Variation, sexual dimorphism, and enlargement of the frontal sinus with age in adult South Africans.

Objectives: To document frontal sinus volume (FSV) in a sample of sub-Saharan Africans with a view to evaluating claims that such populations exhibit comparatively small sinuses. This study also addresses questions related to sexual dimorphism, incidence of sinus aplasia, and the possibility that FSV continues to increase through adulthood.

Materials And Methods: FSV was measured from CT scans of adult crania from the Dart Collection.

Association of brain arterial diameters with demographic and anatomical factors in a multi-national pooled analysis of cohort studies.

Background And Purpose: Brain arterial diameters are markers of cerebrovascular disease. Demographic and anatomical factors may influence arterial diameters. We hypothesize that age, sex, height, total cranial volume (TCV), and persistent fetal posterior cerebral artery (fPCA) correlate with brain arterial diameters across populations.

Metopism in adult South Africans and its relationship to frontal sinus size.

This study documents the incidences of complete and partial metopism and their possible relationship to frontal sinus volume (FSV) in a sample of modern adult black South Africans with a view to evaluating the hypothesis that metopism affects frontal sinus hypoplasia. FSV was measured from CT scans and the incidence of metopism was recorded from direct observations of dried cadaveric crania. The sex of each individual was known.

Accuracy of CT angiography for detecting ruptured intracranial aneurysms.

Background: Digital subtraction angiography (DSA) is invasive, costly and unavailable in many South African hospitals; however, it remains the gold standard for imaging intracranial aneurysms. CT angiography (CTA) is a non-invasive and readily available screening tool prior to DSA.

Objectives: This study aimed to evaluate the diagnostic performance of CTA in detecting ruptured intracranial aneurysms using DSA as the reference standard and to determine the effect of aneurysm size and location on CTA sensitivity.

Endovascular management of intracranial aneurysms at Chris Hani Baragwanath Academic Hospital.

Background: Worldwide, intracranial aneurysms are associated with a high mortality rate. While endovascular management has proven to be the choice of treatment in selected patients, patient demographics and aneurysm characteristics differ between study populations.

Objectives: This study aimed to investigate the profile of patients with intracranial aneurysms who underwent endovascular management in the Interventional Neuroradiology Unit at Chris Hani Baragwanath Academic Hospital.

Synchronous solid pseudopapillary neoplasm of the pancreas with intrahepatic cholangiocarcinoma in a young male patient: An unusual deadly occurrence.

Introduction And Importance: Solid pseudopapillary neoplasm of the pancreas (SPN) is a tumour with low malignant potential, albeit with good prognosis. Intrahepatic cholangiocarcinoma (iCCA) is a malignant and aggressive tumour with poor prognosis.

Clinical Presentation: We report a case of a 38 years old African male patient with abdominal pain for 5 years that worsened in the preceding 5 months.

Secular trends in cranial size and shape among black South Africans over the late 19th and 20th centuries.

Background: Previous studies of secular change in cranial size among black South Africans have produced conflicting results.

Aim: We re-examined cranial size change in this population during the 19th and 20th century by evaluating its relationship with individual year-of-birth, and the significance of trends among eight decennial cohorts.

Subjects And Methods: This study is based on 102 male and 89 female adults born between 1865 and 1959.

Secular decline in limb bone strength among South African Africans during the 19th and 20th centuries.

Objectives: South African Africans have been reported to have experienced negative or null secular trends in stature and other measures of skeletal structure across the 19th and 20th centuries, presumably due to poor living conditions during a time of intensifying racial discrimination. Here, we investigate whether any secular trend is apparent in limb bone strength during the same period.

Materials And Methods: Cadaver-derived skeletons (n = 221) were analyzed from female and male South African Africans who were born between 1839 and 1970, lived in and around Johannesburg, and died between 1925 and 1991 when they were 17-90 years of age.

Influence of Internal Organ Pathology on Vascular Permeability of Related Skin Zones: An Attempt to Visualize Organ Projection Areas.

Pathology of an internal organ/body part changes electrical features of the corresponding skin areas-organ projection areas (OPAs)-which are often identified with traditional acupuncture points/zones. Once the resistance "breakthrough effect" has been induced in these specific skin areas, rectification of applied electrical currents (a diode phenomenon) occurs. In addition, increased impedance can be observed.

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Background: Despite ranking third as a cause of hospital-acquired acute kidney injury (AKI), iatrogenic contrast-induced nephropathy (CIN) impacts significantly on morbidity and mortality and is associated with high hospital costs. In sub-Saharan Africa, the rates and risk factors for CIN and patient outcomes remain unexplored.

