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Biomedical subjects

A R Temple

Publications and source records attributed to A R Temple.

At least 37 records · Page 2Linked to original sources

Acute and chronic effects of aspirin toxicity and their treatment.

Salicylate poisoning remains a major clinical hazard, usually resulting from accidental ingestions in preschool children, suicidal overdoses in adults and teenagers, and therapeutically acquired intoxication in all ages. Alkalemia or acidemia, alkaluria or aciduria, hypoglycemia or hyperglycemia, and water and electrolyte imbalances may occur; nausea, vomiting, tinnitus, hyperpnea, hyperpyrexia, disorientation, coma, and/or convulsions are common. With chronic, therapeutically induced salicylism, these symptoms may be mistaken for symptoms resulting from the illness for which the salicylates were administered. For acute ingestions, the magnitude of the poisoning is clearly dose related. Blood level determinations are good prognostic indicators for acute ingestions but are of limited value in chronic, therapeutically induced salicylism. Fluid and electrolyte management is the mainstay of therapy. Diuresis, hemodialysis, and hemoperfusion are effective, but the latter two rarely are necessary.

Adolescent↗

Dermatitis after exposure to a garden plant (Euphorbia myrsinites).

Six pediatric cases of erythematous papulovescicular skin eruptions were due to exposure to Euphorbia myrsinites. These rashes may be confused with allergies, infections, or other dermatoses. Symptoms followed two to eight hours after exposure to the irritant sap, they increased in severity for an additional 12 hours, and they resolved within three to four days. No sequelae were noticed. Treatment indicated was pain relief, prevention of infection, and reduction of swelling.

Child↗

Treatment of methapyrilene toxicity with physostigmine.

Methypyrilene, 40 mg/kg, was administered to male mongrel dogs, resulting in both central and peripheral anticholinergic effects. Physostigmine in doses of 0.5 to 1.0 mg was effective in reversing the central effects completely and the peripheral effects to a limited degree.

Aminopyridines↗

Pharmacokinetic model for salicyclate in cerebrospinal fluid, blood, organs, and tissues.

The developed pharmacokinetic model, an extension of the Bischoff--Dedrick model, simultaneously predicts the kinetic behavior of salicylate in cerebrospinal fluid, blood, organs, and tissues. The model, which is entirely different from conventional compartment models, is derived from basic considerations of drug distribution with biochemical and physiological meaning. The dog was studied at three different dosages of salicylate: therapeutic, moderate intoxication, and severe intoxication. The predicted kinetics of salicylate in cerebrospinal fluid, blood, plasma, liver, muscle, and adipose tissue by the model agreed well with the experimental data. The effectiveness of hemoperfusion treatment for the severely intoxicated dog by albumin-coated activated carbon and its effect on the kinetic behavior of salicylate in cerebrospinal fluid, blood, organs and tissues were studied. The model was also applied to predict the kinetic changes of salicylate in the body during and after the extracorporeal treatment. The predicted results also agreed with the experimental data.

Adipose Tissue↗

One year's experience in a regional poison control center: The Intermountain Regional Poison Control Center.

The Intermountain Regional Poison Control Center in Salt Lake City, Utah, has served as a regional poison center since 1971. Between 1972 and 1976 the call load has more than tripled, with the highest frequency of calls per population coming from counties most proximate to the center. Two-thirds of the cases involve children age five or less, with 18 or over being the next large group. Adolescents and school-age children comprised the smallest group of cases. Two predominant types of poisonings were encountered: accidental ingestions of toxic substances in children and intentional self-poisonings in adults, but the poison center handled almost every conceivable type of poisoning or toxic situation. A detailed analysis of the center's overall experience as well as these two major categories is presented.

Adolescent↗

Pathophysiology of aspirin overdosage toxicity, with implications for management.

The principal pathophysiologic effect of toxic doses of salicylates are characterized by (1) stimulation of the respiratory center of the brain, leading to hyperpnea and respiratory alkalosis; (2) uncoupling of oxidative phosphorylation, leading to increased oxygen utilization and glucose demand, increased oxygen utilization and glucose demand, increased glyconeogenesis, and increased heat production; (3) inhibition of Krebs cycle enzymes, leading to decreased glucose availability and increased organic acids; (4) alterations in lipid metabolism and amino acid metabolism, enhancing metabolic acidosis; and (5) increased fluid and electrolyte losses, leading to dehydration, sodium depletion, potassium depletion, and loss of buffer capacity. The principal toxic manifestations of respiratory alkalosis and metabolic acidosis, altered glucose availability and depletion, fluid and electrolyte losses, and hypermetabolism result in serious morbidity and are potentially fatal. Therapy of salicylate intoxication should be aimed principally at replacement of fluid electrolytes, correction of acidemia, administration of glucose, and prevention of further salicylate absorption and enhancement of salicylate elimination.

Acidosis↗

Telephone management of poisonings using syrup of ipecac.

Seven hundred and seventy-six cases were studied during a six-month period to see if induction of emesis could be successfully managed at home by telephone. Emesis was successful in 98.8% of cases. In 6.7% of all cases, symptoms were found at 4-hour follow-up that were referrable to the ingestion, but all were considered to be of minor consequence. No complications of vomiting occurred. Twenty-four hour follow-up investigation indicated no significant complications of induction of emesis or complications from managing the patient by telephone. It is our conclusion that, with appropriate telephone supervision, home-induced emesis of ingestions expected to produce mild to moderate symptoms is as effective as emergency room or physician office management of cases. Furthermore, the absence of adverse affects of complications arising from the induction of emesis at home in our cases confirms that this form of management is quite safe.

Adolescent↗

Salicylate poisoning complicated by fluid retention.

We have presented two cases of salicylate poisoning that demonstrate fluid retention in the face of adequate hydration, resembling the syndrome of inappropriate secretion of ADH. These cases necessitated marked alterations from normal fluid therapy. Mannitol was found to be an effective, albeit transient, diuretic for treating the acute symptoms associated with fluid retention, but only strict fluid restriction resulted in a prompt and satisfactory diuresis.

Adult↗

Cadmium, lead, and copper blood levels in normal children.

Cadmium, lead, and copper levels were measured in duplicate whole blood samples from 60 apparently normal children, ranging in age from 2 months to 13 years, who were hospitalized for elective surgery. Metals were measured by atomic absorption spectroscopy after the samples were chemically oxidized and digested. Cadmium was concentrated by dithizone extraction before analysis. Blood cadmium averaged 0.66 mug/100 gm, with a standard deviation of 0.25. No samples had cadmium concentrations less than could be detectable. The average concentration of lead was 15.7 mug/100 gm with a standard deviation of 6.33. Copper averaged 123 mug/100 gm with a standard deviation of 35.5. Tolerance intervals were calculated for each metal in order to estimate the bounds of whole blood metal values in normal children. The intervals containing 95% of normal values with a probability of .95 were 0.22-1.70 mug Cd/100 gm, 0.87-30.5 mug Pb/100 gm, and 40.0-206 mug Cu/100 gm.

Adolescent↗