An unusually large left ventricular thrombus complicating anterior myocardial infarction: the value of multimodality imaging.

Since the emergence of revascularisation for the treatment of myocardial infarction (MI), the incidence of left ventricular thrombus (LVT) has been declining. However, despite this, it is independently associated with increased morbidity and mortality rates. The mainstay of treatment is vitamin K antagonists, although non-vitamin K antagonists have been shown to be effective.

A position statement and practical guide to the use of particulate filtering facepiece respirators (N95, FFP2, or equivalent) for South African health workers exposed to respiratory pathogens including and SARS-CoV-2.

Summary: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is transmitted mainly by aerosol in particles <10 µm that can remain suspended for hours before being inhaled. Because particulate filtering facepiece respirators ('respirators'; e.g.

Electrocardiographic and echocardiographic abnormalities in urban African people living with HIV in South Africa.

Background: Studies from high income countries report that HIV-positive people have an impaired systolic and diastolic cardiac function compared to HIV-negative people. It is unclear if results can be translated directly to the Sub-Saharan Africa context. This study assesses electro- and echocardiographic characteristics in an urban African population, comparing HIV-positive people (treated and not yet treated) with HIV-negative controls.

Multimodality Imaging of a Giant Circumflex Coronary Artery Aneurysm in a Septuagenarian.

• Coronary artery aneurysm is a possible differential diagnosis for chest pain. • Echocardiography allows bedside detection of coronary artery aneurysm. • Cardiac CT permits detailed assessment of a coronary artery aneurysm.

Isoniazid Preventive Therapy and Pregnancy Outcomes in Women Living With Human Immunodeficiency Virus in the Tshepiso Cohort.

Background: Both pregnancy and human immunodeficiency virus (HIV) increase the risk of tuberculosis disease, which results in poor maternal, pregnancy, and infant outcomes. Isoniazid preventive therapy (IPT) reduces mortality among individuals living with HIV in high-burden settings but has recently been associated with adverse pregnancy outcomes when initiated during pregnancy.

Methods: In this secondary analysis, we used multivariable logistic regression to evaluate the association between IPT exposure and adverse pregnancy outcomes (fetal demise, prematurity, low birth weight, congenital anomaly) in pregnant women living with HIV enrolled as controls in the Tshepiso study, a prospective observational cohort of pregnant women living with HIV with and without tuberculosis disease in Soweto, South Africa, from 2011-2014.

Treatment outcomes of pre- and extensively drug-resistant tuberculosis in Johannesburg, South Africa.

Background: Extensively drug-resistant tuberculosis (XDR-TB) has a poor treatment success rate and high mortality. Multidrug-resistant TB (MDR-TB) has worse outcomes when there is added resistance to second-line injectable drugs (pre-XDR-TB) or fluoroquinolones (pre-XDR-TB).

Objectives: Treatment outcomes in patients with pre-XDR-TB and XDR-TB in a high HIV prevalence area were compared.

Differences associated with age at onset in early systemic sclerosis patients: a report from the EULAR Scleroderma Trials and Research Group (EUSTAR) database.

Objective: The aim of this study was to analyse differences in clinical presentation in patients with early (< 3 years' duration) systemic sclerosis (SSc), comparing three age groups according to disease subsets.

Method: Cross-sectional analysis of the prospective EULAR Scleroderma Trials and Research database (EUSTAR) was performed. Patients fulfilling preliminary American College of Rheumatology 1980 classification criteria for SSc, with < 3 years from the first non-Raynaud's SSc symptom at first entry, were selected.

Poor Obstetric and Infant Outcomes in Human Immunodeficiency Virus-Infected Pregnant Women With Tuberculosis in South Africa: The Tshepiso Study.

Background: Before the wide availability of antiretroviral therapy (ART), tuberculosis and human immunodeficiency virus (HIV) disease among pregnant women resulted in poor maternal and neonatal outcomes, including high rates of mother-to-child transmission of both HIV and tuberculosis. We aimed to describe the impact of tuberculosis among HIV-infected mothers on obstetric and infant outcomes in a population with access to ART.

Methods: In this prospective cohort study, we followed up HIV-infected pregnant women with or without tuberculosis disease from January 2011 through January 2014 in Soweto, South Africa.

Effects of age on left atrial volume and strain parameters using echocardiography in a normal black population.

Objective: Normal cut-off values for left atrial (LA) size and function may be altered by aging and ethnic differences. No age-related reference values for LA volumetric measurements or LA strain exist in Africans. We aimed to establish normal age-appropriate values of LA size and function in black Africans.

Left atrial volume and strain parameters using echocardiography in a black population.

Aims: Left atrial (LA) volume is an important predictor of morbidity and mortality in cardiovascular disease. Left atrial strain is a feasible technique for assessing LA function. The EchoNoRMAL study recently highlighted the possibility that ethnic-based differences may exist in LA size.

Tuberculosis in older adults in Soweto, South Africa.

