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Biomedical subjects

C Campbell

Publications and source records attributed to C Campbell.

At least 361 records · Page 20Linked to original sources

Pneumothorax of late onset after chest stabbings.

Pneumothorax is a well known immediate complication of penetrating chest injuries, but its late occurrence is not widely recognized. In a retrospective study of 56 patients who sustained stab wounds of the chest, 6 (10 per cent) developed pneumothorax between twelve hours and three days after injury. Combined thoraco-abdominal stab wounds were present in three patients and surgical emphysema was also apparent in three other patients. We conclude that pneumothorax of late onset may be commoner than has been suspected and this emphasizes the need for observation in hospital for 48 h and for serial radiography of the erect chest to detect this dangerous complication.

Adolescent↗

An epidemic of gastroenteritis in Auckland 1978.

During an epidemic of gastroenteritis which spread throughout New Zealand in 1978, 372 cases of nonbacterial illness were documented in children in Auckland during the months of June and July. A brief account is given of the clinical picture observed. Evidence from virological techniques suggests that some if not all cases were due to rotavirus. The severity of illness may have been greater than most observers to date have noted. From our observations we raise the possibility of air-borne spread, perhaps in addition to faecal-oral. We wish to emphasise that drugs play no part in the treatment of viral gastroenteritis, that home-made electrolyte solutions can be hazardous and that early intravenous therapy can be life-saving.

Disease Outbreaks↗

The prosthetic (Teflon) central aortopulmonary shunt for cyanotic infants less than three weeks old: results and long-term follow-up.

The expanded microporous polytetrafluoroethylene (PTFE) 4 mm vascular prosthesis has been used to create a central aortopulmonary shunt in 20 critically ill infants less than 3 weeks old. The infants ranged from 1 to 18 days old (5.25 days), and from 1.5 to 4.0 kg (2.9 kg). Conduit length ranged from 2 to 6 cm (4 cm). Sixteen patients had atresia of the tricuspid or pulmonary valve. There were 6 early deaths (30%), only 1 of which was shunt related. The mean preoperative arterial oxygen saturation was 62% (range, 33 to 80%), and mean postoperative saturation was 87% (range, 78 to 90%). There were 5 late deaths, 1 probably caused by shunt failure. Nine long-term survivors have done well. Follow-up ranges from 1 to 36 months (18 months). Factors influencing conduit function are length, technical considerations, and pulmonary vascular resistance. Late restudy in 5 of 9 survivors confirms patency and demonstrates bidirectional pulmonary blood flow. Since PTFE shunt flow capability is fixed, the infant may require repair or a second shunt within 24 months of the initial procedure.

Aorta↗

Earlier operation for left-sided Pseudomonas endocarditis in drug addicts.

Three consecutive patients with Pseudomonas endocarditis were treated by early operation with no deaths. The indications for operation were severe failure, systemic embolization, and infection refractory to antibiotics. The organism is aggressive, characterized by early invasion of the myocardium. Wide débridement of the anulus is necessary to remove any vegetations or intramyocardial abscessed wall. Because multiple valve infection is common, it is important to evaluate all four cardiac valves at the time of operation. Removing a second rim of the mitral anulus for separate culture at the time of mitral valve replacement may demonstrate the degree to which the valve resection has removed all infection. Early operation is necessary for reinfection of the prosthetic valve; however, metastatic abscess should also be considered in the face of continued signs of infection postoperatively. Patients should receive a 6 week postoperative course of antibiotics which have been shown by in vitro testing to be serum bactericidal in at least a 1:8 dilution. The operative findings of invasion of the myocardium by the organism and the surgical success in this small series have resulted in our recommending earlier operation in patients with these indications.

Adult↗

Hepatitis B e antigen, DNA polymerase activity, and infection of household contacts with hepatitis B virus.

To determine if the presence of hepatitis B e antigen (HBeAg) and elevated DNA polymerase activity in the serum of chronic HBeAg carriers indicate increased contagiousness in a household setting, the household contacts of 74 carriers were prospectively evaluated for serologic evidence of hepatitis B infection. Thirty of the HBsAg carriers had HBeAg and 44 had anti-HBe. Twenty-eight HBeAg-positive carriers regularly demonstrated elevated DNA polymerase when serially drawn serum samples were analyzed. None of the anti-HBE-positive carriers demonstrated elevation of DNA polymerase activity. Both household contacts of HBeAg-positive and anti-HBe-positive carriers demonstrated serologic evidence of hepatitis B infection (HBsAg, anti-HBs, and anti-HBc). However, infection was significantly more frequent among spouses and sexual partners of carriers who had either HBeAg (P less than 0.001) or elevated DNA polymerase activity (P less than 0.001). Thus, the data indicate that a particular subpopulation of spouses and sexual partners of hepatitis B carriers are at significantly greater risk for acquiring infection.

Adult↗