Near-fatal asphyxiation in sawdust--an unusual tracheobronchial foreign body.
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Accidents, Occupational↗
Biomedical subjects
A G Linegar
Publications and source records attributed to A G Linegar.
Re-use of single-use disposable instrumentation.
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Cost Control↗
Surgical management of airway obstruction in primary tuberculosis in children.
BACKGROUND: The role of surgery in the management of airway obstruction from lymphobronchial tuberculosis is discussed in the present article. METHODS: Nine patients were operated on over a 4-year period and are currently presented. The age of the patients ranged between 5 and 28 months and 7 patients were male. Six patients required preoperative ventilation due to respiratory failure and all received standard posterolateral thoracotomies. Partial dissection and enucleation of bulky lymph nodes was performed in all but 1 patient. In that patient, the group of lymph nodes could be removed fully, including the sheath. RESULTS: All patients showed marked improvement and were weaned off the ventilator between 24 and 72 hours postoperatively. Long term follow-up was available in 7 patients and they are all doing well and are free of symptoms. CONCLUSIONS: Enucleation of mediastinal lymph nodes obstructing the airways in young patients with lymphobronchial tuberculosis is safe. It successfully relieves obstruction and is devoid of complication providing that incision, evacuation, and curettage of lymph nodes is performed avoiding overzealous dissection.
Airway Obstruction↗
Massive thymic hyperplasia.
Massive thymic hyperplasia is an extremely rare form of true thymic hyperplasia most often described in infants and children. Hyperplasia of this order is not known to occur in any other organ, and its etiology and prognostic significance remain unknown. As there is no accurate way of preoperatively differentiating massive thymic hyperplasia from other tumors of the thymus and anterior mediastinum, we advise excision in all cases for histological analysis and relief of mediastinal compression. This description of 4 cases updates the 30 previously reported cases, and includes a literature review.
Child, Preschool↗
Tracheobronchial foreign bodies. Experience at Red Cross Children's Hospital, 1985-1990.
Ninety-six children with suspected tracheobronchial foreign bodies were referred to the Department of Cardiothoracic Surgery at Red Cross War Memorial Children's Hospital, Cape Town, between February 1985 and February 1990. Foreign bodies were removed by rigid bronchoscopy from 63 patients, 79% of whom were under 5 years of age. The majority of patients (59%) presented more than 24 hours after aspiration of the foreign body, and this delay in definitive management was associated with an increased incidence of complications (P = 0.01). Complications occurred in 28 patients, and there was one fatality at bronchoscopy due to overwhelming aspiration of an unanticipated release of pus, following the removal of a chronically impacted foreign body. The complete classic diagnostic triad (sudden onset of coughing, wheezing and decreased air entry) was seldom present, and we recommend diagnostic bronchoscopy in children presenting with either a history of sudden choking or a witnessed aspiration of a foreign body, an unexplained acute wheeze or cough or a chronic pulmonary infection. This report also highlights the continued need for increased awareness on the part of both parents and medical practitioners of the need for early referral if a foreign body is suspected. Furthermore, public education is needed as regards the dangers of allowing young children to eat peanuts. Peanuts were the commonest foreign bodies removed.
Bronchi↗
Accuracy of a portable haemoglobinometer in clinical practice.
The haemoglobin (Hb) levels of 100 blood samples submitted to the haematology laboratory of Groote Schuur Hospital were estimated by 3 clinical observers using the Buffalo Medical Specialties (BMS) portable haemoglobinometer. The average error was between 5% and 6% of the laboratory Hb value (0.6 g/dl). It is concluded that the BMS machine, besides being easy to use and giving a rapid result, is also sufficiently accurate for clinical practice.
Evaluation Studies as Topic↗
A triage system for stab wounds to the chest.
In a study of 200 patients with chest wounds in whom the need for referral to a centre with radiographic facilities was not obvious, careful clinical examination (pulse, blood pressure, respiratory rate, haemoglobin value and chest auscultation) was found to be a reliable triage tool. The sensitivity of one or more positive signs was 99.2% with a false-positive rate of 16% and a false-negative rate of 2%. The positive predictive value of two or more positive signs was found to be 99.1%.
Emergency Medical Services↗