9 research outputs found
Causes and predictors of death in South Africans with systemic lupus erythematosus
No full textFaculty of Health
School of Medicine
9101327d
[email protected] is known about the epidemiological and mortality patterns of systemic
lupus erythematosus (SLE) in Africa. Aims of this study- to determine the
demographics, clinical features and causes and predictors death in patients
attending the Lupus clinic at the Chris Hani Baragwanath hospital in
Soweto. Methods- the records of 226 patients who fulfilled American
College of Rheumatism criteria for the diagnosis of SLE were reviewed.
The mean (± SD) age at presentation was 34 (± 12.5) years. The female to
male ratio was 18:1. The commonest clinical feature found was arthritis in
70.4% of patients. Nephritis was present in 43.8% and CNS lupus in 15.9%
of patients. 55 patients in this group had died and 64 were lost to follow up.
The 5-year survival was 57% uncensored and 72% if censored for loss to
follow up. Infection (32.7%) was the commonest cause of death followed
by renal failure (16.4%). Nephritis, CNS lupus and hypocomplementaemia
were associated with mortality on univariate analysis. Lupus nephritis was
the only independant predictor of mortality on multivariate analysis.
Conclusion- this study confirms the poor outcome of SLE in the developing
world and demonstrates that renal disease is a factor commonly implicated
in mortality. The 5-year survival and pattern of mortality is similar to that
reported elsewhere in the developing worl
Maximising the efficiency of surveillance for COVID-19 in dialysis units in South Africa : the case for pooled testing
No full textThe COVID-19 epidemic in South Africa (SA) is currently in a growth phase with high incidences in most major cities. Patients who are dependent on chronic renal dialysis care, including peritoneal dialysis and haemodialysis, are chronically unwell and usually have multiple comorbidities including hypertension, diabetes and cardiovascular disease. These comorbidities are known to increase the risk of adverse outcomes for COVID-19, including hospitalisation with high care or intensive care admission, and/ or death. Haemodialysis patients throughout the country require facility-based support three times a week, and a typical dialysis visit is ~4 hours.The National Research Foundation of South Africahttp://www.samj.org.zaam2021Medical Microbiolog
Correction: Guidelines for the prevention, detection and management of the renal complications of COVID-19 in Africa
No full textThe authors of the article ‘Guidelines for the prevention, detection and management of the renal complications of COVID-19 in Africa’ [1] wish to acknowledge the contribution of Professor Hussein El Fishawy. Our guidelines drew on various sources, including the Egyptian Ministry of Health guidelines, portions of which were adapted and reproduced with permission from the Egyptian Ministry of Health. Two of the authors of those guidelines, Professors Elsayed and Zaki, are also coauthors of our paper. Professor El Fishawy was the third author of the Egyptian guidelines and we would like to acknowledge his contribution to our review through this source, especially with respect to the treatment algorithms for patients with kidney transplants and those with acute kidney injury. Reference1. Elsayed HM, Wadee S, Zaki MS, Were AJO, Ashuntantang GE, Bamgboye EL, et al. Guidelines for the prevention, detection and management of the renal complications of COVID-19 in Africa. Afr J Nephrol. 2020; 23(1):109-126
A call to action: Temporal trends of COVID-19 deaths in the South African Muslim community
No full textNo abstract
Uniquely South African: Time to Consider Offering HIV-Positive Donor Kidneys to HIV-Infected Renal Failure Patients?
No full textVaccination of adult patients living with chronic kidney disease against SARS-CoV-2: a position statement by the South African Nephrology Society
No full textSafe and effective vaccination of patients living with chronic kidney disease requires an understanding of the unique immunological milieu of this population and of their potential for disease-specific side effects. This Position Statement, issued on behalf of the South African Nephrology Society, provides recommendations for local policy development and for individual practice administration and monitoring of SARS-CoV-2 vaccinations in patients living with chronic kidney disease
Embryonic stem cells: modelling effects ofearly embryo environment
No full textThe Developmental Origins of Health and Disease (DOHaD) hypothesis proposes that embryonic environment can induce permanent changes in metabolism during development, increasing the risk of disease in adults. Adverse environments during critical stages of gestation are sufficient to induce adaptations in offspring and disease susceptibility in later life. Rodent models show that maternal diet exclusively during preimplantation development induces cardiovascular and metabolic disease in adult offspring. Changes must therefore occur within the distinct cell populations of the early embryo and be maintained throughout development. Determining adaptive mechanisms has been challenging due to the small size of the early embryo, and genetic variability in outbred strains previously used. We generated mouse embryonic stem (ES) cells from inbred C57BL/6 mice as a model to overcome these problems. These were used to characterise mechanisms associated with the embryo’s adaptive responses to maternal diet. ES cell lines were derived from blastocysts of C57BL/6 mice assigned to either an isocaloric low protein diet (LPD), or a control diet exclusively through preimplantation development. ES cell lines were characterised for karyotype, sex, gene expression, and functional characteristics including proliferation, death, and metabolism at standardised passages. LPD had no impact on blastocyst formation in vivo or blastocyst cell lineage allocation. Experimental conditions did affect blastocyst outgrowth development in vitro. LPDoutgrowths cultured with less feeder fibroblasts showed slower development than controls. Although LPD blastocyst outgrowth was comparable to controls under high feeder growth conditions, there was a significant reduction in the capacity for ES cell derivation. There was a prominent sex bias towards male ES cell lines. These ES cells retained similar levels of gene expression related to pluripotency, housekeeping and developmental functions irrespective of diet. LPD did not affect growth or metabolism. These cells however showed increased basal apoptosis, and reduced levels of phosphorylated Extracellular signal-regulated kinase (ERK). The reduced ES cell isolation efficiency may indicate a reduced number of pluripotent cells present within the early embryo or increased sensitivity of these cells in response to maternal LPD. Increased apoptosis in ES cells derived from LPD-blastocysts reveal that these cells are indeed more sensitive. Reduced activated ERK may suggest that dysregulated ERK-mediated survival signalling causes enhanced apoptosis. Such adaptations in the early embryo may impact on lineage allocation as differentiation occurs. These ES cell lines may provide a model to investigate such mechanistic adaptations in post-implantation tissues providing further insight into foetal responses to poor nutrition and the induction of adult onset disease
