Browsing by Author "Goussard, P."

Now showing 1 - 7 of 7
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    Airway involvement in pulmonary tuberculosis
    (Health & Medical Publishing Group, 2007-10) Goussard, P.; Gie, R.
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    The diagnosis of asthma in children : an evidence-based approach to a common clinical dilemma
    (Medical Publishing Group, 2018) Masekela, R.; Risenga, S. M.; Kitchin, O. P.; White, D. A.; Davis, G.; Goussard, P.; Manjra, A. I.; Kritzinger, F. E.; Levin, M.; Zar, H.; Green, R. J.
    Background. Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, as well as airway reversibility. The diagnosis of asthma in young children is limited by the inability to perform objective lung function testing in this group of patients and the wide variety of conditions that can phenotypically present with asthma-like symptoms. Objectives. To provide an evidence-based approach for clinicians to accurately diagnose asthma in young children and to assess the level of control to guide therapeutic decisions. Methods. The South African Childhood Asthma Working Group (SACAWG) convened in January 2017 with task groups, each headed by a section leader, constituting the editorial committee on assessment of asthma epidemiology, diagnosis, control, treatments, novel treatments and self-management plans. The asthma diagnosis and control task groups reviewed the available scientific literature and assigned evidence according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system, providing recommendations based on current evidence. Conclusions. Asthma in young children should only be diagnosed if all other causes of wheezing have been considered and excluded, and if there is a response to a therapeutic trial and worsening with withdrawal of asthma medication. Asthma control should be assessed at each visit to guide therapeutic decisions.
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    Does the routine availability of a high-resolution CT (multidetector CT) on the chest in children add significant information? An African setting
    (2008) Erlank, A.; Andronikou, S.; Ackermann, C.; Griffith-Richards, S. B.; Goussard, P.
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    Pediatric thoracic TB lymphadenopathy enucleation: changes in post surgical radiological appearance
    (2008) Maydell, A.; Andronikou, S.; Ackermann, C.; Bezuidenhout, A. F.; Goussard, P.
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    Radiological changes post lymph node enucleation for airway obstruction in children with pulmonary TB
    (2009) Maydell, A.; Goussard, P.; Andronikou, S.; Bezuidenhout, A. F.; Ackermann, C.; Gie, R.
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    Tonsillar hypertrophy and prolapse in a child – is epiglottitis a predisposing factor for sudden unexpected death?
    (BMC (part of Springer Nature), 2020-01-20) Nieuwoudt, I.; Goussard, P.; Verster, J.; Dempers, J.
    Background: Tonsillitis, with associated tonsillar hypertrophy, is a common disease of childhood, yet it is rarely associated with sudden death due to airway obstruction. Lethal complications involving the inflamed tonsils include haemorrhage, retropharyngeal abscess and disseminated sepsis. Case presentation: We report on a case of sudden and unexpected death in an 8-year-old female who was diagnosed with and treated for tonsillitis. The child was diagnosed with acute tonsillitis 2 days prior to her collapse and was placed on a course of oral antibiotics. There were no signs of upper or lower airway obstruction. She was found to be unresponsive by her caregiver and gasping for air in her bed in the early hours of the second morning after the start of treatment. Autopsy showed massive and symmetrically enlarged palatine tonsils. The tonsils filled the pharynx almost completely. The epiglottis and laryngeal mucosa at the base of the epiglottis in the vicinity of the aryepiglottic membrane and the superior aspect of the larynx displayed red-purple discoloration, with mucosal swelling and edema. Histological examination of the palatine tonsils revealed prominent lymphoid hyperplasia, but no evidence of acute inflammation. Conclusion: Palatine tonsillar hypertrophy in infants is a common feature of both viral and bacterial tonsillitis and has been postulated as a possible risk factor for Sudden and Unexplained Death in Infancy (SUDI), based on the theory of mechanical impediment of breathing by narrowing of the upper airway. The rounded shape of the tonsils may facilitate some airflow past the enlarged structures and hence protect against asphyxial death when the enlarged tonsils fill the laryngo-pharynx. Epiglottal and proximal laryngeal edema may play a more significant role in asphyxial unexpected deaths in cases of tonsillitis with tonsillar hypertrophy than previously suspected. This focusses the importance of careful examination of the epiglottis and proximal laryngeal mucosa, as part of a thorough examination of the laryngo-pharynx in cases of sudden death associated with tonsillar hypertrophy.