Wits journal of clinical medicine最新文献_第3页

Potential Dermatological Effects of Climate Change in Africa 气候变化对非洲皮肤病的潜在影响

Wits journal of clinical medicine Pub Date : 2023-01-01 DOI: 10.18772/26180197.2023.v5n1a1

L. Pillay, AR Sema-Ramashala, S. Jessop, N. Raboobee, R. Lehloenya, L. Moosa, A. Mosam

引用次数: 0

Addressing Challenges with Mental Health and Substance Use Disorders Care with Implementation Science 用实施科学解决精神健康和物质使用障碍护理的挑战

Wits journal of clinical medicine Pub Date : 2023-01-01 DOI: 10.18772/26180197.2023.v5n3a9

Elissa Z Faro, Joel Msafiri Francis, Kim Madundo, Blandina T Mmbaga

引用次数: 0

Porphyric neuropathy in black South Africans: a case series 南非黑人卟啉性神经病:一个病例系列

Wits journal of clinical medicine Pub Date : 2023-01-01 DOI: 10.18772/26180197.2023.v5n2a5

A. Koufos, G. Modi

引用次数: 0

Photovoice: An Opportunity to Connect Medicine with Community in South Africa to Advance Health, Racial, and Social Equity Photovoice:将南非的医学与社区联系起来以促进健康、种族和社会公平的机会

Wits journal of clinical medicine Pub Date : 2023-01-01 DOI: 10.18772/26180197.2023.v5n3a8

Shannon McMorrow

引用次数: 0

Artificial Intelligence (AI) in Perioperative Medicine 人工智能在围手术期医学中的应用

Wits journal of clinical medicine Pub Date : 2023-01-01 DOI: 10.18772/26180197.2023.v5n3a7

Lliam Brannigan

引用次数: 0

Patterns of Glomerular Disease at a Large Urban Public Hospital in South Africa- Impact of HIV Infection 南非一家大型城市公立医院肾小球疾病的模式——HIV感染的影响

Wits journal of clinical medicine Pub Date : 2023-01-01 DOI: 10.18772/26180197.2023.v5n3a2

Lazarus Yvette, Davies Malcolm, Nana Mitan, Paget Graham

{"title":"Patterns of Glomerular Disease at a Large Urban Public Hospital in South Africa- Impact of HIV Infection","authors":"Lazarus Yvette, Davies Malcolm, Nana Mitan, Paget Graham","doi":"10.18772/26180197.2023.v5n3a2","DOIUrl":"https://doi.org/10.18772/26180197.2023.v5n3a2","url":null,"abstract":"Abstract Introduction Glomerular disease is an important cause of renal failure. We sought to describe the patterns of glomerular disease in patients undergoing native kidney biopsy at a large urban public hospital in South Africa during the period 2001–2010. Methods We retrospectively reviewed all native kidney biopsies undertaken during the study period. We further characterised and compared clinical, laboratory and demographic data between glomerular pathologies. Results The majority of patients undergoing biopsy were young (median age 34 years) and of Black African descent (83%). Proteinuria was the most common indication for biopsy. Secondary glomerular disease was more common than primary glomerular disease. HIV-associated glomerular diseases were the most common secondary glomerulopathies Focal segmental glomerulosclerosis (FSGS) was the most frequent primary glomerulopathy. Minimal change nephropathy (MCN) was more frequent in younger patients and membranous nephropathy (MN) more common in older patients. Renal function was poorer in FSGS and membranoproliferative glomerular disease. Conclusions HIV is an important contributor to the high rates of secondary glomerular disease. Primary glomerulopathy demonstrates geographic variation in South Africa with FSGS being dominant in Johannesburg. Although clinical parameters may suggest underlying glomerulopathy, an accurate diagnosis to facilitate directed treatment and prevent progression to renal failure requires a renal biopsy.","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":"142 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134889429","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}

引用次数: 0

Clinical Characteristics and Glycaemic Control in Adults Living with Type 1 Diabetes: A 1-Year Retrospective Chart Review at Two South African Public Sector Tertiary Hospitals 成人1型糖尿病患者的临床特征和血糖控制:南非两家公立三级医院1年回顾性图表回顾

Wits journal of clinical medicine Pub Date : 2023-01-01 DOI: 10.18772/26180197.2023.v5n3a1

Naidoo Poobalan, Pauly Bruno, Variava Ebrahim, Pillay Somasundram, Bayat Zaheer, Daya Reyna, Carrihill Michelle, Naidoo Kiolan, Sekhuthe Lauren, Bhana Sindeep

{"title":"Clinical Characteristics and Glycaemic Control in Adults Living with Type 1 Diabetes: A 1-Year Retrospective Chart Review at Two South African Public Sector Tertiary Hospitals","authors":"Naidoo Poobalan, Pauly Bruno, Variava Ebrahim, Pillay Somasundram, Bayat Zaheer, Daya Reyna, Carrihill Michelle, Naidoo Kiolan, Sekhuthe Lauren, Bhana Sindeep","doi":"10.18772/26180197.2023.v5n3a1","DOIUrl":"https://doi.org/10.18772/26180197.2023.v5n3a1","url":null,"abstract":"Abstract Background : An estimated 11.8% of the South African population are living with diabetes. There is a paucity of data related to the clinical characteristics and glycaemic control in people living with T1DM within the South African public healthcare sector. Objective : To describe the clinical characteristics and glycaemic control of people living with T1DM in a public health care setting. Methods : The study was an observational study conducted at two tertiary public sector hospitals in South Africa by means of a chart review. The study involved adults living with T1DM treated with human insulin for 12 months prior to the date of informed consent. Results : A total of 224 patients with T1DM were enrolled, with 190 (84.8%) from Chris Hani Baragwanath Academic Hospital and 34 (15.2%) from Klerksdorp Tshepong Hospital Complex. One patient withdrew consent, leaving a total analysed population of 223. Of the 223 patients, 37 (16.6%) were controlled (most recent glycosylated haemoglobin (HbA1c) < 7%) while the remainder 186 (83.4%) were uncontrolled (most recent HbA1c ≥ 7%). The mean age of the study group was 33 ± 9 years. The majority of participants were female (122 [54.7%]) and of black ethnicity (215 [96.4%]). The mean number of hypoglycaemic events per patient-year was 151.4 (SD ± 213.9). Diabetic ketoacidosis occurred more frequently in the uncontrolled group. Conclusion : The majority of patients in this study did not achieve target HbA1c, placing them at higher risk for long-term diabetes complications. Poor glycaemic control, leading to long term complications, as well as hypoglycaemia and diabetic ketoacidosis adds further strain to the resource constrained public healthcare in South Africa.","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134889758","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}