The impact of tuberculosis (TB) on older adults in Southern Africa is rarely emphasised. The case notification rate in 2004 among the elderly in Soweto was 262 per 100 000 population. The elderly comprised 5.

Support for relactation among mothers of HIV-infected children: a pilot study in Soweto.

Objectives: Breastfeeding is accepted as the healthiest practice for human immunodeficiency virus (HIV)-infected infants, but decisions about infant feeding are made before the child's HIV status is known. We examined the feasibility of counseling to support breastfeeding for newly diagnosed HIV-infected infants, including relactation for those who had never initiated or who had stopped breastfeeding before the infant's HIV status was known.

Materials And Methods: Mothers of 30 HIV-infected infants <12 weeks of age were enrolled in Soweto, South Africa.

Pharmacokinetics of efavirenz and treatment of HIV-1 among pregnant women with and without tuberculosis coinfection.

Background: Pregnancy and tuberculosis treatment or prophylaxis can affect efavirenz pharmacokinetics, maternal human immunodeficiency virus type 1 (HIV-1) treatment outcomes, and mother-to-child transmission (MTCT) risk.

Methods: We evaluated a prospective cohort of pregnant, HIV-infected women with and without tuberculosis in Soweto, South Africa. Pharmacokinetic sampling was performed at gestation week 37 and during the postpartum period.

Relationship between left ventricular twist and circulating biomarkers of collagen turnover in hypertensive patients with heart failure.

Background: Left ventricular (LV) twist may be a compensatory mechanism to preserve ejection fraction (EF). In patients with hypertension, twist varies depending on the left ventricle's degree of remodeling and systolic function; it is increased in those with hypertension with normal EF (HTNEF) and diminished in those with hypertension with low EF (HTLEF). The ratio of collagen-degradation biomarkers in patients with hypertension is higher in those with low EFs than those with preserved EFs and may contribute to remodeling and systolic dysfunction.

A rare case of a chronic syphilitic gumma in a man infected with human immunodeficiency virus.

Objective: This paper reports a rare case of a human immunodeficiency virus infected man with gummatous syphilis of the face.

Case Report: A 39-year-old man presented with an ulcer of the face which had been slowly progressive over the previous 6 years. Examination showed an ulcerative lesion of the midface involving the cheeks, and completely destroying the nose, the upper lip and part of the lower lip.

Extrapulmonary tuberculosis among adults: experience at Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.

Background: Extrapulmonary tuberculosis (EPTB) occurs in 15 - 20% of immunocompetent and 20 - 70% of HIV-infected patients with tuberculosis. There are few recent incidence data for EPTB.

Methods: Adults (N=2 963) with culture-proven EPTB seen over 2 years at Chris Hani Baragwanath Academic Hospital, the main referral hospital serving Soweto, Johannesburg, South Africa, were retrospectively studied for pattern and incidence.

Evaluation of parent-child pairs on antiretroviral therapy in separate adult and pediatric clinics.

In Africa, HIV infection is considered a family disease. A retrospective cohort analysis was performed to describe the characteristics and outcome in 35 parent-child pairs taking antiretroviral therapy (ART) in separate adult and pediatric HIV clinics. In 26 pairs, ART was first initiated in children.

Candidemia among adults in Soweto, South Africa, 1990-2007.

Background: Studies on candidemia occurring among adults in Southern African are limited. We aimed to document the epidemiology of candidemia among adults in Soweto.

Methods: This was a retrospective hospital-based study in three discrete periods, involving 9 years, from 1990 to 2007.

Time to twist: marker of systolic dysfunction in Africans with hypertension.

Aims: Speckle-tracking echocardiography (STE) has emerged as a quantitative technique to assess left ventricular (LV) function via twist mechanics. Hypertension-associated changes in LV twist have not been previously evaluated in African patients with LV systolic dysfunction. This study evaluates LV twist dynamics in hypertensive patients with a low ejection fraction (EF).

Profile of cause of death assigned to adults on antiretroviral therapy in Soweto.

This retrospective cohort study describes causes of death in 305 patients (baseline median CD4 count 26/μl) from 2 943 adults on antiretroviral therapy. Acute sepsis (20%), tuberculosis (18%) and Mycobacterium avium complex (MAC) bacteraemia (14%) were the most common causes. Mortality owing to the disease was 66% for MAC bacteraemia and 23% for non-Hodgkin's lymphoma.

Antiphospholipid antibodies in black south africans with hiv and acute coronary syndromes: prevalence and clinical correlates.

Background: HIV infection is associated with a high prevalence of antiphospholipid antibodies (aPL) and increased thrombotic events but the aetiopathogenic link between the two is unclear.

Findings: Prospective single centre study from Soweto, South Africa, comparing the prevalence of aPL in highly active anti-retroviral therapy (HAART) naïve HIV positive and negative patients presenting with Acute Coronary Syndromes (ACS). Between March 2004 and February 2008, 30 consecutive black South African HIV patients with ACS were compared to 30 black HIV negative patients with ACS.