Critical incidents in gynaecology: a one year audit in an academic hospital in Johannesburg, South Africa.

Introduction: critical incidents are among the ten leading causes of death and disability worldwide. Improving patient safety is a global priority and one way of achieving this goal is to report and analyse critical incidents. We aimed to establish the incidence, describe the profile, patient outcomes and avoidable factors associated with gynaecological critical incidents in an academic hospital in Johannesburg, South Africa.

An unmet need: Pancreatic beta cell replacement.

Diabetes mellitus (DM) is a growing public health concern in South Africa (SA) and poses a substantial economic burden on healthcare globally. A century has passed since the discovery of insulin, and despite advances in diabetes management, exogenous insulin remains a primary treatment for type 1 DM, posing challenges of hyperglycaemia and hypoglycaemia. Pancreas transplantation should be considered a treatment for insulin-deficient DM, offering sustained euglycaemia and preventing complications associated with the disease.

Dyslipidaemia in patients with chronic kidney disease - a neglected cardiovascular risk factor.

Background: Atherosclerotic cardiovascular disease (ASCVD) is a major cause of morbidity and mortality in patients with chronic kidney disease (CKD). In addition, CKD itself is a coronary artery disease equivalent due to its atherogenic potential. Despite the role of CKD in ASCVD and recommendations to control lipid levels aggressively, landmark lipid studies have often excluded patients with advanced CKD.

Expert Recommendations to Bridge Gaps in Heart Failure Patient Support in the Middle East and Africa Region.

Heart failure (HF) remains a serious health and socioeconomic problem in the Middle East and Africa (MEA). The age-standardized prevalence rate for HF in the MEA region is higher compared to countries in Eastern Europe, Latin America, and Southeast Asia. Also cardiovascular-related deaths remain high compared to their global counterparts.

Profile and outcomes of management of patients admitted to obstetric high care unit in a tertiary academic hospital in Gauteng Province, South Africa.

The aim of this study was to describe maternal characteristics and pregnancy outcomes of women admitted in a dedicated obstetric high care unit (OHCU) in a tertiary hospital in Gauteng province, South Africa. The study involved review of clinical records of women admitted to OHCU between January and June 2016. Data collected included maternal demographic data, indication for admission, management and outcomes.

Diagnosis and management of a pelvic solitary fibrous tumor in a postmenopausal woman - a case report.

Background: Solitary fibrous tumors, previously known as hemangiopericytomas, originate from mesenchymal tissue and can occur at many body sites, such as the thorax, head and neck, retroperitoneal space and abdomen. These tumors are generally rare and pelvic location is extremely uncommon. Consequently, pelvic solitary tumors could be mistaken for ovarian cancer in menopausal women.

Cannabis-Associated Myocardial Infarction with Non-Obstructive Coronary Arteries in a Young Patient with Underlying Myocardial Bridge.

BACKGROUND Myocardial infarction (MI) is one of the most ominous medical emergencies because it carries significant morbidity and mortality. A myocardial bridge is an anomaly previously perceived as benign. However, with a better understanding, it is considered a risk factor for angina and MI in some cases.

Breast cancer radiation therapy: A bibliometric analysis of the scientific literature.

Background And Purpose: Breast cancer is the most common malignancy in women and radiation therapy (RT) is crucial in its multimodality management. Since bibliometrics is a powerful tool to reveal the scientific literature, we decided to perform a bibliometric analysis of the literature on breast cancer radiotherapy. We explored emerging trends and common patterns in research, tracking collaboration and networks, and foreseeing future directions in this clinical setting.

COVID‑19 in pregnant women in South Africa: A retrospective review.

Background: The majority of maternal deaths in South Africa (SA) occur as a result of non-pregnancy-related infections (NPRI). Pregnancy is a known risk factor in severe COVID‑19, increasing the burden of NPRI in SA. In this study, we describe the prevalence, profile and clinical outcomes of pregnant women with COVID‑19 admitted to a tertiary facility.

Baseline characteristics of 32 patients with Gaucher disease who were treated with imiglucerase: South African data from the International Collaborative Gaucher Group (ICGG) Gaucher Registry.

Background: Gaucher disease (GD) is a rare inherited autosomal recessive metabolic disorder with a prevalence in the general population of ~1 per 100 000. To optimise the recognition, diagnosis and management of patients with GD in South Africa (SA), it is important to have an understanding of local patterns of presentation of the disease.

Objectives: To describe the baseline pretreatment characteristics of the SA cohort of patients enrolled into the International Collaborative Gaucher Group (ICGG) Gaucher Registry whowere treated with imiglucerase (Cerezyme; Sanofi Genzyme).

The spectrum of male breast disease at Charlotte Maxeke Johannesburg Academic Hospital - a 3-year retrospective review.

Background: The spectrum of male breast disease (MBD) and its relative proportions is not well documented. This study aims to describe the demographics, clinical, radiological and histopathological characteristics of the spectrum of MBD managed at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH).

Methods: This is a retrospective, descriptive study of all male patients diagnosed with MBD at CMJAH between 1 January 2016 and 31 December 2018.

A review of -multidrug-resistant Enterobacteriaceae in a neonatal unit in Johannesburg, South Africa.

Background: Multi-drug resistant organisms are an increasingly important cause of neonatal sepsis.

Aim: This study aimed to review neonatal sepsis caused by multi-drug resistant Enterobacteriaceae (MDRE) in neonates in Johannesburg, South Africa.

Methods: This was a cross sectional retrospective review of MDRE in neonates admitted to a tertiary neonatal unit between 1 January 2013 and 31 December 2015.

A series of patients with unusual lung cancers with unusual presentations.

