Opiate antagonist in traumatic shock.

Abstract:

:In experimental animal studies, opiate receptor antagonists (such as naloxone) and physiological opiate antagonists (thyrotropin-releasing hormone [TRH] have been used with some success to improve outcome and physiological variables following traumatic shock associated with hypovolemia, spinal cord trauma, and head injury. Naloxone at high doses (in the mg/kg range) improves blood pressure and survival following hypovolemic shock in some species subjected to fixed-pressure shock. Similarly, naloxone treatment in the same dose range improves blood pressure and outcome following traumatic spinal shock as well as shock associated with traumatic head injury in selected animal models. The high doses of naloxone required in these studies suggest that the beneficial effects may be due to actions at relatively naloxone-insensitive opiate receptors, such as the kappa-receptor. Changes in the putative kappa-receptor ligand dynorphin are found after hypovolemic shock and traumatic injury to the brain or spinal cord. Opiate receptor antagonists with increased selectivity for the kappa-receptor may be superior to naloxone in the treatment of these conditions. TRH or TRH analogs similarly improve blood pressure and outcome following hypovolemic or spinal shock. Clinical trials of naloxone (at high doses) in human spinal cord injury have begun, and there are plans for clinical trials of naloxone in human head trauma and of TRH in human spinal cord injury.

journal_name

Ann Emerg Med

authors

McIntosh TK,Faden AI

doi

10.1016/s0196-0644(86)80944-1

subject

Has Abstract

pub_date

1986-12-01 00:00:00

pages

1462-5

issue

12

eissn

0196-0644

issn

1097-6760

journal_volume

15

pub_type

杂志文章,评审
  • Tracheobronchial disruption: delayed diagnosis.

    abstract::Traumatic rupture of the tracheobronchial tree is an increasingly occurring complication of blunt chest trauma. Early detection and surgical repair are important for definitive and successful reconstruction. Bronchoscopy is the most reliable diagnostic procedure. Use of a rigid bronchoscope is difficult and traumatic ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(80)80386-6

    authors: Lee TS,Wright BD

    更新日期:1980-05-01 00:00:00

  • Emergency Department Environmental Contamination With Methicillin-Resistant Staphylococcus aureus After Care of Colonized Patients.

    abstract:STUDY OBJECTIVE:Methicillin-resistant Staphylococcus aureus (MRSA) transmission dynamics in the emergency department (ED) are not well defined; environmental surfaces may serve as reservoirs for transmission. This study investigates the effect of patients with a history of MRSA colonization or infection on subsequent M...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2018.12.014

    authors: Liang SY,Jansson DR,Hogan PG,Raclin TW,Sullivan ML,Muenks CE,Munigala S,House SL,Fritz SA

    更新日期:2019-07-01 00:00:00

  • Buffered versus plain lidocaine as a local anesthetic for simple laceration repair.

    abstract:STUDY OBJECTIVE:Buffered lidocaine was compared with plain lidocaine as a local anesthetic for simple lacerations. DESIGN:Randomized, double-blind, prospective clinical trial. SETTING:Urban emergency department. TYPE OF PARTICIPANTS:Ninety-one adult patients with simple linear lacerations were enrolled. Patients wit...

    journal_title:Annals of emergency medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/s0196-0644(05)82603-4

    authors: Bartfield JM,Gennis P,Barbera J,Breuer B,Gallagher EJ

    更新日期:1990-12-01 00:00:00

  • The Captain Morgan technique for the reduction of the dislocated hip.

    abstract:STUDY OBJECTIVE:We present our experience with a novel technique for the reduction of acute hip dislocation in the emergency department (ED). METHODS:We searched the medical records of all patients with a hip dislocation treated in our ED during a 4-year period. We recorded patient demographics, reduction technique, o...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2011.07.010

    authors: Hendey GW,Avila A

    更新日期:2011-12-01 00:00:00

  • Handgun purchase trends, Washington state: differences by age of buyer.

    abstract:STUDY OBJECTIVES:To examine trends in legal handgun purchases from federally licensed dealers and specifically to describe recent changes in age and gender of purchaser and caliber of handguns purchased. METHODS:A cohort study was performed of the adult population of Washington state from 1950 through 1992 using a sta...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(98)70100-3

    authors: Dowd MD,Grossman DC,Cummings P,Britt J

    更新日期:1998-07-01 00:00:00

  • Sequential treatment of a simple pneumothorax.

