South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Seventy-four patients were admitted after cardiac resuscitation to a general intensive care unit; 19, of whom 14 were neurologically normal, were utimately discharged from hospital. It is suggested that elderly patients, those who have had prolonged resuscitation, and patients with a combination of hypothermia, coma, dilated pupils, and apnoea have a very poor prognosis. It is doubtful whether such patients benefit from admission to an intensive care unit.
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The effect of oral magnesium chloride therapy on the QTc and QUc intervals of the electrocardiogram.
The effect of magnesium, given orally as enteric-coated magnesium chloride tablets, on the ECG of 25 randomly selected patients was investigated. Each patient, who served as his own control, was given 4--6 tablets, each containing 0,5 g MgCl26H2O, at night for periods varying from 6 weeks to 2 years. Findings included (i) a statistically significant decrease in OTc and QUc intervals; (ii) a progressive shortening of QTc and QUc intervals with continuing therapy; (iii) reversion to normal of ECG abnormalities, especially of ST segments and T waves.
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A true universal co-axial anaesthetic system has been designed. This system may be used either as a Mapleson A circuit during spontaneous ventilation or as a Mapleson D circuit during controlled ventilation. Conversion to either system may be conveniently carried out by interchanging the pop-off valve and fresh gas inlet, without disconnecting the system from the patient. ⋯ The efficiency of this system in a Mapleson A arrangement was compared with that of a conventional Magill circuit during spontaneous breathing in 2 conscious volunteers. It was shown that no significant difference exists between these systems eith regard to rebreathing, and that the universal co-axial system may be used as efficiently and economically as the Magill circuit during spontaneous ventilation. The co-axial system can be easily connected to a circle system, combining the advantages of the two systems.
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A diagnostic approach to pulmonary complications in the immunocompromised patient is outlined. The importance of early lung biopsy in selected patients is emphasized and the various techniques available are discussed. Successful early diagnosis and management of opportunistic infections ia a challenge for the clinician, bacteriologist and pathologist, and requires these close collaboration.