Biomedical subjects

G Groleau

Publications and source records attributed to G Groleau.

9 recordsLinked to original sources

PubMed1992

Tetanus.

Tetanus causes approximately 50,000 deaths per year worldwide, the incidence being greatest in undeveloped countries. Once tetanus occurs, the risk of death is substantial. Physician attention to the immunization status of patients who present with wounds, chronic and minor, can improve prevention of tetanus. It should be noted that more than 10% of the US population is not properly immunized against tetanus and that those at greatest risk are females of any age, males older than 50, blacks from the rural South, and those without any military experience.

Humans↗

PubMed1992

Rabies.

Rabies is usually contracted through wounds and usually causes death in those infected. The major weapon against rabies infection is postexposure immunization, and by virtue of treating numerous animal bites and scratch wounds, emergency physicians play a key role in keeping rabies rare in the United States. Proper management requires knowledge of the changing epidemiology of animal rabies and its impact on postexposure prophylaxis.

Humans↗

PubMed1988

Echocardiographic diagnosis of acute pericardial effusion in penetrating chest trauma.

Pericardial tamponade persists as a diagnostic challenge to the clinician. The immediate diagnosis is particularly difficult when the patient is well compensated hemodynamically. In contrast to the deceptively stable appearance, the patient is at increased risk due to delayed onset, recognition, and therapy. A case of penetrating thoracic trauma is presented in which the concern about pericardial tamponade was considerable. However, the elements of clinical assessment were inconclusive. Two-dimensional echocardiography was employed in the emergency department to detect a pericardial effusion and thus avoid delayed management. Pericardial tamponade and associated vascular injuries were confirmed at surgery.

Acute Disease↗

PubMed1987

Lithium intoxication: manifestations and management.

The clinical diagnosis of lithium intoxication can be elusive because of the slow onset and diversity of toxic manifestations. Mental status and neurologic symptoms often predominate. After the diagnosis is made, management depends on the clinical presentation and serum lithium level. Hemodialysis is the treatment of choice for severe lithium intoxication. Two cases of lithium intoxication are presented that demonstrate that predisposing factors and drug interactions play major roles. A review is given of the pathophysiology, presenting signs, symptoms, and approaches to treatment of lithium intoxication.

Adult↗

PubMed1986

Complete heart block.

Complete heart block (CHB) occurs when atrial impulses are not conducted to the ventricles. It occurs in association with many conditions, including acute myocardial infarction. In the setting of acute myocardial infarction (MI), certain characteristic conduction disturbances tend to precede development of CHB. Knowledge of these disturbances provides rational indications for emergency temporary pacing of acute MI patients.

Bundle-Branch Block↗

PubMedDate not supplied

The electrocardiographic manifestations of pulmonary embolism.

The electrocardiographic manifestations of pulmonary embolism include rhythm and condition disturbances and changes in the P wave, QRS complex, or T wave. Since these abnormalities are highly variable and frequently transient, they lack the sensitivity necessary to establish the diagnosis of pulmonary embolism. The electrocardiogram may rise the suspicion of pulmonary embolism, but other diagnostic tests are necessary to confirm the diagnosis.

Blood Pressure↗

PubMedDate not supplied

The electrocardiographic manifestations of cyclic antidepressant therapy and overdose: a review.

Cyclic antidepressants may cause changes in the electrocardiogram at therapeutic or toxic serum levels. The most serious complications of cyclic antidepressant toxicity are dysrhythmias, hypotension, and seizures. It is predominantly the cardiotoxic effects that cause mortality. Once cardiotoxicity is evident, the treatment of choice is serum alkalinization, preferably by sodium bicarbonate therapy. In order to predict which overdose patients are at high risk for complications, electrocardiographic criteria have been identified as reliable screens. For "first generation" tricyclic antidepressants, QRS prolongation (particularly greater than 100 msec) and a terminal 40-ms frontal plane axis greater than 120 degrees are the most sensitive. This article reviews antidepressant pharmacology, electrocardiographic manifestations of antidepressant cardiotoxicity, and approaches to treatment of antidepressant-induced conduction disturbances and dysrhythmias.

Antidepressive Agents, Tricyclic↗

PubMedDate not supplied

The importance of an annual report.

An annual report, by summarizing the emergency department's accomplishments, is an effective means of highlighting the vital role of the emergency department within the hospital system and the community. The report should begin with an Executive Summary and proceed to detail the clinical, educational, research, administrative, financial, and other essential aspects of the status and development of the department.

Annual Reports as Topic↗

PubMedDate not supplied

Application of clinical indicators in the emergency department.

Clinical indicators were developed and used to assess the quality of patient care resulting from the system of shared responsibility between emergency department (ED) and radiology department faculty physicians for interpretation of ED roentgenograms. The first indicator--all discrepancies in roentgenogram interpretation between ED and radiology department faculty--measured an overall discrepancy rate of 3.3% (776 films). Three hundred fifty-two apparent discrepancies were not related to the accuracy with which ED faculty interpreted films, resulting in a revised overall discrepancy rate of 1.8%. The second indicator--undesirable patient care outcomes as a result of delayed accurate radiological diagnosis--measured an occurrence rate of 0 after clinical reevaluation of more than 99% of patients within 24 hours of initial ED evaluation. Aspects of the development and use of clinical indicators are discussed in relationship to the broader monitoring and evaluating process necessary for the continuous improvement of patient care.

District of Columbia↗