Procedures most frequently performed by South African-trained general surgeons - implications for training and assessment.

Background: Workplace-based assessment (WBA) is being introduced across postgraduate training in South Africa. This study was undertaken to inform the selection of the core procedures for WBA, by determining the most frequently performed procedures in general surgery practice. These findings may also assist academic centres undertaking curriculum review to determine whether or not they are training surgeons who are competent to meet the current local needs of society.

New Insights Into Dietary Approaches to Potassium Management in Chronic Kidney Disease.

Potassium disorders are one of the most common electrolyte abnormalities in patients with chronic kidney disease (CKD), contributing to poor clinical outcomes. Maintaining serum potassium levels within the physiologically normal range is critically important in these patients. Dietary potassium restriction has long been considered a core strategy for the management of chronic hyperkalemia in patients with CKD.

Endocrine Complications and the Effect of Compliance with Chelation Therapy in Patients with Beta Thalassemia Major in Eastern Province of Saudi Arabia.

Background: Endocrinopathies and metabolic complications are common in beta thalassemia major patients receiving blood transfusions. Chelation therapy has a role in preventing or delaying such complications. However, patients may face difficulties adhering to chelation therapy for several reasons.

Taxation of sugar-sweetened beverages in South Africa: Perspectives of consumers in Cape Town.

Background: Globally, fiscal measures are deemed effective in combating the obesity epidemic at population level. A health promotional levy (HPL) on sugar sweetened beverages (SSBs) was implemented in April 2018 in South Africa to reduce sugar consumption.

Design And Methods: This cross-sectional, descriptive study investigated consumers' understanding and opinion of the HPL, and impact on consumption of SSBs.

Mobile health apps: An assessment of needs, perceptions, usability, and efficacy in changing dietary choices.

Objective: The aim of this study was to explore the use of mobile health applications as dietary self-monitoring tools, and their possible role in improving food choices.

Methods: This descriptive, cross-sectional study used self-administered surveys conducted among students (aged 18-25 y) and consisted of two phases. Phase 1 (N = 991; 65.

The Effect of ß-Glucan Prebiotic on Kidney Function, Uremic Toxins and Gut Microbiome in Stage 3 to 5 Chronic Kidney Disease (CKD) Predialysis Participants: A Randomized Controlled Trial.

There is growing evidence that gut dysbiosis contributes to the progression of chronic kidney disease (CKD) owing to several mechanisms, including microbiota-derived uremic toxins, diet and immune-mediated factors. The aim of this study was to investigate the effect of a ß-glucan prebiotic on kidney function, uremic toxins and the gut microbiome in stage 3 to 5 CKD participants. Fifty-nine participants were randomized to either the ß-glucan prebiotic intervention group ( 30) or the control group ( 29).

Oxygen Saturation and Postoperative Mortality in Patients With Acute Ischemic Stroke Treated by Endovascular Thrombectomy.

Background: Monitored anesthesia care (MAC) and general anesthesia (GA) with endotracheal intubation are the 2 most used techniques for patients with acute ischemic stroke (AIS) undergoing endovascular thrombectomy. We aimed to test the hypothesis that increased arterial oxygen concentration during reperfusion period is a mechanism underlying the association between use of GA (versus MAC) and increased risk of in-hospital mortality.

Methods: In this retrospective cohort study, data were collected at the Cleveland Clinic between 2013 and 2018.

Gastrointestinal symptoms in HIV-positive kidney transplant candidates and recipients from an HIV-positive donor.

Gastrointestinal symptoms (GIS) are common in kidney transplant candidates and recipients and may be worsened by HIV. Objective: To determine the frequency and severity of GIS in HIV-positive kidney transplant recipients from HIV-positive donors, and those waiting to receive one. A GIS rating scale (GSRS) was completed by 76 participants at baseline and at 6 months.

Obesity and Other Nutrition Related Abnormalities in Pre-Dialysis Chronic Kidney Disease (CKD) Participants.

Chronic kidney disease (CKD) is increasing in sub-Saharan Africa. Undernutrition has been prevalent amongst end stage CKD patients, with limited data on the prevalence of obesity. The aim of this study was to assess the nutritional status of CKD patients using various methods sensitive to over and under-nutrition.

Health Literacy Status and Its Relationship with Quality of Life among Nurses in Teaching Hospitals of Shiraz University of Medical Sciences.

Background: Health literacy can be considered as a factor affecting healthcare providers' decision-making. The aim of this study was to investigate health literacy status and its relationship with quality of life among the nurses working in teaching hospitals affiliated with Shiraz University of Medical Sciences in Iran.

Materials And Methods: This cross-sectional study was conducted in 2017.

The relative effects of dexmedetomidine and propofol on cerebral blood flow velocity and regional brain oxygenation: A randomised noninferiority trial.

Background: Dexmedetomidine constricts cerebral blood vessels without a concomitant reduction in cerebral metabolic oxygen consumption. Its safety as a sedative in patients with neurological diseases thus remains uncertain.

