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Publisher: SciELO   (Total: 737 journals)

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Showing 601 - 737 of 737 Journals sorted alphabetically
Revista Facultad de Medicina de la Universidad Nacional de Colombia     Open Access   (SJR: 0.125, CiteScore: 0)
Revista Facultad Nacional de Agronomía, Medellín     Open Access   (SJR: 0.138, CiteScore: 0)
Revista Facultad Nacional de Salud Pública     Open Access  
Revista Gaúcha de Enfermagem     Open Access   (SJR: 0.225, CiteScore: 1)
Revista Geológica de América Central     Open Access  
Revista Geológica de Chile     Open Access   (Followers: 1)
Revista Gerencia y Políticas de Salud     Open Access   (SJR: 0.136, CiteScore: 0)
Revista Habanera de Ciencias Médicas     Open Access   (SJR: 0.211, CiteScore: 0)
Revista Historia y Sociedad     Open Access  
Revista IBRACON de Estruturas e Materiais     Open Access   (Followers: 1)
Revista Ingenieria de Construcción     Open Access   (Followers: 1, SJR: 0.204, CiteScore: 0)
Revista Ingenierías Universidad de Medellín     Open Access  
Revista Integra Educativa     Open Access  
Revista Interamericana de Bibliotecología     Open Access   (Followers: 7)
Revista Internacional de Contaminación Ambiental     Open Access   (SJR: 0.152, CiteScore: 0)
Revista ION     Open Access  
Revista IUS     Open Access  
Revista Katálysis     Open Access  
Revista Lasallista de Investigación     Open Access   (SJR: 0.146, CiteScore: 0)
Revista Latino-Americana de Enfermagem     Open Access   (SJR: 0.339, CiteScore: 1)
Revista Latinoamericana de Bioética     Open Access  
Revista Latinoamericana de Desarrollo Económico     Open Access  
Revista Latinoamericana de Filosofía     Open Access   (Followers: 1)
Revista Latinoamericana de Investigación en Matemática Educativa     Open Access   (SJR: 0.171, CiteScore: 0)
Revista Latinoamericana de Psicopatologia Fundamental     Open Access   (SJR: 0.201, CiteScore: 0)
Revista Medica de Chile     Open Access   (SJR: 0.259, CiteScore: 1)
Revista Médica del Hospital Nacional de Niños Dr. Carlos Sáenz Herrera     Open Access   (Followers: 1)
Revista Médica Electrónica     Open Access  
Revista Médica La Paz     Open Access  
Revista Mexicana de Análisis de la Conducta     Open Access   (SJR: 0.405, CiteScore: 1)
Revista Mexicana de Astronomía y Astrofísica     Open Access   (Followers: 2, SJR: 0.596, CiteScore: 1)
Revista Mexicana de Biodiversidad     Open Access   (SJR: 0.421, CiteScore: 1)
Revista Mexicana de Ciencias Agrícolas     Open Access   (Followers: 1)
Revista Mexicana de Ciencias Geológicas     Open Access   (SJR: 0.308, CiteScore: 1)
Revista Mexicana de Ciencias Pecuarias     Open Access   (Followers: 1, SJR: 0.17, CiteScore: 0)
Revista Mexicana de Economía y Finanzas     Open Access  
Revista Mexicana de Física     Open Access   (SJR: 0.203, CiteScore: 0)
Revista mexicana de física E     Open Access  
Revista Mexicana de Fitopatología     Open Access  
Revista Mexicana de Ingeniería Química     Open Access   (SJR: 0.328, CiteScore: 1)
Revista Mexicana de Investigación Educativa     Open Access   (Followers: 3, SJR: 0.291, CiteScore: 0)
Revista Mexicana de Micologí­a     Open Access  
Revista Mexicana de Sociologí­a     Open Access   (Followers: 9, SJR: 0.142, CiteScore: 0)
Revista Musical Chilena     Open Access   (SJR: 0.1, CiteScore: 0)
Revista MVZ Córdoba     Open Access   (SJR: 0.173, CiteScore: 0)
Revista Odonto Ciência     Open Access   (SJR: 0.101, CiteScore: 0)
Revista Opinión Jurídica     Open Access  
Revista Panamericana de Salud Pública     Open Access   (SJR: 0.452, CiteScore: 1)
Revista Paulista de Pediatria     Open Access   (SJR: 0.472, CiteScore: 1)
Revista Perspectivas     Open Access  
Revista Pilquen : Sección Ciencias Sociales     Open Access  
Revista Portuguesa de Cirurgia     Open Access   (Followers: 1)
Revista Portuguesa de Enfermagem de Saúde Mental     Open Access  
Revista Portuguesa de Imunoalergologia     Open Access   (Followers: 2, SJR: 0.141, CiteScore: 0)
Revista Portuguesa de Ortopedia e Traumatologia     Open Access  
Revista Portuguesa de Saúde Pública     Open Access   (SJR: 0.155, CiteScore: 0)
Revista Portuguesa e Brasileira de Gestão     Open Access  
Revista Signos     Open Access   (SJR: 0.174, CiteScore: 0)
Revista Universitaria de Geografía     Open Access  
Revista Uruguaya de Cardiologia     Open Access  
Revista Veterinaria     Open Access   (SJR: 0.105, CiteScore: 0)
RGO : Revista Gaúcha de Odontologia     Open Access   (SJR: 0.104, CiteScore: 0)
RISTI : Revista Ibérica de Sistemas e Tecnologias de Informação     Open Access   (SJR: 0.213, CiteScore: 1)
