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Biomedical subjects

B H Rumack

Publications and source records attributed to B H Rumack.

At least 109 records · Page 6Linked to original sources
PubMed1981

Acetaminophen overdose. 662 cases with evaluation of oral acetylcysteine treatment.

Six hundred sixty-two consecutive patients with acetaminophen overdoses were evaluated. Those at risk on the basis of their acetaminophen blood levels, as plotted on the study nomogram, were treated with oral acetylcysteine. Statistically significant differences in severity of hepatic toxicity were observed between patients treated within 16 hours after ingestion and those treated between 16 and 24 hours after ingestion. No deaths occurred among patients treated within 24 hours of ingestion, except for one patient who was an alleged gunshot homicide. Seven percent of patients with plasma acetaminophen levels in the potentially toxic range and treated with acetylcysteine within ten hours of ingestion showed transient SGOT level elevations, whereas 29% of those treated between ten and 16 hours after ingestion and 62% of those treated between 16 and 24 hours after ingestion showed such transient toxicity. No consistent difference in hepatotoxicity could be demonstrated between those patients with a history of chronic alcohol use and those patients with no history of chronic alcohol use. Acute alcohol use resulted in less severe toxic reactions than in those patients without acute alcohol use.

Acetaminophen↗
PubMed1981

Age as a variable in acetaminophen overdose.

More than 300 accidental ingestions of acetaminophen products in children 6 years of age and younger have been reported to the Rocky Mountain Poison Center, Denver, during September 1974 to September 1979. Few of these have resulted in toxic reactions, based on clinical examination of the children. This report documents 17 childhood ingestions of acetaminophen in which plasma levels of the substance were measured and liver function was evaluated. Thirteen of these cases occurred as a result of accidental ingestion by children 6 years of age or younger; five of these children had documented plasma levels that were in the toxic range of an adult nomogram and were treated with acetylcysteine. Only minor abnormalities in liver function were observed in the treated children, even when therapy was instituted as late as 20 hours after ingestion.

Acetaminophen↗
PubMed1981

Toxicology of urea formaldehyde and polyurethane foam insulation.

Two types of foam insulation are in wide use. Urea formaldehyde foam is a relatively inexpensive, easily installed, and efficient insulation. Toxicity from this insulation is related to release of free formaldehyde into the home. Mild to incapacitating symptoms have been reported in occupants of urea formaldehyde-insulated homes. Airborne formaldehyde levels frequently have exceeded standards set for occupational exposure. The long-term consequences of such exposure are unknown. Because of publicity over the toxicity of urea formaldehyde foam, many physicians and patients have confused urea formaldehyde and polyurethane foam. Unlike urea formaldehyde, polyurethane foam is fully cured before construction. Toxicity occurs only during manufacture and curing. To date, there have been no reports to our knowledge of toxicity in occupants of polyurethane-insulated homes. However, toxicity caused by pyrolysis products may occur during combustion in homes insulated with either type of insulation. This report details 48 patients in whom complete medical data were obtained out of the first 100 patients contacting the Rocky Mountain Poison Center.

Construction Materials↗
PubMed1981

Methylenedioxyamphetamine. Clinical description of overdose, death, and review of pharmacology.

Methylenedioxyamphetamine is a commonly used "street drug", with a reputation of providing a "good trip". The drug is structurally similar to both mescaline and amphetamine. The following symptoms were found in a patient: sympathomimetic effects, coma, seizures, hyperreflexia, and hyperthermia. The patient's condition was initially stabilized and then deteriorated with uncontrollable hyperthermia, hematologic abnormalities, and coma that culminated in death. Since the hyperthermia is based on both central and peripheral mechanisms, phentolamine (Regitine) mesylate may be the preferred drug to be used in the treatment of future cases. The concept that this drug is primarily a hallucinogen with mild toxicity is erroneous.

3,4-Methylenedioxyamphetamine↗
PubMed1981

Acute carbamazepine toxicity resulting from overdose.

Four patients with an acute overdose of carbamazepine were examined with serial blood level determinations. The clinical spectrum consisted of coma, respiratory depression, seizures, myoclonus, nystagmus, hyperreflexia, hyporeflexia, delayed gastric emptying with cyclic coma, ataxia, sinus tachycardia, and atrioventricular conduction delay. Carbamazepine elimination half-lives varied from 10 to 29 hours, and in one case carbamazepine-10,11-epoxide was measured and had a half-life of 24 hours.

Adolescent↗
PubMed1981

Selenium: childhood poisoning and cystic fibrosis.

