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Biomedical subjects

C J Porter

Publications and source records attributed to C J Porter.

113 records · Page 7Linked to original sources
PubMedDate not supplied

Role of amiodarone in the treatment of fetal supraventricular tachyarrhythmias and hydrops fetalis.

We report three consecutive hydropic fetuses with fetal tachyarrhythmias treated with amiodarone-two in combination with digoxin and one with digoxin, procainamide, and propranolol. Sinus rhythm was achieved in one case and ventricular rate control was achieved in two cases. All fetuses treated with amiodarone gradually improved. Observed side effects of amiodarone were a maternal rash in one mother and transient neonatal hypothyroidism in one infant. We conclude that amiodarone might be effective and safe for fetal tachyarrhythmias and impending hydrops. The small number of patients suggests that a multicenter cooperative approach is required in order to determine if this is correct.

Amiodarone↗
PubMedDate not supplied

Acquired QT prolongation associated with esophagitis and acute weight loss: how to evaluate a prolonged QT interval.

When the physician is confronted with a patient having significant QT prolongation, it is critical to determine whether the patient harbors a genetic defect and a transmissible form of long QT syndrome (LQTS) or whether the QT prolongation has an acquired cause. The distinction has profound ramifications for the type of care provided to the patient and family. We report the case of a previously healthy 14-year-old boy who presented with a 10-day history of painful swallowing, a 10-lb weight loss, and chest pain. A 12-lead electrocardiogram (ECG) showed marked QT prolongation. Endoscopy and culture identified a Herpes simplex esophageal ulcer. After treatment with acyclovir, the patient recovered completely. Three weeks after the resolution of his symptoms and recovery from his acute weight loss, a follow-up ECG showed complete normalization of the QT interval. This case illustrates yet another potential mechanism for acquired QT prolongation. We also provide a diagnostic algorithm for the careful evaluation of a prolonged QT interval.

Acyclovir↗
PubMedDate not supplied

Use of local anaesthetic agents among New Zealand plastic surgeons--their practices and philosophies.

PURPOSE: Skin lesions are treated by a variety of medical practitioners. To describe the method and techniques of use of local anaesthetic (LA) for excision of skin lesions amongst a group of surgeons who are frequent users. METHODS: An open-ended questionnaire was designed to investigate the way LA was used for local excision and reasons behind the practice. All registered Plastic and Reconstructive Surgeons in New Zealand were sent the questionnaire. This group was chosen because they are high frequency users of local anaesthetic for excision of skin lesions. RESULTS: Questionnaires were sent to all 28 Plastic and Reconstructive Surgeons in New Zealand of which twenty-three (82%) responded. The reasons for selection of specific products relate to convenience of product (14), speed of onset (6), effect duration (4), ease to add bicarbonate (3), others (5). Lignocaine and bupivicaine were the most popular LA agent used except when there was concern about cardiac toxicity when Prilocaine was used instead. Adrenaline was used for vasoconstriction induced haemostasis, and avoided in anatomical areas with end arteries due to the risk of tissue ischaemia. This complication was identified as medicolegally indefensible despite a lack of scientific evidence in the literature. The techniques used to reduce patient discomfort of local anaesthetic infiltration relate to patient oriented techniques (15), injection related techniques (25), LA agent related techniques (19). Details of these specific techniques are presented in detail. CONCLUSIONS: LA uses vary according to the specific surgical situation, patient risk factors and according to the individual surgeon. The main reason for selection of a specific LA agent relates to convenience and not pharmacokinetics. Injection related techniques are the most common method to reduce pain from LA.

Anesthesia, Local↗