RLA : revista de linguistica teorica y aplicada     Open Access   (Followers: 1, SJR: 0.192, CiteScore: 0)
Rodriguésia     Open Access   (SJR: 0.734, CiteScore: 2)
SA Orthopaedic J.     Open Access   (Followers: 2)
Salud Colectiva     Open Access   (SJR: 0.22, CiteScore: 0)
Salud Mental     Open Access   (Followers: 1, SJR: 0.173, CiteScore: 1)
Sanidad Militar     Open Access  
São Paulo em Perspectiva     Open Access  
Sao Paulo Medical J.     Open Access   (SJR: 0.334, CiteScore: 1)
Saúde e Sociedade     Open Access   (SJR: 0.384, CiteScore: 0)
Saúde em Debate     Open Access  
Sba: Controle & Automação Sociedade Brasileira de Automatica     Open Access  
Scientia Agricola     Open Access   (SJR: 0.578, CiteScore: 2)
Scientiae Studia     Open Access  
Secuencia     Open Access   (SJR: 0.101, CiteScore: 0)
Serviço Social & Sociedade     Open Access   (Followers: 1)
Sexualidad, Salud y Sociedad (Rio de Janeiro)     Open Access   (Followers: 2)
Si Somos Americanos     Open Access  
Signos Filosóficos     Open Access   (SJR: 0.107, CiteScore: 0)
Silva Lusitana     Open Access  
Sociedade & Natureza     Open Access  
Sociedade e Estado     Open Access   (Followers: 2, SJR: 0.127, CiteScore: 0)
Sociologia : Revista da Faculdade de Letras da Universidade do Porto     Open Access  
Sociologias     Open Access   (Followers: 2, SJR: 0.15, CiteScore: 0)
Sociológica     Open Access   (Followers: 2)
Soldagem & Inspeção     Open Access   (SJR: 0.238, CiteScore: 0)
South African Dental J.     Open Access  
South African J. of Agricultural Extension     Open Access   (Followers: 4)
South African J. of Animal Science     Open Access   (Followers: 3, SJR: 0.387, CiteScore: 1)
South African J. of Childhood Education     Open Access   (Followers: 1)
South African J. of Enology and Viticulture     Open Access   (SJR: 0.301, CiteScore: 1)
South African J. of Industrial Engineering     Open Access   (Followers: 3, SJR: 0.201, CiteScore: 1)
South African J. of Occupational Therapy     Open Access   (Followers: 38)
South African J. of Surgery     Open Access   (Followers: 1, SJR: 0.162, CiteScore: 0)
South African Medical J.     Open Access   (Followers: 5, SJR: 0.45, CiteScore: 1)
Studia Historiae Ecclesiasticae     Open Access   (Followers: 3)
Summa Phytopathologica     Open Access   (SJR: 0.258, CiteScore: 0)
Tecnología Química     Open Access  
Tecnología y Ciencias del Agua     Open Access   (SJR: 0.153, CiteScore: 0)
Temas y Debates     Open Access  
Tempo     Open Access   (Followers: 2, SJR: 0.103, CiteScore: 0)
Tempo Social     Open Access   (Followers: 2, SJR: 0.135, CiteScore: 0)
Teología y Vida     Open Access   (Followers: 1, SJR: 0.122, CiteScore: 0)
Terapia Psicológica     Open Access   (SJR: 0.394, CiteScore: 1)
Texto & Contexto - Enfermagem     Open Access   (SJR: 0.273, CiteScore: 1)
The European J. of Psychiatry (edicion en español)     Open Access   (Followers: 1)
Theologica Xaveriana     Open Access   (SJR: 0.14, CiteScore: 0)
Tinkazos     Open Access  
Tópicos del seminario     Open Access   (Followers: 1)
Toxicodependências     Open Access  
Trabalho, Educação e Saúde     Open Access  
Trabalhos em Linguistica Aplicada     Open Access  
Trans/Form/Ação - Revista de Filosofia     Open Access   (SJR: 0.1, CiteScore: 0)
Transinformação     Open Access   (Followers: 1, SJR: 0.192, CiteScore: 0)
Trends in Psychiatry and Psychotherapy     Open Access   (Followers: 9, SJR: 0.323, CiteScore: 1)
Tydskrif vir Geesteswetenskappe     Open Access   (SJR: 0.193, CiteScore: 0)
Tydskrif vir Letterkunde     Open Access   (SJR: 0.235, CiteScore: 0)
Ultima Década     Open Access  
Universidad y Ciencia     Open Access   (Followers: 1)
Universitas Medica     Open Access   (Followers: 1)
Universitas Philosophica     Open Access  
Universitas Scientiarum     Open Access   (SJR: 0.192, CiteScore: 1)
Universum : Revista de Humanidades y Ciencias Sociales     Open Access   (Followers: 1, SJR: 0.155, CiteScore: 0)
Vaccimonitor     Open Access   (Followers: 1, SJR: 0.177, CiteScore: 0)
Varia Historia     Open Access   (SJR: 0.152, CiteScore: 0)
Veritas : Revista de Filosofí­a y Teología     Open Access   (Followers: 1, SJR: 0.101, CiteScore: 0)
Veterinaria (Montevideo)     Open Access  
Veterinaria México     Open Access  
Vibrant : Virtual Brazilian Anthropology     Open Access  
Visión de futuro     Open Access  
Vniversitas     Open Access   (SJR: 0.16, CiteScore: 0)
Water SA     Open Access   (Followers: 2, SJR: 0.361, CiteScore: 1)
West Indian Medical J.     Open Access   (Followers: 1, SJR: 0.174, CiteScore: 0)
Yesterday and Today     Open Access   (Followers: 1)
Zoologia (Curitiba)     Open Access  

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South African Journal of Surgery
Journal Prestige (SJR): 0.162
Number of Followers: 1  

  This is an Open Access Journal Open Access journal
ISSN (Print) 0038-2361 - ISSN (Online) 2078-5151
Published by SciELO Homepage  [737 journals]
  • Treatment of hepatocellular cancer in sub-Saharan Africa: balancing
           ideals, realities and challenges

    •  
  • Adult liver transplant for hepatocellular carcinoma at Wits Donald Gordon
           Medical Centre in Johannesburg, South Africa

    • Abstract: BACKGROUND: For those with unresectable hepatocellular carcinoma, liver transplantation is considered the treatment of choice. Since 2006, the transplant programme at Wits Donald Gordon Medical Centre (WDGMC) has offered liver transplantation for selected patients with hepatocellular carcinoma. While the number of patients transplanted was small, we are unaware of any published data from Southern Africa describing outcomes in this group of liver transplant recipients. The aim of this study was to describe our experience as a case seriesMETHODS: The records of all patients with HCC who underwent deceased donor liver transplantation between April 2006 and March 2018 were reviewed retrospectively. Data were extracted from transplant clinic patient files, histopathology and pathology laboratory reports and an existing database of all liver transplant recipients at WDGMC. Patient survival was calculated from the time of transplant and survival estimates were determined by the Kaplan-Meier methodRESULTS: Thirty-one liver transplants were reviewed. The most common causes of underlying liver disease were infectious, mostly hepatitis B virus, and diseases of lifestyle including alcoholic/non-alcoholic steatohepatitis. Median age at transplant, 57 years (IQR 44-65 years), was younger than observed internationally, but consistent with reports from Africa. Male recipients predominated, in keeping with published trends. Overall, outcomes were worse than expected but for recipients who were within the University of California at San Francisco (UCSF) criteria for transplantation; survival was comparable to previously published dataCONCLUSIONS: Despite limitations, this is the first documented series of patients undergoing liver transplantation for HCC in South Africa and demonstrates that good results can be achieved in appropriately selected patients
       
  • Living donor liver transplantation in South Africa: the donor
           experience

    • Abstract: BACKGROUND: Living donor liver transplantation (LDLT) plays a crucial role in liver transplant programmes, particularly in regions with a scarcity of deceased donor organs and especially for paediatric recipients. LDLT is a complex and demanding procedure which places a healthy living donor in harm's way. Donor safety is therefore the overriding concern. This study aimed to report our standardised approach to the evaluation, technical aspects and outcomes of LDLT donor hepatectomy at Wits Donald Gordon Medical CentreMETHODS: The study population consisted of all patients undergoing LDLT donor hepatectomy since the inception of the programme in March 2013 until 2018. Sixty five living donor hepatectomies were performed. Primary outcome measures included donor demographics, operative time, peak bilirubin, aspartate and alanine transaminase levels postoperatively, length of hospital stay and postoperative complications using the Clavien-Dindo classificationRESULTS: The majority of the donors were female, most were parents with mothers being the donor almost 85% of the time. The median operative time was 374 minutes with a downward trend over time as experience was gained. The median length of hospital stay was 7 days. There was no mortality and the complication rate was 30% with the majority being minor (Grade 1CONCLUSION: Living donor liver transplant from adult-to-child has been successfully initiated in South Africa. Living donor hepatectomy can be safely performed with acceptable outcomes for the donor. Wait-list mortality however remains unacceptably high. Expansion of LDLT as well as real change in deceased donor policy is required to address this issue
       
  • Outcomes of paediatric liver transplant for biliary atresia

    • Abstract: BACKGROUND: Despite the widespread use of Kasai Portoenterostomy (KPE) for biliary atresia, more than two thirds of these patients require liver transplant. Liver transplantation is not widely available in South Africa, and Wits Donald Gordon Medical Centre is one of two centres performing paediatric liver transplantation in the country, and the only centre performing living related donor transplantsMETHODS: A retrospective review was performed at the centre. Demographic data were collected, and tabulated. Survival analysis was performed using the Kaplan Meier method. Complication rates were categorised into biliary, vascular and enteric, and classified as early and lateRESULTS: Sixty-seven first time liver transplants were performed for biliary atresia at WDGMC from 2005 to 2017. Sixty-nine percent were female patients and thirty-one percent were male patients. Forty-eight percent of patients under the age of 5 years had a z-score of -2 or worse for mid upper arm circumference (MUAC). One year overall survival of the cohort is 84.5%, and overall graft survival is 82.9%. Overall mortality was 22%, with infection being the most common cause of deathCONCLUSION: Early referral of all patients with biliary atresia to a paediatric liver transplant centre is essential for early assessment of indications, and medical and nutritional optimisation of patients. Primary liver transplant should be considered for a select group of patients with unique clinical indications
       
  • Complex bile duct injuries after laparoscopic cholecystectomy: a
           comparative outcomes analysis of patients treated in tertiary private and
           public health facilities in Cape Town, South Africa