    abstract::In a prospective investigation of isolated simple pneumothorax, the treatment of 35 patients with a total of 37 pneumothoraces was studied. A standardized sequential treatment approach was followed for evacuation of the pneumothorax and maintenance of lung reexpansion. The protocol involved catheter placement using a ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(88)80676-0

    authors: Vallee P,Sullivan M,Richardson H,Bivins B,Tomlanovich M

    更新日期:1988-09-01 00:00:00

  • Medical care at the 1982 US Festival.

    abstract::The 1982 US Festival, a three-day outdoor rock music festival, attracted close to 410,000 people. Through a private contractor, a group of physicians participated in the design, administration, and implementation of medical care for this event. Basic ambulatory care was provided by a multitiered approach, using emerge...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(86)80986-6

    authors: Ounanian LL,Salinas C,Shear CL,Rodney WM

    更新日期:1986-05-01 00:00:00

  • Thrombolytic therapy of massive pulmonary embolism during prolonged cardiac arrest using recombinant tissue-type plasminogen activator.

    abstract::Cardiac arrest caused by massive pulmonary embolism is highly refractory to conventional resuscitation. Emergency surgical embolectomy has been considered the only effective intervention. We present the case of a 33-year-old woman who suffered a massive pulmonary embolism with circulatory arrest refractory to one half...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(89)80527-x

    authors: Langdon RW,Swicegood WR,Schwartz DA

    更新日期:1989-06-01 00:00:00

  • Emergency intervention to break the cycle of drunken driving and recurrent injury.

    abstract::Drinking increases motor vehicle crash likelihood starting at blood alcohol levels as low as .02 mmol/L. Clinical experience tells us that drunken drivers "cycle through" the system many times, presenting opportunities for intervention. We describe the drunken driver's risk of occurrence at each juncture in the cycle ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0196-0644(95)70148-6

    authors: Madden C,Cole TB

    更新日期:1995-08-01 00:00:00

  • An Age-Adjusted D-dimer Threshold for Emergency Department Patients With Suspected Pulmonary Embolus: Accuracy and Clinical Implications.

    abstract:STUDY OBJECTIVE:We determine the accuracy of an age-adjusted D-dimer threshold to detect pulmonary embolism in emergency department (ED) patients older than 50 years and describe current ED practices when evaluating possible pulmonary embolism. METHODS:This was a retrospective study of ED encounters for suspected pulm...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2015.07.026

    authors: Sharp AL,Vinson DR,Alamshaw F,Handler J,Gould MK

    更新日期:2016-02-01 00:00:00

  • Emergency physicians' perspectives on their use of health information exchange.

    abstract:STUDY OBJECTIVE:We explore what emergency physicians with access to health information exchange have to say about it and strive to better understand the factors affecting their use of it. METHODS:A qualitative study using grounded theory principles was conducted in 4 urban emergency departments that had health informa...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.annemergmed.2013.09.024

    authors: Thorn SA,Carter MA,Bailey JE

    更新日期:2014-03-01 00:00:00

  • Wound care of spider and snake envenomations.

    abstract::Venomous bites and stings are numerous but severe local tissue damage is uncommon. Venoms may be simple substances or complex mixtures of many poorly characterized components whose interactions are still not fully understood. The best studied example of a dermonecrotic venom is that produced by the brown recluse spide...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0196-0644(88)80360-3

    authors: Wasserman GS

    更新日期:1988-12-01 00:00:00

  • Lumbar spine x-rays: a multihospital study.

    abstract::To define the usefulness of the lumbar spine x-ray series in the emergency department and to generate clinical criteria for optimizing its application, we retrospectively studied 552 consecutive emergency department patients for whom lumbar spine x-rays were ordered. Patients were divided into traumatic (47.6%) and no...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(83)80378-3

    authors: Patrick JD,Doris PE,Mills ML,Friedman J,Johnston C

    更新日期:1983-02-01 00:00:00

  • Prophylactic antibiotics in common dog bite wounds: a controlled study.

    abstract::A double-blind prospective study of 98 patients was carried out, but 57 (58%) returned for follow-up and form the basis of this report. Wound irrigation and debridement were found to be important in reducing infection. Hand wounds were most likely to become infected; face and scalp wounds were at low risk. Puncture wo...

