Abnormal Myocardial Blood Flow Reserve Observed in Cardiac Amyloidosis

We performed real-time myocardial contrast echocardiography on a patient with cardiac amyloidosis and previous normal coronary angiography presenting with atypical chest pain to assess myocardial blood flow reserve (MBFR). Myocardial contrast echocardiography was performed and flash microbubble destruction and replenishment analysis was used to calculate myocardial blood flow. Dipyridamole was used to achieve hyperemia. MBFR was derived from the ratio of peak myocardial blood flow at hyperemia and rest. The results show a marked reduction in MBFR in our patient. Previous reports of luminal obstruction of intramyocardial rather than epicardial vessels by amyloid deposition may be causing microvascular dysfunction

EXTENDED CURRICULUM PROGRAMME EVOLUTION: A ROAD MAP TO ACADEMIC SUCCESS?

Published ArticleThe extended curriculum programme (ECP) in the Faculty of Health Sciences at the Central University of Technology (CUT), Bloemfontein, South Africa, consists of six different instructional programmes. These programmes have been developed for Biomedical Technology, Clinical Technology, Emergency Medical Care, Environmental Health, Radiography and Somatology. This article provides an overview of the progress and development of the health sciences ECP at CUT as a proposed road map to academic success for a specific group of students. To obtain an objective picture of the health sciences ECP students’ success, the assessment results of all the students registered between 2007 and 2012 were retrieved and analysed retrospectively. An increase in articulation was noted from 2010 to 2012 (i.e., from 70% to 84.4%) and an average articulation percentage of 80 per cent was achieved from 2007 to 2012. These figures indicated a successful transition from the ECP to the mainstream programmes. Moreover, 58 per cent of ECP students who registered in 2007 successfully completed their national diplomas in the extended timeframe. This group also delivered three B-Tech candidates and one student registered for a master’s degree. The students’ emotional growth and personal development were also prominent, as observed by the mainstream lecturers. The support offered to students in the current ECP includes a mentorship programme with a qualified psychologist, supplemental instruction (SI) and the sponsorship of all textbooks and registration fees for the Health Professions Council of South Africa (HPCSA) and First Aid training

Marginalisation and demographic change in the semi-arid Karoo, South Africa

Semi-arid areas are often considered to be environmentally and economically marginal, a situation which has been exacerbated by economic change, shifts in agricultural production and land use, and changing state policy. These themes are explored with reference to a semi-arid landscape, namely the Karoo, which covers some 40% of the geographic space of South Africa and is used primarily for extensive livestock farming. Despite long-term decline in agricultural output, the traditional mainstay of the region, and weakening small town economies, the Karoo's population and the economies of its largest service centres are growing. There are, real socio-economic needs and development backlogs, and the situation has been exacerbated by recent political marginalisation. In this study, the small towns of the region are focal points of investigation and provide a lens to investigate the changing demographic and economic dynamics of the Karoo. Most of the region's population lives in these centres which are service, collection, and distribution points for what traditionally has been an agriculture-based regional economy. This paper explores the concept of marginalisation with specific reference to historical, economic, and demographic change

Cytomegalovirus-associated supraglottic mass in a patient on immunosuppressive therapy

A 33-year-old woman on chronic immunosuppressive treatment for rheumatoid arthritis with a history of inhaled methamphetamine use presented with respiratory failure requiring mechanical ventilation for a prolonged period. After being given plasma exchange, pulses of methylprednisolone and a dose of cyclosporine for suspected ANCA (anti-neutrophilic cytoplasmic autoantibodies) vasculitis, she developed an obstructive supraglottic laryngeal mass that required a tracheostomy to bypass. Biopsy findings revealed the mass to be an inflammatory pseudomass secondary to cytomegalovirus (CMV). The mass resolved after several weeks of intravenous ganciclovir therapy. This is an extremely unusual presentation of localised CMV disease, with only two or three similar cases having been reported worldwide

Small-scale, nature-based tourism as a pro-poor development intervention : two examples in Kwazulu-Natal, South Africa

Tourism is widely acknowledged as a key economic sector that has the potential to contribute to national and local development and, more specifically, serve as a mechanism to promote poverty alleviation and pro-poor development within a particular locality. In countries of the global South, nature-based tourism initiatives can make a meaningful impact on the livelihoods of the poor, in particular the subsistence based rural poor. Taking two examples in KwaZulu-Natal Province, South Africa, where small-scale tourism initiatives were developed recently in response to existing natural attractions in the context of coping with local economic crises, this paper broadly assesses the modest benefits to date, as well as drawbacks, in improving conditions of life

The Odonatoptera of the Late Permian Lodève Basin (Insecta)

El descubrimiento de una numerosa y variada fauna de Odonatoptera en el Pérmico Superior rojo de la cuenca de Lodève pone en cuestión la hipótesis de un paleoclima seco a muy seco para este yacimiento. Sugiere la presencia de masas de agua más o menos permanentes, rodeadas por una importante diversidad de medios terrestres. El descubrimiento de grandes a muy grandes ejemplares de Meganeuridae contradice la existencia de una relación directa entre la disminución de la talla de cuerpo y de las alas de los insectos durante el Pérmico Superior, y el decrecimiento de la tasa de oxígeno atmosférico en esta época

Assesseer leesbegripstoetse werklik leesbegrip?

