Research Outputs (Clinical Medicine)
Permanent URI for this collection
Browse
Browsing Research Outputs (Clinical Medicine) by Title
Now showing 1 - 20 of 90
Results Per Page
Sort Options
Item A long walk to freedom: the epidemiology of penetrating trauma in South Africa- analysis of 4 697 patients over a six year period at Chris Hani Baragwanath Academic HospitalBhana, Malini; Fru, Pascaline; Plani, FrancoBackground: Despite the city of Johannesburg having one of the highest rates of crime in the world, no national databank for trauma exists. This study profiles the victims of penetrating trauma and identifies geographical areas in which it occurs, while describing the outcomes and patterns of injury. Methods: A retrospective study including penetrating trauma patients triaged as Priority 1, presenting at the Chris Hani Baragwanath Academic Hospital's (CHBAH) trauma department over a six-year period (2011-2016). Results: A total of 4 697 patients were included. The majority of victims were Black African males (92.1%) between the ages of 29-40 years, and stabbings were the most common mechanism of injury (71.8%), followed by gunshots. The commonest body area affected was the thorax, with a consequent haemothorax the most likely result. Weekends accounted for over 48% of all presentations - the last weekend of the month being the busiest. Region D was the area in Johannesburg with the highest trauma incidence (51.9%), with the oldest townships in Soweto found to be "hot spots". Conclusion: Penetrating trauma is inherently linked to alcohol abuse and interpersonal violence in South Africa,1 primarily affecting its young economic, working-class citizens. The data provided some insight into the burden, structure and challenges of our trauma system. These should be regarded as opportunities to implement change and improve our surveillance and prevention, beginning with a national trauma databankItem 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 Alloplastic Total Temporomandibular Joint Reconstruction A 10Year Experience of the University of the Witwatersrand JohannesburgRisimati Rikhotso; Mmathabo SekhotoItem 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 Are adults just big kids? Can the newer paediatric weight estimation systems be use in adultsOluromini Akinola; Michael Wells; Pano Parris; Lara GoldsteinItem Botulinum neurotoxin injections in essential infantile esotropiaa comparative study with surgery in largeangle deviationsIsmail Mayet; Naseer Ally; Hassan Alli; Mohammed Tikly; Susan WilliamsItem A brief history of South Africa's response to Aids(2014) Simelela, N.P.; Venter, W.D.F.The story of the AIDS response in South Africa over the past 4 years is one of great progress after almost a decade of complex and tragic denialism that united the world and civil society in a way not seen since the opposition to apartheid. Today the country can boast >2 million people on antiretroviral therapy, far and away the largest number in the world. Prevention efforts appear to be yielding results. The estimated number of annual new HIV infections declined by 79 000 between 2011 and 2012. New HIV infections among adults aged 15 - 49 years are projected to decline by 48% by 2016, from 414 000 (2010) to ~215 000 (2016). The national incidence rate has reached its lowest level since the disease was first declared an epidemic in 1992, translating into reductions in both infant and under-5 mortality and an increase in life expectancy from 56 to 60 years over the period 2009 - 2011 alone. This is largely thanks to a civil society movement that was prepared to pose a rights-based challenge to a governing party in denial, and to brave health officials, politicians and clinicians working in a hostile system to bring about change.Item Career choice of anaesthetists in a department of anaesthesiology at tertiary institution in South AfricaGrace Manjooran; Juanett Scribante; Helen Perrie; Cara RedelinghuysItem 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 The challenges of managing breast cancer in the developing world- a perspective from sub- Saharan Africa(2014-05) Edge, J; Buccimazza, I; Cubasch, H; et al.Communicable diseases are the major cause of mortality in lower-income countries. Consequently, local and international resources are channelled mainly into addressing the impact of these conditions. HIV, however, is being successfully treated, people are living longer, and disease patterns are changing. As populations age, the incidence of cancer inevitably increases. The World Health Organization has predicted a dramatic increase in global cancer