention and care. The findings also alert investigators of long-term follow-up studies to be aware of basic differences between nonparticipants and participants.

Adolescent↗

Preparation of a new antivenin by affinity chromatography.

Polyacrylamide gel affinity chromatography was employed to isolate and purify antibodies to the antigens of the venoms of four rattlesnakes. The antivenins were studied for their neutralizing properties on a number of pharmacologic preparations. It was found that the purified antibodies (IgG) were more efficacious than the commercially prepared antivenin in neutralizing the lethal, cytolytic, hemorrhagic, platelet aggregating, and other deleterious effects of the venoms. In addition, the purified antibodies gave no evidence of producing anaphylaxis or anaphylactoid reactions in animals sensitized to horse serum. The proposed technique is also more simple than current production methods, is time-saving, and less expensive.

Animals↗

Prolonged defibrination after a bite from a 'nonvenomous' snake.

The distinction between venomous, potentially dangerous snakes and snakes considered to be harmless to humans is not always clear. A man was bitten by an assumed harmless pet snake, Rhabdophis subminatus (the red neck keelback), that had been obtained from a pet store. The patient experienced a severe coagulopathy with life-threatening hemorrhage unresponsive to transfusion. Since this snake frequently is sold legally in the United States, we wish to alert the medical community to its potential danger and to discuss the pathophysiological mechanism by which the coagulopathy was produced.

Adult↗

Attachment interaction behavior between young teenage mothers and their infants.

Behavioral interaction between teenage mothers and their infants was explored. Twenty-six (low income level) Hispanic teenage mothers (mean age 15 years) and their infants (mean age 13.5 months) were compared with an older control group of 30 mothers (mean age 26 years) and their infants (mean age 14.0 months). Infant attachment, exploration, and stress-adaptation behaviors and maternal ability to contact, encourage, and comfort the infant were evaluated. Twenty-six percent of the control infants showed limited ability to cope with stress compared to 47% of infants of teenage mothers. Control mothers differed significantly from teenage mothers in effective eye, verbal, physical contact, and smiling behaviors. These findings suggest that limited teenage maternal behaviors may potentially have a negative psychologic effect for both infants and their young mothers.

Adaptation, Psychological↗

Infants with birth weight under 1500 g: physical, neurological, and developmental outcome.

One hundred and seventy-eight infants with birth weights less than or equal to 1500 g born in 1973-1975 were followed for a period of 1-3 years, and the physical, neurological, and developmental outcome evaluated. Although there was a high incidence of maternal problems, these did not correlate with outcome. Asphyxia at birth followed by neonatal complications leading to ventilatory assistance was significantly correlated with poor outcome. Over 50% of infants less than 100 g birth weight required assisted ventilation, but the outcome in small ventilated infants was comparable to that of ventilated infants of 1001-1500 g birth weight. Infants with neurological abnormality showed a high incidence of associated abnormalities in growth, vision, hearing, and development. Spastic quadriplegia emerged as the most common neurological diagnosis. Despite the many perinatal problems, 82% of the group were normal neurologically and 66% developmentally. The overall outcome was generally favorable in these infants even for those requiring ventilation.

Child Development↗