Medical Technology SA - Volume 25, Issue 1, 2011
Volume 25, Issue 1, 2011
Electroencephelographic (EEG) & mini mental state examination (MMSE) findings among HIV positive patientsSource: Medical Technology SA 25 (2011)More Less
Objective: To study the role of Folstein's Mini Mental State Examination (MMSE) and the Electroencephalogram (EEG) in the clinical evaluation of patients at risk of cognitive impairment in HIV disease.
Methods: Eighty HIV-positive patients were categorized into 2 groups according to their current immune status (HIV or AIDS). Group 1 consists of asymptomatic HIV-seropositive individuals (HIV) with CD4 counts above 200 cells/ml3, and group 2 consists of individuals with Acquired Immunodeficiency Syndrome (AIDS) with CD4 counts below 200 cells/ml3. Thirty six were males and 44 were females, ranging between the age of 18-60 years. The patients were recruited from The Bay Hospital, Richards Bay, Kwa-Zulu Natal, South Africa. Demographically, 99% of the patients selected were Black and 1% Caucasian. For the detection of cognitive impairment in each patient, MMSE and EEG were performed. The EEG findings were then correlated with results of MMSE, immunosuppression, opportunistic infections, medication (Highly Active Antiretroviral Therapy) and disease classification.
Results: MMSE was significantly associated with the EEG results (p=0.008), immunosuppression (p=0.016), opportunistic infections (p=0.018), and disease classification (p=0.030). EEG did not associate with immunosuppression (p=0.838), opportunistic infections (p=0.074), and disease classification (p=0.259). Neither the MMSE nor the EEG was associated with HAART intake. The mean MMSE score for the AIDS group was 24, marginally less than that of the matched HIV group scoring 27. Twenty one of all patients had a score less than 24, indicative of dementia. EEG was abnormal in 16 patients and borderline in 8 cases.
Conclusion: MMSE may be a sensitive test in detecting cognitive impairment and monitoring its course in AIDS/HIV. EEG abnormalities may indicate a risk of HIV cognitive impairment in otherwise stable individuals.
Author A.J. EsterhuyseSource: Medical Technology SA 25 (2011)More Less
A need for highly skilled and suitably qualified medical laboratory scientists in South Africa has resulted in the development of an internationally comparable 4-year professional degree: Bachelor of Health Sciences in Medical Laboratory Science which will replace the National Diploma: Biomedical Technology. In contrast to all international qualifications investigated, assessment of the South African professional degree is strengthened by incorporation of the professional body requirements into a final practical board examination which is under the authority of the professional body, the Council for Higher Education, by virtue of the registration with the South African Qualifications Authority (SAQA) as a professional degree (NQF level 8) and registered higher education providers. In addition, the South African qualification is further strengthened by the incorporation of a substantial research project undertaken by learners and may lead to study towards higher degrees.
Pathogenesis and future treatments of systemic lupus erythematosus : the role of cytokines and anti-cytokines? : peer reviewed reviewAuthor W.J. MauleSource: Medical Technology SA 25, pp 5 –17 (2011)More Less
Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune connective tissue disorder, which has variable clinical manifestations that range from mild to life-threatening. These can be characterised by multiple organ damage, very high titres of autoantibodies and immune complex deposition. Interestingly the former of these characteristics may precede the clinical manifestations of SLE by many years. It is well recognised that the probable influence of oestrogen hormonal effect in women during childbearing years increases their chances of developing SLE by 10-15 times.
Interaction between NK cells and HLA-G1 at the placental interface of HIV-1 infected pregnant women : additional risk factors or physiological association? : peer reviewed original articleAuthor S. MoodleySource: Medical Technology SA 25, pp 17 –22 (2011)More Less
Background: Human Leucocyte Antigen-G (HLA-G) molecules are involved in the inhibition of cell-mediated immune responses and could promote the propagation of HIV-1 infection across the placental interface thus increasing the risk of vertical transmission. Therefore, the objective of this study was to assess whether the Major Histocompatibility Complex (MHC) - coded molecule HLA-G inhibits Natural Killer (NK) cell activity thereby, assisting viral penetration across the placental barrier in HIV-1 positive pregnant women.
Study Design & Methods: Natural Killer (CD56+) cell activity and placental HLA-G1 expression was assessed using immunohistochemistry and real-time polymerase chain reaction (RT-PCR) techniques, respectively. Studies were performed on a total of fifty five placental samples obtained from HIV-1 infected mothers at birth.
Results: Low numbers of NK cells increased risk of vertical transmission [OR = 3.424 (95%CI 0.65-17.89)]. The risk of babies becoming infected increased by 1.3 with every 1 unit increase in HLA-G1 expression. A positive correlation was observed between mothers' log viral load and transmission of infection to the baby (p = 0.047; 95%CI 1.029-11.499).
