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Biomedical subjects

E L Ong

Publications and source records attributed to E L Ong.

At least 19 recordsLinked to original sources
PubMed2002

Subdural block--from a spinal? A case report.

INTRODUCTION: Multicompartmental blocks are commonly described in epidurals but not spinals. We describe a case of subarachnoid block performed in an obese patient which resulted in a clinical presentation resembling that of a subdural block. CLINICAL PICTURE: A 29-year-old woman, scheduled for saucerisation of thigh carbuncle, was administered 2.1 mL of hyperbaric bupivacaine. The spinal resulted in a late onset of sensory block that extended to the neck and upper limbs. There was no sympathetic or motor blockade. TREATMENT/OUTCOME: The block receded spontaneously without causing any cardiovascular or respiratory compromise. CONCLUSIONS: The diagnosis of subdural block must be considered in patients with unusual presentations after a spinal anaesthetic. Factors affecting spread of hyperbaric bupivacaine are also highlighted.

Adult↗
PubMed2002

A case of pulmonary haemorrhage following jet ventilation for vocal cord surgery.

INTRODUCTION: This case report highlights haemoptysis occurring after post-extubation laryngospasm. CLINICAL PICTURE: General anaesthesia using Sanders jet ventilation with a Benjamin tube was administered for a patient undergoing vocal cord biopsy. He developed laryngospasm followed by significant pulmonary haemorrhage and widespread crepitations in the lung. TREATMENT: Laryngospasm was aborted with assisted ventilation with oxygen 100% via bag and mask. OUTCOME: Oxygenation was well maintained with nasal prongs only postoperatively and haemoptysis resolved after 2 days. CONCLUSION: It is imperative to prevent laryngospasm from occurring and swift action must be taken to avoid pulmonary haemorrhage.

Adult↗
PubMed2001

A case of hypersensitivity to gelafundin.

We report a case of cardiovascular collapse after gelafundin infusion, a commonly used colloid. Risk factors for such a reaction and suggested alternative are reviewed. Awareness of this reaction is highlighted in view of its increasing popularity.

Anaphylaxis↗
PubMed2000

Towards a pain-free venepuncture.

A randomised, prospective trial was conducted to assess the efficacy of various means of alleviating the pain of subcutaneous lidocaine infiltration. One hundred and twenty-two patients were randomly allocated to different groups to receive buffered lidocaine 1%, warmed lidocaine 1% or infiltration by the counter-irritation technique. A visual analogue pain score was recorded at different stages of cannulation and results showed that pain scores were significantly lower in the group receiving buffered lidocaine 1% (p < 0.02) and in the counter-irritation group (p < 0.05). Thus buffering lidocaine 1% and administration of lidocaine 1% by the counter-irritation technique is effective in relieving the pain of lidocaine infiltration.

Anesthesia, Local↗
PubMed2000

Retrospective study of CMV retinitis in patients with AIDS.

OBJECTIVES: To study the characteristics of clinical presentations and treatment outcome of patients with HIV infection who developed cytomegalovirus(CMV) retinitis. METHODS: A retrospective study for the period 1986-97 at the regional Unit of Infectious Diseases, Newcastle General Hospital; a teaching hospital in the north-east of England. Twenty-seven patients with advanced HIV disease and clinically confirmed CMV retinitis were studied. The mean age was 40.8 years, standard deviation +/-6.3 years. The male : female ratio was 25 : 2. Twenty-six of the patients were white Caucasians and one was of Afro-Caribbean origin. RESULT: The median time between the first AIDS-defining diagnosis and development of CMV retinitis was 1.5 years and the CD4+ cell count at the time of diagnosis of CMV retinitis was 7/mm3. After 14 months of treatment. 80% of patients on mono antiretroviral therapy had impairment of sight (visual acuity 3/60) versus 30% for those on triple antiretroviral therapy. In the same period, the survival rate was 18 versus 70% for mono versus triple antiretroviral therapy, respectively. CONCLUSION: The outcome for patients with CMV retinitis was significantly better for those who were on triple than for those on mono antiretroviral therapy.

AIDS-Related Opportunistic Infections↗
PubMed2000

Tuberous sclerosis presenting for laparotomy.

A 30-year-old female patient with tuberous sclerosis presented for anaesthesia and surgery for haemorrhagic renal angiomyolipoma. The anaesthetic management of this case was tailored to the prevention of seizures. Diagnostic features and possible complications of the disease are also described.

Adult↗
PubMed2000

Transurethral surgery and the adductor spasm.

