Vaginale amebiase

No Abstract

Amnionvog-embolisme (amniotic fluid embolism)

n' Bewese geval en n' kort samevatting van die literatuu

Unicornuate uterus with ectopic teratomatous ovary and ectopic kidney

No Abstract

Rupture of the thoracic trachea and main bronchi after blunt external trauma

Over a 30-month period, July 1970 - December 1972, 136 patients with multiple rib fractures and other chest injuries were treated in the Lung Unit at the Karl Bremer Hospital. Of these, 2 patients presented with complete avulsion of the right main stem bronchus at the level of the carina. A third patient sustained a tear of the trachea after being kicked on the sternum. In one case the trachea itself, as well as the left main bronchus, was involved in the tear. The diagnosis was made at bronchoscopy and immediate suture repair was undertaken in 2 patients. The patient with the tracheal tear presented late and was treated conservatively. All 3 patients made a complete recovery. The literature on this type of injury is reviewed and recommendations are made regarding early diagnosis and treatment.S. Afr. Med. J., 48, 1430 (1974)

Boekbespreking

No abstract available

Dynamical downscaling of austral summer climate forecasts over southern Africa using a regional coupled model

The prediction skill of dynamical downscaling is evaluated for climate forecasts over southern Africa using the Advanced Research Weather Research and Forecasting (WRF) model. As a case study, forecasts for the December–February (DJF) season of 2011/12 are evaluated. Initial and boundary conditions for the WRF model were taken from the seasonal forecasts of the Scale Interaction Experiment-Frontier Research Center for Global Change (SINTEX-F) coupled general circulation model. In addition to sea surface temperature (SST) forecasts generated by nine-member ensemble forecasts of SINTEX-F, the WRF was also configured to use SST generated by a simple mixed layer Price–Weller–Pinkel ocean model coupled to the WRF model. Analysis of the ensemble mean shows that the uncoupled WRF model significantly increases the biases (errors) in precipitation forecasted by SINTEX-F. When coupled to a simple mixed layer ocean model, the WRF model improves the spatial distribution of precipitation over southern Africa through a better representation of the moisture fluxes. Precipitation anomalies forecasted by the coupled WRF are seen to be significantly correlated with the observed precipitation anomalies over South Africa, Zimbabwe, southern Madagascar, and parts of Zambia and Angola. This is in contrast to the SINTEX-F global model precipitation anomaly forecasts that are closer to observations only for parts of Zimbabwe and South Africa. Therefore, the dynamical downscaling with the coupled WRF adds value to the SINTEX-F precipitation forecasts over southern Africa. However, the WRF model yields positive biases (>2°C) in surface air temperature forecasts over the southern African landmass in both the coupled and uncoupled configurations because of biases in the net heat fluxesThe Japan Science and Technology Agency (JST)/Japan International Cooperation Agency (JICA) through the Science and Technology Research Partnership for Sustainable Development (SATREPS).http://www2.ametsoc.org/ams/index.cfm/publications/journals/journal-of-climate/hb2016Geography, Geoinformatics and Meteorolog

The satisfactory growth and development at 2 years of age of the INTERGROWTH-21st Fetal Growth Standards cohort support its appropriateness for constructing international standards.

