American family physician
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American family physician · Aug 1992
Review Case ReportsJimson weed toxicity: management of anticholinergic plant ingestion.
Jimson weed is a hallucinogenic plant that is common in rural areas. Consumption of any part of the plant can result in severe anticholinergic toxicity. The clinical presentation of jimson weed toxicity is similar to that seen in cases of atropine poisoning. Treatment is aimed at removing plant material from the gastrointestinal tract, keeping the patient safe and reversing severe anticholinergic sequelae.
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Pulmonary surfactant is an important chemical component of the lung. It decreases surface tension in the alveolar cells to help stabilize the alveoli, and it may help prevent pulmonary edema. Currently, naturally and synthetically derived surfactants are being used to treat neonatal respiratory distress syndrome, a leading cause of death in premature infants. ⋯ Surfactant is administered by endotracheal tube, and the recommended dose is 5 mg per kg. Three doses, given 12 hours apart, is the recommended regimen for prophylactic therapy. Rescue therapy consists of one dose of surfactant given at the onset of respiratory distress and another dose given 12 hours later.
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Head injuries are the most common cause of disability and death in children. Identification of children who require specialized management following a head injury will reduce the associated morbidity and mortality. Thus, it is important to differentiate the child who can be safely observed and who will recover spontaneously from the child who will develop a progressive neurologic deficit from a treatable cause. A thorough history, a tailored neurologic examination and limited radiographic studies will assist the family physician in making this determination.
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Fishhook injuries are fairly common in some geographic areas. Radiography assists in identifying the type of hook and determining its orientation. Two simple techniques can be employed to remove a fishhook safely and easily.