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Biomedical subjects

B H Rumack

Publications and source records attributed to B H Rumack.

At least 73 records · Page 4Linked to original sources
PubMed1986

Ibuprofen overdose: 126 cases.

In this study of ibuprofen overdose, symptoms developed in 19% of patients (24 of 126)--in 7% of children (6 of 88) and in 47% of adults (18 of 38). Central nervous system depression, seizures, gastrointestinal disturbances, bradycardia, hypotension, apnea, abnormal renal functions, hematuria, nystagmus, and blurred vision were observed. No patients became symptomatic more than four hours after ingestion. There was no significant difference (P greater than .05) between symptomatic and asymptomatic adult groups in either total milligrams or milligram-per-kilogram amounts ingested by history. Pediatric patients who became symptomatic had a mean ingestion by history of 440 mg/kg; those who remained asymptomatic had a mean ingestion by history of 114 mg/kg (P less than .001). No patients ingesting less than 99 mg/kg by history developed any symptoms. Two children had seizures or apnea and one died. Ibuprofen occasionally may cause serious toxicity in overdose.

Adolescent↗
PubMed1986

Assessing mistletoe toxicity.

To assess the potential toxicity of mistletoe ingestion, data were collected on 14 cases of ingestion of one to three berries or one or two leaves of American mistletoe (Phoradendron sp) from 1982 to 1985. Eleven patients ingested berries and three ingested leaves; none became symptomatic. Nine patients were observed at home without intervention except poison center telephone follow-up. Five had induced emesis, including two who were referred to emergency departments for evaluation, where no findings other than ipecac-induced vomiting were noted. Also reviewed were data on a total of 318 cases of mistletoe ingestion reported to the Food and Drug Administration Poison Control case reporting system between 1978 and 1983 (n = 177) and the American Association of Poison Control Centers national data collection system (n = 141) in 1984. The majority remained asymptomatic and no deaths were recorded. These data allow the conclusion that ingestion of one to three mistletoe berries or one or two leaves is unlikely to produce serious toxicity.

Adolescent↗
PubMed1986

Acute ingestions of boric acid.

Four patients with elevated serum boric acid levels after single, acute ingestions of 10 to 297 grams were reported to the Rocky Mountain Poison and Drug Center (RMPDC) between January 1983 and August 1985. Systemic effects were absent. In 1983-4, 364 cases of boric acid exposure were reported to the RMPDC with only one fatality from a probable chronic ingestion. Vomiting, nausea, diarrhea, and abdominal cramps were rather common. Systemic effects were notably absent in acute ingestions. Five of three hundred sixty-four patients had measured serum levels and were the only ones hospitalized. These observations suggest that significant poisoning is unlikely to result from a single, acute ingestion of boric acid. Serum boric acid levels appear to correlate poorly with clinical toxicity following acute ingestion.

Acute Disease↗
PubMed1986

Cyanide poisoning from laetrile ingestion: role of nitrite therapy.

A 4-year-old child ingested laetrile and almost died of cyanide poisoning. Treatment with the Lilly cyanide antidote kit resulted in rapid, complete recovery. Extremely high whole blood cyanide levels were documented. The necessity for use of the antidote kit in serious cyanide poisoning has recently been questioned. This case demonstrates benefit from antidotal treatment.

Acute Disease↗
PubMed1986

Management of acute acetaminophen overdose.

Acetaminophen is a popular analgesic and antipyretic medication that has few side effects and little toxicity when used in recommended doses. With ingestion of overdose quantities, accumulation of toxic metabolites may cause hepatotoxicity. Acetylcysteine is an effective antidote when used early in the course of an acute overdose. An accurate history of the time of ingestion and an acetaminophen plasma level will determine which patients require treatment with acetylcysteine.

Acetaminophen↗
PubMed1986

Hemorrhagic pancreatitis associated with acetaminophen overdose.

A 19-yr-old man ingested 25 g of acetaminophen in a suicide attempt. Twenty-one hours after the ingestion the plasma acetaminophen level was potentially hepatoxic at 62 micrograms/ml. The toxicology screen was negative for all other drugs. Thirty-six hours after admission the patient developed an acute abdomen with a serum amylase of 1500 IU. Peritoneal lavage revealed a grossly hemorrhagic fluid. Exploratory laparotomy revealed necrotic pancreatitis. Hepatoxicity with the peak SGOT greater than 2000 IU and a mild renal toxicity with the creatinine of 1.9 mg/dl occurred despite late initiation of treatment with n-acetylcysteine. No other etiology for the pancreatitis was found. Peritoneal irrigation was continuously performed through a surgically placed dialysis catheter. Pancreatitis associated with acetaminophen overdose has been reported twice in the past. Although the pathophysiology of the pancreatic injury is obscure, the lack of other etiological factors and temporal association of the pancreatitis with acetaminophen-induced hepatic and renal toxicity suggest a causal relationship.

