Acute coronary syndromes in treatment-naïve black South africans with human immunodeficiency virus infection.

Background: HIV patients on protease inhibitors have greater risk of acute coronary syndromes (ACS) but little is known about treatment-naïve patients.

Methods And Results: Authors conducted a prospective single-center study from Soweto, South Africa, comparing the clinical and angiographic features of treatment-naïve HIV positive and negative patients with ACS. Between March 2004 and February 2008, 30 consecutive treatment-naïve HIV patients with ACS were compared to the next HIV-negative patient as a 1:1 control.

The in vitro pharmacological activities of 12 South African Hermannia species.

Hermannia species are widely used in traditional medicine in southern Africa, however no extensive study has been conducted on this genus. The acetone extracts of 12 indigenous Hermannia species (flowers, stems and leaves combined) were evaluated for various pharmacological activities. All investigated species displayed promising antimicrobial activity, with Hermannia saccifera being the most active against Staphylococcus aureus (MIC=19.

The bonding effectiveness of five luting resin cements to the IPS Empress 2 all ceramic system.

Background: Variolink II is the only resin cement used for bonding IPS (Ivoclar Porcelain System) Empress 2 ceramic restorations. Alternative luting resin cements need to be investigated for their bonding effectiveness with the IPS Empress 2 ceramic.

Objectives: To determine the shear bond strength (SBS) and the effect of thermocycling, on the bonding effectiveness, of five resin cements to IPS Empress 2 ceramic.

The flexibility of titanium clasps compared with cobalt-chromium clasps.

Retention of a partial denture depends on the amount of undercut engaged on an abutment tooth and the flexibility of the clasp. Flexibility is influenced by clasp length and the denture base material. Titanium clasps are purported to have greater flexibility than cobalt-chromium cast clasps which should enable them to engage deeper undercuts or be used where shorter clasp arms are needed such as on premolar teeth.

The elastic limit of nickel-containing and nickel-free cobalt-chromium circumferential clasp arms.

The purpose of this study was to compare the flexibility and rigidity of the retentive arms of cast circumferential clasps prepared from two nickel-containing alloys (Vitallium and Wironit) with a nickel-free alloy (Biosil). Standardised wax patterns were adapted to 30 specially prepared refractory casts. Ten of these waxed casts were sent to each of three commercial laboratories that specialize in making castings from each of the alloys to be tested.

Flexibility of technopolymer clasps compared with cobalt-chromium and titanium clasps.

Patients often cite lack of retention and poor aesthetics as reasons for not wearing their partial dentures. Traditional metal alloy clasps have been shown to exert forces on abutment teeth that exceed those capable of producing tooth movement. In addition, metal display on anterior teeth is often unacceptable.

An 8-year assessment of maxillofacial prosthetic patients treated in a Department of Prosthetic Dentistry.

The Department of Prosthetic Dentistry at the University of the Witwatersrand, Johannesburg, serves as a referral centre for maxillofacial prosthetic patients from the surrounding general hospitals and local private clinics. This places a time and financial constraint on the department. The aim of this study was to establish the number of new patients seen annually, the causative factors associated with the various types of defects, the treatment provided and the cost per patient in terms of clinical hours and prosthesis fees.

Use of custom-made conformers in the treatment of ocular defects.

The loss of an eye is often followed by scar tissue contracture. The purpose of this article is to describe a procedure for fabricating acrylic resin ocular custom-made conformers to maintain socket size and contour. These custom-made ocular conformers act as an interim measure and as valuable diagnostic indicators of problems experienced by the patients.

Cyanosis and clubbing in a patient with iatrogenic Lutembacher syndrome.

A patient with rheumatic mitral and aortic stenosis is described in whom balloon dilatation of the mitral valve was complicated by an iatrogenic atrial septal defect with a small left to right shunt. Over the course of 4 years, the patient became progressively cyanosed and clubbed and was found to have reversed the shunt across the atrial septal defect due to the occurrence of severe tricuspid stenosis. The tricuspid valve was successfully dilated with re-establishment of a net left to right shunt.

Frequency of prosthetic valve-related complications with very low level warfarin anticoagulation combined with dipyridamole after valve replacement using St. Jude Medical prostheses.

The safety of a very low level of anticoagulation combined with dipyridamole in a rheumatic population (mean age 31 +/- 13 years) with the St. Jude Medical (SJM) prosthesis has not yet been tested. Furthermore, no data are available on the safety of relatively infrequent monitoring of anticoagulation levels and of the necessity for different therapeutic targets according to valve position, number of risk factors, and other baseline risk factors for thromboembolism.

