Virilising ovarian tumour in a postmenopausal woman after bilateral oophorectomy

Ovarian neoplasms are rare tumours of steroid cell origin. These tumours present clinically due to the associated excess production of  either androgenic or oestrogenic gonadal steroid hormones. The clinical picture is dictated by the specific hormone(s) produced and  influenced by the age of the patient. The case is a 59-year-old woman who presented with a fiveyear history suggestive of androgen  excess. She underwent a hysterectomy and right-sided oophorectomy at age 28 years for dysfunctional uterine bleeding. Virilisation was confirmed on clinical examination and the testosterone excess biochemically localised to the ovaries. A left-sided oophorectomy was  performed. The clinical picture and testosterone excess persisted after surgery. Follow-up radiological investigations identified adnexal material that on resection proved to be remnant ovarian tissue. Histopathology confirmed the presence of a steroid cell tumour within the remnant tissue. The biochemical androgen excess resolved and the clinical features improved dramatically

Lipid levels and major adverse cardiovascular events in patients initiated on statins for primary prevention: an international population-based cohort study protocol

Background Clinical guidelines recommend specific targets for low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) for primary prevention of cardiovascular disease (CVD). Furthermore, individual variability in lipid response to statin therapy requires assessment of the association in diverse populations.Aim To assess whether lower concentrations of LDL-C and non-HDL-C are associated with a reduced risk of major adverse cardiovascular events (MACE) in primary prevention of CVD.Design & setting An international, new-user, cohort study will be undertaken. It will use data from three electronic health record databases from three global regions: Clinical Practice Research Datalink, UK; PREDICT-CVD, New Zealand (NZ); and the Clinical Data and Analysis Reporting System, Hong Kong (HK).Method New statin users without a history of atherosclerotic CVD, heart failure, or chronic kidney disease, with baseline and follow-up lipid levels will be eligible for inclusion. Patients will be classified according to LDL-C ([less than]1.4, 1.4–1.7, 1.8–2.5, and ≥2.6 mmol/l) and non-HDL-C ([less than] 2.2, 2.2–2.5, 2.6–3.3, and ≥3.4 mmol/l) concentrations 24 months after initiating statin therapy. The primary outcome of interest is MACE, defined as the first occurrence of coronary heart disease, stroke, or cardiovascular death. Secondary outcomes include all-cause mortality and the individual components of MACE. Sensitivity analyses will be conducted using lipid levels at 3 and 12 months after starting statin therapy.Conclusion Results will inform clinicians about the benefits of achieving guideline recommended concentrations of LDL-C for primary prevention of CVD

Die antropometriese sprongitem-prestasiedeterminante van jong dogtergimnaste

The purposes of this study were firstly to determine the anthropometric variables that differ significantly (p ≤ 0.05) between successful and less successful young, South-African (SA), female gymnasts in the vault item and secondly, to determine the anthropometric variables that contribute to the performance of young SA female gymnasts in the vault item. Twelve young, female gymnasts (13.39 +- 2.14 years) from a gymnastics club in the North-West Province of South Africa participated in this study. Only gymnasts who participated at level 6-9 and junior as well as at the senior Olympic level were selected to participate in this study. Sixty-one anthropometric variables were measured on the dominant side of the body according to the methods of Norton et al. (1996). Independent t-tests and effect sizes revealed that the gymnasts who obtained the highest points (top 5) during the execution of the vault item during the South African Gymnastics Championships had statistical and practical significantly larger relaxed and flexed upper arm, wrist and ankle circumferences as well as higher mesomorphy values than the less successful gymnasts. The cluster analysis-reduced variables were used to perform a forward, stepwise multiple regression analysis, which showed that flexed upper arm circumference (53.93%), midstillion dactillion length (12.38%), foot length(11.50%), fat percentage (8.93%), trochanterion-tibial lateral length (5.77%), chest circumference (3.69%), ectomorphy (1.96%), bideltoied breadth (1.54%), triceps skinfold (0.23%) and iliospinal box height (0.07%) contributed 100% to the variance in gymnasts’ vault performances. Therefore the conclusion that can be drawn is that larger upper arm and upper body circumferences; hand, foot, upper leg and total leg lengths; triceps skinfold and fat percentage as well as a higher ectomorphy value are important anthropometric vaulting performance determinants for young, South African, female gymnasts and should be included in the sport-scientific testing protocols of gymnasts.Key words: Gymnastics; Vault; Anthropometry; Performance; Female; Girls

Die antropometriese vloeritem-prestasiedeterminante van jong dogtergimnaste

The purposes of this study were firstly, to determine the anthropometric variables that differ significantly (p 0.05) between successful and less successful young, South-African female gymnasts who participate in the floor item and secondly, to determine the anthropometric variables that contribute to the floor item performance of those gymnasts. Twelve young, female gymnasts (13.39 ± 2.14 years) from a gymnastics club in the North-West Province of South Africa participated in the study. Only gymnasts who participated at level 6-9 and junior as well as senior Olympic level were selected to participate in the study. Sixty-one anthropometric variables were measured on the dominant side of the body according to the methods of Norton et al. (1996). Independent t-tests revealed that the gymnast who obtained the highest marks (top 5) during the execution of the floor item during the South African Gymnastics Championships had statistical and practical significantly larger relaxed and flexed upper arm, wrist and ankle circumferences as well as mesomorphy values than the less successful gymnasts. The cluster analysis-reduced variables were used to perform a forward, stepwise multiple regression analysis which showed that bi-trochanterion (34.86%), femur (17.07%) and bi-deltoid breadth (4.93%); front thigh skinfold (19.71%); fat percentage (7.68%); acromialradial (4.09%) and foot length (0.05%) as well as waist (6.68%), chest (2.92%) and gluteal thigh circumference (2.02%) contributed 100% to the variance in gymnasts’ floor performances. The contributions of bi-trochanterion breadth, femur breadth, gluteal thigh circumference and foot length to floor-gymnastic performance were significant. Only gluteal thigh circumference showed a negative relationship with floor-gymnastic performance. The conclusion that can therefore be drawn is that larger limb and torso circumferences, waist breadths, fat percentages and front thigh skinfolds, as well as upper arm and foot lengths are important anthropometric floor performance determinants for young, South African female gymnasts and should be included in the sports-scientific testing protocols of gymnasts.Key words: Gymnastics; Floor; Anthropometry; Performance; Females; Girls 

Face-to-face soft skills for entry-level internal auditors : a practice perspective

Practising internal auditors, including entry-level internal auditors, need face-to-face soft skills to effectively manage the increased complexity of their profession. Although many studies have highlighted the need for soft skills, none has identified the various categories of face-to-face soft skills required by entry-level internal auditors when interacting with stakeholders. The aim of this article is to determine the views of practising internal auditors on the face-to-face soft skills required by entry-level internal auditors. A convergent parallel mixed-methods design was used for the study. Two data collection methods were employed to address the research objective. First, a document analysis was conducted to compile a preliminary list of face-to-face soft skills categories. In this regard inductive thematic analysis was adopted. Second, a web-based survey, conducted among selected practising internal auditors in South Africa, confirmed the preliminary list of 21 face-to-face soft skills. Cronbach’s alpha statistics were calculated and interpreted for responses to all Likert-scale questions. The findings indicate that both practitioners and the Institute of Internal Auditors should augment the existing list of imprecise soft skills to include the identified 21 face-to-face soft skills. If this is done, entry-level internal auditors’ face-to-face soft skills will be enhanced.http:/journals.sagepub.com/home/ihehj2021Auditin