INTRODUCTION: Transurethral surgery has become the dominant treatment for bladder and prostatic tumours. Regional anaesthesia is the favoured anaesthetic technique but adductor spasm leading to bladder wall perforation and increased morbidity is not uncommon. This review seeks to outline the cause, risk factors predisposing to this complication and the various techniques that have been adopted to eradicate it. METHODS: Literature search was performed from PubMed (1965 onwards). All studies related to obturator nerve stimulation or adductor spasm in transurethral surgery were short-listed. RESULTS: Various methods have been attempted. These ranged from local blockade of the obturator nerve, periprostatic and subvesical lignocaine infiltration, changing the site of the inactive electrode, reduction of the electrocoagulation voltage and general anaesthesia with muscle relaxants. CONCLUSIONS: Hitherto, local blockade of the obturator nerve, either by the direct method or "3-in-1" method is the most effective in preventing this complication. With the aid of a nerve stimulator, greater accuracy and use of smaller volumes of local anaesthetic will improve the safety of this block.

Female↗
PubMed1998

Retrospective study of malaria cases treated in Newcastle General Hospital between 1990 and 1996.

BACKGROUND: Malaria, in particular Falciparum malaria, continues to pose a substantial risk to travelers to endemic areas. METHODS: In this study we examined 93 case notes of patients with malaria treated in our department between 1990 and 1996. RESULTS: Forty-seven (50.5%) patients had infection with Plasmodium falciparum, 41 (44.1%) had Plasmodium vivax and 5 (5.4%) had Plasmodium ovale. One of these patients had a dual infection with P. falciparum and P. vivax. None of our patients had Plasmodium malariae. Forty-four of the P. falciparum cases (93.6%) were imported from sub-Saharan Africa, 33 of the P. vivax cases (78.5%) were imported from the Indian subcontinent. All the P. ovale cases were imported from sub-Saharan Africa. Fifty-four of our patients (58.1%) did not take any form of chemoprophylaxis. Forty-two out of 93 (45.2%) of the "travelers" were settled immigrants in the UK. Seventy-eight percent of travelers of British caucasian origin took prophylaxis whereas only 13.5% of travelers of ethnic minorities origin took prophylaxis. CONCLUSIONS: Greater awareness of the risk of malaria by travelers and medical practitioners in UK must be encouraged and in particular appropriate chemoprophylaxis instituted for travelers to chloroquine-resistant areas.

Antimalarials↗
PubMed1998

A UK centre's experience of mycobacterial infections in HIV-infected patients.

A descriptive retrospective review of 26 patients with mycobacterial infection; 7 Mycobacterium tuberculosis (MTB), 17 Mycobacterium avium complex (MAC), one M. xenopei and one M. kansasii. Diagnosis of non-tuberculous mycobacteria (NTM) was made mainly from blood in 68%, with biopsy material initially useful in 68%. All MTB were fully sensitive. No patients received MAC chemoprophylaxis, yet resistance to rifabutin, ciprofloxacin and ethambutol was noted. It is important to examine the UK experience of mycobacterial infection; individual centres may find it useful to review infecting organisms and resistance patterns.

AIDS-Related Opportunistic Infections↗
PubMed1997

Greater emotional distress is associated with accelerated CD4+ cell decline in HIV infection.

An investigation was conducted to explore the relationship between emotional distress and HIV progression. One hundred twenty-five homosexual, HIV-positive males participated in a 12-month longitudinal investigation. Psychosocial data were collected at 6-month intervals and CD4+ data were collected from diagnosis to the end of the investigation. Principal component analyses were performed initially to identify factors of emotional distress and health status. In addition, CD4+ reliability assessments were performed to ensure the validity of the prognostic assessments made. As a result of these analyses, 47 individuals were eligible for the main analyses. The results from a stepwise regression revealed that disease progression was significantly predicted by CD4+ count at diagnosis (32% of variance) and emotional distress (17% of variance), but was unrelated to subjective perceptions of health. The data suggest that some of the variability in HIV progression can be attributed to emotional distress.

Adult↗
PubMed1996

Overwhelming pneumoccoccal sepsis in two patients splenectomised more than ten years previously.

Asplenic individuals are known to be at a higher risk of developing serious and occasionally fatal sepsis. Prophylactic measures are generally recommended for the first few years post-splenectomy. We report two cases of severe Pneumococcal Sepsis occurring more than 10 years post-splenectomy leading to prolonged hospitalisation and long term morbidity and suggest that Prophylactic Penicillin should be taken life-long.

Adult↗