788 research outputs found
Crisis management during anaesthesia: sepsis
Get PDF© 2005 BMJ Publishing Group Ltd.BackgroundAnaesthesia with concurrent sepsis is risky, and involves consideration of possible organ dysfunctions-respiratory, cardiovascular, renal, and haematological--as well as ensuring that appropriate antibiotics are given after taking the necessary microbiological specimens. Because prompt attention needs to be paid to so many body systems, the place for a structured approach during anaesthesia for a septic patient was assessed.ObjectivesTo examine the role of a previously described core algorithm "COVER ABCD-A SWIFT CHECK", supplemented by a specific sub-algorithm for sepsis, in the management of sepsis occurring in association with anaesthesia.MethodsThe potential performance of this structured approach for each of the relevant incidents among the first 4000 reported to the Australian Incident Monitoring Study (AIMS) was compared with the actual management as reported by the anaesthetists involved.ResultsSepsis was identified as the primary problem in 13 of the first 4000 reports (ConclusionSepsis involves a serious physiological stress upon multiple organ systems. The use of a structured approach involving a core algorithm and additional sub-algorithms as required provides a series of checklists that can successfully deal with the complex multiple and interrelating problems that these patients present.J A Myburgh, M J Chapman, S M Szekely, G A Osborn
Pharmacokinetics, pharmacodynamics and drug monitoring in critical illness
No full textRichard N. Upton, John A. Myburgh Raymond G. Morrishttp://trove.nla.gov.au/work/991877
The surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2008. An assessment by the Australian and New Zealand intensive care society
No full textHicks, P; Cooper, D J; Webb, S; Myburgh, J; Seppelt, I; Peake, S; Joyce, C; Stephens, D; Turner, A; French, C; Hart, G; Jenkins, I and Burrell, Ahttp://www.highbeam.com/doc/1P3-1470712151.htm
Experiences of women in survivorship following mastectomy in the Cape Metropole
Get PDFCITATION: Stecher, N. E., Cohen, M. A. & Myburgh, E. J. 2018. Experiences of women in survivorship following mastectomy in the Cape Metropole. South African Journal of Surgery, 57(1):19-23, doi:10.17159/2078-5151/2019/v57n1a2746.The original publication is available at http://www.scielo.org.zaBACKGROUND: In spite of significant improvements in the treatment of breast cancer, many women still undergo mastectomy. The effects of breast cancer surgery on the diverse population of South African women have not been well studied. Insight may be gained in how to aid recovery in survivorship by identifying the support needs of women following mastectomy. This study aimed to explore and describe the lived experiences of women in the Cape Metropole following mastectomy in survivorship
METHODS: A qualitative study guided by descriptive phenomenology and grounded in the post positivist philosophy of Husserl. Seven women from the Cape Metropole were interviewed in English following ethical approval. The semi-structured interviews were thematically analysed
RESULTS: Three general themes emerged: Psychological impact of breast cancer diagnosis and treatment, the impact of an altered body image and concern for family and reliance on them for support, with a theme specific to stigmatisation within the Xhosa culture
CONCLUSION: The need to shield family members from breast cancer diagnosis was contrasted by the need for family support. Cultural stigmata still prevail within the South African population.http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0038-23612019000100004&lng=es&nrm=iso&tlng=esPublishers versio
Crisis management during anaesthesia: pulmonary oedema
Get PDF© 2005 BMJ Publishing Group Ltd.BACKGROUND: Pulmonary oedema may complicate the perioperative period and the aetiology may be different from non-operative patients. Diagnosis may be difficult during anaesthesia and consequently management may be delayed. OBJECTIVES: To examine the role of a previously described core algorithm "COVER ABCD–A SWIFT CHECK", supplemented by a specific sub-algorithm for pulmonary oedema, in its management occurring in association with anaesthesia. METHODS: The potential performance of this structured approach for each of the relevant incidents among the first 4000 reported to the Australian Incident Monitoring Study (AIMS) was compared with the actual management as reported by the anaesthetists involved. RESULTS: Pulmonary oedema was identified in 35 (<1%) of the first 4000 