Risk factors for early development of cardiac allograft vasculopathy by intravascular ultrasound.

Background: Cardiac allograft vasculopathy (CAV) is the leading cause of late graft loss. While there are numerous post-transplant factors which may increase the risk of the development of CAV, there is a paucity of data on the impact of donor-derived atherosclerosis (DA), early discontinuation of prednisone, and early initiation of proliferation signal inhibitors (PSI) as assessed by intravascular ultrasound (IVUS).

Methods: Retrospective single-center study of all adult transplant patients (2008-2017) with serial IVUS at baseline and annually for 5 years.

Endocrine profiling in patients with Fanconi anemia, homozygous for a FANCG founder mutation.

Background: Fanconi anemia (FA) is phenotypically diverse, hereditary condition associated with bone marrow failure, multiple physical abnormalities, and an increased susceptibility to the development of malignancies. Less recognized manifestations of FA include endocrine abnormalities. International discourse has highlighted that these abnormalities are widespread among children and adults with FA.

Decreasing Time from Decision to Intubation in Premedicated Neonates: A Quality Improvement Initiative.

Unlabelled: Endotracheal intubation carries the risk of discomfort, decompensation, oral trauma, and endotracheal tube malposition. Treatment with premedications reduces complications, increases overall intubation safety, improves pain control, and improves first-pass success. However, time is frequently a barrier to administration.

Feasibility of the Audio Recorded Cognitive Screen in the Assessment of Individuals Undergoing Electroconvulsive Therapy.

Background: Monitoring for cognitive deficits during a course of electroconvulsive therapy (ECT) is recommended, but cognitive assessment can be time consuming. The Audio Recorded Cognitive Screen (ARCS) is a cognitive test instrument with good psychometric properties that places minimal demands on clinicians' time, but until now, it has not been formally evaluated for monitoring cognition in the context of ECT treatment.

Objectives: This study aimed to assess the feasibility/utility of using the ARCS in the assessment of depressed patients undergoing ECT.

Diagnosis of Fanconi Anaemia by ionising radiation- or mitomycin C-induced micronuclei.

Fanconi Anaemia (FA) is an autosomal recessive disorder characterised by defects in DNA repair, associated with chromosomal instability and cellular hypersensitivity to DNA cross-linking agents such as mitomycin C (MMC). The FA repair pathway involves complex DNA repair mechanisms crucial for genomic stability. Deficiencies in DNA repair genes give rise to chromosomal radiosensitivity.

Incidence of AIDS-defining and Other Cancers in HIV-positive Children in South Africa: Record Linkage Study.

Background: Little is known on the risk of cancer in HIV-positive children in sub-Saharan Africa. We examined incidence and risk factors of AIDS-defining and other cancers in pediatric antiretroviral therapy (ART) programs in South Africa.

Methods: We linked the records of 5 ART programs in Johannesburg and Cape Town to those of pediatric oncology units, based on name and surname, date of birth, folder and civil identification numbers.

Childhood cancer incidence in South Africa, 1987-2007.

Background: Childhood cancer is an emerging problem in Africa. Its extent is hazy because data are scarce, but it should be addressed. This is the first report from the South African Children's Tumour Registry (SACTR), which covers the whole of South Africa (SA).

Recommendations for the management of sickle cell disease in South Africa.

The spectrum of sickle cell disease (SCD) encompasses a heterogeneous group of disorders that include: (I) homozygous SCD (HbSS), also referred to as sickle cell anaemia; (ii) heterozygous SCD (HbAS), also referred to as sickle cell trait; and (iii) compound heterozygous states such as HbSC disease, HbSβ thalassaemia, etc. Homozygous or compound heterozygous SCD patients manifest with clinical disease of varying severity that is influenced by biological and environmental factors, whereas subject with sickle cell trait are largely asymptomatic. SCD is characterized by vaso-occlusive episodes that result in tissue ischaemia and pain in the affected region.

The impact of ethnicity on wilms tumor: characteristics and outcome of a South african cohort.

Background. Nephroblastoma is the commonest renal tumour seen in children. It has a good prognosis in developed countries with survival rates estimated to be between 80% and 90%, while in Africa it remains low.

Hematological consequences of a FANCG founder mutation in Black South African patients with Fanconi anemia.

Fanconi anemia (FA) is a rare disorder of DNA repair, associated with various somatic abnormalities but characterized by hematological disease that manifests as bone marrow aplasia and malignancy. The mainstay of treatment, in developed nations, is hematopoietic stem cell transplantation (HSCT) with subsequent surveillance for solid organ and non-hematological malignancies. In South Africa, FA in the Black population is caused by a homozygous deletion mutation in the FANCG gene in more than 80% of cases.

Malignancies in South African children with HIV.

Objectives: In 2008 the South African Children's Cancer Study Group decided to review the epidemiology, management, and chemotherapy response of HIV-positive children with malignancy.

Methods: This is a retrospective analysis of data collected from the records of HIV-positive children diagnosed with malignancy at 7 university-based pediatric oncology units serving 8 of the 9 provinces in South Africa.

Results: Two hundred eighty-eight HIV-positive children were diagnosed with 289 malignancies between 1995 and 2009.

Fanconi anaemia in black South African patients heterozygous for the FANCG c.637-643delTACCGCC founder mutation.

Background: Fanconi anaemia (FA) is an autosomal recessive, genetically heterogeneous disorder, characterised by interstrand crosslink-induced chromosome breaks, congenital abnormalities and predisposition to malignancies. It has a prevalence of about 1/40 000 in black South Africans (SAs). A founder mutation in the FANCG gene occurs in the homozygous state in 77.

