Browsing by Author "King, J. B."
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- ItemAetiology of pulmonary dysfunction in total hip replacement operations: The influence of nifedipine on the factors involved(Health & Medical Publishing Group, 1987-05) Du Toit, H. J.; Macfarlane, C. M.; Taljaard, J. J. F.; King, J. B.; Cooper, R. C.ENGLISH ABSTRACT: Patients undergoing total hip replacement surgery who developed pulmonary dysfunction (PD) demonstrated evidence of a complement activation and increased thromboxane A2 (TXA2) synthesis. In a double-blind study nifedipine (Adalat; Bayer-Miles) was shown to inhibit complement activation and TXA2 synthesis and thus appears to offer protection against PD.
- ItemHodgkin's disease and acute promyelocytic leukaemia : a case report(Health & Medical Publishing Group, 1980) Rosenstrauch, W. J. C. J.; Van der Merwe, A. M.; King, J. B.A case of Hodgkin's disease is reported in which acute promyelocytic leukaemia developed within 5 months of initiation of chemotherapy. Only 3 other cases, possibly of a similar nature, were found in the literature; these had occurred 15, 77, and 226 months respectively after the initial diagnosis of Hodgkin's disease.
- ItemMethylprednisolone and the adult respiratory distress syndrome(Open access journal, 1984-06) Du Toit, H. J.; Erasmus, F. R.; MacFarlane, C. M.; Taljaard, J. J. F.; King, J. B.; De Klerk, A. J.; Elk, E.Total hip replacement was carried out on 22 patients under general anaesthesia. Of these, 10 were pretreated with methylprednisolone (30 mg/kg); 1 of these developed the adult respiratory distress syndrome (ARDS) and had high levels of thromboxane B2 (TXB2) 5 minutes after fixation of the femoral prosthesis and at the end of the operation. The other 12 patients served as controls; 5 of them developed ARDS and had statistically significant higher TXB2 levels than the other 7 control patients who remained well. All patients who did not develop ARDS had low TXB2 levels. TXB2 and β-thromboglobulin levels followed the same trend and there was good correlation (r = 0.6806; P < 0.01) at the end of the operation in the control group patients who developed ARDS. There was no statistical difference in 6-keto-PGF(1α) levels between the patients who developed ARDS and those in the control group who remained well. Steroids reduce arachidonic acid metabolism by inhibiting the release of substrate for cyclo-oxygenase and lipoxygenase activity. Patients prone to ARDS thus benefit from methylprednisolone administration.
- ItemA nosocomial outbreak of Crimean-Congo haemorrhagic fever at Tygerberg Hospital. Part III. Clinical pathology and pathogenesis(Health & Medical Publishing Group, 1985) Joubert, J. R.; King, J. B.; Rossouw, D. J.; Cooper, R.Crimean-Congo haemorrhagic fever (CCHF) was diagnosed in 8 patients; 7 were staff members at Tygerberg Hospital who had been infected by a patient in whom the disease had not initially been diagnosed. Two patients, the initial case and a staff member, died and 4 became seriously ill. The immunopathogenesis of CCHF appears to be multifactorial. Certain features were common to all patients - leucopenia, thrombocytopenia, elevated liver enzyme values and low serum total protein levels. Ultrastrucutral changes in and around skin capillaries, including intracytoplasmic endothelial tuboreticulated bodies, were found. Virus-like particles were found on electron microscopy. Important individual factors related to prognosis were identified. The patients who survived all mounted a good antibody response, and manifested no coagulation defect extensive enough to explain the haemorrhagic tendency. In the patients who died no evidence of antibody production was detected; both developed diffuse intravascular coagulation and in 1 evidence of immune complex formation and complement consumption was found. Hepatorenal failure and cardiovascular collapse characterized the terminal period. Early clinical recognition of CCHF with specific attention to factors amenable to treatment may vastly improve the prognosis.
- ItemA nosocomial outbreak of Crimean-Congo haemorrhagic fever at Tygerberg Hospital. Part IV. Preventive and prophylactic measures(Health & Medical Publishing Group, 1985) Van de Wal, B. W.; Joubert, J. R.; Van Eeden, P. J.; King, J. B.During the Crimean-Congo haemorrhagic fever (CCHF) outbreak at Tygerberg Hospital a particular problem existed: a simultaneous influenza epidemic complicated the screening of contacts because of its very similar clinical picture to that of early CCHF. The methods of identifying and screening contacts are described. Of 459 listed CCHF contacts, 7 (1.5%) developed the disease; 6 were contacts of the index case and only 1 a contact of a secondary case. Two of the 7 CCHF patients had no direct contact with the index case; this caused a great concern about the dissemination, despite the otherwise full protective measures. Four of 46 blood contacts (8.7%) and 3 of 9 needle contacts (33%) developed the disease. Prophylactic interferon therapy had to be discontinued because of side-effects mimicking the symptoms of CCHF. Ribavirin was used prophylactically in 6 of the 9 inoculation contacts. One of the patients on ribavirin had a mild clinical course while 5 others who received the drug developed neither clinical CCHF nor antibodies to the virus. Two of the 3 needle contacts not treated with ribavirin had a severe clinical course. One contact with needle inoculation and 42 proven blood contacts who had not received ribavirin did not become infected. No firm conclusion can therefore be made about the protective value of prophylactic ribavirin.
- ItemSevere rhesus iso-immunization successfully treated with apheresis and azathioprine : report of 2 cases(Health & Medical Publishing Group, 1986) Odendaal, H. J.; King, J. B.; Oosthuizen, O. J.Two patients are described in whom previous fetal loss had occurred due to rhesus (Rh) disease. In both patients apheresis was performed from a gestational age of 25 weeks in an attempt to remove excessive antibodies. In addition, production of new antibodies was suppressed by the administration of prednisone and azathioprine. A reduction in the antibody titres was accomplished although this was not reflected by a marked decrease in amniotic fluid bilirubin levels. The patients were delivered at gestational ages of 32 and 33 weeks since fetal lung maturity had then been demonstrated. Both babies were surprisingly little affected by the Rh disease and only one exchange transfusion was necessary for each. Neonatal follow-up for 2 years and 1 year respectively revealed no fetal abnormalities.
- ItemSevere staphylococcal infection with pneumonia treated by plasmapheresis and plasma exchange. A preliminary report(Health and Medical Publishing Group -- HMPG, 1980-11) King, J. B.; De Vaal, J. B.Three cases of extremely severe staphylococcal infection are reported. All 3 patients were treated by plasmapheresis and fresh plasma or fresh-frozen plasma replacement, and all made a steady recovery. In all 3 cases blood culture for Staphylococcus aureus was positive, 1 patient had osteitis, and 1 signs of spinal cord compression by an infectious process (an abscess). It is thought that the above-mentioned procedures may offer a useful additional line of therapy for desperately ill patients with staphylococcus infections.