An audit of the establishment of a cardiac magnetic resonance imaging service in a public tertiary hospital setting in the Western Cape Province of South Africa.

Introduction: cardiovascular magnetic resonance imaging is considered the standard of care for many clinical cardiovascular applications. Magnetic resonance imaging is a scarce resource in sub-Saharan Africa, with a paucity of cardiac magnetic resonance imaging clinical services and research. The aim of this audit was to review the cardiac magnetic resonance imaging service provided at a public tertiary hospital in Cape Town, Western Cape Province, South Africa.

Clostridioides difficile infection and testing rates in South Africa: A multicentre study, 2017-2020.

Objectives: To describe Clostridioides difficile infection (CDI) rates and testing practices, at three tertiary/quaternary hospitals in South Africa (SA) for the period 2017 to 2020.

Methods: A retrospective laboratory record review of all C. difficile testing at the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), Tygerberg Hospital (TBH) and Inkosi Albert Luthuli Central Academic Hospital (IALCH) was performed.

The impact of mild COVID-19 on medium-term respiratory function.

Background: There is a paucity of evidence on the impact of mild COVID-19 on the respiratory system, particularly in non-healthcare seeking individuals.

Objectives: To investigate the effects of mild COVID-19 on respiratory function and to identify indicators of decreased lung function.

Methods: We conducted a cross-sectional study in 175 non-healthcare-seeking individuals with confirmed acute SARS-CoV-2 infection who did not require hospitalisation.

Surgery for bronchiectasis in children living with HIV: A case series from a low- to middle-income country.

Background: Bronchiectasis (BE) in children living with HIV (CLWH) remains a significant cause of morbidity and mortality, especially in tuberculosis (TB)-endemic low- and middle-income countries. Treatment modalities for BE in CLWH currently focus mainly on prevention of infections and management of symptoms, while surgical management is indicated for a select group. In contrast, surgical management in non-cystic fibrosis BE is well established.

C-reactive Protein-based Screening of People with Tuberculosis Symptoms: A Diagnostic Accuracy Study.

: C-reactive protein (CRP)-based tuberculosis (TB) screening is recommended for people with HIV (PWH). However, its performance among people without HIV and in diverse settings is unknown. : In a multi-country study, we aimed to determine whether CRP meets the minimum accuracy targets (sensitivity ≥90%, specificity ≥70%) for an effective TB screening test.

Safety, effectiveness and immunogenicity of heterologous mRNA-1273 boost after prime with Ad26.COV2.S among healthcare workers in South Africa: The single-arm, open-label, phase 3 SHERPA study.

Limited studies have been conducted on the safety and effectiveness of heterologous COVID-19 vaccine boosting in lower income settings, especially those with high-HIV prevalence., The Sisonke Heterologous mRNA-1273 boost after prime with Ad26.COV2.

Estimating the causal effect of dexamethasone versus hydrocortisone on the neutrophil- lymphocyte ratio in critically ill COVID-19 patients from Tygerberg Hospital ICU using TMLE method.

Background: Causal inference from observational studies is an area of interest to researchers, advancing rapidly over the years and with it, the methods for causal effect estimation. Among them, Targeted Maximum Likelihood estimation (TMLE) possesses arguably the most outstanding statistical properties, and with no outright treatment for COVID-19, there was an opportunity to estimate the causal effect of dexamethasone versus hydrocortisone upon the neutrophil-lymphocyte ratio (NLR), a vital indicator for disease progression among critically ill COVID-19 patients.

Methods: TMLE variations were used in the analysis.

The ClinGen Syndromic Disorders Gene Curation Expert Panel: Assessing the Clinical Validity of 111 Gene-Disease Relationships.

Purpose: The Clinical Genome Resource (ClinGen) Gene Curation Expert Panels (GCEPs) have historically focused on specific organ systems or phenotypes; thus, the ClinGen Syndromic Disorders GCEP (SD-GCEP) was formed to address an unmet need.

Methods: The SD-GCEP applied ClinGen's framework to evaluate the clinical validity of genes associated with rare syndromic disorders. 111 Gene-Disease Relationships (GDRs) associated with 100 genes spanning the clinical spectrum of syndromic disorders were curated.

Eminence-Based Versus Evidence-Based Imaging of Lung Infection (Pneumonia) in Children - Diagnostic Accuracy of Lung Ultrasound.

Purpose: Lung ultrasound (LUS) has been widely used for detecting pneumonia in children. Although LUS offers multiple advantages, its diagnostic accuracy compared to an imaging gold standard, e.g.

Exploring the Cognitive and Behavioral Aspects of Shprintzen-Goldberg Syndrome; a Novel Cohort and Literature Review.

Shprintzen-Goldberg-syndrome (SGS) is caused by pathogenic exon 1 variants of SKI. Symptoms include dysmorphic features, skeletal and cardiovascular comorbidities, and cognitive and developmental impairments. We delineated the neurodevelopmental and behavioral features of SGS, as they are not well-documented.

