Guest EditorialIs a rethink of our approach to hypertension necessary?

No Abstract.South African Psychiatry Review Vol. 11(4) 2005: 117-12

The geometry of Karoo dolerite dykes and saucers in the Highveld Coalfield : constraints on emplacement processes of mafic magmas in the shallow crust

Thesis (MSc)--Stellenbosch University, 2016.ENGLISH ABSTRACT: This dissertation is a compilation of two case studies that integrates an extensive underground mining and drilling data set on Karoo dolerite intrusions in the Highveld Coalfield to constrain the emplacement processes of the upper-crustal plumbing system of the Karoo large igneous province. Chapter 3 describes by means of a three-dimensional strata model the geometry of a regional-scale Karoo-age (ca. 180Ma) saucer complex locally referred to as the number 8 sill. The saucer complex consists of three saucers largely confined to the Karoo Supergroup underlain by a shallow dipping basement feeder. The model demonstrates the lateral emplacement of magma where a single basement feeder gives rise to several split level saucers that subsequently coalesces into one vast saucer complex. Furthermore, these relationships show a strong spatial and geometric dependency of saucers to their underlying feeders. Lithological interfaces and weak layers control and facilitate the lateral emplacement of magma during the development of saucers in the Karoo Supergroup. The common occurrence of localised dome- and ridge-shaped structures along the flat inner sill of the saucers are likely generated from lobate magma flow processes. Inflation of individual magma lobes induce overlying strata failure along multiple curved faults that facilitates the formation of circular inclined sheets feeding a flat lying roof seated at a higher stratigraphic level. Chapter 4 examines the spatial and temporal relationships between dolerite dykes and the saucers that make up the larger number 8 sill complex. These dykes have distinct short strike lengths, curved geometries and form interconnected and cross-cutting patterns. Moreover, the dykes are often rooted along the upper surface of underlying saucers and cannot be seen to extend below the base (inner sill) of the saucers. Contact relationships show a mainly coeval or contemporaneous emplacement of dykes to the inner sill and inclined sheets of the underlying saucer. The dykes can be described as two diverse sets, namely systematic and non-systematic dykes. Systematic dykes form a well-organised interconnected boxwork or ladder-like pattern of two near-orthogonal dyke sets confined to the inner sill of the underlying saucer. The formation of these dykes is related to the uplift and stretch of the strata directly overlying propagating magma lobes along the inner sill of the underlying saucer. Conversely, non-systematic dykes display a more irregular array of structures that not only overlie the inner sill but often cross-cut or extend outwards from the inclined sheets of the saucer. These dykes are likely the product of multi-directional stretch induced during the emplacement of coeval and adjacent saucers forming a so called “cracked lid” similar to field descriptions of stacked saucers in Antarctica. Dyke-saucer relationships of the Highveld Coalfield highlight the influence of magma emplacement processes and the deformation of host strata rather than far-field tectonic stresses.AFRIKAANS OPSOMMING: Geen opsomming beskikbaa

Gas exchange indices how valid are they?

No Abstract

Effect of 1% and 2% propofol on blood lipids during long-term sedation

Objectives. To compare the effects of 1% and 2% propofol on the maximum and average lipid levels, the relative frequency of hyperlipidaemia, the propofol dose required to achieve an equivalent degree of sedation, the pharmacodynamic effects at the required infusion rates, and the effect on respiratory function.Design. Open, randomised, parallel group, multicentre comparison study.Setting. Intensive care units (ICUs) at the Faculty of Medicine, University of Stellenbosch and at Vergelegen Medicity, Somerset West.Subjects. Patients who were artificially ventilated for at least 72 hours in the ICUs and who required sedation or analgesia..Outcome measures. Continuous intravenous infusion of 1% or 2%  propofol to provide an administration rate in the range of 1 - 4 mg/kg/h. The initial infusion rate was about 2 mg/kg/h, adjusted to achieve the appropriate level of sedation. Results and conclusions. Seventy-five patients were enrolled in the study, of which 72 were evaluable for safety analysis and 58 were evaluable for efficacy analysis. The total daily dose of propofol (ml/ day) in the 2% propofol group was about 60% of that in the 1% propofol group, indicating that the lipid load in the 2% propofol group had only slightly more than half the lipid load in the 1% propofol group. Thirteen of 27 patients (48%) in the 2% propofol group had abnormally

Severe acute respiratory infection with influenza A (H1N1) during pregnancy

The original publication is available at http://www.samj.org.zaABSTRACT FROM JOURNAL: Pregnant women are at high risk of severe acute respiratory infection if infected with the influenza A (H1N1) virus. On 14 August 2009 the first complicated H1N1 obstetric patient was admitted to the obstetric critical care unit (OCCU) at Tygerberg Hospital with respiratory distress. The clinical picture was that of bronchopneumonia, and she tested positive for H1N1. Subsequent pregnant patients admitted to the OCCU with respiratory compromise or flu symptoms were screened for the virus. Eleven days later 13 cases were confirmed. Five patients had acute lung injury and required ventilation and inotropic support. Three of the patients with acute lung injury subsequently died. Three patients required continuous positive airway pressure (CPAP) support only, with no inotropics needed. The remaining 5 patients presented early, received oseltamivir within 48 hours and did not require critical care admission. All the patients admitted to the OCCU and the medical intensive care unit (ICU) initially presented with flu symptoms, respiratory distress and changes on the chest radiograph indicating an active diffuse pulmonary parenchymal process. Six patients underwent uncomplicated caesarean sections for fetal distress after they were stabilised. Maternal and neonatal outcomes varied. The key factor appears to be early clinical diagnosis and oseltamivir within 48 hours of the onset of symptoms. The demographic data and maternal and fetal outcomes are set out in Table I

