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Biomedical subjects

J Belen

Publications and source records attributed to J Belen.

7 recordsLinked to original sources
PubMed1988

Fever and thromboembolic disease in acute spinal cord injury.

Thromboembolic Disease (T.E.D.) is a major cause of morbidity and mortality in the first few months following spinal cord injury. The purpose of this three year retrospective study is to delineate the previously poorly described role of fever as both a common component of T.E.D. manifestation and, on occasion, the sole presenting sign of an otherwise occult T.E.D. process. We reviewed 148 consecutive admissions to the Southeastern Michigan Spinal Cord Injury System (1982-1985). Ten patients with documented T.E.D. were found and extensively reviewed; 3 had inadequate documentation of clinical manifestations and 1 patient was found from venography to have a non-acute thrombosis. Of the remaining 6 cases, all had fever as a sign, and 4 of these patients had fever as the sole presenting sign. Full fever work-ups were performed in each case and no other source for fever could be found. Fever spikes occurred most commonly at night, with a maximum temperature of 100.2 degrees F (oral) to a high in one case of 103.0 degrees F (oral). All fevers resolved within the first week of adequate anticoagulation therapy. These findings indicate that fever may be the earliest and, possibly, only clinical sign of an otherwise occult T.E.D. process.

Acute Disease↗
PubMed1987

Thromboembolic disease presenting as fever in spinal cord injury.

A 45-year-old man had complete C5 quadriplegia after sustaining a C6-7 fracture dislocation in a motor vehicle accident. Twenty-six days after injury the patient spiked nightly temperatures of 100.5F to 102.5F. Before a full fever workup could be completed, the patient developed shortness of breath. Thromboembolism was confirmed via venography and Ventilation/Perfusion scan. Other clinical signs of asymmetric swelling or warmth were notably absent throughout the course of the thromboembolic event. The patient became afebrile on the third day of anticoagulant therapy and remained afebrile. This case indicates that thromboembolic disease can present with fever only and the disease should be included in the differential diagnosis for fever in any patient with acute spinal cord injury.

Fever of Unknown Origin↗
PubMed1985

Orthodromic sensory nerve conduction of the medial and lateral plantar nerves. A standardization.

A standardized method of obtaining orthodromic distal sensory latencies of the medial and lateral plantar nerves is presented. Forty-one normal volunteer subjects were tested. Stimulation is carried out on the plantar aspect of the base of each toe using ring electrodes. Surface recording electrodes are placed posterior to the medial malleolus over the tarsal tunnel at points measuring 14, 16, 18 and 20 centimeters from the dorsum of the base of the great toe. Sixty-four evoked responses were averaged utilizing an electronic averaging technique and temperature was maintained at 31 degrees centigrade. Mean and standard deviation values of the distal sensory latency are reported for each toe. The reliability and ease in performance of these conduction studies will make them necessary and useful aids in the electrodiagnostic evaluation of tarsal tunnel syndrome, peripheral neuropathies and other local neuropathic conditions. Case studies are presented demonstrating the usefulness of this testing.

Adult↗
PubMed1981

Modification of the effect of fiberoptic bronchoscopy on pulmonary mechanics.

Thirty-three patients who were to undergo diagnostic fiberoptic bronchoscopy were studied. Pulmonary function tests were performed before the procedure, after topical lidocaine anesthesia, and immediately and four hours after bronchoscopy. Nine patients received aerosolized isoproterenol (Isuprel) before the topical anesthesia, and nine received aerosolized atropine. Pulmonary function tests were also performed after this intervention. In those patients receiving no premedication, all the indices of expiratory flow were reduced significantly immediately after bronchoscopy, and after the topical anesthesia, the FEV1 and FVC were significantly reduced. In the atropine groups, the FVC and FEV1 increased significantly after atropine, and increased still further following topical lidocaine anesthesia. By four hours after bronchoscopy, however, the midmaximal expiratory flow ws significantly reduced. In the isoproterenol group, only the FEV1 was significantly improved by the drug, and this improvement persisted even after the lidocaine. It decreased transiently immediately after bronchoscopy, but by four hours, was significantly above baseline again. The FVC diminished significantly immediately after bronchoscopy. It is concluded that fiberoptic bronchoscopy deleteriously affects pulmonary function and that inhaled isoproterenol or atropine largely protects against these deleterious effects.

Adult↗