Pediatric Index of Mortality 3-An Evaluation of Function Among ICUs In South Africa.

Objectives: To evaluate the performance of the Pediatric Index of Mortality 3 as mortality risk assessment model.

Design: This prospective study included all admissions 30 days to 18 years old for 12 months during 2016 and 2017. Data gathered included the following: age and gender, diagnosis and reason for PICU admission, data specific for the Pediatric Index of Mortality 3 calculation, PICU outcomes (death or survival), and length of PICU stay.

Instilling a culture of safety for laparoscopic cholecystectomy.

Laparoscopic cholecystectomy (LC) is the preferred and most widely used method for removal of the gallbladder in patients with symptomatic cholelithiasis. Modern laparoscopic equipment provides better illumination and definition with the most recent generation processors and cameras offering the possibility of 3D visualization. The minimal access approach results in smaller wounds, less postoperative pain, faster recovery, shorter hospital stay and ultimately a better cosmetic result.

Demonstration of reinfection and reactivation in HIV-negative autopsied cases of secondary tuberculosis: multilesional genotyping of Mycobacterium tuberculosis utilizing IS 6110 and other repetitive element-based DNA fingerprinting.

Setting: Secondary tuberculosis may follow reinfection or endogenous reactivation. The design of effective preventive and treatment protocols requires knowledge about the relative importance of these mechanisms in specific communities. Molecular typing of Mycobacterium tuberculosis has permitted linkage of cases and demonstration of patterns of inter- or intrapatient strain diversity correlating with reinfection and reactivation.

Activation of p38 MAPK induced by a multi-cycle ischaemic preconditioning protocol is associated with attenuated p38 MAPK activity during sustained ischaemia and reperfusion.

The role of p38 mitogen-activated protein kinase (MAPK) in ischaemic preconditioning remains controversial. Since most previous studies focussed on events only during sustained ischaemia, the aim of this study was to establish the activation pattern of p38 MAPK during a multicycle preconditioning protocol, sustained ischaemia as well as reperfusion and to correlate these events with functional recovery of the isolated perfused rat heart. Isolated perfused rat hearts were preconditioned by 3x5 min global ischaemia followed by 25 min global ischaemia and 30 min reperfusion.

Reduction of postischemic contractile dysfunction of the isolated rat heart by sevoflurane: comparison with halothane.

Our aims were to evaluate the effect of sevoflurane on postcardioplegic functional recovery of the isolated rat heart including the role of the adenosine triphosphate regulated potassium (K(ATP)) channels and to compare the cardioprotective effects of equipotent concentrations of halothane and sevoflurane. Isolated perfused rat hearts were subjected to 45 or 60 min normothermic cardioplegic arrest and 30 min reperfusion. Sevoflurane (0.

Genotyping of Mycobacterium tuberculosis with additional markers enhances accuracy in epidemiological studies.

Two highly polymorphic Mycobacterium tuberculosis genomic domains, characterized by hybridization to the oligonucleotide (GTG)5, were identified as potential DNA fingerprinting probes. These domains were cloned [pMTB484(1) and pMTB484(2K4), respectively] and shown to be useful for genotype analysis by Southern blotting. These probes were used to genotype geographically linked strains of M.

Signal transduction in myocardial ischaemia and reperfusion.

Recent studies in the non-ischaemic myocardium indicated that drugs stimulating cAMP formation inhibit alpha 1-mediated inositol phosphate generation, while alpha 1-adrenergic stimulation lowered tissue cAMP levels, implicating cross-talk between alpha 1- and beta-adrenergic signalling pathways in normal physiological conditions. Massive amounts of endogenous catecholamines, predominantly noradrenaline, are released during myocardial ischaemia and reperfusion, causing stimulation of both alpha 1- and beta-adrenergic receptors which, in turn, may contribute to intracellular Ca2+ overload and subsequent cell damage. Since no information is available regarding cross-talk in pathophysiological conditions, the aim of this study was to evaluate the interactions between alpha 1- and beta-adrenergic signalling pathways during different periods of ischaemia and reperfusion.

Pharmacokinetic model selection for target controlled infusions of propofol. Assessment of three parameter sets.

Background: Computer-assisted target controlled infusions (TCI) result in prediction errors that are influenced by pharmacokinetic variability among and within patients. It is uncertain whether the selection of a propofol pharmacokinetic parameter set significantly influences drug concentrations and clinical acceptability.

Methods: Thirty patients received similar propofol TCI regimens after being randomly allocated to one of three parameter sets.