The way in which a physiotherapy service is structured can improve patient outcome from a surgical intensive care : a controlled clinical trial

The original publication is available at http://ccforum.com/Publication of this article was funded by the Stellenbosch University Open Access Fund.Introduction: The physiological basis of physiotherapeutic interventions used in intensive care has been established. We must determine the optimal service approach that will result in improved patient outcome. The aim of this article is to report on the estimated effect of providing a physiotherapy service consisting of an exclusively allocated physiotherapist providing evidence-based/protocol care, compared with usual care on patient outcomes. Methods: An exploratory, controlled, pragmatic, sequential-time-block clinical trial was conducted in the surgical unit of a tertiary hospital in South Africa. Protocol care (3 weeks) and usual care (3 weeks) was provided consecutively for two 6-week intervention periods. Each intervention period was followed by a washout period. The physiotherapy care provided was based on the unit admission date. Data were analyzed with Statistica in consultation with a statistician. Where indicated, relative risks with 95% confidence intervals (CIs) are reported. Significant differences between groups or across time are reported at the alpha level of 0.05. All reported P values are two-sided. Results: Data of 193 admissions were analyzed. No difference was noted between the two patient groups at baseline. Patients admitted to the unit during protocol care were less likely to be intubated after unit admission (RR, 0.16; 95% CI, 0.07 to 0.71; RRR, 0.84; NNT, 5.02; P = 0.005) or to fail an extubation (RR, 0.23; 95% CI, 0.05 to 0.98; RRR, 0.77; NNT, 6.95; P = 0.04). The mean difference in the cumulative daily unit TISS-28 score during the two intervention periods was 1.99 (95% CI, 0.65 to 3.35) TISS-28 units (P = 0.04). Protocol-care patients were discharged from the hospital 4 days earlier than usual-care patients (P = 0.05). A tendency noted for more patients to reach independence in the transfers (P = 0.07) and mobility (P = 0.09) categories of the Barthel Index. Conclusions A physiotherapy service approach that includes an exclusively allocated physiotherapist providing evidence-based/protocol care that addresses pulmonary dysfunction and promotes early mobility improves patient outcome. This could be a more cost-effective service approach to care than is usual care. This information can now be considered by administrators in the management of scarce physiotherapy resources and by researchers in the planning of a multicenter randomized controlled trial. Trial registration PACTR201206000389290Publishers' Versio

Severe acute respiratory infection with influenza A (H1N1) during pregnanacy

During an eleven day period we admitted twelve obstetric patients with complicated H1N1. Five patients had acute lung injury and required invasive ventilation and inotropic support. Three patients required Continious Positive Airway Pressure (CPAP) support with no inotropes needed. Three of the obstetric patients admitted to critical care units died. Influenza A (H1N1) should not be underestimated in pregnancy. Prevention strategies, early oseltamivir, carefull observation and early transfer to critical care facilities when indicated will decrease maternal and perinatal mortality

Crimean-Congo haemorrhagic fever presenting with undiagnosed chronic myeloid leukaemia

A patient with Crimean-Congo haemorrhagic fever (CCHF) presented with a high white cell count and splenomegaly. Underlying chronic myeloid leukaemia was diagnosed. The management of this complex case was difficult, and the patient demised. This case illustrates that in patients with an acute febrile illness with haemorrhage, a thorough history and examination, as well as a high index of suspicion for concurrent conditions, is important.http://www.tandfonline.com/loi/ojid20am2018Veterinary Tropical Disease

Influence of two sports vision training techniques on visual skills performance of university students

Vision is an essential sense and crucial throughout a student’s academic career. Reading and writing during formal studies require a basic level of visual skills. Training of visual skills to students may improve the way visual stimuli are processed, and subsequently lead to visual skill-, motor- and cognitive performance enhancement. The visual system processes information by way of ‘hardware’- skills (physical, mechanical properties) and the more trainable ‘software’-skills (perceptual, cognitive abilities). Sports vision skills training in athletes indicated faster response to visual information and ultimately improved performance, particularly in fast-ball sports. The efficiency of two sports vision training programmes were tested and compared in undergraduate physiology students of various ethnicities (aged 18-25 years), during a 6-week training period. Three groups were used. One control group and two experimental groups were used. Two programmes were used for the experimental groups (a vision laboratory executed battery of repeated visual skills vs. ‘Eyedrills’ an available webbased training programme). Both comprised ‘hardware’ and ‘software’ skills, and include: visual acuity, focusing, tracking, vergence, sequencing, eye-hand coordination and visualisation. For pretest/ post-test evaluations of all students the repeated laboratory training programme was executed. The control group was only exposed to the pre- and post-test. Individuals trained in the laboratory indicated the highest improvement in all visual skills, except vergence. The ‘Eyedrills’ group displayed significant improvements in focusing, tracking and eye-hand coordination, with the control group indicating the least improvement in visual skills - ruling out the notion of improvement occurring only due to test familiarity. Visual training was verified an essential method of improving visual skills, and fundamental in the expansion of basic visual abilities of university students for enhanced performance.http://www.journals.co.za/content/journal/ajpherd1am2017Biokinetics, Sport and Leisure SciencesPhysiologyPsychologySports MedicineStatistic

Deciphering colorectal cancer genetics through multi-omic analysis of 100,204 cases and 154,587 controls of European and east Asian ancestries

In the version of this article initially published, the author affiliations incorrectly listed “Candiolo Cancer Institute FPO-IRCCS, Candiolo (TO), Italy” as “Candiolo Cancer Institute, Candiolo, Italy.” The change has been made to the HTML and PDF versions of the article