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A by-product of the uranium enrichment process, depleted uranium (DU) contains approximately 40% of the radioactivity of natural uranium yet retains all of its chemical properties. After its use in the 1991 Gulf War, public concern increased regarding its potential radiotoxicant properties. Whereas in vitro and rodent data have suggested the potential for(More)
STUDY OBJECTIVES This study tested the hypothesis that serial creatine phosphokinase (CK)-MB sampling in the emergency department can identify acute myocardial infarction (AMI) in patients presenting to the ED with chest pain and nondiagnostic ECGs. DESIGN Patients more than 30 years old who were evaluated initially in the ED and hospitalized for chest(More)
Rhabdomyolysis is a syndrome often associated with alcohol and drug abuse. It may also be seen following viral infections, but is a complication not often considered. We report a case of severe rhabdomyolysis following an influenza-like illness. Despite the extreme elevation of creatinine phosphokinase, 230,600 IU/L, this patient did not develop acute renal(More)
Human envenomations by Heloderma species are a rare but clinically important medical problem. We report a case of an adult male bitten on the left hand by a 50-cm male, captive specimen of Heloderma suspectum (Gila monster). Immediate signs and symptoms included pain at the bite site radiating into the arm and axilla and swelling of the hand and forearm.(More)
OBJECTIVES Pennyroyal oil ingestion has been associated with severe hepatotoxicity and death. The primary constituent, R-(+)-pulegone, is metabolized via hepatic cytochrome P450 to toxic intermediates. The purpose of this study was to assess the ability of the specific cytochrome P450 inhibitors disulfiram and cimetidine to mitigate hepatotoxicity in mice(More)
Hypotension resulting from calcium channel blocker ingestion often is refractory to standard therapeutic modalities. Amrinone and glucagon have been used separately and in combination with other agents in the treatment of calcium channel blocker overdose. We report the successful use of both amrinone and glucagon in the treatment of a 30-year-old woman who(More)
OBJECTIVES To determine the effectiveness of a simulated emergency department (ED)-based surveillance system to detect infectious disease (ID) occurrences in the community. METHODS Medical records of patients presenting to an urban ED between January 1, 1999, and December 31, 2000, were retrospectively reviewed for ICD-9 codes related to ID(More)
Tricyclic antidepressant (TCA) overdose is a common, potentially life-threatening finding in patients seen in emergency departments. There is a need to rapidly differentiate the TCA overdose from others in the emergency unit population. The Syva EMIT Toxicological Serum Tricyclic Antidepressant Assay for serum tricyclic antidepressant levels on 87 patients(More)
Nitrofurantoin is a widely prescribed antibiotic used for the treatment of urinary tract infections. In some patients it can produce an acute pulmonary reaction ranging from mild dyspnea to noncardiogenic pulmonary edema. Symptoms include fever, dyspnea, chills, cough, and chest pain. Physical examination generally reveals an acutely ill, extremely(More)
The management of snake envenomation is a clinical challenge. The definitive therapy, antivenin, is potentially harmful and should not be used indiscriminately. However, the morbidity and mortality from the envenomation usually outweigh any adverse reactions to the antivenin therapy. Most reactions can be divided into two general categories: type I(More)