Stenting the arterial duct: Practical aspects and review of outcomes

Cyanotic congenital heart lesions with duct-dependent pulmonary blood fl ow often require early intervention. Surgical palliation remains the treatment of choice, but is associated with substantial morbidity and mortality. Ductal stent implantation is becoming a recognised alternative to maintain pulmonary blood fl ow. Results of ductal stenting have improved and outcomes are good. We discuss the outcomes of published data and the practical aspects of ductal stenting

ASD and PDA closure with CeraTM and CeraFlexTM devices

Introduction and aim: Percutaneous closure of congenital cardiac defects is common practice. The aim of the study was to describe our experience in closing PDAs, PFOs and an ASD using the new CeraTM and CeraFlexTM devices. Methods: Twenty patients were included in this retrospectivereview. All patients underwent device closure with the Cera TM and CeraFlexTM devices. Results: All attempts at device closure were successful (n=20). Indications included PDA (n=16), ASD (n=1) and PFO (n=3). Median age at procedure was: PDA 1y 10mo (4mo - 10y 4mo), ASD 27y and PFO 50y 9mo (38y - 70y). Median weight at procedure was: PDA 10.5kg (4.9kg - 70kg), ASD 56kg and PFO 82.5kg (80kg - 113kg). Periprocedural complications consisted of embolisation of 2 PDA devices, which could be repositioned. Conclusion: The CeraTM and CeraFlexTM devices are effective for closure of PDAs, ASDs and PFOs

Visual learning and graphic design : a cooperative strategy

Abstract. The article discusses an exploratory study implemented at three campuses of the Vaal University of Technology, Vanderbijlpark, in response to weak examination results in one of the subjects in the graphic design curriculum. The aim of the study was to investigate the feasibility of utilising a combination of visual learning and cooperative learning strategies in this setting. A comparative assessment methodologies framework was utilised to measure how graphic design first-year learners experience these. The results suggest that although the learners enjoyed and saw value in some aspects of the visual learning and cooperative learning strategies, a combination was seen as disruptive to the learning environment and is thus unlikely to lead to a significant improvement in examination results in the long term

Risk factors for unsuccessful lumbar puncture in children

Background. This descriptive study provides the first information on an association between the use of sedation and a reduction in the prevalence of unsuccessful lumbar puncture (LP) in African children of all races.Objective. Our hypothesis was that children who do not receive any procedural sedation are more likely to have unsuccessful LPs.Methods. A cross-sectional observational study examined LPs performed from February to April 2013, including details of the procedure, sedation or analgesia used, and techniques. The setting was the Medical Emergency Unit at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa, and the participants all children aged 0 - 13 years who had an LP in the unit during the time period.Results. Of 350 children, 62.9% were <12 months of age, the median age being 4.8 months (interquartile range 1.5 - 21.7). The prevalence of unsuccessful (traumatic or dry) LP was 32.3% (113/350). Sedation was used in 107 children (30.6%) and was associated with a reduction in the likelihood of unsuccessful LP (p=0.002; risk ratio (RR) 0.5 (95% confidence interval (CI) 0.34 - 0.78)) except in those <3 months of age, where sedation did not significantly reduce the likelihood (p=0.56; RR 1.20 (95% CI 0.66 - 2.18)).Conclusions. Unsuccessful LP was common. Sedation was not routinely used, but the results suggest that it may be associated with a reduction in the rate of unsuccessful LP. Unsuccessful LP may lead to diagnostic uncertainty, prolonged hospitalisation and unnecessary antibiotic use. Whether a procedural sedation protocol would reduce the rate of unsuccessful LP requires further study

Role of micronutrients in HIV infection

More than 60% of the estimated 40 million persons with HIV/AIDS worldwide live in sub-Saharan Africa, where poverty, social insecurity, food shortages and malnutrition are major problems.1 In children under the age of 5 years, who live in developing countries, malnutrition has been associated with 50% of the 10.8 million deaths mainly caused by neonatal disorders, diarrhoea, pneumonia, malaria and HIV/AIDS.2 Likewise micronutrient deficiencies are widespread and are associated with increased morbidity and mortality particularly in relation to infectious diseases.3 This review focuss on the interaction between micronutrients and HIV/AIDS and discusses recent research findings that may have important public health implications in terms of the case management of persons with HIV/AIDS Southern African Journal of HIV Medicine Vol. 6 (2) 2005: pp. 18-2

An adapted triage tool (ETAT) at Red Cross War Memorial Children’s Hospital Medical Emergency Unit, Cape Town: An evaluation