    journal_title:Annals of emergency medicine

    pub_type: 临床试验,杂志文章

    doi:10.1016/s0196-0644(80)80153-3

    authors: Callaham M

    更新日期:1980-08-01 00:00:00

  • Emergency department thoracotomy.

    abstract::Emergency thoracotomy has become a mainstay in the resuscitation of patients with major thoracic injuries. It also is occasionally useful in several other life-threatening conditions. The specific indications for emergency thoracotomy are reviewed, and expeditious thoracotomy in the emergency department, when necessar...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(81)80057-1

    authors: Hoffman JR

    更新日期:1981-05-01 00:00:00

  • The recidivism characteristics of an emergency department observation unit.

    abstract:STUDY OBJECTIVE:We describe the recidivism characteristics of an adult emergency department (ED) observation unit population and determine whether rates differ according to demographic or clinical features. METHODS:This prospective observational cohort study of a protocol-driven ED observation unit reviewed all discha...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2010.02.012

    authors: Ross MA,Hemphill RR,Abramson J,Schwab K,Clark C

    更新日期:2010-07-01 00:00:00

  • Randomized controlled clinical trial of point-of-care, limited ultrasonography for trauma in the emergency department: the first sonography outcomes assessment program trial.

    abstract:STUDY OBJECTIVE:Annually, 38 million people are evaluated for trauma, the leading cause of death in persons younger than 45 years. The primary objective is to assess whether using a protocol inclusive of point-of-care, limited ultrasonography (PLUS), compared to usual care (control), among patients presenting to the em...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.annemergmed.2006.01.008

    authors: Melniker LA,Leibner E,McKenney MG,Lopez P,Briggs WM,Mancuso CA

    更新日期:2006-09-01 00:00:00

  • Effects of combined treatment with glycopyrrolate and albuterol in acute exacerbation of chronic obstructive pulmonary disease.

    abstract:STUDY OBJECTIVE:To investigate whether the addition of a single aerosolized dose of glycopyrrolate leads to a greater improvement in pulmonary function than treatment with albuterol alone for patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). DESIGN:Prospective, randomized, blinded, cont...

    journal_title:Annals of emergency medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/s0196-0644(95)70260-1

    authors: Cydulka RK,Emerman CL

    更新日期:1995-04-01 00:00:00

  • Mixed fluoxetine/loxapine overdose and atrial flutter.

    abstract::A 19-year-old man who attempted suicide by ingesting approximately 600 mg fluoxetine (Prozac) and 140 mg loxapine (Loxitane) had two episodes of atrial flutter shortly thereafter. Admission serum fluoxetine, norfluoxetine, and loxapine levels were 1,053 ng/mL, 702 ng/mL, and 40 ng/mL, respectively. This case of atrial...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(94)70083-4

    authors: Roberge RJ,Martin TG

    更新日期:1994-03-01 00:00:00

  • Physician exposure to ionizing radiation during trauma resuscitation: a prospective clinical study.

    abstract::A prospective study of emergency physician whole body and extremity exposure to ionizing radiation during trauma resuscitation over a three-month period was conducted. Radiation film badges and thermoluminescent dosimeter finger rings were permanently attached to leaded aprons worn by emergency medicine residents duri...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(05)81797-4

    authors: Weiss EL,Singer CM,Benedict SH,Baraff LJ

    更新日期:1990-02-01 00:00:00

  • Post-dural-puncture headache: characteristics, management, and prevention.

    abstract::Post-dural-puncture headache is a common complication after both diagnostic and therapeutic procedures. Prompt recognition of the clinical syndrome, followed by supportive and corrective actions, can decrease the morbidity in those afflicted. The most useful preventive measure during dural puncture in adult patients i...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0196-0644(05)80416-0

    authors: Leibold RA,Yealy DM,Coppola M,Cantees KK

    更新日期:1993-12-01 00:00:00

  • Medical counterbioterrorism: the response to provide anthrax prophylaxis to New York City US Postal Service employees.