BACKGROUND: The World Health Organization recommends that human growth should be monitored with the use of international standards. However, in obstetric practice, we continue to monitor fetal growth using numerous local charts or equations that are based on different populations for each body structure. Consistent with World Health Organization recommendations, the INTERGROWTH-21st Project has produced the first set of international standards to date pregnancies; to monitor fetal growth, estimated fetal weight, Doppler measures, and brain structures; to measure uterine growth, maternal nutrition, newborn infant size, and body composition; and to assess the postnatal growth of preterm babies. All these standards are based on the same healthy pregnancy cohort. Recognizing the importance of demonstrating that, postnatally, this cohort still adhered to the World Health Organization prescriptive approach, we followed their growth and development to the key milestone of 2 years of age. OBJECTIVE: The purpose of this study was to determine whether the babies in the INTERGROWTH-21st Project maintained optimal growth and development in childhood. STUDY DESIGN: In the Infant Follow-up Study of the INTERGROWTH-21st Project, we evaluated postnatal growth, nutrition, morbidity, and motor development up to 2 years of age in the children who contributed data to the construction of the international fetal growth, newborn infant size and body composition at birth, and preterm postnatal growth standards. Clinical care, feeding practices, anthropometric measures, and assessment of morbidity were standardized across study sites and documented at 1 and 2 years of age. Weight, length, and head circumference age- and sex-specific z-scores and percentiles and motor development milestones were estimated with the use of the World Health Organization Child Growth Standards and World Health Organization milestone distributions, respectively. For the preterm infants, corrected age was used. Variance components analysis was used to estimate the percentage variability among individuals within a study site compared with that among study sites. RESULTS: There were 3711 eligible singleton live births; 3042 children (82%) were evaluated at 2 years of age. There were no substantive differences between the included group and the lost-to-follow up group. Infant mortality rate was 3 per 1000; neonatal mortality rate was 1.6 per 1000. At the 2-year visit, the children included in the INTERGROWTH-21st Fetal Growth Standards were at the 49th percentile for length, 50th percentile for head circumference, and 58th percentile for weight of the World Health Organization Child Growth Standards. Similar results were seen for the preterm subgroup that was included in the INTERGROWTH-21st Preterm Postnatal Growth Standards. The cohort overlapped between the 3rd and 97th percentiles of the World Health Organization motor development milestones. We estimated that the variance among study sites explains only 5.5% of the total variability in the length of the children between birth and 2 years of age, although the variance among individuals within a study site explains 42.9% (ie, 8 times the amount explained by the variation among sites). An increase of 8.9 cm in adult height over mean parental height is estimated to occur in the cohort from low-middle income countries, provided that children continue to have adequate health, environmental, and nutritional conditions. CONCLUSION: The cohort enrolled in the INTERGROWTH-21st standards remained healthy with adequate growth and motor development up to 2 years of age, which supports its appropriateness for the construction of international fetal and preterm postnatal growth standards

Clinical characteristics of women captured by extending the definition of severe postpartum haemorrhage with 'refractoriness to treatment': a cohort study

Background: The absence of a uniform and clinically relevant definition of severe postpartum haemorrhage hampers comparative studies and optimization of clinical management. The concept of persistent postpartum haemorrhage, based on refractoriness to initial first-line treatment, was proposed as an alternative to common definitions that are either based on estimations of blood loss or transfused units of packed red blood cells (RBC). We compared characteristics and outcomes of women with severe postpartum haemorrhage captured by these three types of definitions. Methods: In this large retrospective cohort study in 61 hospitals in the Netherlands we included 1391 consecutive women with postpartum haemorrhage who received either ≥4 units of RBC or a multicomponent transfusion. Clinical characteristics and outcomes of women with severe postpartum haemorrhage defined as persistent postpartum haemorrhage were compared to definitions based on estimated blood loss or transfused units of RBC within 24 h following birth. Adverse maternal outcome was a composite of maternal mortality, hysterectomy, arterial embolisation and intensive care unit admission. Results: One thousand two hundred sixty out of 1391 women (90.6%) with postpartum haemorrhage fulfilled the definition of persistent postpartum haemorrhage. The majority, 820/1260 (65.1%), fulfilled this definition within 1 h following birth, compared to 819/1391 (58.7%) applying the definition of ≥1 L blood loss and 37/845 (4.4%) applying the definition of ≥4 units of RBC. The definition persistent postpartum haemorrhage captured 430/471 adverse maternal outcomes (91.3%), compared to 471/471 (100%) for ≥1 L blood loss and 383/471 (81.3%) for ≥4 units of RBC. Persistent postpartum haemorrhage did not capture all adverse outcomes because of missing data on timing of initial, first-line treatment. Conclusion: The definition persistent postpartum haemo

The role of ultrasound in the management of cervical carcinoma. A preliminary report

ArticleThe original publication is available at http://www.samj.org.zaThirty-five cases of carcinoma of the cervix were examined ultrasonographically in order to assess the role of ultrasound in the management thereof. The method is not sufficiently reliable to detect spread beyond the cervix, but does provide useful information regarding pelvic anatomy and the spatial relationships of the cervix. It can be advantageously applied in the planning of therapy and its use in the day-to-day management of such cases is recommended.Publisher’s versio