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Biomedical subjects

C R Baum

Publications and source records attributed to C R Baum.

12 recordsLinked to original sources
PubMed2000

Serious toxicity in a young child due to ibuprofen.

An 18-month-old male presented to the emergency department (ED) for evaluation of lethargy and apnea. Four hours before presentation, the patient was found with an empty bottle of ibuprofen, an ingestion of as much as 7.2 grams (600 mg/kg). The ED course was remarkable for a 30-second tonic-clonic seizure. Laboratory analysis was notable for metabolic acidosis. Four-hour and 7.5-hour serum ibuprofen levels were 640 and 39 microg/mL, respectively. Following treatment, the patient improved and was extubated the next morning. While metabolic acidosis has been frequently described at doses exceeding 400 mg/kg, seizures occurring early in the course of ibuprofen toxicity have been rarely noted.

Accidents, Home↗
PubMed2000

Fomepizole treatment of ethylene glycol poisoning in an infant.

The enzyme alcohol dehydrogenase metabolizes ingested ethylene glycol (EG) to the toxic compounds glycolic and oxalic acids. Renal failure, acidosis, hypocalcemia, and death may follow. Traditional treatment of EG poisoning may require ethanol, a competitive substrate of alcohol dehydrogenase, and hemodialysis, that removes both EG and its toxic metabolites. A new alcohol dehydrogenase inhibitor, fomepizole (4-methylpyrazole), was approved in 1997 for patients at least 12 years old with suspected or confirmed EG poisoning. Fomepizole has not been studied adequately in the pediatric population. We present a case of an 8-month-old male infant who drank up to 120 mL of EG and developed acidosis and oxalate crystalluria. He was treated with fomepizole and hemodialysis. Even after the completion of hemodialysis, fomepizole appeared to effectively block the production of EG toxic metabolites and to allow the resolution of acidosis; the patient recovered within 48 hours. This is the first report of fomepizole treatment of EG poisoning in an infant.4-methylpyrazole, fomepizole, poisoning, ethylene glycol, hemodialysis, infant, child, pediatrics.

Antidotes↗
PubMed1999

Treatment of mercury intoxication.

The element mercury exists as inorganic, elemental, or organic species. Routes of exposure and toxicity in humans vary according to the species of mercury involved. Treatment of mercury poisoning generally requires the use of sulfhydryl bond-containing chelation agents, including the parenterally administered dimercaprol and its oral congeners. These oral chelators, meso-2,3-dimercaptosuccinic acid and sodium 2,3-dimercapto-1-propanesulfonate, have numerous advantages over dimercaprol, including less toxicity. Although dimercaprol is contraindicated in organic mercury exposures, meso-2,3-dimercaptosuccinic acid and sodium 2,3-dimercapto-1-propanesulfonate may be used to chelate all species of mercury. Recent evidence suggests that their efficacy in organic mercury poisoning is uncertain.

Chelating Agents↗
PubMed1998

Lead and caries.

Explore the source record for details and available documents.

Animals↗
PubMed1998

Toxicology reviews: immunoassay in detecting drugs of abuse.

Ingestion of DOA by children and adolescents continues to be a prevalent problem. Emergency physicians, particularly those in pediatric institutions, should have an understanding of the screening tests for DOA. Several IA techniques provide a rapid, sensitive, and inexpensive screen for DOA. Nevertheless, the physician must be familiar with the limitations of each laboratory and be aware that a negative toxicology screen does not rule out ingestion of many DOA.

Adolescent↗
PubMed1997

The lead concentration of reconstituted infant formula.

OBJECTIVE: To characterize practices of infant formula reconstitution and to measure the lead concentration of the home-prepared reconstituted infant formula. METHODS: Convenience sample of metropolitan Boston infants less than 9 months of age who were being evaluated in an urban pediatric emergency department and had home-prepared reconstituted infant formula available. A questionnaire was administered to gather demographic information and details of formula preparation. A 30-90 mL sample of home-prepared reconstituted infant formula was collected in an acid-washed, distilled water-rinsed glass tube, then analyzed for lead by atomic absorption spectrophotometry (precision +/- 2 micrograms/L or 2 ppb). RESULTS: Forty infants were evaluated. Mean (SD) chronological age was 112 +/- 78 d. Reported daily reconstituted infant formula daily volume was 870 +/- 300 mL. Two of the 40 samples (5% [95% CI: 2.0, 18.2%]) had lead concentrations above 15 micrograms/L, the current action level for safe water according to the Environmental Protection Agency. The two samples with lead concentrations of 17 and 70 micrograms/L were prepared using cold tap water (water run for 5 and 30 sec, respectively) drawn from the plumbing of houses greater than 20 years old. CONCLUSION: These data suggest that the use of infant formulas which require reconstitution may present inadvertent lead hazards to young infants. Pediatricians should provide education about these potentially hazardous practices to parents who use these formulas.

Female↗
PubMed1990

What do physicians in practice do to prevent osteoporosis?

Osteoporosis-associated fractures are a major public health problem in the United States. Although clinicians and policy groups have advocated estrogen replacement therapy and other clinical measures to prevent osteoporosis, few studies have assessed whether these measures are being adopted by physicians in practice. The purpose of this study is to evaluate physicians' use of osteoporosis prevention measures and to assess the impact of physician specialty and practice setting on osteoporosis prevention performance. A survey of nearly 300 physicians was carried out in a large metropolitan area. Gynecologists, general internists, and cardiopulmonary specialists were included from one of three practice settings: fee-for-service private practice, full-time academic medicine, or a large health maintenance organization. Most physicians, regardless of clinical specialty or practice setting, report that they advocate exercise and calcium supplementation. Few physicians prescribe estrogen replacement therapy (ERT) for the majority of their postmenopausal patients. Although there are minimal differences among the three types of practice settings examined, ERT varies markedly by clinical specialty. Of the gynecologists surveyed, 37% report prescribing ERT for the majority of their postmenopausal patients to prevent osteoporosis compared to only 7 and 5% of general internists and cardiopulmonary specialists, respectively (chi 2 = 45.3, p less than 0.0001). Although the efficacy of exercise and calcium supplementation to prevent osteoporotic fractures has not been well established, these measures are commonly advocated by both generalists and subspecialists. Although gynecologists are significantly more likely to prescribe ERT to prevent osteoporosis than the other clinical specialists, in general very few physicians prescribe ERT for most postmenopausal patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiology↗