1/7. carbon monoxide poisoning causes optic neuropathy.PURPOSE: To describe the electrophysiological and psychophysical effects of carbon monoxide (CO) poisoning on visual function. methods: Three patients are presented who suffered CO poisoning, two due to suicide attempts and one in the course of a road traffic accident. After a full ocular examination, Goldmann visual fields, flash and pattern visual evoked potentials (VEPs) and flash and pattern electroretinograms (ERGs) were tested. RESULTS: electrophysiology showed reduced or absent N95 components of the pattern ERG and delayed, reduced VEPs. A positive-negative-positive (PNP) VEP waveform was seen in two cases. In one case, where presentation occurred at an early stage, visual and electrophysiological function was improved with hydroxycobalamine. CONCLUSIONS: The combination of ERG and VEP findings suggest that CO poisoning can cause a toxic optic neuropathy that may have a similar aetiological mechanism to that in tobacco amblyopia. Early treatment with hydroxycobalamine may be of some benefit.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/7. Occupational intoxication with carbon monoxide.The most important safety measure for prevention of CO poisoning is the installation of automatic systems that signal high CO concentrations in the work environment. public health measures that include stringent pollution control, introduction of low-cost CO monitors, and public education aimed at the high-risk population (e.g., new workers, drivers) should decrease the number of deaths from CO poisoning and should save productive years of life. Toxicity of CO is a consequence of tissue hypoxia created by the displacement of oxygen from hemoglobin and the subsequent impairment of oxygen release to the tissues. Early symptoms of CO intoxication are insidious and can resemble other diseases; physical examination may be unremarkable. For these reasons, many cases of CO poisoning are not readily recognized.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/7. Delayed neuropsychiatric impairment after carbon monoxide poisoning from burning charcoal.Poisoning by carbon monoxide from burning charcoal has become one of the popular and lethal ways of attempting suicide in hong kong. survivors of the carbon monoxide poisoning often face acute and delayed adverse problems in both their physical and mental health. We report two cases of delayed onset neuropsychiatric complications caused by carbon monoxide poisoning from burning charcoal. These symptoms were characterised by a latent period, followed by an abrupt and profound deterioration in the neurocognitive function with a seemingly reversible course. The literature is reviewed regarding the aetiology, pathophysiology, and management of this condition. Regular monitoring of their neurocognitive function and forewarning of this potential complication to the survivors of carbon monoxide poisoning and their families should be essential.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/7. Tension pneumothorax associated with hyperbaric oxygen therapy.The authors present three patients who developed a tension pneumothorax while receiving emergent hyperbaric oxygen therapy for acute carbon monoxide poisoning. Each patient was intubated and received closed chest compressions for cardiac arrest prior to hyperbaric oxygenation. Despite the apparent absence of pneumothorax prior to hyperbaric therapy, tension pneumothorax was detected soon after decompression. These cases illustrate the need for vigilance in detecting and addressing pneumothorax prior to hyperbaric decompression in obtunded patients. Serial physical examinations, arterial blood gas determinations, properly positioned chest radiographs, and a high index of suspicion for pneumothorax in the setting of emergent hyperbaric therapy are recommended.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/7. Problem-solving techniques in occupational medicine.The diagnosis of occupational illnesses may be considerably more difficult than is the case with occupational injuries because of a variety of factors: an intervening latency period, uncertainty in identifying the most significant chemical or physical exposures, determination of exposure levels retrospectively, and coordination of the physician with regulatory and workers' compensation bureaucracies. Such problem-solving techniques as retrospective industrial hygiene and attention to in-situ chemistry can act as means of reducing the uncertainty in making the diagnosis of occupational illness. Advance familiarity with workers' compensation and state or federal regulatory agencies can further facilitate diagnosis and patient advocacy.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/7. Compartment syndrome of the upper arm.The physical signs of a compartment syndrome of the upper arm are swelling and tenderness, possibly accompanied by functional impairment of all the nerves of the brachial plexus. The most common cause is exposure of the upper limb over a prolonged period to compression by the body-weight against a solid underground. The resulting tissue lesion leads to rhabdomyolysis. Laboratory investigations show an orthotolidin-positive urine reaction (Hemastix), pigmented granular casts in the urinary sediment, together with a markedly elevated level of serum creatine phosphokinase (CPK). The treatment of choice consists of immediate open fasciotomy. The history is given of two patients, in whom a prolonged period of recumbency due to coma caused the development of an upper-arm compartment syndrome. An explanation is offered to account for the rarity of this phenomenon compared to the more frequently encountered compartment syndrome of the lower leg.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/7. Chronic carbon monoxide exposure: a clinical syndrome detected by neuropsychological tests.Chronic exposure to carbon monoxide produces a clinical syndrome that is often overlooked because of obscure symptomatology, a range of presentations, and lack of awareness of the problem. To help physicians recognize and treat the chronic carbon monoxide exposure syndrome, the authors present its objective symptomatology, an approach to diagnosis emphasizing neuropsychological tests, a treatment protocol, and theoretical considerations for the mechanism of hyperbaric oxygen's therapeutic action. For elucidation, eight patients treated in the hyperbaric chamber at a tertiary care facility are described. diagnosis can be facilitated by recognizing the syndrome based on the patient's history, as well as physical and neuropsychological examinations, with emphasis on identifying potential sources of carbon monoxide exposure. The evaluation and treatment protocols presented, though still experimental, show promise for improving functional, cognitive, and psychiatric capacities.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |