27,741 results match your criteria South African Medical Journal Suid-Afrikaanse tydskrif vir geneeskunde [Journal]


South African dyslipidaemia guideline consensus statement: 2018 update A joint statement from the South African Heart Association (SA Heart) and the Lipid and Atherosclerosis Society of Southern Africa (LASSA).

S Afr Med J 2018 Oct 26;108(11b):973-1000. Epub 2018 Oct 26.

Netcare Sunninghill and Sunward Park Hospitals, Division of Cardiology, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa.

South Africa (SA) is home to a heterogeneous population with a wide range of cardiovascular risk factors. Cholesterol reduction in combination with aggressive management of modifiable risk factors, including nutrition, physical activity, blood pressure and smoking, can help to reduce and prevent morbidity and mortality in individuals who are at increased risk of cardiovascular events. This updated consensus guide to management of dyslipidaemia in SA is based on the updated European Society of Cardiology and European Atherosclerosis Society dyslipidaemia guidelines published in 2016. Read More

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October 2018
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South African dyslipidaemia guideline consensus statement: 2018 update A joint statement from the South African Heart Association (SA Heart) and the Lipid and Atherosclerosis Society of Southern Africa (LASSA).

S Afr Med J 2018 Oct 26;108(11b):973-1000. Epub 2018 Oct 26.

Netcare Sunninghill and Sunward Park Hospitals, Division of Cardiology, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa.

South Africa (SA) is home to a heterogeneous population with a wide range of cardiovascular risk factors. Cholesterol reduction in combination with aggressive management of modifiable risk factors, including nutrition, physical activity, blood pressure and smoking, can help to reduce and prevent morbidity and mortality in individuals who are at increased risk of cardiovascular events. This updated consensus guide to management of dyslipidaemia in SA is based on the updated European Society of Cardiology and European Atherosclerosis Society dyslipidaemia guidelines published in 2016. Read More

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October 2018
4 Reads

Outcomes of self-induced late pregnancy termination in women presenting to a tertiary hospital in the Eastern Cape Province, South Africa.

S Afr Med J 2018 Oct 26;108(11):965-971. Epub 2018 Oct 26.

Walter Sisulu University and Eastern Cape Department of Health, East London, South Africa.

Background: Little is known about the outcomes of self-induced pregnancy termination after 24 weeks' gestation, as previous studies have concentrated on outcomes before 24 weeks.

Objectives: To investigate the gestational age, misoprostol dosage, source of information on misoprostol, reasons for termination and outcomes of self-induced pregnancy termination after 24 weeks' gestation.

Methods: A quantitative, retrospective case series observational research design was utilised. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v108i11.12979DOI Listing
October 2018
4 Reads

Intimate partner violence among HIV-serodiscordant couples in Durban, South Africa.

S Afr Med J 2018 Oct 26;108(11):960-964. Epub 2018 Oct 26.

Department of Psychiatry, School of Clinical Medicine, Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.

Background: South Africa (SA) has a high prevalence rate of intimate partner violence (IPV) and HIV, both of which can be exacerbated further by HIV serodiscordancy in the couple dyad. Further exploration of the discordancy sidedness in known mediating factors, such as alcohol abuse risk and post-traumatic stress (PTS), is required.

Objectives: To investigate the extent of and gender differences in IPV, alcohol abuse risk and PTS symptoms among HIV-serodiscordant couples in Durban, SA, and to analyse these further with regard to female HIV serostatus. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v108i11.13095DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378687PMC
October 2018
1 Read

Twenty-four-hour oesophageal pH studies in rural Eastern Cape Province, South Africa.

S Afr Med J 2018 Oct 26;108(11):957-959. Epub 2018 Oct 26.

Department of Human Biology, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa.

Background: Recent studies in rural Eastern Cape Province, South Africa, have shown an increased number of non-acid gastro-oesophageal reflux events, an increase in baseline gastric pH compared with other published series, and evidence suggestive of duodenogastric reflux. There are no published data on oesophageal pH in this community or in Africa.

Objectives: To ascertain whether oesophageal pH in this rural community is within normal limits. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v108i11.13227DOI Listing
October 2018
1 Read

An evaluation of the quality of discharge summaries from the general paediatric wards at Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.

S Afr Med J 2018 Oct 26;108(11):953-956. Epub 2018 Oct 26.

Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Background: Hospital discharge summaries are deemed to be an essential part of the medical record in South Africa, but formal assessment of their quality is rarely undertaken. At Chris Hani Baragwanath Academic Hospital (CHBAH) in Johannesburg, medical admission notes (bedletters) are difficult to retrieve from the hospital archives and the discharge summary is often the only readily available medical record that documents details of the hospital admission.

Objectives: To determine the proportion of discharge summaries that were appropriately completed for children admitted to the general paediatric wards at CHBAH. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v108i11.12966DOI Listing
October 2018
2 Reads

Anorectal malformations and the impact of HIV on surgical outcome.

S Afr Med J 2018 Oct 26;108(11):947-952. Epub 2018 Oct 26.

Division of Paediatric Surgery, Department of Surgery, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Background: Anorectal malformations (ARMs) represent a significant surgical load in South African (SA) paediatric surgical centres. Surgical treatment of ARMs may be associated with postoperative complications owing to the nature of surgical procedures necessary in the neonatal and infant period. HIV and its effect on the immune response compound postoperative surgical complications. Read More

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http://www.samj.org.za/index.php/samj/article/view/12458
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http://dx.doi.org/10.7196/SAMJ.2018.v108i11.13168DOI Listing
October 2018
5 Reads

Hearing outcomes in children with meningitis at Red Cross War Memorial Children's Hospital, Cape Town, South Africa: A silent crisis.

S Afr Med J 2018 Oct 26;108(11):944-946. Epub 2018 Oct 26.

Department of Audiology, Red Cross War Memorial Children's Hospital and Faculty of Health Sciences, University of Cape Town, South Africa.

Background: Bacterial meningitis is one of the most common causes of hearing loss. Hearing loss develops within the first few days following the onset of meningitis, highlighting the importance of early audiology referrals. Post-meningitis hearing loss may lead to cochlear ossification, making traditional cochlear implantation impossible. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v108i11.13067DOI Listing
October 2018
3 Reads

A retrospective review of Listeria monocytogenes infection at Tygerberg Children's Hospital, Cape Town, South Africa, from 2006 to 2016: Is empirical ampicillin still indicated after the first month of life?

S Afr Med J 2018 Oct 26;108(11):937-943. Epub 2018 Oct 26.

Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

Background: Ampicillin to treat Listeria monocytogenes (LM) infection is empirically added to the treatment of infants (<3 months) with suspected sepsis or meningitis.

Objectives: In view of limited LM cases, the paucity of South African (SA) data and an ampicillin shortage, our objective was to describe the occurrence of LM infections at Tygerberg Hospital (TBH), Cape Town, with the aim of rationalising the paediatric antibiotic policy.

Methods: An 11-year (2006 - 2016) retrospective descriptive study of children (<13 years) from TBH and referral hospitals with a positive blood or cerebrospinal fluid (CSF) culture for LM was conducted. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v108i11.13212DOI Listing
October 2018
3 Reads

Adult liver transplantation in Johannesburg, South Africa (2004 - 2016): Balancing good outcomes, constrained resources and limited donors.

S Afr Med J 2018 Oct 26;108(11):929-936. Epub 2018 Oct 26.

Wits Donald Gordon Medical Centre, University of the Witwatersrand, Johannesburg, South Africa; Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Background: Liver transplantation is the standard of care for the treatment of liver failure worldwide, yet millions of people living in sub-Saharan Africa remain without access to these services. South Africa (SA) has two liver transplant centres, one in Cape Town and the other in Johannesburg, where Wits Donald Gordon Medical Centre (WDGMC) started an adult liver transplant programme in 2004.

Objectives:  To describe the outcomes of the adult liver transplant programme at WDGMC. Read More

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http://www.samj.org.za/index.php/samj/article/view/12463
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http://dx.doi.org/10.7196/SAMJ.2018.v108i11.13286DOI Listing
October 2018
6 Reads

A two-step quality-improvement intervention to address Pap smear quality at public health facilities in South Africa.

S Afr Med J 2018 Oct 26;108(11):926-928. Epub 2018 Oct 26.

Right to Care, Helen Joseph Hospital, Johannesburg, South Africa.

