Causes and predictors of death in South Africans with systemic lupus erythematosus

Faculty of Health School of Medicine 9101327d [email protected] is known about the epidemiological and mortality patterns of systemic lupus erythematosus (SLE) in Africa. Aims of this study- to determine the demographics, clinical features and causes and predictors death in patients attending the Lupus clinic at the Chris Hani Baragwanath hospital in Soweto. Methods- the records of 226 patients who fulfilled American College of Rheumatism criteria for the diagnosis of SLE were reviewed. The mean (± SD) age at presentation was 34 (± 12.5) years. The female to male ratio was 18:1. The commonest clinical feature found was arthritis in 70.4% of patients. Nephritis was present in 43.8% and CNS lupus in 15.9% of patients. 55 patients in this group had died and 64 were lost to follow up. The 5-year survival was 57% uncensored and 72% if censored for loss to follow up. Infection (32.7%) was the commonest cause of death followed by renal failure (16.4%). Nephritis, CNS lupus and hypocomplementaemia were associated with mortality on univariate analysis. Lupus nephritis was the only independant predictor of mortality on multivariate analysis. Conclusion- this study confirms the poor outcome of SLE in the developing world and demonstrates that renal disease is a factor commonly implicated in mortality. The 5-year survival and pattern of mortality is similar to that reported elsewhere in the developing worl

Assessing data quality in survey with healthcare providers on COVID-19 and the measures for improving

Background: Social surveys have also been transformed with the advancements in research methods. However, only through appropriate methods, proper planning and procedures the data quality can be ensured.Aim: The aim of the current research is to present the measures taken up in doing survey with healthcare providers of primary health care facilities during the time of COVID-19 and to assess the data quality.Method: The survey was conducted with all 280 medical and paramedical staff in 24 primary healthcare centers of government to understand the preparedness of primary health care facilities in terms of providing a safe working environment to healthcare providers and to prevent the spread of infection while discharging duties during COVID-19. The study used mix mode of data collection by administering telephonic and self-administered questionnaire.  It is a descriptive study based on review of secondary literature and the different measures adopted in the survey to ensure data quality.Result: The variation found in responses to questions related to training, personal fears, challenges and coping mechanism was low, when asked differently in telephonic and self-administered questionnaire. It shows that the measures taken in conducting survey through mix mode of data collection at the time of COVID-19 were effective in overcoming the data quality challenges of COVID-19 to conduct face-to-face study and maintaining data quality of the survey.Conclusion: It can be concluded that proper planning, preparations and precautions were effective in ascertaining the data quality

Maximising the efficiency of surveillance for COVID-19 in dialysis units in South Africa : the case for pooled testing

The COVID-19 epidemic in South Africa (SA) is currently in a growth phase with high incidences in most major cities. Patients who are dependent on chronic renal dialysis care, including peritoneal dialysis and haemodialysis, are chronically unwell and usually have multiple comorbidities including hypertension, diabetes and cardiovascular disease. These comorbidities are known to increase the risk of adverse outcomes for COVID-19, including hospitalisation with high care or intensive care admission, and/ or death. Haemodialysis patients throughout the country require facility-based support three times a week, and a typical dialysis visit is ~4 hours.The National Research Foundation of South Africahttp://www.samj.org.zaam2021Medical Microbiolog

A call to action: Temporal trends of COVID-19 deaths in the South African Muslim community

No abstract

A Thermodynamic Model for Receptor Clustering

Intracellular signaling often arises from ligand-induced oligomerization of cell surface receptors. This oligomerization or clustering process is fundamentally a cooperative behavior between near-neighbor receptor molecules; the properties of this cooperative process clearly affects the signal transduction. Recent investigations have revealed the molecular basis of receptor-receptor interactions, but a simple theoretical framework for using this data to predict cluster formation has been lacking. Here, we propose a simple, coarse-grained, phenomenological model for ligand-modulated receptor interactions and discuss its equilibrium properties via mean-field theory. The existence of a first-order transition for this model has immediate implications regarding the robustness of the cellular signaling response.Comment: Biophysical Journal, to appea