Imaging of pulmonary vascular disease by intravascular ultrasound.

To assess the ability of intravascular ultrasound (IVUS) to image changes in the pulmonary arterial wall associated with pulmonary hypertension (PHT), 10 subjects requiring diagnostic right and left heart catheterization were studied. In addition to measurements of pulmonary artery pressure and pulmonary vascular resistance and pulmonary angiography, when indicated, all underwent simultaneous IVUS imaging in the pulmonary arterial system using a 20 MHz ultrasound transducer mounted on a 2 mm diameter catheter. Four patients had normal pulmonary artery pressures and 6 had varying degrees of PHT.

Bovine internal mammary artery as a conduit for coronary revascularization: long-term results.

Graft patency after coronary artery bypass grafting depends largely on the choice of conduit. Because an increasing number of patients have insufficient or poor-quality autologous material, there is a need for a suitable synthetic graft that is readily available and easy to handle and that has good long-term patency. Early results suggest that the bovine internal mammary artery graft may meet these criteria.

Repair of asymptomatic aortic valve disease during other cardiac surgery.

Repair of asymptomatic aortic valve disease was performed in 12 patients (9 female, 3 male, mean age 57.5 years) undergoing other cardiac surgery. Stenosis was the predominant aortic valve lesion in 7 (group A) with a mean gradient of 33.

Percutaneous balloon dilatation of the mitral valve in patients who were unsuitable for surgical treatment.

Objective: To assess the effects on haemodynamic function and symptoms of percutaneous balloon dilatation of mitral stenosis in patients unable to undergo surgical treatment because of associated medical/cardiac problems.

Design: A review of clinical outcome in 28 patients (of 108 undergoing balloon dilatation of the mitral valve) who were unsuitable for surgery.

Setting: A tertiary cardiac referral centre: some patients referred were from other cardiac centres in Scotland.

Mitral balloon valvuloplasty for patients aged over 70 years: an alternative to surgical treatment.

We report the results and one-year follow-up of 20 elderly patients (age range 70-82 years) with severe rheumatic mitral stenosis treated by mitral balloon valvuloplasty (MBV). All 20 were breathless at rest despite treatment with diuretics and digoxin. At cardiac catheterization, successful dilatation was achieved in 17 patients: mean transvalvular mitral gradient fell by 45%, mean cardiac output rose by 24% and mean valve area increased by 76%.

Sarcoid dactylitis in black South African patients.

Six black South Africans with sarcoid dactylitis are described. By the term sarcoid dactylitis we mean sarcoid involvement of the bone and soft tissue of the fingers. Three of the six patients developed dactylitis during the course of chronic sarcoid.

Pyoderma gangrenosum and ulcerative colitis in black South Africans. Case reports.

Two patients with pyoderma gangrenosum and ulcerative colitis are described. To our knowledge this is the first report of such an association in Blacks. The unusual vesicopustular form of pyoderma gangrenosum was well demonstrated by one patient who also responded remarkably to clofazimine.

Atypical pulmonary sarcoidosis. A case report.

The pulmonary manifestations of sarcoidosis are varied. This report describes a patient with rapidly progressive pulmonary sarcoidosis which had several unusual features and presented with acute pneumonia with air bronchograms on chest radiographs. Gallium-67 scanning and serum angiotensin-converting enzyme estimations aided in the diagnosis and in determining the response to steroid therapy.

Radiocolloid liver imaging in tuberculous hepatitis.

Twenty of 22 patients with tuberculous hepatitis had abnormal Tc-99m tin colloid liver scans. However, in the majority of the patients the changes were mild and nonspecific. The most frequent scintigraphic picture was a decreased uptake of the radiocolloid by the liver, with shunting to the spleen and bone marrow.

Isolated granulomatous pancreatitis.

Only five patients with clinically apparent noncaseating granulomatous pancreatitis have been recorded, so far as we can tell. We describe a patient with noncaseating granulomas confined to the pancreas who developed obstructive jaundice and acute abdominal pain.

Tuberculosis hepatitis: a clinical review of 96 cases.

Hepatic tuberculosis was confirmed in 96 patients presenting with the features of liver disease, only 14 of whom had other concomitant hepatic pathology. Although respiratory symptoms occurred in 74 per cent of cases, these were overshadowed by the abdominal manifestations. The latter most frequently included right hypochondrial pain, abdominal distension, firm tender hepatomegaly, splenomegaly and ascites.