Background: The endocervical component of a Pap smear is an important indicator of sample quality - or 'adequacy'. However, only 6 of 52 districts in South Africa (SA) meet the Department of Health (DoH) performance benchmark: a 70% adequacy rate. We implemented a quality-improvement (QI) intervention to address suboptimal Pap smear quality in Tshwane District, Gauteng Province, SA. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v108i11.13153DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6335964PMC
October 2018
1 Read

When the Office of Health Standards Compliance inspector knocks: What do I do?

Authors:
H J Van As

S Afr Med J 2018 Oct 26;108(11):922-925. Epub 2018 Oct 26.

Department of Public Law, Faculty of Law, Nelson Mandela University, Port Elizabeth, South Africa.

Inspectors and health officers attached to the Office of Health Standards Compliance (OHSC) may inspect or investigate premises where health services are provided, and may then perform a number of actions, including questioning people, taking samples, requesting documents, and conducting inspections and investigations. The outcomes of these activities may result in a number of sanctions, some of which may seriously impact health establishments and practitioners. This article aims to review the rights that health establishments, healthcare providers and health workers have when subjected to inspections or investigations by the OHSC. Read More

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http://www.samj.org.za/index.php/samj/article/view/12459
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http://dx.doi.org/10.7196/SAMJ.2018.v108i11.13205DOI Listing
October 2018
4 Reads

Lost to follow-up: Challenges to conducting orthopaedic research in South Africa.

S Afr Med J 2018 Oct 26;108(11):917-921. Epub 2018 Oct 26.

Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa.

Loss to follow-up poses a major problem for clinicians and researchers, and several factors that may increase its risk have been postulated. The objective of this study was to describe potential factors that contribute to loss to follow-up as seen in orthopaedic patients participating in a research study and attending the sole public orthopaedic service provider in the Northern Cape Province of South Africa (SA). All patients who underwent ankle fracture surgery at Kimberley Provincial Hospital between January 2012 and July 2013 were included, and the number of follow-up visits attended by each participant was recorded prospectively. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v108i11.13252DOI Listing
October 2018
3 Reads

Avoiding paternalism but not moral perplexity.

Authors:
D R Hall

S Afr Med J 2018 Oct 26;108(11):915-916. Epub 2018 Oct 26.

Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa.

Maternal autonomy has replaced medical paternalism, but conflicts between beneficence and autonomy persist. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v108i11.13328DOI Listing
October 2018
1 Read

Systems thinking: A turning point for improving respectful obstetric care in South African health districts.

S Afr Med J 2018 Oct 26;108(11):910-914. Epub 2018 Oct 26.

Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, South Africa.

Poorly functioning health systems and local health systems barriers affect many women giving birth in low- and middle-income countries. The district clinical specialist teams in South Africa are uniquely positioned to provide facilitation and mentoring during interventions for improving the weak primary healthcare system. To ensure success, four key principles should be considered during scale-up of interventions: systems thinking and awareness of contexts and barriers; a focus on sustainability; harnessing factors known to enhance scalability; and respect for human rights and equity. Read More

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http://www.samj.org.za/index.php/samj/article/view/12464
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http://dx.doi.org/10.7196/SAMJ.2018.v108i11.13312DOI Listing
October 2018
7 Reads

Resource allocation in paediatric burn care: Preliminary results of empowering parents with smartphone assistance.

Authors:
R Martinez H Rode

S Afr Med J 2018 Oct 26;108(11):889-890. Epub 2018 Oct 26.

Department of Paediatric Surgery, Faculty of Health Sciences, Red Cross War Memorial Children's Hospital and University of Cape Town, South Africa.

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http://dx.doi.org/10.7196/SAMJ.2018.v108i11.13587DOI Listing
October 2018
1 Read

Extensively hydrolysed infant formulas: Need for aligned definition of peptide size characteristics and standardisation of analytical methods.

S Afr Med J 2018 Oct 26;108(11):887-888. Epub 2018 Oct 26.

Nestlé Health Science, Vevey, Switzerland.

Letter by Nutten et al. on article by Levin et al. (Levin ME, Blackhurst DM, Kirstein F, Kok D, van der Watt GF, Marais AD. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v108i11.13616DOI Listing
October 2018
1 Read

The National Education, Health and Allied Workers' Union (NEHAWU) strikes.

S Afr Med J 2018 Oct 26;108(11):12474. Epub 2018 Oct 26.

