South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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A patient with fulminant fat embolism syndrome (FES) after a closed fracture of the tibia and fibula is described. Life-threatening FES developed unexpectedly within 9 hours. Patients should be warned about this possibility if they are discharged from hospital early. Those not within reach of adequate care may be better observed in hospital.
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Case Reports
Pseudo-myocardial infarction pattern after aortocoronary saphenous vein bypass graft surgery. A case report.
In a 51-year-old medical colleague with symptomatic atherosclerotic coronary artery disease, coronary arteriography delineated significant left mainstem, left anterior descending and left circumflex coronary artery lesions and cine angiography demonstrated normal left ventricular contractility. Aortocoronary saphenous vein bypass grafting was successful. The postoperative appearance of QS waves on the ECG suggested the possible complication of an acute transmural anteroseptal and anterolateral myocardial infarction (MI). ⋯ The ECG may represent a pseudo-MI pattern, the patient having suffered a post-pericardiotomy syndrome. The importance of excluding postoperative acute MI is stressed. The causes of the appearance of new Q waves after aortocoronary saphenous vein bypass graft surgery are briefly outlined.
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The two phases of breath holding, the voluntary inactive and involuntary active phases, were identified by non-invasive methods using the induction plethysmograph. Eight trained divers and 7 non-diving control subjects familiar with respiratory apparatus were studied. During breath holding from normocapnia and total lung capacity it was not possible to distinguish between the two groups in respect of the pattern or duration of breath holding or alveolar gas tensions at the breakpoint. ⋯ Subjects could also be identified who have either a very short (less than 10 seconds) or very long (greater than 45 seconds) second phase. They were considered to be at risk of developing underwater hypoxia and unexpected loss of consciousness. It is further suggested that analysis of the phases of breath holding holds promise as a screening test of both novice and experienced divers.