reports to AIMS. The most frequent presenting sign was hypoxia (46%) and the most specific sign was the presence of frothy sputum (23%). The core algorithm, although successful in the management of the initial physiological upset, was found to be inadequate for the ongoing management of pulmonary oedema. A specific sub-algorithm for the management of perioperative pulmonary oedema was devised, tested against the reports and would have been effective, if properly applied, in the management of all but one of the reported cases. CONCLUSION: Successful recognition and management of perioperative pulmonary oedema is likely with the application of the structured algorithm and specific sub-algorithm approach outlined in this study.M J Chapman, J A Myburgh, M T Kluger and W B Runcima
Biotransformation and oxidative stress responses in captive Nile crocodile (Crocodylus niloticus) exposed to organic contaminants from the natural environment in South Africa
Get PDFS1 Dataset. Complete chemical analysis dataset.S1 File. Extended methods for chemical analyses and biomarker measurements.In the present study, the biotransformation and oxidative stress responses in relation to
chemical burden in the liver of male and female Nile crocodiles—Crocodylus niloticus—
from a commercial crocodile farm passively exposed to various anthropogenic aquatic pollutants
was investigated. In general, the data showed that male crocodiles consistently produced
higher biotransformation and oxidative stress responses compared to females.
Relationships between these responses and concentrations of aliphatic hydrocarbons and
polycyclic aromatic hydrocarbons (PAHs) were also observed. Specifically, the catalytic
assays for EROD and BROD (not PROD and MROD) showed sex-differences between
male and female crocodiles and paralleled immunochemically determined CYP1A and
CYP3A protein levels; the relatively similar levels of PAHs in both sexes suggest an estrogen-
mediated reduction of this pathway in females. The antioxidant system exhibited higher
levels in male crocodiles with slight or significant higher values for catalase (CAT), glutathione
reductase (GR), glutathione peroxidases-H2O2 (GPx-H2O2), glutathione peroxidases-
Cu (GPx-Cu), total antioxidant capacity towards peroxyl radicals (TOSC-ROO) and
hydroxyl radicals (TOSC-HO), total glutathione (GSH) and malondialdehyde (MDA). On the
other hand, the activities of acyl-CoA oxidase (AOX) and glutathione S-transferases (GST)
were significantly higher in females. Principal component analysis (PCA) produced significant
groupings that revealed correlative relationships (both positive and negative) between
biotransformation/oxidative stress variables and liver PAHs and aliphatic hydrocarbon burden.
The overall results suggest that these captive pre-slaughter crocodiles exhibited
adverse exposure responses to anthropogenic aquatic contaminants with potentially relevant effects on key cellular pathways, and these responses may be established as relevant
species biomarkers of exposure and effects in this endangered species.The National Research Foundation of
South Africa (CB and JM) and the Norwegian
Research Council (AA).http://www.plosone.orgam201
Evaluation of bacterial fermentation and synthetic fortification as a means to enrich yogurt with conjugated linoleic acid
No full textEnglish: Conjugated linoleic acid has proven beneficial health properties. Approximately 18 different
conjugated linoleic acid isomers exist. Two of these isomers (C18:2c9t11 and
C18:2t10c12) are the most biologically active forms of conjugated linoleic acid. Results
from several studies over the past few years confirmed the health benefits of conjugated
linoleic acid. These benefits include anti-carcinogenic, anti-adipogenic, anti-atherogenic,
anti-diabetogenic and anti-inflammatory properties. Conjugated linoleic acid consumption
can also significantly decrease body fat mass without significantly altering the body weight.
To reach maximum health benefits, the recommended dietary allowance for conjugated
linoleic acid is in the range of 3 to 3.5 g per day. This value may vary among individuals.
This is much more than the amount of conjugated linoleic acid present in dairy products,
despite the fact that dairy products are the richest natural source. Approximately 45 kg of
conventional milk must be consumed daily to supply enough conjugated linoleic acid for
maximum health benefits. The aim of this study was therefore to increase the conjugated
linoleic acid content of yogurt to levels closer to the recommended dietary allowance.
