Nontraumatic surgical emergencies in children.

Clinical conditions that require operative intervention are frequent causes of emergency department visits. Common causes such as pyloric stenosis, intussusception, inguinal hernias, torsion of the testicle, and ingested foreign bodies are discussed, and aids in diagnosis and early intervention are addressed. Conditions that mimic surgical problems also are mentioned.

Drug-related emergencies in athletes.

Drug use among athletes, both amateur and professional, is a problem that will remain with us. Athletes will use the drugs that are considered recreational by the general population as well as some that may help them in their individual sport. Team physicians, coaches, and trainers must be aware of the most frequently used and abused drugs, their side effects, interactions, and emergency management. In addition, they must be aware of their athletes who have a drug-related problem in order to advise them and get appropriate medical help. Remember that an athlete may have a significant drug problem yet continue to function well on the team. Early recognition and intervention may save one or many lives. The following are the responsibilities for coach, trainer, and team physician: (1) know what drugs athletes use and their pharmacology; (2) know one's limitations and how to access community resources; (3) know the laws related to drug/ETOH abuse and treatment; (4) understand the management of acute drug ingestion; and (5) know how to be supportive to the athletes.

Tagamet-induced acute dystonia.

A 20-year-old woman presented with an apparent acute dystonic reaction after only five doses of cimetidine (Tagamet). The patient was on no other medications with the exception of oral contraceptives. Emergency administration of IV diphenhydramine HCL brought rapid reversal of this acute dystonic reaction without any neurological sequelae. To our knowledge, this is the first reported case of an acute dystonic reaction associated with cimetidine.

Emergency department management of the intoxicated adolescent.

It is widely recognized that many young people will have experiences with alcohol and with psychoactive recreational drugs before emerging from the adolescent years. It is estimated that before leaving ninth grade, one half of the total student population will have had experience with alcohol, and approximately one third with marijuana. Cocaine also is more available to adolescents. For these reasons, the emergency physician is more likely to see teenage patients for drug-related problems.

Intracytoplasmic membrane structures in Vibrio marinus.

An electron microscope study of Vibrio marinus strains MP-1, an obligate psychrophile, and PS-207, a moderate psychrophile, revealed numerous intracellular membranous structures. The structures were found to occur more frequently in V. marinus strain MP-1 than in strain PS-207. The frequency of occurrence and complexity of structure were related to age of the culture. In early logarithmic phase, cells revealed invaginations of the plasma membrane. More complex membrane forms, found in late logarithmic and stationary phase, were either myelin-like sheaths, for which the term "myelemma" is proposed, or membranes randomly arranged throughout the cells. The complex membrane forms were not observed to be directly connected with the plasma membrane. However, they were often found in approximation to the plasma membrane or associated with vacuoles and circular membrane profiles. Individual membranes were of a tripartite structure and of dimensions similar to the cell wall and plasma membrane.

Morphology and round body fermation in Vibrio marinus.

The morphology of Vibrio marinus MP-1 was studied by phase and electron microscopy. The ultrastructure of the vibrio form of V. marinus was found to be typically gram-negative with a trilaminar plasma membrane and cell wall. The coccoid or round bodies noted in otherwise pure cultures of V. marinus were frequently found in early and late stationary phase of growth. The round bodies in ultrathin section were found to contain at least one, and often three or four, cell units. Three types of round bodies were observed in ultrathin section, each differing in size and behavior: "spherules," "spheres" or the "round body," and "giant cells" or "macrospheres." The round bodies appeared to be associated with, or to result from, the constrictive cell division of V. marinus.