Biomedical subjects
Publications and source records attributed to D Davies.
During a 5-year period, 1970 to 1974, a total of 2 118 new patients were admitted to the Burns Unit of the Red Cross War Memorial Children's Hospital in Cape Town. There were 35 deaths. The main complications and causes of death in these 35 patients are critically analysed and standard management methods are reviewed to highlight mistakes in the management of burns.
Five patients with progressive fibrotic lung disease are described. The dominant symptom was slowly increasing dyspnoea, and cough and sputum were not prominent. Marked weight loss was also a feature. There was severe restrictive impairment of ventilation with normal arterial gas tensions. The changes were confined to the upper parts of the lung in some but others had more generalized disease. The duration has varied so far from two to 17 years. The lung changes are considered to be due to dense progressive fibrosis. Necropsy in two confirmed this. Histologically there was monotonous fibrosis with lymphoid collections and secondary bronchiectasis, a picture similar to that found in association with ankylosing spondylitis. None of these patients had joint disease. Tuberculosis was excluded as a cause by exhaustive bacteriological tests and the failure of chemotherapy to stop deterioration. All other recognized types of infective and non-infective progressive lung fibrosis were also excluded, and this is not considered to be a variant of cryptogenic fibrosing alveolitis. Though these patients have many features in common they do not necessarily have the same pathogenesis. They are presented as an encouragement to further study.
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The Industrial Injuries Advisory Council has reaffirmed the view that simple pneumoconiosis does not produce disability or shorten life. This is often true but, without overlooking the importance of chronic bronchitis, such conclusions are wrong in many instances.Chronic bronchitis is probably commoner in miners without pneumoconiosis than in those with it, and an uneven distribution of bronchitis may mask the effects of pneumoconiosis. Cough and sputum in a miner with pneumoconiosis are not always due to chronic bronchitis. Disability is usually judged on measurement of vital capacity and forced expiratory volume, factors which cannot be expected to be significantly altered by simple pneumoconiosis alone. Other tests may show abnormalities which lead to ventilation and perfusion inequalities and to an increase in the ventilatory cost of exercise. Focal emphysema, often a consequence of simple pneumoconiosis, develops slowly and its influence on disability is delayed.Disagreements arise because epidemiologists expect all lungs with simple pneumoconiosis react in the same way, and they want a quantitative relation between simple pneumoconiosis and emphysema before attributing one to the other.There are major difficulties in assessing disability but there is little justification for the regular application of the rule that if the results of ventilatory tests are normal disability is not present and if they are abnormal this is due to something other than simple pneumoconiosis.
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A woman with ulcerative colitis was treated with sulphasalazine and prednisolone. After four months' treatment she began to get short of breath and she died a month later with severe subacute fibrosing alveolitis. It is believed that the lung disease was caused by sulphasalazine and that prednisolone was not able to prevent its development. A reversible form of lung disease has previously been attributed to this drug.
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The characteristics of seismic waves detected at the Large Aperture Seismic Array in Montana suggest that, beneath the Bonin Island Arc in particular, there are lateral inhomogeneities in the mantle.