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Biomedical subjects

B H Rumack

Publications and source records attributed to B H Rumack.

At least 91 records · Page 5Linked to original sources
PubMed1985

Commentary on 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD).

There is deep concern about the long term health effects of exposure to phenoxy herbicides and the contaminant TCDD; however, there is considerable scientific and medical uncertainty regarding the health effects from exposure to these chemicals. There are at least ten ongoing studies on reproduction, morbidity and mortality as well as studies of tissue concentrations of TCDD that are attempting to determine the health effects of these chemicals (see Table 2). Appropriate efforts should be made to prevent human and environmental exposure and to decontaminate the environment while awaiting the results of these investigations. Animal toxicity studies show such wide variations that extrapolations from a different species to humans are tenuous. Human studies on exposed workers and nonoccupational exposures are difficult to interpret because the exposure has not been quantified and because workers were exposed to mixtures of chemicals. Chloracne appears to be an important specific clinical marker of TCDD exposure, however, it can be caused by structurally similar compounds. Many of the past studies on human health effects of 2,4,5-T and TCDD are controversial. Since the scientific data are not firm, no specific statements can be made regarding the long term health effects at this time. Any individual who has had a significant exposure to TCDD should see his/her physician and have appropriate consultation. Long term follow up will be required. Physicians should be instructed regarding the possible manifestations of TCDD exposure to look for chloracne, soft tissue masses, muscle pain, fatigue, peripheral neuropathy, tender hepatic enlargement, enlargement, elevated liver enzymes, elevated lipids, prolonged prothrombin time, hemorrhagic cystitis and hirsutism.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1984

Acetaminophen overdose in young children. Treatment and effects of alcohol and other additional ingestants in 417 cases.

Four hundred seventeen young children who had ingested a potentially serious amount of acetaminophen were examined and treated in a national multicenter open study. Fifty-five had plasma levels in the potentially toxic range, and 43 had a full course of acetylcysteine treatment. Three of 417 patients had SGOT values consistent with a hepatotoxic reaction. In the children with toxic levels of acetaminophen those who had also ingested alcohol had significantly lower SGOT levels than those who had not ingested alcohol. Patients consuming acetaminophen who had also consumed miscellaneous other ingestants were significantly more likely to be lethargic than those who had not consumed other ingestants. The incidence of transient hepatotoxic effects is significantly lower in children with potentially toxic plasma levels than in adults with similar toxic plasma levels. There were no deaths in this series of children.

Acetaminophen↗
PubMed1984

Monoamine oxidase inhibitor overdose.

Described is the clinical course of a 26-year-old woman who died following an overdose of the MAO inhibitor phenelzine. Signs and symptoms of toxicity were delayed in onset. Initial findings of excessive neuromuscular activity were followed by severe hyperthermia, coma, cardiovascular collapse, acute renal failure, hemolysis, rhabdomyolysis, and disseminated intravascular coagulation. A review of the literature suggests that these features are not unusual following MAO inhibitor overdosage. The pathophysiology and management of MAO inhibitor poisoning are discussed.

Acute Kidney Injury↗
PubMed1984

Acetaminophen overdose.

N-acetylcysteine (NAC) is the treatment of choice for acetaminophen overdose. With this therapy, morbidity from overdose can be held to a minimum. Mortality is rare in any case and virtually nonexistent in treated patients. Unless a high index of suspicion is maintained, the diagnosis may be missed until it is too late for effective antidotal treatment.

Acetaminophen↗
PubMed1983

Acetaminophen overdose.

Acetaminophen is a remarkably safe agent when used in therapeutic doses. Most reported overdoses of acetaminophen are the result of suicide attempts. The clinical course of patients with toxic blood levels follows four distinct stages. Symptoms of nausea, vomiting, diaphoresis, and anorexia usually begin within seven to 14 hours after ingestion. After 24 to 48 hours, these symptoms may diminish, but SGOT, SGPT, bilirubin, and prothrombin time begin to rise. Peak hepatotoxicity occurs at 72 to 96 hours, and SGOT levels of 20,000 I.U. are not unusual. Oral N-acetylcysteine is the drug of choice for acetaminophen overdose. Intravenous use of N-acetylcysteine is advocated in England, Europe, and elsewhere, but it is not available in the United States. Clinical studies of oral and intravenous N-acetylcysteine clearly demonstrate that the drug has a profound effect on reducing morbidity and mortality if it is administered during the first 16 hours after the overdose. In addition, data from these studies have shown that alcohol taken simultaneously with an overdose of acetaminophen is actually hepatoprotective. Therefore, patients who have consumed alcohol at the time of overdose, or those who are chronic alcoholics, should be managed in the same way as patients with no exposure to alcohol. However, study results also reveal that overdose in children under 10 to 12 years of age follows a distinctly different pattern. These children demonstrate a lesser degree of hepatotoxicity and have only minor increases in transaminase levels.

Acetaminophen↗
PubMed1983

Cyclobenzaprine overdosage.

The clinical findings in three patients who ingested 260-900 mg cyclobenzaprine (Flexeril) consisted of delayed onset and long duration of anticholinergic symptomatology. In two of these patients, symptoms responded to treatment with physostigmine. The third patient recovered without specific therapy. Despite its structural similarity to amitriptyline, cyclobenzaprine overdosage did not result in coma, seizures, or cardiac toxicity. The pharmacological properties of cyclobenzaprine may account for the observed toxicity.

Adolescent↗
PubMed1983

Comparison of alphabetic and phonetic retrieval of online drug information.

Alphabetic, phonetic, and combined alphabetic and phonetic methods of retrieving online drug information were compared. Twenty-four volunteers participated in the study representing four user groups: physicians, nurses, pharmacists, and nonhealth-care hospital staff. Each subject performed 150 searches, 50 by each retrieval method. Using the alphabetic method, drug information was retrievable only if the drug name was spelled correctly. Using the phonetic method, searches were conducted based on the phonetic spelling of requests (e.g., "symetadine" for cimetidine). The combined method used a phonetic search only after an initial alphabetic search was unsuccessful. The elapsed time between the first entry and an indication that the information had been found or could not be found was determined, and the number of drug names not found and the number of excess tries were counted. There were no significant differences in elapsed time among the three methods. Pharmacists had the shortest mean elapsed time and physicians the longest. The average number of excess tries using the phonetic system was a third of the number required using the alphabetic method. The number of drugs not found showed only slight differences among the three methods. The subjects found the desired information on the first try 67% of the time with the alphabetic method, 66% with the combined method, and 90% with the phonetic method. The phonetic method had an average of 75 matches versus 20 for the alphabetic and combined methods. These results support use of a combined alphabetic and phonetic system for retrieving drug information.

Drug Information Services↗