Acute history

Category X) and lactation. The HMG-CoA reductase inhibitors are used cautiously in patients with a history of alcoholism, acute infection, hypotension, trauma, endocrine disorders, visual disturbances, and myopathy. 

Sulfosuccinates have a history of safety as their use in consumers products in the past years has proven. However, few toxicity data can be found in the literature, mostly in connection with the evaluation of other surfactants. As the figures show, all sulfosuccinates and sulfosuccinamates described in this chapter have an acute oral toxicity (LD50) of >2000 mg/kg. Results are listed in Table 20. 

Inexperienced users or individuals who are exposed to the drug unexpectedly (e.g., who unknowingly consume PCP-adulterated cannabis) may develop severe anxiety and panic because of the intensity and variety of symptoms. Perceptual distortions have sometimes led to extremely violent behavior, accidents, or self-damaging acts. An especially high risk of violent behavior has been reported in acutely intoxicated PCP users who have a history of psychiatric problems. Intoxication with doses in excess of 150 mg may lead to convulsions, coma, and death from respiratory arrest. Other complications include hypertensive crisis, intracerebral hemorrhage, and renal failure (Table 6-5). 

Exposure Levels in Humans. Methyl parathion has been detected in serum and tissue shortly after acute exposure (EPA 1978e Ware et al. 1975). It is rapidly metabolized and does not persist in serum and tissues for long (Braeckman et al. 1983). Two metabolites of methyl parathion, 4-nitrophenol and dimethyl phosphate, can be detected in urine and tissues for up to 2 days following exposure (Morgan et al. 1977). These compounds are specific for methyl parathion when there is a history of exposure. 

The telemedicine-based evaluation of acute stroke is especially challenging. It requires a rapid neurological assessment, CT image acquisition and review, and a detailed history for rt-PA exclusion criteria. Low-cost teleradiology systems are now available for the transmission of compressed CT images viewable on a conventional personal computer (PC) monitor, in accordance with published standards. 

Many accidents resulting from dangerous reactions have a history of repeating themselves over the years, without the lessons of history being properly drawn. For example, the accident at Seveso, arising from difficulties in controlling the reaction temperature of sodium hydroxide with 1,2,4,5-tetrachlorobenzene, had already happened three times a few years before. The symptoms due to acute intoxication caused by dioxin were already known. 

Increased oxygen demand secondary to increased heart rates and blood pressure has been hypothesized to lead to myocardial infarction (especially in patients with fixed coronary disease) and/or ventricular arrhythmias. In patients with no history of cardiac disease, cocaine is thought to induce acute isehemie complications via vasospasm of the coronaries (Ascher et al. 1988). In addition, Virmani et al. (1988) have reported a 20 percent incidence of myocarditis thought to be secondary to accumulated microvascular injuries. 

Lerner, S.E., and Burns, R.S. Phencyclidine use among youth History, epidemiology and acute and chronic intoxication. In Peterson, R.C. and Stillman, R.C., eds. Phencyclidine (PCP) Abuse An Apprai sal. National Institute on Drug Abuse Research Monograph 21. DHEW Pub. No. (ADM) 78-728. Washington, D.C ... 

The phrase acute heart failure (AHF) is used to signify either an acute decompensation of a patient with a history of chronic heart failure or to refer to a patient presenting with new-onset HF symptoms. Terms commonly associated with HF, such as cardiomyopathy and LV dysfunction, are not equivalent to HF but describe possible structural or functional reasons for the development of HF. 

HF medications deserves special attention, as it is the most common cause of acute decompensation and can be prevented. As such, an accurate history regarding diet, food choices, and the patient s knowledge regarding sodium and fluid intake (including alcohol) is valuable in assessing dietary indiscretion. Nonadherence with medical recommendations such as laboratory and other appointment follow-up can also be indicative of non-adherence with diet or medications. 

Patients with ischemic chest discomfort and suspected acute coronary syndrome are risk-stratified based upon a 12-lead electrocardiogram, past medical history, and results of the creatine kinase myocardial band and troponin tests. The diagnosis... 

Diagnosis of acute pancreatitis is based on the patient s history and presenting signs and symptoms. Evaluation of laboratory results, specifically the serum amylase and lipase, aids in diagnosis. Serum amylase is elevated early in the disease process but may return to normal within 12 hours.10 Serum lipase will remain elevated for days after the acute event and may lend itself more to the diagnosis depending on when the patient presents for evaluation.11... 

The patient s history will identify risk factors for acute pancreatitis, such as age greater than 70 years or history of alcohol abuse. Finally, computed tomography (CT) scan or ultrasound of the abdomen can help to identify pancreatic fluid collections.12... 

Patient Encounter 1, Part 2 Medical History, Physical Exam, and Diagnostic Tests in Acute Pancreatitis... 

Banks PA. Epidemiology, natural history, and predictors of disease outcome in acute and chronic pancreatitis. Gastrointest Endosc 2002 56(6 Suppl) S226-S230. 

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