In hierdie artikel word die vraag gestel of leesbegripstoetse, wat volgens onderwysdepartementele voorskrifte opgestel is, werklik leesbegripsvlakke assesseer. Riglyne van die Nasionale Kurrikulum- en Assesseringsbeleidsverklaring (Suid- Afrika, 2011) is gebruik om twee gelyksoortige leesbegripstoetse (drie tekste elk), wat uit dieselfde tekstipes bestaan, maar handel oor verskillende temas, op te stel om Afrikaanssprekende graad 9-leerders, uit verskillende geografiese gebiede van ’n onderwysdistrik, se leesbegripsvlakke te bepaal. Die moeilikheidsgraad van die leestekste is met leesbaarheidsindekse bepaal en ’n 40-40-20%-verspreiding van kognitiewe vlakke is in die vraagstelling gevolg. Bo en behalwe die berekening van gemiddeldes, frekwensies en persentasies is die Cronbach Alphakoëffisiëntwaardes en die gemiddelde interitem-korrelasiewaardes vir elkeen van die drie tekste binne die twee tematies verskillende leesbegripstoetse vasgestel en leesbegripstoetse se vrae is volgens Bloom se kognitiewe vlakke vergelyk. Die hoofbevinding is dat leerders se leesbegripsvlakke nie akkuraat deur tipiese leesbegripstoetse geassesseer word nie, omdat hulle leesbegrippunte in ’n mindere of ’n meerdere mate op verskillende wyses gekontamineer word.Sleutelwoorde: assessering, kognitiewe vlakke, leesbaarheidsindekse, leesbegrip, Nasionale Kurrikulum- en Assesseringsbeleidsverklarin

The outcome of HIV-positive patients admitted to intensive care units with acute kidney injury

The original publication is available at http://www.intechopen.comPublication of this article was funded by the Stellenbosch University Open Access Fund.Acute kidney injury is a serious clinical problem with significant morbidity and mortality. Several factors are recognized to aggravate the outcome including advanced age, gender, oliguria and the serum creatinine level. What is currently unknown is whether the presence of the human immunodeficiency virus (HIV) aggravates the outcome of patients who develop acute kidney injury (AKI). Sub-Saharan Africa currently bears the brunt of the global HIV pandemic. In South Africa alone more than 5.7 million people are infected ((UNAIDS 2008 report on the global AIDS epidemic, 2009), creating substantial additional pressure on already inadequate social and healthcare infrastructures. Acute kidney injury occurs commonly in HIV-infected patients admitted to hospital and carries with it substantial mortality. In a resource-poor environment clinicians are often forced to select patients with a better chance of survival for admission to the intensive care unit (ICU). A rigorous evaluation of the outcomes of HIV-positive patients admitted to ICU with AKI may assist in identifying factors associated with better survival, and thus aid in the cost-effective management of these patients.Publishers' Versio

The Outcome of HIV-Positive Patients Admitted to Intensive Care Units with Acute Kidney Injury

The original publication is available at http://www.intechopen.comPublication of this article was funded by the Stellenbosch University Open Access Fund.Acute kidney injury is a serious clinical problem with significant morbidity and mortality. Several factors are recognized to aggravate the outcome including advanced age, gender, oliguria and the serum creatinine level. What is currently unknown is whether the presence of the human immunodeficiency virus (HIV) aggravates the outcome of patients who develop acute kidney injury (AKI). Sub-Saharan Africa currently bears the brunt of the global HIV pandemic. In South Africa alone more than 5.7 million people are infected ((UNAIDS 2008 report on the global AIDS epidemic, 2009), creating substantial additional pressure on already inadequate social and healthcare infrastructures. Acute kidney injury occurs commonly in HIV-infected patients admitted to hospital and carries with it substantial mortality. In a resource-poor environment clinicians are often forced to select patients with a better chance of survival for admission to the intensive care unit (ICU). A rigorous evaluation of the outcomes of HIV-positive patients admitted to ICU with AKI may assist in identifying factors associated with better survival, and thus aid in the cost-effective management of these patients.Publishers' Versio