Expression Profiling of PBMC-based Diagnostic Gene Markers Isolated from Vasculitis Patients

Vasculitis (angiitis) is a systemic autoimmune disease that often causes fatal symptoms. We aimed to isolate cDNA markers that would be useful for diagnosing not only vasculitis but also other autoimmune diseases. For this purpose, we used stepwise subtractive hybridization and cDNA microarray analyses to comprehensively isolate the genes whose expressions are augmented in peripheral blood mononuclear cells (PBMCs) pooled from vasculitis patients. Subsequently, we used quantitative real-time polymerase chain reaction (qRT–PCR) to examine the mRNA levels of each candidate gene in individual patients. These analyses indicated that seven genes exhibit remarkably augmented expression in many vasculitis patients. Of these genes, we analyzed G0/G1 switch gene 2 (G0S2) further because G0S2 expression is also enhanced in the PBMCs of patients with systemic lupus erythematodes (SLE). We generated G0S2 transgenic mice that ubiquitously overexpress human G0S2. Although we did not observe any obvious vasculitis-related histopathologic findings in these mice, these mice are unhealthy as they produce only few offspring and showed elevated serum levels of two autoimmunity-related antibodies, anti-nuclear antibody, and anti-double strand DNA antibody. Thus, our large-scale gene profiling study may help finding sensitive and specific DNA markers for diagnosing autoimmune diseases including vasculitis and SLE

Differential Effects of EGFR Ligands on Endocytic Sorting of the Receptor

Endocytic downregulation is a pivotal mechanism turning off signalling from the EGF receptor (EGFR). It is well established that whereas EGF binding leads to lysosomal degradation of EGFR, transforming growth factor (TGF)-α causes receptor recycling. TGF-α therefore leads to continuous signalling and is a more potent mitogen than EGF. In addition to EGF and TGF-α, five EGFR ligands have been identified. Although many of these ligands are upregulated in cancers, very little is known about their effect on EGFR trafficking

Guidelines for the prevention, detection and management of the renal complications of COVID-19 in Africa

Africa trails the rest of the world in COVID-19 cases and deaths. However, as the pandemic spreads through the continent, we expect increases in community infection in the months ahead. Patients with kidney infection, especially those with end-stage kidney disease and those with kidney transplants, are at high risk for acquiring the disease and dying from it. While there is limited evidence for the benefit of interventions, we have the advantage of learning from the experiences of those in China, Europe and the Americas. This document sets forth guidance for dealing with our patients who have acute and chronic kidney disease, including those on renal replacement therapy and the staff involved in their care. Emphasis is placed on preparedness and prevention strategies. As evidence and experience accumulate, it is likely that updated guidance will be needed.L’Afrique suit le reste du monde en termes de nombre de cas et de décès dus à COVID-19. Cependant, alors que la pandémie se propage à travers le continent, nous prévoyons une augmentation de l’infection communautaire dans les mois à venir. Les patients atteints d’une maladie rénale, en particulier ceux atteints d’une maladie rénale chronique en phase terminale et ceux ayant subi une transplantation rénale, courent un risque élevé de contracter la maladie et d’en mourir. Bien que les preuves d’interventions soient limitées, nous avons l’avantage de tirer des enseignements des expériences de ceux qui se trouvent en Chine, en Europe et dans les Amériques. Ce document présente des conseils pour traiter nos patients atteints d’insuffisance rénale aiguë et chronique, y compris ceux sous thérapie de suppléance rénale et le personnel impliqué dans leurs soins. L’accent est mis sur les stratégies de préparation et de prévention. Au fur et à mesure que les preuves et l’expérience s’accumulent, il est probable que des directives actualisées seront nécessaires