Disseminated alveolar rhabdomyosarcoma identified by cytology, presenting as bilateral pneumothoraces.
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Biomedical subjects
Publications and source records attributed to S R Brennan.
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Infection played an important role in prolonging hospitalization and increasing morbidity in 68 children injured in farm settings. Predominantly gram-negative enteric organisms, group D streptococci, and anaerobic organisms were isolated in cultures of specimens obtained from wounds. Infection was more often associated with severe injuries of the large bones of the extremities than in amputation injuries of the digits and crush or roll-over injuries when the skin barrier was intact. The occurrence of infection in farm injuries was associated with prolonged hospitalization for parenteral antibiotic therapy, multiple surgical débridements with a need for general anesthesia, and permanent disability (decreased range of motion and loss of limbs and digits). Early aggressive surgical débridement and antimicrobial therapy guided by isolation and sensitivity testing of the major organisms are required because of polymicrobial invasion of vascularly compromised tissue.
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Severe haemoptysis in a patient with cystic fibrosis was successfully treated on two occasions by bronchial artery embolisation.
A double-blind, placebo controlled study of the effects of disodium cromoglycate (DSCG), administered as a dry powder via the spinhaler, in established exercise-induced asthma, was carried out. DSCG resulted in an increase in the rate of recovery compared with placebo. The findings confirm that DSCG has bronchodilator properties.
Eight subjects induced bronchospasm by free-range running. Four of these demonstrated a late response at 5-6 hr after exercise. When compared to the other group of four subjects, who also developed an early response but no late response, the difference in FEV1 at 5-6 hr was highly statistically significant. Although the phenomenon is not universally manifest it should no longer be held that there is no late response in exercise-induced asthma.
Twelve asthmatic subjects (mean age 23.3 years) exercised on three separate occasions, during which they all received combinations of disodium cromoglycate (DSCG) aerosol (10 mg) or placebo, both before and after exercise in a randomized double-blind study. There was a significant improvement in resting FEV1 in those subjects receiving DSCG before exercise compared with placebo (P less than 0.05). Following exercise there was a more rapid recovery of FEV1 in those receiving DSCG after exercise compared with placebo (P less than 0.005). The greatest differences in FEV1 between placebo and DSCG treated groups were seen in the first 20 minutes after receiving the drug in the post-exercise period. These findings suggest that DSCG has a significant bronchodilator effect.
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Four patients with intractable cough improved for periods of between one and six weeks after treatment with 400 mg of lignocaine by aerosol spray. Suprisingly the lignocaine increased airways resistance in some of them. It is suggested that the excessive cough is due to excessive sensitivity of tracheal cough or irritant receptors, secondary to mucosal damage. The dangers of lignocaine inhalation are referred to.
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