The association of HIV status with triple-negative breast cancer in patients with breast cancer in South Africa: a cross-sectional analysis of case-only data from a prospective cohort study.

Background: Breast cancer is the most common malignancy diagnosed among women in South Africa, with the aggressive triple-negative subtype comprising approximately 15% of breast cancers in this population. South Africa has the largest population of people with HIV in the world. This study aims to evaluate the association between HIV status and the proportion of patients with breast cancer with the triple-negative subtype.

Increases in employment over six months following Khanya: A secondary analysis of a pilot randomized controlled trial of a peer-delivered behavioral intervention for substance use and HIV medication adherence in Cape Town, South Africa.

Introduction: Evidence suggests that brief, skills-based behavioral interventions are effective at improving clinical outcomes related to substance use and HIV, but little data exists on whether such interventions can incidentally improve employment. We examined preliminary changes in employment over six months following Khanya, a brief peer-delivered behavioral intervention to reduce substance use and improve antiretroviral therapy (ART) adherence compared to enhanced treatment as usual (ETAU).

Methods: Adults living with HIV (N = 61) with at least moderate substance use and ART non-adherence were recruited from a primary care clinic in Khayelitsha, South Africa, a community with high rates of unemployment.

A Case Report of the First CEA Transplant in an HIV-Positive Burn Patient in South Africa Using a Novel Composite Culture Technique.

Resource-limited burn centers are usually devoid of cultured epithelial autografts (CEA) owing largely to prohibitive costs. A modified CEA technique at our burn center incorporated cost-effective, routinely-used dressings with favorable outcomes. One unknown concern was the immunosuppressive effect that extensive burns and potentially human immunodeficiency virus (HIV) infection may have on graft take.

In-utero exposure to tenofovir-containing pre-exposure prophylaxis and bone mineral content in HIV-unexposed infants in South Africa.

Introduction: Tenofovir disoproxil fumarate (TDF) is a common drug of choice for pre-exposure prophylaxis (PrEP) or as a combination HIV treatment for pregnant women. In-utero exposure to TDF was found to be associated with lower bone mineral content (BMC) in HIV-exposed uninfected neonates. Data for infants born to women taking TDF-PrEP are lacking.

Bad company? The pericardium microbiome in people investigated for tuberculous pericarditis in an HIV-prevalent setting.

Background: The site-of-disease microbiome and predicted metagenome were evaluated in a cross-sectional study involving people with presumptive tuberculous pericarditis. We also explored the interaction between C-reactive protein (CRP) and the microbiome.

Methods: People with effusions requiring diagnostic pericardiocentesis (n=139) provided pericardial fluid for sequencing and blood for CRP measurement.

Quantification of Replacement Fibrosis in Aortic Stenosis: A Narrative Review on the Utility of Cardiovascular Magnetic Resonance Imaging.

Aortic stenosis (AS) is associated with the development of replacement myocardial fibrosis/scar. Given the dose-dependent relationship between scar and clinical outcomes after aortic valve replacement (AVR) surgery, scar quantity may serve as an important risk-stratification tool to aid decision-making on the optimal timing of AVR. Scar is non-invasively assessed and quantified by cardiovascular magnetic resonance (CMR) imaging.

Fairway to fractures: Income inequality and violent crime as the driving factors for golf club-related assaults - a case series of 21 compound skull fractures.

Background: Golf club-related traumatic brain injuries are an uncommon occurrence in adults, and the use of golf clubs as a weapon of interpersonal assault resulting in compound skull fractures is rare.

Objective: To present a case series of golf club-related compound skull fractures in adults secondary to assault, representing the largest study of this entity to date.

Methods: A retrospective analysis was performed of a prospectively maintained database for patients admitted to Tygerberg Academic Hospital in Cape Town, South Africa, with golf club-related compound skull fractures between 1 January 2018 and 31 December 2021.

The South African guidelines on enuresis: 2024 update.

Background: Enuresis, also referred to as nocturnal enuresis, is characterised by discrete episodes of urinary incontinence during sleep in children aged ≥5 years in the absence of congenital or acquired neurological disorders. This guideline is an update of the 2017 version.

Recommendations: The guideline provides recommendations and suggestions for various therapeutic options for enuresis available in South Africa (SA).

Paediatric cerebral palsy in South Africa: Prevention and care gaps at hospital level.

Background: Population-based data show high proportions of severe cases of cerebral palsy (CP) in resource-poor regions such as sub-Saharan Africa, where most children have potentially preventable risk factors (factors that may increase the likelihood of CP occurrence but can be mitigated through medical interventions).

Objectives: This study aimed to describe the demographic and clinical profile of children living with CP accessing services at Tygerberg Hospital over a period of 10 years (2010-2020), identify the potential gaps in care (proportion of individuals in a country requiring but not receiving suboptimal or inadequate care), and comparison with a similar study at the same centre two decades ago.

Method: This 10-year retrospective study investigated causes and morbidities in children with CP, attending a central hospital in the Western Cape, South Africa.

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.