Hepatitis B co-infection in HIV-infected patients receiving antiretroviral therapy at the TC Newman Anti Retroviral Treatment Clinic in Paarl, Western Cape

Background: Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) co-infection in South Africa is estimated to be between 5% and 23%; however, only limited evidence is available. Co-infection increases the risk of chronification of HBV, liver cirrhosis and death.Objective: To assess the HBV and/or HIV co-infection rate amongst the adult antiretroviral treatment cohort at the TC Newman ART Clinic in Paarl, Western Cape.Methods: In a retrospective, cross-sectional study, the routine hepatitis B surface antigen screening results for all adult HIV patients who were started on antiretroviral treatment over a period of 19 months were collected and analysed for gender, CD4 count and age.Results: Amongst the 498 participants (60% female participants), the Hepatitis B surface Antigen positivity rate was 7.6%. Male gender, age between 50 and 59 years and a low CD4 count were correlated with higher rates.Conclusion: Useful insight could be obtained by analysing routine data. The prevalence of almost 8% confirms the need for testing of HIV-positive patients for hepatitis B

Health professions students' interprofessional experiences on a rural learning platform

HEALTH PROFESSIONS STUDENTS’ LEARNING EXPERIENCES ON A RURAL COLLABORATIVE LEARNING PLATFORM ABSTRACTA Faculty of Health Sciences launched a rural collaborative learning platform to cultivate interprofessional key competencies and to improve health outcomes. The purpose of the study was to describe health sciences students’ experiences of an rural collaborative learning platform. Health professions students created digital stories reflecting on their collaborative learning experiences. Purposive sampling resulted in 23 submissions. Qualitative analysis of content identified themes and categories. Three themes, namely, metaphor, critical consciousness and professional socialisation, were identified. The metaphor categories, Journey, Setting world ablaze, Water, and Puzzle, represent students’ desire to use visual cues to describe their experiences. Transformation, Personal development and Empathy signified critical consciousness. Collaborative practice, Values, Reflective practice, and Key competencies relate to professional socialisation. The researchers gained understanding of students’ experiences on an rural collaborative learning platform. Through digital stories, students became aware of professional interdependency, which linked their experiences to key interprofessional competencies.

Emergent Phenomena Induced by Spin-Orbit Coupling at Surfaces and Interfaces

Spin-orbit coupling (SOC) describes the relativistic interaction between the spin and momentum degrees of freedom of electrons, and is central to the rich phenomena observed in condensed matter systems. In recent years, new phases of matter have emerged from the interplay between SOC and low dimensionality, such as chiral spin textures and spin-polarized surface and interface states. These low-dimensional SOC-based realizations are typically robust and can be exploited at room temperature. Here we discuss SOC as a means of producing such fundamentally new physical phenomena in thin films and heterostructures. We put into context the technological promise of these material classes for developing spin-based device applications at room temperature

Rituximab in B-Cell Hematologic Malignancies: A Review of 20 Years of Clinical Experience

Rituximab is a human/murine, chimeric anti-CD20 monoclonal antibody with established efficacy, and a favorable and well-defined safety profile in patients with various CD20-expressing lymphoid malignancies, including indolent and aggressive forms of B-cell non-Hodgkin lymphoma. Since its first approval 20 years ago, intravenously administered rituximab has revolutionized the treatment of B-cell malignancies and has become a standard component of care for follicular lymphoma, diffuse large B-cell lymphoma, chronic lymphocytic leukemia, and mantle cell lymphoma. For all of these diseases, clinical trials have demonstrated that rituximab not only prolongs the time to disease progression but also extends overall survival. Efficacy benefits have also been shown in patients with marginal zone lymphoma and in more aggressive diseases such as Burkitt lymphoma. Although the proven clinical efficacy and success of rituximab has led to the development of other anti-CD20 monoclonal antibodies in recent years (e.g., obinutuzumab, ofatumumab, veltuzumab, and ocrelizumab), rituximab is likely to maintain a position within the therapeutic armamentarium because it is well established with a long history of successful clinical use. Furthermore, a subcutaneous formulation of the drug has been approved both in the EU and in the USA for the treatment of B-cell malignancies. Using the wealth of data published on rituximab during the last two decades, we review the preclinical development of rituximab and the clinical experience gained in the treatment of hematologic B-cell malignancies, with a focus on the well-established intravenous route of administration. This article is a companion paper to A. Davies, et al., which is also published in this issue

