Voorspelling van oorlewing in 'n chirurgiese intensiewesorgeenheid

Doel: Om die voorspellingswaarde van , 14 bestaande voorspellings programme op chirurgiese intensiewesorgpasiente te toets en om n oorlewingsvoorspellingsmodel vir die chirurgiese intensiewesorgeenheid (ClSE) te ontwikkel wat as instrument kan dien om kliniese besluitneming te vergemaklik. Ontwerp: Retrospektiewe en prospektiewe versameling en rekenarisering van kliniese, fisiologiese en biochemiese veranderlikes. Student se t-toets, logistiese regressie, sensitiwiteits- en spesifisiteitsberekening met behulp van tweerigting tabelle. Plek: Chirurgiese  Intensiewesorgeenheid, H. F. Verwoerd-hospitaal, Pretoria. Pasientpopulasie: Retrospektiewe deel van studie: 188 pasiente; prospektiewe deel: 104 pasiente. Bevindingsmaatstawwe: Statisties betekenisvolle verskille tussen die tellings van oorlewendes en nieoorlewendes. Aanvaarbare sensitiwiteit en spesifisiteit van ontwikkelde model. Resultate: AI 14 bestaande voorspellingsprogramme beskik oor die vennoe om te onderskei tussen die opnamedagtellings van oorlewendes en nie-oorlewendes en het, by implikasie, dus prognostiese geldigheid. Die statistiese betekenisvolheid geassosieer met die onderskeie programme het gewissel van P < 0.01 tot P < 0.0001. 'n Reeks van opeenvolgende oorlewingsvoorspel1ingsmodelle, ontwikkel deur logistiese regressie-analise op die bes passende voorspellingsprogramme, het uiteindelik gelei tot die ontwikkeling van 'n model met 'n sensitiwiteit van 93% en 'n spesifisiteit van 66%. Gevolgtrekking: Verskeie bestaande voorspellingsprogramme kan bydra tot kliniese besluitneming. Voorspellingsmodelle hieruit ontwikkel moet voor implementering herhaaldelik op opeenvolgende groepe van die teikenpopulasie getoets word. Beide die programme en die modelle behoort as bykomstige prognostiese ondersteuningsfaktore gebruik te word eerder as absolute aanduidings van uitkoms.S Afr Med J 1996: 86: 1417 -142

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Sacroiliac tuberculosis masquerading as mechanical lower back pain in a collegiate basketball athlete: a case presentation

Background: Sacroiliac tuberculosis is a rare condition for which early diagnosis and effective management frequently proves challenging. This report describes a case that was initially overlooked due to its presentation and unreported constitutional symptoms.Aim: To alert clinicians about skeletal tuberculosis, an often neglected diagnostic differential, which requires a high index of clinical suspicion, especially for patients from endemic areas.Findings: This patient’s presentation (sports injury) and unreported constitutional symptoms resulted in a delay in the diagnosis and initial institution of treatment.Implications: This report illustrates the importance of specifically asking about constitutional symptoms, even in sports injury settings and being mindful of infectious diseases or other chronic medical conditions, which may masquerade as common sports injuries.Keywords: skeletal tuberculosis, sacroiliitis, hip pai

South Africa's salt reduction strategy: Are we on track, and what lies ahead?

On 2 September 2016, 25 local and international participants from various sectors met in Cape Town to take stock of South Africa (SA)’s progress in salt reduction and develop a roadmap for action. SA is centre stage on salt reduction globally, being the first country to mandate salt reduction across a wide range of processed foods. Excessive salt intake contributed by processed foods and discretionary sources motivated SA to implement a public awareness campaign in parallel with legislation to reduce salt intake to the World Health Organization target of 5 g per day. Five priority areas were identified for continued action on salt reduction, including obtaining research funds for continued monitoring and compliance of salt reduction targets. Determining the contribution of foods eaten out of home to total salt intake and implementing strategies to address this sector were also highlighted as key actions. Lastly, implementing the next stage of the Salt Watch awareness campaign to change

The forgotten coracoid: A case report of a coracoid fracture in a male cyclist

A fall onto the shoulder is a common mechanism of injury in cyclists. However, coracoid fractures remain unreported in the literature in this population. These authors report a case of a coracoid fracture missed on the initial plain film radiographs. Whilst these fractures can be easily missed on standard trauma series radiographs of the shoulder, alternate views and other imaging modalities can be used to detect these fractures. Clinical suspicion, judicious imaging and accurate diagnosis of these fractures are important, as stability of the coracoid influences the entire superior shoulder suspensory complex which allows normal function of the shoulder joint

Chronic exertional compartment syndrome in the forearm of a rower

This case report describes chronic exertional compartment syndrome in the forearm of a professional rower. We consider this to be a rare anatomical location for this type of syndrome. Morever, not much is known about its clinical presentation and the subsequent optimal medical management thereof.

