Biomedical subjects
Publications and source records attributed to J C Stoddart.
The results of measurements made in two cases of tetanus suggest that the level of tetanus antibody in the blood cannot be used as a diagnostic test for the disease. The investigation also indicated that an attack of tetanus does not result in a rise in tetanus antitoxin antibody levels. This confirms the opinion that tetanus is not an immunising disease. In the cases described, the pseudocholinesterase level was not of diagnostic value.
Pseudotetanus is a syndrome which is produced by a variety of non-Clostridial factors. It is usually not difficult to distinguish from tetanus but is must always be considered in the differential diagnosis. Six cases are reported in which tetanus was considered and in one of them the full treatment for the disease was started. It is hoped that by increasing the awareness of clinicians of this relatively common problem the risk of making an incorrect disagnosis will be reduced.
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Two cases of haemolytic streptococcal septicaemia are reported, in one of which DIC was identified. The clinical presentation and the appearance of the patients is described.
After considering the indications for tracheotomy on his intensive care unit, the author describes the risks of this operation and the means of avoiding them. Out of 1940 patients admitted over a period of 5 years on the intensive care unit of the Royal Victoria Infirmary, Newcastle-on-Tyne, 175 were tracheotomised, inclusing 133 who were submitted to intermittent positive pressure ventilation. Only three patients had complications linked to the tracheotomy, complications which were the cause of the death of two of them.
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