The radiological features of HPV-positive vs HPV-negative OPSCC at a South African hospital.

Background: Studies have found that, at presentation, human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) has a less advanced primary tumour, more advanced lymph node spread and commonly has cystic metastatic lymph nodes in comparison to HPV-negative OPSCC.

Objectives: To compare the radiological features of HPV-positive and HPV-negative OPSCC in South African patients.

Method: A retrospective cross-sectional study was conducted at a large South African hospital.

Advanced tumour-induced osteomalacia secondary to sinonasal phosphaturic mesenchymal tumour.

Unlabelled: Phosphaturic mesenchymal tumours (PMT) are rare, benign lesions and the most common tumour to cause tumour-induced osteomalacia (TIO), a paraneoplastic syndrome. Patients frequently exhibit severe osteomalacia, accompanied by multiple fractures, which significantly impair their quality of life. Complete surgical resection is curative.

A resuscitation systems analysis for South Africa: A narrative review.

With a growing incidence in cardiovascular diseases in Africa, including South Africa, and with it a greater incidence of out-of-hospital cardiac arrest (OHCA) there is a need to understand the readiness of these emergency care systems to support a response. Yet, OHCA is expensive and requires comprehensive development across an entire chain of survival in order to gain any benefit in mortality or morbidity. In this narrative review, we provide a resuscitation systems analysis using the Global Resuscitation Alliance's Frame of Survival.

Correlative imaging and histopathology of a complicated sinonasal teratocarcinosarcoma.

Unlabelled: Sinonasal teratocarcinosarcoma (SNTCS) is a highly malignant and rare tumour characterised by a complex admixture of teratomatous and carcinosarcomatous components. In the head and neck area, it almost exclusively occurs in the sinonasal cavities; however, rare instances of nasopharyngeal and oral cavity involvement have been reported, with fewer than 100 cases reported in the literature.

Contribution: The contributed case involves the correlative CT, MRI and histopathology of a sinonasal teratocarcinosarcoma with intracranial involvement.

Virtual fracture clinics: be vigilant for the ligamentous elbow injury.

The Covid-19 pandemic encouraged remote healthcare and led to dependency on virtual fracture clinics (VFC). VFC are orthopaedic consultant-led clinics where cases are reviewed virtually following referral by emergency department clinicians. Success is contingent on a comprehensive initial history and examination.

The lung microbiome in HIV-positive patients with active pulmonary tuberculosis.

Tuberculosis poses one of the greatest infectious disease threats of our time, especially when associated with human immunodeficiency virus (HIV) infection. Very little data is available on the lung microbiome in pulmonary tuberculosis (PTB) in HIV-positive patients. Three patient cohorts were studied: (i) HIV-positive with no respiratory disease (control cohort), (ii) HIV-positive with pneumonia and (iii) HIV-positive with PTB.

Otosyphilis: A rare cause of acute bilateral sensorineural hearing loss in a HIV-negative patient.

Bilateral acute hearing loss is rare, and the aetiology is poorly defined. Less common treatable pathologies such as otosyphilis must be part of the differential diagnosis and should be actively excluded. We present a case of a 23-year-old woman who developed acute bilateral hearing loss due to otosyphilis, confirmed on audiometry and laboratory tests.

Characterisation and Effects of Different Levels of Water Stress at Different Growth Stages in Malt Barley under Water-Limited Conditions.

Malt barley is typically grown in dryland conditions in South Africa. It is an important grain after wheat, but little is known about its water requirements and, most importantly, how it responds to water stress. Determining when water stress sets in and how malt barley responds to water deficit during its growing season is crucial for improved management of crop water requirements.

Corrigendum: Not always 'squame': The rare entity of follicular dendritic cell sarcoma of the tonsil presenting with cervical nodal metastases.

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The incidence of medial end clavicle fractures is higher than had previously been considered.

Background: Previous X-ray epidemiological studies have estimated the incidence of medial end clavicle fractures to account for 2-3% of all clavicle fractures.

Materials And Methods: At our institution X-rays of every patient attending the Emergency Department are reviewed at a Virtual Fracture Clinic by a Consultant Orthopaedic Surgeon. Patients with a fracture are referred to the Shoulder and Elbow Fracture Clinic.

The lay descriptors of out-of-hospital cardiac arrest in the Western Cape province, South Africa.

Introduction: Out-of-Hospital Cardiac Arrest (OHCA) is a time-sensitive emergency requiring prompt identification and emergency care to reduce morbidity and mortality. The first step in managing OHCA is rapid identification by the emergency dispatch centre. Identification of these patients remains challenging in South Africa due to multiple languages and widely differing levels of education.

Seasonal variations of transpiration efficiency coefficient of irrigated wheat.

Global diminishing water resources, especially due to climate change have serious impacts on evaporation (E) from the soil surface, transpiration (T) from plants (crops) and grain yield, which relates to water use efficiency of different crops. A study was conducted at Kenilworth over two wheat cropping seasons (2007 and 2008) with the objectives of: (i) evaluating the effect of soils and seasons on T, E and yield, and (ii) relating these parameters to transpiration efficiency coefficient. The treatments included two soil types and two soil surface treatments (bare and mulched), which were all replicated four times.

Not always 'squame': The rare entity of follicular dendritic cell sarcoma of the tonsil presenting with cervical nodal metastases.