Previously Deputy Director-General and Head Clinical Services, North West Province Department of Health, South Africa; currently Deputy Dean, Faculty of Health Sciences, North-West University, South Africa.

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http://dx.doi.org/10.7196/SAMJ.2018.v108i11.13687DOI Listing
October 2018
1 Read

How good are our guidelines? Four years of experience with the SAMJ's AGREE II review of submitted clinical practice guidelines.

S Afr Med J 2018 Oct 26;108(11):883-885. Epub 2018 Oct 26.

Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa; Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

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http://dx.doi.org/10.7196/SAMJ.2018.v108i11.13646DOI Listing
October 2018
1 Read

Major depressive disorder in patients with diabetes mellitus in Pietermaritzburg, South Africa.

S Afr Med J 2018 Dec 13;109(1):58-61. Epub 2018 Dec 13.

Postgraduate Programme (Master of Medical Science), School of Clinical Medicine, University of KwaZulu-Natal, Durban; and Pietermaritzburg Hospital Complex, KwaZulu-Natal, South Africa.

Background: Diabetes mellitus (DM) and major depressive disorder (MDD) constitute a major burden of disease. A study found that type 2 DM (DM2) is associated with a two-fold increase in risk of developing MDD worldwide - except in Africa. The present study challenges this statement. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v109i1.13356DOI Listing
December 2018
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Histopathological diagnoses on pleural biopsy specimens over a 15-year period at Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa: A retrospective review.

S Afr Med J 2018 Dec 13;109(1):53-57. Epub 2018 Dec 13.

Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Background: Pleural effusions are a common reason for presentation to healthcare facilities. Blind closed pleural biopsy can be a useful tool to diagnose their cause, especially in resource-limited settings.

Objectives: To determine the aetiology, frequency and change in profile of histopathological diagnoses made at Chris Hani Baragwanath Academic Hospital (CHBAH), Johannesburg, South Africa, over the period 1 January 2001 - 31 December 2015. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v109i1.13400DOI Listing
December 2018
3 Reads

South African women's perspectives on self-sampling for cervical cancer screening: A mixed-methods study.

S Afr Med J 2018 Dec 13;109(1):47-52. Epub 2018 Dec 13.

Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of Cape Town, South Africa; SAMRC Gynaecological Cancer Research Centre, Faculty of Health Sciences, University of Cape Town, South Africa; Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, College of Health Sciences, University of Ilorin, Nigeria.

Background: Self-sampling as a method of screening for cervical cancer and its precursors is an attractive option for low-resource settings. However, to allow successful integration of self-sampling into national screening programmes, it is necessary to understand women's perceptions and beliefs surrounding this method of sampling the cervix.

Objectives: To explore women's attitudes to self-collection of samples for cervical screening in a low-resource setting in South Africa (SA). Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v109i1.13278DOI Listing
December 2018
2 Reads

Transitions between lifetime alcohol use, regular use and remission: Results from the 2004 South African Stress and Health Survey.

S Afr Med J 2018 Dec 13;109(1):40-46. Epub 2018 Dec 13.

Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa; School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.

Background: Hazardous alcohol consumption presents a serious threat to the health and wellbeing of all people and is linked to chronic and acute health problems.

Objectives: To: (i) estimate the prevalence of alcohol use disorders and remission from alcohol abuse and dependence in the South African (SA) population; and (ii) determine whether age of onset, education, sex and level of cohort alcohol use are associated with commencement of use, regularity of use, and transitions to and remission from more harmful levels of use.

Methods: The study was a nationally representative sample of 4 315 individuals aged ≥18 years. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v109i1.13061DOI Listing
December 2018
1 Read

Cost of intensive care services at a central hospital in South Africa.

S Afr Med J 2018 Dec 13;109(1):35-39. Epub 2018 Dec 13.

School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.

Background: Intensive care services are one of the largest cost drivers in a hospital. Increasing life expectancy and comorbidities have resulted in an increased need for intensive care beds.

Objectives: To conduct a cost analysis of intensive care services at a central hospital in the public sector in South Africa (SA). Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v109i1.13268DOI Listing
December 2018
2 Reads

Treatment outcomes in perinatally infected HIV-positive adolescents and young adults after ≥10 years on antiretroviral therapy.

