South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde最新文献

{"title":"Creating caring health professionals: Current challenges and opportunities in medical education.","authors":"K Stinson, D Daneman","doi":"10.7196/SAMJ.2026.v116i6b.4038","DOIUrl":"https://doi.org/10.7196/SAMJ.2026.v116i6b.4038","url":null,"abstract":"","PeriodicalId":520778,"journal":{"name":"South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde","volume":"116 6b","pages":"e4038"},"PeriodicalIF":1.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Festschrift in honour of Professor Solomon Benatar's contributions to medicine, academia and society.","authors":"N A B Ntusi, G Meintjes, M Setshedi","doi":"10.7196/SAMJ.2026.v116i6b.5108","DOIUrl":"https://doi.org/10.7196/SAMJ.2026.v116i6b.5108","url":null,"abstract":"","PeriodicalId":520778,"journal":{"name":"South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde","volume":"116 6b","pages":"e5108"},"PeriodicalIF":1.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current follow-up standards for patients with inflammatory bowel disease.","authors":"J P Wright","doi":"10.7196/10.7196/SAMJ.2026.v116i7.5266","DOIUrl":"https://doi.org/10.7196/10.7196/SAMJ.2026.v116i7.5266","url":null,"abstract":"","PeriodicalId":520778,"journal":{"name":"South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde","volume":"116 7","pages":"e5266"},"PeriodicalIF":1.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosing pesticide poisoning deaths.","authors":"K Balme, B Browne, M Eddleston, B Davies, T Cook, S Ferraris","doi":"10.7196/SAMJ.2026.v116i7.5445","DOIUrl":"https://doi.org/10.7196/SAMJ.2026.v116i7.5445","url":null,"abstract":"","PeriodicalId":520778,"journal":{"name":"South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde","volume":"116 7","pages":"e5445"},"PeriodicalIF":1.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is there a necessity for whole-leg lower-limb ultrasound in the setting of deep vein thrombosis?","authors":"E Bowen, L Haupt","doi":"10.7196/SAMJ.2026.v116i7.3807","DOIUrl":"https://doi.org/10.7196/SAMJ.2026.v116i7.3807","url":null,"abstract":"<p><strong>Background: </strong>Isolated distal deep vein thrombosis (IDDVT) is thrombosis that occurs in the lower-limb venous system, limited to the calf veins, with no extension into the popliteal veins. Proximal propagation or proximal DVT (PDVT) has well-defined treatment protocols in which anticoagulation shows clear benefit. IDDVT, however, does not always require treatment because the risk-benefit relationship of anticoagulation is not well established. The divergence in IDDVT treatment has led to two ultrasound approaches: whole-leg and proximal- only ultrasound, with repeat examination when indicated.</p><p><strong>Objective: </strong>To investigate the prevalence of IDDVT using the current ultrasound approach at Universitas Academic Hospital, in order to advise on possible adaptation and tailored approaches in distinct subpopulations.</p><p><strong>Methods: </strong>A retrospective file review of ultrasound investigations performed from 1 January 2015 to 31 December 2020 at the vascular suite in Universitas Academic Hospital, Bloemfontein, South Africa. Demographic data, HIV status and the anatomical site and anatomical extent of the thrombosis were collected.</p><p><strong>Results: </strong>In total, 2 208 files were reviewed, which included 1 203 (54.5%) cases negative for DVT, with an alternative diagnosis possible in 113 (9.4%) of the negative cases. Of the 1 005 (45.5%) positive cases, 983 had adequate data for analysis, with 845 (86.0%) PDVT and 138 (14.0%) IDDVT cases. A female predominance was observed, with a male-to-female ratio of 1:2.02. Black African and mixed-race patients had significantly less IDDVT than white patients. Nearly two-thirds (66.0%) of the patients were HIV positive. However, HIV as a risk factor for PDVT did not meet statistical significance (p=0.053).</p><p><strong>Conclusion: </strong>The low prevalence of IDDVT in the study cohort suggests that a proximal-only ultrasound approach can be adopted. Additionally, black African and mixed-race ethnicity, as well as male sex, were associated with a higher incidence of PDVT. Further prospective evaluation of the propagation rate of IDDVTs might advocate for tailored ultrasound approaches in different demographic groups.</p>","PeriodicalId":520778,"journal":{"name":"South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde","volume":"116 7","pages":"e3807"},"PeriodicalIF":1.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microbiological analysis of complicated urinary tract infections in a specialised urology unit in KwaZulu-Natal Province, South Africa, 2021 - 2023.","authors":"S Konar, M Pye Han, Y Mahabeer, K Swe Swe-Han","doi":"10.7196/SAMJ.2026.v116i7.3299","DOIUrl":"https://doi.org/10.7196/SAMJ.2026.v116i7.3299","url":null,"abstract":"<p><strong>Background: </strong>Complicated urinary tract infections (cUTIs) are a growing burden in urological patients, particularly those with prior catheterisation or surgical procedures. Appropriate empirical antimicrobial therapy is an essential component in the management of these patients; therefore, treatment guidelines need to be reviewed periodically.