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Biomedical subjects

J A Botha

Publications and source records attributed to J A Botha.

8 recordsLinked to original sources
PubMed2004

The effect of a sedation scale on ventilation hours, sedative, analgesic and inotropic use in an intensive care unit.

OBJECTIVE: Sedative drugs are used routinely in critically ill patients to reduce both physical and psychological stresses imposed by the hostile intensive care unit environment. However, drug accumulation, particularly during prolonged administration, often poses difficulties. Sedation scales chart the physiological effect of sedation although many surveys have revealed that few units use them to monitor the effect of sedative agents hence oversedation is common. METHODS: We evaluated the impact of a modified Sheffield sedation scale on ventilation hours, sedative, analgesic and inotropic use in an intensive care unit. After an education course on the use of the sedation scale, it was utilised from June 2000 to February 2001. After this 9 month period, the pharmacy and health information services retrieved data on ventilation hours and sedative, analgesic and inotropic use from June 2000 to February 2001 and compared it with data retrieved from a similar period prior to sedation scale use from June 1999 to February 2000. RESULTS: The population studied during both periods were similar in terms of total ventilated patients (141 versus 147), mean age (59.6 versus 61.2) major case mix groupings, discharge destination and hospital mortality (31% versus 31%). After introducing the sedation scale the average patient ventilated hours decreased from 203.7 to 179.5 hours. The intensive care unit's use of midazolam decreased by 38.38%, morphine use decreased by 52.6% and propofol use decreased by 17.3%. Also the adrenaline use decreased by 13.95%, noradrenaline use decreased by 8.25% and dopamine use decreased by 35.7%. CONCLUSIONS: Our study demonstrates that the use of a sedation scale lead to a decrease in sedative, analgesic and inotrope use with a trend to less ventilated hours in critically ill patients.

Journal Article↗
PubMed2004

Metabolic stridor: a case report.

The clinical features of severe hypokalaemia include constipation, ileus, ventricular and atrial tachycardias, weakness, hypotonicity and rarely an ascending motor paralysis with ventilatory failure. We describe a patient who presented with severe diarrhoea, hypokalaemic normal anion gap metabolic acidosis and hypophosphataemia. He developed stridor and respiratory failure following early correction of his hypokalaemia which was successfully managed with endotracheal intubation, mechanical ventilation and further correction of his fluid and electrolyte abnormalities.

Journal Article↗
PubMed2000

Australian bat lyssavirus infection: a second human case, with a long incubation period.

In December 1998, a 37-year-old Queensland woman died from a rabies-like illness, 27 months after being bitten by a flying fox (fruit bat). Molecular techniques enabled diagnosis of infection with Australian bat lyssavirus (ABL), the second human case to be recognised and the first to be acquired from a flying fox. It must be assumed that any bat in Australia could transmit ABL; anyone bitten or scratched by a bat should immediately wash the wounds thoroughly with soap and water and promptly seek medical advice.

Adult↗
PubMed1994

A review of mycotic nasal granuloma in cattle, with a report on three cases.

Three cases of nasal mycotic granuloma containing fungal cells and hyphae in cattle are described. In 2 animals a mucopurulent or purulent nasal discharge was seen clinically, and epistaxis in the third. Histologically, ulceration of the nasal mucosa and a severe granulomatous inflammation of the nasal submucosa with eosinophils as the predominant cell type were evident in the cattle. Non-pigmented fungal cells identified as chlamydospores and short septate hyphae were demonstrated in giant cells and extracellularly within the granulomatous reactions. In one case, the fungal elements were frequently surrounded by homogeneous eosinophilic (Splendore-Hoeppli) material. Dematiaceous fungi, Bipolaris sp. and Drechslera sp., were isolated from 2 cases. Mycology was not performed on the third animal.

Animals↗
PubMed1986

Unstable angina pectoris secondary to multiple calcified coronary artery masses. Successful treatment with coronary artery bypass surgery.

A 31-year-old doctor's wife suffered from severe unstable angina pectoris (AP) due to two large, heavily calcified masses involving the right coronary artery and the left anterior descending branch of the left coronary artery. The causes of the masses could not be determined with certainty, but in view of the history (which included the ingestion of large quantities of raw boerewors (traditional spiced sausage) and histopathological findings, we believe that they were coronary artery aneurysms which developed secondary to coronary arteritis many years previously. The possibility of echinococcal (hydatid) infection is also discussed. Cardiac surgery entailed total excision of both masses, together with sections of their accompanying coronary arteries which had become fibrotic as a result of the arteritis, and reestablishment of coronary blood flow by the insertion of two saphenous vein coronary artery bypass grafts. Her AP was dramatically relieved and she continues to be asymptomatic without taking anti-anginal drugs.

Adult↗
PubMed1986

Syncope in the elderly. Report of 3 cases with sick sinus syndrome.

Three cases of arrhythmia-induced syncope in the elderly are reported. The patients all showed some features of the sick sinus syndrome and had aortic ejection murmurs. Ventricular tachycardia occurred in 2 patients. The importance of trying to record an arrhythmia during a syncopal attack is stressed, as are the adverse effects of many drugs commonly prescribed in this age group. The relationship between the arrhythmias found and their association with aortic stenosis are discussed.

Aged↗