Life-threatening stridor presenting in a patient with rheumatoid involvement of the larynx.

A case of a female patient with extensive rheumatoid arthritis who presented to the Accident and Emergency Department with life-threatening stridor is described. Although clinical involvement of the larynx is found in over a third of patients with severe rheumatoid arthritis, acute airways obstruction is fortunately a very rare complication. Stridor is probably precipitated in the acute situation in such patients as a result of upper respiratory tract infection.

Computer-unaided diagnosis of acute abdominal pain in an accident and emergency department.

The initial accident and emergency and final in-patient diagnoses of 200 patients with acute abdominal pain made without computer aid or structured data sheet were compared. Sixty-five per cent were correctly diagnosed and 5% had normal laparotomies. These results compare favourably with those obtained using computer aid and structured history-taking forms.

Fournier's gangrene.

Over a 5-year period 43 men with severe classic Fournier's gangrene of the scrotum and perineum and in some cases of the abdominal wall were treated at King Edward VIII Hospital, Durban. There were 8 deaths, an overall mortality rate of 18,6%. The mortality rate was high (33%) when associated with diabetes mellitus and lower (14,7%) among non-diabetic patients.

Prevention of septic complications in massive pelvic-perineal injuries. Case reports.

If they do not immediately lead to death, severe injuries of the pelvis and perineum are frequently complicated by serious invasive infection. This results in a considerable number of late deaths. Adherence to a strict treatment protocol aimed at the prevention of septic complications has undoubtedly reduced the mortality rate related to these injuries.

Behaviour of synthetic absorbable sutures with and without synergistic enteric infection.

The behaviour of synthetic absorbable sutures, polyglycolic acid (PGA) and polydioxanone (PDS), has been tested in an experimental guinea pig model utilising synergistic enteric bacteria. Braided PDS gave a wound sepsis rate of 42%, monofilament PDS 36%, and PGA 26%, while sepsis rate in the controls was 30%. The dissolution characteristics of PGA and monofilament PDS appeared to be unaffected by the presence of infection, while that of braided PDS was significantly increased.