British medical journal
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Secondary drowning (and near-drowning) is one of the post-immersion respiratory syndromes. It is defined as deterioration of pulmonary function that follows deficient gas exchange due to loss or inactivation of surfactant. A review of 94 consecutive cases of near-drowning in childhood showed that this syndrome occurred in five (5%) cases. ⋯ It occurred more rapidly after immersion in fresh water. The two children immersed in salt water died of secondary drowning, while the three immersed in fresh water recovered completely. If it is anticipated, recognised, and treated vigorously prognosis of secondary drowning is good in fresh water cases but bad after salt water immersion.
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Evidence of wide variability in the immediate results of large-bowel surgery stimulated self-assessment during 1979. The hazards of large-bowel surgery can usually be avoided by good bowel preparation, sound anastomotic technique, primary resection in large bowel emergencies, avoidance of anastomosis when hazardous, and antibiotic lavage for extant or potential peritoneal and wound contamination.