Follow-up of kidney donors at a single center in South Africa

Background:There is a worldwide shortage of organ donors. Inour province, KwaZulu / Natal, this problem is morepronounced as the rate of cadaveric donation is verylow. Thus both patients and nephrology staff areunder pressure to seek living donors.Methods and results:We studied 135 living kidney donors in ten yearsperiod: 85 females and 50 males; 78 (57.8%) were ofIndian origin, 33 (24.4%) Black, 15 (11.1%) Whiteand 9 (6.7%) of mixed race groups. The majority ofdonors (57%) were siblings, while 14.8% wereparents, 6.7% children, 17.8% spouses and 3.7%were cousins. The mean age of donors was 34.2 years(range 21-56 years). Donors were hospitalised for amean peroid of 6.1 days (range 3-15). Post-operativecomplications were left lobe atelectasis and chestinfection in 11.1 %, other infections in 5.2%,pneumothorax in 2.2%, ileus in two cases, depressionin one and prolonged pain at the site of surgery in11.1%. Proteinuria was noted in three cases (0.26gm/d and 0.66 gm/d in two donors at 2 years and 0.27gm/d in the third case at 10 years).Blood pressure levels were virtually unchanged frompre-nephrectomy data.Conclusion:This study confirms that unilateral nephrectomy innormal individuals is associated with few major adverse effects and living donors in renal transplantation is a viable option

The antibacterial properties of Malaysian tualang honey against wound and enteric microorganisms in comparison to manuka honey

<p>Abstract</p> <p>Background</p> <p>Antibiotic resistance of bacteria is on the rise, thus the discovery of alternative therapeutic agents is urgently needed. Honey possesses therapeutic potential, including wound healing properties and antimicrobial activity. Although the antimicrobial activity of honey has been effectively established against an extensive spectrum of microorganisms, it differs depending on the type of honey. To date, no extensive studies of the antibacterial properties of tualang (<it>Koompassia excelsa</it>) honey on wound and enteric microorganisms have been conducted. The objectives of this study were to conduct such studies and to compare the antibacterial activity of tualang honey with that of manuka honey.</p> <p>Methods</p> <p>Using a broth dilution method, the antibacterial activity of tualang honey against 13 wound and enteric microorganisms was determined; manuka honey was used as the control. Different concentrations of honey [6.25-25% (w/v)] were tested against each type of microorganism. Briefly, two-fold dilutions of honey solutions were tested to determine the minimum inhibitory concentration (MIC) against each type of microorganism, followed by more assays within a narrower dilution range to obtain more precise MIC values. MICs were determined by both visual inspection and spectrophotometric assay at 620 nm. Minimum bactericidal concentration (MBC) also was determined by culturing on blood agar plates.</p> <p>Results</p> <p>By visual inspection, the MICs of tualang honey ranged from 8.75% to 25% compared to manuka honey (8.75-20%). Spectrophotometric readings of at least 95% inhibition yielded MIC values ranging between 10% and 25% for both types of honey. The lowest MBC for tualang honey was 20%, whereas that for manuka honey was 11.25% for the microorganisms tested. The lowest MIC value (8.75%) for both types of honey was against <it>Stenotrophomonas maltophilia</it>. Tualang honey had a lower MIC (11.25%) against <it>Acinetobacter baumannii </it>compared to manuka honey (12.5%).</p> <p>Conclusion</p> <p>Tualang honey exhibited variable activities against different microorganisms, but they were within the same range as those for manuka honey. This result suggests that tualang honey could potentially be used as an alternative therapeutic agent against certain microorganisms, particularly <it>A. baumannii </it>and <it>S. maltophilia</it>.</p

Beneficial immune modulatory effects of a specific nutritional combination in a murine model for cancer cachexia

The majority of patients with advanced cancer are recognised by impaired immune competence influenced by several factors, including the type and stage of the tumour and the presence of cachexia. Recently, a specific nutritional combination containing fish oil, specific oligosaccharide mixture, high protein content and leucine has been developed aimed to support the immune system of cancer patients in order to reduce the frequency and severity of (infectious) complications. In a recently modified animal model cachexia is induced by inoculation of C26 tumour cells in mice. In a pre-cachectic state, no effect was observed on contact hypersensitivity, a validated in vivo method to measure Th1-mediated immune function, after adding the individual nutritional ingredients to the diet of tumour-bearing mice. However, the complete mixture resulted in significantly improved Th1 immunity. Moreover, in a cachectic state, the complete mixture reduced plasma levels of pro-inflammatory cytokines and beneficially affected ex vivo immune function. Accordingly, the combination of the nutritional ingredients is required to obtain a synergistic effect, leading to a reduced inflammatory state and improved immune competence. From this, it can be concluded that the specific nutritional combination has potential as immune-supporting nutritional intervention to reduce the risk of (infectious) complications in cancer patients

Causes and outcome of bladder injuries in Durban

Objective: To document our experience with the management of bladder injuries.Design: A retrospertive study.Setting: King Edward VIII Hospital in Durban, South Africa.Patients: One hundred and twenty patients with urinary bladder injuries.Interventions: Patients with intraperitoneal bladder injuries underwent laparotomy whereas those with extraperitoneal bladder injuries were managed non-operatively with a supra pubic catheter.Results: The patients' median age was 28.5 years and the male to female ratio was 5:1 Sixty injuries were due to firearms, seven to stabs and fifty three were due to blunt trauma. There were other associated injuries in sixty six patients while fifty four patients had isolated bladder injuries. Ninety four intraperitoneal injuries were repaired while 26 extraperitoneal injuries were managed conservatively. The mortality rate was fourteen percent (twenty four percent for patients with other associated injuries and two per cent for patients with isolated injuries). The mean hospital stay was 18.65± 23.35 days(13.3± 13.5 for firearms 30.56 ±33.39 for blunt injuries and 11.00 ± 2.55 for stabs).Conclusion: The majority of bladder injuries were penetrating and the major cause was firearm wounds. Blunt injuries were associated with prolonged hospital stay. Isolated bladder injuries carried a low mortality rate even in patients with delayed diagnosis, Associated injuries were responsible for the high mortality. Suprapubic cystostomy for exiraperituneal bladder injuries led to no complications in our hands

Nutrition in Liver Disease

Please help us populate SUNScholar with the post print version of this article. It can be e-mailed to: [email protected] Voedin

The in vitro susceptibility of Campylobacter spp. to the antibacterial effect of manuka honey

We report the antimicrobial effect of manuka honey against Campylobacter spp. isolated by a diagnostic laboratory from specimens from a community in New Zealand. The isolates were differentiated according to species level using multiplex PCR. C. jejuni (20 strains) and C. coli (7 strains) were identified. The clinical isolates identified and type culture collection strains of these species were subjected to testing to determine the minimum inhibitory concentration (MIC) of manuka honey using a microdilution technique. The MIC of the manuka honey against all of the Campylobacter tested was found to be around 1% (v/v) honey. The low MIC values suggest that honey might still inhibit the growth of campylobacteria after dilution by fluid in the gut, but the actual concentration of honey that can be achieved in the intestine is unknown. Therefore, clinical investigation is required to establish the efficacy of honey against Campylobacter spp. in the gut environment