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Biomedical subjects

S E Warren

Publications and source records attributed to S E Warren.

At least 73 records · Page 4Linked to original sources
PubMed1979

Digoxin overdose. Limitations of hemoperfusion-hemodialysis treatment.

We used charcoal hemoperfusion coupled with hemodialysis to treat a woman with massive digoxin ingestion complicated by hyperkalemia. Although dialysis controlled the serum potassium levels, hemoperfusion removed less than 1% of the total ingested dose. Hemoperfusion has a relatively minor impact on digoxin elimination and remains of unproved value in the therapy for digoxin overdose.

Adult↗
PubMed1979

Distribution and severity of coronary artery disease in 500 patients with angina pectoris.

The distribution and severity of coronary disease in 500 patients with angina pectoris and at least one area of 50% or greater reduction of luminal diameter in a major coronary artery were compared with respect to patients' age and coronary arterial pattern. The coronary arterial patterns were separated into right (360 patients), mixed (89 patients), and left (51 patients) systems, depending upon the blood supply to the inferior surface of the left ventricle. The following relationships were noted: 1) In patients with angina pectoris, the distribution and severity of coronary artery disease is similar from the third to eighth decade. 2) Coronary arterial stenoses of 50-70% of greater reduction of luminal diameter involve most frequently the proximal portion of the major vessels. Coronary artery disease is multivessel in nature in 80% of cases. In single vessel disease the left anterior descending artery is involved most frequently. 3) The left main coronary artery is moderately to severely obstructed less frequently in individuals with left (2%) as compared to right (8%) and mixed (10%) systems. Otherwise, the distribution of coronary artery disease is similar in right, mixed, and left systems. 4) Coronary artery disease is a diffuse rather than a focal process. As demonstrated by coronary arteriography, patients with coronary artery disease have smaller vessels throughout the arterial tree as compared with individuals free of evident coronary atherosclerosis.

Adult↗
PubMed1979

Treatment of alkalosis with ammonium chloride: a case report.

Coma due to ammonium chloride used in the treatment of severe metabolic alkalosis is reported in a patient with normal hepatic and renal function. All symptoms resolved following discontinuance. Ammonium chloride should be abandoned as a treatment for metabolic alkalosis.

Alkalosis↗
PubMed1979

Historic and angiographic features of young adults surviving myocardial infarction.

Sixty-eight survivors of myocardial infarction occurring before the age of 36 years were studied using selective coronary cinearteriograms, regardless of symptoms. Three groups of patients were delineated; 56 patients (82 percent) had obstructive coronary arterial disease, nine (13 percent) had normal coronary arteries, and three (4 percent) had congenital coronary arterial anomalies. Because the prognosis in these three groups is different, all young patients with myocardial infarction should undergo coronary arteriographic studies after a suitable period of convalescence. Myocardial infarction in the young differs from that in the elderly by virtue of a more heterogeneous underlying coronary anatomy, an overwhelming preponderance of male patients, and a better reported prognosis.

Adult↗
PubMed1979

Cushing's disease: megadose dexamethasone suppression in a case refractory to medical therapy.

A patient with Cushing's disease failed to show complete suppressibility of adrenal function with conventional "high" doses of dexamethasone (8 mg per day). Higher doses were required to achieve suppression. Pituitary irradiation and medical therapy (cyproheptadine, metyrapone, and aminoglutethimide) failed to control the disease, necessitating bilateral adrenalectomy. The diagnostic and therapeutic implications of megadose dexamethasone suppression have not been clearly addressed in the medical literature. It is possible that adrenal suppression achieved only with unconventionally high doses of steroids may be predictive of refractoriness to nonsurgical therapy.

17-Hydroxycorticosteroids↗
PubMed1979

Acid-base and electrolyte disturbances in anorexia nervosa.

The literature on anorexia nervosa largely ignores the acid-base and electrolyte disturbances that may accompany this condition. In an attempt to assess the magnitude of these disturbances in anorexia nervosa the authors reviewed the laboratory profiles of 7 patients with the disease who were consecutively admitted to a hospital over a period of 8 years. Several acid-base and electrolyte disturbances were observed; the most frequent was chloride-responsive metabolic alkalosis. The authors suggest that all patients with anorexia nervosa receive diagnostic studies for these disturbances, including ECG and urinary electrolytes when necessary, so that abnormalities can be diagnosed and treated appropriately.

Acid-Base Imbalance↗
PubMed1978

Transmural myocardial infarction in the absence of coronary arterial luminal narrowing in a young man with single coronary arterial anomaly.

Reported is a case of single coronary arterial anomaly (SCAA) with its origin from the right sinus of Valsalva as demonstrated by selective coronary arteriography. No branches coursed between the great vessels. Electrocardiography and vectorcardiography were consistent with inferior wall myocardial infarction, although subsequent coronary arteriograms were free of luminal narrowing. While this is an infrequently recognized isolated coronary anomaly, it may carry significant risk of myocardial ishcemia. This risk may not depend alone upon the passage of a branch of SCAA between the great vessels. Evidence of precocious ischemic heart disease should alert the angiographer to look for anomalous coronary anatomy.

Adult↗
PubMed1978

Nitroglycerin and nitrate esters.

The expanding applications of nitroglycerin and nitrate esters--in congestive heart failure, in the reduction of infarct size in myocardial infarction and in the long-term prophylaxis of angina--have enhanced the clinical importance of these drugs. This article reviews some of the significant recent investigations of the nitrates and makes specific recommendations regarding clinical use.

Angina Pectoris↗
PubMed1978

Recirculation: a uremic syndrome complicating the use of prosthetic arteriovenous fistulas for hemodialysis.

Malfunction of prosthetic arteriovenous fistulas is described in two patients, unheralded by abnormalities of arterial flow or venous resistance. In each case, significant graft recirculation due to stenosis of the venous limb caused the insidious onset of uremic symptoms in patients apparently receiving adequate hemodialysis. The uremic syndromes disappeared after correction of the faulty vascular access. Recirculation may be a "silent" cause of prosthetic graft malfunction which is promptly diagnosed by a simple mathematical formula. Routine estimates by a simple mathematical formula. Routine estimates of recirculation should be performed in any chronic hemodialysis patient with relapse of uremic symptoms or suspicious serum chemistries despite regular, uncomplicated hemodialysis. Patients found to have significant recirculation should be considered for angiography and graft replacement or revision.

Animals↗