Although squamous cell carcinoma accounts for the overwhelming majority of head and neck malignant neoplasms, extranodal follicular dendritic cell sarcoma (FDCS) of the pharyngeal region can have a similar clinical presentation. The histopathological features of this rare entity have been described and emphasised in the literature. We present the case of a 65-year-old male patient with FDCS of the tonsil to illustrate the radiologic findings of FDCS and also highlight this infrequent but salient differential diagnosis for adult head and neck neoplasia.

Nationwide temporal variability of droughts in the Kingdom of Eswatini: 1981-2018.

For adequate mitigation and adaptation measures, it is essential to have detailed analysis of droughts patterns. This study determined the i) occurrence and severity of droughts ii) drought recurrence frequencies and iii) drought trends across different agro-ecological zones in the Kingdom of Eswatini for the period 1981 to 2018. A Standardised Precipitation Index (SPI) computed from long-term precipitation data measured from six meteorological stations was used to determine drought occurrence and severity.

Mid-term outcomes of surgical management of complex, isolated radial head fractures: a multicentre collaboration.

Objectives: The available literature discussing optimal surgical management of Mason II and III radial head (RH) fractures without concomitant bone or ligamentous injuries is limited. We aim to help determine the appropriate management of these functionally significant injuries.

Design: We present our retrospective cohort study of outcomes of surgically managed isolated, displaced RH fractures SETTING: Study from three trauma centres.

Proximal radioulnar translocations in adults: a tertiary centre study.

We present three cases of proximal radioulnar translocation in adults. Although rare, it is most commonly seen in paediatric cases. There have been three previously documented cases in adults, all requiring surgery and associated with ulnohumeral dislocations.

Not everything is as it seems.

We report a case of a patient operated for shoulder rotator cuff injury under interscalene brachial plexus block and general anesthesia, who developed neurological deficit in the nonoperative upper limb in the immediate postoperative period. As our patient developed neurological deficit on the nonoperative side, it was clear from the beginning that neither the nerve block nor the operative procedure was responsible for it. However, had he developed neurological symptoms on the operative side after having a peripheral nerve block, it would have possibly delayed the timely investigation and diagnosis.

Effect of exogenous surfactant on Paediatric Bronchoalveolar lavage derived macrophages' cytokine secretion.

Background: Bronchoalveolar lavage is a useful bronchoscopy technique. However, studies in "normal" children populations are few. Furthermore, the anti-inflammatory effects of exogenous pulmonary surfactants on the bronchoalveolar cellular components are limited.

Displaced medial end clavicular fractures treated with an inverted distal clavicle plate contoured through 90 degrees.

Background: This study assessed whether treating medial end clavicular fractures using an inverted distal clavicle locking plate, twisted through 90° around its axis, would allow for a less invasive surgical approach and improve screw trajectory insertion.

Materials And Methods: We searched the databases of the 2 senior authors for patients who had sustained an acute, displaced fracture of the medial end of the clavicle and had undergone operative fixation using an inverted distal clavicle plate contoured through 90°. Through an inferior incision, a contoured locking plate was positioned on the anterior surface of the medial end of the clavicle.

The Provision of Primary and Revision Elbow Replacement Surgery in the NHS.

BESS Surgical Procedure Guidelines (SPGs). The British Elbow and Shoulder Society (BESS) SPGs are a series of evidence and consensus developed by BESS surgeons and physiotherapists to help drive quality improvement and achieve the best possible surgical outcomes for UK patients. This SPG on primary and revision elbow replacement surgery is supported and endorsed by both the British Orthopaedic Association (BOA) and the Getting It Right First Time (GIRFT) Programme.

Deposition and transport of linezolid mediated by a synthetic surfactant Synsurf within a pressurized metered dose inhaler: a Calu-3 model.

Background: Previous studies in our laboratory demonstrated that a synthetic peptide containing lung surfactant enhances the permeability of chemical compounds through bronchial epithelium. The purpose of this study was to test two formulations of Synsurf combined with linezolid as respirable compounds using a pressurized metered dose inhaler (pMDI).

Methods: Aerosolization efficiency of the surfactant-drug microparticles onto Calu-3 monolayers as an air interface culture was analyzed using a Next Generation Impactor™.

Arthroscopic Excision of the Sternoclavicular Joint.

Osteoarthritis changes at the sternoclavicular joint (SCJ) have been shown to be present on computed tomography in more than 90% of people over the age of 60 years. Although usually asymptomatic, when symptoms do occur, they can be very debilitating. Most patients respond favorably to conservative treatment, but there is a small cohort of patients who continue to be symptomatic despite adequate conservative treatment.

Increased wound complication with intramedullary screw fixation of clavicle fractures: Is it thermal necrosis?

Purpose: Adult mid-shaft clavicle fractures are common injuries. For displaced fractures, open reduction with plate or intramedullary (IM) fixation is the widely used techniques. All methods have their own potential drawbacks, especially related to local soft tissue complications.

Sternoclavicular joint osteophytosis: a difficult diagnosis to swallow.

Unexplained dysphagia requires prompt investigation to rule out a possible underlying malignancy. We describe the case of a 60-year-old man who presented to his family practitioner with a 1-year history of increasing dysphagia with associated pain over the front of his chest. He was referred on to an ear, nose and throat specialist where no obvious laryngeal pathology was found at direct laryngoscopy, but an 'indentation' of the right anterior larynx, which increased with external pressure on the sternoclavicular joint (SCJ), was noted.