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Biomedical subjects

J Richens

Publications and source records attributed to J Richens.

At least 37 records · Page 2Linked to original sources
PubMed1991

Management of bowel perforation in typhoid fever.

The best survival rates after ileal perforation in typhoid fever are to be found in patients undergoing operation within 24 h. Conservative management of typhoid perforation, which was widely advocated after the introduction of chloramphenicol, appears to be associated with a substantially increased mortality compared to surgery, although randomized comparisons have never been conducted. Clinical, radiological and ultrasound examination assist in the diagnosis of perforation. After vigorous resuscitation, simple surgical closure of the perforation and abdominal irrigation will suffice for most cases. Antibiotics effective against S. typhi, coliforms and anaerobes are required.

Adult↗
PubMed1991

The diagnosis and management of common forms of arthritis in adults in Papua New Guinea.

Reactive arthritis is the leading cause of arthritis in Papua New Guinea, followed probably by gonococcal arthritis. Indomethacin and local hydrocortisone acetate are useful in the treatment of reactive arthritis. Refractory cases of reactive arthritis may be helped by weekly low-dose oral methotrexate or by long courses of doxycycline. When Neisseria gonorrhoeae is thought to be involved treatment should cover penicillinase-producing strains. Infective arthritis due to Staphylococcus aureus and Mycobacterium tuberculosis is less common but should be considered in all patients because prompt and specific treatment is required to avoid permanent damage.

Anti-Inflammatory Agents↗
PubMed1990

Pyoderma gangrenosum in Papua New Guinea.

A severe case of pyoderma gangrenosum in a Papua New Guinean girl aged 11 years in reported. Multiple lesions of the arms, legs, buttocks and mouth were present. There was no associated disease. She was treated with very high doses of prednisolone and slow resolution over 3 months in hospital was observed.

Acute Disease↗
PubMed1990

Fatal post-splenectomy sepsis in a Papua New Guinean highlander.

A fatal case of overwhelming post-splenectomy sepsis (OPSS) occurring 5 years after splenectomy for trauma in a Papua New Guinean highlander is presented. The diagnosis of pneumococcal infection was made from a peripheral blood smear. The finding of OPSS in Papua New Guinea is cited as additional evidence in favour of a policy of conservative management, where possible, of ruptured spleen.

Adult↗
PubMed1990

Hepatitis B surface antigen, e antigen and HBV DNA in healthy antenatal patients attending Goroka Hospital and their relationship to tattooing practices.

The prevalence of hepatitis B surface antigen (HBsAg) in women attending the antenatal clinic at Goroka Hospital was 14%. 32% of those positive for HBsAg also had hepatitis B e antigen (HBeAg), indicative of an infectious state. The mean HBV DNA level in HBeAg-positive women was 1800 pg/ml. These results suggest that vertical transmission of hepatitis B virus may be of importance in Papua New Guinea. Tattooing is common in this population: 91% of women in the study had tattoos. Methods employed in tattooing are a potential health risk but in a community which is now exposed to hepatitis B virus early in life tattooing practices are not important in the transmission of hepatitis B infection.

Adolescent↗
PubMed1989

Campylobacter pylori in patients undergoing gastroscopy at Goroka Base Hospital.

Biopsy specimens were taken from intact areas of antral mucosa in 53 consecutive highlanders presenting for gastroscopy. Spiral or curved bacilli were demonstrated in 31 patients (58%). Campylobacter pylori was cultured from 17 patients (32%). The bacteria were present in 16 (76%) of the 21 patients with gastric ulcer. Histological studies carried out in 25 patients showed gastritis in 21 (84%) and the bacteria were present in all 8 cases of active chronic gastritis and in 5 of 13 cases (38%) of chronic gastritis. These results suggest that infection may play an important role in the aetiology of gastritis and gastric ulcer in Papua New Guinea.

Adult↗