S Afr Med J 2018 Dec 13;109(1):27-34. Epub 2018 Dec 13.

Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.

Background: The burden of paediatric HIV in South Africa has shifted to older children and adolescents. Nevertheless, information on long-term treatment outcomes of perinatally HIV-infected (PHIV) children is limited.

Objectives: To examine long-term immunological and virological outcomes of children who were in care for at least 10 years after starting antiretroviral therapy (ART). Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v109i1.13230DOI Listing
December 2018
1 Read

Overnight oximetry as a screening tool for moderate to severe obstructive sleep apnoea in South African children.

S Afr Med J 2018 Dec 13;109(1):23-26. Epub 2018 Dec 13.

Division of Paediatric Pulmonology, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and Faculty of Health Sciences, University of Cape Town, South Africa.

Background: Obstructive sleep apnoea (OSA) is common in children yet often overlooked, as symptom-based screening is unreliable. Polysomnography is regarded as the gold standard for the diagnosis of OSA, but is not widely available in South Africa (SA). Overnight oximetry is a validated screening tool for OSA. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v109i1.13033DOI Listing
December 2018
5 Reads

Cell and gene therapies at the forefront of innovative medical care: Implications for South Africa.

S Afr Med J 2018 Dec 13;109(1):20-22. Epub 2018 Dec 13.

South African Medical Research Council Extramural Unit for Stem Cell Research and Therapy; and Institute for Cellular and Molecular Medicine, Department of Immunology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa.

The fields of cell and gene therapy are moving rapidly towards providing innovative cures for incurable diseases. A current and highly topical example is immunotherapies involving T-cells that express chimeric antigen receptors (CAR T-cells), which have shown promise in the treatment of leukaemia and lymphoma. These new medicines are indicative of the changes we can anticipate in the practice of medicine in the near future. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v109i1.13425DOI Listing
December 2018
1 Read

Cystic fibrosis: What's new in South Africa in 2019.

S Afr Med J 2018 Dec 13;109(1):16-19. Epub 2018 Dec 13.

Cystic Fibrosis Clinic, Red Cross War Memorial Children's Hospital, Cape Town, South Africa; and Division of Paediatric Pulmonology, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, South Africa.

Cystic fibrosis (CF) is one of the most common autosomal recessive disorders worldwide. The incidence of CF depends on the prevalence of CFTR (cystic fibrosis transmembrane conductance regulator) gene mutations in the population, which is determined by genetic diversity and ethnicity. Over 2 000 CFTR mutation variants, divided into six distinct functional classes, are now identified, but not all cause CF disease. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v109i1.13415DOI Listing
December 2018
19 Reads

Human papillomavirus vaccination acceptance and hesitancy in South Africa: Research and policy agenda.

S Afr Med J 2018 Dec 13;109(1):13-15. Epub 2018 Dec 13.

Institute for Leadership and Research, Pretoria, South Africa.

Cervical cancer is responsible for one-quarter of a million deaths per year worldwide. In South Africa (SA), cervical cancer is the leading cause of cancer deaths among women aged 15 - 44 years. Human papillomavirus (HPV) vaccines provide a safe and highly effective means to reduce the burden of cervical cancer. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v109i1.13723DOI Listing
December 2018
1 Read

Empathy: An essential tool in any doctor's skillset.

Authors:
E Archer R Turner

S Afr Med J 2018 Dec 13;109(1):11-12. Epub 2018 Dec 13.

Centre for Health Professions Education, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

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http://dx.doi.org/10.7196/SAMJ.2018.v109i1.13732DOI Listing
December 2018
5 Reads

Genomic characterisation of Klebsiella michiganensis co-producing OXA-181 and NDM-1 carbapenemases isolated from a cancer patient in uMgungundlovu District, KwaZulu-Natal Province, South Africa.

S Afr Med J 2018 Dec 13;109(1):7-8. Epub 2018 Dec 13.

Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; and Department of Clinical Microbiology, Centre of Expertise and Biological Diagnostic of Cameroon, Yaoundé, Cameroon.

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http://dx.doi.org/10.7196/SAMJ.2018.v109i1.13696DOI Listing
December 2018
9 Reads

Requesting a patient to document her decision for refusal of hospital treatment promotes beneficence.

S Afr Med J 2018 Dec 13;109(1):12519. Epub 2018 Dec 13.

