Standardisation of spirometry

The suggested technical specifications in this document apply to apparatus used by clipicians for the diagnosis of common respiratory diseases and are to be considered as the minimum acceptable standards. Specifications, features and practices which are desirable, but not obligatory, are also presented. It is accepted that a need exists for more sophisticated apparatus for specialised indications (e.g. for use in an academic institution for training or research, or for standardisation of other respiratory equipment). For sophisticated apparatus more stringent specifications apply, some of which can be found in the original documents

The standard of spirometry in the RSA

Standards for high-quality lung function testing have not yet been formally adopted in the RSA, despite the increase in the performance of spirometry. A study was undertaken to determine the standard of spirometry in clinical practice in this country. Forty-five spirometer users agreed to participate. Responses to a questionnaire, administered by personal interview, were graded according to the proportion of correct or appropriate answers: completely unsatisfactory < 33,3%; poor 33,3 - 66,6%; and satisfactory> 66,6%. Only 6 spirometers were regularly calibrated. Knowledge of international standards for spirometry, the basic working mechanism of the spirometer being used and calibration ranged from poor to completely unsatisfactory in most of the practices. Instructions to the patient for performing the manoeuvres were satisfactory, but evaluation of the result for acceptability, reproducibility, selection of the best test and diagnosis of a positive bronchodilator response were generally completely unsatisfactory. Only 18 practitioners knew the source of the reference values they used and 5 had proved their validity with a sample. Fourteen of the 45 practitioners were unable to make the correct diagnoses from two typical test results. Of the 45 practitioners, 40 were interested in a course in practical, clinical spirometry. In the light of the predominantly unsatisfactory results obtained in this study, we consider clinical spirometry to be an urgent priority for all levels of medical education

Oxytocin use in South Africa - a review

Objective. Oxytocin is one of the most frequently used drugs in labour and there are many different dosage regimens. The aim of this study was to examine the use of oxytocin by obstetricians in South Africa. Methods. A specially designed questionnaire was drawn up and distributed to specialists according to an address list obtained from the South African Society of Obstetricians and Gynaecologists. Results. Three hundred and fifty questionnaires were distributed, with 174 processed for analysis. The majority of obstetricians (70.3%) reported that they would not use oxytocin for induction of labour in a patient with a previous would not consider the use of oxytocin in a patient with a multifetal pregnancy. Most respondents used oxytocin for induction of labour in multigravid patients and 91.9% also used oxytocin for augmentation in these patients. However, clinicians would not use oxytocin if the patient was a grand multipara. Conclusions. Most clinicians adhere to accepted protocols practised internationally, with a few exceptions. The use of oxytocin for both induction and augmentation of labour in women with one previous caesarean section is not practised in South Africa, despite evidence suggesting its safety. S Afr Med J 2004; 94: 839-845

Age of diagnosis for congenital hearing loss at Universitas Hospital, Bloemfontein

Background. Congenital hearing loss affects 3 - 6/1 000 children worldwide. The benefits of early identification of hearing loss and early intervention have been clearly established. There are no previous studies reporting on the age of diagnosis of congenital hearing loss in the Free State province.Objectives. To determine the age of diagnosis of congenital hearing loss in the Otorhinolaryngology Clinic at Universitas Hospital. Secondary aims included determining age at first visit, as well as the time delay between first visit and diagnosis, and documenting any interventions which took  place.Methods. A retrospective, descriptive study was undertaken, analysing data from 2001 to 2010.Results. A total of 260 cases of congenital hearing loss were analysed. The median age of diagnosis of hearing loss was 44.5 months. The median age of first visit was 40.9 months, and the median delay between first visit and diagnosis was 49 days.Conclusions. The median age of diagnosis far exceeds national and  international benchmarks. This has a profoundly negative impact on the development and outcomes of children with hearing loss. These results have been used to motivate for the expansion of hearing screening and diagnostic services in the province

Experimental infection of game animals with lumpy skin disease virus (prototype strain Neethling)