Gonadal function in male patients after treatment for malignant lymphomas, with emphasis on chemotherapy

Gonadal function was assessed in male lymphoma survivors based on serum hormone levels (LH, FSH, testosterone, SHBG), and was related to treatment, age and observation time. Male patients ⩽50 years at diagnosis treated for Hodgkin's (HL) and/or non-Hodgkin's lymphoma (NHL) at the Norwegian Radium Hospital from 1 January 1980 to 31 December 2002 were included. Five treatment groups were defined: 1: radiotherapy only and/or low gonadotoxic chemotherapy (both HL and NHL)(‘No/low'), 2: medium gonadotoxicity chemotherapy for NHL (‘med-NHL'), 3: medium gonadotoxicity chemotherapy for HL (‘med-HL'), 4: highly gonadotoxic chemotherapy for NHL (‘high-NHL'), 5: highly gonadotoxic chemotherapy for HL (‘high-HL'). Gonadal hormone levels were categorised into three groups: 1: All gonadal hormones within normal range (normal), 2: Isolated elevated FSH, with LH, SHBG and testosterone within normal range (exocrine hypogonadism), 3: Testosterone below and/or LH above normal range (endocrine hypogonadism). One hundred and forty-four (49%) of the patients had normal gonadal hormones, 60 (20%) displayed exocrine hypogonadism and almost one-third (n=90, 30%) had endocrine hypogonadism. Compared to those treated with no/low gonadotoxic chemotherapy patients from all other treatment groups had significantly elevated risk for exocrine hypogonadism. Patients from the other treatment groups, except those in the med-NHL group, also had significantly elevated risk for endocrine hypogonadism compared with the group treated with no/low gonadotoxic chemotherapy. Men aged above 50 years at survey were about five times more likely to have endocrine hypogonadism compared with those less than 40 years. Because of the adverse health effects following long-lasting endocrine hypogonadism, gonadal hormones should be assessed regularly in male lymphoma survivors, especially after treatment with alkylating agents and high-dose chemotherapy with autologous stem cell support and in male patients who are 50 years and older

Family medicine, primary health care and HIV medicine - a 'new' clinical speciality and its role in the South African HIV pandemic

CITATION: Hagemeister, D. T. 2009. Family medicine, primary health care and HIV medicine - a 'new' clinical speciality and its role in the South African HIV pandemic. South African Family Practice, 51(6):483-485.The original publication is available at http://www.safpj.co.zaContext: Because of the extent of the HIV pandemic, but also due to some specific historical conditions, HIV medicine has evolved as a field of its own in South African medicine. With the massive scale of the roll-out of antiretroviral drugs (ARVs) in South Africa, the need to devolve ARV roll-out into primary health care (PHC) services is currently being discussed. Family medicine was recognised in South Africa as a specialist qualification in August 2007 and is still undergoing an exciting process of defining its content and future role in the community of medical specialities. The South African approach to family medicine focuses strongly on the role of the family physician in the PHC setting at district hospitals and in PHC facilities within the South African district health framework. Objectives: The objectives of this article are to discuss the relation between family medicine and the field of HIV medicine. Key message: Family medicine in the South African context is the clinical discipline most suitable to house HIV medicine. The projected future of the ARV roll-out parallels the structures necessary for the care of (other) chronic conditions in the PHC setting, and the clinical governance for this health care delivery lies in the hands of family medicine. Thus HIV medicine should be regarded and developed as part of family medicine. Conclusion: For the future development of family medicine, it is a natural and necessary step to incorporate HIV care. The field of HIV care as a professional area will benefit from being part of a recognised clinical speciality. Training for the treatment of HIV/AIDS will have to be included as an integral part of the registrar programme in family medicine. © SAAFP.http://www.safpj.co.za/index.php/safpj/article/view/1284Publisher's versio