Conclusion: Low NK cell activity at the placental interface increased the risk of vertical transmission. Maternal viral load remained a strong predictor of viral transmission.
Source: Medical Technology SA 25, pp 27 –32 (2011)More Less
Long term exposure to tertiary-butyl hydroperoxide (TBHP: initiator of oxidation) in the manufacturing of polyester resin coatings might be a cardiovascular risk for workers. The aim of this study was to investigate the effects of TBHP in the serum of rats by assessing the lipid profile and lipid oxidation as biomarkers of cardiovascular disease. Male Wistar rats (n = 6) aged 10 to 12 weeks were randomly placed in two groups (control and treatment) and fed ad lib with standard rat chow and water. Rats in the control group received an intraperitoneal injection of saline while the treatment group received TBHP (20 µM, 70% aqueous, Sigma Chemical Co, South Africa). Six rats were included in each group and injections (0.5 ml) were administered on 5 consecutive days per week for a period of 8 weeks. Cardiovascular biomarkers in the serum was determined by measuring the total cholesterol (TC), high density lipoprotein (HDL), triglycerides (TG) and C-reactive protein (CRP), while the lipid peroxidation in serum was determined by the conjugated diene (CD) measurement, lipid hydroperoxide (LOOH) and by thiobarbituric acid resistance substance (TBARS) assay. The serum of rats injected with 20 µM TBHP had significantly increased the levels of cardiovascular biomarkers and lipid peroxidation. The findings of the study indicate that TBHP injection in rats may increase the susceptibility of the serum to lipid peroxidation which could lead to cardiovascular disease.
Haematological and iron status of Qwa Qwa women in South Africa who ingest clays : peer reviewed original articleSource: Medical Technology SA 25, pp 33 –37 (2011)More Less
Geophagia is the deliberate habitual consumption of soil and clay. This habit is practiced worldwide and is also common in southern Africa. There are many reasons given for the practice of geophagia like cultural, medicinal, religious and mineral deficiency. Geophagia has been associated with anaemia and recently, specifically with iron deficiency anaemia. The reason for this association includes, among others that clay could actually lead to decreased bioavailability of iron for absorption in the body through kaolinite. The aim of was to investigate the link between iron deficiency anaemia and geophagia in QwaQwa women since this link has not been investigated in South Africa. In this pilot study, blood was drawn from five women who do not consume soil (control group), and twelve women who consumed soil (geophagic group). The participants were from the same vicinity (area) or household, with the expectation that they follow similar diets. Full blood count and iron studies were performed in order to determine the prevalence of iron deficiency anaemia. The results indicated that iron deficiency anaemia was not evident in the control group. In contrast half of the geophagic group had iron deficiency anaemia while the rest of the participants had a state of iron deficiency without anaemia. In conclusion, iron deficiency anaemia is associated with geophagia, and geophagia predisposes or contributes to the development of iron deficiency.
Expression of cartilage oligomeric matrix protein in articular cartilage in response to bone morphogenetic protein-7 and tumour necrosis factor : peer reviewed original articleSource: Medical Technology SA 25, pp 38 –43 (2011)More Less
Introduction: The extracellular matrix of articular cartilage consists of collagens, proteoglycans and noncollageneous proteins. Cartilage oligomeric matrix protein (COMP) is a non-collagenous protein isolated from articular cartilage. It is localised in articular cartilage and the proliferative and hypertrophic zones of the epiphyseal growth plate.
Aim: The aim of the study was to investigate the role of bone morphogenetic proteins (BMP-7) and tumour necrosis factor (TNF-α) on expression of COMP in articular cartilage.
Methods: Stifle joints (n=12) from three month-old calves were obtained from a local abattoir. Articular chondrocytes were isolated from three distinct zones of cartilage and cultured as monolayers in a serum-free chemically defined medium.
Results: BMP-7 increased COMP accumulation in dose and time dependent manner. TNF-α was however found to significantly reduce COMP accumulation
Conclusion: BMP-7 was shown to be important regulators of the COMP gene in different zones of articular cartilage
Source: Medical Technology SA 25, pp 44 –51 (2011)More Less
Comparable health care across facilities in South Africa is a public expectation. Past research has shown that medical internships are not always comparable in terms of experience and quality. The aim of this study was to develop guidelines which would assist facilities to manage the quality of internships to comparable standards of practice. A qualitative research approach was used to undertake a case study on newly qualified doctors who registered for internship in 2007. A questionnaire was distributed with logbooks which are given to interns at registration. Questionnaires were returned with the logbook at the completion of the training. The results showed that the standard of internship was uneven and that some interns trained in facilities which met minimum requirements whilst other trained at facilities which did not meet minimum standards for effective internship across geographical distribution of accredited medical training facilities. Guidelines for quality management of WIL covering, policies, planning, resources, procedures for WIL were developed.