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Oakley Ashley posted an update 6 months, 3 weeks ago
% were preterm deliveries(<37 weeks’ gestation). Among neonates with known birthweight (n=176), the mean birthweight was 2 900 g (95% confidence interval(CI) 2 747 – 2 935 g) and 20.5% had a low birthweight (<2 500 g). One congenital malformation (musculoskeletal) and 2 neonatal deaths were recorded.
In recent years, the number of pregnancies in YLPHIV has increased. A considerable proportion of pregnancies occurred inYLPHIV ≤16 years old. A high proportion of pregnancies was electively terminated. The prevalence of elevated VL and poor immunologicalstatus among pregnant YLPHIV is concerning.
In recent years, the number of pregnancies in YLPHIV has increased. https://www.selleckchem.com/products/ipa-3.html A considerable proportion of pregnancies occurred in YLPHIV ≤16 years old. A high proportion of pregnancies was electively terminated. The prevalence of elevated VL and poor immunological status among pregnant YLPHIV is concerning.
Large cohorts of HIV-1 perinatally infected children with long-term follow-up in developing countries are limited.
To explore rates and predictors of virological failure in a paediatric cohort.
A 10-year retrospective study was conducted from January 2004 to December 2013 to determine the incidence of and factors associated with virological failure among 1 659 HIV perinatally infected children in a public sector setting in South Africa (SA). Children aged <17 years who initiated first-line antiretroviral therapy between 1 January 2004 and 31 December 2013 and had at least 5 years of HIV viral load measurements were eligible.
The 1 659 children contributed 7 075 person-years of follow-up (PYFU). In the initial cohort of 2024 children, 51.0% were male and 62.0% were aged <5 years. The incidence of virological failure was 18.7 per 100 PYFU. Virological failure was associated with male gender, death of the mother, concurrent tuberculosis treatment and World Health Organization stage IV disease. Of the 320 HIV isolates successfully amplified, 249 (77.8%) had drug resistance mutations.
We observed high rates of virological failure and emergence of HIV drug resistance mutations. Despite gains made by SA in the treatment of HIV, such results challenge the country’s ability to meet global targets of 90% viral suppression by 2020.
We observed high rates of virological failure and emergence of HIV drug resistance mutations. Despite gains made by SA in the treatment of HIV, such results challenge the country’s ability to meet global targets of 90% viral suppression by 2020.
Most South Africans depend on the public sector for health services. There is an increasing demand for arthroplasty in the public sector, but a paucity of academic data regarding its cost.
To (i) identify the factors that determine the cost of an uncomplicated primary hip arthroplasty; and (ii) make recommendations on cost optimisation.
This was a cross-sectional study. Patients who met the inclusion criteria had their hospital financial records reviewed from October 2015 to March 2017. Six cost centres were utilised inpatient admission, theatre and anaesthesia, ambulatory, prosthesis, physiotherapy and blood bank. The data were statistically analysed.
Fifty-five patients met the study inclusion criteria. Data were stratified into categories. Analysis of variance (ANOVA) was used to test the data, and significant differences were found in the prosthesis, inpatient admission and ambulatory cost centres at a 95% significance level. The least significant difference was used to test the ANOVA results that paired significant categories. No cost centre showed significance over the other categories. Data for the six cost centres were compared with the current literature and industry best practice. Eight recommendations are made.
The study showed that clinicians need to be aware of procedural costing in the current financial climate. There are still opportunities to optimise cost containment in the state sector.
The study showed that clinicians need to be aware of procedural costing in the current financial climate. There are still opportunities to optimise cost containment in the state sector.
We previously retrospectively validated a 6-point severity-of-illness score aimed at identifying patients at risk of dying of tuberculosis (TB) in the intensive care unit (ICU). Parameters included septic shock, HIV infection with a CD4 count <200 cells/µL, renal dysfunction, a ratio of partial pressure of arterial oxygen to fraction of inspired oxygen (P/F) <200 mmHg, a chest radiograph demonstrating diffuse parenchymal infiltrates, and no TB treatment on admission.
To prospectively validate the severity-of-illness scoring system in patients with TB requiring intensive care, and to refine and simplify the score in order to expand its clinical utility.
We performed a prospective observational study with a planned post hoc retrospective analysis, enrolling all adult patients with confirmed TB admitted to the medical ICU of a tertiary hospital in Cape Town, South Africa, from 1 February 2015 to 31 July 2018. The admission data of all adult patients with TB requiring admission to the ICU were1); p<0.001). A score ≥3 v. ≤2 was associated with increased mortality (78.4% v. 29.3%; OR 8.76; 95% CI 3.12 – 24.59; p<0.001).
The 6-point severity-of-illness score identified patients at increased risk of death. We were able to derive and retrospectively validate a simplified 4-point score with superior predictive power.
The 6-point severity-of-illness score identified patients at increased risk of death. We were able to derive and retrospectively validate a simplified 4-point score with superior predictive power.
The COVID-19 pandemic has impacted on the global surgery landscape.
To analyse and describe the initial impact of the COVID-19 pandemic on orthopaedic surgery at Groote Schuur Hospital, a tertiary academic hospital in South Africa.
The number of orthopaedic surgical cases, emergency theatre patient waiting times, and numbers of outpatient clinic visits, ward admissions, bed occupancies and total inpatient days for January – April 2019 (pre-COVID-19) were compared with the same time frame in 2020 (COVID-19). The COVID-19 timeframe included initiation of a national ‘hard lockdown’ from 26 March 2020, in preparation for an increasing volume of COVID-19 cases.
April 2020, the time of the imposed hard lockdown, was the most affected month, although the number of surgical cases had started to decrease slowly during the 3 preceding months. The total number of surgeries, outpatient visits and ward admissions decreased significantly during April 2020 (55.2%, 69.1% and 60.6%, respectively) compared with April 2019 (p<0.
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