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- Volume 22, Issue 4, 2007
Southern African Journal of Epidemiology and Infection - Volume 22, Issue 4, 2007
Volume 22, Issue 4, 2007
Author J. CohenSource: Southern African Journal of Epidemiology and Infection 22, pp 103 –106 (2007)More Less
Sepsis continues to represent an unmet medical need and is a major cause of morbidity and mortality in intensive care units. Recently four major new developments have been reported, each of which appears to have a significant beneficial effect. These are : the use of low dose steroids, early goal-directed therapy, intensive insulin therapy and drotrecogin alfa (activated). Despite early enthusiasm, in each case significant concerns and reservations have emerged. Here, these issues are considered and the current status of these treatments is discussed.
Source: Southern African Journal of Epidemiology and Infection 22, pp 107 –108 (2007)More Less
Until recently the Mantoux or tuberculin skin test has been the standard diagnostic test for latent tuberculosis (TB) infection. However, two new commercial blood assays have recently become available in South Africa for the diagnosis of latent TB infection, the T-spot TB test and the Quantiferon-TB Gold In-Tube. These assays are based on detection of gamma interferon produced by T cells in response to antigens specific for Mycobacterium tuberculosis. We aimed to review and compare these respective tests in our setting.
The use of p16ink4a in further defining atypical squamous cells cannot exclude a high grade lesion on cervical cytology (ASC-H) : results of a pilot studySource: Southern African Journal of Epidemiology and Infection 22, pp 109 –112 (2007)More Less
According to the Bethesda System, the most widely used terminology system for reporting cervical cytology, the category ASC-H, is defined as cells suggestive of a high grade squamous intraepithelial lesion (HSIL) but are qualitatively or quantitatively insufficient for definitive interpretation. It is estimated that 20-50% of women with an ASC-H diagnosis are on colposcopy found to have HSIL. The management of ASC-H is the same as for HSIL viz referral for colposcopy and directed biopsy. An over-expression of p16ink4A, a cyclin dependent kinase inhibitor in human papillomavirus-induced cancers and precancerous lesions of the uterine cervix, has recently been described. The objective of this pilot study was to assess the utility of p16ink4a in determining management of women with an ASC-H diagnosis on cervical cytology to improve selection of patients requiring referral for colposcopy and biopsy. Twenty-five smears called ASC-H on cytology and 10 negative cervical smears were subjected to p16ink4A staining using the Cintec p16ink4A cytology kit (Dako, Glostrup, Denmark, based on technology licensed from MTM Laboratories AG, Germany). Positive p16ink4A staining was observed in all 21 smears called ASC-H on cytology that had histological evidence of HSIL and in two smears called ASC-H on cytology that showed a low grade squamous intraepithelial lesion on histology. Negative p16ink4A staining was observed in all 10 cervical smears reported as negative and in two smears called ASC-H on cytology, which proved negative on biopsy. P16ink4A appears to offer a more independent parameter to further define the category of ASC-H and help to select those women who require additional management. Larger studies in this regard are warranted.
Author G.F. WeldhagenSource: Southern African Journal of Epidemiology and Infection 22, pp 119 –122 (2007)More Less
Selective antibiotic pressure has recently been implicated in possible selection behind point mutations observed in blaGES-type genes. This study subjected two well-characterised clinical isolates with class 1 integron-borne blaGES-type genes to five days incubation in the presence of minimum inhibitory concentrations (MICs) of 15 different antibiotics, including ß-lactams, aminoglycosides and quinolones. Restriction enzyme analysis and DNA sequencing of blaGES-1 and blaGES-2 and their immediate upstream genetic environments failed to demonstrate any changes compared to non-exposed controls. Short-term exposure of resistant pathogens to the MIC of a single antimicrobial agent is thus unlikely to cause significant changes in these ß-lactamase genes or their immediate genetic regulatory mechanisms.
Health service utilisation and health status of children aged 12-23 months in Ubombo district, rural KwaZulu-NatalSource: Southern African Journal of Epidemiology and Infection 22, pp 123 –126 (2007)More Less
This article presents data on child health service utilisation and health status obtained from a maternal and child health survey conducted in Ubombo district, rural north eastern KwaZulu-Natal. Data were collected by interviewing mothers/caregivers of children aged 12-23 months during June-August 1998. The indicators measured were: i) possession of a road-to-health card, ii) vaccination coverage, iii) clinic attendance for growth monitoring and treatment of minor ailments, iv) low birth weight, v) nutritional status and vi) minor ailments for which treatment was sought. Of the 646 children, 95% possessed a road-to-health card. Vaccination coverage ranged from 87.3% for BCG and polio given at birth to 78.2% for measles; 88.5% of children had attended the clinic for growth monitoring and almost all the children had attended the clinic for treatment of minor ailments during the first year of life. There were 6% low birth weight children; 1.2% wasted; 26% stunted and 6.3% underweight. In comparison to previous studies conducted in the same area, the results suggest a high level of child health service utilisation. The rate of low birth weight is probably an under-estimate and requires further attention. Nutritional status shows frequency distributions similar to those reported in South African populations for the past 10-15 years.
Source: Southern African Journal of Epidemiology and Infection 22 (2007)More Less
Emeritus editor of the Southern African Journal of Epidemiology & Infection, Prof Hendrik Koornhof, has been honoured with a Festschrift of the South African Medical Journal on the occasion of his 80th birthday. The Festchrift is made up of articles contributed by past associates, students and collaborators and it represents the very highest regard and esteem for a fellow colleague.