The first approach was to naturally increase full cream and fat free yogurt conjugated
linoleic acid levels using selected starter cultures and linoleic acid sources. Three most
frequently used commercial yogurt starter cultures (YC-180, YC-X11 and ABT-5) were
used. Linoleic acid and sunflower oil as were used as linoleic acid sources. Linoleic acid
and sunflower oil were added to full cream yogurt and fat free yogurt to supply linoleic acid
in a concentration of 1 mg/ml in the media. The full cream control yogurt had a significantly
(p < 0.001) higher total CLA content than the fat free control yogurt. Fat free yogurt with
linoleic acid had a slightly higher CLA content than the fat free yogurt control and fat free
yogurt with sunflower oil. The highest CLA concentration in the full cream yogurt was
obtained with starter culture YC-X11 and the highest CLA concentration in fat free yogurt
was obtained with starter culture YC-180. Approximately 15 kg of this naturally CLA
fortified yogurt however will still need to be consumed on a daily basis to achieve
maximum health benefits. This is closer to the RDA than for conventional yogurt, but still
not nearly sufficient.
The second part of the study was therefore designed to increase CLA levels in yogurt by
direct fortification with synthetic CLA (Tonalin" 60-WDP). The Tonalin" was added in four
treatment levels (0 %, 1.25 %, 2 % and 5 %) and the influence of the fortification over a
six-week storage period was evaluated. The total CLA per 100 g of yogurt increased with
increased Tonalin" levels. The highest level of CLA that was obtained in 100 g of yogurt
was with a 5 % Tonalin" inclusion level yielding approximately 2.8 g CLA. This means that
a 5 % Tonalin® inclusion represents 100 % of the RDA of CLA. In other words, a consumer
would receive 100 % of the CLA needed per day to achieve maximum health benefits, with
the consumption of only 100 g of yogurt of this CLA fortified yogurt. Storage time had no
significant (p < 0.001) influence on the total CLA content of the yogurt. Sensory evaluation
on the yogurt with the four Tonalin® inclusion levels was done. The yogurt with the two
lowest Tonalin'" inclusion levels (0 % and 1.25 %) obtained significantly higher scores than
the yogurt with the two highest Tonalin® inclusion levels (2.5 % and 5 %). The scores for
the yogurt of all four the Tonalin® inclusion levels, were between a score of 6 (like slightly)
to a score of 8 (like very much), which means that not one of the yogurt batches with any
treatment level of Tonalin" were disliked by the consumer panel.
It was established that CLA fortification of yogurt is possible. Natural CLA production by
yogurt starter cultures increased the CLA levels, but CLA levels equal to or close to the
RDA were obtained with direct CLA fortification. Therefore direct fortification with synthetic
CLA may be considered a more realistic approach for the development of a new functional
dairy food product.Afrikaans: Daar is bewys dat inname van gekonjugeerde linoleïensuur 'n aantal voordelige
gesondheids eienskappe inhou. Ongeveer 18 verskillende gekonjugeerde linoleïensuur
isomere bestaan. Twee van hierdie isomere (C18: 2c9t11 en C18: 2t10c12) is die mees
biologies aktiewe vorme van gekonjugeerde linoleïensuur. Die resultate van verskeie
studies het die gesondheidsvoordele van gekonjugeerde linoleïensuur bevestig. Om
maksimum gesondheidsvoordele te bekom, is die aanbevole daaglikse inname (ADI) van
gekonjugeerde linoleïensuur ongeveer 3 tot 3.5 g. Dit is baie meer as die hoeveelheid
gekonjugeerde linoleïensuur in suiwelprodukte, ten spyte van die feit dat suiwelprodukte
die rykste natuurlike bron van gekonjugeerde linoleïensuur is. Ongeveer 45 kg van
konvensionele melk moet op 'n daaglikse basis ingeneem word om genoeg gekonjugeerde
linoleïensuur te verskaf vir maksimum gesondheidsvoordele. Die doel van hierdie studie
was dus om die gekonjugeerde linoleïensuur inhoud van die jogurt te verhoog tot vlakke
nader aan die ADI.
