School of Clinical Medicine
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Browsing School of Clinical Medicine by Department "Internal Medicine"
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Item A qualitative study to identify critical attributes and attributelevels for a discrete choice experiment on oral preexposure prophylaxis PrEP delivery among young people in Cape Town and Johannesburg South AfricaJanan Dietrich; Millicent Atujuna; Gugulethu Tshabalala; Stefanie Hornschuh; Mamakiri Khunwane; Michelle Koh; Nadia Amed; Richard Muhumuza; Kennedy Otwombe; Neil Martinson; A Et AlItem An incidental finding of chronic lymphocytic leukemia in a patient with pulmonary tuberculosisV Parker; Jaclyn Bennet; Ian SanneItem An incidental finding of chronic lymphocytic leukemia in a patient with pulmonary tuberculosisV Parker; Jaclyn Bennet; Ian SanneItem Botulinum neurotoxin injections in essential infantile esotropiaa comparative study with surgery in largeangle deviationsIsmail Mayet; Naseer Ally; Hassan Alli; Mohammed Tikly; Susan WilliamsItem Challenges in recruiting children to a multidrugresistant TB prevention trialS Purchase; E Batist; N Mmile; S Nkosi; J Workman; Neil Martinson; Lee Fairlie; H. S. Schaaf; et al et alItem Clients experiences utilizng a safer conception service for HIV affected individuals implications for differentiated care service delivery modelsSheree Schwartz; Natasha Davies; Nicolette Naidoo; Diantha Pillay; Nokuthula Makhoba; Saiqa MullickItem A descriptive retrospective record review of paediatric patients with intracardiac thrombi associated with dilated cardiomyopathy at Chris Hani Baragwanath academic hospital(2016-02-09) Morar, Deksha FayeIntracardiac thrombi associated with dilated cardiomyopathy in paediatric patients can be a source of significant morbidity and mortality. This study looked at the prevalence, risk factors and outcomes of children complicated by intracardiac thrombi, following a diagnosis of dilated cardiomyopathy at a tertiary centre. METHODS A retrospective review of all children, between the ages of 1 and 14 years, diagnosed with dilated cardiomyopathy from August 1983 to July 2011 were assessed using the paediatric cardiology database at Chris Hani Baragwanath Academic Hospital. The study population comprised of 303 children. RESULTS The prevalence of intracardiac thrombi in the children with dilated cardiomyopathy was 13.2% (40 children). The majority were located in the left ventricle (80%). The children who developed intracardiac thrombi had a lower fractional shortening compared to the group without intracardiac thrombi (p≤0.05). 20 of these children (6.6%) had evidence of embolization (15/20 to the central nervous system). 52 of the 303 children were HIV positive (17.2%). There was no statistically significant association between HIV status and the development of intracardiac thrombi (p = 0.19). The overall mortality was 8.9%. 12 of the 27 deaths occurred in the intracardiac thrombi group showing that the children with intracardiac thrombi had a poorer outcome (p≤0.05). CONCLUSION Intracardiac thrombi is a common occurrence in paediatric patients with dilated cardiomyopathy. There is a significant relationship between the development of intracardiac thrombi and a poor fractional shortening. Patients with echocardiographic evidence of intracardiac thrombi have a worse outcome.Item Factors influencing adolescent girls and young womens participation in a combination HIV prevention intervention in South AfricaTracy McClinton Appollis; Zoe Duby; Kim Jonas; Janan Dietrich; Kealeboga Maruping; A Et AlItem Focal myocarditis in a young male with SARSCoV2 infectionRuchika Meel; Tyral Ramsamy; Rajiv Narsing; Michelle WongItem The identification of differentially expressed cell cycle -related genes in breast and colon cancer cell lines in response to chemotherapeutic drugs(2010-01-27T11:15:07Z) Rupnarain, CharleenWith the high prevalence and high mortality rate of cancer in the global community, it is increasingly essential to accelerate our understanding of the disease, to identify new genetic targets for therapy, and to pursue avenues for improving on the therapies in development and in current use. The aim of this study is to identify cell cycle-related genes whose expression is influenced by the chemotherapeutic drugs curcumin, SAHA, lycopene and thalidomide in breast and colon cancer and normal cell lines. These drugs are currently not in clinical use for cancer in South Africa, and while there have been investigative studies of these chemotherapeutic agents, this study aims to identify the specific genes that are influenced by the drugs. The result of this is that several genes that were not previously documented as targets of these drugs are highlighted. The cell cycle pathway is the area of focus as loss of regulation in the cell cycle is one of the important factors involved in promoting cancer initiation and progression. In the first instance, flow cytometry was used to identify optimal drug concentrations relative to the cell cycle stages. Following this, alterations in gene expression were assessed using a PCR-based differential display after each drug treatment. Subsequently, a more focussed approach was taken in a PCR-array analysis of panels of cell cyclerelated genes. A subset of genes is identified that is implicated in oncogenic transformation in breast cancer. This has the potential to inhibit the genetic pathways