Abdomen, Acute↗
PubMed1985

Human ivermectin exposure.

Ivermectin is a veterinary antiparasitic medication for domestic animals. Two cases of human exposure to veterinary preparations of ivermectin are reported. Patient number one accidentally self-injected ivermectin and developed nausea, pallor, and transient pain and numbness in the affected extremity. Patient number two, a 4-year-old child, ingested an unknown amount of the paste preparation and remained asymptomatic. As ivermectin is being used with increasing frequency in veterinary medicine, more human exposures may be anticipated.

Adult↗
PubMed1985

Hyperbaric oxygen therapy for severe hydrogen sulfide poisoning.

The optimum therapy for hydrogen sulfide poisoning is unclear. Adjuncts used in the treatment of cyanide poisoning have been advocated because of the shared mechanism of toxicity between hydrogen sulfide and cyanide. Following success in cyanide poisoning, hyperbaric oxygen therapy (HBO) has been suggested for use in treating hydrogen sulfide poisoning. A case of severe hydrogen sulfide poisoning was successfully treated with HBO after standard therapy was apparently ineffective. HBO as a therapeutic adjunct in hydrogen sulfide poisoning and the rationale for its use are discussed.

Adult↗
PubMed1985

Blue-green algae poisoning.

Poisoning by blue-green algae occurs after an algal "bloom" caused by warm weather and algal concentration. On death or disintegration, the algae release liver toxins and neurotoxins (fast death factor). Although deaths are common in animal exposures, human exposures have been limited to various allergic reactions, mild liver enzyme elevation, and gastroenteritis. A case of animal deaths and its relationship to human exposures is discussed.

Animals↗
PubMed1985

Mothball differentiation: naphthalene from paradichlorobenzene.

In order to develop a rapid, simple test to differentiate toxic naphthalene from the less toxic mothball ingredient paradichlorobenzene, both types of mothballs were dissolved in isopropyl alcohol, ethanol, methanol, and turpentine. Twenty-five naphthalene and 25 paradichlorobenzene mothballs were weighed, randomly grouped, and then dissolved in the solvents. After 30 minutes, the mothballs were reweighed. Isopropyl alcohol, ethanol, and methanol did not differentially dissolve the mothballs fast enough to provide a useful test. Turpentine, however, dissolved paradichlorobenzene at a much more rapid rate than naphthalene (P less than .001). After 60 minutes, all of the paradichlorobenzene mothballs had dissolved, while at least 25% of the naphthalene remained. Thus, when confronted with an ingestion of unlabeled mothballs, the physician could gain preliminary information regarding possible toxicity by dissolving a remaining mothball in turpentine for 60 minutes.

Chlorobenzenes↗
PubMed1985

Management of acutely poisoned patients without gastric emptying.

During an 18-month period, 592 acute oral drug overdose patients were studied prospectively in a controlled, randomized fashion to determine the efficacy of gastric emptying procedures in altering clinical outcome. Patients presenting on even-numbered days had no gastric emptying procedures performed, and they were compared to patients presenting on odd-numbered days who received either syrup of ipecac or gastric lavage. Patients were carefully followed for evidence of subsequent clinical improvement or deterioration after initial management. Syrup of ipecac did not significantly alter the clinical outcome of patients who were awake and alert on presentation to the emergency department (ED). Gastric lavage in obtunded patients led to a more satisfactory clinical outcome (P less than .05) only if performed within one hour of ingestion. Gastric emptying procedures in the ED for initial treatment of drug overdose are generally not of benefit unless gastric lavage is performed within one hour of ingestion in obtunded patients.

Adolescent↗
PubMed1985

Acetaminophen: acute overdose toxicity in children.

The use of acetaminophen in young children has increased, in part due to concerns over the association of Reye's syndrome with aspirin. Accidental ingestion of acetaminophen in this age group has also increased, and treatment of overdose in children has been controversial. Recommendations for treatment of adolescents and young children are presented, based on the acetaminophen nomogram. It is recommended that children in the highest risk group (above the upper nomogram line) be treated with N-acetylcysteine, even though treatment may be unnecessary in many.

Acetaminophen↗