Two cases of selenium ingestion in children are described; one child with severe cystic fibrosis died. Both children had cystic fibrosis and both had low serum chloride in association with selenium usage. Neither child was exposed to excessive heat or cold weather, factors known to salt-deplete children were cystic fibrosis, although one child was dehydrated during a summer month on initial presentation. One child had protein-calorie malnutrition, a condition known to enhance selenium toxicity in animals. We conclude that selenium is a potential hazard in its use as a health food fad for children with cystic fibrosis and in overdose ingestions. Thus selenium supplementation may have contributed to the morbidity and mortality reported here.

Adolescent↗
PubMed1981

Comparative efficacy of injectable calcium and magnesium salts in the therapy of hydrofluoric acid burns.

Hydrofluoric acid (HF) causes severe skin burns which often progress in severity despite physiologic neutralization. The currently accepted therapy is the subcutaneous injection of calcium (Ca) gluconate to precipitate the residual free fluoride ion. Magnesium (Mg) also forms an insoluble fluoride salt and is less tissue irritating than Ca. This study compared the effects of subcutaneous injection of saline, Ca gluconate, Mg acetate (MgAc), and Mg sulfate (MgSO4) on lesions resulting from HF burns in rats. Burns treated with either Mg compound healed 3.7 +/- 1.7 days faster (p less than 0.05) developed less severe lesions (p less than 0.01) and exhibited left untreated or treated with saline. There was no difference in the incidence of infection between the study groups. The effects of burns treated with calcium were statistically similar to the control groups. This study suggests that Mg may be more effective than Ca in minimizing the duration, depth, and progression of dermal HF burns.

Animals↗
PubMed1981

Neonatal intracranial hemorrhage and maternal use of aspirin.

A prospective study of 108 infants born at 34 weeks' gestation or earlier or weighing 1500 g or less was carried out to determine the incidence of intracranial hemorrhage and the multiple risk factors that may cause or aggravate this hemorrhage in premature infants. On day 2 post partum, mothers were questioned regarding maternal risk factors, including the use of either aspirin or acetaminophen during the last week of pregnancy. Between days 3 and 7 post partum, computed tomographic scanning was performed on the 108 infants. Of the total, 53 (49%) developed intracranial hemorrhage. The incidence of hemorrhage in the infants whose mothers had ingested aspirin was significantly greater (P less than .05) than that seen in infants whose mothers did not take either aspirin or acetaminophen (control group). The incidence of intracranial hemorrhage among infants whose mothers ingested acetaminophen was not significantly different from that of the control group. This study indicates that aspirin is associated with an increased incidence of intracranial hemorrhage in the authors' population. The use of aspirin in the last 3 months of pregnancy is highly questionable and probably inappropriate.

Acetaminophen↗
PubMed1980

Pharmacology of furosemide in the premature newborn infant.

The pharmacokinetic parameters of furosemide were measured in 14 premature newborn infants, one to 20 days of age, and in 12 older infants, aged one to 4 months, following a single intravenous dose of 1 mg/kg of furosemide. Furosemide levels were determined by a high pressure liquid chromatographic method which required 3 microliter of plasma. The volume of distributuion for furosemide was calculated to be 0.24 +/- 0.03 l/kg (mean +/- SE) in all infants studied, regardless of postnatal age. The half-life in the first three weeks of life was found to be 19.9 +/- 3.0 hours. Thus, the half-life of furosemide in the premature infant is considerably longer than in adults or older children, but the volume of distribution is similar. The bioavailability of oral furosemide in infants appeared to be low. The findings of this study indicate that furosemide, 1 mg/kg parenterally, given with a frequency of more than twice daily to the premature infant in the immediate neonatal period, or in parenteral dosages in excess of 2 mg/kg, may lead to plasma levels associated with ototoxicity.

Biological Availability↗
PubMed1980

Naloxone: underdosage after narcotic poisoning.

A case of propoxyphene hydrochloride (Darvon) poisoning was unresponsive to therapeutic doses of naloxone hydrochloride in a 2 1/2-year-old girl. Following prolonged coma and artificial ventilation for three hours, the patient responded immediately to the intravenous administration of 2 mg of naloxone hydrochloride, which is 20 times the manufacturer's recommended dosage. Naloxone is the agent of choice in reversing the effects of narcotics and synthetic opiate derivatives, such as propoxyphene and pentazocine. The manufacturer's present recommended dosage may not be sufficient to reverse the effects of large narcotic ingestions. We therefore recommend that if there is no response within two minutes of the initial 0.01 mg/kg dosage of naloxone hydrochloride, a second dose 0.1 mg/kg (ten times the manufacturer's suggested dose) be given.

Child, Preschool↗