involved in breast malignancy by providing targets that perhaps may not be manipulated in current therapies. The gene expression studies here suggest that lycopene and thalidomide function in inhibiting this transformation, and play significant roles in suppressing the oncogenic state of breast cancer. Curcumin and SAHA also exhibit important functions in inhibiting tumourigenesis in colon cancer. While the results propose that the drugs have clear roles in inhibiting breast and colon cancer, they are also implicated in promoting cancer. This research has defined the genes that must be carefully monitored during drug administering as they may promote these and other cancers. The availability of these results to researchers will aid in selecting the criteria for assessing the success rate of these drugs.Item Impact of longacting therapies on the global HIV epidemicNomathemba Chandiwana; Celicia M Serenata; Andrew Owen; Steve Rannard; Carmen Perez Casas; A Et AlItem Making the case for an obstetric medicine subspecialty in South Africa(Health & Medical Publishing Group, 2020-11) Zamparini, J; Wium, LObstetric medicine is a subspecialty of internal medicine that involves the management of medical conditions that may affect the course of pregnancy. It is an established subspecialty in many parts of the world, with recognised training programmes and an active international society; however, no formal training programme has been developed in South Africa (SA) as yet. Medical problems are responsible for the majority (60%) of maternal deaths in SA and women of childbearing potential are disproportionately affected by medical conditions such as HIV and obesity. Obstetric physicians would play a complementary role in the care of pregnant patients and could contribute to improving maternal health and lowering the maternal mortality rate in SAItem Management of HIV-associated cryptococcal disease in South Africa(2014-12) Govender, N.P; Dlamini, SItem Maternal and neonatal outcomes following the introduction of oral hypoglycaemic agents for gestational diabetes mellitus were comparable to insulin monotherapy in two historical cohortsVeronique Nicolaou; Larske Soepnel; Kenneth Huddle; N Levitt; Kerstin Klipstein-Grobusch; Shane NorrisItem Posttrial perceptions of a symptombased TB screening intervention in South Africa implementation insights and future directions for TB preventive healthcare servicesNicole Salazar-Austin; Minja Milovanovic; Nora West; Grace Barnes; Ebrahim Variava; Neil Martinson; Richard Chaisson; E et alItem Pregnancy and cardiac disease(2014-09) Elliot, C; Sliwa, K; Burton, RMedical disorders in pregnancy are one of the top five causes of maternal mortality in South Africa (SA), cardiac disease (CD) being the main contributor to this group. In developed countries, surgically corrected congenital heart disease (CHD) comprises the greater proportion of maternal deaths from CD. In SA and other developing countries, acquired heart disease such as rheumatic heart disease and cardiomyopathies are the major causes, although CHD remains significantly represented. Both congenital and acquired cardiac lesions may present for the first time during pregnancy. CD may also occur for the first time during or after pregnancy, e.g. peripartum cardiomyopathy. The risk to both the mother and the fetus increases exponentially with the complexity of the underlying disease. Generally, the ability to tolerate a pregnancy is related to: (i) the haemodynamic significance of any lesion; (ii) the functional class – New York Heart Association classes III and IV have poorer outcomes; (iii) the presence of cyanosis; and (iv) the presence of pulmonary hypertension. While the ideal time to assess these factors is before conception, women frequently present when already pregnant. This review discusses risk assessment and management of CD in pregnant women and the role of a combined cardiology and obstetric clinic.Item Successfully controlling malaria in South Africa(2014-03) Blumberg, I; Frean, J; Moonasar, DFollowing major successes in malaria control over the past 75 years, South Africa is now embarking on a malaria elimination campaign with the goal of zero local transmission by the year 2018. The key control elements have been intensive vector control, primarily through indoor residual spraying, case management based on parasitological diagnosis using evidence-based drug policies with artemisinin-based combination therapy since 2001, active health promotion in partnership with communities living in the malaria transmission areas, and cross-border collaborations. Political commitment and long-term funding for the malaria control programme have been a critical component of the programme’s success. Breaking the cycle of transmission through strengthening of active surveillance using sensitive molecular tests and field treatment of asymptomatic persons, monitoring for antimalarial drug resistance and insecticide resistance, strengthening cross-border initiatives, and ongoing programme advocacy in the face of a significant decrease in disease burden are key priorities for achieving the elimination goal.Item The cost and intermediary costeffectiveness of oral HIV selftest kit distribution across 11 distribution models in South AfricaKatleho Matsimela; Linda Alinafe Sande; Cyprian Mostert; Mohammed Majam; Jane Phiri; Vincent Zishiri; Celeste Madondo; Stephen Khama; Thato Chidarikire; et al et al; Gesine Meyer-Rath