Head, Clinical Unit, Department of Obstetrics and Gynaecology, Klerksdorp/Tshepong Hospital Complex, North West Province, South Africa; and Department of Obstetrics and Gynaecology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.

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http://dx.doi.org/10.7196/SAMJ.2018.v109i1.13774DOI Listing
December 2018
1 Read

Establishing a multidisciplinary AIDS-associated Kaposi's sarcoma clinic: Patient characteristics, management and outcomes.

S Afr Med J 2018 Nov 26;108(12):1059-1065. Epub 2018 Nov 26.

Division of Radiation Oncology, Department of Medical Imaging and Clinical Oncology, Tygerberg Academic Hospital and Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

Background: Kaposi's sarcoma (KS) typically occurs in the setting of immunodeficiency and specifically in the presence of HIV infection, when it is called AIDS-associated KS (AIDS-KS). In spite of impressive gains in the South African (SA) antiretroviral therapy (ART) roll-out programme since 2004, AIDS-KS still causes significant morbidity and mortality, and the treatment of advanced disease can be challenging owing to the centralisation of oncology services and the high incidence of concurrent infections. In 2014, a multidisciplinary AIDS-KS clinic (MKSC) was established at Tygerberg Hospital, Cape Town, with the goal of optimising management of AIDS-KS patients. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v108i12.13202DOI Listing
November 2018
2 Reads

Empyema in children hospitalised at Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa: A retrospective study.

S Afr Med J 2018 Nov 26;108(12):1055-1058. Epub 2018 Nov 26.

Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Background: There is a paucity of information on empyema in children from low- and middle-income countries since the introduction of the pneumococcal conjugate vaccine.

Objectives: To describe the aetiology and management of empyema in a setting of high HIV and tuberculosis (TB) prevalence.

Methods: A retrospective descriptive study was undertaken between January 2012 and December 2016 in children aged <14 years at a large secondary-tertiary referral hospital in Soweto, South Africa. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v108i12.13099DOI Listing
November 2018
7 Reads

Another piece to the epidemiological puzzle of traumatic spinal cord injury in Cape Town, South Africa: A population-based study.

S Afr Med J 2018 Nov 26;108(12):1051-1054. Epub 2018 Nov 26.

Department of Physiotherapy, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa.

Background: The epidemiology of traumatic spinal cord injury (TSCI) is poorly understood in developing countries. In South Africa (SA) specifically, two healthcare systems (private v. government funded) exist, and it is therefore important to assess patient characteristics in order to plan appropriately. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v108i12.13134DOI Listing
November 2018
1 Read

An evaluation of warfarin use at an urban district-level hospital in KwaZulu-Natal Province, South Africa.

Authors:
D J Laäs M Naidoo

S Afr Med J 2018 Nov 26;108(12):1046-1050. Epub 2018 Nov 26.

Discipline of Family Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.

Background: Warfarin is a commonly prescribed drug that needs to be monitored regularly.

Objectives: To evaluate the quality of care of patients on warfarin and to determine the cost-effectiveness of this drug in a South African district hospital setting.

Methods: Quality of care was assessed through a structured patient interview, and cost-effectiveness of warfarin was determined by retrospective review of all costs over a 6-month period. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v108i12.13256DOI Listing
November 2018
1 Read

A retrospective review of fatal electrocution cases at Tygerberg Forensic Pathology Services, Cape Town, South Africa, over the 5-year period 1 January 2008 - 31 December 2012.

S Afr Med J 2018 Nov 26;108(12):1042-1045. Epub 2018 Nov 26.

Tonga Hospital, Mpumalanga, South Africa.

Background: Electrocution as a cause of death has been discussed extensively in the international literature. However, research on this topic in South Africa (SA) is scarce.

Objectives: To address the need for further research in this field and emphasise the necessity for preventive measures by determining the demographic and pathological profile of fatal electrocution cases seen in the Tygerberg Forensic Pathology Services, Western Cape Province, SA. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v108i12.13131DOI Listing
November 2018
1 Read

A contextualisation approach to health promotion guideline development in South Africa.

S Afr Med J 2018 Nov 26;108(12):1036-1041. Epub 2018 Nov 26.

Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa.