Objective. To evaluate the efficacy of an adapted Emergency Triage Assessment and Treatment (ETAT) tool at a children’s hospital. Design. A two-armed descriptive study. Setting. Red Cross War Memorial Children’s Hospital, Cape Town, South Africa. Methods. Triage data on 1 309 children from October 2007 and July 2009 were analysed. The number of children in each triage category (red (emergency), orange (urgent or priority) and green (non-urgent)) and their disposal were evaluated. Results. 1. The October 2007 series: 902 children aged 5 days - 15 years were evaluated. Their median age was 20 (interquartile range (IQR) 7 - 50) months, and 58.8% (n=530) were triaged green, 37.5% (n=338) orange and 3.8% (n=34) red. Over 90% of children in the green category were discharged (478/530), while 32.5% of children triaged orange (110/338) and 52.9% of children triaged red (18/34) were admitted. There was a significant increase in admission rate for each triage colour change from green through orange to red after adjustment for age category (risk ratio (RR) 2.6; 95% confidence interval (CI) 2.2 - 3.1). 2. The July 2009 cohort: 407 children with a median age of 22 months (IQR 7 - 53 months) were enrolled. Twelve children (2.9%) were triaged red, 187 (45.9%) orange and 208 (51.1%) green. A quarter (101/407) of the children triaged were admitted: 91.7% (11/12) from the red category and 36.9% (69/187) from the orange category were admitted, while 89.9% of children in the green category (187/208) were discharged. After adjusting for age category, admissions increased by more than 300% for every change in triage acuity (RR 3.2; 95% CI 2.5 - 4.1). Conclusions. The adapted ETAT process may serve as a reliable triage tool for busy paediatric medical emergency units in resource-constrained countries and could be evaluated further in community emergency settings

An adapted triage tool (ETAT) at Red Cross War Memorial Children’s Hospital Medical Emergency Unit, Cape Town: An evaluation

Objective. To evaluate the efficacy of an adapted Emergency Triage Assessment and Treatment (ETAT) tool at a children’s hospital. Design. A two-armed descriptive study. Setting. Red Cross War Memorial Children’s Hospital, Cape Town, South Africa. Methods. Triage data on 1 309 children from October 2007 and July 2009 were analysed. The number of children in each triage category (red (emergency), orange (urgent or priority) and green (non-urgent)) and their disposal were evaluated. Results. 1. The October 2007 series: 902 children aged 5 days - 15 years were evaluated. Their median age was 20 (interquartile range (IQR) 7 - 50) months, and 58.8% (n=530) were triaged green, 37.5% (n=338) orange and 3.8% (n=34) red. Over 90% of children in the green category were discharged (478/530), while 32.5% of children triaged orange (110/338) and 52.9% of children triaged red (18/34) were admitted. There was a significant increase in admission rate for each triage colour change from green through orange to red after adjustment for age category (risk ratio (RR) 2.6; 95% confidence interval (CI) 2.2 - 3.1). 2. The July 2009 cohort: 407 children with a median age of 22 months (IQR 7 - 53 months) were enrolled. Twelve children (2.9%) were triaged red, 187 (45.9%) orange and 208 (51.1%) green. A quarter (101/407) of the children triaged were admitted: 91.7% (11/12) from the red category and 36.9% (69/187) from the orange category were admitted, while 89.9% of children in the green category (187/208) were discharged. After adjusting for age category, admissions increased by more than 300% for every change in triage acuity (RR 3.2; 95% CI 2.5 - 4.1). Conclusions. The adapted ETAT process may serve as a reliable triage tool for busy paediatric medical emergency units in resource-constrained countries and could be evaluated further in community emergency settings

Real-time marker-less multi-person 3D pose estimation in RGB-Depth camera networks

This paper proposes a novel system to estimate and track the 3D poses of multiple persons in calibrated RGB-Depth camera networks. The multi-view 3D pose of each person is computed by a central node which receives the single-view outcomes from each camera of the network. Each single-view outcome is computed by using a CNN for 2D pose estimation and extending the resulting skeletons to 3D by means of the sensor depth. The proposed system is marker-less, multi-person, independent of background and does not make any assumption on people appearance and initial pose. The system provides real-time outcomes, thus being perfectly suited for applications requiring user interaction. Experimental results show the effectiveness of this work with respect to a baseline multi-view approach in different scenarios. To foster research and applications based on this work, we released the source code in OpenPTrack, an open source project for RGB-D people tracking.Comment: Submitted to the 2018 IEEE International Conference on Robotics and Automatio

Spitting cobra (Naja nigricincta nigricincta) bites complicated by rhabdomyolysis, possible intravascular haemolysis, and coagulopathy

Zebra snake (Naja nigricincta nigricincta) bite is a significant health problem in Namibia. Although fatalities are thought to be rare, the severe cytotoxic effects and debilitating consequences of neglected bites are well documented. The focus of our treatment has always been the urgent treatment of necrosis. Although there have been a few reports of infant fatalities, acute renal failure and mild coagulation problems, systemic effects after envenomation were not well documented. Three case reports of patients with rhabdomyolysis, intravascular haemolysis and coagulopathy following N. n. nigricincta bites are presented

The development of protocols and norms for sports vision evaluations

The purpose of this study was to find the most appropriate protocol to establish norms for the most important visual skills required by elite athletes in sports performance. One hundred and fifty eight elite athletes were tested and their visual skills categorized as being: superior, above average, average, ineffective or needs immediate attention. Two methods namely, the percentage method and the mean and standard deviation method were employed to find the most applicable way to establish these categories.  The results indicate that elite athletes perform very well for all the visual skills tested and that the norms thus established suggest the importance of these visual skills in sports performance