545 results match your criteria: "Groote Schuur Hospital and University of Cape Town[Affiliation]"

Introduction: Solitary fibrous bladder tumors are extremely uncommon, with only a few cases reported. These fibroblastic mesenchymal neoplasms are typically benign, indolent, and slow growing.

Case Presentation: A 44-year-old male patient with obstructive uropathy was referred to our unit for workup.

View Article and Find Full Text PDF
Article Synopsis
  • Mothers in Africa face a significantly higher risk of dying from complications after cesarean deliveries compared to high-income countries, primarily due to postpartum hemorrhage (PPH).
  • A survey conducted among anesthesiologists and obstetricians in 140 hospitals across Africa aimed to assess the readiness of these facilities to implement World Health Organization (WHO) guidelines for preventing and treating PPH.
  • The survey found that while many hospitals had access to key medications like oxytocin and crystalloids, there were gaps in the availability of some critical treatments, such as heat-stable carbetocin and intrauterine balloon tamponades, highlighting the need for improved resources and training in PPH management.
View Article and Find Full Text PDF

Objective: B-HOLISTIC was a real-world retrospective study of treatment patterns and clinical outcomes in Hodgkin lymphoma (HL) in regions outside Europe and North America. This subgroup analysis reports findings from Saudi Arabia, Türkiye, and South Africa.

Materials And Methods: Patients aged ≥18 years and diagnosed with stage IIB-IV classical HL receiving frontline chemotherapy (frontline cHL) and/or with relapsed/refractory HL (RRHL) from January 2010 to December 2013 were assessed.

View Article and Find Full Text PDF

Objective: To review the latest evidence on the complications of elevated intrarenal pressures (IRPs) in retrograde intrarenal surgery (RIRS) and the strategies to mitigate the increase of IRP during surgery.

Methods: A literature search of the PubMed, MEDLINE, and Google Scholar databases was conducted from inception to April 2024. The analysis involved a narrative review.

View Article and Find Full Text PDF
Article Synopsis
  • - Anemia is a common issue among heart failure patients, affecting their treatment outcomes, and this study aimed to examine how anemia prevalence changes and its relationship with clinical results in heart failure patients from the STRONG-HF study.
  • - In the study of 1077 patients, anemia rates rose from 27.2% at enrollment to 32.1% at 90 days, with a slightly higher primary composite outcome observed in anemic patients, but the difference wasn't statistically significant.
  • - Patients with baseline anemia showed less improvement in health-related quality of life, while the incidence of anemia was higher in those receiving high-intensity care compared to usual care; factors like male sex and non-European regions were linked to a higher
View Article and Find Full Text PDF

Mortality, perioperative complications and surgical timelines in hip fracture patients: Comparison of the Spanish with the non-Spanish Cohort of the HIP ATTACK-1 trial.

Injury

November 2024

Population Health Research Institute, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.

Background: Hip fractures carry a substantial risk of complications and death. This study aimed to report the 90-day incidence of mortality, major perioperative complications and in-hospital timelines after a hip fracture in the Spanish HIP ATTACK-1 trial cohort, comparing with the non-Spanish cohort.

Methods: Prospective cohort study of Spanish patients nested in the HIP ATTACK-1 trial.

View Article and Find Full Text PDF

Background: Despite the burden of pyelonephritis after kidney transplantation, there is no consensus on initial empirical antibiotic management.

Methods: We surveyed clinicians throughout the world on their practice and opinions about the initial empirical therapy of post-transplant pyelonephritis, using clinical vignettes. A panel of experts from 19 countries on six continents designed this survey, and invited 2145 clinicians to participate.

View Article and Find Full Text PDF
Article Synopsis
  • The STRONG-HF trial tested the effectiveness of rapidly increasing neurohormonal blockade in patients with acute heart failure (AHF) compared to usual care.
  • Patients receiving high-intensity care (HIC) showed significantly higher rates of successful decongestion at day 90 (75%) compared to usual care (68%), alongside improvements in various decongestion markers.
  • Successful decongestion was linked to a lower risk of hospital readmission or all-cause death, indicating that the HIC approach offers better long-term outcomes for AHF patients.
View Article and Find Full Text PDF

Perioperative Transfusion Practices in Adults Having Noncardiac Surgery.

Transfus Med Rev

July 2024

Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Department of Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada; Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.

Surgical patients are often transfused to manage bleeding and anemia. Best practices for red blood cell (RBC) transfusion administration in patient having noncardiac surgery remains controversial and a robust evaluation and description of perioperative transfusion practices is lacking. We characterized perioperative hemoglobin concentrations and transfusion practices from the prospective VISION cohort which included 39,222 patients aged ≥45 years who had inpatient noncardiac surgery.

View Article and Find Full Text PDF

Several complications of retrograde intrarenal surgery have been attributed to inadvertent increases in intrarenal pressure. We recently described the development of an innovative isoprenaline-eluting guidewire (IsoWire). The objective of this study was to investigate the impact of this IsoWire on the intrarenal pressure and evaluate its safety.