    • Abstract: BACKGROUND: The South African healthcare system has an under-financed public sector serving most of the population and a better resourced private sector serving a small fraction of the population. This study evaluated management and outcome in patients with complex bile duct injuries (BDIs) after laparoscopic cholecystectomy referred from either private or public hospitalsMETHODS: The data of patients who underwent hepaticojejunostomy repair were retrieved from a prospectively maintained central departmental BDI database. Patients were treated either in the Surgical Gastroenterology Unit at Groote Schuur Hospital, University of Cape Town (UCT) or the Digestive Diseases Centre, UCT Private Academic Hospital by the same hepatobiliary surgical team. Relevant preoperative clinical data and postoperative complications and outcomes were compared between patients originating either in the public or private sectorRESULTS: One hundred and twenty-five patients were included, 58 from the public and 67 from the private sector. The type of BDI, time to diagnosis, referral and repair were similar. Patients referred from the private sector underwent more percutaneous cholangiograms prior to referral (11.9% vs 1.7%, p = 0.037). Patients referred from the public sector underwent more CT examinations (p = 0.044) and endoscopic retrograde cholangiography (p = 0.038) after admission to our centre. There were no statistically significant differences in 30-day postoperative complications. Primary patency rates were similar for public and private referrals (90% vs 88%, respectively). There were two BDI-related mortalities at 90 daysCONCLUSIONS: Despite differences in public and private healthcare system resources, patients were referred early and appropriately from both sectors and had similar postoperative outcomes when treated in a specialised unit
       
  • A one year audit of the Colorectal Unit at Wits Donald Gordon Medical
           Centre: 2016–2017

    • Abstract: BACKGROUND: Colorectal surgery has developed into an established surgical subspecialty in South Africa, however there is a paucity of data regarding the epidemiology and surgical outcomes of patients with colorectal disease in this country. The objective is to present the findings of a one-year audit of the Wits Donald Gordon Medical Centre (WDGMC) Colorectal Unit with specific reference to indications, surgical procedures and patient outcomesMETHODS: Patient files from December 2016 to November 2017 were included in a retrospective analysis. The MannWhitney U test was used to analyse continuous variables and the Chi-squared test was used to compare categorical variablesRESULTS: During the audit period, 1264 patients were admitted to the Colorectal Unit and a further 564 outpatient endoscopic procedures were performed. There were 306 emergency admissions. 139 elective colorectal resections took place, with a 16% major complication rate, a 12% anastomotic leak rate and no deaths. Rectal resections constituted 66% of the operations and 34% were colonic resections. The median length of stay for all patients undergoing resection was 9 days and there was no statistically significant difference in length of stay between open and laparoscopic casesCONCLUSION: The WDGMC Colorectal Unit manages a high volume of patients presenting with the full spectrum of colorectal disease
       
  • The consequences of major visceral vascular injuries on outcome in
           patients with pancreatic injuries: a case-matched analysis

    • Abstract: BACKGROUND: Major pancreatic injuries are complex to treat, especially when combined with vascular and other critical organ injuries. This case-matched analysis assessed the influence of associated visceral vascular injuries on outcome in pancreatic injuriesMETHOD: A registered prospective database of 461 consecutive patients with pancreatic injuries was used to identify 68 patients with a Pancreatic Injury combined with a major visceral Vascular Injury (PIVI group) and were matched one-to-one by an independent blinded reviewer using a validated individual matching method to 68 similar Pancreatic Injury patients without a vascular injury (PI group). The two groups were compared using univariate and multivariate logistic regression analysis and outcome including complication rates, length of hospital stay and 90-day mortality rate was measuredRESULTS: The two groups were well matched according to surgical intervention. Mortality in the PIVI group was 41% (n = 28) compared to 13% (n = 9) in the PI alone group (p = 0.000, OR 4.5, CI 1.00-10.5). On univariate analysis the PIVI group was significantly more likely to (i) be shocked on admission, (ii) have a RTS < 7.8, (iii) require damage control laparotomy, (iv) require a blood transfusion, both in frequency and volume, (v) develop a major postoperative complication and (vi) die. On multivariate analysis, the need for damage control laparotomy was a significant variable (p = 0.015, OR 7.95, CI 1.50-42.0) for mortality. Mortality of AAST grade 1 and 2 pancreatic injuries combined with a vascular injury was 18.5% (5/27) compared to an increased mortality of 56.1% (23/41) of AAST grade 3, 4 and 5 pancreatic injuries with vascular injuries (p = 0.0026CONCLUSION: This study confirms that pancreatic injuries associated with major visceral vascular injuries have a significantly higher complication and mortality rate than pancreatic injuries without vascular injuries and that the addition of a vascular injury with an increasing AAST grade of pancreatic injury exponentially compounds the mortality rate
       
  • Surgical site infection after penetrating abdominal trauma with bowel
           involvement: a comparison between HIV-seropositive and seronegative
           patients