cases during the next 15 years, the majority of which will occur in low- and middle-income countries. Cancer treatment is expensive and complex and in the developing world 5% of global cancer funds are spent on 70% of cancer cases. This paper reviews the challenges of managing breast cancer in the developing world, using sub-Saharan Africa as a model.Item Charting the path along the continuum of PMCT or HIV-1 to elimination and finally to eradication(2014-01) Ramkissoon, A; Coovadia, HIn this editorial we traverse the continuum of transmission of HIV-1 from mothers to children to highlight the biomedical history of this problem. Treatment has progressed from prevention with antiretrovirals (ARVs) through to a broader set of interventions, including various breastfeeding options and other health system improvements, that have increased the possibility of eliminating mother-to-child-transmission (MTCT) of HIV.Item 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 Clinical access to Bedaquiline Programme for the treatment of drug-resistant tuberculosis(2014-03) Conradie, F; Meintjies, G; Hughes, J; et alWhile clinical disease caused by drug-sensitive Mycobacterium tuberculosis (MTB) can usually be treated successfully, clinical disease caused by drug-insensitive MTB is associated with a poorer prognosis. In December 2012, a new drug, bedaquiline, was approved by the US Food and Drug Administration. This article documents the process whereby the National Department of Health, Right to Care and Médecins Sans Frontières obtained access to this medication for South Africans who might benefit from subsequent implementation of the Clinical Access to Bedaquiline Programme.Item Clinicopathological characteristics among South African women with breast cancer receiving antiretroviral therapy for HIVBoitumelo Phakathi; Herbert Cubasch; Sarah Nietz; Caroline Dickens; Therese Dix-Peek; Maureen Joffe; A Neugut; J Jacobson; Raquel Duarte; Paul RuffItem Congenital Rubella Syndrome Surveillance in South Africa using a sentinel site approach A crosssectional studyNkengafac Villyen Motaze; Jack Manamela; Sheilagh Smit; Helena Rabie; Gary Reubenson; Daynia Ballot; David Moore; E et al; Cheryl Cohen; Melinda SuchardItem The cost of harmful alcohol use in South Africa(2014-02) Matzopoulos, R G; Truen, S; Bowman, B; et al.Background. The economic, social and health costs associated with alcohol-related harms are important measures with which to inform alcohol management policies and laws. This analysis builds on previous cost estimates for South Africa. Methods. We reviewed existing international best-practice costing frameworks to provide the costing definitions and dimensions. We sourced data from South African costing literature or, if unavailable, estimated costs using socio-economic and health data from secondary sources. Care was taken to avoid possible causes of cost overestimation, in particular double counting and, as far as possible, second-round effects of alcohol abuse. Results. The combined total tangible and intangible costs of alcohol harm to the economy were estimated at 10 - 12% of the 2009 gross domestic product (GDP). The tangible financial cost of harmful alcohol use alone was estimated at R37.9 billion, or 1.6% of the 2009 GDP. Discussion. The costs of alcohol-related harms provide a substantial counterbalance to the economic benefits highlighted by the alcohol industry to counter stricter regulation. Curtailing these costs by regulatory and policy interventions contributes directly and indirectly to social well-being and the economy. Conclusions. Existing frameworks that guide the regulation and distribution of alcohol frequently focus on maximising the contribution of the alcohol sector to the economy, but should also take into account the associated economic, social and health costs. Current interventions do not systematically address the most important causes of harm from alcohol, and need to be informed by reliable evidence of the ongoing costs of alcohol-related harms.Item Determinants of poor adherence to antiretroviral treatment using a combined effect of age and education among human immunodeficiency virus infected young adults attending care at letaba hospital hiv clinic Limpopo Province South AfricaK Mabunda; E Ngamasana; Joseph Babalola; M Zunza; Peter NyasuluItem Effect of seasonal variation on the peak presentation of slipped capital femoral epiphysis A comparison of children in Johannesburg South Africa and London UKGregory Firth; Matthew Foster; Carl Pieterse; Yammesh Ramguthy; Alane Izu; Joseph Bacarese-Hamilton; Manoj Ramachandran