Renal papillary necrosis (RPN) in an African population : disease patterns, relevant pathways, and management

Renal papillary necrosis (RPN) is characterized by coagulative necrosis of the renal medullary pyramids and papillae. Multiple conditions and toxins are associated with RPN. Several RPN risk factors, or POSTCARDS, have been identified, with most patients presenting with RPN having at least two contributing risk factors. Currently, there is no specific test to diagnose and confirm RPN; however, several imaging tools can be used to diagnose the condition. RPN is currently underdiagnosed in African populations, often with fatal outcomes. In African clinical settings, there is a lack of consensus on how to define and describe RPN in terms of kidney anatomy, pathology, endourology, epidemiology, the identification of African-specific risk factors, the contribution of oxidative stress, and lastly an algorithm for managing the condition. Several risk factors are unique to African populations including population-specific genetic factors, iatrogenic factors, viral infections, antimicrobial therapy, schistosomiasis, substance abuse, and hypertension (GIVASSH). Oxidative stress is central to both GIVASSH and POSTCARDS-associated risk factors. In this review, we present information specific to African populations that can be used to establish an updated consensual definition and practical grading system for radiologists, urologists, nephrologists, nuclear physicians, and pathologists in African clinical settings.https://www.mdpi.com/journal/biomedicinesam2024Anatomical PathologyAnatomySurgeryUrologySDG-03:Good heatlh and well-bein

Oral literature in South Africa: 20 years on

I offer a retrospective on the field of orality and performance studies in South Africa from the perspective of 2016, assessing what has been achieved, what may have happened inadvertently or worryingly, what some of the significant implications have been, what remain challenges, and how we may think of, or rethink, orality and performance studies in a present and future that are changing at almost inconceivable pace.DHE