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Biomedical subjects

P W du Toit

Publications and source records attributed to P W du Toit.

7 recordsLinked to original sources
PubMed1981

Experience with the intensive care management of organophosphate insecticide poisoning.

During the 5-year period 1975-1979, 41 out of a total of 157 patients treated for 'organophosphate poisoning' (26%) were admitted to intensive care units. Treatment comprised atropine (0,02-0, mg/kg every 15-30 minutes or 0,02 - 0,08 mg/kg/h by continuous intravenous infusion), intermittent mandatory ventilation (IMV) with continuous positive airways pressure (CPAP) where indicated, and general supportive measures including adjustment of electrolyte, fluid and acid-base balance. Oxime-type cholinesterase reactivators were administered to 10 patients. Serum cholinesterase (S-ChE) and erythrocyte acetylcholinesterase (E-AChE) activities were monitored continuously. Despite intensive therapy, 5 patients (12%) died. IMV and CPAP proved to be a near-ideal method of mechanical ventilation. Atropine administered by continuous infusion was found to be superior to intermittent administration during the acute phase, while oral administration of atropine proved adequate thereafter. Oxime-type reactivators were not found to be of any significant value. Clinical recovery (the point at which atropine could safely be discontinued) generally correlated with a recovery of E-AChE activity to 30% or more of normal. Sudden deterioration due to possible 'endogenous re-intoxication' was observed in some patients days after the initial exposure to an organophosphate insecticide.

Adolescent↗
PubMed1981

Unsuitability of evacuated tubes for monitoring heparin therapy by activated partial thromboplastin time.

Activated partial thromboplastin times (APTT) for monitoring heparin therapy for venous thromboembolism tended to be inappropriately short if blood was collected in commercially available evacuated glass tubes. Five types of evacuated tubes marketed under the trade names Vacutainer and Venoject were examined. The APTT of heparinized blood collected in these tubes correlated poorly (r = 0.04 to 4 = 0.25) with that of blood samples from the same patients collected in plastic tubes. Most of the evacuated tube APTT were shorter than that of blood collected in plastic or siliconised glass tubes, but the results were unpredictable and varied from tube to tube and from batch to batch. This effect on heparin is apparently due to an unidentified substances which is eluted from the rubber stoppers of the tubes. Heparin control according to the APTT blood collected in these evacuated tubes is hazardous.

Blood Coagulation Tests↗
PubMed1979

[Septic shock].

It has become necessary to review septic shock in the light of recent experimental work, as well as the clinical implementation of this knowledge. Emphasis is laid on the surgical aspects of management of patients with this condition.

Anti-Bacterial Agents↗
PubMed1978

[Malignant hyperthermia in a black child. A case report].

A case of malignant hyperthermia in a Black boy is presented. He developed this condition during repair of a cleft palate, with halothane as the triggering agent. The importance of the high incidence of malignant hyperthermia in patients with certain musculoskeletal abnormalities is stressed. Despite a cool and well air-conditioned theatre, the patient's temperature was 41 degree C when the condition was suspected. At that stage general muscle rigidity was present. The patient was successfully treated with procainamide, sodium bicarbonate and hydrocortisone; surface cooling (with ice packs) was instituted and the stomach was washed out with ice-cold Ringer's solution. Over a period of 14 days serum creatine phosphokinase values decreased from 630 IU (on the day of the incident) to 12 IU. A muscle biopsy showed variation in muscle fibre size. Electron microscopical studies showed myofibrillar disruption and folding of the basement membrane. A modified version of Denborough's technique was used for the in vitro exposure of muscle strips to halothane and suxamethonium. Isometric contraction was measured and recorded. A severe contraction followed the exposure of muscle strips to halothane, which confirmed the diagnosis.

Child↗