High-Intensity Interval Training and Moderate-Intensity Continuous Training in Ambulatory Chronic Stroke: Feasibility Study.

Background: Poststroke guidelines recommend moderate-intensity, continuous aerobic training (MCT) to improve aerobic capacity and mobility after stroke. High-intensity interval training (HIT) has been shown to be more effective than MCT among healthy adults and people with heart disease. However, HIT and MCT have not been compared previously among people with stroke.

Renal outcome of type 2 diabetes in South Africa--a 12-year follow-up study.

Aims: Previous studies of type 2 diabetes mellitus have indicated a benign renal outcome after long-term follow-up. The aim of this study was to determine how often renal failure due to diabetic nephropathy was a cause of death in patients with type 2 diabetes.

Methods: Prospective observational study of 59 South African patients with type 2 diabetes over a 12-year period.

Pacemaker induced superior vena cava obstruction: management by spiral vein graft.

A 35-year-old male developed superior vena cava (SVC) obstruction due to multiple retained pacemaker leads. This caused cyanosis and suffusion of the head and neck during arm exercise, with desaturation from 99%-90% demonstrated by ear oximetry. The SVC was bypassed using a spiral vein graft because of worsening symptoms.

Significant cost-saving with modification of antihypertensive therapy.

Thirty patients attending Somerset Hospital Outpatient Department, Cape Town, who were on nifedipine for hypertension or chest pain, were followed up for 6 months after alternative therapy was instituted. After the change of treatment, blood pressure control improved and no serious side-effects were encountered. Reserpine combined with a thiazide was a major component of the new regimen which reduced the monthly cost per patient from R54 to R14, a saving of 73%.

Diagnostic role of intravenous urography in acute and chronic renal failure.

High-dose intravenous urography (IVU) was performed 62 times in 59 patients with acute (ARF) and chronic (CRF) renal failure. The major diagnostic categories were chronic glomerulonephritis, malignant hypertension, acute tubular necrosis (ATN), and acute glomerulonephritis. The cause of the renal failure, whether CRF or ARF, oliguric or nonoliguric, could not be reliably determined by either the evolving pattern or density of nephrogram, or the size of the kidneys.

Elevated plasma renin activity associated with renal dysfunction.

Elevated plasma renin activity (PRA) has been documented in patients with established acute renal failure. To study the association of PRA and renal dysfunction, 53 patients who were at risk of developing acute renal failure had serial measurements of PRA, renal function, and urinary beta 2-microglobulin. Those entered for study had pneumonia, septicaemia, volume loss with hypotension, or major surgical procedures with complications.

Systemic lupus erythematosus in 3 black South African men. Case reports.

Only 1 case of systemic lupus erythematosus (SLE) has been documented in a South African Black man. We report 3 further patients, 1 each from Cape Town, Durban and East London, diagnosed between 1978 and 1982. All 3 patients fulfilled the revised American Rheumatism Association criteria for the classification of SLE.

Haemorrhagic right pleural effusion complicating acute-on-chronic pancreatitis. A case report.

A 40-year old man presented with pulmonary symptoms and a right-sided haemorrhagic pleural effusion. Tuberculosis and carcinoma, both primary and secondary, were excluded as a cause. Chronic pancreatitis was diagnosed on the basis of a 5-year history of repeated episodes of alcohol-induced epigastric pain and suggestive findings on endoscopic retrograde cholangiopancreatography.

Ceftazidime and cefamandole in the treatment of pneumonia.

Fifty-nine community-acquired pneumonias were treated in a randomized double blind trial with cefamandole or ceftazidime. A prospective scoring system was used to define severity. This made use of basic clinical data, associated diseases, white blood count, blood gases and chest radiographs.

Pharmacokinetics of ranitidine in patients with chronic renal failure.

The pharmacokinetic behaviour of a single oral 150 mg ranitidine dose was studied in six patients with severe chronic renal failure (CRF) (creatinine clearance 2-18 ml/min) and compared to that in ten patients with duodenal ulceration but normal renal function (N) (creatinine clearance 69-125 ml/min). Although the maximum concentrations (Cmax) were significantly higher in CRF group when compared to N group (p less than 0.025) there was no difference in the time taken to reach Cmax (tmax).

The effect of beta-blockers on ventilatory function in chronic bronchitis.

The effect of propranolol and atenolol on air-flow obstruction in patients with chronic bronchitis was evaluated by means of a double-blind, placebo-controlled cross-over trial. Fifteen patients with chronic bronchitis and mild air-flow obstruction, in whom there was no clinical suggestion of asthma, were studied. Two patients developed symptomatic increases in air-flow obstruction on propranolol and were withdrawn from the study.

Effects of frusemide in chronic renal failure.

The present study was designed to refute or confirm the postulate that the use of high dose frusemide in chronic renal failure will increase the glomerular filtration rate (GFR). 7 patients in stable chronic renal failure were admitted to hospital for 20 days. For 10 days fluid balance was maintained and no diuretics given.

Diagnostic and therapeutic problems of polyarteritis nodosa.

Eleven patients with a diagnosis of polyarteritis nodosa were seen over an 8-year period in Cape Town, and evaluated as to clinical presentation, the most effective diagnostic approach, and the response to therapy. The major features of fever, abdominal pain, peripheral neuritis, myalgia/arthralgia, weight loss, proteinuria, positive urinary sediment and high white blood cell count should readily lead to the diagnosis which can be confirmed by multiple muscle biopsies. At the same time an ellipse of skin and subcutaneous fat can be taken.

Viral hepatitis.

The natural history of and biochemical changes in 27 patients with viral hepatitis are outlined. Analysis is made of the symptomatology and physical signs at the time of presentation as well as a comparison between hepatitis B surface antigen-positive and negative patients. In general, hepatitis B surface antigen-positive patients have a more severe clinical illness as well as greater biochemical derangement and a longer duration of disease.

Lymphoid interstitial pneumonia with associated chronic active hepatitis and renal tubular acidosis.

Various combinations of diffuse interstitial fibrosis, chronic liver disease, and renal tubular acidosis have been recorded. The patient we report is unique in that the features of chronic liver disease and renal tubular acidosis were discovered while the patient was being treated for lymphoid interstitial pneumonia. This sequence of events has not been previously described.

Carbenicillin in acute renal failure.

Three septicaemic patients with acute renal failure required carbenicillin. Septicaemia was caused by Pseudomonas in 2 patients and by Serratia marcescens in the third. Therapy in the first 2 patients was complicated by massive gastro-intestinal and uterine bleeding.

Leukaemoid reaction and disseminated tuberculosis. A case report.

Four cases of leukaemoid reactions to tuberculosis, notwithstanding the presence of Auer's rods in the myeloblasts, have previously been reported. A fifth case of disseminated tuberculosis in which Auer's rods were similarly observed, is described. However, we believe that this association does not mean that Auer's rods occur as part of a leukaemoid response, but rather that it indicates the simultaneous presence of acute leukaemia and tuberculosis.

Isolated partial deficiency of adrenocorticotrophic hormone.

A patient with tuberculous empyema who presented with severe hyponatraemia, is described. In the course of investigation, he was discovered to be suffering from isolated adrenocorticotrophic hormone deficiency.