    • Abstract: BACKGROUND: The influence of HIV-infection on surgical site infection (SSI) after surgery for penetrating abdominal trauma is not investigated and therefore not as yet elucidated. This prospective study was performed with the aim to compare the SSI rate in human immunodeficiency virus (HIV)-seropositive and HIV-negative patients and to identify other risk factors for this abdominal wound complicationMETHODS: 98 patients who underwent small or large bowel resection and subsequent anastomosis due to penetrating abdominal trauma were included in the study. Injury related factors as well as demographical and physiological parameters, including HIV-status were analysed and superficial and deep SSI incidence rates were evaluatedRESULTS: Of the 98 patients, 23 patients (23%) were HIV-seropositive. The overall superficial SSI rate was 45% and the deep SSI rate was 15%. No significant difference in SSI (superficial or deep) in the HIV-seropositive and -negative group was demonstrated (superficial SSI HIV-pos vs HIV-neg: 61% vs 40%; p=0.172, deep SSI 22% vs 13%, p=0.276). Multivariate analysis identified five independent risk factors for SSI: postoperative CD4 count < 250 cells/μ!, postoperative albumin < 30 g/L, relook operation, anastomotic leak and colonic anastomosisCONCLUSION: HIV-infection is not an independent risk factor for developing SSI after penetrating abdominal trauma. Low postoperative CD4 count, irrespective of HIV status, low postoperative albumin, relook operation, anastomotic leak and colonic anastomosis are predictors for SSI irrespective of the HIV-serostatus. These factors should be considered in unison during the decision-making process of abdominal wound closure; planned secondary wound treatment or immediate application of negative pressure dressings in patients with a high-risk profile may decrease the hospital stay and the financial burden on the health care system
       
  • The utility of PET-CT in the staging and management of advanced and
           recurrent malignant melanoma

    • Abstract: BACKGROUND: Accurate pre-operative staging and correct surgical selection of patients with malignant melanoma reduces unnecessary morbidity and mortality, improves distant control and may improve survival. 18F-fluorodeoxyglucose Positron Emission Tomography Computed Tomography (18F-FDG PET-CT) has been shown to be useful in exclusion of metastatic sites and aids in surgical planning in stage III and potentially resectable stage IV disease. The primary objective of the study was to determine whether the use of PET-CT alters the initial staging and management of patients with advanced and recurrent melanomaMETHODS: Retrospective analysis of clinical records of patients with malignant melanoma referred for staging PET-CT over a three-year period at our institution was performed. Pre- and post-PET-CT stage was recorded and a descriptive analysis was done to determine whether PET-CT resulted in a change in stage grouping and whether this change effected a change in clinical managementRESULTS: A change in stage grouping occurred in 21/39 (53.8%) of patients, 76.2% of which were up-staged and 23.8% down staged. On analysis of stage III/Iv and recurrent melanoma, a change in stage occurred in 90% of stage III, 50% of stage IV and 50% of recurrent melanoma patients. This effected a change in management in 86.7% of patients with stage III, IV and recurrent melanoma collectivelyCONCLUSION: PET-CT is a useful tool in the staging and subsequent management of melanoma. Its utility is pronounced in advanced and recurrent melanoma
       
  • The spectrum of animal related injuries managed at a major trauma
           centre in South Africa

    • Abstract: BACKGROUND: Humans come into contact and interact with an array of animals in a number of areas and environments. We set out to review our experience with animal-related injuries in Pietermaritzburg, KwaZulu-Natal, South AfricaMETHODS: All patients who sustained an injury secondary to an interaction with an animal in the period December 2012-December 2017 were identified from the Hybrid Electronic Medical Registry (HEMRRESULTS: There were 104 patients in the study sample. The mean age of patients in the study was 32.8 years, with a range from 1 to 76 years old. 75% (n = 78) were male and 25% (n = 26) female. Out of the 104 animal-related injuries, 67 were blunt trauma, 39 penetrating trauma and 3 a combination of blunt and penetrating trauma. The species causing trauma included dogs (53), horses (29), cows (18), buffalo (1), warthog (1), impala (1) and a single goat (1). The median time from injury to hospitalisation was 46.62 hours (range from 0 to 504 hours). Injuries occurred to the head (n = 32), face (n = 9), neck (n = 32), abdomen (n = 22), urogenital system (n = 6), upper limb (n = 39) and lower limb (n = 39). The Injury Severity Score (ISS) mean for the patients was 8.16, the range 1-4, the median 9 and the standard deviation 6.88. In 49 patients the treatment was non-operative. In the remaining 55 patients, a total of 68 operative procedures were required. Operations included wound debridement/surgical washout (n = 38), laparotomy (n = 9), arterial repair/ligation (n = 8), skin graft (n = 4), craniotomy (n = 5), fasciotomy (n = 2), amputation (n = 1), and placement of an ICP monitor (n = 1). 49 of these operations were for patients with dog bite injuries. The mean hospital stay was 0.13 days with a range of 0-4 days. Four patients were admitted to the Intensive Care Unit (ICU) and two patients diedCONCLUSION: Human interactions with animals may result in injuries which require surgical treatment. The most common animal injury is a dog bite but in the case of the larger domestic farm animals, blunt force type injuries and goring can result in significant injuries which require complex surgical interventions
       
