Transection of the oesophagus for bleeding oesophageal varices.
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Blood Transfusion↗
Biomedical subjects
R N Pugh
Publications and source records attributed to R N Pugh.
Treatment of bleeding oesophageal varices by infusion of vasopressin into the superior mesenteric artery.
Seventeen patients bleeding from oesophageal varices were treated by continuous infusion of vasopressin through a catheter inserted percutaneously and positioned in the superior mesenteric artery and in two other patients catheterization proved technically impossible. Bleeding was completely controlled on only four out of 18 occasions in the 17 patients treated. In seven patients, bleeding was controlled for two or more days but then recurred although the infusion was continued with an increased dose of vasopressin. There was a high incidence of complications, including bleeding from the site of catheter insertion in the groin and septicaemias. Sengstaken balloon tamponade and oesophageal transection had to be used to control bleeding in some patients but only six out of 17 survived to leave hospital.
Adult↗
Combined praziquantel-oxamniquine treatment of schistosomiasis: synergy in low dosage.
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Drug Administration Schedule↗
Varicella infection and pneumonia among adults.
OBJECTIVES: To demonstrate the clinical importance of adult chickenpox in terms of morbidity, mortality, and impact on hospital services, in Al Ain, United Arab Emirates. METHODS: A review was conducted of 607 consecutive hospitalized cases of adult chickenpox (1985-1996, Al Ain Hospital) for clinical findings and risk of developing varicella pneumonia. RESULTS: Leading clinical features were fever (98.9%), myalgia (26.9%), cough (24.6%), headache (15.4%), pharyngitis (14.7%), and profuse rash (12.2%). There were 26 cases of varicella pneumonia, of whom three died with respiratory failure (hospital case fatality 0.5%). Multivariate analysis (odds ratios in parenthesis) showed that cough (12.1), profuse rash (4.5), fever for more than 1 week (3.9), and age over 34 years (2.3) were the most significant predictors of pneumonia. CONCLUSIONS: Early aggressive therapy with intravenous acyclovir is recommended in patients at risk of pneumonia. In the community setting, there is a large proportion of adult immigrants (especially from South Asia) who are seronegative and at risk of complications and hospitalization. It is recommended that the varicella vaccine be offered to new immigrants after screening, to benefit themselves and the nonexposed community, and to reduce the economic burden of chickenpox on the health services and employers.
Acyclovir↗