View Article and Find Full Text PDF

Cefazolin is an antibiotic used to prevent surgical site infections. During cardiac surgery with cardiopulmonary bypass (CPB), its efficacy target could be underachieved. We aimed to develop a population pharmacokinetic model for cefazolin in children and optimize the prophylactic dosing regimen.

View Article and Find Full Text PDF

Objective: To report on the design of a novel 3D-printed retrograde intrarenal surgery (RIRS) benchtop trainer and detail its validation against real-life experiences.

Methods: Digital Imaging and Communications in Medicine (DICOM) files of 2 patients with normal computed tomography of the kidney and bladder were converted into stereolithography files to create 3D triangular mesh models. These images were further refined using Autodesk Meshmixer.

View Article and Find Full Text PDF

Objective: To provide an overview of the current use of Entrustable Professional Activities (EPAs) in postgraduate general surgery training internationally.

Background: Entrustable Professional Activities (EPAs) were introduced to connect clinical competencies and the professional activities to be entrusted to trainees on graduation. The popularity of EPAs as a framework for assessment is growing globally, including in general surgery.

View Article and Find Full Text PDF

Investigating somatic variants and pathways in mismatch repair-deficient (dMMR) colorectal carcinoma in South Africa.

J Clin Pathol

May 2024

Division of Human Genetics, Department of Pathology, Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.

Aims: Colorectal carcinoma (CRC) is a common cause of morbidity and mortality worldwide, and an emerging public health problem in sub-Saharan Africa. Several authors have described an increased frequency of mismatch repair-deficient (dMMR) CRC in sub-Saharan Africa, but these tumours remain poorly characterised molecularly. We sought to interrogate the somatic molecular genetic landscape of dMMR CRC in a cohort of young patients to better inform Lynch syndrome (LS) screening strategies and personalised medicine approaches in our setting.

View Article and Find Full Text PDF

Characteristics, treatment, and outcomes of early vs. late enrollees of the STRONG-HF trial.

Am Heart J

August 2024

Université Paris Cité, Paris, France; Department of Anesthesiology and Critical Care and Burn Unit, Saint-Louis and Lariboisière Hospitals, FHU PROMICE, DMU Parabol, APHP Nord, Paris, France.

Background: The STRONG-HF trial showed that high-intensity care (HIC) consisting of rapid up-titration of guideline-directed medical therapy (GDMT) and close follow-up reduced all-cause death or heart failure (HF) readmission at 180 days compared to usual care (UC). We hypothesized that significant differences in patient characteristics, management, and outcomes over the enrolment period may exist.

Methods: Two groups of the 1,078 patients enrolled in STRONG-HF were created according to the order of enrolment within center.

View Article and Find Full Text PDF

Oral drug formulations and enteral feeds may inadvertently be administered intravenously. Intravenous medications may be inadvertently administered intra-arterially. These examples of wrong-route drug administration errors have the potential to cause significant organ dysfunction and even death.

View Article and Find Full Text PDF

Retrograde intrarenal surgery (RIRS) is associated with complications, many of which are related to the intrarenal pressure (IRP). We aim to describe the design of a novel isoprenaline-eluting guidewire ("IsoWire") and present the results from the first release studies and the first animal studies showing its effect on IRP. The IsoWire comprises a Nitinol core surrounded by a stainless-steel wire wound into a tight coil.

View Article and Find Full Text PDF

Impact of Rapid Up-Titration of Guideline-Directed Medical Therapies on Quality of Life: Insights From the STRONG-HF Trial.

Circ Heart Fail

April 2024

Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Lithuania (J.Č., K.Č-B.).

Background: This analysis provides details on baseline and changes in quality of life (QoL) and its components as measured by EQ-5D-5L questionnaire, as well as association with objective outcomes, applying high-intensity heart failure (HF) care in patients with acute HF.

Methods: In STRONG-HF trial (Safety, Tolerability, and Efficacy of Rapid Optimization, Helped by NT-proBNP Testing, of Heart Failure Therapies) patients with acute HF were randomized just before discharge to either usual care or a high-intensity care strategy of guideline-directed medical therapy up-titration. Patients ranked their state of health on the EQ-5D visual analog scale score ranging from 0 (the worst imaginable health) to 100 (the best imaginable health) at baseline and at 90 days follow-up.

View Article and Find Full Text PDF

This Policy Review sourced opinions from experts in cancer care across low-income and middle-income countries (LMICs) to build consensus around high-priority measures of care quality. A comprehensive list of quality indicators in medical, radiation, and surgical oncology was identified from systematic literature reviews. A modified Delphi study consisting of three 90-min workshops and two international electronic surveys integrating a global range of key clinical, policy, and research leaders was used to derive consensus on cancer quality indicators that would be both feasible to collect and were high priority for cancer care systems in LMICs.

View Article and Find Full Text PDF