PubMed Health⌕ Search

Biomedical subjects

E S Borgstein

Publications and source records attributed to E S Borgstein.

8 recordsLinked to original sources
PubMed2003

The prevalence of HIV infection among burn patients in a burns unit in Malawi and its influence on outcome.

In a 1 year study, 342 patients admitted to the Burns Unit at Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi underwent a voluntary HIV test. Forty (11.7%) tested HIV positive: of those aged above 15 years, 31% (34 out of 112) were HIV positive, whilst 3% (6 of 231) aged under 15 were HIV positive of whom the majority were in those aged under 5 years (5 of 125, 4%). Patients who were HIV positive had an increased risk of death (P=0.04) which was mainly due to sepsis, but those HIV patients, who did not develop infection or recovered from an episode of sepsis, had similar hospital stay, need for skin grafting and graft take as nonHIV patients. There was no difference in pathogens cultured from wound swabs taken from HIV positive and negative patients. HIV positive patients had significantly lower CD4 counts as compared to HIV negative patients (mean 383mm3 (S.D. 320) and 937mm3 (S.D. 497), respectively). However, low CD4 counts were also found in the HIV negative patients (mean 901, range 131-1964) and 24% had CD4 <500/mm3. Both HIV status and the total body surface area (TBSA) burned were independent predictors of CD4 count. TBSA was an independent risk factor for death (odds ratio 1.3; 95% CI 1.1, 1.4). In patients with TBSA burns of over 30%, mortality approached 100% irrespective of HIV status, but in patients with burns of 11-20% TBSA and who were HIV positive have a mortality of 25% compared to 12% in HIV negative patients; for 21-30% TBSA burns mortality was 100% compared to 50% for HIV positive and HIV negative patients, respectively.

Adolescent↗
PubMed2001

Gastroschisis minor.

BACKGROUND: Since 1994 the author has seen a number of cases of what appear to be a minor variant of gastroschisis. METHODS: The case files of all neonates with gastroschisis (GS) presenting to the neonatal ward of the Queen Elizabeth Central Hospital (QECH), a referral hospital in Blantyre, Malawi, from January 1995 to December 1998 were reviewed and the presentation and survival noted. RESULTS: Twenty-one neonates were seen; only 2 of 15 with "normal" GS survived. The other patients had gastroschisis minor (GSM) and all left the hospital alive. CONCLUSION: In the context of the constraints and difficulties encountered in the treatment of gastroschisis in a developing country, this subgroup of patients with a more minor form of gastroschisis shows a distinct survival advantage.

Gastroschisis↗
PubMed1994

Risks and benefits of antireflux operations in neurologically impaired children.

Gastro-oesophageal reflux (GER) in neurologically impaired children often causes feeding problems and complications of oesophagitis and is frequently resistant to medical treatment. Fifty neurologically impaired children underwent anterior gastropexy as anti-reflux operation, combined with gastrostomy in 23, between 1976 and 1992. There was no operative mortality. There were 25 early complications in 14 patients and 9 late complications in 9 patients. Twelve patients needed 17 re-operations for delayed gastric emptying [4], intestinal obstruction [3], para-oesophageal hernia [3], oesophageal stenosis [4], and recurrent GER, revision of gastrostomy, subphrenic abscess (one each). Nine patients died during the follow up period. Death in two children was related to the operation (incarcerated para-oesophageal hernia and blow-out of the stomach). Out of 41 survivors, the operation was judged successful in 35. It is concluded that antireflux operations in neurologically impaired children carry a high risk of complications. Preoperative identification of risk factors is not possible. The improvements in the quality of life achieved in the majority of patients outweigh the risks.

Adolescent↗
PubMed1994

Acquired rectovaginal fistula.

Nine girls presented with an acquired rectovaginal fistula shortly after birth. All mothers tested were seropositive for HIV. It is suggested that an acquired rectovaginal fistula is an early manifestation of HIV infection in girls.

Female↗
PubMed1992

[Experiences in the treatment of intestinal invagination in children].

Intussusception is one of the more common causes of an acute abdomen in infancy. There is discussion about the appropriate method of treatment, and especially about the criteria for hydrostatic reduction. To evaluate the effectiveness of treatment of patients with intussusception presenting at the Paediatric Surgical Centre in Amsterdam, a retrospective study was carried out. 84 Cases were seen between 1980-1990. Three quarters of the children were operated, one-third without prior barium enema. In half the cases an attempt at hydrostatic reduction was made, and this succeeded in only 43%. Ultrasound was only rarely used diagnostically. The literature shows that the use of air to attempt reduction is more likely to be effective and less likely to cause complications than barium.

Barium Sulfate↗
PubMed1990

Endoscopic restoration of esophageal continuity.

Severe stricture formation after repair of esophageal atresia with tracheoesophageal fistula resulted in obliteration of the esophageal lumen. Patency of the esophagus was restored using endoscopic removal of the scar tissue. The stricture recurrence was subsequently controlled by Collis-Belsey reconstruction of the esophagogastric junction.

Esophageal Atresia↗