    abstract:STUDY OBJECTIVE:We describe and analyze a recent rapid deployment of disaster medical assistance teams and other government agencies to provide medical screening and anthrax prophylaxis to New York City US Postal Service employees potentially exposed to letters contaminated with anthrax spores. METHODS:A description o...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1067/mem.2003.105

    authors: Partridge R,Alexander J,Lawrence T,Suner S

    更新日期:2003-04-01 00:00:00

  • Controversies in out-of-hospital emergency airway control: esophageal obstruction or endotracheal intubation?

    abstract::Maintaining an unobstructed airway and providing adequate oxygenation and CO2 elimination, by artificial means if necessary, are among the highest priorities in all life-threatening circumstances. How this goal can best be met in the prehospital setting has become a controversial issue. The esophageal obturator airway...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(84)80434-5

    authors: White RD

    更新日期:1984-09-01 00:00:00

  • Sports-related pneumothorax.

    abstract::Pneumothorax and pneumomediastinum are rare complications of athletic activity. Spontaneous pneumothorax has been reported in association with several sports, but reports of pneumothorax associated with blunt trauma sustained during sporting activity are rare. We present a case series of patients in whom pneumothorax ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(97)70018-0

    authors: Partridge RA,Coley A,Bowie R,Woolard RH

    更新日期:1997-10-01 00:00:00

  • Should payment policy be changed to allow a wider range of EMS transport options?

    abstract::The Institute of Medicine and other national organizations have asserted that current payment policies strongly discourage emergency medical services (EMS) providers from transporting selected patients who call 911 to non-ED settings (eg, primary care clinics, mental health centers, dialysis centers) or from treating ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2013.09.025

    authors: Morganti KG,Alpert A,Margolis G,Wasserman J,Kellermann AL

    更新日期:2014-05-01 00:00:00

  • Web-based self-triage of influenza-like illness during the 2009 H1N1 influenza pandemic.

    abstract::The sudden emergence of 2009 H1N1 influenza in the spring of that year sparked a surge in visits to emergency departments in New York City and other communities. A larger, second wave of cases was anticipated the following autumn. To reduce a potential surge of health system utilization without denying needed care, we...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2010.04.005

    authors: Kellermann AL,Isakov AP,Parker R,Handrigan MT,Foldy S

    更新日期:2010-09-01 00:00:00

  • Interstitial pregnancy: a potential for misdiagnosis of ectopic pregnancy with emergency department ultrasonography.

    abstract::Interstitial pregnancy is a rare and dangerous form of ectopic pregnancy that can be mistaken for a normal intrauterine pregnancy on ultrasonography, leading to catastrophic results. Increasingly, emergency physicians are using ultrasonography to diagnose intrauterine pregnancy. Emergency physicians should be aware of...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1067/mem.2002.125426

    authors: DeWitt C,Abbott J

    更新日期:2002-07-01 00:00:00

  • Clinitest tablet ingestion: an in vitro investigation concerned with initial emergency management.

    abstract::To help establish a rational approach to the initial management of Clinitest tablet ingestion, we investigated the effect of number of tablets, volume of diluent, and type of diluent on dissolution time (TD), temperature generation (delta T), and pH. Dissolution time was independent of the number of tablets and the vo...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(86)80008-7

    authors: Lacouture PG,Gaudreault P,Lovejoy FH Jr

    更新日期:1986-02-01 00:00:00

  • The leukocyte esterase test for detection of cerebrospinal fluid leukocytosis and bacterial meningitis.

    abstract::We conducted a study to assess the efficacy of the dipstick leukocyte esterase test (LET) in the detection of cerebrospinal fluid (CSF) leukocytosis as a quick screen for bacterial meningitis. Nine hundred forty-two CSF samples were collected from 800 patients. The LET was compared in a double-blinded fashion with rou...

    journal_title:Annals of emergency medicine

    pub_type: 临床试验,杂志文章

    doi:10.1016/s0196-0644(89)80058-7

    authors: DeLozier JS,Auerbach PS

    更新日期:1989-11-01 00:00:00

  • Transport and Management of Patients With Confirmed or Suspected Ebola Virus Disease.

    abstract::The foundation of safe care for patients with confirmed or suspected Ebola virus disease is effective infection control practice, which requires implementation of appropriate administrative policies, work practices, and environmental controls, accompanied by focused education, training, and supervision. In 2002, Emory...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2015.04.008

    authors: Isakov A,Miles W,Gibbs S,Lowe J,Jamison A,Swansiger R

    更新日期:2015-09-01 00:00:00