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Biomedical subjects

J B Botha

Publications and source records attributed to J B Botha.

16 recordsLinked to original sources
PubMed1997

Review of 1198 cases of penetrating cardiac trauma.

BACKGROUND: This study was a clinicoforensic analysis of the prevalence and outcome of traumatic cardiac injuries in Durban. METHODS: Between 1990 and 1992, 1198 patients sustained cardiac trauma. Seventy (6 per cent) reached hospital alive and 1128 (94 per cent) were taken directly to the mortuary. Seven hundred victims had suffered stab wounds, 494 gunshot wounds and four blast injuries. Gunshot injuries increased from 34 per cent in 1990 to 50 per cent in 1992. The mean (s.d.) age was 30.5 (5.4) years and the majority (91 per cent) were men. RESULTS: Thirty-five (50 per cent) of those who reached hospital alive died, including all four gunshot victims. Significant factors associated with survival were isolated injury, the presence of cardiac tamponade (univariate and multivariate analysis), right ventricular injury, single cardiac chamber injury and absence of pleural breach (univariate analysis alone). Delay in operative intervention was associated with a higher mortality rate. When analysing the patients who did not reach hospital alive, 202 (18 per cent) with tamponade due to an isolated stab wound were identified as a subset who might have been saved with prompt treatment. CONCLUSION: An increasing number of gunshot injuries in combination with delays in reaching hospital and in receiving treatment accounted for the high mortality rate in this unselected series.

Adolescent↗
PubMed1995

The changing pattern of penetrating torso trauma in KwaZulu/Natal--a clinical and pathological review.

The number of patients who sustained penetrating torso trauma and were admitted to King Edward VIII Hospital and the surgical intensive care unit were reviewed over 10- and 5-year periods respectively. For the last 4 months of 1992, a comparison was made between victims of trauma admitted to hospital and those whose bodies were taken directly to the South African Police medicolegal laboratories in Gale Street, Durban, where the majority of medicolegal autopsies in the Durban metropolitan area are performed. The total number of hospital admissions has not changed during the last decade, but the aetiology of injury has altered considerably. Stab wounds have declined by 30% whereas gunshot wounds have increased by more than 800%. The ratio of stab to gunshot wounds admitted to the intensive care unit reversed within the 5-year period 1987-1992. Direct admission to the mortuary was three times as common in cases of gunshot compared with stab wounds. The hospital mortality rate for gunshot wounds was 8 times that for stab wounds. The establishment of dedicated trauma centres is essential for the treatment of these injuries, and strategies to control the use of firearms are vital.

Abdominal Injuries↗
PubMed1994

Zulu zip-guns and an unusual murder.

Primitive ballistic weapons are used in great numbers in Zululand, South Africa. Their manufacture reflects various degrees of skill. A case with a bullet and a cartridge in the victim is discussed, and a representative pictorial exhibition of weapons is presented.

Child↗
PubMed1981

The management of anal carcinoma.

In a 20-year survey of anal carcinoma at Groote Schuur Hospital 55 cases were studied retrospectively. Patients of mixed race with anal margin carcinoma had a median age 29 years below that of Whites with anal margin carcinoma. Patients in these two groups with anal canal carcinoma had the same median age. Anal margin tumours were smaller than anal canal tumours at presentation and had a substantially better 5-year survival rate. The approach to treatment of these conditions is outlined.

Adult↗
PubMed1977

The incidence of infections in compromised patients at Groote Schuur hospital. An autopsy study.

The results of a retrospective autopsy study of 115 adult patients with haematological or lymphoreticular malignancies or who had undergone transplantation procedures, are presented. The overall incidence of infection was 65%, 123 infections being detected in 75 patients. The bulk of the infections involved the gastro-intestinal and respiratory systems, other systems being considerably less frequently affected. Patients who had received allografts and subsequent immunosuppression had the highest incidence of viral inclusions, especially cytomegalovirus. Candida infections were more common than aspergillosis, and severe fungal infections were most frequent in patients with acute leukaemia who had been treated aggressively. The only other mycosis detected was cryptococcosis. Bacterial pneumonia was the most frequent infection over-all (36%). Tuberculosis, pyelonephritis and Pneumocystis pneumonitis were also encountered.

Heart Transplantation↗
PubMed1977

The effect of laser photocoagulation on the gastric mucosa and bleeding gastric lesions: an experimental study.

An argon ion laser beam was tested experimentally with regard to its histological effect on and penetration of the gastric mucosa of the rat and man and its ability to induce haemostasis in traumatically produced gastric lesions and transected small blood vessels. Localized laser photocoagulation for periods of up to 5 minutes at 1 watt produced a coagulative necrosis of the gastric mucosa and half of the muscularis propria, but transmural necrosis required prolonged exposure. Laser phototherapy markedly reduced the bleeding time in experimental ulcers and small blood vessels, provided the superficial blood could be adequately dispersed from the direct beam of the laser.

Animals↗
PubMed1977

Epithelioid sarcoma. A distinctive clinical presentation.

A case of epithelioid sarcoma occurred in an adult black man. The neoplasm recurred after 15 years in the form of multiple nodules and distinctive annular plaques. To our knowledge, this latter clinical manifestation has not been reported previously.

Adult↗
PubMed1975

Familial haemophagocytic reticulosis. Report of 2 cases in sibs.

Two cases of familial haemophagocytic reticulosis occurring in sibs are described. The disease is characterised by a widespread proliferation of histocytes showing haemophagocytosis and it usually manifests clinically with haematological abnormalities. The initial presentation may be that of a meningo-encephalitic illness, the result of a lymphohistiocytic infiltration of the meninges and cerebral tissues. The clinical course and pathological features are described and the differential diagnosis is discussed.

Autopsy↗