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Effectiveness and side effects of ipecac syrup
International
Notes
International Abstracts Clinical studies in paraquat poisoning. K. Suzuki, S. Tanaka, K. Ogawa, Y. Nakamura, H. Hirose, J. Tanabe, C. Fujii, A. Kohama, J. Hashimoto, Y. Shinkai, G. Ohsawa. Jpn J Acute Med 1986;10:203209. In 19 patients with paraquat intoxication, plasma paraquat concentrations were measured. Urinary paraquat concentration, a quantitative test for paraquat in urine, or ingested volume of paraquat, which is frequently used as an index of severity, was not adequate in assessing the severity and predicting outcome, compared with plasma paraquat concentrations. Acute respiratory failure (ARF) following paraquat poisoning was one of the major determinants of outcome. In 18 fatal cases, survival time was predicted by the interval between the ingestion and the manifestation of ARF symptoms. At a plasma concentration of 6.0 kg/ml, the clearance of paraquat in plasmapheresis was 43 ml/min at a blood flow rate of 100 ml/min and a plasma exchange rate of 26.4 ml/min, indicating the same clearance in hemodialysis as reported by Okonek et al. From the viewpoint of clearance, hemoperfusion was most effective. Effectiveness and side effects of ipecac syrup. M. Yamashita, K. Nakamura, T. Mizutani, K. Koyama, H. Naitou. Jpn J Acute Med 1986;10:219-224. A clinical study was conducted to evaluate the effectiveness and safety of ipecac syrup as an emetic. A total of 35 children aged 0.5-3.5 years were given an ipecac syrup preparation to evacuate their stomachs. Doses administered were 8 ml (under 1 year), 15 ml (1-12 years), and 30 ml (over 12 years). The average time from ipecac administration until emesis induction was 21.6 + 8.9 minutes. Only one patient took more than 30 minutes to vomit. In seven patients, minor side effects such as drowsiness were observed. Nevertheless, because long-term ingestion of ipecac syrup is reported to result in cardiotoxicity, strict adherence to a physician’s prescription is mandatory. Clinical study of arterial injury: An analysis of 45 cases. A. Niino, N. Negishi, Y. Yamaguchi, H. Hagawira, S. Ozaki, Y. Sezai. Jpn J Acute Med 1986;10:211217. 468
Forty-five cases of arterial injury were treated at the 2nd Department of Surgery of Nihon University Hospital. Arterial injury occurred most frequently in males between the ages of 20 and 50 years. It was most often caused by a sharp agent. Many of the arterial injuries were associated with concomitant lesions, such as fractures and vein or nerve trauma. Severe concomitant injuries were associated with blunt trauma. In blunt trauma, arterial injuries are not easily diagnosed, so that a careful observation of the wound is mandatory. In some cases of blunt trauma, recovery was not possible even when reconstruction of the artery was performed at an early stage. Incomplete recovery may be attributed not only to delayed surgery, but also to the presence of extensive concomitant lesions. Most cases of chronic arterial injuries resulted from misdiagnoses or inadequate treatment in the acute stages. Significance of plasma antidiuretic hormone in brain death determination. M. Sasaki, 0. Kinoshita. Jpn J Acute Med 1986;10:225-228. Plasma antidiuretic hormone (ADH) levels in seven brain death patients were studied. Plasma ADH was measured by radioimmunoassay technique at 0, 12, 24, and 48 hours after confirmation of brain death. In four patients, plasma ADH levels were still within a normal range when brain death was diagnosed. In three patients, the plasma ADH presented at normal levels even 12 hours after brain death was diagnosed. These results suggest that the release of ADH continued even after brain death as confirmed by our present criteria. Because normal ADH levels suggest a still-functioning neurohypophysis. Determination of brain death by a criterion that does not include ADH measurement may be inadequate. Surgical results of fourteen perforation carcinomas of the colon and rectum. K. T&kahashi, M. Hatao, A. Kurisu, M. Kanata, T. Kume, A. Yamahiro, H. Maruyama. Jpn J Acute Med 1986;10:345-350. In the ten-year period from 1975 to 1984, the authors experienced 14 cases of perforating carcinomas of the colon and rectum. Six of them were free perforations, and eight were voluminous abscess forma-