  • The profile of thyroid cancer in patients undergoing thyroidectomy at
           Chris Hani Baragwanath Academic Hospital

    • Abstract: BACKGROUND: The histological type of thyroid cancer in well-resourced countries is predominantly papillary. Follicular carcinoma is predisposed by iodine deficiency that was present the Black population of South Africa until salt iodination in 1995. The aim of this study was to analyse the profile of thyroid cancer in Black South Africans from January 2001 to December 2017 and to identify any temporal changes in thyroid cancer histological subtypes since salt iodinationMETHOD: Histopathological reports of patients who underwent thyroidectomy for cancer at Chris Hani Baragwanath Academic Hospital in Johannesburg, South Africa between January 2001 and December 2017 were retrospectively assessed. Data captured included name, age, gender, race, the date when the specimen was sent and the detailed histopathological reportRESULTS: Of the 143 thyroidectomies performed for malignancy, papillary thyroid cancer was the predominant type (65%) with a papillary to follicular thyroid cancer ratio of 4:1. Follicular, medullary and anaplastic cancers were 16.8%, 9.8% and 2.8% respectively. The reports were incomplete in 5 cases and there were 3 non-epithelial neoplasmsCONCLUSION: There is a gradual temporal increase in the frequency of resected papillary cancer over a 16 year period while follicular has remained static. These changes may be attributable to better salt iodination
       
  • Laterality of breast cancer at Dr George Mukhari Academic Hospital

    • Abstract: BACKGROUND: The purpose of this descriptive study was to determine and compare the incidence of left-sided and right-sided breast cancer at Dr George Mukhari Academic Hospital from January 2000 to June 2016. It aimed to determine if there was a significant variation in laterality of breast cancer at our institutionMETHOD: A retrospective study. Medical records of breast cancer (BC) patients who were newly diagnosed from January 2000 to June 2016 were reviewed. Emphasis was on biopsy results (histology and/or cytology) and/or history of chemotherapy, and breast cancer lateralityRESULTS: Out of 1482 patients, 1427 had unilateral BC and 55 (3.7%) bilateral cancer. A total of 789 (55.3%) patients had left-sided breast cancer (LSBC) and 638 (44.7%) had right BC. Left BC was 10.6% more common than right BC with a left to right laterality ratio (LRR) of 1.24. There was a statistically significant relationship between laterality and stage (p = 0.050), with the right breast having more advanced stage cancers (88.7%) compared to the left breast (85%). There was no statistically significant difference between age, site and histological type of BC and laterality (p = 0.740, p = 0.052, p = 0.394 respectivelyCONCLUSION: Left to right BC excess does exist in patients that were newly diagnosed at Dr George Mukhari Academic Hospital, South Africa, from January 2000 to June 2016
       
  • An audit of upper gastrointestinal endoscopy performed on patients at
           Prince Mshiyeni Memorial Hospital in Durban, KwaZulu-Natal

