Non-cirrhotic portal hypertension entity in South Africa? A report of 6 cases

Six patients with portal hypertension and well-preserved liver function as well as classic features of non-cirrhotic portal hypertension on histological examination of biopsy specimens are described. Three of these patients also had extrahepatic portal vein occlusion. All patients had varying degrees of portal hypertension and hypersplenism. Three patients underwent splenectomy and the remainder had sclerotherapy to control variceal bleeding. The overall prognosis is excellent if variceal bleeding can be controlled by appropriate measures. Hence recognition of this infrequently diagnosed entity is important for an accurate prognosis and appropriate therapeutic interventions

The value of abrasive cytology in the early detection of oesophageal carcinoma: A pilot survey in Ciskei

The use of abrasive cytology as a screening procedure in the diagnosis of early cancer of the oesophagus among asymptomatic rural Ciskeians was assessed. An inexpensive, locally manufactured brush biopsy capsule was used to obtain cytological material from 1 336 subjects. The technique gives a high yield, has a high predictive value and identifies a high prevalence of sufferers at the detectable preclinical phase of the disease

Influence of vibratory stress relief on residual stresses in weldments and mechanical properties of struktural steel joint

The welding process can join two similar materials with a bond that has mechanical properties comparable to the original material. Unfortunately, this process induces residual stresses in the weldment, which, if left untreated, can cause distortion of the part, premature fatigue failure or cracking along the weld. A post-weld heat treatment is the traditional method of relieving these stresses, but is costly and a time consuming process. Heat treatment is required for weldments, which have heavy fatigue loading since the post-weld heat treatment reduces the residual stresses in the weldment and generates more uniform mechanical properties. Vibratory stress relief (VSR) techniques could be used to substitute the heat treatment for these types of weldments and save time and money. The purpose of this paper is to provide a brief overview of the generation, measurement, and reduction of residual stresses. Residual stresses in the weld bead were measured by means of X-ray diffraction, ultrasonic technique and hole drilling methods. In addition, welded specimens were subjected to mechanical testing with purpose of determination of VSR effect on weld and heat-affected zone meta

Business process modelling and visualisation to support e-government decision making: Business/IS alignment

© 2017 Springer-Verlag. The final publication is available at Springer via https://doi.org/10.1007/978-3-319-57487-5_4.Alignment between business and information systems plays a vital role in the formation of dependent relationships between different departments in a government organization and the process of alignment can be improved by developing an information system (IS) according to the stakeholders’ expectations. However, establishing strong alignment in the context of the eGovernment environment can be difficult. It is widely accepted that business processes in the government environment plays a pivotal role in capturing the details of IS requirements. This paper presents a method of business process modelling through UML which can help to visualise and capture the IS requirements for the system development. A series of UML models have been developed and discussed. A case study on patient visits to a healthcare clinic in the context of eGovernment has been used to validate the models

Helicobacter pylori prevalence in non-ulcer dyspepsia ethnic and socio-economic differences

Helicobacter pylori is an important cause of gastritis and a number of therapeutic. trials suggest that it may be important in the genesis of duodenal ulcer recurrence. The reported prevalence of gastric colonisation by the organism varies considerably. The aiIn of this cross-sectional survey was to determine its prevalence in non-ulcer dyspeptics and to determine whether this is influenced by age, race, sex, socio-economic status, educational level and the nwnber of persons sharing accommodation. One hundred and sixty-nine patients underwent endoscopy; biopsy speciInens were taken from the antrwn and H. pylori status was determined histologically. Gastric colonisation was found in 106 patients (63%). The prevalence showed a marked ethnic difference: 40% in whites and 71% in coloureds (P < 0,001). The ethnic groups were characterised by significant differences in socio-economic status (P < 10-6), educational level (P < 10-6), number of persons sharing accommodation (P < 10-6 ) and age (P < 0,001). These same differences were found when comparing the H. pylori-positive and negative groups, but were less marked and could be attributed to the marked differences between ethnic groups. We conclude that H. pylori prevalence differs between the ethnic groups studied. This may be because of varying degrees of exposure risk

60. Factors detremining local control in patients (Pts) with locally advanced breast cancer (Labc) managed with radiotherapy (RT) as the primary locoregional treatment

