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Biomedical subjects

A J Tomassoni

Publications and source records attributed to A J Tomassoni.

5 recordsLinked to original sources
PubMed1999

Usefulness of the total iron binding capacity in the evaluation and treatment of acute iron overdose.

The ingestion of iron-containing products is a potential toxicologic emergency. The total iron binding capacity (TIBC) has been used widely as a predictor of end-organ toxicity and a guide to the need for deferoxamine therapy. When the TIBC is greater than the serum iron concentration (SIC), it is held that no free iron is present to cause toxicity. The TIBC fails as a marker of toxicity for several reasons. First, the laboratory methods used to measure TIBC are inaccurate in the setting of iron overload. Second, the presence of deferoxamine, the antidote for iron poisoning, has been shown to make the TIBC measurement inaccurate. Third, TIBC measurements have been shown to be variable. Finally, studies and case reports demonstrate toxicity even when the TIBC is greater than the SIC. These shortcomings of the TIBC invalidate it as a predictor of toxicity in iron poisoning.

Acute Disease↗
PubMed1995

Cardiac problems associated with dysbarism.

Patient salvage rates depend on the extent of injury, speed and appropriateness of treatment, and the patient's age and state of health in addition to other variables. Undertreatment of DII may result in significant morbidity and associated costs. If there is any doubt regarding whether a patient might benefit from treatment, a trial at pressure is indicated. Among those with AGE who reach recompression within 5 minutes, the death rate may be only 5%, and those who survive have little morbidity. Among those whose recompression delay increases to 5 hours, however, mortality approaches 10%, and more than 50% of the survivors experience residua. All dive accidents should be thoroughly investigated by professionals. Sport divers who manifest any symptoms of DII should refrain from further diving because response to therapy for future episodes is generally relatively poor. Victims of DII must have long-term follow-up.

Decompression Sickness↗
PubMed1993

Safety assessment of high-dose narcotic analgesia for emergency department procedures.

STUDY OBJECTIVE: To evaluate the safety of high-dose IV narcotics in patients requiring analgesia for painful emergency department procedures. DESIGN: Prospective multicenter clinical trial. SETTING: Five adult urban EDs. METHODS AND MEASUREMENTS: All patients received IV meperidine (1.5 to 3.0 mg/kg) titrated to analgesia followed by a painful procedure. Vital signs and alertness scale were recorded at regular intervals, and patients were observed for four hours. Adverse events were monitored and documented. Comparisons between baseline and postanalgesia intervals were made with a repeated measures ANOVA (Dunnett's test). RESULTS: Although statistically significant changes in vital signs and alertness scale occurred, they were not clinically significant. Opiate reversal with naloxone was not needed in any patient, and no significant respiratory or circulatory compromise occurred. CONCLUSION: This study of 72 patients demonstrates that high-dose narcotic analgesia is appropriate, well tolerated, and safe when used in selected patients before painful procedures in the ED. Narcotic antagonists and resuscitation equipment nonetheless should be available to maximize safety.

Adolescent↗