引用次数: 0

WJCM Conversations WJCM对话

Wits journal of clinical medicine Pub Date : 2022-03-14 DOI: 10.18772/26180197.2022.v4n1a13

Derek Raal

引用次数: 0

Outcomes of Paediatric Distal Radius Metaphyseal Fractures 小儿桡骨远端干骺端骨折的预后

Wits journal of clinical medicine Pub Date : 2022-03-14 DOI: 10.18772/26180197.2022.v4n1a2

Tlou Boshomane, D. Simmons, A. Robertson

{"title":"Outcomes of Paediatric Distal Radius Metaphyseal Fractures","authors":"Tlou Boshomane, D. Simmons, A. Robertson","doi":"10.18772/26180197.2022.v4n1a2","DOIUrl":"https://doi.org/10.18772/26180197.2022.v4n1a2","url":null,"abstract":"Background: Manipulation and cast immobilisation is the accepted gold standard for management of distal radius metaphyseal fractures in children, with the use of Kirschner wires (K-wires) in cases with potential instability. The primary aim of this study was to determine the outcome of these fractures treated with our current management protocol. We also sought to identify possible risk factors for redisplacement.\u0000Methods: A retrospective study was conducted on 61 children with displaced distal radius metaphyseal fractures under the age of 16 years. Fifty-three patients were treated with manipulation and casting only, while eight patients had K-wire fixation. The primary outcome measured was redisplacement during follow-up. Initial complete displacement, an associated ulna fracture, the quality of reduction, cast and padding indices were assessed as possible risk factors for redisplacement.\u0000Results: A redisplacement rate of 18.8% was reported. We found a statistically significant association between redisplacement and non-anatomical reduction (P = 0.001), cast index (P = 0.030) and padding index (P = 0.031). Non-anatomical reduction resulted in 23.6 times more likelihood of redisplacement (P = 0.008) compared to anatomical reduction. Complete displacement and the presence of an ulna fracture had no effect on redisplacement.\u0000Conclusions: Our current treatment protocol is safe and effective based on the redisplacement rate of 18.8% which is marginally lower than current standards reported in the literature. Poor casting technique and non-anatomical reduction were found to be significant predictors of redisplacement. We suggest that K-wires be used if anatomical reduction is not achieved in older children with limited remodelling capacity.","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89132149","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}

引用次数: 0

An Audit of Blood Cultures in an Emergency Department at a Johannesburg Academic Hospital 约翰内斯堡某学术医院急诊科血培养审计

Wits journal of clinical medicine Pub Date : 2022-03-14 DOI: 10.18772/26180197.2022.v4n1a3

Bradley. Rae, Radha. Gihwala, A. Bentley

{"title":"An Audit of Blood Cultures in an Emergency Department at a Johannesburg Academic Hospital","authors":"Bradley. Rae, Radha. Gihwala, A. Bentley","doi":"10.18772/26180197.2022.v4n1a3","DOIUrl":"https://doi.org/10.18772/26180197.2022.v4n1a3","url":null,"abstract":"Background: Blood cultures (BCs) are the standard test for detecting bacteraemia but have come under scrutiny on their usefulness in the Emergency Departments (EDs) as they have a low yield, tend not to alter patient management and may be subject to high contamination rates especially in resource-limited settings. Identifying patients most at risk of bacteraemia may improve BCs’ usefulness.\u0000Methods: We conducted a retrospective observational, descriptive and comparative study. Reports from all BCs performed in the ED at Helen Joseph Hospital in 2017 were requested from the National Health Laboratory Service. Data from all positive BCs were used to audit cultured organisms and their sensitivity and resistance patterns. Second, clinical and laboratory data from 206 consecutively selected patients (103 positive and 103 negative BC results) were used to calculate the Shapiro score and the Systemic Inflammatory Response Syndrome (SIRS) criteria as screening tools for sepsis.\u0000Results: There was a total of 4011 BCs performed in 2017 of which 715 (17.8%) were positive. Pathogens were cultured in 400 (10.0%) of cases and 315 (7.9%) cultured known contaminants. A positive Shapiro score and SIRS criteria increased the likelihood of a positive BC by 5.6 and 2.3 times, respectively. Positive HIV status, rigors, pulse rate > 115 bpm, deranged mentation, white cells > 18 × 109 cells/L and creatinine > 177 μmol/L were risk factors for positive BCs.\u0000Conclusion: There was a low yield of positive BCs from the ED, and using the SIRS criteria or the Shapiro score improves the pre-test probability of positive BC results in patients with suspected sepsis.","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":"s3-27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90817818","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}

引用次数: 0