Lung malignancies have become increasingly prevalent. Occasionally, an unusual tumour is diagnosed, or a common tumour type presents unusually. This case report reviews 3 cases of thoracic neoplasm, including two cases of uncommon cancers (primary lung adenoid cystic carcinoma and thoracic desmoplastic small round cell high-grade sarcoma) and an atypical presentation of malignant mesothelioma.

Formoterol is more effective than salmeterol in suppressing neutrophil reactivity.

http://ow.ly/Qr9fE.

The Ultrasonographic Determination of the Position of the Mental Foramen and its Relation to the Mandibular Premolar Teeth.

Introduction: The position of the mental foramen has been well researched in cadaver specimens, radiographically as well as intraoperatively. To our knowledge, this landmark study is the first to make use of ultrasonography in a study population to determine the position of the mental foramen in relation to the mandibular premolar teeth. Ultrasonography has great potential to further revolutionize the practice of medicine and dento-maxillofacial surgery.

Antimicrobial stewardship across 47 South African hospitals: an implementation study.

Background: The available data on antimicrobial stewardship programmes in Africa are scarce. The aims of this study were to assess the implementation of an antimicrobial stewardship programme in a setting with limited infectious disease resources.

Methods: We implemented a pharmacist-driven, prospective audit and feedback strategy for antimicrobial stewardship on the basis of a range of improvement science and behavioural principles across a diverse group of urban and rural private hospitals in South Africa.

Viral haemorrhagic fevers in South Africa.

Viral haemorrhagic fevers (VHFs) include a diverse array of diseases caused by a broad range of viruses transmitted from various animal hosts and originating from almost all the continents in the world. These are potentially fatal and highly transmissible diseases without specific treatments or prophylactic vaccines. As has been demonstrated during the Ebola virus disease outbreak in West Africa, the consequences of VHFs are not limited to specific countries - they may become epidemic, and may have considerable economic impact and disrupt local public health and social service structures.

Uptake of Genetic Counseling, Knowledge of Bleeding risks and Psychosocial Impact in a South African Cohort of Female Relatives of People with Hemophilia.

In excess of 200 people with hemophilia (PWH) and their families have received genetic counseling (GC) at the Hemophilia Comprehensive Care Centre at Charlotte Maxeke Johannesburg Academic Hospital. However, very few of their at-risk female relatives have attended GC to discuss their reproductive risks and options, or their potential bleeding risks. Limited research has been conducted internationally on factors influencing uptake of GC and testing amongst female relatives of PWH.

Presentation and management of acute coronary syndromes among adult persons with haemophilia: results of an international, retrospective, 10-year survey.

Sparse data are available on presentation and management of acute coronary syndromes (ACS), including unstable angina and non-ST- and ST-elevation myocardial infarction, among persons with haemophilia (PWH). The aim of this study was to determine demographics, bleeding disorder characteristics, cardiovascular risk factors (CRFs), interventions, haemostatic protocol, revascularization outcomes and complications among PWH with ACS. Members of an international consortium comprising >2000 adult PWH retrospectively completed case report forms for episodes of ACS in a >10-year follow-up period (2003-2013).

Exposure of a 23F serotype strain of Streptococcus pneumoniae to cigarette smoke condensate is associated with selective upregulation of genes encoding the two-component regulatory system 11 (TCS11).

Alterations in whole genome expression profiles following exposure of the pneumococcus (strain 172, serotype 23F) to cigarette smoke condensate (160 μg/mL) for 15 and 60 min have been determined using the TIGR4 DNA microarray chip. Exposure to CSC resulted in the significant (P<0.014-0.

The beta-2-adrenoreceptor agonists, formoterol and indacaterol, but not salbutamol, effectively suppress the reactivity of human neutrophils in vitro.

The clinical relevance of the anti-inflammatory properties of beta-2 agonists remains contentious possibly due to differences in their molecular structures and agonist activities. The current study has compared the effects of 3 different categories of β 2-agonists, namely, salbutamol (short-acting), formoterol (long-acting) and indacaterol (ultra-long-acting), at concentrations of 1-1000 nM, with human blood neutrophils in vitro. Neutrophils were activated with either N-formyl-L-methionyl-L-leucyl-L-phenylalanine (fMLP, 1 µM) or platelet-activating factor (PAF, 200 nM) in the absence and presence of the β 2-agonists followed by measurement of the generation of reactive oxygen species and leukotriene B4, release of elastase, and expression of the β 2-integrin, CR3, using a combination of chemiluminescence, ELISA, colorimetric, and flow cytometric procedures respectively.

A comparison of the pharmacokinetics of Aspen Ceftriaxone and Rocephin in community-acquired meningitis.

Background: Community-acquired bacterial meningitis (CABM) is a life-threatening condition that is common among immunocompromised individuals. Intravenous ceftriaxone, of which Rocephin (ROC) is the originator brand, is recommended as first-line therapy in South Africa. Despite concerns regarding therapeutic equivalence with generic agents, this is the first study that has been conducted comparing clinical pharmacokinetics (PK) of a generic ceftriaxone formulation with the originator.

Burden of depressive symptoms in South African public healthcare patients with established rheumatoid arthritis: a case-control study.

Objectives: The burden of depressive symptoms and how demographic and disease characteristics relate to depressive symptoms in patients with rheumatoid arthritis (RA) that belong to developing populations, are currently unknown and were therefore assessed in a case-control study in public healthcare patients in South Africa, a lower-middle income country. Public healthcare attendance is a surrogate of belonging to the developing population in South Africa.

Methods: Demographic and RA features were recorded in 441 public and 202 private healthcare patients.