Background: Risk factors for chronic illness contribute significantly to the disease burden in South Africa. The National Department of Health (NDoH) commissioned the development of a toolkit of health promotion guidelines for use by healthcare professionals working in the primary care setting to address this burden.

Objectives: To (i) demonstrate the contextualisation approach to evidence-based health promotion recommendations; and (ii) present the development process of a contextually sensitive and illustrated fit-for-purpose product. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v108i12.13129DOI Listing
November 2018
1 Read

Comparison of Xpert GBS v. culture for rapid detection of group B streptococcus in pregnant women: Sensitivity, specificity and predictive values.

S Afr Med J 2018 Nov 26;108(12):1032-1035. Epub 2018 Nov 26.

Department of Medical Microbiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa; National Health Laboratory Service, Tshwane Academic Division, Pretoria, South Africa.

Background: Group B streptococcus (GBS) is a leading cause of invasive disease, particularly in newborns. Seventy-five percent of neonates will be colonised by mothers carrying the organism. Confirmation of maternal colonisation with GBS is essential for prompt treatment and prevention of neonatal sepsis. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v108i12.13079DOI Listing
November 2018
1 Read

What to do when a parent or guardian tries to override a legally competent child's consent to a surgical operation.

S Afr Med J 2018 Nov 26;108(12):1030-1031. Epub 2018 Nov 26.

Centre for Socio-Legal Studies, University of KwaZulu-Natal, Durban, South Africa.

Guidelines are provided for doctors where a parent or guardian tries to override an otherwise legally competent child's consent to a surgical operation by refusing to provide the assistance required by the Children's Act. Consideration is given to whether an otherwise legally competent child is competent to consent to a surgical operation when this can be overridden by their parent or guardian, and the legal position regarding informed consent by a child to the surgical termination of her pregnancy. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v108i12.13492DOI Listing
November 2018
6 Reads

Purpose-orientated stocking of procedure trolleys saves time in busy emergency centres.

S Afr Med J 2018 Nov 26;108(12):1024-1026. Epub 2018 Nov 26.

Division of Emergency Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.

Background: Inefficient storage and sourcing of routinely required consumables located on procedure trolleys result in time wasted when preparing for common procedures in emergency centres (ECs), contributing to poor efficiency and quality of care.

Objectives: We designed a novel purpose-orientated procedure trolley and evaluated its impact on time spent on procedure preparation and efficiency.

Methods: In an urban EC, eight participants were measured each day over 24 days, once using the standard setup and once using the modified procedure setup. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v108i12.13422DOI Listing
November 2018
1 Read

Ethical considerations in the application of cell and gene therapies in children.

S Afr Med J 2018 Nov 26;108(12):1027-1029. Epub 2018 Nov 26.

South African Medical Research Council Extramural Unit for Stem Cell Research and Therapy, Institute for Cellular and Molecular Medicine, Department of Immunology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa.

Rapidly evolving fields such as cell and gene therapies that involve state-of-the-art technology hold out possibilities that may be ahead of what ethics, guidelines and the law have considered. This results in a regulatory lag. Furthermore, ethical and legal considerations are often debated in real time as issues pertaining to these technologies that were previously not considered begin to come to the fore. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v108i12.13585DOI Listing
November 2018
1 Read

Alternative modalities being promoted for breast screening.

Authors:
J Edge L Roodt

S Afr Med J 2018 Nov 26;108(12):1010-1011. Epub 2018 Nov 26.

Division of Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa.

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http://dx.doi.org/10.7196/SAMJ.2018.v108i12.13679DOI Listing
November 2018
1 Read

Genomic characterisation of Staphylococcus aureus ST121 isolated from hospitalised patients in South Africa.

S Afr Med J 2018 Nov 26;108(12):1007-1008. Epub 2018 Nov 26.

Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; Department of Clinical Microbiology, Centre of Expertise and Biological Diagnostic of Cameroon, Yaoundé, Cameroon.

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http://dx.doi.org/10.7196/SAMJ.2018.v108i12.13713DOI Listing
November 2018
1 Read

Sunbeds: A burning issue needing attention in South Africa.

S Afr Med J 2018 Nov 26;108(12):1004-1006. Epub 2018 Nov 26.

Environment and Health Research Unit, South African Medical Research Council; Department of Geography, Geoinformatics and Meteorology, Faculty of Natural and Agricultural Sciences, University of Pretoria, South Africa.

