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Alcohol and the disruption of cognitive processes
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Abstracts peter R o s e n , M D - - e d i t o r professor of Emergency Medicine and Director of the Division of Emergency Medicine, university of Chicago Hospitals and Clinics
B e v e r l y F a u m a n , M D - - assistant e d i t o r Assistant Professor of Emergency Medicine and Psychiatry, University of Chicago Hospitals and Clinics
Alcohol and the disruption of cognitive processes. Parker ES, Arch Gen Psychiatry 31:824-828, (Dec) 1974. The memory functions of alcoholics and nonalcoholics in sober and two alcoholic states were examined. Memory was tested as to digit-span, registration fee recall and category clustering. Results showed t h a t alcoholics under sober conditions had poorer cognitive powers t h a n nonalcoholics but i n the alcoholic state both groups did increasingly worse as the level of alcohol increased. Conclusions were that chronic alcoholism impairs intellectual function p e r m a n e n t l y and alcohol has a similar effect on the memory processes in both the alcoholic and nonalcoholic.
Harvey Meislin, MD
chemical intoxications; drugs, alcohol; alcoholism Botulism - - ten year experience. Cherington M: Arch
Neurol 30:432-437, 1974. Colorado has the highest incidence of botulism of any state in the Union. This is thought to be due to the fact that high altitudes lower the boiling temperature below t h a t needed to destroy heat-resistant spores. Fourteen cases of botulism are reviewed. Botulismotoxin interferes with the release of acetylcholine at the neuromuscular junction. Patients develop symptoms 12 to 24 hours afLer ingestion consisting of blurred vision, diplopia, dizziness, dysarthria and dysphagia followed by descending paralysis and dyspnea. Mental functions and sensations remain intact. Guanidine hydrochloride is reported effec-
Livein less severe cases_
Michael C. Tomlanovich, MD
botulism Cerebellar hemorrhage: diagnosis and treatment. Ott KH, Kase CS, Ojemann RG, et ah Arch Neurol 31:160167, 1974. Several large autopsy series have found intracerebellar hemorrhage at rates from 5% to 13%_ In a retrospective study of 56 patients suffering from intracerebellar hemorrhage, the diagaosis in a majority of cases was made on the basis of clinical evaluation. The commonest predisposing factor was a r t e r i a l hypertension. The symptoms include the sudden onset of n a u s e a and vomiting, headache, dizziness and inability to stand or walk. The physical examination may reveal constricted and reactive Pupils, gait ataxia, periodic respirations, gaze palsy, peripheral facial palsy, and horizontal nystagmus. The most common triad of findings was ataxia, ipsilateral gaze palsy and peripheral fa-
J~P
April 1976
cial palsy_ The t r e a t m e n t consists of craniectomy and the results were highly dependent upon the patient's preoperative mental
status.
Michael C. Tomlanovich, MD
hypertension, arterial; hemorrhage, intracerebellar; craniectomy Influence of syringe material on arterial blood gas determinations. Winkler JB: Chest 66 5:528-521, (Nov) 1974. A comparative analysis of 38 arterial blood gas samples using plastic and glass syringes was u n d e r t a k e n to determine the acceptability of plastic syringes. A l t h o u g h the values for each parameter, ie, pH, PCO2 and POa, varied slightly, the variation was similar to those when samples in two glass syringes were analyzed. It was concluded t h a t plastic syringes are acceptable for routine clinical studies provided t h a t the analysis is made as soon as possible and samples containing large air bubbles are discarded. (Editor's note: Blood gas analyses are frequently performed i n t h e emergency department. It is obviously more practical to be able to use plastic rather than glass syringes.)
Vincent Markovchick, MD
respiration; blood, arterial gas; syringe, plastic vs glass Rupture of the retroperitoneal duodenum after blunt abdominal trauma. Rasaretnam R, Thavendran A: Br J Surg 61:893-895, (Nov) 1974. A history of minor, nonpenetrating abdominal t r a u m a and delay in t h e d e v e l o p m e n t of s i g n i f i c a n t s y m p t o m s and signs are characteristic of rupture of the retroperitoneal duodenum. These characteristics are part of the reason for the high mortality and morbidity rates associated w i t h it. The p a t i e n t may have a symptom-free interval varying from hours to days following trauma. Increasing right upper q u a d r a n t pain and tenderness should alert the examiner to the possibility of this injury. Abdominal guarding may be present but rigidity, distension and absent bowel sounds are very late signs. Vomiting may or may not be present. X-ray films, when positive, usually reveal subcutaneous e m p h y s e m a in t h e posterior abdominal wall and around the right kidney. Lab studies and paracentesis are of very little value. A high index of suspicion and repeated abdominal examination are the best aids to diagnosis.