Die eerste benadering was om die gekonjugeerde linoleïensuur vlakke in volroom en
vetvrye jogurt natuurlik met geselekteerde suurselkulture en linoleïensuur bronne te
verhoog. Drie mees algemene kommersiële jogurt suurselkulture (YC-180, YC X11 en
ABT-5) is gebruik. Linoleïensuur en sonneblomolie was gebruik as bronne van
linoleïensuur en was bygevoeg tot die volroom jogurt en vetvrye jogurt om 'n konsentrasie
van 1 mg linoleïensuur fml media te voorsien. Die volroom jogurt het 'n beduidend (p
<0.001) hoër totale gekonjugeerde linoleïensuur inhoud as die vet vrye jogurt gehad.
Vetvrye jogurt met linoleïensuur het 'n effens hoër gekonjugeerde linoleïensuur inhoud as
die vetvrye jogurt kontrole en vetvrye jogurt met sonneblomolie gehad. Die hoogste
gekonjugeerde linoleïensuur konsentrasie in die volroom jogurt was verkry deur die
gebruik van die suurselkultuur YC-X11, en die hoogste gekonjugeerde linoleïensuur
konsentrasie in die vetvrye jogurt was met die suurselkultuur YC-180 verkry. Ongeveer 15
kg van hierdie natuurlik gekonjugeerde linoleïensuur verrykte jogurt moet derhalwe
daagliks ingeneem word om maksimum gesondheidsvoordele te kan verkry. Dit is nader
aan die ADI as vir konvensionele jogurt, maar is nog steeds vêr van voldoende.
Die tweede deel van die studie was dus om gekonjugeerde linoleïensuur vlakke in die
jogurt te verhoog deur direkte verryking met sintetiese gekonjugeerde linoleïensuur
(Tonalin® 60-WDP). Die Tonalin® is bygevoeg in vier behandelingsvlakke (0 %, 1.25 %, 2
% en 5 %) en die invloed van die Tonalin" oor 'n ses-week opbergingstydperk was
geëvalueer. Die totale gekonjugeerde linoleïensuur per 100 g jogurt neem toe met
verhoogde Tonalin" vlakke. Die hoogste konsentrasie van gekonjugeerde linoleïensuur
was verkry in die 100 g jogurt met 'n 5 % Tonalln" insluitingsvlak, wat ongeveer 2.8 g
gekonjugeerde linoleïensuur oplewer. Bergingstyd het geen beduidende (p <0.001) invloed
op die totale gekonjugeerde linoleïensuur inhoud van die jogurt gehad nie. Dit beteken dat
'n 5 % Tonalin'" insluiting 100 % van die ADI verteenwoordig. Met ander woorde, 'n
verbruiker sal 100 % van die ADI vir gekonjugeerde linoleïensuur met die verbruik van
slegs 100 g van die gekonjugeerde linoleïensuur verrykte jogurt kan inneem. Sensoriese
evaluasie op die jogurt met die vier Tonalin" insluiting vlakke was ook gedoen. Die jogurt
met die twee laagste Tonalin" insluiting vlakke (0 % en 1.25 %) het beduidend (p < 0.001)
hoër tellings as die jogurt met die twee hoogste Tonalin® insluiting vlakke (2.5 % en 5 %)
behaal. Die tellings vir die jogurt van al vier die Tonalin® insluitingsvlakke, was tussen 6
(hou effens van) en 8 (hou baie van), wat beteken dat nie een van die jogurt met enige
behandelingsvlak van Tonalin® nie deur die paneel aanvaar was nie.
Daar is vasgestel dat gekonjugeerde linoleïensuur verryking van jogurt wel moontlik is.
