PubMed Health⌕ Search

Biomedical subjects

D Pudifin

Publications and source records attributed to D Pudifin.

7 recordsLinked to original sources

The association of antiphospholipid antibodies with severe early-onset pre-eclampsia.

OBJECTIVE: To confirm the association of antiphospholipid antibodies with early onset of severe pre-eclampsia before 30 weeks' gestation. STUDY DESIGN: Thirty-four patients with diastolic blood pressure levels > or = 110 mmHg and at least 2+ proteinuria before the 30th week of pregnancy were randomly chosen for inclusion in the study. Blood samples were taken for assessment of anticardiolipin antibodies (ACAs), lupus anticoagulant, syphilitic serology and antinuclear antibodies. Fifteen normal antenatal patients matched for age, parity and gestational age acted as control subjects. RESULTS: Four of the 34 women (11.7%) in the study group had elevated levels of both ACAs and lupus anticoagulant, compared with none in the control group. This was not found to be statistically different. CONCLUSION: Given the low incidence of positive ACAs in early-onset severe pre-eclampsia it is unlikely that they are implicated in its pathogenesis. It is possible that they represent a small subset of patients with alternative or combined pathology.

Adult↗

Characteristics and management of chronic destructive pneumonia.

In 12 years 627 patients presented to Wentworth Hospital, Natal with chronic destructive pneumonia (CDP). Common symptoms were haemoptysis, the production of foul-smelling sputum, and chest pain. The disease pursued a chronic course with acute exacerbations which may be lethal. The majority of patients were African men aged between 20 and 50 years who were free from other significant disease apart from dental infection. Radiographically and pathologically CDP had the characteristics of a necrotising pneumonia, and microbiological investigation showed mixed aerobic and anaerobic flora in the lower respiratory tract. Gram-positive aerobic cocci and Bacteroides species were the predominant organisms. In 120 patients treatment regimens were based on chloramphenicol, in 429 cephalosporins, and in 78 on combination therapy with cephalosporins, penicillin, and metronidazole. One hundred and seventy patients also required operative management in an attempt to control progress of the disease. The overall inpatient mortality rate from CDP was 7.8%. In the group of patients treated with combination therapy the mortality rate was 1.3%.

Adult↗

Systemic lupus erythematosus in Black and Indian patients in Natal.

Seventeen Indian and 13 Black patients were studied. From hospital admission data, systemic lupus erythematosus (SLE) appeared to be more common in Indians than in Blacks in Natal. Renal biopsy specimens were taken from 27 patients and histological examination showed renal changes to be present in 26 patients. The high incidence of renal involvement may be due to the patients presenting at a late stage. Histological examination revealed severe renal changes which correlated with albuminuria, low serum complement and raised blood urea values. Tuberculosis is still a very common disease in Blacks and various matters arose in this connection: (a) the development of tuberculosis as a complication of corticosteroid therapy in an unduly high number (3/30) of our patients suggests that routine isoniazid (INH) prophylaxis is warranted, particularly if the tuberculin skin test is positive, (b) patients presenting with serositis are usually considered to have tuberculosis; the diagnosis of SLE is therefore sometimes initially overlooked, and (c) despite the very widespread use of INH in Blacks, we encountered no case of drug-induced lupus erythematosus.

Adolescent↗

Total electrical alternans in a patient with tuberculous pericarditis.

Total electrical alternans is an uncommon electrocardiographic abnormality in which alternation in the direction and/or amplitude of all the components (P, QRS and T) of the tracing is present. The phenomenon is seen only in association with occasional cases of pericaditis with large effusion's. Knowledge of this fact may help in the often difficult differentiation between a pericardial effusion and cardiomyopathy. An illustrative case report is presented, with a résumé of the mechanisms postulated to explain total electrical alternans.

Adult↗

Severe hemolytic anemia in an adult associated with anti-T.

An adult woman hospitalized because of a stab wound suffered a severe hemolytic crisis during which she was found to be profoundly anemic. There was evidence of increased red blood cell fragility and extravascular hemolysis. Her cells, which were T-activated, were agglutinated spontaneously in vitro by anti-T in her own plasma. They were also agglutinated by some, but not all, human anti-M and anti-N sera, and were mildly aggregated by protamine sulphate. A normal amount of H antigen was present and no agglutination occurred in saline by incomplete Rh antibodies. The findings indicate that T-activation was incomplete. It is suggested that the patient experienced a short episode of acquired autohemolytic anemia caused by the activity of her own anti-T during a period when her normal enzyme-inhibiting substances were either not present or had been rendered temporarily inactive.

Adult↗