Nitrogen deprivation induces triacylglycerol accumulation, drug tolerance and hypervirulence in mycobacteria.

Mycobacteria share with other actinomycetes the ability to produce large quantities of triacylglycerol (TAG), which accumulate as intracytoplasmic lipid inclusions (ILI) also known as lipid droplets (LD). Mycobacterium tuberculosis (M. tb), the etiologic agent of tuberculosis, acquires fatty acids from the human host which are utilized to synthesize TAG, subsequently stored in the form of ILI to meet the carbon and nutrient requirements of the bacterium during long periods of persistence. However, environmental factors governing mycobacterial ILI formation and degradation remain poorly understood. Herein, we demonstrated that in the absence of host cells, carbon excess and nitrogen starvation promote TAG accumulation in the form of ILI in M. smegmatis and M. abscessus, used as surrogate species of M. tb. Based on these findings, we developed a simple and reversible in vitro model to regulate ILI biosynthesis and hydrolysis in mycobacteria. We also showed that TAG formation is tgs1 dependent and that lipolytic enzymes mediate TAG breakdown. Moreover, we confirmed that the nitrogen-deprived and ILI-rich phenotype was associated with an increased tolerance towards several drugs used for treating mycobacterial infections. Importantly, we showed that the presence of ILI substantially enhanced the bacterial burden and granuloma abundance in zebrafish embryos infected with lipid-rich M. abscessus as compared to embryos infected with lipid-poor M. abscessus, suggesting that ILI are actively contributing to mycobacterial virulence and pathogenesis

Pro- and Anti-Inflammatory Cytokines during Immune Stimulation: Modulation of Iron Status and Red Blood Cell Profile

Forty-eight patients were subdivided according to C-reactive protein (CRP) levels, resulting in 19 patients with normal (2.8 ± 2.8 mg/L) and 29 with elevated (82.2 ± 76.2 mg/L) CRP levels. The elevated CRP group had iron and red blood cell (RBC) profiles characteristic of chronic immune stimulation (CIS), and the normal CRP group, profiles of true iron deficiency. Normal relationships between storage iron, bioavailable iron, and RBC indices were absent in the elevated CRP group—implying the role of iron as major determinant of the RBC profile to be diminished during CIS. The elevated CRP group had significant increases in proinflammatory cytokines (INF-γ, TNF-α, Il-1β, Il-6, and Il-8). Anti-inflammatory cytokine levels were normal, except for Il-10, supporting previous indications that Il-10 contributes to reducing bioavailable iron. Regression analysis suggested decreases in transferrin to be related to increases in Il-8 and an increase in ferritin to be related to a decrease in Il-12 levels. TGF-β levels were positively related to transferrin and negatively to ferritin

A cross-cultural study of the representation of shape: Sensitivity to generalized cone dimensions

Many of the phenomena underlying shape recognition can be derived from an assumption that the representation of simple parts can be understood in terms of independent dimensions of generalized cones, e.g., whether the axis of a cylinder is straight or curved or whether the sides are parallel or nonparallel. What enables this sensitivity? One explanation is that the representations derive from our immersion in a manufactured world of simple objects, e.g., a cylinder and a funnel, where these dimensions can be readily discerned independent of other stimulus variations. An alternative explanation is that genetic coding and/or early experience with extended contours - a characteristic of all naturally varying visual worlds - would be sufficient to develop the appropriate representations. The Himba, a seminomadic people in a remote region of Northwestern Namibia with little exposure to regular, simple artifacts, were virtually identical to western observers in representing generalized-cone dimensions of simple shapes independently. Thus immersion in a world of simple, manufactured shapes is not required for the development of a representation that specifies these dimensions independently

Sacroiliac tuberculosis masquerading as mechanical lower back pain in a collegiate basketball athlete: a case presentation

Background:Sacroiliac tuberculosis is a rare condition for which early diagnosis and effective management frequently proves challenging. This report describes a case that was initially overlooked due to its presentation and unreported constitutional symptoms. Aim:To alert clinicians about skeletal tuberculosis, an often neglected diagnostic differential, which requires a high index of clinical suspicion, especially for patients from endemic areas. Findings:This patient’s presentation (sports injury) and unreported constitutional symptoms resulted in a delay in the diagnosis and initial institution of treatment. Implications:This report illustrates the importance of specifically asking about constitutional symptoms, even in sports injury settings and being mindful of infectious diseases or other chronic medical conditions, which may masquerade as common sports injuries