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H D Jacobs

Publications and source records attributed to H D Jacobs.

4 recordsLinked to original sources

Successful ex utero intrapartum treatment (EXIT) procedure for congenital high airway obstruction syndrome (CHAOS) owing to laryngeal atresia.

Congenital high airway obstruction syndrome (CHAOS) caused by laryngeal atresia was diagnosed by prenatal ultrasound in a male fetus at 18-weeks-gestation. Findings included enlarged lungs, inverted diaphragms, dilated trachea distal to the obstruction, and ascites. At 35 weeks' gestation, a planned ex utero intrapartum treatment (EXIT) procedure was performed, allowing bronchoscopic evaluation of the airway and placement of a tracheostomy. The postnatal course was marked by gradual recovery of diaphragmatic function with corresponding weaning from conventional ventilation to positive airway pressure. The sustained improvement in diaphragmatic and pulmonary function after the EXIT procedure for laryngeal atresia is one of the first reported for this entity and provides encouragement for future attempts.

Adult↗

Observer bias and error in the integumentary clinical diagnosis of chronic anaemia.

In 74 patients believed to have chronic anaemia, 1 541 individual clinical assessments of haemoglobin levels were made from various sites. By comparison with laboratory values, there were statistically significant differences in the majority. In most instances these were not clinically important. The conjunctivae, the oral mucosa and the tongue were the integumentary sites that seemed to give the most accurate clinical assessment, while the appearance of nail-bed, palmar creases and facies did not correlate with laboratory findings. Bias appeared to be a factor in clinical estimates. There was no evidence that experience made clinicians more accurate.

Adult↗