</p><p><strong>Objectives: </strong>To evaluate the microbiological causes and antimicrobial resistance (AMR) patterns of cUTIs in a specialised urology department in KwaZulu-Natal Province, South Africa.</p><p><strong>Method: </strong>A retrospective study was conducted on all positive urine cultures of patients attending a urology clinic and ward from 1 January 2021 to 31 December 2023. Samples were processed according to standard operating procedures.</p><p><strong>Results: </strong>A total of 820 specimens were analysed in this study. Escherichia coli was the most common causative agent of cUTIs, accounting for 47% of all isolates, followed by Klebsiella spp. (15%). Enterococcus spp. was the most prevalent Gram-positive uropathogen. Notably, high resistance patterns were observed, with ciprofloxacin resistance rates of 79.4% in E. coli and 50.8% in Klebsiella spp. Extended-spectrum beta-lactamase-producing bacteria were detected in 43.3% of E. coli and 40.2% of Klebsiella spp. isolates, while carbapenem resistance was detected in 15.3% of Klebsiella spp.</p><p><strong>Conclusion: </strong>Our study shows the importance of antibiotic surveillance to guide empirical antimicrobial therapy based on local microbiological data. Owing to the increase in resistance of common uropathogens to commonly used antimicrobials, we advocate revised guidelines for the empirical treatment of cUTIs.</p>","PeriodicalId":520778,"journal":{"name":"South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde","volume":"116 7","pages":"e3299"},"PeriodicalIF":1.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to correspondence regarding 'Deaths from suspected mothball poisoning in children'.","authors":"M Dempster, A M E Millen, S Baijnath, Z Dangor","doi":"10.7196/10.7196/SAMJ.2026.v116i7.5599","DOIUrl":"10.7196/10.7196/SAMJ.2026.v116i7.5599","url":null,"abstract":"","PeriodicalId":520778,"journal":{"name":"South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde","volume":"116 7","pages":"e5599"},"PeriodicalIF":1.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tolerance of chemotherapy in breast cancer patients in different age groups: A single-centre South African study.","authors":"A M Zwane, G Oosthuizen, L Stopforth, M Joffe, L Martin, S Čačala","doi":"10.7196/SAMJ.2026.v116i7.3790","DOIUrl":"https://doi.org/10.7196/SAMJ.2026.v116i7.3790","url":null,"abstract":"<p><strong>Background: </strong>Tolerance of chemotherapy is a special concern in older patients, owing to comorbidities and lower physical reserves compared with younger patients. There has been no substantial research done locally regarding chemotherapy tolerance.</p><p><strong>Objective: </strong>To establish tolerance of chemotherapy in different age groups, as well as outcomes.</p><p><strong>Methods: </strong>This was a single-centre, retrospective, descriptive analysis of prospectively collected data at Grey's Hospital (KwaZulu-Natal, South Africa). It included all patients who received chemotherapy as part of their breast cancer management from January 2016 to December 2018, stratified into three age groups.</p><p><strong>Results: </strong>The 463 patients were divided into three age groups; <60 years (n=306; 66.1%), 60 - 64 years (n=48; 10.4%) and ≥65 years (n=109; 23.8%). Of these patients, 247 (53.3%) had comorbidities. Most patients (357 (77.1%)) had an Eastern Corporate Oncology Group performance status of 0. No difference was noted in the age groups for tumour stage and receptor status. The majority of patients had stage 3 disease (42.1%). Most patients received an anthracycline-based regimen (78.2%). An anthracycline-free regimen was more frequently given with advancing age. Regarding standard dosing, 452 patients (98.7%) received this, while 41 patients (8.9%) had dose delays, reduction and early discontinuation, with no significant difference across age groups. Haematological adverse events occurred in 25.7%, and 4.3% had non-haematological adverse events. There was no significant difference between the age groups for adverse events.</p><p><strong>Conclusion: </strong>No statistically significant difference in tolerance to chemotherapy was found across different age groups, even when comorbidities were factored in.</p>","PeriodicalId":520778,"journal":{"name":"South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde","volume":"116 7","pages":"e3790"},"PeriodicalIF":1.