Natuurlike gekonjugeerde linoleïensuur produksie deur jogurt suurselkulture verhoog die
gekonjugeerde linoleïensuur vlakke, maar gekonjugeerde linoleïensuur vlakke gelyk aan of
nader aan die ADI was verkry met direkte gekonjugeerde linoleïensuur verrysking. Direkte
verryking met sintetiese gekonjugeerde linoleïensuur kan dus beskou word as 'n meer
realistiese benadering tot die ontwikkeling van' n nuwe funksionele suiwel voedselproduk.SAMPR
Investigation of circulating extracellular vesicle microRNA following two consecutive bouts of muscle-damaging exercise
Get PDFCITATION: Lovett, J. A. C., Durcan, P. J. & Myburgh, K. H. 2018. Investigation of circulating extracellular vesicle microRNA following two consecutive bouts of muscle-damaging exercise. Frontiers in Physiology, 9:1149, doi:10.3389/fphys.2018.01149.The original publication is available at https://www.frontiersin.orgPublication of this article was funded by the Stellenbosch University Open Access Fund.Background: Extracellular vesicles (EVs) are nano-sized vesicles that are known to be powerful mediators of intercellular communication via their microRNA (miR) content. A paucity of information on EV-mediated communication arising from skeletal muscle (SkM) in response to exercise-induced muscle damage is present in the published literature. Lack of such information inhibits our understanding of muscle injury and repair processes.
Aims: To assess circulating EV levels and selected miR content within them, in response to two consecutive bouts of muscle-damaging exercise.
Methods: Serum creatine kinase activity (CK) and EVs were analyzed from the blood of 9 healthy, untrained males at baseline, and at 2 and 24 h post-exercise. The exercise regimen consisted of a combination of plyometric jumping and downhill running. Perceived muscle pain (PMP) was assessed on a scale from 1 to 10. Plasma EVs were isolated using size exclusion columns and visualized with transmission electron microscopy (TEM). EV size and number were quantified using nanoparticle tracking analysis (NTA). miR expression was quantified using qPCR, with normalization to an exogenous control (cel-miR-39).
Results: PMP and CK were significantly elevated post-exercise compared to baseline levels, providing indirect evidence for muscle damage. EV visualization using TEM revealed an abundant and heterogeneously sized pool of intact particles within the exosome size range (30–150 nm). No significant change in mean EV size or number was seen over time. The SkM-specific miR-206 in EVs was found to be variable among participants and no significant change occurred in SkM-important miRs; 1, 133a, 133b, 486, and 499a. However, EV miR-31 decreased from baseline to 24 h post-exercise (p = 0.027).
Conclusion: Mild to moderate exercise-induced muscle damage altered the miR-31 profile of circulating EVs within the first 24 h post-exercise, but not that of myomiRs in EVs. These data demonstrate that EVs carry selectively packaged cargo which can be affected by exercise. Future research into the total miR content of EVs in response to exercise-induced muscle damage may reveal other miRs responsive to this relatively mild perturbation. More time points post-muscle-damaging exercise would provide a better understanding of the temporal EV myomiR response.https://www.frontiersin.org/articles/10.3389/fphys.2018.01149/fullPublisher's versio
Response of compressed skinned skeletal muscle fibers to conditions that simulate fatigue
No full textMyburgh, Kathryn H., and Roger Cooke. Response of compressed skinned skeletal muscle fibers to conditions that simulate fatigue. J. Appl. Physiol. 82(4): 1297–1304, 1997.—During fatigue, muscles become weaker, slower, and more economical at producing tension. Studies of skinned muscle fibers can explain some but not all of these effects, and, in particular, they are less economical in conditions that simulate fatigue. We investigated three factors that may contribute to the different behavior of skinned fibers. 1) Skinned fibers have increased myofilament lattice spacing, which is reversible by osmotic compression. 2) A myosin subunit becomes phosphorylated during fatigue. 3) Inosine 5′-monophosphate (IMP) accumulates during fatigue. We tested the response of phosphorylated and unphosphorylated single skinned fibers (isometric tension, contraction velocity, and adenosinetriphosphatase activity) to changes in lattice spacing (0–5% dextran) and IMP (0–5 mM) in the presence of altered concentrations of Pi(3–25 mM), H+(pH 7–6.2), and ADP (0–5 mM). The response of maximally activated skinned fibers to the direct metabolites of ATP hydrolysis is not altered by osmotic compression, phosphorylating myosin subunits, or increasing IMP concentration. These factors, therefore, do not explain the discrepancy between intact and skinned fibers during fatigue.</jats:p
- …
