British medical journal
-
Secondary drowning (and near-drowning) is one of the post-immersion respiratory syndromes. It is defined as deterioration of pulmonary function that follows deficient gas exchange due to loss or inactivation of surfactant. A review of 94 consecutive cases of near-drowning in childhood showed that this syndrome occurred in five (5%) cases. ⋯ It occurred more rapidly after immersion in fresh water. The two children immersed in salt water died of secondary drowning, while the three immersed in fresh water recovered completely. If it is anticipated, recognised, and treated vigorously prognosis of secondary drowning is good in fresh water cases but bad after salt water immersion.
-
British medical journal · Feb 1980
Case ReportsDecompression of malignant biliary obstruction by duodenoscopic intubation of bile duct.
Interest is increasing in non-operative methods of relieving malignant obstruction of the bile duct, and drainage tubes and prostheses may be placed in the bile duct via the percutaneous transhepatic route. Two cases are described, however, in which a duodenoscope was used and the approach was via the papilla of Vater. ⋯ This endoscopic approach is less invasive and should be safer than that by the transhepatic route; furthermore, removing and replacing a blocked endoprosthesis should be easier. Further study is needed, as the procedure is technically more difficult and its role in managing biliary strictures has yet to be defined.
-
In 12 consecutive unselected patients admitted to a consultant maternity unit one single injection of subarachnoid morphine sulphate 1.5 mg abolished pain during the first stage of labour. Pain in the second stage was abolished in four patients and lessened in three. During the early puerperium, pain at the site of the episitotomy was much reduced. ⋯ The high rate of forceps delivery and caesarean section (three cases of each) was not thought to be associated with the use of intrathecal morphine. These findings show that intrathecal morphine can abolish the pain of labour, whether spontaneous or induced, while preserving the mother's full awareness of labour and her co-operation in the second and third stages of labour. Further, controlled, trials are warranted.