Phenotypic consequences in black South African Fanconi anemia patients homozygous for a founder mutation.

Purpose: Fanconi anemia is a genotypically and phenotypically heterogeneous condition, characterized microscopically by chromosomal instability and breakage. Affected individuals manifest growth restriction and congenital physical abnormalities; most progress to hematological disease including bone marrow aplasia. Black South African Fanconi anemia patients share a common causative founder mutation in the Fanconi G gene in 80% of cases (637_643delTACCGCC).

Knee strength retention and analgesia with continuous perineural fentanyl infusion after total knee replacement: randomized controlled trial.

Purpose: Despite providing adequate pain relief, a femoral nerve block can induce postoperative muscle weakness after total knee arthoplasty (TKA). Fentanyl has been shown to have peripheral effects but has not been used as a perineural infusate alone after TKA.

Methods: Sixty patients scheduled for TKA were randomized to one of three blinded groups: a continuous 24 h infusion of either fentanyl 3 μg/ml, ropivacaine 0.

Psychosocial aspects of immune thrombocytopenia and secondary human immunodeficiency virus-related pediatric immune thrombocytopenia in the Republic of South Africa.

Developing countries with an uncontrolled AIDS epidemic have new challenges to meet in ITP. Secondary ITP, HIV related, becomes an increasing problem, which has many aspects that need addressing, including medical, effective counseling, psychosocial and unresolved management issues. Assistance in developing treatment guidelines is urgently needed.

The clinical relevance of raised cardiac troponin I in the absence of significant angiographic coronary artery disease.

Objectives: Cardiac troponins are highly sensitive and specific markers of myocardial cell injury. We wished to determine the clinical relevance of raised troponins in the absence of significant angiographic coronary artery disease.

Design And Methods: We assessed patients admitted to our hospital over the past 3 years with troponin-positive chest pain and no angiographically significant coronary disease.

Pathways to understanding mind: construct validity and predictive validity of maternal mind-mindedness.

The construct validity of maternal mind-mindedness (MM) was investigated in the context of its relations with children's later understanding of mind. MM measures were obtained from infant-mother (N = 52) interactions at 6 months, and from maternal interviews at 48 months. Children's understanding of mind was assessed using theory of mind (ToM) tasks at 45 and 48 months, and a stream of consciousness (SoC) task at 55 months.

Direct stenting may limit myocardial injury during percutaneous coronary intervention.

Background: Direct coronary stenting has been shown to be safe and feasible, with a demonstrable reduction in cost, procedural time and radiation exposure. Direct stenting may limit distal embolization of atherosclerotic plaque and consequently reduce myocardial cell injury following percutaneous coronary intervention, which may have important prognostic implications.

Methods And Results: We assessed cardiac troponin I (cTnI) release in the 24 hours following direct coronary stenting (DS) as compared to stenting with balloon predilatation (PD) in a total of 311 patients and 440 vessels/lesions (vessel to lesion ratio = 1:1) (DS: n = 107 patients and 149 vessels/lesions; PD: n = 204 patients and 291 vessels/lesions).

Maternal mind-mindedness and attachment security as predictors of theory of mind understanding.

This study investigated relations between social interaction during infancy and children's subsequent theory of mind (ToM). Infant-mother pairs (N = 57) were observed in a free-play context at 6 months. Interactions were coded for (a) mothers' use of mental state language that commented appropriately on the infants' mental states, and (b) mothers' use of mental state language that did not appropriately reflect their infants' minds.

Coronary artery perforation during percutaneous intervention: incidence and outcome.

Objective: To examine the clinical outcome of percutaneous coronary intervention where the procedure was complicated by vessel perforation.

Setting: Tertiary referral centre.

Methods: The procedural records of 6245 patients undergoing coronary intervention were reviewed.

The production of synthetic aggregate from a quarry waste using an innovative style rotary kiln.

The large volumes of wastes generated by industrialised society has led to efforts to find practical uses for these wastes, whilst also offsetting the consumption of natural resources. This paper describes the use of an innovative rotary kiln to produce synthetic aggregates from a variety of waste streams. The main waste used was a quarry fines which was blended with either paper sludge, clay, or a dredged harbour sediment.

Intravascular ultrasound-guided stenting in long lesions: an insight into possible mechanisms of restenosis and comparison of angiographic and intravascular ultrasound data from the MUSIC and RENEWAL trials.

The high restenosis rates in long stents may be related to suboptimal stent deployment. In an attempt to understand the potential components associated with restenosis in long stents, this study compares angiographic and intravascular ultrasound (IVUS) data from the MUSIC and RENEWAL studies where IVUS was used to optimize stent deployment in short (< 15 mm) and long (> 20 mm) coronary lesions, respectively. The RENEWAL study, a randomized trial, compared the NIR stent and Wallstent in long (> 20 mm) coronary lesions and used on-line visual IVUS criteria to optimize stent expansion.

Treatment of intractable angina in a nonagenarian patient by direct coronary stenting.

Background: A 91-year-old man presented with a 6-month history of exertional angina. As he was already on maximally tolerated medical therapy, we decided to perform coronary angiography, which revealed severe stenosis of the distal main stem coronary artery,

Outcome: The lesion was crossed with an intra-coronary wire, and a stent placed to cover the distal main stem lesion, without prior balloon dilatation. The result was satisfactory and he remains symptom-free at 6-month follow-up.