Vincent Markovchick, MD
trauma, blunt abdominal; duodenum, retroperitoneal rupture Volume 5 Number 4 Page 297
Abstracts peter R o s e n , M D - - e d i t o r professor of Emergency Medicine and Director of the Division of Emergency Medicine, university of Chicago Hospitals and Clinics
B e v e r l y F a u m a n , M D - - assistant e d i t o r Assistant Professor of Emergency Medicine and Psychiatry, University of Chicago Hospitals and Clinics
Alcohol and the disruption of cognitive processes. Parker ES, Arch Gen Psychiatry 31:824-828, (Dec) 1974. The memory functions of alcoholics and nonalcoholics in sober and two alcoholic states were examined. Memory was tested as to digit-span, registration fee recall and category clustering. Results showed t h a t alcoholics under sober conditions had poorer cognitive powers t h a n nonalcoholics but i n the alcoholic state both groups did increasingly worse as the level of alcohol increased. Conclusions were that chronic alcoholism impairs intellectual function p e r m a n e n t l y and alcohol has a similar effect on the memory processes in both the alcoholic and nonalcoholic.
Harvey Meislin, MD
chemical intoxications; drugs, alcohol; alcoholism Botulism - - ten year experience. Cherington M: Arch
Neurol 30:432-437, 1974. Colorado has the highest incidence of botulism of any state in the Union. This is thought to be due to the fact that high altitudes lower the boiling temperature below t h a t needed to destroy heat-resistant spores. Fourteen cases of botulism are reviewed. Botulismotoxin interferes with the release of acetylcholine at the neuromuscular junction. Patients develop symptoms 12 to 24 hours afLer ingestion consisting of blurred vision, diplopia, dizziness, dysarthria and dysphagia followed by descending paralysis and dyspnea. Mental functions and sensations remain intact. Guanidine hydrochloride is reported effec-
Livein less severe cases_
Michael C. Tomlanovich, MD
botulism Cerebellar hemorrhage: diagnosis and treatment. Ott KH, Kase CS, Ojemann RG, et ah Arch Neurol 31:160167, 1974. Several large autopsy series have found intracerebellar hemorrhage at rates from 5% to 13%_ In a retrospective study of 56 patients suffering from intracerebellar hemorrhage, the diagaosis in a majority of cases was made on the basis of clinical evaluation. The commonest predisposing factor was a r t e r i a l hypertension. The symptoms include the sudden onset of n a u s e a and vomiting, headache, dizziness and inability to stand or walk. The physical examination may reveal constricted and reactive Pupils, gait ataxia, periodic respirations, gaze palsy, peripheral facial palsy, and horizontal nystagmus. The most common triad of findings was ataxia, ipsilateral gaze palsy and peripheral fa-
J~P
April 1976
cial palsy_ The t r e a t m e n t consists of craniectomy and the results were highly dependent upon the patient's preoperative mental
status.
Michael C. Tomlanovich, MD
hypertension, arterial; hemorrhage, intracerebellar; craniectomy Influence of syringe material on arterial blood gas determinations. Winkler JB: Chest 66 5:528-521, (Nov) 1974. A comparative analysis of 38 arterial blood gas samples using plastic and glass syringes was u n d e r t a k e n to determine the acceptability of plastic syringes. A l t h o u g h the values for each parameter, ie, pH, PCO2 and POa, varied slightly, the variation was similar to those when samples in two glass syringes were analyzed. It was concluded t h a t plastic syringes are acceptable for routine clinical studies provided t h a t the analysis is made as soon as possible and samples containing large air bubbles are discarded. (Editor's note: Blood gas analyses are frequently performed i n t h e emergency department. It is obviously more practical to be able to use plastic rather than glass syringes.)
Vincent Markovchick, MD
respiration; blood, arterial gas; syringe, plastic vs glass Rupture of the retroperitoneal duodenum after blunt abdominal trauma. Rasaretnam R, Thavendran A: Br J Surg 61:893-895, (Nov) 1974. A history of minor, nonpenetrating abdominal t r a u m a and delay in t h e d e v e l o p m e n t of s i g n i f i c a n t s y m p t o m s and signs are characteristic of rupture of the retroperitoneal duodenum. These characteristics are part of the reason for the high mortality and morbidity rates associated w i t h it. The p a t i e n t may have a symptom-free interval varying from hours to days following trauma. Increasing right upper q u a d r a n t pain and tenderness should alert the examiner to the possibility of this injury. Abdominal guarding may be present but rigidity, distension and absent bowel sounds are very late signs. Vomiting may or may not be present. X-ray films, when positive, usually reveal subcutaneous e m p h y s e m a in t h e posterior abdominal wall and around the right kidney. Lab studies and paracentesis are of very little value. A high index of suspicion and repeated abdominal examination are the best aids to diagnosis.
Vincent Markovchick, MD
trauma, blunt abdominal; duodenum, retroperitoneal rupture Volume 5 Number 4 Page 297