    • Abstract: BACKGROUND: Resource constraints have resulted in upper gastrointestinal endoscopy (UGE) being deferred where possible. However, delayed investigation is costly and leads to disease progression. This study audits the UGE done at a single institution. It was motivated by the observation that public hospitals often experience an acute shortage of endoscopes, which are prone to frequent breaks and service delivery is further compromised by an increased workloadMETHODS: This was a retrospective observational descriptive study of patients aged 20 to 45 years who had undergone gastrointestinal endoscopy (UGE) at Prince Mshiyeni Memorial Hospital (PMMH) in KwaZulu-Natal, during the period January 2015 to December 2015. One hundred and ninety-four patients' charts and UGE reports were reviewed. Data were analysed using SPSS Statistics version 24. The level of significance was set at p < 0.05. Variables were expressed as mean ± standard deviation or medians (interquartile range IQR) as appropriate. Mean ± standard deviation was compared using the Student's t-test. Proportions and categorical variables were compared using the Pearson's chi-square test or Fisher's exact test as appropriate. An ethical approval was obtained from the University of KwaZulu-Natal BREC (BE 447/17) and the KwaZulu-Natal Department of Health Ethics CommitteeRESULTS: Epigastric pain was found to be the most common indication for UGE, with a total of 112 (57.7%) out of total of 194 patients, followed by upper gastrointestinal bleeding (UGIB) (42) (21.6%). Amongst patients presenting with epigastric pain, only 12(10.7%) patients could be confirmed that they had received acid suppression therapy prior to the testing. In the age group 20-25 years, there was a highest number of patients presenting with corrosive substance ingestion, 11 (25.0%). The commonest finding was gastritis in 99 patients (51.0%), followed by normal findings in 50 (25.7%) patientsCONCLUSIONS: Epigastric pain was the most common indication and gastritis was the predominant finding
       
  • Intradural extramedullary spinal masses treated at the Wits teaching
           hospitals between 2014 - 2017

    • Abstract: BACKGROUND: Intradural extramedullary (IDEM) spinal masses are common lesions with varying histological diagnoses often associated with significant neurological deficits. This study aimed to describe the epidemiology, management and perioperative outcome of IDEM tumours seen at the teaching hospitals of the University of the Witwatersrand, Johannesburg, between 2014 and2017RESULTS: 92 patients were included in the study. The ages ranged from 21 to 87 years, sex ratio was M:F 1:1.4, and duration of symptoms prior to diagnosis ranged between 3 days to 18 months. Local and radicular type pain as well as motor weakness were the commonest symptoms. 67% had severe neurological deficit McCormick Grade III and IV. Schwannoma (26) Neurofibromas (21) and Meningiomas (16) and were the most frequent tumour types. Meningiomas predominantly occurred at the cranio-cervical and thoracic levels. Nerve sheath tumours were mostly found at the cervical and lumbar levels while filum terminale ependymomas occurred at the thoracolumbar area. Laminectomy was the commonest surgical approach employed, and the extent of resection varied, with total excision in half the cases. Neurological function was regained in 3 patients, deteriorated in two and was unchanged in the remainderCONCLUSIONS: IDEM tumours are an important subset of spinal cord compressive lesions Presentation with severe neurological deficit is common and though resection is feasible neurological deficit remains in the vast majority. Earlier detection should improve the results of surgery
       
  • Trans-oral penetrating trauma to the neck: the innocuous pen cap and
           the value of CT Scan

    • Abstract: SUMMARY: A significant number of otorhinolaryngological emergency visits are caused by foreign bodies, and occasionally they can result in life-threatening injury. This report highlights the value of neck CT in the evaluation of suspected radiolucent foreign bodies penetrating the neck from the oral cavity. This guided the surgical approach to remove the foreign body safely without complication
       
  • SAGES Congress 2019: ASSA Abstracts

    • Abstract: SUMMARY: A significant number of otorhinolaryngological emergency visits are caused by foreign bodies, and occasionally they can result in life-threatening injury. This report highlights the value of neck CT in the evaluation of suspected radiolucent foreign bodies penetrating the neck from the oral cavity. This guided the surgical approach to remove the foreign body safely without complication
       
  • SAGES Congress 2019: Hepatopancreaticobiliary Abstracts

    • Abstract: SUMMARY: A significant number of otorhinolaryngological emergency visits are caused by foreign bodies, and occasionally they can result in life-threatening injury. This report highlights the value of neck CT in the evaluation of suspected radiolucent foreign bodies penetrating the neck from the oral cavity. This guided the surgical approach to remove the foreign body safely without complication
       
 
 
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