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Biomedical subjects

A Trevett

Publications and source records attributed to A Trevett.

11 recordsLinked to original sources
PubMed1994

Neurotoxicity and haemostatic disturbances in patients envenomed by the Papuan black snake (Pseudechis papuanus).

Among 335 patients presenting with snakebites in Central Province, Papua New Guinea, nine were proved by enzyme immunoassay to have been bitten by Papuan black snakes (Pseudechis papuanus). Seven showed clinical evidence of envenoming. Early symptoms included vomiting and tender local lymph nodes. Five patients had neurotoxic signs and one required mechanical ventilation. Spontaneous systemic bleeding occurred in two patients. Coagulation studies in four patients showed thrombocytopenia, prolongation of prothrombin time, mild defibrination and depletion of other clotting factors with elevated fibrin(ogen) degradation products and other evidence of fibrinolysis. One patient developed mild renal dysfunction. There was no evidence of intravascular haemolysis or rhabdomyolysis. These clinical observations, which do not distinguish victims of P. papuanus from those of taipans (Oxyuranus scutellatus canni), suggest that the venom contains neurotoxic, haemorrhagic and mild procoagulant activities. Only two other cases of proven envenoming by this species have been reported. There appears to have been a decline in the abundance of this species, and hence its medical importance, over the last 25 years.

Adolescent↗
PubMed1994

Cryptococcal meningitis in children in Papua New Guinea: a reminder.

Two young males from Central Province were referred to Port Moresby General Hospital with chronic headaches. In each case the initial impression of tuberculous meningitis needed revision in the light of strongly positive cryptococcal serology. Cryptococcal meningitis occurs with sufficient frequency in Papua New Guinea that it should be considered in cases of raised intracranial pressure, ataxia, cranial neuropathy and visual disturbances. Delay in treatment may be disastrous. In contrast to the developed world where fungal meningitides show a predilection for the immunosuppressed, the experience to date in Papua New Guinea is that the majority of cases in both adults and children occur in ostensibly immunocompetent individuals. The epidemiology, clinical course and current treatment of this potentially curable disease are discussed.

Amphotericin B↗
PubMed1992

Altitude sickness.

Explore the source record for details and available documents.

Altitude Sickness↗
PubMed1992

A new look at an old drug: artemesinin and qinghaosu.

It is said that William Withering's discovery of digitalis arose out of curiosity engendered during a stage-coach journey, by witnessing an old woman collecting foxgloves by the side of the road. Whilst we are not aware of an analogous stroke of genius reported from ancient China, the story of qinghaosu has certain parallels. Just as foxgloves had been used traditionally for centuries to treat 'afflictions of the heart', the plant Artemesia annua has been used as a treatment for fever in China for almost two thousand years. Artemesia annua, also known as 'sweet wormwood', is found in many parts of the world, but it was not until the early 1970s that Chinese scientists recognized its potential for treating malaria and isolated the active principle, artemesinin or qinghaosu. This paper describes the evidence for the efficacy of this drug and some of its derivatives in the treatment of malaria and the potential of these drugs for the standard management of malaria in Papua New Guinea and elsewhere.

Antimalarials↗
PubMed1988

Secondary lens implantation: incidence, indications and complications.

A retrospective study of 79 secondary intraocular lens implants performed during 1984-87 in a large teaching hospital is reported. The period of follow-up ranged from 6 months to 3.9 years (mean 16.6 months). The principal indication for surgery was contact lens intolerance. Thirty-four per cent of the patients had previously undergone cataract surgery with implantation of the other eye. Eighty-three per cent of the patients achieved a visual acuity within one Snellen line of best-corrected preoperative visual acuity. A further 2.5% lost two lines of Snellen chart acuity, and 14.5% had a substantial reduction in visual acuity. We conclude that in carefully selected patients secondary intraocular lens implantation is an acceptable and often highly successful way of treating monocular aphakia and we discuss the selection and preoperative investigation of such patients.

Adolescent↗