Notes
International Abstracts Clinical studies in paraquat poisoning. K. Suzuki, S. Tanaka, K. Ogawa, Y. Nakamura, H. Hirose, J. Tanabe, C. Fujii, A. Kohama, J. Hashimoto, Y. Shinkai, G. Ohsawa. Jpn J Acute Med 1986;10:203209. In 19 patients with paraquat intoxication, plasma paraquat concentrations were measured. Urinary paraquat concentration, a quantitative test for paraquat in urine, or ingested volume of paraquat, which is frequently used as an index of severity, was not adequate in assessing the severity and predicting outcome, compared with plasma paraquat concentrations. Acute respiratory failure (ARF) following paraquat poisoning was one of the major determinants of outcome. In 18 fatal cases, survival time was predicted by the interval between the ingestion and the manifestation of ARF symptoms. At a plasma concentration of 6.0 kg/ml, the clearance of paraquat in plasmapheresis was 43 ml/min at a blood flow rate of 100 ml/min and a plasma exchange rate of 26.4 ml/min, indicating the same clearance in hemodialysis as reported by Okonek et al. From the viewpoint of clearance, hemoperfusion was most effective. Effectiveness and side effects of ipecac syrup. M. Yamashita, K. Nakamura, T. Mizutani, K. Koyama, H. Naitou. Jpn J Acute Med 1986;10:219-224. A clinical study was conducted to evaluate the effectiveness and safety of ipecac syrup as an emetic. A total of 35 children aged 0.5-3.5 years were given an ipecac syrup preparation to evacuate their stomachs. Doses administered were 8 ml (under 1 year), 15 ml (1-12 years), and 30 ml (over 12 years). The average time from ipecac administration until emesis induction was 21.6 + 8.9 minutes. Only one patient took more than 30 minutes to vomit. In seven patients, minor side effects such as drowsiness were observed. Nevertheless, because long-term ingestion of ipecac syrup is reported to result in cardiotoxicity, strict adherence to a physician’s prescription is mandatory. Clinical study of arterial injury: An analysis of 45 cases. A. Niino, N. Negishi, Y. Yamaguchi, H. Hagawira, S. Ozaki, Y. Sezai. Jpn J Acute Med 1986;10:211217. 468
Forty-five cases of arterial injury were treated at the 2nd Department of Surgery of Nihon University Hospital. Arterial injury occurred most frequently in males between the ages of 20 and 50 years. It was most often caused by a sharp agent. Many of the arterial injuries were associated with concomitant lesions, such as fractures and vein or nerve trauma. Severe concomitant injuries were associated with blunt trauma. In blunt trauma, arterial injuries are not easily diagnosed, so that a careful observation of the wound is mandatory. In some cases of blunt trauma, recovery was not possible even when reconstruction of the artery was performed at an early stage. Incomplete recovery may be attributed not only to delayed surgery, but also to the presence of extensive concomitant lesions. Most cases of chronic arterial injuries resulted from misdiagnoses or inadequate treatment in the acute stages. Significance of plasma antidiuretic hormone in brain death determination. M. Sasaki, 0. Kinoshita. Jpn J Acute Med 1986;10:225-228. Plasma antidiuretic hormone (ADH) levels in seven brain death patients were studied. Plasma ADH was measured by radioimmunoassay technique at 0, 12, 24, and 48 hours after confirmation of brain death. In four patients, plasma ADH levels were still within a normal range when brain death was diagnosed. In three patients, the plasma ADH presented at normal levels even 12 hours after brain death was diagnosed. These results suggest that the release of ADH continued even after brain death as confirmed by our present criteria. Because normal ADH levels suggest a still-functioning neurohypophysis. Determination of brain death by a criterion that does not include ADH measurement may be inadequate. Surgical results of fourteen perforation carcinomas of the colon and rectum. K. T&kahashi, M. Hatao, A. Kurisu, M. Kanata, T. Kume, A. Yamahiro, H. Maruyama. Jpn J Acute Med 1986;10:345-350. In the ten-year period from 1975 to 1984, the authors experienced 14 cases of perforating carcinomas of the colon and rectum. Six of them were free perforations, and eight were voluminous abscess forma-