South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Accidental hypothermia has a mortality rate of 30-80% and should always be borne in mind with comatose, hypotensive patients. It is a preventable condition when adequate safety measures are ensured. ⋯ Resuscitation should be continued until the patient is warm and all biochemical abnormalities have been corrected and intoxication has been ruled out. Resuscitation may be successful in primitive, adverse conditions, as illustrated by this case of a 13-year-old boy with cardiopulmonary arrest and a core temperature of only 25 degrees C, who was successfully reanimated.
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Comparative Study
Distribution and biosocial correlations of blood pressure levels in Johannesburg blacks.
Blood pressures were measured in a sample of Johannesburg Blacks consisting of 5 018 men and 5 028 women attending the local Labour Bureau. Blood pressure levels correlated positively with age and body mass and were higher in males than females when weight was taken into account. ⋯ Correlations of blood pressure with a number of social variables were generally unimpressive. There was some evidence that blood pressure was inversely related to educational status and was higher in young adults who (a) lived apart from their families compared with those who lived in family units, and (b) grew up in a rural area and then migrated to Johannesburg compared with those who had lived in Johannesburg all their lives.
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The long-term anti-arrhythmic efficacy of lorcainide (R15 889) was studied in 20 ambulatory postmyocardial infarction patients. Lorcainide reduced the frequency of ventricular ectopic beats by more than 70% and 90% in 17 and 11 of the patients respectively. ⋯ On electrocardiographic examination, the P-R interval, QTc interval and QRS duration were prolonged, and T-wave changes were noted while the patients were receiving lorcainide. Lorcainide seems to be a useful addition to the available anti-arrhythmic agents, and should form part of the armamentarium against ventricular ectopic activity.
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Psychogenic cough tic is a troublesome complaint. The cough is a noisy bark or honking, repeated frequently while the child is awake, but absent during sleep. Clinical and laboratory findings are negative, and cough suppressants and other medications are ineffective. ⋯ School phobia is frequently a contributory cause, but other psychological problems must also be considered. Treatment is usually by suggestion and identification of the underlying psychological problem. In some cases tranquillizers may be required.
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The toxicity of ferrous sulphate is discussed, with particular reference to fibrosis and stricturing of the stomach. This does not occur in every case, but occasionally, in spite of adequate treatment, ferrous sulphate produces local damage similar to that caused by acid. ⋯ Gastrectomy is often necessary when severe scarring and fibrosis have resulted in damage to the stomach. The need for long-term follow-up of these patients is an important aspect of treatment.