IntroductionRT plays an important role in the management of LABC, yet clinical outcomes still remain far from satisfactory. The aim of this study was to evaluate retrospectively factors determining local control in a large series of consecutive LABC pts managed with RT as the primary locoregional treatment.Material and methodsThe records of 261 primarily inoperable LABC pts treated between 1991 and 1997 at two institutions: Medical University of Gdansk, Poland and Velindre NHS Trust, Cardiff, UK were analysed. All pts received megavoltage RT to the breast with two tangential fields, and the adjacent lymph node areas were irradiated using customised fields. Due to a large scale of RT doses and fractionation schedules, normalised total dose (NTD) was calculated for all patients using a linear quadratic model. In 241 pts RT constituted the only local treatment and the remaining 20 pts were subsequently subjected to mastectomy. Most pts received chemotherapy and/or endocrine therapy prior or after RT.ResultsWithin the median follow-up of 37 months, locoregional recurrence occurred in 95 of 251 evaluable pts (38%). Three-year and five-year locoregional-free survival rates were 59% and 48%, respectively. At multivariate analysis of variables predicting the risk of locoregional relapse, inflammatory carcinoma (

Helicobacter pylori and cancer among adults in Uganda

Data from Africa on infection with Helicobacter pylori (H. pylori) are sparse. Therefore, as part of an epidemiological study of cancer in Uganda, we investigated the prevalence and determinants of antibodies against H. pylori among 854 people with different cancer types and benign tumours. Patients were recruited from hospitals in Kampala, Uganda, interviewed about various demographic and lifestyle factors and tested for antibodies against H. pylori. In all patients combined, excluding those with stomach cancer (which has been associated with H. pylori infection), the prevalence of antibodies was 87% (723/833) overall, but declined with increasing age (p = 0.02) and was lower among people who were HIV seropositive compared to seronegative (p <0.001). Otherwise, there were few consistent epidemiological associations. Among those with stomach cancer, 18/21 (86%) had anti-H. pylori antibodies (odds ratio 0.8, 95% confidence intervals 0.2–2.9, p = 0.7; estimated using all other patients as controls, with adjustment for age, sex and HIV serostatus). No other cancer site or type was significantly associated with anti-H. pylori antibodies. The prevalence of H. pylori reported here is broadly in accord with results from other developing countries, although the determinants of infection and its' role in the aetiology of gastric cancer in Uganda remain unclear

Мастерство педагогического труда и мотивация учебной деятельности у студентов

Aim To gain insight into community nurses' experiences and how they make sense of the expertise they offer in their role Background Globally, the spotlight is currently on community nursing expertise because of the movement of hospital-based to community- based care. Caring for people at home is no longer solely concerned with prevention, but delivering complex care to patients who are acutely unwell or at the end of their life. Little is known about the distinct expertise of community nurses, or their contribution to patient outcomes. There is a need to examine expertise in this group in order to inform current and future care provision within community settings. Design A hermeneutic, phenomenological study. Method Semi-structured interviews were conducted with eight community nurses in Scotland, UK, who hold an additional post-registration, professional qualification. Participants also kept audio-journals. Data were analysed using Interpretive Phenomenological Analysis. Findings Participants described their expertise in three themes; negotiating a 'way in' to care, managing complexity, and 'thinking on your feet'. They did not refer to themselves as specialist practitioners, nor did they perceive that they were viewed as specialist by colleagues or management. They appeared to dismiss their range of expertise which included forming trusting relationships, anticipating care needs and problem-solving, enabling them to undertake complex care management. Conclusions Expertise of community nurses in this study is dynamic, contextualised and action-oriented enabling them to be creative problem-solvers. It reflects engagement with patients and families and all aspects of the setting where care is provided, rather than being solely an identifiable set of specialist skills, Relevance to clinical practice It is vital to recognize community-based expertise internationally, especially if current WHO aims for community-based health care are to be achieved. Highlighting this expertise contributes to current discourse and may be considered in education and practice reviews. This article is protected by copyright. All rights reserved.sch_nur27pub4806pub3-

Sensitivity of markers of DNA stability and DNA repair activity to folate supplementation in healthy volunteers

We have previously reported that supplementation with folic acid (1.2 mg day−1 for 12 week) elicited a significant improvement in the folate status of 61 healthy volunteers. We have examined effects of this supplement on markers of genomic stability. Little is known about the effect of folate supplementation on DNA stability in a cohort, which is not folate deficient. Preintervention, there was a significant inverse association between uracil misincorporation in lymphocyte DNA and red cell folate (P<0.05). In contrast, there were no associations between folate status and DNA strand breakage, global DNA methylation or DNA base excision repair (measured as the capacity of the lymphocyte extract to repair 8-oxoGua ex vivo). Folate supplementation elicited a significant reduction in uracil misincorporation (P<0.05), while DNA strand breakage and global DNA methylation remained unchanged. Increasing folate status significantly decreased the base excision repair capacity in those volunteers with the lowest preintervention folate status (P<0.05). Uracil misincorporation was more sensitive to changes in folate status than other measures of DNA stability and therefore could be considered a specific and functional marker of folate status, which may also be relevant to cancer risk in healthy people