Objective: Our primary objective was to test the hypothesis that dexmedetomidine is noninferior to propofol as regards cerebral blood flow (CBF) velocity and brain oxygenation.

The renin angiotensin system and the brain: New developments.

The traditional renin-angiotensin system (RAS) is indispensable system in adjusting sodium homeostasis, body fluid volume, and controlling arterial blood pressure. The key elements are renin splitting inactive angiotensinogen to yield angiotensin (Ang-I). Ang-1 is then changed by angiotensin-1 converting enzyme (ACE) into angiotensin II (Ang-II).

Intraoperative Hypotension During Second Stage of Deep Brain Stimulator Placement: Same Day versus Different Day Procedures.

Background: We evaluated blood pressure management associated with implantable pulse generator (IPG) procedure on same day (SD) versus different day (DD) from deep brain stimulation (DBS) placement.

Methods: A retrospective chart review of 99 records for vasopressors given during IPG using a negative binomial regression model was performed. An association between SD versus DD, cumulative vasopressor dose, and minimum and maximum mean arterial pressure (MAP) were sought.

Titanium scaffold osteogenesis in healthy and osteoporotic rats is improved by the use of low-level laser therapy (GaAlAs).

The present study aimed to assess the effects of low-level laser therapy (GaAlAs) on the bone repair process within titanium scaffolds in the femurs of healthy and osteoporotic rats. Fifty-six rats were divided into four groups: group Sh: SHAM animals that received scaffolds; group LSh: SHAM animals that received scaffolds and were subjected to laser therapy; group OV: ovarietomized (OVX) animals that received scaffolds; and group LOV: OVX animals that received scaffolds and were subjected to laser therapy. Thirty days following ovariectomy or sham surgery, scaffolds were implanted in the left femurs of all animals in the study.

Factors predicting incremental administration of antihypertensive boluses during deep brain stimulator placement for Parkinson's disease.

Hypertension is common in deep brain stimulator (DBS) placement predisposing to intracranial hemorrhage. This retrospective review evaluates factors predicting incremental antihypertensive use intraoperatively. Medical records of Parkinson's disease (PD) patients undergoing DBS procedure between 2008-2011 were reviewed after Institutional Review Board approval.

A case series discussing the anaesthetic management of pregnant patients with brain tumours.

Pregnancy may aggravate the natural history of an intracranial tumour, and may even unmask a previously unknown diagnosis. Here we present a series of seven patients who had brain tumours during pregnancy. The aim of this case series is to characterize the current perioperative management and to suggest evidence based guidelines for the anaesthetic management of pregnant females with brain tumours.

Perioperative management of intracranial aneurysm and subarachnoid hemorrhage.

Stroke is the third leading cause of death and the leading cause of disability in contemporary society. Aneurysmal subarachnoid hemorrhage (aSAH) is a hemorrhagic stroke which accounts for 7% of all stroke cases and 22 to 25% of cerebrovascular deaths. Aneurysmal subarachnoid hemorrhage is a very complex disease and many controversies on its pathophysiology and management have not yet been settled.

The use of dexmedetomidine in anesthesia and intensive care: a review.

The alpha-2 agonist dexmedetomidine is being increasingly used for sedation and as an adjunctive agent during general and regional anesthesia. It is used in a number of procedures and clinical settings including neuroanesthesia, vascular surgery, gastrointestinal endoscopy, fiberoptic intubation, and pediatric anesthesia. The drug is also considered a nearly ideal sedative agent in the intensive care setting.

Use of α(2)-Agonists in Neuroanesthesia: An Overview.

α(2)-Agonists are a novel class of drugs with mechanisms of action that differ from other commonly used anesthetic drugs. They have neuroprotective, cardioprotective, and sedative effects. These unique characteristics make them potentially useful during neuroanesthesia and intensive care.

Gender rather than choice of intermediate duration opioids affects emergence after craniotomy for large intracranial tumors.

Background: Opioid-based anesthetic techniques are commonly used during neurosurgical procedures. In the present randomized prospective study, we studied emergence after 4 anesthetic regimens combining intermediate duration opioids with isoflurane and nitrous oxide (N(2)O), in patients undergoing craniotomy for large (> 30 mm diameter with intracranial mass effect) intracranial tumors.

Methods: One hundred seven patients were randomized into 4 groups: Group A: fentanyl (≤ 5 µg/kg) + isoflurane (≤ 1 minimum alveolar concentration [MAC]), Group B: sufentanil (1-2 µg/kg plus infusion) + isoflurane (≤ 0.

Delayed awakening in dystonia patients undergoing deep brain stimulation surgery.

We aimed to identify the incidence, duration and causes of delayed emergence from anesthesia in patients with dystonia undergoing surgery for deep brain stimulation (DBS) placement. A retrospective review of patients with dystonia who underwent DBS placement was conducted and the following characteristics were noted: age, gender, comorbid conditions, American Society of Anesthesiologists classification, anesthetic agents used, amount of initial dose, amount of infusion dose, duration of the infusion and the time needed for emergence. Twenty-four patients underwent 33 DBS procedures for dystonia.