Minimally invasive atrioventricular valve surgery – current status and future perspectives

We are currently witnessing rapid evolution in minimally invasive and catheter-based atrioventricular valve interventions as acceptable alternatives to classic sternotomy access (CSA). Collectively, minimally invasive atrioventricular valve surgery (MIAS) is associated with significant learning curves and its routine application is met with varying degrees of enthusiasm in view of strict quality control, clinical governance and outcome reporting. Whether the reported potential benefits and comparable efficacy across a range of long-term outcome measures reported by experienced MIAS centres can be translated into general international surgical practice, are not well defined. This paper describes the historic evolution of MIAS, the contemporary clinical outcomes of MIAS compared with CSA, and the application of MIAS in “real-life” general practice

DNA amplified fingerprinting, a useful tool for determination of genetic origin and diversity analysis in Citrus

We used three short repetitive nucleotide sequences [(GTG)5, (TAC)5, and (GACA)4] either as radiolabeled probes for hybridization with restricted Citrus DNA or as single primers in polymerase chain reaction amplification experiments with total genomic DNA. We tested the ability of the sequences to discriminate between seedlings of zygotic or nuclear origin in the progeny of a Volkamer lemon #Citrus volkameriana# Ten. & Pasq.) tree. The genetic variability within two species [#Citrus sinensis# (L.) Osbeck (sweet oranges) and #Citrus reticulata# Blanco and relatives (mandarins)] was evaluated. DNA amplified figerprinting with single primers was the more successful technique for discriminating between nucellular and zygotic seedlings. Although we were not able to distinguish among 10 cultivars of #C. sinensis#, all 10 #C. reticulata# cultivars tested were distinguishable. However, it still is difficult to identify the putative parents of a hybrid plant when the two parental genomes are closely related. (Résumé d'auteur

Treatment of severe alcoholic hepatitis: A systematic review

Severe alcoholic hepatitis is the most severe form of alcohol-related liver disease. Corticosteroids remain the first choice of treatment. However, they are only effective in a subset of patients and are associated with an increased infection risk. Furthermore, nonresponders to corticosteroids have a poor prognosis with a mortality of 70% over 6 months. As such, there is a high need for a more personalized use of corticosteroids and the development and identification of alternative therapeutic strategies. In this review, we summarize the recent and ongoing randomized controlled trials concerning the treatment of severe alcoholic hepatitis

Progressive familial heart block type I : clinical and pathological observations

CITATION: 1991: .Van der Merwe, P.-L. et al. 1991. Progressive familial heart block type I : clinical and pathological observations. South African Medical Journal, 80:34-38.The original publication is available at http://www.samj.org.zaProgressive familial heart block type I (PFHB-I) is an autosomal inherited disease. It was previously postulated that the disease is limited to the cardiac conduction tissue. The presentation of a patient with dilated cardiomyopathy focused on the possibility that this might be part of PFHB-I. This observation led to routine echocardiographic examination of patients with complete heart block, who belonged to PFHB-I families, and another 5 cases with signs of dilated cardiomyopathy were identified. This is the first time, to our knowledge, that the histological picture of PFHB-I has been described. From these case reports it is clear that in the presence of a dilated cardiomyopathy the prognosis in PFHB-I tends to be poor.Publisher’s versio

Islet neogenesis is stimulated by brief occlusion of the main pancreatic duct

Objective. Current models of islet neogenesis either cause substantial pancreatic damage or continuously stimulate the pancreas, making these models unsuitable for the study of early events that occur in the neogenic process. We aimed to develop a method where the initial events that culminate in increased pancreatic endocrine mass caube studied. Design and methods. Ten 12-week-old female Wistar rats were subjected to a midline laparotomy, the pancreas was isolated and the main pancreatic duct was occluded for 60 seconds. The pancreas was released and carefully relocated within the abdomen. Ten age-, strain- and sex-matched control rats were subjected to a sham operation. The animals were killed 56 days post .occlusion, and the pancreata excised and fiXed tor histological analysis. Body, pancreatic and hepatic weights were .noted at termination. and serum was taken for analysis. The endocrine-to-exocrine. ratio was calculated and the number of endocrine cells in eacn islet from the sectioned pancreata was counted. Results. Occlusion of the main pancreatic ductfor 60 seconds results in an increase in endocrine mass. by 80% 56 days post occlusion. This constitutes an increase in endocrine units (1 - 6 cellst and in small (7 - 30 cells), medium (31 - 60 cells) and large (> 60 cells) islets by 85%, 96%, 95% and 71% respectively. Conclusion. Brief occlusion of the main pancreatic duct results in anincrease in pancreatic endocrine. mass. An increase in endocrine units and small islets is indicative of islet neogenesis. Therefore, owing to the briefness of the stimulation; this model can therefore be used to study the iniUal events that occur during the neogenic process

Severe ovarian hyperstimulation after follicular aspiration

The original publication is available at http://www.samj.org.zaCITATION: Van der Merwe, J. P., Michell, W. L. & Kruger, T. F. 1988. Severe ovarian hyperstimulation after follicular aspiration. South African Medical Journal, 73:426-427.In order to maximise the changes of pregnancy, most successful in vitro fertilisation programmes use a combination of ovulation induction agents. This treatment can lead to the hyperstimulation syndrome. Aspiration of the follicles is believed to avoid this syndrome. Despite this approach, hyperstimulation syndrome may still develop. The clinical picture and treatment of a patient with severe hyperstimulation is discussed.Publisher’s versio

