Subject(s)
Anesthesia, General , Bronchoscopy , Foreign Bodies/therapy , Respiratory System , Child , Child, Preschool , Female , Foreign Bodies/epidemiology , Humans , Infant , Kenya , Male , Retrospective StudiesABSTRACT
At the beginning of the century, splenectomy was used in the treatment of kala-azar, but now is rarely needed, the major indication being for drug resistant kala-azar. Inadvertent splenectomy prior to the diagnosis of kala-azar continues to occur, probably because of a reluctance to perform splenic aspiration in the investigation of splenomegaly. Five Kenyan children underwent splenectomy for drug resistant kala-azar. All were immediately improved, but one died of overwhelming post splenectomy infection (OPSI) two months later and another of a malignant lymphoma seven months after surgery. The other three patients appear to be cured. Splenectomy was considered in a sixth child with kala-azar because of a Salmonella abscess in the spleen, but the abscess ruptured catastrophically before surgery could be arranged.
Subject(s)
Leishmaniasis, Visceral/surgery , Splenectomy , Adult , Animals , Child , Child, Preschool , Drug Resistance , Female , Humans , Leishmaniasis, Visceral/complications , Leishmaniasis, Visceral/drug therapy , Macaca mulatta , Malaria/therapy , Male , Splenectomy/adverse effects , Surgical Wound Infection/etiologySubject(s)
Anesthesia, General/methods , Heart Block/therapy , Hysterectomy , Pacemaker, Artificial , Female , Humans , Middle AgedSubject(s)
Anesthesia, Intravenous , Developing Countries , Neurosurgery , Thiopental , Adolescent , Adult , Child , Dose-Response Relationship, Drug , Female , Humans , Male , Middle AgedSubject(s)
Anesthesia, General/mortality , Surgical Procedures, Operative/mortality , Adolescent , Adult , Age Factors , Aged , Child , Female , Humans , Infant, Newborn , Kenya , Male , Middle AgedSubject(s)
Heart Defects, Congenital/surgery , Twins, Conjoined/surgery , Humans , Infant, Newborn , KenyaSubject(s)
Ants , Botulism/etiology , Disease Outbreaks , Adult , Botulism/epidemiology , Female , Humans , Kenya , MaleSubject(s)
Brain Death , Intensive Care Units , Humans , Internationality , Kenya , Life Support Care/economics , Resource Allocation , Time FactorsSubject(s)
Brain Death , Ethics , Forensic Medicine , Socioeconomic Factors , Brain Stem/physiopathology , Diagnosis , Humans , TransplantationABSTRACT
Percutaneous catheterisation techniques for the axillary vein and proximal portion of the basilic vein based on venepuncture on a visible or palpable vein are described. Results are presented on 73 catheterisation attempts on axillary veins and 68 on proximal basilic veins, in which the failure rate was 4-9% and 6-9% respectively. The advantages of the techniques include simplicity and the absence of acute life-threatening complications. The incidence of phlebitis from indwelling catheters maintained for an average of 5 days (range 1-28 days) is less than 2%. Several aspects of the techniques including background anatomy and anticipated risks are discussed.