Calves of a giraffe, an impala, two buffaloes, and two adult black wildebeests were artificially infected with the Neethling type of lumpy skin disease virus. The giraffe and impala died with typical symptoms and lesions of the disease. Virological examinations confirmed the presence of lumpy skin disease virus in lesions of these animals. Histopathological studies revealed microscopic lesions typical of those reported in cattle suffering from lumpy skin disease. Both intracytoplasmic and intranuclear inclusions were noticed in various cell types and some additional histopathological changes are reported. Neither the wildebeests nor the buffaloes reacted clinically to artificial infection and they failed to show a rise in antibody titre subsequently.The journals have been scanned in colour with a HP 5590 scanner; 600 dpi. Adobe Acrobat v.11 was used to OCR the text and also for the merging and conversion to the final presentation PDF-format..mn201

The significance of sub-threshold symptoms of anxiety in the aetiology of bruxism

Bruxism is an oral parafunctional habit involving clenching and grinding of the teeth. It occurs mainly unconsciously, diurnally and/or nocturnally. It is considered an important contributory factor in the aetiology of myofacial pain (MFP) and temporomandibular disorders (TMD). The etiology of bruxism is considered to be multifactorial, involving physiological and psychological factors. The aim of the study was to examine the relationship between the sub-threshold symptoms of anxiety and bruxism using a spectrum model. Firstly, levels of anxiety and stress were determined using the Spielberger State Trait Anxiety Inventory (STAI) and the Kessler-10 (K-10). Secondly, a tooth wear score was determined by means of a clinical examination, intra-oral photographs and dental casts. Thirdly, bruxism was rated on an ordinal scale according to specified bruxism criteria. A dualistic trend in the relationship between sub-threshold symptoms of anxiety, stress and bruxism was observed in the results. In approximately half of the subjects with higher than average anxiety and stress scores, bruxism behaviour was found. This indicates the possibility of two groups with separate relationships. The dentist could play a role in recognizing that a patient may be experiencing stress or anxiety, expressed through bruxing behaviour and refer the patient for therapy or counselling. An understanding of the psychological factors involved in the etiology of bruxism could encourage a more holistic approach to the treatment of patients with signs of bruxism.Web of Scienc

Schlafen 3 knockout mice display gender-specific differences in weight gain, food efficiency, and expression of markers of intestinal epithelial differentiation, metabolism, and immune cell function

Self-renewal and differentiation are essential for intestinal epithelium absorptive functioning and adaptation to pathological states such as short gut syndrome, ulcers, and inflammatory bowel disease. The rodent Slfn3 and its human analog Slfn12 are critical in regulating intestinal epithelial differentiation. We sought to characterize intestinal function in Slfn3 knockout (KO) mice. Male and female pair-fed Slfn3KO mice gained less weight with decreased food efficiency than wild type (WT) mice, with more pronounced effects in females. RNA sequencing performed on intestinal mucosa of Slfn3KO and WT mice showed gene ontology decreases in cell adhesion molecule signaling, tumor necrosis factor receptor binding, and adaptive immune cell proliferation/functioning genes in Slfn3KO mice, with greater effects in females. qPCR analysis of fatty acid metabolism genes, Pla2g4c, Pla2g2f, and Cyp3c55 revealed an increase in Pla2g4c, and a decrease in Pla2g2f in Slfn3KO females. Additionally, adipogenesis genes, Fabp4 and Lpl were decreased and ketogenesis gene Hmgcs2 was increased in female Slfn3KO mice. Sequencing did not reveal significant changes in differentiation markers, so qPCR was utilized. Slfn3KO tended to have decreased expression of intestinal differentiation markers sucrase isomaltase, dipeptidyl peptidase 4, villin 1, and glucose transporter 1 (Glut1) vs. WT males, although these trends did not achieve statistical significance unless data from several markers was pooled. Differentiation markers, Glut2 and sodium-glucose transporter 1 (SGLT1), did show statistically significant sex-dependent differences. Glut2 mRNA was reduced in Slfn3KO females, while SGLT1 increased in Slfn3KO males. Notch2 and Cdx2 were only increased in female Slfn3KO mice. Although Slfn3KO mice gain less weight and decreased food efficiency, their biochemical phenotype is more subtle and suggests a complex interplay between gender effects, Slfn3, and another regulatory pathway yet to be identified that compensates for the chronic loss of Slfn3