Mechanisms of resistance to groundnut rosette

Rosette (caused by rosette assistor virus, groundnut rosette virus and satellite RNA) resistance in 3 groundnut genotypes (ICGV-SM 90704, ICG 12991 and JL 24) was evaluated, using a vector or mechanical transmission of the virus complex. Branches from rosette-infected plants (groundnut cv. Malimba) were grafted onto 23-day-old healthy stocks of the 3 genotypes, grown in pots in a greenhouse. Eighteen days after grafting, all the new shoots of ICG 12991 and JL 24 stocks showed severe rosette symptoms. The differences in rosette incidence recorded from the graft transmission and field observations may involve resistance to Aphis craccivora. Thus, an experiment was carried out to assess the vector performance on the 3 genotypes. Thirty days after sowing the 3 genotypes in pots in a greenhouse, young leaves were exposed to 5 viruliferous A. craccivora alatae (winged). Aphids were counted 10 days after infestation (DAI) on each plant. Exposed plants were left in a greenhouse up to 60 days after infestation to record rosette symptoms. Results indicated highly significant differences in aphid population counts between the 3 genotypes. At 10 DAI, increased numbers of aphids (alatae plus nymphs) were observed on ICGV-SM 90704 and JL 24, with an average of 93 and 96 aphids per plant, respectively. In contrast, aphid number on ICG 12991 fell from 5 to 3 per plant. There were also significant differences in disease expression at 60 DAI, since JL 24 showed 100% disease incidence, while no symptoms were noted on ICG 12991. Only mild symptoms were observed on ICGV-SM 90704

\u3cem\u3eRhizobium\u3c/em\u3e-White Clover Symbiosis and Nitrogen Fixation along a Soil Organic Carbon Gradient

Sustainable cultivated pasture production in the southern Cape region of South Africa requires management practices that will support soil quality (Swanepoel and Botha 2012). Soil organic carbon (Corg) sequestration is regarded as one of the most important ways to promote soil quality. Dairy farmers in the southern Cape attempt to increase Corg by following minimum-tillage practices. These irrigated dairy-pastures require high levels of nitrogen (N) to maintain highly productive pastures. Nitrogen fertilisers have be-come very expensive and severely strain profitability of these dairy-pastures. Forage legumes are frequently incorporated into the grass pastures to overcome economic and environmental problems associated with high levels of inorganic fertiliser application. Their capacity to fixate atmospheric N contributes greatly to nutritional value, palatability and subsequently profitability of pastures (Botha 2003). Since C and N are biophilic compounds, Corg may have a direct effect on the N-fixating legume plant or the Rhizobium population that infects its roots (Swanepoel et al. 2011). The aim of this study was to determine the effects of Corg on white clover (Trifolium repens) biomass production and N-fixation by host-specific Rhizobium

Evaluation of nutrition care to adult patients on HAART attending primary healthcare facilities in Mpumalanga

CITATION: Schiever, J. F. et al. 2019. Evaluation of nutrition care to adult patients on HAART attending primary healthcare facilities in Mpumalanga, South African Journal of Clinical Nutrition, 32(1):13-20. doi:10.1080/16070658.2017.1412183The original publication is available at https://www.tandfonline.com/toc/ojcn20/currentObjectives: This study aimed to evaluate nutrition care and nursing professional knowledge received by adults on highly active antiretroviral therapy attending primary health care (PHC) facilities Design: Cross-sectional, descriptive study. Subjects and setting: The study was conducted on 263 adults and 75 nursing professionals, recruited from 19 facilities in the Mbombela sub-district, Mpumalanga. Outcome measures: Interviewer-administered questionnaires were completed for each patient. Nursing professionals completed a self-administered questionnaire. Assessment tools were completed for each facility. Results: Some 41% of patients were either overweight or obese, and most females (n = 87; 51.8%) had a BMI ≥ 25 kg/m2. Based on waist circumference, 52.7% (n = 88) of females and 8.4% (n = 8) of males showed increased risk of cardiovascular disease. Although nurses were aware of a nutrition supplementation programme, knowledge of national nutrition guidelines was inadequate. Clinical judgement, rather than eligibility criteria, was used to identify suitable patients, with 13.3% (n = 35) receiving supplementation whereas only 4.9% (n = 13) qualified. Facilities generally had sufficient equipment and fair storage conditions, but stock shortages of nutrition supplements were problematic. Conclusions: Whilst certain positive findings emerged, nutrition care could be improved, largely through adequate training and support to professional nurses. Training should focus on correct execution of assessment measurements and appropriate nutritional counselling, emphasising balanced eating, food security and prevention of over-nutrition. Nurses should be familiarised with national nutrition guidelines and have access to a constant nutrition supplementation supply. Improved monitoring and evaluation of nutrition care to adults on treatment at PHC facilities is needed.https://www.tandfonline.com/doi/full/10.1080/16070658.2017.1412183Publisher’s versio

Straight Line Orbits in Hamiltonian Flows

We investigate periodic straight-line orbits (SLO) in Hamiltonian force fields using both direct and inverse methods. A general theorem is proven for natural Hamiltonians quadratic in the momenta in arbitrary dimension and specialized to two and three dimension. Next we specialize to homogeneous potentials and their superpositions, including the familiar H\'enon-Heiles problem. It is shown that SLO's can exist for arbitrary finite superpositions of $N$-forms. The results are applied to a family of generalized H\'enon-Heiles potentials having discrete rotational symmetry. SLO's are also found for superpositions of these potentials.Comment: laTeX with 6 figure