Methods: We conducted a prospective observational study at the Charlotte Maxeke Johannesburg Academic Hospital, South Africa, from 1 July 2014 to 30 July 2015.

The incidence of tuberculosis among hiv-positive individuals with high CD4 counts: implications for policy.

Background: Intensified case finding (ICF) and earlier antiretroviral therapy (ART) initiation are strategies to reduce burden of HIV-associated tuberculosis (TB). We describe incidence of and associated factors for TB among HIV-positive individuals with CD4 counts > 350 cells/μl in South Africa.

Methods: Prospective cohort study of individuals recruited for a TB vaccine trial.

Advances in stroke treatment are within reach.

Five recent trials have shown that mechanical removal of clot from cerebral arteries after a stroke can achieve a functional independent outcome in up to 60% of patients. This was an absolute benefit of between 13.5% and 31% for patients who had clot removal initiated within 6 hours of symptoms over those who had best medical treatment.

Angioarchitecture and treatment modalities in posttraumatic carotid cavernous fistulae.

Posttraumatic carotid cavernous fistulae are abnormal direct hole communications between the intracavernous carotid artery and the cavernous sinus that can result from both blunt and penetrating trauma. They can be challenging lesions to treat and a variety of modalities and approaches have been proposed since endovascular treatment has become the standard treatment. An analysis of the angioarchitecture of 32 consecutive patients treated in our service demonstrated that seven could be classified as small hole, eight medium and 17 large.

Undiagnosed tuberculosis among HIV clinic attendees: association with antiretroviral therapy and implications for intensified case finding, isoniazid preventive therapy, and infection control.

Objectives: Initiation of antiretroviral therapy (ART) and the 3I's are strategies to prevent HIV-associated tuberculosis (TB). We describe factors associated with undiagnosed TB among HIV-infected patients attending an HIV clinic in South Africa and discuss implications for the 3 Is.

Design: Convenience sample of HIV clinic attendees.

A rare carotid-basilar anastomosis traversing the jugular foramen: origin and clinical implications.

This report describes imaging in a patient with a unique unnamed carotid-basilar anastomosis, where the entry into the skull was via the jugular foramen. There were associated findings of absent right and hypoplastic left vertebral arteries and an aberrant right subclavian artery. We speculate that the persistent anastomosis is developmentally related to the jugular branch of the ascending pharyngeal artery.

Diagnostic accuracy of a urine lipoarabinomannan enzyme-linked immunosorbent assay for screening ambulatory HIV-infected persons for tuberculosis.

Objective: To assess the diagnostic accuracy of the urine lipoarabinomannan (LAM) test among ambulatory HIV-infected persons.

Design: Cross-sectional.

Methods: HIV-infected persons consecutively presenting to the HIV Clinic at Tembisa Main Clinic in Ekhuruleni, South Africa, were screened for symptoms of tuberculosis (TB) and asked to provide sputum and blood samples for smears for acid-fast bacilli and mycobacterial culture and a urine specimen for a LAM enzyme-linked immunosorbent assay.

Paediatric radiology seen from Africa. Part I: providing diagnostic imaging to a young population.

Paediatric radiology requires dedicated equipment, specific precautions related to ionising radiation, and specialist knowledge. Developing countries face difficulties in providing adequate imaging services for children. In many African countries, children represent an increasing proportion of the population, and additional challenges follow from extreme living conditions, poverty, lack of parental care, and exposure to tuberculosis, HIV, pneumonia, diarrhoea and violent trauma.

Paediatric radiology seen from Africa. Part II: recognising research advantages in a developing country.

Radiologists in developing countries cite numerous reasons for poor research output including heavier workloads, poor remuneration (resulting in "brain drain"), poor infrastructure, language barriers, lack of modern imaging equipment, and a disease spectrum that may be of little interest to journals and readers in the developed world. On the other hand, large populations of patients suffering from distinctive diseases, cost-effective healthcare systems, and a set-up with highly centralised tertiary referral hospitals, may be seen as advantages to those willing to tap into this as a data source for research. The lack of resources may even stimulate cost-effective innovations relevant to the needs of poor communities.

Musculoskeletal tuberculosis - imaging using low-end and advanced modalities for developing and developed countries.

Musculoskeletal involvement by TB is rare in comparison to other forms of the disease. It most commonly involves the spine but can also involve large weight-bearing joints, long bones, the skull and the soft tissues. Characteristic appearances of musculoskeletal TB are described for numerous imaging modalities in this paper but it is also highlighted that when based on imaging appearances alone, there is always a differential diagnosis, including other infections and malignancies.