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variations in blood transfusion practices among South African haematology providers: A survey of haemato-oncology and haematopoietic stem cell transplant prescribers.","authors":"J R Du Toit, A Setzer, M D Seftel, M Goeijenbier, E Verburgh, V J Louw","doi":"10.7196/SAMJ.2026.v116i7.4161","DOIUrl":"https://doi.org/10.7196/SAMJ.2026.v116i7.4161","url":null,"abstract":"<p><strong>Background: </strong>Patients with haematological malignancies and haematopoietic stem cell transplant recipients are major consumers of blood products. In South Africa (SA), both medical oncologists and clinical haematologists (haematology providers) manage these patients. We hypothesised that there may be varied blood transfusion practices between these two specialty groups.</p><p><strong>Objectives: </strong>To compare red blood cell (RBC) and platelet transfusion practices among haematology providers in SA, focusing on transfusion thresholds, blood product modifications and differences between clinical haematologists and medical oncologists.</p><p><strong>Methods: </strong>We conducted an online REDCap survey among SA haematology providers, including clinical haematologists (and trainees), medical oncologists (and trainees), paediatric oncologists/haematologists (and trainees) and medical officers managing haemato-oncology patients.</p><p><strong>Results: </strong>The survey response rate was 51% (79/155), of which 58 (73%) responses were complete and eligible for analysis. RBC and prophylactic platelet transfusion thresholds were generally similar across haematology providers. However, significant variation was observed in platelet thresholds for central venous catheter insertion, lumbar puncture and major surgery. Marked inconsistency was also noted in clinicians' understanding of when blood product irradiation is indicated.</p><p><strong>Conclusion: </strong>This study confirms a variation in blood transfusion practices and blood product modification requests between haematology providers. This emphasises the need for targeted education and national standardisation efforts to optimise transfusion practice and ensure patient safety.</p>","PeriodicalId":520778,"journal":{"name":"South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde","volume":"116 7","pages":"e4161"},"PeriodicalIF":1.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The return of congenital syphilis: Disease spectrum and modifiable factors in a semi-rural regional hospital in KwaZulu-Natal Province, South Africa.","authors":"S Tiemersma, P A Setlatjile, J Van Lobenstein, N Moran","doi":"10.7196/SAMJ.2026.v116i7.3064","DOIUrl":"https://doi.org/10.7196/SAMJ.2026.v116i7.3064","url":null,"abstract":"<p><strong>Background: </strong>Despite the World Health Organization's current focus on eliminating congenital syphilis (CS) as part of its triple elimination strategy, the incidence of CS in South Africa (SA) is increasing. This highly preventable disease causes high morbidity and mortality. Recent local data on the clinical presentation of CS and modifiable factors associated with vertical transmission are scarce.</p><p><strong>Objectives: </strong>To describe the maternal and neonatal characteristics of symptomatic and asymptomatic neonates admitted with CS, and to identify the modifiable factors leading to CS infection.</p><p><strong>Methods: </strong>We conducted a retrospective review of all CS cases diagnosed in live-born infants managed at General Justice Gizenga Mpanza Regional Hospital in KwaZulu-Natal Province, SA, between 1 December 2019 and 31 December 2020, describing clinical presentation and modifiable factors that contributed to the occurrence of CS. Outcomes were compared between symptomatic and asymptomatic infants, and clinical features were compared between surviving and non-surviving infants.</p><p><strong>Results: </strong>We recorded 54 cases of CS out of 7 535 live-born infants (0.7%), including two sets of twins. Mothers of infants with CS were more likely to be living with HIV (52% (n=27) v. 38% of all mothers delivering live-born infants at our facility (p=0.032)), and less likely to have attended antenatal care (ANC): 19% (n=10) did not attend ANC, v. 2% overall (p=0.000). Neonatal death occurred in 7 (13%) infants with CS. Forty (74%) of the infants were symptomatic, with hepatosplenomegaly being the most common finding (68% of infants with CS). In total, 78 modifiable factors contributing to CS were identified, and grouped into maternal factors and factors related to timing of diagnosis, the healthcare system, testing and hospital or clinic visits. For 18 mothers (33% of modifiable factors), the result of the syphilis test conducted during pregnancy was not traced, or no treatment was commenced; 14 (27%) seroconverted during pregnancy after an initial negative booking test.</p><p><strong>Conclusion: </strong>Our study confirms high morbidity and mortality associated with CS. We recommend the use of point-of-care rapid diagnostic tests (mono syphilis or dual HIV/syphilis) at regular intervals throughout pregnancy. Elimination of CS is challenging, with a high percentage of mothers of neonates with CS not attending ANC.</p>","PeriodicalId":520778,"journal":{"name":"South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde","volume":"116 7","pages":"e3064"},"PeriodicalIF":1.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}