Search PubMed⌕ Search

Biomedical subjects

Joseph R Shiber

Publications and source records attributed to Joseph R Shiber.

5 recordsLinked to original sources
PubMed2006

Dyspnea.

When evaluating a dyspneic patient in the office, a quick initial assessment of the airway, breathing, and circulation, while gathering a brief history and focused physical examination are necessary. Most often, an acute cardiopulmonary disorder, such as CHF, cardiac ischemia, pneumonia, asthma, or COPD exacerbation, can be identified and treated. Stable patients who improve can be sent home, but those in acute distress with unstable or impending unstable conditions need to be transferred emergently to definitive care. Because of the difficult logistics involved in attempting to work up an outpatient for new onset of SOB, some patients will need to be transferred to the nearest ED for a definitive diagnosis.

Algorithms↗
PubMed2005

Subarachnoid hemorrhage diagnosis by computed tomography and lumbar puncture: are fifth generation CT scanners better at identifying subarachnoid hemorrhage?

This study sought to determine the sensitivity and specificity of modern computed tomography (CT) scans for the diagnosis of subarachnoid hemorrhage (SAH). No studies have been done recently with fifth generation CT scanners to look at the diagnosis of SAH. A retrospective chart review was done of Emergency Department (ED), laboratory, and hospital records at Pitt County Memorial Hospital in Greenville, North Carolina over 1 year from January 1, 2002 to December 31, 2002. Patients presented with headache and had a CT scan of the head with a fifth generation multi-detector CT scanner followed by a lumbar puncture (LP) to rule out SAH. There were 177 patients who presented to the ED with headache and went on to have a CT scan and an LP to rule out SAH. No patients who had a negative CT were found to have a subarachoid hemorrhage. It is concluded that fifth generation CT scanners are probably more sensitive than earlier scanners at detecting SAH.

Emergency Medicine↗
PubMed2002

Serum phosphate abnormalities in the emergency department.

Abnormalities in serum phosphate levels are more prevalent in certain subsets of Emergency Department patients than in the general population. Patients with diabetic ketoacidosis, chronic obstructive pulmonary disease, alcoholism, malignancy, and renal failure are at increased risk. Multiple factors, including nutritional intake, medications, renal or intestinal excretion, and cellular redistribution, are potential etiologies. The clinical manifestations of mild hypophosphatemia or hyperphosphatemia are typically minor and nonspecific (myalgias, weakness, anorexia). When the imbalance is severe, critical complications may occur (tetany, seizures, coma, rhabdomyolysis, respiratory failure, ventricular tachycardia). Mild asymptomatic hypophosphatemia can be treated with oral phosphate supplementation (15 mg/kg daily) on an outpatient basis. Patients with severe or symptomatic hypophosphatemia should be treated with IV phosphate therapy (0.08-0.16 mg/kg over 6 h) and admitted for monitoring and subsequent serum electrolyte testing. Mild asymptomatic hyperphosphatemia is commonly managed in renal failure by limiting dietary intake and reducing absorption with phosphate-binding salts. Hemodialysis may be required for severe hyperphosphatemia with symptomatic hypocalcemia.

Blood Chemical Analysis↗