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http://dx.doi.org/10.7196/SAMJ.2018.v108i12.13715DOI Listing
November 2018
1 Read

The demographic and clinical profiles of women presenting with vaginal discharge syndrome at primary care facilities in South Africa: Associations with age and implications for management.

S Afr Med J 2018 Oct 2;108(10):876-880. Epub 2018 Oct 2.

Centre for HIV and STIs, National Institute for Communicable Diseases, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Background: Current South African guidelines for the management of vaginal discharge syndrome (VDS) do not recommend treatment for sexually transmitted infection (STI) pathogens for women aged ≥35 years whose partners do not have male urethritis syndrome. The guideline assumes that older women are unlikely to have an STI and that their partners do not have asymptomatic infections.

Objectives: To describe the demographic, behavioural and clinical characteristics of women with VDS, comparing older women (≥35 years) with younger women, and to determine the performance of age alone as a criterion for predicting the presence of STI. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v108i10.13027DOI Listing
October 2018
4 Reads

Can routine inpatient mortality data improve HIV mortality estimates? Inpatient mortality at an urban hospital in South Africa.

S Afr Med J 2018 Oct 2;108(10):870-875. Epub 2018 Oct 2.

Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Health Economics and Epidemiology Research Office, Wits Health Consortium, Johannesburg, South Africa; Department of Global Health, School of Public Health, Boston University, USA.

Background: South Africa (SA) has one of the world's largest HIV treatment programmes, to which a dramatic increase in life expectancy has been attributed. However, there continue to be concerns regarding the reporting of HIV-related mortality in SA, which varies by source. As accurate HIV mortality estimates are key to measuring the success of the national programme as well as identifying areas for improvement, we propose a complementary approach to monitoring changes in HIV-related mortality using routine inpatient records to examine trends in causes of death and HIV status over time. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v108i10.13002DOI Listing
October 2018
12 Reads

Is the intravenous giving set a reliable alternative to the spinal manometer in measuring cerebrospinal fluid opening pressure?

S Afr Med J 2018 Oct 2;108(10):865-869. Epub 2018 Oct 2.

Department of Medicine, Edendale Hospital, Pietermaritzburg, and Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.

Background: Measurement of the cerebrospinal fluid (CSF) opening pressure (OP) during lumbar puncture (LP) should be routine practice. In resource-limited centres, spinal manometers are seldom available and alternative procedures to measure CSF OP are undertaken.

Objectives: To investigate whether the intravenous giving set (IVGS) with a measuring tape is a reliable alternative to the spinal manometer. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v108i10.13176DOI Listing
October 2018
4 Reads

Retrospective case-series analysis of haematological malignancies in goldmining areas of South Africa.

S Afr Med J 2018 Oct 2;108(10):858-864. Epub 2018 Oct 2.

Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France.

Background: South Africa (SA)'s high levels of environmental contamination of mine tailings from uranium and its decay products, coupled with remarkably short distances between mine tailings and residential areas, raise concern about whether there is an association between environmental uranium exposure and risk of cancer, including haematological malignancies.

Objectives: We reviewed information on cases from the central hospital offering cancer diagnostics and treatment in a major mining area of SA to describe their basic clinical and demographic characteristics, as part of assessing whether a cancer epidemiological study in this area would be feasible.

Methods: Basic clinical, demographic and residential information on patients with haematological malignancy diagnosed between 2004 and 2013 was collected retrospectively from the patient files at Chris Hani Baragwanath Academic Hospital in Soweto, Johannesburg. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v108i10.13175DOI Listing
October 2018
9 Reads

'Going the extra mile': Supervisors' perspectives on what makes a 'good' intern.

S Afr Med J 2018 Oct 2;108(10):852-857. Epub 2018 Oct 2.

Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

Background: Much has been published on whether newly graduated doctors are ready for practice, seeking to understand how to better prepare graduates for the workplace. Most studies focus on undergraduate education as preparation for internship by investigating knowledge and skills in relation to clinical proficiencies. The conversion from medical student to internship, however, is influenced not only by medical competencies, but also by personal characteristics and organisational skills. Read More

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http://dx.doi.org/10.7196/SAMJ.2018.v108i10.13052DOI Listing
October 2018
12 Reads